{"title": "DNI Gabbard COVID-19 Release — Document Index", "content": "Document Index\n18 June 2026 Release of COVID-19 DocumentsUNCLASSIFIED\n1 2020-05-27 LLNL International Assessments Report:  COVID-19 Lab Modification Conditions Present at WIV\n2 2020-02-03 Agenda - Expert Meeting:  Rapid Response for Assessment of Data Needs for 2019-nCoV\n3 Research Article:  Assembly of long DNA sequences using a new synthetic Escherichia coli-yeast shuttle vector\n4 2020-10-21 CHD press release\n5 DRAFT Weekly Accomplisments COVID Origins Update\n6 2021-07-14 Email: RE: Covid origins - Dr. Fauci recommendations\n7 Fauci readout\n8 2026-07-26 Email: Wall Street Journal piece today on origins\n9 2024-12-03 Email: RE: HOT: Final Congressional COVID Report, Confirms Lab Leak\n10 2023-12-12 Email: Flagging: COVID origins questions today\n112023-09-27 Email: FW: New York Post on Fauci influencing CIA on COVID origins and Congressional Letter\nto HHS\n12 2023-07-12 Email: FW: Readout of contentious HPSCI COVID Origins briefing\n13 2023-07-13 Email: RE: Briefing to COVID Subcommittee on COVID Origins\n14 2023-05-25 Email: FW: Here's the paper from May 2020\n15 2022-03-16 Email: FW: ACTION REQUIRED\n16 2021-09-27 Email: RE: Wash Examiner\n17 2021-09-24 Email: FW: Readout of contentious HPSCI COVID Origins briefing\n18 2021-06-15 Email: FW: [AIN] FW:\n19 2021-06-14 Email: [REDACTED] Update for NCPC - Tuesday, 8 June\n20 2021-02-17 Email: Came across this gem...\n21 2020-09-17 Email: RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID: [REDACTED]\n22 2020-09-15 Email: RE: PubMed Legacy Search CoV\n23 2020-02-04 Email: FW: Readout from NAS Meeting on Coronavirus\n24 2020-02-09 Email: [REDACTED] Assessment on coronavirus (updated)\n25 2021-07-20 Email: RE: Possible reviewers for COVID Origins assessment\n26 2026-05-03 Email: FW: (U) Interest in a discussion about COV SARS2 and gain of function research\n27 2020-09-16 Email: RE: IC interest in Yan report about COVID origins\n28 2020-09-17 Email: RE: Daily Beast counter to \"Yan Report\" on covid origin\n29 2020-09-18 Email: RE: IC interest in Yan report about COVID origins\n30 2020-10-23 Email: RE: reminder - please send updates by noon in lieu of COVID VTC (n/t)\n31 2021-07-20 Email:  RE: Things Probably Coming Your Way…\n32 2021-08-11 Email: ICWPA Complaint re: False Testimony to Congress\n33 2021-06-15 Email: FW: HHS investigation\n34 2021-08-19 Email: Whistleblower Issue -- Revised Letter after Discussion and Transcript Review\n35 2021-09-03 Email: RE: from a [REDACTED]\n36 2021-10-26 Email: FW: NIH now says WIV did Gain of Function\n37 2022-01-13 Email: RE: New Article on COVID\n38 2022-01-13 Email: RE: [Short turn request] FW: New Article on COVID\n39 2020-09-11 Email: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID: [REDACTED]\n40 2023-03-17 Email: FW: BSEG c.2020\n41 2023-11-22 Email: RE: [for [REDACTED]] FW: Vanity Fair Inquiry Re: COVID Origins\n42 2023-11-22 Email: RE: Question on yesterday's Vanity Fair article\n43 2023-11-28 Email: RE: Recent (and upcoming) press on COVID Origins\n442023-10-03 Email: FW: in response to the DDCIA question related to the context of a Fauci engagement\nwith CIA\n45 2023-12-12 Email: Update on COVID origins questions today\n46 2024-09-27 Email: RE: Readout of HPSCI COVID Origins briefing\n47 2021-06-08 Email: FW: Readout of Fauci briefing\n48 2021-06-08 Email: New Daszak video going around\n492021-05-27 Email: Office of the Director of National Intelligence News Summary for Thursday, May 27,\n2021\n50 2021-07-21 Email: FW_ [AIN] FW_ Today's Call_meeting info\n51 Genomic Study Points to Natural Origin of COVID-19 - NIH Director's Blog 2020-03-26\n52 HPSCI SSCI WB Transmittal Letter v.4 -- clean\n53 2021-08-16 Email: Talking Points and Letter on Whistleblower Issue\n54 2021-08-19 Email: Whistleblower Issue -- Revised Letter after Discussion and Transcript Review\n55 iGEM_2013-Wuhan-team\n56 2026-03-05 Email: FW: (U) Interest in a discussion about COV SARS2 and gain of function research\n57 Publication: The proximal origin of SARS-CoV-2\n58 SOW_converted\n59 Total Chemical Synthesis, Assembly of Human Torque Teno Virus Genome\n60 Publication: Synthetic recombinant bat SARS-like coronavirus is infectious in cultured cells and in mice\n61 Position paper about the possible origin of the SARS-CoV-2 coronavirus\n62 2020-02-03 Agenda - Expert Meeting:  Rapid Response for Assessment of Data Needs for 2019-nCoV\n63 SOW_converted\n64 2023-09-26 Letter from Rep Wenstrup\n65 Cable: China Virus Institute Welcomes More U.S. Cooperation on Global Health Security\n66 Cable: China Opens First Bio Safety Level 4 Laboratory\n67  2015-08-17 CIA Intelligence Assessment: [TITLE REDACTED]\nUNCLASSIFIED", "summary": "Cover index for the 18 June 2026 declassified release. Lists every document in Parts 1-4 with a one-line description of each.\n\nFirst-page excerpt: Document Index 18 June 2026 Release of COVID-19 DocumentsUNCLASSIFIED 1 2020-05-27 LLNL International Assessments Report:  COVID-19 Lab Modification Conditions Present at WIV 2 2020-02-03 Agenda - Expert Meeting:  Rapid Response for Assessment of Data Needs for 2019-nCoV 3 Research Article:  Assembly of long DNA sequences using a new synthetic Escherichia coli-yeast shuttle vector 4 2020-10-21 CHD press release 5 DRAFT Weekly Accomplisments COVID Origins Update 6 2021-07-14 Email: RE: Covid origins - Dr. Fauci recommendations 7 Fauci readout 8 2026-07-26 Email: Wall Street Journal piece today on origins 9 2024-12-03 Email: RE: HOT: Final Congressional COVID Report, Confirms Lab Leak 10 2023-12-12 Email: Flagging: COVID origins questions today 112023-09-27 Email: FW: New York Post on…", "source_url": "https://assets.newsweek.com/wp-content/uploads/2026/06/COVID-19-Release-DNI-Gabbard-6-18-Index.pdf", "pdf_url": "/archive-docs/fauci-files/4ff8eeeef553cea2f9f91b47f28de54d/pdf", "doc_date": "2026-06-18", "case": "covid-19-origins", "sub_case": "dni-gabbard-2026-release", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "covid origins", "covid origin", "covid release", "covid coverup", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "biolab", "biolabs", "dni release", "odni release", "intelligence release", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins"], "page_count": 1}
{"title": "Fauci Exposed Files — Part 1", "content": "DECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n\nExpert Meeting\nRapid Response for Assessment of Data Needs for 2019-nCoV\nAgenda\nFebruary 3, 2020\n2:00 p.m.–3:00 p.m. (ET)\nKeck Center, Room 103\n500 5th St NW, Washington, DC 20001\nJoin from PC, Mac, Linux, iOS or Android: https://nasem.zoom.us/j/777284900\nTelephone: +1 646 558 8656\nMeeting ID: 777 284 900\nInternational numbers available: https://nasem.zoom.us/u/aA3S9pYwW\nMeeting Objective:  Assess what data, information and samples are needed to understand the \nevolutionary origins of 2019-nCoV and more effectively respond to the outbreak and resulting \nmisinformation.\n2:00 p.m. Welcome and Introductions  (5 mins )\nANDREW  POPE\nDirector, Board on Health Sciences Policy \nNational Academies of Sciences, Engineering, and Medicine\n2:05 p.m. Statement of Work  (10 mins )\nKELVIN  DROEGEMEIER\nDirector \nOffice of Science and Technology Policy\nD. C HRISTIAN  (“C HRIS”) H ASSELL\nSenior Science Advisor\nU.S. Department of Health and Human Services\n2:15 p.m. Perspective from NIH/NIAID (10 mins )\nANTHONY  (“T ONY”) S. F AUCI\nDirector\nNational Institute of Allergy and Infectious Diseases\nNational Institutes of Health\n1 | P a g e\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n\n2:25 p.m. Discussion of Meeting Objective (30 mins )\n2:55 p.m. Determine Next Steps (5 mins )\n3:00 p.m. Adjourn\n2 | P a g e\n\nVIROLOGICA SINICA 2016, 31 (2): 160–167\nDOI: 10.1007/s12250-016-3730-8\nRESEARCH ARTICLE\nAssembly of long DNA sequences using a new synthetic\nEscherichia coli -yeast shuttle vector\nZheng Hou#, Zheng Zhou#, Zonglin Wang, Gengfu Xiao*\nState Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan\n430071, China\nSynthetic biology is a newly developed field of research focused on designing and rebuilding novel\nbiomolecular components, circuits, and networks. Synthetic biology can also help understand\nbiological principles and engineer complex artificial metabolic systems. DNA manipulation on a\nlarge genome-wide scale is an inevitable challenge, but a necessary tool for synthetic biology. To\nimprove the methods used for the synthesis of long DNA fragments, here we constructed a novel\nshuttle vector named pGF  (plasmid Genome Fast) for DNA assembly in vivo. The BAC plasmid\npCC1BAC, which can accommodate large DNA\n molecules, was chosen as the backbone. The\nsequence of the yeast artificial chromosome (YAC) regulatory element CEN6-ARS4  was\nsynthesized and inserted into the plasmid to enable it to replicate in yeast. The selection sequence\nHIS3, obtained by polymerase chain reaction (PCR) from the plasmid pBS313, was inserted for\nscreening. This new synthetic shuttle vector can mediate the transformation-associated\nrecombination (TAR) assembly of large DNA fragments in yeast, and the assembled products can\nbe transformed into Escherichia coli  for further amplification. We also conducted in vivo  DNA\nassembly using pGF  and yeast homologous recombination\n and constructed a 31-kb long DNA\nsequence from the cyanophage PP  genome. Our findings show that this novel shuttle vector would\nbe a useful tool for efficient genome-scale DNA reconstruction.\nKEYWORDS    synthetic biology; DNA fragment assembly; shuttle vector pGF; transformation-\nassociated recombination (TAR)\nINTRODUCTION\nSynthetic biology aims to create small artificial biologic-\nal circuits and networks, which will benefit the develop-\nment of new biomedical therapeutics, metabolic engin-\neering, and energy supply (Cameron et al., 2014; Khalil\nand Collins, 2010). Synthetic biology originates from\nand progresses with technological advancements in gene\nmanipulation (Cameron et al., 2014). Thus, it is obvious\nthat convenient and effective methods for assemblinglong DNA sequences are necessary tools for this innovat-\nive research field (Merryman and Gibson, 2012).\nFollowing the development of molecular cloning and\nPCR, the synthesis of DNA constructs less than 10 kb\nbecame easier. Nowadays, DNA fragments less than 20\nkb can be constructed conveniently using SOEing PCR\n(splicing by overlap extension PCR) (Hou and Xiao,\n2011; Shevchuk et al., 2004). However, a problem fre-\nquently encountered in PCR is the introduction of ran-\ndom errors during polymerization (Keohavong and\nThilly, 1989), especially during the amplification of long\nand complex sequences. In the early 2000s, researchers\nbuilt a circular DNA by assembling 500–800 bp seg-\nments using type IIS restriction enzymes (Bsa I and Bbs\nI) and DNA ligase (Kodumal et al., 2004). This ligation-\nbased method had been improved to assemble as many\nas six DNA fragments at once. Later, another in vitro\n as-Received: 21 January 2016, Accepted: 17 March 2016,\nPublished online: 11 April 2016\n# These authors contributed equally to this work.\n*Correspondence:\nPhone: +86-27-87198685, Fax: +86-27-87198685,\nEmail: xiaogf@wh.iov.cn\nORCID: 0000-0001-9401-235X\n160  A PRIL 2016   VOLUME 31   I SSUE  2 © Wuhan Institute of Virology, CAS and Springer Science+Business Media Singapore 2016\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n\nsembly method was developed by Gibson and cowork-\ners (Gibson et al., 2008a), which eliminated the need for\nrestriction enzyme sites within the DNA fragments.\nSmall DNA molecules were synthesized with 20–40 bp\noverlapping sequences for assembly. First, exonuclease\nwas used to chew back the 5′ ends, and DNA polymerase\nwas then used to fill gaps in the annealed products. Fi-\nnally, DNA ligase was used to covalently seal the nicks\nin the assembly. Based on this method, Gibson further\ndeveloped a one-step, isothermal assembly method and\nsuccessfully synthesized an entire 16.3-kb long mouse\nmitochondrial genome (Gibson et al., 2010b). Another\nassembly method reported by Li and Elledge (2007) was\nbased on in vitro homologous recombination using RecA\nrecombinase.\nThe construction of long DNA through homologous\nrecombination in vivo in yeast (Stemmer et al., 1995) is\nan alternative method. This method was first used to lig-\nate DNA fragments with a plasmid vector and was re-\nferred to as transformation-associated recombination\n(TAR) by Larionov et al. (1996). Gibson et al. applied\nthis method to assemble large DNA molecules. Several\nlarge DNA fragments were simultaneously assembled\nusing a yeast artificial chromosome (YAC) and yielded\nthe Mycoplasma genitalium genome (Gibson et al.,\n2008a; Gibson et al., 2008b). The 1.08-Mb long Myco-\nplasmamycoides genome was also chemically synthes-\nized using this method (Gibson et al., 2010a). Unlike the\nin vitro assembly methods, TAR-based assembly re-\nquires no enzymes and takes advantage of the homolog-\nous recombination pathway in yeast to achieve a seam-\nless ligation of the DNA fragments. This method espe-\ncially facilitates the assembly of long DNA sequences.\nTo improve this method, we constructed an E. coli-\nyeast shuttle vector for the effective assembly of long\nDNA fragments. The YAC regulatory and selection se-\nquences were introduced into the BAC plasmid to gener-\nate the novel plasmid named pGF (plasmid Genome\nFast), which can mediate the homologous recombination\nreaction, plasmid replication in yeast, and plasmid ampli-\nfication in E. coli. This novel shuttle vector derived from\nthe BAC plasmid can accommodate large DNA mo-\nlecules. The assembled plasmids containing the long\nDNA sequences can also be easily transformed into E.\ncoli for large-scale amplification.\nCyanophage PP is widely distributed in freshwater\nand may play an important role in freshwater microbial\nloops (Zhou et al., 2013). Using our developed shuttle\nvector, we assembled 10 DNA fragments from the cyan-\nophage PP genome and produced a ~31-kb long DNA\nsequence. Thus, the pGF plasmid was successfully ap-\nplied for the synthesis of large DNA molecules. pGF and\nthe associated TAR assembly method will promote de-\nvelopment in the field of synthetic biology, includingviral reverse genetics and bacterial metabolic engineer-\ning (Dueber et al., 2009; Lee et al., 2013).\nMATERIALS AND METHODS\nStrains and media\nThe yeast, Saccharomyces cerevisiae strain VL6–48\n(ATCC), which is highly transformable and has HIS3 de-\nletions, was used for transformation and in vivo homo-\nlogous recombination. The yeast strain was cultured in\nstandard rich medium containing yeast extract, peptone\nand dextrose (YEPD) or minimal medium CM with or\nwithout HIS. Medium supplemented with 1 mol/L D-sor-\nbitol (Sigma Aldrich, St Louis, MO, USA) was used for\nspheroplast transformation. The BAC plasmid CopyCon-\ntrol™ pCC1BAC™ (Epicentre, Madison, WI, USA),\nwhich can accommodate large DNA fragments, was used\nas the vector backbone. YAC plasmid pRS313 (ATCC)\nwas used as the PCR template to obtain the HIS3 se-\nquence. Plasmids were electroporated into the electro-\ncompetent cells of the E. coli strain EPI300 (Epicentre)\nand selected using chloramphenicol at a concentration of\n25 μg/mL and ampicillin at a concentration of 50 μg/mL.\nIsolation of plasmid DNA from yeast or E. coli\nSmall-scale isolation of supercoiled plasmids from yeast\ncells was performed using a TIANprep yeast plasmid\nDNA kit (Tiangen, Beijing, China). Briefly, the yeast\ncells were lysed by treatment with Lyticase. Proteins\nwere then precipitated and eliminated, and the plasmids\nwere further purified by affinity absorption columns. For\nlarge YACs, the circular plasmids from a large volume\nof yeast culture were isolated according to the protocol\ndescribed by Noskov et al. (2011). Plasmid DNA from\nE. coli was isolated from a 5-mL overnight culture using\na Plasmid Miniprep Kit (Omega Bio-tek, Doraville, GA,\nUSA).\nCo-transformation of the DNA fragments into\nyeast\nTo prepare the yeast spheroplast, the cells collected from\n4 mL of yeast culture grown overnight were treated with\nzymolyase and β-mercaptoethanol to remove the cell\nwall. The DNA fragments and vector were then mixed\nwith the prepared spheroplasts as described previously\n(Kouprina and Larionov, 2008). Positive yeast colonies\nwere selected on histidine-deficient (−His) plates after\nincubation at 30 °C for 2–3 days.\nElectroporation of E. coli\nThe purified plasmids were added into 100 μL of com-\npetent E. coli cells. After incubation on ice for 5 min, the\ncells were gently mixed and transferred into a 0.2 cm\npre-chilled electroporation cuvette and pulsed with 2.5Zheng Hou et al\nwww.virosin.org APRIL 2016   VOLUME 31  ISSUE 2  161\n\nkV, 25 μF, 200 Ω. The contents of the cuvette were then\ntransferred into an Eppendorf tube, 1 mL SOB medium\nwas added and incubated at 37 °C for 1 h while shaking\nat 225 rpm. All the recovered cells were then plated on\nLB-kanamycin plates.\nConstruction of the  E. coli -yeast shuttle vector,\npGF\nTo construct a shuttle plasmid that can replicate both in\nyeast and in E. coli cells, the yeast centromere sequence\n(CEN) and autonomously replicating sequence (ARS)\nwere inserted into the BAC plasmid pCC1BAC, which\nformed the backbone. The yeast HIS3 gene was also in-\nserted to work as a selectable marker in yeast.\nThe HIS3 selection marker was PCR amplified with\nspecific primers using plasmid pRS313 as the template.\nThe CEN6-ARS4 sequence was manually synthesized by\nSangon Biotech Co. Ltd., based on the GenBank plas-\nmid sequence with the accession number U03439. The\nHIS3 and \nCEN6-ARS4 sequences were then ligated and\namplified by overlapping extension PCR. For the first\nstep, 25 μL of PCR mixture containing 2.5 μL 10×\nKOD-Plus buffer, 2.5 μL 2 mmol/L dNTPs, 1.25 μL 25\nmmol/L MgSO4, 0.5 μL KOD-Plus polymerase, 1.5 μL\nHIS3, and 1.5 μL CEN6-ARS4 templates was used\nwithout primers. The PCR conditions were as follows:\n94 °C for 2 min, followed by 35 cycles of 94 °C for 15 s,\n55 °C for 25 s, and 68 °C for 2 min, and a final incuba-\ntion at 68 °C for 5 min. For the second round of PCR, the\nproducts obtained from the first round were used as the\ntemplate and the primer pairs were designed to contain 5′\nend overlapping sequences with ends of Afe I-linearized\npCC1BAC. The PCR mixture (25 μL) contained 2.5 μL\n10× KOD-Plus buffer, 2.5 μL 2 mmol/L dNTPs, 1.25 μL\n25 mmol/L MgSO4, 0.5 μL KOD-Plus polymerase, 1 μL\ntemplate, and 1 μL of each primer. The PCR conditions\nwere as follows: 94 °C for 2 min, followed by 28 cycles\nof 94 °C for 15 s, 58 °C for 25 s, and 68 °C for 2 min,\nand a final incubation at 68 °C for 5 min. The \npCC1BAC\nplasmid was linearized with the restriction endonuclease\nAfe I, dephosphorylated using alkaline phosphatase\nFastAP (Thermofisher), purified, and then recovered us-\ning the E.Z.N.A. Gel Extraction Kit (Omega).\nThe CEN6-ARS4-HIS3 sequence and the linearized\npCC1BAC plasmid were co-transformed into yeast\nVL6–48 spheroplasts. The positive homologous recom-\nbinants were selected on −His plates after incubation at\n30 °C for 2–3 days. After streaking in selective media,\ncolonies were cultured in 5 mL −His medium and the\nplasmids were mini-prepared. The constructed novel\nshuttle plasmid was verified by sequencing and named as\npGF (plasmid Genome Fast).Preparation of the assembly vector and\ncyanophage PP fragments\nThe shuttle plasmid \npGF was then used for the prepara-\ntion of the assembly vector. This vector was PCR ampli-\nfied using primers containing an approximate 20 bp\noverlap with ends of the \nBamH I-linearized vector and a\n40–60 bp overlap with the target DNA fragments. A\nrare-cutting restriction site Not I (5'-GCGGCCGC-3')\nwas additionally added in the middle of the primers for\nthe easy release of the assembled products from the cir-\ncular plasmids.\nThe DNA fragments used for the assembly were amp-\nlified by PCR using the cyanophage PP\n genome as the\ntemplate (Zhou et al., 2013). Each assembly unit of the\nDNA fragments (A1, A2, A3, A4, B1, B2, B3, B4 and\nC1 of ~3 kb each and C2 of ~4 kb) was amplified with\nspecific primers containing 40–60 bp overlapping se-\nquences with the adjacent fragments (as listed in Supple-\nmentary Table S1). The PCR products were then separ-\nated using 0.6% agarose gel electrophoresis and purified\nusing the E.Z.N.A. Gel Extraction Kit (Omega).\nThe DNA fragments and pGF vector were co-trans-\nformed into yeast VL6–48 spheroplasts to achieve as-\nsembly of the long DNA sequence. The positive colon-\nies were selected on −His plates after incubation at 30 °C\nfor 2–3 days.\nRestriction digestion and PCR analysis of the\nassembled long DNA sequences\nSince the rare-cutting restriction site Not I was intro-\nduced in the linearized pGF shuttle plasmid, the as-\nsembled intermediates or the full 31-kb DNA sequence\ncould be released by Not I digestion. EcoR I, which also\nexist as the unique restriction site in pGF and the as-\nsembly products, could be used to linearize the circular\nplasmid for determining the length of the synthetic DNA\nsequences.\nThe assembled plasmids were isolated from the yeasts\nor E. coli cells as described before. PCR analyses were\nperformed using the 2× Taq PCR MasterMix kit with the\nspecific pairs of primers (as listed in the Supplementary\nmaterial) designed to amplify all the initial DNA frag-\nments or the sequences across the neighboring DNA\nfragments. The PCR mixture (10 μL) contained 1 μL ex-\ntracted DNA, 1 μL each of the forward and reverse\nprimers, and 5 μL 2× Taq PCR mixture. The PCR condi-\ntions were as follows: 94 °C for 2 min, followed by 32\ncycles of 98 °C for 15 s, 58 °C for 30 s, and 72 °C for 1\nmin, and a final incubation at 72 °C for 5 min. The PCR\nproducts were loaded on 1% agarose gels and the gels\nwere run at 100 V for 30 min.DNA assembly using synthetic E. coli-yeast shuttle vector\n162  A PRIL 2016   VOLUME 31   I SSUE  2\n  VIROLOGICA SINICA\n\nRESULTS\nConstruction of the shuttle plasmid  pGF\nAs shown in Figure 1, the shuttle plasmid was construc-\nted based on the BAC plasmid pCC1BAC and YAC plas-\nmid pRS313. pCC1BAC normally replicates as a single\ncopy under the regulation of the F-factor, and SopA, B,\nand C are all important for plasmid partitioning during\ncell division in E. coli. When an inducer is added, the\nnumber of plasmid copies could be increased to 10–20 in\nthe EPI300 strain under the control of oriV. Besides, the\nphage COS\n sequence in the plasmid enables it to accom-\nmodate large-size DNA sequences. The YAC plasmidpRS313 contains CEN6 and the ARS associated with\nHIS3 elements. The yeast centromere CEN6 and the\nautonomous replicating sequence ARS enable the plas-\nmid to replicate in yeast cells, while the \nHIS3 is a select-\nable marker for positive colony screening. The yeast reg-\nulatory component CEN6-ARS4 and the HIS3 sequences\nwere introduced into the appropriate sites of pCC1BAC.\nThis novel synthetic plasmid can mediate the homolog-\nous recombination of DNA fragments and stably main-\ntain the assembled plasmids in the yeast. Further, the as-\nsembled plasmids purified from the yeast cells could be\ntransformed into E. coli for amplification.\nTo construct the shuttle plasmid pGF described above,\nFigure 1. The construction of pGF shuttle plasmid used for in vivo TAR assembly of DNA fragments. The BAC plasmid\npCC1BAC used as the backbone allows the replication of the assembled DNA in E. coli for amplification. CEN6-ARS4\nand HIS3 sequences introduced at the Afe I sites of pCC1BAC allow the propagation of plasmids and positive colony\nselection in yeast.Zheng Hou et al\nwww.virosin.org APRIL 2016   VOLUME 31  ISSUE 2  163\n\nthe CEN6-ARS4 and HIS3 sequences were inserted into\nthe Afe I site of the BAC plasmid pCC1BAC. Specific-\nally, the HIS3 sequence (~1.5 kb) was PCR amplified\nfrom the YAC plasmid pRS313, and the \nCEN6-ARS4 se-\nquence (~0.5 kb) was obtained by DNA synthesis based\non the GenBank sequence with the accession number\nU03439. These two sequences were tandemly linked by\noverlapping extension PCR to generate the CEN6-ARS4-\nHIS3 sequence (~2 kb). Then, the CEN6-ARS4-HIS3 se-\nquence was co-transformed with the Afe I-linearized\npCC1BAC vector (~8 kb) into yeast and ligated by TAR\nhomologous recombination. The positive colonies were\nselected and plasmids were isolated and sequenced. The\nsuccessful assembly of the pGF vector (~10 kb) by TAR\ncloning indicated that this in vivo homologous recombin-\nation system in yeast could effectively ligate the DNA\nfragments into the vector with the 5′ end overlapping se-\nquences.\nAssembly of the 31-kb long DNA from the\ncyanophage PP genome\nFigure 2 shows the flowchart for the assembly of 10 \ncy-\nanophage PP DNA fragments into a ~31-kb DNA mo-\nlecule. In the first step, the DNA fragments of Part A\n(A1, A2, A3 and A4, each of ~3 kb), Part B (B1, B2, B3\nand B4, each of ~3 kb), or Part C (C1 of ~3 kb and C2 of\n~4 kb) with the \npGF vector were co-transformed into\nyeast. The neighboring fragments with overlapping ends\ncould be ligated together by homologous recombination\nto generate pGF-Part A, Part B, or Part C, respectively.\nThese plasmids were then digested by Not I so that the\nthree intermediates Part A, Part B, and Part C could be\nreleased and recovered by agarose gel separation and ex-\ntraction. Next, the assembled intermediates Part A (~12\nkb), Part B (~12 kb) and Part C (~7 kb) with the vector\npGF (~10 kb) were co-transformed into yeast cells and\nfurther assembled to form the 31-kb long DNA se-\nquence.\nAccording to the homologous recombination strategy,\nthe pGF vector and the cyanophage PP DNA fragments\nshould be prepared by PCR amplification to add the spe-\ncific overlapping ends. The 5′ ends of the primers were\ndesigned to contain 20–40 bp extension sequences ho-\nmologous to the neighboring fragments. A rare-cutting\nrestriction site Not I (5'-GCGGCCGC-3') adjacent to the\noverlaps needed to be added to the primers for the ampli-\nfication of the pGF vector for the convenient release of\nthe assembly products. The products of PCR amplifica-\ntion of the pGF vector performed using high fidelity\npolymerase were exhibited as the main electrophoresis\nbands approximately 10 kb in size (Figure 3A). The Part\nA (A1, A2, A3 and A4, each of ~3 kb), Part B (B1, B2,\nB3 and B4 each of ~3 kb), and Part C (C1 of ~3 kb and\nC2 of ~4 kb) DNA fragments were also PCR amplifiedand purified using the Gel Extraction Kit (Figure 3B).\nAlternatively, these ~3-kb long DNA fragments also\ncould be obtained by chemical synthesis as described be-\nfore (Hou and Xiao, 2011).\nNext, the Part A, Part B, and Part C intermediates\nwere assembled individually by transforming the PCR-\namplified DNA fragments and pGF vectors into yeast\nprotoplasts. The potential positive colonies were selec-\nted on His plates. As shown in Figure 4A, the assembled\nproducts of Part A, Part B, and Part C were isolated from\nthe yeast cells and identified by restriction digestion.\nWhen the positive plasmids were digested with unique\ncut sites for EcoR I, the linearized pGF-Part A, -Part B,\nand -Part C separated on 0.6% agarose gels were exhib-\nFigure 2. Scheme for the assembly of the ~31-kb DNA\nsequence. In the first stage of assembly, four DNA frag-\nments of Part A and Part B and two DNA fragments of\nPart C were ligated together to generate the intermedi-\nates pGF-Part A, Part B, and Part C. In the next step,\nthe assembled Part A, Part B, and Part C were re-\nleased by digestion by the endonuclease NotI and re-\ncovered. The three intermediates together with pGF\nwere then co-transformed into yeast cells to generate\nthe complete ~31-kb PartABC integrated sequence in\nthe pGF vector.\nFigure 3. Preparation of the pGF vector and cyano-\nphage PP DNA fragments. (A) The ~10-kb pGF vector\nwas amplified using PCR and the homologous 5′ ends\nbracketing the inserted DNA fragments were inserted.\n(B) The DNA fragments A1-C2 were amplified using\nPCR from the \ncyanophage PP genome. Similarly, the 5′\nend overlapping sequences were introduced using\nprimer pairs.DNA assembly using synthetic E. coli-yeast shuttle vector\n164  A PRIL 2016   VOLUME 31   I SSUE  2\n  VIROLOGICA SINICA\noc \n\nited as single bands significantly larger than 10 kb in size\n(the maximum size of the Marker). Not I digestion was\nused to clearly resolve the inserted fragments in the as-\nsembly products. The electrophoresis of the assembled\nintermediates treated with Not I showed separated bands.\nThe ~10 kb and ~12 kb bands in lane 3 corresponded to\nthe free pGF vector and the assembled intermediate Part\nA, respectively. Similarly, the ~10 kb and ~12 kb bands\nin lane 5 corresponded to the free pGF vector and the as-\nsembled Part B intermediate, and the ~10 kb and ~7 kb\nbands in lane 7 corresponded to the free pGF vector and\nthe assembled intermediate Part C, respectively. These\nresults indicated that the in vivo recombination-based as-\nsembly method could effectively join 2–4 DNA frag-\nments, each of ~3 kb. Moreover, the assembled products\ncould be amplified using the shuttle vector pGF in E.\ncoli and could be conveniently released from the vector\nby endonuclease digestion. The sequencing of the as-\nsembled intermediates by Sangon Biotech Co. Ltd. indic-\nated that the sequences were accurate, which meant this\nin vivo recombination method using the shuttle vector\npGF exhibited higher accuracy and greater convenience\ncompared with conventional PCR-based methods.\nThe three assembled DNA intermediates together with\nthe pGF vector were then co-transformed into yeast cells\nto generate pGF-Part ABC. As indicated in Figure. 4B,\nthe EcoR I-linearized pGF-Part ABC was about 41 kb in\nsize (lane 2), as determined using the high molecularweight marker, which was in accordance with the full\nlength of the target product. As mentioned above, the\nplasmid \npGF-Part ABC could release the inserted as-\nsembled long DNA sequence upon treatment with Not I.\nLane 3 in Figure 4B shows that two bands of ~10 kb and\n~31 kb were separated on a 0.6% agarose gel, which cor-\nresponded to the free pGF vector and the assembled Part\nABC, respectively.\nTo further verify the positive colonies, the assembled\nplasmids were extracted and analyzed by PCR. As\nshown in \nFigure 5A, the PCR performed using the\nprimer pairs of each DNA fragment all generated\nproducts with target sizes (A1, A2, A3, A4, B1, B2, B3,\nB4 and C1, each of ~3 kb and C2 of ~4 kb), which indic-\nated that all the 10 cyanophage PP DNA fragments were\npresent in \npGF-Part ABC. Next, specific primer pairs\n(FV/RA1, FA1/RA2, FA2/RA3 and so on; \nFigure 5B)\nwere designed to amplify the sequences across the two\nadjacent DNA fragments (as listed in Supplementary Ta-\nble S2). The correct order of the assembly was verified\nby PCR amplification using these primers. The result\nshowed that all the PCR products separated on the\nagarose gel exhibited molecular sizes consistent with\nthose of the designed target products (indicated below\nthe amplified fragments in Figure 5B). This result fur-\nther confirmed the fact that the 10 cyanophage PP DNA\nfragments were assembled in the desired order and\nformed the 31-kb long DNA sequence.\nOne-step assembly of the 31-kb long DNA from\nthe cyanophage PP  genome\nTo investigate the assembling capability of the in vivo re-\ncombination system in yeast, we also tried to co-trans-\nform all the 10 cyanophage PP DNA fragments and the\npGF vector into yeast protoplasts at once to achieve one-\nstep assembly. The ~41-kb pGF-Part ABC, which con-\ntained the ~31-kb assembled Part ABC sequence and the\n10-kb pGF\n vector, was successfully obtained by in vivo\nrecombination. The assembled plasmids were isolated\nfrom the yeast cells and transformed into E. coli EPI300.\nThe plasmids amplified in EPI300 were then extracted\nusing a Plasmid Miniprep Kit and analyzed by endonuc-\nlease digestion and PCR as described above. As shown\nin Figure 6, after the plasmid was digested with \nNot I,\nthe vector \npGF and the released assembled DNA se-\nquence were separated on a 0.6% agarose gel. The ob-\nserved two bands corresponded to the ~10-kb free pGF\nvector and the ~31-kb assembled Part ABC. In addition,\nthe PCR analyses further revealed the orderly assembly\nof all the fragments in pGF-Part ABC. These results\nwere similar to those shown in Figure 5 and not shown\nanymore.\nFigure 4. Restriction digestion analysis of the as-\nsembled DNA sequences. (A) Verification of the as-\nsembled intermediates of Part A, Part B, and Part C.\nYeast colonies containing positive assemblies were\nverified by digestion with the endonucleases EcoR I\n(lanes 2, 4 and 6) and Not I (lanes 3, 5 and 7). A mo-\nlecular weight marker was loaded in lane 1. (B) Analys-\nis of the ~41-kb assembled pGF-PartABC by digestion\nwith the endonucleases EcoR I (lane 2) and Not I (lane\n3). Standard and high molecular weight markers were\nloaded in lane 1 and lane 4, respectively.Zheng Hou et al\nwww.virosin.org APRIL 2016   VOLUME 31  ISSUE 2  165\n\nDISCUSSION\nThe assembly of long DNA molecules requires a more\naccurate and effective scheme rather than a routine liga-\ntion-based cloning method. Although PCR enzymes with\nhigh fidelity have been developed, the random errors in-\ntroduced during the amplification process are an obvious\nlimitation of long sequence PCR. The complexity of dif-\nferent DNA templates influences the accuracy of PCR,\nespecially in the case of amplification of long DNA se-\nquences (Kumar and Kaur, 2014; Varadaraj and Skinner,\n1994). The in vitro Gibson assembly method can ligate\nseveral DNA fragments to produce large DNA se-\nquences by using single-strand DNA 3′ overhangs.\nHowever, this method needs exonucleases to chew back\nfrom the DNA 5′ end, DNA polymerase to fill the gaps,\nand DNA ligase to remove nicks, which increases the\ncost of using this method. In addition, the concentrations\nof the DNA fragments and enzymes must be regulated\naccurately in order to achieve successful assembly. In\naddition, the yield of positive colonies may decrease\nwhen assembling more than 5 DNA fragments at once.\nThe shuttle plasmid pGF and in vivo TAR assembly\nmethod described here provides an alternative way to\ncombine DNA fragments to form large DNA sequences.The shuttle plasmid pGF containing the YAC regulatory\nelements could be ligated with several DNA fragments\nwith overlapping ends through homologous recombina-\ntion in yeast. Moreover, the assembled products could be\namplified in  E. coli .\nUsing the yeast recombination system, the appropriate\nDNA fragments with 5′ end overlapping sequences could\nbe assembled in the yeast cells. Notably, the 5′ overlap-\nping sequences could be introduced into the DNA frag-\nments by PCR using synthetic specific primers, thus\neliminating the need for the chewing back step by exo-\nnuclease, which was required in the Gibson model. The\nhomologous recombination-based TAR method is very\nhelpful especially for the assembly of long DNA se-\nquences. Using this method, the assembly and the modi-\nfication of a viral genome from small DNA fragments\ncould be conveniently achieved. The fidelity of the as-\nsembled large DNA molecule was only associated with\nthe fidelity of the assembly units (relatively small DNA\nfragments). The sizes of the small DNA fragments used\nfor the assembly were designed to be below 5 kb, so that\nthe fidelity of the synthetic large DNA molecule could\nbe guaranteed. Alternatively, DNA fragments less than 5\nkb in size can also be easily obtained by using the DNA\nsynthesizer.\nGenomes of living organisms will always contain\nsome gene regulatory elements such as long terminal re-\npeat (LTR) sequences. It should be noted that these se-\nquences always have a high G + C content and may form\ncomplex secondary structures, thus influencing effective\nassembly. To ensure the fidelity of such DNA fragments,\na specific high-fidelity polymerases (such as Q5 High-\nFidelity DNA polymerases from NEB) designed to amp-\nlify the high G + C template should be used, and DMSO\nand other reagents should be added at appropriate con-\ncentrations to lower the Tm value. In addition, the se-\nFigure 5. PCR analysis of the assembled ~41-kb long\nDNA sequence. (A) Amplicons of all the 10 cyano-\nphage PP DNA fragments were present in the com-\nplete assembled product pGF-PartABC. (B) Amplifica-\ntion of the DNA sequences across the adjacent frag-\nments. To ensure the correct order of the assembled\nDNA fragments, specific primers located on the inner\nside of each fragment were designed. The forward\nprimers of the pGF vector (FV) and the reverse primer\nof A1 (RA1) were used in pairs to amplify the se-\nquences across the vector and A1. Similarly, FA1/RA2,\nFA2/RA3, and so on were used in pairs to amplify the\nsequences across two adjacent fragments. The precise\nsizes of the target PCR products are marked.\nFigure 6. Verification of the one-step assembly of the\nplasmid pGF-Part ABC by digestion with the endonuc-\nlease  Not I.DNA assembly using synthetic E. coli -yeast shuttle vector\n166  A PRIL 2016   VOLUME 31   I SSUE  2\n  VIROLOGICA SINICA\nD\n\nquences that readily form complex secondary structures\nshould be arranged to be in the middle of the DNA frag-\nments, and not at the 5′ or 3′ ends. Regulatory sequences\nmay also sometimes be toxic for E. coli. The recombina-\ntion-based assembly in yeast could circumvent the tox-\nicity to E. coli, but the assembled products could be pre-\npared only from large-scale culture of yeast cells in this\ncase.\nIn conclusion, the present work provided a novel syn-\nthetic E. coli-yeast shuttle plasmid pGF and a TAR-\nbased assembly method for the construction of large\nDNA sequences. Using this method, the reconstruction\nof a mini genome of various viruses from the relatively\nsmall torque teno virus (TTV) and adeno-associated vir-\nus (AAV) to the large baculovirus like autographa cali-\nfornica multicapsid nucleopolyhedrovirus (AcMNPV)\ncould be achieved efficiently. The novel synthetic shuttle\nplasmid pGF and the associated DNA assembly method\nwill not only aid in the design of artificial biological sys-\ntems like in bacterial metabolic engineering, but will also\naccelerate the progress of synthetic virology including\nmini-genome construction and vaccine research and de-\nvelopment against new recombination viruses.\nACKNOWLEDGMENTS\nWe thank Dr. Zhihong Hu, Dr. Zhengli Shi, and Dr. Fei\nDeng of the Wuhan Institute of Virology, Chinese\nAcademy of Sciences, China, for their advice, encour-\nagement, and support in conducting this work. This study\nwas supported by the 973 program, Grant No. 2012CB\n721102.\nCOMPLIANCE WITH ETHICS GUIDELINES\nThe authors declare that they have no conflict of interest.\nThis article does not contain any studies with human or\nanimal subjects performed by any of the authors.\nAUTHOR CONTRIBUTIONS\nZH and ZLW carried out experiments for the construc-\ntion of the pGF vector and cyanophage PP genome as-\nsembly; ZZ wrote the manuscript and participated in\nsome of the experiments. GFX was the corresponding\nauthor who conceived and supervised the project.\nSupplementary Tables are available on the website of\nVirologica Sinica: www.virosin.org; link.springer.com/\njournal/12250.\nREFERENCES\nCameron DE, Bashor CJ, Collins JJ. 2014. A brief history of syn-\nthetic biology. Nat Rev Microbiol, 12: 381–390.\nDueber JE, Wu GC, Malmirchegini GR, Moon TS, Petzold CJ,\nUllal AV, Prather KL, Keasling JD. 2009. Synthetic proteinscaffolds provide modular control over metabolic flux. Nat Bio-\ntechnol, 27: 753–759.\nGibson DG, Benders GA, Andrews-Pfannkoch C, Denisova EA,\nBaden-Tillson H, Zaveri J, Stockwell TB, Brownley A, Thomas\nDW, Algire MA, Merryman C, Young L, Noskov VN, Glass JI,\nVenter JC, Hutchison CA, 3rd, Smith HO. 2008a. Complete\nchemical synthesis, assembly, and cloning of a Mycoplasma\ngenitalium genome. Science, 319: 1215–1220.\nGibson DG, Benders GA, Axelrod KC, Zaveri J, Algire MA,\nMoodie M, Montague MG, Venter JC, Smith HO, Hutchison\nCA, 3rd. 2008b. One-step assembly in yeast of 25 overlapping\nDNA fragments to form a complete synthetic Mycoplasma gen-\nitalium genome. Proc Natl Acad Sci U S A, 105: 20404–20409.\nGibson DG, Glass JI, Lartigue C, Noskov VN, Chuang RY, Al-\ngire MA, Benders GA, Montague MG, Ma L, Moodie MM,\nMerryman C, Vashee S, Krishnakumar R, Assad-Garcia N, An-\ndrews-Pfannkoch C, Denisova EA, Young L, Qi ZQ, Segall-\nShapiro TH, Calvey CH, Parmar PP, Hutchison CA, 3rd, Smith\nHO, Venter JC. 2010a. Creation of a bacterial cell controlled by\na chemically synthesized genome. Science, 329: 52–56.\nGibson DG, Smith HO, Hutchison CA, 3rd, Venter JC, Merryman\nC. 2010b. Chemical synthesis of the mouse mitochondrial gen-\nome. Nat Methods, 7: 901–903.\nHou Z, Xiao G. 2011. Total chemical synthesis, assembly of hu-\nman torque teno virus genome. Virol Sin, 26: 181–189.\nKeohavong P, Thilly WG. 1989. Fidelity of DNA polymerases in\nDNA amplification. Proc Natl Acad Sci U S A, 86: 9253–9257.\nKhalil AS, Collins JJ. 2010. Synthetic biology: applications come\nof age. Nat Rev Genet, 11: 367–379.\nKodumal SJ, Patel KG, Reid R, Menzella HG, Welch M, Santi\nDV. 2004. Total synthesis of long DNA sequences: synthesis of\na contiguous 32-kb polyketide synthase gene cluster. Proc Natl\nAcad Sci U S A, 101: 15573–15578.\nKouprina N, Larionov V. 2008. Selective isolation of genomic loci\nfrom complex genomes by transformation-associated recombin-\nation cloning in the yeast Saccharomyces cerevisiae. Nat Protoc,\n3: 371–377.\nKumar A, Kaur J. 2014. Primer Based Approach for PCR Ampli-\nfication of High GC Content Gene: Mycobacterium Gene as a\nModel. Mol Biol Int, 2014: 937308.\nLarionov V, Kouprina N, Graves J, Chen XN, Korenberg JR, Res-\nnick MA. 1996. Specific cloning of human DNA as yeast artifi-\ncial chromosomes by transformation-associated recombination.\nProc Natl Acad Sci U S A, 93: 491–496.\nLee BR, Cho S, Song Y, Kim SC, Cho BK. 2013. Emerging tools\nfor synthetic genome design. Mol Cells, 35: 359–370.\nLi MZ, Elledge SJ. 2007. Harnessing homologous recombination\nin vitro to generate recombinant DNA via SLIC. Nat Methods,\n4: 251–256.\nMerryman C, Gibson DG. 2012. Methods and applications for as-\nsembling large DNA constructs. Metab Eng, 14: 196–204.\nNoskov VN, Chuang RY, Gibson DG, Leem SH, Larionov V,\nKouprina N. 2011. Isolation of circular yeast artificial chromo-\nsomes for synthetic biology and functional genomics studies.\nNat Protoc, 6: 89–96.\nShevchuk NA, Bryksin AV, Nusinovich YA, Cabello FC, Suther-\nland M, Ladisch S. 2004. Construction of long DNA molecules\nusing long PCR-based fusion of several fragments simultan-\neously. Nucleic Acids Res, 32: e19.\nStemmer WP, Crameri A, Ha KD, Brennan TM, Heyneker HL.\n1995. Single-step assembly of a gene and entire plasmid from\nlarge numbers of oligodeoxyribonucleotides. Gene, 164: 49–53.\nVaradaraj K, Skinner DM. 1994. Denaturants or cosolvents im-\nprove the specificity of PCR amplification of a G + C-rich DNA\nusing genetically engineered DNA polymerases. Gene, 140:\n1–5.\nZhou Y, Lin J, Li N, Hu Z, Deng F. 2013. Characterization and\ngenomic analysis of a plaque purified strain of cyanophage PP.\nVirol Sin, 28: 272–279.Zheng Hou et al\nwww.virosin.org APRIL 2016   VOLUME 31  ISSUE 2  167\n\n(U) Robert F. Kennedy, Jr. and Children's Health Defense Call for\nCongressional Investigation of COVID origin\nIdentifiers:\nMessaging System: \nDocument Number:\nIngestion ID: \nGUIDE: \nDates:\nDate Published: 21-Oct-2020 20:00:00\nDate Received: 22-Oct-2020 10:33:24\nPublisher:\n(U) Full inquiry into circumstances leading to global loss of lives and economic devastation should\nbe lawmakers' top priority\nWASHINGTON, Oct. 22, 2020 /PRNewswire/ -- Robert F. Kennedy, Jr. and Children's Health\nDefense (CHD) are calling upon Congress to conduct a thorough investigation of the\ncircumstances behind the global COVID-19 crisis that is taking an overwhelming toll on human\nlives and livelihoods. In a letter to lawmakers Mr. Kennedy, Chairman and Ms. Redwood,\nPresident of CHD, emphasized the urgent need to address the many unanswered questions\nregarding the origin of COVID-19.\n\"Consider this hypothetical scenario: an important gain-of-function experiment involving a virus\nwith serious pandemic potential is performed in a well-regulated, world-class laboratory by\nexperienced investigators, but the information from the experiment is then used by another\nscientist who does not have the same training and facilities and is not subject to the same\nregulations. In an unlikely but conceivable turn of events, what if that scientist becomes infected\nwith the virus, which leads to an outbreak and ultimately triggers a pandemic?\"\nThese are the words of Anthony Fauci, director of the NIAID, in a letter to the microbiology journal\nmBio advocating for gain-of-function experiments in 2012. But Dr. Fauci's scenario may not be\npurely hypothetical. Such concerns are supported by reports US science diplomats made to the\nState Department in 2018 after visiting the Wuhan Institute of Virology (WIV), a Chinese research\nlaboratory conducting US funded gain-of-function research on bat coronaviruses. The reports warn\nabout inadequate safety measures at the lab, which was conducting risky studies on\ncoronaviruses from bats that could result in human transmission and a new SARS-like pandemic.\nIt would be unthinkable to not investigate the causes of the space shuttle Challenger disaster, the\nChernobyl nuclear accident or the Exxon Valdez oil spill. Today we have a virus that has led to the\ndeaths of thousands of people--mostly the elderly--caused severe global economic damage, and\ndestroyed thousands of small businesses across America, and there is little serious consideration\nas to where this virus originated.\n\"It falls upon the leadership of the U.S. Congress to accept its moral duty and God-given and\nlegally pre-ordained responsibility to launch complete and transparent investigations. If we doUNCLASSIFIED\nUNCLASSIFIED 1\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n\nnothing, history will hold us and our system of government accountable,\" stated Kennedy and\nRedwood.\nContact\nLaura Bono\n202.854.1310\nView original content:http://www.prnewswire.com/news-releases/robert-f-kennedy-jr-and-childrens-\nhealth-defense-call-for-congressional-investigation-of-covid-origin-301158110.html\nSOURCE Children's Health Defense\n/Web site: http://www.childrenshealthdefense.org\n(END)\nCollection: OW\nCreator:\n#2\nCompilation Title: PR NEWSWIRE\nDescription: (U) Full inquiry into circumstances leading to global loss of lives and economic\ndevastation should be lawmakers' top priority\nLanguage: eng\nSource:\nPublisher Type: open-source\nSourced Text: null\nLanguage: eng\nSource ID: prco20201022002592\nSource Type: Wire Services\nPOC #1\nOffice Name: PR NEWSWIRE ASSOCIATION, INC.\nPOC #2\nOffice Name: \nTitle: Robert F. Kennedy, Jr. and Children's Health Defense Call for Congressional Investigation\nof COVID origin\nCompilation Title: PR NEWSWIRE\nInformation Date: 21-Oct-2020 20:00:00\nInformation Cutoff Date: 21-Oct-2020 20:00:00UNCLASSIFIED\nUNCLASSIFIED 2\n\nSubject: PR NEWSWIREUNCLASSIFIED\nUNCLASSIFIED 3\n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n \n \nWeekly Accomplishments  \n8 Jul 2021  – 14 Jul 2021  \n \n - In coordination with the IC, ODNI re -issued the CEM with expanded releasability  to include \nFinland and Sweden in response to requests from Helsinki and Stockholm Stations.  \n \nUpcoming  \n Key Stakeholders Meeting                                Fri 7/23/21  \n- The NIC is planning to have an in -person Key Stakeholder’s meeting on 23 Jul to discuss  Agency \npositions ahead of drafting the 90 -day COVID Origins Tasking Assessment. The NIC will solicit \neach agency for their assessments on COVID origins.  \n- The meeting will be limited to one to two  people from each agency  and will include discussions on \nhow to structure the final product.  \n\n1From:\nSent: Wednesday, July 14, 2021 3:12 PM\nTo:  \nCc:  \nSubject: RE: Covid origins - Dr. Fauci recommendations\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nThanks for the feedback. In this particular case, given Dr Fauci’s background we absolutely would like to follow-up on his \noutreach suggestions. In this case he’s not a policymaker….he’s a SME with a wealth of knowledge about current and \nhistorical research who probably knows better than most who the real Coronavirus experts are.  \n \nFrom:   Sent: Wednesday, July 14, 2021 4:00 AM \nTo:  \n \n \nCc:  \n \n \nSubject: RE: Covid origins - Dr. Fauci recommendations \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nHi  \n \nSetting aside the process for contacting  individuals on any subject, I think the first question is whether the NIC wants \nto make the effort after it weighs whether to take a policymaker’s recommendations on who we should consult as part \nof an IC study--particularly given the various strong views on the subject and statements regarding their own \nconclusions.  If the NIC wants to proceed, we can then determine how we would facilitate such contact. \n \nFrom:   Sent: Tuesday, July 13, 2021 9:05 PM \nTo: \n \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Cc:  \nSubject: FW: Covid origins - Dr. Fauci recommendations \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nAll, \n \nFor those who don’t know me, I’m the  and, as such, leading the IC’s 90-day POTUS COVID origin study. Per \nbelow, Dr Fauci recommended that the IC reach out to the below individuals who were coauthors of the attached paper \nas part of the study.  is on the list of SMEs the IC has already consulted, , but  \n and , and, as far as I know, neither has been consulted. As of today, we have 43 days \nbefore our final paper is due to the President, so if we’re going to reach out to them we need to do so ASAP. Is this \ndoable? Please let me know if there’s anything I can do to facilitate this from my end. Thanks! –   \n \n \n \n  \n  \n \n \n \n \n \n \n \nFrom: Alan S. Macdougall-DNI-   Sent: Monday, July 12, 2021 3:14 PM \nTo:  \nCc:  \n \n \nSubject: FW: Covid origins - Dr. Fauci recommendations \n \nClassification: UNCLASSIFIED  \n====================================================== \n and  \n \n(U )  FYSA from last week’s IC Weekly Update.  We can discuss further based on my chat with  \n \nVR, \nAlan \n \n \nFrom:   Sent: Monday, July 12, 2021 2:50 PM \n\n3To: Alan S. Macdougall-DNI-  \nCc: Morgan Muir-DNI-  \nSubject: Covid origins - Dr. Fauci recommendations \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nAlan – The article that Dr. Fauci highlighted last week is attached, and the authors whose views he thought were \nparticularly important were: \n \n  \n  \n  \n \nAs discussed, it might be worth considering the article and talking with these individuals in connection with the 90-day \nstudy.  In addition, the COVID report rollout is scheduled to be discussed on Friday at the IC Weekly.  Please provide any \nmaterials or information you want the DNI to convey NLT Thursday COB. \n \nThanks, \n \n \n \n \n \nChief of Staff, ODNI \n \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n1From:\nSent: Monday, July 26, 2021 1:26 PM\nTo:\nSubject: Wall Street Journal piece today on origins\nClassification: UNCLASSIFIED \n====================================================== \n \nFYI, Here’s a WSJ piece today on Covid origins. \n \n-  \n \n \n \nUNCLASSIFIED \n(U) Anthony Fauci, Rand Paul and Wuhan \nIdentifiers: \n \nDocument Number: \n \nIngestion ID: \n \nNews ID: \n \nGUIDE: \n Dates: \n \nDate of Version: \n26-Jul-2021 06:03:26 \nDate Created: \n26-Jul-2021 06:03:26 Coverage: \n \nGeographic Area: \nWuhan, United States \nPublisher: \n \nDate: \n20210726 \nName: \nFactiva, The Wall Street Journal \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2No one should expect the Chinese Communist Party to cooperate with a real inquiry into the origins of Covid-\n19. More disappointing is the lack of candor from American scientists and officials whose conflicts of interest \ndeserve more scrutiny. \nMore than a year-and-a-half after Chinese researchers published a draft genome of Covid-19, the world still \ndoesn't know where the virus came from. The leading theories are an accidental lab leak or zoonotic spillover \nfrom a bat or other intermediary species. \n--- \nA World Health Organization team visited Wuhan this year but Chinese officials provided little useful \ninformation. Even WHO director-general Tedros Ghebreyesus, typically a Chinese ally, criticized Beijing for a \nlack of transparency. He called for an audit of laboratories in Wuhan as part of the origin investigation's next \nphase, but Beijing rejected the idea last week. \nA senior Chinese public-health official said WHO's plan \"did not respect common sense and violated science.\" \nThe Chinese Foreign Ministry has called instead for an investigation into Fort Detrick, a U.S. military lab. A \nWuhan Institute of Virology official said that his lab \"did not contact, preserve or study the novel coronavirus, \nand it never designed, made or leaked the virus,\" according to Chinese state-media. He added that there have \nbeen zero pathogen leaks or human infections since the institute opened its high-level BSL-4 lab in 2018. A \nChinese official must say this or risk disappearing. \nThe WIV has handled coronaviruses. U.S. experts visited the lab in 2017 and 2018 and warned about a \ndangerous mix of subpar safety standards and infectious bat coronaviruses. In January the State Department \npublished a fact sheet warning that several WIV researchers had been sick with Covid-like symptoms in the fall \nof 2019. It also noted that the group had been conducting gain-of-function research that could possibly enable \nviruses to infect a new species -- all while collaborating with the People's Liberation Army. And the WIV's \ncritical virus databases were taken offline, ostensibly for security purposes. The U.S. knows something about the research conducted at the WIV, because American taxpayer dollars helped \nfund it. This was the crux of last week's dispute between Sen. Rand Paul and Anthony Fauci, who had cast \ndoubt on the lab-leak hypothesis in the past. In their latest bout, the Kentucky Senator accused Dr. Fauci of lying to Congress, a federal crime, when he said this year that the National Institutes of Health had never funded \ngain-of-function research in Wuhan. The exchange descended into shouting. \nThe reality is complicated. The NIH gave almost $600,000 to the WIV through a nonprofit over several years to \nstudy bat coronaviruses. Mr. Paul cited a 2017 paper from WIV researchers that included experiments \ncombining parts of viruses to study how to better infect human cells. But Dr. Fauci said the project was \"judged \nby qualified staff up and down the chain as not being gain-of-function.\" \nThis might be technically true, as a 2014 federal government definition describes such research as that which \n\"increase the ability of infectious agents to cause disease by enhancing its pathogenicity or by increasing its \ntransmissibility.\" But some scientists think the government definition is too limited and can allow de facto gain-\nof-function research to bypass safety protocols. Rutgers molecular biologist Richard Ebright says the NIH-\nfunded work \"was -- unequivocally -- gain-of-function research.\" \nIn early 2020, Dr. Fauci emailed his deputy a paper co-written by gain-of-function pioneer Ralph Baric and a \nWuhan scientist. The official responded that they would \"try to determine if we have any distant ties to this \nwork abroad.\" The next day Dr. Fauci organized a call with several nongovernment virologists, but the email \nchain after the meeting was redacted. Weeks later, a group of scientists published a letter in The Lancet \n3condemning \"conspiracy theories suggesting that COVID-19 does not have a natural origin.\" Dr. Fauci and the \npublic-health elite echoed the letter's views for months. \nMr. Paul, excitable as he may be, is a medical doctor who did his homework. The Senator clearly sees a \npolitical benefit in hammering Dr. Fauci and China, but the celebrity scientist and his allies have obvious \nconflicts of interest. The Lancet letter was organized by Peter Daszak, president of the EcoHealth Alliance, \nwhich had funneled the NIH money to the WIV. \nMr. Daszak, Dr. Fauci and all researchers involved in gain-of-function research would suffer significant \nreputational damage and perhaps lose funding if scientific research they supported caused a pandemic. On \nSunday Dr. Fauci said the research cooperation was necessary because \"SARS-CoV-1 originated in China.\" But \nexactly what did that cooperation yield? \n--- \nCongress should thoroughly investigate the process that led to the approval of money for the WIV and possible \ngain-of-function research. It should also debate limits on this kind of research in the U.S. and push for \ninternational standards. While China is unlikely to budge, its opacity has aroused justifiable suspicion around \nthe world, and the White House should keep the pressure on Beijing and the WHO. \nDemocrats and much of the media will avoid the topic because Mr. Paul and the populist right have taken up \nthis cause. Such groupthink is what prevented the lab-leak theory from being treated seriously for more than a \nyear. Making the same mistake twice is inexcusable. \nLicense this article from Dow Jones Reprint Service  \nLanguage: \nen \nSubject: \nAnthony Fauci, Rand Paul and Wuhan \nUNCLASSIFIED \n \n \n \n \n \n \nDeputy NIO for WMD & Proliferation-Missiles \nNational Intelligence Council,  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED \n \n\n1From:\nSent: Tuesday, December 3, 2024 8:35 AM\nTo:\nSubject: RE: HOT: Final Congressional COVID Report, Confirms Lab Leak\nClassification: UNCLASSIFIED  \n====================================================== \n \nODNI was going to give them a heads up but not sure what happened to that… we probably need to engage OCA. \n \nFrom:   \nSent: Tuesday, December 3, 2024 8:34 AM \nTo:  \nSubject: RE: HOT: Final Congressional COVID Report, Confirms Lab Leak \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nDoes Congress have any idea about the Germans? \n \nFrom:   Sent: Tuesday, December 3, 2024 8:27 AM \nTo:  \n \nCc:  \n \n \nSubject: RE: HOT: Final Congressional COVID Report, Confirms Lab Leak \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nHi  \n \nThanks for flagging—adding a bunch of people who should be tracking on this one. \n \nThanks again, \n \n \nWorldwide BW Analyst \nWCPMC/CBD/WMAAB  \n \n \n \nFrom:   Sent: Tuesday, December 3, 2024 7:14 AM \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2To:  \nCc:  \n \nSubject: HOT: Final Congressional COVID Report, Confirms Lab Leak \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nHi all, \n \nThe Select Subcommittee released a 520-page final report last night detailing the findings of its two-year investigation \ninto the COVID-19 pandemic, which highlights lessons learned and a path forward for preparing for and responding to \nfuture pandemics.  \n \nThe report concludes that COVID-19 most likely emerged from a laboratory in Wuhan, China, and criticizes the WHO’s \nresponse to the pandemic, as well as the US government's handling of relief funds, mask mandates, and vaccine \ndevelopment. The report also identifies widespread corruption, misinformation, and obstruction of its investigation by \ngovernment officials, researchers, and organizations, including Dr. Anthony Fauci, EcoHealth Alliance, and the Biden \nAdministration's CDC. \n \nThe leading theories that led the committee to their conclusions: 1. The virus possesses a biological characteristic that is not found in nature. \n2. Data shows that all COVID-19 cases stem from a single introduction into humans. This runs contrary to previous \npandemics where there were multiple spillover events. \n3. Wuhan is home to China’s foremost SARS research lab, which has a history of conducting gain-of-function \nresearch at inadequate biosafety levels. \n4. Wuhan Institute of Virology (WIV) researchers were sick with COVID-like virus in the fall of 2019, months before \nCOVID-19 was discovered at the wet market. \n5. By nearly all measures of science, if there was evidence of a natural origin it would have already surfaced. \n \nI’ll look into pulling over the entire assessment into HIVE for those interested. I’ll continue to monitor the open source \nfor any developments. \n \nThanks, \n  \n \n \n  \n \nOpen Source Specialist, WCPMC \nChemical & Biological Department (CBD)  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n\n3 \n====================================================== \nClassification: UNCLASSIFIED  \n \n\n1From:\nSent: Tuesday, December 12, 2023 7:06 PM\nTo:\nCc:\nSubject: Flagging: COVID origins questions today\nAttachments: FW: in response to the DDCIA question related to the context of a Fauci e... (661 KB)\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nOCA,  \n \nJust wanted to give you a heads up that an NSC director asked us for some talking points on CIA’s engagement with Dr. \nFauci ahead of a House Coronavirus subcommittee meeting tomorrow.  \n \nHHS, USAID, and DoS are attending a Coronavirus subcommittee hearing tomorrow on Reforming the WHO: Ensuring \nGlobal Health Security and Accountability. The NSC was concerned that questions about Fauci and CIA might come up \nafter Rand Paul’s interview promoting his new book on COVID origins, “ Deception: The Great COVID Cover-Up .  \n \nWe suggested that if questions in the hearing come up about CIA, then they need to be passed to CIA through official \nchannels (ie OCA). So there is no action for you or us right now: just flagging for your awareness. \n I’ve also attached for your reference the email we sent up to DDCIA a couple months ago on the background of our Fauci \nengagement.  \n \nThe Rand Paul interview is transcribed below, but here’s the key part: \n \n So, there really was an orchestrated cover-up on this. We also now know that he [Fauci] was visiting the CIA in early \n2020. We know that the CIA scientists, seven of them, voted six to one to say it came from the lab, and then they were \nreversed by superiors. We need to know whether Anthony Fauci influenced the superiors, or perhaps the opposite. Did \nthe CIA influence Anthony Fauci? \nBut we also need to know how often he was visiting and what he was there for. Our understanding is that he wasn't \nrecorded on visitor logs, but he was appearing frequently at the CIA. You have to realize that he was not a scientist in \ncharge of a cure for cancer. He was also in charge of a lot of bioweapons money and in charge of a lot of things that had \ndual use. \nAnd they won't reveal any of this to us. They had weekly meetings on dangerous dual-use research concerns and gain-\nof-function, and not one item of any of those meetings has been released to us, despite us asking for it for over three \nyears. \n \n \n \n \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2 \n \n \n \n \nFrom:   \nSent: Tuesday, December 12, 2023 12:26 PM \nTo:  \nSubject: (U) COVID-19 \n \nClassification: UNCLASSIFIED \n====================================================== \n \nMARIA BARTIROMO », FOX NEWS ANCHOR: \nAnd that's South Dakota Governor Kristi Noem with me last week on this program with some disturbing commentary, \ncommunist China still controlling America's supply of medicine four years after the outbreak of COVID-19 from a lab in \nWuhan that has killed more than 1.1 million Americans so far. \nThe CCP has yet to provide evidence on how that deadly virus originated and explain its cover-up that followed. Next \nmonth, Dr. Anthony Fauci is set to testify for two days before the House on the origins of COVID-19 and his handling of \nthe pandemic, where Republicans are expected to grill him on overseeing funding of gain-of-function research at the \nWuhan lab, as well as discrediting the theory the virus originated from a lab leak. \nJoining me right now is Kentucky Senator Rand Paul. He is vowing to hold hearings on the origins of COVID in the Upper \nChamber if Republicans retake control next year. Senator Paul is also the author of the new book \"Deception: The Great \nCOVID Cover-Up,\" available right now. \nSenator, thanks very much for joining us this morning. \n \nSEN. RAND PAUL (R-KY): \nThank you, Maria. \n \n«BARTIROMO »: Well, you have been an incredible truth-teller throughout all of this, and you have studied all of this now for several \nyears. \nWhat can you tell us about what you have learned, what you have taken away from the entire COVID experience? \n \nPAUL: \nWell, the problem is, is that the Chinese have destroyed any kind of reputation they had. I mean, we can no longer believe any kind of pronouncements from them, which makes us suspicious. Right now, there's \na host of disease affecting young people, respiratory disease and pneumonia, in China, and they tell us, well, there's \nnothing to see here. \nAnd maybe that's true, but they have destroyed any kind of foundation we had in trusting them, and they still haven't \ncome clean. In early 2020, when COVID came out, they said, oh, we're not having human-to-human transmission, and \nwe don't seem to be having an extraordinary amount of flooding in the hospitals or deaths. \nAll of that was untrue, and they knew for at least three or four weeks. They also knew the sequence of the virus, and \nthey kept that secret as well. I think they also knew that three of their workers got sick at the Wuhan Institute of \nVirology in November 2019. I think they knew all of this. \nAnd I think they absolutely know it now, and the only way they can restore trust is to own up to it. Look, I don't blame \nthem completely for this. I think it was an accident, but cover-up is not an accident. If they were to come clean and say, \nwe're punishing the scientists who did what they weren't supposed to, I think then that we could restore some trust. \nBut, right now, we have really no trust with the Chinese government. \n \n«BARTIROMO »: Well, what about the accountability here, and why the Biden administration does not push for it? \n\n3I mean, right now, as we speak, there are American investors continuing to underwrite the CCP by buying those \ncompanies that are tied to the Chinese military. It seems this administration is not willing to pull the economic lever, and \nthat is shut off the capital markets to Chinese communist companies that may have been involved in that cover-up or \ntied to the military. \n \nPAUL: \nWell, we still continue to fight the Biden administration every day just for unclassified information, and they resist at \nevery turn. \nWe have had to basically withhold nominees and withhold legislation to try to get anything from the Biden \nadministration. And I'm not sure what it is. Either it's sympathy or believing that relations with China are so important \nthat the truth can be obscured. \nBut there's also a certain amount of culpability in the Biden administration throughout several different departments, \nUSAID, NIH, HHS. They're withholding documents because they funded the lab in Wuhan, not just once, not just twice, \nbut for a decade they were funding. \nAnd we have Anthony Fauci on record as saying that, even if a pandemic occurs, even if a gain-of-function research \ninfects a scientist and a pandemic occurs, that the knowledge would be worth the risk. And I think most people who had \na loved one die from COVID either here or around the world would disagree and think Anthony Fauci made a disastrous \njudgment call. But he also took the research, and it didn't go before the normal scrutiny. There's a safety committee that was supposed \nto review this, and Anthony Fauci allowed this research to be done at his signature, at his conclusion, at his approval \nwithout the approval of the safety committee. \nAnd this -- for this, he really should go down in history perhaps as one of the worst people in public office ever and \nresponsible for probably more deaths than other -- any other individual in the medical world. \n \n«BARTIROMO »: Well, I mean, there was so much censorship of so much information that was vital for Americans to see and understand \nabout COVID and about the vaccines, but they censored it. \nCan we even trust health officials in this government? \n \nPAUL: Well, it was directed explicitly by him. We go over this in the book, because he commissioned scientists who were saying \nin private that they thought it was a manipulative virus, manipulated a lab and came from a lab. \nHe convinced them in public to say the opposite. He commissioned and edited a paper that said that absolutely this did \nnot come from a lab, while, privately, all of these same scientists were saying, in all likelihood, it did come from a lab. So, there really was an orchestrated cover-up on this. We also now know that he was visiting the CIA in early 2020. We \nknow that the CIA scientists, seven of them, voted six to one to say it came from the lab, and then they were reversed by \nsuperiors. We need to know whether Anthony Fauci influenced the superiors, or perhaps the opposite. Did the CIA \ninfluence Anthony Fauci? \nBut we also need to know how often he was visiting and what he was there for. Our understanding is that he wasn't \nrecorded on visitor logs, but he was appearing frequently at the CIA. You have to realize that he was not a scientist in \ncharge of a cure for cancer. He was also in charge of a lot of bioweapons money and in charge of a lot of things that had \ndual use. \nAnd they won't reveal any of this to us. They had weekly meetings on dangerous dual-use research concerns and gain-\nof-function, and not one item of any of those meetings has been released to us, despite us asking for it for over three \nyears. \n \n«BARTIROMO »: Do you believe COVID was a bioweapon? \n \nPAUL: \n4I think that it was probably developed for a vaccine. I think they developed a coronavirus. They inserted this cleavage \nsite in to make it more infectious to humans, and then they had a vaccine very early on, because I think they were \ndeveloping a vaccine against COVID, and then COVID got out. \n \n«BARTIROMO »: Yes. \n \nPAUL: \nBut the interesting thing is the scientist, Dr. Zo Yusin [ph], who developed it, died mysteriously two months after the \ndevelopment of the virus. He fell from a tall building in Beijing. And there's a lot of questions as to the circumstances of \nhis death. \n \n«BARTIROMO »: Wow. I did not realize that, that he died from a tall building in Beijing. That's incredible. \nLet me switch gears, ask you about the supplemental package. You all are leaving for the holidays next week. But you're \nright now debating this $100 billion supplemental package that Joe Biden wants, money sent to Ukraine, if you're going \nto send money to Israel. \nAnd the Republicans so far have dug in, saying, we want policy changes at the border. Where is this going? \n \nPAUL: \nWe don't have the money. \nAnd the biggest threat -- while I agree the border should be secured, an even bigger threat is to the dollar and to our \ncurrency. I follow Jim Grant. I think he's one of the smartest guys out there looking at the economy and the Fed. He \npredicted a lot of the things that happened in 2008, when we had the housing bubble burst. \nHe thinks we're due for interest rates, high interest rates, for a long period of time, but we're accumulating debt at a \ntrillion dollars every three months now. This is an extraordinary thing. And interest rates are now becoming the highest \nor one of the largest items in our budget. \nSo, really, people can talk about wanting to help other countries. We don't have the money. It has to be printed up. It's \ndestroying our currency. And it's why it costs more to go to the grocery store to buy your groceries. We can't allow this \nto happen. \nThere is a possibility we could go too far with this, and we could have a cataclysmic economic downturn, recession, \ndepression, destruction of the currency. \n \n«BARTIROMO »: Wow. \n \nPAUL: \nI know that sounds over the top, but that's what I'm worried about, because we're accumulating debt so fast. \n \n«BARTIROMO »: Well, I agree with you about Jim Grant. Jim Grant is a regular of mine on \"Mornings With Maria\" over on the FOX \nBusiness Network. And he's been sounding the alarm about all of this debt for a long time. \nBut you have got a package at hand, and you have got a vote on this coming up. Where is this going? Is -- are you guys \ngoing to go to the holiday and not send any money to Ukraine? What do you expect this -- to happen? How does this \nplay out, rather? Pardon me. \n \nPAUL: \nMy hope is that Speaker Johnson will stick to his word. He said Israel aid would be separate and paid for. He immediately voted for it, and the House passed it, and they paid for \nit by taking money away from the IRS. I hope he stands by his word. I think he has an enormous leverage, if he will use it.  \n5Now, he's getting pushed by all the establishment Republicans, particularly on the Senate side. He's being pushed to put \nall the aid together with Ukraine. I think, if he keeps it separate and keeps it paid for, I think that he will win the day, \nultimately. But he needs to realize he has all the power, if he will stay where he is and not capitulate. \n \n«BARTIROMO »: All right, Senator, we will be watching all of that. \nThank you again for being a truth-teller in all of these health issues. \n \nPAUL: \nThank you. \n \n«BARTIROMO »: We appreciate your time this morning, sir. \nThank you, Senator Rand Paul, for joining us. \n \n \n \nDirector for Biodefense and Biotechnology Risk \nNational Security Council \n \n  \n \n====================================================== \nClassification: UNCLASSIFIED \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Wednesday, September 27, 2023 12:23 PM\nTo:\nSubject: FW: New York Post on Fauci influencing CIA on COVID origins and Congressional Letter \nto HHS\nAttachments: Scan-20230927115303.pdf\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \nChief, Weaponization, Modeling, and Agents Analysis Branch and Disease Threat Intelligence Cell \nWCP/CBD \n \n \n \n \n \nFrom:   \nSent: Wednesday, September 27, 2023 12:10 PM \nTo:  \n \nCc:  \nSubject: New York Post on Fauci influencing CIA on COVID origins and Congressional Letter to HHS \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n \n. \n \n \nAll – found this NY Post article by chance just now on AIN.  It is not in today’s Media clips.  The \nattachment also includes a letter from Congress to HHS.   \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Separately and below is the CLASSIFIED readout of one meeting with Dr. Fauci (thanks to \n for pulling it).  Not sure but appears this was a VTC rather than in person (see my \nhighlight below): \n \n-  \n \n \n \nFrom:   \nSent: Monday, June 7, 2021 7:18 AM \nTo:\n \nSubject: Quick Recap of 4 June Dr. Fauci Briefing \n \n \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \nClassification:  \nHi, \n \nWPC/  WCP/  WCP/  and EAPMC/  attended the briefing.  COO  also attended, \nand NSC Director Beth Cameron SAP & Senior Director for Global Health Security & Biodefense “mediated/facilitated” \nthe briefing.  briefed the key points of the 4 May 2021 PDB/WIRe   Worldwide: Origin of COVID-19 Pandemic Remains Elusive . Briefing lasted about 40 minutes (with some audio technical difficulties). \n \nDr. Fauci offered the following thoughts/insights when asked about certain points Camille raised from the PDB/WIRe. \n \n On China’s pangolin research, Dr. Fauci said it was important to obtain details of the experiments. \n On the 3 sick WIV researchers, Dr. Fauci said key gaps that need to be filled are 1) If they were sick, what does \ntheir medical records show; 2) Do we have blood culture of these sick researchers; and 3) Did we ask China \nabout/for this information? \n On the single lineage issue, Dr. Fauci recommended that IC take a look at Tulane’s  paper on two \nlineages from two separate markets (NFI). To Dr. Fauci, this paper’s findings were a clear indication of natural \norigins of COVID-19. This research was republished with  recently. \no Dr. Fauci reminded the group that even for SARS, it took 12 years to make the link to a bat even though \nit only took 4 months to identify the natural reservoir. \no We still haven’t identified source/origin of Ebola. We need to be careful of the links we make to these \nprevious cases. \n Dr. Fauci noted that China has good scientists but made an epidemiological mistake when China “cleaned” the \nmarket… China inadvertently shot themselves in the foot. On single lineage, it’s like looking for a needle in the \nhaystack; it may not be a whole group of animals but a single animal, which is difficult to identify; and again, Dr. \nFauci asked why China didn’t look more carefully into the market before “cleaning” it out. \n Dr. Fauci recommended contacting a group of US scientists who closely follow this issue, especially to combine \ninvestigative/forensics/intel with scientific community’s research, including , \nand  [WCP is already in contact/in the plans to contact some of these individuals.] \n \n\n3Thanks! \n \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Wednesday, July 12, 2023 3:59 PM\nTo:\nSubject: FW: Readout of contentious HPSCI COVID Origins briefing \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n \nFrom:   \nSent: Thursday, September 23, 2021 3:50 PM \nTo:  Morgan Muir-DNI-  \n \nSubject: Readout of contentious HPSCI COVID Origins briefing  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n and I, along with three reps from NCPC and  from OLA, briefed the HPSCI this morning on the COVID \nOrigins assessment. It did not go well. After Opening remarks from Reps Schiff and Nunes, I started off with prepared \nremarks that went about 10 minutes, going over the processes involved in the 90-day study and then highlighting the \nkey takeaways. Rep Schiff asked a couple of easy questions and then turned it over to Rep Nunes, who yielded his time \nto Rep. Wenstrup. Then everything went downhill.  \n \nRep Wenstrup spent the first big chunk of his time identifying a number of open source documents that he wanted read \ninto the record (which was agreed to), in particular papers on the threat of SARS as a bioterror weapon (from 2005), \nstatements Fauci made on the general idea of gain of function research back in 2012, Ralph Baric’s work on chimeric \nviruses in 2015, and similar stuff. After quite a while of talking he finally started to ask questions. They mostly centered \non the names of the experts the IC reached out to on COVID origins. I told him that I was unable to reveal the names of \nthe experts we reach out to. Which is also exactly what I told the staffers during the pre-briefing we did on Tuesday. Rep \nWenstrup even acknowledged before he asked the first time that he knew what my response would be but was going to \nask anyway. He was, to put it mildly, not happy with my answer. In fact, he seemed pretty outraged. After that, it was \nmore of the same. Every single minority member who asked questions spent the first two-three minutes of their allotted \nfive minutes expressing outrage and disdain over my behavior. One, not sure who because this was all a blur, even said \n“shame on you.” At one point, a member turned his time back to Rep Wenstrup who went through a long list of names \nof “experts” (air quotes because the expertise of some he named is iffy in my mind) and asked me if anyone in the IC had \nconsulted with them…apparently because he wanted me to be on the record each time saying “I am not going to \ncomment on that.” I repeatedly tried to explain that IC policy was to not reveal the names of the experts we reached out \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2to for source protection reasons, which just seem to enrage then all even more. Several of the minority members \nclaimed that they had been staunch defenders of the IC in the past but now “will not have your back.” I heard a lot of \n“nobody has ever come in here and refused to answer our questions” and the comments/question got heated on their \nend and were pretty over the top. Several times I tried to answer a question only to be interrupted by whoever asked \nthe question and a couple even said something along the lines of “I don’t want to hear that ‘it’s against policy’ crap.”  \n \nNot to pick on the minority members, some of the majority members also were not pleased with the briefing. Rep. \nSpeier seemed annoyed that our assessment focused too much on  and wanted us to agree to talk to \none of her constituents who was in Wuhan in November of 2019 on a riverboat cruise (I kid you not). Her time ran out \nbefore she asked that and she didn’t press the issue. Rep Krishnamoorthi also expressed surprise and disappointment \nover my refusal to identify the experts and said it made us (the IC) “look bad.” \n \nIt seemed clear to me that few if any of the members actually read the Updated Assessment…or were paying attention \nto my prepared remarks. One of the minority members (I can’t remember which) challenged me to identify anything \nnew that I had mentioned up to that point that was not in open sources. That question frankly baffled me, but I pointed \nout that I had literally just talked about  WIV researchers who were reportedly sick in the Fall of 2019. \nMembers from both parties seemed surprised and confused that FBI came to a different conclusion than other IC \nagencies. More than one asked me if FBI had access to information that they had not shared with the IC, and one \nmember (I think it was Rep Carson) asked me and  if we thought FBI was an equal and honest partner in the \nprocesses (despite some of our issues with FBI, we both stated “yes”). Nobody seemed to understand what “low \nconfidence” means; even after I explained multiple times that low confidence meant that we had  \n I got the same confused questions about \nconfidence levels.  \n \nWith regard to the minority members question on experts, I think this was a set-up. They were looking for a reason to \ndistance themselves from the Updated Assessment and that was the issue they chose. Again, they knew we were not \ngoing to name the experts because this came up at the pre-brief Tuesday. And at no time during that call did any of the \nminority staffers indicate that this was going to be a problem  \n Maybe I could have explained the reason we weren’t going to provide the names in a \nway that would have resulted in less vitriol…but I doubt it.  \n \nAnyway, I would expect the DNI  to receive angry letters from the Hill calling my professionalism into question and \ndemanding that the IC name names. And maybe that I be fired.  \n \n \n \n  \n  \n \n \n \n \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Thursday, July 13, 2023 8:46 AM\nTo: Michael L. Collins-DNI-\nCc:\nSubject: RE: Briefing to COVID Subcommittee on COVID Origins \nAttachments: FW: Readout of contentious HPSCI COVID Origins briefing  (18.4 KB)\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nI talked to OLA yesterday afternoon. Apparently there is a push to do an open briefing in addition to the classified \nbriefing for Wenstrup’s committee, and because Morgan was (according to OLA) going to do the open briefing, they \nthought it made sense for him to do the classified briefing as well. I take it there’s a meeting today between OLA and \nMorgan and maybe the DNI where they’ll work this out.  \n What’s a little concerning to me is that the person in OLA I spoke to also noted that they have been advised by “staffers” \n(presumably from the HPSCI) to not have me attend briefings involving Wenstrup. My impression is that this guidance \noriginated back in late 2021 and was the result of the COVID-O briefing I gave the HPSCI after we published the 2021 \nNICA. That briefing admittedly didn’t go well (readout of that meeting attached), but that’s hardly a justification to not \nhave me brief now, almost two years later. I am perfectly capable of briefing in front of a hostile audience.  \n \nFrom:   Sent: Wednesday, July 12, 2023 1:15 PM \nTo: Michael L. Collins-DNI-  \nCc:  \nSubject: RE: Briefing to COVID Subcommittee on COVID Origins  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nI reached back to OLA to see what the deal is. I’ll let you know what I hear back.  \n \nFrom: Michael L. Collins-   \nSent: Wednesday, July 12, 2023 12:57 PM \nTo:  \nCc:  \nSubject: FW: Briefing to COVID Subcommittee on COVID Origins  \n \nClassification:  \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Classified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \nDo you need me to call OLA on this?  You should be the briefer.  I’d like to talk in advance, however. \n \nMike  \n \nFrom:   \nSent: Wednesday, July 12, 2023 12:02 PM \nTo: Morgan Muir-DNI-  \nCc: Michael L. Collins-DNI- \n \nSubject: RE: Briefing to COVID Subcommittee on COVID Origins  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n Ha…news to you that you were briefing? I don’t think I ever said I didn’t think I was the right choice…I just heard about it \nthis morning. I have often joked about the last time I briefed Wenstrup on COVID-O, and how well that went…but I am \nmore than happy to do so for this or any other briefing.  \n \nFrom: Morgan Muir-DNI-   \nSent: Wednesday, July 12, 2023 11:35 AM \nTo:  \nCc: Michael L. Collins-DNI- \n \nSubject: RE: Briefing to COVID Subcommittee on COVID Origins  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nHi, \n \nHmmm. News to me.  I heard that you didn’t think you were the right choice but I thought it was still up in the air.   \n \nI’ll ask but she has never said that to me and it doesn’t sound like her.  We all know there is a division over there that \ncan’t be bridged but I have never heard percentages attached to either side. \n \nM \n \nFrom:   Sent: Wednesday, July 12, 2023 10:41 AM \n\n3To: Morgan Muir-DNI-  \nCc: Michael L. Collins-DNI- \n \nSubject: Briefing to COVID Subcommittee on COVID Origins  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nHey Morgan,  \n \nI heard from CIA and OLA that you’ll be leading the COVID origins briefing for Rep Wenstrup’s COVID Subcommittee on \nthe 27th. We’re obviously ready to support this is any way you need. Just let us know. The briefing we did for the \nSubcommittee’s staffers last month went pretty well. DOE and FBI didn’t do a particularly good job explaining their \nassessments…but that’s been the case for most of these briefings. CIA did get one strange question from the lead \nmajority staffer about their position, though, that I wanted to flag as it may come up in your briefing. According to the \nstaffer, the DNI told Rep Wenstrup that CIA was 2/3 in the “lab leak” camp but that they were being “held back” by 1/3 \nof the analysts. He asked the CIA briefer if that was true. She responded that she had never heard that…as did I. CBD \nmanagement has pinged me a couple of times since to see if the DNI actually told Wenstrup this or if there was another \nexplanation for the source of the claim. I imagine whoever CIA sends to the briefing with you will also want to know so \nthey can answer accordingly. –   \n \n \n  \n  \n \n \n  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Derived From:  \nDeclassify On:  \n====================================================== \n \n – hopefully I didn’t misspeak when we chatted. NCMI learned of this from our OCC colleagues who were \nnotified by DARPA Legislative Affairs. They provided the links below for where the article was circulating on Monday. I’ve \nalso attached a document that I was provided this morning that is allegedly what was posted on line. It does not contain \nyour comments (thankfully) but is very similar to the V11 I shared with you yesterday. \nYou can see a flavor of the resulting coverage:  \nhttps://www.theblaze.&#65279;com/news/leaked-pentagon-paper-indicates-the-us-government-suspected-all-along-\nthat-fauci-s-covid-19-natural-origins-theory-was-rubbish   \n  \nThis account has screenshots  \nhttps://twitter.&#65279;com/billybostickson/status/1658307176702828545   \n. The individual is associated with drasticresearch.org, which has been tied to other leaked information.   \nv/r \n \n \n \n \n \n \n \n \n \n \n \n \nFrom:   \nSent: Wednesday, May 24, 2023 4:53 PM \nTo:  \nSubject: RE: Here's the paper from May 2020 \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \nHi  \n \n\n3Thank you again for letting me know about the upcoming origins meeting. You mentioned NCMI found out via the news. \nDo you have a copy of the article(s)? If not, which news outlets did you see it in?  \n \nThank you! \n \n \nFrom:   \nSent: Wednesday, May 24, 2023 2:05 PM \nTo:  \nSubject: Here's the paper from May 2020 \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nHere you go \n \n \n \n \n \n \n \n \n \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Wednesday, March 16, 2022 8:04 AM\nTo:\nSubject: FW: ACTION REQUIRED: (U ) FOIA Litigation Search Request | \nDF-2021-00235 (21-cv-01619)\nClassification: UNCLASSIFIED  \n====================================================== \n \nStand down on this for now. Maybe we’ll get clarification that will lower the burden of this ridiculous request. Also note, \nhowever, that this is one of six requests this person filed on COVID origin stuff…so more probably on the way to us.  \n \nFrom:   \nSent: Wednesday, March 16, 2022 7:51 AM \nTo: DNI_MI_NIC_TASKERS Mailbox  \nSubject: RE: ACTION REQUIRED:  (U ) FOIA Litigation Search Request | DF-2021-00235 (21-cv-\n01619) \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nWhat are we supposed to do with this? Shouldn’t this be sent to the “senior” DOS, NIH, or ODNI officials for them to \nsearch their records? And what is a “senior” official for these agencies? –   \n \n \nFrom:  On Behalf Of DNI_MI_NIC_TASKERS Mailbox Sent: Tuesday, March 15, 2022 9:58 PM \nTo: DNI_MI_NIC  DNI_MI_NIC  \nCc: DNI_MI_NIC_TASKERS Mailbox  \nSubject: ACTION REQUIRED:  (U ) FOIA Litigation Search Request | DF-2021-00235 (21-cv-\n01619) \nImportance:  High \n \nClassification: UNCLASSIFIED  \n====================================================== \nNIO , D/  \n \nSuspense: COB Tuesday, 15 MAR 2022 \n \nThis FOIA specifically asks for all records, communications, or briefings created, generated, forwarded, \ntransmitted, sent, shared, saved, received, or reviewed by any senior level DOS, NIH, or ODNI official referencing, connected to, or regarding in any way Anthony Fauci, the Wuhan Institute of Virology, and \nCOVID-19 (including any shorthand, pseudonyms, or synonyms used for those terms). \n \nTimeline: May 1, 2020, to the date this request is processed \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Keyword Search : Fauci AND Wuhan \n  : Fauci AND COVID-19 AND Wuhan \n  : Fauci AND COVID AND Origins \n  : Biden AND COVID-19 AND Wuhan \n  : Biden AND COVID AND Origins \n \n \nThanks, \n \n \n \nAnalytic Program Manager \nNational Intelligence Council \nOffice of the Director of National Intelligence \nODNI  |  DDMI  | NIC FO \n \n \nBooz Allen Hamilton Contractor Support \n \n \n \n \n \nFrom:  On Behalf Of DNI_MI_Taskers Mailbox \nSent: Monday, March 07, 2022 1:01 PM \nTo: DNI-MI-NIMC-Taskers Mailbox  DNI_MI_NIC_TASKERS Mailbox\n \nSubject: FW: [Direct][Action]  (U ) FOIA Litigation Search Request | DF-2021-00235 (21-cv-\n01619) \nImportance:  High \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nAttn: NIMC, NIC \nAction:  Please provide any responsive materials for the subject FOIA. \nSuspense to MI FO: COB 15 MAR 2022 \n \n \n \nFrom:   \nSent: Friday, March 4, 2022 5:05 PM \nTo: DNI_MI_Taskers Mailbox  \nCc:  \nSubject: [Direct][Action]  (U ) FOIA Litigation Search Request | DF-2021-00235 (21-cv-01619) \nImportance:  High \n\n1From:\nSent: Monday, September 27, 2021 12:24 PM\nTo:\nSubject: RE: Wash Examiner\nClassification: UNCLASSIFIED  \n====================================================== \n \nDo we have the actual letter?  \n \nFrom:   \nSent: Monday, September 27, 2021 12:00 PM \nTo:  \nSubject: FW: Wash Examiner \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nFYI Only \n \n \nLegislative Liaison Officer (NIM-EA, NIM-SA, JHTS) \nManagement Advisory Group Rep \nODNI Legislative Affairs \n \n \n \n \n  \n \nFrom:    \nSent: Monday, September 27, 2021 9:20 AM \nTo: Matthew Rhoades ;  ;  \n  \nSubject: Wash Examiner \n \n  \n \nHouse Intel GOP demand Biden instruct top spy office to reveal scientists who  \nhelped with COVID-19 origins report \n \nby Jerry Dunleavy, Justice Department Reporter  \n |  \n \n  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2 \n | September 26, 2021 07:20 PM \n \n  \n \nHouse Intelligence Committee Republicans accused the Biden administration's  \ntop intelligence office of \"stonewalling\" congressional overseers from learning  \nabout outside doctors and scientists whom U.S. spy agencies relied upon to put  \ntogether a report assessing the origins of COVID-19. \n \nRep. Devin Nunes, the ranking member on the panel, was joined by nine fellow  \nGOP members who said they had no confidence in the origins assessment because  \nthe Office of the Director of National Intelligence personnel who briefed them  \nhad declined to identify which scientists were consulted during the  \ninvestigation, which did not provide a definitive conclusion on whether the  \nvirus was transmitted to humans naturally or through a lab leak in China. \n \n\"This is fundamental oversight of the IC?s work. We need this information to  \ndetermine whether there was any selection bias in choosing the outside  \nscientists to consult. We also need it to determine whether any of the  \nscientists had conflicts of interest that should affect the weight given their  \nanalyses,\" the Republicans wrote in a letter to Biden dated Friday. \n \nNunes, a California Republican, revealed the letter during an appearance on  \nSunday Morning Futures on Fox News. \n \n?It looks like there needs to be an entire new report that needs to be  \nwritten, because Republican members on the committee have basically had enough  \nof this. It just looks like this is another attempt to obfuscate and protect  \nChina  \n \n once again by the Biden administration,\" he told   \n \nhost Maria Bartiromo. \n \nThe interview took place shortly after the   \n \nWall Street Journal   \n \nreported   \n \nthat a panel of scientists investigating the origins of the COVID-19 virus had  \ndisbanded, citing concerns about its links to EcoHealth Alliance, a New  \nYork-based nonprofit group that had used U.S. funds for research on bat  \ncoronaviruses with the Wuhan Institute of Virology. EcoHealth Alliance  \nPresident Peter Daszak, who dismissed    \n \nthe lab leak hypothesis in March, recused himself from the investigation over  \nthe summer. \n \nA letter    \n \nsigned by 27 scientists, including Daszak, was published in Lancet in February  \n2020, dismissing the lab leak hypothesis as a conspiracy theory. Numerous  \noutlets pointed to the letter and to Daszak, who had recruited scientists to  \nsign the letter, to shut down the debate over COVID-19?s origins. \n \nDr. Anthony Fauci quietly worked behind the scenes to cast doubt on the lab  \nleak hypothesis in 2020, and he and Daszak were in communication at the time,  \nemails   \n \nshow. \n3 \nDaszak was also a key member of the World Health Organization-China   \n \njoint study team earlier this year. The WHO-China    \n \nreport was widely considered a failure, partly due to the lack of access to key  \ndata and Chinese influence over the investigation. \n \nThe WHO-China study deemed the lab leak theory ?extremely unlikely,? and  \nmeeting minutes with the Wuhan lab dismissed it as a ?conspiracy theory.? \n \nIn July, WHO Director-General Tedros Adhanom Ghebreyesus said    \n \nthere was a \"premature push\" to dismiss the lab theory, but the Chinese  \ngovernment shot down    \n \nthe suggestion of a second investigation. \n \nIn their new letter, the House Intelligence Republicans claimed ODNI staff  \ndid not respect the oversight role the panel has over the U.S. intelligence  \ncommunity. \n \n?Shockingly, ODNI has repeatedly refused to tell the Committee which  \nscientists the IC consulted. When pressed on the basis for this refusal during  \nour hearing, ODNI staff acknowledged there is no law or regulation prohibiting  \nthem from revealing these names to us. Instead, they simply refused again in a  \nhostile manner, claiming it is their ?policy? to do so,? the GOP group said. \n \nAfter Biden called on   \n \nthe intelligence community to ?redouble? its origins investigation in May and  \ngave it a 90-day clock, an unclassified report was released by ODNI last month. \n \nThe assessment stated   \n \nthat one U.S. intelligence agency assesses with ?moderate confidence? that  \nCOVID-19 most likely emerged from a Chinese government lab    \n \nin Wuhan, while four U.S. spy agencies and the National Intelligence Council  \nbelieve with ?low confidence? COVID-19 most likely has a natural origin. Other  \nparts of the U.S. intelligence community remain on the fence. \n \nThe one unnamed spy agency leaning toward the Wuhan lab theory with \"moderate  \nconfidence\" assessed that \"the first human infection with SARS-CoV-2 most  \nlikely was the result of a laboratory-associated incident, probably involving  \nexperimentation, animal handling, or sampling\" by the Wuhan Institute of  \nVirology. The four unnamed spy agencies, along with the NIC, with \"low  \nconfidence\" in the natural origin hypothesis assessed \"the initial SARS-CoV-2  \ninfection was most likely caused by natural exposure to an animal infected with  \nit or a close progenitor virus.? \n \nThe Republicans argued in their letter that the intelligence community failed  \nto live up to Biden's own words when he said on May 26, ?I have asked the  \nIntelligence Community to keep Congress fully apprised of its work,\" and urged  \nhim to crack down. \n \n?Outside doctors and scientists who were consulted for their technical  \nanalyses of COVID?s potential origins are not clandestine sources or spies.  \nThey are consultants and there is no basis for stonewalling the Committee about  \ntheir identities ? I respectfully ask that you rectify this situation by  \ninstructing the ODNI to cease stonewalling Congressional oversight and to  \nimmediately disclose to the Committee the full list of all outside doctors and  \n4scientists consulted in the investigation of COVID?s origins,\" Nunes and his  \nfellow Republicans wrote. \n \nNunes also stressed that what ODNI presented in the summer did not match what  \nhe demanded in the spring. \n \n?In May, I wrote to you requesting that you initiate a whole-of-government  \neffort to identify the origins of the virus. However, you opted for a much  \nnarrower review solely by the Intelligence Community,? Nunes and his fellow  \nRepublicans told Biden. ?The Committee has reviewed the resulting IC report and  \nreceived a briefing from Office of the Director of National Intelligence  \npersonnel. Based on the IC?s appalling lack of transparency and the ODNI  \nstaff?s hostile response to simple questions, we have little confidence in the  \nDNI?s report.? \n \nThe Washington Examiner reached out to ODNI for comment. \n \n \nhttps://www.washingtonexaminer.com/news/house-intelligence-gop-demand-biden-instruct-top-spy-office-reveal-scientists-helped-covid-19-origins-report  \n  \n \n \n  \n \n \n \nPublic Affairs Officer \n \nOffice of the Director of National Intelligence (ODNI) \n \n \n \n \n \n   \n \n  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n\n1From:\nSent: Friday, September 24, 2021 10:50 AM\nTo:\nSubject: FW: Readout of contentious HPSCI COVID Origins briefing \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nFYI…fun stuff. Morgan says he won’t fire me.  \n \nFrom:   \nSent: Thursday, September 23, 2021 3:50 PM \nTo:  Morgan Muir-DNI-  \n \nSubject: Readout of contentious HPSCI COVID Origins briefing  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n and I, along with three reps from NCPC and  from OLA, briefed the HPSCI this morning on the COVID \nOrigins assessment. It did not go well. After Opening remarks from Reps Schiff and Nunes, I started off with prepared \nremarks that went about 10 minutes, going over the processes involved in the 90-day study and then highlighting the \nkey takeaways. Rep Schiff asked a couple of easy questions and then turned it over to Rep Nunes, who yielded his time \nto Rep. Wenstrup. Then everything went downhill.  \n \nRep Wenstrup spent the first big chunk of his time identifying a number of open source documents that he wanted read \ninto the record (which was agreed to), in particular papers on the threat of SARS as a bioterror weapon (from 2005), \nstatements Fauci made on the general idea of gain of function research back in 2012, Ralph Baric’s work on chimeric \nviruses in 2015, and similar stuff. After quite a while of talking he finally started to ask questions. They mostly centered \non the names of the experts the IC reached out to on COVID origins. I told him that I was unable to reveal the names of \nthe experts we reach out to. Which is also exactly what I told the staffers during the pre-briefing we did on Tuesday. Rep \nWenstrup even acknowledged before he asked the first time that he knew what my response would be but was going to \nask anyway. He was, to put it mildly, not happy with my answer. In fact, he seemed pretty outraged. After that, it was \nmore of the same. Every single minority member who asked questions spent the first two-three minutes of their allotted \nfive minutes expressing outrage and disdain over my behavior. One, not sure who because this was all a blur, even said \n“shame on you.” At one point, a member turned his time back to Rep Wenstrup who went through a long list of names \nof “experts” (air quotes because the expertise of some he named is iffy in my mind) and asked me if anyone in the IC had \nconsulted with them…apparently because he wanted me to be on the record each time saying “I am not going to \ncomment on that.” I repeatedly tried to explain that IC policy was to not reveal the names of the experts we reached out \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2to for source protection reasons, which just seem to enrage then all even more. Several of the minority members \nclaimed that they had been staunch defenders of the IC in the past but now “will not have your back.” I heard a lot of \n“nobody has ever come in here and refused to answer our questions” and the comments/question got heated on their \nend and were pretty over the top. Several times I tried to answer a question only to be interrupted by whoever asked \nthe question and a couple even said something along the lines of “I don’t want to hear that ‘it’s against policy’ crap.”  \n \nNot to pick on the minority members, some of the majority members also were not pleased with the briefing. Rep. \nSpeier seemed annoyed that our assessment focused too much on  and wanted us to agree to talk to \none of her constituents who was in Wuhan in November of 2019 on a riverboat cruise (I kid you not). Her time ran out \nbefore she asked that and she didn’t press the issue. Rep Krishnamoorthi also expressed surprise and disappointment \nover my refusal to identify the experts and said it made us (the IC) “look bad.” \n \nIt seemed clear to me that few if any of the members actually read the Updated Assessment…or were paying attention \nto my prepared remarks. One of the minority members (I can’t remember which) challenged me to identify anything \nnew that I had mentioned up to that point that was not in open sources. That question frankly baffled me, but I pointed \nout that I had literally just talked about  WIV researchers who were reportedly sick in the Fall of 2019. \nMembers from both parties seemed surprised and confused that FBI came to a different conclusion than other IC \nagencies. More than one asked me if FBI had access to information that they had not shared with the IC, and one \nmember (I think it was Rep Carson) asked me and  if we thought FBI was an equal and honest partner in the \nprocesses (despite some of our issues with FBI, we both stated “yes”). Nobody seemed to understand what “low \nconfidence” means; even after I explained multiple times that low confidence meant that  \n  I got the same confused questions about \nconfidence levels.  \n \nWith regard to the minority members question on experts, I think this was a set-up. They were looking for a reason to \ndistance themselves from the Updated Assessment and that was the issue they chose. Again, they knew we were not \ngoing to name the experts because this came up at the pre-brief Tuesday. And at no time during that call did any of the \nminority staffers indicate that this was going to be a problem . Maybe I could have explained the reason we weren’t \ngoing to provide the names in a way that would have resulted in less vitriol…but I doubt it.  \n \nAnyway, I would expect the DNI  to receive angry letters from the Hill calling my professionalism into question and \ndemanding that the IC name names. And maybe that I be fired.  \n \n \n \n  \n  \n \n \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From: -\nSent: Tuesday, June 15, 2021 11:52 AM\nTo:  \nSubject: FW: [AIN] FW: \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nFrom:   \nSent: Tuesday, June 15, 2021 11:43 AM \nTo:  \n \nSubject: FW: [AIN] FW:  \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nfyi \n \n \nFirst on CNN: HHS watchdog announces review of NIH \ngrants that likely includes  \nmoney connected to Wuhan lab \n \n \nBy Kristen Holmes  and  \nPriscilla Alvarez , CNN \n \nUpdated 10:30 AM ET, Tue June 15, 2021 \n \n  \n \nUS intelligence working on report about Covid-19 origins 04:04 \n \n(CNN)Federal government investigators said Tuesday that they are launching a  \nreview into how the National Institutes of Health manages and monitors its  \ngrant program, which likely includes money connected to a Wuhan lab that GOP  \nlawmakers have been scrutinizing.  \n \n \nRepublicans have zeroed in on NIH's relationship with EcoHealth Alliance, the  \nglobal nonprofit that helped fund some research at China's Wuhan Institute of  \nVirology, to attack Dr. Anthony Fauci   \nand  \nscore political points. \n \nThe comprehensive review also coincides with renewed questions   \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2over the origin of the Covid-19 virus and the potential role that China's Wuhan  \nInstitute of Virology may have played. \n \n\"We share stakeholders' concerns regarding compliance and oversight of NIH  \ngrant funds. We have been monitoring this issue for some time and consider it a  \nhigh-priority matter that can pose a threat to the integrity of the NIH grant  \nprogram,\" Tesia Williams, the director of communications for the Department of  \nHealth and Human Services Office of Inspector General, told CNN. \n \n\"Based on our preliminary research and analysis, HHS-OIG has decided to  \nconduct an extensive audit reviewing how NIH monitored selected grants and how  \nthe grantees and subgrantees used and managed federal funds between years 2014  \nthrough 2021,\" Williams said. \n \nRoughly 80% of NIH funding goes to supporting research grants, including  \ngrants to foreign organizations. According to the work plan on the review, it  \nwill look at how these grants are monitored and making sure the recipient's use  \nand management of NIH grant funds is in accordance with federal requirements. \n \nEnter your email to sign up for CNN's \"What Matters\" Newsletter. \n \n <> \n \n\"close dialog\" <> \n \n  \n \nTop of Form \n \n  \n \nSign up for CNN What Matters Newsletter \n \nEvery day we summarize What Matters and deliver it straight to your inbox. \n \nSign Me Up \n \nNo Thanks \n \nBy subscribing you agree to our \n \n  \n \nprivacy policy.  \n \n  \n \nBottom of Form \n \nOne NIH official, who spoke under the condition of anonymity in order to  \ndiscuss the review openly, called it \"political\" in nature but believed that  \nultimately it would be a good thing and would clear NIH of any wrongdoing. \n \n\"It's an opportunity to educate the public,\" the official said. \n \nQuestions about the relationship between NIH and EcoHealth Alliance have  \ngrown louder after Fauci, the director of the National Institute of Allergy and  \nInfectious Diseases within NIH, confirmed to lawmakers earlier this year that  \nhundreds of thousands of dollars that NIH had given to the New York-based  \nglobal nonprofit went to the Wuhan Institute of Virology to study coronaviruses  \nin bats. \n \n3\"About $600,000 was spent over a five-year period,\" Fauci said during a  \ncongressional budget hearing. \"That comes to anywhere between $125 (thousand)  \nand $150,000 per year that went to collaboration with Wuhan.\" \n \nA recent US intelligence report found that several researchers at China's  \nWuhan Institute of Virology fell ill in November 2019  \n \n and had to be hospitalized, a new detail about the severity of their symptoms.  \nIt's not clear what might have affected the researchers, there is no indication  \nthey caught Covid-19 and the lab strongly denied the report, calling it a lie  \nto push the so-called lab-leak theory for the disease origin. \n \nThere are competing theories about how the pandemic got started. One is that  \nit developed naturally in the wild and transferred from animal to human, as  \nmany other viruses have in the past. Another is that such a naturally  \noriginating virus was studied in a lab and accidentally infected someone. A  \nthird theory, most widely discounted by scientists, is that it was engineered  \nin a lab and somehow leaked to humans. \n \nFor much of 2020, pursuing the lab leak theory was treated publicly as  \nxenophobic, and, thanks in part to an open letter signed by 27 scientists and  \npublished in an influential medical journal in February 2020, scientifically  \nunsound. \n \nBut in recent months  \n \n, the classified intelligence emerged that three researchers at the Wuhan  \nInstitute of Virology who were conducting the kind of controversial research  \nthat some scientists now believe may have led to the pandemic had gotten sick  \nin the autumn of 2019, before the outbreak was known to have begun, although  \nthere's no evidence they were infected with Covid-19. \n \nConservative attacks on Fauci have also intensified after media organizations  \nreleased a trove of the doctor's emails. \n \nIn one email sent to Fauci in April 2020, an executive at EcoHealth Alliance  \nthanked him for publicly stating that scientific evidence supports a natural  \norigin for the coronavirus and not a lab release  \n. \n \nFauci recently told CNN's John Berman the email was being misconstrued and  \ncalled claims he had a cozy relationship with the people behind the Wuhan lab  \nresearch \"nonsense.\" \n \n\"I have always said, and will say today to you, John, that I still believe  \nthe most likely origin is from an animal species to a human, but I keep an  \nabsolutely open mind that if there may be other origins of that, there may be  \nanother reason, it could have been a lab leak,\" Fauci told Berman. \"I believe  \nif you look historically, what happens in the animal-human interface, that in  \nfact the more likelihood is that you're dealing with a jump of species. But I  \nkeep an open mind all the time. And that's the reason why I have been public  \nthat we should continue to look for the origin. \n \n\"You can misconstrue it however you want -- that email was from a person to  \nme saying 'thank you' for whatever it is he thought I said, and I said that I  \nthink the most likely origin is a jumping of species. I still do think it is,  \nat the same time as I'm keeping an open mind that it might be a lab leak.\" \n \nNonetheless, Republicans are using the emails -- and controversy about how  \nthe pandemic began and whether US government grant money can be connected to it  \n-- to fundraise and campaign against the Biden administration. \n \n4GOP Sen. Rand Paul of Kentucky  \n \n has lashed out at Fauci, calling for his ouster. \n \n\"He's continuously and deliberately misleading the public at every turn. It's  \ntime to FIRE FAUCI,\" a Paul fundraising email read. \"There are 2,000 emails  \nproving Fauci chose his own ego over the facts.\" \n \nFlorida Sen. Marco Rubio recently penned a Fox News op-ed  \n \n titled \"If Biden Believes in Science, He Must Fire Fauci.\" \n \nPresident Joe Biden was asked earlier this month if he still had confidence  \nin Fauci. \n \n\"Yes, I am very confident in Dr. Fauci,\" Biden said. \n \nCNN's Maggie Fox contributed to this report. \n \n·           \n \n·           \n \n  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n\n1From:\nSent: Monday, June 14, 2021 12:49 PM\nTo:  \nCc:\nSubject: RE:   Update for NCPC - Tuesday, 8 June\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nFYI: there’s likely going to be a follow-on to that Fauci briefing adding the NIC and we may get pulled into it. \n \n-  \n \n----------------------------------- \n \n  \n \n \n \n \n \nFrom:   \nSent: Monday, June 14, 2021 12:36 PM \nTo:  \n \nSubject: FW:   Update for NCPC - Tuesday, 8 June \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2 \n \nFYI. \n \n briefed Dr. Fauci on the COVID origins on 4 June. \n \n 4 June:   Briefing for Dr. Anthony Fauci on COVID Origins:   officers met with the Chief \nMedical Advisor to the President and Director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony \nFauci, to present our analysis on the COVID origins topic as well as our approach to the intelligence question. Dr. \nFauci expressed concern about Beijing’s quick and thorough cleaning of the Wuhan wet market, which may have \ndestroyed clues related to the pandemic’s origin.  He did not find it alerting that China had not yet found any \nevidence of a zoonotic transmission or intermediate animal host. He was particularly interested in the specific details \n provided on the research WIV was doing and on their work with pangolins. \n \nV/r \n \n \n  \nOffice of the National Intelligence Management for Counterproliferation (NIM-CP) \n  \n \n \n \n \n \nFrom:   Sent: Monday, June 14, 2021 12:25 PM \nTo: \n \n \n \n \n \n \n \n \n \n \n \n \nSubject:   Update for NCPC - Tuesday, 8 June \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n\n1From:\nSent: Wednesday, February 17, 2021 9:12 PM\nTo:  \nSubject: Came across this gem...\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nSO MANY CONSPIRACIES. \n \n \n \n \n \n \n \n(U) New Zealand: The superspreaders behind top Covid-19 conspiracy theories - NZ Herald \nIdentifiers: \n \nDocument Number: \n \nDIN: \n \nDocument Version: \n1 \nIngestion ID: \n \nGUIDE: \n Source: \n \nPublisher Type: \nopen-source \nSourced Text: \nnull \nLanguage: \neng \nSource ID: \n \nCountry Code: \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2NZL \nSource Type: \nInternet \nCity: \nAuckland \nCountry Code: \nNZL \nCompilation Title: \nThe New Zealand Herald Online \nDescription: \nAuckland The New Zealand Herald Online in English Website of a daily newspaper distributed mainly in the greater \nAuckland area, but with the highest readership in New Zealand. Audited circulation of 108,790 as of 2018. Owned New \nZealand Media and Entertainment; URL: http://www.nzherald.co.nz/ (source last reviewed 15 Mar 19) \nInformation Date: \n15-Feb-2021 19:00:00 \nInformation Cutoff Date: \n15-Feb-2021 19:00:01 \nOriginating System: \nOSE Dates: \n \nDate Posted: \n16-Feb-2021 04:57:06 \nDate Published: \n16-Feb-2021 04:57:13 \nDate Received: \n16-Feb-2021 12:28:29 Description: \n(U) As the coronavirus spread across the globe, so too did speculation about its origins. Perhaps the virus escaped from a \nlab. Maybe it was engineered as a bioweapon.Legitimate questions about the virus created perfect conditions for \nconspiracy theories.... \nWarnings:(U) Not for Law Enforcement Use: OSE content may not be used as the basis for any US legal proceeding \nwithout prior written authorization from OSE. This includes but is not limited to: presentation to grand/petit juries or \nadministrative bodies; incorporation into affidavits or other documents relating to subpoenas, search, electronic \nsurveillance, or arrest warrants; and/or as evidence in criminal proceedings. The content may be used for lead purposes \nonly and is intended solely as background information for recipients in developing their own collateral leads. \n \n(U) This product may contain copyrighted material; authorized use is for national security purposes of the United States \nGovernment only. Any reproduction, dissemination, or use is subject to the OSE usage policy and the original copyright. \n(U) PRODUCT DESCRIPTION  \n(U) The body of this product is a transcription of original English-language material. \n(U) CAVEATS  \n(U) Computer selected and disseminated without OSE editorial intervention. \n3(U) BODY \n(U) As the coronavirus spread across the globe, so too did speculation about its origins. Perhaps the virus \nescaped from a lab. Maybe it was engineered as a bioweapon. \n(U) Legitimate questions about the virus created perfect conditions for conspiracy theories. In the absence of \nknowledge, guesswork and propaganda flourished. \n(U) College professors with no evidence or training in virology were touted as experts. Anonymous social \nmedia users posed as high-level intelligence officials. And from China to Iran to Russia to the United States, \ngovernments amplified claims for their own motives. \n(U) The Associated Press collaborated with the Atlantic Council's Digital Forensic Research Lab on a nine-\nmonth investigation to identify the people and organisations behind some of the most viral misinformation \nabout the origins of the coronavirus. \n(U) Their claims were explosive. Their evidence was weak. These are the superspreaders. \n(U) FRANCIS BOYLE \n(U) WHO HE IS: A Harvard-trained law professor at the University of Illinois, Boyle drafted a 1989 law \nbanning biological weapons and has advised the nation of Bosnia and Herzegovina and the Palestinian \nAuthority. \n(U) Francis Boyle, a law professor at the University of Illinois. Photo / APBoyle has no academic degree in virology or biology but is a longstanding critic of research on pathogens. He has claimed Israeli intelligence was \ninvolved in the 1993 World Trade Centre bombing; that SARS, the swine flu and Ebola have been genetically \nmodified; and that West Nile virus and Lyme disease escaped from a US biowarfare lab. He has also claimed \nthat Microsoft founder Bill Gates \"was involved\" in the spread of Zika. \n(U) COVID CLAIM: Boyle says the coronavirus is a genetically engineered bioweapon that escaped from a \nhigh-level lab in Wuhan, China. He maintains it shows signs of nanotechnological tinkering and the insertion of \nproteins from HIV, the human immunodeficiency virus . He alleges that US researchers helped create it, and that \nthousands of doctors, scientists, and elected leaders are conspiring to hide the truth. \n(U) Boyle promoted his claim in an email to a list of news organizations and personal contacts on January 24, \n2020. That same day, he was interviewed on a podcast called \"Geopolitics and Empire.\" That podcast was cited \nby a little-known Indian website, GreatGameIndia, and went viral, with Boyle's comments picked up and \nfeatured in Iranian-state TV, Russian state media, and fringe websites in the US and around the world. He's \nsince repeated his claims on Alex Jones' show Infowars. \n(U) EVIDENCE? Boyle bases his argument on circumstantial evidence: the presence of a Biosafety Level 4 lab \nin Wuhan, the fact that other viruses have escaped from other labs in the past, and his belief that governments \naround the world are engaged in a secret arms race over biological weapons. \n(U) Biosafety Level 4 labs - or BSL4 labs - have the highest level of biosafety precautions. \n(U) \"It seemed to me that obviously, this came out of the Wuhan BSL 4,\" Boyle told The Associated Press. \n(U) A World Heath Organisation team concluded it was extremely unlikely the virus escaped from the Wuhan \nlab, and other experts have said the virus shows no signs of genetic manipulation. \n4(U) GREATGAMEINDIA \n(U) WHAT IT IS: A website that was an early promoter of the theory that the coronavirus was engineered. \n(U) Its January 26, 2020, story on \"Coronavirus bioweapon- How China Stole the Coronavirus From Canada and \nWeaponised It\" was picked up by far-right financial blog Zero Hedge and shared to thousands of social media \nusers before it was promoted by conservative website RedStateWatcher and received more than 6 million \nengagements. \n(U) COVID CLAIM: GreatGameIndia claims that the virus, which has now killed more than 2 million people \nworldwide, was first found in the lungs of a Saudi man and then sent to labs in the Netherlands and then \nCanada, where it was stolen by Chinese scientists. The article relies in part on speculation from Dany Shoham, \na virologist and former lieutenant colonel in Israeli military intelligence. \n(U) Shoham was quoted discussing the possibility that Covid is linked to bioweapon research in a January 26, \n2020, article in the conservative US newspaper The Washington Times. In that article, Shoham was quoted \nsaying there was no evidence to support the idea that the virus has escaped from a lab, but GreatGameIndia did \nnot include that context in its piece. \n(U) \"We do stand by our report,\" said website co-founder Shelley Kasli wrote in an email. \"In fact, recently Canadians released documents which corroborated our findings with Chinese scientists... A lot of information is \nstill classified.\" \n(U) EVIDENCE? The coronavirus most likely first appeared in humans after jumping from an animal, a World \nHealth Organisation panel announced this month, saying an alternate theory that the virus leaked from a \nChinese lab was unlikely. \n(U) America's top scientists have likewise concluded the virus is of natural origin, citing clues in its genome and \nits similarity to SARS, or severe acute respiratory syndrome. Vincent Racaniello, a professor of microbiology \nand immunology at Columbia University, who has been studying the virus since its genome was first recorded, \nhas said it is clear that the virus was not engineered or accidentally released. \n(U) \"It is something that is clearly selected in nature,\" Racaniello said. \"There are two examples where the \nsequence tells us that humans had no hand in making this virus because they would not have known to do these \nthings.\" \n(U) THE CENTRE FOR RESEARCH ON GLOBALISATION \n(U) WHAT IT IS: The Montreal-based centre publishes articles on global politics and policy, including a \nhealthy dose of conspiracy theories on vaccines and the September 11, 2001, terrorist attacks. It's led by Michel \nChossudovsky, a professor emeritus of economics at the University of Ottawa and a conspiracy theorist who has \nargued the US military can control the weather. \n(U) The centre publishes authors from around the world - many of whom have advanced baseless claims about \nthe origins of the outbreak. In February, for instance, the centre published an interview with Igor Nikulin \nsuggesting the coronavirus was a US bioweapon created to target Chinese people. \n(U) The centre's website, globalresearch.ca., \"has become deeply enmeshed in Russia's broader disinformation \nand propaganda ecosystem\" by peddling anti-US conspiracy theories, according to a 2020 US State Department \nreport which found that seven of its supposed writers do not even exist but were created by Russian military \nintelligence. \n5(U) COVID CLAIM: While the centre has published several articles about the virus, one suggesting it \noriginated in the US caught the attention of top Chinese officials. \n(U) On March 12, Chinese Foreign Ministry spokesperson Zhao Lijian retweeted an article published by the \ncentre titled: \"China's Coronavirus: A Shocking Update. Did The Virus Originate in the US?\" \n(U) \"This article is very much important to each and every one of us,\" he posted in English on Twitter. \"Please \nread and retweet it. Covid-19: Further Evidence that the Virus Originated in the US.\" \n(U) He also tweeted: \"It might be US army who brought the epidemic to Wuhan. Be transparent! Make public \nyour data! US owe us an explanation.\" \n(U) The story by Larry Romanoff, a regular author at the centre, cites several debunked theories, including one \nthat members of the US military brought the virus to China during the Military World Games in fall 2019. \nRomanoff concludes that it has now \"been proven\" that the virus originated from outside of China, despite \nscientific consensus that it did. \n(U) EVIDENCE? The World Health Organisation has concluded that the coronavirus emerged in China, where \nthe first cases and deaths were reported. No evidence has surfaced to suggest the virus was imported into China \nby the US. \n(U) Chossudovsky and Romanoff did not respond to repeated messages seeking comment. Romanoff's \nbiography lists him as a visiting professor at Fudan University in Shanghai, but he is not listed among the \nuniversity's faculty. The university did not respond to an email asking about Romanoff's employment. \n(U) Romanoff's original article was taken down in the spring, but Zhao's tweet remains up. \n(U) IGOR NIKULIN \n(U) WHO IS HE? A four-time failed political candidate, Nikulin is prominently quoted in Russian state media \nand fringe publications in the west as a biologist and former weapons inspector in Iraq who served on a UN \ncommission on biological and chemical weapons in the 1990s. \n(U) COVID CLAIM: Nikulin argues the US created the virus and used it to attack China. He first voiced the \nbelief in a January 20, 2020, story by Zvezda, a state media outlet tied to the Russian military. He appeared on \nRussian state TV at least 18 times between January 27, 2020, and late April of that year. \n(U) Russian national Igor Nikulin last year. Photo / APOnce the virus reached the US, Nikulin changed his \ntheory, saying \"globalists\" were using the virus to depopulate the earth. (U) Nikulin has expressed support for weaponising misinformation to hurt the US in the past. On his website, he \nsuggests claiming the US created HIV as a way to weaken America from within. Russian intelligence mounted \na similar 1980s disinformation campaign dubbed \"Operation INFEKTION.\" \n(U) \"If you prove and declare... that the virus was bred in American laboratories, the American economy will \ncollapse under the onslaught of billions of lawsuits by millions of AIDS carriers around the world,\" Nikulin \nwrote on his website. \n(U) EVIDENCE? Nikulin offered no evidence to support his assertions, and there are reasons to doubt his \nveracity. \n6(U) Former UN weapons inspector Richard Butler, for whom Nikulin claims to have worked, said he had no \nmemory of Nikulin, and that his story sounded \"sloppily fabricated, and not credible.\" \n(U) No UN records could be found to confirm his employment. \n(U) In an exchange with the AP over Facebook, Nikulin insisted his claims and background are accurate, \nthough he said some records from UN work were destroyed in an American bombing during the Iraq invasion. \n(U) When told that Butler didn't know him, Nikulin responded \"This is his opinion.\" \n(U) GREG RUBINI \n(U) WHO HE IS: Greg Rubini is the name of an internet conspiracy theorist who claims to have high-level \ncontacts in intelligence and listed his location on Twitter as \"classified,\" until he was kicked off the platform. \nHis posts have been retweeted thousands of times by supporters of QAnon, a conspiracy theory centered on the \nbaseless belief that Trump is waging a secret campaign against enemies in the \"deep state\" and a secret sect of \nsatanic paedophiles and cannibals. \n(U) COVID CLAIM: Rubini has tweeted that Dr Anthony Fauci created the coronavirus and that it was used as \na bioweapon to reduce the world's population and undermine Trump. \n(U) EVIDENCE? Rubini's doesn't appear to be the intelligence insider that he pretends to be. (U) Greg Rubini's permanently suspended Twitter account. Photo / APBuzzfeed attempted to track down Rubini \nlast year and determined it is the alias of a 61-year-old Italian man who has worked in marketing and music \npromotions. A previous version of his Twitter bio indicates he is a fan of classic rock and the films of Stanley \nKubrick. \n(U) Attempts to reach Rubini online and through business contacts were unsuccessful. \n(U) Rubini has bristled at efforts to verify his claims. When a social media user asked: \"My question to you \n@GregRubini is, 'Where and what is your proof?' Rubini responded curtly: \"And my question is: why should I \ngive it to you?\" \n(U) Twitter suspended Rubini's account in November 2020 for repeated violations of its policies. \n(U) KEVIN BARRETT \n(U) WHO HE IS: A former lecturer on Islam at the University of Wisconsin-Madison, Barrett left the university \namid criticism for his claims that the September 11, 2001, terrorist attacks were orchestrated by people linked to \nthe US and Israeli governments. \n(U) Barrett calls himself \"a professional conspiracy theorist, for want of a better term\" and has argued \ngovernment conspiracies were behind the 2004 Madrid bombing, the 2005 London bombing, the 2013 Boston \nMarathon bombing and the 2016 Orlando nightclub shooting. \n(U) COVID CLAIM: Barrett said he is \"80%\" sure coronavirus was created by elements within the US \ngovernment as a bioweapon and used to attack China. \n7(U) University of Wisconsin- Madison lecturer Kevin Barrett in 2006. Photo / APIran was a secondary target, he \nhas argued. Writing for Iran's PressTV, he said the early outbreak in that country \"suggests that the Americans \nand/or their partners the Israelis... may have deliberately attacked Iran.\" \n(U) Barrett further detailed his views during an interview with the AP. \n(U) \"It seemed fairly obvious to me that the first hypothesis one would look at when something as extraordinary \nas this Covid pandemic hits, is that it would be a US bio-war strike,\" he said. \n(U) EVIDENCE? Barrett cited reports that the US warned its allies in November 2019 about a dangerous virus \nemerging from China. Barrett said that's long before authorities in China knew about the severity of the \noutbreak. \n(U) Official sources have denied issuing any warning. If the US did know about the virus that soon, it was likely \nthanks to intelligence sources within China, which may have known about the virus as early as November 2019, \naccording to former Secretary of State Mike Pompeo. \n(U) LUC MONTAGNIER \n(U) WHO HE IS: Montagnier is a world-renowned virologist who won the Nobel prize in 2008 for discovering \nHIV. \n(U) COVID CLAIM: During an April interview with the French news channel CNews, Montagnier claimed that \nthe coronavirus did not originate in nature and was manipulated. Montagnier said that in the process of making \nthe vaccine for AIDS, someone took the genetic material and added it to the coronavirus. \n(U) Scientist Luc Montagnier in Paris in 2006. Photo / APMontagnier cites a retracted paper published in \nJanuary from Indian scientists who had said they had found sequences of HIV in the coronavirus. AP made \nmultiple unsuccessful attempts to contact Montagnier. \n(U) EVIDENCE: Experts who have looked at the genome sequence of the virus have said it has no HIV-1 \nsequences. In January, Indian scientists published a paper on bioRXIV, a repository for scientific papers that \nhave not yet been peer-reviewed or published in a traditional scientific journal. The paper said that the scientists \nhad found \"uncanny similarity of unique inserts\" in Covid-19 and HIV. Social media users picked up the paper \nas proof that the virus was engineered. As soon as it was published, the scientific community widely debunked \nthe paper on social media. It was later withdrawn. \n(U) SUPREME LEADER ALI KHAMENEI and HOSSEIN SALAMI \n(U) WHO THEY ARE: Khamenei is the second and current Supreme Leader of the Islamic Republic of Iran. \nHe has the final say on all matters of state, including the economy, military and health divisions. \n(U) Since being elected to office in 1981, Khamenei has maintained his skeptical view of the US as Iran's \nforemost enemy. The tensions between the two countries boiled over in 2018 when Trump pulled the US out of \nthe Iran nuclear deal and reimposed crippling sanctions. At the time, Khamenei remarked, \"I said from the first \nday: Don't trust America.\" \n(U) Hossein Salami was appointed by Khamenei as commander of Iran's Revolutionary Guard in April 2019. He leads the country's paramilitary force that oversees Iran's ballistic missile programme and responds to threats \nfrom both inside and outside the country. \n8(U) COVID CLAIM: Salami declared on March 5, 2020, that Iran was engaged in a fight against a virus that \nmight be the product of an American biological attack. On those grounds, Salami ordered a Ground Force \nBiological Defence Manoeuvre to test the country's ability to combat a biological attack. Beginning March 16, \nthe Ground Force, in close collaboration with the Health Ministry, began holding nationwide biodefense drills. \n(U) Iranian supreme leader Ayatollah Ali Khamenei. Photo / APKhamenei was among the first and most \npowerful world leaders to suggest the coronavirus could be a biological weapon created by the US. During his \nannual address on March 22 to millions of Iranians for the Persian New Year, Khamenei questioned why the US \nwould offer aid to countries like Iran if they themselves were suffering and accused of making the virus. \n(U) Khamenei went on to refuse US assistance, saying \"possibly (US) medicine is a way to spread the virus \nmore.\" Last month, he refused to accept coronavirus vaccines manufactured in Britain and the US, calling them \n\"forbidden.\" The Iranian Mission to the United Nations in New York did not respond to multiple requests for \ncomment. \n(U) EVIDENCE: There is no evidence that the US created the virus or used it as a weapon to attack Iran. \n(U) SOURCE DESCRIPTOR  \n(U) Auckland The New Zealand Herald Online in English -- Auckland The New Zealand Herald Online in \nEnglish Website of a daily newspaper distributed mainly in the greater Auckland area, but with the highest \nreadership in New Zealand. Audited circulation of 108,790 as of 2018. Owned New Zealand Media and \nEntertainment; URL: http://www.nzherald.co.nz/ (source last reviewed 15 Mar 19)  \nAttachments: \ne2bc6a76-0b63-4c...  \nPublisher: \n \n#1 \nAgency Acronym: \nCIA \nOffice Name: \nOSE \nPhone Numbers: \n \nEmail Addresses: \n \n \n#2 \nLNI Producer: \nOSE \n \n Creator: \n \n#1 \nAgency Acronym: \n\n9CIA \nOffice Name: \nOSE \nPhone Numbers: \n \nEmail Addresses: \n \n \n#2 \nCompilation Title: \nThe New Zealand Herald Online \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Thursday, September 17, 2020 2:04 PM\nTo:\nSubject: RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID: \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nSure thing, I’ve added you to this list. There is a VTC tomorrow (10-1130, conf ID  if you are available. Also \nflagging the wider CIA COVID email slug ( ) if you want to get added to that group for \nbroader SA. \n \n \n \n \n \n \nOffice of the Director of National Intelligence \n \n \n \nIn the event I am out of the office, please contact the following alternate POCs at the NIC: \n NIC COVID alias:   \n NIO WMD & Proliferation:   \n \nAs of early July, the NIO-WMD team will be on an alternating BLUE/GOLD schedule as follows: \n BLUE:  ( ) and  (COVID – )  \n GOLD:  (COVID – ),  ( )and \n ( ) \n \nFrom:   \nSent: Thursday, September 17, 2020 1:57 PM \nTo:  \nSubject: FW: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID: 149422246) \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Hello, \n \nI was wondering if I could be added for distro for these VTCs?  I’m the  and am currently \nhelping out with one related effort –  \n \nThanks, \n \n \n \nFrom:   Sent: Friday, September 11, 2020 11:01 AM \nTo:  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n3 \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nCc:  \nSubject: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nGood morning, \n \nToday’s COVID VTC discussed IC efforts to understand vaccine progress as most agencies reported a steady-state \nworkload for the week. Highlights include: \n  (U ) As NIC/WMD works to balance our WMD and COVID workloads, we welcome your feedback on the \nfrequency of these VTCs . Does your department or agency rely on the weekly nature of these meetups to help \nwith workforce turnover? Do you prefer that the VTCs continue but are open to whatever schedule suits the \n\n5Classification: UNCLASSIFIED  \n====================================================== \n \nGood morning, \n \nThe NIC will host the weekly COVID-19 analytic synch VTC this Friday, 11 September, from 1000-1130 AM EDT. Topics of \ndiscussion will include introductions and a summary of key questions, policy engagements, and recent or upcoming \nproduction.  \n \nFor those interested, new to COVID-19, or in touch with colleagues at home, I thought I’d flag this free course by MIT on \nCOVID-19, which involves one one-hour lecture each week. Details, including a syllabus, are available at \nhttps://biology.mit.edu/undergraduate/current-students/subject-offerings/covid-19-sars-cov-2-and-the-pandemic/ . Upcoming topics include vaccines, immunology, and epidemiology related to COVID-19. Please follow your agency’s \nguidance for outside training. About 2000 people watched the first lecture, which did not have an ASL interpreter but \ndid have captions in English. Lectures are available a few days later on YouTube.  \n  \nCOVID-19, SARS-CoV-2 and the Pandemic \nIn Fall 2020, all MIT students and the general public are welcome to join Professors Richard Young and Facundo Batista as they discuss the science of the pandemic during this new class. Special guest speakers include: Anthony \nFauci, David Baltimore, Britt Glaunsinger, Bruce Walker, Eric Lander, Michel Nussenzweig, Akiko Iwasaki, Arlene \nSharpe, Kizzmekia Corbett, and others. The class will run from September 1, 2020 through December 8, 2020 and \nbegin each Tuesday at 11:30 a.m. ET. The live stream will be available to the public, but only registered students \nmay ask questions during the Q&A. Miss a class? You’ll be able to view a video of the lecture on this page. \n \nIf you have any VTC questions or would like to be added to Friday’s conference, please do not hesitate to contact the \nVideo Operations Center (VOC) at  (I cannot add gateways and such myself). If you are dialing in, you can call \nthe VOC from a secure phone up to 10 minutes before the meeting.  Have the conference ID ready, the VOC will then \ntransfer your secure phone into the meeting. \n \n Conference ID:  Conference Name: COVID COI Synch  \nSubject: POC-   \nNotes: CIA3-   \nStart Setup Time: 11 SEP 2020 09:50  EST/DST  End Conference Time: 11 SEP 2020 11:30  EST/DST  \nStart Conference Time: 11 SEP 2020 10:00  EST/DST Requestor: CIA 3 \n \nConference Status: Resolved   \nNCMI 1 Resolved  \nCIA  Resolved  \nNGA NCE  Resolved  \nFBI CLK  Resolved  \nCDC ATLANTA Resolved  \nDHS HQ GW 3 Resolved  \nNSAW GATEWAY 03 Resolved  \nONI  Resolved  \nROWE VTC  Resolved  \n\n6LLNL-NAI 2 Resolved  \nA2 BLDG  Resolved  \n \n \n \n \n \n \n \n \nIn the event I am out of the office, please contact the following alternate POCs at the NIC: \n NIC COVID alias:  \n NIO WMD & Proliferation:  \n \nAs of early September, WMD’s team schedule is the following: \n 9/8-11:  (COVID – ),  ( ), \nand  ( ) \n 9/14-18:  (Acting NIO for WMD & Proliferation – ) and  \n(COVID – ) \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Tuesday, September 15, 2020 6:12 PM\nTo:\nSubject: RE: PubMed  Legacy Search CoV (UNCLASSIFIED )\nClassification: UNCLASSIFIED  \n====================================================== \n \nHere’s what Daily Beast wrote. My remarks, which you’d probably already expect me to say \n Coming from a lab (we think this is possible) =/= manmade (we think this is unlikely based on available evidence)  \n Coming from a lab =/= intentionally released from a lab (we def think this is unlikely) \n New virus =/= suspicious virus \n I do think that some journals/media organizations are slamming down any lab-related theories as conspiracies, \nso, sure, I’d be frustrated if I wanted attention, too. \n \n \nhttps://www.thedailybeast.com/steve-bannon-linked-groups-push-study-claiming-china-manufactured-covid/  \n \nSteve Bannon Is Behind Bogus Study That China Created COVID \n \nThe study goes against basically all scientific evidence and expert opinion.  \nBut it fits with the former Trump adviser?s anti-China posture. \n \n  \n \nAdam Rawnsley  \n \n  \n \nLachlan Markay  \n \n  \n \nUpdated Sep. 15, 2020 4:18PM ET / Published Sep. 15, 2020 3:16PM ET  \n \n  \n \nA new study purporting to show that the novel coronavirus was manufactured in  \na Chinese lab was published  by  \na pair of nonprofit groups linked to Steve Bannon, the former top Trump  \nstrategist now facing felony fraud charges. \n \nThe study, co-authored by a Chinese virologist who fled Hong Kong this year,  \nclaims that ?laboratory manipulation is part of the history of SARS-CoV-2.? Its  \nfindings were quickly picked up by a handful of prominent news organizations  \nsuch as theNew York Post, which  hyped the ?explosive? allegations that run counter to \nvirtually all existing  \nscientific literature on the source of the virus. \n \nThe study is the work of the Rule of Law Society and the Rule of Law  \nFoundation, sister nonprofit organizations that Bannon was instrumental in  \ncreating. According to documents posted on the Society?s website last year, he  \nserved as that group?s chair. The Bannon connection was first spotted by Carl  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Bergstrom, a biology professor at the University of Washington, whocalled the  \nstudy  ?bizarre and unfounded.? \n \nA search of Google Scholar and the Rule of Law Society and Rule of Law  \nFoundation websites indicates that the organizations have not previously  \npublished scientific or medical research, and it?s unclear whether the paper  \nreceived any peer review. It was posted on Monday on the website Zenodo, a  \npublicly available repository of scientific and academic research to which  \nanyone can upload their work. \n \nBoth of the nonprofits behind the study were formed in conjunction with  \nexiled Chinese billionaire Guo Wengui, with whom Bannon has collaborated on a  \nnumber of advocacy efforts targeting the Chinese government and business  \nendeavors that have drawn the scrutiny of federal law enforcement officials. \n \nIn addition to their work on the Rule of Law nonprofits, Bannon and Guo have  \nalso collaborated  on a news website, G News, that has published stories  \n suggesting that the coronavirus was manufactured by the Chinese military. \n \nIn July, Bannon appeared to tease forthcoming scientific studies supporting  \nhis contention that the coronavirus originated in a lab in Wuhan, China. He  \ntold theDaily Mail  that scientists from the lab had ?defected? to the U.S. and were \ncollaborating  \nwith American intelligence agencies. On the ?War Room: Pandemic? podcast,  \nBannon has hosted others who have speculated that the virus may have been a  \nChinese ?bioweapon,? but he has said that he believes the most plausible  \nexplanation is that it ?came out of experiments that were going on? at that  \nWuhan lab. \n \nThat?s a line that has been echoed by some prominent U.S. officials.  \nPresident Donald Trump and Secretary of State Mike Pompeo have both alluded  \n to intelligence reports supporting that theory. ?This evidence is  \ncircumstantial, to be sure,? wrote Sen. Tom Cotton (R-AR) in an April column  \n \n for theWall Street Journal, ?but it all points toward the Wuhan labs.? \n While an accidental leak from the virology lab in Wuhan remains a theoretical  \npossible source of the initial outbreak in the city, the vast majority of the  \nscientific literature on the virus has determined that its origins were  \nnatural, and that it was not laboratory manufactured. Dr. Anthony Fauci, the  \nTrump administration?s coronavirus point-person, has stressed repeatedly   that all evidence indicates the virus was not man-made. \n \nThe study published by Bannon?s group on Monday is therefore particularly  \nincendiary. ?This virus is not from nature,? declared Dr. Li-Meng Yan, one of  \nthe scientists who conducted the study, during a Monday appearance on a British  \ntalk show. She called reports that the virus originated in a Wuhan meat market  \n?a smoke screen? designed to obscure its true origins. \n \nBut other virologists don?t agree and say the paper makes false claims about  \na number of basic facts. ?Basically, it's all circumstantial and some of it is  \nentirely fictional,? Dr. Angela Rasmussen, a virologist at Columbia University,  \ntold The Daily Beast of the study. \n The paper leads with a claim that the coronavirus' genes are \"suspiciously  \nsimilar to that of a bat coronavirus discovered by military laboratories\" in  \nChina?an assertion Rasmussen says, that shouldn?t be surprising because they  \nare related SARS-like coronaviruses. \n The study?s authors made a similar claim about a portion of the SARS-CoV-2  \nspike protein?which viruses use to breach and infect cells?and wrote that it?s  \nsimilar to the original SARS virus in a ?suspicious manner? and suggests  \n3genetic manipulation. ?SARS-CoV also used ACE2 as a cellular receptor, as do  \nother SARS-like bat coronaviruses,? Rasmussen says. ?It is not suspicious and  \nis in fact expected that the receptor binding domains that bind the same  \nprotein would be similar.? \n \nRasmussen also said that the paper misrepresented basic facts about another  \npart of coronavirus spike proteins known as furin cleavage sites. The authors  \nclaim that SARS-CoV-2?s cleavage site is ?unique? and unseen elsewhere in  \nnature. But according to Rasmussen, ?Furin cleavage sites occur naturally in  \nmany other beta-CoVs, including MERS-CoV and other SARS-like bat coronaviruses.? \n \nYan has said that she fled China to avoid reprisals from the government there  \nover her allegations that it was not being forthcoming about the origin and  \nnature of the virus. She said she warned officials in December that the virus  \nwas highly transmissible between humans but that her allegations were ignored. \n \nThe University of Hong Kong?s school of public health, where Yan was  \nemployed, has disputed  her allegations that the university failed to heed her warnings \nprior to the  \noutbreak in China. \n \nIn August, Yan appeared on Bannon?s podcast. During that show, Bannon said  that he was ?still not in the camp that believes they purposely let it out but  \nI?ve been strongly in the camp from the beginning that it came out of the Wuhan  \nP4 lab.? \n \nUnrelated to his work with the Rule of Law groups, Bannon is also facing  \nfelony charges over what federal prosecutors say was an effort to extract  \nmillions of dollars from a nonprofit seeking to privately finance the  \nconstruction of a wall on the southern U.S. border. Bannon has pleaded not  \nguilty to the charges.  \n \n \n \nFrom:   Sent: Tuesday, September 15, 2020 12:19 PM \nTo:  \nSubject: FW: PubMed Legacy Search CoV (UNCLASSIFIED ) \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n – \n \nI know you’ve got a lot going on…. But if you have 5 minutes, I’d love to hear your take on this.   \n \n \n \n \n \n \n \n \nNIO/WMD Alias:  -- please use if you don’t hear from me  \n  \n\n4 \n \nFrom:   \nSent: Tuesday, September 15, 2020 12:04 PM \nTo:  \n \nSubject: FW: PubMed Legacy Search CoV (UNCLASSIFIED ) \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nFYI \n \n \n \nNational Intelligence Council / Office of the Director of National Intelligence \n \n \n \n \n \nFrom:   \nSent: Tuesday, September 15, 2020 11:34 AM \nTo:  \nCc:  \nSubject: RE: PubMed Legacy Search CoV (UNCLASSIFIED ) \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n(U) Check out attached….plausible? \n \n \n \nFrom:   \nSent: Monday, September 14, 2020 2:07 PM \nTo:  \nCc:  \nSubject: PubMed Legacy Search CoV \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nI wanted to get this to you despite it still being in a very, very, rough format.  If you feel that you’d like to share it, please \ndo so with the caveat that this is simply a data catch at this point.  In that light, with respect to the attachments: \n \n\n51. Word file.   This is simply a cut/paste of a retrieval from a PubMed Legacy Search Engine (not the new one) using the \nsearch parameters in the Advanced Search box as  (coronavirus) AND (wuhan institute of virology) on 28-Aug-20. The \nformat chosen was Abstract (Text) with 200 articles.  There were 130 references retrieved.  Please note that the new \nsearch engine introduced on the site ~February 2020 does not seem to allow retrieval of the institutional affiliations.  \n \n2. Excel Spread Sheet .  The Reference numbers on the sheet are the ones assigned to the references in the word \nfile.  The retrieval is reverse chronology.  Whenever possible duplicate institutions WERE NOT included in the \ncollaboration list.  Sub-departments were sometimes delineated but NOT within WIV.. e.g. collaborations were recorded \nby Institution not individual researcher, duplicate institutions generally  entered once from 2015 onward.   The \ncollaborations go roughly 10 institutions deep, if there were additional institutions they might have been included in the \n“additional collaborations column” OR just noted as more collaborations (e.g. 22 institutions listed).  I tried to provide a \ngeneral sense of what technologies were used out to, if needed,  five major categories.  Here are two examples:  \n \nArticle 26: \n Nucleotide analog inhibitors, antivirals (remdesivir and favipiravir)             \n in vitro pharmaceutical assays     \n structural and kinetic analyses    \nArticle 40: \n Protein design and synthesis (Mpro - mediates viral replication and transcription)               \n anti-viral development  Protein structure and function analysis (x-ray crystallography)      \n pharmacokinetic and toxicity analysis in vivo \n \n3. PowerPoint.   This is simply my trying to visual some of the items on the spread sheet.  It’s in the rough stages. Your \ncomments, concerns  and questions are more than welcome. I think it’s probably fairly self-explanatory.  The boxes \nwhich are filled in white are Asian institutions, those which are filled with color are non-Asian.  The colored borders \nshow affiliations by article, there isn’t a rhyme or reason for the color selection.  The black lines are simply my trying to \nfollow author affiliations (by institution) which occur more than once on the page.  It’s an unfinished visual \nrepresentation. \n \nAnyway, I’ll still be working on it to try to get a sense of the science and technology behind the articles. I haven’t reached \nout yet to the individual you’ve e-introduced me to.  My apologies, I need to get in touch with them. Once again, \nquestions and comments are more than welcome.   \n \nV/r, \n \n \n  \n \nSenior Science and Technology Advisor  (Microbiologist/Geneticist) \nPerspecta   \nContractor Support:     \n     ODNI/PC/STG (Science & Technology Group) \n      \n      \n      \n       \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n\n6 \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Good afternoon, ETB Bio folks! \n \nThis afternoon a meeting on coronavirus was held at the National Academy of Science (NAS, or NASEM).  We (IC) were \nasked to just listen.  This was not a technical meeting, but rather a meeting on what the academic community of experts \nin this virus would like to see in terms of additional data.  A readout follows: \n \nShort version: \n Consensus: Not BW.  If someone was trying to optimize this for BW, we know too much about SARS that wasn’t \nimplemented \n Consensus: Natural or laboratory accident \n Additional sequences with temporal and geographic diversity would be helpful, particularly from early \nDecember.  Value was placed on temporal over geographic diversity, but the academics want it all if they can get \nit. \n 1-2 products from the National Academy will go out soon.  First is a “Based on science…” article on their website \nthat will discuss the findings from the meeting and provide a public-facing vehicle for the findings.  Second may \nbe a letter from the Presidents of the Academies.   \n \n  and others will be making a request that all sequences and data related to 2019-nCoV be made \nopen source. \n \nAttendees (gov): \nNAS:  (chair),  \nHHS:  (chair),  (phone) \nODNI:  (chair) \nNIAID: Anthony Fauci (phone) \nOSTP:  (phone) \nSeveral intel folks.  Will share the list later. \n \nAttendees (academic, via phone): \n (NYU) (academic chair) \n (Scripps) \n (the Hutch) \nPeter Gaszak (EcoHealth Alliance) – collaboration with Wuhan Institute of Virology (WIV) \nRalph Baric (UNC) – collaboration with WIV \n (Johns Hopkins) \n (Iowa) \n \n\n3Charge of the committee:  “OSTP and HHS requested that the NASEM examine and identify data requirements that \nwould help determine the origins of the 2019-nCoV, specifically from an evolutionary/structural biology \nstandpoint.  NASEM will also consider whether this should include more temporally and geographically diverse clinical \nisolates, etc.  This review will help prepare for future events by establishing a process for quickly assembling subject \nmatter experts for evaluation of other potentially threatening organisms.” \n \nBackstory (Why was this work request made?):  Head of  along with  and the  called Fauci \n(NIAID) on Friday night.  Callers have background in bat coronavirus and were concerned by inserts they were seeing at \nFurin cleavage sites that don’t follow the expert’s expectations (“improbable mutations”).  They likened it to a ten step \nprocess (as an example for explanation and not to be taken as a literal 10 step process) where we have sequences from \nstep 1-6 and from step 10, but are missing steps 7-9.  Was the step 10 sequence derived via modification, serial passage, \nor have we just not found sequences that show steps 7-9?  A call with more experts was held on Saturday where it was \nnoted that WIV had been working on gain of function of hACE2 receptor binding.  On Sunday, another call was held with \n, and other experts.  On that call, two experts said that the sequences were natural, the rest \n(number not given) said they were unsure.  It was determined that a panel of experts should be convened, probably \noperating under WHO to not cause problems with China and limit access, to investigate further.   also \nsuggested a US-based look into the issue.  Today’s meeting was to discuss data requirements. \n \nKey Points: \nBaric: \n He is not aware of WIV introducing mutations into the hACE2 receptor.  He is aware of some chimera work, \nwhich was published. \n Insertion of furin cleaved site not unprecedented.  He gave some examples where this was done as part of \nmouse adaptation during passage.  However, that work was not done in this group of coronaviruses. \n In terms of Baric’s involvement on the panel, he did mention that he has been linked to chimera work in 2016 \nthat social media claims is linked to nCoV and he suggested that could make his membership a political \nproblem.  The academics and the academy disagreed.  I think he was bringing it up as more of a “no surprises” \nthing rather than trying to be excused from the committee. \n \n Mutations in hACE2 do NOT look like perfect engineering (i.e. the sequences were not modified to give textbook \nperfect binding).  If the sequence were engineered, one would expect that it would be engineered as perfectly \nas possible.  Hence, evidence for natural evolution. \n Wet markets as vehicles for passage \n Binding was optimized to humans based on modelling (Baric dissented).  3 papers are currently on \nbiorXiv.  Questions: Was this the case early in the outbreak or was this affinity acquired through other host, etc? \n Biochemical data for hACE2 receptor modification would be useful \n With furin site introduction, it could open new classes of drugs to try \n Rules out BW (“nothing there”); consistent with natural evolution \n Several hundred sequences that the Chinese currently have are not being made available \n Can’t rule out lab accident \n Will never be able to distinguish between natural vs. lab accident with current data \n Can rule out BW \n \n \n\n4 Earliest available samples are from Dec 24.  Need samples before this time point (both market and non-\nmarket) from Wuhan more than we need geographically-diverse samples \n Europe, Australia, and Singapore are sharing genomes.  Not a hindrance.  CDC is the central point for \nsequencing efforts for US samples. \n Phylogenetics are clear, but tying modifications to function is not clear.  Need sequences from animal \nreservoir and human from earlier in the outbreak. \n Quite possible there were other mutations/strains that sputtered out in early December before dying off \nand 2019-nCoV took over.  Need sequences from that time period to check. \n Agreed with  that lab accident can’t be ruled out, but also that there is no way to distinguish from \nnatural at this time. \n \n Needs obth temporally and geographically diverse samples \n We are assuming that there is only a single lineage/introduction, when there may be multiple.  Need more \nsequences from earlier than Dec 24 to try to find out (  comment: Finally!). \n Request should prioritize sequences over isolates.  Isolates can be made synthetically if needed.  Other members \nwanted isolates. \nDaszak: \n 96% homology across the genome to strains that infect bats. \n Possible that other animal viruses have the same inserts and they could have been acquired in the host \n The range of the bat is southeast Asia.  Might be worth getting samples from neighboring countries. \n Communication in China has dried up (scientists who normally talk are not doing so).  Daszak stated that the \nfolks at WIV are normally more open that typical Chinese, state-sponsored scientists based on prior interactions  \n \nOthers had a random comment here or there, but the principals are all listed above. \n \nI’m happy to go into further detail or answer any questions when I am back in the office. \n-  \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n7 \n====================================================== \nClassification:", "summary": "Internal Intelligence Community communications and DNI memos documenting Fauci's role in shaping the COVID-origin assessment process.\n\nFirst-page excerpt: DECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026  Expert Meeting Rapid Response for Assessment of Data Needs for 2019-nCoV Agenda February 3, 2020 2:00 p.m.–3:00 p.m. (ET) Keck Center, Room 103 500 5th St NW, Washington, DC 20001 Join from PC, Mac, Linux, iOS or Android: https://nasem.zoom.us/j/777284900 Telephone: +1 646 558 8656 Meeting ID: 777 284 900 International numbers available: https://nasem.zoom.us/u/aA3S9pYwW Meeting Objective:  Assess what data, information and samples are needed to understand the  evolutionary origins of 2019-nCoV and more effectively respond to the outbreak and resulting  misinformation. 2:00 p.m. Welcome and Introductions  (5 mins ) ANDREW  POPE Director, Board on Health Sciences Policy  National Academies of Sciences, Engineering, and Medicine 2:05 p.m.…", "source_url": "https://assets.newsweek.com/wp-content/uploads/2026/06/COVID-19-Release-DNI-Gabbard-6-18-Part-1.pdf", "pdf_url": "/archive-docs/fauci-files/493a4d44a5bb4aae77d3ba6dbf8700c7/pdf", "doc_date": "2026-06-18", "case": "covid-19-origins", "sub_case": "dni-gabbard-2026-release", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "covid origins", "covid origin", "covid release", "covid coverup", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "biolab", "biolabs", "dni release", "odni release", "intelligence release", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins"], "page_count": 94}
{"title": "Fauci Exposed Files — Part 2", "content": "1From:\nSent: Tuesday, July 20, 2021 8:11 AM\nTo:\nCc:\nSubject: RE: Possible reviewers for COVID Origins assessment \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n  is …which I gather make him some kind of lobbyist, since that firm’s sole \npurpose to promote the imagery products of its parent company to the US government.  is a  \n.  is an interesting idea, given his background at CIA and the NIC. \nI’ll add him to the list and drop  and Clapper.  \n \nFrom:   \nSent: Monday, July 19, 2021 3:48 PM \nTo:  \nCc:  \nSubject: RE: Possible reviewers for COVID Origins assessment  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nAlso, not Sue Gordon.    Or Beth.    \n \nFrom:   Sent: Monday, July 19, 2021 3:46 PM \nTo:  \nCc:  \nSubject: RE: Possible reviewers for COVID Origins assessment  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2I think Clapper is probably too politically “hot.”  Not Fauci; in addition to being a customer, he’ll be seen by many as \nhaving a conflict of interest. \n \nI could live without “formers.”  But other possibilities might be people like    Is  retired?  Some CIA \ntypes, maybe.     Would  do it? \n \nNot Morell.    Too public.   \n \nFrom:   Sent: Monday, July 19, 2021 2:14 PM \nTo:  \nCc:  \nSubject: Possible reviewers for COVID Origins assessment  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n: \n \nBelow are the names for potential reviewers that we’ve come up with. The first four all have medical/scientific \nbackgrounds and extensive experience in public health and infectious diseases.  and  also have substantial \ngovernment (particularly CDC) experience as well.  is a political scientist by training, but has done a lot of work \nin and out of the government on global health and international security. We added Clapper because we think we need \na reviewer with a deep background in the IC to look at this in addition to experts with more of an infectious disease \nbackground.  \n \n  \n  \n  \n \n  \n \n  \n \ns \n \n \n James Clapper  – Harvard, former Director of National Intelligence  \n \nThese names notwithstanding, the name that came up probably the most when thinking of outside reviewer was Fauci, \nbut we’re not clear on how appropriate that would be, given he’s a potential customer of the paper. If he’s acceptable, \nwe’d include him.  \n \nInterested in your thoughts on these names and any others you think might be good to approach to review the paper. \nWe’ve already started the vetting process and are shooting for some time between 9-13 August to have them review the \ndraft (FYI: BSEG will re view the draft on 9 August). Also note that most of the above individuals are not in the WMA area, \nso we’d need to fly them down and put them up in a hotel. Thanks –   \n\n3 \n \n  \n  \n \n \n \n \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n4I've been detailed down to  I've been focused mostly on \nmodeling coordination so far (since Thursday...) but this definitely fits with my current mission also. \n \n \n \n \n \n \n \n--------------------------------------- \n \n \n \n \n \nChief Intelligence Officer \n \nJoint Program Executive Office for CBRN Defense                                                                                                               \n \nDepartment of Defense \n \n \n \n \n \n \n \n \nFrom:   \nSent: Monday, March 23, 2020 3:02 PM \nTo:  \n \nCc:   \n \nSubject: RE: (U) Interest in a discussion about COV SARS2 and gain of function research \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nNothing further from me. I have not responded to any of  emails yet because I haven't had time today and have \nhigher priorities. \n \n \n \n\n5From:   \nSent: Monday, March 23, 2020 2:54 PM \nTo: \nCc:  \n \n \n \nSubject: RE: (U) Interest in a discussion about COV SARS2 and gain of function research --- UNCLASSIFIED  \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nDoes anyone have more info on the \"colleague who has put together an analysis that may be wise to discuss at some \npoint.\"?? Some of our policymakers have heard from a specific person at MITRE claiming the virus is genetically \nengineered - but we haven't seen any specific analysis supporting the claim. Would love to learn more if someone has \nseen this sort of analysis.  \n \n \n \n \n \n \n \n \n \nBureau of Intelligence and Research \n \nU.S. Department of State \n \n \n \n \n \n \n \n \n \nFrom:   \nSent: Monday, March 23, 2020 11:32 AM \nTo:  \nCc:  \n \n \n\n6 \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nNothing to add; just letting everyone know  is out this week, so you're stuck with me in NIO S&T.  My molecular \nbiology and genetics are pretty thin, but my BS meter is strong. Please keep me in the loop and let me know if there's \nanything I can do to assist. \n \n \n \n-           \n \n \n \n \n \n \n \n  \n \n \n \n  \n \n \n \nFrom:   \nSent: Friday, March 20, 2020 6:54 PM \nTo:  \nCc:  \n \n \n \n \nSubject: RE: (U) Interest in a discussion about COV SARS2 and gain of function research \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nHi  \n \n \n \nWhen I saw in the cc line- \"COV SAR2 and gain of function research\", it got my attention. \n\n7 \n \n \nI've been tracking this pretty closely in the literature, and would advise to set a very high threshold for any GOF \ninterpretation as an origin of SAR COV-2.  \n \nNot saying it is impossible, but I think Occam's razor is the best guidance here. \n \nWhile clearly the S protein furin cleavage site appears consistent with a GOF modification, there is precedent for co-\ncirculating COV strains recombining.  \n \nDifferent coronaviruses do co-circulate in hosts, and this amino acid sequence is present in COVs circulating in other bat \nhosts that are regionally co-located with the host from which RaTG13 was isolated.  \n \nAlso, phylogenic analysis identifies this site as undergoing a high degree of homoplasy - so it's an adaptation hot spot.    \n \nSo- lots of room for a natural explanations-many that I've captured and highlighted in my attached notes.  \n \n \n \nI'm aware of the accumulating evidence that opens the door for WIV GOF research on COV, and there maybe some \n stuff I'm missing.  \n \nSo I'm not saying WIV isn't guilty of creating this strain, but I think we need to pin it down hard before we make this \nassessment.  \n \nTo be honest - I cannot imagine the Chinese NOT doing this type of research, but an escaped P3+/P4 LAI would be \nextraordinary. \n \n \n \n is on the fence with this, and maybe leaning toward the GOF explanation, but as an actual trained \ncoronavirus virologist, he would be the first person I'd ask ( and I have). \n \nIf he goes all in on the GOF assessment, I'd bring Ralph Baric ii. \n \nI think the IC needs to be very thorough with this analysis. \n \n \n \nHopefully you will find my notes helpful, but feel free to ignore them... they are really just for my own  use as you will \nsee. \n \n \n \nI'm out next week, unless  or  are unable to come in. \n \n \n \nGood luck, and stay healthy! \n \n \n\n8 \n \n \n \n \n \n \nNational Intelligence Council / Office of the Director of National Intelligence \n \n \n \n \n \n \n \n \n \n \n \nFrom:   \nSent: Friday, March 20, 2020 2:03 PM \nTo:  \nCc:  \nSubject: RE: (U) Interest in a discussion about COV SARS2 and gain of function research \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \n \n \nFrom:   \nSent: Friday, March 20, 2020 2:02 PM \nTo:  \nCc:  \nSubject: (U) Interest in a discussion about COV SARS2 and gain of function research \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \n(U ) Hi  provided me your name when I called him a few minutes ago. We are colleagues from \nDOE-IN. I recently took a three year appointment as a  at  hence the different email. \n \n\n9 \n \n(U ) I was hoping we could discuss the various information and analysis that is churning around regarding S \nprotein manipulation in the virology community and how the NIC is interpreting the information. I have a colleague who \nhas put together an analysis that may be wise to discuss at some point. \n \n \n \n(U ) If there is a good time and number to reach you on Monday, please let me know. \n \n \n \nSincerely, \n \n \n \n \n \n \n \n \n \n \n \n \n \nSupport to ODNI   \n \n \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n\n10====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Wednesday, September 16, 2020 10:16 AM\nTo:\nSubject: RE: IC interest in Yan report about COVID origins\nAttachments:\n~_The_probable_final_draft_of_a_position_paper.pdf\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \nHi  \n \nJust a thought: it would be interesting to compare the arguments in this report with the  in \n, which also argued that the virus was  \n \nBest, \n  \n \n \nFrom:   Sent: Wednesday, September 16, 2020 9:16 AM \nTo:  \n \n \n \n \n \n \nSubject: IC interest in Yan report about COVID origins \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nThe below email thread may not have reached us at ODNI or CIA. I removed the distro lists because it was enormous and \nmade it difficult to read the actual emails. Regardless,  flagged it in his VTC reminder this morning so  was \nexpecting it to come up on Friday anyway. \n \nFrom:   \nSent: Tuesday, September 15, 2020 6:57 PM \nTo:  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Subject: FW:  RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  --- \n \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nLooks like you’re on the email, although perhaps the too-large distro prevented your receipt.  \n \n \nBureau of Intelligence and Research \nU.S. Department of State \n \n \n \n \n \nFrom:   Sent: Monday, September 14, 2020 8:34 PM \nSubject: RE:  RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n  \n \nWe have done an initial read on the paper and some of the science looks credible, at first blush.  We are going to circle \nup this week to discuss the specific merits and drawbacks of the paper.  Its got a lot of technical content that deserves \nscrutiny. \n \nLooping in some of our LANL colleagues. \n \nWe hope to have a solid read on the specific details by the Friday COVID-19 weekly Synch VTC. \n \nRegards \n \nLawrence Livermore National Lab \n \n \nFrom:   Sent: Monday, September 14, 2020 9:23 AM \nSubject: RE:  RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  --- \n \n \n\n3Classification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nA couple virologists at State and I reviewed a version of her paper – it’s been circulating for at least a month or so. In \nshort, it’s nonsense. The conclusions she draws require some real misinterpretations of the science and many \ncontradicted by published work on the virus evolution/genetics.  \n \n \nBureau of Intelligence and Research \nU.S. Department of State \n \n \n \n \n \nFrom:   Sent: Monday, September 14, 2020 10:20 AM \nSubject:  RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  ---  \n \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nHi team – Is anyone looking at the open source report that a Chinese virologist claims to have proof that COVID-19 was \nmade in a Wuhan lab? We’re getting questions from our leadership and I figured those with more technical expertise \nprobably have already evaluated this report. (New York Post, Chinese Virologist Claims She has Proof COVID-19 was \nMade in Wuhan Lab, 11 September 2020)  \n \n \n \nOffice of Intelligence & Analysis \n \n \n \nFrom:   Sent: Friday, September 11, 2020 11:01 AM \nSubject: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n \nClassification:  \n \nClassified By:  \nDerived From:  \n\n5Classification: UNCLASSIFIED  \n====================================================== \n \nSee you at 10! \n \nFrom:   \nSent: Wednesday, September 09, 2020 9:31 AM \nSubject: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nGood morning, \n \nThe NIC will host the weekly COVID-19 analytic synch VTC this Friday, 11 September, from 1000-1130 AM EDT. Topics of \ndiscussion will include introductions and a summary of key questions, policy engagements, and recent or upcoming \nproduction.  \n \nFor those interested, new to COVID-19, or in touch with colleagues at home, I thought I’d flag this free course by MIT on \nCOVID-19, which involves one one-hour lecture each week. Details, including a syllabus, are available at \nhttps://biology.mit.edu/undergraduate/current-students/subject-offerings/covid-19-sars-cov-2-and-the-pandemic/ . Upcoming topics include vaccines, immunology, and epidemiology related to COVID-19. Please follow your agency’s \nguidance for outside training. About 2000 people watched the first lecture, which did not have an ASL interpreter but \ndid have captions in English. Lectures are available a few days later on YouTube.  \n  \nCOVID-19, SARS-CoV-2 and the Pandemic \nIn Fall 2020, all MIT students and the general public are welcome to join Professors Richard Young and Facundo \nBatista as they discuss the science of the pandemic during this new class. Special guest speakers include: Anthony \nFauci, David Baltimore, Britt Glaunsinger, Bruce Walker, Eric Lander, Michel Nussenzweig, Akiko Iwasaki, Arlene \nSharpe, Kizzmekia Corbett, and others. The class will run from September 1, 2020 through December 8, 2020 and \nbegin each Tuesday at 11:30 a.m. ET. The live stream will be available to the public, but only registered students \nmay ask questions during the Q&A. Miss a class? You’ll be able to view a video of the lecture on this page. \n \nIf you have any VTC questions or would like to be added to Friday’s conference, please do not hesitate to contact the \nVideo Operations Center (VOC) at  (I cannot add gateways and such myself). If you are dialing in, you can call \nthe VOC from a secure phone up to 10 minutes before the meeting.  Have the conference ID ready, the VOC will then \ntransfer your secure phone into the meeting. \n \n Conference ID:  Conference Name: COVID COI Synch  \nSubject:   \nNotes:   \nStart Setup Time: 11 SEP 2020 09:50  EST/DST  End Conference Time: 11 SEP 2020 11:30  EST/DST  \nStart Conference Time: 11 SEP 2020 10:00  EST/DST Requestor: CIA 3 \n \nConference Status: Resolved   \nNCMI 1 Resolved  \nCIA GW 13 Resolved  \nNGA NCE GW 02 Resolved  \n\n6FBI CLK GW 3 Resolved  \nCDC ATLANTA Resolved  \nDHS HQ GW 3 Resolved  \nNSAW GATEWAY 03 Resolved  \nONI 3A102 Resolved  \nROWE VTC RM 3051 Resolved  \nLLNL-NAI 2 Resolved  \nA2 BLDG 5681.4 Resolved  \n \n \n \n \n \n \n \n \nIn the event I am out of the office, please contact the following alternate POCs at the NIC: \n   \n   \n \nAs of early September, WMD’s team schedule is the following: \n 9/8-11:  \n \n 9/14-18:  \n \n \n \n \n \n \n \n \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n7====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Thursday, September 17, 2020 9:17 AM\nTo:\n \nCc:\nSubject: RE: Daily Beast counter to \"Yan Report\" on covid origin\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n \n I am going to touch base with  As with past requests on IC evaluation of these types of \nquestions, since, as you note, these are better suited for the broader scientific community. I am going to \nrecommend that  steer  to the CDC-led SPHERES effort. SPHERES is a consortium \n(includes federal, state, private, academic, research, corporate, and international health entities) looking \nat the genome of SARS-CoV-2.  \n \n(U) SPHERES: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/spheres.html    \n \n(U) ======================================== \n \n \n \n  \n   \n                                     \n \n==========================================  \n \nFrom:   \nSent: Wednesday, September 16, 2020 1:45 PM \nTo:  \n \n \n \nSubject: RE: Daily Beast counter to \"Yan Report\" on covid origin \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n4From:   \nSent: Tuesday, September 15, 2020 6:15 PM \nTo:  \n \n \nSubject: Daily Beast counter to \"Yan Report\" on covid origin \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nI haven’t read the report itself yet but consider yourself braced \n \nFrom:   \nSent: Tuesday, September 15, 2020 5:56 PM \nTo:  \nSubject: [AIN]  \n \nCLASSIFICATION: UNCLASSIFIED   \n \nhttps://www.thedailybeast.com/steve-bannon-linked-groups-push-study-claiming-china-\nmanufactured-covid/  \n \nSteve Bannon Is Behind Bogus Study That China Created COVID \n \nThe study goes against basically all scientific evidence and expert opinion.  \nBut it fits with the former Trump adviser?s anti-China posture. \n \n  \n \nAdam Rawnsley  \n \n  \n \nLachlan Markay  \n \n  \n \nUpdated Sep. 15, 2020 4:18PM ET / Published Sep. 15, 2020 3:16PM ET  \n \n  \n \nA new study purporting to show that the novel coronavirus was manufactured in  \na Chinese lab waspublished  by  \na pair of nonprofit groups linked to Steve Bannon, the former top Trump  \nstrategist now facing felony fraud charges. \n \nThe study, co-authored by a Chinese virologist who fled Hong Kong this year,  \nclaims that ?laboratory manipulation is part of the history of SARS-CoV-2.? Its  \nfindings were quickly picked up by a handful of prominent news organizations  \nsuch as theNew York Post, which  hyped  \n \n the ?explosive? allegations that run counter to virtually all existing  \nscientific literature on the source of the virus. \n \nThe study is the work of the Rule of Law Society and the Rule of Law  \nFoundation, sister nonprofit organizations that Bannon was instrumental in  \ncreating. According to documents posted on the Society?s website last year, he  \nserved as that group?s chair. The Bannon connection was first spotted by Carl  \n\n5Bergstrom, a biology professor at the University of Washington, whocalled the  \nstudy  ?bizarre  \nand unfounded.? \n \nA search of Google Scholar and the Rule of Law Society and Rule of Law  \nFoundation websites indicates that the organizations have not previously  \npublished scientific or medical research, and it?s unclear whether the paper  \nreceived any peer review. It was posted on Monday on the website Zenodo, a  \npublicly available repository of scientific and academic research to which  \nanyone can upload their work. \n \nBoth of the nonprofits behind the study were formed in conjunction with  \nexiled Chinese billionaire Guo Wengui, with whom Bannon has collaborated on a  \nnumber of advocacy efforts targeting the Chinese government and business  \nendeavors that have drawn the scrutiny  \n \n of federal law enforcement officials. \n \nIn addition to their work on the Rule of Law nonprofits, Bannon and Guo have  \nalso collaborated  \n \n on a news website, G News, that has published stories  \n suggesting that the coronavirus was manufactured by  \nthe Chinese military. \n \nIn July, Bannon appeared to tease forthcoming scientific studies supporting  \nhis contention that the coronavirus originated in a lab in Wuhan, China. He  \ntold theDaily Mail  \n \n that scientists from the lab had ?defected? to the U.S. and were collaborating  \nwith American intelligence agencies. On the ?War Room: Pandemic? podcast,  \nBannon has hosted others who have speculated that the virus may have been a  \nChinese ?bioweapon,? but he has said that he believes the most plausible  \nexplanation is that it ?came out of experiments that were going on? at that  \nWuhan lab. \n \nThat?s a line that has been echoed by some prominent U.S. officials.  \nPresident Donald Trump and Secretary of State Mike Pompeo have both alluded  \n \n to intelligence reports supporting that theory. ?This evidence is  \ncircumstantial, to be sure,? wrote Sen. Tom Cotton (R-AR) in an April column  \n \n for theWall Street Journal, ?but it all points toward the Wuhan labs.? \n \nWhile an accidental leak from the virology lab in Wuhan remains a theoretical  \npossible source of the initial outbreak in the city, the vast majority of the  \nscientific literature on the virus has determined that its origins were  \nnatural, and that it was not laboratory manufactured. Dr. Anthony Fauci, the  \nTrump administration?s coronavirus point-person, has stressed repeatedly  \n \n that all evidence indicates the virus was not man-made. \n \nThe study published by Bannon?s group on Monday is therefore particularly  \nincendiary. ?This virus is not from nature,? declared Dr. Li-Meng Yan, one of  \nthe scientists who conducted the study, during a Monday appearance on a British  \ntalk show. She called reports that the virus originated in a Wuhan meat market  \n?a smoke screen? designed to obscure its true origins. \n \nBut other virologists don?t agree and say the paper makes false claims about  \na number of basic facts. ?Basically, it's all circumstantial and some of it is  \nentirely fictional,? Dr. Angela Rasmussen, a virologist at Columbia University,  \ntold The Daily Beast of the study. \n6 \nThe paper leads with a claim that the coronavirus' genes are \"suspiciously  \nsimilar to that of a bat coronavirus discovered by military laboratories\" in  \nChina?an assertion Rasmussen says, that shouldn?t be surprising because ?they  \nare related SARS-like coronaviruses.?  \n \nThe study?s authors made a similar claim about a portion of the SARS-CoV-2  \nspike protein?which viruses use to breach and infect cells?and wrote that it?s  \nsimilar to the original SARS virus in a ?suspicious manner? and suggests  \ngenetic manipulation. ?SARS-CoV also used ACE2 as a cellular receptor, as do  \nother SARS-like bat coronaviruses,? Rasmussen says. ?It is not suspicious and  \nis in fact expected that the receptor binding domains that bind the same  \nprotein would be similar.? \n \nRasmussen also said that the paper misrepresented basic facts about another  \npart of coronavirus spike proteins known as furin cleavage sites. The authors  \nclaim that SARS-CoV-2?s cleavage site is ?unique? and unseen elsewhere in  \nnature. But according to Rasmussen, ?Furin cleavage sites occur naturally in  \nmany other beta-CoVs, including MERS-CoV and other SARS-like bat coronaviruses.? \n \nYan has said that she fled China to avoid reprisals from the government there  \nover her allegations that it was not being forthcoming about the origin and  \nnature of the virus. She said she warned officials in December that the virus  \nwas highly transmissible between humans but that her allegations were ignored. \n \nThe University of Hong Kong?s school of public health, where Yan was  \nemployed, has disputed  \n \n her allegations that the university failed to heed her warnings prior to the  \noutbreak in China. \n In August, Yan appeared on Bannon?s podcast. During that show, Bannon said  \nthat he was ?still not in the camp that believes they purposely let it out but  \nI?ve been strongly in the camp from the beginning that it came out of the Wuhan  \nP4 lab.? \n \nUnrelated to his work with the Rule of Law groups, Bannon is also facing  \nfelony charges over what federal prosecutors say was an effort to extract  \nmillions of dollars from a nonprofit seeking to privately finance the  \nconstruction of a wall on the southern U.S. border. Bannon has pleaded not  \nguilty to the charges. \n \n  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n7====================================================== \nClassification:  \n \n\n1From:\nSent: Friday, September 18, 2020 12:01 PM\nTo:  \nCc:\nSubject: RE: IC interest in Yan report about COVID origins\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nThanks  \n \n \n \nFrom:   \nSent: Friday, September 18, 2020 9:11 AM \nTo:  \n \nCc:  \nSubject: RE: IC interest in Yan report about COVID origins \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \nGood Morning, \n \nWith respect to technical feasibility, known capabilities and a parsimonious starting point for cloning I’d like to flag this \nsection of the Yan report from page 19:  \nStep 4: Produce the designed viral genome using reverse genetics and recover live viruses (0.5 month)  \n \nThe input is a text file of the desired viral genome (no physical DNA/RNA backbone or virus specimen required) – thus \nremoving the need for many of the mutagenesis and cloning steps from the first part of the Yan report.  \n Baric’s lab demonstrated this synthetic approach in a 2008  PNAS paper titled, \"Synthetic recombinant bat SARS-like \ncoronavirus is infectious in cultured cells and in mice\" (pdf attached).  \n^”The genomic cDNA fragments were commercially synthesized, inserted into vectors, assembled into a full- length cDNA, \nand transcribed in vitro to yield genomic RNA .\" [The in vitro product was then electroporated into cells.] \n \nIn reviewing WIV and Wuhan capabilities I found a few references of note for synthesis and assembly of long nucleic acid \nsequences – these approaches could be used to generate a SARS backbone entirely from chemical synthesis of \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2researcher-specified genetic sequence from a text file or from a hybrid of PCR fragments and chemically synthesized \nfragments – resulting in a fully-engineered genome of desired sequence.  \n \nUnknown is whether the WIV does nucleic acid synthesis in-house or outsources. But the examples below shows the \nexpertise and tools are both at the WIV and other Wuhan institutions and were easy enough to teach to undergrads in \n2013. Notably these methods aren’t new as highlighted by the dates below – and they would have only improved since \nthen.  \n 1)            One was a Wuhan team from a 2013 iGEM competition where university (undergrad) students were using \nGibson assembly. Although the students weren’t working on viruses for iGEM, their mentor, Yu Chen, was/is a SARS \nvirologist who has used nucleic acid synthesis to produce desired constructs from sequence data, “The cDNA of MERS-\nCoV nsp14 was chemically synthesized according to the deposited sequence of MERS-CoV (GenBank accession No. \nKF192507.1) and cloned into pMceK294A.” (iGEM word doc attached; MERS ref above is from Antiviral Research  104 \n(2014) 156–164).  \n 2)            In 2016 a WIV researcher published a shuttle vector for transformation-associated recombination (TAR) \nassembly of large DNA fragments in yeast (pdf attached, Virologica Sinica  2016, 31 (2): 160–167 DOI: 10.1007/s12250-\n016-3730-8). The senior author, Gengfu Xiao, did SARS research c. 2004, then seemed to work on other viruses at the \nWIV but reappeared on a bunch of SARS-CoV-2 papers in 2020. He’s also WIV Deputy Director-General and Secretary of \nParty Committee at the WIV, from Wikipedia. \n 3)            Other WIV chemical synthesis of viruses, Virologica Sinica  2011, 26(3) (pdf attached)  \nAbstract: Torque teno virus (TTV) is a nonenveloped virus containing a single-stranded, circular DNA genome of \napproximately 3.8kb. We completely synthesized the 3808 nucleotides of the TTV (SANBAN isolate) genome, which \ncontains a hairpin structure and a GC-rich region. More than 100 overlapping oligonucleotides were chemically \nsynthesized and assembled by polymerise chain assembly reaction (PCA), and the synthesis was completed with splicing \nby overlap extension (SOEing). This study establishes the methodological basis of the chemical synthesis of a viral \ngenome for use as a live attenuated vaccine or gene therapy vector. \n \nBest, \n \n \n \nFrom:   Sent: Wednesday, September 16, 2020 9:16 AM \nTo:  \n \n \n \n \n \nSubject: IC interest in Yan report about COVID origins \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n\n3The below email thread may not have reached us at ODNI or CIA. I removed the distro lists because it was enormous and \nmade it difficult to read the actual emails. Regardless,  flagged it in his VTC reminder this morning so  was \nexpecting it to come up on Friday anyway. \n \nFrom:   \nSent: Tuesday, September 15, 2020 6:57 PM \nTo:  \nSubject: FW:  RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  --- \n \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nLooks like you’re on the email, although perhaps the too-large distro prevented your receipt.  \n \n \nBureau of Intelligence and Research \nU.S. Department of State \n \n \n \n \n \nFrom:   \nSent: Monday, September 14, 2020 8:34 PM \nSubject: RE:  RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n  \n \nWe have done an initial read on the paper and some of the science looks credible, at first blush.  We are going to circle \nup this week to discuss the specific merits and drawbacks of the paper.  Its got a lot of technical content that deserves \nscrutiny. \n \nLooping in some of our LANL colleagues. \n \nWe hope to have a solid read on the specific details by the Friday COVID-19 weekly Synch VTC. \n \nRegards \n \nLawrence Livermore National Lab \n \n\n4 \nFrom:   \nSent: Monday, September 14, 2020 9:23 AM \nSubject: RE:  RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  --- \n \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nA couple virologists at State and I reviewed a version of her paper – it’s been circulating for at least a month or so. In \nshort, it’s nonsense. The conclusions she draws require some real misinterpretations of the science and many \ncontradicted by published work on the virus evolution/genetics.  \n \n \nBureau of Intelligence and Research \nU.S. Department of State \n \n \n \n \n \nFrom:   Sent: Monday, September 14, 2020 10:20 AM \nSubject:  RE: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  ---  \n \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nHi team – Is anyone looking at the open source report that a Chinese virologist claims to have proof that COVID-19 was \nmade in a Wuhan lab? We’re getting questions from our leadership and I figured those with more technical expertise \nprobably have already evaluated this report. (New York Post, Chinese Virologist Claims She has Proof COVID-19 was \nMade in Wuhan Lab, 11 September 2020)  \n \n \n \nOffice of Intelligence & Analysis \nU.S. Department of Homeland Security \n \n \n \nFrom:   Sent: Friday, September 11, 2020 11:01 AM \nSubject: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n\n6 \nFrom:   \nSent: Friday, September 11, 2020 8:50 AM \nSubject: FW: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nSee you at 10! \n \nFrom:   Sent: Wednesday, September 09, 2020 9:31 AM \nSubject: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nGood morning, \n \nThe NIC will host the weekly COVID-19 analytic synch VTC this Friday, 11 September, from 1000-1130 AM EDT. Topics of \ndiscussion will include introductions and a summary of key questions, policy engagements, and recent or upcoming \nproduction.  \n \nFor those interested, new to COVID-19, or in touch with colleagues at home, I thought I’d flag this free course by MIT on \nCOVID-19, which involves one one-hour lecture each week. Details, including a syllabus, are available at \nhttps://biology.mit.edu/undergraduate/current-students/subject-offerings/covid-19-sars-cov-2-and-the-pandemic/ . Upcoming topics include vaccines, immunology, and epidemiology related to COVID-19. Please follow your agency’s \nguidance for outside training. About 2000 people watched the first lecture, which did not have an ASL interpreter but \ndid have captions in English. Lectures are available a few days later on YouTube.  \n  \nCOVID-19, SARS-CoV-2 and the Pandemic \nIn Fall 2020, all MIT students and the general public are welcome to join Professors Richard Young and Facundo Batista as they discuss the science of the pandemic during this new class. Special guest speakers include: Anthony \nFauci, David Baltimore, Britt Glaunsinger, Bruce Walker, Eric Lander, Michel Nussenzweig, Akiko Iwasaki, Arlene \nSharpe, Kizzmekia Corbett, and others. The class will run from September 1, 2020 through December 8, 2020 and \nbegin each Tuesday at 11:30 a.m. ET. The live stream will be available to the public, but only registered students \nmay ask questions during the Q&A. Miss a class? You’ll be able to view a video of the lecture on this page. \n \nIf you have any VTC questions or would like to be added to Friday’s conference, please do not hesitate to contact the \nVideo Operations Center (VOC) at  (I cannot add gateways and such myself). If you are dialing in, you can call \nthe VOC from a secure phone up to 10 minutes before the meeting.  Have the conference ID ready, the VOC will then \ntransfer your secure phone into the meeting. \n \n Conference ID:  Conference Name: COVID COI Synch  \nSubject: POC-   \nNotes: -   \nStart Setup Time: 11 SEP 2020 09:50  EST/DST  End Conference Time: 11 SEP 2020 11:30  EST/DST  \nStart Conference Time: 11 SEP 2020 10:00  EST/DST Requestor: CIA 3 \n \nConference Status: Resolved   \n\n7NCMI 1 Resolved  \nCIA GW 13 Resolved  \nNGA NCE GW 02 Resolved  \nFBI CLK GW 3 Resolved  \nCDC ATLANTA Resolved  \nDHS HQ GW 3 Resolved  \nNSAW GATEWAY 03 Resolved  \nONI 3A102 Resolved  \nROWE VTC RM 3051 Resolved  \nLLNL-NAI 2 Resolved  \nA2 BLDG 5681.4 Resolved  \n \n \n \n \n \n \n \n \nIn the event I am out of the office, please contact the following alternate POCs at the NIC: \n NIC COVID alias:  \n NIO WMD & Proliferation:  \n \nAs of early September, WMD’s team schedule is the following: \n 9/8-11:  \n \n 9/14-18: Zack Bernstein   \n \n \n \n(U) CIA Special Procedures FISA: This dissemination includes FBI information from FBI FISA collection.  Such information, \nand any information derived therefrom, may only be used in a US legal or administrative proceeding with the advance \nauthorization of the Attorney General.  Any recipient interested in obtaining authorization for such use in a US legal or \nadministrative proceeding should contact FBI Headquarters.  Any further dissemination outside of intelligence channels \nand/or for law enforcement purposes must be made through FBI Headquarters.  Any reproduction, dissemination, or \ncommunication (including, but not limited to oral briefings) of this information must be accompanied by a statement of \nthese restrictions. \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification:  \n\n8 \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Friday, October 23, 2020 8:53 AM\nTo:  \nSubject: RE: reminder - please send updates by noon in lieu of COVID VTC (n/t)\nAttachments: CHD's Letter to Congress Urging COVID-19 Origins Investigation_20201021.docx; CHD-\npress-release_21-Oct-2020.pdf\nClassification: UNCLASSIFIED  \n====================================================== \n \nAlso in the news FYSA - letter and press release attached.  \n \n(U) Robert F. Kennedy, Jr. and Children's Health Defense Call for Congressional Investigation of COVID origin \n21-Oct-2020 \n \nExcerpts: \n“Consider this hypothetical scenario: an important gain-of-function experiment involving a virus with serious pandemic \npotential is performed in a well-regulated, world-class laboratory by experienced investigators, but the information from \nthe experiment is then used by another scientist who does not have the same training and facilities and is not subject to \nthe same regulations. In an unlikely but conceivable turn of events, what if that scientist becomes infected with the \nvirus, which leads to an outbreak and ultimately triggers a pandemic?”[5] \n \nThese are not our words, but rather they are the words of Anthony Fauci, director of the NIAID, in a 2012 letter to the \nmicrobiology journal mBio advocating for gain-of-function experiments. Today, questions about the origin of COVID-19 \nhave largely been dismissed without answers. We believe Dr. Fauci laid out a scenario eight years ago that deserves a \nfull investigation today, particularly when you consider that the Wuhan Institute of Virology was doing the very type of \nresearch set forth in Dr. Fauci’s hypothetical scenario.[6] \n Moreover, Ralph Baric, a leading U.S. coronavirus researcher, has pointed out that it is possible to engineer a virus \nwithout leaving a trace.[34] He notes that SARS-CoV-2 was not engineered with any known published genetic \ninformation and that it is not possible to tell if it was engineered using an unpublished genetic sequence.[35] \n \nThe Lancet COVID-19 Commission, which chose Daszak to lead their investigation into the origins of the virus, cannot be \ntrusted to effectively eliminate conflicts of interest from their investigation.[52] \n [5] Anthony S. Fauci, “Research on Highly Pathogenic H5N1 Influenza Virus: The Way Forward,” MBio 3, no. 5 (October 9, \n2012), https://doi.org/10.1128/mBio.00359-12. \n \n[34] “Possibile creare un virus in laboratorio senza lasciare traccia? La risposta dell’autore della chimera del 2015 di cui \nparlò Tg Leonardo,” L’HuffPost, September 14, 2020, https://www.huffingtonpost.it/entry/e-possibile-creare-un-virus-\nin-laboratorio-senza-lasciare-traccia-la-risposta-dellesperto it 5f5f3993c5b62874bc1f7339 . \n \n[35] Sarah Scoles, “How Do We Know If a Virus Is Bioengineered?,” Medium, August 5, 2020, \nhttps://onezero.medium.com/how-do-we-know-if-a-virus-is-bioengineered-541ff6f8a48f .  \nFrom:   \nSent: Friday, October 23, 2020 7:37 AM \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2To:  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n3 \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nSubject: reminder - please send updates by noon in lieu of COVID VTC (n/t) \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n3 \nOn your list of external reviewers,  is a reporter for  Not sure that changes your calculus- she’s a \nfantastic journalist and I’m a huge fan (her twitter is where I first heard about the glory that is Schitt’s Creek).  \n \nYou may also want to consider   – he was the \nfirst  officer to respond to the cases of HIV in the US in 1980 and led the charge to tracking down the index case and \nidentify the virus. I do not believe he has publicly stated a position on COVID-19.  \n \n-  \n \n \nDisease Threat Intelligence Cell \nWeapons and Counterproliferation Mission Center \n \n \n \nFrom:   \nSent: Monday, July 19, 2021 3:18 PM \nTo:\n \nSubject: Things Probably Coming Your Way...  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n(U )  \n \n \n \n \n \nHi all, \n \nThanks again for meeting with me last week to discuss the COVID-19 Origins paper—this certainly helped me to better \nscope the potential annexes, graphics, and sections. I wanted to follow-up on two things: annexes/graphics that we will \nbe asking CIA for help with AND outside review . \n \nAnnexes & Graphics— After Friday, we will officially send out an outline. I’m avoiding sending it out electronically just \nyet to avoid influencing individual agencies’ internal discussions. That being said, I wanted you to have a sense of what \nwe will be asking you for help with (*not set in stone ). If any of this doesn’t make sense, let me know. For the \ngraphics, we have a meeting w/ our graphics team on Thursday and will get a sense of their bandwidth (i.e. do we need \nactually graphics help on the CIA side too)… \n\n5====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From: Tamara A. Johnson-DNI-\nSent: Wednesday, August 11, 2021 11:23 AM\nTo: Avril D. Haines-DNI-\nCc:\nSubject: ICWPA Complaint re: False Testimony to Congress\nAttachments:  Letter to DNI re COVID origin urgent concern with enclosures \nSigned.pdf\nFollow Up Flag: Follow up\nFlag Status: Flagged\nClassification:  \n \nUpon removal of attachments, this document is UNCLASSIFIED  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n***Please disregard and delete previous transmission.  The system sent my message before I completed the \nclassification. *** \n \nDirector Haines— \n \n(U ) Attached please find the whistleblower complaint and underlying documentation we discussed during our \nlast monthly meeting.  The complaint alleges Dr. Fauci provided false testimony to Congress related to the conduct of \ngain of function research at the National Institutes of Health, thereby ”misleading the American people and \nCongressional oversight.”  We determined this complaint does not meet the urgent concern standard because the \nallegedly false statement was made by a non-IC official and it pertains to an activity that the IC IG has no reason to \nbelieve is related to an intelligence activity or has a direct impact on any IC element, personnel, or capability.   As such, \nwe are not required to transmit this matter to you, but do so in the interest of keeping you fully informed.  The statute \nas interpreted by the September 3, 2019 OLC opinion does not require you to transmit this matter to the congressional \nintelligence committees. \n \n(U ) During our meeting we discussed referring this complaint to the HHS OIG.  My team and I considered this \noption and determined that, given the anonymous nature of the submitter rendering us unable to follow up to obtain \nadditional information, and the classification levels of the underlying information forming the basis of the submission, \nwe are very limited in what information we can share with HHS OIG.  Additionally, the general dispute about “gain-of-\nfunction” research is already in the public domain making it highly probable that the HHS-OIG would already be aware of \nthe allegation that the Dr. Fauci’s testimony was inaccurate (albeit from a different source, not our ICWPA \nsubmitter).  Consequently, we determined there would be no merit in referring the matter to HHS OIG. \n \n(U) I am available to discuss if you have any questions.  Our Counsel team is providing a copy of the documentation to \n for his situational awareness.  Please let me know if you would like me to copy PDDNI Dixon on these matters as \nwell going forward. \n \nRegards, \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2  -- Tamara \n \n Tamara A. Johnson \nActing Inspector General \nOffice of the Inspector General of the Intelligence Community (IC IG) \n \n \n \n \n \n \n \n \n====================================================== \nClassification:  \n \n\n1From: -\nSent: Tuesday, June 15, 2021 11:42 AM\nTo:\nSubject: FW: HHS investigation\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nDoes this help get the IC off the hook? \n \nFrom:   \nSent: Tuesday, June 15, 2021 11:41 AM \nTo:  \nSubject: [AIN] HHS investigation \n \nCLASSIFICATION: UNCLASSIFIED   \n  \n \n \n \n \n  \n \n        \n \n  \n \nFirst on CNN: HHS watchdog announces review of NIH grants that likely includes  \nmoney connected to Wuhan lab \n \nBy Kristen Holmes and Priscilla Alvarez, CNN \n \nUpdated 10:30 AM ET, Tue June 15, 2021 \n \n  \n \n(CNN) Federal government investigators said Tuesday that they are launching a  \nreview into how the National Institutes of Health manages and monitors its  \ngrant program, which likely includes money connected to a Wuhan lab that GOP  \nlawmakers have been scrutinizing. \n \nRepublicans have zeroed in on NIH's relationship with EcoHealth Alliance, the  \nglobal nonprofit that helped fund some research at China's Wuhan Institute of  \nVirology, to attack Dr. Anthony Fauci and score political points. \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2The comprehensive review also coincides with renewed questions over the  \norigin of the Covid-19 virus and the potential role that China's Wuhan  \nInstitute of Virology may have played. \n \n\"We share stakeholders' concerns regarding compliance and oversight of NIH  \ngrant funds. We have been monitoring this issue for some time and consider it a  \nhigh-priority matter that can pose a threat to the integrity of the NIH grant  \nprogram,\" Tesia Williams, the director of communications for the Department of  \nHealth and Human Services Office of Inspector General, told CNN. \n \n\"Based on our preliminary research and analysis, HHS-OIG has decided to  \nconduct an extensive audit reviewing how NIH monitored selected grants and how  \nthe grantees and subgrantees used and managed federal funds between years 2014  \nthrough 2021,\" Williams said. \n \nRoughly 80% of NIH funding goes to supporting research grants, including  \ngrants to foreign organizations. According to the work plan on the review, it  \nwill look at how these grants are monitored and making sure the recipient's use  \nand management of NIH grant funds is in accordance with federal requirements. \n \nOne NIH official, who spoke under the condition of anonymity in order to  \ndiscuss the review openly, called it \"political\" in nature but believed that  \nultimately it would be a good thing and would clear NIH of any wrongdoing. \n \n\"It's an opportunity to educate the public,\" the official said. \n \nQuestions about the relationship between NIH and EcoHealth Alliance have  \ngrown louder after Fauci, the director of the National Institute of Allergy and  \nInfectious Diseases within NIH, confirmed to lawmakers earlier this year that  \nhundreds of thousands of dollars that NIH had given to the New York-based  \nglobal nonprofit went to the Wuhan Institute of Virology to study coronaviruses  \nin bats. \n \n\"About $600,000 was spent over a five-year period,\" Fauci said during a  \ncongressional budget hearing. \"That comes to anywhere between $125 (thousand)  \nand $150,000 per year that went to collaboration with Wuhan.\" \n \nA recent US intelligence report found that several researchers at China's  \nWuhan Institute of Virology fell ill in November 2019 and had to be  \nhospitalized, a new detail about the severity of their symptoms. It's not clear  \nwhat might have affected the researchers, there is no indication they caught  \nCovid-19 and the lab strongly denied the report, calling it a lie to push the  \nso-called lab-leak theory for the disease origin. \n \nThere are competing theories about how the pandemic got started. One is that  \nit developed naturally in the wild and transferred from animal to human, as  \nmany other viruses have in the past. Another is that such a naturally  \noriginating virus was studied in a lab and accidentally infected someone. A  \nthird theory, most widely discounted by scientists, is that it was engineered  \nin a lab and somehow leaked to humans. \n \nFor much of 2020, pursuing the lab leak theory was treated publicly as  \nxenophobic, and, thanks in part to an open letter signed by 27 scientists and  \npublished in an influential medical journal in February 2020, scientifically  \nunsound. \n \nBut in recent months, the classified intelligence emerged that three  \nresearchers at the Wuhan Institute of Virology who were conducting the kind of  \ncontroversial research that some scientists now believe may have led to the  \npandemic had gotten sick in the autumn of 2019, before the outbreak was known  \nto have begun, although there's no evidence they were infected with Covid-19. \n \n3Conservative attacks on Fauci have also intensified after media organizations  \nreleased a trove of the doctor's emails. \n \nIn one email sent to Fauci in April 2020, an executive at EcoHealth Alliance  \nthanked him for publicly stating that scientific evidence supports a natural  \norigin for the coronavirus and not a lab release. \n \nFauci recently told CNN's John Berman the email was being misconstrued and  \ncalled claims he had a cozy relationship with the people behind the Wuhan lab  \nresearch \"nonsense.\" \n \n\"I have always said, and will say today to you, John, that I still believe  \nthe most likely origin is from an animal species to a human, but I keep an  \nabsolutely open mind that if there may be other origins of that, there may be  \nanother reason, it could have been a lab leak,\" Fauci told Berman. \"I believe  \nif you look historically, what happens in the animal-human interface, that in  \nfact the more likelihood is that you're dealing with a jump of species. But I  \nkeep an open mind all the time. And that's the reason why I have been public  \nthat we should continue to look for the origin. \n \n\"You can misconstrue it however you want -- that email was from a person to  \nme saying 'thank you' for whatever it is he thought I said, and I said that I  \nthink the most likely origin is a jumping of species. I still do think it is,  \nat the same time as I'm keeping an open mind that it might be a lab leak.\" \n \nNonetheless, Republicans are using the emails -- and controversy about how  \nthe pandemic began and whether US government grant money can be connected to it  \n-- to fundraise and campaign against the Biden administration. \n \nGOP Sen. Rand Paul of Kentucky has lashed out at Fauci, calling for his  \nouster. \n \n\"He's continuously and deliberately misleading the public at every turn. It's  \ntime to FIRE FAUCI,\" a Paul fundraising email read. \"There are 2,000 emails  \nproving Fauci chose his own ego over the facts.\" \n \nFlorida Sen. Marco Rubio recently penned a Fox News op-ed titled \"If Biden  \nBelieves in Science, He Must Fire Fauci.\" \n \n  \n \nPresident Joe Biden was asked earlier this month if he still had confidence  \nin Fauci. \n \n\"Yes, I am very confident in Dr. Fauci,\" Biden said. \n \n  \n \nCNN's Maggie Fox contributed to this report. \n \n====================================================== \nClassification:  \n \n\n1From: Christopher C. Fonzone-DNI-\nSent: Thursday, August 19, 2021 9:13 PM\nTo: Avril D. Haines-DNI-\nCc: Stacey A. Dixon-DNI-; Morgan Muir-DNI-; \n; Matthew C. Rhoades-DNI-; \nSubject: Whistleblower Issue -- Revised Letter after Discussion and Transcript Review\nAttachments: HPSCI SSCI WB Transmittal Letter v.4 -- clean.docx; HPSCI SSCI WB Transmittal Letter \nv.4.docx;  Letter to DNI re COVID origin urgent concern with \nenclosures Signed.pdf\nFollow Up Flag: Follow up\nFlag Status: Flagged\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nAvril – \n \nFollowing up on our conversation this morning, we have reviewed \ntranscripts from some of Dr. Fauci’s appearances on the Hill.  \n \nBased on that review, it seems likely that the whistleblower complaint was \nreferring to exchanges Dr. Fauci had with Senator Paul on May 11 and July \n20.  During the May 11 hearing, Dr. Fauci stated that “the NIH has not \never and does not now fund gain of function research in the Wuhan \nInstitute.”  During the July 20 hearing, Senator Paul confronted Dr. Fauci \non the prior statement, asking him if he wanted to retract it; Dr. Fauci \nof course stood behind it.   \n \nThus, while it is possible that Dr. Fauci has spoken to Congress about \ngain-of-function research at some other point (he’s testified a number of \ntimes!), I think the key thing is that what we’ve seen is consistent with \nthe point that Secretary Becerra made to you – that this is something \nthey’ve considered and that Dr. Fauci has point he’s repeated about the \nNIH not funding gain-of-function at the WIV. \n \nWe’ve thus updated the draft letter to note this point and to refer the \ncomplaint to Secretary Becerra, rather than the HHS IG; tracked changes \nand clean versions are attached.  We’ve also attached the original letter \nfrom the IC IG, so you have everything in one place. \n \nMany thanks, and happy to discuss, if it would be helpful to do so,  \n \nChris  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2 \n \n====================================================== \nClassification:  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n1From:\nSent: Tuesday, October 26, 2021 11:19 AM\nTo:\nSubject: FW: NIH now says WIV did Gain of Function \nClassification: UNCLASSIFIED \n====================================================== \n \n \n \nFrom:   \nSent: Tuesday, October 26, 2021 11:12 AM \nTo:  \nSubject: RE: NIH now says WIV did Gain of Function  \n \nClassification: UNCLASSIFIED \n====================================================== \n \nIsn’t the strategy meeting w/ the DNI today? w/ legal, , etc? \n \nFrom:   Sent: Tuesday, October 26, 2021 11:10 AM \nTo:  \nSubject: RE: NIH now says WIV did Gain of Function  \n \nClassification: UNCLASSIFIED \n====================================================== \n \nWhat’s the meeting today? \n \nFrom:   \nSent: Tuesday, October 26, 2021 10:47 AM \nTo:  \nSubject: RE: NIH now says WIV did Gain of Function  \n \nClassification: UNCLASSIFIED \n====================================================== \n \nYes, this and the lobsters. The meeting today will be key to figuring out a way forward.  \n \nFrom:   \nSent: Tuesday, October 26, 2021 10:40 AM \nTo:  \nSubject: NIH now says WIV did Gain of Function  \n \nClassification: UNCLASSIFIED \n====================================================== \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2 \n \nI somehow missed this last week, but the NIH sent a letter to Congress basically saying that WIV did GOF after all…while \nalso saying that what they were working on could not have developed into SARS-CoV-2. Rand Paul then went on Axios \non HBO and claimed this is proof Fauci lied to Congress. So…this is just never going to end.  \n  \n \n \nOne person who might know what really happened in Wuhan  \nPrint  25 October 2021  |  \nhttps://www.washingtonpost.com   |  \nOpinion  \nHits: 298  \nToo many questions are still unanswered about the origins of the pandemic. Though China’s doors remain \nclosed, there are significant and promising avenues for investigation in the United States. \nThe two major hypotheses for the virus origins are zoonotic spillover, from an animal to human perhaps with an \nintermediate host, or that it leaked or escaped from a laboratory accident in Wuhan. The Wuhan Institute of \nVirology (WIV) is one of the world’s major centers of study of bat coronaviruses, and was developing \ngenetically-modified variants able to infect human lung cells. \nZoonotic spillover is a plausible explanation based on historical experience, and scientists should pursue it \nvigorously. But similar efforts must be made to discover whether a laboratory release or infection led to the \npandemic. Peter Daszak, the president of EcoHealth Alliance, a nonprofit based in New York, organized a five-\nyear research program funded by the U.S. National Institutes of Health to study bat coronaviruses and potential \nspillover risk to people, with significant participation by the WIV and its scientist, Shi Zhengli. The government \nof China, Ms. Shi and Mr. Daszak all insist the laboratory could not be the source of the pandemic strain. Mr. \nDaszak has been particularly aggressive in promoting the zoonotic spillover hypothesis and attacking the \nlaboratory leak as a “conspiracy theory.” \nLast week, it was disclosed that the EcoHealth Alliance in August filed a report on its research in 2018-2019 — \nthe report was two years late. This just happens to be the two-year period of the pandemic and intense debate \nabout the virus origins. No reason has been given. Mr. Daszak did not respond to our query. The tardy report \ndescribes experiments, approved in advance by the NIH, to test the infectivity of the genetically-manipulated \nviruses on mice with cells resembling those of the human respiratory system. The manipulations made the \nviruses more lethal to the mice. Although the NIH continues to insist this did not fit the definition of “gain of \nfunction” research, and could not have led to the pandemic strain, it certainly should have met the U.S. \ngovernment’s own requirements for stricter oversight. \nStill, much is unknown. There is no direct evidence of zoonotic spillover, nor of a laboratory leak. But unanswered questions keep emerging about Mr. Daszak and the WIV. He was at the center of public debate \nover virus origins, the only American appointed to the joint World Health Organization-China mission. Why \ndid he not disclose his 2018 proposal to the Defense Advanced Research Projects Agency (DARPA) for \nresearch on bat coronaviruses with the WIV and others, which called for engineering a modification onto spike \nproteins of chimeric viruses that would make them infect human cells in the way the pandemic strain did? What \n3does he know about the databases of viruses that WIV took offline in 2019 and never brought back? Does he \nknow what research the WIV may have done on its own, during or after their collaboration? What was being \ndone at WIV in the months before the pandemic? \nMr. Daszak must answer these questions before Congress. His grants were federal funds, and it is entirely \nappropriate for Congress to insist on accountability and transparency. He might also help the world understand \nwhat really happened in Wuhan. \n©2021 https://www.washingtonpost.com , All Rights Reserved.  \n \n \n \n \n  \n  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED \n \n====================================================== \nClassification: UNCLASSIFIED \n \n====================================================== \nClassification: UNCLASSIFIED \n \n====================================================== \nClassification: UNCLASSIFIED \n \n====================================================== \nClassification: UNCLASSIFIED \n \n\n1From:\nSent: Thursday, January 13, 2022 9:12 AM\nTo:\nCc:\nSubject: RE: New Article on COVID\nAttachments: JAG_Docs_pt1_Og_WATERMARK_OVER_Redacted.pdf\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nJust so all are tracking, attached is one of the documents on  \n \n \n \n \n \n \n \n \n \n \n \n \nFrom:   Sent: Thursday, January 13, 2022 8:55 AM \nTo:  \nCc:  \nSubject: RE: New Article on COVID \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nYup, that should be doable. I think we’re looking at having the sync on the 28th.  \n \nFrom:   Sent: Thursday, January 13, 2022 8:52 AM \nTo:  \nCc:  \nSubject: RE: New Article on COVID \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Classification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nExcellent.    I liked the bat mist idea.   Wandering the caves of Yunnan with giant spray bottles.   Like the old DDT days.    \n \nCould you do up a memo on the sync that’s polished enough that we could dissem it?    Not a NICM, SOCM.   Probably \nnot a To-From memo, since I want to make it widely available on  (including ).    We can fiddle with \nfinal format later.  Just do it almost as “report of the IC experts committee.”  \n \nFrom:   Sent: Thursday, January 13, 2022 8:31 AM \nTo:  \nCc:  \nSubject: RE: New Article on COVID \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nSome of what’s in this is new to me, at least. In particular the statement that SARS-CoV-2 is “an American-created \nrecombinant bat vaccine.” A lot of it is not new, though. Some of the claims in this article are flat out wrong, while other \nclaims seem to conflate facts and make wild analytic leaps. DRASTIC is not, as identified in the article, associated with \nthe US government. It is a loose group of individuals on Twitter who describe themselves as “internet researchers and \nsleuths” who post articles on COVID origins arguing that the pandemic was caused by a lab-related incident.  \n \nWe’ll dig more into this today. FYI, we are also setting up another COVID sync with the IC in the next couple of weeks.  \n \n \nFrom:   Sent: Thursday, January 13, 2022 7:43 AM \nTo:  \nCc:  \nSubject: New Article on COVID \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nIs any of this new to you?   Particularly “DRASTIC?”  (see end of article.) \n \nThanks \n \n--   \n \n\n3 \n \n1. Marine researcher: COVID virus made in Chinese lab as bat vaccine \nBill Gertz, https://www.washingtontimes.com , 12 January 2022 \nA Marine Corps officer working with the Defense Advanced Research Projects Agency disclosed in a memorandum last \nAugust that his study of the virus behind the COVID-19 pandemic concluded that it was produced as part of vaccine \nresearch at the Wuhan Institute of Virology, according to documents made public by a conservative investigative group.  \nMaj. Joseph P. Murphy notified the Pentagon inspector general that his analysis of the virus origin concluded the \nnongovernment organization EcoHealth Alliance, the National Institutes of Health, and the Wuhan Institute of Virology \nproduced the virus known as SARS-CoV-2 through controversial gain-of-function research outlined in a Pentagon grant \nproposal.  \n“SARS-CoV-2 is an American-created recombinant bat vaccine, or its precursor virus,” Maj. Murphy stated in an August \n13, 2021, memo made public this week by Project Veritas. “It was created by an EcoHealth Alliance program at the \nWuhan Institute of Virology (WIV), as suggested by the reporting surrounding the lab leak hypothesis.”  \nAsked about the 24 pages of internal documents made public by Project Veritas, DARPA spokesman Jared Adams told \nInside the Ring in an email that federal regulations prohibit the agency from commenting on DARPA programs or \ndocuments.  \n“We are precluded by Federal Acquisition Regulations from discussing who may or may not have bid on a DARPA \nprogram, and are unable to confirm the authenticity of the documents Project Veritas has published,” Mr. Adams wrote.  \nMaj. Murphy and the Office of Naval Research did not immediately respond to an email request for comment.  \nAccording to Project Veritas, Maj. Murphy declined to discuss the document but told the group: “To those that seek \nanswers I offer encouragement. There are good people striving for truth, working together in and out of government, and \nthey succeed. … Don’t let a lie be our legacy to posterity.”  \nAccording to Maj. Murphy, now with the Office of Naval Research, details of the program were hidden since the pandemic \nbegan in Wuhan, China in December 2019. New facts were uncovered by Maj. Murphy from a grant proposal made to \nDARPA by the New York-based EcoHealth Alliance in March 2018 and “not publicly disclosed,” he stated.  \nThe proposal was made in response to DARPA’s Project Defuse, aimed at addressing what the agency called the threat \nposed by bat-borne coronaviruses. SARS-CoV-2 is a bat coronavirus.  \nThe proposal lists several U.S. researchers who would take part in the work and included the Wuhan Institute of Virology, \nlocated in the city considered the epicenter of the possible pandemic.  \nChina’s government has denied the virus leaked from any of its laboratories, but has refused to provide information about \nthe virus’s origin. Beijing also has accused the U.S. military of launching the pandemic.  \nThe $14 million grant proposal to DARPA was produced by Peter Daszak, president of EcoHealth Alliance who worked \nclosely on dangerous virus research at the Wuhan Institute of Virology. Mr. Daszak did not immediately respond to an \nemail request for comment.  \nDARPA rejected the grant as potentially dangerous virus work, despite Mr. Daszak claiming in the proposal that the work \nwould not violate U.S. restrictions on gain-of-function research.  \nHowever, the National Institute of Allergy and Infectious Diseases, headed by Anthony Fauci, approved a grant for the \nEcoHealth Alliance, and work on bat coronaviruses continued until halted by the federal government in April 2020.  \nDr. Fauci has repeatedly denied during congressional testimony that the U.S. government funded any gain-of-function \nvirus research in China.  \nIn the 2018 proposal, Mr. Daszak stated that “we will intensively sample bats at our field sites where we have identified \nhigh spillover risk SARSr-CoVs” – the term for bat coronaviruses.  \n“We will sequence their spike protein, reverse engineer them to conduct binding assays and insert them into bat SARS-\nCoVs (WIV1, SHC014) backbones (these use bat-SARSr-CoV backbones, not SARS-CoV, and are exempt from dual-use \nand gain of function concerns) to infect humanized mice and assess capacity to cause SARS-like disease,” Mr. Daszak \nstated.  \nThe work was aimed at developing a vaccine to be sprayed on bats that the researchers believed would prevent another \ndisease outbreak like the first SARS outbreak in China in 2003.  \n4Mr. Daszak said the work would include Shi Zhengli, the Chinese virologist at the Wuhan Institute of Virology who was to \nlead research on infecting humanized mice with the lab-created bat vaccine. Ms. Shi has also denied the lab has any role \nin the origins of COVID-19 or its spread among the local population.  \nU.S. intelligence agencies concluded in a public assessment last year that the virus was caused by either a leak from a \nChinese laboratory or from emergence from an infected animal. The Murphy memorandum reflects the views of a good \nportion of U.S. intelligence analysts who believe the virus came from the Wuhan institute.  \nMaj. Murphy stated that his analysis is that the COVID virus likely emerged as a precursor, “deliberately virulent, \nhumanized recombinant” virus that was reverse-engineered into a live bat vaccine.  \nRegarding efforts to conceal the work, Maj. Murphy said Pentagon officials placed the unclassified EcoHealth Alliance \nproposal in a top-secret file within DARPA’s Biological Technologies Office.  \nMaj. Murphy stated that the COVID virus is a synthetic “chimera” or lab-produced virus engineered to infect human cells. \nThe virus is likely a live vaccine that escaped from the Chinese laboratory before it could be engineered into a less \ndangerous state, he added.  \n“It leaked and spread rapidly because it was aerosolized so it could efficiently infect bats in caves,” Maj. Murphy said, \nadding that initial escape took place in August 2019. The virus should be called “SARS-CoV-Wuhan,” Maj. Murphy stated. \nThe document also discloses the identity of a U.S. government team of experts who first concluded the virus came from a \nleak at the Wuhan lab. The group is called the Decentralized Radical Search Team Investigating COVID-19, or DRASTIC. \n“This collection of scientists and sleuths broke open the lab-leak hypothesis into the mainstream and has picked apart \nChinese and World Health Organization (WHO) reports on SARS-CoV-2’s origins in Wuhan,” he said.  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n4Asked about the 24 pages of internal documents made public by Project Veritas, DARPA spokesman Jared Adams told \nInside the Ring in an email that federal regulations prohibit the agency from commenting on DARPA programs or \ndocuments.  \n“We are precluded by Federal Acquisition Regulations from discussing who may or may not have bid on a DARPA \nprogram, and are unable to confirm the authenticity of the documents Project Veritas has published,” Mr. Adams wrote.  \nMaj. Murphy and the Office of Naval Research did not immediately respond to an email request for comment.  \nAccording to Project Veritas, Maj. Murphy declined to discuss the document but told the group: “To those that seek \nanswers I offer encouragement. There are good people striving for truth, working together in and out of government, and \nthey succeed. … Don’t let a lie be our legacy to posterity.”  \nAccording to Maj. Murphy, now with the Office of Naval Research, details of the program were hidden since the pandemic \nbegan in Wuhan, China in December 2019. New facts were uncovered by Maj. Murphy from a grant proposal made to \nDARPA by the New York-based EcoHealth Alliance in March 2018 and “not publicly disclosed,” he stated.  \nThe proposal was made in response to DARPA’s Project Defuse, aimed at addressing what the agency called the threat \nposed by bat-borne coronaviruses. SARS-CoV-2 is a bat coronavirus.  \nThe proposal lists several U.S. researchers who would take part in the work and included the Wuhan Institute of Virology, \nlocated in the city considered the epicenter of the possible pandemic.  \nChina’s government has denied the virus leaked from any of its laboratories, but has refused to provide information about \nthe virus’s origin. Beijing also has accused the U.S. military of launching the pandemic.  \nThe $14 million grant proposal to DARPA was produced by Peter Daszak, president of EcoHealth Alliance who worked \nclosely on dangerous virus research at the Wuhan Institute of Virology. Mr. Daszak did not immediately respond to an \nemail request for comment.  \nDARPA rejected the grant as potentially dangerous virus work, despite Mr. Daszak claiming in the proposal that the work \nwould not violate U.S. restrictions on gain-of-function research.  \nHowever, the National Institute of Allergy and Infectious Diseases, headed by Anthony Fauci, approved a grant for the \nEcoHealth Alliance, and work on bat coronaviruses continued until halted by the federal government in April 2020.  \nDr. Fauci has repeatedly denied during congressional testimony that the U.S. government funded any gain-of-function \nvirus research in China.  \nIn the 2018 proposal, Mr. Daszak stated that “we will intensively sample bats at our field sites where we have identified \nhigh spillover risk SARSr-CoVs” – the term for bat coronaviruses.  \n“We will sequence their spike protein, reverse engineer them to conduct binding assays and insert them into bat SARS-\nCoVs (WIV1, SHC014) backbones (these use bat-SARSr-CoV backbones, not SARS-CoV, and are exempt from dual-use \nand gain of function concerns) to infect humanized mice and assess capacity to cause SARS-like disease,” Mr. Daszak \nstated.  \nThe work was aimed at developing a vaccine to be sprayed on bats that the researchers believed would prevent another \ndisease outbreak like the first SARS outbreak in China in 2003.  \nMr. Daszak said the work would include Shi Zhengli, the Chinese virologist at the Wuhan Institute of Virology who was to \nlead research on infecting humanized mice with the lab-created bat vaccine. Ms. Shi has also denied the lab has any role \nin the origins of COVID-19 or its spread among the local population.  \nU.S. intelligence agencies concluded in a public assessment last year that the virus was caused by either a leak from a \nChinese laboratory or from emergence from an infected animal. The Murphy memorandum reflects the views of a good \nportion of U.S. intelligence analysts who believe the virus came from the Wuhan institute.  \nMaj. Murphy stated that his analysis is that the COVID virus likely emerged as a precursor, “deliberately virulent, \nhumanized recombinant” virus that was reverse-engineered into a live bat vaccine.  \nRegarding efforts to conceal the work, Maj. Murphy said Pentagon officials placed the unclassified EcoHealth Alliance \nproposal in a top-secret file within DARPA’s Biological Technologies Office.  \nMaj. Murphy stated that the COVID virus is a synthetic “chimera” or lab-produced virus engineered to infect human cells. \nThe virus is likely a live vaccine that escaped from the Chinese laboratory before it could be engineered into a less \ndangerous state, he added.  \n5“It leaked and spread rapidly because it was aerosolized so it could efficiently infect bats in caves,” Maj. Murphy said, \nadding that initial escape took place in August 2019. The virus should be called “SARS-CoV- Wuhan,” Maj. Murphy stated. \nThe document also discloses the identity of a U.S. government team of experts who first concluded the virus came from a \nleak at the Wuhan lab. The group is called the Decentralized Radical Search Team Investigating COVID-19, or DRASTIC. \n“This collection of scientists and sleuths broke open the lab-leak hypothesis into the mainstream and has picked apart \nChinese and World Health Organization (WHO) reports on SARS-CoV-2’s origins in Wuhan,” he said.  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Friday, September 11, 2020 11:01 AM\nTo:  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n3 \nAs of early September, WMD’s team schedule is the following: \n 9/8-11:  \n \n 9/14-18:  \n \n \nFrom:   \nSent: Friday, September 11, 2020 8:50 AM \nSubject: FW: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nSee you at 10! \n \nFrom:   Sent: Wednesday, September 09, 2020 9:31 AM \nSubject: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:  \n \nClassification: UNCLASSIFIED  \n====================================================== \n \nGood morning, \n \nThe NIC will host the weekly COVID-19 analytic synch VTC this Friday, 11 September, from 1000-1130 AM EDT. Topics of \ndiscussion will include introductions and a summary of key questions, policy engagements, and recent or upcoming \nproduction.  \n \nFor those interested, new to COVID-19, or in touch with colleagues at home, I thought I’d flag this free course by MIT on \nCOVID-19, which involves one one-hour lecture each week. Details, including a syllabus, are available at \nhttps://biology.mit.edu/undergraduate/current-students/subject-offerings/covid-19-sars-cov-2-and-the-pandemic/ . Upcoming topics include vaccines, immunology, and epidemiology related to COVID-19. Please follow your agency’s \nguidance for outside training. About 2000 people watched the first lecture, which did not have an ASL interpreter but \ndid have captions in English. Lectures are available a few days later on YouTube.  \n  \nCOVID-19, SARS-CoV-2 and the Pandemic \nIn Fall 2020, all MIT students and the general public are welcome to join Professors Richard Young and Facundo \nBatista as they discuss the science of the pandemic during this new class. Special guest speakers include: Anthony \nFauci, David Baltimore, Britt Glaunsinger, Bruce Walker, Eric Lander, Michel Nussenzweig, Akiko Iwasaki, Arlene \nSharpe, Kizzmekia Corbett, and others. The class will run from September 1, 2020 through December 8, 2020 and \nbegin each Tuesday at 11:30 a.m. ET. The live stream will be available to the public, but only registered students \nmay ask questions during the Q&A. Miss a class? You’ll be able to view a video of the lecture on this page. \n \nIf you have any VTC questions or would like to be added to Friday’s conference, please do not hesitate to contact the \nVideo Operations Center (VOC) at  (I cannot add gateways and such myself). If you are dialing in, you can call \nthe VOC from a secure phone up to 10 minutes before the meeting.  Have the conference ID ready, the VOC will then \ntransfer your secure phone into the meeting. \n \n Conference ID:  Conference Name:  \n\n4Subject: POC-   \nNotes:   \nStart Setup Time: 11 SEP 2020 09:50  EST/DST  End Conference Time: 11 SEP 2020 11:30  EST/DST  \nStart Conference Time: 11 SEP 2020 10:00  EST/DST Requestor: CIA 3 \n \nConference Status: Resolved   \nNCMI 1 Resolved  \nCIA GW 13 Resolved  \nNGA NCE GW 02 Resolved  \nFBI CLK GW 3 Resolved  \nCDC ATLANTA Resolved  \nDHS HQ GW 3 Resolved  \nNSAW GATEWAY 03 Resolved  \nONI 3A102 Resolved  \nROWE VTC RM 3051 Resolved  \nLLNL-NAI 2 Resolved  \nA2 BLDG 5681.4 Resolved  \n \n \n \n \n \n \n \n \nIn the event I am out of the office, please contact the following alternate POCs at the NIC: \n NIC COVID alias:  \n NIO WMD & Proliferation:  \n \nAs of early September, WMD’s team schedule is the following: \n 9/8-11:  \n \n 9/14-18:  \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Friday, March 17, 2023 6:05 PM\nTo:\nCc:  \nSubject: FW: BSEG c.2020\nAttachments: Readout: Friday 10am: COVID-19 Weekly Analytic Synch VTC (Conference ID:... (49.9 KB)\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \nHello, \n \nPer  email, in the spreadsheet please add State to the core group of people invited to the small group meetings.  \n \nThank you, \n \n \n \n \n \n  \n \nOffice of the Director of National Intelligence \n \n \n \nFrom:   Sent: Friday, March 17, 2023 5:25 PM \nTo:  \nCc:  \nSubject: RE: BSEG c.2020 \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nSorry just responding,  reached out and I think I got  what you needed? If not, let me know.  \n \nFor the below directly, the last BSEG quarterly in Jan 2020 where we had  give a brief, that was physically hosted by \n per the normal procedures at their office in Arlington for which you had to pass clearances (and thus  \nwould have that list). After that, when things shut down, we started with weekly unclassified phone calls that  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2hosted with their telephone bridge that required a pin to join,  thought that was a \nmore secure mechanism than some other unclass options. Those weekly unclass calls  wouldn’t know who \nparticipated, but our emails organizing those would have the names, and I think  has that now. I also pointed  to \n Bio community email group, which is what we used for the broad BSEG meetings historically.  \n \nAnother angle if this isn’t helping is I think we used the same audience as  weekly COVID sync meeting, example \nattached. \n \nI was able to find some of my emails, here’s one with distro: \n \nFrom:   \nSent: Tuesday, December 08, 2020 6:26 PM \nTo:  \n \n \n \n \n \n \n \n \n \n \n  \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nCc:  \n\n3 \n \n \n \n \n \n \nSubject: RE: BSEG COVID19 Small Group: Unclass Call: 4 December 3:30pm EST \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nHi Everyone,  \n \nAttached are my notes from the call just now, I’m sharing with the caveat that these are rough notes, no QC has been done for technical accuracy and these are not comprehensive and should not be viewed as a transcript (there were large \nsections I missed capturing entirely).  \n \n-  \n \n----------------------------------- \n \nPLEASE NOTE: WORKING PM SHIFT (Beginning at 1300)  \n \n \n  \n \n \n \n \n \n \n \nFrom:   Sent: Thursday, March 16, 2023 1:23 PM \nTo:  \n \n\n4Cc:  \nSubject: BSEG c.2020 \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nWe are trying to recreate the BSEG attendance for those early 2020 meetings. Any chance you have notes from CENTRA \nfrom this time, or recall where soft or hardcopy notes might be located? \n \nThanks \n \n \n \nChief, Chemical & Biological Warfare Group  \n \n \n \n  \n  \n  \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification: SECRET  \n \n====================================================== \nClassification: SECRET  \n \n\n1From:\nSent: Wednesday, November 22, 2023 9:15 AM\nTo:\nSubject: RE: [for  FW: Vanity Fair Inquiry Re: COVID Origins\nAttachments: 20200527 LLNL COVID-19 Lab Modification Conditions Present at WIV \n( ).pdf\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nThanks. Attached is the May 2020 Z-Division analysis that may be related to the claim that the former DOE Dep Sec told \nFauci that “DOE scientists had found evidence suggesting that the pandemic had originated at the WIV.” This, of course, \nis not what the paper says. It only says that LLNL assessed that “all of the necessary conditions for an accidental release \nof a laboratory-modified coronavirus…were present…” at the WIV. Which, by the way, is not substantiated in the paper. \nIt claims one of the necessary conditions was “access to a potential SARS-CoV-2 precursor coronavirus,” but we do not now, nor did we back in 2020, have ANY reporting suggesting WIV had such a virus.  \n   \n \nFrom:   \nSent: Tuesday, November 21, 2023 5:29 PM \nTo:  \nSubject: RE: [for  FW: Vanity Fair Inquiry Re: COVID Origins \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nThanks,  \n \n the ref to the ODNI 2016 document was probably the ATA: \n \n  We continue to monitor emerging technologies that are potentially disruptive for WMD, as well as the \nhealth and economic sectors.  For example, research in genome editing conducted by countries with different \nregulatory or ethical standards than those of Western countries increases the risk of the creation of potentially \nharmful biological agents or products.[i][ii][iii][iv][v][vi][vii][viii][ix]  Given the broad distribution, low cost, and accelerated \npace of development of this dual-use technology, its deliberate or unintentional misuse might lead to far-reaching \neconomic and national security implications.  Advances in genome editing in 2015 have compelled groups of \nhigh-profile US and European biologists to question unregulated editing of the human germline (cells that are relevant for reproduction), which might create inheritable genetic changes.[x][xi][xii]  Genome editing systems could \nenable states to develop enhanced or advanced BW agents; however, states would almost certainly face \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2technical challenges to using genome editing systems to create advanced BW agents.  We have no intelligence \nreporting that any country is using these systems for offensive purposes, although legitimate and nefarious \npurposes are very hard to distinguish, given that the facilities are small and the commercial incentive is great.   \n \n \nFrom:   \nSent: Tuesday, November 21, 2023 5:00 PM \nTo:  \nSubject: RE: [for  FW: Vanity Fair Inquiry Re: COVID Origins \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \nFor this one: \n Is there a copy of this warning? Or how widely was it circulated? In mid-2019, an Energy Department official \nwent so far as to issue a specific warning to NIAID about the coronavirus research the agency was funding at the \nWIV. \n \nMaybe consider: \n Can we get a copy of this? How widely was it circulated? In mid-2019, an Energy Department official went so far \nas to issue a specific warning to NIAID about the coronavirus research the agency was funding at the WIV.  \n \n \nFor this one:  \n The article makes reference to a DOE plan from 2016 to monitor sale of genetic components and better detect \nevidence of genetic engineering is cited as being funded by Congress since 2019 – Welcome insight into better \nunderstanding those efforts. Is this a reference to the work captured in DOE ETIP analytic products?  \n \nI don’t think this could be ETIP because I don’t think that’s the scope of the program and I believe it wasn’t funded \nofficially by congress until FY22.  Might just strike the last sentence. \n \n \n \nFrom:   Sent: Tuesday, November 21, 2023 4:42 PM \nTo:  \nCc:  \nSubject: [for  FW: Vanity Fair Inquiry Re: COVID Origins \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n  \n\n3 \nDefer to you on best way to engage DOE to follow-up on anything from the VF article; below are some things that I \nwould suggest:  \n \n What data on COVID origins is being referred to in this statement? In October 2020, VF has learned, Dan \nBrouillette told Fauci that DOE scientists had found evidence suggesting that the pandemic had originated at the \nWIV. \n What is the scientific analysis that is being referred to in this statement? single lineage? A source with \nknowledge of the DOE’s investigation tells VF that the agency had long been more confident in its scientific \nanalysis, and only later became more comfortable with the intelligence supporting it.  \n Is there a copy of this warning? Or how widely was it circulated? In mid-2019, an Energy Department official \nwent so far as to issue a specific warning to NIAID about the coronavirus research the agency was funding at the \nWIV. \n The article makes reference to a DOE plan from 2016 to monitor sale of genetic components and better detect \nevidence of genetic engineering is cited as being funded by Congress since 2019 – Welcome insight into better \nunderstanding those efforts. Is this a reference to the work captured in DOE ETIP analytic products?  \n In the March 2023 NICA,   \n \n \n \n \n \n \n \nFrom:   \nSent: Tuesday, November 21, 2023 12:56 PM \nTo:  \n \nCc:  \nSubject: RE: Vanity Fair Inquiry Re: COVID Origins \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nFor awareness, the Vanity Fair story, attached, published today.  The reporting describes differences—notably between \nNIH and DOE—within the USG on risks associated with US-funded biology research.  As expected, the story references \nour published assessment on COVID origins. \n \nTake care,  \n \nFrom:   Sent: Monday, November 06, 2023 12:55 PM \nTo:  \nCc:  \nSubject: RE: Vanity Fair Inquiry Re: COVID Origins \n\n4 \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nThank you (belatedly!) for the insight below – I appreciate it.  We ultimately did not provide the reporter with any \nuseable lines and stressed off the record the range of expertise across the IC.   \n \nThank you again,  \n \nFrom:   Sent: Monday, October 30, 2023 12:52 PM \nTo:\n \nCc:  \nSubject: RE: Vanity Fair Inquiry Re: COVID Origins \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n(taking  off as she is no longer at the NIC)  \n \nSome comments below in red. Let us know if you need anything else.  \n \nFrom:   Sent: Thursday, October 26, 2023 4:29 PM \nTo:  \n \nCc:  \nSubject: Vanity Fair Inquiry Re: COVID Origins \n \nClassification: UNCLASSIFIED  \nDELIBERATIVE PROCESS PRIVILEGED DOCUMENT \n====================================================== \n \nHi All, \n \n a contributing editor at Vanity Fair who covers “medical and scientific mayhem,” contacted SC about a \npiece  writing regarding dual research of concern.  A sizeable portion of  piece will focus on COVID origins, to \ninclude the impact that the unresolved origins of the virus has on Biden Admin policy.   looking at the USG’s \nresearch on COVID origins within which  report on the IC and posed some questions to SC.  I’m aiming to respond \nto  no later than Tuesday next week.     \n \n\n5Specific to ODNI,  cited the June 2023 “Potential Links Between WIV and the Origin of the COVID- 19 Pandemic” \nreport and asked for guidance on the following bullets; during our conversation I provided  some general off-the-\nrecord thoughts, but I advised I would consult with our analysts further.   \n \n Is it possible to name the “four other IC agencies” referenced alongside the NIC that assess the virus was most \nlikely caused by natural exposure? \no I advised that we cannot name these agencies.  I imagine this is the case, but please confirm for me.   \n We cannot name the other IC agencies  \n \n How much did the inputs of outside experts factor into the respective assessments of each IC agency?  Can you \ndescribe the weight given by each IC element to the inputs from outside experts?   \no I advised that consultation with outside experts is among the resources the IC used alongside \nintelligence reporting and study of academic literature.  I don’t think there’s any further specifics we can \nadd, but please advise.   \n Agree that’s about all we can say.  \n \n Who are the key players in the IC on this analysis?  What kind of expertise and scientific staffing does the IC \nbring to this problem?  Sources claim that FBI and DOE have the deepest scientific benches in the IC – is this \ntrue? \no I generally advised that the IC has a breadth of expertise that varies depending on the organization.  I \ntold  we cannot provide specific staffing levels.  If possible, I’d like to be able to provide  with a \nline that lists the variety of experts within the IC on this issue.  For example, the IC has immunologists, \nbiologists, etc. What do you all think?  \n I don’t think it’s the NIC’s call on this. That said, I think it’s fair to say that many IC agencies \nemployee officers with backgrounds in biological sciences.  \n \n Is it accurate to report that DOE assesses that the virus was genetically engineered? DOE is an outlier in this \nassessment, but sources say DOE has “new intelligence” that may have contributed to their assessment. \no I told  to contact DOE, but I welcome any thoughts here on the ground truth to help determine \nwhether any engagement on this point is warranted.   \n Yeah, I’d refer  to DOE. To be clear: this is not what DOE assesses. In fact, they changed \ntheir assessment in the March NICA to “not” genetically engineered. But that position has not \nbeen declassified. So yeah:  should definitely check with them.  \n \nIf there are any other points you all recommend to help illustrate the IC’s expertise on this issue, I welcome your \nthoughts. \n \nMany thanks in advance,  \n \n \n \nIC Press Secretary  \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n\n6 \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n \n ====================================================== \nClassification:  \n \n \n \n \n[i] [Journal Article | Danilo Maddalo, et al. | Nature Magazine | In vivo engineering of oncogenic chromosomal rearrangements with the CRISPR/Cas9 \nsystem | 18 December 2014 | 423-427 |  | 23 January 2015 | ] \n[ii] [Journal Article | Wen Xue, et al. | Nature | CRISPR-mediated direct mutation of cancer genes in the mouse liver | 16 October 2014 | 380-384 |  | 30 \nMarch 2015 | ] \n[iii] [Journal Article | Rafael B. Blasco, et al. | Cell Reports | Simple and Rapid In Vivo Generation of Chromosomal Rearrangements using CRISPR/Cas9 \nTechnology | 20 November 2014 |  |  | 30 March 2015 | ] \n[iv] [Journal Article | Haifeng Wan, et al. | Cell Research | One-step generation of p53 gene biallelic mutant Cynomolgus monkey via the CRISPR/Cas \nSystem | 28 November 2014 |  |  | 30 March 2015 | ] \n[v] [Journal Article | Yuyu Niu, Bin Shen, Yiqiang Cui, Yongchang Cen, Jianying Wang, et al. | Cell | Generation of gene-modified cynomologous monkey \nvia Cas9/RNA-mediated gene targeting in one-cell embryos | 13 February 2014 |  |  | 6 March 2015 | ] \n[vi] [Internet Site |  | Thermo Fisher Scientific | Life Technologies Releases CRISPR Products for Simple, Rapid Gene Editing | n/a |  | \nwww.lifetechnologies.com/us/en/home/about-us/news-gallery/press-releases/2014/life-technologies-releases-CRISPR-products-for-simple-gene-\nediting.html | 23 March 2015 | ] \n[vii] [Internet Site |  | GE Healthcare | Edit-R CRISPR-Cas9 Gene Engineering | n/a |  | dharmacon.gelifesciences.com/gene-\nediting?wt.mc_id=PaidSearch_Google_ALL&wm_camp=Google_ALL&gclid=COg6b6RV8qcfchcfgodF6AQQ | 23 March 2015 | ] \n[viii] [Internet Site |  | Clontech | The CRISPR/Cas9 System for Targeted Genome Editing | n/a |  | \nwww.clontech.com/US/Products/Genome_Editing/CRISPR_Cas9_resources/About_CRISPR_Cas9 | 23 March 2015 | ] \n[ix] [Internet Site |  | System Biosciences | CRISPR/Cas9 Smart Nucleases | n/a |  | https://www.system.bio.com/crispr-cas9-systems | 23 March 2015 | ] \n[x] [Online Publication | Baltimore, Berg, Botchan, Church, Doudna, et al. | A Prudent Path Forward for Genomic Engineering and Germline Modification | \nScience | 19 March 2015 |  | www.sciencemag.org/content/348/6230/36.full.pef | 4 November 2015 | ] \n[xi] [Medical Journal Article | Edward Lanphier, Fyodor Urnov, et al. | Don't Edit the Human Gene Line | Nature | 26 March 2015 |  |  | 4 November 2015 | ] \n[xii] [Medical Journal Article | Junjiu Huang et al. | CRISPR/Cas9- Mediated Gene Editing in Human Tripronuclear Zygotes | Protein & Cell \n| 18 April 2015 |  |  | 4 November 2015 | ] \n\n1From:\nSent: Wednesday, November 22, 2023 1:42 PM\nTo:\nCc:\nSubject: Question on yesterday's Vanity Fair article \nAttachments: Secret Warnings About Wuhan Research Predated the Pandemic _ Vanity Fair.pdf\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n  \n \nFirst, Happy Thanksgiving! I realize you are probably going to get a lot of questions about the piece that ran in Vanity Fair\nyesterday, and I hate to add to your workload, but I have a few questions on how the piece characterized DOE’s position \non COVID-O over the last few years. I realize that whoever leaked to the reporter probably got their details wrong, and I \nthink I know the answer to some of these questions, but I want to be prepared to answer anything that comes down \nfrom the ODNI FO next week.  \n \n The piece claims that in mid-2019, Deputy Energy Secretary Dan Brouillette told a NIAID official that the \ncoronavirus research the US was helping to fund at the WIV risked being misappropriated for military purposes. \nDo you know if this warning actually happened and, if so, what it was based on? I know that there were \nconcerns over WIV’s coronavirus research prior to the pandemic, but my recollection is that this concern was \nover biosafety issues, not over the possibility that the research could be used for military purposes. To the best \nof my knowledge, nobody in the IC was worried about that in mid-2019…and I know of no assessments \nsuggesting anyone is worried about it today.  \n \n The piece also states that Brouillette in October 2020 told Fauci that DOE scientists had found evidence \nsuggesting that the pandemic had originated at the WIV. Do you know if this actually happened and, if so, what \nthe statement is based on? It is inconsistent with everything I’ve seen from DOE.  \n \n The piece states that “…DOE scientists, using an array of advanced tools and working out of several different \nlabs, including Lawrence Livermore, Argonne, and Oak Ridge, could not rule out the possibility that the virus’s \nsequence had been engineered.” While the statement is true on its face that neither DOE nor any IC agency has \n“ruled out” anything regarding COVID-O, the implication here is that there is a significant number of DOE \nscientists across multiple labs who think SARS-CoV-2 was engineered. Is this true?  \n \n With regard to DOE’s early 2023 assessment that the pandemic was the result of a laboratory-associated \nincident, the piece states that DOE “…had long been more confident in its scientific analysis, and only later \nbecame more comfortable with the intelligence supporting it.” The next sentence indicates that DOE’s \nassessment was based on “…new intelligence related to a coronavirus variant being studied by China’s Center \nfor Disease Control in Wuhan.” These statements are wildly inconsistent with the earlier claim that at least some \nDOE scientists apparently believe SARs-CoV-2 was genetically engineered. I’m curious if you have any \nexplanation for these mutually exclusive statements?  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2 \nI appreciate any insight you can provide to the above questions and any thoughts on the piece itself. Thanks! –   \n \n \n \n \n \n  \n  \n \n \n  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Tuesday, November 28, 2023 11:56 AM\nTo:\nSubject: RE: Recent (and upcoming) press on COVID Origins \nAttachments: Australian Weekend Magazine_COVID.docx\nImportance: High\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nWORD version of the Australian article on COVID-O. A lot of what’s in here has already been reported in other press \npieces, but I highlighted some of the more interesting passages. The biggest deal is Kadlec’s claim that the pandemic \narose from the vaccine research AMMS scientists  was doing in fall 2019. This was the theory he pushed \nduring his HELP study and that we tried to tell him multiple times was incorrect. Another interesting tidbit is that a \n“relative of  is in the US and  claims that FBI has interviewed them at least twice regarding COVID-O. This \nis  They have never said  was \ninterviewed for COVID-O.  also claims that WIV had 22,000 viruses…which is just insane.  \n \nFrom:   Sent: Monday, November 27, 2023 1:54 PM \nTo: Morgan Muir-DNI- Michael L. Collins-DNI-  \n \nCc:  \n \nSubject: Recent (and upcoming) press on COVID Origins  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nI wanted to flag three recent press pieces that have been published over the last week on COVID-Origins, all of which \ntalk about the IC’s investigation.  \n \nThe first piece is an article that ran in Vanity Fair last week . It’s ostensibly on the debate over the utility in doing so-\ncalled “gain of function” research but focuses a lot on what the author describes as warnings DOE provided to the \nNational Institute of Allergy and Infectious Diseases (NIAID) and its parent organization, the National Institutes of Health \non the nature of research being conducted at the WIV. In particular, the piece alleges that:  \n …then Deputy Energy Secretary Dan Brouillette in mid-2019 told a NIAID official that the coronavirus research \nthe US was helping to fund at the WIV risked being misappropriated for military purposes.  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2 …Brouillette in October 2020 told Fauci that DOE scientists had found evidence suggesting that the pandemic \nhad originated at the WIV \n …DOE scientists, using an array of advanced tools and working out of several different labs, including Lawrence \nLivermore, Argonne, and Oak Ridge, could not rule out the possibility that the virus’s sequence had been \nengineered. \n …and that, in regard to DOE’s  early 2023 assessment that the pandemic was the result of a laboratory-\nassociated incident, that DOE “…had long been more confident in its scientific analysis, and only later became \nmore comfortable with the intelligence supporting it.”  \n \nMuch of these statement appear to be garbs…by the sources the reporter spoke to and possibly even by Brouillette for \nhis alleged statements. Nobody in the IC was or has ever been worried about the PLA misappropriating the WIV’s \ncoronavirus research…certainly not in mid-2019. DOE did not assess a lab-associated cause of the pandemic until early \nthis year; it seems to me that Brouillette’s alleged claim that DOE came to this assessment by late 2020 was probably a \nreference to a May 2020 DOE (LLNL) paper that simply assessed the necessary conditions for a lab leak were present at \nthe WIV.  \n \nThe second attachment is a piece that ran in Sky News  today by  claiming that former SFG director \n had an inappropriate relationship with the WHO and unduly influenced the IC’s assessments on COVID \norigins. This article, which appears to be heavily based on statements provided to Sky News by former Acting Assistant \nSecretary of State of the Arms Control, Verification, and Compliance Bureau  is filled with factual \ninaccuracies. The one piece of evidence it cites to justify the claim she influenced the IC is a recording of a meeting \nbetween AVC and State/INR officials and outside experts in which  questioned the veracity of a Bayesian \nanalysis conducted by . Her comment was perfectly reasonable; lots of people (including me) have major \nissues with  analysis. Regardless, this happened when she was still at INR. She had almost nothing to do with the \n90-day study.  \n \nThe third piece is a related article published today in The Australian , also by  in which former DHS Assistant \nSecretary for Preparedness and Response Bob Kadlec claims that he initially downplayed the lab leak scenario in the \nearly days of the pandemic to encourage cooperation with China. This is a pretty interesting statement coming from \nKadlec, who after he left the Trump Administration was the lead Republican staffer on the Senate HELP committee and \nthe main driver behind that committee’s “Muddy Waters” investigation into COVID origins.  \n \n has a new documentary on COVID origins set to run tonight/tomorrow in which she promises to reveal more \nways in which the US government, and ODNI in particular, has covered up the real lab-related origins of the pandemic.  \n \n \n \n \n \n  \n  \n \n \n \n  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n\n3 \n1From:\nSent: Tuesday, October 3, 2023 4:13 PM\nTo:  \nCc:\nSubject: FW: in response to the DDCIA question related to the context of a Fauci engagement \nwith CIA\nAttachments: 26 Sept Letter from Rep Wenstrup.pdf\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nThanks CBD for pulling this together so quickly at DA FO request. Record copy. \n \nFrom:   \nSent: Tuesday, October 03, 2023 4:12 PM \nTo:  \nCc:  \n \nSubject: in response to the DDCIA question related to the context of a Fauci engagement with CIA \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nThe various press articles that are coming out are probably drawn from the 26 September letter from the Select \nSubcommittee on the Coronavirus Pandemic (attached). We wanted to provide context from our records related to \nclaims that were made.  \n \nOn 4 June 2021, WCP/DAD, WCP/CBD Chief of Analysis, a WCP/CBD analyst, an EAPMC analyst, CIA COO  and NSC officials met with Dr. Fauci over a SVTC for about 40 minutes. The NSC’s Global Health Security & Biodefense section \nfacilitated the briefing. The WCP/CBD analyst briefed the key points of the 4 May 2021   \n. WCPMC/CBD has no record of Dr. Fauci coming to CIA headquarters to \ndiscuss the origins of COVID-19. \n \n During this SVTC, Dr. Fauci offered thoughts related to certain points the CBD analyst raised from the  \nincluding China’s pangolin research, early illnesses detected at the Wuhan Institute of Virology, single- versus \nmulti-lineage evolution of the virus, and China’s early epidemiological mistakes.  \n Dr. Fauci recommended contacting a group of US scientists who closely follow this issue, including some WCP \nhad already met with or planned to meet with. \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Please let us know of additional questions.  \n \nThank you, \n \n \n \n \nCIA/WCPMC/Deputy Chief Analysis \n \n \n \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n3From:   \nSent: Tuesday, December 12, 2023 12:26 PM \nTo:  \nSubject: (U) COVID-19 \n \nClassification: UNCLASSIFIED \n====================================================== \n \nMARIA BARTIROMO », FOX NEWS ANCHOR: \nAnd that's South Dakota Governor Kristi Noem with me last week on this program with some disturbing commentary, \ncommunist China still controlling America's supply of medicine four years after the outbreak of COVID-19 from a lab in \nWuhan that has killed more than 1.1 million Americans so far. \nThe CCP has yet to provide evidence on how that deadly virus originated and explain its cover-up that followed. Next \nmonth, Dr. Anthony Fauci is set to testify for two days before the House on the origins of COVID-19 and his handling of \nthe pandemic, where Republicans are expected to grill him on overseeing funding of gain-of-function research at the \nWuhan lab, as well as discrediting the theory the virus originated from a lab leak. \nJoining me right now is Kentucky Senator Rand Paul. He is vowing to hold hearings on the origins of COVID in the Upper \nChamber if Republicans retake control next year. Senator Paul is also the author of the new book \"Deception: The Great \nCOVID Cover-Up,\" available right now. \nSenator, thanks very much for joining us this morning. \n \nSEN. RAND PAUL (R-KY): \nThank you, Maria. \n \n«BARTIROMO »: Well, you have been an incredible truth-teller throughout all of this, and you have studied all of this now for several \nyears. \nWhat can you tell us about what you have learned, what you have taken away from the entire COVID experience? \n \nPAUL: \nWell, the problem is, is that the Chinese have destroyed any kind of reputation they had. \n\n4I mean, we can no longer believe any kind of pronouncements from them, which makes us suspicious. Right now, there's \na host of disease affecting young people, respiratory disease and pneumonia, in China, and they tell us, well, there's \nnothing to see here. \nAnd maybe that's true, but they have destroyed any kind of foundation we had in trusting them, and they still haven't \ncome clean. In early 2020, when COVID came out, they said, oh, we're not having human-to-human transmission, and \nwe don't seem to be having an extraordinary amount of flooding in the hospitals or deaths. \nAll of that was untrue, and they knew for at least three or four weeks. They also knew the sequence of the virus, and \nthey kept that secret as well. I think they also knew that three of their workers got sick at the Wuhan Institute of \nVirology in November 2019. I think they knew all of this. \nAnd I think they absolutely know it now, and the only way they can restore trust is to own up to it. Look, I don't blame \nthem completely for this. I think it was an accident, but cover-up is not an accident. If they were to come clean and say, \nwe're punishing the scientists who did what they weren't supposed to, I think then that we could restore some trust. \nBut, right now, we have really no trust with the Chinese government. \n \n«BARTIROMO »: Well, what about the accountability here, and why the Biden administration does not push for it? \nI mean, right now, as we speak, there are American investors continuing to underwrite the CCP by buying those \ncompanies that are tied to the Chinese military. It seems this administration is not willing to pull the economic lever, and \nthat is shut off the capital markets to Chinese communist companies that may have been involved in that cover-up or \ntied to the military. \n \nPAUL: \nWell, we still continue to fight the Biden administration every day just for unclassified information, and they resist at \nevery turn. \nWe have had to basically withhold nominees and withhold legislation to try to get anything from the Biden \nadministration. And I'm not sure what it is. Either it's sympathy or believing that relations with China are so important \nthat the truth can be obscured. \nBut there's also a certain amount of culpability in the Biden administration throughout several different departments, \nUSAID, NIH, HHS. They're withholding documents because they funded the lab in Wuhan, not just once, not just twice, \nbut for a decade they were funding. \nAnd we have Anthony Fauci on record as saying that, even if a pandemic occurs, even if a gain-of-function research \ninfects a scientist and a pandemic occurs, that the knowledge would be worth the risk. And I think most people who had \na loved one die from COVID either here or around the world would disagree and think Anthony Fauci made a disastrous \njudgment call. But he also took the research, and it didn't go before the normal scrutiny. There's a safety committee that was supposed \nto review this, and Anthony Fauci allowed this research to be done at his signature, at his conclusion, at his approval \nwithout the approval of the safety committee. \nAnd this -- for this, he really should go down in history perhaps as one of the worst people in public office ever and \nresponsible for probably more deaths than other -- any other individual in the medical world. \n \n«BARTIROMO »: Well, I mean, there was so much censorship of so much information that was vital for Americans to see and understand \nabout COVID and about the vaccines, but they censored it. \nCan we even trust health officials in this government? \n \nPAUL: Well, it was directed explicitly by him. We go over this in the book, because he commissioned scientists who were saying \nin private that they thought it was a manipulative virus, manipulated a lab and came from a lab. \nHe convinced them in public to say the opposite. He commissioned and edited a paper that said that absolutely this did \nnot come from a lab, while, privately, all of these same scientists were saying, in all likelihood, it did come from a lab. So, there really was an orchestrated cover-up on this. We also now know that he was visiting the CIA in early 2020. We \nknow that the CIA scientists, seven of them, voted six to one to say it came from the lab, and then they were reversed by \n5superiors. We need to know whether Anthony Fauci influenced the superiors, or perhaps the opposite. Did the CIA \ninfluence Anthony Fauci? \nBut we also need to know how often he was visiting and what he was there for. Our understanding is that he wasn't \nrecorded on visitor logs, but he was appearing frequently at the CIA. You have to realize that he was not a scientist in \ncharge of a cure for cancer. He was also in charge of a lot of bioweapons money and in charge of a lot of things that had \ndual use. \nAnd they won't reveal any of this to us. They had weekly meetings on dangerous dual-use research concerns and gain-\nof-function, and not one item of any of those meetings has been released to us, despite us asking for it for over three \nyears. \n \n«BARTIROMO »: \nDo you believe COVID was a bioweapon? \n \nPAUL: \nI think that it was probably developed for a vaccine. I think they developed a coronavirus. They inserted this cleavage \nsite in to make it more infectious to humans, and then they had a vaccine very early on, because I think they were \ndeveloping a vaccine against COVID, and then COVID got out. \n \n«BARTIROMO »: Yes. \n \nPAUL: \nBut the interesting thing is the scientist, Dr. Zo Yusin [ph], who developed it, died mysteriously two months after the \ndevelopment of the virus. He fell from a tall building in Beijing. And there's a lot of questions as to the circumstances of \nhis death. \n \n«BARTIROMO »: Wow. I did not realize that, that he died from a tall building in Beijing. That's incredible. \nLet me switch gears, ask you about the supplemental package. You all are leaving for the holidays next week. But you're \nright now debating this $100 billion supplemental package that Joe Biden wants, money sent to Ukraine, if you're going \nto send money to Israel. \nAnd the Republicans so far have dug in, saying, we want policy changes at the border. Where is this going? \n \nPAUL: \nWe don't have the money. \nAnd the biggest threat -- while I agree the border should be secured, an even bigger threat is to the dollar and to our \ncurrency. I follow Jim Grant. I think he's one of the smartest guys out there looking at the economy and the Fed. He \npredicted a lot of the things that happened in 2008, when we had the housing bubble burst. \nHe thinks we're due for interest rates, high interest rates, for a long period of time, but we're accumulating debt at a \ntrillion dollars every three months now. This is an extraordinary thing. And interest rates are now becoming the highest \nor one of the largest items in our budget. \nSo, really, people can talk about wanting to help other countries. We don't have the money. It has to be printed up. It's \ndestroying our currency. And it's why it costs more to go to the grocery store to buy your groceries. We can't allow this \nto happen. \nThere is a possibility we could go too far with this, and we could have a cataclysmic economic downturn, recession, \ndepression, destruction of the currency. \n \n«BARTIROMO »: Wow. \n \nPAUL: \nI know that sounds over the top, but that's what I'm worried about, because we're accumulating debt so fast. \n6 \n«BARTIROMO »: \nWell, I agree with you about Jim Grant. Jim Grant is a regular of mine on \"Mornings With Maria\" over on the FOX \nBusiness Network. And he's been sounding the alarm about all of this debt for a long time. \nBut you have got a package at hand, and you have got a vote on this coming up. Where is this going? Is -- are you guys \ngoing to go to the holiday and not send any money to Ukraine? What do you expect this -- to happen? How does this \nplay out, rather? Pardon me. \n \nPAUL: \nMy hope is that Speaker Johnson will stick to his word. He said Israel aid would be separate and paid for. He immediately voted for it, and the House passed it, and they paid for \nit by taking money away from the IRS. I hope he stands by his word. I think he has an enormous leverage, if he will use it.  \nNow, he's getting pushed by all the establishment Republicans, particularly on the Senate side. He's being pushed to put \nall the aid together with Ukraine. I think, if he keeps it separate and keeps it paid for, I think that he will win the day, \nultimately. But he needs to realize he has all the power, if he will stay where he is and not capitulate. \n \n«BARTIROMO »: All right, Senator, we will be watching all of that. \nThank you again for being a truth-teller in all of these health issues. \n \nPAUL: \nThank you. \n \n«BARTIROMO »: We appreciate your time this morning, sir. \nThank you, Senator Rand Paul, for joining us. \n \n \n \n \n \n \n  \n \n====================================================== \nClassification: UNCLASSIFIED \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From: Morgan Muir-DNI-\nSent: Friday, September 27, 2024 2:39 PM\nTo:  Michael L. Collins-DNI-;  \nCc:\nSubject: RE: Readout of HPSCI COVID Origins briefing \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nThanks.  That seems about as good as it gets these days.   \n \n intervention tracks with my recollection as well. \n \nLet me know if we don’t hear back from FBI. \n \nM \n \nFrom:   Sent: Friday, September 27, 2024 2:26 PM \nTo: Michael L. Collins-DNI-  \n \nCc:  \nSubject: Readout of HPSCI COVID Origins briefing  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n Yesterday, the HPSCI Oversight and Investigations Subcommittee had a closed IC briefing/hearing (it was on the \nrecord) on COVID origins. I was the lead briefer, with speakers from CIA, DIA/NCMI, FBI, and DOE. Subcommittee Chair \nWenstrup and Ranking Member Gomez attended, along with Reps Jackson and Fitzpatrick.  \n \n This HPSCI briefing went a lot better than the one I led in September 2021 (my readout of that below). Rep Wenstrup began his opening statement by pointing out that the last time he was briefed on this issue the IC refused to \nanswer his simple questions…which was specifically directed at me (and a gross mischaracterization of what happened \nthree years ago). But then he dropped the issue and moved on. In fact, the briefing was remarkably nonconfrontational \n(or at least no more so than usual) considering the tone of the COVID-O briefings held by Wenstrup’s other \nsubcommittee, the Select Subcommittee on the Coronavirus Pandemic, which have been decidedly anti anyone not \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2holding the lab leak theory. To be fair, Wenstrup, Jackson, and Fitzpatrick all pushed back on any response to their \nquestions that didn’t support the lab leak narrative…but Wenstrup and Jackson were both polite about it (Fitzpatrick \nwas not, but left after about 20 minutes) and even went out of their way to express their appreciation for all of the IC’s \nwork on the issue.   \n \n Things did a tad heated when Wenstrup asked NCMI about a “white paper” some of their analysts did in 2020 in \nresponse to the “Proximal Origins” paper that has been the source of so much angst. The authors of that “white paper” \nfelt that their conclusions were ignored by broader DIA and ODNI leadership and testified to this fact in Wenstrup’s \nother subcommittee. The NCMI rep seemed unprepared for the question (I don’t know why…it seemed obvious to me \nthat they would be asked about it), which annoyed Wenstrup. He also elliptically asked CIA about reports that their \nanalysts shifted from lab to undecided. This was in reference to another “whistleblower” who testified to his other \nsubcommittee that CIA paid its analysts to not make the lab leak call. , who was back-benching his WCPMC \nbriefer, jumped in and explained that he made the call to stop the shift to lab because  had come in the day \nbefore they were ready to publish which made them back off the call.  \n \n One potential problem did come up related to FBI. Wenstrup asked the FBI briefer point \nblank if they had interviewed   \n He also asked if any information  \ninformed FBI’s assessment. The FBI rep replied that they had interviewed  on COVID origins and that the information \ndid inform their assessments. The problem here is that we know  had not been \ninterviewed by FBI until late June 2021 (outside of a non-related interview in 2010)…three months after FBI made their \norigins call. We also know that at that interview  said nothing about COVID origins. If they interviewed  \nabout COVID-O it has not been disseminated, as far as I can tell. Meaning: FBI has either been withholding information \nfrom the rest of the IC, or they provided inaccurate information on the record yesterday. I sent a note to the briefer this \nmorning requesting follow-up, but she has not responded.  \n \nThanks! –   \n \nFrom:   Sent: Thursday, September 23, 2021 3:50 PM \nTo:  Morgan Muir-DNI-  \n \nSubject: Readout of contentious HPSCI COVID Origins briefing  \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n and I, along with three reps from NCPC and  from OLA, briefed the HPSCI this morning on the COVID \nOrigins assessment. It did not go well. After Opening remarks from Reps Schiff and Nunes, I started off with prepared \nremarks that went about 10 minutes, going over the processes involved in the 90-day study and then highlighting the \nkey takeaways. Rep Schiff asked a couple of easy questions and then turned it over to Rep Nunes, who yielded his time \nto Rep. Wenstrup. Then everything went downhill.  \n \nRep Wenstrup spent the first big chunk of his time identifying a number of open source documents that he wanted read \ninto the record (which was agreed to), in particular papers on the threat of SARS as a bioterror weapon (from 2005), \nstatements Fauci made on the general idea of gain of function research back in 2012,  work on chimeric \nviruses in 2015, and similar stuff. After quite a while of talking he finally started to ask questions. They mostly centered \n\n3on the names of the experts the IC reached out to on COVID origins. I told him that I was unable to reveal the names of \nthe experts we reach out to. Which is also exactly what I told the staffers during the pre- briefing we did on Tuesday. Rep \nWenstrup even acknowledged before he asked the first time that he knew what my response would be but was going to \nask anyway. He was, to put it mildly, not happy with my answer. In fact, he seemed pretty outraged. After that, it was \nmore of the same. Every single minority member who asked questions spent the first two-three minutes of their allotted \nfive minutes expressing outrage and disdain over my behavior. One, not sure who because this was all a blur, even said \n“shame on you.” At one point, a member turned his time back to Rep Wenstrup who went through a long list of names \nof “experts” (air quotes because the expertise of some he named is iffy in my mind) and asked me if anyone in the IC had \nconsulted with them…apparently because he wanted me to be on the record each time saying “I am not going to \ncomment on that.” I repeatedly tried to explain that IC policy was to not reveal the names of the experts we reached out \nto for source protection reasons, which just seem to enrage then all even more. Several of the minority members \nclaimed that they had been staunch defenders of the IC in the past but now “will not have your back.” I heard a lot of \n“nobody has ever come in here and refused to answer our questions” and the comments/question got heated on their \nend and were pretty over the top. Several times I tried to answer a question only to be interrupted by whoever asked \nthe question and a couple even said something along the lines of “I don’t want to hear that ‘it’s against policy’ crap.”  \n \nNot to pick on the minority members, some of the majority members also were not pleased with the briefing. Rep. \nSpeier seemed annoyed that our assessment focused too much on  and wanted us to agree to talk to \none of her constituents who was in Wuhan in November of 2019 on a riverboat cruise (I kid you not). Her time ran out \nbefore she asked that and she didn’t press the issue. Rep Krishnamoorthi also expressed surprise and disappointment \nover my refusal to identify the experts and said it made us (the IC) “look bad.” \n \nIt seemed clear to me that few if any of the members actually read the Updated Assessment…or were paying attention \nto my prepared remarks. One of the minority members (I can’t remember which) challenged me to identify anything \nnew that I had mentioned up to that point that was not in open sources. That question frankly baffled me, but I pointed \nout that I had literally just talked about  WIV researchers who were reportedly sick in the Fall of 2019. \nMembers from both parties seemed surprised and confused that FBI came to a different conclusion than other IC \nagencies. More than one asked me if FBI had access to information that they had not shared with the IC, and one \nmember (I think it was Rep Carson) asked me and  if we thought FBI was an equal and honest partner in the \nprocesses (despite some of our issues with FBI, we both stated “yes”). Nobody seemed to understand what “low \nconfidence” means; even after I explained multiple times that low confidence meant that we had gaps in our \ncollection/reporting on issues (and went into specific details in a few cases) I got the same confused questions about \nconfidence levels.  \n \nWith regard to the minority members question on experts, I think this was a set-up. They were looking for a reason to \ndistance themselves from the Updated Assessment and that was the issue they chose. Again, they knew we were not \ngoing to name the experts because this came up at the pre-brief Tuesday. And at no time during that call did any of the \nminority staffers indicate that this was going to be a problem It’s actually kind of laughable, because every expert they \nnamed was consulted by the IC. Maybe I could have explained the reason we weren’t going to provide the names in a \nway that would have resulted in less vitriol…but I doubt it.  \n \nAnyway, I would expect the DNI  to receive angry letters from the Hill calling my professionalism into question and \ndemanding that the IC name names. And maybe that I be fired.  \n \n \n \n  \n  \n \n \n \n \n\n4 \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\n1From:\nSent: Tuesday, June 8, 2021 9:31 AM\nTo:\nSubject: FW: Readout of Fauci briefing\nAttachments: fauci readout.ida.docx\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \n \n \n \nChief of Analysis, Chemical Biological Department \nWeapons and Counterproliferation Mission Center \n   \n \nFrom:   \nSent: Monday, June 7, 2021 5:08 PM \nTo:  \n \nCc:  \nSubject: Readout of Fauci briefing \n \nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nHi All, \n \nAttached and pasted below you’ll find a readout of the Dr. Fauci briefing.  There was clearly a bit of a disconnect with \nthe NSC about the scope of the briefing, but I was in touch with  today via email who expressed interest in a \nsecond follow-on briefing for Fauci in person.  He provided a few promising POCs for DA outreach—including Andersen \nat Scripps who we are meeting, with DTIC, next week.  Dr. Fauci was also interested, and presumably not tracking, the \nspecific pangolin coronavirus research that the WIV was doing.  You’ll see this reflected in a WCP update too. \n \nHappy to answer any questions. \n \nBest, \n \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026", "summary": "NIAID, NIH grant records, EcoHealth Alliance contracts and related funding documentation linking US dollars to Wuhan Institute of Virology gain-of-function research.\n\nFirst-page excerpt: 1From: Sent: Tuesday, July 20, 2021 8:11 AM To: Cc: Subject: RE: Possible reviewers for COVID Origins assessment  Classification:     Classified By:   Derived From:   Declassify On:   ======================================================    is …which I gather make him some kind of lobbyist, since that firm’s sole  purpose to promote the imagery products of its parent company to the US government.  is a   .  is an interesting idea, given his background at CIA and the NIC.  I’ll add him to the list and drop  and Clapper.     From:    Sent: Monday, July 19, 2021 3:48 PM  To:   Cc:   Subject: RE: Possible reviewers for COVID Origins assessment     Classification:     Classified By:   Derived From:   Declassify On:   ======================================================    Also, not Sue…", "source_url": "https://assets.newsweek.com/wp-content/uploads/2026/06/COVID-19-Release-DNI-Gabbard-6-18-Part-2.pdf", "pdf_url": "/archive-docs/fauci-files/3a34ae9a412df66ed9f0e9af67a92130/pdf", "doc_date": "2026-06-18", "case": "covid-19-origins", "sub_case": "dni-gabbard-2026-release", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "covid origins", "covid origin", "covid release", "covid coverup", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "biolab", "biolabs", "dni release", "odni release", "intelligence release", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins"], "page_count": 97}
{"title": "Fauci Exposed Files — Part 3", "content": "1From:\nSent: Tuesday, June 8, 2021 12:35 PM\nTo:\nSubject: New Daszak video going around\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nHey guys, \n \nJust saw this video online. It’s from a 2016 NY Academy of Medicine meeting where Daszak talks about his colleagues in \nChina manipulating the spike protein on coronavirus to make them more virulent. \n \nSorry I can’t glide the video over. I have a contact in OSE but we don’t have access to a common shared drive location to \ndrop the video. You’ll have to retype the link into your browser on the low side. \n \nhttps://rumble.com/vi8qwj-fauci-funded-daszak-describes-colleagues-in-china-manipulating-viruses-into.html   \n-  \n \n \n \n \n \n \n \n \n \n====================================================== \nClassification:  \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n1From:\nSent: Thursday, May 27, 2021 5:37 AM\nTo:\nSubject: Office of the Director of National Intelligence News Summary for   Thursday, May 27, \n2021 - [Link to Attachment(s)]\nClassification: UNCLASSIFIED \n====================================================== \n \nOFFICE OF THE DIRECTOR OF NATIONAL INTELLIGENCE NEWS SUMMARY \n \nTO: THE DIRECTOR AND SENIOR ODNI STAFF \n \nDATE: THURSDAY, MAY 27, 2021 5:30 AM EDT \n \nTODAY'S TABLE OF CONTENTS \n \nLEADING THE NEWS: \n + Biden Directs Intelligence Community To Investigate Origins Of Coronavirus.  \n<> \n \nOFFICE OF THE DIRECTOR OF NATIONAL INTELLIGENCE: \n + NCSC Acting Director Takes Part In “CNBC Evolve.” <> \n + Three GOP Senators Oppose Fonzone’s Nomination Over Huawei Work. <> \n \nINTELLIGENCE COMMUNITY: \n \nCIA: \n + Trump Sent CIA To Obtain PPE Ahead Of Other Countries During COVID-19  \nPandemic, Former Top UK Aide Says. <> \n \nNSA: \n + NSA Shifts Focus To “New Physical, Virtual Hubs” For Unclassified Work. <> \n \nArmy: \n + Senate Reverses Wormuth’s Confirmation As First Woman Army Secretary. <> \n + US ARL Launches $68M AI, Robotics Partnership With Maryland Universities. <> \n \nAir Force: \n + Air Force Secretary Says No Further MQ-9 Reaper Procurement Needed. <> \n + Air Force Develops Strategies For Data Sharing. <> \n \nDEPARTMENT OF DEFENSE: \n + Gen. Milley Cites “Fraying” Relations With China, Russia. <> \n + DCSA’s Trusted Workforce 2.0 Initiative To Include All Agencies,  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2Contractors By End Of 2023. <> \n + US Lawmakers Seek Funding For Defense Industrial Facilities. <> \n \nJUSTICE DEPARTMENT: \n + DOJ Reportedly Mulling Further Charges Over 2016 Election Misinformation. <> \n + Sources: DOJ Prepared To Sue Developer If He Does Not Register As Lobbyist  \nUnder FARA. <> \n \nU.S. NEWS: \n + New Research Indicates COVID Immunity Could Last Over A Year. <> \n + GOP Expected To Filibuster January 6 Panel Thursday. <> \n + Biden Calls For Congressional Action In Wake Of San Jose Mass Shooting. <> \n + Amid Rising Crime, Cities Restore Police Funding. <> \n + Biden Expected To Tap Burns As Ambassador To China, Garcetti As Ambassador  \nTo India. <> \n + ATF Nominee Faces Pushback From GOP, But Likely To Be Confirmed. <> \n + Jean-Pierre Presides Over Historic First Televised White House Briefing. <> \n + Biden Under Pressure To Confront Anti-Semitism After Attacks. <> \n + Sen. Tim Scott: “June Or Bust” For Reaching Deal On Police Reform. <> \n + ExxonMobil Dealt “Major Blow” In Board Shake Up. <> \n + Diplomats Ask State Department To Provide More Support For “Havana  \nSyndrome” Victims. <> \n + Execs Say Biden Plan To Import Metals For EVs Could Keep Us From Meeting  \nClimate Goals. <> \n + Mayorkas Defends Title 42. <> \n + Democrats Unable To Move Forward With Plan To Lower Prescription Drug  \nPrices. <> \n + Columnist Highlights GAO Report About Making Government More Efficient,  \nWith Savings Of $1B Or More. <> \n + Michigan Secretary Of State “Deeply Concerned About The Future Of Our  \nDemocracy.” <> \n \nINTERNATIONAL NEWS: \n \nAfrica: \n + After Military Takeover, Interim President, PM Of Mali Resign. <> \n + Suspected Islamist Attack Kills 22 In The Democratic Republic Of Congo. <> \n + UN Official Warns That Ethiopia’s Tigray Region Is On The Brink Of Famine.  \n<> \n + NBC: US “Quietly Returning” To Libya. <> \n + Report On Italian Ambassador’s Death In Congo Indicates “Poorly Planned,  \nClumsily Executed Act.” <> \n \nNear East: \n + Blinken Departs Middle East With Cease-Fire Intact, Pledges To Aid With  \nRebuilding. <> \n + Assad Votes In Former Rebel Stronghold, Touts Election As Evidence Of  \nSyrian Unity. <> \n3 + Iraqi Forces Arrest Militia Commander Over Alleged Involvement In Attacks  \nOn Air Base Used By US. <> \n + Hamas Leader Says 80 Fighters Killed. <> \n \nIran: \n + IAEA Head: Iran Enriching Uranium At Weapons-Grade Level. <> \n \nEurope: \n + WHO COVAX Program Falls Short Despite Intentions Of Developed Nations,  \nVaccine Manufacturers. <> \n + EU Tells Brussels Court AstraZeneca Failed To Fulfill Its Vaccine  \nCommitments. <> \n + Slovakia Authorizes Use Of Russia’s Sputnik V Vaccine. <> \n + France Praises YouTube Users Who Resisted Vaccine Misinformation Campaign.  \n<> \n \nRussia & Eurasia: \n + Lukashenko Accuses West Of Engaging In “Hybrid War” Against Belarus. <> \n + Sasse Among Those Critical Of Biden’s Decision To Meet With Putin. <> \n \nChina: \n + NSC’s Kurt Campbell: Broad Engagement With China “Has Come To An End.” <> \n + CRS: China Supplying Nuclear, Missile Technology To North Korea, Iran. <> \n + Senate GOP Could Block Bipartisan Plan To Confront China. <> \n + Senate Legislation Would Add National Security Reviews Of Chinese Donations  \nTo US Universities. <> \n + Tesla To Establish Data Center In China For Local Data Storage. <> \n + Closed Chinese Consulate In Houston Was “Major Hub” For Espionage, Study  \nIndicates. <> \n \nEast Asia: \n + Japan Facing New COVID Surge Ahead Of Summer Olympics. <> \n + Espionage Trial Of Australian Blogger To Open In China On Thursday. <> \n + Campbell: US Hoping For Fall Quad Meeting On Infrastructure. <> \n + Kim Vows “Uncompromising Struggle” To Build Socialism In North Korea. <> \n + McConnell Praised Administration For Burma Coup Response. <> \n + US Envoy Confident Taiwan Can Deal With Spike On Covid Cases. <> \n \nSouth Asia: \n + Taliban Warns Afghanistan’s Neighbors Against Hosting US Troops. <> \n + Pakistani Journalist Alleges Intelligence Agents Attacked Him In His  \nApartment. <> \n + WhatsApp Sues Indian Government Over Message Traceability Rules. <> \n + NYTimes: Official Figures “Grossly Understate” Pandemic Impact In India. <> \n \nWestern Hemisphere: \n + AMLO’s Party Expected To Maintain Control Of Lower House. <> \n + Mayoral Candidate Killed In Mexico, 34th Of This Election Cycle. <> \n4 + Former Bolivian Interior Minister Arrested In US For Money Laundering. <> \n \nCYBERSECURITY: \n + Colonial Pipeline Rebuffed TSA Security Review Before Hack. <> \n + Biden Budget Request To Grow Cyber Command. <> \n + Russia’s FSB Reports “Unprecedented” Hacking Campaign. <> \n + Facebook: Russia Top Producer Of Disinformation. <> \n + Hackers Release New Zealand Patient Data. <> \n + Canada Post Notifies Business Customers Of “Data Breach Affecting 950K  \nCustomers.” <> \n + Bipartisan Encryption Bill Introduced In House. <> \n \nEDITORIAL ROUNDUP: \n + Washington Post. <> \n + Wall Street Journal. <> \n \nTHE BIG PICTURE: \n + Headlines From Today’s Front Pages. <> \n \nLeading The News: \n \nBIDEN DIRECTS INTELLIGENCE COMMUNITY TO INVESTIGATE ORIGINS OF CORONAVIRUS. <>  \nCNN  \n \n (5/26,Judd, 89.21M) reports on its website that on Wednesday, President Biden  \n“said...he has directed the US intelligence community to redouble their efforts  \nin investigating the origins of the Covid-19 pandemic and report back to him in  \n90 days.” According to CNN, “The announcement comes after a US intelligence  \nreport found several researchers at China’s Wuhan Institute of Virology fell  \nill in November 2019 and had to be hospitalized – a new detail that fueled  \nfurther debate about the origins of the coronavirus pandemic.” \n \nUSA Today  \n \n (5/26,Groppe, 12.7M) reports that Biden “also said he wants to know what  \nfurther areas of inquiry are needed, including specific questions for China.”  \nBut USA Today says “it’s not clear how the administration will get cooperation  \nfrom China, which has accused the United States of hyping ‘the lab leak  \ntheory.’” On Wednesday, White House Principal Deputy Press Secretary Karine  \nJean-Pierre said, “We’re just going to continue to work with (the World Health  \nOrganization) and WHO is going to continue to work with China on this.” USA  \nToday reports that Jean-Pierre “declined to say whether the 90-day report’s  \nconclusions will be made public.” \n \nReuters  \n \n (5/26) reports that Biden “said that U.S. intelligence are looking into two  \ndifferent scenarios, that they do not have high confidence in their current  \n5conclusions and that they are divided on which is most likely.”Politico  \n  \n(5/26, Leonard, 6.73M) says that in his statement, Biden “notably did not  \ndetail the two theories between which the intelligence community is split,” but  \n“did note that he had ordered a review of the pandemic’s origins, ‘including  \nwhether it emerged from human contact with an infected animal or from a  \nlaboratory accident.’” According to Politico, Biden “said two elements of the  \nintelligence community lean toward one scenario while another element of the  \ncommunity leans toward another, ‘each with low or moderate confidence.’”  \nHowever, “the remainder of the intelligence community, which Biden said  \nconstituted its majority, ‘do not believe there is sufficient information to  \nassess one to be more likely than the other.’” \n \n The New York Times  \n  \n(5/26, Gamio, Glanz, 20.6M) reports that “in the past several days, the White  \nHouse had downplayed the need for an investigation led by the United States and  \ninsisted that the World Health Organization was the proper place for an  \ninternational inquiry.” According to the Times, “Biden’s statement was an  \nabrupt shift, though officials declined to be specific about the shift.” \n \n The Washington Post  \n \n (5/26, 10.52M) reports that on Tuesday, Health and Human Services Secretary  \nBecerra “told an annual ministerial meeting of the World Health Organization  \nthat international experts should be given ‘the independence to fully assess  \nthe source of the virus and the early days of the outbreak.’” According to the  \nPost, “Becerra’s remarks...signaled that the Biden administration would  \ncontinue to press the WHO to expand its investigation to determine the virus’s  \norigins.” TheWall Street Journal  \n \n (5/26, A1, Leary,Gordon, Subscription Publication, 8.41M) reports that China  \nresponded to Secretary Becerra, arguing that the WHO completed its  \ninvestigation earlier this year. The Chinese representative added that the WHO  \nshould begin investigating other nations instead. \n \n The Washington Post  \n \n (5/26, 10.52M) says, “The new message from the White House reflects the  \nrapidly changing views about the origins of the virus.” According to the Post,  \n“In recent weeks, a theory has gained more support that the source of the  \ncoronavirus...may have emerged from the Wuhan Institute of Virology in China,  \nthough that is far from proved.” The Post adds, “Some Republicans had pushed  \nthe idea early on, including former president Donald Trump, who at times used  \ninflammatory language to describe the virus and its origins in China. But the  \nidea was dismissed by many influential scientists and Democrats, who viewed the  \nGOP focus on the lab as part of a larger attack on China that fueled an  \nincrease in hate crimes against Asian Americans.” \n6 \nCNN  \n \n (5/26,Judd, 89.21M) notes that it “reported on Tuesday  \n \n that Biden’s team shut down a closely held State Department effort launched  \nlate in the Trump administration to prove that Covid-19 originated in a Chinese  \nlab over concerns about the quality of its work.” However,The Hill  \n \n (5/26, Schnell, 5.69M) reports that “individuals in the Trump administration  \nwho worked on the project...rebuffed criticisms of their work...contending that  \ntheir intention was to analyze scientific research and information from the  \nU.S. intelligence community that bolstered the Wuhan lab leak theory, and  \nreveal more information on how the virus could have leaked from a lab.” \n \nPolitico  \n \n (5/26,Desiderio, Banco, 6.73M) reports that at the same time, “support is  \ngrowing in Congress for a probe of the origins of the Covid-19 pandemic, an  \neffort that could pit Democratic lawmakers against the Biden administration as  \nChina hawks draw new attention to the theory that the virus leaked from a Wuhan  \nlab.” According to Politico, “The ongoing discussions on Capitol Hill represent  \na remarkable bipartisan agreement” after Democrats “previously dismissed the  \nlab leak theory as a GOP talking point. ... ‘As we analyze what went wrong and  \nwhat we can do in the future, we have to have answers to these questions, too,’  \nsaid Sen. Tim Kaine (D-Va.), a member of the Senate’s health committee.” \n \n Lauren Frias writes for Insider  \n \n (5/26, 2.74M) that “Rep. Adam Schiff said Wednesday it is ‘critical’ for the  \nUS to finish its investigation into the origins of COVID-19 to ‘avoid any  \npremature or politically-motivated conclusions.’” \n \nCNBC  \n \n (5/26,Wilkie, Mendez, 7.34M) reports on its website that “the hypothesis that  \nthe virus may have escaped from a Chinese laboratory, while initially dismissed  \nby some as a conspiracy theory, has in recent months gained more mainstream  \ntraction.” CNBC points out that Centers for Disease Control and Prevention  \nDirector Rochelle Walensky “recently said in Senate testimony that a lab-leak  \norigin ‘certainly’ was ‘one possibility.’” CNBC adds that “the scrutiny on that  \nlab ramped up this week when The Wall Street Journal reported that three  \nresearchers there had been sick with Covid-like symptoms in November 2019,  \nshortly before the first cases of the virus were reported.” \n \n Primetime media coverage of Biden’s announcement includes NBC Nightly News  \n \n (5/26, story 2, 1:50, Holt, 4.76M),CBS Evening News  \n7 \n (5/26, story 2, 2:20,O'Donnell, 3.75M), and ABC World News Tonight  \n \n (5/26, story 2, 3:20,Muir, 6.02M). \n \nFox News  \n \n (5/26,Singman, 23.99M), Bloomberg  \n \n (5/26,Wingrove, 3.57M), and The Hill  \n \n (5/26,Chalfant, Weixel, 5.69M) provide additional coverage of Biden’s  \nannouncement. \n \nSenate Unanimously Passes Bill Ordering ODNI To Declassify Documents On  \nCOVID-19’s Origin. Newsweek  \n \n (5/26,Villarreal, 2.67M) reports The Senate has unanimously passed “a bill  \ndeclassifying federal information on the origins of COVID-19 as President Joe  \nBiden ordered a deep investigation into the cause of the global pandemic.” The  \nSenate bill “orders the Director of National Intelligence (DNI) to declassify  \ndocuments detailing any of the WIV’s connections to COVID-19.” \n \nFox News  \n \n (5/26, Ruiz, 23.99M) also reports. \n \nChinese Embassy In US Warns About Politicizing Origins Of COVID-19. Reuters  \n \n (5/27,Stanway) reports politicizing the origins of COVID-19 “would hamper  \nfurther investigations and undermine global efforts to curb the pandemic,  \nChina’s U.S. embassy said after President Joe Biden ordered a review of  \nintelligence about where the virus emerged.” In a statement on its website  \nWednesday evening, the embassy in Washington said “some political forces have  \nbeen fixated on political manipulation and (the) blame game.” The Chinese  \nembassy said it supports “a comprehensive study of all early cases of COVID-19  \nfound worldwide and a thorough investigation into some secretive bases and  \nbiological laboratories all over the world.” \n \nFauci Defends US Funding To Chinese Research Organizations. Fox News  \n \n (5/26,McFall, 23.99M) reports that during an appearance at the Senate on  \nWednesday, NIAID Director Dr. Fauci “told lawmakers that he trusted Chinese  \nscientists at the Wuhan Institute of Virology, saying he did not believe they  \nattempted to modify viruses to make them more contagious.” Sen. John Kennedy  \n(R-LA) asked Fauci, “How do you know they didn’t lie to you and use the money  \nfor gain of function research anyway?” Fauci, in his response, “explained that  \nthe National Institutes of Health (NIH) had seen the results of the experiments  \n8conducted using U.S. government funds, adding that the viruses studied could  \nalso be found in public databases.” Fauci said, “In our experience with  \ngrantees, including Chinese grantees…they’re very competent, trustworthy  \nscientists.” \n \nFacebook Reverses Policy, Allowing Posts Claiming COVID-19 Man-Made. Politico  \n  \n(5/26,Lima, 6.73M) reports Facebook will no longer “take down posts claiming  \nthat Covid-19 was man-made or manufactured, a company spokesperson told  \nPOLITICO on Wednesday, a move that acknowledges the renewed debate about the  \nvirus’ origins.” Facebook’s “policy tweak” arrives as support “surges in  \nWashington for a fuller investigation into the origins of Covid-19 after the  \nWall Street Journal reported that three scientists at the Wuhan Institute of  \nVirology were hospitalized in late 2019 with symptoms consistent with the  \nvirus.” A Facebook spokesperson said Wednesday, “In light of ongoing  \ninvestigations into the origin of COVID-19 and in consultation with public  \nhealth experts, we will no longer remove the claim that COVID-19 is man-made  \nfrom our apps.” \n \nThe Hill  \n \n (5/26, Polus, 5.69M),Axios  \n \n (5/26,Falconer, 1.26M), and ABC News  \n \n (5/26,Pezenik, Gallagher, 2.44M) also report. \n \nWPost: China Must Increase Transparency To Support International COVID  \nResearch. The Washington Post  \n \n (5/26, 10.52M) argues that the ongoing international investigation into  \nCOVID’s origins is critical, and China “should help solve this mystery, but it  \nso far has thrown a cloak over it.” While China “steadfastly denies there was  \nan inadvertent leak from the Wuhan Institute of Virology,” the only way to  \nresolve the question of China’s potential culpability is to support the WHO’s  \nongoing investigation. \n \nWSJournal: The Lab-Leak Theory Deserves True Scrutiny. The Wall Street Journal  \n \n (5/26, Subscription Publication, 8.41M) examines the efforts made by  \nscientists, media personalities, and government officials to disregard the  \nlab-leak COVID origin theory last year, and it criticizes the slow reversal of  \nopinion over the past few months. The Journal calls on scientists and other  \nexperts to conduct a thorough investigation in order to better protect the US  \nfrom future pandemic threats. \n \nOffice of the Director of National Intelligence: \n \n9NCSC ACTING DIRECTOR TAKES PART IN “CNBC EVOLVE.” <> CNBC  \n \n (5/26,Javers, 7.34M) reports its “CNBC Evolve: Cybersecurity” livestream event  \non May 26 explored “efforts to protect our nation’s cyber infrastructure and  \nidentify threats, with actionable advice on ways the government and private  \nenterprise can work together to anticipate threats before they happen.” Eamon  \nJavers led the “conversation with John Demers, Department of Justice’s National  \nSecurity Division Assistant Attorney General and Michael Orlando, National  \nCounterintelligence and Security Center Acting Director.” \n \nCNBC  \n \n (5/26,Rosenbaum, 7.34M) reports separately that Orlando said, “We do know that  \ncountries like Russia and China, Iran and others certainly create safe havens  \nfor criminal hackers as long as they don’t conduct attacks against them. But  \nthat’s a challenge for us that we’re going to have to work through as we figure  \nout how to counter ransomware attacks.” Orlando also “said it would be a  \nmistake to focus only on ransomware, but it is true that the nation state  \nactors are most interested in inserting malware into those systems.” \n \nTHREE GOP SENATORS OPPOSE FONZONE’S NOMINATION OVER HUAWEI WORK. <> CNBC  \n \n (5/27,Ng, 7.34M) reports three Republican senators have “jointly voiced  \nopposition to a Biden administration nominee for legal counsel at the Office of  \nthe Director of National Intelligence because of his past work for Chinese tech  \ngiant Huawei.” Of the members of the “Senate Select Committee on Intelligence,  \nfour voted against Christopher Fonzone’s nomination, including senators Ben  \nSasse of Nebraska, Marco Rubio of Florida and Tom Cotton of Arkansas.” \n \nIntelligence Community: \n \nCIA: \n \nTRUMP SENT CIA TO OBTAIN PPE AHEAD OF OTHER COUNTRIES DURING COVID-19  \nPANDEMIC, FORMER TOP UK AIDE SAYS. <> Newsweek  \n \n (5/26,Cole, 2.67M) reports Dominic Cummings “said that ex-President Donald  \nTrump sent the CIA in order to obtain Protective Personal Equipment ahead of  \nother countries during the coronavirus pandemic.” The article adds that  \n“Cummings, who left Downing Street in November 2020 after a bitter split with  \nJohnson, said the U.K. had been lagging in its efforts to get essential  \nequipment and that the British Department of Health’s PPE procurement process  \nwas ‘completely hopeless.’” Cummings added, “At this point we had Trump sending  \nthe CIA round trying to gazump everybody on PPE.” \n \nNSA: \n \nNSA SHIFTS FOCUS TO “NEW PHYSICAL, VIRTUAL HUBS” FOR UNCLASSIFIED WORK. <>  \n10FedScoop  \n \n (5/26,Mitchell) reports the NSA has developed “new physical and virtual  \nworkspaces to support collaboration around its unclassified work.” The  \ncoronavirus forced the NSA “to accelerate the launch of the hubs where NSA  \npersonnel and contractors can securely work together in-person and online on  \nunclassified workloads, said Rebecca Guzman, who leads the rollout of the  \nUnclassified Work Environment program.” Speaking to Riverbed’s Network  \nTransformation Summit, Guzman cited an effort to “establish a more agile, more  \nefficient way to sustain our workforce, regardless of where they were coming  \nfrom. And so as a result, we’ve created new unclassified options, both  \nvirtually and physically.” Guzman also “said it forced NSA to bring greater  \nfocus to using non-customized commercial technologies both for the speed of  \ndelivery and the collaborative utility inherent in off-the-shelf software.” In  \nits physical collaboration spaces, NSA provides “modernized technology and  \nsmart devices to allow folks to have a space to be able to do some of that  \ncollaboration with partnership outside the agency,” Guzman said. \n \nArmy: \n \nSENATE REVERSES WORMUTH’S CONFIRMATION AS FIRST WOMAN ARMY SECRETARY. <> Army  \nTimes  \n \n (5/26, Winkie, 395K) reports Christine Wormuth nearly became “the first woman  \nin US history to ascend to the Army’s top civilian post when the Senate  \nconfirmed her Wednesday evening – until the body reversed her confirmation just  \nhours later in an unusual development.” CSPAN footage of the proceedings “shows  \nMajority Leader Sen. Chuck Schumer, D-NY, announcing the reversal,” and  \nSchumer’s staff did not “immediately respond to a request for clarification  \nfrom Army Times, and the senator deleted a previous tweet hailing Wormuth’s  \nconfirmation.” In a tweet Wednesday, Roll Call reporter Andrew Clevenger called  \nthe move as “more like a procedural hiccup than a threat to her historic  \nconfirmation.” \n \nUS ARL LAUNCHES $68M AI, ROBOTICS PARTNERSHIP WITH MARYLAND UNIVERSITIES. <>  \nTheBaltimore Business Journal  \n \n (5/26,Eichensehr, Subscription Publication, 858K) reports the US Army Research  \nLaboratory is “partnering with the University of Maryland, College Park and  \nUniversity of Maryland, Baltimore County to develop new artificial  \nintelligence, robotics and autonomous technologies that can help soldiers and  \nfirst responders operate more safely and efficiently in dangerous situations.” \n \nAir Force: \n \nAIR FORCE SECRETARY SAYS NO FURTHER MQ-9 REAPER PROCUREMENT NEEDED. <> Defense  \nNews  \n \n11 (5/26,Insinna, 73K) reports a “battle is brewing” over the fate of “the MQ-9  \nReaper, with a letter from the U.S. Air Force’s top civilian signaling that the  \nservice will again seek to curtail procurement of the General Atomics-made  \ndrone in the upcoming fiscal 2022 budget.” \n \nAIR FORCE DEVELOPS STRATEGIES FOR DATA SHARING. <> ExecutiveGov  \n \n (5/26, Martin) reports the Department of the Air Force has developed “four  \noptions to guide the data-sharing activities of both the U.S. Air Force and  \nU.S. Space Force, Breaking Defense reported Tuesday.” The department developed  \n“these options based on the results of the Data and Infrastructure Architecture  \nSummit, which commenced in March and ran for two weeks.” Air Force leaders will  \n“assess the options and decide in June 2021 on which to execute. The  \ndepartment’s Chief Architect Integration Office will then develop a minimum  \nviable product based on what Air Force leadership decides on.” \n \nDepartment of Defense: \n \nGEN. MILLEY CITES “FRAYING” RELATIONS WITH CHINA, RUSSIA. <> Fox News  \n \n (5/26,McFall, 23.99M) reports in a commencement address to “Air Force Academy  \ngraduates, General Mark Milley, Chairman of the Joint Chiefs of Staff, said the  \nUS is toeing a dangerous line in maintaining an appropriate level of  \ncompetition with China and Russia.” Milley told the graduates “We are now in  \nthe 76th year of the great power peace following WWII. And it is under stress,  \nwe can see it fraying at the edge,” adding, “Right now we are in a great power  \ncompetition with China and Russia. And we need to keep it at competition and  \navoid great power conflict.” \n \nDCSA’S TRUSTED WORKFORCE 2.0 INITIATIVE TO INCLUDE ALL AGENCIES, CONTRACTORS  \nBY END OF 2023. <> Defense News  \n \n (5/26,Bur, 73K) reports the DCSA’s new program for “continuously monitoring  \nindividuals with security clearances, Trusted Workforce 2.0, should have all  \nagencies and contractors onboarded by the end of 2023, the agency’s director,  \nWilliam Lietzau, said at a May 26 roundtable with the House Oversight and  \nReform Committee.” Trusted Workforce 2.0 aims to “have clearance-holders  \nundergo continuous vetting, meaning that investigation systems are continuously  \ncollecting data about individuals to evaluate their security risk.” \n \nDOD Making Progress On Security Clearance Progress, “But Reciprocity, IT  \nIssues Remain.” NextGov  \n \n (5/26,Jasper) reports as the DCSA makes progress “on an issue the National  \nSecurity Commission on Artificial Intelligence pinpointed as in need of  \n‘substantial reform,’ problems around the status of both the legacy and new IT  \nsystems that deal with background investigations as well as with reciprocity,  \nor the ability of one agency to accept an individual’s security clearance  \n12granted by another agency, remain.” DCSA Director William Lietzau reported  \nWednesday to a House Committee on Oversight and Reform “government operations  \nsubcommittee roundtable hosted by Rep. Gerry Connolly, D-Va., chairman of the  \nsubcommittee.” Within the last year, “the agency established a building block  \nfor its Trusted Workforce 2.0 continuous vetting program called Trusted  \nWorkforce 1.25, which has allowed for continuous vetting of some 3 million  \nsecurity clearances.” Lietzau “acknowledged that there’s still work left to be  \ndone.” \n \nUS LAWMAKERS SEEK FUNDING FOR DEFENSE INDUSTRIAL FACILITIES. <> Politico  \n \n (5/26,Bender, 6.73M) reports bipartisan advocates of “military depots and  \narsenals are now pressing House leaders to incorporate funding for a host of  \ndefense industrial facilities into a potential multitrillion-dollar package.”  \nReps. Cheri Bustos of Illinois “and Blake Moore of Utah, who co-chair the House  \nMilitary Depot, Arsenal, Ammunition Plant and Industrial Facilities Caucus, are  \ngathering support for a planned letter to Speaker Nancy Pelosi urging money for  \nlong-deferred upgrades for military industrial facilities as well as defense  \nlabs and test facilities and ranges be incorporated into an infrastructure  \nproposal.” However, Rep. John Garamendi, “who chairs the HASC panel that  \noversees shipyards, depots and arsenals, said he’ll “seriously oppose” funding  \ndefense projects through the infrastructure plan instead of the normal defense  \nbudgeting process.” \n \nJustice Department: \n \nDOJ REPORTEDLY MULLING FURTHER CHARGES OVER 2016 ELECTION MISINFORMATION. <>  \nAccording toReuters  \n \n (5/26,Menn), “The indictment of a far-right internet activist on charges of  \ninterfering with the 2016 U.S. election reflects a strategic shift by the  \nDepartment of Justice and sets the stage for new cases against more prominent  \nright-wing actors.” Reuters says “federal prosecutors debated for years whether  \nand how to pursue criminal cases against Americans suspected of disseminating  \nfalse voting instructions,” but “after former...Attorney General William Barr  \nresigned in December, a compromise emerged: One charge to start, against a  \ndemonstrably influential person,” Douglass Mackey, “where evidence pointed to a  \nreal impact.” The DOJ is expected to follow up with charges against others. \n \nSOURCES: DOJ PREPARED TO SUE DEVELOPER IF HE DOES NOT REGISTER AS LOBBYIST  \nUNDER FARA. <> Citing a Wall Street Journal  \n \n (5/26,Viswanatha, Subscription Publication, 8.41M) article, The Hill  \n \n (5/26,Castronuovo, 5.69M) reports unidentified individuals who are familiar  \nwith the matter said US Department of Justice (DOJ) prosecutors are prepared to  \nsue Steve Wynn if the Las Vegas casino developer does not register as a  \nlobbyist under the Foreign Agents Registration Act (FARA). The Hill specifies  \n13that this matter is related to Wynn’s alleged 2017 effort to have Guo Wengui,  \n“who fled China in 2014 to seek asylum in” the US, sent back to China. \n \nU.S. News: \n \nNEW RESEARCH INDICATES COVID IMMUNITY COULD LAST OVER A YEAR. <> The New York  \nTimes  \n  \n(5/26, Mandavilli, 20.6M) reports that, according to two new studies, COVID  \nimmunity “lasts at least a year, possibly a lifetime, improving over time  \nespecially after vaccination.” The studies also “suggest that most people who  \nhave recovered from Covid-19 and who were later immunized will not need  \nboosters,” but vaccinated individuals “likely will need the shots.” University  \nof Pennsylvania Immunologist Dr. Scott Hensley said of the research, “The  \npapers are consistent with the growing body of literature that suggests that  \nimmunity elicited by infection and vaccination for SARS-CoV-2 appears to be  \nlong-lived.” \n \nVir Biotechnology Inc, GlaxoSmithKline PLC Announce FDA Approval Of COVID  \nAntibody Drug. The Wall Street Journal  \n \n (5/26, Walker, Subscription Publication, 8.41M) reports Vir Biotechnology Inc  \nand GlaxoSmithKline PLC announced that the FDA authorized their monoclonal  \nantibody COVID drug, which is called sotrovimab. Sotrovimab is the third  \nantibody medicine approved to treat patients at risk of severe infections, and  \na study of the drug found it reduced hospitalizatios or death by 85 percent. \n \nCDC Warns Immunocompromised Americans To Continue Wearing Masks Following  \nVaccinations. The CBS Evening News  \n \n (5/26, story 7, 1:55,O'Donnell, 3.75M) reported that the CDC “is warning that  \n10 million Americans are compromised immune systems that they will need to  \ncontinue wearing face masks, even after being vaccinated against COVID.” Johns  \nHopkins transplant surgeon Dr. Dorry Segev said of the risks, “I’m hearing of  \ntransplant and other immunosuppressed people who got vaccinated and relaxed  \ntheir safety behaviors, and are now being admitted to hospitals, and some are  \ndying because they get COVID-19.” \n \nHealth Officials Call For Continued Vigilance Ahead Of Holiday Weekend. NBC  \nNightly News  \n \n (5/26, story 3, 2:25, Holt, 4.76M) reported that while a growing share of  \nAmericans “have received at least one COVID vaccine dose,” health officials  \ncontinue to “warn, despite positive trends, [that] we have to remain on alert  \ngoing into the holiday weekend.” Domestic travel is “expected to be up 60% from  \nlast year with tens of millions planning to hit the roads, rails, and skies  \nthis weekend.” \n \n14ABC World News Tonight  \n \n (5/26, story 3, 3:15,Muir, 6.02M) reported CDC Director Dr. Rochelle Walensky  \nsaid of the holiday weekend, “If you are vaccinated, you are protected, and you  \ncan enjoy your Memorial Day. If you are not vaccinated, our guidance has not  \nchanged for you. You remain at risk of infection. You still need to mask and  \nmake other precautions.” \n \nLaw Firm Supporting Growing Movement To Challenge COVID Vaccine Mandates. The  \nWashington Post  \n \n (5/26, A1,Stanley-Becker, 10.52M) reports that Siri & Glimstad, which “has  \ndone millions of dollars of legal work for one of the nation’s foremost  \nanti-vaccination groups,” are supporting a new set of legal campaigns  \nchallenging state COVID vaccine mandates across the country. The lawsuits “show  \nthat a groundswell against compulsory immunization is being coordinated, at  \nleast in part, from a law office on Park Avenue in midtown Manhattan,” and the  \nfilings “offer a window into a wide-ranging and well-resourced effort to  \ncontest vaccine requirements in workplaces and other settings critical to the  \ncountry’s reopening — a dispute with sweeping implications for public health,  \nstate authority and individual rights.” \n \nOhio To Announce First Vaccine Lottery Winners. The AP  \n \n (5/26,Welsh-Huggins) reports that two Ohioans will “be announced Wednesday  \nnight as the first winners of the state’s Vax-a-Million incentive prizes which  \ninclude $1 million for those 18 and older and a full-ride college scholarship  \nfor teens.” Ohio Gov. Mike DeWine (R) “announced the program May 12 to boost  \nlagging vaccination rates,” and it led to an additional 2.7 million adult  \nvaccinations as well as 100,000 children between the ages of 12 and 17. TheNew  \nYork Times  \n \n (5/26,Mervosh, 20.6M) reports Athens County Health Department Administrator  \nJack Pepper said of the program’s impact, “I think we did close to 400 people  \nin four hours.” He added, “Anywhere I go, people are joking with me, ‘Hey, when  \nam I going to win my million dollars?’” \n \n The CBS Evening News  \n \n (5/26, story 4, 1:50,O'Donnell, 3.75M) reported that other states “are rolling  \nout incentives to get residents to roll up their sleeves,” and five states,  \nincluding Colorado, are “offering $1 million to five vaccinated state  \nresidents.” The segment adds that Maryland “had its first $40,000 vaccine  \nlottery winner” on Tuesday. \n \n In an op-ed for the New York Times  \n \n (5/26, 20.6M), Ohio Gov. Mike DeWine (R) defends his decision to create a  \n15lottery to encourage Ohioans to get the COVD vaccine. DeWine writes, “The  \ndecision to create Vax-a-Million...came about like those other pandemic  \ndecisions: out of necessity.” DeWine argues while some “have called it ‘a  \ngimmick,’ an ‘insane $5 million bribe,’ a ‘misuse of money’ and ‘a waste of  \ntaxpayer dollars,’” the “real waste – when the vaccine is readily available to  \nanyone who wants it – is not doing enough to save people’s lives.” \n \nGOP EXPECTED TO FILIBUSTER JANUARY 6 PANEL THURSDAY. <> The AP  \n \n (5/27, Jalonick,Mascaro) reports that Senate Republicans are “ready to deploy”  \nthe filibuster to block legislation to create a commission to investigate the  \nJan. 6 insurrection, “shattering hopes for a bipartisan probe of the deadly  \nassault on the U.S. Capitol and reviving pressure on Democrats to do away with  \nthe procedural tactic that critics say has lost its purpose.” The “vote  \nexpected Thursday would be the first successful use of a filibuster this year  \nto halt Senate legislative action.” \n \nRomney Warns Republicans Opposing Jan. 6 Commission Will Be Blamed For Hiding  \nThe Truth. CNN  \n \n (5/26,Raju, Barrett, 89.21M) reports on its website that Sen. Mitt Romney  \n(R-UT) “warned Republicans they would be blamed for hiding the truth if they  \nblock a bill to investigate the January 6 Capitol attack.” Romney told CNN on  \nWednesday, “I think the perception is on the part of the public that the  \nJanuary 6 Commission just trying to get to the truth of what happened, and that  \nRepublicans would be seen as not wanting to let the truth come out. ... I don’t  \nbelieve that’s what’s the motivation but I think that’s the perception.” \n \nCollins Will Vote For Bill To Create Commission. Romney’s comments came the  \nsame day Sen. Susan Collins (R-ME) announced she “will vote for a House-passed  \nbill to create a commission to probe the Jan. 6 Capitol attack during a key  \ntest vote that will take place as soon as Thursday,”The Hill  \n \n (5/26,Carney, 5.69M) reports. Collins “will support the bill during an initial  \nhurdle so that she can offer an amendment making changes to the legislation, an  \naide confirmed to The Hill.” Collins told reporters, “I want to see a  \ncommission. ... There are a lot of unanswered questions, and I’m working very  \nhard to secure Republican votes for a commission.” Collins is “the third GOP  \nsenator to say they will support the bill during an initial vote, where it will  \nneed 60 votes to move forward.” \n \n A New York Times  \n \n (5/26,Hulse, 20.6M) analysis that with the vote on creating the commission,  \nDemocrats “are finally bumping up against the limits of what they can  \naccomplish in the evenly divided Senate without changes to the filibuster  \nrules.” Republicans “are poised to employ the procedural weapon to block the  \nformation of the inquiry as early as Thursday, potentially dooming it while  \n16underscoring the power of a determined Senate minority to kill legislation even  \nif it is popular and has bipartisan support.” \n \nSicknick’s Mother, Partner Request Meetings With All GOP Senators. The  \nWashington Post  \n \n (5/26, 10.52M) reports Gladys Sicknick and Sandra Garza, the “mother and  \npartner of the late Capitol Police officer Brian D. Sicknick are requesting  \nmeetings with all Republican senators to urge them to establish an independent  \ncommission to investigate the Jan. 6 attack on the Capitol by a pro-Trump mob.” \n \nMilbank Condemns McConnell’s Handling Of Issue. Dana Milbank writes in the  \nWashington Post  \n \n (5/26, 10.52M) Senate Minority Leader McConnell this week “actually admitted”  \nhe puts “party before country” when he “told Republican colleagues that they  \nshould oppose the creation of a Jan. 6 commission, no matter how it is  \nstructured, because” it “could hurt the party’s midterm election message.”  \nEarlier this month, Milbank writes, McConnell said, “One hundred percent of my  \nfocus is on stopping this new Administration,” and, “true to his word,  \nMcConnell has blocked everything – even if it means undercutting Republican  \nnegotiators.” \n \nWashington Man Arrested In Capitol Siege Probe. The AP  \n \n (5/26) reports from Battle Ground, Washington, “A southwest Washington man who  \nfederal investigators say was seen on video saying, ‘Our house,’ while inside  \nthe U.S. Capitol with his father on Jan. 6 made his first appearance in federal  \ncourt in Portland, Oregon, on Wednesday.” Jeremy Grace, of Battle Ground, “is  \naccused of illegal entering, disorderly conduct and demonstrating inside the  \nrestricted building, The Oregonian/OregonLive reported. Grace, 37, was arrested  \nin Molalla, Oregon, on Wednesday, according to federal officials. His father,  \nJeffrey Grace, 62, was arrested in February and charged with unauthorized  \nentering or remaining in any restricted building or grounds. Although the  \nsenior Grace told FBI agents he didn’t think his son had entered the Capitol, a  \nsearch of the father’s phone turned up video in a ‘trash’ folder that showed  \nboth men in the building, according to a federal complaint.” \n \nFlorida Woman Charged In Capitol Siege Probe. The Palm Beach (FL) Post  \n \n (5/26,Musgrave, 223K) reports, “Using Facebook photos and video captured  \nduring the Jan. 6 riot at the U.S. Capitol, the FBI this week accused a  \none-time Palm Beach County commission candidate and former GOP heavyweight of  \njoining the deadly rampage.” Jody Tagaris, 67, “who lives near Jupiter, is  \ncharged with four federal misdemeanors, accusing her of illegally entering a  \nrestricted building and being disruptive and disorderly once inside. She faces  \na maximum year-long prison sentence on each count. After a brief video hearing  \nbefore a U.S. magistrate in West Palm Beach on Tuesday, she was released after  \n17posting a $50,000 bond. She is to appear in federal court in Washington at an  \nunspecified date to enter a plea to the charges, court records show.” The Post  \nadds, “In court papers, FBI agents say Tagaris’ undoing began when they were  \nalerted that she had posted a photo of herself on Facebook, sitting in a broken  \nwindow of the Capitol.” \n \nTexas Man Arrested In Capitol Siege Probe. HuffPost  \n \n (5/26,Reilly, 363K) reports, “Adam Weibling, a 38-year-old Texas man, made no  \nsecret in recent months of his contempt for the FBI, likening its agents to  \nNazis and ‘terrorists’ in a series of conspiracy-laden tweets. His dislike for  \nthem surely grew on Tuesday when they arrested him for storming the U.S.  \nCapitol on Jan. 6.” HuffPost adds, “FBI agents arrested Weibling in Katy,  \nTexas, on charges of unlawfully entering restricted grounds and engaging in  \ndisorderly conduct inside the Capitol, according to court records. His first  \nvirtual appearance in D.C. court is scheduled for June 3. According to an  \naffidavit filed May 19 in the U.S. District Court for the District of Columbia  \nand signed by an FBI task force officer, Weibling can be seen in video recorded  \nby a reporter pushing his way past police in riot gear to get inside the  \nCapitol around 2:30 p.m. on Jan. 6.” \n \nMan Arrested In Connection With US Capitol Breach Allegedly Claimed To Be DEA  \nAgent. The Houston Chronicle  \n \n (5/26, 982K) reports Dallas resident Troy Smocks has been arrested in  \nconnection with a US Capitol breach incident that occurred early this year. The  \nChronicle adds, “Smocks previously falsely presented himself as a DEA agent  \nduring the execution of a search warrant, a Secret Service agent, an FBI agent,  \nan Army colonel and more,” according to charging documents. \n \nOath Keepers Seek Dismissal Of Capitol Siege Lawsuit. The Washington Post  \n \n (5/26, Hsu, 10.52M) reports, “Lawyers for the Oath Keepers urged a federal  \njudge Wednesday to toss out a lawsuit accusing the group, former president  \nDonald Trump, lawyer Rudolph W. Giuliani and another far-right organization of  \ninciting the Jan. 6 storming of the Capitol, calling its actions a form of  \npeaceful political protest protected by the First Amendment.” The Post adds,  \n“The Oath Keepers said it was ‘conclusory and speculative’ to assert that its  \nmembers planned anything other than to attend a speech of the president at the  \nEllipse near the White House that day, march to the Capitol and make known to  \nCongress their views opposing the presidential election certification. The  \ngroup added that 11 House lawmakers led by Homeland Security Committee Chairman  \nBennie Thompson (D-Miss.) had no right to file suit in their personal  \ncapacities or as individuals under the Ku Klux Klan Act...as opposed to a case  \nbrought by the whole House.” \n \nAlabama Man In Capitol Siege Probe Had Militia Ties, Reached Out To Cruz. The  \nDecatur (AL) Daily  \n18 (5/26,  \nFleischauer, 53K) reports that a Falkville, Alabama man “tied to the Jan. 6  \nCapitol riot had Molotov cocktails not only in D.C. but at his Alabama home,  \nhas ties to Texas militia dating back to 2014 and tried to speak with U.S. Sen.  \nTed Cruz about ‘election fraud’ weeks before the Capitol attack, according to  \ncourt records.” Lonnie Leroy Coffman, 71, “on Monday was denied his second  \nrequest to be released from a Washington, D.C., jail in a 24-page opinion by”  \nUS District Judge Colleen Kollar-Kotelly. The Daily adds, “While much of the  \nevidence relied upon by U.S. District Judge Colleen Kollar-Kotelly in denying  \npretrial release is under seal, her opinion adds new information about evidence  \ncollected during the FBI investigation surrounding a 17-count indictment that  \nincludes possession of unregistered destructive devices and numerous gun  \nviolations.” \n \n The Montgomery (AL) Advertiser  \n \n (5/24,Brown, 72K) reports that Judge Kollar-Kotelly “denied Lonnie Coffman’s  \nbid for pre-trial release, writing the evidence against Coffman demonstrates he  \ncould present ‘a concrete and prospective threat to the community.’ New  \nevidence against Coffman was revealed in Kollar-Kotelly’s order, including  \nCoffman’s 2014 militia ties and that Coffman made a trip to Washington D.C.  \njust weeks before his arrest. His truck, where police would find  \ngasoline-filled mason jars and weapons on Jan. 6, was tracked circling the U.S.  \nCapitol and attempting to drive to Sen. Ted Cruz’ home on Dec. 11.” Coffman,  \n71, “was not charged with illegally entering a federal building or civil  \ndisorder, though prosecutors allege they have evidence that places him at the  \nCapitol, but faces a slate of weapons charges.” \n \nBIDEN CALLS FOR CONGRESSIONAL ACTION IN WAKE OF SAN JOSE MASS SHOOTING. <> The  \nWashington Post  \n  \n(5/26,Wagner, 10.52M) reports that on Wednesday, President Biden “released a  \nstatement on the latest mass shooting, in which at least eight people were  \nkilled in a San Jose, Calif., rail yard, and urged Congress ‘to help end this  \nepidemic of gun violence in America.’” TheSan Jose Mercury News  \n \n (5/26, 432K) carries the President’s full statement on the shooting, which  \nreads, “There are at least eight families who will never be whole again. There  \nare children, parents, and spouses who are waiting to hear whether someone they  \nlove is ever going to come home. There are union brothers and sisters – good,  \nhonest, hardworking people – who are mourning their own. ... Once again, I urge  \nCongress to take immediate action” against gun violence \n \n Asked on MSNBC  \n \n (5/26, 799K) about gun control legislation in the wake of a mass shooting in  \nSan Jose, California, White House Office of Public Engagement Director Cedric  \nRichmond said, “There are bills right now...that the Senate could take up and  \n19pass to protect people, protect families. There are eight families that have  \nlost a loved one today. ... We should not only offer our prayers and  \ncondolences and our thoughts, but we ought to offer some action and do things  \nto prevent this.” \n \nGunman Kills Eight, Himself. The New York Times  \n (5/26, Fuller,  \nHauser, 20.6M) reports that “a transit worker opened fire at a rail yard in San  \nJose, Calif., early Wednesday, killing eight people, many of them fellow  \nemployees, according to the Santa Clara County Sheriff’s Office, which reported  \nthat the gunman was also dead.” TheWashington Post  \n (5/26,  \n10.52M) reports that “the suspect is also dead, Santa Clara County Sheriff’s  \nOffice spokesman Russell Davis said during a news conference.” TheAP  \n \n (5/26,Gecker, Chea) reports that the employee launched his assault during a  \nunion meeting “in two buildings that are part of a light rail facility for the  \nValley Transportation Authority, which provides bus, light rail and other  \ntransit services throughout Santa Clara County, the most populated county in  \nthe San Francisco Bay Area.”NBC Nightly News  \n \n (5/26, lead story, 3:15, Holt, 4.76M) reported the “massacre” is “the 61st  \nmass shooting in the US in the month of May alone.” \n \n The CBS Evening News  \n \n (5/26, lead story, 3:35,O'Donnell, 3.75M) reported investigators “are still  \npouring over the scene” of the rampage and are “worried about possible  \nexplosives.” CBS added that it was necessary to suspend “rail service for  \nthousands of commuters” to allow investigators, including a bomb-sniffing dog,  \nto “search for explosives they believe may have been left by” the shooter. \n \nABC World News Tonight  \n \n (5/26, lead story, 4:10,Muir, 6.02M) reported the “suspect” in the shooting is  \n57-year-old Samuel Cassidy. ABC added that “bomb squads” were “moving in on”  \nCassidy’s home, which “authorities say he set fire to it just before driving to  \nthe rail yard.”Reuters  \n \n (5/26) reports that Cassidy, “the eight victims shot dead, and a survivor who  \nwas hospitalized in critical condition were all employees of the transit  \nagency.” Reuters says Cassidy “had worked for the transit authority since at  \nleast 2012, when he was listed as an ‘electro-mechanic,’ and was promoted to  \n‘substation maintainer’ in 2015, according to records posted by the nonprofit  \nwebsite Transportation California.” \n \n The San Jose Mercury News  \n \n20 (5/26, 432K) reports that “the Santa Clara County Medical Examiner-Coroner’s  \nOffice identified the eight victims as 42-year-old Paul Delacruz Megia,  \n36-year-old Taptejdeep Singh, 29-year-old Adrian Balleza, 35-year-old Jose  \nDejesus Hernandez III, 49-year-old Timothy Michael Romo, 40-year-old Michael  \nJoseph Rudometkin, 63-year-old Abdolvahab Alaghmandan and 63-year-old Lars  \nKepler Lane.” \n \nUSA Today  \n \n (5/26,Groppe, 12.7M) highlights President Biden’s “plea” for Congress to act  \non gun control legislation and notes the Administration’s prior efforts to  \naddress the issue in April through “half a dozen executive actions aimed at  \ncurbing the proliferation of so-called ghost guns, or untraceable weapons that  \ncan be constructed from parts purchased online, as well as tightening  \nregulations on...stabilizing braces for pistols.”The Hill  \n \n (5/26,Rahman, 5.69M) reports that “while speaking to reporters at an event on  \nbroadband infrastructure,” Vice President Harris “called the shooting  \n‘absolutely tragic.’” \n \n In another article, USA Today  \n \n (5/26,Bacon, Ortiz, Hauck, 12.7M) reports on California Gov. Newsom’s reaction  \nto the shooting, writing that at a press conference on Wednesday afternoon,  \nNewsom was “visibly emotional” and “expressed frustration.” Newsom “said he  \nfelt a ‘sameness’ and ‘numbness’ in the wake of yet another mass shooting.” USA  \nToday also quotes the governor as saying, “‘It begs the damn question: What the  \nhell is going on in the United States of America?’ ... ‘We rinse and repeat  \nsomeplace else in this country.’”Politico  \n \n (5/26,Marinucci, 6.73M) adds, “the Democratic governor has long railed against  \ngun violence and has criticized Republicans and the National Rifle Association  \nin the past for opposing restrictions on weapons.” \n \n The Wall Street Journal  \n \n (5/26,Carlton, Lazo, Mai-Duc, Subscription Publication, 8.41M) also reports on  \nthe shooting, among many others. \n \nAMID RISING CRIME, CITIES RESTORE POLICE FUNDING. <> The Wall Street Journal  \n \n (5/26,Elinson, Frosch, Jamerson, Subscription Publication, 8.41M) reports that  \namid rising crime rates, some cities which pursued policies to defund the  \npolice in the wake of the George Floyd protests are reversing course and  \nreinstating funds for police departments. The Journal cites actions by  \nofficials in New York City, Oakland, Baltimore, and Los Angeles as examples. \n \nBIDEN EXPECTED TO TAP BURNS AS AMBASSADOR TO CHINA, GARCETTI AS AMBASSADOR TO  \n21INDIA. <> The AP  \n \n (5/27,Balsamo, Blood) reports that President Biden “is expected to announce he  \nis nominating former senior State Department official Nicholas Burns to serve  \nas his ambassador to China and Los Angeles Mayor Eric Garcetti to be his  \nambassador to India, according to a person familiar with the matter.” With the  \npicks, the AP says, Biden “is turning to a seasoned diplomat and a longtime  \npolitical ally to serve in two of the country’s highest-profile diplomatic  \npostings.” It is not clear when the announcement will come. \n \nBiden Expected To Nominate Wall Street Executive To Be His Ambassador To  \nIsrael. Reuters  \n \n (5/26) reports that President Biden is “expected to nominate Thomas Nides, an  \nexperienced diplomat and Wall Street executive, to serve as U.S. ambassador to  \nIsrael.” Reuters adds, “It was not immediately known when Biden planned to  \nannounce Nides’ nomination but a person familiar with the matter said it would  \nhappen soon.” \n \nATF NOMINEE FACES PUSHBACK FROM GOP, BUT LIKELY TO BE CONFIRMED. <> The New  \nYork Times  \n  \n(5/26,Thrush, 20.6M) reports that during a confirmation hearing on Wednesday,  \nDavid Chipman, President Biden’s nominee to head the Bureau of Alcohol,  \nTobacco, Firearms and Explosives, “faced withering criticism...from Republican  \nsenators over his history of scathing comments about gun ownership.” The Times  \nsays Chipman, “a two-decade veteran of the A.T.F. who has served as an adviser  \nto gun control groups, was chosen in part because of his willingness to bluntly  \nconfront” the gun industry.Roll Call  \n \n (5/26,Ruger, 130K) reports that Chipman “told senators that he took one  \nposition as an advocate on potential gun control laws, but would only enforce  \nthe current laws as director.” \n \n The Washington Post  \n \n (5/26,Kane, 10.52M) reports that in “an emotional moment to which gun critics  \npoint to illustrate ATF’s importance, Sen. Dianne Feinstein (D-Calif.) informed  \nChipman that while he was testifying, an employee at a San Jose light-rail  \nfacility had opened fire, killing at least eight.” \n \n The Wall Street Journal  \n \n (5/26, Levy, Subscription Publication, 8.41M) reports that while Senate  \nJudiciary Chair Dick Durbin said Chipman’s “knowledge of the agency and its  \npurview is unparalleled,” Sen. Chuck Grassley, the panel’s minority leader,  \nlikened Chapman’s nomination to “putting a tobacco executive in charge of the  \nDepartment of Health and Human Services.” \n22 \nThe Hill  \n \n (5/26,Gangitano, 5.69M) reports that Chipman “said... he supports banning the  \nAR-15.” Chipman said, “I support a ban as has been presented in a Senate bill  \nand supported by the president. The AR-15 is a gun I was issued on ATF’s swat  \nteam and it’s a particularly lethal weapon and regulating it as other  \nparticularly lethal weapons, I have advocated for.” Chipman “was also  \nquestioned by Republicans on his support for Congress to ban assault weapons  \nand for universal background checks during the hearing, two actions Biden also  \nsupports.” \n \n In a second piece, the New York Times  \n (5/26,  \nRussonello, 20.6M) reports that while the ATF has been without a director for  \n13 of the last 15 years, President Biden “is trying to become the second  \npresident since 2006 to fill the position.” Chipman “stands a good chance: The  \nDemocrats’ two most consistently centrist senators, Kyrsten Sinema and Joe  \nManchin, have signaled they’re likely to support his nomination — and that may  \nwell be enough to get him confirmed,” even if the GOP is united in its  \nopposition. \n \nJEAN-PIERRE PRESIDES OVER HISTORIC FIRST TELEVISED WHITE HOUSE BRIEFING. <> The \nNew York Times  \n \n (5/26,Rogers, 20.6M) that on Wednesday, White House Principal Deputy Press  \nSecretary Karine Jean-Pierre “held a televised briefing for the first time...a  \nbaptism-by-fire moment” following as it did a mass shooting in California and  \nthe President’s request for an intelligence community investigation into the  \norigins of the coronavirus. The Times adds that Jean-Pierre “showed little  \ninterest in getting ahead of the president or the Administration, a tactic that  \nis frustrating to reporters, but one that drew praise from members of the  \nAdministration, including Ron Klain.” \n \nPolitico  \n \n (5/26, Niedzwiadek, 6.73M) reports that Wednesday’s briefing was “widely  \nviewed as an audition to take over for White House press secretary Jen Psaki  \nwhen she eventually steps down.” According to Politico, “In addition to  \nJean-Pierre, some observers have pegged White House communications director  \nKate Bedingfield, Vice President Kamala Harris spokesperson Symone Sanders, and  \nState Department spokesperson Ned Price as potential successors.” \n \nUSA Today  \n \n (5/26,Gilbert, 12.7M) notes the historic nature of the appearance, reporting  \nthat Jean-Pierre “became the first Black woman in decades to lead a press  \nbriefing at the White House on Wednesday.” She also “made history” by “being  \n23the first openly gay spokeswoman as she stood behind the podium and answered  \njournalists’ questions.” \n \nThe Hill  \n \n (5/26,Samuels, 5.69M) reports that when “asked about the rarity of a Black  \nwoman standing behind the podium,” Jean-Pierre said, “I appreciate the historic  \nnature. I really do. But I believe that being behind this podium, being in this  \nroom, being in this building isn’t about one person. It’s about what we do on  \nbehalf of the American people. Clearly the president believes representation  \nmatters, and I appreciate him giving me this opportunity.” \n \nBIDEN UNDER PRESSURE TO CONFRONT ANTI-SEMITISM AFTER ATTACKS. <> The New York  \nTimes  \n  \n(5/26,Graham, Stack, 20.6M) (5/26, Graham, Stack, 20.6M) reports that “the past  \nseveral weeks have seen an outbreak of anti-Semitic threats and violence across  \nthe United States, stoking fear among Jews in small towns and major cities.  \nDuring the two weeks of clashes in Israel and Gaza this month, the  \nAnti-Defamation League collected 222 reports of anti-Semitic harassment,  \nvandalism and violence in the United States, compared with 127 over the  \nprevious two weeks.” \n \nThe Hill  \n \n (5/26,Gangitano, 5.69M) says that “Democratic lawmakers and outside groups are  \npushing” President Biden to take additional action “to stop antisemitism” amid  \nthe rise “in violent attacks targeting the U.S. Jewish community.” The Hills  \nsays “five prominent Jewish advocacy groups – the Anti-Defamation League...the  \nAmerican Jewish Committee, the Orthodox Union, the Jewish Federations of North  \nAmerica, and Hadassah, The Women’s Zionist Organization of America, Inc. – in a  \nFriday letter to Biden expressed concern about a surge in attacks.”  \nAdditionally, Reps. Josh Gottheimer (D-N.J.), Elaine Luria (D-Va.) and Kathy  \nManning (D-N.C.) wrote to Biden on Tuesday and asked him to “nominate a United  \nStates ambassador-at-large to monitor and combat antisemitism.” \n \nAmericans Believe Anti-Asian Discrimination Has Worsened. The AP  \n \n (5/26,Fingerhut) reports that a poll by the AP-NORC Center for Public Affairs  \nResearch shows “a majority of Americans across racial and ethnic groups believe  \ndiscrimination has worsened in the last year against Asian Americans, who  \nbecame the target of attacks after being unfairly blamed for the coronavirus  \npandemic.” The poll “also finds about 6 in 10 Americans say racism in the US in  \ngeneral is a ‘very’ or ‘extremely’ serious problem. And a majority of Asian  \nAmericans say they feel unsafe in public because of their race.” \n \nEighth Noose Found At Amazon Work Site In Connecticut. ABC World News Tonight  \n \n24 (5/26, story 7, 0:15,Muir, 6.02M) reported, “Tonight yet another disturbing  \ndiscovery at the same construction site of a new Amazon facility in Windsor,  \nConnecticut. The NAACP says an eighth noose was found at the work site.  \nConstruction shut down yet again days after restarting. The investigation under  \nway.” \n \nSEN. TIM SCOTT: “JUNE OR BUST” FOR REACHING DEAL ON POLICE REFORM. <> The Hill  \n \n (5/26,Carney, 5.69M) reports that the lead Republican negotiator Sen. Tim  \nScott (R-SC) told reporters on Wednesday that a deal on police reform is  \nexpected in June. Referring to the timeline, Tim Scott said, “I think it’s June  \nor bust. ... I think we have three weeks in June to get this done.” \n \nRichmond: Everybody Negotiating In “Good Faith.” Asked on MSNBC  \n \n (5/26, 799K) about the status of police reform proposals in Congress, White  \nHouse Office of Public Engagement Director Cedric Richmond said, “I think  \neverybody is negotiating in good faith trying to get to a substantive bill that  \none would honor the memory of George Floyd but more importantly would stop the  \ncarnage that we see on the streets in terms of the interactions between police  \nand the communities they police.” \n \nDOJ Official Says Civil Rights Probes Of Local Police Help Fight Crime. The  \nWall Street Journal  \n \n (5/26,Gurman, Subscription Publication, 8.41M) reports that Associate Attorney  \nGeneral Vanita Gupta said federal civil rights probes of local police  \ndepartments help fight violent crime. The Journal says Gupta’s comments rebut  \ncriticism that the DOJ’s civil rights investigations are hurting officer morale  \nat a time when violent crime is increasing. \n \nEXXONMOBIL DEALT “MAJOR BLOW” IN BOARD SHAKE UP. <> Reuters  \n \n (5/26,Hiller, Herbst-Bayliss) reports that ExxonMobil suffered a “major blow”  \non Wednesday during a shareholder vote as at least two board members were  \nunseated by a small hedge fund, Engine No. 1, in a move to “force the company’s  \nleadership to reckon with the risk of failing to adjust its business strategy  \nto match global efforts to combat climate change.” Reuters says the counting  \n“is not finished, so Engine No. 1 could potentially see three of its four  \nnominees join the Exxon board.” The group’s successful nominations so far are  \nGregory Goff, a former executive from Marathon Petroleum and Andeavor, and  \nKaisa Hietala, a former Neste Oyj executive. \n \n The New York Times  \n  \n(5/26,Krauss, 20.6M) reports the two Engine No. 1 candidates were “nominated by  \nactivist investors who pledged to steer the company toward cleaner energy and  \naway from oil and gas.” The Times calls the result a “sharp rebuke” ExxonMobil  \n25CEO Darren Woods, who opposed the board challenge. TheWall Street Journal  \n \n (5/26,Matthews, McFarlane, Subscription Publication, 8.41M) reports that the  \nsetback for ExxonMobil highlights the dramatic shift in landscape for oil and  \ngas companies as pressure from environmental groups continues to mount. \n \n The Wall Street Journal  \n (5/26,  \nSubscription Publication, 8.41M) editorializes that the upset to ExxonMobil is  \ndue to political pressure on its shareholders to appeal to progressives in  \npower. The Journal warns that Exxon will not do well if it abandons fossil  \nfuels to focus on renewables. \n \nDutch Court Orders Shell To Reduce Emissions By 45%. The AP  \n \n (5/26,Bussewitz) reports that Royal Dutch Shell was ordered by a district  \ncourt in The Hague on Wednesday to reduce its net carbon emissions by 45% by  \n2030 compared to 2019 levels, following a case brought by climate change  \nactivists. The AP says the court “ruled that the energy giant had a duty to  \nreduce emissions and that its current reduction plans were insufficient.” \n \nProtections For Lesser Prairie Chicken May Curb New Oil And Gas Development.  \nThe Hill  \n \n (5/26,Guzman, 5.69M) reports that on Wednesday the US Fish and Wildlife  \nService proposed categorizing the lesser prairie chicken as “endangered” in  \nparts of New Mexico and Texas and “threatened” in more northern parts where the  \nspecies is found. The Hill says that the “move by the Biden Administration  \ncould have big consequences for the fossil fuel industry as the range of the  \nspecies that could be federally protected overlaps with the oil and gas-rich  \nPermian Basin,” adding that such “federal protections would likely impose  \nrestrictions on new oil and gas developments in the region where the birds  \nroam.” \n \nSenators Introduce Bill Extending Tax Credits To Nuclear Power Plants. Reuters  \n \n (5/26,Gardner) reports three Democratic senators “introduced a measure on  \nWednesday to boost existing nuclear plants to a wide energy tax reform bill,  \nafter the Biden administration pushed for such a change to help curb carbon  \nemissions.” \n \nDIPLOMATS ASK STATE DEPARTMENT TO PROVIDE MORE SUPPORT FOR “HAVANA SYNDROME”  \nVICTIMS. <> The Hill  \n \n (5/26,Castronuovo, 5.69M) reports American diplomats and other “government  \nofficials who say they are victims of ‘Havana Syndrome’ attacks are calling on  \nthe State Department to do more to provide proper medical care and support.” In  \na letter dated Tuesday and “obtained byNBC News  \n26 \n, a group of 21 government workers and their spouses demanded Deputy Secretary  \nof State Brian McKeon adopt a series of recommendations to ‘ensure injured  \nemployees and families’ are ‘fully supported’ and that the US government is  \n‘fully prepared to respond to future incidents.’” The 11 recommendations  \ninclude “benefits assistance for victims of the attacks, care plans and  \nresponses for newly injured employees and their families, long-term monitoring  \nof affected individuals and the establishment of an accountability review board  \nfor China and other countries that have had suspected Havana Syndrome cases.”  \nThe signatories also argued that “counterparts in the defense and intelligence  \ncommunity have had a different level and frequency of engagement.” \n \nPentagon Drafting “Havana Syndrome” Reporting Memo. CNN  \n \n (5/26,Starr, Williams, Herb, 89.21M) reports the Pentagon is drafting a “memo  \nto the entire military and civilian workforce asking personnel to report any  \nso-called anomalous health symptoms that might indicate they have been victims  \nof a mysterious illness that has struck US diplomats, spies and military  \npersonnel around the world, according to two defense officials.” No final  \ndecision has “been made on whether to issue the memo, but the fact it’s being  \nconsidered underscores the growing concern at the Pentagon’s senior levels that  \nthey need to gather more information on what” has become known as “Havana  \nSyndrome.” \n \nEXECS SAY BIDEN PLAN TO IMPORT METALS FOR EVS COULD KEEP US FROM MEETING  \nCLIMATE GOALS. <> Reuters  \n \n (5/26, Scheyder) reports “industry executives” say the Biden Administration’s  \n“plan to rely on ally nations for most of the metals needed to build electric  \nvehicles ignores the complexity of modern mining and could keep the United  \nStates from meeting aggressive climate goals.” James Calaway, chairman of  \nioneer Ltd, said, “The approach is deeply naive and very dangerous to the  \nUnited States supply chain for electric vehicles,” and Jon Evans, chief  \nexecutive of Lithium Americas Corp, said, “Given the administration’s timeline,  \nthey have no choice but to allow more domestic mines.” Although the  \nAdministration “may want to rely on mineral deposits in ally nations, it will  \nhave competition from China, which is willing to pay top dollar, industry  \nleaders said.” \n \nMAYORKAS DEFENDS TITLE 42. <> The Hill  \n \n (5/26,Beitsch, 5.69M) reports that before a House Appropriations subcommittee  \non Wednesday, DHS Secretary Mayorkas “defended the Administration’s retention  \nof” Title 42, “a Trump-era policy that allows the swift removal of migrants due  \nto COVID-19 as well as a narrowing in those sought for deportations by law  \nenforcement officials.” While there is “increasing pressure” to scrap Title 42,  \nMayorkas “reiterated [the] Administration’s position that the policy is  \nnecessary as a public health measure.” He added, “We will not restrict travel  \n27one day more than the public health imperative requires. That is the assurance  \nI can give.” \n \nDEMOCRATS UNABLE TO MOVE FORWARD WITH PLAN TO LOWER PRESCRIPTION DRUG PRICES.  \n<> The Los Angeles Times  \n \n (5/26,Haberkorn, Stokols, 3.37M) reports, “Despite widespread support among  \nDemocrats, the idea” of implementing a plan to lower prescription drug prices  \n“has sputtered.” President Biden did not include such a plan in his  \ninfrastructure proposal and his budget is not expected to include one.  \nDemocrats in Congress, meanwhile, “remain noncommittal about how they might  \nenact” a plan to lower prescription drug prices. \n \nCOLUMNIST HIGHLIGHTS GAO REPORT ABOUT MAKING GOVERNMENT MORE EFFICIENT, WITH  \nSAVINGS OF $1B OR MORE. <> In an opinion piece for the Washington Post  \n \n (5/25, 10.52M), columnist Joe Davidson says that “as President Biden pushes  \nbig spending plans to spur the country’s economic recovery, he might welcome  \nsuggestions for saving a few bucks – or much more.” A new GAO “report  \n about how to make the government  \nmore efficient includes 14 areas to target, each with possible savings of $1  \nbillion or more.” The “report said” another “potential efficiency” action is  \n“improving coordination of infectious-disease work by the Department of Health  \nand Human Services to better identify duplication and overlap among agencies.”  \nThese include “extending cost-reduction and efficiency programs at two of the  \nEnergy Department’s National Nuclear Security Administration sites to other  \nlocations” for a savings of $515 million over five years. \n \nMICHIGAN SECRETARY OF STATE “DEEPLY CONCERNED ABOUT THE FUTURE OF OUR  \nDEMOCRACY.” <> In an interview with the AP  \n \n (5/26, Cassidy,Eggert), Michigan Secretary of State Jocelyn Benson (D) was  \nasked about “GOP-controlled legislatures seeking to exert more control over  \nelection officials.” Benson said, “I’m deeply concerned about the future of our  \ndemocracy and about all of the things that we’re seeing and have seen on a near  \nweekly basis emerge throughout our country, but particularly in states that  \nwere high profile in 2020 – Michigan, Georgia, Arizona, Nevada – to  \nconsistently propagate the ‘big lie,’ propagate this idea, this falsehood that  \nthe election was anything but safe and secure, to codify legislation in  \nfurtherance of that and really undo a lot of the policies that led to such  \nenormous turnout and security in 2020.” \n \nInternational News: \n \nAfrica: \n \nAFTER MILITARY TAKEOVER, INTERIM PRESIDENT, PM OF MALI RESIGN. <> Reuters  \n \n28 (5/26) reports that the interim president and prime minister of Mail resigned  \non Wednesday, “two days after they were arrested by the military, an aide to  \nthe vice president said.” Miliary forces “led by interim Vice President Assimi  \nGoita, arrested President Bah Ndaw and Prime Minister Moctar Ouane and took  \nthem to a military base on Monday after a cabinet reshuffle in which two  \nofficers lost their posts.” The actions by the military have jeopardized the  \nnation’s return to democracy after a coup last year. \n \nSUSPECTED ISLAMIST ATTACK KILLS 22 IN THE DEMOCRATIC REPUBLIC OF CONGO. <>  \nReuters  \n \n (5/26) reports that at least 22 civilians were killed with knives and machetes  \nin a night-time raid by suspected Islamist militants in the eastern part of the  \nDemocratic Republic Of Congo. The attack “comes more than three weeks after the  \ngovernment declared martial law in North Kivu and Ituri, two provinces  \nbordering Uganda, in an attempt to stem worsening bloodshed.” \n \nUN OFFICIAL WARNS THAT ETHIOPIA’S TIGRAY REGION IS ON THE BRINK OF FAMINE. <>  \nTheNew York Times  \n  \n(5/26,Gladstone, 20.6M) reports that Mark Lowcock, the UN’s under secretary  \ngeneral for humanitarian affairs, is warning that “famine is now knocking on  \nthe door of Ethiopia’s Tigray region, where a civil war that erupted last year  \nhas drastically cut the food supply and prevented relief workers from helping  \nthe hungry.” The Times says that “in a confidential note to the United Nations  \nSecurity Council,” Lowcock “said sections of Tigray, a region of more than 5  \nmillion people, are now one step from famine – in part because the government  \nhas obstructed aid shipments.” \n \nNBC: US “QUIETLY RETURNING” TO LIBYA. <> NBC News  \n \n (5/27, 4.91M) reports the US is “wading back into Libya, with the Biden  \nadministration launching a fresh diplomatic bid to pull the country out of a  \nviolent spiral and making plans to reopen the U.S. Embassy in Tripoli seven  \nyears after it was closed.” Last week, the highest-ranking “US diplomat to  \nvisit the country since 2014 arrived in Tripoli, and the administration has  \ndeployed a team there to work out the daunting logistics of reopening the  \nembassy, two sources familiar with the matter said.” A State Department  \nspokesperson said, “Our intent is to begin to resume operations in Libya as  \nsoon as the security situation permits and we have the necessary security  \nmeasures in place. The process for that to occur, however, entails careful  \nlogistical and security planning, plus interagency coordination to meet  \nsecurity and legal requirements. “ \n \nREPORT ON ITALIAN AMBASSADOR’S DEATH IN CONGO INDICATES “POORLY PLANNED,  \nCLUMSILY EXECUTED ACT.” <> Reuters  \n \n (5/26, Holland, Katanty) reports from Goma, Democratic Republic of Congo that  \n29a new incident report from the Virunga National Park Rangers regarding the  \n“botched kidnapping” of Italian Ambassador Luca Attanasio “paints a picture of  \na poorly planned, clumsily executed act, and runs counter to the assumption  \namong some officials and media at the time that Attanasio was the target of a  \ncarefully orchestrated operation.” The report was “corroborated by three UN  \nofficials and an Italian judicial source – all with knowledge of probes into  \nthe attack.” The attackers “never displayed awareness of ambassador Attanasio’s  \nidentity or diplomatic status, two of the UN sources close to the  \ninvestigations said.” \n \nNear East: \n \nBLINKEN DEPARTS MIDDLE EAST WITH CEASE-FIRE INTACT, PLEDGES TO AID WITH  \nREBUILDING. <> The New York Times  \n  \n(5/26,Jakes, 20.6M) reports that as Secretary of State Antony Blinken left the  \nMiddle East on Wednesday, he “said he was returning to Washington from the  \nbrief but urgent visit with new promises to help fund a massive humanitarian  \nand reconstruction effort in the Gaza Strip.” Speaking to reporters in Amman  \nafter meeting with King Abdullah, Blinken said, “We see the cease-fire not as  \nan end, but as a beginning – something to build on.” Blinken “said Egypt had  \noffered to contribute $500 million to rebuild Gaza, and noted Jordan’s ‘vital  \nrole’ in working with the Palestinian Authority” in the West Bank. \n \nReuters  \n \n (5/26) reports that on Wednesday in Amman, Jordan, Blinken “said...he had a  \nlengthy discussion with Egyptian President Abdel Fattah al-Sisi about Cairo’s  \nhuman rights record.” Reuters adds that Blinken “also said he raised with Sisi  \nthe issue of Americans who have been detained in Egypt.” \n \n According to the AP  \n \n (5/26, Magdy,Federman), Blinken’s “mission made little headway in resolving  \nthe deeper issues at the heart of the Israeli-Palestinian conflict.” The AP  \nadds, “After two days of talks with Israeli, Palestinian and Arab allies,  \nBlinken acknowledged that any resumption of peace talks remained far off. In  \nthe meantime, he said he had made progress toward the more modest goals of  \ncementing the cease-fire and rebuilding hard-hit Gaza.” \n \nEviction Issue Continues To Test Cease-Fire. NBC Nightly News  \n \n (5/26, story 5, 1:40, Holt, 4.76M) reported, “That fragile cease-fire between  \nIsrael and Hamas is facing new pressure tonight over an Israeli plan to evict  \nsome Palestinians from their homes.” NBC (Mitchell) added, “Protests today in  \nEast Jerusalem, where 700 more Palestinians are fighting evictions to make room  \nfor Jewish settlers. The first question I was asked when I got here is, ‘What  \ndid Blinken say?’” about the situation. NBC (Mitchell) adds, “Today, they have  \n30new hope after Blinken said Israel should stop demolishing their homes, trying  \nto avoid a spark that could ignite another round of violence.” \n \nBoot: Preserving Status Quo With Iran Doesn’t Boost Hamas. Max Boot writes in  \ntheWashington Post  \n \n (5/26, 10.52M) that “the right wing in Israel and the United States” believe  \n“the recent 11-day Gaza war makes a compelling case against concluding a  \nnuclear deal with Iran.” However, Boot argues, the “negotiations to revive the  \nnuclear deal are continuing. The Biden administration has not actually lifted  \nsanctions on Iran.” But that has not “hampered Hamas’s ability to rocket  \nIsrael. ... It’s hard to see how the U.S. exit from the JCPOA has hurt Hamas in  \nany way. ... So I am struggling to figure out how preserving the status quo is  \nenhancing Israel’s security. Spoiler alert: It’s not.” \n \nASSAD VOTES IN FORMER REBEL STRONGHOLD, TOUTS ELECTION AS EVIDENCE OF SYRIAN  \nUNITY. <> Reuters  \n \n (5/26) reports that on Wednesday, Syrian President Bashar al-Assad “voted...in  \nan election certain to extend his rule...casting his ballot in the former rebel  \nstronghold of Douma where a suspected chemical weapons attack in 2018 prompted  \nWestern air strikes.” Assad said after voting, “Syria is not what they were  \ntrying to market, one city against the other and sect against the other or  \ncivil war. Today we are proving from Douma that the Syrian people are one.” \n \n According to the AP  \n \n (5/26,Aji), “The vote is the second presidential election since the country’s  \nconflict began 10 years ago and has been dismissed as a sham by the opposition  \nand Western countries, including the United States. ... ‘The Assad regime’s  \nso-called presidential election is neither free nor fair,’ U.S. Secretary of  \nState Anthony Blinken said in a Twitter post Wednesday.” The AP says Assad  \n“blasted countries that have dismissed the vote as illegitimate, saying most of  \nthose nations ‘have colonial history’ and ‘we as a state are not concerned  \nabout such statements.’” \n \n The Washington Post  \n \n (5/26, 10.52M) says the election “delivers a rebuke to a decade of Syria  \ndiplomacy by the United States and its allies aimed at securing a transition to  \ndemocracy. By the time Assad’s new term ends in 2028, he will have been in  \npower for 28 years, topping the 27 years his father, Hafez, served as  \npresident.” \n \nCNN  \n \n (5/26, Karadsheh, 89.21M) reports on its website that in 2014, Assad “received  \n88.7% of the vote in an election that took place in government-controlled parts  \n31of the country. At the time, opposition groups ran large swathes of Syria –  \nAssad’s forces have since wrested control over most of that territory.” On its  \nwebsite,CBS News  \n \n (5/26, 5.39M) says, “Thanks to support from Russia that helped turn the tide  \nin the war, Assad’s rule is no longer seriously threatened by ISIS or the  \nrebels who’ve enjoyed varying degrees of support from the West.” \n \nIRAQI FORCES ARREST MILITIA COMMANDER OVER ALLEGED INVOLVEMENT IN ATTACKS ON  \nAIR BASE USED BY US. <> Reuters  \n \n (5/26) reports that the Iraqi military said that security forces on Wednesday  \narrested militia commander Qasim Muslih in a “move security sources said was  \nlinked to attacks on a base that hosts U.S. forces.” A pair of security sources  \ntold the news outlet that Muslih “was arrested in Baghdad for involvement in  \nseveral attacks including recent assaults on Ain al-Asad air base, where U.S.  \nand other international forces are housed.” \n \n The AP  \n \n (5/26) reports “tensions mounted in Iraq’s capital” on Wednesday after the  \narrest. Shortly after, forces “affiliated with the PMF, which maintains offices  \ninside the heavily fortified Green Zone, were deployed surrounding Prime  \nMinister Mustafa al-Kadhimi’s headquarters.” Tensions reached a “fever pitch  \nwhen Iraqi security forces and the elite Counter-Terrorism Service were  \ndeployed to protect the government and diplomatic missions, sparking fears of  \nviolence. Some armed PMF factions gathered around the Green Zone’s entrance  \ngates.” \n \nHAMAS LEADER SAYS 80 FIGHTERS KILLED. <> The AP  \n \n (5/26,Akram, Akram) reports Hamas’ leader in the Gaza Strip “on Wednesday said  \n80 militants were killed during the 11-day war with Israel that ended last  \nweek, providing the group’s first official tally for losses sustained in the  \nfighting.” Gaza’s Hamas-run Health Ministry has “put the number of Palestinians  \nkilled in the Israeli offensive this month at 254, including 66 children, 39  \nwomen, and 17 people above the age of 60” but did not provide “a breakdown  \nbetween civilians and combatants.” Speaking to The Associated Press, “Hamas  \nleader Yehiyeh Sinwar said those killed last week included 57 members of his  \ngroup’s armed wing, 22 members of the smaller Islamic Jihad group and one  \nmember of a small group called the Popular Resistance Committees.” \n \nIran: \n \nIAEA HEAD: IRAN ENRICHING URANIUM AT WEAPONS-GRADE LEVEL. <> Insider  \n \n (5/26,Haltiwanger, 2.74M) reports Iran is enriching uranium “up to purity  \nlevels that ‘only countries making bombs are reaching,’ the head of the UN’s  \n32nuclear watchdog warned in an interview with the Financial Times.” Rafael  \nGrossi, director-general of the International Atomic Energy Agency (IAEA), told  \nthe Times, “A country enriching at 60% is a very serious thing – only countries  \nmaking bombs are reaching this level.” Grossi added, “You cannot put the genie  \nback into the bottle – once you know how to do stuff, you know, and the only  \nway to check this is through verification. The Iranian programme has grown,  \nbecome more sophisticated so the linear return to 2015 is no longer possible.  \nWhat you can do is keep their activities below the parameters of 2015.” \n \nEurope: \n \nWHO COVAX PROGRAM FALLS SHORT DESPITE INTENTIONS OF DEVELOPED NATIONS, VACCINE  \nMANUFACTURERS. <> The Wall Street Journal  \n \n (5/26, A1,Steinhauser, Hinshaw, McKay, Subscription Publication, 8.41M)  \nreports about why the WHO’s COVAX program has struggled to provide shots to  \ndeveloping countries despite its good intentions. By December 2020, “Moderna,  \nPfizer, AstraZeneca, Sinopharm and Sputnik V had all announced promising  \nefficacy results from clinical trials.” However, concerns about coronavirus  \nvariants and material shortages caused agreements between the WHO, developed  \nnations, and vaccine manufacturers to follow through. \n \nWHO Needs More Information To Authorize Sinovac’s COVID-19 Vaccine. The Wall  \nStreet Journal  \n \n (5/26, Deng,Hinshaw, Subscription Publication, 8.41M) reports the WHO is  \nrequesting more data from Sinovac as it considers approving the Chinese  \ncompany’s COVID-19 vaccine, Coronavac. While it is not clear what information  \nis missing, the agency cleared another Chinese vaccine from rival Sinopharm  \naround the same time it met to discuss Coronavac. \n \nEU TELLS BRUSSELS COURT ASTRAZENECA FAILED TO FULFILL ITS VACCINE COMMITMENTS.  \n<> The AP  \n \n (5/26,Petrequin) reports that on Wednesday, the European Union “took on  \nvaccine producer AstraZeneca in a Brussels court...and accused the drugmaker of  \nacting in bad faith by providing shots to other nations when it had promised  \nthem for urgent delivery to the EU’s 27 member countries.” According to the AP,  \n“During an emergency hearing, the EU asked for the delivery of missing doses  \nand accused AstraZeneca of postponing deliveries so the Anglo-Swedish company  \ncould service Britain, among others.” The AP adds that AstraZeneca “denies any  \nwrongdoing and said it has always done its best to fulfill delivery  \ncommitments.” \n \n The New York Times  \n \n (5/26, Pronczuk,Stevis-Gridneff, 20.6M) reports that “lawyers representing the  \nbloc told the judges in a Brussels courtroom that they would seek €10 (about  \n33$12) a dose for each day that delivery is delayed, along with €10 million a day  \nfor each of four alleged breaches of contract.” According to the Times, “The  \nbloc is demanding 90 million doses from the company by the end of June, and  \nanother 180 million by the end of September. The proposed penalties, if  \naccepted by the judge, would begin on July 1 and could quickly balloon into  \nbillions of euros.” \n \nSLOVAKIA AUTHORIZES USE OF RUSSIA’S SPUTNIK V VACCINE. <> The AP  \n \n (5/26) reports that on Wednesday, Slovakia “became the second European Union  \ncountry to authorize use of the Russian-made Sputnik V vaccine, which has not  \nyet been approved by the bloc’s drug regulator.” According to the AP, “The  \nSlovak government asked Health Minister Vladimir Lengvarsky – who has expressed  \nreservations about the Russian COVID-19 vaccine – to make it available by June  \n7.” The AP says Slovakia “has 200,000 doses of Sputnik V in stock but had not  \nallowed its use until now.” \n \nFRANCE PRAISES YOUTUBE USERS WHO RESISTED VACCINE MISINFORMATION CAMPAIGN. <>  \nTheAP  \n \n (5/26,Leicester) reports France’s government offered “strong praise Wednesday  \nto YouTubers and other social media influencers who resisted a mysterious  \neffort to recruit them for a smear campaign to spread disinformation to their  \nmillions of young followers about the Pfizer COVID-19 vaccine.” Multiple  \nFrance-based influencers “with sizable audiences on Twitter, Instagram and  \nother platforms said they were contacted with offers of hush-hush payments to  \nmake bogus claims about supposed deadly Pfizer vaccine risks.” \n \nRussia & Eurasia: \n \nLUKASHENKO ACCUSES WEST OF ENGAGING IN “HYBRID WAR” AGAINST BELARUS. <> Axios  \n \n (5/26,Allassan, 1.26M) reports that on Wednesday, Belarus President Aleksandr  \nLukashenko, “who diverted a passenger airplane carrying a journalist and  \ngovernment dissident on board this week, defended his actions Wednesday as  \nnecessary to quell a bomb threat.” Axios adds, “EU nations have banned  \nBelarusian airlines, told European airlines not to fly over the country, and  \npromised more economic sanctions. Lukashenko described the retaliation as a  \n‘hybrid war’ to ‘strangle’ Belarus.” \n \nReuters  \n \n (5/26) reports that Lukashenko also alleged that Raman Pratasevich, the  \njournalist “pulled off a plane that was forced to land in Minsk, had been  \nplotting a rebellion.” According to Reuters, “In his speech to parliament,  \nLukashenko gave no details of the ‘bloody rebellion’ he accused...Protasevich  \nof planning.” TheAP  \n \n34 (5/26, Karmanau) reports that Lukashenko “also warned his other foes abroad  \nthat the authorities will go after them,” saying, “We know your faces, and it’s  \njust a matter of time for you to be brought to account before the Belarusian  \npeople.” \n \n The Washington Post  \n \n (5/26, 10.52M) reports that Lukashenko, who is “known for often outlandish  \nremarks, suggested that by diverting the plane, he also prevented a potential  \nnuclear catastrophe, as the airliner could have triggered the defense systems  \non the country’s Astravec power plant.” The Post reports that Lukashenko “said  \nthe decision to intercept the plane filled with Lithuanian tourists coming back  \nfrom Greece was prompted by a bomb threat, which he now claims originated from  \nSwitzerland.” The Post says Belarusian officials “previously said the threat  \ncame via email from Hamas.” \n \nPolitico Europe  \n \n (5/26, 15K) reports that Lukashenko “also downplayed reports that the plane  \nwas forced to turn for Minsk by a fighter jet, putting the blame for the  \ndecision to land in the Belarusian capital on the crew, and saying that the  \nfighter had been scrambled ‘according to all the rules.’” Politico adds, “Those  \njustifications are unlikely to lessen the outrage over the Ryanair incident,  \nand its impact on European aviation.” \n \n The New York Times  \n \n (5/26,Troianovski, 20.6M) says that with his decision to divert the flight,  \nLukashenko has “ushered in a new and even more brittle phase in one of the  \npost-Soviet region’s most convoluted and consequential relationships: the one  \nbetween” Lukashenko and Russian President Vladimir Putin. According to the  \nTimes, “The two are increasingly leaning on each other in the face of conflict  \nwith the West, but they have sharply diverging interests.” \n \nSASSE AMONG THOSE CRITICAL OF BIDEN’S DECISION TO MEET WITH PUTIN. <> CNBC  \n \n (5/26,Ellyatt, 7.34M) reports on its website that ahead of President Biden and  \nRussian President Vladimir Putin’s summit in Geneva next month, “there are  \ndoubts whether the summit can achieve much, given the poor state of relations.”  \nAnd CNBC adds that “not everyone is happy about the summit even going ahead.”  \nSen. Ben Sasse (R-NE), a member of the Senate Select Committee on Intelligence,  \n“was among those voicing disapproval of the Biden-Putin summit.” Sasse released  \na statement reading: “We’re rewarding Putin with a summit? ... Instead of  \ntreating Putin like a gangster who fears his own people, we’re giving him his  \ntreasured Nord Stream 2 pipeline and legitimizing his actions with a summit.  \nThis is weak.” Andrius Tursa, Central and Eastern Europe advisor at Teneo  \nIntelligence, is quoted a saying, “The Russian state-owned media will spin the  \nPutin-Biden summit in a way that emphasizes Russia’s great power status and its  \n35indispensable role in addressing various global challenges.” \n \nRubin: Putin Summit “Doesn’t Make The US Look ‘Weak.’” The Washington Post  \n \n’s (5/26, 10.52M) Jennifer Rubin writes that good behavior “has never been the  \nprecondition for US presidents meeting with adversarial powers,” and that a  \n“meeting in which Biden signals the free pass from the United States has  \nexpired may prompt Putin to more carefully assess the costs and benefits of  \nfuture conduct. If that is the outcome, it will have been worth the trip.” \n \nChina: \n \nNSC’S KURT CAMPBELL: BROAD ENGAGEMENT WITH CHINA “HAS COME TO AN END.” <>  \nBloomberg  \n \n (5/26, 3.57M) reports the US is entering a “period of intense competition with  \nChina as the government running the world’s second-biggest economy becomes ever  \nmore tightly controlled by President Xi Jinping, the White House’s top official  \nfor Asia said Wednesday.” Speaking at a Stanford University event, Kurt  \nCampbell, the US coordinator for Indo-Pacific affairs on the National Security  \nCouncil, said, “The period that was broadly described as engagement has come to  \nan end.” Campbell predicts US policy toward China will now operate under a “new  \nset of strategic parameters,” adding that “the dominant paradigm is going to be  \ncompetition.” Chinese policies under Xi “are in large part responsible for the  \nshift in U.S. policy, Campbell said, citing military clashes on China’s border  \nwith India, an ‘economic campaign’ against Australia and the rise of China’s  \n‘wolf warrior’ diplomacy.” Beijing’s behavior was “emblematic of a shift toward  \n‘harsh power, or hard power’ which ‘signals that China is determined to play a  \nmore assertive role,’ he said.” \n \nCRS: CHINA SUPPLYING NUCLEAR, MISSILE TECHNOLOGY TO NORTH KOREA, IRAN. <> The  \nWashington Times  \n \n (5/26,Gertz, 626K) reports China is continuing to “sell dangerous nuclear  \ntechnology and missiles around the world, mainly to North Korea and Iran,  \naccording to the Congressional Research Service.” A CRS report published  \n“earlier this month reveals that the Chinese government seems to have ceased  \ndirect involvement in nuclear arms proliferation and sales of complete missile  \nsystems in favor of hiding behind cutout entities.” In specific, the report  \nstates the Chinese government “has apparently ended its direct involvement in  \nthe transfer of nuclear- and missile-related items, but Chinese-based companies  \nand individuals continue to export goods relevant to those items, particularly  \nto Iran and North Korea.” \n \nSENATE GOP COULD BLOCK BIPARTISAN PLAN TO CONFRONT CHINA. <> Politico  \n (5/26,  \nDesiderio, Bade, 6.73M) reports Senate Republicans “are indicating that they  \nmay derail debate on” a bipartisan measure “confronting China’s growing  \n36economic and geopolitical influence before the Senate leaves town for a recess  \nlater this week. Some in the GOP are pressing for more votes on their  \namendments to the China legislation, a top priority of Majority Leader Chuck  \nSchumer.” Sen. Mike Crapo (R-ID) “said he was particularly frustrated by what  \nhe described as Democratic leadership’s refusal to consider a trade amendment”  \nhe has offered with Sen. Ron Wyden (D-OR). Politico says the “latest Republican  \nresistance imperils Schumer’s plans for a final vote on the bill, which  \nallocates billions in new funding for scientific research and technology to  \ncounter China’s economic rise.” \n \nThe Hill  \n \n (5/26,Bolton, 5.69M) reports, “Some Republicans now say Schumer won’t get the  \n60 votes he needs to advance the bill unless he relents and allows a vote on”  \nthe Crapo-Wyden measure. After Wednesday’s lunch, a GOP senator said “‘it would  \nbe hard to imagine’ the China bill getting 10 Republican votes to advance until  \nSchumer backs down and allows a vote on the Wyden-Crapo deal to update and  \nreauthorize expired trade programs.” \n \nSENATE LEGISLATION WOULD ADD NATIONAL SECURITY REVIEWS OF CHINESE DONATIONS TO  \nUS UNIVERSITIES. <> Reuters  \n \n (5/26,Zengerle) reports US senators introduced legislation “on Wednesday that  \nwould require national security reviews of major Chinese gifts and contracts to  \nUS universities.” They hope that limiting “such reviews to China alone would  \nease concerns in academia that reviews of foreign funding could threaten  \nresearch.” The measure, an “amendment to a broad bill seeking to boost U.S.  \ncompetitiveness with China, would require the federal government’s Committee on  \nForeign Investment in the United States (CFIUS) to review grants and contracts  \nfrom China whose value exceeds $1 million.” TheWashington Times  \n \n (5/26,Taylor, 626K) also reports. \n \nTESLA TO ESTABLISH DATA CENTER IN CHINA FOR LOCAL DATA STORAGE. <> TechCrunch  \n (5/26, Liao,  \n502K) reports, Tesla “said it has established a data center in China to carry  \nout the ‘localization of data storage,’ with plans to add more data facilities  \nin the future, the company announced through its account on microblogging  \nplatform Weibo.” All data generated “by Tesla vehicles sold in mainland China  \nwill be kept domestically.” Tesla is acting in “response to new requirements  \ndrafted by the Chinese government to regulate how cameras- and sensors-enabled  \ncarmakers collect and utilize data.” \n \nCLOSED CHINESE CONSULATE IN HOUSTON WAS “MAJOR HUB” FOR ESPIONAGE, STUDY  \nINDICATES. <> The Washington Times  \n \n (5/26,Lovelace, 626K) reports, “The Chinese consulate in Houston, ordered  \nclosed by the Trump administration last year, was a ‘major hub’ for Beijing’s  \n37global science and technology collection efforts, according to a newstudy  \n \n.” Georgetown University’s Center for Security and Emerging Technology  \n“examined 642 ‘international technological cooperation opportunities’ between  \n2015 and 2020 identified by Chinese diplomats and found the Houston post was  \nthe key hub for science and technology (S&T) collection globally.” US critics  \n“say intellectual property theft and piracy have been key to China’s drive to  \nclose the technology gap with the U.S. and the West.” \n \nEast Asia: \n \nJAPAN FACING NEW COVID SURGE AHEAD OF SUMMER OLYMPICS. <> NBC Nightly News  \n \n (5/26, story 6, 1:30, Holt, 4.76M) reported that the Summer Olympics will open  \nin eight weeks, but Japan is “reporting roughly 5,000 new COVID cases a day”  \nand Tokyo OIC organizers “say they’re not considering cancelling the Olympics.”  \nJapanese apprehension to cancel the Olympics is leading to new pressure both  \ndomestic and international, and US scientist “say ‘calling off the games may be  \nthe safest option.’” \n \n Henry Olsen writes in the Washington Post  \n \n (5/26, 10.52M) while there is growing pressure on Japanese Prime Minister  \nYoshihide Suga “to again postpone this summer’s Olympic Games in Tokyo,” the  \ngames “should go on as scheduled, and the world should chip in to help ensure  \nthe Japanese people stay safe as they do.” Olsen argues the world “needs an  \nexample that life can be normal again.” \n \nESPIONAGE TRIAL OF AUSTRALIAN BLOGGER TO OPEN IN CHINA ON THURSDAY. <> Reuters  \n \n (5/26) reports that a Chinese court “will hear an espionage case on Thursday  \nagainst Australian blogger Yang Hengjun, detained by Chinese authorities two  \nyears ago as he arrived from New York, against a backdrop of worsening ties  \nbetween the two nations.” Details of the case “have been shrouded in secrecy,”  \nand Australia has “complained that Chinese authorities have not provided ‘any  \nexplanation or evidence for the charges.’” \n \nCAMPBELL: US HOPING FOR FALL QUAD MEETING ON INFRASTRUCTURE. <> Reuters  \n \n (5/26,Brunnstrom, Martina) reports that the US is “looking to convene an  \nin-person meeting of its partners the Quad group of countries – Australia,  \nIndia and Japan – in the fall with a focus on infrastructure in the face of the  \nchallenge from China,” Kurt Campbell, President Biden’s policy coordinator for  \nthe Indo-Pacific, said Wednesday. Speaking during an online event, Campbell  \nsaid, “We want to look this fall to convene an in-person Quad and the hope will  \nbe to make a similar kind of engagement on infrastructure more generally,”  \nadding that if “there are other countries that believe that they’d like to  \nengage and work with us, the door will be open as we go forward.” \n38 \nKIM VOWS “UNCOMPROMISING STRUGGLE” TO BUILD SOCIALISM IN NORTH KOREA. <> The AP \n  \n \n (5/27,Kim) reports North Korean leader Kim Jong Un has “vowed an  \n‘uncompromising struggle’ against anti-socialist elements at home, state media  \nreported Thursday, as he tries to fortify his power amid pandemic-related  \ndifficulties and US-led economic sanctions.” Kim’s comments come “as doubts  \nincrease about both North Korea’s economy and whether it will engage in serious  \ndisarmament talks with Washington.” \n \nMCCONNELL PRAISED ADMINISTRATION FOR BURMA COUP RESPONSE. <> The Hill  \n \n (5/26,Axelrod, 5.69M) reports that Senate Minority Leader McConnell “offered  \nrare praise Wednesday for the Biden Administration over its response to the  \nmilitary coup in Myanmar.” McConnell said, “I have been in close touch with the  \nBiden Administration on Burma, discussing how to best support opposition to the  \njunta while standing up new targeted sanctions and export licensing bans to hit  \nthe leaders of the military coup where it hurts: in the wallet. And I’ve been  \nencouraged by the Administration’s swift response.” \n \nUS ENVOY CONFIDENT TAIWAN CAN DEAL WITH SPIKE ON COVID CASES. <> Reuters  \n \n (5/26) reports that on Wednesday, Brent Christensen, “the outgoing de facto  \nU.S. ambassador in Taipei,” maintained that he is “confident Taiwan could  \ncontrol a spike in COVID-19 cases, noting its infection numbers remained quite  \nlow, and that they were in talks on vaccines though did not say shots were on  \nthe way.” According to Reuters, “After months of relative safety, Taiwan is  \nbattling a surge in domestic COVID-19 cases, but has only vaccinated around 1%  \nof its more than 23 million people.” Last week, Taiwan’s health minister “spoke  \nto his U.S. counterpart to ask for help after President Joe Biden said he would  \nsend at least 20 million more COVID-19 vaccine doses abroad by the end of June.” \n \nSouth Asia: \n \nTALIBAN WARNS AFGHANISTAN’S NEIGHBORS AGAINST HOSTING US TROOPS. <> Reuters  \n \n (5/26) reports that on Wednesday, the Taliban “warned nearby nations against  \nallowing the United States to use their territory for operations in the country  \nafter they withdraw from Afghanistan.” According to Reuters, “Experts and  \ndiplomats have speculated that Washington’s future role in the region could  \ninclude bases in nearby countries, especially Pakistan.” Reuters adds that “in  \nrecent days, there has been a spate of talks between senior Pakistani and U.S.  \nofficials, including a meeting between Biden’s National Security Adviser Jake  \nSullivan and his Pakistani counterpart.” \n \nUS Carrier To Move To Support Afghan Withdrawal. In an “exclusive,” the Wall  \nStreet Journal  \n39 \n (5/26,Youssef, Lubold, Subscription Publication, 8.41M) reports that the  \nPentagon is expected to move the USS Ronald Reagan, the only carrier in the  \nAsia-Pacific region, toward the Middle East to support the withdrawal of US  \nforces. The warship is expected to depart its home port of Yokosuka, Japan and  \nhead for the region this summer, and operate there for three to four months.CNN  \n \n (5/27, 89.21M) reports analysts “say the move could leave a gap in US carrier  \ncoverage in East Asia at a time when Beijing is turning up the heat over the  \nSouth China Sea and Taiwan.” \n \n In an editorial, the Wall Street Journal  \n (5/26,  \nSubscription Publication, 8.41M) says that the move will leave the US without a  \ncarrier in the Western Pacific, which sends a clear message that the US needs  \nto boost its naval assets and adjust its strategies to current realities. \n \nPAKISTANI JOURNALIST ALLEGES INTELLIGENCE AGENTS ATTACKED HIM IN HIS APARTMENT. \n <> The AP  \n \n (5/26) reports a journalist critical of “Pakistan’s powerful military and  \nintelligence agencies was severely beaten by three unidentified men in an  \nattack at his apartment in Islamabad, the journalist and colleagues said  \nWednesday.” Asad Ali Toor, who works “for the Aaj News Pakistani TV channel,  \ntold police in a statement the attackers claimed they were intelligence agents.” \n \nWHATSAPP SUES INDIAN GOVERNMENT OVER MESSAGE TRACEABILITY RULES. <> The AP  \n \n (5/26, Saaliq,Soo) reports new regulations for technology companies that  \noperate in India prompted WhatsApp to file a lawsuit “in the Delhi High Court.”  \nThe suit, which was filed against India’s government, alleges that “rules  \nregarding the traceability of messages are unconstitutional and undermine the  \nfundamental right to privacy.” WhatsApp “uses end-to-end encryption for its  \nmessaging service, which encrypts messages in such a way that no one apart from  \nthe sender and receiver are able to read the messages sent between them.”Reuters \n  \n \n (5/26,Menn) reports that when it was asked to comment on its suit, WhatsApp  \nstated, “Requiring messaging apps to ‘trace’ chats is the equivalent of asking  \nus to keep a fingerprint of every single message sent on WhatsApp, which would  \nbreak end-to-end encryption.” \n \nNYTIMES: OFFICIAL FIGURES “GROSSLY UNDERSTATE” PANDEMIC IMPACT IN INDIA. <> The \nNew York Times  \n \n (5/25, Gamio, Glanz, 20.6M) examines the ongoing COVID surge in India, and,  \nwhile India “recorded the largest daily death toll for any country during the  \npandemic,” the official figures “grossly understate the true scale of the  \n40pandemic.” The Times interviewed a variety of public health experts to better  \nunderstand the scope of the tragedy facing India, and their assessment found  \nthat estimated infections and death “far exceed official figures.” The “most  \npessimistic” conclusions “show a toll on the order of millions of deaths — the  \nmost catastrophic loss anywhere in the world.” \n \nWestern Hemisphere: \n \nAMLO’S PARTY EXPECTED TO MAINTAIN CONTROL OF LOWER HOUSE. <> Reuters  \n \n (5/26) reports Mexican President Andres Manuel Lopez Obrador’s “National  \nRegeneration Movement (MORENA) and its allies are expected to maintain control  \nof the lower house of Congress in elections on June 6, but with fewer seats, an  \nopinion poll showed Wednesday.” The May 15-18 survey “of 1,500 registered  \nvoters by polling firm GEA-ISA showed the leftist MORENA winning 209 seats in  \nthe 500-seat lower house, compared to the 253 it currently holds.” MORENA’s  \nallies the “Green Party and the Labor Party were seen picking up 50 seats  \nbetween them to ensure a majority, giving their alliance 259 in total, the poll  \nsaid.” \n \nMAYORAL CANDIDATE KILLED IN MEXICO, 34TH OF THIS ELECTION CYCLE. <> The AP  \n \n (5/26,Arredondo) reports Mexican mayoral candidate Alma Barragán was killed  \nTuesday “while campaigning for the mayorship of the city of Moroleón in  \nviolence-plagued Guanajuato state.” Barragán’s death brings “to 34 the number  \nof candidates murdered nationwide ahead of the June 6 elections.” President  \nAndrés Manuel López Obrador “said Wednesday the killing was ‘without doubt’ the  \nwork of organized crime gangs.” \n \nFORMER BOLIVIAN INTERIOR MINISTER ARRESTED IN US FOR MONEY LAUNDERING. <> The  \nAP  \n \n (5/26,Goodman) reports Bolivia’s former interior minister “has been arrested  \nin the US for allegedly taking part of $602,000 in kickbacks from Florida-based  \nbusinessmen accused of selling tear gas at inflated prices to the conservative  \ngovernment of former interim President Jeanine Áñez.” Arturo Murillo was  \ncharged “with a single count of conspiring to commit money laundering,  \naccording to a Department of Justice statement on Wednesday.” \n \nCybersecurity: \n \nCOLONIAL PIPELINE REBUFFED TSA SECURITY REVIEW BEFORE HACK. <> The Wall Street  \nJournal  \n \n (5/26,Uberti, Subscription Publication, 8.41M) reports that Colonial Pipeline  \nCo. last year did not submit to a requested federal security review of its  \nfacilities and was in the process of arranging a separate audit of its computer  \nnetworks when it was hacked earlier this month. The Journal adds that it is  \n41unclear if the TSA security assessment would have uncovered network  \nvulnerabilities that were exploited by the hacking group DarkSide, authorities  \nsaid. \n \nTSA, CISA Working With Private Companies On Cybersecurity. The AP  \n \n (5/25) reports TSA and CISA “are working with private companies to address  \ncyber threats,” according to statements by DHS.. “The Biden Administration is  \ntaking further action to better secure our nation’s critical infrastructure,”  \nit said. The American Petroleum Institute “said in a statement that its members  \nare working with the administration to develop reporting policies and that any  \nnew regulations” should include “reciprocal information sharing and liability  \nprotections.” \n \n The Washington Post  \n \n (5/26,Schaffer, 10.52M) reports DHS plans to go “even further in coming weeks,  \nreleasing mandatory cybersecurity protections that pipeline companies must  \nimplement and steps they must take if they’re hacked.” The companies would face  \n“financial penalties if they fall short on those cyber protections.” Federal  \nagencies are themselves “still far behind in protecting against cyberattacks  \nthat tunnel in through their web of IT contractors, a government auditor  \nyesterday told lawmakers on the House Committee on Science Space and  \nTechnology.” \n \nNPR  \n \n (5/26,Schneider, 3.69M) also reports. \n \nGAO: Federal Agencies “Struggling” With Supply Chain Security. Gov Info  \nSecurity  \n \n (5/26,McGee) reports more than five months “after the SolarWinds supply chain  \nattack came to light, federal agencies continue to struggle with supply chain  \nsecurity, according to a Government Accountability Office official who  \ntestified at a congressional hearing Tuesday.” Since the attack, “only a  \nhandful of executive branch departments have made updates to their security  \nprotocols, and none are fully protected against these types of intrusions,  \nVijay D’Souza, GAO’s director of information technology and cybersecurity,  \ntestified.” The GAO released an “audit in December 2020 that found 14 of 23  \nlarge federal agencies had not implemented any of seven supply chain risk  \nmanagement practices that the agency had previously recommended.” Since that  \nreport was “released, only six of the 23 agencies have provided the GAO with  \nupdates about plans to implement more of the supply chain risk management  \nprotections, D’Souza told members of Congress.” \n \nBIDEN BUDGET REQUEST TO GROW CYBER COMMAND. <> Politico  \n \n42 (5/26,Matishak, Seligman, 6.73M) reports President Biden’s upcoming “budget  \nrequest will propose growing US Cyber Command’s main digital warfighting force  \nover the next two years, according to two people familiar with the request, as  \nthe new administration reels from a series of cyberattacks.” Biden wants to  \n“increase the size of the Cyber Mission Force – a cadre of roughly 6,200  \npersonnel culled from the military branches and divided into 133 teams – by  \nabout 600 people, or 10 percent.” The exact “composition of the proposed teams  \nremains unclear, one of the people said.” Such a move “would mark the first  \nexpansion of the Cyber Mission Force since its structure was set in 2012.” \n \nRUSSIA’S FSB REPORTS “UNPRECEDENTED” HACKING CAMPAIGN. <> Reuters  \n \n (5/26) reports foreign hackers compromised “Russian federal agencies in a  \ndigital espionage campaign that Russian officials described as unprecedented in  \nscope and sophistication.” The “little-noticed report” published this month by  \nthe FSB and Rostelecom-Solar provides an “unusually detailed look at a  \npurportedly state-backed cyber spying operation aimed at the Russian state.”  \nCiting the hackers’ “‘thorough preparation’ and their intimate knowledge of  \nRussian antivirus firm Kaspersky Lab’s software,” the report said, “Assessing  \nthe attackers’ level of preparedness and qualification...we are inclined to  \nrefer to this group as cyber mercenaries, pursuing the interests of a foreign  \nstate.” Kaspersky told Reuters it “was aware of the report, but had no  \ninformation to suggest that the hackers had exploited any vulnerabilities in  \nits products.” \n \nFACEBOOK: RUSSIA TOP PRODUCER OF DISINFORMATION. <> The Washington Post  \n \n (5/26, 10.52M) says “a Facebook report released Wednesday says that Russia is  \nstill the largest producer of disinformation.” According to the Post, Facebook  \n“says it has uncovered disinformation campaigns in more than 50 countries since  \n2017,” and the report “highlights how such coordinated efforts have become more  \nsophisticated and costly to run in recent years – even as these operators  \nstruggle to influence large numbers of people as they once did.” \n \nCNN  \n \n (5/26,Fung, 89.21M) reports that in addition to Russia, Iran was also tagged  \nas a major producer of disinformation. However, during the 2020 elections, “it  \nwas US domestic actors, not foreign operatives, who were increasingly  \nresponsible for sowing disinformation.” \n \n The AP  \n \n (5/26,Lardieri) reports that according to the “report, of the 150 networks  \nFacebook has dismantled since 2017, 45% were targeting domestic audiences, with  \n38% targeting countries abroad. Of the countries most frequently targeted by  \nforeign disinformation networks, the US was the top target, followed by Ukraine  \nand the United Kingdom.” \n43 \nNBC News  \n \n (5/26, 4.91M) reports Facebook “says it shut down 150 networks of fake  \naccounts between 2017 and the end of 2020.” Facebook doesn’t attribute “the  \ncampaigns to governments, but many of the Russian and Iranian campaigns had all  \nthe hallmarks of intelligence influence operations, private researchers said.”  \nThe report does not cover “the post-election misinformation campaign that paved  \nthe way for the Jan. 6 capital riots, which did not involve fake accounts.” \n \nSex Trafficking Survivor Asks Facebook To Delay End-To-End Encryption  \nMessaging Plan. The Daily Dot  \n \n (5/26, Goforth, 353K) reports “sex trafficking survivor Sarah Cooper” asked  \nFacebook to study sex trafficking on its site “before it adds additional  \nend-to-end encryption to its messaging services.” Cooper made that request on  \nWednesday, during “Facebook’s annual shareholders meeting.” Copper’s request  \ncomes after a US Department of Justice push to gain access to encrypted  \nmessages prompted some, including a Tufts University computer security  \nprofessor named Susan Landau, to express concern. In 2019, Landau stated, “It  \nis very easy to listen in on communications. Securing data is a clear national  \nsecurity interest.” But on Wednesday, Cooper said a failure to delay  \nimplementing Facebook’s end-to-end encryption messaging plan would make  \nFacebook “one of the world’s most dangerous platforms for children.” Cooper  \nsaid Facebook “should absolutely delay expanding encryption on its platform  \nuntil it can protect children.” \n \nHACKERS RELEASE NEW ZEALAND PATIENT DATA. <> The Hill  \n \n (5/26,Miller, 5.69M) reports hackers sent patient data “stolen during an  \nattack on New Zealand’s Waikato District health system to local media outlets  \non Wednesday, with the outlets declining to publish the sensitive information.”  \nThe Waikato District Health Board (DHB) “confirmed the attack” in a statement  \nWednesday, saying that it is “aware that the media have received what appears  \nto be personal and patient information from Waikato DHB information systems.” \n \nCANADA POST NOTIFIES BUSINESS CUSTOMERS OF “DATA BREACH AFFECTING 950K  \nCUSTOMERS.” <> CTV News (CAN)  \n \n (5/26, 278K) reports the Canada Post has informed “44 of its large business  \ncustomers that information relating to more than 950,000 customers was  \ncompromised after one of its suppliers fell victim to a malware attack late  \nlast week.” On Wednesday, the postal agency “announced that Commport  \nCommunications, an electronic data interchange solution supplier, had notified  \nthem that manifest data held in their systems, which are associated with Canada  \nPost customers, had been ‘compromised’ in an attack on May 19.” \n \nBIPARTISAN ENCRYPTION BILL INTRODUCED IN HOUSE. <> MeriTalk  \n44 \n (5/26, Polit) reports Reps. Ted Lieu (D-CA) and Nancy Mace (R-SC) led a  \n“bipartisan group of legislators in reintroducing the Ensuring National  \nConstitutional Rights for Your Private Telecommunications (ENCRYPT) Act.” The  \nlegislation, which was “first introduced in 2016, would supersede state and  \nlocal government encryption laws to ensure a uniform, national policy for the  \ninterstate issue of encryption technology.” \n \nEditorial Roundup: \n \nWASHINGTON POST. <> “Who Were The First Coronavirus Cases? China Should Help  \nSolve The Mystery.” The Washington Post  \n \n (5/26, 10.52M) argues that the ongoing international investigation into  \nCOVID’s origins is critical, and China “should help solve this mystery, but it  \nso far has thrown a cloak over it.” While China “steadfastly denies there was  \nan inadvertent leak from the Wuhan Institute of Virology,” the only way to  \nresolve the question of China’s potential culpability is to support the WHO’s  \nongoing investigation. \n \n“John Warner Was The Kind Of Republican The Country Needs Now.” The Washington  \nPost  \n \n (5/26, 10.52M) said that while former Sen. John W. Warner (R-VA) was a  \n“rock-ribbed Republican,” his “brand of Republicanism — suspicious of populism,  \nrepelled by extremists, prizing principle over partisanship — is all but  \nunrecognizable today.” The Post notes that he endorsed by Hillary Clinton in  \n2016 and Joe Biden in 2020. Today, the Post concludes, “in an era of lockstep  \nparty loyalty, Mr. Warner may look like a throwback. In fact, he was the  \nembodiment of patriotic public service.” \n \nWALL STREET JOURNAL. <> “The Virus Lab Theory’s New Credibility.” The Wall  \nStreet Journal  \n \n (5/26, Subscription Publication, 8.41M) examines the efforts made by  \nscientists, media personalities, and government officials to disregard the  \nlab-leak COVID origin theory last year, and it criticizes the slow reversal of  \nopinion over the past few months. The Journal calls on scientists and other  \nexperts to conduct a thorough investigation in order to better protect the US  \nfrom future pandemic threats. \n \n“The Proxy Coup At Exxon.”  \n \n“Illinois’s Big Labor Bill Of Rights.”  \n \n“The Missing Aircraft Carrier.” The Wall Street Journal  \n (5/26,  \nSubscription Publication, 8.41M) says in an editorial that on Wednesday, the  \n45Pentagon will dispatch the USS Ronald Reagan to the Middle East to cover the  \nU.S. and NATO withdrawal from Afghanistan, thus leaving the U.S. without a  \ncarrier in the Western Pacific for several months. The Journal refers to this  \nmove by President Biden as a misuse of naval resources, commenting that it  \nwould have made more sense for the U.S. to remain in Afghanistan with reduced  \nforces. \n \nThe Big Picture: \n \nHEADLINES FROM TODAY’S FRONT PAGES. <>  \n \nWall Street Journal: \nOil Giants Are Dealt Major Defeats On Climate-Change As Pressures Intensify  \n \nBiden Calls For Intelligence Report On Origins Of Covid-19  \n \nWhy A Grand Plan To Vaccinate The World Against Covid Unraveled  \n \nCities Reverse Defunding The Police Amid Rising Crime  \n \nGoogle Strikes Deal With Hospital Chain To Develop Healthcare Algorithms  \n \nAmericans Are On The Move. Their Stuff Doesn’t Always Follow.  \n \n \nWashington Post: \nBiden Asks For Report On Virus’s Origins  \n \nGroup’s Legal Blitz Deters Vaccine Mandates  \n \nWorker Fatally Shoots 8 At Calif. Rail Yard  \n \nStockholders, Court Deliver Reckoning To Big Oil  \n \n5-Term Senator From Va. Often Went His Own Way  \n \nAmazon Expands Its Hollywood Ambitions  \n \n \nFinancial Times: \nCummings Launches Stinging Attack On Johnson And Handling Of Covid Crisis  \n \nClimate Activists Hail Breakthrough Victories Over Exxon And Shell  \n \nLabour Shortages Hit Advanced Economies Despite Many Out Of Work  \n \nAmazon Agrees Deal To Buy MGM For $8.45BN  \n \n46 \nStory Lineup From Last Night’s Network News: \nABC: San Jose Shooting; COVID Origins; COVID Update; Severe Weather;  \nCalifornia-BB Gun Shootings; Idaho-Daybell Case; Amazon-Noose At Work Site;  \nSen. John Warner Death; Chadwick Boseman Tribute; Man With Down Syndrome Hired  \nFull Time At UPS. \nCBS: San Jose Shooting; COVID Origins; Memorial Day Travel; COVID Update;  \nSevere Weather; Idaho-Daybell Case; COVID-Immunocompromised Folks; Sen. John  \nWarner Death; Amazon-MGM; Boston-Apartment Fire; Lunar Eclipse; Remembering  \nSamuel E. Wright. \nNBC: San Jose Shooting; COVID Origins; COVID Update; Marjorie Taylor Greene  \nComments; Israel/Gaza; Tokyo Olympics; Sen. John Warner Death; Amazon-MGM; Los  \nAngeles-Criminal Justice System; 10-Year-Old Chess Master. \n \nNetwork TV At A Glance: \n San Jose Shooting – 11 minutes, 0 seconds \n COVID Origins – 7 minutes, 30 seconds \n COVID Update – 7 minutes, 30 seconds \n Sen. John Warner Death – 0 minutes, 55 seconds \n \n \nCopyright 2021 by Bulletin Intelligence LLC Reproduction or redistribution  \nwithout permission prohibited. Content is drawn from thousands of newspapers,  \nnational magazines, national and local television programs, radio broadcasts,  \nsocial-media platforms and additional forms of open-source data. Sources for  \nBulletin Intelligence audience-size estimates include Scarborough, GfK MRI,  \ncomScore, Nielsen, and the Audit Bureau of Circulation. Data from and access to  \nthird party social media platforms, including but not limited to Facebook,  \nTwitter, Instagram and others, is subject to the respective platform’s terms of  \nuse. Services that include Factiva content are governed by Factiva’sterms of use \n . Services including  \nembedded Tweets are also subject toTwitter for Website's information and  \nprivacy policies . The Director  \nof National Intelligence News Summary is published five days a week by Bulletin  \nIntelligence, which creates custom briefings for government and corporate  \nleaders. We can be found on the Web at BulletinIntelligence.com, or called at  \n(703) 483-6100. \n \n \n \nWatch Officer – Team 1| DNI Watch \nOffice  of the Director of National Intelligence \n  \n \n \n====================================================== \nClassification: UNCLASSIFIED \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n \n     \n \n \n \n       \n \n&* ORIGINAL EMAIL ATTACHMENTS HAVE BEEN QUARANTINED ***  \nThe following original attachment(s) are awaiting your approval:\nimage001.png\nAgenda- 2019-nCoV.docx\nSOW.docx\nIf you trust the sender, click the following to have your message and original attachments resent\nto you: \nQuarantine link ---> https://glide.cia/glide/Quarantine/Quarantine.html?id=1240695673  \nThese attachment(s) will be available for retrieval for 14 days (Wed Aug 04 13:59:04 EDT 2021).\nFor additional information regarding the attachment removal (quarantine) function, please visit thefollowing site: https://confluence.devops.cia.ic.gov/display/ECDSSUP/ANTE+Up+Overview\n .\n============================ ====================\nClassification: UNCLASSIFIED\n \n\nGenomic Study Points to Natural Origin of COVID-19 – NIH Director's Blog https://directorsblog.nih.gov/2020/03/26/genomic-resear ch-points-to-natural-origin-of-covid-19 /\n1 of 9 3/27/2020, 9:48 AM\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\nGenomic Study Points to Natural Origin of COVID-19 – NIH Director's Blog https://directorsblog.nih.gov/2020/03/26/genomic-resear ch-points-to-natural-origin-of-covid-19 /\n2 of 9 3/27/2020, 9:48 AM\nGenomic Study Points to Natural Origin of COVID-19 – NIH Director's Blog https://directorsblog.nih.gov/2020/03/26/genomic-resear ch-points-to-natural-origin-of-covid-19 /\n3 of 9 3/27/2020, 9:48 AM\nGenomic Study Points to Natural Origin of COVID-19 – NIH Director's Blog https://directorsblog.nih.gov/2020/03/26/genomic-resear ch-points-to-natural-origin-of-covid-19 /\n5 of 9 3/27/2020, 9:48 AM\n\nGenomic Study Points to Natural Origin of COVID-19 – NIH Director's Blog https://directorsblog.nih.gov/2020/03/26/genomic-resear ch-points-to-natural-origin-of-covid-19 /\n6 of 9 3/27/2020, 9:48 AM\nGenomic Study Points to Natural Origin of COVID-19 – NIH Director's Blog https://directorsblog.nih.gov/2020/03/26/genomic-resear ch-points-to-natural-origin-of-covid-19 /\n8 of 9 3/27/2020, 9:48 AM\n\nGenomic Study Points to Natural Origin of COVID-19 – NIH Director's Blog https://directorsblog.nih.gov/2020/03/26/genomic-resear ch-points-to-natural-origin-of-covid-19 /\n9 of 9 3/27/2020, 9:48 AM\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n1From: Christopher C. Fonzone-DNI-\nSent: Monday, August 16, 2021 9:08 PM\nTo: Avril D. Haines-DNI-\nCc:  Matthew C. Rhoades-DNI-;  \nSubject: Talking Points and Letter on Whistleblower Issue\nAttachments:  Letter to DNI re COVID origin urgent concern with enclosures \nSigned.pdf; HPSCI SSCI WB Transmittal Letter v.3.docx\nFollow Up Flag: Follow up\nFlag Status: Flagged\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nAvril – \n \nGiven everything that’s going on, I’m sure this is the last thing that you want to deal with.  But, as we discussed late last \nweek, we’ve pulled together:  (1) some draft points that you could use to call S/HHS or DS/HHS (or I could use, with \nslight adaptations, to call GC/HHS) concerning the whistleblower complaint; and (2) a letter that you (or potentially you \nand S/HHS) could send to accompany the transmission of the complaint to Congress.  (I’ve also attached the relevant \nletter so you have it all in one place.) \n \nI know your schedule is probably a mess tomorrow (and in coming days), but, if you have a minute after tomorrow \nmorning’s stand-up, perhaps we can touch base quickly on next steps.  Of course, if that doesn’t work or isn’t a good \ntime, I am happy to try to make work any time that is good for you. \n \nMany thanks, \n \nChris  \n \n \n \nDRAFT TALKING POINTS  \n I wanted to call to tell you about a whistleblower complaint the Acting Inspector General \nof the Intelligence Community (“IC IG”) recently brought to my attention. \n The complaint alleges that there is intelligence reporting contradicting Dr. Fauci’s \ntestimony to the Congress that no “gain-of- function research” occurred (or at least wasn’t \n“paid for” by NIH) at the Wuhan Institute of Virology.  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2 The Acting IC IG could not conclude that the intelligence reporting cited by the \ncomplaint contradicted the relevant testimony, and my understanding, based on a \nconversation my team had with our expert on the topic, is that there is substantial \ndisagreement within the scientific community as to what even constitutes “gain-of-\nfunction research.”   \n Nonetheless, given the nature of the complaint – which is classified – I believe we should \nprovide it to the congressional intelligence committees.     \n Before we did so, however, I wanted to reach out to you to make sure you were aware of \nthe situation and to discuss what steps it would be appropriate to take – and inform \nCongress we were taking – in light of the complaint.   \n To that end, one idea would be for the Acting IC IG to transmit the complaint to HHS’s \nInspector General, so that official can also take a look.  If we go that route, I would \ncommit to ensuring that the HHS IG has access to the intelligence necessary to review the \ncomplaint. \n We could also then simultaneously inform Congress of the complaint and our plans for \naddressing it.   \n \n====================================================== \nClassification:  \n \n\n1From: Christopher C. Fonzone-DNI-\nSent: Thursday, August 19, 2021 9:13 PM\nTo: Avril D. Haines-DNI-\nCc: Stacey A. Dixon-DNI-; Morgan Muir-DNI-; \n; Matthew C. Rhoades-DNI-; \nSubject: Whistleblower Issue -- Revised Letter after Discussion and Transcript Review\nAttachments: HPSCI SSCI WB Transmittal Letter v.4 -- clean.docx; HPSCI SSCI WB Transmittal Letter \nv.4.docx;  Letter to DNI re COVID origin urgent concern with \nenclosures Signed.pdf\nFollow Up Flag: Follow up\nFlag Status: Flagged\nClassification:  \n \nClassified By:  \nDerived From:  \nDeclassify On:  \n====================================================== \n \nAvril – \n \nFollowing up on our conversation this morning, we have reviewed \ntranscripts from some of Dr. Fauci’s appearances on the Hill.  \n \nBased on that review, it seems likely that the whistleblower complaint was \nreferring to exchanges Dr. Fauci had with Senator Paul on May 11 and July \n20.  During the May 11 hearing, Dr. Fauci stated that “the NIH has not \never and does not now fund gain of function research in the Wuhan \nInstitute.”  During the July 20 hearing, Senator Paul confronted Dr. Fauci \non the prior statement, asking him if he wanted to retract it; Dr. Fauci \nof course stood behind it.   \n \nThus, while it is possible that Dr. Fauci has spoken to Congress about \ngain-of-function research at some other point (he’s testified a number of \ntimes!), I think the key thing is that what we’ve seen is consistent with \nthe point that Secretary Becerra made to you – that this is something \nthey’ve considered and that Dr. Fauci has point he’s repeated about the \nNIH not funding gain-of-function at the WIV. \n \nWe’ve thus updated the draft letter to note this point and to refer the \ncomplaint to Secretary Becerra, rather than the HHS IG; tracked changes \nand clean versions are attached.  We’ve also attached the original letter \nfrom the IC IG, so you have everything in one place. \n \nMany thanks, and happy to discuss, if it would be helpful to do so,  \n \nChris  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n2 \n \n====================================================== \nClassification:  \n \n\n \nhttp://2013.igem.org/Team:WHU -China/noteProtocal  \nhttp://2013.igem.org/Team:WHU -China/teammember#our team  \nHello world, we are 2013 iGEM WHU- China. \nWe are the third team of Wuhan University attending iGEM jamboree. Of course, it is great to have a good tradition here, the senior team member lead us to this amazing field of synthetic biology and give us tremendous help either in experiment or other parts of this match.  \nWhat is more important is that we combine those with our novel ideas, passion and efforts. Every time when we carry out a brain storm, when we debate for a better solution or when we do experiment throughout the whole night, fire are burning in our heart, because we know the world will be a little different, a little better by what we are doing.  \nFrom December 2012, we have passed 8 months. And steps never stop, even in the Spring Festival, meeting online kept \nour minds together. Although we have experienced the pains of member changing, everyone who loves this team \ndevotes what he or she can.  \nNow it is the time for WHU -China to give you all a surprise.  \nAnd it is time for us to give a answer to ourselves!  \nHere we come.  \n Yang LIU | Senior in Biological Sciences  \nYang is our funny and optimistic buddy, the “laughs producer”. He has participated in a molecular virology lab for more \nthan two years. His skill in experiment is indispensable. He is also the lab manager and diplomatist, who tackles with \nissues with our funder and keeps the experiment run. He never let us down.  \n \nYu CHEN  \nOur instructor, Dr. Chen  joined the virology department of college of life science in Wuhan University as associate \nprofessor in July, 2009, having moved from biotechnology research institute, the University of Helsinki, where he held the project of the mechanism of RNA virus’ RN A capping. His degree is BA in Biotechnology in Wuhan University (2003), \nfollowed by PhD in modern molecular virology in Wuhan University (2008). Doctor Chen’s research interests extends \nfrom SARS Coronavirus Nonstructural Protein nsp16, siRNA to the mechanism of RNA virus replication and transcription.  \nDoctor Chen is a responsible and approachable teacher and he offered us a lot of constructive suggestions based on his rich experience in molecule cloning.  \n \nhttp://2013.igem.org/Team:WHU -China/noteProtocal  \n \n \n \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\nhttp://2013.igem.org/Team:WHU -China/introduction  \n \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n4I've been detailed down to OSD to manage the science portfolio for DoD's COVID-19 TF. I've been focused mostly on \nmodeling coordination so far (since Thursday...) but this definitely fits with my current mission also. \n \n \n \n \n \n \n \n--------------------------------------- \n \n \n \n \n \nChief Intelligence Officer \n \nJoint Program Executive Office for CBRN Defense                                                                                                               \n \nDepartment of Defense \n \n \n \n \n \n \n \n \nFrom:   \nSent: Monday, March 23, 2020 3:02 PM \nTo:  \n \nCc:   \n \nSubject: RE: (U) Interest in a discussion about COV SARS2 and gain of function research \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nNothing further from me. I have not responded to any of  emails yet because I haven't had time today and have \nhigher priorities. \n \n \n \n\n5From:   \nSent: Monday, March 23, 2020 2:54 PM \nTo: \nCc:  \n \n \n \nSubject: RE: (U) Interest in a discussion about COV SARS2 and gain of function research --- UNCLASSIFIED  \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nDoes anyone have more info on the \"colleague who has put together an analysis that may be wise to discuss at some \npoint.\"?? Some of our policymakers have heard from a specific person at MITRE claiming the virus is genetically \nengineered - but we haven't seen any specific analysis supporting the claim. Would love to learn more if someone has \nseen this sort of analysis.  \n \n \n \n \n \n \n \n \n \nBureau of Intelligence and Research \n \nU.S. Department of State \n \n \n \n \n \n \n \n \n \nFrom:   \nSent: Monday, March 23, 2020 11:32 AM \nTo:  \n \n \nSubject: RE: (U) Interest in a discussion about COV SARS2 and gain of function research \n\n6 \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nNothing to add; just letting everyone know  is out this week, so you're stuck with me in NIO S&T.  My molecular \nbiology and genetics are pretty thin, but my BS meter is strong. Please keep me in the loop and let me know if there's \nanything I can do to assist. \n \n \n \n-           \n \n \n \n \n \n \n \n  \n \n \n \n  \n \n \n \nFrom:   \nSent: Friday, March 20, 2020 6:54 PM \nTo:  \nCc:  \n \n \n \n \nSubject: RE: (U) Interest in a discussion about COV SARS2 and gain of function research \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \nHi  \n \n \n \nWhen I saw in the cc line- \"COV SAR2 and gain of function research\", it got my attention. \n\n7 \n \n \nI've been tracking this pretty closely in the literature, and would advise to set a very high threshold for any GOF \ninterpretation as an origin of SAR COV-2.  \n \nNot saying it is impossible, but I think Occam's razor is the best guidance here. \n \nWhile clearly the S protein furin cleavage site appears consistent with a GOF modification, there is precedent for co-\ncirculating COV strains recombining.  \n \nDifferent coronaviruses do co-circulate in hosts, and this amino acid sequence is present in COVs circulating in other bat \nhosts that are regionally co-located with the host from which RaTG13 was isolated.  \n \nAlso, phylogenic analysis identifies this site as undergoing a high degree of homoplasy - so it's an adaptation hot spot.    \n \nSo- lots of room for a natural explanations-many that I've captured and highlighted in my attached notes.  \n \n \n \n \n  \n \n \n  \n \nTo be honest - I cannot imagine the Chinese NOT doing this type of research, but an escaped P3+/P4 LAI would be \nextraordinary. \n \n \n \n is on the fence with this, and maybe leaning toward the GOF explanation, but as an actual trained \ncoronavirus virologist, he would be the first person I'd ask ( and I have). \n \nIf he goes all in on the GOF assessment, I'd bring  ii. \n \nI think the IC needs to be very thorough with this analysis. \n \n \n \nHopefully you will find my notes helpful, but feel free to ignore them... they are really just for my own  use as you will \nsee. \n \n \n \nI'm out next week, unless  or  are unable to come in. \n \n \n \nGood luck, and stay healthy! \n \n \n\n8 \n \n \n \n \n \n \nNational Intelligence Council / Office of the Director of National Intelligence \n \n \n \n \n \n \n \n \n \n \n \nFrom:   \nSent: Friday, March 20, 2020 2:03 PM \nTo:  \nCc:  \nSubject: RE: (U) Interest in a discussion about COV SARS2 and gain of function research \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \n \n \nFrom:   \nSent: Friday, March 20, 2020 2:02 PM \nTo:  \nCc:  \nSubject: (U) Interest in a discussion about COV SARS2 and gain of function research \n \n \n \nClassification: UNCLASSIFIED  \n====================================================== \n \n \n \n(U ) Hi  -  provided me your name when I called him a few minutes ago. We are colleagues from \nDOE-IN. I recently took a three year appointment as a  at  hence the different email. \n \n\n9 \n \n(U ) I was hoping we could discuss the various information and analysis that is churning around regarding S \nprotein manipulation in the virology community and how the NIC is interpreting the information. I have a colleague who \nhas put together an analysis that may be wise to discuss at some point. \n \n \n \n(U ) If there is a good time and number to reach you on Monday, please let me know. \n \n \n \nSincerely, \n \n \n \n \n \n \n \n \n \n \n \n \n \nSupport to ODNI   \n \n \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n\n10====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification: UNCLASSIFIED  \n \n \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n====================================================== \nClassification:  \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\nStatement of Work\nRapid Response for Assessment of Data Needs for 2019-nCoV\nFebruary 3, 2020\nStatement of Task: \nIn response to a request from OSTP , the NASEM will examine information and identify data requirements that \nwould help determine the origins of 2019-nCoV, specifically from an evolutionary/structural biology standpoint.  \nNASEM will also consider whether this should include more temporally and geographically diverse clinical \nisolates, sequences, etc.  Although a widely-disputed paper posted on a pre-print server last week has since been\nwithdrawn, the response to that paper highlights the need to determine these information needs as quickly as \npossible.  As part of a broader deliberative process, this review will  help prepare for future events by establishing\na process for quickly assembling subject matter experts for evaluation of other potentially threatening \norganisms.  \nWorkplan:\nNASEM will hold a meeting of experts to assess what data, information and samples are needed to address the \nunknowns, in order to understand the evolutionary origins of NCoV and more effectively respond to both the \noutbreak and any resulting misinformation. A statement from the National Academies will be prepared and \npublished on the Web as a “Based on Science” article that summarizes the status and needs for more and what \ntypes of data. A more in-depth examination of the issues will be established as a follow up as needed. \n500 Fifth Street, NW, Washington, DC 20001\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\nSynthetic recombinant bat SARS-like coronavirus\nis infectious in cultured cells and in mice\nMichelle M. Beckera,1, Rachel L. Grahamb,1, Eric F. Donaldsonb, Barry Rockxb, Amy C. Simsb,c, Timothy Sheahanb,\nRaymond J. Picklesd,e, Davide Cortif, Robert E. Johnstonc, Ralph S. Baricb,c,d,2, and Mark R. Denisona,g,2\nDepartments ofaPediatrics andgMicrobiology and Immunology, Vanderbilt University, Nashville, TN 37232; Departments ofbEpidemiology and\ndMicrobiology and Immunology,eCystic Fibrosis/Pulmonary Research and Treatment Center and Department of Medicine, andcCarolina Vaccine\nInstitute, University of North Carolina, Chapel Hill, NC 27599; andfInstitute for Research in Biomedicine, CH-6500 Bellinzona, Switzerland\nEdited by Peter Palese, Mount Sinai School of Medicine, New York, NY, and approved October 14, 2008 (received for review August 18, 2008)\nDefining prospective pathways by which zoonoses evolve and\nemerge as human pathogens is critical for anticipating and controllingboth natural and deliberate pandemics. However, predicting tenablepathways of animal-to-human movement has been hindered bychallenges in identifying reservoir species, cultivating zoonotic or-ganisms in culture, and isolating full-length genomes for cloning andgenetic studies. The ability to design and recover pathogens recon-stituted from synthesized cDNAs has the potential to overcome theseobstacles by allowing studies of replication and pathogenesis with-out identification of reservoir species or cultivation of primary iso-lates. Here, we report the design, synthesis, and recovery of thelargest synthetic replicating life form, a 29.7-kb bat severe acuterespiratory syndrome (SARS)-like coronavirus (Bat-SCoV), a likelyprogenitor to the SARS-CoV epidemic. To test a possible route ofemergence from the noncultivable Bat-SCoV to human SARS-CoV, wedesigned a consensus Bat-SCoV genome and replaced the Bat-SCoVSpike receptor-binding domain (RBD) with the SARS-CoV RBD (Bat-SRBD). Bat-SRBD was infectious in cell culture and in mice and wasefficiently neutralized by antibodies specific for both bat and humanCoV Spike proteins. Rational design, synthesis, and recovery of hy-pothetical recombinant viruses can be used to investigate mecha-nisms of transspecies movement of zoonoses and has great potentialto aid in rapid public health responses to known or predicted emerg-ing microbial threats.\nemerging pathogens /H20841synthetic biology /H20841vaccine development /H20841zoonoses\nEmergence of zoonotic-human pathogens is increasingly recog-\nnized as a threat to public health (1). Human population growth\nand environmental changes have created new opportunities forcontact between humans and zoonotic organisms that may result incross-species transmission and human disease (1, 2). Recent exam-ples include RNA viruses such as severe acute respiratory syndromecoronavirus (SARS-CoV), Ebola, Hanta, Nipah, and Chikungunyaviruses (2). However, the determinants regulating successful trans-species movement remain poorly understood due to challenges inidentifying viral precursors and animal reservoirs, thereby compli-cating vaccine and therapeutic design (3). SARS-CoV, whichexemplifies the challenges inherent in studying emerging patho-gens, was the first 21st century emerging virus to exhibit efficienthuman-to-human transmission and rapid global spread (4–6).Although zoonotic SARS-CoV strains were isolated from civetsand raccoon dogs (7–9), the epidemic likely originated from strainscirculating in bats (Bat-SCoVs) (10–12). Bat CoVs cluster in bothmajor mammalian CoV taxonomic groups, raising the possibilitythat Bat CoVs may be progenitors to all 4 known pathogenic humanCoVs (11, 13). Bats are also predicted to function as reservoirs forother important emerging human and animal viruses (14, 15).Although several complete Bat CoV genome sequences are avail-able, no Bat CoV has been successfully cultivated in cell culture orin animals (11, 13), severely limiting the identification of determi-\nnants of zoonotic CoV transspecies movement.\nThe SARS-CoV Spike is a 180-kDa type I membrane glycopro-\ntein that contains a well-defined receptor-binding domain (RBD).The SARS-CoV genome is likely a mosaic of sequences derived\nfrom multiple recombination events, although this hypothesis issomewhat controversial (16). However, recombination within Spikehas been described often (17), suggesting that the RBDs may beinterchangeable between strains (18–20). During the SARS-CoVoutbreak, evolution in the Spike RBD allowed for more efficientuse of human angiotensin-converting enzyme 2 (hACE2) as areceptor for entry (21, 22). Because future zoonoses are likely, it iscritical to identify strategies used by viruses to adapt in humanpopulations. In this study, we have combined phylogenetic andbioinformatics analyses, large-scale cDNA synthesis, chimeric genedesign, and reverse genetics to generate a consensus Bat-SCoV.Successful recovery of the infectious chimeric virus, Bat-SRBD,which includes the RBD within Spike from human SARS-CoV,demonstrates the plasticity of the CoV type I glycoprotein. Thesynthetic reconstruction and recovery of this novel chimeric virusidentifies a necessary genetic element for CoV cross-species trans-mission, establishes a model system for testing experimental evo-lution of zoonotic CoVs, and allows for testing of vaccine andtherapeutics against possible future zoonotic strains.\nResults\nConsensus Bat-SCoV Sequence Design and Construction. When this\nstudy was initiated, 4 Bat-SCoVs had been identified (HKU3–1,\nHKU3–2, HKU3–3, and RP3) as the virus reservoir populationsfrom which SARS-CoV emerged (10–12). Because none had beenrecovered in culture, the infectivity of the reported viral genomicRNA sequences was hypothetical, having been derived from RT-PCR sequencing of bat fecal or rectal swab samples. Sequencedatabases have error frequencies from 1/500 to 1/10,000, makingviable genome reconstruction problematic with increasing size (23).Therefore, we used the 4 reported Bat-SCoV sequences to establisha putative consensus Bat-SCoV sequence (GenBank accession no.FJ211859) and designed cDNA fragments with junctions preciselyaligned to the existing SARS-CoV reverse genetics system [Fig. 1 A;\nsupporting information (SI) Fig. S1 ] (24). The defined and func-\ntional SARS-CoV 5/H11032 UTR and transcriptional regulatory sequences\nAuthor contributions: M.M.B., R.L.G., E.F.D., R.S.B., and M.R.D. designed research; M.M.B.,\nR.L.G., E.F.D., B.R., and A.C.S. performed research; R.L.G., E.F.D., T.S., R.J.P., D.C., and R.E.J.contributed new reagents/analytic tools; M.M.B., R.L.G., E.F.D., B.R., A.C.S., R.J.P., and R.S.B.analyzed data; and M.M.B., R.L.G., R.S.B., and M.R.D. wrote the paper.\nConflict of interest statement: R.E.J. is a coinventor of the Venezuelan Equine Encephalitis\n(VEE) expression vector technology and holds an equity interest in AlphaVax, Inc., thecompany that has licensed this technology from the University of North Carolina.\nThis article is a PNAS Direct Submission.Freely available online through the PNAS open access option.Data deposition: The sequences reported in this paper have been deposited in the GenBank\ndatabase (accession nos. FJ211859 and FJ211860).\n1M.M.B and R.L.G. contributed equally to this work.\n2To whom correspondence may be addressed. E-mail: rbaric@email.unc.edu or mark.denison@vanderbilt.edu.\nThis article contains supporting information online at www.pnas.org/cgi/content/full/\n0808116105/DCSupplemental .\n© 2008 by The National Academy of Sciences of the USA\n19944–19949 /H20841PNAS /H20841December 16, 2008 /H20841vol. 105 /H20841no. 50 www.pnas.org/H20862cgi/H20862doi/H2086210.1073/H20862pnas.0808116105\nDownloaded by guest on September 17, 2020 \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\nThus, new methodologies to rapidly recover and test emerging\nzoonotic pathogens are critical. Recent studies have providedcrucial steps toward the goal of synthetic reconstruction of largemicrobial genomes. The 7.5- and 5.6-kb genomes of poliovirus and\n/H9278X174, respectively, were reconstructed from known sequences by\nusing commercially synthesized cDNA fragments and PCR assem-bly (37, 38). Similarly, the segmented genome of the 1918 strain ofinfluenza was reconstructed, in part, by using synthetic design (39).Human endogenous retroviruses were assembled by PCR-directedassembly of synthetic oligonucleotides into a consensus provirus(40), and recombinant SARS-CoVs bearing synthetic zoonoticSpike sequences were derived by our group (22, 32). Last, thecloning of the 580-kb microbial genome of Mycoplasma genitalium\nwas reported, although this work has not yet yielded a replicatingorganism (41). To our knowledge, no studies to date have used asynthetic approach to assess potential mechanisms of zoonoticemergence of a noncultivable virus.\nBecause it is possible that even minor events of recombination\nand mutation-driven evolution can alter CoV population structureand promote emergence (22, 32, 42), CoVs may select for alter-ations in discrete regions of Spike to achieve host-range expansion.The CoV Spike, a type I fusion protein, contains 2 discrete regions,a carboxyl-terminal S2 region that encodes fusion and heptadrepeat domains in an arrangement shared by other viral attachmentproteins possessing type I architecture (43), whereas the S1 regionencodes the RBD. Studies in our and other laboratories haveidentified mutations in both S1 and S2 regions associated with CoVhost-range expansion (42, 44). These 2 regions may also indepen-dently or cooperatively mediate transspecies expansion and neu-tralization escape, in that some mAbs that target the SARS-CoV S1RBD select for escape mutants in the RBD, but also in the S2 region(45). These data suggest that coordinated interactions between theS1 RBD and select S2 domains may be important in epitopepresentation and Spike function.\nWe have identified several hmAbs that bind distinct, conserved\nlocations in the SARS-CoV RBD and neutralize strains thatoriginate from animal and human hosts (31). These hmAbs didefficiently neutralize Bat-SRBD, an important finding as it was notpreviously clear that mAbs targeting the SARS-CoV RBD wouldneutralize virus in the context of a different Spike backbone. It isalso informative that antibodies specific for the Bat-SCoV Spikeprotein neutralize Bat-SBRD, which expresses a chimeric Spikeprotein, but not SARS-CoV, indicating the existence of neutralizingantibodies that target portions of Spike outside the RBD. Impor-tantly, these results suggest that hmAbs specific for SARS-CoV, andby inference the current panel of SARS-CoV vaccines, may providesignificant protection against other SARS-like CoVs that emergefrom zoonotic pools by natural recombination or are deliberatelydesigned to cross species. Second, both SARS-CoV RBD-specifichmAbs and Bat-SCoV mpAbs specific for Spike epitopes outside ofthe RBD are able to recognize and neutralize virus even in thesetting of a chimeric Spike, providing important safety features forstudies of emerging zoonotic CoVs.\nIt has been shown that the 5 /H11032UTRs of CoVs can influence the\ncapacity of the virus to replicate in cells (46). Although the 5 /H11032UTR\nin the synthetic Bat-SCoV originated from SARS-CoV, the soledifference between Bat-SCoV, which was not capable of amplifi-cation in cell culture, and Bat-SRBD, which could be recovered, wasthe RBD derived from SARS-CoV. Our results also confirm andextend a previous report predicting that deletions and mutationswithin the Bat-SCoV RBM ablate interaction with hACE2 andcACE2 molecules (47). Thus, in this report, we show that the CoVSpike RBD is interchangeable, is sufficient to confer efficientgrowth and infectivity in cells from multiple species, and likelyrepresents a critical determinant of transspecies movement ofzoonotic CoVs.\nTo protect against future emerging zoonotic pathogens, it is\ncrucial to develop cell culture and animal models to test vaccinesand therapeutics, ideally against entire families of organisms, suchas CoVs. Both SARS-CoV and Bat-SRBD replicated efficiently inHAE cultures, providing a direct human airway model for com-parison of existing and new antivirals. However, Bat-SRBD repli-cated poorly in vivo, calling for additional modifications to facilitatestudies in mouse models. Robust structural information exists onthe RBD-ACE2 interaction (29), mutations affecting this interac-tion have been identified (22, 31), and Rosetta-modeling of shortrange RBD-mACE2 receptor interfaces can identify key residuesessential for retargeting the host specificity of Bat-SRBD ( Fig. S3)\n(48). Previous studies had identified a mutation in the RBD of theMA15 strain, Y436H, but its exact role in vivo was not clear (36).By using structural modeling algorithms, we predicted that theY436H substitution would enhance the interaction of Bat-SRBDwith mACE2. Bat-SRBD-MA did exhibit increased growth effi-ciency in aged mice. However, this did not result in clinical disease,suggesting the requirement for additional adaptive changes. Forexample, SARS-CoV encodes at least 5 IFN antagonists, predictedto function in virulence (49–52). Our model system will allowmapping of the domains in the Bat-SCoV and SARS-CoV geneticbackgrounds involved in regulation of virulence in aged animals.\nIn this report, sequence and structural information was inte-\ngrated with synthetic genomics, reverse genetics, and protein designto recover a zoonotic precursor virus from a hypothetical infectioussequence. The resulting chimera exhibited cross-reactivity withpreviously identified therapeutics and highlighted possible previ-ously undescribed mechanisms for host-range expansion. Here, wearticulate a model to predict and directly test tenable emergencepathways. Paired with a greater availability of reagents and thera-peutics, our studies represent an approach for rapid recovery andtesting of newly identified pathogens, and which may improvepublic health preparedness and intervention strategies againstnatural or intentional zoonotic-human epidemics.\nMaterials and Methods\nCells and Viruses. VeroE6 cells (Vero) were maintained in MEM (Invitrogen), and\ndelayed brain tumor (DBT, murine astrocytoma) cells were maintained in Dul-\nbecco’s MEM (Invitrogen) containing 10% FBS. DBT-hACE2 and DBT-cACE2 cellswere cultured as described (22). HAE cells were plated and differentiated asdescribed (33). SARS-CoV Urbani strain (hereafter, SARS-CoV) and Bat-SCoV wildtype and chimeric viruses were propagated and assessed by plaque assay on Verocells. All studies with viable SARS-CoV and SARS-CoV-like viruses were performedin certified BSL3 laboratories in biological safety cabinets, by using safety proto-cols that were reviewed and approved by the Institutional Biosafety Committeesof Vanderbilt University and the University of North Carolina at Chapel Hill.\nDetermining the Consensus Sequence for Synthetic Bat-SCoV and Conceptual\nDesign of the Bat-SCoV Clone. HKU3–1 (DQ022305), HKU3–2 (DQ084200),\nHKU3–3 (DQ084199), and RP3 (DQ071615) genomes were aligned by usingClustalXv1.83 to determine a consensus sequence ( Fig. S1 and Figs. S4–S6) (Gen-\nBank accession no. FJ211859). The consensus Bat-SCoV sequence was designed toligate interchangeably with the SARS-CoV infectious clone (24). Notably, therewas no consensus at the 5/H11032 end of the Bat-SCoV genomes, so we used the 5/H11032 most\nregion of SARS-CoV to append the T7 promoter site to the 5 /H11032end of the Bat-A\nfragment.\nConstruction of Chimeric Spike Variants. Insertions of SARS-CoV sequence in\nplace of Bat-SCoV sequence were engineered by using PCR and the primers\nshown in Table S3. PCR amplicons for Bat-SRBD (GenBank accession no. FJ211860)\nand Bat-SRBM were generated by using fragments Bat-E2, and SARS-E. PCRamplicons for Bat-Hinge (Bat-SRBM plus 6 additional residues from SARS-CoVSpike) were generated by using Bat-SRBM as template. PCR-generated productswere cloned into the Bat-E2 plasmid by using unique 5 /H11032-BstBI and 3/H11032 -MscI sites.\nSuccessful insertions of SARS-CoV sequence were confirmed by restriction diges-tion and nucleotide sequencing across the region of PCR amplification.\nGeneration of SARS-CoV and Bat-SCoV Mutant Viruses. Viruses containing\nPCR-generated insertions within the viral coding sequence were produced by\nusing the SARS-CoV assembly strategy (24, 33, 53) with the following modifica-tions. Briefly, for Bat-F virus, full-length cDNA was constructed by ligating restric-tion products from SARS-CoV fragments A–E and Bat-SCoV fragment F, whichrequired a BglI-NotI digestion. For Bat-SCoV and Bat-SRBD, Bat-SRBM, and Bat-\n19948 /H20841www.pnas.org/H20862cgi/H20862doi/H2086210.1073/H20862pnas.0808116105 Becker et al.\nDownloaded by guest on September 17, 2020 \nHinge, plasmids containing the 7 cDNA fragments of the Bat-SCoV genome were\ndigested by using BglI for Bat-A, Bat-B, Bat-C, and Bat-D, BglI and AflII for Bat-E1and Bat-E2, and BglI and NotI for Bat-F. Digested, gel-purified fragments weresimultaneously ligated together. Transcription was driven by using a T7 mMes-sage mMachine kit (Ambion), and RNA was electroporated into Vero cells (24, 53).Virus viability was determined by cytopathic effect and progeny viruses werepassaged at low MOI. RNA was recovered from infected cell monolayers by usingTRIzol (Invitrogen) according to the manufacturer’s instructions, and genomeorigins were verified by RT-PCR and nucleotide sequencing.\nAssay for Bat-SCoV Leader-Containing Transcripts in Electroporated Cells and\nMouse Lungs. At days 2 and 5 p.e., generation of leader-containing N (ORF9) and\ngenome (ORF1) transcripts was determined by RT-PCR. Briefly, RT-PCR was per-formed by using random hexamers (ABI) and SuperScript III (Invitrogen) togenerate first-strand cDNA at an extension temperature of 55 °C for 1 h. Leader-containing cDNAs were amplified by PCR by using Taq with Thermopol buffer(NEB) and the following primers: 5/H11032 -CAGGAAAAGCCAACCAACCTTG (leader) and\n5/H11032-CGCTACGACCGAACTGAATGCC to detect Bat-SCoV genomic RNA; and leader\nand 5/H11032 -GTGAGAGCTGTGAACCAAGACG to detect mRNA 9 transcripts. Presence\nor absence of PCR products was assessed by electrophoresis on 1.5% agarose gels.\nViral Growth and Plaque Assays. Vero, DBT, DBT-hACE2, or DBT-cACE2 cells were\ninfected at a MOI of 1 or 0.01 PFU/cell. After1ha t3 7 ° C ,t h einocula were\nremoved, cells were washed and samples were taken at different times p.i. Todetermine viral titer, samples were diluted, inoculated onto Vero cell monolayersin 6-well plates for 1 h, and overlaid with complete media plus 1% agar. Plaqueswere visualized between 48 and 52 h p.i. by neutral red staining (Sigma).Generation of Polyclonal Bat-SCoV Spike-Specific Sera and Neutralization Assay.\nMurine pAbs specific for the Bat-SCoV Spike were generated as previously de-scribed (33). Neutralizing titers for mpAbs and hmAbs S109.8, S227.14, andS230.15 were determined by plaque reduction neutralization titer assay(PRNT50%) (31). The percentage of neutralization was calculated as follows:1-(number of plaques in the presence of antibody/number of plaques in theabsence of antibody) x 100%.\nInfection of Aged BALB/c Mice. Ten each of aged (14 months) female BALB/c mice\n(National Institute of Aging) were lightly anesthetized and infected intranasally\nwith 10\n5PFU of Bat-SRBD, Bat-SRBD-MA, or SARS-CoV; 5 additional mice were\ninoculated with an equivalent volume (50 /H9262L) of PBS. Mice were weighed daily\nthrough 4 days p.i., and on days 2 and 4 p.i., 5 mice of each group were killed andlungs harvested for determination of viral titer. Lungs were weighed and ho-mogenized in 500\n/H9262L of PBS at 6,000 rpm for 60 s in a MagnaLyser (Roche).\nClarified homogenates were then diluted serially, and titers were determined byplaque assay on Vero cells.\nACKNOWLEDGMENTS. We thank XiaoTao Lu and Sunny Lee for technical assis-\ntance, Susan Burkett for maintenance of the HAE cultures, Perry Myrick for\nimmunofluorescence assays, and the University of North Carolina Cystic FibrosisTissue Culture Core for HAE cells. M.M.B., R.L.G., R.S.B., and M.R.D. are supportedby the National Institute of Allergy and Infectious Diseases Public Health ServiceAward P01 AI59943. Additional support was provided by Public Health ServiceAward CA68485 to the Vanderbilt University DNA Sequencing Shared Resourceof the Vanderbilt–Ingram Cancer Center. The Baric laboratory is supported by theGillings Innovation Fund.\n1. Weiss RA, McMichael AJ (2004) Social and environmental risk factors in the emergence\nof infectious diseases. Nat Med 10:S70–76.\n2. Woolhouse ME, Gowtage-Sequeria S (2005) Host range and emerging and reemerging\npathogens. Emerg Infect Dis 11:1842–1847.\n3. Webby R, Hoffmann E, Webster R (2004) Molecular constraints to interspecies trans-\nmission of viral pathogens. Nat Med 10:S77–81.\n4. Drosten C, et al. (2003) Identification of a novel coronavirus in patients with severe\nacute respiratory syndrome. N Engl J Med 348:1967–1976.\n5. Ksiazek TG, et al. 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Wathelet MG, Orr M, Frieman MB, Baric RS (2007) Severe acute respiratory syndrome\ncoronavirus evades antiviral signaling: Role of nsp1 and rational design of an attenu-ated strain. J Virol 81:11620–11633.\n53. Graham RL, et al. (2005) The nsp2 replicase proteins of murine hepatitis virus and severe acute\nrespiratory syndrome coronavirus are dispensable for viral replication. J Virol 79:13399–13411.\nBecker et al. PNAS /H20841December 16, 2008 /H20841vol. 105 /H20841no. 50 /H2084119949\nMICROBIOLOGY\nDownloaded by guest on September 17, 2020 \n \n \n \n \n \n \n \n \n Position paper about the possible origin of the SARS-CoV-2 coronavirus  \n \n \n \nThe COVID-2019 coronavirus pandemic, which originated in Wuhan city, Peoples' Republic \nof China (PRC) in December 2019, is rapidly expanding around the world, including to the Russian \nFederation. The virus was named SARS-CoV-2 because of the proximity of the symptoms of \ndisease to Severe Acute Respiratory Syndrome (SARS), an epidemic which occurred in 2002 in \nChina. The SARS-CoV-2 genome is most similar to the genome of the bat coronavirus, Bat-CoV-\nRaTG13. Coincidence of the causative agent genomes is 96.2%. However, the difference in the \nneutral sections of the genome constitutes 17%, which makes it possible to postulate a more \nsignificant degree of divergence between these two viruses [1]. Coincidence of the SARS-CoV-2 \ngenome with the genome of the SARS-CoV coronavirus – the causative agent of SARS, comprised \nabout 79%, and homology with the causative agent of MERS-CoV (Middle Eastern Respiratory \nSyndrome - about 50% [2.3]. \nThe SARS-CoV-2 genetic information is presented in the form of (+) - a chain of linear \nsingle-chain RNA, presenting as mRNA. The transcription process in coronaviruses occurs via \nsynthesis with the aid of the RNA-dependent negative chain polymerase RNA, which serves \nsubsequently as a matrix for (+) – RNA chain accumulation. The size of the SARS-CoV-2 genome \nis 29903 nucleotides. The GC-composition of genomic RNA - about 40%. \nThe SARS-CoV-2 genome can be recorded simply as follows - 5 ' - UTR-ORF1a/b (rep) - S-\nE-M-N-UTR-3'-polyA (figure 1).  \n \n \nFigure 1 - Simplified diagram of the genomic organization of SARS-CoV-2 \nThe coronavirus RNA has on the 5'-end a methylated cap and untransmitted region with an \nextent of 200 to 400 nucleotides. On the 3' - molecule ends RNA also is an untransmitted region of \n200- 400 nucleotides and then the poly (a) - sequence. In SARS-CoV-2, the first open reading frame \n(ORF1a/b) occupies about an entire two thirds of the whole genome and codes 16 nonstructured \nproteins (nsp), initially organized into two polypeptides - 1a and 1b, designated as \nreplicase/transcriptase 1A and 1B. Further there follows four ORFs, which code four structural \nproteins – spike protein S, the small protein of the shell E (envelope), the membrane glycoprotein \nM, and the nucleocapsid protein N. Additionally, in this region of the genome are present nucleotide \nsequences which encode a series of auxiliary peptides with unknown functions. The determination \nof the biological functions of these proteins is a purpose of further studies. Possibly just one or \nseveral of them have an observable effect in the course of the pandemic, selectivity of the course of \nthe disease, and size of the lethality among the population of the different countries, determining \ngenetic predisposition toward the end of the disease. \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n \n \n A comparison of 95 full genomic sequences of SARS-CoV-2 isolates from the different \ncount\nries of the entire world showed their very high homology (from 99.91% to 100%) [4]. In \naddition, a comparison was conducted of full genomes of the SARS-CoV-2 isolate sequenced in \nThailand with 23 other SARS-CoV-2 isolates from different countries showed that there exists from \n0 to 9 single nucleotide distinctions in their genomes, which is extremely small taking into account \nthe length of the molecular RNA of almost 30,000 nucleotides [5]. As can be seen from given data, \nthe RNA sequence of SARS-CoV-2 practically does not change (figure 2). This proves the low \nfrequency of the appearance of mutations during the multiplication of the corona virus of SARS-\nCoV-2 due to the presence of exoribonuclease (ExoN), which edits the replication of coronavirus \nRNA in the eukaryotic cell. Mutations, which were discovered in the S-gene spike, lead to the \namino-acid replacements of nos. 49 and 860, occurring external to the preserved sector, responsible \nfor binding with the receptor of the S-protein sector (figure 2). \n Figure 2. Table, summing up fundamental substitutions in RNA, found as a result of the full \ngenome sequencing of the isolates of the SARS-CoV-2 coronavirus [4] \n \nIn the course of studies, it is confirmed that for the penetration into the cells of human \nalveolar tissue, the SARS-CoV-2 coronavirus uses a receptor angiotensin converting enzyme of II \n(ACE2) as with the SARS-CoV virus [6]. During the alignment of S-genes of SARS-CoV, Bat-\nCoV-RaTG13 (bat coronavirus), SARS-CoV-2 and Pangolin-CoVMT084071.1 (mammalian \npangolin coronavirus) a unique insert of 12 nucleotides-TCCTCGGCGGGC (figure 3) in the \ngenome of SARS-CoV-2 coronavirus was revealed. \nFigure 3. result of the realignment of the S-gene of SARS-CoV, Bat-CoV-RaTG13, SARS-CoV-2 and Pangolin-\nCoVМТ084071.1 \n A search in the BLAST NCBI computer program produced a correlation of 91.7% with the \nnucl\neotide sequence of the detected insert and the six nucleotides of SARS-CoV-2 \n(TAATTCTCCTCGGCGGG) preceding it, the SARS-CoV-2 with the fragment of misc-RNA of the \nlarge brown bat (Eptesicus fuscus) (fig. 4). misc-RNA performs a majority of functions, including \n\n \n \n enzyme-like catalysis and processing RNA. It is assumed that misc-RNA serves for switching - \ntur\nning on or turning off, of genes. \n \n \n \nFigure 4 – Result of the comparison of the nucleotide sequence of the 12 nucleotide insert of SARS-CoV-2 with \nfragments of large brown bat genome RNA. \nIt should be noted that for creating the specialized cellular lines intended for the cultivation \nof coronaviruses, eucaryotic cells obtained from the cells of the kidney of the large brown bat are \nused [7]. Therefore, it is completely probable that the inclusion of segments of genetic material from \na eukaryotic cell into the genome of the virus SARS-CoV-2 occurred during cultivation. The \nprobability percentages of this type of insertion into the genome of virus increase with repeated \nlaboratory passages using the cultures of the designated cellular line.  \nIt is known that the 6 amino-acid remainders appear (Y442/L455, L472/F486, N479/Q493, \nD480/S494, T487/N501, Y491/Y505), which lie at the region of the SARS-CoV/SARS-CoV-2 \ncoronavirus S-protein, coded as the S-gene [8], are the most significant for binding with the receptor \nACE2. Likely, this is associated with a change in the tertiary structure of S-the protein, which forms \n\"spikes\" on the surface of the SARS-CoV-2 coronavirus, and, consequently, an increase in its \naffinity with the receptors of the ACE2 transmembrane protein. (figure 5). \n \nFigure 5 – Model of the S-protein of the SARS-CoV-2 coronavirus (this simulation was produced on the open \nresource https://swissmodel.expasy.org/). Green indicates the RBD region. \n \nThe bioinformation analysis of the amino-acid sequences of S - proteins of SARS-CoV, \nBatRaTG13 (MN996532) and SARS-CoV-2 showed a difference in five of six amino acids, which \n\n \n \n It is necessary to especially note that the three-dimensional structural analysis showed that \nthe\n S-gene of the shaft of SARS-CoV-2 has 10-20 times higher affinity for binding with ACE2, than \ndid SARS-CoV [9, 10]. \nAt the same time, analysis of the amino-acid sequences of the SARS-CoV-2 and pangolin \ncoronavirus MT084071.1 S-proteins showed complete congruence of all six amino acids, and the \nviruses S-gene sequences practically completely coincide [11]. In this case comparison of the \ngenomes of the coronavirus of SARS-CoV-2 and pangolin coronavirus MT084071.1 showed \nsufficiently low homology of their nucleotide sequences -79%. \nThere has been discussion abroad of an alternative version about the origin of the SARS-\nCoV-2 coronavirus through the natural recombination of the S-genes of the bat and pangolin \ncoronaviruses in the pangolin. However, Xiaolu Tang and co-authors in their studies showed that \nwith the synonymous speed of substitution, which is 1.67 - 4.67 x 103 sites/year, this recombination \nhad t\no occur 19.8-55.4 years ago, but not now. Thus, this hypothesis is improbable [1]. In the \nopinion of the authors, the general identity of the critical sections of SARS-CoV-2 and GT \nPangolin-CoV S-genes can be caused by random mutations in combination with natural selection \n[1]. However, in the study, there is no calculation data about the period of the time which is required \nfor the natural appearance of the pool of such mutations in one strain of virus.  \nWith the comparison of many full genomic sequences of SARS-CoV-2 isolated by foreign \nauthors, is reliably proven that the sequence RNA of corona virus is sufficiently conservative and \npractically did not change during the time of the pandemic. In their genomes, there are from 0 to 9 \nsingle nucleotide replacements, which is extremely small taking into account the length of the virus \nRNA molecule of approximately 30,000 nucleotides [5]. The low mutability in the coronaviruse \ngenome of is explained by the exoribonuklease activity of the ExoN ferment, whose gene enters into \nthe composition of the coronovirus genomes of this family, which edits the coronavirus replication \nRNA in the eukaryotic cell. Therefore, the concrete change of four of five key nucleotides in the \nBat-CoV-RaTG13 coronavirus S-gene in the acquisition of virulence for humans, whose general \ngenome has greatest homology with the SARS-CoV-2 genome, in the process of evolution and \nnatural selection, it is extremely difficult to explain by random mutations. \nOne of the circumstantial confirmations of the artificial origin of SARS-CoV-2 is the \npresence in Wuhan city, where the epidemic began, the virological laboratories (Laboratory of \nSpecial Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences), \nwhich have for more than 5 years conducted molecular-biological studies of coronaviruses. \nIt is necessary to note that up to now, the \"zero patient\", the first person infected by COVID -\n19, has not been reliably established - The information agency, [named U.S. media organization], on \nApril 16, 2020, citing numerous sources, offered the theory of the artificial origin of the SARS-\nCoV-2 virus. The authors of the investigation assert that the coronavirus was created in the \nLaboratory of Special Pathogens and Biosafety (city of Wuhan) to demonstrate to the USA the \noutstanding results achieved by Chinese scientists in the study of viruses. Following the accidental \ninfection of the indicated laboratory researcher, the infection spread, causing the epidemic. The \n[named UK media organization] previously advanced a similar version. However, the PRC officially \nrefutes the indicated information. However, the authorities of China, upon the appearance of the first \ncases of COVID-19 infection, when still nothing it was officially known about the disease, took \nunprecidented measures for the non-admission of the propagation of infection (declaration of total \n\n \n \n quarantine, the notification of the population regarding the danger of infection), and also the \nel\nimination of unnecessary witnesses and elimination via arson of the place of the assumed initial \ninfection, a market for sea products, which also indirectly confirms assumption about the artificial \norigin of the virus of SARS-CoV-2. \nThus, in the course of the conducted primary theoretical and experimental investigations, on \nthe basis of the analysis of the genomes of the enumerated corona viruses, and taking into account \ncircumstantial confirmation, there is a high probability of a laboratory-produced genetically altered \nvariant - SARS-CoV-2, for example, from the corona virus of the bat of BatRaTG13, by replacing \nthe nucleotide sequence of the S-protein of parental strain in the sequence of the S-protein of the \nMT084071.1 strain of the coronavirus of the mammalian pangolin, or by the difficultly \ndemonstrated target localized single nucleotide replacements with the use of laboratory technology \nCRISPR-CAS9. In this case, in the stage of conducting repeated laboratory passages of the SARS-\nCoV-2 virus on the culture of the specific cellular line obtained from the eukaryotic cell of Eptesicus \nFuscus (large brown bat), in the RNA-virus genome occurred random 12 nucleotide insertions of the \nmisc - RNA fragment. \n \nOn the basis of details outlined above, the following conclusions are made: \n \n1. The insertion of corresponding fragment misc-RNA of large brown bat (Eptesicus \nFuscus) into the SARS-CoV-2 genome.  \n2. For compiling of the specialized cellular lines, intended for the cultivation of corona \nviruses, eukaryotic cells obtained from the cells of the kidney of the large brown bat, are \nused. \n3. Five of six amino acids of the S-strain of SARS-CoV-2, which specify the effectiveness \nof the penetration of coronavirus into the cells of human lung alveoli due to this the high \nvirulence of agent, differ from the same found in SARS-CoV and Bat-CoV-RaTG13. \n4. One of the different amino acids of the S-protein of the spike of the SARS-CoV-2 \ncoronavirus, Q493, enters into the active center of receptor-binding domains (RBD). \n5. SARS-CoV-2 has 10-20 times higher affinity than SARS-CoV of binding with ACE2. \n6. The natural recombination of the S-genes of the bat and pangolin coronaviruses in \npangolins is improbable. \n7. Based on conclusions 1-6, it is possible to assume the high probability of a laboratory \nproducing the genetically changed version of the SARS-CoV-2 coronavirus. \n8. During further investigations, it is advisable to define the function of unknown proteins \ntransmitted from the sequences of the open reading frames of the genome SARS-CoV-2 \nwith the goal of determination of the genetic predisposition different ethnic groups to \noutcome of illness  \n9. It is necessary to reliably define determinants of the causative agent’s immunogenicity. \n \nSource listing \n \n1. X\niaolu Tang, Changcheng Wu, Xiang Li, Yuhe Song, Xinmin Yao, Xinkai Wu, \nYuangeDuan, Hong Zhang, Yirong Wang, Zhaohui Qian, Jie Cui, Jian Lu, On the origin and \ncontinuing evolution of SARS-CoV-2, National Science Review, nwaa036, \nhttps://doi.org/10.1093/nsr/nwaa036. \n2. Lu R. et al., Genomic characterization and epidemiology of 2019 novel coronavirus: \nimplication for virus origins and receptor binding // Lancet. 2020 doi:10.1016/S0140-\n6736(20)30251-8. \n3. Gralinski L.E. et al., Return of coronavirus:2019-nCoV // Viruses. 2020. 12. 2 \ndoi:10.3390/v12020135. \n4. Wang C, Liu Z, Chen Z, et al.The establishment of reference sequence for SARS ‐\nCoV‐2and variation analysis// J Med Virol. 2020;1–8. \n\n \n \n 5. Okada P. et al., Early transmission patterns of coronavirus disease 2019(COVID-19) \ni\nn travelers from Wuhan to Thailand, January 2020 // Euro Surveill. 2020;25(8):pii=2000097. \nhttps://doi.org/10.2807/1560-7917.ES.2020.25.8.2000097. \n6. Zhou P et al., Discovery of a novel coronavirus associated with recent pneumonia \noutbreak in humans and its potential bat origin // bioRxiv. 2020. \n7. Banerjee Aet al., Generation and Characterization of Eptesicusfuscus (Big brown bat) \nkidney cell lines immortalized using the Myotis poliomavirus large T-antigen // J.Virol Methods. \n2016. Nov 237: 166-173. \n8. Vinet D Menachery et al., A SARS-like cluster of circulating bat coronaviruses \nshows potential for human emergence // Nature Medicine. 2015. doi:10.1038/nm.3985. \n9. Wrapp D, Wang N, Corbett KS, Goldsmith JA, Hsieh C-L, Abiona O, et al. Cryo-EM \nStructure of the2019-nCoV Spike in the Prefusion Conformation. bioRxiv. \n2020:2020.02.11.944462. doi:10.1101/2020.02.11.944462. \n10. Hoffmann, M.; Kleine-Weber, H.; Schroeder, S.; Kruger, N.;Herrler, T.; Erichsen, S.; \nSchiergens, T. S.; Herrler, G.; Wu, N.-H.; Nitsche, A.; Muller, M. A.; Drosten, C.; Pohlmann, S. \nSARS-CoV-2Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven \nProtease Inhibitor. Cell 2020, DOI: 10.1016// j.cell.2020.02.052. [Epub ahead of print] \n11. Wong MC, Cregeen SJJ, Ajami NJ, Petrosino JF. Evidence of recombination in \ncoronaviruses implicating pangolin origins of nCoV-2019. bioRxiv. 2020. \n \n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n \n \nStatement of Work \nRapid Response for Assessment of Data Needs for 2019- nCoV \nFebruary 3, 2020  \nStatement of Task:  In response to a request from OSTP, the NASEM will examine information and identify \ndata requirements that would help determine the origins of 2019- nCoV, specifically \nfrom an evolutionary/structural biology standpoint.  NASEM will also consider whether this should include more temporally and geographically diverse clinical \nisolates, sequences, etc.  Although a widely- disputed paper posted on a pre- print \nserver last week has since been withdrawn, the response to that paper highlights \nthe need to determine these information needs as quickly as possible.  As part of a \nbroader deliberative process, this review will help prepare for future events by \nestablishing a process for quickly assembling subject matter experts for evaluation \nof other potentially threatening organisms.    \nWorkplan: \nNASEM will hold a meeting of experts to assess what data, information and samples \nare needed to address the unknowns, in order to understand the evolutionary origins \nof NCoV and more effectively respond to both the outbreak and any resulting misinformation. A statement from the National Academies will be prepared and \npublished on the Web as a “Based on Science” article that summarizes the status and \nneeds for more and what types of data. A more in- depth examination of the issues \nwill be established as a follow up as needed.    \n \n \n \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n         \n     \n   \n      \n     \n   \n     \n     \n   \n   \n       \n    \n    \n   \n    \n         \n         \n      \n          \n             \n             \n            \n           \n             \n            \n           \n              \n               \n         \n            \n              \n              \n    \n            \n              \n            \n         \n               \n  \nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n     \n   \n  \n            \n        \n           \n            \n             \n            \n   \n           \n             \n             \n            \n         \n           \n             \n           \n             \n            \n           \n            \n           \n             \n            \n            \n         \n            \n    \n         \n            \n            \n     \n          \n             \n          \n         \n                \n           \n \n    \n      \n     \n   \n  \n \n    \n \n        \n      \n1.(U) Table of Contents\n \n(U// ) China Virus Institute Welcomes More U.S. Cooperation on Global Health Security \n UNCLASSIFIED//\nUNCLASSIFIED// 1\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\nIdentifiers\nDocument Number: 18 WUHAN 38\n(U// ) E.O. 13526: N/A\nTAGS: SHLH, PGOV, CN, PREL, TBIO, KGHI, CDC, EAID, KHIV, IN, JP, TW, TSPL, PINS, SENV\nSUBJECT: China Virus Institute Welcomes More U.S. Cooperation on Global Health Security\nREF: 18 BEIJING 138\n17 BEIJING 2458\n11 MUMBAI 630\n17 TOKYO 716\n13 SEOUL 790\n1. ) Summary with Comment: China's Wuhan Institute of Virology, a global leader in virus\nresearch, is a key partner for the United States in protecting global health security. Its role as\noperator of the just-launched Biosafety Level 4 (or \"P4\") lab -- the first such lab in China -- opens\nup even more opportunities for expert exchange, especially in light of the lab's shortage of trained\nstaff (Ref A). Given the legacy of SARS and the likelihood that the next global pandemic will\noriginate in China, the United States should prioritize expanding our already significant\ncooperation with this institute. This should include partnering with the institute on basic science\nresearch and the Global Virome Project (Ref B), and possibly trilateral U.S.-China-EU projects,\nbuilding on the institute's strong ties with France. End Summary with Comment.\n2. (U) Wuhan Institute of Virology researchers and staff gave an overview of the lab and current\ncooperation with the United States to visiting Environment, Science, Technology and Health\nCounsellor Rick Switzer and Consulate Wuhan Consul General Jamie Fouss in late March. In the\nlast year, the institute has also hosted visits from the National Institutes of Health (NIH), National\nScience Foundation, and experts from the University of Texas Medical Branch in Galveston. The\ninstitute reports to the Chinese Academy of Sciences in Beijing.\nP4 Lab is Open and Transparent, Officials Emphasize\n3. ( ) The Wuhan P4 lab, referring to labs with the highest level of safety precautions, became\nfully operational and began working with live viruses early this year. Institute officials said they\nbelieved it is the only operational P4 lab in Asia aside from a U.S. Centers for Disease Control\n(CDC)-supported facility in Pune, India (Ref C). China plans to stand up a second P4 lab in\nHarbin. Institute officials said Japan's biosafety labs are \"old\" and lack cutting-edge equipment, so\nthey consider Japan's labs to be \"P3 Plus\" (Note: the Japanese government says it has one P4-\nlevel lab in the Tokyo suburbs, though its activities are limited, and Japan is building a new P4 lab\nin Nagasaki, see Ref D. Taiwan operates at least HYPERLINK\n\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404250/\"one P4 lab. South Korea was close toUNCLASSIFIED//\nUNCLASSIFIED// 2\n\nHYPERLINK \"http://www.koreaherald.com/view.php?ud=20170316000902\"opening a P4 lab as of\nlast year, see Ref E. End Note.) Wuhan's lab is located about 20 miles from the city center in\nZhengdian district, and the institute plans to gradually consolidate its other training, classroom and\nlab facilities at that location.\n4. (U) Officials described the lab as a \"regional node\" in the global biosafety system and said it\nwould play an emergency response role in an epidemic or pandemic. The lab's English brochure\nhighlighted a national security role, saying that it \"is an effective measure to improve China's\navailability in safeguarding national bio-safety if [a] possible biological warfare or terrorist attack\nhappens.\"\n5. ( ) Institute officials said there would be \"limited availability\" for international and domestic\nscientists who had gone through the necessary approval process to do research at the lab. They\nstressed that the lab aimed to be a \"worldwide, open platform\" for virology. They said they\nwelcomed U.S. Centers for Disease Control (CDC) experts, noting that the Chinese Academy of\nSciences was not strong on human disease expertise, having only focused on it in the last 15\nyears, after the SARS outbreak. A Wuhan-based French consulate official who works on science\nand technology cooperation with China also emphasized that the lab, which was initiated in 2004\nas a France-China joint project, was meant to be \"open and transparent\" to the global scientific\ncommunity. \"The intent was to set up a lab to international standards, and open to international\nresearch,\" he said. French experts have provided guidance and biosafety training to the lab, which\nwill continue, the French official said. Institute officials said that France provided the lab's design\nand much of its technology, but that it is entirely China-funded and has been completely China-run\nsince a \"handover\" ceremony in 2016.\n6. (U) In addition to French assistance, experts from the NIH-supported P4 lab at the University of\nTexas Medical Branch in Galveston have trained Wuhan lab technicians in lab management and\nmaintenance, institute officials said. The Wuhan institute plans to invite scientists from the\nGalveston lab to do research in Wuhan's lab. One Wuhan Institute of Virology researcher trained\nfor two years at the Galveston lab, and the institute also sent one scientist to U.S. CDC\nheadquarters in Atlanta for six months' work on influenza.\nNIH-Supported Research Revises SARS Origin Story\n7. (U) NIH was a major funder, along with the Natural Science Foundation of China (NSFC), of\nSARS research by the Wuhan Institute of Virology's Shi Zhengli and Cui Jie. The researchers\nspent five years of investigation and genome sequencing to show that a population of bats in a\ncave in Yunnan Province harbored a virus with all the \"building blocks\" of SARS. This lends weight\nto the theory that SARS originated in bat populations before jumping first to civet cats (likely via\nbat feces) and then to humans, after people transported the civet cats from Yunnan to Guangdong\nProvince animal markets. The results were published late last year in HYPERLINK\n\"https://www.nature.com/articles/d41586-017-07766-9\"Nature and other publications. Shi said that\nU.S. scientist Peter Daszak, a leading expert on emerging diseases and president of the NewUNCLASSIFIED//\nUNCLASSIFIED// 3\n\nYork-based EcoHealth Alliance, was a \"strong partner.\" Daszak's team has provided support in\nstatistical modeling to assess the risk of more coronaviruses like SARS crossing over to human\npopulations.\nReady to Help with the Global Virome Project\n8. (U) Institute officials expressed strong interest in the Global Virome Project (GVP), and said\nChinese funding for the project would likely come from Chinese Academy of Sciences funding\nalready earmarked for One Belt, One Road-related initiatives. The HYPERLINK\n\"http://science.sciencemag.org/content/359/6378/872.full\"GVP aims to launch this year as an\ninternational collaborative effort to identify within ten years virtually all of the planet's viruses that\nhave pandemic or epidemic potential and the ability to jump to humans. \"We hope China will be\none of the leading countries to initiate the Global Virome Project,\" one Wuhan Institute of Virology\nofficial said. China attended a GVP unveiling meeting in January in Thailand and is waiting for\nmore details on the initiative. The officials said that the Chinese government funds projects similar\nto GVP to investigate the background of viruses and bacteria. This essentially constituted China's\nown Virome Project, officials said, but they noted the program currently has no official name.\n9. ( ) The Wuhan Institute of Virology's Shi Zhengli is the China Country Coordinator for the\nUSAID-funded PREDICT project, which is designed to show \"proof of concept\" and be a\nforerunner to the Global Virome Project. Li Hongying, with the EcoHealth Alliance (a New York\nCity-based NGO that is working with the University of California, Davis to manage the PREDICT\nproject), recently planned to visit Wuhan to meet with Shi. Li noted that China has expressed\ninterest in building the GVP database, which would put China in a leadership position. Other\ncountries have confidence in Chinas ability to build such a database, but are skeptical on whether\nChina could remain transparent as a \"gatekeeper\" for this information, she said. Li expressed\nfrustration with the slow progress so far in launching GVP, noting that the effort lacked funding\nsources, needed to hire a CEO, and would have to boost its profile at G7, G20 and other high-\nlevel international meetings.\nU.S.-China Workshop Explores Research Partnerships\n10. (U) The Institute also has ongoing collaboration with the U.S. National Science Foundation,\nincluding a just-concluded workshop in Shenzhen, involving about 40 scientists from the United\nStates and China, on the topic of the \"Ecology and Evolution of Infectious Diseases.\" Co-\nsponsored by the Natural Science Foundation of China (NSFC), the Chinese lead for this\nworkshop was the Wuhan Institute of Virology's Hu Zhihong, and the U.S. co-chair was the\nUniversity of Oklahoma's Xiao Xiangming. The workshop explored opportunities for U.S.-China\nresearch cooperation in areas like using \"big data\" to predict emerging infectious diseases, climate\nchanges effect on vector-borne diseases, and pathogen transmission between wildlife, domestic\nanimals and humans.UNCLASSIFIED//\nUNCLASSIFIED// 4\n\n11. ( ) Some workshop participants also expressed skepticism about the Global Virome\nProject's (GVP) approach, saying that gaining a predictive understanding of viruses with pandemic\npotential would require going beyond the GVPs strategy of sample collection, to take an\n\"ecological\" approach that considers the virome beyond vertebrate systems to identify\nmechanisms driving pathogen evolution. A follow-on workshop will be held in June at the\nUniversity of Berkeley. NSF and NSFC hope to jointly announce a funding call for collaborative\nprojects later this year.\nUNCLASSIFIED//\nClick here to view/download the image file.(U/ ) NO TEXT AVAILABLE\n18 BEIJING 138 17 BEIJING 2458 11 MUMBAI 630 17 TOKYO 716 13 SEOUL 790-UNCLASSIFIED//\nUNCLASSIFIED// 5\n\n1.(U) Table of Contents\n \n(U/ ) China Opens First Bio Safety Level 4 Laboratory \n UNCLASSIFIED\nUNCLASSIFIED 1\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n1.  Summary and Comment: The Chinese Academy of Sciences (CAS) has recently\nestablished what is reportedly Chinas first Biosafety Level 4 (BSL-4) laboratory in Wuhan. This\nstate-of-the-art facility is designed for prevention and control research on diseases that require the\nhighest level of biosafety and biosecurity containment. Ultimately, scientists hope the lab will\ncontribute to the development of new antiviral drugs and vaccines, but its current productivity is\nlimited by a shortage of the highly trained technicians and investigators required to safely operate\na BSL-4 laboratory and a lack of clarity in related Chinese government policies and guidelines.\nChina must invest in the development of the technical and scientific expertise needed to safely\nand efficiently operate this facility if it wishes to become a fully-engaged and collaborative global\npartner in infectious disease research and control. In addition, government BSL research decision-\nmaking processes need to be more transparent so that international partners and Chinese\nscientists are confident that the government is providing informed oversight that meets the highest\nglobal standards. To achieve full operation of this facility, China is likely to need additional\ntechnical assistance and advice from the international community. End Summary and Comment.\nChina Investing in Infectious Disease Control\n2. (U) Between November 2002 and July 2003, China faced an outbreak of Severe Acute\nRespiratory Syndrome (SARS), which, according to the World Health Organization, resulting in\n8,098 cases and leading to 774 deaths reported in 37 countries. A majority of cases occurred in\nChina, where the fatality rate was 9.6%. This incident convinced China to prioritize international\ncooperation for infectious disease control. An aspect of this prioritization was Chinas work with the\nJean Merieux BSL-4 Laboratory in Lyon, France, to build Chinas first high containment laboratory\nat Wuhans Institute of Virology (WIV), an institute under the auspices of the Chinese Academy of\nSciences (CAS). Construction took 11 years and $44 million USD, and construction on the facility\nwas completed on January 31, 2015. Following two years of effort, which is not unusual for such\nfacilities, the WIV lab was accredited in February 2017 by the China National Accreditation Service\nfor Conformity Assessment. It occupies four floors and consists of over 32,000 square feet. WIV\nleadership now considers the lab operational and ready for research on class-four pathogens (P4),\namong which are the most virulent viruses that pose a high risk of aerosolized person-to-person\ntransmission.\nUnclear Guidelines on Virus Access and a Lack of Trained Talent Impede Research\n3.  In addition to accreditation, the lab must also receive permission from the National Health\nand Family Planning Commission (NHFPC) to initiate research on specific highly contagious\npathogens. According to some WIV scientists, it is unclear how NHFPC determines what viruses\ncan or cannot be studied in the new laboratory. To date, WIV has obtained permission for\nresearch on three viruses: Ebola virus, Nipah virus, and Xinjiang hemorrhagic fever virus (a strain\nof Crimean Congo hemorrhagic fever found in Chinas Xinjiang Province). Despite this permission,\nhowever, the Chinese government has not allowed the WIV to import Ebola viruses for study in the\nBSL-4 lab. Therefore, WIV scientists are frustrated and have pointed out that they wont be able to\nconduct research project with Ebola viruses at the new BSL-4 lab despite of the permission.UNCLASSIFIED\nUNCLASSIFIED 3\n\n1. Hu B, Zeng L-P, Yang X-L, Ge X-Y, Zhang W, Li B, et al. (2017) Discovery of a rich gene pool\nof bat SARS-related coronaviruses provides new insights into the origin of SARS coronavirus.\nPLoS Pathog 13(11): e1006698. https://doi.org/10.1371/journal.ppat.1006698\nBRANSTAD\nUNCLASSIFIED//SBU\n-\nCollection\nCC\nCreator\nAgency Acronym: State\nOffice Name: BEIJING\nDescription\n(U) None\nDistribution List\nZEN/SECSTATE WASHDC\nLanguage\neng\nPrecedence\nR\nSource\nOriginating System: EMS\nAttributions: STATE\nSubject\nSHLH, ETRD, ECON, PGOV, CN, TRAD, ECON, DEPSUNCLASSIFIED\nUNCLASSIFIED 5\n\nDECLASSIFIED BY DNI GABBARD ON 18 JUNE 2026\n \n \nii \n  \n   \n \n \n \n \n \n \n \n \n•  \n \n \n \n• \n \n \n \n  \n \n \n \n (U) Scope Note \n\n \n \n2 \n •  \n \n \n \n \n•  \n \n \n  \n \n(U/\n) States Probably Weighing Costs Against \nBenefits \n  \n \n \n \n  (U/ )  Gain-of-Function (GOF) Research Prov ides Valuable Public Health Data \n(U//FOUO)  GOF experiments can generate strains of path ogens—including viruses, bacteria, fungi, and \ntoxins—suitable for laboratory research that might help scientists predict or understand how \npathogens could mutate in nature and whether those mutations will affect human health. GOF \nexperiments can also inform biosurveillance and countermeasure development or selection.   \n• (U/ )  In early 1999, Western scientists described adapting Ebolavirus zaire  for guinea pigs, \nproviding a safer and less expensive animal model than monkeys for studying the virus, how it \naffects its animal host, and how to develop treatment options, according to a scientific journal article. Such adaptation experiments a\n…[truncated]", "summary": "Lawrence Livermore National Laboratory Z Program assessment (27 May 2020) and supporting analytical materials on lab-leak origin pathways.\n\nFirst-page excerpt: 1From: Sent: Tuesday, June 8, 2021 12:35 PM To: Subject: New Daszak video going around Classification:     Classified By:   Derived From:   Declassify On:   ======================================================    Hey guys,    Just saw this video online. It’s from a 2016 NY Academy of Medicine meeting where Daszak talks about his colleagues in  China manipulating the spike protein on coronavirus to make them more virulent.    Sorry I can’t glide the video over. I have a contact in OSE but we don’t have access to a common shared drive location to  drop the video. You’ll have to retype the link into your browser on the low side.    https://rumble.com/vi8qwj-fauci-funded-daszak-describes-colleagues-in-china-manipulating-viruses-into.html    -                    …", "source_url": "https://assets.newsweek.com/wp-content/uploads/2026/06/COVID-19-Release-DNI-Gabbard-6-18-Part-3.pdf", "pdf_url": "/archive-docs/fauci-files/387f6618b1b5d2b7548ebde79908175e/pdf", "doc_date": "2026-06-18", "case": "covid-19-origins", "sub_case": "dni-gabbard-2026-release", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "covid origins", "covid origin", "covid release", "covid coverup", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "biolab", "biolabs", "dni release", "odni release", "intelligence release", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins"], "page_count": 122}
{"title": "Fauci Exposed Files — Part 4", "summary": "Whistleblower statements, congressional testimony excerpts and supporting evidence of retaliation against IC officers who challenged the published assessment.", "source_url": "https://assets.newsweek.com/wp-content/uploads/2026/06/COVID-19-Release-DNI-Gabbard-6-18-Part-4.pdf", "pdf_url": "/archive-docs/fauci-files/a9e5277f23e375990019ac3e36a9ac57/pdf", "doc_date": "2026-06-18", "case": "covid-19-origins", "sub_case": "dni-gabbard-2026-release", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "covid origins", "covid origin", "covid release", "covid coverup", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "biolab", "biolabs", "dni release", "odni release", "intelligence release", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins"], "page_count": 78}
{"title": "Fauci Transcribed Interview — House COVID Subcommittee, Part 1 (8 Jan 2024) (Part 1 of 2)", "content": "1 \n 1 \n 2 \n 3 \n 4 \nCOMMITTEE ON OVERSIGHT AND ACCOUNTABILITY,  5 \nSELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC,  6 \nU.S. HOUSE OF REPRESENTATIVES,  7 \nWASHINGTON, D.C.  8 \n 9 \n 10 \n 11 \n 12 \n INTERVIEW OF:  ANTHONY S. FAUCI  13 \n 14 \n 15 \n 16 \nMonday, January 8, 2024  17 \n 18 \nWashington, D.C.  19 \n 20 \n 21 \nThe interview in the above matter was held in room CVC -268, Capitol Visitor 22 \nCenter, commencing at 9:58 a.m.  23 \nPresent:  Wenstrup, Griffith, Jordan, Malliotakis, Cloud, Joyce, Greene, Dingell, 24 \nand Castor.  25 \n  \n  2 \nAppearances:  1 \n 2 \n 3 \n 4 \nFor the SELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC:   5 \n 6 \nMITCH BENZINE, STAFF DIRECTOR.  7 \nJOSEPH CIPOLLONE, COUNSEL  8 \nJACK EMMER, SENIOR COUNSEL  9 \nERIC OSTERHUES, CHIEF COUNSEL  10 \n 11 \nANNA -BLAKE LANGLEY, RESEARCH ASSISTANT  12 \n MINORITY STAFF DIRECTOR  13 \n MINORITY CHIEF COUNSEL  14 \n MINORITY COUNSEL  15 \n MINORITY SENIOR COUNSEL  16 \n 17 \n 18 \nFor the COMMITTEE ON ENERGY AND COMMERCE,  19 \nSUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS:   20 \n 21 \nJOHN STROM, SENIOR COUNSEL  22 \n MINORITY CHIEF COUNSEL  23 \n 24 \nFor the U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES:  25 \n\n  \n  3 \n 1 \nPERRIN COOKE, SENIOR OVERSIGHT COUNSEL  2 \n 3 \n 4 \nFor the WHITE HOUSE:  5 \n 6 \nKEVIN BARSTOW  7 \n 8 \n 9 \nFor ANTHONY S. FAUCI:  10 \n 11 \nDAVID SCHERTLER  12 \nDANNY ONORATO  13 \n 14 \nALSO PRESENT:  15 \n 16 \n 17 \n 18 \nGRACE MCMAHON (PARALEGAL)  19 \nMATT LAGANZA (PARALEGAL)  20 \n 21 \n 22 \n 23 \n 24 \nMr. Benzine.   Dr. Fauci, my name is Mitch Benzine, and I'm the staff director for 25 \n\n  \n  4 \nthe majority staff of the Select Subcommittee on the Coronavirus Pandemic.  I want to 1 \nthank you again for voluntarily being here for this interview today and tomorrow.   2 \nI'm going to kick it to my colleague, Eric, who's going to read you the rules.  3 \nDr. Fauci.   Thank you.   4 \nMr. Osterhues.   Good morning, Dr.  Fauci.   5 \nThis is a transcribed interview of Dr.  Fauci, conducted by the House Select 6 \nSubcommittee on the Coronavirus Pandemic and the Committee on Oversight and 7 \nAccountability under the authority granted to them by House Resolution 5, House rule X, 8 \nand the rules of the Committee on Oversight and Accountability.   9 \nThis interview was requested by Chairman Brad Wenstrup and Chairman James 10 \nComer as part of the committee's oversight of the Federal Government's response to the 11 \ncoronavirus pandemic.   12 \nFurther, pursuant to House rule -- Resolution 5, the select subcommittee has 13 \nwide -ranging jurisdiction but specifically to investigate the origins of the coronavirus 14 \npandemic, including but not limited to the Federal Government's funding of 15 \ngain -of-function research; the implementation or effectiveness of any Federal law or 16 \nregulation applied, enacted, or under consideration to address the coronavirus pandemic 17 \nand prepare for future pandemics; the development of vaccines and treatments and the 18 \ndevelopment and implementation of vaccination policies for Federal employees and 19 \nmembers of the Armed Forces; the societal impact of the decisions to close schools, how 20 \nthe decisions were made, and whether there is evidence of widespread learning loss or 21 \nother negative effects as a result of these decisions; and executive branch policies, 22 \ndeliberations, decisions, activities, and internal and external communications related to 23 \nthe coronavirus pandemic.   24 \nPursuant to House rule X, the Committee on Oversight and Accountability has 25 \n  \n  5 \njurisdiction to investigate any matter at any time.   1 \nAt the discretion of Chairman Wenstrup, one member of the majority and one 2 \nmember of the minority staff of the Committee on Energy and Commerce have been 3 \ngranted permission to attend and participate in this interview.   4 \nFurther, the chairman and ranking member of the Committee on Energy and 5 \nCommerce, Subcommittee on Oversight and Investigations, or their designee are also 6 \ngranted permission to attend and participate in this interview.   7 \nCan the witness please state his name and spell his last name for the record?   8 \nDr. Fauci.   My name is Anthony S. Fauci, and my last spelling name is F as in Frank, 9 \na-u-c-i.   10 \nMr. Osterhues.   Thank you, Dr.  Fauci.   11 \nMy name is Eric Osterhues.  I'm the chief counsel for the majority staff of the 12 \nselect subcommittee.  I want to thank you for coming in today for this interview.  We 13 \nrecognize that you are here voluntarily, and we appreciate that.   14 \nUnder the select subcommittee and Committee on Oversight and Accountability's 15 \nrules, you're allowed to have an attorney present to advise you during this interview.   16 \nDo you have an attorney representing you in a personal capacity present with you 17 \ntoday?   18 \nDr. Fauci.   Yes, I do.   19 \nMr. Osterhues.   Will counsel please identify themselves for the record?   20 \nMr. Schertler.   Yes.  David Schertler.   21 \nMr. Onorato.   Danny Onorato.   22 \nMr. Osterhues.   Thank you.   23 \nIs there an attorney present representing the Department of Health and Human 24 \nServices with you today?   25 \n  \n  6 \nDr. Fauci.   Yes.   1 \nMr. Osterhues.   Will counsel please identify themselves for the record?   2 \nMr. Cooke.   Perrin Cooke, senior counsel with HHS.   3 \nMr. Osterhues.   Is there also an attorney present representing the White House 4 \nwith you today?   5 \nDr. Fauci.   Yes, there is.   6 \nMr. Osterhues.   Will counsel please identify themselves for the record?   7 \nMr. Barstow.   Kevin Barstow, White House Counsel's Office.  8 \nMr. Osterhues.   For the record, can additional staff please introduce themselves 9 \nwith their name, title, and affiliation?   10 \nMr. Benzine.   Mitch Benzine, staff director for the majority staff of the select 11 \nsubcommittee.   12 \nMr. Strom.   John Strom, senior counsel, Committee on Energy and Commerce, 13 \nmajority, Subcommittee on Oversight and Investigations.   14 \nMr. Emmer.   Jack Emmer, senior counsel for the majority, Select Subcommittee on 15 \nthe Coronavirus Pandemic.   16 \nMr. Cipollone.   Joseph Cipollone, counsel for the majority, Select Subcommittee 17 \non the Coronavirus Pandemic.  18 \n chief counsel for the minority, Energy and 19 \nCommerce Committee, Subcommittee on Oversight and Investigations.   20 \n minority counsel, the select subcommittee.   21 \n minority staff, select subcommittee.   22 \n chief minority counsel, select subcommittee.   23 \n Democratic staff director of the select 24 \nsubcommittee.   25 \n\n  \n  7 \nMs. Langley.   Anna -Blake Langley, professional staff member, Select 1 \nSubcommittee on the Coronavirus Pandemic, majority.   2 \n   3 \nMr. LaGanza.   Matt LaGanza, paralegal.   4 \nMs. McMahon.   Grace McMahon, paralegal.   5 \n   6 \nMr. Osterhues.   Thank you.   7 \nFor the record, can the Members please introduce themselves?   8 \nDr. Wenstrup.   Brad Wenstrup, chairman of the Select Subcommittee on the 9 \nCoronavirus Pandemic.  10 \nMr. Griffith.   Morgan Griffith, chairman of the Subcommittee on Oversight and 11 \nInvestigations for Energy and Commerce.   12 \nMr. Jordan.   Jim Jordan, Ohio 4.   13 \nMs. Malliotakis.   Nicole Malliotakis, New York 11.   14 \nMrs. Dingell.   Debbie Dingell, Michigan, select subcommittee and E&C.   15 \nMr. Osterhues.   Thank you all.   16 \nDr. Fauci, before we begin, I would like to go over the ground rules for this 17 \ninterview.   18 \nThe way this interview will proceed is as follows:  The majority and the minority 19 \nstaff will alternate asking questions 1 hour per side per round until each side is finished 20 \nwith their questioning.  The majority staff will begin and proceed for an hour, and then 21 \nthe minority staff will have an hour to ask questions.  We will alternate back and forth in 22 \nthis manner until both sides have no more questions.   23 \nIf either side is in the middle of a specific line of questions, they may choose to 24 \nend a few minutes past the hour to ensure completion of that specific line of questioning, 25 \n\n  \n  8 \nincluding any pertinent followups.   1 \nIn this interview, while one member of the staff for each side may lead the 2 \nquestioning, additional staff may ask questions.   3 \nThere is a court reporter taking down everything I say and everything you say to 4 \nmake a written record of this interview.  For the record to be clear, please wait until the 5 \nstaff questioning you finishes each question before you begin your answer, and the staff 6 \nwill wait until you finish your response before proceeding to the next question.   7 \nFurther, to ensure the court reporter can properly record this interview, please 8 \nspeak clearly, concisely, and slowly.  Also, the court reporter cannot record nonverbal 9 \nanswers such as nodding or shaking your head, so it is important that you answer each 10 \nquestion with an audible, verbal answer.   11 \nExhibits may be entered into the record.  Majority exhibits will be identified 12 \nnumerically.  Minority exhibits will be identified alphabetically.   13 \nThis is not a secure room.  If a question elicits a classified answer and you recall 14 \nthe information, you should answer any unclassified portions to the best of your 15 \nrecollection and affirmatively state, there is more information but it is classified.  Do you 16 \nunderstand?   17 \nDr. Fauci.   I do.   18 \nMr. Osterhues.   We want you to answer our questions in the most complete and 19 \ntruthful manner possible.  If you have any questions or do not fully understand a 20 \nquestion, please let us know, and we will attempt to clarify, add context, or rephrase our 21 \nquestions.  Do you understand?   22 \nDr. Fauci.   I do.   23 \nMr. Osterhues.   If we ask about specific conversations or events in the past and 24 \nyou are unable to recall the exact words or details, you should testify to the substance of 25 \n  \n  9 \nthose conversations or events to the best of your recollection.  If you recall only a part of 1 \na conversation or event, you should give us your best recollection of those events or parts 2 \nof conversations that you do recall.  Do you understand?   3 \nDr. Fauci.   I do.   4 \nMr. Osterhues.   Although you are here voluntarily and we will not swear you in, 5 \nyou are required, pursuant to Title 18, Section 1001 of the United States Code, to answer 6 \nquestions from Congress truthfully.  This also applies to questions posed by congressional 7 \nstaff in this interview.  Do you understand?   8 \nDr. Fauci.   I do.   9 \nMr. Osterhues.   If at any time you knowingly make false statements, you could be 10 \nsubject to criminal prosecution.  Do you understand?   11 \nDr. Fauci.   I do.  12 \nMr. Osterhues.   Is there any reason you are unable to provide truthful testimony 13 \nin today's interview?   14 \nDr. Fauci.   No.   15 \nMr. Osterhues.   The select subcommittee follows the rules of the Committee on 16 \nOversight and Accountability.  Please note that if you wish to assert a privilege over any 17 \nstatement today, that assertion must comply with the rules of the Committee on 18 \nOversight and Accountability.   19 \nPursuant to that, committee rule 16(c)(1) states, for the chair to consider 20 \nassertions of privilege over testimony or statements, witnesses or entities must clearly 21 \nstate the specific privilege being asserted and the reason for the assertion on or before 22 \nthe scheduled date of the testimony or appearance.  Do you understand?   23 \nDr. Fauci.   Yes.  24 \nMr. Osterhues.   Ordinarily, we will take a 5 -minute break at the end of each hour 25 \n  \n  10 \nof questioning, but if you need a longer break or a break before that, please let us know 1 \nand we will be happy to accommodate.  However, to the extent that there is a pending 2 \nquestion, we would ask that you finish answering the question before we take a break.  3 \nDo you understand?   4 \nDr. Fauci.   Yes.  5 \nMr. Osterhues.   Do you have any other questions before we begin?   6 \nDr. Fauci.   No.   7 \nMr. Osterhues.   Thank you.   8 \nDr. Wenstrup.   First of all, Dr.  Fauci, thank you very much for volunteering to come 9 \nin today.  I want to congratulate you on your retirement  --  10 \nDr. Fauci.   Thank you.  11 \nDr. Wenstrup.   -- and your many, many years of service.  I appreciate it.   12 \nI haven't met you in person before, but I want to take this opportunity in person 13 \nto thank you for the time that you and Dr. Collins took during the pandemic.  We did a 14 \nvirtual meeting at NIH with the two of you to discuss mRNA technology and the creation 15 \nof vaccines during Operation Warp Speed, and that was greatly appreciated as you did 16 \nthat with the Doctors Caucus.   17 \nI've looked at this entire event, if you will, not just your time here.  The goal of the 18 \nselect subcommittee is to be an after -action review so that we can have lessons 19 \nlearned  -- I guess that's my military background coming through on that  -- with the goal of 20 \nbeing possibly able in the future to predict a pandemic, to prepare for it, to protect 21 \nourselves from it, and possibly prevent it.  And I think that's a lot of the goal.   22 \nI would say, due to the complexity of this entire situation, virology, et cetera, 2 23 \ndays of discussion may not be really enough, but I appreciate you being here for these 2 24 \ndays.   25 \n  \n  11 \nWere there any additional titles -- I mean, America clearly recognized you early on 1 \nas the face of the government response to the pandemic under both administrations 2 \nduring the pandemic.  Were there any additional formal titles?  Or what were your formal 3 \ntitles in the Trump administration and the Biden administration?   4 \nDr. Fauci.   Are you asking only in that context or my title as the director of 5 \nnational -- you want to know all my titles?   6 \nDr. Wenstrup.   Well, your titles within the administration during the pandemic, 7 \nrelated to the pandemic.   8 \nDr. Fauci.   Okay.  Related to the pandemic.   9 \nIn the Trump administration, I was a member of the Coronavirus Task Force, and 10 \nduring the Biden administration, I was a member of the Coronavirus Response Team and 11 \nthe chief medical advisor to President Biden.   12 \nDr. Wenstrup.   Okay.  Well, thank you very much.   13 \nI do want to say one thing too.  I'm sorry that there's been such a concern for your 14 \nsecurity.  I'm grateful that you have security with the marshals.  As someone who has 15 \nbeen shot at at a baseball field, if not for Capitol Police being there, we might have had 20 16 \nMembers of Congress killed that day.  So I appreciate the situation you're in, and I 17 \nappreciate the marshals being here and serving all of us today.  Thank you.   18 \nDr. Fauci.   Thank you.  19 \nEXAMINATION  20 \nBY MR. BENZINE:  21 \nQ Dr. Fauci, I want to open, again, by reiterating what the chairman just said 22 \nand thanking you for your decades of service and multiple public health responses that 23 \nyou have responded to.   24 \nIn your 55 years of government service, you've obviously seen and experienced 25 \n  \n  12 \nquite a lot, so us picking a 4 -year chunk is probably very limiting in how influential you 1 \nhave been.   2 \nBefore we get started, I want to ask a few more baseline questions regarding this 3 \ninterview.   4 \nAs you have stated, you're represented by personal counsel but also accompanied 5 \nby both Department and White House counsel.  Are you aware that those representatives 6 \ndo not represent your interests but instead those of the United States Government?  7 \nA I do.  8 \nQ Are you aware that it's possible that your personal interests may diverge 9 \nfrom those of the United States Government?  10 \nA Yes.  11 \nQ These representatives may exert privileges on behalf of the government and 12 \ninstruct you to not answer questions.  Are you aware that the decision to answer 13 \nquestions, even if instructed not to, resides solely with you?  14 \nA Yes.  15 \nQ Are you aware that if you refuse to answer any questions today, either as 16 \ninstructed or otherwise, the select subcommittee has the authority to compel your 17 \ntestimony?  18 \nA Yes.  19 \nQ Thank you.   20 \nThe chairman did it a little bit, but I want to run through your education and 21 \nexperience a little bit more, primarily the NIAID chunk, but we'll ask a few broader 22 \nquestions.   23 \nWhere did you attend undergraduate school and what degree did you graduate 24 \nwith?  25 \n  \n  13 \nA I attended the College of the Holy Cross in Worcester, Massachusetts, and I 1 \nhad a BA in Greek and philosophy and science.  2 \nQ Where did you get your medical degree?  3 \nA I got my medical degree at Cornell University Medical College in New York 4 \nCity.  5 \nQ And then who is your current employer and current title?  6 \nA I am currently a distinguished university professor at Georgetown University, 7 \nwith a joint appointment in the depar - -- in the School of Medicine and in the McCourt 8 \nSchool of Public Policy.  9 \nQ And then, very briefly, just probably titles and date ranges if that works for 10 \nyou, run through your Federal career until you retired.   11 \nA After I finished my years of residency, I came to the NIH in 1968 as a fellow 12 \nin infectious diseases and immunology at the National Institute of Allergy and Infectious 13 \nDiseases.  I left for 1 year to be chief medical resident, again, at the New York 14 \nHospital -Cornell Medical Center from '71 to '72.   15 \nI came back to the NIH in 1972, and I started off as a senior investigator to a 16 \nsection head in one of the labs to the chief of the laboratory of immunoregulation in 17 \n1980, a position I held until I stepped down at the end of 2022.   18 \nIn 1984, I became the director of NIAID, and that was a position I held until I 19 \nstepped down at the end of 2022.  20 \nQ And then beginning in January of 2021, as you mentioned, you became chief 21 \nmedical advisor to President Biden.  Did you have additional responsibilities in that role 22 \non top of your directorship at NIAID?  23 \nA My responsibility was to be  -- as I mentioned to the chairman  -- was to be a 24 \nmember of the Coronavirus Response Team and to be the chief medical advisor to the 25 \n  \n  14 \nPresident.  1 \nQ Did that come with more direct access to the President than --  2 \nA Not any more than any member of the Coronavirus Response Team.  3 \nPerhaps I would get asked a question in which they were not there.  Like, you know, any 4 \nkind of medical question.  It was mostly just asking medical questions.  5 \nQ Did that role include a pay adjustment?  6 \nA No.  7 \nQ Do you currently hold any honorary positions?  8 \nA No, I don't.  You mean at the NIH or anywhere?   9 \nQ Or anywhere.   10 \nA No.  The only affiliation I have now is with Georgetown University.  11 \nQ Do you currently hold or have you previously held any positions on boards of 12 \ncompanies, nonprofits, publishers, or academic institutions?  13 \nA I have been a member of a charitable foundation -- a board of a charitable 14 \nfoundation, the Doris Duke Charitable Foundation.  15 \nQ Going to your time as director, did you report directly to the NIH director?  16 \nA I did.  We report directly to the NIH director, but we often do it, in some 17 \nrespects, through the deputy director.  18 \nQ Okay.  And then for the course of the pandemic, the NIH director was Dr. 19 \nCollins the entire time.  Is that correct?  20 \nA Yes, that is correct.  21 \nQ Was the deputy director Dr. Tabak the entire time?  22 \nA Yes, he was.  23 \nQ As director of NIAID, just really briefly, what are some examples of decisions 24 \nthat you're able to make on your own versus ones that you would have to check with 25 \n  \n  15 \nDr. Collins or check with Dr.  Tabak on?  1 \nA Well, for example, in the beginning of the -- a typical prototypic example 2 \nwould be, in the beginning of the AIDS epidemic  -- pandemic in 1981, I established within 3 \nmy depar - -- within my institute the Division of AIDS because I felt that not enough 4 \nactivity was being directed towards this emerging pandemic.  So that's something that I 5 \nhad the capability of doing within my own.  And that's a typical type of thing.  6 \nQ Okay.  Thank you.   7 \nIn 2004, you received a permanent pay adjustment in accordance with an increase 8 \nin responsibilities.  The increased responsibilities correlated to biodefense research 9 \nactivities and response to bioterrorism.  Can you explain what that role was?  10 \nA I'm actually not sure what you mean an increase in pay associated with that.  11 \nI don't recall what the reason for the increase in pay, but I don't believe there was an 12 \nincrease in pay associated with new responsibilities.  I believe it was just the usual Office 13 \nof Personnel Management type of increase, at least to my recollection.  I don't recall that 14 \nit was associated with a particular  -- it may have been, but I don't recall.   15 \nQ Okay.  Did you have responsibilities outside of your NIAID directorship for 16 \nbiodefense research activities?  17 \nA I had no official title, but when we had the anthrax attacks, we developed a 18 \nbiodefense program mostly against smallpox, anthrax, botulism, et cetera.  But I didn't 19 \nhave a specific title associated with that.  20 \nQ At that point, did you receive a security clearance?  21 \nA I have received security clearances, yes.  22 \nQ What level did you have them?  23 \nA You know, I don't recall what the level was, but I think it was a pretty high 24 \nlevel.   25 \n  \n  16 \nQ Okay.  Do you --  1 \nA I don't recall what it is, but --  2 \nQ Does TS/SCI sound familiar?  3 \nA You know, I don't want to speculate about that.  4 \nQ Yeah.   5 \nA But I know it was more than just the regular -- 6 \nQ Okay.  7 \nA -- security clearance.  8 \nQ During the pandemic, did you receive any classified briefings regarding the 9 \norigins of COVID -19 or China or COVID -19 in general?  10 \nA I did.  I don't recall how many, but I did.  11 \nQ Do you recall about when they started?  12 \nA You know, it was -- I don't really recall.  I hesitate to speculate when they 13 \nstarted.  14 \nQ You've said before, and I think everybody in this room would widely consider 15 \nyou an expert in any number of things.  As the chairman kind of alluded to, there's a lot of 16 \ndifferent specialties in medicine.  What is your specific expertise?  17 \nA I'm trained in infectious disease and immunology.  My specific degree of 18 \nexpertise is in HIV/AIDS and in immune -mediated diseases.  19 \nQ Beyond kind of the medical expertise, you've been in government quite a 20 \nlong time as a director of an institute that has a multibillion -dollar budget.  Would you 21 \nconsider yourself an expert in anything nonmedical related?  The appropriations process?  22 \nPolicymaking?  Anything like that?  23 \nA I don't think I would call myself an expert in that.  I've obviously been the 24 \ndirector of NIAID for almost 40 years, so I've testified at a lot of Appropriations 25 \n  \n  17 \nsubcommittee meetings.  So I don't think I know the ins and outs of appropriations, but I 1 \nknow I've testified at Appropriations.  2 \nQ I don't know if the Appropriations Committee knows the ins and outs of 3 \nappropriations, if that makes you feel better, but I appreciate that.   4 \nI want to go ahead and start and introduce what'll be majority exhibit No. 1.  5 \n    [Fauci Majority Exhibit No. 1  6 \n    was marked for identification.]  7 \nBY MR. BENZINE:  8 \nQ So as this goes around the table, this is a March 16th, 2022 letter from, at 9 \nthe time, Ranking Member Scalise to you inviting you to testify at a March 30th, 2022 10 \nhearing.  The panelists at that hearing were Surgeon General Murthy, Assistant Secretary 11 \nO'Connell, and former CDC Director Walensky.   12 \nDo you recall receiving this letter?   13 \nA You know, I received a lot of letters that don't usually come directly to me.  14 \nThey come from different channels.  I can't say I recall specifically receiving this.  Often, 15 \nletters, when they do come from the Congress, they don't come directly to us.  So I can't 16 \nsay I specifically remember this letter.   17 \nQ We'll go ahead and introduce exhibit 2.  18 \n    [Fauci Majority Exhibit No. 2  19 \n    was marked for identification.]  20 \nBY MR. BENZINE:  21 \nQ So this is a letter from you back to Ranking Member Scalise from March 22 \n28th, 2022.   23 \nBefore I ask you if you recall this one, I've been here a while, sent a lot of letters, 24 \nand usually, like you just said, if Congress sends a letter directly to you, we get a letter 25 \n  \n  18 \nback from the NIH or NIH Leg Affairs or HHS.  This one came back directly from you.   1 \nDo you recall this letter?  2 \nA The only thing I recall about this -- I don't recall this specific letter.  It has my 3 \nsignature on it.  But, again, as you mentioned, there were a large number of letters 4 \ncoming in from the Congress through either the NIH or the Department.   5 \nBut I do recall that there was  -- upon reading this, it says, \"In my roles as 6 \ndirector\" -- yada, yada  -- \"I defer to Chairman Clyburn to issue invitations to testify before 7 \nthe subcommittee.  I am always willing to testify upon the request of the committee chair 8 \nand agreement by the administration to discuss ongoing critical efforts.\"   9 \nSo the only thing I remember about this is that we were told that we should 10 \nnot -- that we would not be allowed to testify unless it came from the chair of the 11 \ncommittee.  12 \nQ As much as you can recall, understanding it was a little while ago and a lot 13 \nhas happened since then and you get a lot of letters, did you want to accept the invitation 14 \nto testify?   15 \nMr. Cooke.   Yeah, Mitch, I'm going to jump in here.  To the extent that you're 16 \ngetting into the details of discussions leading up to, you know, this communication, as 17 \nwe've discussed in other TIs, those are deliberations for which the executive branch has a 18 \nconfidentiality interest, and we're not going to be able to get into those details in this 19 \nsetting.   20 \nMr. Benzine.   And, respectfully, whether or not he wanted to testify is not a 21 \ndeliberation.  That is a yes or no question.   22 \nMr. Cooke.   I take that to be, you know, an input into the deliberation over what 23 \nbecame of this response.  So I would view that as deliberative.   24 \nMr. Benzine.   Okay.   25 \n  \n  19 \nBY MR. BENZINE:  1 \nQ You just testified that you were told that in order to accept a congressional 2 \ntestimony invitation, it had to come from the chair.  If the invitation had come from the 3 \nchair, would you have testified at that hearing?  4 \nA If the invitation came from the chair, yes, of course.   5 \nQ Okay.  And along that same sentence, you said you were told that it had to 6 \ncome from the chair.  Were you told anything else regarding accepting this invitation?   7 \nMr. Cooke.   Yeah.  Again, you're getting into the details of those deliberations.  8 \nWe're not going to be able to get into that here.   9 \nMr. Benzine.   I want to introduce another letter.  It will be majority exhibit 3.  10 \n    [Fauci Majority Exhibit No. 3  11 \n    was marked for identification.]  12 \nBY MR. BENZINE:  13 \nQ This is a letter from June 23rd, 2022.  And it is front and back, just so you 14 \nknow.  And it's from Mr. Scalise, Mr.  Comer, and Mr. Jordan, and it is inviting you to 15 \ntestify at a transcribed interview.   16 \nDo you recall receiving this letter?  17 \nA Let me read it first.  Okay.   18 \nAgain, there were many, many letters.  I mean --   19 \nMr. Schertler.   Why don't we wait for the question.  20 \nDr. Fauci.   Oh, I'm sorry.  Yeah.   21 \nBY MR. BENZINE:  22 \nQ Just, do you recall receiving this letter?  23 \nA Do I recall receiving the letter?  Again, to be honest with you, I don't 24 \nspecifically recall receiving this letter, because in the context of letters, many, many 25 \n  \n  20 \nletters were coming in through various channels.  So I can't say, ah, I recognize this letter.  1 \nQ Do you recall any conversations about requests for you to testify for a 2 \ntranscribed interview?  3 \nA I recall there were requests.  I don't exactly recall what the discussions 4 \naround it were.  5 \nQ Perfect.  Thank you.   6 \nI'm going to ask you to bear with me while I run through a long list of names, just 7 \ntrying to set a baseline of the level of communications.   8 \nSo it's, for now, a yes or no of whether or not you communicated with these 9 \nindividuals regarding the origins of COVID, the Wuhan Institute of Virology, or EcoHealth 10 \nAlliance.  And for yeses, we'll come back, and if we need to refresh your recollection as 11 \nwe go through, we can.  12 \nMr. Schertler.   And then just to be clear, so communications on, I think, those 13 \nthree topics?   14 \nMr. Benzine.   Correct.  15 \nMr. Schertler.   Could you just repeat those again so that --  16 \nMr. Benzine.   Yes.  Origins of COVID, the Wuhan Institute of Virology, or EcoHealth 17 \nAlliance.   18 \nMr. Schertler.   Okay.  Thank you.   19 \nMr. Benzine.   Yeah.   20 \nMr. Cooke.   And, of course, this is to the best of his recollection.   21 \nMr. Benzine.   Yes.  And it's just yes or no for now.  We don't need to get into what 22 \nthe conversations were.   23 \nDr. Fauci.   What if I don't recall?  Then that's not a yes and it's not a no.  24 \nBY MR. BENZINE:  25 \n  \n  21 \nQ Yes, sir.  So \"yes,\" \"no,\" or \"I don't recall\" works.   1 \nPresident Trump?  2 \nA EcoHealth, origins  --  3 \nMr. Schertler.   And Wuhan.  4 \nDr. Fauci.   -- and Wuhan.   5 \nI don't recall.   6 \nBY MR. BENZINE:  7 \nQ Vice President Pence?  8 \nA I don't recall specific conversations.  9 \nQ Mick Mulvaney?  10 \nA Again, the same thing.  I don't recall specific conversations with Mick.  Could 11 \nhave been, but I don't recall.   12 \nQ Mark Meadows?  13 \nA Same thing.  I don't recall specifically discussions.   14 \nQ Matthew Pottinger?  15 \nA I don't recall specifically talking about the three issues that you were talking 16 \nabout, but let me answer it as honestly  -- I'll say, a specific conversation of me with Matt 17 \nPottinger about that, I don't recall.   18 \nQ Any conversations with him about China generally during the pandemic?  19 \nA The precisely correct answer to that question is, I don't recall the substance 20 \nof a conversation, but Matt spoke a lot about China, either directly in the Coronavirus 21 \nTask Force meetings or peripherally around, but I don't recall a specific back -and-forth 22 \nconversation.  But I believe he was in China, so I believe he spoke a fair amount about 23 \nChina.   24 \nMr. Onorato.   These are yes or no, remember?  25 \n  \n  22 \nMr. Benzine.   Yeah.   1 \nBY MR. BENZINE:  2 \nQ Robert O'Brien?  3 \nA I don't recall.  4 \nQ Joe Grogan?  5 \nA I don't recall.  6 \nQ Phil Ferro ?  7 \nA I'm trying to remember who Phil is.   8 \nQ I think he was biodefense at the NSC.   9 \nA I don't recall a specific conversation with him about that.  10 \nQ Mark Milley?  11 \nA Chairman of the Joint Chiefs of Staff?  I don't recall any conversations with 12 \nhim about that.  13 \nQ Lieutenant General Robert Ashley?  14 \nA Robert Ashley, I don't recall any conversations with him.  15 \nQ Lieutenant General Scott Berrier?  16 \nA Again, I don't recall any conversations with him.  17 \nQ Anthony Ruggiero?  18 \nA I don't recall specific conversations, but to my recollection, the answer is no.  19 \nI don't recall a specific conversation with him.  20 \nQ Ambassador Andrew Bremberg?  21 \nA No, I don't recall any conversation.  22 \nQ Russell Vought?  23 \nA You know, I have to tell you, I don't recall who these people are.  24 \nQ Okay.  That's fair.   25 \n  \n  23 \nA I can't recall.   1 \nQ Then that counts.   2 \nJohn Ratcliffe?  3 \nA No, I don't recall a conversation with him.  4 \nQ Gina Haspel?  5 \nA No, I don't know who they are.  6 \nQ Mike Pompeo?  7 \nA I don't recall.  8 \nQ Alex Azar?  9 \nA Yes, but I don't recall the substance of the conversation.  10 \nQ Brett  Giroir ?  11 \nA Don't recall precisely.  12 \nQ Robert Kadlec?  13 \nA Yes.  14 \nQ Deborah Birx?  15 \nA Yes.  16 \nQ Robert Redfield?  17 \nA Yes.  18 \nQ President Biden?  19 \nA I don't recall a conversation with the President about that.  20 \nQ Vice President Harris?  21 \nA I don't recall.  22 \nQ Ron Klain?  23 \nA Again, I don't recall.  24 \nQ Jake Sullivan?  25 \n  \n  24 \nA I'm trying to think in my mind if I had a conversation about that, and I don't 1 \nrecall specifically that I did.  2 \nQ That's fair.   3 \nRaj Punjabi?  4 \nA I don't recall, no.  5 \nQ Ashish Jha?  6 \nA I'm trying to take the three points that you're saying, and I don't recall a 7 \nspecific conversation.  8 \nQ Jeff Zients?  9 \nA Again, not specifically.  10 \nQ Andy Slavitt?  11 \nA I don't recall specifically.  12 \nQ Rob Flaherty?  13 \nA Don't recall for sure.  14 \nQ Avril Haines?  15 \nA Avril Haines?   16 \nQ The current Director of National Intelligence.   17 \nA I don't recall that, no.  18 \nQ Bill Burns?  19 \nA I don't recall.  20 \nQ Christopher Wray?  21 \nA I don't recall, no.  22 \nQ Xavier Becerra?  23 \nA I don't recall.  24 \nQ Antony Blinken?  25 \n  \n  25 \nA Again, I don't recall specific conversations.  1 \nQ Jennifer Granholm?  2 \nA Again, I don't recall specific conversations.  3 \nQ Susan Rice?  4 \nA I don't recall specific conversations.  5 \nQ Neera Tanden?  6 \nA I don't recall specific conversations.  7 \nQ Shalanda Young?  8 \nA OMB?   9 \nQ Yeah.   10 \nA I don't recall specific conversations.  11 \nQ Major General Paul Friedrichs?  12 \nA I don't recall specific conversations.  13 \nQ Francis Collins?  14 \nA Yes.  15 \nQ Lawrence Tabak?  16 \nA Yes.  17 \nQ Hugh Auchincloss?  18 \nA Yes.  19 \nQ David Morens?  20 \nA Yes.  21 \nQ Ping Chen?  22 \nA I don't recall.  23 \nQ Cliff Lane?  24 \nA Yes.  25 \n  \n  26 \nQ Ian Watson?  1 \nA Don't recall.  2 \nQ Andrew Pope?  3 \nA Don't recall.  4 \nQ Victor Dzau?  5 \nA Don't recall.  6 \nQ Michael Lauer?  7 \nA Again, I'd have to say I don't recall.  8 \nQ Christian Hassell?  9 \nA You're talking about specific conversations with them.  I mean, the 10 \nidea -- yeah, I don't recall.  11 \nQ Yeah.  Understanding that there's sometimes a large number of people.   12 \nA Yeah, there's large people talking about things, but a specific conversation 13 \nwith them, no.  14 \nQ Christian Hassell?  15 \nA No.  16 \nQ Gray Handley?  17 \nA Yes.  18 \nQ Greg Folkers?  19 \nA Yes.  20 \nQ Erik Stemmy?  21 \nA Yes.  22 \nQ Emily Erbelding?  23 \nA Yes.  24 \nQ Dr. Tedros?  25 \n  \n  27 \nA I don't recall a specific conversation with him.  1 \nQ Jeremy Farrar?  2 \nA Origins is one of the three?   3 \nQ Yes, sir.   4 \nA Yes.  5 \nQ Kristian Andersen?  6 \nA Yes.  7 \nQ Michael Farzan?  8 \nA I don't recall specifically talking to Dr. Farzan.  9 \nQ Eddie Holmes?  10 \nA Again, I want to make sure I'm precisely honest.  When you say specifically 11 \ntalking to them about origins, the answer is, I didn't specifically talk to him about origins, 12 \nbut Eddie Holmes was on the phone call, so obviously.   13 \nQ But it wasn't -- Dr. Holmes was not a one -on-one or like  --  14 \nA No. 15 \nQ -- a group of three?  16 \nA No.  17 \nQ It was a larger group?  18 \nA No, no.  It was a larger group.  19 \nQ Ian Lipkin?  20 \nA Yes.  21 \nQ Andrew Rambaut?  22 \nA Again, part of a larger group but not specifically.  23 \nQ Christian Drosten?  24 \nA Part of a larger group.  25 \n  \n  28 \nQ Were both of those part of the February 1st -- the conference call with the --  1 \nA To my recollection, they both were.  I'm not 100 percent sure, but the names 2 \non the list sound familiar.  3 \nQ Is that the reasoning for the \"yes\", that that conference call, not any other 4 \nconversations?  5 \nA No.  There were no other communications with him.  6 \nQ All right.   7 \nMr. Schertler.   And just to be clear for the record, we're talking about this 8 \nFebruary 1st, 2020 conference call?   9 \nMr. Benzine.   Yes, sir.   10 \nBY MR. BENZINE:  11 \nQ Ron Fouchier?  12 \nA Part of the conference call.  13 \nQ Marion Koopmans?   14 \nA Part of the conference call.  15 \nQ Peter Daszak?  16 \nA I don't recall conversations about that.  17 \nMr. Schertler.   With him?   18 \nDr. Fauci.   With him.  I don't recall a specific conversation with him about that.   19 \nBY MR. BENZINE:  20 \nQ Michael Worobey?  21 \nA Again, I'm not sure he was on the call, but the answer is, I don't recall any 22 \nspecific conversation.  23 \nQ Jonathan Pekar?  24 \nA I don't recall specific conversations with him.  25 \n  \n  29 \nQ James LeDuc?  1 \nA Origins, Wuhan -- I don't recall a specific conversation, but I did talk to James 2 \nLeDuc about China, because apparently -- yeah, I did talk to him about China, but I don't 3 \nrecall the substance of the conversation.  4 \nQ Do you recall about the timing?  5 \nA I don't.  6 \nQ Shi Zhengli?  7 \nA I don't recall any conversations with her.  8 \nQ George Gao?  9 \nA I know I spoke to George.  I'm not sure if it was  -- when it was.  If it was after 10 \nthe pandemic, I might have spoken to him about that, but I don't recall specifically.  But I 11 \nhave spoken to George Gao.  12 \nQ Ralph Baric?  13 \nA I don't recall speaking to Ralph about that.  14 \nQ I'm going to flip back to a couple and just see if  -- I'll start at the top.  And 15 \njust, again, the extent that you can recall content, give us a little bit more substance here.   16 \nMr. Cooke.   And, again, I'm just going to note that, to the extent you're asking 17 \nabout details of conversations related to internal deliberations in the executive branch, 18 \nwe're not going to be able to answer that here.   19 \nMr. Benzine.   But not just conversations generally.  It has to lead to a decision, 20 \ncorrect?   21 \nMr. Cooke.   I mean, I don't know what type of question you're going to ask, but I 22 \npresume that if you're asking about his conversations related to some of these topics, 23 \nthat you're ultimately interested in the deliberations.  So, again, we wouldn't be able to 24 \nget into that here.   25 \n  \n  30 \nMr. Benzine.   All right.   1 \nGenerally, what were the content of the conversations with Dr. Kadlec?  2 \nMr. Cooke.   And, again, you're asking just for general topics?   3 \nMr. Benzine.   Or what he can recall about the conversations.   4 \nDr. Fauci.   You know, I don't recall the specifics of the conversations, but -- I really 5 \ndon't recall the specific of the conversation about those three topics, but Bob was the 6 \nassistant secretary for preparedness and response, and we were on the phone a lot back 7 \nand forth with the Department.  So that certainly could have come up, but I don't 8 \nspecifically  --  9 \nMr. Benzine.   Dr. Birx?   10 \nMr. Barstow.   I'm going to step in there.   11 \nMr. Benzine.   On what grounds?   12 \nMr. Barstow.   There are  executive branch confidentiality interests in those 13 \nconversations.   14 \nMr. Benzine.   On these three -- on everything about these three topics?   15 \nMr. Barstow.   Do you have a more specific question?   16 \nBY MR. BENZINE:  17 \nQ What were the general conversations you had with Dr. Birx regarding the 18 \norigins of COVID, the Wuhan Institute of Virology, or EcoHealth Alliance?  19 \nA You know, I don't recall having specific conversations about those three 20 \nthings, but Dr. Birx was the coordinator of the COVID response team, and it is certainly 21 \nconceivable that that topic came up, but I don't remember a specific conversation I had 22 \nwith Dr. Birx about that.  23 \nQ Thank you.   24 \nGenerally, again, if you recall the content of the conversations with Dr. Collins?  25 \n  \n  31 \nA Well, I talk to Dr.  Collins all the time, so I'm not --  1 \nQ Well, we'll save him for later with more specific exhibits.   2 \nA Yeah.  3 \nQ And we'll save some of these others too.   4 \nDo you recall the conversations you had with Dr. Lipkin?  5 \nA Again, I have to be perfectly honest.  I know I speak to Ian Lipkin 6 \nintermittently.  He's an old friend.  That subject may have come up, but if you were to ask 7 \nme, can I give you the content of the conversation, I can't.  I don't recall.   8 \nQ All right.  Thank you.   9 \nAll right.  We'll move on.  And, again, just generally, to the best of your 10 \nrecollection, kind of outside the specific people that we mentioned, do you recall any 11 \nconversations with anyone affiliated with Fort Detrick?  12 \nA I don't recall any specific conversations.  13 \nQ What about --  14 \nA By the way, I'd have to add, like, who?   15 \nQ No, I know.   16 \nA I wouldn't know if they were from Fort Detrick.   17 \nQ I don't know who works at Fort Detrick either  --  18 \nA Yeah.  19 \nQ -- so, like, I just didn't know if you knew.   20 \nWhat about any conversations with anyone affiliated with the State Department?  21 \nA The State Department?  You know, I'm trying  -- again, I'm trying to --  22 \nMr. Schertler.   We're still talking about the same three topics?   23 \nMr. Benzine.   Yes, sir.   24 \nMr. Schertler.   Okay.  25 \n  \n  32 \nDr. Fauci.   I don't recall specifically talking to anybody.  The answer is that there 1 \nwas a State Department person on the Coronavirus Task Force in the Trump 2 \nadministration.  I don't recall conversations that I specifically had with that person about 3 \nthe three topics you're talking about.  4 \nBY MR. BENZINE:  5 \nQ Who was that person?  6 \nA Steve Biegun.  Biegun.  Biegun, I think it is.  The first name is Steve, I believe.   7 \nQ What about any conversations with anyone affiliated with the Federal 8 \nBureau of Investigation?  9 \nA You know, I don't recall FBI.  There were a lot of security people that often 10 \nwould come in and out and talk.  I don't know if there was a specific FBI person.  There 11 \ncould have been, but I don't recall.  12 \nQ Do you recall any communications with anyone affiliated with the Central 13 \nIntelligence Agency?  14 \nA Yes.  I was briefed once or twice in a secure facility at the NIH, and I believe 15 \nin the -- yes.  The answer is yes to your question.  16 \nQ You said once or twice at the NIH, and then you were about to say 17 \nsomething else.  At Langley as well?  18 \nA No, no.  19 \nQ No?  20 \nA No.  The only thing I can recall is that there were two instances of briefing 21 \nwith the CIA, possibly more.  One was in the NIH SCIF and one was in the -- one of the 22 \nsituation rooms in the White House.  23 \nQ Do you recall about the dates?  Was it 2020 or  2021?  24 \nA I cannot recall.  25 \n  \n  33 \nQ All right.  What about any communications with anyone affiliated with the 1 \nDefense Intelligence Agency or the National Center for Medical Intelligence?  2 \nA I can't recall, but I wouldn't know -- I don't distinguish these  --  3 \nQ Okay.   4 \nA -- security people.  So it could have been --  5 \nQ That's fair.  There's a lot of three -letter agencies out there.   6 \nA Yes.  Right.   7 \nQ We talked about a few, but do you recall any conversations with anyone 8 \naffiliated with the Department of Energy?  9 \nA I don't recall.  10 \nQ Vanity Fair reported recently that, in mid -2019, then -Deputy Secretary Dan 11 \nBrouillette alerted one of your top advisors that the coronavirus work funded at the 12 \nWuhan Institute of Virology risked being misappropriated for military purposes.  Do you 13 \nrecall receiving that warning?  14 \nA I don't recall receiving that warning at the time.  That has been brought up 15 \nsubsequent, but -- in newspapers.   16 \nQ In newspapers?  17 \nA But I have not -- I certainly don't recall receiving any communications 18 \nfrom -- I can't even pronounce his name.  19 \nQ It's either Brouillette or Brouillette.  I don't know if it's a double L.    20 \nA I don't recall specifically then, but it's been brought to my attention since.  21 \nQ Since the Vanity Fair reporting or before that?  22 \nA I think the Vanity Fair reporting was a big surprise to me when I heard it.  23 \nQ Okay.  I'm going to keep walking through, and, again, if it's just the Vanity 24 \nFair reporting, please let us know.   25 \n  \n  34 \nThey also reported that, in October of 2020, he was then -Secretary Brouillette, 1 \ncontacted you and told you that the Department of Energy scientists had evidence 2 \nsuggesting that COVID -19 originated at the Wuhan Institute of Virology.  Do you have any 3 \nrecollection of that?  4 \nA Contacted me?   5 \nQ Yes.   6 \nA Personally?  I do not recall that at all.  7 \nQ They also reported that the Secretary offered Department of Energy national 8 \nlaboratory resources and computing capacity to the NIH.  Do you have any recollection of 9 \nthat?  10 \nA I don't recall that.  11 \nQ Do you recall if NIAID ended up partnering or working with any of the 12 \nnational labs during the pandemic?  13 \nA I don't recall.  14 \nQ Throughout the course of the pandemic  -- I'm going to ask you a few entities, 15 \nand I know one of them -- we're going to exclude family members in this.  If you had any 16 \ncommunications with anyone that worked -- like, is employed at these entities that is not 17 \na member of your family.   18 \nTwitter?  19 \nA Employees of Twitter?  No.   20 \nQ Yes, sir.   21 \nA No.  22 \nQ Facebook?  23 \nA Is Facebook Mark Zuckerberg?   24 \nQ Yes.   25 \n  \n  35 \nA Yes.  So the answer is yes.  I did some podcasts with Mark.   1 \nQ Instagram is also Mark Zuckerberg, but anyone else at Facebook or 2 \nInstagram?  3 \nA No, not to my knowledge.  4 \nQ What about --  5 \nA The reason I say that is because I did interviews on Instagram, but I didn't 6 \nknow if they were people who used Instagram or they were Instagram employees.  7 \nQ They were probably not Instagram employees.   8 \nA I don't know much about social media, so you have got to help me with that.  9 \nQ Yes.   10 \nMr. Barstow.   Sorry.  Are we still talking about the three topics?   11 \nMr. Benzine.   Yes.   12 \nAny communications with anyone at YouTube?  13 \nDr. Fauci.   Not to my knowledge.  I don't recall.   14 \nMr. Benzine.   Do you recall any conversations with anyone at -- within the Federal 15 \nGovernment regarding providing information to any social media platforms?   16 \nMr. Cooke.   On those three topics?   17 \nMr. Benzine.   On those three topics.   18 \nDr. Fauci.   On those three topics?   19 \nBY MR. BENZINE:  20 \nQ Yes.   21 \nA No.   22 \nQ No.   23 \nA few more baseline questions.  The select subcommittee originally invited you to 24 \ntestify back in February.  We worked to then make these dates happen.   25 \n  \n  36 \nOutside of your counsel, Department counsel, and White House counsel, have you 1 \nhad any conversations with anyone regarding this interview?  2 \nA Well, it's been in the newspapers, and people have called me up and said 3 \ngood luck.   4 \nQ Okay.   5 \nA So, I mean -- but I haven't done anything more than that.  6 \nQ Have you had any conversations with Dr. Andersen about this interview?  7 \nA With Kristian?  No.   8 \nQ Okay.  What about Dr. Farrar?  9 \nA No.  10 \nQ Throughout the pandemic, did you ever have any off -the-record 11 \nconversations with anyone in the press?  12 \nMr. Schertler.   Mitch, just to -- so throughout the pandemic, you know, just 13 \ngenerally assume the timeframe from January of 2020 --  14 \nMr. Benzine.   January until retirement.  15 \nMr. Schertler.   -- through the retirement in December of  2022?  16 \nMr. Benzine.   Uh-huh.   17 \nMr. Cooke.   And are we still referring to the same three topics?  18 \nMr. Benzine.   Yes, same three topics.   19 \nMr. Cooke.   So off -the-record conversations with the press regarding those same 20 \nthree topics?   21 \nMr. Benzine.   Yes.   22 \nDr. Fauci.   You know, I can't recall off the record, on the record.  I mean, obviously, 23 \nI've been on a lot of interviews with people directly asking me questions and make 24 \naccusations and all those sorts of things, but I can't separate the two  --  25 \n  \n  37 \nBY MR. BENZINE:  1 \nQ Okay.   2 \nA -- because the press is one big glob to me.  So I'd say it's possible, but I don't 3 \nspecifically recall.  4 \nQ Do you remember any times you had a conversation that wasn't approved 5 \nby HHS or the White House with the press on these three topics?  6 \nA All of my press things get cleared through the appropriate press people.  7 \nQ Thank you.   8 \nI want to introduce majority exhibit 4.   9 \nThat one's got a bad staple.  I'll use that one.   10 \n    [Fauci Majority Exhibit No. 4  11 \n    was marked for identification.]  12 \nMr. Schertler.   This looks like it's a little lengthy.   13 \nMr. Benzine.   Yes.  I'm only going to ask about one particular section, though.   14 \nMr. Schertler.   Okay.  Then I would like just to have --  15 \nMr. Benzine.   He can flip through.  While I identify it, if you would like to flip 16 \nthrough.   17 \nDr. Fauci.   Yeah, what is it?   18 \nMr. Benzine.   It is an email conversation from a number of individuals:  Dr. 19 \nHolmes, Dr. Goldstein, Jason Gale, who's a reporter, Dr. David Morens in NIAID, Dr. Garry.   20 \nAnd for the record, it is Bates marked GARRY, G -A-R-R-Y, 1346 through 1352.  The 21 \nemail that I want to draw your attention to is on page 1347.   22 \nDr. Fauci.   Actually, I'm a little confused because this is a long email.  I want to 23 \nmake sure I get it in context.  So let me -- sorry, but --  24 \nMr. Benzine.   No, no problem.   25 \n  \n  38 \nMr. Schertler.   And, Mitch, just like most emails, it looks like the beginning --  1 \nMr. Benzine.   The beginning is at the end and then it works its way up.   2 \nDr. Fauci.   So I want to make sure.  So the thing that says, \"Jason Gale, 27 July, 3 \n04:03,\" that's the first one?  4 \nBY MR. BENZINE:   5 \nQ Yes, sir.   6 \nA Okay.  So --   7 \nQ If it makes it easier, I won't necessarily be asking about the content of Mr. 8 \nGale's email.   9 \nA I know.  I'm a little confused about this email anyway, but let me read it at 10 \nleast.   11 \nWho's Jason Gale?  Is he -- 12 \nQ He's a Bloomberg reporter in Australia.   13 \nA Okay.  I'm coming to the end of this.  Hold on. 14 \n  \n  39 \n[10:59 a.m.]  1 \nDr. Fauci.   Okay.  So that's Jason Gale to Buesching and Newman.  Who are they?  2 \nOkay.  3 \nBY MR. BENZINE:  4 \nQ And on 1348, Mr.  Gale appears to forward it to -- 5 \nA Right.  6 \nQ -- Dr. Morens and Dr.  Garry, Dr. Holmes.   7 \nA Hold on a second.   8 \nOkay, that's that.  And then -- okay.   9 \nQ So the email I want to ask about is from Dr.  Morens on page 1347.   10 \nA Okay.  He -- so I want to make sure I'm not missing something.  So Jason sent 11 \nit to David and says, \"Ahhh.  This makes more sense!  By the way, I'm making some 12 \nprogress\"  --  13 \n.  And, Mitch, just so I know, does the hour include the preamble?   14 \nMr. Benzine.   No. 15 \n  It does not.  16 \nDr. Fauci.   Okay.  Yes?   17 \nBY MR. BENZINE:  18 \nQ Okay.  I'm going to ask you about some specific lines in this email.   19 \nStarting off, Dr. Morens writes, \"I can almost always talk on background or off the 20 \nrecord, and if needed I MIGHT be able to speak ON the record.  In the US government we 21 \nall have to get approval from HHS or the Whitehouse to speak to the press.\"   22 \nDo you recall what NIAID's press policy was when you were the Director?  Could 23 \nNIAID employees speak off the record to the press without approval?  24 \nA NIAID employees had to let the press office know and get approval.   25 \n\n  \n  40 \nYou know, it really depends on  -- it's a question with a complicated answer 1 \nbecause there are various levels.  If the press is somebody asking you a factual question 2 \nabout, by the way, what  -- you know, what kind of mosquito transmits malaria, that's 3 \nsomething that's less needing approval than, do you want to go on \"Meet the Press\" on 4 \nSunday?  So there are really various  -- various levels.   5 \nQ Okay.  So it wouldn't necessarily, on its face, be a violation of a press policy 6 \nfor someone to speak -- 7 \nA No. 8 \nQ -- off the record with a reporter?  9 \nA No.  Again, it depends on what the issue is.  If it's an issue that's a 10 \nfactual  -- and I gave an example.  It may sound facetious, but it's actually a good example.  11 \nCalling up the subject -matter expert and say, you know, dengue in South America, what 12 \ndo you know about that?  That kind of thing.  I don't think the press  -- but if they're 13 \ntalking about something that relates to policy or that has implications for the institute, 14 \nthat requires approval.   15 \nQ Okay.   16 \nFinishing out that top paragraph, Dr. Morens writes, \"Sometimes they are touchy 17 \nabout certain issues\"  -- \"they\" referring to the HHS and the White House  -- \"and say no.  18 \nFor many months, I have not been approved to talk about 'origins' on the record.\"   19 \nDo you recall  -- this is July 2021.  Do you recall whether or not there was a limit on 20 \nNIAID employees talking about origins on the record at that time?  21 \nA It depends on who the employee was.  I don't think you could say all 22 \nemployees.   23 \nThe press office wants to make sure qualified people speak about things, because 24 \nsometimes press would call an inexperienced person and the person will say something 25 \n  \n  41 \nthat winds up being not actually true or  -- not that they're lying, but that doesn't really 1 \nreflect what's going on.  So they're careful about that.   2 \nI don't know what he means about that, so you'd have to ask him  -- 3 \nQ Okay.   4 \nA -- because I don't know what he meant by that.  5 \nQ Going to the next paragraph down, \"... to my total surprise, my boss 6 \nTony\"  -- I believe he's referring to you  -- \"actually ASKED me to speak to the National 7 \nGeographic on the record about origins.  I interpret this to mean that our government is 8 \nlightening up but that Tony doesn't want his fingerprints on origin stories.\"  9 \nDid you have any conversations with Dr. Morens about what he could or could not 10 \ndiscuss regarding origins?  11 \nA No.  I never tell somebody what they could or could not discuss, because 12 \nthat's a press office thing.   13 \nQ He said that he interpreted your asking him to discuss origins as you didn't 14 \nwant your fingerprints on origin stories.  Any idea what that meant?  15 \nA I have no idea what he's talking about.  Yeah.   16 \nQ Okay.  17 \nThe eventual National Geographic story that Dr.  Morens is quoted in, he said, 18 \n\"There is a progenitor virus out there somewhere, and we should look for it.  But at some 19 \npoint, it crosses over from doing due diligence to wasting time and being crazy.  We may 20 \nhave seen that point already.\"   21 \nAbout a month after that story came out, the Office of the Director of National 22 \nIntelligence released their declassified origins analysis that stated, \"All agencies assess 23 \nthat two hypotheses are plausible:  natural exposure to an infected animal and a 24 \nlaboratory -associated incident.\"   25 \n  \n  42 \nDo you agree with Dr.  Morens's characterization that, at that time, investigating 1 \nthe origins was \"wasting time and being crazy\"?  2 \nMr. Schertler.   So -- and I know  -- I'm sorry, that was a bit of a complicated 3 \nquestion.  So you're really just asking  -- you're quoting something that Morens said from a 4 \nNational Geographic article, correct?   5 \nMr. Benzine.   Yes, sir.   6 \nMr. Schertler.   And then basically asking Dr. Fauci if he agrees with that?   7 \nMr. Benzine.   Yeah.   8 \nMr. Schertler.   I apologize.  Would you just mind repeating the quote -- 9 \nDr. Fauci.   What's your --  10 \nMr. Schertler.   -- from the National Geographic?   11 \nDr. Fauci.   Yeah.  12 \nBY MR. BENZINE:  13 \nQ The quote was, \"There is  a progenitor virus out there somewhere, and we 14 \nshould look for it.  But at some point, it crosses over from doing due diligence to wasting 15 \ntime and being crazy.  We may have seen that point already.\"  16 \nI am interpreting this, and I think a reasonable person would, as that by July  21st it 17 \nis now wasting time and being crazy, searching for the origins.  And, I guess, do you 18 \nagree?  19 \nA I would disagree with that in the context of what I have repetitively said:  20 \nthat we don't know precisely what the origin is, and we have to keep an open mind.  And 21 \nI've said that many, many, many times.   22 \nSo, with that as my statement -- 23 \nQ Uh-huh.  24 \nA -- that would disagree with what he's saying -- 25 \n  \n  43 \nQ Okay.  1 \nA -- that it's a waste of time.  2 \nQ Yeah.  Thank you.   3 \nWe are  pretty close to our hour and at a good stopping point, so we can go off 4 \nthe record.  5 \n[Recess.]  6 \nWe can go back on the record.  7 \nDr. Fauci, my name is   I'm chief minority counsel for the select 8 \nsubcommittee.  Thank you for coming in today.  We appreciate it.  9 \nDr. Fauci.   Thank you.  10 \nEXAMINATION  11 \nBY  12 \nQ I'd like to ask a few questions, organized by topics.  And perhaps if we could 13 \nstart with the broad topic of gain -of-function research and specifically in the context of 14 \nthe Wuhan Institute of Virology.   15 \nThere was and still is a NIAID grant to an organization called EcoHealth Alliance.  It 16 \nwas to study bat coronaviruses.  That grant originally included a sub -award to the Wuhan 17 \nInstitute of Virology.   18 \nAre you generally familiar with that grant?  19 \nA I'm familiar now, after all this, with the sub -award to the Wuhan Institute of 20 \nVirology from EcoHealth, yes.   21 \nQ Great.   22 \nThere was certain lab work done in the Wuhan Institute  -- I will just call it \"WIV\"  -- 23 \nA WIV.  24 \nQ -- to shorten things -- that has been the subject of significant scrutiny and 25 \n\n  \n  44 \nattention.  And a lot of that attention has focused on the question of whether or not that 1 \nwork was, quote, \"gain -of-function research.\"   2 \nAnd there's been significant attention but, I think, also confusion about that term 3 \nas a term of art and what exactly it means.  And I think that a fair amount of that 4 \nconfusion has been caused by the fact that we have heard people use the same term, the 5 \nsame three words, to mean completely different things at different times with different 6 \ndefinitions.   7 \nAnd so I'd like you to help me untangle some of that, if you wouldn't mind.   8 \nI will lay out that we have heard that phrase, \"gain -of-function,\" used in at least 9 \nthree different ways, different definitions.   10 \nFirstly, we have heard I think what I would call a layman's definition.  It's basically 11 \njust a literal usage.  Has something been modified in a way that there has been a gain in 12 \nfunction?  And some people seem to include the idea of a loss of function or a change in 13 \nfunction.  But, regardless, this seems to be a very casual, sort of literal approach to the 14 \nquestion.   15 \nAre you generally familiar with that usage of the phrase?  16 \nA I am familiar with that.  And I'm also familiar with the confusion that that 17 \ncauses when you apply it to a specific set of experiments.   18 \nQ Great.   19 \nSo, getting more specific from there, a second usage of the term that we have 20 \nheard is \"gain -of-function\" but specifically in the context of the 2014 Federal 21 \ngain -of-function moratorium.  And this now includes specific limitations; it's just 22 \nparticular viruses.  It's a forward -looking test.   23 \nAre you generally familiar with that usage of the term?  24 \nA Yes, I am.   25 \n  \n  45 \nQ Great.   1 \nAnd then, thirdly, we have heard people use the phrase \"gain -of-function\" in the 2 \ncontext of the 2017 HHS P3CO framework, which replaced the 2014 moratorium, and that 3 \nnow involves an even more specific set of definitions:  potential pandemic pathogen, 4 \nwhich is a multipart definition, and all sorts of carve -outs.   5 \nAre you generally familiar with that usage of the term?  6 \nA Yes, I am.   7 \nQ Great.   8 \nSo I'd like to talk in a little bit of detail about each of those three definitions, the 9 \nways in which they are either similar or different and may be more or less useful from 10 \neach other  -- 11 \nA Right.   12 \nQ -- starting with that layman's definition.   13 \nSo I will introduce an exhibit that I think is a good example of that as minority 14 \nexhibit A.  15 \n    [Fauci Minority Exhibit A  16 \n    was marked for identification.]  17 \nBY : 18 \nQ And I'll give you some time to look that over so you're familiar with what 19 \nwe're looking at.  My focus will be on the first page, but, please, take your time to look at 20 \nthe document.   21 \nA Okay.  22 \nQ All right.  So, for starters, I don't know exactly what this is.  I don't know if 23 \nyou do.  It looks like maybe it's some kind of informational toolkit or something of that 24 \nnature.   25 \n\n  \n  46 \nA Right.   1 \nQ Let's do this:  If I direct your attention down on the first page under the 2 \nheader \"Gain -of-Function Research,\" I'll read out loud what seems to pretty closely track 3 \nthe idea of a layman's definition.   4 \n\"The term gain -of-function research describes a type of research that modifies a 5 \nbiological agent so that it confers new or enhanced activity to that agent.\"  It also says 6 \nthat, \"Some scientists use the term broadly to refer to any such modification.\"  7 \nI'll stop there.  That feels like a relatively broad definition.   8 \nA Correct.   9 \nQ We read recently that there was some work done last year that genetically 10 \nmodified bacteria so that they could detect tumors.   11 \nA Right.  12 \nQ That's great.   13 \nA Right.  14 \nQ It seems  -- but, please, you tell me  -- that that would also fit this definition.  15 \nIs that right?  16 \nA That is correct, as well as making an influenza vaccine.  Yeah.  17 \nQ To the extent that you recall, maybe because of its breadth, did this 18 \ndefinition, in your time as Director, have any formal, regulatory significance?  This is not a 19 \npolicy -- 20 \nA No. 21 \nQ -- or regulation -- 22 \nA No. 23 \nQ -- that we're looking at?  24 \nA No.  It's a broader definition.  It did not.   25 \n  \n  47 \nQ Just on the idea of \"new or enhanced activity,\" because it has helped me to 1 \nhear some examples, putting aside the \"biological agent\" concept, but agriculture 2 \ncommunity messes around with strawberries to make them taste better.  That is a new or 3 \nenhanced activity on the part of the strawberry?  Is that fair?  4 \nA Right.   5 \nQ When you talk about this issue, this broader issue of gain -of-function and 6 \nWuhan Institute of Virology, publicly  -- for example, the high -profile exchange with 7 \nSenator Rand Paul -- 8 \nA Right.  9 \nQ -- and if you say that NIH, quote, \"has not ever and does not now fund 10 \ngain -of-function research in the Wuhan Institute of Virology,\" is this layman's definition 11 \nthe definition that you are talking about in those occasions?  12 \nA No.   13 \nQ Great.  What would you be talking about in those situations?  14 \nA What I was referring to when Senator Paul asked me and I repeated multiple 15 \ntimes that we were not doing gain -of-function research, no -- I said that the NIH 16 \nsub-award to the Wuhan Institute was not to do gain -of-function research.  I was 17 \nreferring specifically to the operative definition of \"gain -of-function\" at the time, which is 18 \nthe P3CO framework.   19 \nAnd the P3CO framework is a policy and a framework that came out of a policy 20 \nguidance from 3 years of discussions led by OSTP, the National Academies of Sciences, 21 \nand multiple scientific working groups that came out with a very precise definition.   22 \nAnd the precise definition was:  any experiment that is reasonably anticipated to 23 \nresult in the enhancement of a  -- and by \"enhancement,\" it is meant an increase in the 24 \ntransmissibility and/or the pathogenesis of a PPP.  And what a PPP is is a potential 25 \n  \n  48 \npandemic pathogen.  So if you enhance it, it's referred to as \"ePPP.\"   1 \nSo then you ask the question, what is a PPP?  And by the regulatory definition, it is 2 \nthe following:  It is a pathogen that is likely to be highly transmissible and spread widely in 3 \na population and a pathogen that likely will cause a high degree of morbidity and 4 \nmortality in humans.   5 \nSo, when I was asked the question, did the grant that was a sub -award to Wuhan 6 \nfund experiments that were enhanced PPP, that is what I was referring to when I said we 7 \ndo not fund gain -of-function -- gain -of-function according to the strict definition, which I 8 \nrefer to as the operative definition of \"gain -of-function.\"   9 \nSo, when someone asks me, as a scientist, are you doing gain -of-function, is that 10 \ngain -of-function, I always apply it to the operative definition of \"gain -of-function.\"   11 \nQ That is very helpful.  Thank you for drawing that distinction.   12 \nAnd at the time of that exchange, it was the P3CO framework.  There was also a 13 \ntime, I think from 2014 to 2017, when the gain -of-function moratorium was the operative 14 \npolicy.   15 \nA Right.  16 \nQ So a similar analysis, I assume, would've been the case for that -- 17 \nA Right.  18 \nQ -- period of time.   19 \nA Yes.   20 \nQ So I think it might make sense to look in more detail at both of those sets of 21 \ndefinitions.  You may end up repeating yourself a little bit.  22 \nA Right.  23 \nQ I think it's helpful for folks like me.   24 \nSo I will introduce as minority exhibit B the 2014 moratorium.  25 \n  \n  49 \n    [Fauci Minority Exhibit B  1 \n    was marked for identification.]  2 \nBY  3 \nQ And although I imagine you are familiar with it, you're welcome to take a 4 \nglance at it and refamiliarize yourself with it.   5 \nA I'm pretty familiar with it.  6 \nQ I imagine you are.   7 \nA Yeah.  8 \nQ All right.  So I think what I might do -- the operative language is on the 9 \nsecond page of the paper, the first page of full text, in italics in the middle of that page.  10 \nI'm just going to read that single paragraph out loud so that we're all working  off of the 11 \nsame thing.   12 \n\"New USG\" -- the U.S. Government  -- \"funding will not be released for 13 \ngain -of-function research projects that may be reasonably anticipated to confer attributes 14 \nto influenza, MERS, or SARS viruses such that the virus would have enhanced 15 \npathogenicity and/or transmissibility in mammals via the respiratory route.  The research 16 \nfunding pause would not apply to characterization or testing of naturally occurring 17 \ninfluenza, MERS, and SARS viruses, unless the tests are reasonably anticipated to increase 18 \ntransmissibility and/or pathogenicity.\"   19 \nThat's the end of the policy.   20 \nSo my first question:  Am I right that this was, for the time that it was in effect, a 21 \nformal and binding policy?  22 \nA Correct.   23 \nQ Great.  Can you talk maybe just a little bit for us about what this policy is, 24 \nhow it came to be, and what its purpose was?  25 \n\n  \n  50 \nA Well, the reason is that this followed the pause, which was the event that 1 \ncaused people to take a good, serious look at gain -of-function that might be of concern, 2 \nthat could be dangerous.  So a policy was put forth that the viruses that were of concern 3 \nwere threefold.  They wanted to narrow it down so that you wouldn't get confused about 4 \na broader.   5 \nSo the policy at the time, as you correctly articulated, is any project, research 6 \nprojects and experiments, that might be reasonably anticipated to confer attributes to 7 \nthree very specific pathogens -- influenza, MERS, and SARS -- such that that experiment 8 \nwould have enhanced the pathogenicity or transmissibility in mammals via the 9 \nrespiratory route.   10 \nSo it was a restrictive regulatory description of what gain -of-function research of 11 \nconcern would be, and it was restricted to three separate pathogens.   12 \nQ Out of curiosity, why those three in particular?  Was there some particular 13 \nconcern about those?  14 \nA Well, this was at a time when we were post the H5N1 concern about bird flu 15 \nthat might evolve from an animal, predominant zoonotic in a chicken, to a human with a 16 \nhigher degree of transmissibility, of pathogenesis.   17 \nTurn the clock back to the original discussions that were going on -- and still to this 18 \nday, actually -- about bird viruses, predominantly chickens, influenza viruses, that rarely 19 \njump species but when they did they had a high degree of morbidity and mortality.  And 20 \nthe concern was that they would be more transmissible -- hence the word \"reasonably 21 \nanticipated\" to confer increased transmissibility or pathogenesis.  22 \nThe next was that we had MERS in 2012 and SARS -- the SARS -1 in 2002 and 2003.  23 \nSo those were the major concern of people doing experiments that have a reasonable 24 \nassumption to increase transmissibility and/or pathogenesis in mammals by the 25 \n  \n  51 \nrespiratory route.   1 \nQ That's very helpful.  Thank you.   2 \nAnd an additional aspect of the policy  -- it's a nuance, but I think it gets lost 3 \nsometimes  -- is that it seems to be a forward -looking policy.  In other words, the moment 4 \nof decision -making  -- 5 \nA Right.  6 \nQ -- occurs before  -- 7 \nA Right.  8 \nQ -- the experiment has occurred.  Is that correct?  9 \nA Exactly.   10 \nAnd the reason for that was, back when we didn't have these kinds of official 11 \nregulatory restrictions, the thing that triggered all of this, the H5N1 influenza ferret 12 \nstudies, was only really brought to everyone's attention after the experiments were done 13 \nand the data was submitted to a scientific journal.   14 \nAnd that was a great concern, that we don't want that to happen again.  So you've 15 \ngot to essentially regulate before the fact, as opposed to make a harried decision after 16 \nthe fact.  17 \nQ And so that also means that, when we think specifically about whether 18 \nparticular research is or is not implicated by this policy, it's not as simple as looking at a 19 \nfigure after the research has already happened  -- 20 \nA No.  21 \nQ -- and measuring that.  It's about putting yourself back into the shoes of the 22 \ndecision  --  23 \nA Right.  24 \nQ -- before the research occurred.   25 \n  \n  52 \nA Right.  In other words, the scope of research  -- the scope of the research 1 \nproject.   2 \nQ And I would imagine that that type of analysis would have to ask oneself 3 \nquestions about, okay, what type of virus is this?  Does it even come under the pause in 4 \nthe first place?  Is it novel?  What do we know about it?  How would we expect it to 5 \nbehave in these proposed experiments?   6 \nThose would all be part of that decision -making process, right?  7 \nA Correct.   8 \nQ And, as we understand it, there was a system at NIAID for doing all of that.  9 \nThere was a committee, at least in the DMID division  --  10 \nA Right, Division of Microbiology and Infectious Disease.  11 \nQ So, in that division, there was a gain -of-function and dual -use research of 12 \nconcern committee  -- 13 \nA Correct.  14 \nQ -- whose job it would be, it sounds like, to ask and answer all those types of 15 \nquestions.   16 \nA Correct.   17 \nQ And we've heard a little bit about how that process would typically work.  18 \nAnd it sounds like  -- I'm generalizing  -- that, typically, a program officer would sort of flag 19 \na question and maybe have a conversation with the grantee, have a discussion, ask for 20 \nsome information, take that information back to the committee that we just described, 21 \nand then they would all sit together and make a decision on the moratorium question.   22 \nIs that basically your understanding as well?  23 \nA Yes, that's my understanding.   24 \nQ And specifically in the context of this EcoHealth grant, which is what we've 25 \n  \n  53 \nspent most of our time on, our understanding is that that is basically how that process 1 \nunfolded.   2 \nIs that your basic understanding, that that process happened  -- 3 \nA Yes.  4 \nQ -- with respect to this grant?  5 \nA That is my basic understanding.   6 \nQ That was in the summer of 2016.  Were you on that gain -of-function 7 \ncommittee that took a look at that question?  8 \nA No.   9 \nQ Were you the program officer on the grant?  10 \nA No.   11 \nQ Were you involved in that decision at that time, now 8 years ago, in any 12 \nway?  13 \nA No.  14 \nQ Just because it can help us to see what the org chart looks like, 15 \napproximately how many reporting levels, in the context of NIAID, would exist between 16 \nthe folks who were making that decision and yourself, in your regular duties as Director?   17 \nA Multiple -- 18 \nQ Would you be anywhere near it?  19 \nA I wasn't even close to it.  It was multiple layers, up through the chain of the 20 \ndivision and then to the Deputy Director.  So I was not involved in that in any way.  21 \nQ So, for you, as Director, when folks come and ask, okay, well, was there or 22 \nwas there not research that should or shouldn't have happened under that 2014 23 \nmoratorium, how do you go about answering that question?   24 \nI would think it would basically be as simple as saying:  Well, we have a 25 \n  \n  54 \ncommittee.  Did the committee look at it?  If so, what did they look at and what did they 1 \nfind?   2 \nIs that basically what your process would be?  3 \nA Exactly.   4 \nQ Okay.   5 \nAnd, in this case, as we understand it, a program officer did flag the question, the 6 \ncommittee did look at it, and they decided that that answer was no.   7 \nIs that also your understanding?   8 \nA Yes, it is.   9 \nQ And I imagine  -- you tell me  -- that you might do some kind of spot -check.  In 10 \nother words, you might say, \"Hey, just walk me through the way that you guys 11 \napproached it.\"  But I would not think that you would be starting over from scratch.  You 12 \nwould certainly have some degree of understanding that your folks, as subject -matter 13 \nexperts, did things as they're supposed to do them.   14 \nA Right.   15 \nQ This is a little bit more of a comment than a question, but I will say that I 16 \nthink we do think that it's fair for us now to be thoughtful about how the committee did 17 \ngo about approaching that question.   18 \nAnd we have done that in, I'll say, almost excruciating detail with the program 19 \nofficer.  We've sat with that individual as well as with the grantee.  We've talked about 20 \nthe extent to which they were using this particular virus as a comparator for purposes of 21 \nincrease or decrease, whether that was the right one.   22 \nWe've heard explanations about, hey, wild -type SARS doesn't actually cause 23 \ndisease in mice, so if we're talking about a mice experiment, there has to be some sort of 24 \nmouse -adapted -- 25 \n  \n  55 \nA Right.  1 \nQ -- strain.  We discussed the extent to which that's apples -to-apples or not.   2 \nMy only point is, I don't think that there's a need to go back over all of that with 3 \nyou, but I do think those are important questions  -- 4 \nA Right.  5 \nQ -- which we've done with the right folks.   6 \nA Right.   7 \nQ I think it would make sense maybe to look at the third definition, which is 8 \nthe P3CO framework.  So I will introduce that as minority exhibit C.  9 \n    [Fauci Minority Exhibit C  10 \n    was marked for identification.]  11 \nBY  12 \nQ And you described this in some detail, but, again, take your time to look back 13 \nover it.   14 \nA Okay.   15 \nQ Great.  So this is probably the most complicated set of definitions that we 16 \nhave seen yet.   17 \nA Yes.   18 \nQ I think what I will do is read not the whole thing but a core, key part of it, 19 \nwhich is on the second page, parts A and B, which you were alluding to earlier.  I'll read 20 \nthose out loud.   21 \nIn part A, it says, \"A potential pandemic pathogen (PPP) is a pathogen that 22 \nsatisfies both of the following:  1.  It is likely highly transmissible and likely capable of 23 \nwide and uncontrollable spread in human populations; and 2.  It is likely highly virulent 24 \nand likely to cause significant morbidity and/or mortality in humans.\"   25 \n\n  \n  56 \nAnd then B, \"An enhanced PPP is defined as a PPP resulting from the 1 \nenhancement of the transmissibility and/or virulence of a pathogen.  Enhanced PPPs do 2 \nnot include naturally occurring pathogens that are circulating in or have been recovered 3 \nfrom nature, regardless of their pandemic potential.\"   4 \nI'll stop there.   5 \nCould -- you did already a little bit, but if you wouldn't mind again just describing a 6 \nlittle bit about how this framework came to be, how it's interrelated with the moratorium 7 \nthat we just looked at, and how it differs.  This seems like an awfully high bar that is being 8 \nset.  \"Wide and uncontrollable spread,\" that's sort of a dramatic phrase.   9 \nSo could you just talk a little bit about your view of this?   10 \nA Yeah.  Well, what happened is that, as you mentioned in the description 11 \nof the second of the three definitions, namely the one that is the pause definition, an 12 \nintegral part of that was an interim regulatory process that would lead to something that 13 \nwould ultimately be more definitive and more specific.   14 \nSo that's how we evolved from the pause, which was then stopped, to then have 15 \nall the experiments fall under this regulatory approach.   16 \nQ And am I right that one difference between this and the moratorium, the 17 \nmoratorium was a pause?  18 \nA Right.  19 \nQ Work under that simply would not occur during the pause?   20 \nA Right.   21 \nQ And this, there's been established a framework -- 22 \nA Right.  23 \nQ -- to further review work that meets these definitions.  Is that right?  24 \nA Right.  In fact, an important point:  HHS will periodically reevaluate and 25 \n  \n  57 \nmodify this review process, as necessary, to reflect scientific advances, et cetera.   1 \nQ We've heard a little bit elsewhere about the system for sending projects to 2 \nP3CO review.  In other words, in order for that further review to occur, there has to be a 3 \ndecision to refer it.   4 \nA Right.  5 \nQ And it seems to be a multistep process  that maybe involves some peer 6 \nreviewers and a program officer all discussing amongst themselves.   7 \nIs that generally  -- I know I'm generalizing, but is that your general understanding 8 \nof how that -- 9 \nA Yes. 10 \nQ -- process works?  11 \nA That is the general understanding of how the process works.   12 \nQ And we understand that specifically with respect to this EcoHealth grant that 13 \nthat process occurred.  In other words, there was a conversation amongst the program 14 \nofficer and other people that that person deemed appropriate about whether or not this 15 \nwork should be referred for further review under the P3CO framework.  And our 16 \nunderstanding is that the answer to that question at that level was no.   17 \nIs that also your understanding?  18 \nA That is correct.   19 \nQ We have, I think, significantly less paper on that decision.  My assumption is 20 \nthat's because that was not quite as difficult of a decision.  In other words, \"likely capable 21 \nof wide and uncontrollable spread in humans\" seems like a relatively high bar that that 22 \nwork would have to meet.   23 \nIs that generally fair?  24 \nA Yes.   25 \n  \n  58 \nQ Okay.   1 \nAnd would your analysis -- if you're asked, well, was any particular grant or the 2 \nEcoHealth grant, was that gain -of-function under the P3CO framework, I would assume 3 \nthat your process for answering that question would be more or less the same as it was 4 \nfor the moratorium, which is:  We've got a committee; we've got folks.  Did they look at 5 \nthat question, and, if so, what was their answer?   6 \nIs that right?  7 \nA That is correct.   8 \nQ And, in this case, particularly since you helped us by explaining that in that 9 \nparticular exchange with Senator Paul P3CO was what you were talking about, I would 10 \nthink that that is what you were communicating.   11 \nA Right.  I was communicating to Senator Paul when I used the word 12 \n\"gain -of-function\" my  -- my definition of \"gain -of-function\" is the operative definition of 13 \n\"gain -of-function,\" which we have just discussed now under the P3CO.   14 \nSo, when I said to Senator Paul that we have not funded from EcoHealth with a 15 \nsub-award to Wuhan gain -of-function research, I was referring to the operative definition 16 \nunder the P3CO.   17 \nQ And \"operative,\" I think, is a really helpful term.  That very first definition we 18 \nlooked at off of a website pull, was that definition ever operative, that you can -- 19 \nA No. 20 \nQ -- recall, in your time as Director?  21 \nA No.  That definition was not operative, because it includes, as you 22 \nmentioned, so many other things that are of benefit, such as the ones you mentioned.  23 \nQ Great.   24 \nIf I could ask a quick, more global question, when it comes to EcoHealth Alliance 25 \n  \n  59 \nor Dr.  Peter Daszak, there's been significant focus on him.  There have been suggestions, 1 \nsometimes, that you and he somehow collaborated or conspired to hide something.   2 \nLet me just ask, what is the extent to which you knew Dr.  Daszak prior to the 3 \npandemic, let's say?  4 \nA Prior to the pandemic, I really don't recall any specific interaction with him.   5 \nIn the course of all of these activities that were going on, someone  -- I guess it was 6 \nin the press  -- showed a picture of me with Dr.  Daszak.  I take probably thousands of 7 \npictures with people at scientific meetings.   8 \nSo the picture shows I've met him.  If you ask me, do I have a relationship of 9 \nback -and-forth discussions with him, the answer to that would be \"no.\"   10 \nQ Would that relationship, as you just described it, be pretty similar to other 11 \nwell-known folks in their respective fields who have grants with the agency?  12 \nA I would say less so.  And the reason I say \"less so\" is that there are people 13 \nwho are grantees who are in an area of research that I am very familiar with and that I'm 14 \ninvolved with.   15 \nFor example, my relationship with many people in the field of HIV/AIDS research is 16 \nsomething in which I talk to them all the time.  Sometimes I collaborate with them on 17 \nresearch.  I see them at the scientific meetings that I go to.   18 \nThat is not the relationship I had with Dr.  Daszak.   19 \nQ That's helpful.   20 \nAlso, you touched on it, but you may want to expand on the idea that, under the 21 \numbrella of NIAID, I mean, there are all sorts of grants on all sorts of different branches of 22 \nsubject matter.  You have this intimate relationship with HIV, professionally.  How would 23 \nyou describe your, sort of, links to the coronavirus field prior to, of course, the pandemic?  24 \nA Very little.   25 \n  \n  60 \nIn the division of microbiology and infectious diseases, I would have much more 1 \ninteraction with things like malaria and tuberculosis and things like that.   2 \nCoronaviruses, except for a brief period of time during that very small window in 3 \n2002 -2003 with coronavirus, I am not integrated, as it were, into the coronavirus field of 4 \nresearchers.  I know them now.  Obviously, there's a lot of discussion about them.  But we 5 \nhave thousands of grants and grantees, and on each grant there may be many 6 \ninvestigators.  So we have a lot of people coming by, talking to me, meeting me at 7 \nmeetings.   8 \nQ And that's helpful.   9 \nWhat is the extent to which you were familiar with not necessarily Dr.  Daszak as a 10 \nperson but this particular grant prior to all the scrutiny?  11 \nA Yeah.  I do not recall any familiarity with this grant prior to the outbreak.   12 \nQ Would you recall approximately how many grants NIAID would have at any 13 \ngiven time?  14 \nA A few thousand, I guess, between 2 - and 3,000.  I'll have to check that.  I 15 \ndon't know what it is now; I've been out.   16 \nBut, around that time, there were grants that are new grants -- you know, there's 17 \ntwo types of grants.  There's a grant that's submitted as a new grant, and then there's the 18 \ncontinuing grants for 5 years.  So, if we look at all the grants, I would say it would  -- my 19 \nrecollection  -- I'm not 100 percent sure, but my recollection is somewhere, a couple - up 20 \nto three thousand, I think.  21 \nQ Okay.  22 \nA Yeah.  23 \nQ Great.   24 \nSo I'm going to attempt to summarize what we've talked about so far.   25 \n  \n  61 \nWhen we think about the term \"gain -of-function,\" there are various definitions 1 \nwhich we have heard folks elsewhere mix and match by simply using the words 2 \n\"gain -of-function\" regardless of what exactly they mean.   3 \nOne of those definitions is more of a layman's definition that we talked about.  It 4 \nfocuses more on the literal question of whether there has been a gain of function.  It's not 5 \nparticularly useful, as we saw with the tumor -detecting bacteria example.  It was not 6 \noperative for your purposes as Director.  And I would assume that nobody at the agency 7 \never looked into that exact question for that very reason.   8 \nIs that all basically right?  9 \nA That is correct.   10 \nQ Great.   11 \nAs for the more significant question of whether the work under the EcoHealth 12 \ngrant at the Wuhan Institute of Virology fit the regulatory and operative definitions in the 13 \n2014 moratorium or subsequently in 2017 and P3CO, the agency did look at those 14 \nquestions, and the answer was \"no\" both times.   15 \nIs that correct?  16 \nA That is correct.   17 \nQ And when you attempt to answer this question in public forums, such as in 18 \nthe exchange that we described with Senator Paul, you are referring to the operative 19 \nregulatory definitions, not the layman's definition.  Is that correct?  20 \nA That is correct.   21 \nQ And, I suppose, lastly, you were not particularly aware of or focused on 22 \nperhaps at all this particular grant until everyone else was too, at which point you learned 23 \nabout it along with the rest of us.  Is that basically right?  24 \nA That is correct.   25 \n  \n  62 \nQ Great.   1 \nI think at that point it's a natural pivot to my colleague , who can discuss 2 \nsome other topics.   3 \nDr. Fauci.   Thank you.   4 \n.  Thank you.   5 \n  Before I jump in, we had a member enter the room, and I would just like 6 \nfor her to put herself on the record.  7 \nMs. Castor.   Thank you.   8 \nI'm Kathy Castor.  I represent the State of  Florida.  From the Energy and 9 \nCommerce Committee.  10 \n  All right.  Good afternoon, Dr. Fauci.  It just hit noon.   11 \nBY  12 \nQ In the prior hour, you discussed a little bit of your background with the NIH 13 \nand your long career there.  So I just want to go over a little bit about prior pandemics 14 \nthat you were a part of the response to in your role at NIAID.  So I'm just going to go 15 \nthrough a couple one by one and ask for your experience and how that informed the 16 \nCOVID response.   17 \nA All right.  18 \nQ So the first one  -- you mentioned it a little bit  -- is the SARS -CoV-1, or the 19 \nbird flu.  What was your experience working on that pandemic?  20 \nA The primary responsibility of the institute that I direct is to do research and 21 \nstudy, either in our own scientists or quantitatively more our grantees, anything from the 22 \npathogenesis to diagnostics to the development of vaccines and therapeutics.   23 \nSo our first role in the SARS -1 would be to start to begin to develop a vaccine to 24 \nsee if we can actually prevent it, if it turns out to be something that got out of control, 25 \n\n  \n  63 \nwhich it did not.  The other would be to understand the pathogenesis of it through our 1 \ngrantees and perhaps develop diagnostics and therapeutics.   2 \nSo it was fundamentally the research effort associated with that outbreak.   3 \nQ And did anything about the SARS -CoV-1 outbreak inform the response to the 4 \nrecent COVID -19 pandemic?  5 \nA I'm not sure what you mean by informing the response, but, you know, 6 \nthere -- well, please explain, yeah.   7 \nQ I just mean, were any lessons learned during the SARS -CoV-1 response that 8 \nwere useful?  9 \nA Well, it wasn't a lesson learned from the response, but it was -- the research 10 \ndone by some of our grantees and others is that it was ultimately shown that it was a 11 \nzoonotic that jumped from an animal reservoir, from a bat to a civet cat to a human.   12 \nThe lesson learned is that, yet again, another pathogen that originates in an 13 \nanimal reservoir  -- it is probably not particularly appreciated that anywhere between 70 14 \nto sometimes 80  -- I don't think it's 80, but probably 70 to 75  percent of all the new 15 \npathogens are zoonotic, in that they jump from an animal reservoir, sometimes with a 16 \none-off little blip; sometimes with a slightly sustained, as we saw with the original H5N1, 17 \nwhere a few humans got it; and sometimes it explodes into an outbreak, as happened 18 \nwith HIV, which went from a chimpanzee to a human.   19 \nQ And my next question was actually about the H1N1 or swine flu pandemic.  If 20 \nyou can tell us anything about NIAID's role in the response to that?   21 \nA Well, H5N1 is a chicken virus.  And in the beginning, when we had individuals 22 \nthat were getting infected, there was little indication of human -to-human transmissibility 23 \nbut there were a number of species jumps, from the chicken to the human, with a high 24 \ndegree of mortality.   25 \n  \n  64 \nSo we put a  1 \nmajor effort in developing vaccines for H5N1, bird flu.  And, in fact, in 2 \ncollaboration with other elements of the Department, namely BARDA at HHS, we 3 \ndeveloped a vaccine that was actually put into a Strategic National Stockpile.  So that was 4 \nHVN2.   5 \nAnd the other one you asked about was the swine flu.   6 \nQ Yes.   7 \nA Exactly the same with the swine flu.  I mean, our investigators were out 8 \nthere determining pathogenesis, looking about the virus, how it binds, and all the kinds of 9 \nfundamental basic research.   10 \nSomething not very well -appreciated, for example, is what we do versus other 11 \nagencies like the CDC.  Our responsibility is to conduct and fund basic and clinical 12 \nresearch into the pathogenesis, diagnostic, prevention, vaccines, and treatment of 13 \nexisting diseases and of emerging diseases.  And that's what we did with virtually all of 14 \nthe outbreaks.   15 \nQ And I've got a couple more on my list that you may want to lump together, 16 \nor not, the next being Ebola and Zika.   17 \nA Yeah.  Same thing.  In fact, it's very, very similar.   18 \nVery briefly, Ebola, we were involved in the development of a vaccine that our 19 \nteam actually tested in West Africa during the West African outbreak of 2013, '14, '15.  20 \nWe also did some studies on various therapeutic interventions, such as remdesivir and a 21 \nmonoclonal antibody, that ultimately was used with Ebola.  So that was that.   22 \nVery similar to Zika.  When Zika came, we had our team of vaccine developers at 23 \nour Vaccine Research Center, which is a subgroup of the intramural program of NIAID, 24 \nwhich developed what looked like a promising vaccine for Zika.  The only trouble is that, 25 \n  \n  65 \nwhen we were ready to test it in a phase 3 study, Zika had fell off the radar screen and 1 \njust stopped spreading in South America and the Caribbean.   2 \nBut there still is work that's, you know, kind of smoldering along, waiting for the 3 \nnext outbreak -- another example of the research and its ultimate application to 4 \ninterventions in the form of diagnostics, therapeutics, and vaccines.   5 \nQ And I think you've been very clear that on multiple fronts vaccines were one 6 \nof the priorities.  And it seems that, to me, when people are dying of a disease, it makes 7 \nsense that a vaccine would be a priority.  Is that what the thinking is?  8 \nA Yeah.  Well, that's the thing that we did immediately.  In fact, we  -- I guess 9 \nyou're getting up to that -- with COVID.   10 \nSo, as soon as we knew what the sequence of the virus was, we 11 \nimmediately -- because we had been working, you know, I would say, for years on the 12 \ndevelopment of vaccine platforms and immunogen design, fundamentally but not 13 \nexclusively at our Vaccine Research Center -- we had a number of grantees throughout 14 \nthe country, but -- we had a very high density of experts in the development of vaccine.   15 \nAnd, in fact, my team at the NIAID Vaccine Research Center, led by John Mascola 16 \nand Barney Graham and others, were actually the individuals that developed the 17 \nstabilized immunogen that has gone into virtually all of the vaccines  -- Moderna, Pfizer, 18 \nJ&J, all of them.  That immunogen was developed by my team at the NIAID.   19 \nSo our job was to develop a vaccine.  We also did other things.  We did the basic 20 \nand clinical research, sometimes  -- often, actually -- in collaboration with industry, for the 21 \ndevelopment of Paxlovid, for the development of molnupiravir, and for the development 22 \nof remdesivir, and with the development of monoclonal antibodies.   23 \nSo our job was to do the vaccine, which was highly successful, as we all know  -- it 24 \nsaved millions of lives throughout the world  -- but also to develop certain of the 25 \n  \n  66 \ninterventions, which were twofold:  monoclonal antibodies and direct antiviral agents, 1 \nsuch as molnupiravir and remdesivir.  2 \nQ And I think we all thank you and your staff at NIAID for all that work on 3 \nvaccines that we've seen be so useful.   4 \nSimilarly but slightly different, we know that most of your career has been focused 5 \non HIV/AIDS and that epidemic.  Can you please tell us about your work on that, 6 \nspecifically related, first, to vaccine development?   7 \nA Yeah.   8 \nAgain, AIDS is a very complicated disease.  We did a lot of work -- I know myself, 9 \npersonally, in my lab, worked on the pathogenic mechanisms of HIV.  So we were 10 \nresponsible  -- not alone; a lot of other investigators did it; we weren't the only ones  -- to 11 \ndelineate the fundamental pathogenic mechanisms of HIV, which led to the ability to 12 \ndesign drugs that could actually treat -- and, ultimately, one of the major successes in 13 \nbiomedical research is the combination of drugs for HIV.   14 \nThat is what my institute did in collaboration with industry, was to develop those 15 \ndrugs.   16 \nWith vaccines, it has not been as successful.  We have funded, literally starting in 17 \n1987, vaccine trials.  Unfortunately, several of which in our network of  vaccine trial 18 \nnetwork, not only domestically but internationally, you've probably heard, a 19 \nfew -- several -- three of the African trials did not actually lead to any substantial 20 \nprotection.  So we're now working on a much more sophisticated approach towards 21 \ndeveloping broadly neutralizing antibodies.   22 \nAnd that's what we've done.  But there are a number of other things that we did.  I 23 \nmean, you might want to  -- well, I'll wait for you to ask about them.  24 \nQ Well, I know there are a number of drugs on the market now to prevent 25 \n  \n  67 \ninfection --  1 \nA Right.  2 \nQ -- from HIV.  I don't know if you want to talk about that a little bit?   3 \nA Yeah.  Yeah.  The great, great success of what we did with HIV is that the 4 \ndrugs that took  -- the first drugs were in 1986 -'87 with AZT.  By the time we got to 1996, 5 \nwe had a combination of three drugs that were usually given in the form of multiple pills 6 \nthat were difficult to take.  We now have a single pill with three drugs in it that can drop 7 \nthe level of virus in persons with HIV to below detectable and keep it there.   8 \nThat has led to one of the most important breakthroughs in biomedicine in 9 \ndecades, and that is what's called \"undetectable equals untransmissible,\" which means, if 10 \nyou treat someone who's infected, who's living with HIV, and get the virus to below 11 \ndetectable, it is virtually impossible for that person to transmit the virus to somebody 12 \nelse.   13 \nWe also developed what's called pre -exposure prophylaxis, or PrEP, which is given 14 \nas one pill per day to a person who's at risk for acquiring HIV.  Has a 99 -percent efficacy if 15 \nthe pill is taken every day.   16 \nThe most recent exciting advance is we now have a long -acting injectable, which, 17 \ngiven every 2 months and hopefully every 6 months, has greater than a 95 -percent 18 \nefficacy in men and women.   19 \nSo a lot of success stories in what comes out of my in - -- my former institute with 20 \nHIV.  21 \n  \n  68 \n[12:13 p.m.]  1 \nBY  2 \nQ And I think that is definitely work you can be very proud of.   3 \nAnother piece of the HIV/AIDS epidemic that you worked on was outreach to the 4 \nLGBTQ+ communities.  I think everyone recalls -- 5 \nA Right.  6 \nQ -- back in the late '80s, there was a lot of frustration from that community 7 \ntowards the Federal Government and you, yourself.  But you were able to overcome that 8 \nand work with the community together to  move forward.   9 \nA Right.  10 \nQ Can you tell us a little bit about that?  11 \nA Yeah.  In the beginning of the outbreak, understandably but unfortunately, 12 \nthe regulatory community, as well as the scientific community, including myself, 13 \napproached HIV in the standard rigid way of clinical trials that were designed with very 14 \nstrict entry and exclusion criteria that would take a very long period of time to get an 15 \nanswer.   16 \nThe regulatory restrictions were very, very pristine.  They worked well for other 17 \ndiseases but not for a disease with someone who, when they present to a clinic, they had 18 \na life expectancy of no more than 15 months.  19 \nAnd the gay community predominantly  -- it was the activist community but mostly 20 \nthe gay community -- felt that they wanted to be part of the discussion of the design of 21 \nthe trials, the inclusion and exclusion criteria.  And the scientific community didn't pay 22 \nany attention to them.  So they demonstrated in a very iconoclastic, disruptive, and 23 \ntheatrical way.   24 \nMost of the scientific community and the regulatory community withdrew from 25 \n\n  \n  69 \nthat.  I think one of the best things I've ever done in my career was to listen to them and 1 \nput myself in their shoes and say, \"What would I do if I were in their shoes?\"  And I would 2 \nhave done the same thing.   3 \nSo I brought them into our fold, and I brought them in and met with them in a 4 \nconference room similar to this.  And that was the first time any government official has 5 \never spoken to an activist in the gay community.   6 \nThat led to, I think, one of the most important transformations in the relationship 7 \nbetween advocacy groups and scientists because now those populations  -- mostly but not 8 \nexclusively of gay men  -- are all integrated into the decision  making of clinical trials into 9 \nthe scientific agenda.   10 \nSo what turned into a confrontative relationship turned out to be one of the most 11 \nproductive involvements of advocacy communities in the scientific endeavor.   12 \nQ And we appreciate that work as well.  13 \nAnother group where HIV/AIDS was of particular concern was the developing 14 \nworld, particularly in Africa.   15 \nHow did you work with researchers around the world to help solve the problem of 16 \nHIV/AIDS in those places as well?   17 \nA Well, we did it with science by developing and working with companies to 18 \nget drugs that were cheap enough to be used there.   19 \nBut the contribution that I think was one of the most transforming contributions 20 \nand the thing that, of all the things in my five -and-a-half decade career that I'm most 21 \nproud of, is that I was one of the principal architects of the PEPFAR program, the 22 \nPresident's Emergency Plan for AIDS Relief, where President George W. Bush sent me to 23 \nAfrica on a fact -finding mission and with the direction to come back to him with a 24 \nprogram that is accountable and transforming, because people in Africa, as late as 2002, 25 \n  \n  70 \nwere dying at the same way that my own patients that I took care of in 1981, '2, '3, '4, '5, 1 \nnot that there were no drugs available, but they could not afford the drugs and they 2 \ndidn't have the drugs.  3 \nSo he asked me to put together a program.  And I spent about  -- I went to Africa 4 \nmultiple times.  I met with the African physicians.  And I came back and I worked with the 5 \nWhite House staff, mostly George W. Bush's staff, Josh Bolten and a bunch of people that 6 \nsome of you may know, over a period of 7 or 8 months.  And I put together a program 7 \nthat initially was a $15 billion program over 5 years to treat 2 million people, prevent 7 8 \nmillion infections, and care for 10 million people, including AIDS orphans.  9 \nI convinced the President, to his great credit, George W. Bush, to put that program 10 \ninto effect in 2003, announced it in the State of the Union address in January 28th, 2003.  11 \nAnd we just had a dinner in Washington a little bit over a year ago to celebrate the 20th 12 \nanniversary of PEPFAR.   13 \nAnd fast -forwarding from that time when I developed the program to then, has 14 \nspent $115 billion and is responsible for saving 25 million lives.  15 \nQ That's an impressive feat.  16 \nAnd now just to loop this all back to COVID -19, all of your work on SARS -CoV-1, 17 \nswine flu, Ebola, Zika, HIV/AIDS, I assume all of that informed the work you were doing on 18 \nthe COVID -19 pandemic as well.   19 \nA Oh, absolutely.  I mean, it's the question of using cumulatively all the 20 \nknowledge you learn about the development of vaccines, how you develop what's called 21 \ntargeted antiviral therapy.  I mean, I think AIDS deserves much of the credit for that 22 \nbecause an enormous amount of money was put into the AIDS effort.   23 \nAnd, for example, I know sometimes the lay public has difficulty understanding 24 \nthat, but the two things that make a vaccine are, one, the platform  -- in this case it was 25 \n  \n  71 \nthe mRNA platform, it wasn't the only one, but it was absolutely suited to COVID; and the 1 \nother one is immunogen design, namely, what you put into the vaccine.  2 \nAnd many of the immunogens did not induce an adequate immune response.  But 3 \nthe immunogen that we developed at the Vaccine Research Center, which related to the 4 \nstructure -based vaccine design that we were working on for years for HIV and for other 5 \nvaccines and, in fact, the recently approved respiratory syncytial virus that is now 6 \nrecommended for people 65  -- 60 years of age and older, and for pregnant women, that 7 \nvaccine was developed by the structure -based vaccine design in my institute at the VRC.  8 \nThat work with RSV totally informed us in how we could hit the ground running 9 \nand making a vaccine for COVID.  And as you know, the story is very, very clear.  When 10 \nthe sequence became available on January the 10th, my team, I met with them, like, on 11 \nthe 4th or 5th.  I said, as soon as we get a sequence, let's get the vaccine going.   12 \nAnd we got a vaccine phase  1 trial in 69 days, a phase  2 trial in a 13 \nhundred -some -odd days.  And 11 months later, in a completely unprecedented way, we 14 \nhad a vaccine that was going into the arms of people that was more than 90 percent 15 \neffective and safe.   16 \nThat is completely beyond any precedent.  Mostly that would have taken about 7 17 \nto 10 years, and it was done in 11 months.   18 \nSo all of those previous experiences that you referred to in those other diseases 19 \nallowed us to culminate in the situation with HIV  -- I mean with COVID.  20 \n  And I would love to talk to you for another hour about all of that, but 21 \nwe are at ours.  So we will go off the record.  22 \n[Recess.]  23 \nMr. Benzine.   We can go back on the record.   24 \nDr. Wenstrup.   Dr. Fauci, you know, as a doctor who's always treating patients, 25 \n\n  \n  72 \nyou know, you don't always talk to your patients with the same terms and definitions that 1 \nyou might with your fellow scientists or doctors, right, because it's a different level.   2 \nSo I just want to go through some definitions and then at the end if you disagree 3 \nwith any of them.  But this is more for constituents or nonscientists that may be reading 4 \nwhat we're talking about.  So I just want to go through them.  I got them from a science 5 \nclass, but we'll just see if you disagree.  6 \nIt says science, a study of the natural world; scientist, a person that asks questions 7 \nabout the natural world; observations, information collected using the five senses; 8 \nevidence, data gathered during an investigation; hypothesis, an idea or explanation that 9 \ncan be tested with an investigation; investigation, a procedure carried out to gather data 10 \nabout a subject or an event.  Objective observations deal with facts.  Subjective 11 \nobservations deal with opinions.   12 \nAre you good with those?   13 \nDr. Fauci.   Sounds good.  14 \nDr. Wenstrup.   All right.   15 \nJust one question.  Would assumptions fall under objective or subjective 16 \nobservations, in your opinion?   17 \nDr. Fauci.   Assumptions?  You know, I think there's varying degrees of 18 \nassumptions, depending upon what the assumption is based on.  And, you know, I don't 19 \nwant to expand too much on that.   20 \nBut I think you're familiar with, when you do models, models are only as good as 21 \nthe assumptions that are put into the model.  Sometimes the assumptions are really very, 22 \nvery close to what the reality is, and sometime s they're just wild -out assumptions.  23 \nBut, in general, assumptions would fall more under the, what was not  --  24 \nDr. Wenstrup.   Objective or subjective.  25 \n  \n  73 \nDr. Fauci.   Subjective.  Yeah.  1 \nDr. Wenstrup.   Thank you.  Appreciate it.   2 \n  \n  74 \nBY MR. STROM:  1 \nQ So, Dr. Fauci, just to reintroduce myself, I'm John Strom with Energy and 2 \nCommerce, majority.   3 \nI wanted to circle back on something that was touched on the last hour regarding 4 \nyour exchange with Senator Paul at the hearing.   5 \nI believe that hearing was May 11th, 2021.  Does that sound correct?   6 \nA I'm not certain.  7 \nQ Okay.   8 \nA Yeah.  9 \nQ I know you  had help periodically, so --  10 \nA Yeah.  Right.  11 \nQ But in the May 11th, 2021, hearing, where Doctor  -- Senator Paul, I think, 12 \ntook exception to some of your testimony, when you were stating that no 13 \ngain -of-function work had been done at the WIV sponsored by NIAID, at that time, 14 \nthough, you didn't  -- NIAID did not have the year 5 progress report?   15 \nA Right.  16 \nQ Is that correct?  17 \nA I'm not certain about that.  But just to correct  --  18 \nQ Yes, sir.   19 \nA -- my statement was that the grant that went through the EcoHealth as a 20 \nsubaward did not fund gain -of-function research, according to my definition.  21 \nQ Okay.  And I guess what I'm actually getting to is that I assume, given NIAID 22 \nhas several thousand grants a year, or maybe even just several thousand issued every 3 23 \nmonths or so, 4 months  --  24 \nA Not several thousand every few months but the totality  --  25 \n  \n  75 \nQ Okay.   1 \nA -- is about two or three thousand, correct.  2 \nQ And so there's one grant, and there's a subrecipient of a grant.  3 \nA It's a $120,000 grant.   4 \nQ Yeah.  5 \nA And a budget of 5 billion.  6 \nQ Right.  So I'm assuming that you had to rely on Dr.  Erbelding's division to sort 7 \nof get you the relevant information for the  -- on the grant, among maybe other sources.   8 \nA Yeah.  I mean, I had no direct access into the grants.  This was always, as was 9 \nsaid in the questioning before, this was handled very much at the programmatic level.  10 \nQ Sure.   11 \nA Right.  12 \nQ So, I mean, do you recall being sort of frustrated that when you were making 13 \nthese  -- when you were testifying at Congress that you  -- well, let me not get ahead of 14 \nmyself.   15 \nDo you recall when you first found out that the year 5 progress report was missing 16 \nfrom the EcoHealth grant?  17 \nA I don't recall precisely.  It was somewhere in a briefing that the staff gave to 18 \nme.  I don't know exactly  when that was.  It could have been later.  I don't know.  19 \nQ Okay.  Do you think, just to the best of your recollection, whether it was 20 \nbefore you were aware that the year 5 progress report was late before May 2021 or it 21 \nwould have been after?  22 \nA I don't recall.  23 \nQ Okay.  And I guess what I'm wondering of, and it's come up in a number of 24 \nour interviews with the program office staff, is it seems strange that they would miss that 25 \n  \n  76 \nprogress report for so long.   1 \nWe've had, I think, an explanation as to why that might be the case.  But it does 2 \nstrike me as odd that, when this grant gets a lot of scrutiny, that the program office staff 3 \nnever went back and looked at the file and noticed that, you know, a progress report is 4 \ngone.   5 \nIs that something that is common for grants or  --  6 \nA I can't comment on that because that kind of compliance issues never raises 7 \nto the level of me, the director  of the institute.  So I would be hesitant to speculate on 8 \nsomething that -- a process that I essentially never get involved in.  9 \nQ Sure.  And, again, I guess in context of your coming to testify to the Senate, I 10 \nguess it probably would have been nice to know whether or not the grant file was 11 \ncomplete at the time.   12 \nA I'm wondering if we're apples and oranges here, because whether 13 \na -- somebody complies or not is not, in my mind, directly related to the question:  Did 14 \nyou, did NIAID fund a grant whose work scope was gain -of-function  --  15 \nQ Sure.   16 \nA -- according to the operative definition?   17 \nSo in many respects a progress report or not does not change the answer to the 18 \nquestion:  Was the grant that was funded with a work scope that was not gain -of-function 19 \nby the operative definition?   20 \nQ Uh-huh.   21 \nA So I didn't get  -- and I don't know what the timeframe is of that, of that 22 \nprogress report.  I may have heard about it only after the fact.  23 \nQ Okay.   24 \nA Right.  25 \n  \n  77 \nMr. Strom.   We can move forward.  1 \nMr. Benzine.   Thank you.   2 \n  \n  78 \nBY MR. BENZINE:  1 \nQ I want to talk about, as much as you know, the NIAID grant process and what 2 \nindividual terms mean.  This is my first foray into what  --  3 \nA Right.  4 \nQ -- how the Federal Government does all these grants.   5 \nCan you just very briefly run from proposal to funding for  -- how long that would 6 \ntake, what the steps are, those kinds of things?  7 \nA Yeah, it varies, depending upon what the grant is and whether it's in 8 \nresponse to a request for application or whether it's a response to a de novo grant that 9 \njust comes in what we call investigator -initiated grant.   10 \nBut the process of a grant being submitted, getting reviewed by a study section, 11 \ngetting the grant either approved or not  -- or, what happens frequently, it gets sent back 12 \nfor revision and then resubmission, then it goes  -- and that process takes months and 13 \nmonths.  And then it goes to the study section, which makes the priority score.   14 \nAnd then the grant, which is usually the case, is funded on the basis of a priority 15 \nscore cutoff.   16 \nSo if you have enough money to fund something that has a priority score of X, 17 \nanything worse than that doesn't get funded.  Anything better than that does.   18 \nThen it goes to the next level of review, which is approval by the National Advisory 19 \nCouncil of the institute.  And that's how the grant ultimately then gets funded, which is 20 \nusually sometime after that.   21 \nSo the process is several months, sometimes up to a year.   22 \nQ During the peer review process, which I  -- the study section would be the 23 \npeer review, right?  Is the advisory council government employees?   24 \nA The advisory council fundamentally are not, but there are  some ad hoc 25 \n  \n  79 \nmembers that we have from different agencies that are part of the council.  1 \nBut the predominant population of the council are outside scientists.  2 \nQ Would you describe both of those levels as peer review?   3 \nA The real hardcore peer review is the study section.  The peer  -- it would be 4 \nconsidered by some as peer review because these are peers  that are reviewing the 5 \ndecision of peers.  So it's a secondary review of something.   6 \nFor example, if you have a grant that gets sent to a study section, people sit 7 \naround a room like this, you get a stack of things like that, and they go over every single 8 \npage, and it takes a long period of time.  They make their determination.   9 \nWhen you give it to the council, the council may look at the summary report and 10 \nput other things into that and then come to the conclusion.  11 \nQ So it would be kind of fair to say the study section is what most people 12 \nwould look at as peer  -- as the big peer review.   13 \nA Yeah, the big peer review.  And the council looks at special issues, right.  14 \nQ During the study section, can  -- if you know  -- can those peer reviewers see 15 \nwho the applicant is?  So an example, EcoHealth, if I'm in the study section of EcoHealth  --  16 \nA Yeah.  17 \nQ -- does it say application number one by EcoHealth Alliance or does it just list 18 \nwhat the  --  19 \nA You know, that's a good question.  I don't know where we are now.  There 20 \nwas a period of time when the person who is submitting the grant is known by the study 21 \nsection.  I had heard, I'm not sure, but I heard there's some talk now about anonymizing 22 \nthat, but I don't know exactly where we are with that.  23 \nQ We've heard from Dr.  Daszak that  -- and I think the picture that you 24 \nreferenced earlier  -- was at an event that EcoHealth threw at the Cosmos Club about I 25 \n  \n  80 \nforget which virus it was.  But Dr.  Daszak mentioned that he threw those  -- he threw 1 \nthose events in order to meet funders and get kind of like face -to-face interactions with 2 \nfunding agencies.  3 \nIn your understanding, does kind of the reputation or name recognition of an 4 \napplicant matter in the peer review process?   5 \nA Again, it depends on w         here you are in the process.  The various different 6 \ncriterias are originality, applicability, capability of an institution to carry it out.   7 \nAnd I believe, but I'm not a hundred percent sure, since I don't get involved in the 8 \ngranting part of it, I believe that at one point track record was something that was 9 \nconsidered.   10 \nBut right now, again, I'm saying I believe that they're moving away from that to try 11 \nand make it more just on the basis of what the proposal is.  12 \nQ Do you know if peer reviewers have to sign a nondisclosure agreement?   13 \nA I believe they do, but I'm not a hundred percent sure.  14 \nQ And then, you've mentioned it a couple of times in the scoring process, my 15 \nunderstanding is a low score is good.  It's like golf.   16 \nA Yeah.  It confuses people.  17 \nQ Yeah.   18 \nA The lower the score, the better you are, right.  19 \nQ And you mentioned some of the categories.  They're  --  20 \nA Yeah.  21 \nQ Grants are scored on each of those categories.   22 \nA I don't know what they are.  I'm picking them out empirically.  I think that  -- I 23 \nhaven't looked at the menu of that recently.  24 \nQ But is that how the scoring process works in general?  There's categories.  25 \n  \n  81 \nThey're scored on each category?   1 \nA And they're weighted.  They're not equally weighted.  2 \nQ Okay.   3 \nA They're weighted relatively.  4 \nQ And you touched on this a little bit.  If a grant receives a fundable score, does 5 \nthat guarantee funding?  6 \nA Well, you know, it depends on  the fund -- which you say fundable score, it 7 \ndepends on where you are in the budget  process.  8 \nSo, for example, when you set a pay line, which is a percentile, you could set it at, 9 \nlike, 14, which is pretty good.  If it goes to 18  -- see, it's the opposite with the pay line.  So 10 \nif the pay line is the 14th percentile, then if you're in the 18th percentile you're in trouble 11 \nbecause you've got to go all the way down to the low percentile.   12 \nPercentiles are set.  And then it depends on what the budget is.  And the 13 \nappropriation process often, particularly when you have continuing resolutions, lags 14 \nbehind.  15 \nSo I could get a score that looks like it might be fundable.  And then when the 16 \nmoney comes in, it's not fundable.  And you can get a score that may look like it's not 17 \nfundable.  And then you may get  -- the Congress may give more money than what the 18 \nPresident's request is.  So you might wind up being fundable.   19 \nSo there's not a real guarantee depending until the money is there.  20 \nQ I guess that's what I'm kind of wondering, that if a grant could go through 21 \nthe peer review process, it could go through the study section, receive a score, go 22 \nthrough the advisory council, receive a score, all check the right boxes, but then not 23 \nsubsequently get funded, depending on what the appropriations look like.   24 \nA Yeah.  It's almost  -- the way it works  -- and, again, there are always 25 \n  \n  82 \nexceptions  -- but the way it works is it almost never is a situation that if a grant gets a 1 \ngood score, and you have enough money, that you would not fund that grant.  2 \nThere are other things called select pay where you might have a grant that's of 3 \nparticular interest of something that was emerging that you would then, even though the 4 \nscore wasn't a particularly good score, you would pay it.  5 \nBY MR. STROM:  6 \nQ Would you ever have a circumstance where, say, four grants are fundable or 7 \nget a fundable score, but because presumably each grant has a different sort of budget 8 \nproposal, you might pick one, three, and four, because two is really expensive, and you 9 \ncan do more science if you spread it out a little bit out of order?   10 \nA That, again, I don't get involved at all  --  11 \nQ Sure.   12 \nA -- in that.  That's a programmatic decision.   13 \nQ Uh-huh.   14 \nA But from what I hear, when it ever gets up to my level, which is not frequent, 15 \nit may be that, when you have three or four grants that have the same thing, that you 16 \ncould tell the very expensive grant:  We can't fund it at that level.  You need to bring 17 \ndown your costs if you want to fit into the funding scheme.  18 \nAnd they go back.  They revise the grant.  And they come in with a different 19 \nproposal.  They cut out  --  20 \nQ Sure.   21 \nA -- one or two things.  22 \nMr. Strom.   Okay.  Thank you.  23 \nBY MR. BENZINE:  24 \nQ And we got kind of through the National Advisory Council, and I'm just  -- as 25 \n  \n  83 \nJohn has said, we've talked to a number of people in the program office, in DMID, and it's 1 \nkind of unclear who gives the stamp of approval.   2 \nIs it kind of by coalition in the advisory council, or is there a final approval for 3 \nfunding a grant?  4 \nA We have a council agreement.  We have a council meeting three times a 5 \nyear.  And the grants en bloc get presented to the different subcategories.  There's a 6 \nDMID advisory group.  There's an AIDS advisory group.  And there's an EI, allergy, 7 \nimmunology, infectious disease group.   8 \nThey look at the grants, and they give their stamp of approval.  Sometimes there's 9 \na question of a grant.  This is a grant that is on an extension or has some circumstance, 10 \nand the council usually handles that.  11 \nAt the end of the council, they en bloc approve it, and then it just comes in for 12 \nfinal approval.  13 \nQ Who gives the final approval?  14 \nA You know, technically, I sign off on each council, but I don't see the grants 15 \nand what they are.  I never look at what grants are there.  It's just somebody at the end of 16 \nthe council where they're all finished and they go, \"Here,\" and you sign it.   17 \nQ Is it -- and as well as you know  -- is it -- does it have to be unanimous from 18 \nthe council?  Is it 51 percent?  How does  --  19 \nA You know, I'm not actually sure.  I don't  -- I don't think it has to be totally 20 \nunanimous.  I think  -- I'm not sure.  21 \nQ All right.   22 \nA Yeah.  23 \nQ Are there instances  -- and, again, I'm posing a hypothetical.  So if it never 24 \nhappens, just let me know.  But --   25 \n  \n  84 \nA So, but, anyway, but when you get back to majority  -- when these things are 1 \nen bloc, there almost never is, you know, majority versus unanimous.  There's unanimous.  2 \nQ It's unanimous.   3 \nA Yeah, I don't think that there's a, \"I object to 600 grants.\"  4 \nQ Yeah.   5 \nA I don't think that has ever happens.  6 \nQ Okay.   7 \nA Yeah.  8 \nQ If -- and, again, I'm sorry, it's a hypothetical  -- but if the council is kind of 9 \ndivided, how do you -- how is the division resolved?   10 \nA Yeah.  I can't speculate on the hypothetical.  I really have to know the real 11 \ndetails of the circumstance, and I've not really even heard of that.   12 \nQ Okay.   13 \nA To be honest with you.  14 \nQ No, that's totally fair.  I appreciate it.  15 \nYou mentioned this a little bit, and I want to ask again.  Could a grant that did not 16 \nreceive a fundable score end up getting funded?   17 \nA The answer is that's possible according to select pay mechanism, which 18 \nmeans that a grant might just miss by a point or two, but there's a really good reason to 19 \nwant to keep that particular grant going  because of the quality of the work or that 20 \nthe -- maybe the study section missed something that was important in it.  That's what's 21 \ncalled select pay.  22 \nQ Do you at NIAID have the authority to terminate or suspend a grant?   23 \nA Terminate a grant?   24 \nQ Or suspend.   25 \n  \n  85 \nMr. Schertler.   Do you mean  director --  1 \nBY MR. BENZINE:  2 \nQ Yeah, the director level.   3 \nA No.  4 \nQ Who would have that authority?  Would that only be an NIH authority?  5 \nA Yeah, that's a compliance issue.  So that's  -- if they even have that authority.  6 \nI -- well, I certainly didn't as the  --  7 \nQ Okay.  So we've walked through kind of the, I guess, the standard practice 8 \nof standard operating procedure of how a grant gets approved.   9 \nAnd you had testified previously that you do not individually approve grants, 10 \nwhich is substantially similar to what you just said, and they go through multiple levels of 11 \npeer review.  \"So I would not have by standard way things work, have seen this, read it, or 12 \nindividually approved it.\"   13 \nYou were discussing the EcoHealth grant.   14 \nThe -- and, again, if I'm wrong, please correct me  -- the use of \"standard\" there at 15 \nleast implies that there is a not standard way that this would work.  Is there  -- are there 16 \nprocedures where a grant could get funded without going through these steps?  17 \nA I've never heard of that.  18 \nQ Okay.  Have there ever  -- and, again, to the best of your recollection  -- have 19 \nthere ever been any grants that you individually approved outside of the en bloc process?  20 \nA I don't individually approve grants.  21 \nQ I want to  -- we want to ask a couple questions about grants that involve a 22 \nforeign component.   23 \nDo you know the process for vetting or certifying foreign labs to then receive U.S. 24 \ntaxpayer money?   25 \n  \n  86 \nA I don't think I could give you chapter and verse of it, but there is  -- first of all, 1 \nwhenever you have a foreign grant, the State Department has to know about it at least.  2 \nThat's one thing.  And the other thing, it requires special attention of the council.  3 \nMr. Strom.   Which council, just for clarity?   4 \nDr. Fauci.   The National Advisory Council of the institute.  So often you see 5 \nsomething that gets special attention.  And it'll be, you know, too much money, blah, 6 \nblah, blah.  It says foreign grant.  They have to get special attention of the council.  7 \nQ Does  -- as much as you know, what's the involvement of the State 8 \nDepartment?   9 \nA You know, I don't know for sure.  I'd hesitate to surmise.  But there's some 10 \ninvolvement that I think has to do of at least making them be aware of it.  11 \nQ I guess what we're trying to learn going forward is, obviously, U.S. labs are 12 \nvetted, certified, and there's a standard of how U.S. labs operate.   13 \nAre foreign labs held to the same standard as U.S. labs when they receive U.S. 14 \nmoney, or are they the standards of the country in which they operate?   15 \nA I am not certain.  I have heard  -- again, I think it was subsequent to  -- of 16 \ncourse, that was never brought up.  17 \nQ Uh-huh.   18 \nA When I was the director, no one ever asked me, you know, who determines, 19 \nyou know, what the standards of a foreign lab are.   20 \nBut so the answer to your question is I don't know, okay?   21 \nQ Okay.   22 \nA You can go on to that, but the answer is I don't know, yeah.  23 \nQ Did -- you kind of just alluded that it had gotten brought up since the 24 \nEcoHealth issue?  25 \n  \n  87 \nA Well, no, it got brought up about, someone mentioned that it's the standard 1 \nof the country involved that you give it to.  2 \nQ Do you recall who that someone  --  3 \nA I don't recall who that was, yeah.  4 \nQ Okay.  So to your knowledge, NIAID wouldn't kind of independently verify 5 \nthe biosafety of a foreign lab.   6 \nA Again, I'd have to say I'm not sure.  To my knowledge, I wouldn't be able to 7 \nmake a statement that I would be confident it would be.  8 \nQ No, that's fair.   9 \nAnd this question may be a compliance issue, so it may be better for NIH, and I 10 \napologize if it is.  11 \nBut is there a mechanism to even do that?  How would  -- obviously, it's kind of up 12 \nto the foreign country if they're going to let an American go into their lab.  How would the 13 \nU.S. even go about vetting these labs?   14 \nA Again, speculation.  I wouldn't know how we would do that.   15 \nQ Same kind of questions but for foreign collaborators.  Do you know what the 16 \nprocess is for vetting a foreign collaborator?   17 \nA It depends on what you mean by a foreign collaborator.  If we have grants 18 \nthat are submitted as investigator -initiated awards or as a co -investigator together with 19 \nan American investigator, some of those are individual grants and some of them are part 20 \nof large consortia.   21 \nSo the thing I would think about with regard to a large consortia is one of the 22 \nthings I mentioned in questioning from the minority, that in the AIDS clinical trial groups 23 \nit's an international network of clinical trials.  So you have investigators from South Africa, 24 \nyou have investigators from Australia, and you have investigators from Canada and the 25 \n  \n  88 \nUnited States.   1 \nAnd that whole grant, to my knowledge, and I think I'm correct but there may be 2 \nsome technical thing I'm missing, but that goes through the same peer review process as 3 \nif it were only an American grant.   4 \nQ Okay.   5 \nA But then the foreign  -- when there's a foreign component, that's when the 6 \ncouncil comes in and approves it.  7 \nQ I guess what  -- and, again, it might be in the divisions and in the council that 8 \nthis happens  -- but trying to get an understanding of, like, if there's  -- how individuals and 9 \nlabs are getting vetted.  If there's an Iranian nuclear lab listed on a grant  --  10 \nA Yeah.  11 \nQ -- is NIAID just going to check the box and move ahead?  12 \nA You know, I, honestly, Mitch, I  -- that's not what I get involved with.  13 \nQ Okay.   14 \nA That's a compliance issue.  So I would not have any knowledge of that.  15 \nQ Okay.  I appreciate that.   16 \nDo you know if NIAID works with any agency other  -- any agency on the vetting of 17 \nindividuals?   18 \nA I don't  -- I'm not aware.  Possible, but I'm not aware.   19 \nQ You -- and this is from a long time ago  -- you testified in front of HSGAC in 20 \n2012 that it was the Department of Justice that screens individuals.  Does that refresh 21 \nyour recollection?   22 \nA Department of Justice?   23 \nQ Screens foreign collaborators on U.S. grants.   24 \nA I don't recall saying that, yeah.  25 \n  \n  89 \nQ Do you know if NIAID grants go through any type of national security review 1 \nas part of the process?   2 \nA National security review?   3 \nQ So, like, through the National Security Council or  --  4 \nA No.  5 \nQ -- or anyone in the  --  6 \nA Not to my knowledge.  7 \nQ Okay.   8 \nA Again, I'm saying not to my knowledge.  It's conceivable that at the 9 \nprogrammatic level, when something gets checked off, they put it through.  But I am not 10 \naware of anything going through national security.  11 \nQ Okay.  And I want to talk about how stereotypically pandemics kind of 12 \nemerge or viruses kind of spill over.   13 \nMr. Osterhues.   Mitch, before we move on, can I ask?   14 \nMr. Benzine.   Yeah.   15 \nMr. Osterhues.   Dr. Fauci, understanding that you didn't get involved in some of 16 \nthe compliance issues, can you ever recall in your time as the director an instance where 17 \nthe council did not approve a foreign collaborator or lab or something that was proposed 18 \nfor funding?   19 \nDr. Fauci.   I don't recall.  It's possible, but I don't recall that.  Yeah.  20 \nMr. Osterhues.   Thanks.   21 \n  \n  90 \nBY MR. BENZINE:   1 \nQ And as we go through this section, I'm a lawyer, not a scientist, so bear with 2 \nme as I try to describe some of these things, and please correct if I am wrong.  3 \nMy general understanding is that for a  -- the two most viable pathways for a 4 \nspillover into humans is either zoonotic, so animal directly to human; animal -animal; 5 \nintermediary source -human; or some kind of laboratory or research -related accident.   6 \nIs that generally correct?   7 \nA The answer is generally correct, too.  But there's different versions of 8 \nlaboratory things.  9 \nQ I'll ask some.   10 \nA Okay.  11 \nQ And we'll go through it, yeah.  12 \nI'm going to start with zoonotics.  And, again, my general understanding is two 13 \nkind of main ways that happens, direct from an animal, spillover into the humans, or 14 \nsome kind of path with multiple animals into humans.   15 \nHave there been major zoonotic coronaviruses spilled over before?  16 \nA Major coronaviruses spillover before.   17 \nQ Uh-huh.   18 \nA Yes, there have been.  19 \nQ SARS and MERS being maybe the two that come to mind?  20 \nA Those are the two that come to mind.  We don't know the historical etiology 21 \nof the common cold coronaviruses before.  There's speculation that way, way, way, way 22 \nback it jumped over, and then it became part of the human system.  But the ones that we 23 \nknow of are SARS in 2002 -2003 and MERS in 2012.  24 \nQ Do you recall how many worldwide cases SARS has?  SARS -1?  25 \n  \n  91 \nA SARS -1 had about close to 8,000 with 784 deaths.  1 \nQ And do you recall with MERS?   2 \nA MERS was different because MERS was multiple introductions.  It had a very 3 \nhigh mortality.  But it was more like a spurt and there'd be an outbreak and a bunch of 4 \npeople would get infected, a high percentage of death, go under the radar screen, a few 5 \nmonths later spurt up again, and then go back down.  6 \nSo MERS was not a sustained outbreak that went down, whereas SARS -1 was one 7 \nthat went up a little higher than MERS and then came back down.  8 \nQ And is that tracking  -- and understanding every virus is different and maybe 9 \nmy understanding is wrong  -- that the viruses that are more infective aren't necessarily 10 \nmore deadly because they want to keep their host alive so that they can infect more 11 \nhosts?  12 \nA That is generally what is the  -- I'm trying to figure out the right word  -- the 13 \naccepted  narrative about that, but that's not quite so sure.  14 \nQ Okay.   15 \nA But, in general, when you have jump -overs, I mean, for example, historically 16 \nthe H5N1 was able to jump but didn't adapt itself well  to humans.  It had a high degree of 17 \npathogenesis and a low degree of tansmissibility.   18 \nBut that's not always the case.  When you have HIV, it transmits, but without 19 \ntherapy it kills almost everyone.   20 \nSo, you know, you can't categorize them, A, black and white.  It's not that way.  21 \nQ Do you know, and off the top of your head, how many COVID -19 cases 22 \nthereabout there are now?   23 \nA You know, it's really interesting.  We have a lot more handle on deaths and 24 \nhospitalizations than we do on cases because there are so many asymptomatic cases  and 25 \n  \n  92 \nmildly symptomatic cases.  And what's going on right now  -- and I believe in your 1 \nquestion, Mitch, you said \"now\" -- and right now many people are getting infected and 2 \nthey don't even want to get tested.  3 \nSo they just get a cold.  They blow their nose.  They don't tell anybody because 4 \nthey don't want to be out from work.   5 \nBut if you look at the wastewater, there are probably millions of cases per day 6 \nnow.  And we're not seeing hospitalizations and deaths because such a large proportion 7 \nof the populations have either been vaccinated or infected.   8 \nSo the impact of an infection in 2024 on the population level  is much less than the 9 \nimpact on a virgin population that has no immunity either through vaccines or natural 10 \nimmunity.  11 \nSo the answer is the last time that they were doing a lot of testing, it was 12 \nsomething like there are, you know, 7 million cases worldwide and probably  -- 7 million 13 \ndeaths worldwide, probably 20 million cases.   14 \nRight now in the United States the last time they did a wastewater model they  -- I 15 \nread it yesterday in the newspaper, that 1 in 24 people right now are currently infected 16 \nwith COVID.   17 \nQ So two or three in this room?  18 \nA Yeah.   19 \nQ This is just my own curiosity.  Do you think maybe, like, do you think it's 20 \nplausible that almost everyone in the world has had COVID once and maybe just didn't 21 \nknow it?   22 \nA Yeah.  You know, in biology, you know, you don't ever say never.  23 \nQ Yeah.   24 \nA There are going to be some people who maybe have some genetic 25 \n  \n  93 \npolymorphism that we're not familiar with yet that protects them the same way that 1 \npeople have a Delta32 deletion on one of their genes are protected from HIV.  So we 2 \ndon't know, there may be some genetic polymorphism.  3 \nBut right now, if you look at the estimate in the United States, is that, like, 98 4 \npercent of people have either been infected, vaccinated, or both.  And there's no reason 5 \nto believe that in the rest of the world that we're seeing the same thing.  6 \nQ Another curiosity is, why the big difference between SARS, MERS, and 7 \nCOVID?  The last time I looked at the case numbers, understanding that it's based off 8 \ntesting, it was 800 million -ish worldwide?   9 \nA Right.  10 \nQ SARS had 8,000, MERS 3,000 -ish?   11 \nA Right.  12 \nQ Why  -- that's a really big gap for being in kind of a very similar virus.   13 \nA Yeah.  I believe it's the ease and efficiency of transmissibility.  So, for 14 \nexample, if you look carefully at the cases that were reported in the literature with SARS, 15 \nit was mostly transmitted by people who were symptomatic, and a lot of it was associated 16 \nwith the healthcare setting.  17 \nBut when you got into the general population, it didn't seem to efficiently spread 18 \nat all.  So there were cases of people going into a clinic and coughing around and 19 \neverybody in the clinic got infected.  20 \nBut it wasn't the situation where you had individuals who were asymptomatically 21 \ninfected, went out into the environment, and then infected everybody.   22 \nSo the short answer to your question, Mitch, is the degree of what's called 23 \nefficiency of transmissibility and the ability to handle something by classical public health 24 \nmeasures, because SARS got handled, SARS -1, by identification, isolation, contact tracing, 25 \n  \n  94 \nand some quarantining, which did it.  It shut it off.  1 \nQ The effective transmissibility, is that the R naught?  2 \nA Yeah.  Yeah.  3 \nQ All right.  Back to zoonotic and lab, just to kind of wrap my head around 4 \nwhat would be, like, the stereotypical zoonotic spillover of maybe a farm or a market has 5 \na couple cases, probably a farm, and then the animals are shipped and a couple of cases 6 \nhere, a couple of cases there, until it gets to a metropolitan area where there's a lot of 7 \npeople where it could spread a lot.  Is that  --  8 \nA That's one of the scenarios of it, yeah.  9 \nQ And then we haven't really seen this in this case, though, right?  Is that just 10 \nbecause the backtracking hasn't been done?  11 \nA You know, yeah, the backtracking haven't been done.  And it really varies.  I 12 \nmean, there are some infections that, when they jump species, they just take off.  I mean, 13 \nyou hear people say, well, it's got to somehow adapt itself.   14 \nSwine flu, in 2009, just jumped out and, whew, it just went right across the world.  15 \nFortunately for us, it didn't have a high degree of pathogenesis, but it had a high degree 16 \nof transmissibility right from the get -go. 17 \nSometimes something needs to adapt itself sort of underneath the radar screen 18 \nbefore, as you say, you get into a population, then it explodes.  19 \nQ So it'd be possible that COVID -19 acted as one of those viruses, that it didn't 20 \nneed the time to adapt to humans, or did we just not notice it?   21 \nA I think it's possible, and we don't know.  22 \nQ Okay.   23 \nA I just don't think we can make any speculations about that.  There's not 24 \nenough known about it.  25 \n  \n  95 \nQ So you brought up kind of what a laboratory or research -related accident is.   1 \nA Right.  2 \nQ And I want to run through some scenarios, and you can say whether or not 3 \nyou think it is or isn't.   4 \nA Right.  5 \nQ A researcher intentionally manipulating viruses like the construction of 6 \nchimeric viruses and getting infected.   7 \nA Well, I'm not going to say, because you're jumping into chimeric.  8 \nQ Okay.   9 \nA You're talking about a specific situation.   10 \nIt depends on whether that virus is actually adaptable to be able to affect a human 11 \nbecause you can get somebody  -- you could be playing with viruses in the lab and they 12 \ndon't have the capability of infecting humans.  13 \nQ No, no, I'm saying if it does infect a human while they're doing that 14 \nexperiment, would that be a lab accident?   15 \nA Lab accidents are much more common, much  -- in fact, I'm pretty sure that 16 \nthey're the only documented ones where people are working with a virus that is known 17 \nto infect humans, like they're working with tularemia or another bacteria or another virus 18 \nthat's already well adaptive.   19 \nThey're studying it in the lab, they're looking for an antibiotic sensitivity, or they're 20 \ntrying to get the right confirmation for a vaccine, and they get infected.  Then that's a lab 21 \naccident.   22 \nNow, if that's a pathogen that is not out in the community but it is well known to 23 \nbe able to infect the community and the person gets infected accidentally, goes outside 24 \nand spreads it, that's a lab accident of a pathogen that's already pathogenic and 25 \n  \n  96 \ntransmissible.  Nobody did anything to it.  It was an accident  that that person got 1 \ninfected.  2 \nThe other one is the one that's hypothetical, that we don't see, at least I can't give 3 \nyou any good examples of that, it may have happened, but I don't know any examples, 4 \nwhere somebody is manipulating a virus than has never infected anybody, that then 5 \ninfects that person and then goes out.   6 \nI think that's theoretically possible, but I haven't heard of that as something that 7 \ndid that and caused a pandemic.  8 \nQ Both of those scenarios, though, in your mind would be a laboratory 9 \naccident.  I guess I'm not trying to  -- I'm not trying to delineate, like, how it would spread.   10 \nA Right.  11 \nQ Just, like, what  -- trying to get an understanding of what the term means, 12 \nbecause we've heard  -- the last one on my list is a researcher in doing field work, getting 13 \ninfected in the field, and bringing it back to the lab.   14 \nA Yeah.  See, the only thing with that, that people get confused  -- so, well, you 15 \nask your question because, I mean  --  16 \nQ I guess, you would consider that to be a research  --  17 \nA Well, you got to be careful, because if somebody goes in the environment 18 \nand gets infected, okay, while they're out there, and goes into a laboratory, that person 19 \nhas already been infected by something that has jumped from an animal to a human.   20 \nSo if they go in the lab and then infect the people in the lab and then the people in 21 \nthe lab infect other people, I wouldn't call that a lab accident.  I would call that a natural 22 \nspillover that spread.  But the natural spillover was someone who happened to be a lab 23 \nperson who was out there looking for whatever they were looking for, right?   24 \nQ Okay.  No, that is helpful.   25 \n  \n  97 \nOne of the primary purposes of our subcommittee is to investigate this in order to 1 \nprepare for any future pandemics.   2 \nWhat do origins of a virus like COVID -19 tell us to help prepare for the next 3 \npandemic?   4 \nA Oh, goodness.   5 \nQ Briefly.  6 \n[Laughter.]  7 \nA There are lessons learned.  There are lessons learned that I've spoken about 8 \nin a lot of lectures, you know.  9 \nQ Uh-huh.   10 \nA The first lesson is in preparedness investment in the scientific community, 11 \nbecause, as I said in response to one of the questions, that if we had not made the 12 \ninvestment in platform technology and in immunogen design, we would not have had the 13 \nvaccine as quickly as possible.   14 \nThe first lesson, when you're dealing, because with an outbreak there's 15 \npreparedness and there's response.  So preparedness can be scientific preparedness.  16 \nPreparedness can be the preparedness of any of a number of factors that help you to 17 \nrespond.  18 \nResponsiveness is a public health issue.  How well do you control it?  For example, 19 \ndo you have the local public health capability of identifying, surveillance, communication, 20 \nthose kind of things?  So that's one of the lessons.   21 \nDr. Wenstrup.   What lessons learned on personnel?  You talked about response.   22 \nDr. Fauci.   Yeah.  23 \nDr. Wenstrup.   That requires personnel.   24 \nDr. Fauci.   Yeah.  25 \n  \n  98 \nDr. Wenstrup.   So what are your thoughts there, how we can do better?   1 \nDr. Fauci.   Well, I think we need trained personnel.  We need to make sure that 2 \namong the global population of personnel that there's transmiss  -- excuse 3 \nme -- transparency among them.   4 \nI mean, one of the things that was so helpful to us  -- I'm not sure we responded as 5 \nwell -- was the South Africans, when they found omicron, they let us know in a phone call 6 \non my Thanksgiving dinner to say, \"Hey, we got to get together.  We got something new 7 \nhere.\"  8 \nThat was really helpful because it allowed us to realize we now have a virus that's 9 \nso different from the alpha, beta, delta that we were going to have to start thinking about 10 \nisolating it and finding out does the vaccine work or not.   11 \nSo we need trained personnel, and we need people who are transparent.   12 \nDr. Wenstrup.   Thanks.  13 \nBY MR. BENZINE:  14 \nQ I want to in the time we have left in this hour shift to when COVID first 15 \nemerged, it was reported on ProMED first on December 30th, 2019, and then China 16 \nreported it December 31st.   17 \nWhen did you first become aware?  18 \nA I first became aware of an outbreak in China, I believe it was the first day of 19 \n2020, January 1st.  Yeah, I believe it was that.  I may have vaguely heard about something 20 \nbefore, but I first specifically heard about it on January 1st.  21 \nQ Did you hear that, as it was reported, a pneumonia, or at that point you had 22 \nheard it was a new coronavirus?   23 \nA I had heard it was a pneumonia.  You know, the first thing you think of when 24 \nyou hear about a new pneumonia coming out of China, based on the experience with 25 \n  \n  99 \nSARS -1, is the first thing you want to think of is it a coronavirus.  Could be something else.  1 \nCould be a strain.   2 \nYou think of two things.  You think is it influenza, I mean, because influenza 3 \nhistorically comes out of the Far East except for 2009 when it came from California and 4 \nMexico but that's another story.  5 \nBut the other thing you think of because of the history with coronavirus that could 6 \nit be a coronavirus.  So the first thing I heard it was a pneumonia.  So we thought, well, 7 \nwhat is it?   8 \nQ Is pneumonia kind of like a standard term for any respiratory disease?  I 9 \ndon't  -- when I think of pneumonia I think of like in high school you have pneumonia and 10 \nyou don't feel good.  But to you, when you read pneumonia, does that read as this is a 11 \nrespiratory virus?  12 \nA Yeah.  Pneumonia to me means a respiratory virus of the lower airway, not 13 \nsomebody just coughing and sneezing, but of the lower airway which, if you examine, you 14 \nhear crackles, you hear dullness.  If you do an X -ray, you see either haziness or a cavity or 15 \na pleural effusion.  It's just objective disease in the lower airway.  16 \nQ Okay.  Do you recall how you learned of COVID on the first day of January?   17 \nA You know, I was trying to remember specifically.  But I believe it was a 18 \nreporter  -- and I forgot, I don't know who it was -- who called me up and said, \"Dr.  Fauci, 19 \nthere's a new pneumonia that's in China.  Do you have any comment on it?\"   20 \nAnd I said, \"Well, I think we need to learn more about it before I have any 21 \ncomment on it.\"  22 \nQ Do you recall when the sequence of the virus was released?   23 \nA Yes. 24 \nQ What date was that?  25 \n  \n  100 \nA I believe it was January 10th, I believe.  1 \nQ And what can the  -- understanding it's just the sequence, it's not an isolator 2 \nor --  3 \nA Right.  4 \nQ -- something more specific  -- what can the sequence itself tell you about the 5 \nvirus?  6 \nA Well, it was very important for us.  And I know we don't have a lot of time 7 \nbut I'll try to be  --  8 \nMr. Schertler.   We have plenty of time.  9 \n[Laughter.]  10 \nBY MR. BENZINE:  11 \nQ We can be succinct.  We'll take succinct.   12 \nA No, I'll be succinct.   13 \nSo apropos of what I had mentioned to a question about what we do at NIAID 14 \nversus what others do, the first thing that we think of is, if this is something that is going 15 \nto be a problem, we're going to need a vaccine.  So see if we can mobilize.   16 \nAnd what I did before January 10th is I called a meeting with the senior members 17 \nof the Vaccine Research Center, Barney Graham, John Mascola, and others, and I said, 18 \n\"Get prepared when we find out what this thing is.\"   19 \nAnd Barney said, and the reason I remember January 10th, he said, \"Tony, get me 20 \nthe sequence and we are now really perched because we have the platform and mRNA.  21 \nWe've been working with Moderna.  We have the immunogen because we've already 22 \ndone it successfully for RSV and for MERS.  So get us the sequence.\"   23 \nJanuary 10th came.  The sequence came.  And we had another meeting.  They 24 \nsaid, \" Let's go do it.  Let's get a vaccine starting to go.\"   25 \n  \n  101 \nAnd we had a conversation.  He said, \"That's great, but, you know, we don't have 1 \nany money.\"  2 \nAnd I said, \"Let me worry about the money.  Start the work on the vaccine.\"  3 \nSo within 5 days we had the vaccine going, and then we had a phase  1 trial in 69 4 \ndays, which was the record of ever getting into a phase  1 trial.  5 \nQ Yeah.  No, it was impressive.  If memory serves me, the Moderna vaccine 6 \nstarted within, like, a couple days of the sequence.   7 \nA Five days.  8 \nQ Five days coming out of the sequence.  9 \nIn Dr.  Farrar's book, he wrote about the sequence.  I don't know if you've read his 10 \nbook.  11 \nA I haven't.  Is that -- it's called \"Spike\"?   12 \nQ \"Spike.\"   13 \nA \"Spike\"?  \"Strike\"?  14 \nQ Yeah.   15 \nA Something like that.  16 \nQ \"Spike.\"  17 \nA Yeah, right.  18 \nQ He wrote:  \"Eddie\"  -- he's talking about Eddie Holmes  -- \"has screenshots 19 \ntaken from social media in China about the coronavirus sequence.  They suggest the full 20 \ngenome was known by a genomics company in China by December 27th, 2019, and then 21 \nreported to the Chinese CDC and a hospital who provided the sample on the 27th and 22 \n28th of December.\"   23 \nDo you have any awareness of that?   24 \nA No, I'm not aware of it.  25 \n  \n  102 \nQ In our transcribed interview with Dr.  Daszak this past November he testified 1 \nsimilarly that by December 31st, 2019, he was aware of a coronavirus that was 20 percent 2 \ndivergent from SARS -1 circulating in Chinese.  And he said that was strangely accurate 3 \ninformation because SARS -CoV-2 is 20 percent divergent from SARS -1. 4 \nSo he had pretty solid information 12 days before the sequence was released.  Did 5 \nyou have any awareness of that?  6 \nA I did not.  7 \nQ Do you have any awareness of whether or not a sequence prior to January 8 \n10th or 11th was submitted to NIH or any other databases?   9 \nA To my knowledge, no.  I mean, we were waiting for a sequence because of 10 \nwhat I said about  getting my team together that needed a sequence to start the vaccine.   11 \nQ Do you recall who made the sequence publicly available?   12 \nA I believe it was on a publication from  -- again, I didn't know it at the time but 13 \nit was shown to me after that.  I think Eddie Holmes and a Chinese person. 14 \n  \n  103 \n[1:50 p.m.]  + 1 \nBY MR. BENZINE:  2 \nQ Zhang Yongzhen, does that sound right?   3 \nA With no disrespect, they all -- that sounds the same to me.   4 \nQ Dr. Yongzhen's lab was shut down the next day after the sequencers 5 \nreleased by Chinese authorities.  Do you have any awareness of that?  6 \nA No, I don't.  7 \nQ Shifting back to the sequence a little bit, one of the things that's interesting 8 \nand has come up in lots of conversations that I know you've had with some of these 9 \nscientists and we've had in Congress, is that in SARS -CoV-2's lineage, there's never been 10 \nat least an observed furin cleavage site before and that this would be the first one.   11 \nAnd you talked about that the kind of explosion of the cases compared to SARS -1 12 \nand MERS was the transmissibility.  And, again, my kind of layman's understanding is the 13 \nfurin site assists with that, that it can pierce the ACE2 receptor to bind with cells  --  14 \nA ACE1, ACE2.  15 \nQ Yeah.  And then infect the host.  Is that close to accurate?  16 \nA Well, yeah.  I mean, the furin cleavage site creates a greater capability of 17 \nbinding to the ACE2 receptor.   18 \nQ Could you tell that it -- maybe not you, but could a scientist tell that it has a 19 \nfurin site by looking at the sequence, or would you need an isolate or more --   20 \nA I believe -- that's not my lane.  I'm not an evolutionary virologist, so  --  21 \nQ Do you recall any conversations where people said, here's the sequence, it's 22 \ngot a furin cleavage site in it?  23 \nA You know, certainly furin cleavage sites are sort of like, you know, popcorn.  24 \nQ Yeah.  25 \n  \n  104 \nA They talk about it all the time.  I don't recall when I first heard the word 1 \n\"furin cleavage site.\"   2 \nQ We'll come back to it in the context of some other things, but I want to run 3 \nthrough some quick questions about kind of the initial outbreak, what you were hearing 4 \nout of China, what -- if you were aware of things that China was doing.   5 \nSo I talked about Dr. Yongzhen's lab getting shut down.  You didn't have any 6 \nawareness.   7 \nA No.  8 \nQ It was also reported that kind of the -- for lack of a better phrase, the original 9 \nCOVID -19 whistleblower, Dr.  Li Wenliang, who passed away from COVID, was forced to 10 \nsign a nondisclosure agreement to not publicly discuss the virus, and then there were 11 \nreports of China locking up journalists and gagging scientists.  Did you have any 12 \nawareness on any of that?  13 \nA You know, I was hearing indirectly -- you know, you hear all kinds of strange 14 \nthings about what goes on in China and their lack of transparency.  I mean, that's not an 15 \nunusual thing.  You know, there was lack of transparency early on with SARS when it was 16 \nin Guangdong Province.  The Chinese tend to be nontransparent even when they don't 17 \nhave to be nontransparent.   18 \nQ Another thing that was reported  -- and I can introduce the exhibit if you 19 \nwant me to, but did you have any awareness of China hoarding PPE early in the 20 \npandemic?  21 \nA Not that I recall.  22 \nQ Okay.  And some of this  -- again, not a scientist, so if the words in the 23 \nscientific publications don't mean what I think they mean, tell me.   24 \nOn January 3rd, ProMED came out with an update on this and said the number of 25 \n  \n  105 \ncases in Wuhan was rising and that there were now cases in Hong Kong.  Does not only 1 \nthe rise in cases but also shifting out of kind of the original metropolitan area within a few 2 \ndays mean that there might have been human -to-human transmission already?  3 \nA Yeah.  I think when you have spread like that, it has to, you know, 4 \nparticularly when you have it disassociated in different places.  That strongly suggests 5 \nhuman -to-human transmissibility.  6 \nQ Is that about the time that you would have started at least estimating that 7 \nthere was human -to-human transmission of this virus?  8 \nA You know, again, I'm trying to recall now 4 years ago what the evolution of 9 \nmy understanding was.  And it was really evolving, because the first thing we heard was 10 \nthat it was likely an animal to a human, and it wasn't particularly transmitted efficiently 11 \nfrom human to human.  Then somehow, a week or so went by, and they said, well, maybe 12 \nit is transmitted human to human.  And then another few days to a week goes by, and it's, 13 \nwell, it's pretty well -transmitted from human to human.   14 \nAnd then you start hearing cases from the news media that there were cases over 15 \nhere, that you say, well, it really is transmitted.  And then you get the report that the 16 \nChinese are building a thousand -bed hospital overnight.  Then you say, I think it's 17 \ntransmitted pretty fast.   18 \nBY MR. STROM:  19 \nQ Bearing in mind what you mentioned about the Chinese being not 20 \ntransparent even when they don't have a reason for it, do you -- is it plausible there were 21 \nonly 177 cases in December of 2019?   22 \nIf you go back, the Chinese were fairly adamant  -- and these were the 23 \nrepresentations they made to the WHO  -- that the earliest case was December 8th.  And 24 \nso it's always struck me as remarkable that you can go from a handful of cases  -- you 25 \n  \n  106 \nknow, 177 cases in December to hundreds of thousands of cases in January.   1 \nA Yeah.  You know, I really hesitate, you know, to speculate on that at all 2 \nbecause there are many factors that we don't know.  The degree of transmissibility 3 \namong asymptomatic people, how long that was going on, and where it was going on.  So 4 \nthis would be really speculation on my part.  So I wouldn't want to guess on that.  5 \nQ I guess, you said -- I think you said earlier not enough is known about the 6 \nearly cases.  Are you referring to those 177 or just generally to -- because assuming even 7 \nif they were transparent and doing the best they could, they would miss some early cases.  8 \nA Yeah.  9 \nQ I mean, asymptomatic spread makes up a quarter thereabouts, maybe more 10 \nearly on.   11 \nA I wasn't getting any -- first of all, as the director of NIAID, I have to make sure 12 \nthat you understand and I reconfirm.  What my job was was to develop a vaccine and 13 \nwasn't the surveillance of what's going on at different places.  It was not that.  I mean, I 14 \nwas interested in it.  15 \nQ Sure.   16 \nA I'm an infectious disease person.  Of course, I'm interested in what's going 17 \non.  But I don't really -- I can't really speculate about, you know, whether this number of 18 \ncases was truly reflected.  All I knew, it was kind of like a moving target in the first few 19 \nweeks.  That it went, you know, like I told you, from something that generally was 20 \nreported as not particularly transmissible to something that, weeks down, clearly was 21 \nspreading rapidly.   22 \nQ I guess last thing I'll say is, we're trying to understand, because we get a lot 23 \nof -- we've reviewed a lot of emails both from Dr.  Daszak, from people in NIH and HHS 24 \nwrit large, where they're saying, oh, I think -- they basically seem to be thinking it's going 25 \n  \n  107 \nto be SARS -1 all over again.  That you'll have sustained but sort of stuttering transmission, 1 \nand eventually, the interventions will work and it'll die out.   2 \nWas that your initial expectation?  3 \nA Well, you know, you never make final conclusions because emerging 4 \ninfectious diseases continue to fool you.  For example  -- again, not to belabor this  -- but, 5 \nfor example, when -- I was one of the first people in the country to take care of persons 6 \nwith HIV, and when we first started taking care of patients, we only saw the patients that 7 \nwere really critically ill that were brought to the attention of a hospital.  Little did we 8 \nknow that that was the tip of the iceberg of people who were infected for years.   9 \nAnd when we finally got the diagnostic test, my heart sank because, you know, 10 \ninstead of the several hundred people that I was taking care of at the NIH personally, 11 \nthere were thousands of young men out there in the Castro and in New York and in L.A. 12 \nthat were infected.   13 \nSo, right now, when you talk about what was going on then, it was the moving 14 \ntarget of trying to understand just what the scope of this was.  And it did sort of -- like, 15 \nevery -- when you hear \"coronavirus,\" the people who would -- and there were several 16 \nthat were making what I think was your suggestion.  Oh, it's a coronavirus.  It's like SARS, 17 \nyou know.  It'll go boom, and then it'll go down.  18 \nQ Yeah.  Really unlucky if you get it, but it'll be fine.  19 \nA Well, you know  -- but if you do it, you could identify, isolate, contact -trace, 20 \nand then we're done.  But it became clear as the weeks went by that this was different.   21 \nQ Thank you.   22 \nMr. Benzine.   We have about a minute left, but I know the chairman has one or 23 \ntwo questions to finish out the hour.   24 \nDr. Wenstrup.   Yeah.  We were talking about transparency.  I always refer to 25 \n  \n  108 \nReagan's line of trust but verify.   1 \nAnd, yeah, there was a tremendous concern, at least on my part, that the CDC was 2 \nnot allowed boots on the ground in early 2020.  And the WHO called it, it's a regional 3 \nproblem only.  So it seems like we were getting misinformation.   4 \nWere you suspicious that they weren't being totally transparent?  And you kind of 5 \nalluded to that maybe that wasn't your lane in your work on the vaccine, but who should 6 \nbe in that lane?   7 \nDr. Fauci.   Yeah.  I mean, it wasn't my lane for sure, but, I mean, I could not help 8 \nbut wonder why we're not going to be allowed to go in there.  But, again, Mr.  Chairman, 9 \nthe Chinese fundamentally in every lan e -- and the point I was just making  -- even when 10 \nthey don't need to be opaque, they're opaque.   11 \nDr. Wenstrup.   Yeah.  And they had this Li Wenliang.  He was warning about this 12 \ndangerous virus, and he later published a letter that reprimanded him for issuing that 13 \nwarning.  He later died.   14 \nBut I do have one question before this ends.  When our CDC was not allowed in 15 \nChina, was your relationship with George Gao affected?  You know, did you trust him 16 \nafter that, the way he was telling you things?  17 \nDr. Fauci.   You know, I never had what one would call a relationship with George 18 \nGao.  I knew him.  I met him at a meeting here in the United States once, that I recall.  I 19 \nmay have seen him at other scientific meetings, but it wasn't like I had a relationship.   20 \nI mean, he had a position of significance in China.  He was the director of the 21 \nChinese CDC, which was essentially, you know, the Chinese equivalent of the United 22 \nStates CDC.   23 \nDr. Wenstrup.   So maybe that's a better question for CDC then?   24 \nDr. Fauci.   Yeah, I think so.  Yeah.  25 \n  \n  109 \nDr. Wenstrup.   All right.  Thank you.   1 \nMr. Benzine.   All right.  We can go off the record.   2 \n[Recess.]  3 \n  We can go back on the record.   4 \nBY  5 \nQ Dr. Fauci, I wanted to discuss and ask a few questions about another topic 6 \nthat's been of significant interest, and that is the proximal origin paper, which I imagine at 7 \nthis point you are generally familiar with what that paper is.  Is that correct?  8 \nA That is correct.  9 \nQ Great.  I will say at the beginning of this conversation, I do not think it makes 10 \nsense to drag you all the way into the details of the science of that paper.  We have flown 11 \nall over the country to interview the authors of the paper, and we have done all of that 12 \nwith them.  We have discussed furin cleavage sites and receptor binding domains and 13 \nO-linked glycans -- 14 \nA Wow.   15 \nQ -- and pangolins.  We have done it all with them, so I'm not going to repeat 16 \nall of that with you.   17 \nI will say, however, just because it's interesting, we had a discussion with one of 18 \nthe coauthors about the furin cleavage site and the extent to which it has been found to 19 \ngo away in serial passage, which has created a little bit of confusion about the role that it 20 \nactually is or is not playing in transmission.  But whatever.  Neither here nor there.  I'm 21 \nnot going to do that with you unless you really, really want to.   22 \nA I don't.  23 \nQ Okay.  Great.  What I think would make sense to discuss is the separate 24 \nquestion of who organized this paper.  Of course, the authors wrote it, but there has been 25 \n\n  \n  110 \nsome discussion of whether there was anybody else who had the idea that it should be 1 \nwritten or maybe helped organize it.  That might be of slightly more interest to our 2 \ncolleagues in the majority than ourselves, but we've tried to take a close look at that 3 \nquestion.   4 \nAnd for us, when we read the documents and we've done these interviews with 5 \nthe authors of the paper, it feels as if -- our perception is that Dr. Jeremy Farrar, who's a 6 \nBritish scientist  -- to the extent that anybody was playing that sort of a role, it seems as if 7 \nhe was playing that role.   8 \nI'll just start with, from 30,000 feet, is that your general  --  9 \nA Yeah.  10 \nQ -- recollection?  11 \nA Yeah.  Dr. Farrar, who you correctly mentioned, is a -- at the time was the 12 \ndirector of the Wellcome Trust, which is a scientific funding organization in the U.K., was 13 \nthe one who initiated the process, both the original call that these evolutionary virologists 14 \nwere on, and about, what are we going to do about it?  So you are correct in saying that 15 \nhe was the prime mover of getting people together.  16 \nQ Okay.  Great.  I'd like to go into a little bit more detail.  This whole sequence 17 \noccurred over a few different phases.   18 \nA Right.   19 \nQ That first phase, I think, is an initial phone call between yourself and 20 \nDr. Kristian Andersen, I think on January 31st --  21 \nA Correct.   22 \nQ -- 2020.   23 \nOur understanding is that Dr. Farrar reached out to you, said that you should talk 24 \nto Dr. Andersen.   25 \n  \n  111 \nA That is correct.  1 \nQ Is that your general recollection?  2 \nA Yeah.  I got a call from Jeremy in the afternoon, evening of the 31st of 3 \nJanuary saying, I just got off the phone with Kristian, and I believe he said Eddie Holmes 4 \nwas also in the discussion.  He said, you really need to call Kristian.   5 \nSo Kristian called me up and -- or I called him.  I think I called him.  I'm not sure.  6 \nAnd he explained to me that when a smaller group of these evolutionary virologists were 7 \nlooking at the sequence of the virus, they were disturbed that there was something about 8 \nit that looked like it could have been engineered.  And my response was, wow, we have to 9 \nlook into that much more carefully, and we should probably get, you know, a group 10 \nof -- broader group of evolutionary virologists together.   11 \nAnd that's what happened the next day on February 1st.  And I think I responded 12 \nto Jeremy right after that.   13 \nQ If you'd like, I can save you the trouble, because there's an email chain, I 14 \nthink, that draws out this entire sequence of events.  So I'll just introduce it, for ease of 15 \nreference, as minority exhibit D.  16 \n    [Fauci Minority Exhibit No. D  17 \n    was marked for identification.]  18 \nBY   19 \nQ And although it's probably familiar to you, I'll give you a moment to look it 20 \nover.  Like other chains, it starts at the back and works its way forward.   21 \nA Right.  Yeah, well, the emails accurately project what I just mentioned, that 22 \nJeremy called me and suggested that I call Kristian Andersen.   23 \nIt says here, \"Can you phone Kristian Andersen?\"  And I do.   24 \nAnd after I get off the phone call with Kristian, I wrote an email to Jeremy.  And, 25 \n\n  \n  112 \nyou know, the email, I guess, tells us about where my mind was, and it says, \"I just got off 1 \nthe phone with Kristian, and related to me his concern about the furin site mutation in 2 \nthe spike protein of the currently circulating 2019 -nCoV.  I told him that as soon as 3 \npossible he and Eddie Holmes should get a group of evolutionary virologists together to 4 \nexamine carefully the data to determine if his concerns are validated.  And he should do it 5 \nvery quickly, and if everyone agrees with this, they should report it to the appropriate 6 \nauthorities.  And I would imagine that, in the United States, that would be the FBI, and in 7 \nthe U.K., that would be MI5.  And it would be important to quickly get confirmation of the 8 \ncause of his concern by experts in the field of coronaviruses and evolutionary biology.  9 \nAnd in the meantime, I\" -- me, Tony  -- \"will alert my U.S. Government official colleagues 10 \nof my conversation with you and Kristian and determine what further investigation they 11 \nwould recommend.  Let's stay in touch.\"   12 \nSo it was my response to the call that I had with Kristian.   13 \nQ So as a reader, I take away from that that you are communicating, hey, if you 14 \nthink that this could be from a lab, specifically the product of deliberate manipulation, 15 \nyou need to learn more and tell somebody, alert the authorities.   16 \nA Right.   17 \nQ Is that right?  18 \nA Absolutely.  I said it very explicitly in the email.   19 \nQ This is sort of speculative, but that feels not consistent with what we would 20 \nexpect to see if you were somehow trying to suppress the idea that it might have come 21 \nfrom a lab?  22 \nA I think that's obvious, yes.   23 \nQ We have heard from Dr. Andersen that, in this phone conversation, as far as 24 \nthe question of writing any kind of paper went, his recollection is your only remark that 25 \n  \n  113 \nwould fall into that category was, if you think this was from a lab, you should write a 1 \npaper about that.   2 \nA Right.   3 \nQ In other words, that that remark was specific to the idea that the paper 4 \nwould be arguing that it may have come  --  5 \nA Right.   6 \nQ -- from a lab.  Is that generally your recollection?  7 \nA Yeah.  No, I said if -- almost exactly what you're saying.  But my thinking was 8 \nthat, if, in fact, you think this is the case, put out all the information in a peer -reviewed 9 \npaper so that it could be publicly scrutinized, because of my  -- you know, as a scientist, 10 \npeer review is the openness of it.  Let the peers look at it and scrutinize it and put the 11 \ninformation and what opinions they're having and see what happens.  12 \nQ So as we understand it, subsequent to that conversation, Dr. Farrar goes and 13 \norganizes another larger phone call for February 1st that's got all sorts of folks from all 14 \nover the world on it.  Do you generally recall that phone call?  15 \nA I do.  16 \nQ Great.   17 \nA I do.  18 \nQ So there's been some question -- before even getting to who said what on 19 \nthe call, there's been some question of, whose call was it?  And we've seen some 20 \ndocuments on that question, so I'm just going to introduce minority exhibit E.  21 \n    [Fauci Minority Exhibit No. E  22 \n    was marked for identification.]  23 \nBY   24 \nQ I'll give you a second to look that over.  It's a pretty short email exchange.   25 \n\n  \n  114 \nA Right.  Yes.  1 \nQ So I would just sort of -- the part that I'm focused on in the middle of that 2 \nfirst page  -- which is Bates labeled SSCP_NIH -796 -- we've got an email from Dr.  Farrar on 3 \nFebruary 1st to yourself.   4 \nSubject is \"Regarding conference details,\" and the email is, \"Could you join?  5 \nTrying to set up an initial call with\"  -- and then he lists a bunch of the folks that ended up 6 \non that call.   7 \nIs your recollection, if you can remember, that it's the February 1st  --  8 \nA Yeah.  9 \nQ -- conference call?  10 \nA No, I remember very clearly.  He called me and asked me could I join, and 11 \ntold me he has a bunch of these other people who are listed there that he's trying to get 12 \non the call.  13 \nQ So it's not a difficult question, but is it fair to say from this or from your own 14 \nmemory that it was Dr. Farrar who set up that call?  15 \nA Yes, it was Dr. Farrar who set up the call.  16 \nQ All right.  With respect to the question of what happened on the call and 17 \nhow did that call unfold, we have also seen some documents that help us understand that 18 \nquestion.  And so I will introduce minority exhibit F.  19 \n    [Fauci Minority Exhibit No. F  20 \n    was marked for identification.]  21 \nBY   22 \nQ And I'll give you a moment to look that over as well.   23 \nA Okay.   24 \nQ So this email chain includes within it, it looks like dial -in details for the call, 25 \n\n  \n  115 \nan agenda, list of participants.  I'll just sort of walk through it maybe in reverse order 1 \nstarting on the first page, but we've got an email starting with from Dr. Farrar with the 2 \ndial-in code.   3 \nAnd it's neither here nor there, but the +44 we understand certainly not to be 4 \nyour dial -in code, right?  That's an English phone number?  5 \nA That is correct.   6 \nQ All right.  And then in the email preceding that, again, from Dr. Farrar, it's got 7 \na lot of content.   8 \nSo he lays out -- and the recipients here, I think, are the folks who end up joining 9 \nthe call.  He lays out the dial -in details starting at the top of the second page.  He explains 10 \nthat he'll be on email throughout the call.   11 \nHe says to email Paul or I -- and Paul is somebody who works for Dr.  Farrar, based 12 \non the cc line  -- if there are any problems.  If somebody can't make it, they're supposed to 13 \ncall Jeremy.   14 \nThere's an agenda here, which starts off with an introduction and a focus and 15 \ndesired outcomes.  That's Dr.  Farrar.  It wraps up with a summary as well as next steps.  16 \nThat's also Dr. Farrar.   17 \nSo in between there, some of these other evolutionary virologists do some of the 18 \ncontent and the substance, but in terms of who is sort of the master of ceremonies here, 19 \nit feels to us as readers that that is Dr. Farrar.  Is that generally your recollection as well?  20 \nA That is correct.  21 \nQ We've talked to some of the folks who were on that call, and Dr. Andersen 22 \ntold us that the call was organized by Dr. Farrar and that he did not remember you, Dr. 23 \nFauci, chiming in.  Dr.  Garry told us that it was Dr. Farrar's call and that you, Dr.  Fauci, 24 \nidentified yourself, said, I am here, at the beginning, but then didn't say much or anything 25 \n  \n  116 \nof substance.   1 \nAgain, is that consistent generally with what you remember about the call?  2 \nA That is correct.  3 \nQ Great.  As far as you as a listener on the call in terms of what actually 4 \nhappened and the content, I think you have written a little bit contemporaneously about 5 \nthe content of the call.  And so I think it would be useful to introduce that document as 6 \nminority exhibit G.  7 \n    [Fauci Minority Exhibit No. G  8 \n    was marked for identification.]  9 \nBY   10 \nQ And I'll give you a moment to look that over and familiarize yourself with it.   11 \nA Okay.   12 \nQ So the part of this email chain -- which, for the record, is Bates labeled 13 \nSSCP_NIH -1796  -- the part of interest is on the second page, 1797.  And this is a pretty 14 \nlengthy email from yourself to other colleagues who I think have HHS sort of email 15 \nbranches.   16 \nDo you generally recall this email?  What was the context of it?  17 \nA Yeah.  The email was  -- as you said, I virtually said nothing but introduced 18 \nmyself.  This was a report of that February 1st conference call with the evolutionary 19 \nvirologists, and I was reporting what I had heard and what I had witnessed on the call, 20 \nand I was doing it because it was part of what I had suggested in a prior email that I want 21 \nto notify my superiors at HHS.   22 \nAnd if you look at the people to whom it was sent, it was sent to Garrett Grigsby, 23 \nwho's the director of the Office of Global Health Affairs.  It was sent to Brian Harrison, the 24 \nchief of staff to the Secretary of HHS.  It was sent to Larry Kerr, who was in the office 25 \n\n  \n  117 \nof -- I think he's a biosecurity kind of guy in HHS.  And to Robert Kadlec, who was the 1 \nassistant secretary for preparedness and response.  And it was sort of like -- you know, 2 \nyou talk about trip reports?  This was a phone call report.  3 \nQ That's really helpful.   4 \nAnd although the email is lengthy, I think it's all connected to itself.  In other 5 \nwords, it's hard to take one sentence out of this and read it.  So I'm just going to read the 6 \nemail out loud, which might take a little time  --  7 \nA Sure.   8 \nQ -- but the record will be clear.   9 \nIt reads, \"Folks, the call with Jeremy Farrar (Wellcome Trust) went very well.  10 \nFrancis Collins joined, and there were several highly credible scientists (including and in 11 \naddition to the two that I spoke with last night) on the call with expertise in evolutionary 12 \nbiology.  One point to make clear, and this was brought up on the Task Force call.  Most of 13 \nthe rumors that are going around relate to the paper by an Indian group saying that there 14 \nare HIV gene sequences inserted into the 2019 -nCoV virus.  All of the scientists on our call 15 \nfelt that this was not credible, and they dismissed it as they the two did last night.  That is 16 \nnot what they were concerned about.  They were concerned about the fact that upon 17 \nviewing the sequences of several isolates of the nCoV, there were mutations in the virus 18 \nthat would be most unusual to have evolved naturally in the bats and that there was a 19 \nsuspicion that this mutation was intentionally inserted.  The suspicion was heightened by 20 \nthe fact that scientists in Wuhan University are known to have been working on 21 \ngain -of-function experiments to determine the molecular mechanisms associated with 22 \nbat viruses adapting to human infection and the outbreak originated in Wuhan.  Upon 23 \nconsiderable discussion, some of the scientists felt more strongly about this possibility, 24 \nbut two others felt differently.  They felt that it was entirely conceivable that this could 25 \n  \n  118 \nhave evolved naturally, even though these mutations have never been seen in a bat virus 1 \nbefore.  The reasons for each side of the argument are too complicated to bother you 2 \nwith.  Bottom line is that they all agreed with my strong suggestion to gather an even 3 \nlarger group under the auspices of an internationally credible organization.  After some 4 \ndiscussion, they all felt that the WHO would be the most appropriate convener of such a 5 \ngroup and that the scientific experts be broadly representative of the global scientific 6 \ncommunity.  Jeremy Farrar and Francis Collins will contact Tedros and ask him to do this.  7 \nThey hope to initiate this in the next day or so.   8 \n\"They pass no judgment at all at this point and feel that the group's mandate 9 \nshould be:  'What are the evolutionary origins of 2019 -nCoV, important for future risk 10 \nassessment and understanding of animal/human coronaviruses.'  In this way, there is no 11 \nassumption of foul play or guilt on anyone's part and merely an intense scientific look at 12 \nthe evolutionary origins of this virus.  Where that leads remains to be seen.  Happy to 13 \nchat with any of you about this.  Best regards, Tony.\"   14 \nThat's the end of the email.  I think for some folks what jumps out to them is the 15 \nmention of, \"Scientists in Wuhan University are known to have been working on 16 \ngain -of-function experiments.\"   17 \nCould you, if you recall, discuss a little bit what that sentence meant by you at the 18 \ntime?  19 \nA Yeah.  Yeah.  I was reporting what I had heard by  -- and I don't know exactly 20 \nwho it was.  You know, it could have been Kristian.  It could have been one of the others.  21 \nBut in the discussions back and forth.   22 \nAnd if you look at the wording, it says they were concerned about the fact upon 23 \nviewing the sequences, that there was mutations that most unusual naturally in the bats, 24 \nand there was suspicion that this mutation was intentionally inserted.   25 \n  \n  119 \nAnd the suspicion by them on the call was heightened by the fact that 1 \napparently  -- at least during the call  -- I used the word \"by the fact.\"  Probably shouldn't 2 \nhave used the word \"the fact.\"  But saying, but the discussion that scientists at Wuhan 3 \nwere known to have been working on gain -of-function experiments to determine 4 \nwhatever.   5 \nSo it was a report of what I had heard on the call that someone -- and certainly 6 \nsomeone said it.  I think it was Kristian.  I'm not sure.  But said that they had heard that 7 \nthere was gain -of-function research going on and, therefore, that makes it even more 8 \ncompelling to look into this.  9 \nQ And so you are basically repeating something you heard in this remark?  10 \nA Absolutely, yeah.  11 \nQ And so if you are repeating something that you heard somebody else say, 12 \nwhen we go back to this long conversation about what exactly the term 13 \n\"gain -of-function\" means, particularly here, if you're just parroting the fact that you heard 14 \nsomebody else say the words \"gain -of-function,\" would you have known -- do you have 15 \nany idea which version of gain -of-function?  16 \nA Absolutely not.  I mean, it was sort of like -- in fact, I'm not even sure they 17 \nused those words.  They could have said manipulated the virus, and I interpreted it as 18 \ngain -of-function of some sort.  I don't really recall.  But it was what was said by them on 19 \nthe conference call.  20 \nQ And it seems like a lot of this discrete conversation about intentional 21 \nmanipulation on this call, it seemed to revolve around the furin cleavage site.  22 \nA Right.   23 \nQ Is that right?  24 \nA That's correct.  25 \n  \n  120 \nQ I think -- in our conversations with the coauthors of the paper later on, I 1 \nthink it is not clear the extent to which, at this point, they had their arms around the idea 2 \nthat furin cleavage sites may not have previously been observed in sarbecoviruses per se, 3 \nbut they are perhaps not so unusual when you move up to beta coronaviruses.   4 \nA Right.   5 \nQ It's not a question.  It's just an observation, if you feel this way, that the body 6 \nof knowledge upon which this whole conversation is based evolved subsequently to this 7 \ncall.   8 \nA Right.  Yeah.  The thing I do remember about the call  -- and I think I may 9 \nhave been alluding to  it -- there was discussion back and forth about what some people 10 \nthought and what other people thought.  But the underlying theme was, we don't know 11 \nall that needs to be known right at this moment.  We have to go back and start looking at 12 \na whole bunch of other sequences to see similarities or not.   13 \nSo there was a feeling not of what we talk about on this call is the final 14 \ndetermination.  It's, we need to be thinking about it more and looking more into it.  15 \nQ And is it right that  -- I think from the email we can tell  -- there was already 16 \ndisagreement amongst this group to begin with on February 1st, right?  17 \nA Oh, there were those in there who felt that this most likely was a 18 \nmanipulated or created virus, and there were those in the group who felt, no, they have 19 \nno concern at all, and there were those in the group that were somewhere in the middle.  20 \nIt was definitely -- it was not a unidimensional discussion.   21 \nQ Could I ask  -- this reference to HIV gene sequences, we've seen passing 22 \nmentions of that.  What was that conversation about?  23 \nA Yeah.  There was an Indian paper that came out that was making claims that 24 \nthere were HIV sequences or similar repeat sequences in the published sequence of 25 \n  \n  121 \nSARS -CoV-2.  That the reason that -- even the ones who thought this may have 1 \nmanipulated, those who didn't think so, and those in the middle, everybody universally 2 \nsaid, anybody that knows anything about molecular virology knows that that is a 3 \ncompletely ridiculous assumption.   4 \nSo that's the reason why I said, that's not what they were concerned about.  They 5 \nsaid that that's nonsense.  There's nothing that resembles HIV in those sequences.  So 6 \nthat's when they went on to talk about what they were really concerned about.   7 \nQ That's very helpful.  Thank you.   8 \nSo after that February 1st call, what we've heard is that the authors of the paper 9 \nwent off and wrote the paper.  And as far as the paper itself went  -- who was writing it 10 \nand who was guiding it  -- we've talked about that with the coauthors.   11 \nDr. Andersen told us that Dr. Farrar was a, quote, father figure to the paper, which 12 \nis sort of a curious but illustrative phrase, and that you played no role in the paper, as far 13 \nas he could see.   14 \nDr. Garry has called Dr. Farrar a leader, an amazing leader of the paper, but 15 \nreported that, from his vantage point, he didn't influence the paper in any way.   16 \nAnd Dr. Ian Lipkin, who joined the paper a little bit later than the others, told us 17 \nthat nobody suggested to him that you were even involved in the paper.   18 \nSo as far as the substance of the paper went, is that generally consistent with your 19 \nrecollection of your own role?  20 \nA That is correct.  21 \nQ We have seen emails where sometimes the authors would write up a draft, 22 \nand they would share the draft with Dr. Farrar, and he would occasionally forward those 23 \ndrafts on to yourself or on to Dr.  Collins.   24 \nWhen that would happen, just as a general matter  -- we can look at a few 25 \n  \n  122 \nexamples  -- but, in general, if you recall, how would you have seen your role as the 1 \nrecipient of those forwarded emails?  Is it more that, oh, Jeremy is sending me this so 2 \nthat I can open up a version, go in, and make line edits?  Or is it, from your point of view, 3 \nmore of an FYI situation?  4 \nA Absolutely, an FYI and a courtesy.  5 \nQ So we can look, I think, at an example of that.  And so I will introduce 6 \nminority exhibit H.  7 \n    [Fauci Minority Exhibit No. H  8 \n    was marked for identification.]  9 \nBY   10 \nQ And I'll give you a second to familiarize yourself with that.  For the record, 11 \nthe Bates label of this email chain is SSCP_NIH -751.   12 \nI won't take too long with the exhibit itself.  I won't quiz you on the contents of 13 \nthe draft.   14 \nSo this is February 4th.  So we're now 3 days out from the conference call.  And at 15 \nthe top of the first page, it looks like we have what we just talked about.  Eddie Holmes, a 16 \ncoauthor of the paper, sends to Jeremy Farrar, hey, \"Here's our summary so far.\"   17 \nAnd then Jeremy Farrar forwards that on to yourself and Dr.  Collins and says, 18 \n\"Please treat in confidence.  A very rough first draft from Eddie and team.  They will send 19 \non the edited, cleaner version later.\"   20 \nIs this basically an example of exactly what you were just saying?  21 \nA Yeah.  To me, this was an FYI and a courtesy to let you know where we are in 22 \nthe process.  23 \nQ So when it comes to -- that's helpful in terms of your process role, the role or 24 \nlack thereof that you were playing.   25 \n\n  \n  123 \nWhen it comes to the substance of the paper, I do want to say there's been a fair 1 \namount of discussion about whether or the extent to which the authors somehow 2 \nflip-flopped.  That on February 1st, these folks were saying, hey, gosh, I think this came 3 \nfrom a lab, and just merely days later, they somehow changed their minds.  All of a 4 \nsudden, they're saying it couldn't have come from a lab and that there must be 5", "summary": "Official transcript, Part 1 of Anthony Fauci's 14-hour closed-door transcribed interview before the House Select Subcommittee on the Coronavirus Pandemic (8-9 January 2024).\n\nExcerpt: 1   1   2   3   4  COMMITTEE ON OVERSIGHT AND ACCOUNTABILITY,  5  SELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC,  6  U.S. HOUSE OF REPRESENTATIVES,  7  WASHINGTON, D.C.  8   9   10   11   12   INTERVIEW OF:  ANTHONY S. FAUCI  13   14   15   16  Monday, January 8, 2024  17   18  Washington, D.C.  19   20   21  The interview in the above matter was held in room CVC -268, Capitol Visitor 22  Center, commencing at 9:58 a.m.  23  Present:  Wenstrup, Griffith, Jordan, Malliotakis, Cloud, Joyce, Greene, Dingell, 24  and Castor.  25       2  Appearances:  1   2   3   4  For the SELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC:   5   6  MITCH BENZINE, STAFF DIRECTOR.  7  JOSEPH CIPOLLONE, COUNSEL  8  JACK EMMER, SENIOR COUNSEL  9  ERIC OSTERHUES, CHIEF COUNSEL  10   11  ANNA -BLAKE LANGLEY,…", "source_url": "https://oversight.house.gov/wp-content/uploads/2024/05/Fauci-Part-1-Transcript.pdf", "pdf_url": "/archive-docs/fauci-files/2a847d8c6ce196e4ee11f9d2b94ee787/pdf", "doc_date": "2024-01-08", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "transcribed interview", "house oversight", "select subcommittee", "coronavirus pandemic", "congress", "fauci testimony", "hearing transcript", "testimony-house-2024-jan-part1"], "part_number": 1, "page_count": 227}
{"title": "Fauci Transcribed Interview — House COVID Subcommittee, Part 1 (8 Jan 2024) (Part 2 of 2)", "content": "something improper about that process.   6 \nI think -- it is useful because I think that that timeline sometimes has gotten a little 7 \nbit foggy.   8 \nI'm going to introduce just one more draft of the paper that was forwarded on to 9 \nyou, as minority exhibit I.  10 \n    [Fauci Minority Exhibit No. I  11 \n    was marked for identification.]  12 \nBY   13 \nQ And I'll give you a moment to look that over.  I may want to chat a little more 14 \nabout the substance in the draft, so take your time.   15 \nThis Bates number, for the record, is REV411.   16 \nA Yeah.  17 \nQ Great.  So this email chain is now February 8th.  So we are a full week out 18 \nfrom that February 1st conference call.  And it's another similar example, it looks like, 19 \nwhere Dr. Farrar is forwarding the current draft, but in this case  -- I just want to know, as 20 \na preliminary matter, the to line is not just yourself, Dr.  Collins in this case.  It's other folks 21 \nwho were on the February 1st conference call, right?  Such as Ron Fouchier, for example?  22 \nA Right.   23 \nQ Who is Dr. Fouchier, if you recall?  24 \nA He's a Dutch scientist.  25 \n\n  \n  124 \nQ What is his general field of expertise?  I think it's virology, maybe evolution.   1 \nA No.  He's an evolutionary virologist.  2 \nQ Got it.  So the body of Dr. Farrar's email here looks a little bit different than 3 \nthe last one in that he appears to be soliciting a little bit of substantive input.  Is this 4 \nreasonably balanced?  Does anybody disagree?   5 \nI just wanted to ask just as a threshold matter whether  -- if you recall it's more 6 \nlikely that Dr. Farrar is interested in the opinion on those questions of somebody like Dr. 7 \nFouchier, or somebody like yourself who, as I understand it, is not a virologist?  8 \nA Well, he's certainly interested in what Andrew Rambaut and Ron Fouchier 9 \nand Marion Koopmans -- I couldn't comment on this because I'm not an evolutionary 10 \nvirologist.  This really is not even close to my lane.   11 \nQ That's exactly my question.   12 \nAnd then with respect to the content of this particular draft, the draft at this point 13 \nwalks through three possible scenarios for the origin of SARS -CoV-2:  natural selection in 14 \nhumans, natural selection in an animal host, or selection during passage, being sort of the 15 \nlab origin option.   16 \nAnd on the very last page, Bates numbered 414, under \"limitations and 17 \nrecommendations,\" I'll just read out loud the first sentence there, which is, \"The 18 \nevolution scenarios discussed above are largely indistinguishable and current data are 19 \nconsistent with all three.  It is currently impossible to prove or disprove either, and it is 20 \nunclear whether future data or analyses will help resolve this issue.\"  That's the end of the 21 \nquote.   22 \nSo it's less of a question, more an observation.  And if you recall, it seems to us as 23 \nreaders that, you know, in the days after the February 1st call, the position of these folks 24 \nseems to have been , we honestly couldn't tell you whether it's from a lab or from an 25 \n  \n  125 \nanimal.   1 \nIs that basically your recollection?  2 \nA Yeah.  I think they -- I don't know.  Let me read it.   3 \nI think the idea of artificially creating it was out.  But they said -- they didn't rule 4 \nout that it could have come from a lab for the reasons that are -- so they had a pretty 5 \nopen mind about where it came from.  6 \nQ Precisely.  And when the article ultimately came out  -- which I think was a 7 \nmonth or a month and a half after this  -- at that point, it had some language in it that 8 \nfolks have pointed to that was a little bit more definitive about, we don't think that any 9 \nlaboratory -based scenario is plausible.   10 \nMy point is simply that that seems to have come much later in the process.  Is that 11 \nyour general -- to the extent you would even know.   12 \nA No.  I don't know  -- 13 \nQ Yeah.   14 \nA -- but I assume that after further examination of sequences and backbone 15 \nviruses and all that, that there was strength in that it would be less, less likely given 16 \nthe -- what you would need to be able to manipulate it in passage, that it is unlikely that 17 \npassage would have been the case.  18 \nQ And that's some of what we've heard from them of, hey, we started learning 19 \nabout the furin cleavage sites that are a little more common than we thought, and it turns 20 \nout that the receptor binding domain is really prone to mutations in a way that maybe we 21 \ndidn't appreciate at first, and we've got a receptor binding domain out there in nature 22 \nthat looks like a 99 percent match to the one in SARS -CoV-2.   23 \nSo it seems like they were accumulating data points as they went along that led 24 \nthem to wherever they ended up -- is our perception of how this process unfolded.   25 \n  \n  126 \nA Right.   1 \nQ One last point on this.  It's a narrow one, which is, there's been this 2 \nsuggestion that  -- I mean, \"bribe\" is an extreme word, but there's been a suggestion that 3 \nyou somehow bribed the authors of the paper to write a paper that would suppress the 4 \nlab leak theory in exchange for a $9 million grant to Dr. Andersen and Dr.  Garry.   5 \nWe went and asked Dr. Andersen about this.  We did the same for Dr.  Garry.  Dr. 6 \nAndersen told us that the allegations are false and that he had not even talked to you 7 \nabout the grant application.   8 \nAnd we had an exchange with Dr.  Garry on this topic that  I think I'll introduce as 9 \nan exhibit and read out loud because I think it's helpful.  So I will mark that as minority 10 \nexhibit J.  11 \n    [Fauci Minority Exhibit No. J  12 \n    was marked for identification.]  13 \nBY   14 \nQ So on the back page of that exhibit -- I'll give you a moment to glance at it, 15 \nbut I'm just going to read an excerpt from the middle of that page while you also read 16 \nover it.   17 \nWe can see in the middle of that page that -- we asked Dr.  Garry, quote, \"Did Tony 18 \nFauci or Francis Collins ever threaten you or bully you or intimidate you into concealing or 19 \naltering the findings of your paper or in any other way?\"  20 \nTo which Dr.  Garry said, \"No.\"   21 \nAnd we asked him, \"Okay.  Did Drs. Fauci or Collins ever threaten to revoke or 22 \nwithhold Federal funding from you in any way?\"   23 \nAnd Dr.  Garry answered, \"No.\"   24 \nThen we asked him, \"Are you aware of any efforts by Drs.  Fauci or Collins to 25 \n\n  \n  127 \nsuppress scientific inquiry into the origins of the virus?\"   1 \nDr. Garry answered, \"No.\"   2 \nTo which we asked him, \"Is there any version of this question that I haven't asked 3 \nyou yet to which the answer would somehow be yes?\"   4 \nTo which he answered, \"There is not.\"   5 \nSo we'll do our diligence and ask you as well.   6 \nDid you, in any way, ever threaten to withhold Federal funding from the authors 7 \nof the paper or award Federal funding to the authors of the paper in exchange for 8 \nchanging their scientific findings?  9 \nA No.  10 \n  Great.   11 \nI'm going to kick it to my colleague,  for a few more questions.   12 \nBY :  13 \nQ Dr. Fauci, it is additionally our understanding that the grant review process 14 \nthroughout NIH at all the institutes is thoughtfully designed to prevent undue influence.  15 \nIs that right?  16 \nA Correct.   17 \nQ In the last hour, you spent a lot of time with our colleagues going through 18 \nthe grant review process.  I'm not going to go through the entire thing with you, but I just 19 \nwant to get some clarification on a few aspects.   20 \nYou said the initial peer review or the study section is conducted by scientists and 21 \nacademics who are not employees of NIH.  Is that correct?  22 \nA That is correct.  23 \nQ And are those members of that committee -- or that peer -review committee, 24 \nare they fully vetted for potential conflicts of interest and to ensure that they have the 25 \n\n  \n  128 \nappropriate expertise to join that peer -review panel?  1 \nA Yes.  2 \nQ Similarly, you spoke about the NIAID advisory council and their secondary 3 \nreview of grant applications.  And those are also predominantly external to NIH, correct?  4 \nA Correct.   5 \nQ Are the members of the NIAID advisory committee also fully vetted for 6 \npotential conflicts of interest and to ensure they have the appropriate expertise prior to 7 \njoining the advisory council?  8 \nA Right.  Not only are they vetted, but whenever there is a vote on the en bloc 9 \napproval, you specifically say, is there anyone that has a conflict of interest with one of 10 \nthese grants that have been discussed?  If so, you need to get up and leave the room and 11 \nnot be involved in the discussion.  So it's in general and specific.   12 \nQ Perfect.  And in my review of the entire application process for grants 13 \nthroughout NIH, I saw many references to preventing conflicts of interest.  So it seems to 14 \nme that this is a high priority for NIH and for NIAID, and that this is to protect the integrity 15 \nof the grant application process.  Is that correct?  16 \nA That is correct.  17 \nQ All right.  And just to reiterate, you, as director of NIAID, were not involved in 18 \nthe grant -making process, correct?  19 \nA That is correct.   20 \n  Thank you, Dr. Fauci.   21 \nI'm going turn things over to my colleague .   22 \nBY    23 \nQ Dr. Fauci, while we have you here today and tomorrow, I think one of the 24 \nmost important things we can do is collect your perspective on reforms and positive steps 25 \n\n  \n  129 \nwe can take for future pandemic preparedness and response.  And so with that, I would 1 \nlike to look back at the COVID -19 pandemic starting with contact tracing.   2 \nAt the outset of the pandemic, it was suggested that contact tracing was going to 3 \nplay a key role in containing the spread of COVID -19.  For the record, could you explain 4 \nthe public health practice of contact tracing?  5 \nA Yeah.  Contact tracing is a process when you're trying to determine 6 \nexposures and potential mechanisms of spread throughout the population.   7 \nSo if I get infected and I'm known to be infected, and I'm in close contact with 8 \nfamily members, fellow employees, or whomever, that you then trace the contact and 9 \nyou observe them to see if they are being -- if they're sick, and if they are, then you 10 \nisolate them depending upon the nature of the infection.   11 \nSo it's identification, isolation, contact tracing.  That works well when you have a 12 \nvirus that has symptoms always associated with it. 13 \n  \n  130 \n[3:02 p.m.]  1 \nBY  2 \nQ And so, looking back at the outbreaks that my colleague  covered in 3 \nthe previous round, how was contact tracing successful in containing prior outbreaks of 4 \ninfectious diseases?  5 \nA Well, when you have a disease or an infection that is transmitted mostly by 6 \nsyndromic transmissibility -- someone who is obviously sick -- that contact tracing 7 \nbecomes much, much more easy and effective in getting people to be isolated.  It 8 \nbecomes much more difficult when there's community spread, because you can't identify, 9 \ncontact, and trace it if you don't know who they came into contact with.   10 \nSo that's when things really fall apart, particularly when you have widespread 11 \ncommunity spread where someone just appears in the emergency room or in a clinic and 12 \nis infected, and you say, well, who did you come into contact with?  And they say, I never 13 \ncame into contact with anybody that I knew was infected.  It becomes problematic.   14 \nSo contact tracing is really good under certain circumstances, but in others it's less 15 \neffective.   16 \nQ And so, looking back to the earliest days of the COVID -19 pandemic, what 17 \nsteps were taken across the board to stand up nationwide contact tracing?  And what did 18 \ncollaboration between the Federal Government and State and local governments look like 19 \nto do that?  20 \nA Well, you know, it was problematic.  I can't  -- I don't think it would be  -- I 21 \nwant to be perfectly honest about it, is that I was not involved in all of the issues of 22 \nsetting up contact tracing, doing the testing, because, as I mentioned to you, my 23 \nresponsibility as a scientist was to direct the NIH's and NIAID's vaccine effort.   24 \nIn the beginning, there were problems with contact tracing because the diagnostic 25 \n\n  \n  131 \ntest we were using was not an adequate test.  That really created a problem, because if 1 \nyou can't test somebody to see if they're infected, it becomes really problematic to 2 \ncontact trace.  So I would say the contact tracing in the beginning did not work very well.   3 \nQ So what about COVID -19 specifically  -- for example, the ways it 4 \nspread  -- made contact tracing so difficult to stand up in the United States?  5 \nA Yeah.  We found this out gradually, but then it became very clear that, 6 \nanywhere, depending upon your study, between 50 to 60 percent of the transmissions 7 \noccurred from a person who had no symptoms.  Either they never would have any 8 \nsymptoms or they were in the pre -symptomatic phase.   9 \nSo, if you have at least half of the infections in the community are spreading, it 10 \nbecomes really difficult to make contact tracing effective.   11 \nQ So, looking to the potential for future outbreaks or future pandemics, it's my 12 \nsense that contact tracing could take a greater role under certain circumstances.   13 \nAre there lessons from the initial COVID -19 response that we should be taking 14 \naway -- 15 \nA Yes. 16 \nQ -- for the deployment of contact tracing?  17 \nA Yeah.  Contact tracing is intimately associated with your local public health 18 \ncapability of mobilizing people to do the contact tracing.   19 \nWhat became clear -- it became clear to me, because what I would do after a 20 \nwhile, because I'm a physician who takes care of patients, I would call up my colleagues in 21 \ndifferent places and say, how's contact tracing going?  And they were saying that contact 22 \ntracing is not working very well because we don't have the public health infrastructure in 23 \nplace to make it work.   24 \nSo my recommendation for what are lessons learned, that we need to support 25 \n  \n  132 \nmore the local public health capability of doing contact tracing.   1 \nOur local public health infrastructure, as good as it was decades ago, has sort of 2 \nattenuated a lot, almost as victims of our own success, because we have good vaccines 3 \nand we have antibiotics, so the local public health people who go out into the community 4 \nand do public health things has diminished greatly over the last several years.  People 5 \nwho have left their jobs have not been rehired.   6 \nSo one of the big lessons learned is that, you know, public health at the local level 7 \nis absolutely critical, and we were weak in that regard.   8 \nQ And so, then, looking at the role of the Federal Government both in investing 9 \nin local public health infrastructure and revitalizing our public health workforce, what 10 \nmore could Congress be doing to support those efforts?  11 \nA You know, again, I'm not really quite sure.  I don't want to speak for 12 \nCongress.  But they certainly, from a resource standpoint, they could give more resources 13 \nand/or make sure that resources that are directed to different agencies ultimately get to 14 \nthe local public health infrastructure.   15 \nQ You mentioned just now testing, which is something we'd like to dig into a 16 \nlittle bit more as well.   17 \nAs I understand it, testing is a key pillar of the public health response to any sort of 18 \ndisease outbreak.  Could you elaborate specifically on the role of testing in containing 19 \noutbreaks?  20 \nA Yeah.  I mean, testing is your eyes on what's going on in the community.   21 \nSo, I mean, right from the very beginning, if you go back and look at quotes that I 22 \nhave made, is, we've got to absolutely  -- what did I quote?  -- flood the system with 23 \ntesting, both people who are symptomatic as well as asymptomatic individuals, to get 24 \nsome vision into what's going on in the community.   25 \n  \n  133 \nBecause if you wait for people to get sick and present to a clinic or to a hospital, 1 \nyou are already weeks behind what's actually going on in the community.  In order to stay 2 \nahead of it, you've got to test very, very robustly.  3 \nQ Now, as I understand it, in epidemiology, there are two key measures of a 4 \ntest's performance or effectiveness; those are sensitivity and specificity.  Do those 5 \nconcepts sound familiar?  6 \nA They do.  7 \nQ And so, as I understand it, sensitivity is the ability of a test to identify true 8 \npositive cases; specificity, the ability of a test to identify true negatives.   9 \nA Right.   10 \nQ I also understand that there are different kinds of COVID -19 tests -- for 11 \nexample, PCR tests and antigen tests.   12 \nCould you explain for us how the different types of COVID -19 tests that we've 13 \ndeployed across the pandemic are different, for example, in terms of sensitivity and 14 \nspecificity?   15 \nA Yeah.  I mean, the PCR test, if done properly, is both very sensitive and also 16 \nvery specific.  The problem is, if not done properly, there could be some contamination, 17 \nso there are some false negatives and false positives.   18 \nThe antigen tests are clearly less sensitive, in the sense of picking up an individual.  19 \nWhen you do get a positive antigen test, it usually is quite specific for the particular 20 \nantigen.   21 \nQ And so, when we look at how each of these tests were deployed as part of 22 \nthe COVID -19 response, are there different pros or different cons to each of the types of 23 \ntests you described?  24 \nA Well, yeah, I mean, the pro of a rapid antigen test is that you can just give it 25 \n  \n  134 \nto people to go ahead and test and report it in, and you could be done very rapidly.  You 1 \ncan do it in 15 minutes.  Some of them are even 12 minutes or 10 minutes.  For those of 2 \nus who've tested ourselves in positive, you sometimes find out in 1 minute that you're 3 \npositive when the band appears.   4 \nWhereas the PCR test, as very specific and sensitive as it is, is a test that requires, 5 \nat least what's available now, a specialized lab to do it.  And it usually  -- again, you get 6 \nbetter and better at it.  If you really want to do it in an emergency, you might get it 7 \novernight, but usually you've got to wait several days.  And one of the problems, again, 8 \ngetting back to your original question of contact tracing, is that if you have to wait several 9 \ndays to find out if something is positive, then that really makes things very complicated.  10 \nQ Thank you.  11 \nNow, when it comes to testing for COVID -19, I recall we experienced some initial 12 \nstumbles in developing effective tests.  For example, the CDC's early COVID -19 tests were 13 \nboth contaminated and contained initial design flaws.  Is that correct?  14 \nA Correct.   15 \nQ Could you elaborate on those specific issues that we observed with the early 16 \nrollout of the CDC's COVID tests?  17 \nA Well, I don't have the specifics of the defect, but it became very clear that 18 \nwhen the tests were made by the CDC and then distributed, there were people who were 19 \ncalling in and saying, wait a minute, we're getting false positives here, it's not working 20 \nvery well.   21 \nThat became pretty clear when they were distributed out into the community.  22 \nThe exact detail of what the defect was, I don't think I can give you a totally accurate 23 \nanswer to that, but they were clearly inadequate.   24 \nQ And so you mentioned earlier in this round the role of testing, obviously, and 25 \n  \n  135 \ncontact tracing, some difficulties, that the testing rollout -- the way that that informed 1 \ncontact tracing and standing up that effort in the United States.   2 \nAre there other ways in which the rollout of the COVID -19 tests and some of those 3 \nearly missteps undermined our early response to the pandemic?  4 \nA Yeah.  I think, you know, if you're relying solely on a test, a single test, to get 5 \neyes on the outbreak and that test doesn't work, in some respects, you're really operating 6 \nblindly about what's going on.  That was a real problem.   7 \nCommercial firms were not drawn in quickly enough, I believe, to substitute for a 8 \ndefective case.  Kept on trying to make it better, trying to fix it, trying to fix it.  They 9 \nultimately never really fixed it.  And then the commercial tests came in and took over.   10 \nSo February was a month that really was an issue with regard to testing.   11 \nQ We're approaching the end of the hour, and we will have additional 12 \nquestions on testing, but before we conclude the round, I just want to turn it, in case 13 \nCongresswoman Dingell or Congresswoman Castor have any followup questions.   14 \nDo either of you?  15 \nMrs. Dingell.   I do, but do we want to wait until the next hour?   16 \nMs. Castor.   Yeah, we'll wait to the next hour.  Thank you.   17 \nThen, in which case, I think we can go off the record.  Thank you.   18 \n[Recess.]  19 \nMr. Benzine.   We can go back on the record.   20 \nBY MR. BENZINE:  21 \nQ Dr. Fauci, when I was running through the really long list of names what feels 22 \nlike forever ago now, I brought up Dr.  Ping Chen.  She was stationed by NIAID in Beijing up 23 \nuntil mid -December 2019 and had toured the Wuhan Institute of Virology in 2017.   24 \nAfter the pandemic emerged, did you ever request to meet with her?  25 \n\n  \n  136 \nA No.  1 \nQ Why not?  2 \nA There was no reason to meet with her.  She reported to Gray Handley, and if 3 \nthere were any issues, Gray, I'm sure, would've brought it up.  So  --  4 \nQ Did you ever talk to Mr.  Handley about anything related to Dr.  Chen 5 \nstationed in Beijing?  6 \nA Ultimately, when everyone started  -- yeah, I mean, the first time was when 7 \nall the hearings started and all the questions started getting asked.   8 \nQ Okay.  But not, kind of, contemporaneously?  9 \nA Contemporaneously, as things are happening, I didn't even know she 10 \nexisted.  11 \nQ It just seems  -- and we talked to Mr.  Handley, and he said pretty much what 12 \nyou just said, that he didn't recall you requesting a meeting or anything.   13 \nIt's just, in this particular aspect, from where we're sitting, is, you have someone 14 \nin Beijing while the outbreak is going on -- we didn't know it was going on, but it was 15 \ngoing on --    16 \nA Right.  17 \nQ -- who had been to the laboratory that was being at least somewhat 18 \nblamed  -- 19 \nA Right.  20 \nQ -- maybe not, for the outbreak, it just seems to us that she's kind of, like, a 21 \nmaterial witness in some of this and, you know, would be of interest in determining 22 \nhow -- 23 \nA No. 24 \nQ -- China was behaving.  But no?  25 \n  \n  137 \nA That didn't  upset the -- I didn't look upon it that way.  I barely knew she 1 \nexisted, so it was tough to say, \"Let me talk to Ping Chen.\"  Gray Handley was the one 2 \nwho handled those kind of global -affair issues.  3 \nQ Okay.   4 \n  Sorry.  If you could just go a little bit louder, just for the end of the 5 \ntable, if you can.  6 \nDr. Fauci.   Sorry.  Do you want me to repeat what I said?   7 \n  It's up to the members.   8 \nMrs. Dingell.   I heard the answer.  9 \nMr. Benzine.   Okay.  10 \nMs. Castor.   And the name of the person you're inquiring about?   11 \nMr. Benzine.   Ping Chen, C -h-e-n. 12 \nMs. Castor.   That is what we didn't hear.  13 \nDr. Fauci.   Yeah, Ping Chen.  Yes.  14 \nMs. Castor.   Thank you.  15 \nMr. Schertler.   And the other name, just for the record?   16 \nDr. Fauci.   Oh, the other name is Gray Handley.  Ping Chen reports directly to Gray 17 \nHandley, who's the head of our Office of Global Health Affairs.   18 \nSo the question was, did I interact at all with Ping Chen, and the answer is no.   19 \nBY MR. BENZINE:  20 \nQ We also talked about Dr.  Stemmy a little bit earlier.  Did Dr.  Stemmy ever 21 \nbrief you about any information he was gathering from Wuhan?  22 \nA The only time that Dr.  Stemmy directly briefed me, multiple times, was in 23 \npreparation for the multiple hearings that I had.  24 \nQ In early January 2020, Dr.  Stemmy had multiple communications with 25 \n\n  \n  138 \nDr. Daszak about the outbreak.  He never told you about that?  1 \nA No, he didn't.   2 \nQ And then also in early January 2020, Dr.  Chen spoke to Dr.  Zhengli Shi at the 3 \nWuhan Institute of Virology about the outbreak.  No one told you about that?  4 \nA No.  5 \nQ We touched on it very briefly, but Dr.  Redfield has previously testified that in 6 \nJanuary of 2020 he was working with Dr.  Gao to get a CDC team into China.  Were you 7 \naware of those efforts?   8 \nA In January of 2020?   9 \nQ Uh-huh.  10 \nA I was aware that we all were trying to get  -- not me personally, but the 11 \nCoronavirus Task Force as well as the CDC were trying to get their team in.  I believe that 12 \nwas before  -- I'm not sure, but before the WHO became the convening group to get a 13 \nteam in.  14 \nQ Okay.   15 \nA But it was clear that the CDC wanted to get a team in there.  Yes.   16 \nQ And then in mid -February 2020, two U.S. scientists, Dr.  Lane from NIAID and 17 \nan individual from the CDC, were part of a 13 -person WHO team that joined a team of 12 18 \nChinese scientists touring a couple cities around China.   19 \nIs that what you were just referencing?  20 \nA Yes.  21 \nQ Did you help coordinate this trip for Dr.  Lane?  22 \nA I'm not sure what you mean by \"coordinate.\"   23 \nQ Were you involved in setting up this trip at all?  24 \nA No, I was not involved in setting up.   25 \n  \n  139 \nI was asked -- and I don't recall by whom; it likely  -- likely, but I don't know for 1 \nsure -- was by HHS -- who would be the best person, who's the most knowledgeable 2 \nabout infectious diseases.  And that certainly would be Cliff Lane, so I recommended Cliff 3 \nLane.   4 \nQ Do you recall any reluctance on the part of the Chinese to let a WHO team 5 \nin?  6 \nA In February, I'm not sure if it was reluctance, but I do recall it was difficult 7 \nfinally getting the team to be allowed to go in.   8 \nQ Uh-huh.   9 \nA It wasn't  -- I don't recall the back -and-forth of the reluctance, but it was clear 10 \nthat they kept on asking to get the team in, and for one reason or other it didn't happen, 11 \nand then finally it did happen.  12 \nQ The \"they\" in that answer is the WHO?  13 \nA No.  It was, I believe, the Chinese -- again, I'm saying I believe, but I don't 14 \nknow for sure  -- that the Chinese were  -- not the Chinese -- the WHO was trying to get a 15 \nteam to go and it was not happening as quickly as people wanted it to happen.   16 \nQ Were there any conversations about why it wasn't happening as quickly?  17 \nA No.  I don't know.   18 \nQ Do you know Dr.  Bernhard Schwartlander?  19 \nA Bernhard Schwartlander is a senior official at the WHO.   20 \nQ Did you ever receive an intelligence briefing regarding Dr.  Schwartlander?  21 \nMr. Schertler.   And, I'm sorry, when you say intelligence briefing \"regarding\" him, 22 \nis it from him or -- 23 \nMr. Benzine.   No, no.  24 \nMr. Schertler.   -- about him?  25 \n  \n  140 \nMr. Benzine.   About him.  1 \nDr. Fauci.   About him?  2 \nMr. Benzine.   Uh-huh.  3 \nDr. Fauci.   I don't recall receiving an intelligence briefing about him, no.  4 \nBY MR. BENZINE:  5 \nQ Did you receive any other types of briefings regarding Dr.  Schwartlander?  6 \nA I don't recall ever receiving a briefing regarding Dr.  Schwartlander.  He's a 7 \nwell-known figure in WHO, and I certainly over the years have had conversations with him 8 \nat meetings or in correspondence.  But I don't ever recall being briefed about him.   9 \nQ Okay.   10 \nThere were some emails early on with him and you about this trip, and, in one of 11 \nthem, you expressed concern about maybe getting zero Americans on this trip.  Do you 12 \nremember that?  13 \nA Could you show me the email?   14 \nQ I can.   15 \nMr. Schertler.   And this is an email with Dr.  Schwartlander; is that correct?   16 \nMr. Benzine.   Yes.   17 \nSo this will be majority exhibit 5.  18 \n    [Fauci majority exhibit No. 5  19 \n    was marked for identification.]  20 \nBY MR. BENZINE:  21 \nQ And it is an email chain from February 9th, and it has Garrett Grigsby, 22 \nDr. Schwartlander, Larry Kerr, Brian Harrison, eventually you, and Dr.  Kadlec and 23 \nDr. Redfield.  And it was produced via FOIA.   24 \nAnd at the very top of the second page is an email from you, where it says, \"I do 25 \n  \n  141 \nnot like the sound of this.  So now we are in the queue with other countries?  Seems like 1 \nhe is talking about at best 1 USA person and maybe even 0 USA people.\"  And you're 2 \nreferring to an email from Dr.  Schwartlander on the second -to-last page.   3 \nMr. Schertler.   I don't know that we've seen this before.  Is it okay if he takes a few 4 \nminutes to just read it?   5 \nMr. Benzine.   Yes.   6 \nMr. Schertler.   So I think you start at the back, if you haven't already, because 7 \nthat's  where the first page would be.   8 \nDr. Fauci.   So the back is just an announcement by  -- it isn't really an email.  He's 9 \njust --  10 \nBY MR. BENZINE:  11 \nQ No, that's just a  --  12 \nA Yeah.  13 \nQ And then  --  14 \nA And then the  --  15 \nQ -- Mr. Grigsby emails Dr.  Schwartlander.  It's all redacted.  And 16 \nDr. Schwartlander responds and  --  17 \nA So Bernhard says, \"We have three people on the way to Beijing who will 18 \nwork with our Chinese counterparts on finalizing the TOR,\" whatever that is -- 19 \nQ Terms of reference.   20 \nA -- okay -- \"and composition of the joint\"  -- oh, so they're trying to put 21 \ntogether the group.   22 \nQ Uh-huh.  23 \nA I see.  Okay.   24 \n\"As you are well aware, the US has given us a number of names who will be able 25 \n  \n  142 \nand willing to join such a mission.  We have received similar proposals from other 1 \ncountries and will now match the 'long list' of experts with the required specific expertise.  2 \nWe hope to have more clarity...keep you in the loop...overall number....\"   3 \nAnd Grigsby says, \"Many thanks!  I know I'll be asked, so I will pass [it along].\"   4 \n\"Brian -- more clarity from 'the horse's mouth'....\"   5 \nAnd I say, \"I don't like the sound of this.  So now we are in the queue with other 6 \ncountries?  Seems like he is talking about at best 1 person and maybe 0 people.\"   7 \nSo I was concerned that we were not going to get eyes on what's going on.   8 \nQ Did you have any communications with anyone at the WHO about ensuring 9 \nthat -- 10 \nA No. 11 \nQ -- Americans were on the trip?  12 \nA No.  I didn't communicate with the WHO about that.  I just wrote to Garrett, 13 \nsaying, I don't like the idea that we might not have anybody going.  14 \nQ Uh-huh.   15 \nAnd you said you recommended Dr.  Lane for this trip?  16 \nA Yeah.   17 \nQ Was he your first choice?  18 \nA Yeah.   19 \nQ He was on the way to Japan to see the Diamond Princess at the time?  20 \nA Yes.   21 \nQ And we talked to Dr.  Lane, and he said that, pretty much, he was, like, 22 \non -- he was boarding a plane at Dulles when he got a call from you that said, \"When you 23 \nland in Japan, you're going to get on a plane and go to Beijing and go on this trip.\"   24 \nDoes that sound like that's what happened?  25 \n  \n  143 \nA Unfortunately for him, that was correct.   1 \nQ Okay.  2 \nA No.  Let me explain what I mean by \"unfortunately for him,\" is that he was 3 \nsort of, like, traveling all over the place.  He was in Japan trying to set up a remdesivir 4 \nstudy on the people who were there.  And no sooner did he land than we said, \"Sorry, but 5 \nnow you gotta go to China.\"  That's what I meant by \"unfortunately.\"   6 \nQ And then he said, while he was on the plane to Tokyo, he got plane WiFi and 7 \nthe State Department and NIH worked on getting him all set up to go to China and the 8 \ncomplications that went with that.   9 \nWhile he was on the trip, he nor the CDC individual were chosen to go to Wuhan?  10 \nA Correct.   11 \nQ Do you -- is that correct?  12 \nA That is correct.   13 \nQ Did you have any conversations with anyone about that?  14 \nA I didn't have any conversations with anyone, but it just  -- I was disappointed, 15 \nbecause Cliff is a very competent person.   16 \nQ Would there have been  -- why do you think they weren't chosen to go to 17 \nWuhan?  18 \nA I don't think they specifically were not chosen.  I think that they allowed  -- if 19 \nmy recollection is correct -- it might not be.  But I think they allowed one person to go to 20 \nWuhan.  And you could understand, if they have a group of multiple people, that they 21 \ndidn't pick Cliff.   22 \nI don't think they specifically said, \"I don't want Cliff to go.\"  I think they just 23 \ndecided they were going to pick somebody else.   24 \nQ Did Dr.  Lane brief you when he returned?  25 \n  \n  144 \nA Yes.   1 \nQ What was the content of that briefing?  2 \nMr. Cooke.   So, again, if we're getting into the details of internal communications, 3 \nwe have a confidentiality interest in maintaining the  --  4 \nMr. Osterhues.   So facts are what you're concerned about disclosing?   5 \nIt has to be deliberative.  Facts are not deliberative.  If he's telling him what he 6 \nsaw -- I mean, come on.  We've been through this in every one of these.  I know you've 7 \nbeen out for a while.  But, again, it has to be deliberative, pre -decisional.  Getting a 8 \nbriefing on what happened in Wuhan or in Beijing is -- should be primarily factual.   9 \nMr. Cooke.   If you recall the general topics you discussed, you can speak to that.  10 \nDr. Fauci.   Yeah.  11 \nBY MR. BENZINE:  12 \nQ So what were the general topics that Dr.  Lane briefed you on?  13 \nA They were mostly clinical topics.  What Cliff was impressed with was the 14 \nequipment and the number of personnel they had working in these hospitals where  -- he 15 \nspent most of his time talking about how effective they were in, you know, every bed has 16 \na monitor, and every bed has a pulmonary physiologist, every bed has a physician, every 17 \nbed has a nurse.  He said, they really are putting a major effort at good clinical care to 18 \nthem.   19 \nOf course, that's his area.  I mean, he's --   20 \nQ Uh-huh.  21 \nA -- one of the best clinicians around.  22 \nQ Dr. Lane said that the final WHO China report, some of the more narrative 23 \nsections should be taken with a grain of salt, is the quote from Dr.  Lane.   24 \nDid you have any conversations with him regarding the language in the report or --  25 \n  \n  145 \nA No.  1 \nQ No?  2 \nA No, I did not.  3 \nQ Did you have any conversations with him regarding whether or not he 4 \nbelieved, being there, that China was controlling the message?  5 \nA I don't remember specific conversations with Cliff that they were controlling 6 \nthe message, but I do recall that he would've liked to have gone to Wuhan.   7 \nQ Uh-huh.  Did you have any discussions with him about whether or not he felt 8 \nlike China was being forthcoming?  9 \nA You know, that wasn't the conversation that I had with Cliff.  Most of the 10 \nconversation with Cliff is how they were handling the people who were sick or who were 11 \nat risk.  It was mostly a kind of a public health commentary about the kinds of things that 12 \nthey were doing.   13 \nQ Dr. Lane wrote that China was good at controlling the outbreak, albeit at 14 \ngreat cost, is again a quote from him.   15 \nA Yeah.  16 \nQ Did you have any conversations with him regarding, kind of, China's extreme 17 \nlockdown policies at that time and their effectiveness?  18 \nA The only thing I can recall about what Cliff said back then was that their 19 \nsocial distancing seemed to have been working, in that  -- I didn't get into the details of 20 \nhow stringent it was, but I remember him saying that their social -distancing program 21 \nseems to be working well in controlling the infection.   22 \nAnd then, as I mentioned a moment ago, the other part of the conversation was 23 \nhe was really struck by their really competent intensive care.   24 \nQ Did you have any conversations with him that would suggest China knew this 25 \n  \n  146 \nwas worse than what they were publicly portraying?  1 \nA No, I didn't.  I think that by the time I had a conversation with him it was very 2 \nclear that there was a big -time disease going on.  3 \nMr. Benzine.   I want to introduce majority exhibit 6.  4 \n    [Fauci majority exhibit No. 6  5 \n    was marked for identification.]  6 \nBY MR. BENZINE:  7 \nQ This is an entry from your calendar from January  17, 2020.   8 \nAnd I have a just, kind of, question on what one thing means.  At 3 o'clock, there's 9 \nan entry, \"Call to Discuss CDC Gao Writing Request.\"  Do you recall what that was?  10 \nA I believe  -- I don't know if this was a specific thing, but around  -- again, I 11 \ndon't know the timing, but Dr.  Gao had approached me about writing an article with him, 12 \nwhich I don't think I did.  But that's what I think this is referring to, to call  -- Gray, I 13 \nbelieve, set it up, because Gao went through Gray -- Gray Handley, that is -- 14 \nQ Uh-huh.  15 \nA -- to try and see if we could co -author a scientific paper.  And, as I recall, I 16 \nbelieve I declined.  Yeah.   17 \nQ Had you had any conversations with Dr. Gao regarding the outbreak prior to 18 \nthis?  19 \nMr. Schertler.   Prior to January?   20 \nBY MR. BENZINE:  21 \nQ Prior to mid -January?   22 \nA You know, I believe I had a conversation with Dr.  Gao, but I'm not sure 23 \nexactly when in the time.  I may have had one conversation.   24 \nLike I said when I was asked before, the only thing I remember about Dr. Gao is 25 \n  \n  147 \nonce I met him here and once I spoke to him on the phone.  But I don't know exactly 1 \ntimeframe, when that was.   2 \nQ We have a few documents to hopefully nail down the timeframe of the 3 \nphone call.   4 \nA Okay.  Sure.   5 \nQ I'm going to introduce majority exhibit 7.  6 \n    [Fauci majority exhibit No. 7  7 \n    was marked for identification.]  8 \nBY MR. BENZINE:  9 \nQ This is an email chain with Mr.  Handley, and then it also has Dr.  Chen and a 10 \ncouple others on it, and is Bates marked SSCP_NIAID 1 and 2.  11 \nYou're not on these emails.  There's no reason that you should have seen these 12 \nemails before.   13 \nAnd I just want to draw your attention to the one from Mr.  Handley at the bottom 14 \nof the first page.  And he said, \"I have asked Ping to reach out to George Gao to see if he 15 \nis interested in having a research information sharing call with ASF.  We will see if he has 16 \ntime to respond.\"   17 \nI'm assuming \"ASF\" is you?   18 \nA That's me.  It's usually only me --   19 \nQ Yeah.  20 \nA -- right?  21 \nQ Dr. Chen responds with a draft invitation to Dr.  Gao with some Chinese 22 \nlanguage in it, which makes sense, and, \"Please let me know if this is acceptable.\"   23 \nMr. Handley responds with some suggestions -- it's unclear, based on this email, 24 \nwhat his suggestions were -- and then said, \"Good to send it via WeChat.\"   25 \n  \n  148 \nA baseline  -- and you may not know:  Does NIAID have any policies regarding the 1 \nuse of WeChat for official purposes?   2 \nA I only heard about WeChat a couple days ago, so I think -- 3 \nQ Okay.  4 \nA -- I think not.   5 \nQ Okay.   6 \nDr. Chen reached out to Dr. Gao.  And, based on these messages, it looks like the 7 \ncall got eventually set up for the night of January 31, 2020.   8 \nNot these messages; the WeChat messages.  I'm happy if you want to see them.   9 \nA No, I don't.   10 \nQ Does that sound about right -- 11 \nA Yeah.  12 \nQ -- for the timeframe with Dr. Gao?  13 \nA Yeah.   14 \nQ Do you recall if there was anyone else on the phone with you?  15 \nA I don't recall.  I don't recall the phone call.  I mean, I don't recall what we 16 \nsaid.   17 \nQ Uh-huh.  18 \nA But when you just mentioned here  -- let me see the thing that  -- \"interested 19 \nin having a research information sharing\" -- that doesn't trigger the conversation I had 20 \nwith George Gao, but it tells me that that's not at all incompatible with somebody 21 \nwanting to talk to me about a research agenda.  Since I'm in charge of infectious diseases 22 \nresearch, that somebody who's in China might want to talk to me about what are the kind 23 \nof things that we might do.  But I don't recall the details of that call.   24 \nQ So what you're saying there -- and I'm just trying to distill it down a little -- is, 25 \n  \n  149 \nthe call may not have been, like, about the Chinese response, but it might have been 1 \ntrying to set up or understand the research agenda to attack COVID -19.  Is that  --  2 \nA In fact, that would be strongly like - -- not \"strongly likely,\" but that would 3 \nbe -- if you were to ask me, what would a call be when someone wants to talk about 4 \nresearch information, it's not rare that when a problem arises that someone would call 5 \nme and say, what is your idea about it?  I mean, how best to investigate?  You know, is a 6 \nvaccine feasible?  How long do you think it would take to get a vaccine?  Or stuff like that.   7 \nQ Uh-huh.  8 \nA That's what I think this is about.   9 \nQ Did you ever speak with  -- to the best of your recollection, did you ever 10 \nspeak to Dr.  Redfield about this call?  11 \nA To my recollection, no, but it's possible.  Yeah.   12 \nQ You kind of just answered it, that you're obviously  -- NIAID is more of a 13 \nresearch organization, maybe, than how people would view the American CDC being.   14 \nA Right.   15 \nQ So that might answer this question.  But was it odd to have this not be a 16 \nCDC-to-CDC kind of conversation versus NIAID -to-Chinese -CDC?  17 \nA I think if he was talking about what kind of research  -- because we're the big, 18 \nyou know, 600 -pound gorilla when it comes to research --  19 \nQ Uh-huh.  20 \nA -- with the amount of money we put in.  So I don't think it would be unusual 21 \nfor him to call me to kind of get a feel for what kind of research is being done and what 22 \nare the best research questions.  23 \nQ Okay.   24 \nI'm going to move on from Dr. Gao and move to Dr.  Baric and just ask a couple 25 \n  \n  150 \nquestions about a couple documents.   1 \nThis will be majority exhibit 8.  2 \n    [Fauci majority exhibit No. 8  3 \n    was marked for identification.]  4 \nMr. Benzine.   And while that exhibit is being passed around, a few members have 5 \ncome in the room.   6 \nDr. Joyce and Ms.  Greene, do you mind identifying yourselves for the court 7 \nreporter?   8 \nMr. Joyce.   John Joyce, representing Pennsylvania's 13th Congressional District.   9 \nMs. Greene.   Marjorie Taylor Greene, Georgia 14.   10 \nMr. Benzine.   I think I caught everyone.  11 \nBY MR. BENZINE:  12 \nQ So this is an entry from your calendar, Dr. Fauci, from January 31, 2020.   13 \nExcuse me.  This is the wrong exhibit.  We can ignore this one.  This is the wrong 14 \ncalendar exhibit.  This was just a -- a Dr. Gao meeting was not on here, but --  15 \nA Right.  16 \nQ -- you think it was around that time.   17 \nA Right.   18 \nQ Since it's already been introduced, we'll move on to 9.  19 \n    [Fauci majority exhibit No. 9  20 \n    was marked for identification.]  21 \nBY MR. BENZINE:  22 \nQ Okay.  Now we have the right exhibit.  So, an entry from your calendar from 23 \nFebruary 11, 2020.   24 \nAnd at 2:30 it looks like, it says, \"HOLD -- Meeting with Dr  Ralph Baric (and 25 \n  \n  151 \nerbelding).\"   1 \nDo you recall if you met with Dr.  Baric?  2 \nA You know, I don't recall, but it's here on the calendar.  So, I mean, it's not 3 \nunusual for me to meet with scientists who pass through D.C., so it's not surprising.  But I 4 \ndon't recall the meeting or what was discussed at the meeting.   5 \nQ Do you recall if anyone else was meeting with Dr.  Baric?  6 \nA If it's in  -- 7A18 is my conference room.  7 \nQ Okay.   8 \nA So it is likely that there are other people involved.  Because when it's a 9 \none-person meeting, I usually meet in my office, which is a couple of  -- you know, a 10 \ncouple of doors down.   11 \nQ Since it says \"Erbelding\" next to it, would it be safe to assume that 12 \nDr. Erbelding would've attended that meeting?  13 \nA It's safe to assume that Dr.  Erbelding would've attended that meeting, yes.   14 \nQ All right.  15 \nA Yeah.  16 \nQ I want to introduce majority exhibit 10 and make sure I have the right one 17 \nthis time.   18 \n    [Fauci majority exhibit No. 10  19 \n    was marked for identification.]  20 \nBY MR. BENZINE:   21 \nQ So this is a memorialization of a Slack message from the Vineet Menachery 22 \nand Matt Frieman.  And it was produced via FOIA, and Bates marked UTSystem 58871.   23 \nDo you know either Dr.  Frieman or Dr.  Menachery?  24 \nA I don't recall.  No, I don't.  Vineet Menachery?  No, I'm sorry.  I may have met 25 \n  \n  152 \nthat person.  Again, when you put scientists in front of me, I meet hundreds of them.  1 \nSo --  2 \nQ Uh-huh.  3 \nA Matt Frieman, same.  I don't see anything.  So let me read this email.   4 \nQ Uh-huh.  5 \nA Yeah.   6 \nQ So I'm going to read the message into the record.   7 \nDr. Frieman writes, \"I talked to Ralph for a long time last night.  He sounds beat.  8 \nHis ACE2 mice are breeding up but not ready for anyone to have.  He said he sat in Fauci's 9 \noffice talking about the outbreak and chimeras.  Clearly he is in other kinds of meetings 10 \nthan what we are invited to!  I joked about his link to WIV, he wasn't very amused.\"  And 11 \nthen a few other things.   12 \nTo avoid beating a dead horse, do you recall anything about Dr.  Baric during this 13 \nmeeting discussing -- 14 \nA No, I don't.  15 \nQ -- the WIV or chimeras?  16 \nA I don't recall, really.  Honestly, I don't.   17 \nQ In 2018, Dr.  Baric, Dr.  Daszak, and Dr. Shi submitted a proposal to DARPA 18 \nnamed \"DEFUSE.\"  Are you aware of that proposal?  19 \nA I heard about a proposal that was submitted to DARPA.  Yes.  It got a lot of 20 \npublicity.  21 \nQ So you heard through the press?  22 \nA I heard through the press, yes.   23 \nMr. Schertler.   And just to be clear, when did you hear about it?  24 \nDr. Fauci.   Yeah.  I don't recall when I heard about it, but I heard through the press 25 \n  \n  153 \nthat Daszak and a couple of others had submitted a proposal to DARPA to do some 1 \nexperiments.  I heard about it because I -- I heard it through the press.  I think there was a 2 \nconfusion that that was an NIH proposal, and it wasn't.  3 \nBY MR. BENZINE:  4 \nQ It came out, kind of, within the last year.  Does that sound about right?  Like, 5 \nit wasn't at the time; it wasn't in 2020.   6 \nA No.  No, no, no.  It was definitely after that, yeah.   7 \nQ So Dr.  Baric didn't tell you about this proposal during that meeting?  8 \nA The first I heard about the proposal was from the newspapers, not Dr.  Baric.   9 \nQ Thank you.   10 \nI want to  -- I will avoid retreading a lot of past topics, but -- talk about 11 \ngain -of-function a little bit.   12 \nAnd and the minority, I think, laid out there's multiple definitions, 13 \nthere's a lot of confusion.  People say \"gain -of-function,\" people say \"gain -of-function of 14 \nconcern,\" people say \"ePPP,\" and they're all talking about different things at different 15 \ntimes and different places under different definitions.   16 \nSo, again, I want to walk through, and, to avoid introducing a whole lot of paper, if 17 \nyou still have them, I'm going to use what the minority introduced as exhibits.  I'll 18 \nannounce them as I go.  19 \nSo, going through this section, I want to focus on the definitions, not necessarily 20 \nthe policies that govern them.   21 \nA Right.   22 \nQ And I'll wait for  -- it's going to be A, is what we're going to start with.   23 \nMr. Schertler.   Yeah, I think we've got the three exhibits here.   24 \nMr. Benzine.   So this is minority exhibit A.   25 \n\n  \n  154 \nMr. Schertler.   I don't think we have the number on it.  What is the title of A?   1 \nMr. Benzine.   It's this one.   2 \nMr. Schertler.   Okay.  Yeah.  3 \nMr. Benzine.   It's the NIH website, \"Gain -of-Function Research Involving Potential 4 \nPandemic Pathogens.\"   5 \nBY MR. BENZINE:  6 \nQ So this page was last reviewed by the NIH on July  12, 2021.  So this page was 7 \nonline until at least July  12, 2021.  We know it was online until October 20, 2021.   8 \nAnd you were read the definition under the header \"Gain -of-Function Research\" 9 \nas describing a type of research that modifies a biological agent so that it confers new or 10 \nenhanced activity to that agent.   11 \nAnd you generally agree with that definition as would apply to broad, big -level, 12 \nkind of the top level of gain -of-function research?  13 \nA The broad generic.  14 \nQ Yes.   15 \nA Not the operational definition or the regulatory definition.  16 \nQ Correct.   17 \nThen, I believe it was  -- I'm going to skip over the pause, but minority exhibit C 18 \noutlined the definition for what would fall under further HHS scrutiny as research that 19 \nwould involve an enhanced potential pandemic pathogen.   20 \nAnd that's defined as -- a potential pandemic pathogen, one that is likely of wide 21 \nand uncontrollable spread in humans and likely to cause significant morbidity and/or 22 \nmortality in humans resulting from the enhancement of the transmissibility and/or 23 \nvirulence of the pathogen.   24 \nSo that's research enhancing potential pandemic pathogens; is that right?  25 \n  \n  155 \nA Reasonably anticipated to enhance the  --  1 \nQ So it would be  -- this definition would be applied when someone proposes 2 \ndoing an experiment?  3 \nA Right.   4 \nQ And the difference between these two, beyond the \"reasonably 5 \nanticipated,\" is primarily the \"enhanced potential pandemic pathogen\" part of it?  6 \nA Right.   7 \nQ A definition that was not introduced but I want to touch on is \"dual -use 8 \nresearch of concern,\" which is defined by the Assistant Secretary for Preparedness and 9 \nResponse as life sciences research that, based on current understanding, can be 10 \nreasonably anticipated to provide knowledge, information, products, or technologies that 11 \ncould be directly misapplied to pose a significant threat, with broad potential 12 \nconsequences to public health and safety, agricultural crops and other plants, animals, 13 \nthe environment, materiel, or national security.   14 \nDoes that sound about right?  15 \nA That was the definition way -- 16 \nQ Okay.  17 \nA -- back before that.  I think the dual -use research of concern was the thing 18 \nthat was discussed, like, years ago.  This, here, supplanted that.  19 \nQ Is there not  a -- I guess, could something be ePPP research, so fall under this 20 \nframework and this definition, but not dual -use research?  21 \nA I'm not sure what you're saying.  I'm just saying that this is the policy 22 \nguidance that was determined by OSTP that the Department created a framework from 23 \nto guide us on research with these types of organism.  This is the framework that was 24 \nused for our definition of the operative definition of \"gain -of-function research of 25 \n  \n  156 \nconcern.\"   1 \nQ Okay.  I guess I'm trying  -- and I'm sorry, and I'll drop it after this.  I'm trying 2 \nto figure out if there are three buckets or if there are two buckets; if there is a bucket of 3 \nhigh -level gain -of-function, that first definition we just talked about, big, broad 4 \ngain -of-function; ePPP gain -of-function  -- 5 \nA Right.  6 \nQ -- and then dual -use research.   7 \nA Yeah.  I believe that the dual -use thing was, in many respects, part of the 8 \nconfusion of what it is that does it.  And these were the things that became the regulatory 9 \nguidelines.   10 \nSo, when I  -- to repeat, when I'm asked is something gain -of-function, I'm referring 11 \nto the operative definition of gain -of-function according to the framework of the 3PCO.   12 \nQ Okay.   13 \nA That's my definition.  That is the regulatory operational definition.   14 \nAnd as we were talking about before, other people use the word 15 \n\"gain -of-function\" -this, \"gain -of-function\" -that, and everybody's got their own 16 \ninterpretation of it.  But when you're deciding whether a grant should be funded, this is 17 \nthe operational definition.   18 \nAnd when I was asked anywhere -- by the Congress, by the Senate, by Senator 19 \nPaul -- this is what I was referring to.   20 \nQ This website has been changed -- and we're going to talk about that in a little 21 \nbit too -- I imagine, in part, because of the confusion.  It's just the timing on the change  -- 22 \nA Right.  23 \nQ -- is kind of interesting.   24 \nBut this was up and confirmable by July 12, 2021.  If this isn't the NIH's definition 25 \n  \n  157 \nfor gain -of-function research, why is it on the website?  1 \nA I can't answer that, because I had nothing to do with putting -- 2 \nQ Okay.  3 \nA -- the definition on their website.   4 \nQ Do you think it being on the NIH website was confusing?  5 \nA I think  -- I don't want to surmise.  That's a speculation.  But I would imagine 6 \nthey changed it because they thought it was confusing.   7 \nQ Okay.  8 \nUnder these definitions -- broad gain -of-function, ePPP gain -of-function -- can 9 \nsomething fall under definition  under Exhibit A and not under definition under exhibit C?  10 \nMr. Schertler.   Could you just clarify that?  So exhibit  A is the website's definition, 11 \nright?  12 \nMr. Benzine.   Yeah.  Could research meet the definition of \"gain -of-function\" on 13 \nexhibit A?   14 \nMr. Schertler.   So which \"gain -of-function\" definition on exhibit A?  Because it 15 \ngoes into  --  16 \nMr. Benzine.   The one under the heading \"Gain -of-Function Research.\"   17 \nMr. Schertler.   So the big, broad definition?   18 \nMr. Benzine.   Yes.  19 \nDr. Fauci.   So the term \"gain -of-function\" describes the type of research that 20 \nmodifies a biological agent so that it confers new or enhanced activity to that agent.   21 \nNow, there are many, many gains -of-functions that  --  22 \nMr. Schertler.   So, if you have that definition, why don't we just go with --  23 \nBY MR. BENZINE:  24 \nQ I'm not disputing that there are many gains -of-function.  I'm trying to 25 \n  \n  158 \ndetermine if something can meet that definition without meeting the standard of more 1 \nregulatory review under the P3CO framework.   2 \nA Yeah.   3 \nQ Yes?  4 \nA Yeah.  I'm trying to think of an example.  So, if a gain -of-function where you 5 \nmake a virus grow better in eggs so that you can then make enough virus to create a 6 \nvaccine, you've made that influenza virus have a gain -of-function.  That does not fall 7 \nunder an ePPP, because it is not a pandemic potential pathogen.   8 \nQ Okay.  Thank you.   9 \nA All right.  10 \nQ I want to introduce majority exhibit 11.  11 \n    [Fauci majority exhibit No. 11  12 \n    was marked for identification.]  13 \nBY MR. BENZINE:  14 \nQ So this is majority exhibit 11.  It is an op -ed in The Washington Post written 15 \nby you, Dr. Gary Nabel, and Dr.  Collins and published December 30, 2011.   16 \nI'll give you a minute to skim it over, but do you generally recall this, writing this 17 \npiece?  18 \nA Yeah.   19 \nQ Why did you draft this article?  20 \nA I believe this was about the time when there was a lot of discussion and 21 \nsome confusion about the articles that were submitted for publication and published on 22 \nthe ferret studies that were done by the Dutch and the University of Wisconsin 23 \ninvestigators.   24 \nQ And that was taking avian influenza, H5N1, and making it transmissible in 25 \n  \n  159 \nferrets.  Is that correct?  1 \nA Right.  2 \nQ At the top of the third paragraph on the first page, you say, \"... important 3 \ninformation and insights can come from generating a potentially dangerous virus in the 4 \nlaboratory.\"   5 \nWhat did you mean by that?  6 \nA I explained that, I believe, in the subsequent part, and I also explained it in a 7 \nsubsequent article in Science Magazine, which means that there are some questions that 8 \nare important for the public health, such as determining are there mutations that signal 9 \nthe evolution of a virus that you would have to be concerned about or that might signal 10 \nyou to the type of antiviral drug that you want to make -- that this important information 11 \ncan come from that, but it needs to be done under very, very careful circumstances by 12 \nvery highly trained and competent investigators.   13 \nQ In this article, you also say that it's important  -- and you kind of just touched 14 \non it  -- it's important that a risk -benefit analysis comparing the -- 15 \nA Yeah.  16 \nQ -- risk of the research to the  --  17 \nA Yeah.  And I was  -- we were very careful in this article, as well as in the 18 \nScience article that was written by Francis and I and not by Gary Nabel, in which we said 19 \nthat, when you do it, you've got to be very careful and you've got to do it with a good 20 \nreason and you've got to make sure that the information you get is important for the 21 \npublic health.   22 \nQ So, in researching for this, there was a -- \"argument\" may be too strong a 23 \nword, but -- a back -and-forth on whether or not Dr.  Fouchier and the University of 24 \nMadison and his Erasmus in the Netherlands should publish their work on H5N1, that, by 25 \n  \n  160 \nvirtue of publishing it, it could be misappropriated -- 1 \nA Right.  2 \nQ -- and used poorly.  3 \nA Right.  4 \nQ How does NIAID review that sort of situation?  Like, do you get a heads -up 5 \non when publications come in that might describe research that could be 6 \nmisappropriated?  7 \nA Well, now you're talking 2024 and 2023.  Absolutely.   8 \nQ Okay.  9 \nA But, back then, things were not as strict.  In fact, this whole scenario of the 10 \nNetherlands -Wisconsin experiments on the ferret are what triggered the pause.  Because 11 \nwhat happened is that these manuscripts were submitted to a journal, and the journal 12 \neditors as well as people who were reviewing it said, wow, you know, they did this 13 \nexperiment; was this done properly?   14 \nIt happened to have been done by very experienced, highly trained investigators.  15 \nBut that allowed the field to say, we really need to start looking at things before the 16 \nexperiments are done.  And that's when the pause occurred.   17 \nAnd, during that pause, we had the 3 -year deliberation of, what are the things 18 \nthat really need to be regulated?  And that's how we came up with the policy guidance 19 \nand the framework.   20 \nBut, back then, this was a wake -up call, yes.   21 \nBY MR. STROM:  22 \nQ So, within NIAID, who does that risk -reward assessment that you guys talked 23 \nabout needing to be done in advance of the experiment?  Is that 24 \nanother  DM- -- Dr. Erbelding's division?  25 \n  \n  161 \nA Yeah.  Well, that's a combination -- now that, you know, we had the wake -up 1 \ncall about those experiments that, fortunately, were done by very competent people who 2 \ndid it correctly -- 3 \nQ Uh-huh.  4 \nA -- that right now there's, I believe, two levels at least, maybe more, of 5 \nreview.   6 \nQ Uh-huh.  7 \nA The peer review who looks at it makes an estimate of it.  But before the 8 \nthing even gets submitted as a grant, the boards at the institutional level -- I think it's 9 \ncalled the Institutional Review Board of an institution -- makes a determination on 10 \nwhether or not it should even be submitted.   11 \nOnce it's submitted, then the DMID, the Division of Microbiology and Infectious 12 \nDisease, staff also makes a determination of whether it's worth doing given the risk.    13 \n  \n  162 \n[4:15 p.m.]  1 \nBY MR. BENZINE:  2 \nQ What about the review process for publications?  So like you said, this kind 3 \nof triggered a thought on  -- \"censoring\" is too strong a word  --  4 \nA Yeah.  5 \nQ -- but reviewing publications  --  6 \nA Yeah.  7 \nQ -- on that could lay out research that could be misappropriated.  How does 8 \nthat --  9 \nA Yeah, right now, most of the time, not always, but most of the time the 10 \npeople who are doing the experiments, who write the paper up, send it in to the program 11 \nstaff out of courtesy to show that we have now a productive amount of research from the 12 \nfunding you give.  13 \nBut sometimes papers come out  -- remember, these are papers that are now 14 \nmodern, being approved  -- that the staff doesn't know about it.   15 \nBut usually they send it to their program staff out of courtesy, and I believe it's to 16 \ntheir benefit because it's telling this program staff, \"See, you funded us, and, look, we 17 \nnow have some productive results from that.\"  18 \nQ Thank you.   19 \nI want to introduce majority exhibit 12.   20 \n  \n  163 \n    [Fauci majority exhibit No. 12  1 \n    was marked for identification.]  2 \nDr. Wenstrup.   While that's going around, let me ask, is virtually all research 3 \npublished?   4 \nDr. Fauci.   The answer is probably not.  And the reason is that sometimes when 5 \nyou get a negative result and you submit it, the journals reject it.   6 \nAnd that's one of the issues that I believe the scientific community is dealing with, 7 \nis that how do you get data out, that you did an experiment, it didn't work, it was a 8 \nfailure, but you submit it to the New England Journal and they say, \"Sorry, we're not 9 \ninterested,\" you submit it to the Annals of Internal Medicine, they say, \"Sorry, we're not 10 \ninterested,\" and then nobody really sees it.  So --   11 \nDr. Wenstrup.   What about not submitting it at all for fear of rejection?   12 \nDr. Fauci.   Oh, i doubt that.  I think most investigators, when they put enough 13 \nwork in it  -- I mean, I can't speak, Mr.  Chairman, for everybody  -- but most investigators, 14 \nwhen they put a lot of work in it, they want to submit it somewhere, even if it's a 15 \nthird -tier journal, just so that they can, you know, get some credit on their CV for it.   16 \nI doubt it.  If there's  -- I mean, I'm sure there's somebody that's done that, 17 \nthat's  decided --  18 \nDr. Wenstrup.   I mean, if their premise was way off, they may not be anxious to  --  19 \nDr. Fauci.   Yeah.  20 \nDr. Wenstrup.  -- show that to the world.   21 \nDr. Fauci.   Yeah, yeah.  22 \nDr. Wenstrup.   So --  23 \nDr. Fauci.   Yeah, I see what you're saying, yeah.   24 \nDr. Wenstrup.   Yeah.  Thank you.  25 \n  \n  164 \nMr. Benzine.   So this is majority exhibit 12.  It's an article written by you in mBio 1 \nentitled, \"Research on Highly Pathogenic H5N1 Influenza Virus:  The Way Forward.\"  And 2 \nit's from the September/October 2012 issue, 2012 issue, so about a year or so later than 3 \nthe Washington Post article.   4 \nI want to draw your attention to one particular section that you wrote in here 5 \nbecause it really stood out.  The second paragraph on the left -hand column about halfway 6 \nthrough, there's a sentence that starts \"Putting aside  -- \" 7 \nDr. Fauci.   Uh-huh.  8 \nMr. Benzine.   I don't know if you see it.  9 \nDr. Fauci.   Yeah.  10 \nMr. Schertler.   Second  --  11 \nDr. Fauci.   Yeah, right here.  12 \nMr. Benzine.   And it reads, \"Putting aside the specter of bioterrorism for the 13 \nmoment, consider this hypothetical scenario:  an important gain -of-function experiment 14 \ninvolving a virus with serious pandemic potential is performed in a well -regulated, 15 \nworld -class laboratory by experienced investigators, but the information from the 16 \nexperiment is then used by another scientist who does not have the same training and 17 \nfacilities and is not subject to the same regulations.  In an unlikely but conceivable turn of 18 \nevents, what if the scientist becomes infected with the virus, which leads to an outbreak 19 \nand ultimately triggers a pandemic?\"   20 \nWhat stood out to me is at least from some of the people we've talked to is this 21 \nsounds almost premonitionary of what could have happened, what one of the possible 22 \nscenarios is for COVID -19 of a well -known, world -class laboratory and scientist, in 23 \nDr. Baric and UNC, collaborating with the Wuhan Institute with known biosafety and 24 \ntraining lapses, them attempting to recreate a UNC experiment, and a lab worker 25 \n  \n  165 \nsubsequently getting infected.  1 \nYou wrote this in 2012.  Is that  -- is the scenario you authored then still possible 2 \ntoday?  3 \nDr. Fauci.   Well, you know, what I was really referring to here is that  -- and it's a 4 \nbroader picture, and I think that's something, Mr.  Chairman, when you said you want 5 \nsuggestions about lessons learned  -- what we really need, even if we have the strictest, 6 \nbest control of what we fund in the United States, we don't have control of what's done 7 \nin other places.  8 \nAnd I would think that if you were to ask  -- and you did ask  -- what lessons that I 9 \ncould suggest to the group, I think we would need a broader international organization, a 10 \nstrengthened WHO or a U.N. or something, to have much more regulatory control of 11 \nwhat everybody does.   12 \nBecause if you just do what we're doing here with this, which our framework, 13 \nwhich is good for us, that doesn't control what's being funded privately or what's being 14 \nfunded by other organizations.  15 \nDr. Wenstrup.   And that's my concern.  I agree with what you just said on that, 16 \nDoctor.   17 \nAnd as I read this, too, you know, I'm a soldier.  I sit on the Intelligence 18 \nCommittee.  I've been concerned about bioweapons before COVID ever came around.  19 \nOur State Department said as far back as 2005 China's interested in bioweapons.   20 \nWhat may be good intentions don't always end up good intentions.  I don't think 21 \nthe Wright brothers ever thought that what they invented could be used to kill 3,000 22 \npeople in one day by flying planes into buildings.  But there's always nefarious people out 23 \nthere, and there's nefarious components to especially adversarial governments.   24 \nAnd that is one of my  -- one of my concerns in this whole process is to what are 25 \n  \n  166 \nwe doing, doing this  -- these research projects in China at all  --  1 \nDr. Fauci.   Right.  2 \nDr. Wenstrup.  -- at all, especially you're familiar with the AMMS, I believe, the 3 \nAcademy of Military Medical Science in China.  Where are they located?   4 \nDr. Fauci.   Yeah.  5 \nDr. Wenstrup.   In Wuhan.  6 \nDr. Fauci.   Right.   7 \nDr. Wenstrup.   I'll let Mitch continue, but I'm just expressing my concerns  --  8 \nDr. Fauci.   Sure.  9 \nDr. Wenstrup.  -- as you are here, I think.  10 \nDr. Fauci.   Yeah, no, I am.  And I think historically that the collaborations that we 11 \nhave had with China for decades have been quite productive, leading to things that could 12 \nbe very beneficial for public health.   13 \nWhat the situation is now, I can't surmise on.  But we've had very good 14 \ncollaborations with the Chinese over the years.  15 \nDr. Wenstrup.   I was in China years ago, and I mentioned that to them.  I said, 16 \nwhen I get my surgical journals, I see papers written by Chinese physicians.  So there's a 17 \nlot we can do together.  But I was more there to talk about fentanyl at the time.   18 \nDr. Fauci.   Okay.  Sorry.  Thanks.   19 \n  \n  167 \nBY MR. BENZINE:  1 \nQ I want to, sitting here today, do you still agree that -- or do you still think 2 \nthat the benefits outweigh the risks regarding this type of research?   3 \nA I think you have to take it on a case -by-case basis.  What is the question 4 \nyou're trying to ask and answer?  Is this the best way to get it?  Is the risk -benefit worth 5 \nit?   6 \nAnd all of those things need to be taken on a case -by-case basis as to what 7 \npathogen you're dealing with, what is the risk of that pathogen.  It's very complicated.  8 \nYou can't say, though, I still agree with this.  You really have to apply it to a specific case.  9 \nQ Okay.  Really quickly, wrapping up our hour, if you could turn back to 10 \nminority exhibit B, it's the gain of function, the deliberative pause document, that one.   11 \nA This one here?   12 \nQ Yes, sir.   13 \nWere you involved in crafting the deliberative pause?   14 \nA Crafting the pause?   15 \nQ Yeah, the language.   16 \nA No.  17 \nQ No?   18 \nA No.  19 \nQ Do you recall who was?   20 \nA No, I don't.  I assumed it was OSTP was involved, I believe.  But the honest 21 \nanswer, I don't know who crafted it.  22 \nQ All right.  And then flipping to minority exhibit C, the P3CO document?  23 \nA This one here?   24 \nQ Yes, sir.   25 \n  \n  168 \nWere you involved in drafting that?   1 \nA No.  2 \nQ Do you know who was?   3 \nA Well, this was at the departmental level.  What it was, was the 3  -- to my 4 \nunderstanding  -- I was not involved  -- is that the 3 -year pause was a combination of OSTP, 5 \nthe National Academies of Science, Engineering, and Medicine, and multiple scientific 6 \nworking groups that were discussing it with individuals who put together a guidance, 7 \npolicy guidance, which then months later the Department used that policy guidance to 8 \ncome up with the framework which came to the paragraph that we've read multiple 9 \ntimes.  10 \nQ Yes.   11 \nA Right.  12 \nQ HHS is the only department to use that OSTP guidance, and NIAID is the only 13 \ndivision within NIH to submit any proposals under the P3CO.   14 \nDoes it  -- it comes across a little strange that NIAID wouldn't be involved in the 15 \ndrafting of the policy that they then have to work under.   16 \nA Well, you know, they may have  -- and, again, I'm not certain -- but they may 17 \nhave tapped into some of our subject matter experts at the program level.  But I certainly 18 \nwas not involved in the drafting of these.  19 \nQ Sitting here today, we've been through, like, obviously been through a 20 \nonce -in-a-generation pandemic.  All of this has come under the microscope.  Do you think 21 \nthe P3CO policy is sufficient?   22 \nA As I've said in the past, we have got to continually  -- and I think it was said 23 \nhere, too, as part of it  -- I didn't say it -- but I think part of it says  HHS will periodically 24 \nreevaluate and modify the process, as necessary, to reflect scientific advances and 25 \n  \n  169 \nchanges in the regulatory landscape.  1 \nSo my feeling, and I publicly expressed this, that I'm always very much in favor of 2 \ntaking a look back and say, do we need to modify these, do they need to be broader, do 3 \nthey need to be changed?   4 \nAnd I believe, if I'm not mistaken  -- I've been out of government for a year  -- I 5 \nbelieve that there is a process ongoing now to relook, do they want to broaden this and 6 \nnot make it so  restrictive to this type of a PPP.  7 \nQ Yes, the NSABB put out recommendations to OSTP to  --  8 \nA Right.  9 \nQ -- to broaden it.  Were you contacted by NSABB during  that process?  10 \nA No, I was not.  11 \nQ Do you think, in your opinion, that it should be broader?   12 \nA Well, my feeling is that there should be more wiggle room, because clearly 13 \nthe amount of anxiety and concern that has been generated by this process means we 14 \nneed to consider, you know, the general public's comfort in this, as well as people who, 15 \nyou know, who made this in a good -faith way over 3 years of discovering it.  16 \nAnd, quite frankly, you recall part of the process wasn't just NSABB and the OSTP 17 \nand others.  They had broad public input.  So now we have the situation where there's a 18 \nlot of concern and discussion  -- test assess, we're sitting here at this table.   19 \nSo I think that we really do.  We need to relook at it, you know, and maybe get 20 \nmore opportunity for people to look at things more carefully to avoid this kind of 21 \nconfusion about what was done correctly or not.   22 \nMr. Benzine.   We are coming up at the end of our hour.  Unless John has any 23 \nquestions, we can  --  24 \nMr. Strom.   I don't.  25 \n  \n  170 \nMr. Benzine.   We can go off the record.   1 \n[Recess.]  2 \n  All right.  We can go back on the record.   3 \nBY  4 \nQ Dr. Fauci, I just wanted to start with a few questions on the general concept 5 \nof zoonotic spillover as it relates to viruses in general.   6 \nWe've talked a little bit about SARS -CoV-2.  But just to start with, I think we, at 7 \nleast here in the subcommittee, we've spent a lot of time examining what a lab accident 8 \ncould look like, exact details, chimeric work, serial passage, different BSL levels.  It's all 9 \ngreat.  That's all important.  We agree.   10 \nBut I'm not sure whether we have always spent the same amount of time fleshing 11 \nout what a zoonotic origin might look like.   12 \nSo could you start and help us by just talking a little bit about historical context for 13 \nzoonotic jumps, whether with coronaviruses or other viruses or whatever pathogen you 14 \nmight choose?   15 \nA Sure.  So as I mentioned earlier, about 70, 70 -plus, maybe 75 percent of all 16 \nthe new infections, namely infections that we had not experienced before, are zoonotic in 17 \nthat they are fundamentally a reservoir in an animal and jump species.  18 \nSo the classical ones that have been studied for years are influenza, the bird flu, 19 \nwhich was the H5N1 and the H7N9, which jumped from a bird, in one case a clearly 20 \nidentifiable chicken outbreak, that led to human infections and then human transmission 21 \nbut not efficient transmission.  22 \nAnother example of a zoonotic is HIV, which clearly, it took several, several years 23 \nto determine what the source was, but it's a chimpanzee.  Very clearly jumped probably 24 \ndecades and decades before the actual recognizable outbreak.  And it was only change in 25 \n\n  \n  171 \ndemographic and sociological circumstances that allowed it to explode in a population.  1 \nSo that's another one.  2 \nAnother zoonotic is Ebola.  And the interesting thing about Ebola is that we still 3 \ndon't know exactly what the steps of it.  We know that bats can harbor Ebola, and we 4 \nknow that there might be a reservoir in forest animals.  We don't know whether the 5 \nforest animal infects the bat or the bat infects it.  But it's a zoonotic that jumps into 6 \nhumans.  It isn't primary.   7 \nAnd you can go on and on.  There are multiple, multiple examples of that.   8 \nNow, just  -- well, I'll wait for your question.  9 \nQ No, please.   10 \nA But to go on a little bit more, sometimes, in fact maybe more often than not, 11 \nwhen there's a jump from an animal species to a human, it doesn't adapt very well for 12 \ntransmissibility, and it's sort of easy to stop.  There are some examples of that.   13 \nOne that we worry about a fair amount in pandemic preparedness for what are 14 \nthe risk viruses that we need to look at sooner rather than later is Nipah virus is one of 15 \nthem that can jump species, infect humans, but we don't have a global Nipah outbreak.  16 \nBut it's something you're concerned about.  17 \nSo there are a number of viruses, and depending upon the species and depending 18 \nupon the fact of they can either jump a species, a zoonotic, and not spread rapidly or they 19 \ncould jump.  And I gave an example in the prior discussion of the 2009 H1N1 influenza, 20 \nwhich clearly was a swine flu, jumped into humans and immediately began to spread 21 \nrapidly.  So various versions.  22 \nQ Is there  -- we've heard sometimes, what, if any, is the special significance of 23 \nbats as the originators?  24 \nA Yeah.  Bats are bad actors.  I mean, we know that.  Bats very, very often are 25 \n  \n  172 \nable to harbor viruses without getting sick and without dying from it.  It's something 1 \nunique about the bats' immune system or lack of the ability to cause disease in different 2 \norgans.  And they are the source of a number of infection s, Nipah being one of them, 3 \nyeah.   4 \nQ Are there  -- when we think about China specifically, I know that that has 5 \nbeen a place where a lot of this research has been focused.  Does China as a country have 6 \nany characteristics or traits that might make it ripe for zoonotic spillover?  7 \nA Yeah, yeah.  I mean, we've studied that and written about that.  And if you 8 \nlook at the animal -human interface, and there are two ways to have an animal -human 9 \ninterface.  You can encroach upon their habitat, or you could bring them into your 10 \nhabitat.  11 \nAnd when we had the H5N1 crises that prompted us to stockpile tens of millions 12 \nof doses of an H5N1 virus, I actually went on a fact -finding trip to multiple countries in 13 \nSoutheast Asia.   14 \nAnd what became patently obvious to us was what we saw were people who were 15 \nsleeping in the chicken coops where there were pig coops next to it and waterfowl were 16 \nlanding on  -- I mean, talk about a perfect storm of people being close to a virus, namely 17 \nflu, that can be a mixing bowl in a pig and that often has occurred by waterfowl.   18 \nSo that's a classic example of Far East  -- China, Indonesia, Laos, Thailand  -- where 19 \nyou see that kind of interaction.   20 \nThe other one is when you bring into a market where you have forest animals not 21 \ncultured, cultivated animals where you sort of have a chicken farm where you have 22 \ncontrol over it, where you bring in exotic animals that never really have an opportunity to 23 \nhave much interaction with people.  So they could harbor an infection that you never 24 \nreally noticed because the public doesn't go into contact with these.  25 \n  \n  173 \nBut when you bring them into a market where you have a lot of people 1 \ncongregating, that really is a perfect setup for I think perturbing a normal animal -human 2 \ninterface.  That was shown to have happened with SARS -1 where it was clear that a bat 3 \ninfected a civet cat.  And civet cats are ceremonial, festive meals, very, very common in 4 \nChina and in Guangdong Province, and that almost certainly is what happened there.  5 \nSo it depends on how you perturb the normal animal -human interface.  That's 6 \nwhat zoonotic infections do.  7 \nQ Great.  So then zooming into SARS -CoV-2 specifically, knowing that we don't 8 \nknow the answer, but in theory what might a zoonotic origin have looked like in the 9 \ncontext of this current virus?   10 \nA Well, a zoonotic origin might look like a bat who is generally the ones that 11 \nare the reservoirs of that interacting with animals in the wild.   12 \nAnd when animals are brought into a marketplace and people have direct contact 13 \nwith that, that could be the scenario where it jumps species, maybe infects someone or 14 \naffects a few people.  Maybe it doesn't have much impact on them, and then that person 15 \ninfects another person.  And then you'll reach a critical point where it actually explodes 16 \ninto a major outbreak.  17 \nQ So there's a body of research out there sort of examining data points on that 18 \nquestion.  If you're able to talk a little bit about your understanding of it, for example, 19 \nthere's a question of whether the extent to which early cases may have been clustered 20 \naround the Huanan Seafood Market.  I don't know if you're familiar with that wor k.   21 \nA I am.  But not being an evolutionary virologist, there are a number of papers, 22 \ntwo in particular, one written by a person called Pekar  and another one written by a 23 \nperson called Worobey in Science magazine, with a commentary in Cell, in which they use 24 \ngeospatial, epidemiological, and virological investigation to come up with not a 25 \n  \n  174 \nconclusion but what they consider  -- and I have to rely on these evolutionary virologists 1 \nwho are international and highly, highly respected people, who feel that it is very likely 2 \nthat the scenario of animals that were illegally in the Huanan fish market in Wuhan  -- and 3 \nwe know that they were there because, according to the papers, that photographs were 4 \ntaken of raccoon dogs and others that should not have been in there, that we know 5 \nanimals were in the market that shouldn't have been there.  Virus was isolated from a 6 \npart of the market where the animals were known to have been.   7 \nAnd then here's where you get into molecular virology that I rely on the expertise 8 \nof people  -- and that's not my lane of expertise  -- is that there were two lineages that 9 \ncame out which really indicate that there were multiple introductions which would be 10 \nvery, very much compatible with there being infection among animals and different 11 \npeople getting infected.  12 \nQ In the case of -- SARS -1 is a good example  -- was it instantaneous that folks 13 \nwere able to pin down that pathway  --  14 \nA No. 15 \nQ -- you described?  16 \nA No, it took quite a while.  And the actual definitive molecular proof took 17 \nyears, even though it, you know, the published data say, well, they strongly suspected this 18 \nafter  -- I don't know, I'll have to take a guess but, you know, a year, we'll say.  But it really 19 \ntook a while.  It took decades, well over a decade to make the connection with HIV for 20 \nsure.   21 \nQ Is it fair to expect that sorting through something like that, you know, even 22 \nin this case would take some time?   23 \nA It would take some time if you had easy access to the potential species that 24 \nare carrying it, which is, you know, one of the reasons why I and others have said it would 25 \n  \n  175 \nbe wonderful if we could be able to go in and sample these animals.   1 \nBecause apparently what happened  -- I wasn't there  -- but apparently what 2 \nhappened was that as soon as there was a realization of the outbreak, the animals were 3 \nkilled and disposed of.  So the evidence might have already been knocked out, which is 4 \nunfortunate.  5 \nQ Knowing that it's not possible to know definitively, do you have a personal 6 \npoint of view about what you think is more likely in this case?   7 \nA I do.  I mean, I, as I've said and I'll say it here, in total open honesty, I have a 8 \ncompletely open mind that it could be either a lab leak or a natural occurrence.  9 \nWhen I read the papers written by an international group of highly, highly 10 \nrespected evolutionary virologists, I lean much more heavily that this is a natural 11 \noccurrence because I don't see any specific data except coincidental innuendoes and 12 \nthings like that, that it's a lab leak.  It certainly could be.  It certainly could be.   13 \nAnd I keep that very open.  And even though people have said that I don't have an 14 \nopen mind, that I'm very open about that.   15 \nBut because something is possible doesn't mean it's equally probable.  And if you 16 \nlook at the scientific data, I think the probability weighs much more heavily toward it 17 \nbeing a natural occurrence.  18 \n.  I appreciate it.   19 \nI think, with that, I'm going to hand it to my colleague,    20 \n  Great.  Thank you.  21 \nBY  22 \nQ Thank you, Dr. Fauci.  I'm  from the Energy and Commerce 23 \nCommittee.   24 \nI just want to echo my colleagues.  Thanks for your time.  Thank you for all of your 25 \n\n  \n  176 \nwork and walking through all of this with us today.  1 \nTo pick up where  left off, you know, you're talking a lot in terms of prior 2 \nflu viruses, other viruses that originated from wildlife reservoirs and that we know that 3 \nthese are circulating and other viruses that have not yet jumped to humans.   4 \nAnd presumably we know what is circulating -- or at least in part -- because of 5 \nwildlife surveillance and monitoring work.  Is that accurate?   6 \nA That is accurate.  In fact, some recent studies, even like a month or two ago, 7 \nthree ago, have shown that there are viruses out in bat populations that are quite similar.  8 \nQ And so just taking a step back, broadly, in terms of thinking about pandemic 9 \npreparedness, understanding not only, you know, what we are directly facing that we 10 \nknow is transmissible to humans but what could become transmissible to humans, could 11 \nyou just talk about where wildlife surveillance and monitoring sort of fits among all the 12 \nother pieces that we've talked about today?   13 \nA Yeah, it is -- it's an essential part of knowing what the threat is, what the 14 \nrisks that are out there, because if you don't have any idea of what's going on out there 15 \nyou have to do surveillance.  Surveillance is absolutely critical.   16 \nIn fact, just dating back to 2009, one of the criticisms of the scientific community 17 \nwith the swine flu of 2009 is we weren't doing surveillance in the pigs to look for viruses 18 \nthat might have the capability of jumping species.   19 \nI remember that very clearly because there was, you know, criticism about that.  20 \nWhy don't we have better surveillance in the animal -human interface, you know, the 21 \npeople who are talking about One Health, namely looking at animals together with 22 \nhumans to be able to have a good idea of the surveillance.   23 \nQ And can you just explain again at a high level what changes have to occur in 24 \na virus that exists in an animal reservoir for it to become transmissible to humans, and 25 \n\n  \n  177 \nhow do we look for that?  1 \nA Yeah.  Well, there's various levels of it.  There could be animals  -- there could 2 \nbe viruses that are in a animal that just needs to jump and it'll go right ahead and infect 3 \nan individual.  It doesn't have to change much.   4 \nThere are other viruses that need to adapt in a host.  And that's the reason why 5 \nthe bat virus that was originally the one that infect  -- not the bat virus but the type of 6 \nvirus that infected the civet cat likely adapted itself in the civet to get the right number of 7 \nmutations to become transmissible and pathogenic to form SARS -CoV-1.  8 \nSo really it is sometimes direct.  There are no good examples that have been well, 9 \nwell documented to my knowledge of bats directly infecting humans with those viruses.  10 \nSo usually what we've seen is a bat will directly infect another species, and the 11 \nvirus will evolve in that species to develop the ability to infect and transmit in humans.    12 \nQ So in many ways is it fair, if we're thinking about the spectrum of pandemic 13 \npreparedness and response, you know, we're at the far end, you have things like 14 \ntherapeutics and vaccines, that this is really at the very, very front end  --  15 \nA Right.  16 \nQ -- of preparedness and understanding what could become a pandemic?   17 \nA Yes.  18 \nQ Okay.  So as a result of that, you know, it's a crucial part of pandemic 19 \npreparedness to sustain and even bolster the wildlife surveillance activities that are out 20 \nthere currently.   21 \nA There's a whole discipline of that in One Health of surveying animals and 22 \nlooking to see what's out there that might actually have even a distant capability of being 23 \nable to transmit.  24 \nQ And can you just talk a little bit about the importance of international 25 \n  \n  178 \ncollaboration in this particular aspect?  I mean, some of the other things we've talked 1 \nabout, you know, you have a gene sequence, for example.  You can, you know, analyze 2 \nthat in your lab from ostensibly wherever.  You don't need the presence of something.  3 \nYou just need data, right?  You can sort do have that kind of analysis.   4 \nBut it seems that wildlife surveillance needs to happen where the wildlife  --  5 \nA Right.  6 \nQ -- is around the globe.   7 \nA Right.  8 \nQ So can you talk about that?  9 \nA It's absolutely critical because once you get a disease that becomes a 10 \npandemic, it doesn't know geographic boundaries.  And we're experiencing that right 11 \nnow.  We have a virus and a disease that evolved in China, and the whole world has 12 \ngotten infected.   13 \nHowever, there are certain pathogens which are very, very specific for particular 14 \nparts of the world.  And if you want to stay ahead of the potential of a pandemic evolving 15 \nfrom that, you have to go to and/or collaborate with scientists in that part of the world.   16 \nYou know, when people ask me that and I try and explain it in lay language is you 17 \ndon't go to Jersey City, New Jersey, to study malaria.  You know, you go to Africa to study 18 \nmalaria or certain countries in South America.   19 \nIt's very much the same when you talk about the diseases we're talking about.  20 \nYou have to have enough global international collaboration to be able to study viruses 21 \nthat might originate in one country but affect any of a number of other countries.   22 \nQ So when there's a reduction for whatever reason in international 23 \ncollaboration in various regions, fair to say then that that limits our ability to see what 24 \nmight be coming at us.   25 \n  \n  179 \nA Right.  As I was mentioning, it takes your eyes off what's possible.  That's one 1 \nof the problems.  2 \nQ Earlier, when you were talking about testing, you said that, you know, 3 \ntesting for SARS -CoV-2 or really any other disease is our eyes during a pandemic in terms 4 \nof the human population.  So fair to think of, like, wildlife monitoring as our eyes in the 5 \nwildlife population, this is what is happening there that could come to us?   6 \nA The analogy is appropriate.  7 \nQ Okay.  I mean, are there instances that you've  seen where work that has 8 \nbeen done in monitoring wildlife and viruses that either have not yet jumped to humans 9 \nor, you know, some ancestor of it may have jumped to humans like some of the other 10 \nviruses that we talked about or the actual work of wildlife monitoring itself and things 11 \nthat we learned about those reservoirs contributed to response of a pandemic like in 12 \nSARS -CoV-2?   13 \nA I think monitoring of wildlife, of waterfowl has allowed us to appreciate, if 14 \nyou look at the history of H5N1, when it got  -- appeared first in China and then it went to 15 \nEastern Europe and then it went to other countries, it was by anticipating that it would 16 \noccur by the flight patterns of wildfowl that actually were going to be ultimately landing, 17 \nas you know, in a certain place.   18 \nAnd it was quite predictive that the wildfowl got infected, and you had spread of 19 \nH5N1 from what was probably the original nidus in China.  It started to be seen in a 20 \nnumber of other countries.   21 \nQ So if I'm understanding correctly, I mean, we've talked a lot about 22 \ntherapeutics, and we'll talk about vaccines and all of that.  But at a sort of practical level, 23 \nthere are things about wildlife surveillance that could inform things like agricultural 24 \nranching practices that are not necessarily as sophisticated as developing a vaccine but 25 \n  \n  180 \nhave the practical effect of mitigating or in some cases maybe even eliminating risk of 1 \nhuman  --  2 \nA Right, yeah, yeah.  So let me give you an example.  3 \nIf you do  -- there are two types of surveillances.  Well, there are more than two.   4 \nBut two in particular are what's called sero -surveillance, where you take serum 5 \nsamples from a large group of people representative of different demographic groups, 6 \ndifferent occupation, different risks, and you could determine from antibodies that are 7 \npresent in an individual whether or not they have been exposed to a potentially harmful 8 \nvirus.   9 \nAnd that actually was done in some of the studies in question where you know 10 \nthat X percent of the population, and you could determine were those farmers, were 11 \nthose peoples that cleaned guano out of caves, were they people who worked in the 12 \nmarkets.   13 \nSo sero -surveillance is one way of do it.  You survey the human population.  14 \nThe other surveillance is to go into the wild, get bat viruses out, and see if those 15 \nviruses might actually be, are they or are they not capable of infecting a human?  Not 16 \ntrying to make them capable, but are they or are they not?   17 \nSo those are the two ways that -- surveillance either of the bat population or 18 \nsurveillance of the human antibody population.  19 \nQ So in terms of, you know, lessons learned from the COVID -19 pandemic, 20 \nwhere does wildlife surveillance fit, if anywhere, in there?  You know, do we need to 21 \nincrease wildlife monitoring, maintain it, add more safety processes?   22 \nA Yeah, I think you need to maintain it.  But you've certainly got to make sure 23 \nit's safely done.  And that's where we get into the question of international collaboration 24 \nand international guidelines of how to do it.   25 \n  \n  181 \nYou've got to do it in a way that's safe and that the risk of doing that is 1 \ncommensurate with the information that you'll get out.  But you really have to keep 2 \nsurveying the potential of what's out there.  3 \n.  At this point I want to turn it over to Congresswoman Dingell for 4 \nsome questions.  5 \nMrs. Dingell.   We're gettin' there.  We're gettin' there.   6 \nDr. Fauci.   No, no, no.  No, Deb, I got to tell you, my phone just went off, and I 7 \nwanted to make sure it wasn't my daughter calling me.  So I was looking at my Apple 8 \nWatch.   9 \nMrs. Dingell.   No worries.  No worries.   10 \nLet's go back to testing, to finish up on what we were talking about.   11 \nSo once we got a good test, there was still a  -- the focus became on focusing up 12 \nthe accessibility of the test.  And it was hard at the beginning.  13 \nWhat was the role of the Federal Government in scaling up the nationwide 14 \ntesting?   15 \nDr. Fauci.   In doing what with the Nation?   16 \nMrs. Dingell.   Scaling up  --  17 \nDr. Fauci.   Scaling.   18 \nMrs. Dingell.   -- the Nation.   19 \nDr. Fauci.   Well, the role of the Federal Government was that we should have 20 \nmade, and did in some respects, make testing widely available.  I mean, if you go back in 21 \nstatements that I've made way back is that the words I use is that we should be flooding 22 \nthe system with tests in the same way that we mentioned keeping eyes on what's going 23 \non, particularly as we got more information that the virus was spread in many cases by 24 \nasymptomatic people.  25 \n\n  \n  182 \nMrs. Dingell.   So let me  -- how did you partner with State and local government?  1 \nAnd by the way, that didn't happen at the beginning, as you well know.   2 \nDr. Fauci.   Right.  3 \nMrs. Dingell.   So what were the issues?  Why did  -- and how do we prevent 4 \nsomething like that happening in the future?   5 \nDr. Fauci.   Well, if you're talking about the issue of lessons learned and how do 6 \nyou prevent that in the future, you've got to immediately, when you have a test, you've 7 \ngot to get the private sector involved in making tests that are inexpensive, sensitive, 8 \nspecific, and available to everyone who needs it, and particularly when you're dealing 9 \nwith a highly transmissible virus like a respiratory virus.   10 \nAnd you're right, that was not done.  And when it finally got close to that, it took a 11 \nlong time to get there.   12 \nMrs. Dingell.   So what was the role of the Federal Government?  How did you 13 \npartner with State and local?  I mean, I remember going through tents for  -- I mean, we 14 \nhad drive -through testing for a long time.   15 \nSo what is  -- what  -- and what challenges did the Federal Government play?  16 \nWhat's the Federal Government's role?  What's the State and local role?   17 \nDr. Fauci.   You know, that's a good question that's argued about that.  There are 18 \nsome that feel that this is a local issue and the States should be the ones that are 19 \nresponsible for that.   20 \nBut when the States don't do it and you have a situation where there's a public 21 \nhealth issue at hand, that's when you start talking about maybe the Federal Government 22 \nshould step in and do that.  23 \nMrs. Dingell.   I think that's going to become a bigger issue, because when you 24 \nwere talking about public health before  --  25 \n  \n  183 \nDr. Fauci.   Right.  1 \nMrs. Dingell.   -- a lot of public -- local public health departments aren't being 2 \nfunded.  Local governments don't even have the money.  So  --  3 \nDr. Fauci.   Yeah, I'm totally aware of that, Congresswoman.  And I've learned that 4 \nby I -- one of the comments that I made in response to a question that was asked, I'm not 5 \nsure if it was from the majority or the minority, that when I got on the phone and spoke 6 \nto the people in the trenches, and there were multiple cities that I called every other 7 \nTuesday  -- L.A., Seattle, Washington, Chicago, New Orleans, and D.C. -- and they all said 8 \nexactly what you said, \"We don't have any tests.\"  And that was really a problem.  9 \nMrs. Dingell.   So what were the challenges that the Federal Government faced in 10 \ngetting it scaled up more quickly?  Or was it that you  -- the Federal Government didn't 11 \nthink it was  --  12 \nDr. Fauci.   Well, in the beginning there weren't good tests that could be used.  So 13 \nthere was a whole period that we just didn't have the tests that were sensitive, specific, a 14 \n15-minute test that could be used by anybody.   15 \nWhen we finally did get it, we didn't get enough of them distributed.  And in order 16 \nto -- there were a lot of different problems.  Like one of them was, you know, a test could 17 \nbe used  -- this was before the rapid test  -- a test could not be used unless somebody was 18 \nthe contact of someone who has a symptom.  But that was almost oxymoronic because 19 \nmost of the people were not  asymptom -- were asymptomatic.   20 \nSo if you can only get a test by someone who was the contact of a symptomatic 21 \nperson, you're missing all of the asymptomatics.   22 \nMrs. Dingell.   So what are lessons learned that you'd recommend for the future?   23 \nDr. Fauci.   I think we should put in an extraordinary  amount of -- not 24 \nextraordinary  -- an ample amount of resources into making tests widely available at the 25 \n  \n  184 \nlocal level.   1 \nMrs. Dingell.   If we had been able to do that sooner than we did, would it have 2 \nmade a difference in what happened in this country?   3 \nDr. Fauci.   I think it would have made a difference.  The degree of the difference, I 4 \ndon't think I can accurately quantitate.  But I think if we had a test easily available 5 \nthat -- and people were encouraged to utilize the test, people would not have 6 \ninadvertently infected anybody, particularly vulnerable people.  7 \nI mean, if there was a test where someone knew, I test myself, I'm not going to go 8 \nand visit my grandmother or my mother who's, you know, has a compensated  -- I mean a 9 \ncompromised immune system, I wouldn't do that.   10 \nMrs. Dingell.   So we're looking at an increase in COVID -19 right now.   11 \nDr. Fauci.   Right.  12 \nMrs. Dingell.   There's nobody in this room that doesn't know somebody that has 13 \nit.   14 \nDoes testing still play a role  --  15 \nDr. Fauci.   Oh, absolutely.  16 \nMrs. Dingell.  -- in managing it?   17 \nDr. Fauci.   Absolutely.  18 \nMrs. Dingell.   And then how do we make sure  -- I'm very concerned that not 19 \neverybody  -- I test every day only because I don't know who's got it and who doesn't.  20 \nAnd I'm with a  -- this is the smallest group of people I'm with in a room.   21 \nBut how do we  -- what do we need to do to make sure that  -- a lot of people can't 22 \nafford to get a test every day.   23 \nWhat's the Federal Government's responsibility?  State and local?  What do we do 24 \nto address this going forward?   25 \n  \n  185 \nDr. Fauci.   Again, I don't have control over that.  But if I were able to do that, I 1 \nwould say we need to make copious tests freely available to anyone who wants it, 2 \nparticularly when you're in the middle of now a resurgence.   3 \nMrs. Dingell.   So I guess -- I have a lot more questions.  But I want you to have 4 \ntime, and I know he's going to be ready to go.  5 \nSo I'm going to turn it over to Kathy Castor so we can end this for you at some 6 \npoint.   7 \nMs. Castor.   Dr. Fauci, I'm Kathy Castor.  I'm in my 17th year in Congress.  A lot of 8 \nthat time has been on the Energy and Commerce Committee.  So over the years you have 9 \nadvised us.  I remember very well during Ebola many of your visits.  The symptoms of 10 \nEbola were  -- are scary.  So that did capture a lot of attention.   11 \nYou were there as we were grappling with Zika.  Zika was of particular concern 12 \nbecause I represent the State of Florida.  It's a mosquito -borne illness.   13 \nAnd it was surprising along the way because at first it was, I guess, did it 14 \ndetermine in Brazil and it passed from mother to fetus and caused some very significant 15 \nencephalitis.  16 \nBut then we  -- it evolved over time, and it turned out it was also you could pass 17 \nalong that disease through sexual transmission.  That was a surprise, wasn't it?   18 \nDr. Fauci.   Correct.  19 \nMs. Castor.   And then throughout the COVID -19 pandemic we relied on you.   20 \nAnd I just want to thank you for your years of advising policymakers like us that 21 \ndon't have that base of scientific knowledge and always putting it in real -world terms so 22 \nthat we can understand it, so that we can pass along to our  -- the folks we represent back 23 \nhome the best advice as things evolve with a lot of these epidemics and pandemics.  24 \nI also want to focus a little bit on lessons learned, build a little bit on -- not on 25 \n  \n  186 \ntesting, but on what we've learned on public health data.   1 \nWe -- right off the bat folks back home, after COVID -19 blew up in early 2020, they 2 \nwanted to know where is it, who is susceptible to it, where  -- and we were grappling with 3 \nall of those issues.   4 \nMeanwhile, we can look at  -- we had kind of a baseline of different public health 5 \nauthorities.  The State of Florida at that time had  -- we had a pretty strong public health 6 \nsystem built up over decades that helped report illnesses at the county level, reported up 7 \nto the State.  The State had pretty good dashboards.  A lot of communities did not have 8 \nthat kind of public health data.   9 \nI think a lot of folks thought the CDC, you could go right to the CDC website and 10 \nsee a lot of information.  But their data gathering over time, it's not immediate, is it?  You 11 \ncan't go to a CDC page and see a dashboard in real time of public health concerns in a 12 \ncommunity.  Is that correct?   13 \nHow would you characterize it?   14 \nDr. Fauci.   Yeah.  I would  -- I would characterize what you're bringing up as one of 15 \nthe major stumbling blocks and problems that we had with the pandemic.  It's a 16 \ncombination of the CDC not having the capability or even the authority of getting 17 \non-the-ground local public health information that in real time they could know what's 18 \ngoing on.  19 \nIt's -- and, in fact, when you know the CDC went through an internal review, and 20 \nthat was one of the many difficulties that were pointed out, is that they don't get data in 21 \nreal time.   22 \nPart of it might be their fault, but part of it is the  fault of the system where data 23 \nthat comes in at the local public health is so fractionated in our country, we don't have 24 \none system that when a  -- and I'm going get to and I'll be concise about it -- but get into 25 \n  \n  187 \nan example of that.  1 \nIf someone comes in and they're infected, that test may not get reported.  If it 2 \ndoes, it gets reported locally.  And it doesn't necessarily go to a central system.   3 \nSo at any given time, depending upon how well the local is collecting data, how 4 \nwell the local who collects data is giving it to the central system, so that the central 5 \ndashboard is generally anywhere from weeks to, believe it or not, months behind.   6 \nAnd we knew that because in the middle of many of the waves of variants that we 7 \nhad, the information that we, and I even personally as part of the various Coronavirus 8 \nTask Force and Coronavirus Response Teams, we had to get on the phone with our 9 \ncolleagues in South Africa to figure out what was going on with the trend of the virus.  We 10 \nhad to get on the phone with our colleagues from Israel and find out.  We had to get on 11 \nthe phone with our colleagues from the U.K.   12 \nIt was a humbling experience that they knew more about what the trend of the 13 \nvirus was than we did in our own country.  That is a lesson learned we've got to correct.   14 \nMs. Castor.   So in the  -- Congress did act, and through the public health 15 \nemergency we kind of unlocked some data streams.  So hospitals were required to report.  16 \nI think skilled nursing centers were required to report.  They would report infections.  17 \nThey would report deaths.  They would  -- I guess they were  -- we were trying to get a 18 \nhandle on age -related data, race -related data, urban, rural.   19 \nWas that helpful to you?   20 \nDr. Fauci.   It was helpful but -- it was necessary, but it was not sufficient.  It wasn't 21 \ndone completely to make it equivalent to what our colleagues in other countries who 22 \nknew essentially immediately in real time what was going on.  23 \nIt was the right direction, and we need to keep going in that direction, but it didn't 24 \nsolve the problem.   25 \n  \n  188 \nMs. Castor.   So I learned from folks back home in the Tampa Bay area that it's so 1 \noutdated that they were even reporting basic public health data to CDC via fax machine in 2 \nthe year 2020, 2021.  3 \nDr. Fauci.   That is true.  4 \nMs. Castor.   Is -- and I know that they  -- we gave -- the Congress, bipartisan, in the 5 \nearly CARES Act, I think, we -- no, it was  -- yes, I think it was in the CARES Act.  We said 6 \nhere are resources to help modernize so that locals don't have to go through faxing this 7 \nmaterial.  8 \nBut there's a better way, isn't there, in this digital age to be more efficient and 9 \nsave taxpayer money rather than relying on fax machines and doing things digitally?  10 \nWould you agree?   11 \nDr. Fauci.   I would agree.  I would agree with you.  12 \nMs. Castor.   And that would also help us understand any kind of health concerns 13 \nin a region or locally or among a certain population or in a rural area, wouldn't it?  14 \nWouldn't that kind of real -time data be helpful to preventing the spread of disease or 15 \ntackling any problem?   16 \nDr. Fauci.   The answer is an overwhelming yes, of course.  When you're dealing 17 \nparticularly with a rapidly moving target, the way COVID was clearly a premier example of 18 \na rapidly moving target, you have to stay with it and hopefully ahead of it instead of 19 \nweeks, if not months, behind it.  20 \nMs. Castor.   So the  -- that's why it was entirely frustrating, coming from the State 21 \nof Florida, where we had invested over time in public health and we had good  -- fairly 22 \ngood reporting systems, and yet kind of withered.  Like Rep. Dingell mentioned, across 23 \nthe country, it's kind of declined, the State and local investment in public health and local 24 \nhealth departments.  25 \n  \n  189 \nBut there was a point where leaders in my State started to hide the data.  And this 1 \nwas a particular concern because we have in our State constitution a requirement for 2 \npublic records law.   3 \nSo a lot of this was public records that my hospitals but just all of my neighbors, 4 \nthey wanted to know how widespread are the infections, can their kids go safely back to 5 \nschool in this area.   6 \nAnd at the time of the Delta surge in 2021 it seemed like there was this political 7 \nturn by leaders in my State.  And they actually started to take down public health data 8 \nthat had been publicly available.  And it just seems like from  -- you know, I think it cost 9 \nlives.  10 \nThey're downplaying the vaccine efficacy.  Some of the misinformation.  And now 11 \nwe're running into, at the time the delta surge is on the increase, heading into the 12 \nsummer of 2021, to withhold that data would be just the last thing that you would want 13 \nto do.  14 \nDid that ever get your attention at that point?   15 \nDr. Fauci.   No, I don't recall  --  16 \nMs. Castor.   Well  --  17 \nDr. Fauci.   -- coming to my specific attention that Florida was withholding data.  18 \nThat would be much more something that would come to the attention of the CDC.  19 \nMs. Castor.   Oh, and it did.  And it did.  And it actually, there  -- this is top of mind 20 \nbecause it is in our State constitution, public records, and we have a strong public records 21 \nlaws.  Governor DeSantis was sued for it, and just a couple weeks ago they had to settle 22 \nthe case and admit they were wrong and pay attorneys ’ fees.  23 \nBut that's why it kind of goes back to we've got to  -- it seems like it would  be -- it 24 \nwould be wise and cost effective and it would save lives if we did have some basic 25 \n  \n  190 \nrequirement that States report real -time health data to the CDC really and that you 1 \nmodernize it.   2 \nWould you agree  --  3 \nDr. Fauci.   Yeah.  4 \nMs. Castor.   -- with that?   5 \nDr. Fauci.   Yeah.  I'm not -- I can't address Florida specifically, but, in general, the 6 \nidea of a requirement to report data centrally so that there could be the kind of robust 7 \ndashboard that we're talking about I believe is one of the things that was discussed in 8 \nhow you get the CDC to be a more effective agency.   9 \nPart of it was to making sure they get the data in real time on time, and one of the 10 \nways to do that is to make it a requirement that the States give them the data.   11 \nMs. Castor.   It's the same kind of consternation we have with China, isn't it?  We 12 \nknow they haven't been transparent.  That's been one of our  -- something that's  -- that's 13 \nconfounded us along the way.   14 \nDo we know how many people died in China  --  15 \nDr. Fauci.   No.  16 \nMs. Castor.  -- based upon COVID -19?   17 \nDr. Fauci.   No.  I mean, they report a certain amount, but I don't think many 18 \npeople take that as what the actual number is.  But I don't know myself how many people 19 \ndied in China.  20 \nMs. Castor.   So the same consternation applies to here in the United States.  21 \nBut I'm concerned when State officials deny us the transparent information that 22 \nwe need, just like we get fed up with China not being transparent.  And what they did 23 \nimpacted the world and we can't  -- we still can't  -- don't have the animal samples that we 24 \nneeded to take conclusions farther.  25 \n  \n  191 \nBut this is the same frustration at the State level, too.  We need this basic data for 1 \npeople to make decisions about their lives.  2 \nSo thank you very much for letting me go over that.   3 \nI'll turn it over to you.  4 \n  So just to follow up on a finer point on something that 5 \nCongresswoman Castor raised, as I understand it, when we look at the process of 6 \ncollecting public health data in the United States, one key obstacle we're navigating is 7 \nthat there is a lack of a uniform standard or baseline for reporting data to the CDC.   8 \nIs that correct, Dr. Fauci?  9 \nDr. Fauci.   That is correct, yes.  10 \nAnd so as we look to planning for future pandemics, as we look to 11 \npreventing and addressing future outbreaks, are there modifications to the process of 12 \ncollecting public health data through the CDC that we made during this past pandemic 13 \nthat we should consider carrying forward for future outbreaks or future public health 14 \npreparedness? 15 \n\n  \n  192 \n[5:29 p.m.]   1 \nDr. Fauci.   You know, I'm not actually sure exactly what modifications you're 2 \ntalking about.  So I can't answer that question in a way that I feel comfortable with.   3 \nBY    4 \nQ Okay.  But as a general matter, establishing that baseline threshold  -- kind of 5 \nwhat Congresswoman Castor was describing -- or a baseline standard would be a step 6 \nforward?  7 \nA Yeah.  I can say that the ability to get all the data and make it available in a 8 \ncentral depot where you can utilize that data for the good of the entire country is 9 \ncertainly a desirable direction to go in.   10 \nQ And I think as we have been discussing or deliberating over the topic of 11 \nstrengthening Federal public health data collection, some have expressed reticence or 12 \nconcern about that being an overreach or that being intrusive.   13 \nDo you have sort of a perspective on that criticism?  Or what would you say to 14 \nthose folks who have concerns about public health data collection?  15 \nA Well, as a physician and someone who's been involved with this, I would 16 \nwant to know why they think that would be an overreach.  I mean, if it's data that is going 17 \nto have the ultimate effect of being able to respond better to an outbreak both nationally 18 \nand locally, I'd try to sit down and talk to them and find out why they feel that that's 19 \nsomething that is not beneficial.  20 \nQ Because, of course  -- and I anticipate you will agree  -- but just for the record, 21 \nup-to-date public health data is the foundation of ensuring accurate and responsive 22 \npublic health guidance during times of crisis.  23 \nA Yes.   24 \nQ Is that correct?  25 \n\n  \n  193 \nA I mean, up -to-date public health data is absolutely important in general, but 1 \nalso very important when you're in the middle of an outbreak.  2 \nQ Is there anything else you'd like to add on the topic of public health data 3 \ncollection?  4 \nA No.  That's good.  5 \nQ So then, again, looking to the idea of preparing for future pandemics, taking 6 \nlessons we've learned from COVID -19, and carrying them forward, I'd like to discuss with 7 \nyou where things stand with therapeutics for COVID -19 and continued efforts to develop 8 \nCOVID -19 therapeutics, and then the idea of getting ahead of -- the process to develop 9 \nmedical countermeasures for future health threats.   10 \nSo although the public health emergency for COVID -19 ended last year, it 11 \nobviously is very important to stay on top of COVID -19.  We discussed the current uptick 12 \nin cases.  We understand that COVID -19 continues to pose a threat to the medically 13 \nvulnerable, people like the elderly, those who are immunocompromised.   14 \nJust briefly, could you explain for us why COVID -19 continues to be a threat for 15 \nthose populations specifically?  16 \nA Well, it's certainly a threat because we're having an upsurge in cases right 17 \nnow, which is the second largest uptick in surging cases since the beginning of the 18 \noutbreak.  It isn't nearly as high as the highest, but it is the second highest.  And we still 19 \nhave a considerable number of people in the population who are vulnerable.   20 \nAnd the deaths are going up right now.  The last that I saw a couple of days ago, 21 \neven though the deaths are very much lower than they were at the worst part, when you 22 \ncompare it to what the deaths were a couple of weeks to a month or so ago, we were 23 \ndown to less than 100 deaths per day, and now, the last time that I looked, was 1,400 24 \ndeaths in a week, which means that there was 200 deaths a day.  So it's going up.  So 25 \n  \n  194 \nwe're not -- COVID is not completely behind us by any means.   1 \nQ And so an important way we can continue to reduce the threat of 2 \nCOVID -19 -- the ongoing threat of COVID -19 to vulnerable populations is by investing in 3 \nthe development and continued availability of therapeutics.   4 \nYou mentioned some of these therapeutic options earlier during today's rounds, 5 \nbut for the record, would you mind just briefly explaining for us the current therapeutic 6 \noptions that are available to treat COVID -19?  7 \nA The therapeutic options are a number of drugs.  The one that has been used 8 \nthe most and is effective in a number of studies to show it decreases hospitalizations, 9 \nparticularly for those who are at a higher risk, is Paxlovid.  And there's molnupiravir, and 10 \nthen there is remdesivir, and then there's a drug from a Japanese company  -- Shionogi is 11 \nthe company.  I don't know what their latest name of the drug is.   12 \nBut antiviral drugs are really critically important to continue to develop them.  13 \nAnd, in fact, before I left when I was the director, we put together a proposal to have a 14 \ndrug development program that would be developing new drugs for COVID that 15 \nunfortunately did not get the funding that it needed.   16 \nQ And so you mentioned Paxlovid specifically.  I'd like to zoom in on that just a 17 \nlittle bit.   18 \nFor those of us who are not scientists, would you mind just briefly explaining why 19 \nPaxlovid is particularly effective at treating COVID -19?  20 \nA Well, Paxlovid is a drug that interferes with one of the enzymes that the 21 \nvirus needs to replicate.  So it is what's called a direct antiviral drug.  It's a drug that's 22 \ngiven over -- well, initially over a 5 -day period, and it diminishes the likelihood that you're 23 \ngoing to have advanced disease and go to a hospital and die.  So it's an important tool in 24 \nour armamentarium against COVID.   25 \n  \n  195 \nQ So you mentioned the importance of taking Paxlovid within that 5 -day 1 \nwindow.   2 \nA No, no.  I said it's given on a 5 -day course.   3 \nQ Thank you.  As I understand it, however, taking Paxlovid within sort of the 4 \nimmediate realization of your symptoms or your immediate infection is a critical 5 \ncomponent of ensuring that the treatment is as effective as it can be.  6 \nA Right.  7 \nQ Is that correct?  8 \nA It is most effective if given within the first 24 to 48 hours, but it has some 9 \neffect after.  Most effective -- the earlier you give it, the better.   10 \nQ And so could you, just for the record, you know, briefly explain the process 11 \nby which a patient would go about accessing Paxlovid?  12 \nA Well, you know, the reason I'm hesitating is that, when I was at the NIH, we 13 \nwere in a tertiary hospital.  So the easiest way my patients would get it is I would 14 \nprescribe it and give it to them, and they would go to the pharmacy and get it.   15 \nBut an outside patient would have to get a prescription from the 16 \npharmacy -- excuse me -- a prescription from their physician to allow them to go to a 17 \ndrugstore and get the Paxlovid.   18 \nQ And so recognizing that that process can be time -consuming, are there steps 19 \nthat we should be considering or that could be considered to streamline the process by 20 \nwhich patients access Paxlovid?  Again, recognizing that the first 24 - to 48 -hour period is 21 \ncritical.   22 \nA There was a program -- and I have to tell you, I am not sure what the status 23 \nof that program is, whether -- it may have gotten started or may not have gotten off the 24 \nground  -- which was called Test and Treat, which was a program where you can go to a 25 \n  \n  196 \npharmacy and you could get a test for COVID, and if you're positive, the positive test 1 \nalone would allow you to get the prescription.  2 \nQ And so some patients, as I understand it, have expressed a hesitation to take 3 \nPaxlovid over this concept of rebounding  -- a reemergence of symptoms, testing positive 4 \nafter testing negative  -- following taking a course of Paxlovid.   5 \nWhat would you tell COVID -19 patients who may be concerned about this concept 6 \nof rebounding?  7 \nA I would tell them that the risk of rebound is overcome by the enormous 8 \nbenefit of the drug itself.  So when you talk -- we've been talking today a lot about 9 \nrisk-benefits.  That if an individual takes Paxlovid, the data is showing the positive impact 10 \nin preventing progression of severe disease, particularly in those who are at a higher risk, 11 \nis well worth any increase or not in the rebound percentage associated with Paxlovid.   12 \nThe one thing that I might mention that's another unfortunate aspect of the 13 \nunderutilization of Paxlovid is the fear on the part of physicians of the drug -drug 14 \ninteraction.  And there is a misperception.  For example, the most common drug that 15 \npeople are on that synergizes, in a sense, with Paxlovid and is one of the drug -drug 16 \ninteractions is the lipid -lowering agents.   17 \nAnd what people don't understand is that if you're taking Lipitor or Crestor or one 18 \nof those drugs for your cholesterol or your triglycerides, if you stop that drug for the 5 19 \ndays of the Paxlovid, nothing bad is going to happen to you vis -à-vis your cholesterol.  20 \nAnd yet there's this unrealistic feeling that, oh, my goodness, I'm on Lipitor.  I can't take 21 \nPaxlovid.   22 \nAnd people are not doing it feeling that there's some horrible consequence of the 23 \ndrug -drug interaction when, in fact, you stop your Lipitor for 5 days and go back on it 24 \nafter 5 days and there's no problem, and yet you have the benefit of Paxlovid.   25 \n  \n  197 \nQ And then just with the few moments remaining in this round, I'd appreciate 1 \nyour perspective on the current landscape for ongoing work to develop new COVID -19 2 \ntherapeutics.  Are we doing enough to develop new COVID -19 therapeutics?  Could we be 3 \ndoing more?  And if so, what would that look like?  4 \nA Yes.  I believe we can be doing more, because when I was the director, we 5 \nput together a program that was an individual program of which I put one of my own 6 \npeople on as the leader of that program, and we were supposed to get a considerable 7 \namount of money, and we did not because of the restrictions on the budget.   8 \nBefore closing out this round, I just wanted to take a moment to 9 \nsee.   10 \nCongresswoman Dingell, Congresswoman Castor, any followup from this round?   11 \nOkay.  Then I think we can go off the record.   12 \n[Recess.]  13 \nMr. Benzine.   We can go back on the record.   14 \nBY MR. BENZINE:  15 \nQ I want to talk really briefly generally about the Wuhan Institute of Virology 16 \nand your knowledge of it.   17 \nDid you have any knowledge of the Wuhan Institute of Virology prior to the 18 \npandemic?  19 \nA I don't recall specific knowledge about it.  Again, as I mentioned several 20 \ntimes, when we have discussions in our conference room about grants, someone may 21 \nhave mentioned Wuhan, but I didn't specifically know Wuhan, and Wuhan is doing this, 22 \nand et cetera.  So the first time I really heard about it was after the outbreak.  23 \nQ The Office of Director of National Intelligence reported that WIV personnel 24 \nhave worked with the People's Liberation Army.  Do you have any awareness of that?  25 \n\n  \n  198 \nA No, I have not.  1 \nQ They also reported that --  2 \nA I heard all these things after.  I mean, you know  --  3 \nQ As the reports kind of came out?  4 \nA Well, I mean, after all of these hearings and investigations about --  5 \nQ Okay.   6 \nA I had no knowledge of any connection with the Army or the Communist 7 \nParty or anything like that.  8 \nQ ODNI also reported that the WIV first possessed SARS -CoV-2 in late 9 \nDecember of 2019.  We've talked about this a lot.   10 \nA Right.   11 \nQ Obviously no knowledge of that?  12 \nA No.  13 \nQ Along this line of discussion that we've talked about a lot, Dr. Holmes, Dr. 14 \nFarrar, a Chinese genomics company, the Chinese CDC, Dr.  Daszak, whoever told 15 \nDr. Daszak, seems like there was an awful lot of people that knew that this was a 16 \ncoronavirus by late December, yet China was reporting undiagnosed pneumonia.   17 \nIs that kind of standard in disease outbreak reporting, or would that concern you?  18 \nA I'm sorry.  The question is what?   19 \nQ We've talked about a lot today that there were a lot of people that knew 20 \nthat it was a coronavirus.  The Chinese Government knew that it was a coronavirus.  ODNI 21 \nassessed that, and the Chinese CDC had the sequence.  Dr.  Daszak knew it was a 22 \ncoronavirus.  Dr. Farrar knew it was a coronavirus.  Dr. Gao knew it was a coronavirus.  23 \nDr. Holmes knew it was a coronavirus.  Yet the public reporting was undiagnosed 24 \npneumonia.   25 \n  \n  199 \nI'm just wondering if that's kind of -- like, in outbreak reporting --  1 \nA No, I can't comment on that.   2 \nQ Okay.   3 \nA I don't know what they were thinking and why they didn't report it.   4 \nQ Okay.  Okay.  The ODNI also reported that the WIV has the capability of 5 \noperating genetic engineering projects that would make it difficult to detect intentional 6 \nchanges.  Do you have any knowledge of that?  7 \nA No.  8 \nQ Dr. Baric at UNC uses similar techniques known as \"no see'm\" techniques.  9 \nDo you have any knowledge of that?  10 \nA No.  I've heard comments about that in association with these investigations, 11 \nbut I never -- before the fact, I didn't -- I'd never heard of that.  Again, as I mentioned to 12 \nyou in response to other questions, this is not my area of lane of expertise as molecular 13 \nand evolutionary virology.  14 \nQ Just a few more on the WIV.   15 \nODNI also reported that the WIV did not use adequate biosafety precautions at 16 \nleast some of the time prior to the pandemic in handling SARS -like coronaviruses.  Do you 17 \nhave any knowledge of that?  18 \nA Again, only after the fact that people were saying that that was the case, but 19 \nI had no direct knowledge of it.  Certainly not before my knowledge of Wuhan, which was 20 \nafter the outbreak.  21 \nQ Okay.  And then, finally, ODNI reported that several WIV researchers fell ill in 22 \nfall 2019 with symptoms, some of the symptoms consistent but not diagnostic of 23 \nCOVID -19.  Do you have any knowledge of that?  24 \nA I heard about that, again, after the fact.  I didn't hear about people in 25 \n  \n  200 \nDecember getting sick.  Yeah.   1 \nQ During the course of the pandemic, did you receive any briefings specific to 2 \nthese issues?   3 \nMr. Schertler.   Just to be clear, Mitch, when you say \"these issues\" --  4 \nMr. Benzine.   Specific to concerns at the Wuhan Institute of Virology on biosafety 5 \nor their capabilities.   6 \nDr. Fauci.   Again, all after the fact when questions were being asked and 7 \ninvestigations and hearings and things like that.  It was not something that I was -- like, 8 \nagain, getting back to my original premise, I didn't even know there was that before the 9 \noutbreak.   10 \nBY MR. BENZINE:  11 \nQ We talked very briefly about Dr.  Chen and her trip to the WIV.  12 \nContemporaneously, she went in October of 2017.  Were you aware of her going to the 13 \nWIV?  14 \nA Not to my recollection, no.  15 \nQ She wrote in her trip report that a technician told her that the WIV planned 16 \non reverse -engineering Ebola because it was against Chinese regulations to import Ebola.  17 \nDid anyone ever tell you that?  18 \nA Again, I heard that well after the outbreak, months into it, but I didn't hear it 19 \nexactly that way.  What I heard was that they wanted to study Ebola, and the Chinese 20 \nauthorities did not want to bring Ebola into the country, and a technician made a 21 \ncomment that, well, I can just go ahead and reverse -generate it  -- reverse -engineer it.  I 22 \ndon't think it was said in the context that the Chinese were deciding they were going to 23 \nreverse.  It was a comment from a technician, according to what I heard.   24 \nQ Who did you hear that from?  25 \n  \n  201 \nA I probably heard that from Gray Handley.  1 \nQ Okay.  Did Mr. Handley -- there was a widely publicly reported State 2 \nDepartment cable from -- it was reported by The Washington Post regarding biosafety at 3 \nthe WIV.  Dr.  Chen's trip was some of the information that went into that cable.   4 \nDid Mr. Handley ever have any discussions with you regarding that cable?  5 \nA He did.  6 \nQ When?  7 \nA I don't recall exactly when, but he did have some discussions about what I 8 \nthink he felt was misinterpretations of the cable.  9 \nQ Do you recall the substance?  10 \nA Yeah.  Yeah.  The substance of the discussion -- and, again, I don't recall 11 \nwhen -- but was that they were working with -- they being the Chinese in Wuhan -- were 12 \nworking with the French to put together a BSL -4 facility, and the Chinese were asking for 13 \nhelp in training about how to operate a BSL -4.   14 \nAnd according to Gray, that that was misinterpreted that they kind of didn't know 15 \nwhat they were doing, they needed training, when anybody who starts a BSL -4 needs 16 \nextra training, including our own BSL -4s here in this country.  That's what Gray told me.   17 \nQ All right.  The cable didn't include the language about the technician saying 18 \nmaybe off the cuff, I'll just reverse -engineer Ebola?   19 \nA I don't know if the cable said that.  I know I heard that from Gray.   20 \nQ The cable didn't say it.  21 \nA Yeah.  22 \nQ It was not put in the cable.   23 \nDid Mr. Handley relay anything to you about why or why not or his involvement in 24 \nthat cable?  25 \n  \n  202 \nA No.  No, I didn't get that.   1 \nQ Okay.  A general baseline.  Do you know or have you ever interacted with 2 \nPaul Dabbar, D -a-b-b-a-r?  3 \nA Not to my recollection, no.  4 \nQ And then quickly closing out the WIV section.   5 \nYou had already separated from Federal service, but on July 17th, 2023, HHS 6 \nsuspended the WIV from receiving Federal funds.  Prior to your retirement, were you 7 \ninvolved in any aspect of that decision?  8 \nA No.  9 \nQ And then on September 19th, 2023, HHS debarred the WIV for a period of 10 10 \nyears.  Prior to your retirement, were you involved in any aspect of that decision?  11 \nA No.  That was a compliance type.  Was this before I left?   12 \nQ No, it was after.  I just didn't know how long the lead -up was.   13 \nA No.  I don't know what the lead -up was, but I was not involved in any of that.  14 \nThose were all compliance issues.   15 \nQ Okay.  Thank you.   16 \nBY MR. STROM:  17 \nQ One question on the WIV.  Is it safe to sort of summarize that your minimal 18 \nknowledge of the WIV is almost, like, no awareness of it pre -pandemic, perhaps beyond 19 \nmaybe some published papers and research?  20 \nA Right.   21 \nQ But operationally, no knowledge, I guess, other than they had a BSL -4 or 22 \nwere building one?  23 \nA Again, I heard about the BSL -4 after the outbreak when there was a lot of 24 \ndiscussion about cables and discussions in safety and things like that.  25 \n  \n  203 \nQ But any of this  -- I think Ian Lipkin maybe and some others have noted that, 1 \nyou know, some of their work in BSL -2 might not have been viewed as -- it would have 2 \nbeen at a BSL -3 in the U.S.   3 \nA Right.  4 \nQ You weren't aware of any of that prior to the reporting on that?  5 \nA No, no.  Prior to the reporting, I was not aware of that at all.  6 \nQ Okay.  Thank you.   7 \nBY MR. BENZINE:  8 \nQ We have touched on this a little bit.  And just to the best of your 9 \nrecollection  -- probably month and year versus actual day at this point, if you can  -- when 10 \ndid you become aware of NIAID funding EcoHealth?  I guess, EcoHealth  -- specifically, the 11 \nemerging bat coronavirus grant.   12 \nA Yeah.  To the best of my recollection, the first time I was aware of that, I 13 \nbelieve -- I mean, things get confused now because there were so many briefings and 14 \nhearings.   15 \nBut the first I became aware of what experts we had in coronavirus and who we 16 \nwere funding  -- I didn't learn about what we were funding but who we were 17 \nfunding -- was when we were getting ready to have our first press conference task force 18 \nmeeting at the end of July -- excuse me.  I'm sorry.  At the end of January, not July.  Sorry.  19 \nIt's getting late, and my mind --  20 \nQ No.   21 \nA It was probably -- maybe January 27th or something I got an email from Greg 22 \nFolkers, whose job is to essentially brief me and staff on important issues, and we were 23 \ngetting prepared to go to the first task force meeting and to have a press conference.   24 \nSo I wanted to know, what's going on with coronavirus?  And he gave an email 25 \n  \n  204 \nthat, you know, said, you know, we have Baric, and we have this, and we have this, and 1 \nwe have that, et cetera.  And that was in the email.   2 \nIt was a combination of who was doing what, and these are the experts that we 3 \ncan call upon to help brief us about what we're doing.  It was an informative 4 \ndata -collecting email.  That's the first that I was consciously aware that there was a 5 \nWuhan Institute and that's, you know, what was going on, though I didn't know from that 6 \nemail exactly what we were doing in that.   7 \nQ I want to introduce majority exhibit 13.  Give me one second.   8 \n    [Fauci majority exhibit No. 13  9 \n    was marked for identification.]  10 \nMr. Schertler.   Thanks.  Thirteen, you said?   11 \nMr. Benzine.   Yes.   12 \nThis is an email chain with Dr. Morens and Dr.  Stemmy and Dr.  Daszak.  Really, I 13 \nonly want you to focus on the page that looks like this.  It's an email from Dr.  Daszak.   14 \nMr. Schertler.   Would you mind if he just took a minute to get the context of it?   15 \nMr. Benzine.   Yeah.   16 \nDr. Fauci.   Yes.  So this is the email -- Peter Daszak, January 27th?   17 \nMr. Benzine.   Yes, sir, that you sent to Dr.  Morens and Dr.  Stemmy.   18 \nDr. Fauci.   Right.   19 \nMr. Benzine.   Concurrent with that exhibit being 13, I want to introduce exhibit 14.  20 \n    [Fauci majority exhibit No. 14  21 \n    was marked for identification.]  22 \nMr. Benzine.   This is just a one -page exhibit.  And this is an email from Mr. Folkers 23 \nto you that I believe you were just referencing  -- January 27th, 2020  -- with some 24 \ninformation about coronavirus experts that NIAID funds:  Dr.  Daszak, Dr.  Baric, Dr.  Lipkin.   25 \n  \n  205 \nOn Exhibit 14, there's a line that starts, \"From David M.\"   1 \nDr. Fauci.   Yes.  2 \nMr. Benzine.   And then it's, I believe, an almost near identical version of the page 3 \nwe were just discussing on exhibit 13.   4 \nDr. Fauci.   I'm sorry  --  5 \nMr. Schertler.   So I think -- can you direct us to the page on 13?   6 \nMr. Benzine.   Yes.  There isn't a Bates number.  It looks like -- he's got it in front.   7 \nDr. Fauci.   Here?   8 \nBY MR. BENZINE:   9 \nQ Yes, sir.   10 \nA And what was the question?   11 \nQ I guess, did you know that when you were getting these talking points, you 12 \nwere getting them straight from Dr.  Daszak in EcoHealth?  13 \nA I don't recall that I was.  I know I got them from Greg, who was my 14 \ninformation gatherer.  I know he got them from a number of sources, but I don't 15 \nspecifically remember, well, this was from Daszak, and this was from Baric, and this was 16 \nfrom -- I knew it was from multiple sources.  17 \nQ Would it be -- and if you don't know, that's okay.  Would it be common for 18 \nMr. Folkers to reach out beyond expertise at NIAID to get this kind of information?  19 \nA Sometimes he would do that, he would call a grantee, but I'm not so sure he 20 \ndid.  I think he spoke mostly with David.  Yeah.  Again, I can't tell from this whether Greg 21 \nwent out to an outside person.  But, you know, he generally doesn't, but occasionally, he 22 \nwill.  23 \nQ It would appear that Dr. Morens emailed Dr.  Lipkin and Dr.  Daszak and asked 24 \nfor information on the new coronavirus, and this is what Dr.  Daszak sent back, and then it 25 \n  \n  206 \ngot transferred into an email to you.   1 \nA It looks like this was David Morens to Greg, Greg to me.  That's what it looks 2 \nlike.   3 \nQ Yeah.  But it wouldn't be terribly unusual for people in your office to go to 4 \nthe grantee instead of say, like, the grant file to find this kind of information?  5 \nA Well, again, I don't know what you mean by \"unusual.\"  I mean, when you 6 \nsaid that -- for example, if a grantee was very familiar -- like, some of the AIDS grantees.  7 \nLike, we have people at Harvard and people at Cornell and people in San Francisco.  It 8 \nwouldn't be completely out of the question for Greg to call up Deeks in UCSF and ask him 9 \nabout what's going on with HIV.  He wouldn't do that.  Normally, he would go through the 10 \nprogram people, but occasionally, he would speak to a grantee.  11 \nQ Okay.  Thank you.   12 \nPutting those aside, I just want to ask your general understanding of what the 13 \nscope of work is that NIAID funded EcoHealth for.  Now, obviously, you were unaware  --  14 \nA Right.   15 \nQ -- going into the pandemic, but -- 16 \nA Right.   17 \nQ -- as you've testified I don't know how many times now --  18 \nA Right.  Right.  19 \nQ -- and obviously gotten this question an awful lot, so what is your general 20 \nunderstanding of that award?  21 \nA My general understanding of that award was that it was a surveillance 22 \naward.  I believe the title is right here in front of me:  \"Understanding the Risk of Bat 23 \nCoronavirus Emergence.\"   24 \nAnd my understanding is that there were two parts to it.  One was sero- 25 \n  \n  207 \nsurveillance to determine what particular demographic group might have been exposed, 1 \nand was it related to any particular risk occupation.  And I believe they found a relatively 2 \nsmall percentage; 3, 5 percent or something like that.   3 \nAnd the other was to do surveillance by getting bat viruses and determine if, in 4 \nfact, they might bind or not to in vitro ACE2 cell cultures as well as mice that have been 5 \ntransgenic for an ACE2.  Not humanized mice, but mice that were transgenic for a human 6 \nACE2 receptor.   7 \nAnd it was fundamentally -- which we discussed a bit ago  -- a surveillance.  What is 8 \nin the population that might have been exposed, and what bat viruses are out there that 9 \nmight potentially infect a human?   10 \nQ Just for my own edification, what's the difference between a humanized 11 \nmouse and one that just shows ACE2?  12 \nA A humanized mice is when you have -- every aspect of it is like a humanized 13 \nimmune system.  Like, when you take a mouse and you want to determine if they can 14 \nreplicate HIV, you give them a whole new stem cell transgenic insertion of a gene for the 15 \nwhole immune system.  Then you could do it for a variety of other things.  But this was 16 \none specific receptor that was a human receptor.  The rest of it was all mouse.  17 \nQ And the second part of the grant, as you just described it, would be 18 \ntaking -- was there work taking backbones and dropping spike proteins into them and 19 \nseeing if they could infect the ACE2?  20 \nA Right.  Right.  Right.  Exactly.  21 \nQ Okay.   22 \nA They didn't modify it.  They just see if it infected.  Right.   23 \nQ Didn't modify --  24 \nA They didn't take the spike and do anything with the spike.  They took a 25 \n  \n  208 \nbackbone, which was WIV, and they took the spike from a number of different bat 1 \nviruses.  And my understanding  -- which when it was explained to me is that if you take a 2 \nbat virus and you try and sequence the whole virus to then see if it would bind to the ACE 3 \nas opposed to studying just the head, it would take an inordinate if not infinite amount of 4 \ntime to sequence all the viruses.   5 \nSo what they do, they get a backbone, which they know how to work with and it's 6 \nsomething that's a tool that they're familiar with, and they just take different spikes, put 7 \nit on, see if it binds, spike, put it on, see if it binds.  And that's called a chimera, which 8 \npeople go like that with.  But that's essentially a research tool.  9 \nQ Splicing together different pieces?  10 \nA Right.  Right.  Exactly.  11 \nQ And I'm going to go through this probably pretty quickly.  I have the letters if 12 \nyou need them, but you said that you weren't involved in a lot of the compliance issues.  13 \nSo I'm just going to ask you if you were aware of them, and if the answer is no, then we'll 14 \njust move on.   15 \nA Okay.   16 \nQ In May 28th of 2016, Dr. Stemmy sent a letter to EcoHealth requesting 17 \ninformation regarding some proposed experiments and if they met the definition of the 18 \ngain -of-function funding pause.  Were you involved at all in that?  19 \nA 2016?   20 \nQ Yes, sir.   21 \nA No.  22 \nQ We touched on this a little bit, but in between that and the next letter, the 23 \nP3CO Framework came out.  And when the framework came out, Dr. Stemmy sent 24 \nanother letter July 5th, 2018, to EcoHealth informing them that their grant and the 25 \n  \n  209 \nproposed research did not fall under the P3C O Framework.  Were you involved in any of 1 \nthat?  2 \nA At that time, no.  3 \nQ What do you mean by \"at that time, no\"?  4 \nA No, that I wasn't aware of it then.  5 \nQ Oh, okay.   6 \nA Yeah.  I mean, after everybody started talking about it with all the 7 \ninvestigations and the briefings, the hearings, they mentioned that.  But since, that was 8 \nan issue that I was not involved with in any way.  9 \nQ But you weren't involved in the decision -making process?  10 \nA No, I was not involved in the decision -making process.  11 \nQ And forgive me if this has been touched on.  To your recollection, how is a 12 \ngrant referred to the P3C O?  Obviously, they propose the grant to NIAID, NIAID would 13 \nlook at it, and then determine whether or not it goes to the P3C O.   14 \nA Right.  Right.   15 \nQ Is there a structure or a process that that goes through?  16 \nA It's a committee that starts off with the program people.  I don't know if 17 \nthere's anyone lower than Erik.  Not that he's low.  He's a very knowledgeable person.  18 \nBut it would be Erik and Diane Post and someone else whose name I forget, and then it 19 \nwould go to Emily Erbelding, and that group would make a decision whether or not it 20 \nwould go up.  21 \nQ We talked about this a little bit before in the grant process, but does anyone 22 \nhave the final determination on whether or not to refer a grant to the P3C O?  23 \nA I believe the final determination is the -- that committee who reports to 24 \nEmily.  25 \n  \n  210 \nQ So would it be Dr.  Erbelding that would be kind of the final thumbs up or 1 \nthumbs down?  2 \nA You know, to be honest with you, I don't know precisely whether that would 3 \nbe Diane Post, who was a senior person, versus going up to Emily.  It might not.  If they 4 \nhave a kind of question, if it's a close call, I guess -- and I'm just guessing -- that it might go 5 \nto Emily.  But the exact process of that, I'm not familiar who has the final call.  6 \nQ But would you have any decision -making authority over grants that would be 7 \nreferred to the P3?  8 \nA No.  That's something I totally delegated below me.  9 \nQ Okay.  I want to shift to a time period a little closer  -- it's still 2020, but it's at 10 \nleast closer than 2016  -- and ask a blanket question first.   11 \nDr. Lauer testified that he would not sign or send a letter that he disagreed with.  12 \nDo you have any reason to doubt that assertion?  13 \nA He would not sign --  14 \nQ Or send a letter that he disagreed with.   15 \nA I can't speak for him.   16 \nQ Okay.  I want to introduce majority exhibit 15.  17 \n    [Fauci majority exhibit No. 15  18 \n    was marked for identification.]  19 \nBY MR. BENZINE:  20 \nQ This is a letter sent by Dr. Lauer to EcoHealth and Columbia 21 \nUniversity  -- Columbia University by mistake  -- on April 19th, 2020.  And I'll give you a 22 \nminute to familiarize yourself with the letter  --  23 \nA Okay.   24 \nQ -- but the second paragraph kind of sums it up.   25 \n  \n  211 \n\"While we review these allegations during the period of suspension, you are 1 \ninstructed to cease providing any funds from the above noted grant to the WIV.\"   2 \nSo this keeps the grant intact to EcoHealth but severs their relationship with the 3 \nWuhan Institute of Virology.   4 \nA So let me read it.   5 \nYeah.   6 \nQ Were you aware of this letter before today?  7 \nA No, not to my recolle - -- I wouldn't say no.  I mean, a lot of discussion went 8 \nback and forth about compliance.  I may have been aware of a letter that was sent about 9 \nstopping funding, but the fact that it's to Columbia University, I'm a little puzzled.  Why is 10 \nit to Columbia University?   11 \nMr. Schertler.   So I think the question is, are you familiar with this letter?   12 \nDr. Fauci.   I'm not.  I mean, I don't recall being familiar with it.   13 \nMr. Benzine.   I'm going to introduce the one I think you might be more familiar 14 \nwith as majority exhibit 16.  15 \n    [Fauci majority exhibit No. 16  16 \n    was marked for identification.]  17 \nMr. Benzine.   This is a letter sent from Dr. Lauer to Drs. Chmura and Daszak from 18 \nApril 24th, 2020  -- so 5 days after this one was sent  -- that terminates the entire grant 19 \n\"Understanding the Risk of Bat Coronavirus Emergence.\"   20 \nWere you previously aware of this letter?   21 \nDr. Fauci.   Let me read it.  Hold on.   22 \nI was aware that the grant was terminated.  I'm not -- I don't recall this particular 23 \nletter that I saw at the time.  I think I was shown -- I don't think I was shown this, but I 24 \ndon't recall seeing this letter at the time it was sent.  25 \n  \n  212 \nMr. Benzine.   You testified in June of 2020 before the House Committee on Energy 1 \nand Commerce.  You were asked about this grant and the cancellation and said, \"Why 2 \nwas it canceled?  It was canceled because the NIH was told to cancel it.  I don't know the 3 \nreason, but we were told to cancel it.\"   4 \nDo you have any recollection of who told you to cancel it?   5 \nMr. Cooke.   Yeah.  So as I think we covered with  during their hour, we're not 6 \ngoing to be able to get into the details of those deliberations.   7 \nBY MR. BENZINE:  8 \nQ All right.  I'll relay to you what Dr.  Tabak told us was the chain of events, and 9 \nyou can just tell me if that's accurate to the best of your recollection.   10 \nDr. Tabak testified that Chief of Staff Mark Meadows called the Office of General 11 \nCounsel at HHS, who then called Dr.  Tabak, who then called Dr. Lauer, who was instructed 12 \nto cancel the grant.  Is that consistent with your memory?  13 \nA Yes.  14 \nQ All right.  Did you have any conversations with anyone at NIAID or NIH about 15 \nthe legitimacy of canceling this grant?  16 \nA I don't remember who I spoke to, but I asked -- no, I didn't ask.  Someone 17 \nmentioned, and I don't recall who that was.  It may have been Hugh Auchincloss, possibly, 18 \nbecause he was the level to which these things came up to.  As I said, I was far removed 19 \nfrom the compliance aspects of this, and this is falling under the general category of 20 \ncompliance.  That the question was raised as, can you actually do that?  Can you actually 21 \ncancel a grant?  I remember discussions about that.   22 \nQ When the discussion -- first, the kind of chain of events that I just laid out, 23 \nhow did you become aware of those?  24 \nA I don't recall.  It was likely that Hugh Auchincloss, who was following this, 25 \n\n  \n  213 \ntold me that the grant has been canceled.  1 \nQ How did you become aware of the actual people involved, though?  2 \nA I wasn't sure.  What I heard was that it was someone from the White House.  3 \nI didn't know who that was, so it was compatible with my answer to your question.  Mark 4 \nMeadows, to the Department, to Lauer.  I heard it came from the White House.  I didn't 5 \nknow exactly who in the White House had told him to cancel it.  6 \nQ Did you express any concerns to anyone regarding the cancellation of this 7 \ngrant?  8 \nA I don't recall if I expressed concerns, but I do remember that there were 9 \nconcerns on the part of the scientific community that a grant could all of a sudden just be 10 \ncanceled.   11 \nQ The compliance efforts went well into 2023, past your term as director, and 12 \nDr. Lauer ended up -- I mean, EcoHealth was 22 months late on a progress report.  They 13 \nhad faulty subaward agreements.  They hadn't disclosed the Wuhan Institute of Virology 14 \nas a subaward.   15 \nDo you recall having any conversations while those efforts were going on that NIH 16 \nwas actually finding troubling aspects about the grant?  17 \nA No.  That was compliance things that I -- I mean, I may have vaguely been 18 \nhearing that they were discussing compliance issues, but I was not directly involved in the 19 \nconversations of what they were and how that was going to be.  Like I said, in general, the 20 \ncompliance issues were things that I didn't get involved in.  21 \nQ One more kind of on that.  Did you have any -- we went through NIAID and 22 \nNIH, but did you have any conversations with anyone at the White House regarding the 23 \ntermination of this grant?   24 \nMr. Barstow.   I'm going to step in here.  I'm going to step in here.  25 \n  \n  214 \nMr. Benzine.   On what grounds?   1 \nMr. Barstow.   It's an executive branch confidentiality interest potentially.  2 \nMr. Benzine.   Potentially, but you don't know?   3 \nMr. Barstow.   I'm happy to talk to Dr. Fauci.   4 \nMr. Benzine.   Yeah.   5 \nDr. Fauci.   What's the question?  6 \nMr. Benzine.   You're going to talk to Mr. Barstow.  7 \n[Discussion off the record.]  8 \nDr. Fauci.   Question?   9 \nBY MR. BENZINE:  10 \nQ Did you have any conversations with anyone at the White House regarding 11 \nthis grant?  12 \nA The truth is I don't recall having questions at the White House level about 13 \nthis.   14 \nQ All right.  John touched on it a little bit, and I just want to reiterate or ask if 15 \nyou recall more clearly.   16 \nWhen did you become aware that EcoHealth was late on their progress report?  17 \nA During preparations for one of the hearings that I was going to.  The hearings 18 \nnow, a couple years later, are a bit of a blur.   19 \nQ I bet.   20 \nA I've been in a number of hearings, and I remember in preparation for it they 21 \nwere trying to brief me as much as possible about what was going on.  I think I heard it at 22 \none of those briefings.  23 \nQ All right.  Dr.  Daszak testified that EcoHealth attempted to submit the 24 \nprogress report in a timely manner but was locked out of the NIH system, and Dr. Lauer 25 \n  \n  215 \ntestified that the NIH did a forensic analysis of their system and found no evidence that 1 \nEcoHealth was unable to submit the progress report.  Did you ever get a briefing on that?  2 \nA Again, in the same situation in preparation for a hearing.  And in that 3 \npreparation, it was all compliance things that -- even though I got briefed, I didn't get 4 \nbriefed because I felt I wanted to explain it to anybody.  I just said that I got briefed 5 \nbecause that's a compliance issue, thank you very much.   6 \nQ As much as you can recall the substance of that briefing, was it similar to 7 \nwhat I just said, that NIH had done a forensic analysis of their systems to determine --  8 \nA No, I don't recall that.  I do recall that there was a disagreement, that 9 \nEcoHealth said that they did this, and the NIH compliance said, no, you didn't.  That may 10 \nhave been what you're talking about.  But there was -- my recollection in one of my 11 \nbriefings that EcoHealth was saying that they were compliant in something, and the NIH 12 \ncompliance people  -- namely Lauer  -- were saying, no, you weren't.  I don't know if it was 13 \nforensic stuff that you're talking about.   14 \nQ Okay.  I want to introduce majority exhibit 17.  15 \n    [Fauci majority exhibit No. 17  16 \n    was marked for identification.]  17 \nBY MR. BENZINE:  18 \nQ So this is a letter from Dr.  Tabak to then -Ranking Member James Comer 19 \nfrom October 20th, 2021.  I'll give you a minute to familiarize yourself with this.   20 \nA Both sides.  Okay.  Just give me a minute.  I'm a slow reader.   21 \nYes.   22 \nQ Were you aware of this letter prior to just now?  23 \nA I believe I got some briefing on this letter, yeah.   24 \nQ Were you involved at all in the drafting of this letter?  25 \n  \n  216 \nA No.  1 \nQ I want to start on the back page.  And the tiny little paragraph before \"if you 2 \nor your staff have any questions\" reads, \"The analysis attached confirms that the bat 3 \ncoronaviruses studied under the EcoHealth Alliance grant could not have been the source 4 \nof SARS -CoV-2 and the COVID -19 pandemic.\"   5 \nWere you involved at all in putting together an analysis like that?  6 \nA No.  7 \nQ Do you agree with that statement?  8 \nA Again, I'm not an evolutionary virologist, but every evolutionary virologist 9 \nwithout exception that's been asked about that is pretty confident that, when you look at 10 \nthe bat viruses that were studied, that they are phylogenetically so distant that that could 11 \nnot have been the source of SARS -CoV-2.  12 \nMr. Schertler.   Bat viruses studied in Wuhan?   13 \nDr. Fauci.   In Wuhan, yeah.   14 \nBY MR. BENZINE:  15 \nQ And, again, I'm a lawyer, and words -- black -and-white words matter.  And as 16 \nyou discussed with the chairman, I think 2 hours ago at this point, not everyone publishes 17 \neverything.  Not everyone makes everything available.  This is an unequivocal statement 18 \nthat every bat coronavirus studied under the EcoHealth Alliance grant could not have 19 \nbeen the source for the COVID -19 pandemic.   20 \nA Right.   21 \nQ It reads to me like an exaggeration of -- and I'm not saying this is what 22 \nhappened.  I'm not saying that an EcoHealth virus started the pandemic.  All I'm saying is 23 \nthat you can't make an unequivocal statement when you don't know all the facts.  And it's 24 \nimpossible to know all the facts.   25 \n  \n  217 \nI guess, first, do you agree that this statement would  -- that there are potentially 1 \nfacts missing in this statement?  2 \nA Well, let's parse it out in saying that the work scope of the grant and the 3 \nviruses that came in under the work scope are viruses that could not have been the 4 \nsource of SARS -CoV-2.   5 \nI think the point that you're making is that people cannot know what's going on in 6 \nanother part of Wuhan or in Shanghai or in Beijing, but the NIH subaward work scope was 7 \ninvolved with viruses that could not have turned into SARS -CoV-2.  8 \n  \n  218 \n[6:40 p.m.]   1 \nBY MR. BENZINE:  2 \nQ Would it be  more --  3 \nA So I think  -- I'm pretty sure that's what Larry was saying.   4 \nQ Would it be more accurate to say the analysis attached confirms that the 5 \npublished bat coronaviruses could not have been COVID -19?  Peter Daszak has gone on 6 \nrecord saying that he has not published every sequence of every coronavirus that he has 7 \ncollected.   8 \nA There is no  -- there is no record anywhere, I believe, of any virus that was 9 \nstudied that has been described in a bat that is close enough to have been SARS -CoV-2.   10 \nThat's the reason why they're looking for adaptation in an  intermediary host that 11 \nwould have made it closer, because all the bat viruses that are known are distant enough 12 \nthat they could not have been the source of SARS in and of themselves.  13 \nQ And I'll belabor the point one more time, but that's kind of my point, is that 14 \nat this point I don't know how  -- what the fatality toll was, but it was pretty significant.  15 \nAnd there was obviously a lot of calamity surrounding this grant, calamity surrounding 16 \nthe origins of COVID.  17 \nAnd, like, to us and to the people we hear from and the people, you know, our 18 \nbosses represent, like, words matter.  And when you see an unequivocal statement when 19 \nyou know there are unknowns, you know EcoHealth hasn't published every virus that we 20 \nhave funded, in fact, that's one of the reasons that they're still getting funding, do you 21 \nthink it could have been worded clearer?  22 \nA I don't want to surmise about how Larry would have worded it.  I'll leave that 23 \nup to Larry.   24 \nQ I want to flip over to the front page of this letter and read an excerpt from 25 \n  \n  219 \nthe fourth paragraph down.   1 \n\"The limited experiment described in the final progress report provided by 2 \nEcoHealth Alliance was testing if spike proteins from naturally occurring bat coronaviruses 3 \ncirculating in China were capable of binding to the human ACE2 receptor in a mouse 4 \nmodel.  All other aspects of the mice, including the immune system, remained 5 \nunchanged.  In this limited experiment laboratory, mice infected with the SHC014 WIV 1 6 \nbat coronavirus became sicker than those infected with the WIV 1 bat coronavirus.  This 7 \nwas an unexpected result of the research, as opposed to something the researchers set 8 \nout to do.\"   9 \nSo this is kind of what you were describing earlier in the aims of the grant, that 10 \nthey were using the WIV 1 backbone, dropping spike proteins onto it and seeing if it could 11 \nbind with ACE2.  Is that right?  12 \nA Right.  13 \nMr. Benzine.   I want to introduce the year 5 progress report as majority exhibit 18.  14 \n    [Fauci majority exhibit No. 18  15 \n    was marked for identification.]  16 \nMr. Benzine.   And in the nature of time, it's a long report, so I'd ask you not to 17 \nread the whole report, but I'm going to draw your attention to a discrete paragraph.  It's 18 \non page 15 under aim 3.1.     19 \nMr. Schertler.   Are you sure you don't want him to read the whole report?   20 \nMr. Benzine.   I'm pretty sure I don't want you to read the whole report.  21 \nBY MR. BENZINE:  22 \nQ And I believe, and Dr. Tabak has confirmed that in his letter he is referring to 23 \nthe experiment outlined in this paragraph.   24 \nAnd I'm going to  -- you have it in front of you, but I'm going to read it in kind of 25 \n  \n  220 \nlayman's terms so it's comprehendible.   1 \nBut, in essence, it says that mice were infected with four strains of SARS -related 2 \ncoronaviruses with different spike proteins, including full -length recombinant virus of 3 \nSARS -related WIV 1 and 3 chimeric viruses, with the backbone of WIV 1 and the spike 4 \nproteins from three other bat coronaviruses.  So that's what we were just discussing.   5 \nAll four of the viruses caused lethal infection in human ACE2 transgenic mice, but 6 \nthe mortality rate varied among the four groups.  Fourteen days post -infection, five out of 7 \nthe seven mice infected with just the WIV 1 backbone remained alive, while only two out 8 \nof eight mice infected with the SHC014 chimera survived.   9 \nAnd the paragraph ends with, \"These results suggest that the pathogenicity of 10 \nSHC014 is higher than other tested bat SARS -related coronaviruses in transgenic mice 11 \nthat express human ACE2.\"   12 \nI'll give you a minute to read the full version in the progress report.  I know I kind 13 \nof summarized it.   14 \nA [Reviewing.]  Yeah.   15 \nQ So to me, it sounds like seven mice infected with the full -length WIV 1; five 16 \nsurvived.  Eight mice infected with a chimera of WIV 1 and SHC014 and two survived.  Is 17 \nthat your understanding as well?  18 \nA That's what it says, yeah.   19 \nQ This to me sounds like the experiment that EcoHealth conducted by creating 20 \na chimera increased the pathogenicity of the underlying virus.  Is that fair?  21 \nA The underlying virus is WIV.  22 \nQ Correct.   23 \nA And the spike that they put on indicated that the virus was more pathogenic 24 \nthan the WIV.  25 \n  \n  221 \nQ Correct.  Is that right?  So by replacing the WIV 1 spike with the SHC spike  --  1 \nA Yes, yes.  But, again, you got to put it into context because, again, these 2 \nviruses, when you  -- if you  -- are you hearkening back to the definition of whether  --  3 \nQ I'm getting there.   4 \nA Yeah, but then let's go there, okay?   5 \nThe fact is that what was built into the scope of the conditions was that if you do 6 \nget an increase in viral load or pathogenesis, you've got to report it or reevaluate it, but it 7 \nstill doesn't change the underlying premise that this is not a PPP.   8 \nThat's the point.  That's the conclusion -- that's the confusion people get.  By the 9 \noperative definition of gain -of-function of concern, even with this, this is merely an added 10 \ngoing the extra mile that if something like this happens you stop and you look at it and 11 \ndiscuss whether or not to go forward, et cetera.   12 \nAnd, to my understanding, that even if you do that, this still doesn't change that 13 \nyou're not dealing with a virus that's very likely to lead to widespread transmission, et 14 \ncetera, et cetera.   15 \nSo it doesn't change the definition or the operative guideline for this experiment, 16 \nbut it tells you, you should report this, because that was part of the fail -safe.   17 \nQ And I don't disagree with you that it's not an ePPP  --  18 \nA Yeah, right.  19 \nQ -- and it doesn't fall under the P3CO framework.   20 \nWhat I think we're trying to understand is this was submitted, I mean, well, late, 21 \nbut the work was conducted during 2018 for the fiscal year 2018 to 2019 and the year 5 22 \nprogress report.   23 \nAt that time, this definition of gain -of-function was still live on the website of 24 \nenhancing a biological agent.  And I guess what I'm trying to understand, and the minority 25 \n  \n  222 \ntalked about it too, is you said what your intent was with Senator Paul, that when you 1 \nsaid NIH does not now and has not ever funded gain -of-function research in Wuhan was 2 \nthat you meant to say or you intended ePPP research.   3 \nA I said that before and I'll repeat it again.  When I talk about gain -of-function, 4 \nI talk about  -- a gain -of-function of concern  -- I am talking about the operative definition 5 \nof gain -of-function of concern, which for me is the P3CO that we've discussed multiple 6 \ntimes.   7 \nQ And I agree, again, agree that this experiment did not meet the P3 definition.  8 \nWould you agree that it meets that broad definition of gain -of-function that was on NIH's 9 \nwebsite when this research was conducted?  10 \nA Again, I don't use the terminology \"gain -of-function\" because it can be very 11 \nconfusing, which was the reason why we went through 3 years of discussion to avoid the 12 \nkind of confusion that we're going to get into now if we start going back and forth about 13 \nthis.   14 \nThat was the whole reason for 3 years of deliberation to establish a regulatory 15 \nguideline based on a guiding policy that led to a framework.   16 \nSo, regardless of how you slice it, when I spoke to  -- when I responded to 17 \nDoctor  -- to Senator Paul, I was referring to the gain -of-function research of concern as 18 \ndefined by the P3CO framework.   19 \nQ My last question.  That hearing was May 11th, 2021.  When you testified, 20 \nlike -- again, I apologize, but if I was a general C -SPAN watcher or watching the news 21 \nafterwards it obviously became a big deal, and I went and I googled NIH gain -of-function 22 \nresearch, this is what would come up.   23 \nDo you think you could have -- like, you knew that you meant ePPP.   24 \nA Yes.  25 \n  \n  223 \nQ Do you think you could have been more specific in your answer?  1 \nA Well  --  2 \nMr. Schertler.   I don't think he can really opine as to what CNN news watchers, 3 \nC-SPAN, whatever  --  4 \nMr. Benzine.   No, I'm asking him  -- I'm asking him -- he knew -- he knew the rules, 5 \nhe knew the definition.  6 \nDr. Fauci.   I think  -- I think in terms of 3PCO, and that's embedded in my mind, he 7 \ndidn't appreciate what gain -of-function according to the regulatory guidelines are.  I was 8 \nspeaking in that term.  So he was thinking of a different thing.   9 \nWhen I spoke to him, I'll stand by my statement that when I said we do not do 10 \ngain -of-function I was referring to gain -of-function of concern according to the 3PCO 11 \nguideline, done, full stop.   12 \nDr. Wenstrup.   Can I?  13 \nMr. Benzine.   Yes, sir.  14 \nDr. Wenstrup.   Do you think that would have helped, if you explained that that 15 \nday?   16 \nDr. Fauci.   I'm not so sure, to be honest with you, sir, that -- Rand Paul has a thing 17 \nabout me.  18 \nDr. Wenstrup.   I'm not talking about Rand Paul, but for me  --  19 \nDr. Fauci.   Yeah.  20 \nDr. Wenstrup.   -- listening and watching.  21 \nDr. Fauci.   Yeah.  22 \nMr. Schertler.   And I think he can only talk about his interchange with Rand Paul.   23 \nDr. Fauci.   Rand Paul.   24 \nDr. Wenstrup.   He can have a retrospective opinion.   25 \n  \n  224 \nMr. Schertler.   Well, I don't know that we need a retrospective opinion of his 1 \nanswer.  I think he's trying to answer your question  --  2 \nDr. Wenstrup.   Well, he's saying it now.  3 \nMr. Schertler.   -- as straightforwardly as he can.  4 \nDr. Wenstrup.   The thing is he's saying it now.  Why didn't he say it that day?  5 \nThat's all.  That's fine.   6 \nMr. Schertler.   So maybe Rand Paul could have asked better questions.  And 7 \nmaybe if Rand Paul had asked clearer, better questions, he would have gotten a more 8 \nspecific answer.   9 \nSo it can go both ways.  Wouldn't you agree, Chairman?  I mean, wouldn't you 10 \nagree with that?   11 \nDr. Wenstrup.   What's your answer?  12 \nDr. Fauci.   No, I agree with that.  I mean  --  13 \nDr. Wenstrup.   So it was his questions that kept you from being more specific?   14 \nDr. Fauci.   No, when he asked me  --  15 \nMr. Schertler.   I didn't say it was his question.  I said he could have asked better 16 \nquestions.  You're going back now and you're saying, could somebody have said it better?  17 \nCould somebody have asked it better?  I don't think it's a fair question.   18 \nMr. Osterhues.   But this was the definition on the website.   19 \nMr. Schertler.   That is not the definition that was referred to.  20 \nMr. Osterhues.   That is on the NIH website.   21 \nMr. Schertler.   Then if Rand Paul had said, this is the definition on your website, 22 \nwe'd have gone with the definition on your website.   23 \nDr. Wenstrup.   Sir, we're going to have a conversation here for a second about 24 \nwhat the average American perceives.  You may not be out talking  -- you may not be out 25 \n  \n  225 \ntalking to the average American every day.  I have to.   1 \nSo all I'm saying is, because as he says this today it's an explanation for why he 2 \nsaid it.  So all I'm saying is, in retrospect, do you think it would have been perceived 3 \nbetter  -- I think it would have been  -- let me just say it as a statement then.   4 \nI think it would have been perceived better by the American people if he 5 \nexplained that at the time.   6 \nNow, regardless of the situation, I'm just giving you that opinion of the average 7 \nAmerican, because all they heard was that, and what's on the website is not that.  So 8 \nthat's the point I'm trying to make.   9 \nMr. Schertler.   Chairman, I appreciate that.  And I appreciate your point.  And I 10 \nappreciate, you know, dealing and communicating with the average American.  I don't 11 \nmean  -- I don't mean to  --  12 \nDr. Wenstrup.   I'm not doubting your intent and what you thought it meant.  I'm 13 \njust giving you the perception of the average American, and then you go to the website 14 \nand it says something different from what you were thinking.   15 \nMr. Schertler.   Okay.  So we've got the chairman's statement.   16 \nBY MR. BENZINE:  17 \nQ The last thing I'll say is we interviewed Dr. Tabak on Friday  -- it's been a long 18 \nweekend  -- and we asked him a similar question.  \"What's described in the EcoHealth year 19 \n5 progress report would fit the definition  -- the broad definition of gain -of-function 20 \nresearch?\"  And he answered, \"The generic, broad description of what gain -of-function is, 21 \nyes.\"   22 \nWould you agree with Dr. Tabak?   23 \nA You know, again, we're going in circles, because it's going to get the same 24 \nconfusion that the chairman was just talking about.   25 \n  \n  226 \nQ I'm --  1 \nA Because then, if I say yes, then, \"Ah, yes, he says it was gain -of-function.\"   2 \nIt is not gain -of-function of concern that is associated with the regulatory 3 \noperative definition of gain -of-function.   4 \nQ No.  And I'm entirely willing to stipulate that and stipulate that it didn't need 5 \nto go through the P3CO and it didn't meet the definition of ePPP.   6 \nAnd I'll end on this, and if it's the same answer it's the same answer.  But we've 7 \nasked Dr.  Auchincloss this question.  We've asked Dr. Tabak this question.  Both have said 8 \nthat it meets the definition, the broad definition of gain -of-function research.   9 \nI'm not trying to catch you in a trap.  I'm not trying to catch you  --  10 \nA But the thing is I have been living a life over the last few years of getting 11 \ntotal distortion of things that I've said and done, and you know that.  So if you want me 12 \nto --  13 \nMr. Schertler.   So, look, I think you've asked and answered the question.  But if 14 \nyou'd like to answer it again, you can answer it again.  15 \nMr. Benzine.   You don't need to answer again.  I'll take that what you meant is 16 \nwhat  -- 17 \nDr. Fauci.   Right.  18 \nMr. Benzine.   And I agree that that is what you meant.  I'm not trying to go against 19 \nthat.  I'm just  -- when people read things in black and white and words are said, it's hard 20 \nto distinguish sometimes.   21 \nDr. Fauci.   Yes.   22 \nMr. Benzine.   Our hour is up, and we can go off the record.  Our day is up too.  23 \n[Whereupon, at 6:57 p.m., the interview was recessed, to reconvene at 10:00 24 \na.m., Tuesday, January 9, 2024.] 25 \n  \n  227 \n   Certificate of Deponent/Interviewee  1 \n 2 \n 3 \n I have read the foregoing ____ pages, which contain the correct transcript of the 4 \nanswers made by me to the questions therein recorded.  5 \n 6 \n 7 \n 8 \n     _____________________________  9 \n      Witness Name  10 \n 11 \n 12 \n     _____________________________  13 \n          Date  14 \n 15", "summary": "Official transcript, Part 1 of Anthony Fauci's 14-hour closed-door transcribed interview before the House Select Subcommittee on the Coronavirus Pandemic (8-9 January 2024).\n\nExcerpt: something improper about that process.   6  I think -- it is useful because I think that that timeline sometimes has gotten a little 7  bit foggy.   8  I'm going to introduce just one more draft of the paper that was forwarded on to 9  you, as minority exhibit I.  10      [Fauci Minority Exhibit No. I  11      was marked for identification.]  12  BY   13  Q And I'll give you a moment to look that over.  I may want to chat a little more 14  about the substance in the draft, so take your time.   15  This Bates number, for the record, is REV411.   16  A Yeah.  17  Q Great.  So this email chain is now February 8th.  So we are a full week out 18  from that February 1st conference call.  And it's another similar example, it looks like, 19  where Dr. Farrar is forwarding the current draft, but…", "source_url": "https://oversight.house.gov/wp-content/uploads/2024/05/Fauci-Part-1-Transcript.pdf", "pdf_url": "/archive-docs/fauci-files/2a847d8c6ce196e4ee11f9d2b94ee787/pdf", "doc_date": "2024-01-08", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "transcribed interview", "house oversight", "select subcommittee", "coronavirus pandemic", "congress", "fauci testimony", "hearing transcript", "testimony-house-2024-jan-part1"], "part_number": 2, "page_count": 227}
{"title": "Fauci Transcribed Interview — House COVID Subcommittee, Part 2 (9 Jan 2024) (Part 1 of 3)", "content": "1 \n 1 \n 2 \n 3 \n 4 \nCOMMITTEE ON OVERSIGHT AND ACCOUNTABILITY,  5 \nSELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC,  6 \nU.S. HOUSE OF REPRESENTATIVES,  7 \nWASHINGTON, D.C.  8 \n 9 \n 10 \n 11 \n 12 \n 13 \n INTERVIEW OF:  ANTHONY S. FAUCI (DAY 2)  14 \n 15 \n 16 \n 17 \n 18 \nTuesday, January 9, 2024  19 \n 20 \nWashington, D.C.  21 \n 22 \n 23 \nThe interview in the above matter was held in room CVC -268, Capitol Visitor 24 \nCenter, commencing at 10:00 a.m.  25 \n  \n  2 \nPresent:  Representatives Wenstrup, Griffith, Malliotakis, Jackson of Texas, 1 \nCloud, McCormick, Ruiz, Ross, Dingell, and Castor.  2 \n  \n  3 \nAppearances:  1 \n 2 \n 3 \n 4 \nFor the SELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC:   5 \n 6 \nMITCH BENZINE, STAFF DIRECTOR.  7 \nMADELINE BREWER, COUNSEL  8 \nANNA -BLAKE LANGLEY, PROFESSIONAL STAFF MEMBER  9 \nERIC OSTERHUES, CHIEF COUNSEL  10 \n 11 \nPETER SPECTRE, PROFESSIONAL STAFF MEMBER  12 \n MINORITY STAFF DIRECTOR  13 \n MINORITY CHIEF COUNSEL  14 \n MINORITY COUNSEL  15 \n MINORITY SENIOR COUNSEL  16 \n 17 \n 18 \nFor the COMMITTEE ON ENERGY AND COMMERCE,  19 \nSUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS:   20 \n 21 \nALAN SLOBODIN, SENIOR CHIEF COUNSEL  22 \nJOHN STROM, SENIOR COUNSEL  23 \n MINORITY CHIEF COUNSEL  24 \nFor the U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES:  25 \n\n  \n  4 \n 1 \nPERRIN COOKE, SENIOR OVERSIGHT COUNSEL  2 \n 3 \n 4 \nFor the WHITE HOUSE:  5 \n 6 \nKEVIN BARSTOW, SENIOR COUNSEL AND  7 \nSPECIAL ASSISTANT TO THE PRESIDENT  8 \n 9 \n 10 \nFor ANTHONY S. FAUCI:  11 \n 12 \nDAVID SCHERTLER, PARTNER  13 \nDANNY ONORATO, PARTNER  14 \nSCHERTLER, ONORATO, MEAD & SEARS LLP  15 \n555 - 13TH STREET, NW  16 \nWASHINGTON, DC  20004  17 \n 18 \nALSO PRESENT:  19 \n 20 \n 21 \n 22 \nGRACE MCMAHON (PARALEGAL)  23 \nMATT LAGANZA (PARALEGAL)  24 \n  We can go on the record.   25 \n\n  \n  5 \nGood morning, Dr.  Fauci.   1 \nDr. Fauci.   Good morning.   2 \n  Thank you for coming back.   3 \nJust a couple of housekeeping items.  One is that all the same rules from 4 \nyesterday's conversation will also apply to today's conversation.  Another is that the 5 \nexhibit labels, both majority and minority, will be continuous.  We'll just pick up where 6 \nwe left off yesterday.   7 \nAnd with that, I think we'll have folks in the room identify themselves.  It might 8 \nbe logical just to start here.   chief minority counsel, select 9 \nsubcommittee.   10 \n   chief counsel for the minority, Energy and 11 \nCommerce Committee, Oversight and Investigations Subcommittee.   12 \n   senior counsel, Democratic staff, select subcommittee.   13 \n  , minority counsel, select subcommittee.   14 \n   Democratic staff director of the select 15 \nsubcommittee.   16 \nMrs. Dingell.   Debbie Dingell, select committee member, Energy and Commerce 17 \nCommittee member, and the Representative for the University of Michigan.  Go Blue.   18 \nDr. Wenstrup.   Brad Wenstrup, Ohio Second District.   19 \nMr. Benzine.   Mitch Benzine, staff director for the majority of the select 20 \nsubcommittee.   21 \nMr. Strom.   John Strom, senior counsel, House Energy and Commerce 22 \nCommittee majority, Subcommittee on Oversight and Investigations.   23 \nMs. Brewer.   Madeline Brewer, majority counsel, select subcommittee.   24 \nMr. Spectre.   Peter Spectre, professional staff member, select subcommittee 25 \n\n  \n  6 \nmajority.   1 \nMs. Langley.   Anna -Blake Langley, professional staff member, majority, select 2 \nsubcommittee.   3 \nMr. Osterhues.   Eric Osterhues, chief counsel, majority, select subcommittee.   4 \n     5 \nMr. LaGanza.   Matt LaGanza, paralegal.   6 \nMs. McMahon.   Grace McMahon, paralegal.   7 \n     8 \nMr. Barstow.   Kevin Barstow, White  House Counsel's Office.   9 \nMr. Cooke.   Perrin Cooke, senior counsel at HHS.   10 \nMr. Onorato.   Danny Onorato, counsel for Dr. Fauci.   11 \nMr. Schertler.   David Schertler, counsel for Dr.  Fauci.   12 \nDr. Fauci.   Anthony Fauci, former director of NIAID; currently, professor at 13 \nGeorgetown.   14 \n  Great.  Thank you, all.  We'll start our timer.  15 \nEXAMINATION  16 \nBY   17 \nQ Dr. Fauci, I will just start with a few pretty discrete , narrow questions about 18 \na few things that were discussed in the last hour of yesterday's conversation.   19 \nAnd the first one of those is just, there was a conversation about Dr.  Ping Chen at 20 \nNIAID and her trip to the Wuhan Institute of Virology BSL -4 lab, and her observations as it 21 \nrelated to the training levels of the folks working at that lab.  You provided a little bit of 22 \ncontext about how the French helped the Chinese build that lab.   23 \nI just want to ask, our understanding is it's not at all clear to us that that is the lab 24 \nwhere the EcoHealth work occurred.   25 \n\n  \n  7 \nWe understand that it seems much more likely to be the case that that work, the 1 \nyear 5 report, all those experiments that we keep talking about, occurred in a BSL -2 or 2+ 2 \nor 3, whatever environment on a completely different campus that's like 45  minutes away 3 \nby car from the BSL -4 lab.   4 \nI don't know if you have a similar understanding.   5 \nA I have an understanding of the relationship between a BSL -4 lab and the 6 \nexperiments that were conducted under the NIH subaward through Eco to the Wuhan 7 \nInstitute of Virology, and those experiments would not have all been done or required to 8 \nbe done in BSL -4.   9 \nSo I think the confusion, if I might say, that occurs when people bring up reference 10 \nto a BSL -4 and/or the training that might be required of or requested for individuals who 11 \nwill be working in BSL -4 is unrelated to the experiments that were done, which would 12 \nbe either BSL -2 or BSL -3.   13 \nI'm not sure of the physical location of the two.  But the one thing that's clear is 14 \nthat what we're all talking about here are not BSL -4 experiments.   15 \nQ I appreciate it.  Thank you.   16 \nMy next question relates to majority exhibit  13, and that's an email starting with 17 \nDr. David Morens.  It does not have a Bates number, but I'll give counsel a moment to 18 \nfind it and I'll give you a moment to flip back through it.   19 \n[Pause.]  20 \nA Okay.  Yes.   21 \nQ My only item of interest is on the third page of the physical document.  22 \nDown at the bottom there's an email from Dr.  Morens to Dr.  Daszak that starts with, 23 \n\"Great info, thanks.\"  I don't know if you see that.   24 \nA I see it.   25 \n  \n  8 \nQ I'm going to read the sort of pertinent part out loud.   1 \n\"Great info, thanks.  Tony doesn't maintain awareness of these things and 2 \ndoesn't know unless program officers tell him, which they rarely do, since they are across 3 \ntown and may not see him more than once a year, or less...\"   4 \nSo just setting a little bit of context, it's a little bit of what we talked about 5 \nyesterday.  It sounds like this is sort of contemporaneous, late January even, Dr.  Morens 6 \nis saying, hey, in general, Dr.  Fauci doesn't know anything about a particular grant at any 7 \ngiven moment, and in this particular conversation about EcoHealth Alliance, he does not 8 \nhave awareness of what we're talking about.   9 \nIs that what you read here, and is that what you recall?  10 \nA It's what I read, and it's what I recall.   11 \nAs I mentioned yesterday, we have thousands of grants.  We have very highly 12 \ntrained subject matter experts at the program level that look at the grants and monitor 13 \nthe grants.  It would be physically impossible for me to get into and look at every grant.   14 \nAnd that's the reason why you have trained personnel at the program level, one of 15 \nwhich, for example, is Cristina Cassetti, who's the deputy director of the Division of 16 \nMicrobiology and Infectious Diseases.  She is Emily Erbelding's deputy.   17 \nAnd then, as we spoke yesterday, you have the people down the line in the 18 \nprogram, Erik Stemmy, Diane Post, and et cetera, et cetera.   19 \nQ I understand.  Thank you.  Great.   20 \nI also have a question or clarification about majority exhibit  17, and I'll give folks a 21 \nminute to flip to it.  That's an October  20th, 2021, letter from Dr.  Tabak to 22 \nRepresentative Comer.   23 \nMr. Schertler.   What exhibit number is that?   24 \n  Seventeen is what I have.   25 \n\n  \n  9 \nMr. Schertler.   Got it.  Thanks.   1 \nBY   2 \nQ So I'll give you a moment just to glance back over that, if you'd like to.   3 \nA Is that the one dated October  20th?   4 \nQ It is.   5 \nA Okay.   6 \n[Pause.]  7 \nA Yes.   8 \nQ Great.   9 \nSo my question is, on the second page of the letter, there's a little bit of 10 \ndiscussion.  I might just read a few excerpts, starting with above those bullet points.   11 \nThere's a sentence that reads, \"The second document,\" which is not seen here but 12 \nwas attached to the letter, \"is a genetic analysis demonstrating that the naturally 13 \noccurring bat coronaviruses used in experiments under the NIH grant from 2014 to 2018 14 \nare decades removed from SARS -CoV-2 evolutionarily.\"   15 \nAnd then subsequent to that are a series of five bullet points describing five 16 \ndifferent viruses.  The fourth bullet point there is RaTG13.  I'm just going to read that 17 \none.  18 \n\"RaTG13, one of the closest bat coronavirus relatives to SARS -CoV-2 collected by 19 \nthe Wuhan Institute of Virology.\"   20 \nIn the paragraph following that, there's a discussion of how a 96 or a 97  percent 21 \nmatch actually represents decades of evolutionary distance; therefore, the conclusion is 22 \nthe bat coronaviruses studied under the EcoHealth Alliance grant could not have been the 23 \nsource of SARS -CoV-2 and the COVID -19 pandemic.   24 \nThere was some discussion yesterday about this general part of the letter.  I 25 \n\n  \n  10 \ndon't know to the extent to which you're familiar or not, but I just wanted to ask, we're 1 \nnot sure, and, in fact, I think we think that RaTG13, although it has gotten lots of interest 2 \nbecause it's sitting at that 96  percent match, it's not clear to us that that had anything to 3 \ndo with the NIH grant or the EcoHealth work.  It seems that that was collected in  --  4 \nA Right.   5 \nQ -- field work done by the Wuhan Institute on its own time, on its own dime.   6 \nDo you have any sense of that?  7 \nA That is my understanding.  The virus that was part of the experiments that 8 \nwere funded through that subaward is WIV -1.  That's different than RaTG13.   9 \nQ Precisely.  And so I only clarify it because the phrasing of the letter could 10 \nlead a reader to think that every virus named here was part of the NIH work.  I don't 11 \nthink that that is actually the case.   12 \nA That is not the case, yeah.   13 \nQ All right.  Great.   14 \nThe last question or clarification from me is that  -- there's no exhibit for this.  I'm 15 \njust going to read something to you.   16 \nThere was some discussion towards the end of the day yesterday about the 17 \nprevious exchanges that you have had with Senator Rand Paul on the general topic of 18 \ngain -of-function, the extent to which those exchanges were either clear or not so clear.   19 \nI'm just not sure that they are as unclear as maybe it seems like, listening to our 20 \nconversation yesterday.  So I just want to read a few excerpts from those conversations, 21 \nif it's okay with you.   22 \nIn the May  2021 Senate HELP hearing, which I think is the same hearing that has 23 \nthe initial quote that we discussed yesterday that we did not ever fund gain -of-function, 24 \nSenator Marshall asked you, \"My point is, is there national security implications with 25 \n  \n  11 \nsomething as theoretically lethal as viral gain -of-function?'\"   1 \nYou answered, \"Sure, there is.  That is why we have committees.  We have a 2 \nP3CO committee, which is the Potential Pathogen\"  -- \"Pandemic Pathogen Care and 3 \nObservation\"  -- \"and Oversight,\" excuse me.   4 \nSo my point is just to note that it does seem as if within the context of that 5 \nhearing you pointed folks to the P3CO  framework.   6 \nA Yes.  I did.  7 \nQ Great.   8 \nIn a separate hearing, in November  2021, where yourself and Senator Paul again 9 \ndiscussed this same topic, you said the following to Senator Paul.  10 \nQuote, \"Senator, with all due respect, I disagree with so many of the things that 11 \nyou have said.  First of all, gain -of-function is a very nebulous term.  We have 12 \nspent  -- not us but outside bodies  -- a considerable amount of effort to give a more 13 \nprecise definition to the type of research that is of concern that might lead to a 14 \ndangerous situation.  You are aware of that.  That is called P3CO.\"   15 \nThat's the end of the quote.   16 \nSo I just wanted to highlight that to emphasize it.  It seems to us that for a 17 \nlistener  --  18 \nA Right.  19 \nQ -- of those exchanges  --  20 \nA Right.   21 \nQ -- there would have been some degree of clarity  --  22 \nA Right.  23 \nQ -- about what you were talking about.   24 \nA Yeah.  I'm glad you brought that up.   It didn't come into the conversation 25 \n  \n  12 \nyesterday.  But it isn't as if P3CO was never brought up in the discussions that I had.  As 1 \nyou said there, it was brought up twice, at least, maybe more.  2 \nQ And there are others that  --  3 \nA Yeah.  4 \nQ -- I won't bother to sit here and read them.   5 \nA Maybe more, at least once to Senator Paul and clearly once to Senator 6 \nMarshall.  7 \nQ It looks like you may have read him out loud the whole definition about 8 \nhighly transmissible  and uncontrollable, et cetera.   9 \nA Yeah.   10 \nQ Great.  That was all, I think, I had.  And with that I'll turn it over to my 11 \ncolleague Will.   12 \n  Great.  Thank you.   13 \nBefore I start on questions, I know that a couple members joined immediately 14 \nafter introductions.  Now is a good point of  --  15 \nMs. Castor.   Congresswoman Kathy Castor.   16 \nMs. Malliotakis.   Congresswoman Nicole Malliotakis.   17 \n  Great.  I think that's everybody.   18 \nBY   19 \nQ Good morning, Dr.  Fauci.   20 \nA Good morning.   21 \nQ I recall at the end of yesterday's long 7  hours of questions there was an 22 \nexchange that my colleague  was just going through some of the clarification on 23 \ntestimony, and something that you said I wanted to revisit.   24 \nYou know, you mentioned that you've endured roughly 3  years now of people 25 \n\n  \n  13 \ntaking things that you had said, taking them out of context, mischaracterizing them, using 1 \nthem in ways that are political, nefarious, disingenuous, et cetera.   2 \nSo, candidly, I actually thought that many of yesterday's questions from both sides 3 \nwere helpful and I thought illuminated a lot of what your role was at NIAID, the crucial 4 \nlifesaving work you and your colleagues did in the middle of the pandemic, and a lot of 5 \nwhat the lessons were that we learned and should apply going forward to prevent illness, 6 \nsave lives, prevent or address the inevitable next emerging threat.   7 \nSo that's why  -- last night, the select subcommittee on their Twitter account  -- this 8 \nis the Republicans, they're in the majority, so they control the committee Twitter 9 \naccount  -- they sent out their version of how they saw the day's testimony.   10 \nLet me first ask, I know you're not a social media guy.  I think everybody who's 11 \nread a lot of stuff here knows that you're not on social media platforms.   12 \nA Right.  13 \nQ You didn't see the tweets  --  14 \nA I didn't.   15 \nQ -- last night?  Okay.   16 \nA I didn't see the tweets, no.   17 \nQ Okay.  So I thought  -- and you didn't tweet out your own recap of 18 \nyesterday's  --  19 \nA I don't know how to tweet.   20 \nQ Okay.  Great.  I didn't think so.   21 \nMs. Malliotakis.   I wish I didn't either.  22 \n  Okay.  23 \nMrs. Dingell.   My staff won't let me.  24 \n  So I just thought you should see them as we enter a second day 25 \n\n  \n  14 \nof questioning, in case you wanted to react to them or clarify anything for any confusion.   1 \nSo there is a thread of tweets, a series of tweets, and we'll just take them one at a 2 \ntime.   3 \nSo I'm introducing first as exhibit J.  This is the first tweet  in the -- K?  Oh, we're 4 \non K.  I'm sorry.  We ended on J.  We are on K.   5 \nSo this is exhibit K.   6 \n    [Fauci Minority Exhibit K  7 \n    was marked for identification.]  8 \nBY : 9 \nQ And this is the first tweet in the series from the Select Subcommittee on the 10 \nCoronavirus Pandemic Twitter account @COVIDSelect.  I know it's X now, but I just can't 11 \nstop calling it Twitter, so I'll just keep calling it Twitter.   12 \nSo this tweet reads  -- and I'll just read it for the record.  It's short.  There's some 13 \nred sirens around the first part.   14 \n\"DR.  FAUCI DAY 1 TAKEAWAYS:  Today, @COVIDSelect questioned Dr.  Anthony 15 \nFauci for seven  hours about his role during the COVID -19 pandemic.  Dr.  Fauci's 16 \ntestimony uncovered drastic and systemic failures in America's public health systems.\"  17 \nAnd then, \"Key highlights below.\"   18 \nSo I wanted to, you know, ask your impression of this statement that your 19 \ntestimony, quote, \"uncovered drastic and systemic failures in America's public health 20 \nsystems.\"   21 \nNow, I know that, you know, we talked about lessons learned, we talked about 22 \nthings we can improve.  I think there was some great exchanges particularly on public 23 \nhealth data, you know  --  24 \nA Right.  25 \n\n  \n  15 \nQ -- therapeutics  --  1 \nA Right.  2 \nQ -- countermeasures, all of that.   3 \nBut do you think it's a fair characterization of your testimony yesterday that we 4 \nuncovered drastic and systemic failures in America's public health systems?  5 \nA No.  I mean, it was discussed under lessons learned.  And one of the 6 \nthings that I said yesterday is that the CDC, for example, and the public  -- local public 7 \nhealth infrastructure, we don't have that kind of realtime communication that goes back 8 \nand forth, and that needs to be corrected so that we can get realtime data in our decision 9 \nmaking .  But I wouldn't characterize it as a drastic and systemic failure.   10 \nQ Okay.  Thank you.   11 \nSo I'll introduce now the next tweet in that thread, exhibit L.  I'll read it for you as 12 \nwell.  13 \n    [Fauci Minority Exhibit L  14 \n    was marked for identification.]  15 \nBY  16 \nQ So the next tweet in the thread read, \"Dr.  Fauci claimed that he 'did not 17 \nrecall' pertinent COVID -19 information or conversations more than 100 times.\"   18 \nSo as anybody who was sitting here yesterday, particularly during the first hour, I 19 \nthink this is a pretty distorted characterization of what actually happened.  So I want to 20 \nunpack this a little bit with you and see if your recollection squares with mine.   21 \nSo do you recall in the first hour of your testimony yesterday being asked whether 22 \nyou had conversations with a long list of individuals about three particular topics?  I 23 \nthink it was COVID origins, the Wuhan Institute of Virology, or EcoHealth Alliance.  Is 24 \nthat your recollection as well?  25 \n\n  \n  16 \nA Correct.   1 \nQ Okay.  And there was a long list, I think, you know, off the top of my head 2 \nmaybe 50, 60 different individuals, at least.  Is that about right?  3 \nA It was a large number.  I don't remember.  4 \nQ Okay.  A large number.   5 \nSo you were asked essentially if over a 3 -year period during which you were 6 \nplaying a key role in our country's response to a novel coronavirus pandemic whether you 7 \nrecalled specific conversations with specific individuals on three specific topics, right?  8 \nA Correct.  9 \nQ Okay.  And I imagine that during that period you likely had thousands of 10 \nconversations easily with different individuals around the world, scientists, public 11 \nofficials, about the coronavirus in some fashion.  Is that fair?  12 \nA Correct.  13 \nQ Okay.  So when you were answering in those instances that you did not 14 \nrecall whether you had conversations with specific individuals, that may well be because 15 \nyou either didn't have a conversation with them about something or you may have, but 16 \nthe conversation about a specific grant, for example, among the thousands and 17 \nthousands of conversations you were having about COVID generally wasn't memorable in 18 \nthe context of a pandemic that at its peak was killing thousands of Americans every day.   19 \nIs that fair?  20 \nA That is correct.  21 \nQ Okay.  So in a few instances, if I recall correctly, you even volunteered that 22 \nsomeone may have been part of a conference call or a broader group, and that even if 23 \nthat didn't fit in the literal definition of having a specific conversation with them, that you 24 \nwanted to be clear and transparent, they may have been part of a conversation, they may 25 \n  \n  17 \nhave been included in a conversation even if you didn't speak with them directly about a 1 \ntopic.   2 \nIs that right?  3 \nA That's correct.  4 \nQ Okay.  And I'm assuming that the reason you did that is because you take 5 \nthis seriously, you want to be as transparent as possible, and you don't want to be 6 \naccused improperly of hiding anything or not being forthcoming.  Is that right?  7 \nA That's correct.  8 \nQ Okay.  Thank you.  And we appreciate that.   9 \nLet's move to the next tweet in the thread.  This will be exhibit M.   10 \n    [Fauci Minority Exhibit M  11 \n    was marked for identification.]  12 \nBY  13 \nQ Okay.  I'll read this into the record as well.  These are all short.   14 \n\"Dr. Fauci profusely defended his previous testimony where he stated NIH does 15 \nnot fund gain -of-function research in Wuhan.  Today, he repeatedly played semantics 16 \nwith the definition of gain -of-function in an attempt to avoid conceding that NIH funded 17 \nthis dangerous research.\"   18 \nSo, now, I think the first part of this tweet we probably generally agree on.  You 19 \ndid defend your prior testimony because, as my colleague just walked you through again, 20 \nfor the sake of being clear for the record, your previous testimony was accurate.   21 \nIs that right?  22 \nA It was accurate, correct.  23 \nQ So, now, the second part says that you, quote, \"played semantics with the 24 \ndefinition of gain -of-function,\" end quote.   25 \n\n  \n  18 \nDo you think that's a fair characterization of your testimony yesterday?   1 \nA No, that was unfair  --  2 \nQ Okay.  3 \nA -- because that's not what I was doing.   4 \nQ And if I remember correctly, you were being precise about using a term with 5 \na specific regulatory meaning.   6 \nIs that right?  7 \nA Correct.  8 \nQ Okay.  And so as we've discussed, and I imagine it will come up again today, 9 \nif I had to guess, that the use of gain -of-function broadly is meaningless in one sense, and 10 \nthen for you, in the context in which you were evaluating whether something was 11 \ngain -of-function and in congressional testimony when you were being asked if something 12 \nwas gain -of-function, that hit a specific meaning due to a regulatory framework that 13 \ndetermined if something was gain -of-function.   14 \nIs that right?  15 \nA Correct.  16 \nQ Okay.  Do you consider that to be semantic or precise?  17 \nA Precise.   18 \nQ Okay.  I do, too.   19 \nSo, in fact, not only did you state that the research funded through a subaward at 20 \nthe Wuhan Institute did not meet the gain -of-function  -- the definition of gain -of-function 21 \nunder the P3CO framework, but I actually recall majority staff agreeing with you several 22 \ntimes toward the end that research conducted at the Wuhan Institute of Virology through 23 \nthe subaward was not subject to the P3CO framework and its definition of 24 \ngain -of-function.   25 \n  \n  19 \nSo I think people seem to understand in the room, despite the tweet suggesting 1 \notherwise.   2 \nSo we can move on to the next one in the thread, which we'll mark as exhibit N.   3 \n    [Fauci Minority Exhibit N  4 \n    was marked for identification.]  5 \nBY  6 \nQ Okay.  And I'll read this one as well.   7 \n\"Dr. Fauci testified that he signed off on every foreign and domestic NIAID grant 8 \nwithout reviewing the proposals.\"   9 \nNow, we talked about this just a second ago, but I think, again, just to clear up any 10 \nconfusion, do you think that's a fair and accurate characterization of your testimony?  11 \nA That is quite unfair.   12 \nQ Okay.  In fact, you testified yesterday and then just before, you know, I 13 \nstarted questions that there are multiple layers of review by numerous experts before 14 \ngrant approvals came to your desk for your signature.   15 \nIs that right?  16 \nA That is correct.  17 \nQ Okay.  And do you think that's important context that should have been 18 \nincluded here?  19 \nA I do think that this is very misleading.   20 \nQ Okay.  And you testified yesterday and then this morning as well that, you 21 \nknow, in any given year there could be a thousand, thousands, I'm sure it fluctuates, 22 \nof -- or so grants each year, just under NIAID, right?  23 \nA Correct.  24 \nQ Okay.  And do you think it would have made sense  -- you already touched 25 \n\n  \n  20 \non this, so you know where I'm going  -- do you think it would have made sense for you to 1 \npersonally review the entire proposal of each submitted grant proposal that had already 2 \nbeen scrutinized and reviewed and approved by numerous subject matter experts within 3 \nand outside NIAID?  4 \nA It would not have been appropriate and necessary and would've been 5 \nphysically impossible, literally.  I mean, to do my job and review every grant, it would 6 \nhave been essentially temporally physical ly impossible to do that.   7 \nQ And that's why you and many in government and elsewhere, many people in 8 \nthis room, rely on the expertise and the hard work of other people to make sound 9 \nrecommendations, right?  10 \nA Correct.  11 \nQ Okay.  I'll move on to the next one.  We're marking this as exhibit O.   12 \n    [Fauci Minority Exhibit O  13 \n    was marked for identification.]  14 \nBY : 15 \nQ So I'll read this aloud while it's going around the room.   16 \n\"A 2020 email, previously released by the Select Subcommittee, proved Dr.  Fauci 17 \nwas aware of dangerous gain -of-function research occurring in Wuhan, China.  Today, 18 \nhe backtracked by arguing he should not have stated that as 'fact.'\"   19 \nOkay.  Do you think that's a fair and accurate characterization of your testimony 20 \nyesterday?  21 \nA Definitely not.  22 \nQ Okay.  And, in fact, if I recall correctly, you provided context yesterday that 23 \nexplained why you thought that the single word picked out of one email was imprecise.   24 \nIs that right?  25 \n\n  \n  21 \nA Correct.  1 \nQ Okay.  And could you just, to the extent that you recall what that email 2 \nwas --  3 \nA Yeah.   4 \nQ -- and what they're discussing here, provide that again?   5 \nA It was an email in which I gave the summary of the February  1st conference 6 \ncall among the evolutionary virologists in which I attended on a listen mode.  And I was 7 \nreporting to my superiors at HHS what the content of that discussion by others were.   8 \nAnd the phrase of talking about gain -of-function research in Wuhan was said at 9 \nthe conference by one of the people who were on the call, not me.  I was reporting what 10 \nother people were saying.   11 \nQ Okay.  So this was  -- again, just to reiterate, because there seems to be 12 \nsome confusion  -- this was not about something you had personal knowledge of.  This 13 \nwas you relaying something that you had heard but not yet personally pressure tested or 14 \nsubstantiated.   15 \nA Yeah.  Everything that was in that email, it was sort of, you know, like an 16 \nafter -activity report.  This was an after -telephone -call report to my superiors.   17 \nQ So, again, just to sort of put in context, you know, here we are, we 18 \nhave  -- we're in our second day of talking about this.  You've been subjected to 19 \nnumerous congressional hearings, some productive, some not as productive perhaps, and 20 \nyou've spoken about this a lot.   21 \nYou were working pretty hard during the pandemic, to be  -- is that fair?  22 \nA Yeah, like about 16 to 18  hours a day, yes.  23 \nQ Okay.  That's what I figured.   24 \nA Right.   25 \n  \n  22 \nQ So you were on a lot of phone calls, read a lot of emails, wrote a lot of 1 \nemails, had lots of meetings, basically all day.  That was probably your day most days, 2 \nright?  3 \nA Correct.   4 \nQ Okay.  So do you think it's  -- do you think it's accurate to say that your 5 \nchoice of a single word in a single email in which you are describing what you heard on a 6 \ncall, absent any other evidence, proves that you were aware of certain research as this 7 \ntweet indicates?  8 \nA Absolutely not.   9 \nQ Okay.  And do you think it is fair for somebody to look at a single email 10 \namong hundreds, thousands, and many of the other things that you have repeatedly said 11 \nin public forums, including congressional hearings and to the press, and use that to 12 \nsomehow suggest that you had knowledge that you never talked about anywhere else?  13 \nDo you think that that's fair?  14 \nA No, it's not fair.   15 \nQ Okay.  We'll move on to the next exhibit, marking this as exhibit P.   16 \n    [Fauci Minority Exhibit P  17 \n    was marked for identification.]  18 \nBY  19 \nQ This is the next tweet in the thread.  It was a long thread, but we're almost 20 \nthere.   21 \nSo exhibit P.  \"Dr.  Fauci was unable to confirm if NIAID has ANY mechanisms to 22 \nconduct oversight of the foreign laboratories they fund.\"  23 \nOkay.  Do you think this is a fair and accurate characterization of your testimony 24 \nyesterday?  25 \n\n  \n  23 \nA No.  1 \nQ Okay.  In fact, what's missing in part from this tweet is you explained that 2 \nthe State Department has an important role in which it conducts some sort of review.  3 \nYou don't work for the State Department so you don't know the mechanics of it, but you 4 \nknow that either making them aware or getting some sort of signoff from the State 5 \nDepartment is integral to approval of international research.   6 \nIs that right?  7 \nA Correct.  8 \nQ Okay.  Any  -- anything else that  -- any other context you think with you was 9 \nmissed from this that you would want to add?  10 \nA Well, I think, it was that \"any mechanisms to conduct oversight\" I think was 11 \nan exaggeration.  I was saying that when you talk about the oversight, one, you 12 \nmentioned the State Department thing, but also the determination of what oversight 13 \ngoes down at   what you called compliance and other elements of the grant, which is the 14 \npeople that I spoke about at various levels in my own staff.   15 \nAnd I could not pinpoint precisely what they did in oversight, but there was 16 \nforeign oversight, and one of them was the State Department.   17 \nBut to say that I couldn't confirm any mechanisms because I wanted to be precise 18 \nand careful, because I didn't know exactly what that individual mechanism was, but to 19 \nsay -- to assume that there's no mechanism of oversight I think was a bit unfair.  20 \nQ Well, it also seems a little strange, because I feel like we spent a lot of time 21 \nyesterday going through exhibits that actually demonstrated  --  22 \nA Right.   23 \nQ -- oversight  --  24 \nA Right.   25 \n  \n  24 \nQ -- over research.   1 \nA Right.   2 \nQ We talked about a suspension  --  3 \nA Right.  4 \nQ -- of a subaward.  We talked about cancellation of a grant.  We talked 5 \nabout all the terms and conditions that were put in place upon the resumption of that.   6 \nA Right.  7 \nQ So it strikes me as a little odd  --  8 \nA Sure.  Yeah.  9 \nQ -- that that was the takeaway.  Is that fair?  10 \nA I mean, the practicality of what happened was proof that this is unfair.  11 \nQ Okay.  Thank you.   12 \nAnd we're now at the end of the thread.  This is exhibit Q.   13 \n    [Fauci Minority Exhibit Q  14 \n    was marked for identification.]  15 \nBY :   16 \nQ This tweet  reads, \"Clearly, the American people and the United States 17 \nGovernment are operating with completely different expectations about the 18 \nresponsibilities of our public health leaders and the accountability of our public health 19 \nagencies.  More accountability coming soon!\"   20 \nSo, again, I thought this characterization was a little interesting.  I actually recall 21 \nyou having what at least appeared to me at the end of the table to be a very productive 22 \nexchange with one of the members about ways to possibly increase or at least evaluate 23 \nthe adequacy of current oversight measures over potentially risky research, including 24 \nover international research, research that's not funded through Federal grants, and other 25 \n\n  \n  25 \ndomestic, non -federally funded research.   1 \nDo you recall that exchange?  2 \nA I do.  3 \nQ Okay.  Did you think that was productive to talk through at the time?  4 \nA I thought it was a good conversation.  5 \nQ Okay.  I did, too.   6 \nSo do you think that  -- you know, I wanted to give you the opportunity here again 7 \nto just provide any context and clarity to your testimony.   8 \nDo you think that the government and the American people are totally different 9 \nabout expectations for public health agencies?  10 \nA What I gathered from this, from reading this for the first time here, showing 11 \nit to me, is that it's implying seemingly strongly that the American people really care 12 \nabout responsibilities and the United States Government doesn't.  And that's not so, 13 \nbecause we do care very much about our responsibilities.   14 \nQ Did you take your role seriously during the pandemic when you held it?  15 \nA I took my role very seriously.  16 \nQ Okay.  And is that why you worked 16 -, 18-hour days?  17 \nA Yes.  18 \nQ Okay.  Thank you.  That's the end of my questions.  I just wanted to 19 \nmake sure that you understood how your testimony was being interpreted, give you the 20 \nopportunity to provide any context and clarity to those that we all have the same 21 \nunderstanding going forward into our second day.  So thank you.   22 \nA Thank you.   23 \nBY :  24 \nQ Good morning, Dr.  Fauci.   25 \n\n  \n  26 \nA Good morning.  1 \nQ I want to apologize from the start, because my question line here is probably 2 \nnot going to be the most pleasant for you, but I do think it is important for the record.   3 \nDuring the course of the COVID -19 pandemic, did you receive threats to your life 4 \nand safety in your role as a leading voice on the pandemic response?  5 \nA Yes.  6 \nQ When did those threats begin to occur?  7 \nA You know, I don't recall exactly when they began to occur, but they certainly 8 \nreached a point when I began pushing back a bit on some of the statements that were 9 \ncoming out from the Trump White  House, for example, about hydroxychloroquine and 10 \nthe virus is going to disappear and go away.  And I was saying, no, that's not the case.  11 \nThen I started getting threats and they accelerated and accelerated.   12 \nQ And what was the nature of those threats, if you recall?  13 \nA Well, some of them were outright death threats.  Some were documented.  14 \nAnd a couple of individuals were arrested, one who had an AR -15 in their car with 15 \nmultiple magazines of ammunition and a bulletproof vest with a GPS going to 16 \nWashington.  And he was stopped in a traffic stop and asked where he was going, and 17 \nhe was going to go to kill me and a couple of other people.   18 \nOthers were harassing phone calls.  They made it very clear, whoever they were, 19 \nthat they knew  --  20 \nQ I -- this is  -- it's hard.   21 \nA Time out for a second.   22 \nQ Yeah, take your time.  23 \nMr. Schertler.   Yeah.  Take a break.   24 \n  If you need a moment to leave the room  --  25 \n\n  \n  27 \nMr. Schertler.   Yeah.  Would it be all right if we go off the record?  1 \n.  Yes.  We can go off the record.   2 \n[Discussion off the record.]  3 \nBY  4 \nQ Back on the record.   5 \nA Yeah, I'm sorry about that, but it just  --  6 \nQ No.   7 \nA I don't want to talk too much about it because I don't want to get it.   8 \nBut it was constant threats to me, my wife, and my children, calling up -- I have 9 \nthree daughters, and they're, you know, at the time 28, 31, and 33, calling them up and 10 \nsaying  -- I don't know how they got their phone number  -- but calling them up and telling 11 \nthem, \"We know where you live, we know where you work,\" and very, very aggressive, 12 \nviolent, sexually explicit threats against them and against my wife, so  -- not to mention 13 \nthe threats against me, which, you know, I get used to, which triggered the need for 14 \nsecurity, which I still have to this day.   15 \nAnd every time somebody gets up, and every time Senator Rand Paul gets up and 16 \nsays I'm responsible for the death of 4 million people, the death threats go up off the 17 \nwall, the threats against me and my wife and my children go off of the wall.   18 \nQ Thank you for sharing.  I can personally not even imagine what you and 19 \nyour family went through.  And it sounds like, just to reiterate, that it started because 20 \nyou used your scientific data and knowledge to disagree with misinformation from 21 \nPresident  Trump.   22 \nIs that correct?  23 \nA That's correct.  24 \nQ And you mentioned your security detail.  Public reporting states that that 25 \n\n  \n  28 \nbegan in early April  --  1 \nMr. Barstow.   I'm going to stop you here.  I don't think we should.  I think he 2 \nacknowledges that he's being provided security.  I don't think we should have further 3 \nconversation about that detail or why those decisions were made.   4 \n.  All right.  I was just going to ask and confirm when it started, if that's 5 \nokay?  If not, we can move on.   6 \nMr. Barstow.   I think  we have established  that he was provided a security detail.  7 \nIt started in 2020, and it continues .   8 \nBY   9 \nQ We can move on.   10 \nDid any threats that you received impact the staff at NIAID who worked closely 11 \nwith you?  12 \nA I'm not sure what they  -- but they were very, very shook up that their leader 13 \nwas being threatened and his family was being threatened.   14 \nSo I don't know what kind of threats they got, but they certainly were shaken  up 15 \nby the fact that it was clear that I was  -- I was being threatened.  I guess they were 16 \nworried about me but also worried about themselves being associated with me.   17 \nQ And I want to get into a little bit about threats to other scientists, because 18 \nyou were not the only one who experienced threats during the pandemic.   19 \nIs that correct?  20 \nA That is correct.  21 \nQ And, in general, does this treatment of scientists discourage them from 22 \nspeaking publicly about their work?  23 \nA Yes, very profoundly.  In fact, when scientists would sometimes want to 24 \npush back at the misinformation and disinformation that's out there, as soon as they do, 25 \n\n  \n  29 \nalmost immediately they wind up getting threats.  I don't know how that happens, but it 1 \nhappens quickly.  Like, it's clear that when somebody gets up and defends Tony Fauci on 2 \nsocial media or what have you, within an hour they get threats themselves.   3 \nSo that's the reason why many of the scientists who want to come out and say, 4 \n\"Hey, what are you doing, this is not what happened,\" et cetera, et cetera, they're afraid 5 \nto come out and publicly defend.  And they've told me so, that they're afraid.  \"I'm 6 \nsorry I'm not defending you, but if I do, I'm going to start getting threatened.\"  7 \nQ And there's the concerns obviously for those scientists in the moment; but in 8 \na future -looking way, are there concerns about how this might impact bright young 9 \nscholars going into science and public service and sharing that information with the 10 \nworld?  11 \nA It is in my opinion, but it's well documented by people who have done 12 \nsurveys that people are very reluctant now to get into public health.  People have left 13 \npublic health and people don't want to get into it because of what's going on, of the 14 \nthreats on individuals in public health.  15 \nQ You're right, there have been studies that have actually proven this.  In 16 \nparticular, a GAO report titled, \"Pandemic Origins:  Technologies and Challenges for 17 \nBiological Investigations,\" which was issued in January of  2023, said, \"Researchers may 18 \nexperience unwanted attention or pressure because of their involvement in pandemic 19 \norigin investigations and leave the field or refuse to participate.\"   20 \nWhat kind of impact on science might that have if people are refusing to take part 21 \nin investigations or leaving the field because of fear?  22 \nA That's going to have an obvious negative impact, because if the best and the 23 \nbrightest don't want to go into a field that right now is really very, very important, maybe 24 \neven more important than it has been, given the history over the last couple of -- few 25 \n  \n  30 \ndecades of emerging infectious diseases, you know, that we spoke about yesterday, from 1 \nHIV to Ebola to Zika to pandemic flu to COVID, et cetera, we need good people in public 2 \nhealth, and if they're intimidated about going into public health then we have a problem 3 \nin this country.   4 \nQ Similarly, Nature published an article in October  2021 titled, \"I Hope You Die:  5 \nHow the COVID Pandemic Unleashed Attacks on Scientists.\"  This article included dozens 6 \nof researchers who shared their stories about death threats or threats of physical or 7 \nsexual violence.   8 \nThere was an associated editorial, also in Nature, that said, \"Institutions at all 9 \nlevels must do more to protect and defend scientists and to condemn intimidation.\"   10 \nThey further said, \"Taking steps to support scientists who face harassment does 11 \nnot mean silencing robust open criticism and discussion.  The coronavirus pandemic has 12 \nseen plenty of disagreement and changing views as new data has come in, as well as 13 \ndiffering stances on which policies to adopt.  Scientists and health officials should expect 14 \ntheir research to be questioned and challenged and should welcome critical feedback that 15 \nis given in good faith.  But threats of violence and extreme online abuse do nothing to 16 \nencourage debate and risk undermining science communication at a time when it has 17 \nnever mattered more.\"   18 \nDo you agree with those statements?  19 \nA Absolutely.  20 \nQ And is that in line with your experience?  21 \nA Very much in line with my experience.  22 \nQ And what can the United States do to ensure we have a properly staffed and 23 \nqualified workforce for scientific research and, specifically, pandemic preparedness?  24 \nA Well, I think there are a lot of things.  One of the things is to show obvious 25 \n  \n  31 \nsupport for public health officials.   1 \nYou had mentioned, there certainly are disagreements that are valid 2 \ndisagreements for discussion.  But when public health officials and individuals are 3 \ndemonized, I think there needs to be a lot of support for those people publicly by 4 \neveryone, including at all branches of government.   5 \nQ I agree with that.   6 \nI'm going to go back to the threats specifically to you.  I'm not going to go into a 7 \nlot of detail, but I do want to get this on the record.  So I am going to introduce this as 8 \nminority exhibit R.   9 \n    [Fauci Minority Exhibit R  10 \n    was marked for identification.]  11 \nBY :  12 \nQ This exhibit is an affidavit filed in Federal Court in Maryland on July  26th, 13 \n2021, by Brett Rowland.  It was filed in support of criminal charges against someone 14 \nnamed Thomas Patrick Connally for threatening to kill you and members of your family.   15 \nAre you generally familiar with this case?  16 \nA Yes, I am.   17 \nQ This affidavit is full of tremendously violent and awful language, and we do 18 \nnot need to get into that.  Obviously, it's very emotional for everybody.   19 \nSo on page 3 of the affidavit  -- and you don't need to look at it if you don't want to 20 \nbecause I'm going to read some of this  -- there's an email that was sent to you with the 21 \nsubject, \"Hope you get a bullet in your compromised satanic elf skull today.\"   22 \nThe email goes through various other threats to you that are horrific.  It has been 23 \npassed around.  It is now in the record.  So I will allow others to read those for 24 \nthemselves.   25 \n\n  \n  32 \nBut do you recall these threats being made to you?  1 \nA Yes.  2 \nQ And, clearly, they had a profound impact on you?  3 \nA [Nonverbal response.]   4 \nQ The reference to you  -- or some of these references to you clearly came from 5 \nmedia coverage of public officials who were making similar statements, maybe not as 6 \nextreme.  But the language of calling you an elf seems to clearly have come from Florida 7 \nGovernor Ron DeSantis.   8 \nDo you recall him using that language?  9 \nA Yes.  I believe he said he wants to throw that elf over the Potomac River.   10 \nQ And so it's clear that statements from public officials, you mentioned 11 \nPresident Trump, now Florida Governor Ron DeSantis, their statements had an effect on 12 \nthe threats that were made towards you?  13 \nA I believe they had a strong effect.  14 \nQ And I think with that, we can end the questions on this tough subject and 15 \nmove onto something a little more palatable.   16 \nBY   17 \nQ Yeah, I actually did have just one discrete follow -up on that.   18 \nYou know, I think it's very clear from what we just heard how much you and public 19 \nhealth officials and scientists did take on during the pandemic, how much of this vitriol 20 \nwas present.   21 \nI think there are thousands of young people at this point in time who are 22 \ncontemplating careers in science, careers in public health, careers in medicine, and 23 \nprobably feel apprehensive based on how people in these professions have been treated 24 \nin the past 3 or 4  years.   25 \n\n  \n  33 \nI'd be curious, as a leading public health official, what you would tell people who 1 \nare considering those careers but feeling fearful as a result.   2 \nA You know, I would encourage them to get into public health because the 3 \npositive impact you can have on your country, the citizens of your country, is worth it.  I 4 \nwish there were not these kind of threats, but I would encourage them to not be put 5 \naback, and hopefully something will be done to diminish that.   6 \nAnd by diminishing it, I mean what you were referring to, stop having the  -- well, 7 \nyou can't stop people from doing things because they can say whatever they want to say.  8 \nBut when public officials and media demonize health officials that is a real strong 9 \ndisincentive.   10 \nAnd I would encourage them to try to look past that at the rewards of what public 11 \nhealth does, is namely taking care of people, which is what I and many of my colleagues 12 \nhave done for a very long period of time.   13 \nAgain, it's a tough situation because you can't, because of freedom of speech, you 14 \ncan't prevent someone from saying what it is that they want to say.   15 \nOne of the things that we could do is to encourage public officials, who 16 \nsupposedly have the good of the country involved, not to be part of the problem of 17 \ndemonizing.  And I have been demonized by a lot of public officials.  I mean, I have 18 \nbecome a campaign slogan throughout some of the election cycles, which is very, very 19 \nclear.  20 \nAnd that's no secret.  I can say that definitively as opposed to \"I can't recall.\"  I 21 \ndo recall definitively what that is.  I have been completely demonized in various 22 \nelections, you know.  \"Fire Fauci.  Throw him in jail.  Vote for me.\"   23 \nQ Thank you.   24 \nI'd like to move again back to this idea we were discussing yesterday, the 25 \n  \n  34 \nimportance of looking at the hours we have with you today and learning from you and 1 \nyour perspective on how we can approach our perspective on the COVID -19 pandemic, 2 \napply lessons learned for future pandemic preparedness and response.   3 \nI'd actually like to look at the discrete issue of long COVID for a few minutes.   4 \nDuring the course of the pandemic, I think it became clear rather quickly that the 5 \nprocess of recovering from COVID -19 was not the same for everyone.   6 \nIn particular, it appeared that some patients were carrying forward residual 7 \nsymptoms for months, potentially years following their infection in a phenomenon that 8 \neventually became known as long COVID.   9 \nSo, Dr.  Fauci, could you explain for us in just a bit more detail what we know about 10 \nlong COVID so far?  11 \nA Yeah.  We know it's real.  Long COVID is a syndrome, and it varies in what 12 \nthe percentage is, in some studies as little as 5  percent, some as high as 20.  The real 13 \nnumber may be probably somewhere around 7 percent.   14 \nBut we're still trying to figure out because of the, I would say, the looseness first 15 \nearly on of the definition of it.  But it really is the persistence of symptomatology long 16 \nafter the acute phase of COVID infections subsides and by normal testing the person is no 17 \nlonger infected.   18 \nAnd yet, anywhere from weeks to months and in some cases to years, they have a 19 \nconstellation of signs and symptoms that are very puzzling, because there is, at this point, 20 \nwith some recent data showing some hints as to what the potential underlying 21 \nmechanism might be.  But they have everything from sleep disturbances to very severe 22 \npost -exercise fatigue, particularly seen in young people, athletes, who were very well 23 \ntrained, who get tired walking up a flight of stairs.   24 \nThey have what's called unexplained tachycardia, autonomic disturbances, 25 \n  \n  35 \ntemperature dysregulation , sweating, hair loss, a whole variety, which is really very 1 \nconfusing.   2 \nSome of the -- in fact, there was an article that came out yesterday or the day 3 \nbefore, while we were here, that there were even a considerable number of deaths 4 \nassociated with long COVID, people who had cardiovascular and neurovascular and 5 \nneurological symptomatology that ultimately led to their death.   6 \nUsually it is not a lethal syndrome, but it has disrupted the lives.  And if the 7 \npercentage of people who actually have long COVID is even as low as a very, very small 8 \npercent on the spectrum of the different reports, then we have a significant problem 9 \nbecause of the fact that so many millions and hundreds of millions of people throughout 10 \nthe world have gotten infected.   11 \nSo we really need to know a precise handle on what the actual occurrence of it is, 12 \nbecause it's a heterogeneous syndrome.  It isn't -- if it's a one, unidimensional 13 \nsyndrome, it's easy to follow and easy to do studies.  But because it's so heterogeneous, 14 \nwe really need to get a better feel on the epidemiology of it and then look at what the 15 \npathogenic mechanisms are to be able to intervene.   16 \nA recent study showed that even in people who, long after you think the acute 17 \nphase is over, they still have recognizable, subtle immune abnormalities and some subtle 18 \npersistence of nucleotides of the virus that you can identify.  So maybe there's not 19 \nactive infection but residual of infection.   20 \nThat's a little bit of a long -winded answer to your question, but that's, you know, 21 \nthat usually happens when you don't know a lot about something.  The more concise 22 \nthe answer, the more precisely you know about things.  23 \nQ And so just for the record and for sort of lay folks, when you are saying that 24 \nlong COVID is heterogeneous in nature, what you're saying is that long COVID is not 25 \n  \n  36 \nnecessarily manifesting the same way in every patient.   1 \nA Oh, absolutely.  Wide variety of manifestations, wide variety.   2 \nI mean, some people, for example, have just chronic fatigue, and other people 3 \nmight have dysesthesias, which are neurological tingling in their feet or in their hands.  4 \nIn fact, that's what Senator Tom (sic) Kaine has.   5 \nQ And then just taking a step backwards, looking at the larger picture of 6 \ncommunicable diseases, I'm curious, are there other communicable diseases that similarly 7 \nresult in these longer -term residual symptoms for patients, or is this a phenomenon that 8 \nis pretty unique to COVID -19?  9 \nA Well, it in some respects is unique, but it's not unprecedented to get 10 \npost -viral syndromes.   11 \nFor example, the classic one that probably all of us recognize was mononucleosis.  12 \nI mean, when you know the stories of kids who are in school, they get mononucleosis, 13 \nthey seem to recover, and they're out of school for weeks and weeks and weeks.  That is 14 \na post -viral asthenia or a post -viral washout or weakness.   15 \nInfluenza occasionally does that in some people.  They get influenza and they 16 \ndon't bounce back for a considerable period of time.  And there have been some studies 17 \nshowing that post -influenza there are an increased incidence of heart attack 6  months 18 \nafter a bad influenza season.   19 \nSo there are situations of post -viral persistent symptomatology, but nothing as 20 \nobvious and as high percentage as this.   21 \nThis is unique in that respect, but the concept of a post -viral syndrome is not 22 \nunique.  And there's the whole issue of myalgic encephalomyelitis/chronic fatigue 23 \nsyndrome, which very likely is related to a prior unrecognized infection.   24 \nQ And so you obviously mentioned earlier in this discussion that there is a 25 \n  \n  37 \ngreat deal that remains unknown about long COVID.   1 \nAre you able to offer perspective on the current steps our scientific community, 2 \nour medical community is taking to better understand long COVID?  Are we doing 3 \nenough there?  Should we be doing more?   4 \nA Yeah.  5 \nQ What more could we be doing?   6 \nA Yeah.  We should be doing more, no doubt, because we don't have the 7 \nanswers.   8 \nInitially, the President's budget and the Congress agreed to give to the NIH 9 \n$1.15  billion to do a very large cohort study to try and determine.   10 \nWe need more studies.  A study came out in, I believe, Cell, the journal Cell, 11 \nyesterday from a large group of people who did a systems biology approach and broke it 12 \ndown into four types of what they call phenotypes of COVID.  One is minimal, one is 13 \nphysical, one is mental and cognitive, and one is mixed.   14 \nAnd they showed that there were various immunological abnormalities associated 15 \nwith each, like activated B cells or various cytokine expressions, et cetera.   16 \nThat's a big  -- that's a good start, but it's only the tip of the iceberg of what we 17 \nneed to learn.  So the answer to your question is, we absolutely need to do more.   18 \nQ Before we conclude on long COVID, is there anything more you'd like to offer 19 \nperspective -wise on the topic?   20 \nA Yeah.  There are a lot of things that we need to learn.  I mean, there are 21 \nmany, many lessons that we can learn from this.   22 \nOne of them is that we never realized  -- and you brought it up  -- long COVID.  I 23 \nmean, there's a lot that these viruses have effect on us, and we really need to learn a lot 24 \nmore about it.   25 \n  \n  38 \n  Before we conclude the round, I just want to make sure, 1 \nCongresswoman Castor, Congresswoman Dingell, anything you'd like to add on any of the 2 \ntopics we covered in this hour?   3 \nMs. Castor.   I think I'll wait till the next hour.   4 \n  Okay.  In which case, I think we can go off the record.  5 \n[Recess.] 6 \n\n  \n  39 \n[11:14 a.m.]  1 \nMr. Benzine.   We can go on the record.  2 \nDr. Fauci, last hour, there was a significant amount of time devoted to threats and 3 \nwhat public health officials and you in particular have experienced.   4 \nI want to reiterate what the chairman said at the beginning of this interview, that 5 \nwe, of course, unequivocally denounce all threats against you, anybody, for doing 6 \nanything, and say for the record I've received death threats.  I've received emails awfully 7 \nsimilar to \"I want to put a bullet in your head and see blood spill down the steps in 8 \nWashington.\"  Some of them parrot talking points from my minority colleagues.   9 \nSo we're all kind of in the same boat here.  This morning, the chairman got a call 10 \nsaying that it would be better if he was just dead.   11 \nLike, I think we spent an awful lot of time on it, and it is terrible, and I wanted to 12 \nsay that we unequivocally condemn anything against you.  13 \nMoving on, you went through a lot of ours, the committee's social media in the 14 \nlast hour as well.  I want to introduce majority exhibit 19.  15 \n    [Fauci Exhibit No. 19  16 \n    was marked for identification.]   17 \nBY MR. BENZINE:  18 \nQ This is the press release issued by the minority of the committee last night.  19 \nI don't want to talk about the content of the release, but, just for the record, the ranking 20 \nmember of the committee is Raul Ruiz.  Do you remember seeing Dr. Ruiz in this room 21 \nyesterday?  22 \nA No, I didn't see him in the room.  23 \nQ All right.  Thank you.   24 \nAll right.  Shifting gears to talk about the conference call, the February 1, 2020, 25 \n  \n  40 \nconference call.   1 \nA Yes.   2 \nQ I'm sure there are 10,000 conference calls that you've been a part of, but 3 \nwhen I say \"conference call\" in the spirit of this interview, this is the one I mean.   4 \nAnd I want to introduce majority exhibit 20.  5 \n    [Fauci Exhibit No. 20  6 \n    was marked for identification.]  7 \nBY MR. BENZINE:  8 \nQ So this is an email chain that you were also presented with yesterday.  As I 9 \njust said, it's from a different custodian, though, and Bates numbered REV 750 through 10 \n753.   11 \nAnd since you had time to review it yesterday, I just want to go ahead and flip to 12 \nthe last page, so the first email in the chain.  And it's a January 31st email from 13 \nDr. Farrar to you, saying, \"Really would like to speak with you this evening.  ... 10pm 14 \nnow UK.  Can you phone me on\" -- whichever phone number that is.   15 \nPrior to this call -- at least, we haven't seen it; maybe it's outside of, kind of, the 16 \norigin space -- had you had communications with Dr. Farrar about the pandemic?  17 \nA Not to my recollection, no, I don't think so.  No.   18 \nQ In this --  19 \nA You know, I don't think so.  I'm trying to  remem - -- no, I really can't recall if 20 \nI had anything prior to this about the pandemic.  21 \nQ No, that's  -- thank you.  I appreciate it.   22 \nBefore I mis -title her, is Patricia Conrad a doctor?  23 \nA No.  24 \nQ Okay.  Ms.  Conrad then  -- 25 \n  \n  41 \nA Yes.   1 \nQ -- responds on your behalf and says, \"Will call shortly.\"   2 \nAnd then the next email up from Dr. Farrar  -- I'm assuming you spoke to Dr. Farrar 3 \nthat morning -- 4 \nA Yes.   5 \nQ -- on January  31st?  6 \nA I did.  7 \nQ Do you remember any of the content of that conversation?  8 \nA He said that he and Kristian Andersen and -- I believe it was also Eddie 9 \nHolmes -- but he and maybe one or two other people, one of which certainly was Kristian 10 \nand very likely Eddie Holmes, but I'm not 100 percent sure about Eddie; maybe Bob 11 \nGarry -- 12 \nQ Uh-huh.  13 \nA -- I'm not sure  -- have looked at the virus and they had some concerns 14 \nregarding the molecular configuration of it, that it could possibly be something that was 15 \nmanufactured.  He said, why don't you call Kristian and get more information from 16 \nhim -- 17 \nQ All right.  18 \nA -- which I did.  19 \nQ I don't know how Dr. Farrar relayed it.  Obviously, in this email, he 20 \nmentions the people involved are Dr.  Andersen, Dr.  Garry, and Dr. Holmes.   21 \nA Uh-huh.  22 \nQ Prior to this point in time, to the best of your recollection, had you had any 23 \ninteractions with Dr.  Andersen, Dr.  Garry, or Dr. Holmes just in, kind of, your normal role 24 \nas Director of NIAID?  25 \n  \n  42 \nMr. Schertler.   You just mean in the past?   1 \nMr. Benzine.   In the past, yeah.  2 \nBY MR. BENZINE:  3 \nQ I'm just trying to figure out if this is the first time that those names hit your 4 \nradar screen or  --  5 \nA I mean, I obviously know who Kristian Andersen is.  He's a very 6 \nwell-respected molecular virologist.   7 \nBob Garry is somebody that I may have had communication with years and years 8 \nago, back in the influenza day s.  So I can't say that I've never had any interaction with 9 \nBob.  It's possible that I did.  10 \nQ Uh-huh.  11 \nA Eddie Holmes, I doubt.  I mean, Eddie's Australian, and it would  -- not that 12 \nthat means I wouldn't have contact with him.  But I would say that this was the first time 13 \nthat I had any meaningful contact with these people.   14 \nQ All right.   15 \nMr. Strom.   Dr. Fauci, is Dr.  Andersen a coronavirus virologist, I guess, prior to 16 \nCOVID -19?  17 \nDr. Fauci.   I don't know.  I don't know.  I'd have to guess.  I'm not sure if he 18 \nwas a corona - -- but he is clearly a well -recognized evolutionary virologist.  19 \nMr. Strom.   Thank you.   20 \nBY MR. BENZINE:   21 \nQ And then the next -to-the bottom email on the first page, the first one from 22 \nyou, that we went through briefly yesterday, you relay to Dr. Farrar, \"I just got off the 23 \nphone with Kristian Andersen and he related to me his concern about the furin site 24 \nmutation in the spike protein of the currently circulating 2019 novel coronavirus.  I told 25 \n  \n  43 \nhim that as soon as possible he and Eddie Holmes should get a group of evolutionary 1 \nbiologists together to examine carefully the data to determine if his concerns are valid.\"   2 \nAnd then you say, \"He should do this very quickly and if everyone agrees with this 3 \nconcern, they should report it to the appropriate authorities.  ... in the USA this would 4 \nbe the FBI and in the UK it would be MI5.\"  5 \nAnd then, \"In the meantime, I will alert my US Government colleagues of my 6 \nconversation with you and Kristian and determine what further investigation they 7 \nrecommend.\"  8 \nI'm going to kind of parse this out a little bit and start with the FBI and MI5 9 \nreference.  Prior to this, had you worked with the FBI before?  10 \nA Worked with them, no --   11 \nQ No. 12 \nA -- but, you know, given them  -- years ago, they wanted me to give a lecture 13 \nto their people about  -- I don't even remember what it was.  But I haven't interacted 14 \nwith them in a  -- what's the right word? -- in a criminal justice way.   15 \nQ Okay.  So, when you wrote \"I would imagine,\" you literally meant \"I would 16 \nimagine.\"  There wasn't a, kind of, experience saying the FBI are the people to call?  17 \nA I don't have experience about who to call, but they were the first ones that 18 \ncame to my mind.  19 \nQ No, that's totally fair.   20 \nAnd, then, moving down in the email, you wrote, \"In the meantime, I will alert my 21 \nUS Government official colleagues of my conversation....\"  22 \nAnd we discussed it a little bit yesterday, the, kind of, email after the February 1st 23 \nconference call.  You said that that satisfied this sentence, that that was you alerting  --  24 \nA Yes.  25 \n  \n  44 \nQ -- Mr. Harrison and Dr.  Kadlec --  1 \nA Yeah.  And I believe -- I believe -- then I gave a quick call to Alex Azar and 2 \nthe Department, saying, \"I'm going to be getting on a call with the group of these people.  3 \nI'll get back to you after.\"  And the getting back was the email we discussed yesterday.  4 \nQ All right.   5 \nSo that was the nature of my next question.  Because the way you wrote 6 \nthis -- and, again, excuse me if I'm, like, taking it out of context -- \"I will alert my US 7 \nGovernment colleagues of my conversation with you and Kristian,\" that sounds like 8 \nalerting of the January 31st phone call, not the February 1st phone call.  So  --  9 \nA Yeah.  In other words, what I believe I did  -- and I think there are emails 10 \nthat would verify that -- I believe I got on the phone with Alex Azar and probably Garrett 11 \nGrigsby, but certainly Alex, and said, \"I'm going to have a phone call tomorrow with a 12 \ngroup of evolutionary virologists.  I'll give you a followup about that call.\"  And that 13 \nfollowup was my email to  -- to -- I forgot who it was.   14 \nQ Brian Harrison and Dr.  Kadlec.   15 \nA Brian Harrison and -- yeah, yeah.     16 \nQ We'll talk about that in a minute too.  17 \nA Yeah.  Right.   18 \nMr. Strom.   Can I ask one quick question?   19 \nWhen you mentioned the FBI, did you have in mind because they were sort of the 20 \nlead agency for past  -- I'm thinking, like, the anthrax mailings and stuff like that?  21 \nDr. Fauci.   Yep.  Yep.  22 \nMr. Strom.   Was that the basis for thinking -- 23 \nDr. Fauci.   Exactly.  24 \nMr. Strom.   -- of them instead of  DHS -- 25 \n  \n  45 \nDr. Fauci.   Exactly.  1 \nMr. Strom.   -- or somebody?  2 \nDr. Fauci.   Exactly.  You know, I had a lot of experience with the anthrax from a 3 \nmedical standpoint  -- 4 \nMr. Strom.   Sure.   5 \nDr. Fauci.   -- so I kind of knew what they were doing.  6 \nMr. Strom.   Okay.  7 \nBY MR. BENZINE:  8 \nQ And,  then, at this point, I guess, to the best of your recollection -- we'll get to 9 \nan email, but -- do you recall if the February 1st call had been set at this point, or was it 10 \nstill in motion?  11 \nMr. Schertler.   And this is, like, that Friday evening  -- 12 \nMr. Benzine.   The Friday --  13 \nMr. Schertler.   -- the Friday of this email.  Is that correct?   14 \nMr. Benzine.   Yes.  Yes, sir.  15 \nMr. Schertler.   Thanks.  16 \nDr. Fauci.   I recall that there were  -- in fact, you may have shown  -- I may have 17 \nbeen shown it yesterday.  I believe that there were a bunch of emails back and forth 18 \nabout logistics.  Here's a number; you know, these are the -- 19 \nMr. Benzine.   Uh-huh.  20 \nDr. Fauci.   -- kind of people on the call, et cetera, et cetera.  That was 21 \nessentially orchestrated by Jeremy.   22 \nQ Okay.  Let me  -- okay, I'll keep going on this one.   23 \n\"Orchestrated by Jeremy,\" so meaning setting up the logistics, maybe who was on 24 \nthe call, was Jeremy?  25 \n  \n  46 \nA Yes.  1 \nQ You wrote in here, \"I told him,\" meaning  Dr. Andersen, \"that as soon as 2 \npossible he and Eddie Holmes should get a group of evolutionary biologists together to 3 \nexamine carefully the data to determine if his concerns are validated.\"   4 \nDo you think it was that push from you that got the call going, or do you think the 5 \ncall was already going?  6 \nA I think it was a combination.  I think Kristian already in his mind felt that he 7 \nwanted to make sure that he had other input from other people.  And somehow that 8 \nmerged into my saying, you know, we really should do that.  9 \nQ Uh-huh.  10 \nA Yeah, it was a combination.  I don't think it was Kristian alone or me alone.   11 \nI just felt that it was important to be as transparent as possible.  It was all part of 12 \nthe theme of the email.  You know, get virologists together, get the FBI, get MI5, get the 13 \nDepartment, just -- let's open this up.   14 \nQ Uh-huh.  15 \nA There's no -- you know, there's no  -- we really need to make this, you know, 16 \ntransparent.  17 \nQ I appreciate that and agree.  I'm trying to kind of, I guess, bifurcate the 18 \nsetting -up-the-logistics version verse, like, setting up the call itself.  19 \nA Right.  20 \nQ And I think the minority has introduced exhibits of Dr.  Farrar sending around 21 \ncall-in numbers, sending around  -- 22 \nA Right.  23 \nQ -- you know, all those kinds of things.  So I think it's pretty well -established 24 \nthat Dr. Farrar set up the logistics of the call.  25 \n  \n  47 \nA Right.  1 \nQ But trying to get a better understanding if the decision to actually need to 2 \nhave a call -- 3 \nA Yeah.  4 \nQ -- was originated with you or a combination.   5 \nA No, I think it was a combination.  I have to say  -- I mean, it was years ago, 6 \nso I don't remember exactly what it was -- 7 \nQ Uh-huh.  8 \nA -- but I think it was very likely it was a combination of Kristian saying, \"We 9 \nreally need to discuss this with other people,\" with my saying, \"Yeah, why don't we get 10 \ntogether a call and do it,\" you know?   11 \nQ So you would say  -- and this will be my last question on it  -- that the logistics 12 \nside, clearly Dr.  Farrar.  The phone number we've --  13 \nA Right.  14 \nQ -- seen, who's on it.   15 \nA Right.  16 \nQ But the idea to discuss the topic would've been you, Dr. Farrar, and 17 \nDr. Andersen -- 18 \nA Yes. 19 \nQ -- kind of coalesced together?  20 \nA Right.  I think so.   21 \nQ Thank you.  22 \nI want to introduce majority exhibit 21.  23 \n    [Fauci Majority Exhibit No. 21  24 \n    was marked for identification.]  25 \n  \n  48 \nBY MR. BENZINE:  1 \nQ This is an email we haven't seen yet, but the vast majority of the email is an 2 \narticle by Jon Cohen that came out on January 31st regarding \"Mining Coronavirus 3 \nGenomes for Clues to the Outbreak's Origins.\"   4 \nI don't necessarily have any questions about that article, more about the email, 5 \nso -- 6 \nA Yeah.  Sure.  7 \nQ -- I won't go through it.  But, for the record, it's an email  -- emails between 8 \nMr. Folkers, yourself, Dr.  Andersen, Dr. Farrar, and is from a FOIA production but Bates 9 \nmarked NIH 2396 through 2402.   10 \nAnd you forward that Science article, which I think everyone will stipulate is about 11 \nthe origins of COVID and what we need to find in order to determine it, to Dr. Farrar and 12 \nDr. Andersen and say, \"You may have seen it.  If not, it is of interest to the current 13 \ndiscussion.\"   14 \nAnd this is when  -- and I'm sure you've seen  -- if you don't recall this email from 15 \nsending it, you certainly recall it from the news reports since --   16 \nA Yes.  17 \nQ -- Dr. Andersen's email back, where he said, \"The\"  -- he said a number of 18 \nthings, but -- \"The unusual features of the virus make up a really small part of the genome 19 \nso one has to look really closely at all the sequences to see that some of the features 20 \n(potentially) look engineered.\"   21 \nI'll get to, kind of, the next line, but do you recall, was the feature he was 22 \ndiscussing there the furin cleavage site?  23 \nA I'm not sure.  24 \nQ Okay.  25 \n  \n  49 \nA Yeah.  1 \nQ He then  --  2 \nA Yeah, I'm not sure, because I  -- I'm not sure if the idea of the furin cleavage 3 \nsite was specifically brought up in my telephone call with Kristian prior to set up the email 4 \nor whether it was after.  5 \nQ If you want to just briefly look back at 20.   6 \nMr. Schertler.   Give us a second.  7 \nMr. Benzine.   Yeah.  8 \nMr. Schertler.   Any particular place?  9 \nMr. Benzine.   Just the top line of Dr. Fauci's email to Dr. Farrar:  \"I just got the 10 \nphone with Dr.  Andersen and he related to me his concern about the furin site mutation 11 \nin the spike protein.\"  12 \nDr. Fauci.   Right.  Okay.  Sure.  Refreshed my memory, yeah.  13 \nBY MR. BENZINE:   14 \nQ So, fair enough to say the unusual feature that he was worried about is the 15 \nfurin site?  16 \nA Right.   17 \nQ Dr. Andersen continues in the second paragraph, \"I should mention that 18 \nafter discussions earlier today, Eddie, Bob, Mike, and myself all find the genome 19 \ninconsistent with expectations from evolutionary theory.  But we have to look at this 20 \nmuch more closely and there are still further analyses to be done, so those opinions could 21 \nstill change.\"   22 \nIs your  -- again, we've asked Dr.  Andersen, but just your understanding when you 23 \ngot this email, that \"Eddie\" was Dr.  Holmes, \"Bob\" was Bob Garry, and \"Mike\" was Dr. 24 \nFarzan?  25 \n  \n  50 \nA Certain that \"Bob\" was Garry.  \"Mike\" probably was Farzan.  1 \nQ Okay.   2 \nAgain -- I've said it probably 15 times at this point over day one and will say it 15 3 \ntimes today -- not a scientist, and understand that there are some terms of art that 4 \nmaybe look one way on paper but not -- not what they meant.   5 \nWhat does \"inconsistent with expectations from evolutionary theory\" mean?  6 \nA I believe what he was referring to  -- again, I can't say what's in somebody's 7 \nmind, but I would believe what he's saying is:  inconsistent with the natural evolution of 8 \na virus.   9 \nQ So, at this point  -- and, granted, Andersen hedged a little bit --  10 \nA But his next sentence  -- 11 \nQ Yes. 12 \nA -- is very critical.  13 \nQ That more work needs  --  14 \nA He says, \"We have to look at this much more closely and there are still 15 \nfurther analyses needed to be done, so these opinions could still change.\"   16 \nQ And I was going to ask about that, too.  Dr.  Andersen's at least first blush 17 \nwas that it looks  --  18 \nA His first blush was that it was inconsistent with natural evolution.  19 \nQ But hedged and said, we need to do a little bit  --  20 \nA And said, this could change when you do further analysis.  21 \nQ I want to introduce majority exhibit 22.  22 \n    [Fauci Majority Exhibit No. 22  23 \n    was marked for identification.]  24 \nMr. Benzine.   And it's just one email.  And, for my own clarity, the sent time is 25 \n  \n  51 \nSaturday, February 1, 2020.  It says 12:29, but the 0000 after that is Greenwich Mean 1 \nTime?   2 \nMr. Schertler.   I think that's right.   3 \nDr. Fauci.   Right.   4 \nMr. Benzine.   So -- 5 \nDr. Fauci.   Just add  -- just go back 5 hours.  This was  -- 6 \nMr. Benzine.   Like, 7:30 in the morning?  7 \nDr. Fauci.   7:30, yeah.   8 \nMr. Benzine.   Is that consistent across your emails, that they're in  -- did you set it 9 \nthat way, I guess?  10 \nDr. Fauci.   I didn't.   11 \nMr. Schertler.   I think it's the way  --  12 \nDr. Fauci.   I don't know where they got this from.   13 \nMr. Schertler.   We've had this happen before.  14 \nDr. Fauci.   I think you got this from the Brits.   15 \nMr. Benzine.   Maybe.  I don't know.  16 \nMr. Schertler.   I think sometimes it's just the way it's printed out when it's 17 \nproduced.  18 \nMr. Benzine.   Okay.  Yeah.  I just wanted to make sure that we're talking 7:30 19 \nin the morning.   20 \nDr. Fauci.   We're talking 7:30 in the morning.  21 \nBY MR. BENZINE:  22 \nQ All right.  Perfect.   23 \nAnd, again, I'm sure you're familiar with this email by this point --   24 \nA Yes.  25 \n  \n  52 \nQ -- but you write to Dr.  Auchincloss, \"It is essential that we speak this AM.  1 \nKeep your cell phone on.  I have a conference call at 7:45 AM with Azar,\" so 15 minutes 2 \nlater.  \"It will likely be over at 8:45 AM.  Read this paper as well as the e -mail that I will 3 \nforward to you now.  You will have tasks today that must be done.\"  4 \nSo, in conjunction with this one, I want to introduce majority exhibit 23.  5 \n    [Fauci Majority Exhibit No. 23  6 \n    was marked for identification.]  7 \nBY MR. BENZINE:  8 \nQ And, in this one, you're forwarding to Dr.  Auchincloss and Dr.  Lane, now, the 9 \nsame Science article that you had forwarded to Dr.  Andersen and Dr. Farrar.   10 \nAnd I just want to ask, is this the email that \"I will forward to you now\" that is 11 \nbeing referenced in exhibit 22?  12 \nA I'm sorry.  Now I'm confused about exhibits.  13 \nQ So, in 22, you say, \"Read this paper\"  -- there's a paper attached; I'm 14 \nassuming that's what you're referencing  -- \"as well as the email that I will forward to you 15 \nnow.\"  And then 9 seconds later you're forwarding an email to Dr.  Auchincloss with an 16 \narticle.   17 \nIs it safe to assume that 22 is referencing 23?  18 \nA Yeah.  Again, I don't recall that, but the circumstances -- 19 \nQ Yes. 20 \nA -- of the emails strongly suggest that.  21 \nQ All right.  I want to talk briefly about exhibit  22.   22 \nSo you'd kind of just had your first call with Dr.  Andersen and Dr. Farrar the day 23 \nbefore, had been told about potential irregularities, at least unexpected irregularities, 24 \nparticularly with the furin site, and the next morning emailed your deputy, 25 \n  \n  53 \nDr. Auchincloss.   1 \nAnd, taking the first line, \"It is essential that we speak this AM.  Keep your cell 2 \nphone on.\"   3 \nWhy?  I guess, why?  Why was it essential?  What information did you need to 4 \nrelay to Dr.  Auchincloss?  5 \nA I wanted  him to \"keep your cell phone on\" because I wanted to find out a 6 \nlittle bit more about what was going on.  Because we went from  -- there's information 7 \nthat I was getting, emails way back from Greg Folkers about \"these are the kinds of things 8 \nthat are going on, these are the experts\" that was, sort of, information gathering.   9 \nQ Uh-huh.  10 \nA Then I'm told by someone that he has concern about a possibility of an 11 \nengineered virus.   12 \nSo then I said to myself -- I put two and two together.  It was natural for me to 13 \nsay, okay, now I really need to know some details about what we are doing in our grants 14 \nso that I will know what we're doing.  And I need to know.   15 \nSo it says, \"Keep your cell phone on.  I may need to get back to you.  I have a 16 \nconference call.  Read this paper as well as the email that I will forward to you.  You 17 \nhave tasks.\"  And the task was:  find out and get back to me about what we're doing.   18 \nQ So you were  -- and correct me if this is a mischaracterization, but -- you had 19 \nbeen told that there was NIAID work in Wuhan January 27th --   20 \nA The original  -- yeah.  I didn't get any information about what it was and 21 \nwhat they were doing.   22 \nQ Yeah.  23 \nA But I knew that we were doing  -- well, you saw the email.  It was, you 24 \nknow, Baric's doing this, and these are the experts, and the other person's doing that, and 25 \n  \n  54 \nwe're doing this, et cetera, et cetera.   1 \nSo that was fine.  That's information preparing me for the press conference.   2 \nQ Uh-huh.  3 \nA Like, what are we doing, as well as who are the experts that we can tap to 4 \nlearn a little bit more about coronaviruses and what might potentially be going on, just as 5 \ninformation.   6 \nThen, when I had the telephone call with Kristian and with Jeremy that there is 7 \nnow suspicion that there may have been an engineered virus, then it turned from not 8 \nonly information but, really, what, specifically, are we doing.   9 \nQ So -- and apologies if this is, like, way dumbing it down -- but, at this point, it 10 \nwas an attempt to determine if your broad understanding of NIAID work in Wuhan could 11 \nhave facilitated what Dr.  Andersen -- 12 \nA Right.  13 \nQ -- just warned you of.   14 \nA Yes.  Yes.   15 \nQ Okay.  16 \nA It was a natural  -- I believe I would've been irresponsible not to do that.   17 \nQ Yes.  I just wanted to  -- there's a lot of email traffic -- 18 \nA Yes. 19 \nQ -- and I'm trying to figure it out.  20 \nIn this email in exhibit 22, you forward a paper called \"Baric, Shi,\" \"SARS Gain of 21 \nfunction.\"  22 \nDo you recall who  --  23 \nMr. Schertler.   I think you said  -- is that  in --  24 \nMr. Benzine.   Twenty -two.   25 \n  \n  55 \nMr. Schertler.   Okay.  I'm sorry.  I see.  1 \nMr. Benzine.   It's under the \"Attachments.\"  2 \nMr. Schertler.   Yep.  Got it.   3 \nBY MR. BENZINE:  4 \nQ I have it if you need it, but I'm just going to ask if you recall, why -- why that 5 \npaper?  6 \nA What we were trying to do is  -- I believe that was sent to me by Greg Folkers 7 \nas -- you know, he's an information fount, in fact, in a very good way.  He just keeps 8 \nsending things.  Like, you know, \"Give us all the information we have.\"  He's the person 9 \nthat briefs me for the  -- any variety of things I might do.   10 \nSo I just  -- I believe  -- I don't recall why I did this, to be quite honest.  I don't 11 \nknow why I sent this.  But it is entirely compatible with, \"Greg sent me this.  Here, take 12 \na look at this.  This is another paper of the things we're funding.\"  But this is the North 13 \nCarolina -- 14 \nQ Uh-huh.  15 \nA -- work.  This isn't Wuhan work.   16 \nQ No.  And we don't need to get into the whole paper, but the paper 17 \ndescribes an experiment that resulted in an underlying virus gaining pathogenicity.  And 18 \nBaric actually warns that these kinds of experiments could be dangerous.   19 \nSo I was just wondering, why -- like, why that paper?  Was it specific to that, or 20 \njust in general that it was Wuhan -affiliated?  21 \nA Well, it wasn't Wuhan -affiliated.  It was  --  22 \nQ No, the work was done in UNC -- 23 \nA Yeah.  24 \nQ -- but had Wuhan as a collaborator.   25 \n  \n  56 \nA We had, I think -- at least, what I found out subsequent to this, way 1 \nsubsequent, is that a collaboration gave Shi the sequence of a virus.  That's the extent of 2 \nthe collaboration.  There were no experiments done in Wuhan.  They gave him a 3 \nsequence.  So that was the collaboration.   4 \nI'm not sure why I sent it to him, but I think it was just the flow of things that Greg 5 \nwas sending me that I was sending to our people, \"Hey, heads -up, take a look at this.\"  6 \nQ Yeah.  7 \nA It was the same thing, I think  -- well, I don't know.  I may have sent 8 \nsomething to  -- in fact, you just showed it to me.  I sent something to Kristian, then said, 9 \n\"Take a look.\"  He said, \"I know.  I'm actually\"  --  10 \nQ Quoted in it, yeah.  11 \nA Yeah.  12 \nQ Do you recall if you ended up speaking with Dr.  Auchincloss after your 13 \nconference call with the Secretary?  14 \nA I know there was an email.  Yeah, I believe I did, but I don't know exactly 15 \nwhen.   16 \nI recall an email where he said, yeah, the work that Baric  -- yeah, show it to me -- 17 \nQ Yeah.  18 \nA -- and we'll go over  -- 19 \nQ We'll introduce that as majority exhibit 24.  20 \n    [Fauci Majority Exhibit No. 24  21 \n    was marked for identification.]  22 \nBY MR. BENZINE:  23 \nQ Is this the email that you were just thinking about?  24 \nA \"The paper you sent says the experiments were performed before the gain 25 \n  \n  57 \nof function pause but have since been reviewed and approved by NIH.\"   1 \nSo that's good.  Thank you.   2 \n\"Not sure what that means since Emily is sure that no Coronavirus work has gone 3 \nthrough the P3 framework.  She will try to determine if we have any distant ties to 4 \nthis....\"  5 \nAnd -- 6 \nMr. Schertler.   \"... to this work abroad.\"  7 \nDr. Fauci.   Yeah.  And \"work abroad,\" I believe he was referring to China.   8 \nMr. Benzine.   Uh-huh.  9 \nDr. Fauci.   I cannot imagine -- I'm not sure what else we were doing.   10 \nYeah, I recall this email.  11 \nMr. Benzine.   So Dr.  Auchincloss would be referencing the Baric -Shi paper, not 12 \nnecessarily the  -- we've talked to him, and he was  referencing the Baric -Shi paper, not 13 \nnecessarily the article that you had also forwarded.   14 \nMr. Schertler.   And the article is  just a --  15 \nMr. Benzine.   It's just an article.  16 \nMr. Schertler.   That's an article from Cohen  --  17 \nDr. Fauci.   Right, right.  18 \nMr. Schertler.   -- on January 30th or 31st -- 19 \nMr. Benzine.   Correct.  20 \nMr. Schertler.   -- which was also forwarded to Dr.  Auchincloss.   21 \nMr. Benzine.   Yes.   22 \nDr. Fauci.   So there were two that were forwarded to him.  23 \nBY MR. BENZINE:  24 \nQ And, in this email, he's referencing the paper, the Baric -Shi paper.   25 \n  \n  58 \nA Right.  1 \nQ \"... experiments were performed before the gain of function pause\" -- so 2 \nthat would've been pre -2014 -ish?   3 \nA Right.  Right.  4 \nQ \"... but have since been reviewed and approved by NIH.\"   5 \nWhat is that process?  6 \nA Again -- we went over it yesterday -- it depends on the years.  If the years 7 \nwere '14 to '17, it would have been the pause.  If it's '17 on, it would've been the P3CO.  8 \nQ I guess what is confusing is they were conducted before the pause; 9 \ntherefore, like, they were all good.  They didn't violate anything that was in place.  10 \nWhy would they be reviewed afterwards if the experiment was already concluded?  11 \nA I'm not sure what he meant by that.   12 \nQ Okay.  13 \nA I'd have to ask him.  You could ask  Hugh, or you might've already asked 14 \nhim.   15 \nQ He didn't really know either, so  --  16 \nA So, if he didn't know, for sure I don't know.  17 \nQ Yeah.  18 \nAnd, as you read, Dr.  Auchincloss continues, \"Not sure what that means since 19 \nEmily is sure that no Coronavirus work has gone through the P3 framework.\"   20 \nI guess this is what we're trying to understand, is, in kind of, like, the process 21 \nwithin NIAID of reviewing these things, the research was done before there was any 22 \nprogrammatic pause --  23 \nA Right.   24 \nQ -- or definition.  The pause went into effect.  It looks like, from how they 25 \n  \n  59 \ntreated the EcoHealth grant  --  1 \nMr. Schertler.   And, Mitch, if I could just -- I'm not sure it's clear that, you know, 2 \nwhether experiments were done before the pause and then after the pause and then 3 \nafter the pause may be reviewed.  I know the  article --  4 \nMr. Benzine.   Yeah, I don't know.  5 \nMr. Schertler.   -- is a 2015 article, I believe, so  -- 6 \nDr. Fauci.   I'm not sure what he's referring to.  But what is in this email is that 7 \nEmily is sure that no coronavirus work, in general  -- I don't think she was referring  -- has 8 \ngone through the P3C framework.   9 \nMr. Benzine.   Uh-huh.  10 \nDr. Fauci.   Which means that no coronavirus work that we are funding has been 11 \nof the kind that would go through the definition we went over multiple times yesterday.  12 \nWhich means that we're good with regard to coronavirus work.  It's all gone through the 13 \nappropriate -- 14 \nMr. Benzine.   Okay.  15 \nDr. Fauci.   -- evaluation, and it was determined that it did not need to go up to a 16 \nhigher level.   17 \nSo it's pretty clear.  I mean, it says it very explicitly:  is sure that no coronavirus 18 \nwork has gone through the P3CO.  19 \nBY MR. BENZINE:  20 \nQ And then you respond, \"OK.  Stay tuned.\"   21 \nDo you recall if you talked to Dr.  Auchincloss after this email?  22 \nA I don't recall, but I might have.  I mean, likely that I did.  And he confirmed 23 \nthat, in fact, nothing went through.  But I don't recall if I specifically spoke to him.  I 24 \nlikely did.  25 \n  \n  60 \nQ Moving on further through the February 1st chronology and introducing 1 \nmajority exhibit 25.  2 \n    [Fauci Majority Exhibit No. 25  3 \n    was marked for identification.]  4 \nBY MR. BENZINE:  5 \nQ This is an email chain.  At the very bottom is the logistics email from Dr. 6 \nFarrar to you from 6:00 in the morning someone's time; I'm not sure whose.  And this 7 \nemail is Bates marked SSCP_NIH 1902 to 1903 and has the call -in details for the February 8 \n1st conference call that we've talked about.   9 \nYou then forwarded the information to Dr.  Collins.  Dr.  Collins says he'd join.   10 \nAt some point, Dr.  Tabak gets included, says, \"Would you like me to join?\"  11 \nCollins says, \"Fine with me, but I note Jeremy says he wants to keep this a 'really tight 12 \ngroup.'  Tony, what do you think?\"   13 \nAnd then Dr. Tabak, after the call, introduces a publication.   14 \nI think it's pretty clear for the record, but just one more time:  You were on the 15 \nFebruary 1st call?  16 \nA I was on the February 1st call.  17 \nQ Okay.  And Dr.  Collins was also on?  18 \nA Dr. Collins was on the February 1st call.   19 \nQ And was Dr. Tabak also on the call?  20 \nA Well, Tabak was not officially on the call.  You know, I don't know who was 21 \non a speakerphone, but he was not on the call.   22 \nMr. Schertler.   So, if you could just give us your recollection of -- 23 \nDr. Fauci.   My recollection is that Dr. Tabak was not on the call.   24 \nBY MR. BENZINE:  25 \n  \n  61 \nQ Not?  1 \nA Yeah.  I don't recall him being on the call.  2 \nQ Were there any other  -- do you recall any other government employees 3 \nbeing on the call?  4 \nA To my knowledge, it was just Francis and I.  I don't recall Larry being on the 5 \ncall.   6 \nQ We --  7 \nA He could have been, but I don't recall him being on the call.   8 \nQ Okay.  That's fair.  We talked to Dr. Tabak.  He was on the call, and he 9 \ntalked about O -linked glycans on the call.  But  --  10 \nA Well, he was silent, at least.  11 \nQ So I want to talk about the first forward of yours to Dr.  Collins.  Did 12 \nDr. Collins request to be on the call?  Like, how did the process  -- you obviously 13 \nforwarded the call -in details to Dr.  Collins.  How did that process play out?  14 \nA Well, Dr.  Collins is my boss.  So this seemed like a pretty important call for 15 \nNIH, so I thought it would be a good idea to let my boss know.   16 \nQ So you got invited  -- or you had the January  31st call, got invited to the 17 \nconference call after Farrar set it all up, and then went and was like, \"Dr.  Collins, there's 18 \nthis call happening.  Would you like to take part?\"  Is that fair?  19 \nA I believe that's the way it went, because  -- yeah, I believe that's the way it 20 \nwent.  21 \nQ Okay.   22 \nIt's been in  the news for a while and Dr.  Redfield has talked about this a lot and 23 \ntestified in front of us in March that he was not included in the call.  He was very clear to 24 \nsay he was not  -- he's not testifying that he was intentionally excluded, just that he was 25 \n  \n  62 \nnot included.   1 \nAt any point, did  --  2 \nA Actually, he said that I kept him out of the call because he had a different 3 \nviewpoint.  4 \nQ He did say that  --  5 \nA He said that clearly.   6 \nQ Do you recall having any conversations with  --  7 \nA Sorry.  8 \nQ No.  No problem.  Do you recall having any conversations with 9 \nDr. Redfield about the call?  10 \nA No.  No.  11 \nQ Why not?  12 \nA Because why would I do that?  This was a call that was organized by Jeremy 13 \nFarrar, who was the organizer of the call, and it wasn't my call who was in and on.  But it 14 \nwas perfectly appropriate for me to notify my boss.   15 \nQ This is the beginning of a pandemic, discussing how to respond to the 16 \npandemic.   17 \nA Yeah.  Yeah.  18 \nQ Dr. Redfield is the head of the CDC --   19 \nA No, I'm sorry, I disagree with you.   20 \nQ Okay.  21 \nA I disagree with you completely.  It is my responsibility to notify my boss.  22 \nThe next morning, I notified the chief of staff of the Department of Health and Human 23 \nServices, who is the chief of staff to the Secretary, who is Bob Redfield's boss.   24 \nQ Did you have any conversations with Dr.  Redfield after the fact regarding the 25 \n  \n  63 \ncall?  1 \nA I don't recall.  2 \nBY MR. STROM:  3 \nQ And just for completeness, would the same chain -of-command concern also 4 \napply to Dr.  Kadlec?  So you said  --  5 \nMr. Schertler.   I'm sorry.  Could you just clarify that, Jon?  6 \nBY MR. STROM:  7 \nQ You said that it was appropriate for you to go to Dr.  Collins and then email 8 \nHarrison a summary of the chat, of the call, but that reaching out directly to Bob Redfield, 9 \nbecause he's the head of the CDC, would've been  -- and I'm not trying to put words in 10 \nyour mouth; I'm just trying to understand  -- would've been inappropriate.   11 \nDoes that same concern apply to Dr.  Kadlec, as the Assistant Secretary?   12 \nA Does what same concern?  I'm sorry.  I'm a little confused.  13 \nQ I'm trying to understand why, without the distorting light of hindsight, why 14 \nDr. Redfield wouldn't be invited just as, like, a courtesy or as, like, you know, someone 15 \nwho's also working the response issue.   16 \nA You'd have to ask Dr. Farrar.  He was the one -- 17 \nQ Okay.  18 \nA -- that organized the call.  He invited me on the call -- 19 \nQ Uh-huh.  20 \nA -- and I felt it was my responsibility to let my boss know that I was going to 21 \nbe on that call.  22 \nQ Okay.  Thank you.   23 \nA Yeah.  24 \nQ I'm just trying to understand.   25 \n  \n  64 \nA Yeah.  1 \nBY MR. BENZINE:  2 \nQ Prior to notifying Dr.  Collins, did you ask Dr.  Farrar if you could invite 3 \nDr. Collins?  4 \nA Dr. Collins and Dr. Farrar are pretty good friends.  So I didn't think that that 5 \nwas going to be an issue.  6 \nQ Okay.   7 \nThis was introduced yesterday, but I'm going to introduce it again, but you've 8 \nalready looked at this email, majority exhibit 26.  9 \n    [Fauci Majority Exhibit No. 26  10 \n    was marked for identification.]  11 \nBY MR. BENZINE:  12 \nQ And as we went through yesterday, we're going to  -- this is Bates marked 13 \nSSCP_NIH 1796 through 1798.   14 \nAnd the email on 1797, like we talked about yesterday, is, kind of, your summary 15 \nof the conference call and, as you said earlier this hour, your, I guess, notification that the 16 \ncall happened -- 17 \nA Right.  18 \nQ -- to the chief of staff and a few others, Dr.  Kadlec being one of them.   19 \nAnd we talked about this email quite a bit yesterday, so I'm not going to harp too 20 \nmuch on it.  We focused a lot on the line about \"the fact that scientists in Wuhan 21 \nUniversity are known to have been working on gain -of-function experiments to determine 22 \nthe molecular mechanisms associated with bat viruses adapting to human infection, and 23 \nthe outbreak originated in Wuhan.\"   24 \nAnd the, kind of, context of that statement is that, now that we've walked through 25 \n  \n  65 \nall this, from Dr.  -- I believe it was Dr.  Andersen that told you that particular line.   1 \nMr. Schertler.   So I'm not sure that that  -- I'm not sure that Dr. Fauci had a clear 2 \nrecollection of who told him that.   3 \nDr. Fauci.   Yeah.  I said I wasn't sure who said that.  4 \nMr. Benzine.   Okay.  5 \nDr. Fauci.   That was my statement.   6 \nBY MR. BENZINE:  7 \nQ No, no, I'm saying I believe from our investigation it was Dr.  Andersen.   8 \nA You believe from your investigation -- 9 \nQ Yes. 10 \nA -- it was Dr.  Andersen?   11 \nQ Not your recollection.  12 \nA Okay.  13 \nQ So I'm walking back through the timeline a little bit.   14 \nJanuary 31st, Farrar asked you to call Dr.  Andersen.  On the call with 15 \nDr. Andersen, he expresses some concern about this being inconsistent with evolutionary 16 \ntheory and the furin cleavage site looking possibly like an intentional mutation.   17 \nAnd then it's that concern coupled with the outbreak originating in Wuhan that 18 \nkind of pieces together what is happening  -- what research is happening in Wuhan, that 19 \nnow we're concerned about the research happening in Wuhan.   20 \nAnd you said yesterday  that -- and apologies again if I mischaracterize it, 21 \nbut -- that you maybe shouldn't have said \"by the fact\" that scientists in Wuhan 22 \nUniversity have been known to do gain -of-function research, that it was something that 23 \nwas relayed to you, not --  24 \nA Right.  25 \n  \n  66 \nQ -- something that you knew as fact.   1 \nA I didn't know, myself, as a fact.   2 \nThis entire email is a report of the phone call, of which I was in listening mode.  3 \nAnd I was reporting, as you say, all of the scientists on the call felt that this was 4 \nnot -- blah, blah, blah.  They were concerned about the fact that, upon reviewing the 5 \nsequences -- yada ya.   6 \n\"The suspicion was heightened\" -- their suspicion was heightened by their 7 \nstatement -- 8 \nQ Uh-huh.  9 \nA -- that they had heard that there was gain -of-function or whatever it is that 10 \nwas going on at Wuhan.   11 \nQ And just if you do recall, you wrote \"Wuhan University.\"  Did you mean 12 \nWuhan Institute of Virology, or do you not  --  13 \nA I can tell you that my knowledge of Wuhan, the Wuhan Institute of Virology, 14 \nWuhan University, was so vague that I don't believe at the time that -- even though there 15 \nwas an email from Greg that said these are the things we're doing, I didn't make that 16 \nconnection.  So I didn't even know there was a Wuhan Institute of Virology, and I called 17 \nit Wuhan University.   18 \nHe may have said \"Wuhan Institute of Virology\" during that call, but I believe that 19 \njust goes to show you how little I knew about what was going on in Wuhan.  20 \nQ So it'd be more fair  -- obviously, you're relaying what someone told you on a 21 \nconference call, but it would be more fair to read this sentence as:  \"... the fact 22 \nthat\"  -- well -- \"scientists in Wuhan,\" maybe cutting out the \"University\" -- that you didn't 23 \nknow  -- that you knew the suspicion was in Wuhan, but not necessarily which institution 24 \nin Wuhan.   25 \n  \n  67 \nA I said \"Wuhan University\" -- I didn't say it.  I thought that that's -- 1 \nQ Okay.  2 \nA -- what he said.  Therefore, I misinterpreted what he said.   3 \nQ Outside of this email, do you recall anything else that was discussed on the 4 \nconference call?  5 \nA Well, I believe we said it yesterday, but I'll re -say it again if you'd like.  6 \nThere was different discussions -- it was different opinions of different people.  Some 7 \npeople said that they didn't think that this was an issue at all.  Other people said, you 8 \nknow, I think that this is something that we really need to look at carefully.  And then a 9 \nfew people said, yeah, I'm not sure either, let's look at it.   10 \nThe final takeaway was, I believe, articulated by me in the last paragraph:  \"They 11 \npass no judgment at all at this point,\" and they feel we need to look at it a little more 12 \ncarefully.  \"No assumption.\"  \"Scientific look\" at the evolutionary virology.  What that 13 \nleads to \"remains to be seen.\"   14 \nSo the tenor of the conversation, which I summarized in this email, was that we 15 \nneed to find out more.  16 \nQ A few lines down from the Wuhan line, there's a sentence that starts with 17 \n\"Bottom line.\"  Let me know when you find it.   18 \nA \"Bottom line.\"  19 \nQ Yeah.  \"Bottom line is that they all agreed with my strong suggestion to 20 \ngather an even larger group under the auspices of an internationally credible 21 \norganization.\"   22 \nOn the call, did you make that suggestion?  23 \nA I must have.  I wrote it down, so  --  24 \nQ And the next sentence:  \"After some discussion they all felt that the WHO 25 \n  \n  68 \nwould be the most appropriate convener of such a group.\"   1 \nI guess I'm just trying to understand the flow.  WHO didn't investigate the origins 2 \nfor, like, another year after this.  3 \nA Right.  4 \nQ And trying to understand what the, kind of, direction after the call was 5 \nsupposed to be.  6 \nA Yeah.  7 \nQ So there are some communications with you, Dr.  Collins, and Dr. Farrar after 8 \nthis about this convening a WHO group.  9 \nA Right.  10 \nQ Is that what you meant?  11 \nA Yeah.  The responsibility to nudge the WHO to put a group together was 12 \nJeremy's, predominantly, perhaps a bit of Francis.  You can ask Francis.   13 \nQ Uh-huh.  14 \nA Or you maybe already asked Francis; I don't know.  But it was 15 \npredominantly Jeremy.  But Jeremy and Francis, I believe, went back and forth about the 16 \nWHO.   17 \nMy responsibility, which is what I did, was to let the people on the Department 18 \nknow, particularly Garrett Grigsby, who's the international affairs guy, as well as Bob 19 \nKadlec, as well as Brian Harrison, to let the Secretary know.   20 \nAnd I believe that the Department  -- it was a multifaceted approach.  I believe 21 \nthat the Department was going to take the lead in getting the National Academy of 22 \nSciences to take a look at it.  23 \nQ I want to introduce majority exhibit 27.  24 \n    [Fauci Majority Exhibit No. 27  25 \n  \n  69 \n    was marked for identification.]   1 \nMr. Benzine.   And it's very tiny font, and I apologize for that, but that's how it 2 \nwas printed.  3 \nMr. Schertler.   Get your glasses out.  4 \nMr. Benzine.   Yeah, get the glasses out.  5 \nDr. Fauci.   Even with glasses, it's  --  6 \nMr. Benzine.   It's small.  Hopefully Dave can read it and can assure him that 7 \nwhat I'm reading is  --  8 \nMr. Schertler.   So, listen, I've got an app --  9 \nMr. Benzine.   Oh, we don't need to do all that.  I'll just read it.   10 \nBY MR. BENZINE:  11 \nQ So this is a Slack conversation that is Bates marked REV 2902 that was 12 \nprovided to us by Dr.  Andersen.  In the conversation is Dr.  Andersen, Dr. Holmes, 13 \nDr. Rambaut, and eventually Dr.  Garry.   14 \nThe very top message -- these messages are from February  1, 2020 -- Andersen 15 \nsays, \"Yes, call.  Cheers.\"  16 \nAndrew Rambaut says, \"Stay on here in case we need to message.\"   17 \nAndersen agrees.   18 \nIt goes down a little bit further.  The first message from Eddie Holmes, who's the 19 \nsquare avatar, says, \"Big ask!\"   20 \nDo you think he's referring to your ask of a WHO -convened group?  21 \nA You know, I can't speculate what he meant by -- I can't even see it, but I can't 22 \nspeculate what Eddie meant by \"Big ask!\"   23 \nBut let me ask you, it says here  --  24 \nMr. Schertler.   The time sequence would be top to bottom?   25 \n  \n  70 \nMr. Benzine.   Top to bottom, yes, sir.  1 \nMr. Schertler.   Okay.  2 \nDr. Fauci.   -- \"Yes, call.  Cheers.\"   3 \n\"Stay on here in case we need to message.\"   4 \n\"Yup.\"  5 \n\"Just FYI - o-linked glycan also present in bat.\"   6 \n\"Crap, don't know the context around 5 that make them glycan sites.  I might be 7 \nwrong.  The series are there in the bat.\"   8 \nI don't know what \"Big ask!\" means.  I don't  -- I'm not sure what he means.   9 \nBY MR. BENZINE:  10 \nQ The next message, which is the last one that I want to ask about, Andersen 11 \nsays, \"Destroy the world based on sequence data.  Yay or nay?\"   12 \nAny recollection of something like that happening on the conference call?  13 \nA No.   14 \nQ No?  Okay.  15 \nAfter the conference call broke, besides the, kind of, summary email that you sent 16 \nup your chain, did you have any other conversations with anyone in the government 17 \nregarding the call?  18 \nA You know, I don't recall that I did.  I just don't.  I've been thinking about it 19 \nand thinking about it.  I don't recall anything after that, except that I  -- you know, I felt I 20 \nfulfilled my responsibility.   21 \nQ Yeah.  22 \nA You know, I told my boss, I told this, I told this, I told that, I told the chief of 23 \nstaff to the Secretary.  I kind of covered the bases.  24 \nBY MR. STROM:  25 \n  \n  71 \nQ There's a letter from OSTP to the National Academies.   1 \nA Yeah.  2 \nQ Do you recall talking to OSTP about this?  Or was that --  3 \nMr. Schertler.   I'm sorry.  Could you  --  4 \nMr. Strom.   There's a letter from OSTP to the National Academies asking them to 5 \nconvene.  6 \nMr. Schertler.   When would that  -- could you give us a little date?   7 \nMr. Strom.   It would be after February 4th, so after this initial call.   8 \nBY MR. STROM:  9 \nQ Do you recall having any discussions with OSTP about the issue?   10 \nA You know, I don't.  I don't.  11 \nQ Okay.   12 \nAnd then you mentioned thinking about the FBI being the appropriate agency.  13 \nYou don't recall talking to them about it?  14 \nA No, I don't.  15 \nQ Okay.  Thanks.   16 \nBY MR. BENZINE:  17 \nQ At any point on either of the calls, January 31st or February 1st, do you recall 18 \nsuggesting drafting a paper or a manuscript or any kind of publication about what they 19 \nwere doing?  20 \nA You know, there was some back -and-forth about a report or what have you, 21 \nvaguely, back and forth.  Yeah.   22 \nQ Do you recall whose suggestion it was to draft  --  23 \nA No, I don't know what it was, but I remember when the report  -- when the 24 \ndiscussion came up about what to do with it, I said, if you do anything with it, you've got 25 \n  \n  72 \nto do it in a peer -reviewed way so that it can get evaluated outside of this group.   1 \nI think if you can look at the emails that I have been shown since, which I 2 \nforgot -- and I don't have access to them, because I don't have access to the NIH 3 \nanymore -- 4 \nQ Yeah.  5 \nA -- is that my whole tenor throughout the entire thing was transparency, not 6 \nonly transparency in letting everybody know but also, if you're going to do it, make sure 7 \nyou do it in a way that gets peer -reviewed, not just coming out with your opinion.  Get 8 \nyour opinion peer -reviewed.   9 \nQ Eventually -- and we talked about it yesterday a little bit, but I want to ask a 10 \nfew final, kind of, clarifying questions on the \"Proximal Origin\" paper that came out first 11 \nas a blog post on Virological in the middle of February and then in Nature, Nature 12 \nMedicine, in March.  13 \nDid you ever edit or suggest any edits to that paper?  14 \nA No.  15 \nQ To your knowledge, did Dr.  Collins ever edit or suggest any edits to that 16 \npaper?  17 \nA To my knowledge, he did not, but you'll have to ask him.   18 \nQ And, to your knowledge, did Dr. Farrar ever edit or suggest any edits to that 19 \npaper?  20 \nA I cannot speak for Dr. Farrar.  I don't know.   21 \nQ As the minority said, we've talked to all the U.S. -based authors or those who 22 \nare acknowledged on that paper, so I won't go through all of the science in it, except for I 23 \nwant  -- you were sent drafts periodically?  24 \nA Right.   25 \n  \n  73 \nQ A couple.  I think it was less than 10, more than 5, drafts  -- 1 \nA Right.  2 \nQ -- periodically.  Do you recall ever reviewing the drafts as they were coming 3 \nin?  4 \nA It depends on what you mean by \"review.\"  I took a look at them.  I didn't 5 \nmake any editing or modification of it.   6 \nAs they came in, I remember once saying -- after maybe the final one came in, and 7 \nsaid, you know, \"Well done, nice job,\" sort of a courtesy response.   8 \nBut, again, not being an evolutionary virologist, I didn't quite understand the 9 \nsequences.  10 \nQ Yeah, yeah.  No, I understand.  They're difficult to follow, that's for sure.   11 \nA Yes. 12 \nQ It's kind of drinking from a fire hose.   13 \nSo I want to understand that correctly.  The drafts would come in.  You maybe, 14 \nmaybe not, would open them, read them  -- 15 \nA Yes.  16 \nQ -- and then say, \"Thanks,\" something like that, in response?   17 \nA Yeah.  It was mostly \"Thanks,\" you know, \"Appreciate it.\"  18 \nQ The paper made two primary conclusions by the March publication.  It 19 \nchanged a little bit between February and March in the peer -review process.   20 \nThe first one was, \"Our analyses clearly show that COVID -19 is not a laboratory 21 \nconstruct or a purposefully manipulated virus.\"   22 \nDo you agree with that statement?  23 \nA I'm not sure what you mean, do I \"agree.\"  I didn't examine the molecular 24 \nbiology, so I would only say that I have faith in people that I know are very, very 25 \n  \n  74 \naccomplished evolutionary virologists.  So, when you say \"agree with it,\" I mean, I 1 \nhaven't examined it myself and said, \"Ah, this is my conclusion.\"  There are certain 2 \nthings that, when you're out of your lane of expertise, you have to rely on the consensus 3 \nof people who make a statement.  So, in that respect, I would agree.  But it's not my 4 \nevaluation of it.   5 \nQ The second major conclusion was, \"However, since we observed all notable 6 \nCOVID -19 features, including the optimized receptor -binding domain and polybasic 7 \ncleavage site, in related coronaviruses in nature, we do not believe that any type of 8 \nlaboratory -based scenario is plausible.\"   9 \nYou've said that you have an open mind about the outcome of the virus, but -- 10 \nA Right.  11 \nQ -- that's a definitive statement:  No laboratory -based scenario is plausible.   12 \nI'm going to ask you the same question.  Do you agree with their outcome in that 13 \nnature?  14 \nA Again, I would have to agree  -- let me go step by step so we don't get any 15 \nmisinterpretation.   16 \nWhen I say I have an open mind, I have an open mind of a lab leak or I have an 17 \nopen mind that it is a natural occurrence of a spillover.   18 \nI believe specifically what he's saying is something that's manufactured.  And as I 19 \nmentioned to the chairman yesterday, you know, a lab leak could be somebody, you 20 \nknow, gets a virus in the environment, comes to the lab, and then it leaks out of the lab.  21 \nSo that's what I meant by that.   22 \nI can't say I agree or disagree, except that I trust the evolutionary virologist who 23 \nexamined it.  And I believe when he went over it, over it, and over it again, he looked at 24 \nwhat it would require for this to have been manufactured, and he didn't think that that 25 \n  \n  75 \nwas a plausible explanation.  And several very good evolutionary virologists agree with 1 \nhim.   2 \nSo when you say do I agree, I agree that, usually, almost always, I take the 3 \nrecommendation of a group of highly respected people.  And, in that respect, I would 4 \nhave to say I don't necessarily agree because of me but I take their word.  5 \nQ I guess what -- we talked a little bit about yesterday that, like, words on 6 \npaper matter as, kind of, people are reading this.   7 \nA Right.  8 \nQ And we talked about this, so this isn't necessarily a question to you.  But 9 \nthe intent versus what was written down appears to be different, of -- they wrote down, 10 \n\"We do not believe any type of laboratory -based scenario is plausible.\"  That would 11 \neliminate, in my mind, any type of laboratory -based scenario, not just purposeful genetic 12 \nmanipulation.   13 \nSo I don't have a question for you, because I think you'll just say, we'll go with 14 \nwhat they said or -- 15 \nA Right.  16 \nQ -- you're not in Dr.  Andersen's head.  17 \nA Yeah.  18 \nDr. Wenstrup.   Mitch, can I --   19 \nMr. Benzine.   Yes. 20 \nDr. Wenstrup.   First of all, I appreciate talking about some of the scientific 21 \nfindings.  You know, we were talking about long COVID before and medical challenges.  22 \nAnd when COVID started and we're in lockdown, I'm on the phone with another doctor in 23 \nOhio; we're trying to research anything we can.  Our first thought is, how the heck do 24 \nwe treat this thing, you know?  But, also, you know, where did this come from?   25 \n  \n  76 \nAnd so, you know, in that vein, I guess, I'm looking at the Slack message from 1 \nDr. Andersen, April 17, 2020.  And he says, \"We also can't fully rule out engineering.  2 \nThat furin site could have been inserted via Gibson assembly.  And, clearly, creating the 3 \nreverse genetic system isn't hard  -- the Germans managed to do exactly that for 4 \nSARS -CoV-2 in less than a month.\"   5 \nWell, this is the same day, the very same day, that you talked about \"Proximal 6 \nOrigins\" paper on the White House lawn, and there was no discussion.  It was just  -- you 7 \nknow, I'm just telling you what people perceive at home, right?  8 \nDr. Fauci.   Uh-huh.  9 \nDr. Wenstrup.   There was no discussion about what Dr.  Andersen said the very 10 \nsame day, and he's the one who was one of the authors of \"Proximal Origins.\"   11 \nOther concerns that he had -- you know, we started hearing about lab leaks  --  12 \nMr. Schertler.   Chairman, I don't  mean to interrupt.  Is this a document that Dr. 13 \nFauci was on?  Or is this  --  14 \nDr. Wenstrup.   I'm just framing my experience here, okay?  So nothing  -- just 15 \nfor the record, this is what I saw and what I heard.  16 \nMr. Schertler.   No, I just wondered if he should've been familiar with this or if he 17 \nhad seen it before.  18 \nDr. Wenstrup.   Well, he introduced \"Proximal Origins\" on the White House -- 19 \nMr. Schertler.   No, I --  20 \nDr. Wenstrup.   -- lawn that same day.   21 \nMr. Schertler.   But you're talking about a Slack message.  I wasn't sure what 22 \nthat was.  23 \nDr. Wenstrup.   Well, they've been public.  We've already produced them.   24 \nBut, anyway, I'm just telling you, this is my experience, okay?  Can you accept 25 \n  \n  77 \nthat?   1 \nMr. Schertler.   Yes, of course.   2 \nDr. Wenstrup.   Okay.  Okay.  3 \nAnd so, also, Ian Lipkin.  \"The Wuhan Institute  of Virology\" -- this is October 30th 4 \nof '22.  \"The Wuhan Institute of Virology has worked with bat samples and cultured bat 5 \nviruses at BSL -2.  This is a matter of published record  -- materials and methods in two 6 \npapers.  This is unacceptable.\"   7 \nThat seemed to be the feeling of most of the authors on \"Proximal Origins,\" from 8 \nsome of the things that have been revealed in their comments.   9 \nSo this is, like, February of '20 that I start looking for stuff with another friend of 10 \nmine at home.  And I see, in 2012, you wrote a paper asking for Dr.  Fouchier  -- I might 11 \nbe saying it  incorrectly.  12 \nDr. Fauci.   Fouchier.  13 \nDr. Wenstrup.   Fouchier -- for his research to be banned because it revealed the 14 \nfour mutations needed for H5N1 to go human to human.  That sounds pretty dangerous.  15 \nI think I agree with you on seeking a ban for that.  16 \nThen I also found an article with you and Dr.  Collins from 2011 where you were 17 \ntalking about potential benefits of gain -of-function research -- I'm not sure which 18 \ndefinition, but that doesn't matter -- gain -of-function research and that there are some 19 \nrisks involved.  That's in the article.   20 \nAnd then you had an interview in 2012 that I found with Weekend Australias.  21 \nAnd one of the questions they posed to you was, are you concerned about the potential 22 \nof a lab leak and creating a pandemic with this type of research?  You responded by 23 \nsaying that you thought that the benefits outweighed the risk.   24 \nAnd so, you know, that gives me a lot of concern, and I do want to note what's 25 \n  \n  78 \ngoing on.  And so, you know, you talk about it coming from nature.  That's fine.  But, 1 \nalso, we're talking about certain capabilities within a lab.   2 \nAnd, you know, in medicine and a lot of times when people come to me and want 3 \nto pass a bill, I have kind of a golden rule:  Well, okay, but who disagrees with you and 4 \nwhy?  And I think that's important to hold onto.   5 \nAnd so you're referencing the environmental virologist, which I am not, but, you 6 \nknow, I've read their writings.  But I've also read some other writings.   7 \nSo are you familiar with the published works of Rossana Segreto and Yuri Deigin, 8 \nD-e-i-g-i-n, regarding their analysis of the SARS -CoV-2 genome?   9 \nDr. Fauci.   Not to my recollection, no.   10 \nDr. Wenstrup.   Well, their works were published in 2020 and 2021, ultimately 11 \nfrom scientists from six different countries not aligned with China or the CCP -- from 12 \nAustria, Canada, Japan, Spain, the U.S., and Australia.   13 \nJust, it might be good to review their work.  I think it's very interesting and might 14 \ncalibrate your overall thoughts on the origins of COVID, and, as you said, you're open to 15 \nother suggestions.   16 \nOne of the things they wrote in there is, \"Considering the devastating impacts of 17 \nSARS -CoV-2 and the importance of preventing future pandemics, researchers have a 18 \nresponsibility to carry out a thorough analysis of all possible SARS -CoV-2 origins.\"   19 \nDo you agree with that?   20 \nDr. Fauci.   The responsibility to look at all  -- yeah.  That's why I say I have an 21 \nopen mind.  22 \nDr. Wenstrup.   They also said, \"Both the cleavage site and the specific 23 \nreceptor -binding domain could result from site -directed mutagenesis, a procedure that 24 \ndoes not leave a trace.\"   25 \n  \n  79 \nAre you familiar with the published research on site -directed mutagenesis?   1 \nDr. Fauci.   No.  No, I'm not.  2 \nDr. Wenstrup.   Okay.  3 \nWell, this is where I think we need to go, is the point I'm trying to make.  We 4 \nhaven't had enough conversation.  And you can say \"I'm open to everything,\" but if we 5 \ndon't open a book or open our ears or listen to others, we're never going to get there.   6 \nAnd so, as we're talking about this, lessons learned, things we can do better or 7 \nthings we can do now, we need to do this.  And would you agree?   8 \nDr. Fauci.   I did.  And I've actually publicly said that we need to continue to 9 \nlook  --  10 \nDr. Wenstrup.   Who is \"we\"?   11 \nDr. Fauci.   Excuse me?   12 \nDr. Wenstrup.   Who's \"we\"?   13 \nDr. Fauci.   Me.  I said \"we,\" being the scientific community.   14 \nDr. Wenstrup.   That's fine.   15 \nDr. Fauci.   Yeah.  16 \nDr. Wenstrup.   That answers it.  17 \nDr. Fauci.   Yeah.  18 \nDr. Wenstrup.   Have you  ever -- well, obviously never spoke to these two, 19 \nSegreto and Deigin .  Have you ever spoken to or read any of the works of Dr.  Steven 20 \nQuay?   21 \nDr. Fauci.   The name is  -- I recognize the name, but I don't believe I've  -- yeah.  22 \nDr. Wenstrup.   Dr. William Muller?   23 \nDr. Fauci.   No.  24 \nDr. Wenstrup.   Dr. Richard Ebright?   25 \n  \n  80 \nDr. Fauci.   Are they  -- is Quay a virologist?  What is his area of expertise?   1 \nDr. Wenstrup.   I don't know his exact  --  2 \nDr. Fauci.   Yeah, I think he's  --  3 \nDr. Wenstrup.   -- expertise.   4 \nDr. Fauci.   Yeah, I don't -- 5 \nDr. Wenstrup.   He might be a physicist with NIH.   6 \nDr. Fauci.   Yeah, that -- 7 \nDr. Wenstrup.   NIH has written about how physicists should be involved with 8 \nthis.  That's something else I found, because I thought that was kind of odd, when I saw 9 \nthat.   10 \nDr. Fauci.   Yeah.  I would -- 11 \nDr. Wenstrup.   I think Muller's a physicist, anyway.   12 \nDr. Fauci.   Yeah, but they're not virologists, so -- 13 \nDr. Wenstrup.   No, but I'm just wondering -- you know, let's talk to everybody, 14 \nright?  NIH has said it's important that we talk to physicists.  They wrote that.   15 \nDr. Fauci.   Well, I didn't write it.  16 \nDr. Wenstrup.   You can find it.  17 \nDr. Fauci.   Yeah.  So I didn't write it.  18 \nDr. Wenstrup.   I'm just, again, giving you my view.  19 \nDr. Fauci.   I hear you, Mr.  Chairman.  I hear you.  20 \nDr. Wenstrup.   And how about Dr.  Richard Ebright?   21 \nDr. Fauci.   I've heard of Dr.  Ebright, yeah.   22 \nDr. Wenstrup.   All right.  23 \nWith that, that's all I have.  24 \nMr. Benzine.   All right.  25 \n  \n  81 \nDr. Fauci.   Okay.  Thank you.   1 \nMr. Benzine.   We can go off the record.   2 \n[Recess.] 3 \n  \n  82 \n[12:50 p.m.]   1 \n  We can go back on the record.   2 \nFirst, just some housekeeping.  In the previous hour, Congress Members Cloud 3 \nand Joyce joined, are not currently with us, and if other Members who have since joined 4 \ncould identify themselves as well, please.   5 \nDr. McCormick.   Dr. Rich McCormick.   6 \nMr. Griffith.   And Morgan Griffith, chairman of the Oversight and Investigations 7 \nSubcommittee on Energy and Commerce.   8 \n  Great.  Thank you.   9 \nBY  10 \nQ So, Dr.  Fauci, if I could ask a few questions about some of the emails and 11 \ndocuments that we walked through in the previous hour.  And so you or your counsel 12 \nmay need access to those, starting with what I have marked as majority exhibit No. 20, 13 \nand that's Bates number REV750.   14 \nYou have seen this email more than once and more than twice, but you're 15 \nwelcome to flip through it if you would like to.   16 \nA Just one second.   17 \nQ Sure, of course.   18 \nA Got it.   19 \nQ Great.  So  in your email to Jeremy at the bottom of the first page, I just 20 \nwanted to focus on a small excerpt, which is, you say, \"He,\" being Dr. Andersen, \"should 21 \ndo this very quickly,\" meaning get a group of evolutionary biologists together to examine 22 \nthe concerns.  And you say that, \"If everyone agrees with this concern, they should 23 \nreport it to the appropriate authorities.\"  You go on to talk about the FBI and MI5.   24 \nIt's just a point of clarification, but I think one worth making, that your own memo 25 \n\n  \n  83 \ndescribing what you heard on the February 1st conference call -- which is a different 1 \nemail, but we've looked at that several times.  I won't make you look at it again.  But it 2 \nis crystal clear, I think, that the participants on that call, the virologists  -- evolutionary 3 \nvirologists  -- were disagreeing amongst themselves from the get -go.  In other words, not 4 \neveryone did agree with this concern.   5 \nA Right.   6 \nQ Isn't that right?  7 \nA Yes.  8 \nQ Okay.  Great.  And when you talk in this email about, hey, Dr. Andersen, 9 \nas soon as possible, you and Dr.  Holmes should get a group together to examine it  -- I'm 10 \nrepeating myself from yesterday, but I'll do it anyway.   11 \nThe point of this at this point was, people were saying that they thought it may 12 \nhave come from a lab.   13 \nA Right.   14 \nQ And your point is, if you think it came from a lab, you need to examine that 15 \nurgently.   16 \nA Yes.  Correct.  17 \nQ In other words, that is sort of the opposite of what we would expect to see if 18 \none were trying to suppress a lab leak theory.  Is that right?  19 \nA That is correct.  20 \nQ All right.  Great.   21 \nIn exhibit -- majority exhibit 21 -- I'll give you a moment to glance at that.  That 22 \nseems to have a Bates number at the bottom of NIH -2396.  I'll give you a moment to 23 \nglance at it if you'd like.   24 \nA Yes.  25 \n  \n  84 \nQ So Dr. Andersen's email in the middle of the first page, he talks in his first 1 \nparagraph about unusual features of the virus are a really small part of the genome.  2 \nYou have spoken with ourselves as well as the majority at length about how that is likely 3 \nreferring to the furin cleavage site.   4 \nI just want to emphasize that we spoke to Dr. Andersen, who was very clear with 5 \nus that, at this point in the chronology, he was not yet aware of the extent to which furin 6 \ncleavage sites existed in beta coronaviruses, the genus above whatever subgenus we're 7 \ndealing with here.   8 \nA Right.   9 \nQ And so I don't know the extent to which you  -- because you're one degree 10 \nremoved from him  -- would even have been aware of any of that, but I suspect if I ask 11 \nyou, you would say you likely don't recall that type of detail.  Is that right?  12 \nA That is correct.  13 \nQ All right.  Well, then I'm simply letting you know that Dr. Andersen did not 14 \nknow that at the time he wrote this, and that he learned it, and he learned all sorts of 15 \nother things, ultimately resulting in a shift in that paper from probably where they started 16 \nwhen you first talked to them.   17 \nA Yeah.  18 \nQ Great.   19 \nA Correct.   20 \nQ Okay.  A minor point on majority exhibit 22.  So that's a Bates number 21 \nNIH-2432.  It's an email from yourself to Dr.  Auchincloss.   22 \nSo just a point on that particular paper, the Baric -Shi paper, which we do not have 23 \nin front of us.  I'm not going to make us have it in front of us, but there was a mention 24 \nabout certain chimeric viruses in that paper resulting in increased pathogenicity.  I don't 25 \n  \n  85 \nexpect that you would have memorized that paper sitting here, but -- 1 \nA No.  2 \nQ -- I think our understanding is that when we talk about the backbone of the 3 \nchimeric virus performing on its own at the full genome length -- 4 \nA Right.   5 \nQ -- that, as compared to the chimera, there was, in fact, a loss of function.   6 \nA Right.   7 \nQ So not a gain -of-function, a loss of function.   8 \nA Correct.   9 \nQ Decreased pathogenicity.   10 \nWhere the complexity sometimes comes into play is Dr.  Baric included sort of a 11 \nside discussion of the extent to which the chimera compared to wild -type --  12 \nA Right.   13 \nQ -- SARS.  The backbone is mouse -adapted.  That's a loss of function.   14 \nA Right.   15 \nQ Wild -type, maybe a gain -of-function.  I don't know if you recall that nuance, 16 \nbut I did just want to note that.   17 \nA Right.  I recall this being explained to me long after the fact in my 18 \npreparations for hearings.  It's exactly like you said.  When you're talking about any 19 \ngain -of-function at all, that you have to make sure you have the correct comparator.  20 \nAnd what you stated was correct.  If you do the appropriate comparator, it was actually 21 \nloss of its function and not gain.   22 \nQ Great.  That was the sole point I wanted to make there.   23 \nWith respect to majority exhibit 24, if you could pull that up.  That's got an 24 \nNIH-2415 number at the bottom.  I'll give you just a moment to glance back over that 25 \n  \n  86 \none.   1 \nA Got it.  2 \nQ Just two discrete points from Dr.  Auchincloss' email.  He ends by saying 3 \nthat, \"Emily is going to try to determine if we have any distant ties to this work abroad.\"   4 \nI think we've deduced from context that we are likely here still talking about that 5 \nBaric -Shi paper.   6 \nA Yes.  7 \nQ I just want to note that that work -- it was noted in a previous round, but I'm 8 \ngoing to note it again -- was not abroad, right?  9 \nA The Baric work was done in North Carolina.  10 \nQ That is my only question for you.   11 \nAnd then, in addition, I just wanted to ask, the way that Dr.  Auchincloss sort of 12 \nthinks about this type of a question in this email, we can see that he immediately refers 13 \nto the gain -of-function pause --  14 \nA Right.   15 \nQ -- to the P3 framework.   16 \nWould you say that that is consistent with what we talked about at length 17 \nyesterday?  In other words, you and your folks think in terms of what are the regulations 18 \nthat govern us and what are the right decisions inside of that box?  19 \nA Correct.  What I believe that Dr.  Auchincloss was referring to was exactly 20 \nwhat you said, that no work has gone through the P3 framework, which means none of 21 \nthat work elevated to the need for further scrutiny according to the framework that we 22 \ndiscussed in detail yesterday about P3C0.  23 \nQ And Dr.  Auchincloss' analysis does not include a reference to whatever that 24 \nother website -- layman's concept?  25 \n  \n  87 \nA No.  No.   1 \nQ Great.  This is more a point about I think what you might not know, which is 2 \nthis factual question of, Dr.  Baric's experiments for this paper, were they before the 3 \ngain -of-function pause?  Were they during?  Were they after?  How did that approval 4 \nwork?   5 \nI just want to ask, consistent with the idea that you would not typically be 6 \ninvolved in the minutia e of particular grants, you would not have been involved with any 7 \nof those questions.  Is that right?  8 \nA I was not involved in any of those questions.  9 \nQ And I'll just say that there are plenty of folks who probably were or at the 10 \nvery least would know a little bit more about it that we have either spoken to or are going 11 \nto speak to, and so I think we should just ask them.   12 \nA I think that's a good idea.   13 \nQ Great.  On majority exhibit 25, it has a Bates number NIH -1902.  I'll give 14 \nyou a moment to glance over that one.   15 \nA Got it.  16 \nQ All right.  So towards the top of that first page, we have this exchange 17 \nwhere there's a question of whether Dr.  Tabak is going to join the February 1st call or not 18 \njoin that call, and Dr.  Collins says it's fine with him, but he knows that Jeremy says that 19 \nhe -- being Jeremy  -- wants to keep this call a really tight group.   20 \nI think we're getting into almost, like, philosophical questions about who felt 21 \nconnected to this call, but just from your point of view, it would seem that the very most 22 \ninfluence a person can have over a call is a decision about who's going to be on it and is it 23 \ngoing to be big or small.   24 \nIs your recollection essentially that Dr. Farrar was making the substantive 25 \n  \n  88 \ndecisions as it related to this February 1st phone call?  1 \nA That is correct.  2 \nQ Great.  And I will not read it to you because I don't have it handy, but I will 3 \nnote for you that we have sat and read in detail Dr. Farrar's book \"Spike\" in which he talks 4 \nat length about how he set up this call not as an administrator who had particularly 5 \nconvenient dial -in lines, but because he was substantively concerned about the possibility 6 \nof genetic manipulation and the implications of that possibility.  So I just wanted to note 7 \nthat context for you as well.   8 \nI'm going to go, if I could, to majority exhibit 26, and this is your sort of lengthy 9 \nemail summarizing what happened on the February 1st call.   10 \nA Yes.  11 \nQ I've got a very, very small point of detail, but there's some discussion about 12 \nthe words \"Wuhan University\" here and whether that possibly could have been Wuhan 13 \nInstitute of Virology that you heard.  Who knows?   14 \nI just want to know, are we sure that it wasn't Wuhan University?  Because 15 \nWuhan University had a subaward under this EcoHealth Alliance grant, had some other 16 \nseparate grant from NIH, and I think had a funding stream through USAID and the 17 \nPREDICT program.   18 \nSo I just want to ask you whether we are sure whether or not what you heard 19 \nsomebody else say was, in fact, Wuhan University or WIV or we don't know.   20 \nA We don't know.  I'm not sure what that was.  I put down \"university,\" and 21 \nI'm not sure whether that is exactly what I heard or something else.   22 \nQ Great.  And then some discussion about the aspect of this that talks about 23 \nconvening a group under the auspices of an internationally credible organization like the 24 \nWHO.   25 \n  \n  89 \nIt's sort of a comment followed by a question.  We, again, spoke at length with 1 \nDr. Andersen, Dr.  Garry, and I as a reader read this and said, okay, this WHO idea is what 2 \nturned into \"Proximal Origin.\"  The two of them say to me, no, it's not.  There were 3 \ntwo different conversations going on.  There was a conversation about convening the 4 \nWHO to look at this question, and then we got into a separate conversation with Dr. 5 \nFarrar about the importance of looking at the same question but maybe a little bit faster 6 \nin a peer -reviewed context starting with a report, then a peer -reviewed article.   7 \nSo I assume, is it right, that you personally don't remember anything about those 8 \ndistinctions because, again, you're just repeating what other people have said?  9 \nA Correct.   10 \nQ Great.  For your information, it sounds like the people who said it say that 11 \nthis is a different conversation from what turned into \"Proximal Origin.\"   12 \nA Right.   13 \nQ And my only last thing -- we don't have \"Proximal Origin\" in front of us, but 14 \nyou were asked about some specific excerpts from the paper, some of the paper's 15 \nconclusions.   16 \nA Right.   17 \nQ I would just  -- having, again, sat in excruciating detail with the folks who 18 \nwrote it  -- urge caution when it comes to trying to interpret exactly what they meant 19 \nwithout the benefit of talking to them about it for 8 hours because they say that when 20 \nthey use the phrase \"laboratory construct\"  -- which, to me, as a total layperson, I read as 21 \nanything that was in a lab.  They say, well, no, we meant that as a term of art.  That 22 \nwas referring more to the idea of deliberate --  23 \nA Creating.  24 \nQ -- deliberately created, right?   25 \n  \n  90 \nAnd so that, in and of itself, to them, it sounds like, was not really commenting on 1 \nsomething lab -like, but not fitting that, such as serial passage.   2 \nA Right.   3 \nQ And I'll just read an excerpt elsewhere in that paper, which can be read to 4 \nconflict a little bit with some of their other conclusions.   5 \nThey say elsewhere in the paper that, \"Although the evidence shows that 6 \nSARS -CoV-2 is not a purposefully manipulated virus, it is currently impossible to prove or 7 \ndisprove the other theories of its origin described here.\"   8 \nAnd one of those other theories was serial passage in a lab.  So although that 9 \ndoes not fit neatly with “no lab -based scenario is plausible, ” I just -- is it right for you as a 10 \nreader that the paper did seem to leave itself some wiggle room with respect to lab 11 \nversus animal?  12 \nA Yes, it did.  It explicitly said that.  13 \n  Great.   14 \nThat is all I had.  And with that, I'm going to turn it over.   15 \n  Great.  16 \nBY  17 \nQ Good afternoon, Dr.  Fauci.   18 \nA Good afternoon.   19 \nQ Yesterday, throughout the various questions  – at several points, 20 \nactually  -- you spoke about how impressive the COVID -19 vaccine development process 21 \nwas compared to the typical vaccine development process that you've been aware of.   22 \nSo to help us fully understand that and how impressive the COVID -19 vaccine 23 \ndevelopment was, I think it would help to start with, what is the typical process for 24 \nvaccine development?  25 \n\n  \n  91 \nA The typical process, if it's a brand -new pathogen, is to identify the pathogen 1 \nand then develop the appropriate platform and immunogen to become your ultimate 2 \nvaccine, to test it in an animal model to determine if there's anything grossly 3 \nadverse -event -associated, but more importantly, to determine if it has an effect in an 4 \nanimal model.   5 \nThen you go into a phase 1 study, which is usually measured in tens to a hundred 6 \nindividuals  -- not very many more than that  -- primarily to safety, but then to determine 7 \nthe hint of any degree of efficacy.   8 \nBut the numbers in a phase 1 trial, you're not going to get clinical efficacy.  You'll 9 \nlikely get to get a laboratory indication that might project that you might be efficacious.   10 \nThen when that's finished, you go into a phase 2 trial, which is measured in 11 \nseveral hundreds and sometimes up to a thousand or so to determine further information 12 \nabout safety, but more information about the level of the immune response, and then is 13 \nthere an even stronger hint of efficacy.   14 \nWhen that's finished, you then go into a phase 3 trial, which is generally measured 15 \nsometime depending upon the incidence of infection, that could be measured in several 16 \nyears.  For example, HIV trials have gone on for 8 or 9 years before it was shown they 17 \ndidn't work.  The Zika trial, even though we didn't need the Zika vaccine, took a few 18 \nyears to do.   19 \nThat whole process, from the time you know what the pathogen is to the time you 20 \nget a vaccine made, tested in the multiple phases, really is measured generally in 7 to 10 21 \nyears, when you're successful.  Sometimes it's 20 years, but 7 to 10 years is a reasonable 22 \ntime for that.   23 \nAnd what was happened, as you know  -- as I outlined yesterday  -- the amount of 24 \ninvestment that was made in basic and clinical research and platform technology, 25 \n  \n  92 \ntogether with immunogen design, allowed us to start a process of vaccine development 1 \nwithin about 5 days from the awareness of the genomic sequence.  That is amazingly 2 \nbeyond precedent.  That usually takes years before you do that  -- a few years.   3 \nAnd then we went into high -risk clinical trial.  High risk means, instead of waiting 4 \nfor the end of one phase, you start preparing and going into another phase.  If you were 5 \njust a pharmaceutical company, you wouldn't take the risk of the investment in 6 \ndeveloping a phase 2 until you knew the phase 1 was done, and you certainly would not 7 \nprepare for a 30,000 -person clinical trial in a phase 3 unless you knew what the phase 2 8 \nshowed.   9 \nSo there was a big risk that was taken, not to mention the purchase of vaccines, 10 \neven though we didn't know what the exact efficacy was.  So a multi -, multiyear process 11 \nwas truncated into 11 months.  So that was, you know, by anybody's imagination, an 12 \nunbelievably unprecedented feat.   13 \nQ Absolutely.  And when you mention the normal timeline being 7 to 10 14 \nyears, is that just the development, or is that development and approval?  15 \nA The approval sometimes adds a couple of years to that, yes.   16 \nQ So when you think about that, you know, that 10 could become 12, 13?  17 \nA Right.  Yeah.  I mean, I have a slide that I show when I talk about vaccines, 18 \nthat if you look at -- on the one scale is the time that the vaccine -- that the virus was 19 \nidentified, and on the other scale, how long it took to get a vaccine.   20 \nAnd it's kind of, in many respects, almost a tongue -in-cheek.  You know, typhoid, 21 \nit took 102 years.  You know, the other ones, 50, 20, 30, 10.  And then when you get 22 \ndown to SARS, you saw it was 11 months  -- SARS -CoV-2.   23 \nQ And that 11 months for SARS also includes sort of releasing it to the public.  24 \nIt included the manufacture --  25 \n  \n  93 \nA Right.   1 \nQ -- as well, which also can sometimes take time.   2 \nA Right.   3 \nQ With that sped -up timeline, how was safety still ensured with the vaccine?  4 \nA Well, it went through the classic safety hurdles, as it were, with the phase 1 5 \nand then the phase 2.  They were following it very, very carefully.   6 \nTo have a 30,000 -person phase 3 trial with no safety concerns of -- you know, I 7 \nmean, nothing is 100 percent safe.  Like, sitting here, I could fall off the chair and break 8 \nmy neck.  But it's a very, very rare adverse event, if any.   9 \nBut then after that 20,000, 30,000 phase trial, when the vaccine is finally approved 10 \nor at least given an emergency use authorization and administered to literally hundreds 11 \nof millions if not billions of people, that's an after -approval safety observation.  And the 12 \nsafety profile of the vaccine is now in billions of people, which is also unprecedented in 13 \nthe number of people who've received it.  It has a very, very strong safety profile.  Of 14 \ncourse, there are rare adverse events associated with any intervention, but the adverse 15 \nevents were extraordinarily rare.   16 \nQ And I assume, in order to ensure safety and ensure approval, NIH worked 17 \nwith FDA and potentially other Federal agencies on this vaccine development process.  18 \nIs that correct?  19 \nA That's correct.  20 \nQ How did that interagency relationship work in relation to the vaccine?  21 \nA Well, we provide data from the clinical trials.  So the NIH was in 22 \ncollaboration with several of the pharmaceutical companies that utilized our clinical trial 23 \ninfrastructure that we built up actually dating back to the AIDS years.  That was built to 24 \ndo testing of drugs, vaccines, prevention.  We mobilized our team and collaborated with 25 \n  \n  94 \nthe pharmaceutical companies, and that data we made available to the FDA to analyze it 1 \nboth for its efficacy and its safety.  2 \nQ Generally, how does research on what makes a virus more or less 3 \ntransmissible contribute to the development of vaccinations?  4 \nA How does a vaccine that determines more or less -- well, to understand if 5 \nyou're dealing with a very transmissible virus -- and one of the parameters that you're 6 \ngoing to use is, does it protect against infection?  If you do experiments understanding 7 \nthe virus and all aspects of the virus, it will give you an idea of the level of immune 8 \nresponse that will be required to ultimately protect either against initial infection and/or 9 \ndisease following initial infection.  10 \nQ And I just want to follow up with a point you made that there was already 11 \nresearch that had been done prior to the COVID -19 outbreak that really helped speed this 12 \nprocess along.   13 \nSo there is a value in doing research without sort of the pressure of having a n 14 \noutbreak or the pressure of having a known infection?  15 \nA Yeah.  Well, it's essential.  It's not just okay.  It's essential.  I mean, the 16 \npaper that we funded together with a variety of other funders that led to the initial 17 \nobservation that you can modify a molecule of RNA to make it appropriate for a vaccine 18 \nwas in 2005.  So, you know, we started on the vaccine in 2020.  So you're talking 15 19 \nyears of research.  The work that led to the optimal immunogen design is work that goes 20 \nback at least two to three decades on structural biological development of confirmation 21 \nthat's the proper design of an immunogen.   22 \nSo all that work that had gone on for a few decades was just perched to then just 23 \njump into when we had the outbreak.  So the work before an outbreak is absolutely 24 \nessential.  That's part of prepared.   25 \n  \n  95 \nAnd, by the way, as I think it was implied in your question, when Drew Weissman 1 \nand Katy Kariko were doing the RNA -- mRNA work, they didn't have any pathogen on 2 \ntheir mind, much less COVID.  And when Barney Graham and Jason McLellan and Kizzy 3 \nCorbett were doing work on the immunogen design, they started that work way before 4 \nCOVID.  They were doing it with regard to respiratory syncytial virus.  5 \nQ And so these researchers did not have COVID in mind, but without the work 6 \nthey had done, that 11 -month timeline would have been impossible?  7 \nA It would have been totally impossible.  Right.  8 \nQ And I assume that that work that's been done, the work that's been done on 9 \nCOVID -19, will also potentially give a benefit to future viruses that we don't yet know 10 \nabout?  11 \nA Oh, absolutely.  COVID -19, it turns out, as we've discussed before, to be a 12 \nvery, very unusual virus in its ability to continue to have new variants.  And even today, 13 \nyou know, if you look at the statistics, we have now the variant that's a subvariant of XBB, 14 \nthat's it's a JN.1 that is a subvariant of Omicron.  So they keep having subvariants.   15 \nQ You mentioned the mRNA technology.  I think we all heard a lot about that 16 \nwhen the vaccine was in development and how it was new but not really new because it 17 \nhad been worked on for 15 years.   18 \nIs there anything else you want to tell us about that technology and that research 19 \nand what potential it holds for future vaccine development?  20 \nA Well, the proof of the pudding is what's going on.  So, right now, the 21 \nextraordinary success of the mRNA vaccine with COVID has triggered a real wave of very 22 \neloquent research that is being -- using the mRNA technology for any of a number of 23 \npathogens, including for some cancers.  Vaccines against cancer.  So the mRNA 24 \ntechnology, because of its great success, has been adopted by the scientific community to 25 \n  \n  96 \nuse broadly.   1 \nSo I think as the years go by, you're going to see a lot of other successes.  We're 2 \ndoing it with HIV.  We're doing it with malaria.  We're doing it with some cancers.  3 \nThere's an awful lot of work going on using the initial success with COVID for that.   4 \nQ Good.  Something for us all to look forward to.   5 \nWe talked about ensuring safety in a general way, but there are specific 6 \npopulations that need to be examined for safety due to differing circumstances, 7 \nspecifically children, pregnant people, and the elderly.   8 \nHow specifically was the COVID vaccine ensured to be safe for those populations?  9 \nA Of course, trials were done specifically.  And, I mean  -- so that's what we 10 \ndid.  Whenever you do clinical trials, you always start with healthy adults, and then you 11 \ngo and -- if it's okay in healthy adults, then children that are more vulnerable, pregnant 12 \nwomen who are more vulnerable  -- then you do the study and then -- to try and make 13 \nsure that when you give the vaccine to those subgroups, that it is equally as safe and 14 \nequally as effective.   15 \nQ And I think that also played out in the rollout of the vaccine.  I think we saw 16 \nadults were given access to the vaccine before children were recommended to take the 17 \nvaccine.   18 \nA Right.  That's correct.  19 \nQ And speaking about the rollout of the vaccine, what role, if any, did you have 20 \nin the strategy of how to distribute the vaccine?  21 \nA Of how to distribute it?  I really didn't have any major role in how to 22 \ndistribute it.  It was -- my role was major into development of the vaccine.   23 \nQ Do you have any thoughts on how effective the government's vaccination 24 \ncampaign was when the vaccine was first released?  25 \n  \n  97 \nA Well, it was -- you know, it was released in the end of November, the 1 \nbeginning of December, and then there was a month and a half to 2 months of one 2 \nadministration, and then you had another administration.  What administration are you 3 \nreferring to?   4 \nQ The initial rollout, which I believe was -- it crossed over the lines.  It was 5 \nDecember of 2020 going into January of 2021 when the vaccine was first released to the 6 \npublic.   7 \nA In the beginning, the mechanism of the distribution  -- though what was put 8 \ninto place was a mechanism of doing that through General Perna and others -- it didn't 9 \nget off the ground quickly.  And I wouldn't say quickly.  It had some growing pains in 10 \nthe beginning.   11 \nQ And I believe at the very beginning when the vaccine was first released, 12 \nthere was quite a demand.  I remember, you know, lines.  You could look up online 13 \nwho had a vaccine available.  There were wait lists to get it, that sort of thing.  So there 14 \nwas clearly demand for the vaccine.   15 \nWhat was done to speed up production or help with production to meet the 16 \ndemand?  17 \nA You know, I'm not really sure, because that was -- you know, that was in a 18 \ntotally different lane than my lane.  That had to do with FEMA and General Perna and 19 \nthat whole group, which I didn't get deeply involved in that at all.  So, I mean, I was 20 \nprobably in on some discussions about that at the Coronavirus Task Force, but I don't 21 \nrecall what specific mechanisms were used.  22 \n  I understand.  Thank you.   23 \nI'm going to turn things over to my colleague.  24 \n  Great.   25 \n\n  \n  98 \nSo picking up where  left off, Dr.  Fauci, I'd like to discuss with you the role 1 \nthat COVID -19 vaccines played in turning the tide on the pandemic.  And I'd like to focus 2 \nour initial phase of this discussion on a December 2022 Commonwealth Fund study that 3 \nI'd like to enter into the record.  This will be exhibit S.  4 \n    [Fauci Minority exhibit No. S  5 \n    was marked for identification.]  6 \nBY   7 \nQ I'll give you a moment to take a look at that, Dr.  Fauci.   8 \nA Okay.   9 \nQ So this Commonwealth Fund study has a number of different findings.  I'd 10 \nlike to walk through a few of them.   11 \nFirst, the study finds that the first 2 years of administering the COVID -19 vaccine 12 \nwas responsible for or contributed to 3 million prevented deaths and the prevention of 18 13 \nmillion hospitalizations.   14 \nDoes this finding surprise you?  15 \nA It didn't surprise me because we knew from the degree of efficacy from the 16 \nclinical trials and the large number of infections that were occurring at the time that a 17 \nvaccine with a good degree of efficacy to the tune, at least initially, of 93, 94, 95 percent, 18 \nwould have a very, very profound effect on preventing hospitalizations and deaths and 19 \nsaving, you know, $1.1 trillion in healthcare costs.   20 \nIt wasn't surprising.  I was very pleased to see it, but it didn't surprise me.  It's 21 \nwhat the power of vaccines are when you're in the middle of a pandemic.   22 \nQ And in your conversation with  a few minutes ago, you discussed 23 \nsome details about the way that the vaccine works to protect people to build immunity 24 \nand save lives.   25 \n\n  \n  99 \nIs there anything you'd like to add detail  wise about the sort of underlying science 1 \nor way in which the vaccine works to achieve the results found here with respect to lives 2 \nsaved and hospitalizations prevented?  3 \nA Well, there's even a multiplier effect because, obviously, the vaccine turned 4 \nout, but in the beginning, it did prevent some infections, not as much as it prevented 5 \nhospitalizations.  But a multiplier effect would be that, for those infections which you 6 \nprevented, you then would multiply another certain amount of people who would be 7 \nsaved from getting to the hospital and dying because they never would have been 8 \ninfected.   9 \nLater on, as we all know, as the virus evolved, the ability to prevent infection was 10 \nless, but the ability to prevent hospitalizations and deaths sustained itself, particularly 11 \nwith boosters later on.  12 \nQ You bring up a very interesting point, which was, at the beginning of the 13 \nrollout of the vaccine, we observed, I think, greater strength or effectiveness with respect 14 \nto preventing infection.   15 \nA Right.   16 \nQ At the current state of the pandemic, we understand the vaccine remains 17 \nincredibly effective with respect to preventing severe symptoms and death.  But some 18 \nhave suggested that because the vaccine does not prevent every instance of infection, it 19 \ndoes not work.   20 \nIs there anything you would say to correct the record on that?  21 \nA Yeah.  Well, that's just not the case.  I mean, the primary goal is to 22 \nprevent people from getting sick.  And in this case, since it's a virus with such a high 23 \ndegree of pathogenic potential, a lot of people, particularly vulnerables, have gotten 24 \nseriously ill.  So a vaccine that prevents hospitalizations and deaths is a very, very 25 \n  \n  100 \nsuccessful vaccine.   1 \nThere are charts that I know -- because I've lectured on it and I have slides on 2 \nit -- where if you show the hospitalizations and deaths of unvaccinated individuals and 3 \nthe hospitalizations and deaths of vaccinated individuals, the difference is profound.  4 \nThere's a multifold advantage in the sense of death and hospitalization for the vaccinated 5 \nversus the unvaccinated.   6 \nQ So moving from deaths and hospitalizations, this report also found that, 7 \nduring the first 2 years that the COVID -19 vaccine was available, it contributed to the 8 \nsavior of more than $1 trillion in medical costs.   9 \nYou touched on this a little bit in the previous questions, but just to put a finer 10 \npoint on it, could you explain how COVID -19 vaccines serve a role in reducing medical 11 \nexpenditures in the American healthcare system?  12 \nA Yeah, I will.  It's pretty obvious.  When you keep people out of the 13 \nhospital  -- particularly when you look at the hospital costs of people with COVID, their 14 \nhospital cost is often prolonged.  I mean, there are examples of people in the hospital 15 \nand in ICUs that's measured in weeks and weeks, and those who are more vulnerable 16 \nvery often succumb, leading to the 1.16 million lives that have been lost thus far in this 17 \ncountry.   18 \nSo the healthcare costs of not only hospitalizations but that hospitalizations that 19 \noften require intensive care, the healthcare cost of that is phenomenal, leading to the 20 \nestimate that $1.19 trillion was saved during that 2 -year period.  We're now in year 5 as 21 \nof a few weeks ago -- about a week ago  -- so that's probably a lot more than just that 3 22 \nmillion.   23 \nQ Right.  And stemming from that, probably fair to say as well, not just lives 24 \nsaved, but hospitalizations prevented, medical expenditures reduced, all of that likely 25 \n  \n  101 \ngreater now 5 years in than this 2 -year period estimate?  1 \nA Yeah, obviously.  And just another thing to mention that it doesn't relate 2 \nnecessarily to the United States, but this is 3 million deaths and 18 million hospitalizations 3 \nin the United States.  If you look at the fact that a few billion people have been 4 \nvaccinated worldwide, there are probably tens and tens and tens of millions of lives 5 \nsaved.   6 \nQ Important.   7 \nAnother point in this study.  So the study also points to the role of the vaccine in, 8 \nI think, two very important things for American society coming out of the most acute 9 \nphase of the COVID -19 pandemic:  the resumption of safe, in -person learning in schools, 10 \nand the reopening of businesses in our economy.   11 \nCan you provide your perspective or your assessment of the role of the COVID -19 12 \nvaccine in achieving those two aims?  13 \nA Oh, yes.  I mean, obviously, if you prevent people  -- to some extent, 14 \nagain  -- to get infected -- but now, as we know, that's not as effective as it was  -- but the 15 \ndegree to which you prevent infection, you're going to prevent children from getting 16 \ninfected and workers from getting infected  -- not only infected, from being in the 17 \nhospital  -- that has an important impact on the economy, of keeping businesses open.   18 \nI mean, back in the height of the outbreak, we saw that there were many people 19 \nin different industries who were infected and couldn't go to work, and many died.   20 \nQ And so since the rollout of the initial COVID -19 vaccine  -- and you mentioned 21 \nthis at a few points in the past day and a half  -- we have seen the deployment of boosters 22 \nand updated vaccines.   23 \nCould you explain the need for boosters and updated vaccines and the role that 24 \nthese serve in continuing to control and have a handle on COVID -19?  25 \n  \n  102 \nA Well, there are two aspects of a booster that I think are important:  the 1 \nduration of the protection of a given vaccine against a given strain, and the fact that we're 2 \nliving in a very unusual situation where we have the evolution of different strains 3 \nthat -- when Alpha evolves to Beta, to Delta, to Omicron, to B45, to XBB.1, to all of the 4 \nothers that we're dealing with  -- that it escapes the protection not only from protection 5 \nto the extent that there is protection against infection, but to the protection against 6 \nsevere disease.   7 \nAnd, again, the data validates that, because when you look at those same charts, 8 \nthat if you have unvaccinated deaths here, vaccinated deaths here, vaccinated with 9 \nboosters deaths here, which means for -- I know you can't see that on the recording, but 10 \nit means that there are more deaths in the unvaccinated than there are in the vaccinated, 11 \nand there are more deaths in people who are vaccinated but not boosted than there are 12 \nin people who are vaccinated and boosted.   13 \nQ And so in the previous exchange you had with , she mentioned the 14 \nenthusiasm that existed for the primary series of the COVID -19 vaccine.  Lines out the 15 \ndoor, very difficult to get appointments initially through online platforms and the like.   16 \nI think it's fair to say we haven't seen that same level of enthusiasm for boosters 17 \nor updated vaccines, and I'm curious why you think that might be.   18 \nA It's complicated.  I think there are multiple conflating reasons.  One of 19 \nthem is that there is a disturbing anti -vax trend in this country where vaccines are, for 20 \nreasons that don't make any sense to me, essentially have a negative connotation to a 21 \nnumber of people.   22 \nAnd we know that.  I mean, there are studies that you're all perfectly aware of, 23 \nthat the vaccination rate in some States is significantly different than others, and in the 24 \nStates in which the vaccination rate is low compared to a State in which it's high, there 25 \n\n  \n  103 \nare more deaths in the State in which the vaccination rate is low than there are in that.  1 \nThat's one thing that gets people.   2 \nAlso, I believe that there's misinformation and disinformation out there about 3 \nvaccines, such as -- you know, whenever somebody dies who's a young person, they 4 \nalways say, well, that person got vaccinated within the last few months.  It must have 5 \nbeen the vaccination.  We've seen that particularly with certain athletes.  So that's 6 \nanother reason why.   7 \nAnd I think a third reason of conflating is that people are tired of COVID.  They 8 \nwant to put COVID behind them.  And they have the misperception that, you know, my 9 \ngoodness, I've already been vaccinated, or I've gotten infected, so I just don't want to be 10 \nbothered with anything that has to do with COVID.  And that's really unfortunate 11 \nbecause I believe less than 20 percent of the people who are eligible to get the latest 12 \nXBB.1 vaccine have gotten the vaccine, and yet we now have something like 1,400 deaths 13 \nlast week with COVID, and the hospitalizations are going up again.   14 \nSo, right now, to think that COVID is behind us and gone is a misperception.  And 15 \nyou add that misperception to the misinformation about vaccines, you know, to all of the 16 \nother things that are going on about people who are anti -vax, I just think that's an 17 \nunfortunate situation we have in this country.   18 \n  I think that segues very well to a few questions Congresswoman 19 \nCastor has.   20 \nMs. Castor.   Yes.   21 \nThank you, Dr.  Fauci.   22 \nIf we go back to the early days of vaccinations and the initial rollout at the end of 23 \n2020, but it really didn't take off until passage of the American Rescue Plan in March of 24 \n2021, where the Congress provided billions of dollars to get widespread vaccination plans 25 \n\n  \n  104 \nunderway.  Do you agree with that?   1 \nDr. Fauci.   Well, certainly, I'm not sure of cause and effect, but I can say that 2 \nwhat you're saying is correct.  That the vaccine took off pretty -- I would say the sharp 3 \nincline in vaccines took place according to the timeline you mentioned associated with 4 \nwhat you mentioned.   5 \nMs. Castor.   The American Rescue Plan was passed in March -- early March of 6 \n2021 and provided billions of dollars for COVID -19 vaccine distribution and 7 \nadministration.  It provided funds to our local communities, to our States, to bolster 8 \ntheir public health systems, to hire people.   9 \nI remember very well, in Tampa, with the help of FEMA and the National Guard, 10 \nwe set up a mass vaccination site at an old dog track that had a huge parking lot and 11 \npeople could just drive through.  I remember very well setting up the same kind of 12 \nsystem at our big VA hospital.  And people were so relieved at that time that a safe and 13 \neffective vaccine was available.   14 \nYou know, Florida is an interesting case study, and one of the tragic consequences 15 \nof the pandemic across the board is that many people died who should not have died 16 \nbecause they were not vaccinated for whatever reason.  In the early days, we didn't 17 \nhave the vaccine.   18 \nAnd then just what you were talking about, this anti -vax thread that has kind of 19 \ntaken hold.  There was one study by Brown University Public Health, Brigham and 20 \nWomen's Hospital, MicroAI, that said that death -- about 318,000 deaths could have been 21 \nprevented if they had gotten the vaccine.  And that was a study that -- they just looked 22 \nat January 2021 through April 2022.   23 \nWhat I saw in Florida, early on, people were hungry for that vaccine.  They 24 \nwanted to get back to normal.  And early on, our State did pretty well.  We have -- our 25 \n  \n  105 \npopulation skews older, so it's very important to get our older neighbors and in nursing 1 \nhomes and those over 65 to get vaccinated.   2 \nBut something changed due to politics with our governor.  At a September 2021 3 \npress conference, he was asked whether people should get vaccinated.  He said, at the 4 \nend of the day, though, it's about your health and whether you want protection or not.  5 \nIt really doesn't impact me or anyone else.   6 \nWas Governor DeSantis correct when he said that someone choosing not to get 7 \nvaccinated doesn't impact anyone else?   8 \nDr. Fauci.   I think that what he was referring to was the notion that -- I don't 9 \nknow what he was actually referring to.  But let me have you ask the question again, 10 \nbecause I don't want to be saying something that is not --  11 \nMs. Castor.   Well, I'll ask a different question.   12 \nDr. Fauci.   Yeah.  13 \nMs. Castor.   How do vaccination rates impact the course of an infectious 14 \ndisease?   15 \nDr. Fauci.   Yeah.  Well, in two major ways.  Number one, it protects people 16 \nfrom getting sick and overwhelming the hospital system.  You might recall that during 17 \nthe peak of  -- and, in fact, we're even getting close to it now.  When you overwhelm a 18 \nhospital system with a disease that's vaccine -preventable, that there are many people 19 \nwho have other diseases who don't have access in the hospital.  So it does impact 20 \nsociety.  Things like elective operations, things like preventive medicine gets impacted.   21 \nThe other is, to the extent that vaccines prevent infection, that you can interfere 22 \nto a certain extent with the spread of infection from one person to another.  As the 23 \nvaccines -- as the virus evolved and became more and more variant -prone, the ability to 24 \nprotect against infection actually went down.  Not completely, but it went down.   25 \n  \n  106 \nMs. Castor.   So the decision not to get vaccinated can have broad repercussions?   1 \nDr. Fauci.   Yeah.  Broad repercussions on the hospital system, broad 2 \nrepercussions on individuals, and broad repercussions about the spread to a certain 3 \nextent.   4 \nMs. Castor.   Had anything changed by summer of 2021 as we were going into the 5 \nDelta surge?  Did anything change with the efficacy of the vaccine  -- the COVID -19 6 \nvaccine?  Were we learning that it was safe and effective, or were we learning that, boy, 7 \nthere are some issues with it?   8 \nDr. Fauci.   No.  What we learned was that the durability of protection -- more 9 \nso against infection but less so against severe disease -- diminished over time.  It was 10 \nnot a highly durable protection, which led to the need for booster shots.   11 \nI mean, if you compare a vaccine like measles or a polio vaccine, where the 12 \ndurability of protection is measured minimally in decades and maximally for lifetime, that 13 \nwas not the situation with COVID.  The durability was limited to several months, and you 14 \nsaw a diminution more so in protection against infection and less so against protection 15 \nagainst disease.   16 \nThat was the reason why we were recommending appropriately that people who 17 \nare vaccinated over a period of time get boosted to bring back up.  The safety issues 18 \nremained essentially the same.  The more you learned about vaccines with the few rare 19 \nadverse events that were noticed, the more we realized that the vaccines were actually 20 \nquite safe.   21 \nMs. Castor.   Yeah.  You know, as a policymaker  -- I was on the Health 22 \nSubcommittee.  I'm very attune to what was happening with the population across my 23 \ncommunity and just was taken aback by some of the politicization of the vaccine.   24 \nGovernor DeSantis hired someone to come in and replace our former surgeon 25 \n  \n  107 \ngeneral who was sidelined in October 2022.  The new Florida surgeon general, Joseph 1 \nLadapo, said that some COVID response mitigation measures were manipulative, 2 \ndestructive, and divisive policy.  He said -- he started talking about the -- how 3 \nvaccines  -- you could not rely on the COVID vaccine.  In fact, we have -- he wrote to the 4 \nFederal Government to say we disagree here in the State of Florida that vaccines are the 5 \nway to go.   6 \nWill, do you happen to have the early response from  --  7 \nThis has been ongoing now for over -- well over a year.  This is -- and I want to 8 \ncheck on time.  We may need to --  9 \n  We have 5 minutes.   10 \nMs. Castor.   Five minutes.  I think we can pass it around.   11 \n  Okay.  This is exhibit T.  12 \nThank you.  13 \n    [Fauci Minority exhibit No. T  14 \n    was marked for identification.]  15 \nMs. Castor.   And do you also have The New York Times article?   16 \nBecause I know we can talk a little bit more about the politicization of the vaccines 17 \nand public health and how that has cost lives, because what I witnessed in Florida, as the 18 \npolitics changed, a new surgeon general who discounted public health protocols that 19 \nwere widely accepted, as we were trying to communicate as policymakers to our 20 \nneighbors what they could do to save their lives and be healthy and then get back to 21 \nwork, get back to school as soon as possible, we were running into this misinformation 22 \ncampaign that really took a toll coming into the summer of 2021 with the Delta surge, 23 \nwhere studies subsequent looking at that says, in the State of Florida, more people died 24 \nafter the COVID -19 vaccine became available than beforehand.   25 \n\n  \n  108 \nThis just seemed like a complete abdication of the governor's and the surgeon 1 \ngeneral's role to protect the people of my State.  And I think, as you said, there are 2 \nsevere repercussions when you do not -- if you are not following public health protocols 3 \nand your advice to get the vaccine, to the point where Dr. Ladapo was -- has been taken 4 \nto task by the FDA and the CDC.  Here, they write that -- let me pick a good part here.   5 \n\"Focusing on adverse events in the absence of causal association and without the 6 \nperspective of countervailing benefits is a great disservice to both individuals and public 7 \nhealth.  Like every other medical intervention, there are adverse effects from 8 \nvaccination.  Serious adverse events from COVID -19 vaccines are rare and are far 9 \noutweighed by the benefits of these vaccines for every age group.\"   10 \nJust recently, Dr. Ladapo called into question -- again, wrote to the FDA and the 11 \nCDC alleging that DNA fragments from the Pfizer and Moderna mRNA vaccines could 12 \nintegrate with the DNA of the person they're injected into, causing a host of harmful side 13 \neffects.  And just weeks ago, he called for the halt for the use of the mRNA vaccines.   14 \nDo you have any idea what he is talking about when he says that mRNA vaccines 15 \ncould integrate into a person's DNA that they're injected into?   16 \nDr. Fauci.   I have an idea of what he's talking about, but it doesn't make any 17 \nsense.   18 \nMs. Castor.   Have you heard of DNA fragments from the Pfizer and Moderna 19 \nmRNA vaccines integrating with a person's DNA that they're injected into?   20 \nDr. Fauci.   There's no evidence whatsoever that that happens, and the 21 \nmechanisms that would be required for an integration are not present in the cell.  So 22 \nthat is sort of physiologically very difficult to comport that with the statement that is 23 \nmade by Dr. Ladapo.   24 \nMs. Castor.   So you previously reviewed for us the kinds of studies and controls 25 \n  \n  109 \nthat went into the research and approval of the mRNA COVID vaccine for it being safe and 1 \neffective.   2 \nWhat does this kind of anti -vax propaganda from a health official that leads the 3 \nState, what does that do, in your opinion?  Does it risk lives?   4 \nDr. Fauci.   Well, it certainly confuses people and would lead to people not 5 \ngetting vaccinated.  And as we've said multiple times, vaccines save lives, and when you 6 \ncompare the death and hospitalization of vaccinated versus unvaccinated people, you can 7 \nmake a reasonable conclusion that if people don't get vaccinated, they have a greater risk 8 \nof being hospitalized or dying.  I think that's a scientific medical public health fact that's 9 \nnot disputed.   10 \nMs. Castor.   Well, just to close out, the FDA agreed with you and had to write 11 \nback to Dr. Ladapo that, \"The challenge we continue to face is the ongoing proliferation of 12 \nmisinformation and disinformation about these vaccines, which results in vaccine 13 \nhesitancy that lowers vaccine uptake.  Given the dramatic reduction in the risk of death, 14 \nhospitalization, and serious illness afforded by the vaccines, lower vaccine uptake is 15 \ncontributing to the continued death and serious illness toll of COVID -19.\"   16 \nI'll close there.   17 \n  And we can go off the record. 18 \n\n  \n  110 \n[2:06 p.m.]   1 \nMr. Benzine.   All right.  We can go back on the record.  2 \nMr. Strom.   Dr. Fauci, I want to, I guess, circle back on a couple things that were 3 \nmentioned both earlier today and in our discussions yesterday.   4 \nYou talked a lot about the scope of NIAID's research that was  -- excuse me, 5 \nNIAID -funded research at the WIV versus the broader scope of general coronavirus 6 \nresearch at the WIV, and how delineating sort of that small portion of NIAID funding 7 \nversus the overall institute activities was  -- I think you get lost in the discussion, for lack of 8 \na better way to phrase it.   9 \nSo just for the benefit of the record, even though the NIAID -funded work was 10 \ndetermined not to qualify under the P3CO framework for further review, that's a separate 11 \nquestion from whether or not Wuhan was doing gain -of-function research of concern on 12 \ncoronaviruses.  13 \nDr. Fauci.   Right.  14 \nMr. Strom.   Is that  -- were you able to get that?  15 \nThe Reporter.   Can you repeat that?  16 \nBY MR. STROM:  17 \nQ Just a little bit louder, sir, for the microphone.   18 \nA No, I'm sorry.   19 \nI don't have eyes onto or knowledge of the scope of what's going on in Wuhan, in 20 \nChina, or in any other place.  The only thing that I had eyes on through my staff was 21 \nwhat was done according to the subaward that was granted to the Wuhan.   22 \nSo I have no way of knowing, nor does anyone, I think, what's going on in other 23 \nlaboratories in China.   24 \nQ And then, the other issue I wanted to talk on and has come up more today is 25 \n  \n  111 \nthat you mentioned several times that when you're  -- where you're trying to sort through, 1 \nI mean, the various iterations as to the origins of the virus, all the way from sort of the 2 \nHI -- the real out there stuff of the HIV insert to the more maybe rational discussion about 3 \nthe two  -- the two accepted hypotheses.   4 \nA Right.   5 \nQ That you had to defer to subject matter experts.   6 \nAnd so one of the things I think our committee is interested on trying to delineate 7 \nis how do you deal with a circumstance where a lot of the experts, coronavirus virologists, 8 \nthe people that you would need to consult with, because it's a relatively small specialized 9 \nresearch field, have research ties or have interests that may not be immediately apparent 10 \nto the public with respect to the debate about origins.   11 \nAnd so to be just a little more specific, if we're talking about somebody like, I think 12 \nPeter Daszak is probably the most prominent example, he has what appears to me to sort 13 \nof meet the definition of a conflict of interest or a competing interest that should be 14 \ndisclosed, particularly when you have sort of public -facing or widely disseminated articles 15 \nto the public, that he has collaborated extensively with the WIV, that he is reliant on the 16 \nWIV for viral samples and things like that.   17 \nAnd so I was wondering if  -- and this isn't necessarily a financial conflict of 18 \ninterest; it's a non -financial conflict of interest or the appearance of a conflict of interest.   19 \nAnd so I was wondering if you had thoughts on whether Dr.  Daszak should have 20 \nfiled competing interest statements when he was weighing in on these issues, whether 21 \nthrough the National Academies or other venues.   22 \nA You know, I hesitate to speculate about what someone else should do.  The 23 \nonly people that I am involved with is my own staff, who we've mentioned many times in 24 \nthis discussion, who don't have a conflict of interest.   25 \n  \n  112 \nQ Sure.   1 \nA I mean, they are there working for the Federal Government, the NIH, HHS.   2 \nSo, I mean, I would hesitate to comment on what he should and should not have 3 \ndone.  I guess, that's somebody's own individual decision.   4 \nQ If I can do one more potential example, and I'll read this to you.  This is 5 \nfrom Taylor & Francis, which I believe is an academic publishing house.   6 \nSo Dr.  Holmes is another one that I've had  -- I think a layman would consider 7 \nhaving potential conflicts of interest or competing interests.  He does a lot of 8 \ncollaborations with researchers in China.  He's obviously, as with Dr.  Daszak, you're 9 \ndependent on where the viruses are.  I mean, if they're in southern China, you've got to 10 \nwork with  --  11 \nA Right.  12 \nQ -- those individuals, including their government.   13 \nAnd so one of the non -financial conflict of interest examples that Taylor & Francis 14 \nmentions is access to data repositories, archival resources, museum collections by an 15 \nentity that might benefit or be at a disadvantage financially or reputationally from the 16 \npublished findings.   17 \nAnd so, again, would we have been better served during the debate if these sort 18 \nof competing interests had been more forthrightly  -- I can understand how a scientist 19 \nreading a Nature article would understand that by virtue of Dr.  Holmes' specialty and 20 \nfocus that he likely has a lot of ties to the Chinese researchers, because that's who he's 21 \ngot to collaborate with.   22 \nBut when you start talking about the general public being interested in a topic of 23 \nthis magnitude, I mean, would a competing interest note  -- should that have been filed in 24 \nsome of these papers?  25 \n  \n  113 \nA You know, I don't think I could give an opinion on that, because if you look at 1 \nthe larger scope of the discussions, I mean, in the discussions that I've been in with 2 \nscientists in which someone might have a conflict of interest that has not been publicly 3 \ndisclosed, the culture of science is that you don't get away with that when you're dealing 4 \nwith 12, 13, 14, 15 scientists.  I mean, it's almost a self -corrective process as opposed to 5 \nan official filing of something when you're dealing with the scientific community.   6 \nQ And I guess, again, what I'm struck by, and I think this could apply to some of 7 \nthe more  direct and forceful proponents of a lab leak, is that these are very strongly held 8 \nviews that these individuals have, that many of the people that are so adamant, I think 9 \nperhaps beyond what the evidence would suggest that it's a zoonotic origin, are also the 10 \nindividuals that have professionally benefited and continue to perform gain -of-function 11 \nresearch of concern.   12 \nAnd so obviously you do have sort of a  -- at least the appearance of competing 13 \ninterests here, where if it is in some fashion conclusively established or determined that 14 \nit's a lab leak, these people would  -- the work that they do would be directly impacted 15 \nfrom a regulatory standpoint, things like that.   16 \nA From my knowledge and decades of experience with scientists, I think  -- I 17 \nmean, that is possible.  But the culture of the scientists that I've been associated with, 18 \nthat would be something that would be very unusual, that they would have that kind of a 19 \nconflict interfere with their honest appraisal of what was going on.   20 \nQ Would you be, just as a general matter, in favor of additional disclosures 21 \nwhen you have a potential high -impact, prominent paper that laymen are going to read?  22 \nA Well, my mantra has always been, and I've mentioned that multiple times in 23 \nthis discussion, one of transparency.  I've always been that way myself, and I would 24 \nhope that other people would be.  25 \n  \n  114 \nQ Great.  Thank you.   1 \nA Yes.   2 \nMr. Benzine.   Thanks, John.  3 \nI want to close out the conversation on proximal origins and introduce majority 4 \nexhibit  28.   5 \n    [Fauci Majority Exhibit No. 28  6 \n    was marked for identification.]  7 \nMr. Benzine.   This is a letter from Mr.  Comer and Mr.  Jordan to Secretary Becerra 8 \nfrom January  11th, 2022.  It's like a 30 -page letter, so I'm just going to flip to the page 9 \nthat I want you to look at.  We don't need to look at the whole thing.  There is no 10 \ncontext you are missing.  It is a copy of an email.   11 \nMr. Schertler.   It could take up a good 30  minutes.  12 \nMr. Benzine.   I know it could.   13 \nBY MR. BENZINE:  14 \nQ So this is, you can see, the top portion is the email that has been redacted.  15 \nThe bottom portion is a transcription from staff that we're allowed to view this email in 16 \ncamera.   17 \nI want to state for the record that despite this email being responsive to select 18 \nsubcommittee requests for now 11 months, it has not yet been produced to the select 19 \nsubcommittee, so all we can go off of is this transcription.   20 \nA What do you mean by a transcription?  In other words  --  21 \nQ I went to the HHS headquarters.  They showed me the email.  I wrote it all 22 \ndown and then typed it out.   23 \nA And unredacted?   24 \nQ Correct.   25 \n  \n  115 \nA Oh, good.  Good.  Good for you.  1 \n[Laughter.]  2 \nQ And in the minority that's about the best you can get.  In the majority, it's 3 \nsupposed to  --  4 \nA Things work in the world, right.   5 \nQ Sometimes.   6 \nA Yes.   7 \nQ So the  -- it doesn't match up precisely with what the gray boxes look like, but 8 \nthe bottom is what Dr.  Collins wrote in this email.  And I want to read it out loud.  9 \n\"Wondering if there is something NIH can do to help put down this very 10 \ndestructive conspiracy with what seems to be growing momentum.\"  It's then a link to a 11 \nBret Baier article regarding the outbreak starting in a Wuhan lab.   12 \n\"I hoped the Nature Medicine article on the genomic sequence of SARS -CoV-2 13 \nwould settle this.  But probably didn't get much visibility.  Anything more we can do?\"   14 \nYour response is on the next page.  But it's, to your credit, it's pretty bland.   15 \n\"I would not do anything about this right now.  It's a shiny object that'll go away 16 \nin time.\"   17 \nA Right.  18 \nQ Do you recall having any conversations with Dr.  Collins regarding this email?  19 \nA I don't think we had a conversation, but I think the conversation was an 20 \nemail conversation as opposed to a  verbal.  We could've, but I don't recall it.  But I 21 \nrecall my saying, \"Calm down, Francis.\"  Yeah.   22 \nQ And we'll have an opportunity to ask Dr.  Collins these questions.   23 \nA Yes.   24 \nQ But you're sitting in front of us.  And if you would rather us ask Dr.  Collins, 25 \n  \n  116 \njust let me know.   1 \nA Yeah.   2 \nQ He seems to  -- well, he doesn't seem to.  He writes down that, at least 3 \nbased off the headline of this article, that the outbreak starting in a Wuhan lab is a very 4 \ndestructive conspiracy.   5 \nI take it by your own public statements that you have an open mind, that you 6 \ndisagree with that statement?  7 \nA Well, first of all, A, for the record, you have to ask Dr.  Collins what he meant 8 \nby that.   9 \nI've not used that language.  I still have an open mind.  But I think it would be 10 \nimportant in the context of really wanting to get down to what's going on.   11 \nAnd I'm looking at the date, April  16th, which is sort of months into that.  And 12 \nFrancis will tell you, I think, that there was a lot of strange things going on in social media.   13 \nI think I alluded to that on our first marathon day, that there were really an 14 \namazing number of things going on.  And I think that probably was frustrating Francis 15 \nabout the things that just didn't make much sense.  But I believe Francis could clarify 16 \nthat for you.   17 \nQ Just you sitting here today, do you think the possibility or the hypothesis that 18 \nthe coronavirus emerged from a laboratory accident is a conspiracy theory?  19 \nA Well, it's a possibility.  I think people have made conspiracy aspects from it.  20 \nAnd I think you have to separate the two when you keep an open mind, that it could be a 21 \nlab leak or it could be a natural occurrence.   22 \nI've mentioned in this committee that I believe the evidence that I've seen weighs 23 \nmy opinion towards one, which is a natural occurrence, but I still leave an open mind.   24 \nSo I think that in and of itself isn't inherently a conspiracy theory, but some people 25 \n  \n  117 \nspin off things from that that are kind of crazy.   1 \nQ No, that's fair.   2 \nA Okay.   3 \nQ Dr. Collins continues, \"I hoped the Nature Medicine article --\" I'm going to 4 \npresume you  -- don't have to presume  -- that he's referencing the proximal origin of 5 \nSARS -CoV-2.   6 \nA Yes, I would imagine that's the case.   7 \nQ \"-- would settle this.\"  And then he said, \"Anything more we can do?\"   8 \nAnd again, I'm nitpicking words here, and you said that, and I believe that you 9 \nwere testifying truthfully, that no edits, no revisions, nothing to Proximal Origin.   10 \n\"Anything more we can do?\"  \"More\" kind of signifies that you've already done 11 \nsomething.   12 \nA No.  I think what he was  -- my impression -- and, again, ask him, I'm pretty 13 \nsure he'll verify what I'm saying.   14 \nI believe  -- I know Francis  -- I believe what he was saying, is there anything more 15 \nwe can do to make this particular paper and what's in the paper more widely known, 16 \nbecause his next sentence is, \"Ask the National Academy to weigh in.\"   17 \nYou should ask  -- I know you're going to ask him that.  But if you ask him that, he 18 \nmay verify what my opinion is, is what he meant by doing anything more is let's get the 19 \nAcademy involved in this.   20 \nQ The chairman alluded to this, but the next day, on April  17th, you were asked 21 \na question at a White  House briefing  --  22 \nA Right.   23 \nQ -- regarding the origins of the coronavirus.   24 \nA Right.   25 \n  \n  118 \nQ And you said at the time  -- I don't  -- I'm not going to quote it  -- but that you 1 \ndidn't remember the authors' names, but that they  -- evolutionary biologists or virologists 2 \njust came out with a new paper.   3 \nA Right.  4 \nQ And then, after the fact, a reporter followed up and you sent him Proximal 5 \nOrigin.   6 \nA Right.   7 \nQ Did -- first, did you know that that question was going to get posed at that 8 \npress conference?  9 \nA No.   10 \nQ No?   11 \nA No.   12 \nQ Had you told anyone at the White  House about Proximal Origin by that 13 \npoint?  14 \nA I don't recall that I did.  15 \nQ Did -- so you just kind of said, and I don't want to mischaracterize it, but was 16 \nthat in response  -- was citing Proximal Origin in response to this email?  You just said 17 \nDr. Collins seemed to want -- 18 \nA No. 19 \nQ -- more visibility.   20 \nA No.   21 \nQ No?  22 \nA No.  I mean, I just  -- I was asked a question, and I responded with that.   23 \nQ Okay.  I'm going to shift gears a little bit and very, very briefly talk about 24 \nthe WHO investigation into the origins.   25 \n  \n  119 \nThe WHO, from January  14th, '21, to February 10th, 2021, sent a team to China to 1 \ninvestigate the origins of COVID -19.   2 \nWhat we've heard is that the United States submitted three names to be on that 3 \ntrip.  We have yet to hear who those three names were.   4 \nDo you have any knowledge as to who the United States submitted?  5 \nA This is the original WHO trip to China?   6 \nQ No, no, no.  The origins investigation in 2021, not the Cliff Lane trip in 2020.   7 \nA No, I don't, I don't know about that one.   8 \nQ Did you have any conversations with Dr.  Lipkin about that trip?  9 \nA You know, Mitch, I might have.  I just don't recall.   10 \nI know there was a trip.  I mean, I get called a fair amount, \"Hey, you got any 11 \nnames for us?\"  So it is quite conceivable that Ian might have called me and says, \"Tony, 12 \nwhat do you think about this person?\"  13 \nBut I really, honestly, don't recall that.   14 \nQ Do -- the WHO produced a report from that trip.  Do you recall reading it?  15 \nA No, I did not read it.   16 \nQ At the time it came out  --  17 \nA I mean, I skimmed through it, I believe  --  18 \nQ Yeah.  19 \nA But I -- I mean, the easiest way to get me not to read something is to make it 20 \nmultiple, multiple, multiple pages.  21 \nQ And this was like 350, so it was  --  22 \nA Yeah, so forget it.  I didn't read it.  23 \nQ It was quite the read.   24 \nA Okay.   25 \n  \n  120 \nQ Dr. Daszak , who we've talked about an awful lot over the last 10  hours, was 1 \nthe only American on that trip.  Before, by John, you were asked whether or not you 2 \nthought he should submit competing interests.   3 \nA Right.  4 \nQ I'm going to ask your opinion now.  He has obviously been intertwined with 5 \nthe Wuhan Institute for a long time, has made numerous public statements, has 6 \nnow  -- over the past 3  years, we've seen numerous compliance issues with his grants.   7 \nDo you think that he has a conflict of interest in investigating the origins question?  8 \nA I believe that he could've saved himself a lot of trouble if he did.  9 \nQ If he did disclose a conflict of interest?  10 \nA Yeah, yeah, because he's obviously received a lot of flak about that and had 11 \ndoubts about his credibility on that.  I think, retrospectively, thinking about it, he 12 \nprobably would've said it would have been a better idea to do.   13 \nQ That's fair.   14 \nDo you recall, when Dr.  Daszak returned from that trip, whether or not he briefed 15 \nyou regarding it?  16 \nA I guess this is going to go into the thing of Fauci said so many times he can't 17 \nrecall, but I can't recall.   18 \nQ I won't do it on this one.  He did brief you after the trip.   19 \nA Okay.  20 \nQ He briefed you and Dr.  Lane.   21 \nA Okay.   22 \nQ I won't ask you about the contents of the briefing because  --  23 \nA Mitch, do you have any clue about how many times I get briefed over  -- I 24 \nmean, like hundreds of times.  Okay.   25 \n  \n  121 \nQ I'm not going to say I get as many as you, but I  -- 1 \nA Yeah.  2 \nQ There's an awful lot.  Just trying to figure  -- you know, understand 3 \nwhat  -- what's stood out.   4 \nI'm going to stay on the same big topic but switch a little bit of topics.   5 \nSince early 2020, the intelligence community at large has been investigating the 6 \norigins of COVID -19.  At any point during their review, were you contacted by anyone in 7 \nthat community to assist in that investigation?   8 \nA It depends on what you mean by assisting in the investigation.  I do  -- again, 9 \nI brief a lot.   10 \nOne briefing I do recall was the National Security Council people with Beth 11", "summary": "Official transcript, Part 2 of Anthony Fauci's transcribed interview before the House Select Subcommittee on the Coronavirus Pandemic.\n\nExcerpt: 1   1   2   3   4  COMMITTEE ON OVERSIGHT AND ACCOUNTABILITY,  5  SELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC,  6  U.S. HOUSE OF REPRESENTATIVES,  7  WASHINGTON, D.C.  8   9   10   11   12   13   INTERVIEW OF:  ANTHONY S. FAUCI (DAY 2)  14   15   16   17   18  Tuesday, January 9, 2024  19   20  Washington, D.C.  21   22   23  The interview in the above matter was held in room CVC -268, Capitol Visitor 24  Center, commencing at 10:00 a.m.  25       2  Present:  Representatives Wenstrup, Griffith, Malliotakis, Jackson of Texas, 1  Cloud, McCormick, Ruiz, Ross, Dingell, and Castor.  2       3  Appearances:  1   2   3   4  For the SELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC:   5   6  MITCH BENZINE, STAFF DIRECTOR.  7  MADELINE BREWER, COUNSEL  8  ANNA -BLAKE LANGLEY, PROFESSIONAL…", "source_url": "https://oversight.house.gov/wp-content/uploads/2024/05/Fauci-Part-2-Transcript.pdf", "pdf_url": "/archive-docs/fauci-files/5d2a4d9c67a0adfae432c247137247c2/pdf", "doc_date": "2024-01-09", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "transcribed interview", "house oversight", "select subcommittee", "coronavirus pandemic", "congress", "fauci testimony", "hearing transcript", "testimony-house-2024-jan-part2"], "part_number": 1, "page_count": 246}
{"title": "Fauci Transcribed Interview — House COVID Subcommittee, Part 2 (9 Jan 2024) (Part 2 of 3)", "content": "Cameron asked me to come to the Executive Office Building and was just asking me 12 \nscientific questions, and I remember that.   13 \nThere may have been other times when I was asked by people in the White  House 14 \nframework of security.  15 \nBut the one  -- the thing that I do remember is the briefing of Beth Cameron and 16 \nher team in the Security Council.   17 \nQ A whistleblower came forward to this committee, and according to him, you 18 \nvisited CIA headquarters and assisted the CIA in their investigation.   19 \nA Right.  20 \nQ Have you ever been to the CIA headquarters?  21 \nA I have been to the CIA headquarters several years ago, I believe during either 22 \nthe anthrax attacks or something.  And I went there, I believe, with one of the other 23 \nscientists.  I forgot who it was.  Joshua Lederberg, I think, and I went, I'm pretty sure.  24 \nBut it was decades ago, decades ago.   25 \n  \n  122 \nQ But not since 2020?  1 \nA No.  No.   2 \nQ Okay.  Thank you.   3 \nMy final  -- maybe final origins question and then a couple other questions.  4 \nYou said numerous times here, numerous times publicly you keep an open mind, 5 \nto mean  -- and you've also said that the evidence that you've seen pushes you towards 6 \nnatural evolution.   7 \nOpen mind, at least in my mind, and you can correct me if I'm wrong, means 8 \nthere's a part of you that thinks a lab leak is possible, which I guess you kind of touched 9 \non.  It's not a conspiracy theory.   10 \nA Right.  11 \nQ It's definitely a possibility.   12 \nSo I'm interested in  -- I think I know what papers you're referring to in Nature.  13 \nYou've talked about Dr.  Worobey, Dr.  Pekar, obviously proximal origins.   14 \nA Right.  15 \nQ But why the open mind about the possibility of a lab leak?  16 \nA Because the authors themselves said that we have not had  definitive proof.  17 \nThey said that in both of those papers.  They said they believe the heavy weight of 18 \nevidence points towards a natural occurrence.   19 \nAnd the way I think about things scientifically, unless you have a definitive proof 20 \nscientifically of something, you can have a strong opinion that it is a natural origin, but if 21 \nyou really want to keep an open mind, we may find out that some lab that we don't even 22 \nhear of, we don't even know about, somewhere in Wuhan or in a place close to Wuhan, 23 \nactually was playing with a virus and it leaked.   24 \nSo in my mind, I keep that open.  That often gets conflated with a specific grant 25 \n  \n  123 \nthat we're funding, et cetera.   1 \nSo those things  -- I mean, my open mind is that it certainly could've been 2 \nsomething else.  I don't know what it is.  And I've said that if evidence accumulates 3 \nthat definitively proves it's something else, then I will, you know, accept that definitive 4 \nevidence.   5 \nQ What would be  -- we know the kind of stereotypical zoonotic evidence, 6 \nfinding an intermediary host, finding a virus in the wild.   7 \nA Right.  8 \nQ What would be evidence, in your mind, to kind of move the needle towards 9 \na lab origin?  10 \nA I think we would need much, much cooperation from the Chinese to be able 11 \nto do that, yeah.   12 \nQ Do you think  -- we're 4  years and 9  days post pandemic beginning, post virus 13 \ncoming out.  Do you think we'll ever know?  14 \nA Given the relationship and the tension and the back -and-forth -type 15 \naccusations that have gone on, I think that makes it less and less likely that we'll ever 16 \nknow.   17 \nQ I'm going to shift gears and talk about  --  18 \nQ Fauci: Mitch, before  -- I just -- I apologize, because it's going back to the 19 \nWHO 2021 trip.   20 \nSo understanding, you know, if you have the choice, if they came to you and said, 21 \n\"Dr. Fauci, whoever you name, pick two or three names, U.S. scientists to be on that trip,\" 22 \nwho would you have picked?   23 \nA Fauci: You know, I know a lot of very, very brilliant people, several of whom 24 \nare Nobel laureates.  I probably would've picked one of those.   25 \n  \n  124 \nQ Fauci: Just, I mean, one or two off the top of your head, I mean, specifically 1 \ngiven the particular issues, you know, in your consideration.   2 \nA Fauci: You know why I hesitate, because I could see those guys standing out 3 \nthere saying, \"Well, Dr.  Fauci, said such and such.\"  So I'm not going to go there with 4 \nyou.   5 \nQ Mitch: You don't want any hurt feelings among your colleagues.   6 \nA Fauci: No.  I don't want to go there.  7 \nQ Mitch: I understand.  Okay.   8 \nA Fauci: Yeah.   9 \nQ Mitch: Fair enough.  10 \nMr. Slobodin.   Do you recall  --  11 \nMr. Benzine.   Could you identify yourself first?   12 \nBY MR. SLOBODIN:  13 \nQ Oh, I'm sorry.  Alan Slobodin with the House Energy and Commerce 14 \nCommittee.   15 \nDr. Fauci, do you recall attending a National Security Council meeting  -- this would 16 \nhave been during the Trump administration, maybe September  2020, might have been a 17 \nmeeting convened by Matt Pottinger  -- do you have any recollection?  18 \nA No, I don't recall.  I mean, I've spoken to Matt a bunch of times.  He hangs 19 \naround the White  House.  He was part of the group.  But I don't recall specifically a 20 \nNational Security Council meeting with Matt.  It could've happened, Alan, but I don't 21 \nrecall it.   22 \nQ Is it possible  -- just trying to see if this might help refresh any kind of 23 \nrecollection  -- at such a meeting you remember Secretary of Energy Dan Brouillette being 24 \nin attendance?  25 \n  \n  125 \nA No, don't recall.   1 \nQ Okay.  Thank you.   2 \nA No, I don't recall.  3 \nMr. Benzine.   I want to shift gears and talk about some of the policies and 4 \nmitigation measures and various aspects that went into those dynamics.  And as we're 5 \ngoing through this, we are trying to figure out kind of what worked, what went wrong, 6 \nwhat went well, and how we may apply those aspects in the future.   7 \nAt a task force briefing on April  13th, 2020, you said that you recommended travel 8 \nrestrictions be instituted at  -- I believe, at that point, they had been instituted to China, 9 \nEurope, and the U.K.  Did you recommend instituting travel restrictions in response to 10 \nthe pandemic?   11 \nMr. Barstow.   I'm going to step in here.   12 \nMr. Benzine.   On what grounds?   13 \nMr. Barstow.   On you're asking about recommendations as part of the 14 \nWhite  House task force.  We have executive branch confidentiality interests in that -- in 15 \nthat discussion.   16 \nBY MR. BENZINE:  17 \nQ Dr. Fauci, in your opinion, are travel restrictions a good public health tool?  18 \nA It's context and circumstance dependent , and it depends on what's  -- in 19 \ngeneral.  I'm talking generically.  I'm not talking about your question.   20 \nIt depends on at what stage of the outbreak you do it.  It depends on the level of 21 \nthe particular infection in question that is already in your country.  It depends on the 22 \nefficiency of the transmissibility of a particular infection, because if you have people in 23 \nyour country that are already infected and it's highly transmissible, it doesn't make a lot 24 \nof sense to restrict.   25 \n  \n  126 \nBut in a very, very precise period of time when you have virtually nothing in there, 1 \nyou may want to have a temporary restriction to give you time to prepare.  That's one of 2 \nthe things that we did.   3 \nQ Did you agree with the President's decision to restrict travel from China?  4 \nA I did, and I said there were caveats to restrictions.  I agreed with it, but I 5 \nsaid that we've got to be careful because sometimes when you do restrictions they have 6 \nnegative consequences in that you don't have open access to help or even information.   7 \nBut fundamentally I agreed at that time, since we had almost no infections that 8 \nwe knew of in our country, that at least a temporary restriction would be important.  9 \nQ Did you also agree with the EU travel restriction?  10 \nA I agreed with the suggestion that that be done, yes.  11 \nQ Did you agree with the U.K. travel restriction?  12 \nA Yes, I did.  13 \nQ Does immigration, legal or illegal, influence America's public health during an 14 \noutbreak of a respiratory virus?  15 \nA Again, it goes right back to what I said, Mitch.  It's really very much context 16 \ndependent, like what is the level of infection elsewhere, what is the level of infection in 17 \nthe country, what is the degree of transmissibility.  18 \nQ Since  -- well, for a while now, but particularly since 2021, we've seen an 19 \ninflux of immigration at the southern border, both legal and illegal.  Did you have any 20 \nconversations with anyone in the White  House regarding the conditions at the southern 21 \nborder?   22 \nMr. Barstow.   I'm going to step in here again.   23 \nMr. Benzine.   On what grounds?   24 \nMr. Barstow.   Executive branch confidentiality interests in potential White  House 25 \n  \n  127 \ndiscussions.   1 \nMr. Benzine.   I didn't ask if he was recommending  -- like what specific grounds?   2 \nMr. Barstow.   Can you ask your question again?   3 \nMr. Benzine.   Did you have any conversations with anyone in the White  House 4 \nregarding the conditions at the southern border?   5 \nMr. Barstow.   He can ask -- or answer whether he had discussions but not reveal 6 \nthe substance of those.  7 \nMr. Benzine.   All right.  8 \nDr. Fauci.   I don't really recall having discussions about the southern border 9 \nthat -- I might have.  But, you know, I generally tend to stay away from those kinds of 10 \ndiscussions.   11 \nBut it's possible that when we were in the task force meeting that somebody 12 \nbrought it up and I made a comment about that, but I don't recall the content of it.   13 \nDr. Wenstrup.   Can I jump on that for just a second?   14 \nWere you concerned at all, like I was, that people were coming across the border 15 \nby the thousands, for one thing, but they weren't getting tested or vaccinated?   16 \nDr. Fauci.   Well, it depends, Mr.  Chairman, at what points they were coming 17 \nover.  I mean, if you have  --  18 \nDr. Wenstrup.   Well, they've been coming over for 3  years.   19 \nDr. Fauci.   No, no, no, no.  I mean, if you're talking about people coming over 20 \nfrom the border when we already are having thousands and thousands and thousands of 21 \ninfections of a highly transmissible agent in our own country, to think that someone 22 \ncoming into the country is going to make it any worse is probably not the case.   23 \nWhat I would think would be important, it would be great if we could, when 24 \npeople come in, provide them with care and vaccination and treatment if necessary.   25 \n  \n  128 \nDr. Wenstrup.   Yeah, but we weren't doing that.   1 \nDr. Fauci.   Yeah, but that would be nice if we did.  Yeah.   2 \nDr. Wenstrup.   Thank you.   3 \nDr. Fauci.   You're welcome.   4 \nBY MR. BENZINE:  5 \nQ Thank you, sir.   6 \nI'm going to shift again, and you've talked about masks a little bit, but talk about 7 \nmasks a little bit more.   8 \nAt the beginning of the pandemic, did you support universal masking?  9 \nA In the beginning of the pandemic, no, I did not.  10 \nQ Why not?  11 \nA Well, there were three reasons, and I've said that many times, but let me 12 \nrepeat it for the record, and I'll do it as succinctly as possible.  13 \nQ Thank you.   14 \nA All right.  The three reasons were, A, it was clear to us at the time, and it 15 \nwas made clear to us in the task force, that there was already or would be a shortage of 16 \nmasks since PPE for our healthcare providers was in scarcity.  And there was a concern 17 \nthat if you told everybody to get a mask that the masks would be completely and very 18 \nquickly used up in a non -medical setting that would therefore endanger our healthcare 19 \nworkers, point number one.   20 \nPoint number two, it was  -- first of all, also this is point 1A, this is 1B  -- is that that 21 \nwas also recommended by the Surgeon General under the Trump administration and the 22 \nCDC under the Trump administration, that we don't wear masks early on.   23 \nSo point number two, there was not any good evidence that outside of the 24 \nhospital setting that a mask is effective in preventing the acquisition or transmissibility.   25 \n  \n  129 \nAnd number three, we did not fully appreciate at the time that a substantial 1 \nproportion, 50 to 60  percent of the people in the country who were transmitting, were 2 \nasymptomatic.   3 \nSo those three things we didn't know.  I know you didn't ask it, but I hope you 4 \ndo, that that changed as the months went by.  We learned the answers to those three 5 \nquestions, which had me change my position about the importance of masks, otherwise 6 \nreferred to some as flip -flopping.  But I didn't flip -flop.   7 \nQ So before I introduce exhibits and ask specific things, you reviewed data 8 \nthroughout the pandemic that then changed your perspective on things.   9 \nA Right.  10 \nQ Is that fair?  11 \nA Yeah.   12 \nQ Okay.   13 \nA Yeah.   14 \nQ I want to introduce majority exhibit  29.   15 \n    [Fauci Majority Exhibit No. 29  16 \n    was marked for identification.]  17 \nBY MR. BENZINE:  18 \nQ And I'm sure you're aware of this email as it caught a lot of news when it 19 \ncame out.   20 \nA Yes.  It's my -- I don't even have to read it.  21 \nQ Oh, okay.  Perfect.  Even better.   22 \nA This is my email to Sylvia.   23 \nQ We don't need to  -- he said we didn't need to read it.   24 \nA So, no, but let's read it so that everybody can hear it.   25 \n  \n  130 \nQ Well, I just want to ask about  -- you pretty much just walked through -- you 1 \nwalked through this in your original.   2 \nA Right.   3 \nQ One of the questions I have though, the typical mask you buy in the 4 \ndrugstore is not really effective in keeping out virus, which is small enough to pass 5 \nthrough the material.  That didn't change throughout the pandemic, though, the size of 6 \nthe fabric  --  7 \nA Right.  8 \nQ -- the weave in the mask  --  9 \nA Right.  10 \nQ -- nor the size of the virus changed.  How did  --  11 \nA No, no.  What it is that most people, if you look at it, who wear the masks 12 \nthat you buy, they don't fit well, they're open on the side, and they often have tatters on 13 \nthem that  -- so clearly you're not going to effectively keep virus out.  That's what I was 14 \nreferring to, to Sylvia.   15 \nQ But that was the primary mask worn throughout the pandemic, was we 16 \ncould just go to CVS and get surgical masks and they didn't fit and they had gaps.   17 \nA Right.  18 \nQ So I'm just trying to understand kind of like, we're going to get to it, but the 19 \nvalidity of, you know, mandating someone wear something that is not  -- does not work  --  20 \nA Yeah.   21 \nQ -- as well as maybe it could.   22 \nA But studies did come out  -- you might have them  -- that if you look at the 23 \ngradation of protection, that there's some protection with a cloth mask or a surgical 24 \nmask, there's better protection with a KN -95, and there's much better protection with an 25 \n  \n  131 \nN-95.   1 \nSo it isn't a question of all or none; it's the gradation of the degree of protection.  2 \nQ Were those studies double blind?  3 \nA I don't recall.  I'd have to  -- well, it's kind of tough to do a double -blind 4 \nstudy of something you're putting on your face.   5 \nQ You'd have to infect people, right?   6 \nA Yeah.  7 \nQ Like that'd be kind of hard.   8 \nA Yeah, let me try that one, double blind.   9 \nQ On April  3rd, 2020, the CDC recommended masks for people who were 10 \nconfirmed or suspected to have COVID -19.   11 \nWere you involved in that recommendation?  12 \nA Say that again, Mitch, please.   13 \nQ It was April  3rd, 2020.  It was the first time the CDC recommended wearing 14 \nmasks.  And it was  -- the recommendation was specific to those who were confirmed or 15 \nsuspected to have COVID -19.   16 \nA I don't  -- I don't recall being involved in that recommendation.  I probably 17 \nheard about it.  Probably it was brought to the attention of the task force.  But I was 18 \nnot involved in that decision or discussion to my recollection.   19 \nQ Do you recall any disagreements among the task force regarding masking?  20 \nMr. Barstow.   I'm going to step in here.   21 \nMr. Benzine.   On what grounds?   22 \nMr. Barstow.   Again, you're talking about discussions at the task force level.  23 \nThe executive branch has confidentiality interests in those conversations.   24 \nBY MR. BENZINE:  25 \n  \n  132 \nQ Were you ever part of a discussion with anyone where they  -- anyone in the 1 \nFederal Government where they expressed disagreements or differing opinions on 2 \nmasking?  3 \nA I don't recall those discussions, but I would be surprised.  I don't think 4 \nanybody fully has a hundred  percent agreement on anything.  So I would imagine that in 5 \nsome discussions somewhere there were people who said that they didn't agree that 6 \nmasks should be worn.   7 \nQ You talked briefly kind of the levels of protection, homemade probably being 8 \nthe lowest, cloth and homemade, surgical, K -95, N -95.  Is that fair?  9 \nA Right.  10 \nQ You had said at one point that it became clear that we had enough 11 \nprotective equipment and that cloth masks and homemade masks were as good as masks 12 \nthat you would buy from surgical supply stores.   13 \nWhat did you mean?   14 \nA I'm sorry, are you quoting?  Can I see what you're saying?   15 \nQ Yes, I'm quoting you.   16 \nA Yeah.   17 \nMr. Cooke.   And for the record, can you tell us where this quote comes from?   18 \nMr. Benzine.   It was an interview that he did with InStyle magazine.   19 \nMr. Cooke.   Is there a date?   20 \nMr. Benzine.   I can tell you the date when I get it back.   21 \nMr. Schertler.   July 15th, 2020.  22 \nDr. Fauci.   It's July  15th, 2020.   23 \nMr. Cooke.   Okay.  I just want to make sure the record is clear.   24 \nDr. Fauci.   Yeah, I'm not sure why  -- what made me say that at that time.  I must 25 \n  \n  133 \nhave been referring to something, but I'm not sure.   1 \nMr. Benzine.   Okay.  2 \nDr. Fauci.   That was 4  years ago or 3 and a half years ago.  3 \nMr. Benzine.   No, I understand.   4 \nWhen  -- on the first day of the Biden administration he signed two executive 5 \norders, one mandating masks in commercial travel, planes and trains, and one for Federal 6 \nemployees.   7 \nDo you recall those orders?   8 \nDr. Fauci.   Yeah.  I mean, I don't recall discussion about it, but I recall the 9 \norders.  10 \nMr. Benzine.   Were you involved at all in crafting those orders?  11 \nDr. Fauci.   I wasn't involved in crafting them.   12 \nMrs. Dingell.   Can you speak louder?  We can't hear down here.   13 \nDr. Fauci.   I said, I wasn't involved in crafting the orders.   14 \nMrs. Dingell.   Thank you.   15 \nBY MR. BENZINE:  16 \nQ The commercial mask mandate was struck down by a judge in Florida.  And 17 \nin response you said, \"We are concerned about that, about courts getting involved in 18 \nthings that are unequivocally a public health decision.  This is a CDC issue.  It should 19 \nnot have been a court issue.\"   20 \nYou also said, \"I think it is unfortunate that a court order came in and I believe 21 \nsuperseded the authority of the CDC.\"   22 \nWhat were you basing those statements off of?  23 \nA I believe the CDC knows more about public health than most courts.   24 \nQ Do you believe that courts do not have jurisdiction over public health?  25 \n  \n  134 \nA I believe that courts have jurisdiction over whatever it is they're supposed to 1 \nhave jurisdiction of, and when a court makes an order then you obey the order of the 2 \ncourt.   3 \nBut I was a little bit concerned that we were getting a judge who may or may not 4 \nhave had any experience in health or public health overriding the order of the Centers for 5 \nDisease Control and Prevention.  6 \nQ You've been asked this before more combatively than I'm going to ask it 7 \nnow.  I believe the exact quote before is  -- like is around the lines of, do you believe the 8 \nConstitution can be suspended in times of public health emergency?  I'm going to ask 9 \nmore  --  10 \nA I've never -- other people have said the Constitution could be suspended.  I 11 \nhaven't said that.   12 \nQ No, and I agree.  I'm saying you've been asked that before.   13 \nA Yeah.  Okay.   14 \nQ But I'm going to ask for the record today, do you believe that Americans 15 \nretain constitutional rights during public health emergencies?  16 \nA I believe strongly in the Constitution of the United States.  17 \nQ All right.  Thank you.   18 \nAnother question that we get a lot in the masking space is the masking of children, 19 \nparticularly kids down to 2  years old.   20 \nA Right.   21 \nQ The WHO recommended against masking children less than 5 because masks 22 \nare, and I'm quoting them, not in the overall interest of the child, and then against 23 \nchildren 6 to 11 from wearing masks because, and, again, quoting, of the potential impact 24 \nof wearing a mask on learning and psychological development.   25 \n  \n  135 \nWas there ever a cost -benefit analysis done on the unintended consequences of 1 \nmasking kids versus the protection that it would give them?  2 \nA Not to my knowledge.  3 \nQ Do you believe that masking children as young as 2 was necessary?  4 \nA I think it's context dependent.  It really depends on where you are.  I think 5 \nyou were having a time like when you're having a tsunami of infections and you're 6 \ndesperately trying to protect people from getting infected and dying to the point where 7 \nevery one of our healthcare facilities are in danger of overrunning, you might want to do 8 \nsomething that might seem  -- what's the right word? --  excessive, whereas under most 9 \nother circumstances you won't.   10 \nAnd I believe the CDC felt at that time that that's what was needed given the 11 \ndire -- I would say the dire situation that we were in.   12 \nQ This was kind of, I won't say  -- it was definitely a novel virus, but new also in 13 \nkind of the way that it didn't affect children very much.  Like there were obviously kids 14 \nthat caught it, there were obviously kids that transmitted it, and there was obviously, 15 \nsadly, kids that passed away.   16 \nA Well, I would just correct it a little bit, Mitch.   17 \nQ Okay.   18 \nA I don't think there is really strong evidence that it doesn't infect children as 19 \nwell.   20 \nQ Affect.   21 \nA Yeah, affect in the sense of serious illnesses.   22 \nChildren, compared to adults, which was a public health crisis of adults with all the 23 \ndeaths we've had, didn't have as much likelihood of developing severe consequence 24 \nleading to hospitals and death.   25 \n  \n  136 \nBut there was, you know, a considerable number of children who have died 1 \ncompared to something like influenza, multifold, right.   2 \nQ Do you recall reviewing any studies or data supporting masking for children?  3 \nA You know, I might have, Mitch, but I don't recall specifically that I did.  I 4 \nmight have.   5 \nQ Since the  -- there's been a lot of studies that have come out since the 6 \npandemic started, but specifically on this there have been significant on kind of like the 7 \nlearning loss and speech and development issues that have been associated with 8 \nparticularly young children wearing masks while they're growing up.  They can't see 9 \ntheir teacher talk and can't learn how to form words.   10 \nHave you followed any of those studies?  11 \nA No.  But I believe that there are a lot of conflicting studies too, that there 12 \nare those that say, yes, there is an impact, and there are those that say there's not.  I 13 \nstill think that's up in the air.   14 \nI mean, I'm very sensitive to children.  I have children and I have grandchildren.  15 \nSo I don't want to have anything that would do to harm them.   16 \nBut I think that there was a conflicting discussion about the negative impact on 17 \nspeech and formation of the bones of the face, and that I think was debunked pretty 18 \neasily.   19 \nQ Okay.  I appreciate that.   20 \nDo you think this  -- going forward that  -- I mean, obviously this hit our shores 21 \nquickly.  We had to react quickly.  The first little while you're just kind of like reading 22 \nand reacting, right?   23 \nA Right.  24 \nQ You're not  -- you don't have time to go read 15 studies and then make a 25 \n  \n  137 \ndecision.   1 \nA Correct.   2 \nQ Do you think going forward  -- like do you think it's important that public 3 \nhealth officials, as science and data come out, that they change their mind?   4 \nA Absolutely, that you go with the data.  And if the data essentially negates 5 \nyour first decision -- and getting back to the question you asked me about 8  minutes ago 6 \nwhen I made my discussions about the use of masks, the three hypotheses that I put forth 7 \nwere all disproven, and I changed my mind about masks, and I said we should be wearing 8 \nmasks.   9 \nSo I definitely agree that as data come out, that you should adjust your decisions, 10 \nyour guidelines, your recommendations according to the data that comes out.   11 \nQ You also  -- and it was recently, I believe, this year made a statement that 12 \nkind of universal or mass masking works on the margins, is I believe your exact quote, 10 13 \npercent or something on the margins.   14 \nDo you recall that statement?  15 \nA No.  What was  --  16 \nQ I don't have it.   17 \nA Yeah.  Some  -- I don't  --  18 \nQ I don't have it in front of me.   19 \nA Okay.  20 \nQ But I was just wondering.   21 \nI'm going to shift gears and stick kind of in the children aspect of the pandemic.   22 \nSchools K through college closed pretty quickly.  And I think, and I have heard 23 \nnumerous times, that it was probably the right thing to do the spring semester, like we 24 \njust talked about.  No one knew what was going on.   25 \n  \n  138 \nA Right thing to do.   1 \nQ Right thing to do is to learn and come back.   2 \nDid you have any role in  -- obviously the administration was helping those 3 \nsituations.  Did you have any role in that?  4 \nA I didn't make a decision to close the schools.  5 \nQ No, I'm not asking  that.  I'm  --  6 \nMr. Schertler.   Could you just be clear, role in  -- 7 \nMr. Benzine.   Did you -- were you a part of conversations where the topic of 8 \ninitially closing schools came up?  9 \nDr. Fauci.   Not specifically closing schools.  I was involved  -- and, again, I think 10 \nI'll have to turn to Kevin because of the decisions of when we were doing the 15 -day 11 \npause and then the 30 -day pause, which, in fact, included schools, I believe.   12 \nMr. Barstow.   He just answered that he was involved in conversations.   13 \nBY MR. BENZINE:  14 \nQ Okay.  And you just answered this, that at the beginning, because of all the 15 \nunknowns, supportive of closing schools in the beginning?  16 \nA Right.  17 \nQ In -- we then saw through the summer there was obviously some like 18 \nsummer camp things and some infections at camps.  And then a lot of schools began 19 \nreopening going into the fall semester of 2021.   20 \nDo you recall any conversations regarding advocating for school reopening -- 21 \nA Yeah.  I -- 22 \nQ -- in the fall of 2020?  23 \nA Yeah.  I think if you  -- I'm surprised you haven't shown me something that I 24 \nsaid.  I have often said we need to open up the schools as quickly and as safely as 25 \n  \n  139 \npossible, and I must have said that 500 times on TV.   1 \nQ I have it a couple times  --  2 \nA Yeah.  3 \nQ -- but I figured I'd just ask you.   4 \nA Yes.  Yes.  That was my sound bite to the world, we need to reopen the 5 \nschools as quickly and as safely as possible.   6 \nQ So that's been pretty consistent across the board, and we get different  from 7 \nlike -- we've talked to CDC folks, obviously you, other public health professionals, but also 8 \nthe unions and teachers and parents and kids, and everyone has a different definition of 9 \nwhat \"safely\" meant.   10 \nA Right.   11 \nQ What was yours?  12 \nA My -- it depends on where you were.  For example, if you had vaccines 13 \navailable, you really want to make sure that you surround the children with people who 14 \nare vaccinated.  That you use the money that has been set aside to increase the 15 \nventilation in schools.  You have some distancing.  You make sure that the people who 16 \nare driving the children to school.  You surround the children with a cocoon of safety.  17 \nThat's one of the things that you could do.   18 \nQ You mentioned ventilation.  Was upgrading ventilation, in your mind, a 19 \nprerequisite for opening  --  20 \nA I thought it was very important.  I thought that  -- I know that there was a 21 \nconsiderable amount of money that was allocated to the CDC to enhance safety.  22 \nAnd I know it's difficult sometimes, particularly in some of the older schools, to 23 \nincrease the ventilation.  But I felt ventilation was absolutely critical, particularly as we 24 \ngot more information that the virus could be spread by an asymptomatic person.   25 \n  \n  140 \nSo a child could come to school feeling perfectly well, and then somebody sitting 1 \nright next to them is going to get possibly infected, whereas we know getting infected out 2 \nof doors is much, much less likely than indoors, and the more you ventilate the more you 3 \napproximate an outdoor situation.   4 \nQ Part of that answer was going to be my next question, and Dr.  Collins has 5 \ntouched on this recently in an interview that he just did of public health determinations, 6 \nkind of not taking necessarily into account the practicality of those recommendations.  7 \nLike you mentioned difficult to increase ventilation in  older schools.  8 \nA Right.   9 \nQ Our understanding is it would also be difficult in poorer schools, inner -city 10 \nschools, those kinds of areas.   11 \nIf school districts went strictly based off  -- if CDC recommended you can't reopen 12 \nuntil your ventilation is increased, I mean, I don't know a school district that would've 13 \nreopened regardless of how much money  Congress passed.   14 \nA Right.  15 \nQ Do you think it's  important --  16 \nA Well, that would've been almost an inherently impossible recommendation, 17 \nand I would doubt  -- I would think that would be foolish to make a recommendation like 18 \nthat.   19 \nQ Do you think public health officials should take into account the practicality 20 \nof the recommendations that they're making?  21 \nA No.  I think public health officials should be sensitive to the negative 22 \nconsequences, but public health officials should give information to the deciders as to 23 \nwhat the public health implications are, and the deciders should balance the other factors 24 \nthat go with it.   25 \n  \n  141 \nI don't think that a public health official should say, \"Well, we think you should do 1 \nthis and this, but, by the way, the economy will do this and the stock market would drop 2 \nthat.\"   3 \nThat's not what a public health official should do.  But that doesn't mean that a 4 \npublic health official should be insensitive to the secondary effects of what they're talking 5 \nabout, but they should give the information to the people who make the decision about 6 \nwhether you're going to close this or whether you're going to recommend that.   7 \nQ And along those lines, and this is just me from my outside perspective, that 8 \nyou would see  -- you would see that on the task force there was a makeup around the 9 \nboard, like you had FEMA, you had you, you had domestic policy, you had national 10 \nsecurity policy, you had economic policy all on the task force, and I think that continued 11 \nthrough to the response team, is the Biden administration one.  Is that right?  12 \nA Right.   13 \nQ But then  --  14 \nA Wait a minute, it wasn't as much.  I mean, the response team was mostly 15 \nmedical people.   16 \nQ Okay.   17 \nA Yeah.  It was not multiple different agencies.  It was  --  18 \nQ So the task force had the  multiple.  19 \nA The task force had more non -public health people than public health people.   20 \nQ Okay.   21 \nA Whereas the response team under the Biden administration was almost 22 \nexclusively public health people, except for Jeff and then -- Jeff Zients and Ashish Jha.   23 \nQ So I guess my  --  24 \nA And Ashish Jha, by the way, was a public health person.  25 \n  \n  142 \nQ Yes, he was.   1 \nI guess, my long -winded point is that you see kind of the flows of advice going to 2 \nthe decisionmakers.  The decisionmakers go and then say what the decision was.  But 3 \nthen some of the advisers would go and undermine the decision.   4 \nAnd I'm not blaming you, but various press conferences where the President 5 \nwould say we're going to do this, excluding some of the more outlandish comments, and 6 \nthen a reporter would ask you a question and you'd be like, well, that's not what I advise 7 \nfor public health.   8 \nA Right.  9 \nQ Like, do you have concerns with that?  Do you think it should, like, for a 10 \nfuture pandemic should be  --  11 \nA Can you -- I'm sorry, Mitch, I don't mean  -- I don't suggest that you're tricking 12 \nme.    13 \nQ No, no, no.  I  --  14 \nA But give me chapter and verse of what I said.  15 \nQ It was more hypothetical.  So I'll frame it not in people that we know.   16 \nA Okay.   17 \nQ If you have a decisionmaker, the President of the United States, takes all the 18 \nadvice into account and makes a decision, goes out into a press conference, has all his 19 \nadvisers behind him, says the decision.   20 \nA reporter asks one aspect of it, so asks the economic person, you know, \"What 21 \ndid you advise?\" and the economic person has said, \"Well, I advised something different 22 \nthan what the President just told you.\"  23 \nDo you think it's important in future responses to have kind of one voice leading 24 \nthe public -facing response to a pandemic?  25 \n  \n  143 \nA I think there should be one decisionmaker and that decisionmaker should 1 \ntake in information from a number of sources and make their decision.   2 \nQ Okay.  In the time I have remaining, moving through schools still a little bit.   3 \nIn December  2020, President -elect Biden announced that he wanted the majority 4 \nof schools to reopen within a hundred  days of his new administration.  Do you recall 5 \nthat?  6 \nA I recall them saying that, yes.   7 \nQ At the time, what did you think about that promise?  8 \nA I thought it was a good idea if we could do it, and that's when I kept on 9 \nsaying let's open the schools as safely as we possibly can.   10 \nQ At the  -- close to what you said at the time of that may not happen because 11 \nthere may be mitigating circumstances, new variants  --  12 \nA Right.  13 \nQ -- various things like that.  Obviously, we were pretty early in the vaccine 14 \nrollout as well.   15 \nA Right.  16 \nQ A few days into office, President Biden walked it back in saying he didn't 17 \nmean all schools, he meant kindergarten through eighth grade, not high school.   18 \nDo you recall that?  19 \nA I didn't have any input into that delineation between one group or another.  20 \nThat was mostly a CDC type of advice.   21 \nQ Did -- you've said here your kind of public advice, and I assume private 22 \nadvice, has always been reopen the schools as quickly and safely as possible.   23 \nA Yes.  24 \nQ Did you advise the incoming transition team on COVID -19?  25 \n  \n  144 \nA I was on  -- oh, the transition team?   1 \nQ Yes, sir.   2 \nA No, I spoke with the transition team, but I didn't advise them much on 3 \nanything.   4 \nQ Did you have any conversations with President Biden while he was 5 \nPresident -elect?  6 \nA I had  --  7 \nMr. Barstow.   Dr. Fauci.   8 \nDr. Fauci.   Yeah.  Sorry.   9 \nMr. Barstow.   You're allowed to say whether you had conversations  --  10 \nDr. Fauci.   I'm sorry.   11 \nMr. Barstow.   -- but you shouldn't talk about the substance of those 12 \nconversations.   13 \nMr. Schertler.   You can say you had conversations, but don't discuss the 14 \nsubstance.   15 \nDr. Fauci.   Yeah.   16 \nI don't recall conversations with the President.  I had conversations with Ron 17 \nKlain.   18 \nBY MR. BENZINE:  19 \nQ Okay.  Do you generally, without  --  20 \nA And,  now, let me just back off and say, I don't recall whether I had 21 \nconversation like a day before he was inaugurated or a day after he was inaugurated.   22 \nQ Okay.   23 \nA Okay?   24 \nQ No, that's fair.   25 \n  \n  145 \nA But I didn't have a lot of conversations with the President.  I won't say what 1 \nI said.  But I didn't have multiple conversations with the President -elect.  I had a few 2 \nconversations with Ron Klain.   3 \nQ Generally, without getting into kind of any advice that you gave during those 4 \nconversations, do you recall the topics with either the President or Mr.  Klain?   5 \nA I think the topic might have been vaccination.  6 \nQ Did you have any  -- she was not CDC Director yet  -- but did you have any 7 \nconversations with CDC Director Walensky during the kind of post -election, 8 \npre-inauguration timeframe?  9 \nA Yes.  10 \nQ Regarding what?  11 \nA That I was recommending her to be the Director of CDC.  12 \nQ Did you have any conversations with her regarding school reopenings?  13 \nA No.  14 \nQ And in the scope of this question, I understand that you have done events 15 \nwith the American Federation of Teachers, so I'm not asking about conversations 16 \nregarding those events.  But have you had any conversations with Randi Weingarten 17 \nregarding school reopenings?  18 \nA I don't know whether it was regarding school reopenings.  I think I was on a 19 \nZoom or podcast or something with her, but I didn't make any recommendations, in my 20 \nmind, that I can recall.  I don't recall recommendations of saying you should or should 21 \nnot reopen schools.   22 \nQ Going  -- as we got further into 2021 and vaccines became more available, 23 \nwas it ever your opinion that vaccination for students and teachers was a prerequisite of 24 \nreopening schools?  25 \n  \n  146 \nA I don't recall that I would say it was a prerequisite.  I was very much in 1 \nfavor of vaccinating the children who were eligible for vaccination and vaccinating the 2 \nteachers.   3 \nI don't recall whether I said anything about a prerequisite.   4 \nQ Same question.  But was it ever your opinion that mask mandates were 5 \nnecessary or a prerequisite for reopening schools?  6 \nA Again, I think the operative word here, Mitch, is \"prerequisite.\"  I don't 7 \nrecall that I said \"prerequisite.\"  I may have said, we really should get people wearing 8 \nmasks in schools by both the teachers and certain children of a certain age.   9 \nQ But they didn't  -- like, it wasn't necessary to reopen the school?  10 \nA I don't recall that I said prerequisite.  I just don't recall.   11 \nQ No, that's  --  12 \nA I mean, you have a lot of discussions.  I just don't recall.   13 \nQ That's all I was asking.   14 \nFinishing out our hour really quickly, I think everyone in here will agree COVID -19 15 \nhit the elderly and nursing home population quite hard, both early on and throughout the 16 \npandemic.   17 \nOne of the decisions that we've been investigating was by, at that point, New  York 18 \nGovernor Andrew Cuomo and the March  25th, 2020, order that directed nursing homes 19 \nto accept potentially or COVID -positive patients without testing them.   20 \nDo you recall any conversations regarding that order amongst the task force or in 21 \nyour job?  22 \nA Not to my recollection, no.   23 \nQ Did you ever speak to Governor Cuomo during the pandemic?  24 \nA I spoke  -- I did, a few times.   25 \n  \n  147 \nQ On what topics?  1 \nA A variety of topics, you know, vaccination, how were things going, you know, 2 \nwhat do you think about where we're going, what's  -- you know, just medical questions.   3 \nQ Did you ever have any discussions with him regarding nursing homes or that 4 \norder?  5 \nA No.  No.  6 \nQ Did you ever speak with New  York Health Commissioner Zucker?  7 \nA I know Howard.  I'm trying to remember if I spoke to him.  I don't recall, 8 \nbut it would not be surprising to me if I did.  Yeah.   9 \nQ But just  -- so just for the record, you don't recall conversations, so therefore, 10 \nprobably don't recall if the conversations were about the nursing home -- the nursing 11 \nhome order?  12 \nA Right.  I don't recall any conversations about nursing homes with him.   13 \nQ Okay.  Do you recall  -- this came in the news pretty  -- around the summer 14 \nof 2020, and CMS Administrator Verma said some things.  We've talked to Dr.  Birx, and 15 \nshe told us that she thought the Cuomo guidance violated CMS guidance at the time.   16 \nDo you recall any conversations about that?  17 \nA I didn't have conversations with that, no.   18 \nQ All right.  I have about 60  seconds left in my hour, so I'm going to try to tick 19 \noff two more questions.   20 \nOne of the kind of interesting things that we heard is the different  -- and please 21 \ncorrect me if I'm like way off base on this  -- but the difference of dying from COVID or 22 \nwith COVID and how that would affect the death statistics.   23 \nDo you have any knowledge or anything to share on that?  24 \nA I know that that was a topic of heated discussion and disagreement.   25 \n  \n  148 \nQ When?  1 \nA Just pervasive.   2 \nQ Beginning in 2020?  3 \nA I don't know when it began, but I remember that topic came up.  If 4 \nsomebody  -- you know, it  -- I'm going to dribble around here and run the clock out, but 5 \nI'm not going to  --  6 \n[Laughter.]  7 \nA I'm not trying to run the clock out.  I'll even give you an extra minute or so.   8 \nBut the fact is that it's a complicated issue, because if someone comes in who 9 \nis -- has COVID and nothing else wrong with them and they die from COVID, that's a clear 10 \nCOVID death.   11 \nIf someone comes in who got hit by a car and had his head crashed in but happens 12 \nto test positive, that's not a COVID death.   13 \nBut if someone comes in with significant aortic valve dysfunction and bad flow 14 \ncongestive heart failure and they get COVID and get febrile and get a pneumonia, yeah, 15 \nthat's a COVID death even though they died of congestive heart failure.   16 \nQ So there's kind of  --  17 \nA You agree?   18 \nDr. Wenstrup.   Yeah.   19 \nBY MR. BENZINE:  20 \nQ Kind of three  buckets there.  A very, very clear nothing wrong with you, 21 \nwhich I'm sure maybe zero  percent of the population  --  22 \nA Right.  23 \nQ -- has nothing wrong with them, got COVID, died.  24 \nA very, very clear had COVID, didn't, like, maybe knew, maybe didn't, got in a car 25 \n  \n  149 \naccident and died.   1 \nA Right.  2 \nQ And then the underlying condition COVID exacerbated and then died.   3 \nA And the person would not have died if they didn't get COVID.   4 \nQ Okay.   5 \nA I mean, that's the way I would say it.   6 \nDr. Wenstrup.   But both conditions should be listed as to why.   7 \nDr. Fauci.   Well, I think if someone  --  8 \nDr. Wenstrup.   So it wasn't just respiratory.   9 \nDr. Fauci.   Yeah.  I mean, yeah, if somebody has congestive heart failure that's 10 \nbarely compensated and they get COVID and get a COVID respiratory infection and die, 11 \nthat's a COVID death.  I think you should list that as a COVID death.   12 \nDr. Wenstrup.   Well, they both contributed.   13 \nDr. Fauci.   Yes.  Yeah.   14 \nBY MR. BENZINE:  15 \nQ My last question, and I appreciate not entirely dribbling out the clock on that 16 \none.   17 \nThe same kind of thing happened with case counts.  So if I  -- everybody going to 18 \nthe hospital was tested for COVID.  If they tested positive they were listed as a COVID 19 \nhospitalization.   20 \nAnd very much agree with testing everybody that goes into the hospital for COVID 21 \nso you get a good idea of case counts.   22 \nBut do you think there should've been a better  -- like, if I broke my leg and went 23 \ninto the hospital and got tested, should I have been  --  24 \nA That should not be considered a hospitalized COVID case, in my opinion as a 25 \n  \n  150 \nphysician.  1 \nQ Okay.   2 \nA I mean, if a person is  -- you know, breaks their leg and goes in, and is a 3 \n19-year -old person who broke their leg in a football game, and they put a cast on and 4 \nthey walked out, and that person happened to test positive for COVID, that's not a COVID 5 \nhospitalization.   6 \nQ Perfect.   7 \nA That's a COVID case but not a COVID hospitalization.   8 \nMr. Benzine.   Perfect.  Thank you very much.   9 \nWe can go off the record.  10 \n[Recess.] 11 \n  \n  151 \n[3:23 p.m.]  1 \n  We can go on the record.  2 \nI just want to start off this next hour with a few housekeeping items.  I first want 3 \nto revisit quickly two items that Congresswoman Castor introduced for the record last 4 \nround and register them into the record.   5 \nThe first is the letter from Dr.  Marks to Florida Surgeon General Dr.  Ladapo.  This 6 \nis going to be exhibit U.  7 \n    [Fauci Minority Exhibit U  8 \n    was marked for identification.]  9 \n  And then the second exhibit is going to be the L.A. Times article 10 \nthat the Congresswoman referenced.  This is going to be exhibit V.  11 \n    [Fauci Minority Exhibit V  12 \n    was marked for identification.]  13 \n  And then while we're passing those around, we have a new 14 \nmember who's joined us.   15 \nCongresswoman Ross, could you introduce yourself for the record?  And if 16 \nthere's anything you'd like to say at the start of the round, please do.  17 \nMs. Ross.   Thank you.   18 \nDr. Fauci, thank you so much for your patience, but, most importantly, thank you 19 \nfor your service -- 20 \nDr. Fauci.   Thank you.  21 \nMs. Ross.   -- to our country and to public health.  My father is a physician, and I 22 \nknow it's not easy providing all the answers under uncertain circumstances.   23 \nDr. Fauci.   Thank you.   24 \nMs. Ross.   I represent the Research Triangle area of North Carolina.  In fact, 25 \n\n  \n  152 \nDr. Mandy Cohen is my constituent.   1 \nAnd I just want to share  -- I know I'm coming late to this party, but I do want to 2 \nshare how important it has been to my area of the country to really follow the science 3 \nand take care of the most vulnerable.  We have a very 4 \nscience/technology/medical -oriented district.  We were one of the only places in the 5 \ncountry that provided free testing from the very beginning of the pandemic.  We had a 6 \nlab, which is in my district, that had come up with early testing.   7 \nEvery time I drove  -- and I drive from North Carolina here, and, of course, I had to 8 \ndo it during the pandemic  -- I would stop at the hospital, in the most compromised area 9 \nof my district, in the parking lot and get my test.   10 \nAnd I want to applaud you for following the science as you found it; for making 11 \nsure that we always focused on the most vulnerable populations.  Because, of course, 12 \nwhen vaccines were available, people who had access to physicians and means and could 13 \nget different places, they could get what they needed, but you always paid attention to 14 \nthe most vulnerable.   15 \nMy district, the State of North Carolina, we followed your advice, and North 16 \nCarolina had better outcomes because of it.  And I know that the most vulnerable 17 \npeople in my district had better outcomes because of your advice and your service.   18 \nSo I know it's been a, you know, kind of interesting couple  days for you, but I want 19 \nyou to know toward the end of the process how much the people of this country and my 20 \ndistrict appreciate your service.   21 \nDr. Fauci.   Thank you.  Thank you.   22 \n  With that, I will turn it over to Congresswoman Dingell.   23 \nMrs. Dingell.   So I want to return to the subject of the masks, which we can all 24 \nagree is a point of contention, but I think that there are some facts that we need to make 25 \n\n  \n  153 \nsure we really are getting on the record.  I want to discuss both the efficacy and the 1 \neffectiveness of masking.   2 \nFirst, Dr. Fauci, could you please explain for us the different kinds of masks or face 3 \ncoverings that were used during the pandemic?  Were some better at protecting people 4 \nfrom COVID -19 than others, and why?  You got into it a little, but can we expand on 5 \nthat?   6 \nDr. Fauci.   Yeah.  There are, as I mentioned, let's say, four separate classes.   7 \nThere's a cloth mask.  And that really, really varies, because people make their 8 \nown cloth masks -- different people, different companies.  So that's one level.  That's 9 \nprobably the most inconsistent in its protection, and it's probably relatively less than the 10 \nothers.   11 \nThe next is the surgical mask you buy in the store.  That is the next level, a bit 12 \nmore, but not as good as the next two, which is a KN95, which is quite good, but the one 13 \nthat's the state of the art is the N95, which is very good at protecting both the person 14 \nwho might be acquiring it as well as the transmission to someone else.   15 \nMrs. Dingell.   How did our understanding of the importance of masks and 16 \nmask -wearing evolve over the course of the COVID -19 pandemic?   17 \nDr. Fauci.   Well, it evolved because of what we realized.  As I mentioned in 18 \nanswer to a prior question, that in the beginning there was not a lot of enthusiasm or 19 \nrecommendation for wearing masks for I said three reasons but there's probably a fourth 20 \nreason, because at the time when we had few cases in this country, when, retrospectively 21 \nthinking, would've been a time when people should've been wearing masks, because it 22 \nwas sort of the silent virus underneath the surface spreading throughout the country.   23 \nBut the other three reasons were this understanding, which turned out to be a 24 \nmisunderstanding, that there was such a shortage of masks that if you wore masks in the 25 \n  \n  154 \ngeneral public you could take away from the masks that were available for the people 1 \nwho really needed it, who were the healthcare providers taking care of people in the 2 \nhealthcare setting.   3 \nNext, the data which accumulated over a period of months to years about the 4 \neffectiveness or not of masks in preventing acquisition versus transmission.  We didn't 5 \nhave any information that outside of the hospital setting masks were pretty protective.  6 \nWe knew that in the hospital setting, that when you're dealing with a tuberculosis patient 7 \nin the tuberculosis ward, they clearly were good.  We didn't know that, whether that 8 \napplied to the general population.   9 \nAnd, thirdly, we didn't realize  -- even though there was hints of it, we didn't 10 \nrealize the rather substantial proportion of people who were transmitting in an 11 \nasymptomatic way.   12 \nSo the reason that's important is that it would be, well, I'm in a room here and 13 \nthere's nobody that's coughing or sneezing, and, by the syndromic approach to viral 14 \ntransmission, you'd say, why should you really wear a mask?  There's nobody sick here.   15 \nBut then when we realized that, in fact, 50 to 60 percent of the people who are 16 \ntransmitting are asymptomatic, that negated the first  -- the third hypothesis.   17 \nThe second hypothesis was negated by the fact that, when studies were done 18 \nsequentially, finally, over time, it became clear that masks had a significant degree -- they 19 \nweren't 100 -percent protective, but they had a significant degree of protection outside of 20 \nthe setting of a hospital, namely people in the community.   21 \nAnd then, third, it became  -- third or fourth, it became clear that there wasn't a 22 \nPPE shortage among healthcare providers with regard to masks, that if you went out and 23 \ngot a K95 or an N95, you were not preventing a nurse somewhere from getting it.   24 \nWhen those three things coalesced, then it became clear that masks really needed 25 \n  \n  155 \nto be used, because they were effective.  1 \nMrs. Dingell.   I'm going to argue that point with you in a minute -- 2 \nDr. Fauci.   Okay.  3 \nMrs. Dingell.   -- because I remember the supply chain.   4 \nDr. Fauci.   Right.  5 \nMrs. Dingell.   But I want to stay on this right now, just because I can remember 6 \nbeing on the phone with people in China having to check the quality of masks, and nurses 7 \nthat were microwaving masks or rewearing.  And I want to ask if we're ready for the 8 \nnext time.   9 \nBut the consensus of the medical and scientific community is that wearing a 10 \nwell-fitting mask reduces the threat.  That has been.  I think there are multiple studies 11 \nthat I could quote now.   12 \nBut could you explain a few examples of the scientific studies that demonstrate 13 \nwhy masks are effective at preventing COVID -19 and how they did evolve?   14 \nDr. Fauci.   Well, they evolved, for example, when you had one particular cohort 15 \nthat's maybe a school or a workplace where they were able to demonstrate that, when 16 \nyou compare a place that regularly used masks or required masks versus a place that 17 \ndidn't have mask use at all, there was clearly a difference in the infection.  That was the 18 \nstandard type of study that was used.   19 \nOther studies were more specific, where you would actually in  a controlled 20 \nsituation show that a mask protected against a particular infection.   21 \nSo there were controlled studies and there were cohort studies.   22 \nMrs. Dingell.   So, in epidemiology and public health, there is a distinction 23 \nbetween the concepts of efficacy and effectiveness.  Could you explain this distinction?   24 \nDr. Fauci.   Yes.   25 \n  \n  156 \nMrs. Dingell.   Would you?   1 \nDr. Fauci.   I will.   2 \nSo efficacy is the capability of a particular intervention to prevent and/or treat a 3 \nparticular disease, let's say.   4 \nAnd let's talk about health, because there's efficacy and effectiveness of things 5 \nthat have nothing to do with health.  But in the arena of health, efficacy means that you 6 \nhave shown, usually in a clinical trial, that if you have a well -controlled experiment that 7 \nthis is better than nothing or this is better than that.  That is the efficacy of that in 8 \nintervention.   9 \nThe effectiveness is, in the real world, what does that particular intervention, 10 \nwhich may have been shown to be quite efficacious -- is it effective?  A typical 11 \nsimple -to-understand explanation of that is that, if you have an intervention that in a 12 \ncontrolled clinical trial is very efficacious but nobody uses it, nor do they use it properly, 13 \nthen it is not an effective intervention, even though in a clinical trial it's efficacious.   14 \nMrs. Dingell.   So, in your assessment, is this distinction relevant for 15 \nmask -wearing to reduce the threat of COVID -19?   16 \nDr. Fauci.   It is absolutely relevant.  For example, if you have a mask that is 17 \nproperly worn and properly fitted and used all the time when you're in a risk situation, 18 \nthat mask could be very efficacious.   19 \nIf that same mask is worn intermittently, not properly fitted, and loosely used, 20 \nthen that mask that is efficacious in a trial can be completely ineffective.   21 \nAnd I think what you're getting to is the importance that sometimes studies say, 22 \n\"Well, masks didn't work,\" and they didn't work because they were not properly used or 23 \nthey weren't fitted well or people used them 30 percent of the time or people say, \"Well, 24 \nI wore a mask all the time except when I went into a crowded restaurant and had a meal, 25 \n  \n  157 \nand I got infected; therefore, masks don't work.\"  No.   1 \nMrs. Dingell.   So you got ahead of me --  2 \nDr. Fauci.   I'm sorry.  3 \nMrs. Dingell.   No, no, but that's exactly where I was going to go.  And in some of 4 \nthe instances, a lot of the critics of mask -wearing pointed to studies that suggested that 5 \nthe mask -wearing initiatives were ineffective.  But, as you just said, your assessment is 6 \nthat that's wrong.   7 \nSo is there anything you want to say to elaborate that for the record so that we 8 \nreally do get the difference between the two?   9 \nDr. Fauci.   Yeah.  You know, my comment would be that, when you're 10 \nevaluating a study, you've got to make sure if there are any confounding variables in the 11 \nstudy.  And if a confounding variable is that a person uses the mask 50  percent of the 12 \ntime, that, to me, negates a conclusion on whether something does or does not work, 13 \nthat you have to have the conditions that adequately evaluate the effectiveness of the 14 \nmask, not the efficacy of the mask.  15 \nMrs. Dingell.   And I have one  -- this was not your area of responsibility per se, 16 \nbut the supply chain did have issues at the beginning.  I remember going  and getting 17 \ngarbage bags from neighbors to take to nursing homes and the nurses that would cry in 18 \ntears.  It was bad in some of the hospitals.  And, as you say, we were  -- I became a 19 \nsupply -chain expert, with our Governor, trying to get stuff at the beginning.   20 \nAre we doing what we need to do if there's another pandemic, in your opinion?  21 \nNot that it was your responsibility, but I'm just curious.   22 \nDr. Fauci.   I would have to say that I have been out of government and off the 23 \ncoronavirus response team for now a year and 4 days --  24 \nMrs. Dingell.   How many minutes?   25 \n  \n  158 \nDr. Fauci.   -- and I can't answer that question adequately.  But the one thing I 1 \ndo know, we really need to be doing more.   2 \nMrs. Dingell.   Is there anything else that you want to elaborate on in this area?   3 \nDr. Fauci.   No, I think it's really important, and I think that I'm glad you brought 4 \nup that particular issue, which is rarely brought up in discussions, of the disparity that 5 \npeople have in their appreciation of whether something works or does not work.   6 \nAnd I think that really leads to a lot of confusion, because every time you have a 7 \nstudy that shows one thing, somebody will read a study that shows another thing, and it's 8 \nnot really a valid study.  That doesn't mean the investigators are bad investigators, but 9 \nit's not a valid study.   10 \nMrs. Dingell.   Thank you.   11 \nI'll turn this back over to  12 \nBY  13 \nQ So, Dr. Fauci, I would like to just briefly revisit a topic that my majority 14 \ncolleagues discussed in the last hour.  That was the process of resuming in -person 15 \nlearning safely here in the United States.   16 \nAnd so, when COVID -19 took hold in March of 2020, a number of in -person 17 \nactivities that were a routine part of our everyday lives were suspended in an effort to 18 \nslow the spread of the virus, and one of these activities was in -person learning in 19 \nclassrooms across America.   20 \nSo, Dr. Fauci, just for the record, can you remind us, at that period in time in 21 \nMarch 2020, what we knew and what we didn't know about the virus and how it spread 22 \nat the time when in -person learning was suspended in communities?   23 \nA At that time, when the 15 -day \"flatten the curve\" followed by the 30 -day 24 \nextension was put into effect, it was crisis in the United States.  It was at a time where 25 \n\n  \n  159 \nNew York was just on the cusp of getting overwhelmed, when there were freezer trucks 1 \noutside of Elmhurst Hospital and New York Hospital and the hospitals in Boston, that 2 \nsomething needed to be done very, very quickly.   3 \nThere were things we didn't know about the virus except that it was spreading 4 \nwidely in the population.  And it was at that point that the decision was made that we 5 \nneeded to do something to flatten that curve, because if the curve continued to do that, 6 \nwe would run out of hospital beds.   7 \nQ And we've discussed this at a few points over the past day and a half; 8 \nCongresswoman Dingell brought it up just now.  But, at that point in time, what 9 \nchallenges were we experiencing with critical supplies of PPE, with testing, with other 10 \nnecessary resources, that further impeded the ability to learn safely in person?  11 \nA It was really a crisis, because we didn't have enough masks, we didn't have a 12 \nvaccine, and the virus was spreading rapidly throughout our society, which was the 13 \nfundamental reason why it was important, even though it was aware that there were 14 \ngoing to be consequences of it, to just do something quickly to stop this exponential 15 \nincrease.   16 \nQ And so, digging a little bit more into the decision -making process that 17 \ncommunities undertook with respect to in -person learning, just to be clear, you, Dr.  Fauci, 18 \nwere not a single person who enacted policies that suspended in -person learning across 19 \nthe United States.   20 \nA The answer to that is, absolutely true.  And I know I should just answer 21 \n\"yes\" or \"no,\" but that is the big misperception, when people are out there saying, \"Fauci 22 \nclosed the schools.\"  Fauci did not close the schools.   23 \nQ Is there anything more you would like to say, just while we're on the topic, 24 \nabout how Fauci did not close -- 25 \n  \n  160 \nA No. 1 \nQ -- the schools?  2 \nA I did not close the schools.  And it became the widespread situation where I 3 \nbecame a political target.   4 \nIn fact, I just  -- yesterday, the New York Post had one of their usual misleading 5 \nstories and had as one of the hyperlinks \"How Fauci Shut Down the Schools and Hurt Our 6 \nChildren,\" something along the line of that.  It was yesterday, after this hearing.   7 \nQ And this may sound redundant, but you, yourself, Dr.  Fauci, were not a 8 \nperson with the authority to decide if and when schools across the country resumed 9 \nin-person learning.  Is that correct?  10 \nA That is correct.   11 \nQ In fact, that process, the process by which communities suspended and 12 \nresumed in -person learning, was largely decided at the State and local levels of 13 \ngovernment.  Is that correct?  14 \nA That is correct.  15 \nQ And so the Federal Government's role in the resumption of safe in -person 16 \nlearning was largely an advisory and support function for State and local 17 \ngovernments -- for example, things like ensuring adequate supplies of mitigation 18 \nmeasures, like we just discussed, tests and PPE, as well as developing roadmaps and 19 \nguidance documents for schools to reopen safely.   20 \nDoes that sound right?  21 \nA That is correct.   22 \nQ And did the Federal Government experience issues with fulfilling these 23 \nresponsibilities throughout 2020?  24 \nA The States sometimes did not respond, right.   25 \n  \n  161 \nQ But the Federal Government with respect to the discrete issues of, let's say, 1 \nensuring that there's an adequate supply of mitigation measures, like tests and PPE, 2 \ngetting those to States and communities  --  3 \nA Oh, I misunderstood your question.  Yeah, I mean, as I told you, one of the 4 \nthings that I did to try and get a good feel for what was happening in the trenches, I 5 \nhad -- maybe every couple of weeks, I would get on a phone with local health officials in 6 \nL.A., Chicago, New Orleans, Washington, New York City, and I would say, what's going on?  7 \nDo you have enough tests?  Are you being able to adequately identify, test, contact 8 \ntrace, et cetera?  What about PPE?  Do you have enough PPE?   9 \nAnd the universal response was, \"No, we don't.\"  And yet there would seem to 10 \nbe a discussion that there was enough, and there wasn't enough.   11 \nQ Right.  12 \nAnd on the, sort of, second tranche of Federal responsibilities as it relates to 13 \nin-person learning and a resumption of in -person learning, do you have a view on 14 \nwhether or not, in calendar year 2020, the Federal Government was doing a sufficient job 15 \nin putting together guidance documents, roadmaps, equipping community policymakers 16 \nwith the resources that were necessary in order to successfully implement safe in -person 17 \nlearning?  18 \nA What I was hearing  -- I mean, I didn't evaluate it myself, but what I was 19 \nhearing at the local level, that they were not.   20 \nQ In July 2020, former President Trump tweeted that he was considering 21 \ncutting off Federal funding if schools were not, quote, \"open.\"   22 \nAbout a week later, then -Education Secretary Betsy DeVos echoed these 23 \nsentiments during a \"Fox News Sunday\" interview, stating, and I quote, \"If schools aren't 24 \ngoing to reopen and not fulfill that promise, they shouldn't get the funds.\"   25 \n  \n  162 \nIn your view, Dr. Fauci, would cutting off Federal funding from public schools 1 \nduring the summer of 2020 have undermined or helped efforts to safely resume 2 \nin-person learning in the United States?  3 \nA Well, I think you'd have to say, if you cut off funding to the schools, it's going 4 \nto certainly impede their ability to open up safely.   5 \nQ And so, shortly after the Biden administration began its work in 2021, the 6 \nCenters for Disease Control and Prevention issued an operational strategy that offered 7 \ncomprehensive guidance for schools to safely resume in -person learning.  This 8 \ndocument was complemented by additional roadmaps that were put out by the 9 \nDepartment of Education.   10 \nDid Federal guidance documents of this nature play a role in facilitating the 11 \nprocess of resuming safe in -person learning in communities across the country?  And, if 12 \nso, how?   13 \nA Well, I don't know if I can comment about the details of that.  But certainly 14 \nit was generally felt that if you had Federal guidelines and resources to allow you to fulfill 15 \nthose guidelines that that would be a big step in the right direction of getting schools 16 \nopen.   17 \nBut I wasn't involved in that much of the detail.  That was much more of a CDC 18 \nissue than my issue.   19 \nQ And, then, on the flip side to a question I had asked just a bit earlier, shortly 20 \ninto 2021, Democrats in Congress and President Biden passed and signed into law the 21 \nAmerican Rescue Plan, which included comprehensive investments across the board in 22 \npublic health and in our education infrastructure, in part to ensure the resumption of safe 23 \nin-person learning.   24 \nFor example, the American Rescue Plan allocated $122  billion in Federal funding 25 \n  \n  163 \nto the ESSER program that's operated out of the Department of Education.   1 \nIs it your view that this influx of Federal funding would've supported the goal of 2 \ngetting kids back in classrooms for safe in -person learning?   3 \nA Yes.   4 \nQ Great.   5 \nAnd, to your recollection  -- and this is a discrete statistic, but we have seen and we 6 \nhave heard from our witnesses here in the select subcommittee that when President 7 \nBiden took office the number of students who were learning safely in classrooms in 8 \nperson was about 46 percent, kindergarten through middle school.  A year into the 9 \nBiden administration, that number hit 95 percent.   10 \nDoes that sound familiar -- 11 \nA Yes. 12 \nQ -- or roughly correct to you?   13 \nA Yes.  14 \nQ Great.   15 \nWith that, I will turn it over to my colleague, .   16 \nBY : 17 \nQ Thank you, Dr. Fauci.   18 \nDuring the last hour, you were asked whether you recall visiting the CIA 19 \nheadquarters during the pandemic.  And just to make sure I had it correct, your answer 20 \nwas no.  You recall during a prior time, perhaps during the anthrax scare, but not during 21 \nthe COVID -19 pandemic.   22 \nIs that correct?   23 \nA That's correct.   24 \nQ Okay.   25 \n\n  \n  164 \nSo the select subcommittee had sent a letter on September 26, 2023, to the 1 \nInspector General of HHS.  Are you generally aware of that, of what I'm talking about?  2 \nA No.  3 \nQ Okay.  I can give you some context.   4 \nSo there was a letter sent to the Inspector General from the select subcommittee.  5 \nThis was a public letter.  And I'm just going to read to you from a key paragraph here.   6 \n\"According to information gathered by the select subcommittee, Dr.  Anthony 7 \nFauci, then -Director of the National Institute of Allergy and Infectious Diseases, played a 8 \nrole in the Central Intelligence Agency's review of the origins of COVID -19.  The 9 \ninformation provided suggests that Dr. Fauci was escorted into Central Intelligence 10 \nAgency, CIA, headquarters without a record of entry and participated in the analysis to 11 \n'influence' the Agency's review.\"   12 \nSo that is part of -- that is an allegation in a letter that was sent on September 26, 13 \n2023.   14 \nSo you were not aware of that letter?   15 \nA I had heard that there was an accusation that somehow I got into the CIA 16 \nwithout anybody knowing about it, a.k.a.  Jason Bourne.   17 \nQ So that is  -- that's the origin of, I think, that allegation, is  --  18 \nA I didn't know what the origin of it was, but I had heard the fantastical 19 \naccusation that somehow I got into the CIA without there being a record.  And having 20 \ngone into the CIA when the anthrax situation was, anybody who knows anything about 21 \nthe CIA knows that that's about as impossible as you can get, is to sneak into the CIA.  22 \nQ Well, we've put one origin to rest here today, which is good.   23 \nSo, just so you know, I mean, that letter was public, and it accompanied a press 24 \nrelease that sort of recapped the allegations in here.   25 \n  \n  165 \nAnd, I guess, given some of the things that we talked about, particularly earlier 1 \nthis morning, does it concern you that, you know, this allegation is made publicly, that 2 \nyou somehow surreptitiously or with the cooperation of the CIA entered without a record 3 \nand, you know, intended to influence improperly the intelligence community's analysis on 4 \nthe origins of COVID?  Do you find that concerning?   5 \nA Well, it's really concerning, because it made me go home and say, maybe I 6 \nsomehow went into a fugue state and went into  -- but then I realized that you can't get 7 \ninto the CIA without the CIA knowing about it.   8 \nSo it did concern me.  I mean, any real falsification of reality regarding me gets 9 \nback to what we said before.  It has been an extraordinary couple of years of complete 10 \nfabrications about me.  This is just one of a large number of fabrications, all of which 11 \nhave been debunked.  And, you know, you may have heard about them.  And I don't 12 \neven want to bring them up, but they're really bizarre.   13 \nQ So that actually brings  me to a good question.  Do you think it's fair to you 14 \nthat allegations  -- we'll just take this one  -- that this allegation was made in a letter that 15 \nwas made public, along with a press release, and that your answer, your response, to 16 \nboth majority staff's one or two questions on this and then my questions here, that those 17 \nanswers might remain behind closed doors if the transcript of this interview is not 18 \nreleased?  Is that concerning to you?  19 \nA Yes.  20 \nQ Do you think that's fair?  21 \nA It's unfair, and it's concerning.  22 \nQ Okay.  Thank you.   23 \nMrs. Dingell.   Back to me?  Okay.  24 \nWe've discussed quite a bit yesterday and today the importance of scientific 25 \n  \n  166 \nprocesses and how data and robust studies are essential to making informed decisions 1 \nabout public health, including treatments.   2 \nI'd like to talk with you about the risk to the public when treatments are promoted 3 \nthat have not received rigorous analysis.   4 \nIn the spring of 2020, President Trump began promoting hydroxychloroquine as a 5 \ntreatment for COVID.  I'd like to walk through the timeline and your reaction to the 6 \nevents that happened.   7 \nFirst, at a Coronavirus Task Force press briefing on March 18, 2020, Dr.  Birx 8 \nreceived a question about some work that French researchers had done with 9 \nhydroxychloroquine and whether that might be a therapeutic in the U.S.   10 \nDr. Birx responded, in part, that the President asked for a critical briefing on that 11 \ntoday and also that there's always anecdotal reports and we're trying to figure out how 12 \nmany anecdotal reports equal real scientific breakthroughs.   13 \nDo you generally agree with what Dr.  Birx appeared to be saying here, that it's 14 \nimportant to not take anecdotal evidence as dispositive and, instead, take the step, 15 \nwhere warranted, and subject a potential treatment to solid, methodological, scientific 16 \nscrutiny to test if it really works as a reliable process?   17 \nDr. Fauci.   Yes.  And I've said that myself many, many times.   18 \nMrs. Dingell.   The next day, again, at a COVID Task Force press briefing that was 19 \non March 19, 2020, President Trump said the following:  \"Now, a drug, 20 \nchloroquine -- and some people would add to it hydroxy, hydroxychloroquine.  So 21 \nchloroquine or hydroxychloroquine.  Now, this is a common\"  -- this is President Trump 22 \nsaying this.   23 \n\"This is a common malaria drug.  It is also a drug used for strong arthritis, if 24 \nsomebody has pretty serious arthritis.  Also use this in a somewhat different  -- they also 25 \n  \n  167 \nuse it in a somewhat different form.  But it is known as a malaria drug, and it's been 1 \naround for a long time, and it's very powerful.   2 \n\"But the nice part is, it's been around for a long time, so we know that if things 3 \ndon't go as planned it's not going to kill anybody.  When you go with a brand -new drug, 4 \nyou don't know what's going to happen.  You have to see and you have to go long test.  5 \nBut this has been used in different forms, very powerful drug in different forms.  And it's 6 \nshown very encouraging -- very, very encouraging early results.   7 \n\"And we're going to be able to make this drug available almost immediately.  8 \nAnd that's where the FDA has been so great.  They've gone through the approval 9 \nprocess.  It's been approved, and they did it.  They took it down from many, many 10 \nmonths to immediate.  So we're going to be able to make the drug available by 11 \nprescription for States.\"   12 \nSo, first, just so we are clear on this, chloroquine  -- for you, Dr. 13 \nFauci -- chloroquine and hydroxychloro --  14 \nDr. Fauci.   Hydroxychloroquine.   15 \nMrs. Dingell.   -- thank you -- are two different, distinct drugs, right?   16 \nDr. Fauci.   They are.  The chloroquine and hydroxychloroquine are used for 17 \nmalaria.  For the people who have rheumatoid arthritis, you would prescribe 18 \nhydroxychloroquine 200 milligrams twice a day at first and then bring it down to 200 19 \nmilligrams a day.  20 \nMrs. Dingell.   So it's actually two distinctive drugs.  21 \nDr. Fauci.   Yeah.  Yeah.  But they're related.  They're related.  22 \nMrs. Dingell.   So -- but we've gone in one day from Dr.  Birx saying that there are 23 \nsome anecdotes that may lead to  more rigorous examination of this drug as a treatment 24 \nto President Trump saying that the FDA has approved that treatment.  Is that correct?   25 \n  \n  168 \nDr. Fauci.   Yeah.  But I think  -- can I  --  1 \nMrs. Dingell.   You might as well tell me your reaction.   2 \nDr. Fauci.   Okay.  So there's a couple of things there.  3 \nJust because a drug has been used for one disease in a population at a certain 4 \ndose does not mean that it's effective  -- that doesn't mean it's effective for another 5 \ndisease in which there's only anecdotal information that it works.   6 \nAnd as you probably know, you may get to, I was asked a similar question by a 7 \nreporter at a press conference, in which President Trump said that, hydroxychloroquine, I 8 \ndon't know, I have a good feeling about it, I think it works, you know, why not this, et 9 \ncetera, et cetera.  I got up and said, \"No, it's anecdotal, and I would only use a clinical 10 \ntrial to make a decision about that.\"   11 \nAnd I think the problem here is that there was a confu - -- not a confusion, but 12 \nthere was a statement that, yes, it's been approved by the FDA for rheumatoid arthritis, 13 \nmalaria, and other autoimmune diseases, but it was not approved for COVID.  And what 14 \nwe needed was randomized, controlled clinical trials to show that it was safe and 15 \neffective, and they were not done.   16 \nAnd people were individually giving the President anecdotes that it worked, and I 17 \nwas saying that anecdotes are not the final say when you make a decision about a drug 18 \nfor someone.   19 \nAnd, as it turned out when the studies finally came in, it showed to be not only 20 \nineffective but actually not particularly safe.   21 \nMrs. Dingell.   So -- I was going to paraphrase you, so you did a great job of 22 \nparaphrasing yourself.   23 \nDr. Fauci.   Right.  24 \nMrs. Dingell.   But it seems to me that what you're saying here is pretty 25 \n  \n  169 \ncompatible with what Dr.  Birx was saying in the first press briefing.  You received 1 \nanecdotal evidence, and maybe, as a result of that, something is put into the pipeline for 2 \nrigorous study.  Do you agree with that?   3 \nDr. Fauci.   Yes.  Anecdotes should suggest doing a clinical study.  But 4 \ncontinued anecdotes are not the definitive answer.   5 \nMrs. Dingell.   And if --  6 \nDr. Fauci.   So you could have a friend tell you it worked in them and another 7 \nfriend said it worked in them and another friend said it worked in them.  That's not a 8 \nclinical study.   9 \nMrs. Dingell.   And if you'll recall, the President at the time said it's giving people 10 \nhope.   11 \nDr. Fauci.   Right.  12 \nMrs. Dingell.   But hope can have consequences if it's not  -- can have 13 \nconsequences.  And I know that because my stepson took it and doctors told me he may 14 \nnot live.  He was in the hospital for weeks.   15 \nBut can you talk about the potential harm about just hoping that a treatment will 16 \nwork and giving it to patients without that clinical assessment, without the  --  17 \nDr. Fauci.   Yeah, I think that's quite risky.  And, in fact, a study came out 18 \nyesterday or the day before from multiple different countries which showed that if you 19 \ndo look at people who have received hydroxychloroquine, that a modeling study showed 20 \nthat that likely led to up to 16 - to 17,000 deaths.   21 \nMrs. Dingell.   On March --  22 \nDr. Fauci.   These are COVID patients.   23 \nMrs. Dingell.   Yeah, no, I know that.  That's what my stepson took for COVID.   24 \nDr. Fauci.   Right.  25 \n  \n  170 \nMrs. Dingell.   On March 28th, the FDA issued  -- of that year -- issued an 1 \nEmergency Use Authorization for hydroxychloroquine and chloroquine to be used in 2 \nhospitals under certain conditions, including that they be placed on careful heart 3 \nmonitoring.   4 \nWhat was your reaction to that decision?  And were you involved in it at all?   5 \nDr. Fauci.   I was not involved in the decision.  And I was a bit perplexed that it 6 \nwas -- because I still felt you needed more information before you gave it an Emergency 7 \nUse Authorization.   8 \nMrs. Dingell.   So I'm going to ask you, do you think that the narrow 9 \ncircumstances for this were properly communicated, for the Emergency Use, by the FDA?   10 \nDr. Fauci.   Well, the FDA's  -- what am I trying to say?  The FDA's criteria for an 11 \nEmergency Use Authorization is that there's at least a hint of efficacy and very unlikely to 12 \nbe any toxicity associated with it.   13 \nSo, again, I wasn't particularly happy that it would be widely used without a study.   14 \nMrs. Dingell.   And knowing that the President communicating that would 15 \nprobably have other people  -- my stepson is a very strong supporter of the former 16 \nPresident and, because he said it, took it.   17 \nSo I don't want to get you too political here today, but how do we make  -- do you 18 \nhave any comments about how we keep things scientific and don't  --  19 \nDr. Fauci.   It's easy.  Just keep things scientific.   20 \nMrs. Dingell.   There you go.   21 \nAnd as an apparent consequence of this treatment, there were several 22 \nunintended but foreseeable events.  There were instances of individuals becoming 23 \npoisoned with non -medicinal chloroquine.  One man died in Arizona, you may 24 \nremember, for example, due to the ingestion of non -pharmaceutical chloroquine, which 25 \n  \n  171 \nis used to clean fish tanks, and others who took this drug off -label experienced heart 1 \nproblems, as we discussed.   2 \nAs a result, FDA issued a warning on April 24, 2020, less than a month after the 3 \nEUA, that concluded the following:  \"The FDA is aware of reports of serious heart 4 \nrhythm problems in patients with COVID -19 treated with hydrochloric\"  -- I don't know 5 \nwhy I'm having such a problem today  -- \"hydroxychloroquine or\"  --  6 \nDr. Fauci.   Just say \"HC.\"  7 \nMrs. Dingell.   -- \"HC or C, often in combination with erythromycin or other 8 \nQT-prolonging medicines.  We are also aware of increased use of these medicines 9 \nthroughout patient prescriptions.  Therefore, we would like to remind healthcare 10 \nprofessionals and patients of the known risks associated with both HC and chloroquine.  11 \nWe will continue to investigate risks associated with the use of HC and chloroquine for 12 \nCOVID -19 and communicate publicly when we have more information.\"   13 \nThey have not been shown to  -- and they said then that it had not been shown to 14 \nbe safe and effective for treating or preventing COVID -19.   15 \nOn June 15, 2020, FDA revoked the EUA altogether.  FDA stated that, \"We made 16 \nthis determination based on recent results from a large, randomized clinical trial in 17 \nhospitalized patients that found these medicines showed no benefit for decreasing the 18 \nlikelihood of death or speeding recovery.  This outcome was consistent with other new 19 \ndata, including those showing the suggested dosing for these medicines are unlikely to kill 20 \nor inhibit the virus that causes COVID -19.\"   21 \nSo, when we went from one anecdotal study being discussed on March 18th to an 22 \nFDA EUA on March 28th, an FDA warning on April 24th, and a revocation on June 15th, 23 \ndoes that seem like a rather rapid rise and fall for the use of a drug?   24 \nDr. Fauci.   Yes.   25 \n  \n  172 \nMrs. Dingell.   And then you are aware, because you brought it up.  Are you 1 \naware of a recently published study that estimates the number of deaths that appear to 2 \nbe caused by off -label -- 3 \nDr. Fauci.   Right.  4 \nMrs. Dingell.   -- which is a different study?  \"This meta -analysis examined 5 \nnumerous reports across 6 countries and estimates that over 12,000 individuals in the 6 \nU.S. may have died as a result.\"   7 \nBut since we're trying to learn from the pandemic, what are the lessons you think 8 \nwe should take away from this particular episode?  Do you think that it's dangerous for 9 \npolitical pressure to dictate scientific decisions?   10 \nDr. Fauci.   Yes.   11 \nMrs. Dingell.   Do you think it is dangerous to rely on anecdotal evidence to make 12 \nlarge -scale health policy decisions?   13 \nDr. Fauci.   I think that anecdotal data should trigger a clinical trial and should not 14 \nbe used to make broadly applicable health decisions.   15 \nMrs. Dingell.   And do you think it's especially important for political and public 16 \nhealth leaders to ensure that their guidance is sound and evidence -based when people 17 \nare particularly scared and need help?   18 \nDr. Fauci.   Yes.   19 \nMrs. Dingell.   And, with that, I turn it back to    20 \nMs. Castor.   Can I ask one thing?   21 \nI just want to make sure, this is the February 2024 Biomedicine and 22 \nPharmacotherapy article.  Just for the transcript purposes, that we ought to put in there 23 \nthat the use of hydroxychloroquine during COVID led to an estimate of 17,000 24 \nunnecessary deaths in the 6 countries analyzed.  Is that the  --  25 \n\n  \n  173 \nDr. Fauci.   Yes, that's the paper.   1 \nMs. Castor.   Thank you.  2 \n3 \n  \n  174 \n 1 \nMrs. Dingell.   Do you have anything else?   2 \nBY  3 \nQ So, Dr. Fauci, I just wanted to quickly touch on a topic that my majority 4 \ncolleagues covered briefly at the tail end of the last hour, and that is COVID -19 in nursing 5 \nhomes and congregate care facilities.   6 \nI think a key takeaway from the COVID -19 pandemic is the importance of 7 \nbolstering infrastructure that's in place to protect medically vulnerable populations, 8 \nparticularly people who are elderly, particularly people with disabilities.  And this is 9 \nparticularly important for nursing homes, it's important for assisted living facilities, and 10 \nit's important for other congregate care facilities.   11 \nDr. Fauci, just briefly, why are residents of congregate care facilities at particular 12 \nrisk when it comes to respiratory infections like COVID -19?   13 \nA Well, when you go into a facility like that, you have people who mostly are 14 \ncompromised, either because of a medical condition or age or a medical condition plus 15 \nage.  So, inherently, they're already susceptible to any infection that they might get.   16 \nWhen you're in a closed situation where there's not the ability to move around 17 \nand are congregated together in rooms like this or in rooms that are adjacent to each 18 \nother, a respiratory illness in that circumstance can spread rapidly.   19 \nAnd that's historically very, very clear when you see influenza outbreaks in nursing 20 \nhomes or intermediate care homes.  And the typical prototype of that is influenza, but 21 \nwe saw that very clearly with COVID when it happened.   22 \nQ And so my next question was going to be, are there specific or unique 23 \nfeatures of COVID -19 compared to other respiratory diseases that made it particularly 24 \ndangerous for residents in congregate care facilities?   25 \n\n  \n  175 \nA Yeah.  It was  -- it's much  -- particularly the most recent variants like 1 \nOmicron is highly, highly transmissible even when people don't have symptoms.  So you 2 \ncould have a situation where a person seems reasonably well, goes to the common game 3 \nroom of an intermediate facility, and could spread it very easily to the rest of the folks in 4 \nthere.   5 \nBut the critical issue of those types of facilities is the overwhelming proportion of 6 \nvulnerable people in those facilities.   7 \nQ And, then, looking back to March 2020, when COVID -19 first really struck 8 \nacross the country, in your view, did nursing homes and other congregate care facilities 9 \nacross the country have adequate infection -control measures in place to sufficiently 10 \nprotect their residents and staff?   11 \nA You know, I believe it was even the opinion of Seema Verma at the time that 12 \nit wasn't; we didn't have enough, and we needed to do better.  And she was one that 13 \nwas pushing that we needed better infection control in places.  14 \nQ And so, to the idea or the mission of doing better on infection control, what 15 \nlessons should we be taking away?  What policies, as a government, can we be pushing 16 \nor pursuing to better insulate congregate care facilities from the threat?   17 \nA Well, I think you should have better training, better ventilation, all the things 18 \nthat we spoke about.  That might even be applicable to schools.   19 \nBut one of the things that we spoke about that's important is that you should do it 20 \nbefore the fact, not chasing an outbreak.   21 \nSo, right now, we should be -- lessons learned for the future -- and that's what I 22 \nbelieve this whole thing should be about, is lessons learned -- is that we should be now 23 \npreparing those facilities for the possibility of yet again another outbreak.  Speaking of 24 \nwhich, we are not finished with COVID yet.   25 \n  \n  176 \nQ Right.  1 \nSo, with the 10 or so minutes that remain in this round, I wanted to revisit a topic 2 \nand pick up where Congresswoman Castor left off in a previous round, that topic being 3 \nvaccine hesitancy.   4 \nNow, during the course of the COVID -19 pandemic, I think we saw a number of 5 \ndifferent misrepresentations about the safety and efficacy of the COVID -19 vaccine.   6 \nDr. Fauci, is it your view during the COVID -19 vaccine that vaccine hesitancy grew 7 \nor increased?  8 \nA It grew, yes.   9 \nQ And so Ms.  Castor, in her round, mentioned a few striking examples of these 10 \nmisrepresentations.  Are there any others that you'd quickly like to address or add for 11 \nthe record?  12 \nA Well, nothing specific, except that there clearly is a disparity of acceptance 13 \nof vaccines depending upon what State you're in, which I have found, as a nonpolitical 14 \nperson who's been a nonpolitical person all my career, that it just is so painful to see that 15 \npeople are not getting vaccinated on the basis of the political ideology of a State.   16 \nI mean, why should red States have more suffering and deaths than blue States 17 \nbecause of a lower level of vaccination?  I just think that's unfair to the citizens in those 18 \nStates, to not get vaccinated by a vaccine that is safe and effective and life -saving.   19 \nQ And so, looking at vaccine hesitancy, I, personally  -- I believe you'll agree, but 20 \nfor the record  -- believe that vaccine hesitancy has the potential to be one of the most 21 \nsignificant public health threats of our time, to undermine confidence in one of the most 22 \nintegral tools we have to protect public health here in the United States and across the 23 \nworld.   24 \nDo you agree with that?   25 \n  \n  177 \nA I definitely agree with that.  And my concern is that vaccine hesitancy will 1 \nspill over from COVID to other vaccines, which would really be a problem.   2 \nI mean, for example, we know that whenever there's a diminution in the critical 3 \nlevel of people, children, who are vaccinated for measles, that you get measles outbreaks.  4 \nThat's happened time and again.  Whenever you fall below the critical level in the 5 \ncommunity of vaccinations with measles, children get vaccinated (sic).  And measles is a 6 \nvery serious disease.   7 \nSo vaccine hesitancy not only has a negative impact on health for COVID, but if it 8 \nspills over into other vaccines that have been proven to be life -saving for children and 9 \npreventing children from getting severe disease, then vaccine hesitancy is going to spread 10 \nto any of a number of other areas.   11 \nQ And so you mentioned measles.  Over the course of the past 2, 3, 4 years, 12 \nwe, I think as a society, have seen an uptick in outbreaks of diseases, diseases that we had 13 \npreviously thought eliminated.   14 \nAside from measles, are there other diseases or outbreaks that have been  --  15 \nA Mumps, pertussis.  I think those are the two most important in addition to 16 \nmeasles.  17 \nQ And you mentioned that we are seeing a decline in vaccination rates for 18 \nroutine vaccinations, such as vaccines for measles, mumps, and rubella, as collateral to 19 \nsome of what we've observed with respect to misrepresentations regarding the COVID -19 20 \nvaccine.   21 \nI want your perspective here.  Because sometimes these declines or these drops 22 \nin vaccination rates may be a tenth of a percent, 1 percent.  But what does that mean, 23 \npractically, for the number of children in this country or the number of people who are 24 \ngetting vaccinated for diseases like measles, mumps, and rubella?   25 \n  \n  178 \nA Well, it puts them at risk, I mean, because now you're talking about vaccines 1 \nthat prevent the spread of infection.  So, when you wind up having people who go 2 \nbelow the critical level of protection -- we've seen examples.  This is not surmising 3 \nbetween you and I.   4 \nI mean, when there was the big outbreak at Disney World in California, it was from 5 \na group of people, you know, who had  -- measles, you should have 90 -plus percent of the 6 \npopulation vaccinated.  When it goes down to in the low -80s, you wind up with an 7 \noutbreak.   8 \nThey had a population in the Rockland section, a community just north of New 9 \nYork City, where there was a major measles outbreak because one child came in from 10 \nIsrael who had been infected with measles and mingled with the children in the 11 \ncommunity, in which measles was under vaccinated , and there was a significant number 12 \nof cases in that community.   13 \nSo it isn't hypothetical.  It's happened, and it will happen again.   14 \nQ And so, as we look to address the rise of vaccine hesitancy in the United 15 \nStates and internationally as well, there is, as I believe it and understand it, a population 16 \nof people who are apprehensive about vaccines but could be convinced or could be, sort 17 \nof, persuaded otherwise to obtain the vaccine.   18 \nHow should public health professionals approach -- 19 \nA Yeah.  20 \nQ -- this community of people and the goal of combating vaccine hesitancy?  21 \nA Yeah.  Yeah, that's a great question.  I'll try to be as succinct as possible.   22 \nOf the people who are not getting vaccinated, there are some people who are 23 \nhardcore anti -vax.  No matter what you do, they're not going to get vaccinated.  But 24 \nthere are other people that are influenced by the anti -vax and say, \"Well, if these people 25 \n  \n  179 \ndon't want to get vaccinated, there must be a reason.\"  So they're less anti -vax than 1 \nhesitant to get vaccinated.   2 \nAnd I think that what we need to do is not treat them all as the same and attack 3 \npeople who are hesitant about vaccination because they need more information or that 4 \nthey have a cultural reason to be concerned about something that's offered from the 5 \ngovernment.   6 \nYou've got to be reaching out to them and not condemn them for being hesitant 7 \nto be vaccinated.  Because, again, you've got to separate somebody who's propagating 8 \n\"don't get vaccinated, don't get vaccinated\" versus the people who are innocently 9 \nhesitant because they want more information.   10 \nYou can convince a lot of those people to get vaccinated if you provide them with 11 \nthe proper information and get them to understand that the misinformation that's being 12 \npropagated about vaccines -- like, we've heard the example with the Surgeon General in 13 \nFlorida -- I mean, we've got to convince people that that's not true.   14 \nQ And you mentioned in our discussion over these past few questions the 15 \nnotion that vaccines have become politicized.  In your view, how has the vaccine 16 \nbecome politicized, or vaccines writ large?  And what have the ramifications of that 17 \nbeen?   18 \nA Well, you know, it's a pretty complicated situation about how it's become 19 \npoliticized, is because political leaders in general either don't promote vaccines or are 20 \noutright against vaccines.  And that's, I think, detrimental to the health of their 21 \nconstituencies, as we've seen, under certain circumstances.  So, to me, that is something 22 \nthat is really unfortunate.  23 \n  We have a few minutes left.  I want to make 24 \nsure -- Congresswoman Castor, Congresswoman Dingell, do you have any questions on 25 \n\n  \n  180 \neither of these topics?   1 \nMs. Castor.   Well, another vaccine comes to mind; that's HPV.  Because we 2 \nwere kind of on an upswing before the pandemic, but I've noted that the vaccine uptake 3 \nfor HPV has gone down.  And that's a cancer prevention  --  4 \nDr. Fauci.   Right.   5 \nMs. Castor.   -- vaccine.  And coming at it from a parent's point of view, if there's 6 \na vaccine that would prevent my daughters from contracting certain cancers, I rushed to 7 \nmake sure that they were vaccinated at the appropriate time.   8 \nSo what does that mean -- with vaccine hesitancy growing and now we have a 9 \ndrop -off of parents getting their children vaccinated for human papillomavirus, what does 10 \nthat mean in the outer years for cancer in families?   11 \nDr. Fauci.   No, I think it's pretty obvious what it'll mean.  The effect of the HPV 12 \nvaccine on HPV infection and subsequent cancers is pretty clear.  If you have people 13 \nwho pull back and don't get vaccinated, you're going to wind up X  number of years from 14 \nnow seeing an increase in that condition.   15 \nMs. Castor.   It'll cost lives.   16 \nDr. Fauci.   Yeah.   17 \n.  So, Dr. Fauci, we do have -- just for the record, we have the study 18 \nwe were talking about in terms of excess mortality that appears to be caused by 19 \nhydroxychloroquine worldwide.   20 \nCandidly, I was not necessarily going to introduce it as an exhibit, because I figured 21 \nyou were too busy this past week, I think, when this came out to have read it.  And then 22 \nyou spontaneously brought it up.  So, because you did and because you've obviously 23 \nread it, I'll just circulate it so everybody has a copy.   24 \nThis is exhibit W, I think we're up to on the minority side.  This is exhibit W.  25 \n\n  \n  181 \n    [Fauci Minority Exhibit W  1 \n    was marked for identification.]  2 \nBY  3 \nQ So this is a paper -- I think this was just the online publication -- that was 4 \ngoing to appear in Biomedicine & Pharmacotherapy entitled \"Deaths induced by 5 \ncompassionate use of hydroxychloroquine during the first COVID -19 wave:  an 6 \nestimate.\"   7 \nAnd, as we discussed, it's a review of 44 different cohort studies across, I think, 6 8 \ndifferent countries estimating the number of excess mortality caused by 9 \nhydroxychloroquine, including I think it's over 12,000 deaths in the United States.   10 \nSo, if you have any additional comments on it, that's fine.  But, again, I didn't 11 \nwant to put this in front of you and make you read it.  But you'd already read it.   12 \nA No, I have not read the complete paper.   13 \nQ Okay.  14 \nA I wanted to make sure for the record.   15 \nQ Okay.  16 \nA I heard about it, I pulled it up, and I looked at the abstract and just quickly 17 \nskimmed through it, and I just looked at what the results are.  I'm going to have to read 18 \nthe paper carefully, but I have not read the paper carefully.  19 \nQ You got a copy now.   20 \nA But I was aware of it, and I read the abstract.  21 \nQ Okay.  22 \nMs. Castor.   You know what struck me too?  Because I did read it, and I started 23 \ngoing into a couple of the footnotes, actually.  And one area ripe for, I would hope, a 24 \nselect subcommittee like this or Energy and Commerce O&I is the fly -by-night online 25 \n\n  \n  182 \npharmacies that help push a lot of this misinformation that likely made off with millions 1 \nof dollars at the expense of the health of so many Americans, whether it's 2 \nhydroxychloroquine or ivermectin or some other.   3 \nI don't know if that's something you ever dove into as  --  4 \nDr. Fauci.   No, I have not.  No, I have not.   5 \nMs. Castor.   Thank you.   6 \n  And, with that, I think we can go -- 7 \n  Off the record, yeah.  8 \n  -- off the record.  9 \n[Recess.] 10 \n\n  \n  183 \n[4:34 p.m.]   1 \nMr. Benzine.   We can go back on the record.  2 \nBY MR. BENZINE:  3 \nQ I want to talk about a couple of other mitigation policies specific to COVID, 4 \nbut then how we can apply them going forward.   5 \nThere was a, obviously, big to -do about lockdowns and social distancing and all 6 \nthat that kind of caused.  And you mentioned previously the 15 days to slow the spread, 7 \n30 days to slow the spread that we had seen at least in New York, like, on the tipping 8 \npoint  --  9 \nA Right.   10 \nQ -- of being overwhelmed.   11 \nOur -- I'm going to use \"lockdowns\" colloquially -- but, obviously, we did not see 12 \nwhat we did -- what happened in Wuhan did not happen in the United States.  And I 13 \nthink you've gone on record saying it probably wouldn't have worked very well in the 14 \nUnited States.  15 \nA Right.  16 \nQ It's just a different --  17 \nA We had significant social distancing as opposed to lockdown --  18 \nQ Yes. 19 \nA -- in a lockdown sense.   20 \nQ Do you recall when discussions regarding, kind of, the at -least -a-6-foot 21 \nthreshold began?  22 \nA The 6 -foot in the school?   23 \nQ Six-foot overall.  I mean, 6 -foot was applied at businesses --   24 \nA Yeah.  25 \n  \n  184 \nQ -- it was applied in schools, it was applied here.  At least how the messaging 1 \nwas applied was that 6 -foot distancing was the distance that needed to be  --  2 \nA You know, I don't recall.  It sort of just appeared.  I don't recall, like, a 3 \ndiscussion of whether it should be 5 or 6 or whatever.  It was just that 6 -foot is --  4 \nQ Did you see any studies that supported 6 feet?  5 \nA I was not aware of studies that -- in fact, that would be a very difficult study 6 \nto do.  7 \nQ I know.  I'm just trying to figure out why 6 versus 3 or 4 or 5.   8 \nA Yeah.  Yeah.   9 \nQ Like, 6 is a significant distance.  I mean, you've testified here.  I think you 10 \ntestified in front of Mr.  Scalise a couple times when I was working for him.  And recalling 11 \nthe hearing rooms, instead of, like, seven members on the top of the dais, there's two, 12 \nand --  13 \nA Right.   14 \nQ -- it was just two staffers behind.   15 \nA Yeah.  Yeah.  I think it would fall under the category of empiric.  Just an 16 \nempiric decision that wasn't based on data or even data that could be accomplished.   17 \nBut I'm thinking hard as I'm talking to you.   18 \nQ Uh-huh.  19 \nA I don't recall, like, a discussion of, \"Now it's going to be\" -- it sort of just 20 \nappeared, that 6 feet is going to be the distance.   21 \nQ We, some members of the staff, took visits to Los Alamos and Livermore 22 \nNational Laboratories  --  23 \nA Yeah.  24 \nQ -- and met with some of their, like, high -throughput computing people and 25 \n  \n  185 \ntheir epidemiologists.  And they said -- and I just want to get your opinion on this, and I 1 \ntrust that what they're saying is a capability that they are able to do -- but that they could, 2 \nin essence, high -throughput compute and map a sneeze and determine the distance of 3 \nthe germ spread to then kind of figure out what the distance needs to be.   4 \nDo you recall anything like that?  5 \nA I've seen in literature that I've read and passed through recently and even 6 \nsome time ago, you know, the picture of somebody sneezing, and they show -- 7 \nQ Uh-huh.  8 \nA -- the spray and what the distance of the spray is.  But that doesn't take 9 \ninto account aerosol.   10 \nQ Like, wind?  11 \nA Yeah.  Or particles that, even without wind, just hang around for a while.  12 \nQ Okay.  I didn't think that through, I guess.   13 \nBut do you think that there are aspects to the government that could be better 14 \nleveraged in a future pandemic?  15 \nA That's a pretty broad question.  Like, what do you mean?   16 \nQ I guess, like, when we visited -- I'm going to use the labs specifically, but I 17 \nthink there's, like, lots of aspects in the government beyond NIH and CDC that have 18 \nexpertise that could try to attack a pandemic, this being one example.   19 \nA Yeah.  20 \nQ Do you think, kind of, going beyond just the public health aspect would be 21 \nbetter in attacking a pandemic?  22 \nA You know, I think the public health element should drive it, but they should 23 \nget input.   24 \nFor example, you know, that \"Gesundheit Machine\" that is used, I think, at the 25 \n  \n  186 \nUniversity of Maryland or up at Hopkins?   1 \nQ Uh-huh.  2 \nA I think many of the people who are there are not officially public health 3 \npeople but they have technical expertise.   4 \nQ Thank you.   5 \nI guess one of the things that we're evaluating is trying to leverage the 6 \nDepartment of Energy, the labs in particular, a little bit more.  They also  -- like, the -- I'm 7 \ndribbling out the clock now, so -- but they said they could use their, kind of, like, nuclear 8 \nexpertise on the radiation clouds to map how things were going through the air  --  9 \nA Right.   10 \nQ -- and stuff like that.  So I think just  --  11 \nA Yeah.  12 \nQ -- for your own -- I don't know -- as we move forward, that that kind of stuff 13 \nis of interest.   14 \nA You know, I think the -- I actually, after a while, had some communications 15 \nwith -- I wanted to learn more about aerosol, and there was a group that was doing an 16 \naerosol study.  And it was really interesting to see that a lot of things that we thought go 17 \nquickly to the ground actually stay up much, much longer than they do.  And that would 18 \nbe someone who's an aerosol expert.   19 \nQ Uh-huh.  20 \nA Yeah.   21 \nQ All right.  I want to talk about some specific things.  And, early on, you 22 \ntalked about the 15 days to slow the spread.  What was the basis for 15 days at that 23 \ntime?  24 \nA It was Debbie Birx who actually was the main driver of that.  And I'm not 25 \n  \n  187 \nsure exactly why she picked 15.  I imagine she wanted to get a good start on it, I think, 1 \nknowing deep down that it was going to be more -- 2 \nQ Uh-huh.  3 \nA -- than 15, but let's try to get the President to agree to 15, and if he agreed 4 \nto 15, then maybe we, as a Coronavirus Task Force, could convince him to extend it to 30.  5 \nBecause no one, I think, really believed that a pause for 15 days with an outbreak that's 6 \ndoing this exponentially is going to be the final solution.   7 \nSo I think it was an empiric choice on the part of Debbie.   8 \nQ The -- and, again, this is kind of for my own edification.  The goal of the 15 9 \ndays wasn't necessarily to kill the outbreak but to get it to a point that we could 10 \nrecuperate some PPE  --  11 \nA Yeah.  12 \nQ -- recuperate some hospital space.  Is that right?  13 \nA Right.  It was to flatten the curve, so that it wasn't necessarily geared at 14 \ndecreasing the ultimate number of cases, but the number of cases that we could actually 15 \nhandle.   16 \nIt was very much triggered by a real concern that the hospitals were going to get 17 \noverrun.  And one of the things about hospitals getting overrun that was very, very 18 \nconcerning is to put our healthcare providers in the position of having to decide between 19 \ntwo essentially equal people who is going to get the ventilator -- 20 \nQ Uh-huh.  21 \nA -- or who is going to get the intensive care unit bed.  That would've been 22 \nreally devastating, to -- and, to me, as a physician, that would be a position I would never 23 \nwant to be in.   24 \nQ Uh-huh.  25 \n  \n  188 \nAnd then you said it was subsequently extended to 30  days --  1 \nA Thirty days, yeah.  2 \nQ -- I think, a little bit before the 15 was over?  Or was it on the 15?  3 \nA Yeah.  No, no, no, no.  I mean, it was clear that  -- the 30 -day proposal was 4 \npresented to the President while we were in the 15 -day period because it was clear that it 5 \nwas not going to last.  6 \nQ Yeah.  And, again, the goal there wasn't -- it was to flatten the curve --   7 \nA Right.  8 \nQ -- to get to a point where we could have a manageable response.   9 \nA Right.  Exactly.  10 \nQ And at that point, and I guess probably never, the goal of these was not to 11 \nshut down the economy or, like, you know, kick people out of their jobs or anything like 12 \nthat?   13 \nA That certainly wasn't the goal, to do that.  I think there was a realization on 14 \nthe part of -- I don't know.  I'm talking about White House discussions, so I'm getting 15 \nnervous now.  So --   16 \nMr. Barstow.   You're okay.   17 \nDr. Fauci.   Am I okay?   18 \nBY MR. BENZINE:   19 \nQ Kevin will tell you if you're not doing okay.   20 \nA Okay.   21 \nSo there was a discussion -- and that gets to what we were saying about who's the 22 \nultimate decider.   23 \nYou know, when Debbie presents -- so the way it went is that Debbie came up 24 \nwith this plan.  She showed it to me, you know, relatively soon before she presented it, 25 \n  \n  189 \nand then showed it to the Vice President, and it was agreed to go to the President.   1 \nAnd, then, when she made the presentation, there was a discussion by the 2 \neconomy people, saying, you know, whoa, wait a minute, you know, what effect is this 3 \ngoing to have?  4 \nQ Uh-huh.  5 \nA And the ultimate decision was made, let's go with it for now and see what 6 \nhappens.   7 \nSo it wasn't directed because we wanted to hurt the economy --   8 \nQ Yeah, yeah.  9 \nA -- but the economic people weighed in and said, you know, we'd better at 10 \nleast consider the economic implications of this.   11 \nQ So it's what we were talking about earlier, that  --  12 \nA Yeah.  13 \nQ -- there should be multiple people at the table during  --  14 \nA And there were --  15 \nQ Yes. 16 \nA -- multiple people, and the table was the Resolute  desk.    17 \nQ And I'm agreeing with you that  -- 18 \nA Yeah.   19 \nQ -- during a pandemic, that there needs to be multiple voices.  While, 20 \nobviously, their health and keeping people alive needs to be the primary driver  -- 21 \nA Right.   22 \nQ -- but taking into consideration other aspects.   23 \nI mean, we've touched on this very briefly, but, at that point, you know, 24 \nrelationships with China were starting to be a little fraught, and, obviously, economic 25 \n  \n  190 \nsituations, school situations.   1 \nSo, I guess, while we're preparing for the future, having a response that is 2 \nwell-rounded is better than single -point -driven.  Is that correct?  3 \nA Yeah.  4 \nQ Okay.   5 \nWe've talked a decent amount about vaccines, and I want to talk a little bit more, 6 \nparticularly just COVID vaccines.  I think we can all agree that COVID vaccines saved 7 \nprobably innumerable lives at this point, kept enumerable people out of the hospital, and 8 \nprobably kept innumerable people from getting sick.   9 \nIn April 2020 was when Operation Warp Speed was announced.  Were you 10 \ninvolved in, kind of, the planning process for that program, kind of like the brain trust that 11 \nsays, if we put this on paper, we can do this?  12 \nA No, but -- and, if so, in a very minor way.   13 \nWhen we were talking about it, the concept that we were going to have to do 14 \nsomething that was really unprecedented in getting this vaccine done, my part was the 15 \nscientific part.   16 \nQ Uh-huh.  17 \nA You know, how quickly can you get something into clinical trial?   18 \nOperation Warp Speed was a bit more of an implementing function, as opposed to 19 \ngetting the research to be translated to a vaccine.  So my responsibility, which I 20 \ndiscussed in detail before the group here, was to make sure that we got the vaccine work 21 \nstarted, we got it into a phase 1 trial, and we quickly did it the other.   22 \nOperation Warp Speed was a combination of making sure that companies knew 23 \nthat we were going to pay and take all the risks financially -- because the companies 24 \nwould not  -- for two ways:  the risks of the clinical trials, which they did not have to pay 25 \n  \n  191 \nfor, we paid for, \"we\" being the Federal Government, and to pre -purchase -- 1 \nQ Uh-huh.  2 \nA -- the vaccine before it was proven to be effective.  So the risk was that, if it 3 \nisn't effective, we, being the Federal Government, lost a lot of money, and the companies 4 \nwouldn't lose any money.   5 \nAll of that I was not involved in.  What I was involved in was the scientific 6 \ncomponent of it.   7 \nQ And maybe it was delineated more internally, but at least publicly, part of it 8 \nwas kind of -- \"loosening\" regulations isn't the right word, but figuring out where we can 9 \nspeed up the process --  10 \nA Right.   11 \nQ -- obviously, knowing a vaccine was important, where we can speed up the 12 \ntrial process, the approval processes, that kind of stuff.   13 \nWere you involved in any of those discussions?  14 \nA I might've been.  And I'm trying to think about to what extent I was 15 \ninvolved with it.  It could've been something like, we want to make sure we speed it up 16 \nbut we don't speed it up by compromising safety.  17 \nQ Uh-huh.  18 \nA And that's one of the things that I probably would've gotten in a discussion 19 \nin, as opposed to the logistics of getting all of these things done would be more  -- how 20 \nmany people do we need on a clinical trial?  We need 30,000, you know, total, 15,000 21 \nprelim.  It's likely I got involved in that discussion of it.  It was more of something that 22 \nrelated very closely to the science and clinical trials.  23 \nQ Do you think the process of Operation Warp Speed, the, kind of, medical side 24 \nthat you were talking about, but also when you were -- you probably saw the other 25 \n  \n  192 \naspects, right?  Like, you were  --  1 \nA No, I was there.  I definitely saw it.  2 \nQ -- at least in the room to talk about distribution and that kind of stuff?  3 \nA Oh, yeah.  Yeah.  Yes.  4 \nQ Do you think that kind of thought process could be scaled to other 5 \npharmaceuticals?  6 \nA I think it can.   7 \nI mean, I don't think anybody would argue that Operation Warp Speed was a great 8 \nsuccess.  No doubt about that.  I think that an Operation Warp Speed -like approach 9 \ncould be applied -- and, I guess, when you talk about lessons learned for other diseases, it 10 \ncould be applied to other diseases.   11 \nThere was a great, I would say, social and almost emotional need to do this 12 \nbecause we were in the middle of a crisis.  I would like to see an Operation Warp Speed 13 \napproach of a great collaboration and synergy between industry and the Federal 14 \nGovernment and academia, the way it was, be done in situations that were not only 15 \ncrises.  In other words, there are other diseases that we could do this on that are not in 16 \na crisis mode.   17 \nAnd I think a lesson could be learned, how successful it is when you get good 18 \npartnership between the Federal Government and the private sector, which is essentially 19 \nwhat Operation Warp Speed was.  20 \nQ So maybe applying the thought process to target diseases to prevent a 21 \nfuture pandemic or at least attempt to prevent a future pandemic?  22 \nA Yeah.  Right.   23 \nQ On December 11, 2020, the FDA authorized a COVID vaccine  -- I think it was 24 \nPfizer at that point --  25 \n  \n  193 \nA Right.  1 \nQ -- for EUA.  Were you involved at all in the EUA process?  2 \nA You know, I know it sounds strange when I say, I don't recall.  But I 3 \nprobably was involved in the discussion of, let's take a look at the data, and do these -- so 4 \nI would say, I can't say definitively -- 5 \nQ Uh-huh.  6 \nA -- but it is likely that I was involved in an analysis of the data.  7 \nQ When we talked to Dr. Birx, now, in 2021 -- October  2021 is when Dr. Birx sat 8 \nfor a 2 -day interview, just like you -- she said that, at that point, she was having 9 \ndiscussions about compassionate use for the vaccine; that, I guess, the trials had shown 10 \nthat it wasn't dangerous but not yet proven that it was effective, and that, at that point, 11 \nyou know, you could apply for compassionate use.   12 \nDo you recall anything about that?  13 \nA I don't recall -- I don't recall at the time -- I don't recall that that's what she 14 \nwas saying at the time.  But I know, after the fact, that that's what I think she had 15 \nmentioned.  She wrote it in her book or --  16 \nQ Yeah.   17 \nA Yeah.  I think that's where I remember it.   18 \nQ I want to -- and you've touched on it a little bit, some of the misinformation 19 \nand, kind of, things that surrounded the vaccine.  As I said in the beginning, like, it has 20 \nsaved millions of lives, kept millions of people out of the hospital.   21 \nAnd a theme of the past 2 days, I think, across the aisle, has been:  Words of 22 \npeople that are in at least perceived positions of authority and public faces matter, and 23 \nhow you say things matters, and promises you make matter.   24 \nIn March of 2021  -- and we asked Director Walensky about this before, too  -- but 25 \n  \n  194 \nshe was on TV and said, \"Our data from the CDC suggests that vaccinated people do not 1 \ncarry the virus and don't get sick.\"   2 \nI think, as I've just admitted and will admit time and time again, the vaccine was 3 \nwildly important, but there were breakthrough cases.   4 \nA Yeah.  5 \nMr. Schertler.   I'm sorry.  What date was that, Mitch?   6 \nMr. Benzine.   March 2021.   7 \nMr. Schertler.   Okay.  Got it.  8 \nBY MR. BENZINE:  9 \nQ And saying, if you get vaccinated, the quote is, \"You don't get sick.\"  That's 10 \njust not accurate, right?  11 \nA You know, I think she was speaking in generalities, and with every one of 12 \nthose, there's exceptions.   13 \nWhat I believe that Dr.  Walensky was referring to is that, at the time when you're 14 \nprotected -- you know, we know that the efficacy, or the effectiveness, as it were, 15 \nessentially wanes after X number of months.  I think what she was saying  -- that when 16 \nyou're at a point of maximum protection, it is very unlikely that you're going to get sick.   17 \nAnd I think when public health people speak about \"you're not going to get sick,\" 18 \nit means there's always an exception to that.  And I would imagine that Dr.  Walensky 19 \nhad in mind that there would be exceptions to that.   20 \nQ You didn't go quite that far in one statement.  You said the vaccine made 21 \nyou a dead -end for the virus.  Do you recall that statement?  22 \nA No, I don't.  23 \nQ It was May 2021.  \"When you get vaccinated, you not only protect your 24 \nown health and that of the family, but also you contribute to the community health by 25 \n  \n  195 \npreventing the spread of the virus throughout the community.  In other words, you 1 \nbecome a dead -end to the virus.\"   2 \nA Right.  That was at a time when the data had shown, at least with the 3 \nvariance that we were talking about, that there was a significant degree of protection 4 \nagainst infection as well as against serious disease.   5 \nAs I mentioned during one of the previous questions, as we develop different 6 \nvariants, particularly the Omicron variant, the protection against actual infection, which 7 \nwould protect you from getting infected -- 8 \nQ Uh-huh.  9 \nA -- and essentially make it a dead -end for you  -- not a dead -end for the 10 \ncommunity, but a dead -end for you -- that was a correct statement.   11 \nBut that statement really, as we got more and more information about the waning 12 \nof protection against infection  -- so, right now, I believe if you ask me  -- which you 13 \nwill -- or anybody else, that, right now, vaccines do not necessarily protect very well at all 14 \nagainst infection, but the ability to protect you from getting into the hospital is still pretty 15 \nstrong.  16 \nQ Uh-huh.  And, I mean, putting aside, kind of, the long -COVID symptoms, the 17 \ngoal of most vaccines is to keep you from dying.  Is that accurate?  18 \nA Well, from getting sick.  I mean --   19 \nQ Yeah.   20 \nA -- I don't like to be in the hospital -- I don't know about you -- 21 \nQ Well, yeah.   22 \nA -- and walk out alive; I'd rather not go to the hospital.  But -- 23 \nQ Yeah.  That's fair.   24 \nA Okay.   25 \n  \n  196 \nQ Along the same lines, in July of 2021, President Biden was giving a townhall, 1 \nand he said, \"If you're vaccinated, you're not going to be hospitalized, you're not going to 2 \nbe in the IC unit, and you're not going to die.\"   3 \nTo my knowledge, President Biden is not a public health expert, so I'm not going 4 \nto -- he's not -- 5 \nA Yeah.   6 \nQ -- he doesn't have the benefit of speaking in generalities like you just said.   7 \nA Yeah.  8 \nQ That, to me  -- I mean, by July 2021, there were vaccinated people in the 9 \nhospital, correct?  10 \nA Right.   11 \nQ There were vaccinated people in the IC unit, correct?  12 \nA Yeah.  Unusual, but there were people, obviously, who -- I mean, much, 13 \nmuch, much, much -- 14 \nQ Yes.   15 \nA -- less of a chance than if you were unvaccinated.  But, yes, there were 16 \nvaccinated people who wound up getting sick and dying.  17 \nQ And vaccinated people had passed away by this point?  18 \nA Right.  Right.   19 \nQ I think we've talked a lot about misinformation.  Misinformation -- 20 \nA Yeah.  21 \nQ -- cuts both ways.   22 \nA Yeah.  But I believe, I believe sincerely, that the President meant \"for the 23 \nmost part,\" as opposed to \"100  percent.\"  24 \nQ And I get that.  And I -- it's just, it's a recurring theme, not just with you, not 25 \n  \n  197 \njust with the President, but that we see people -- this implies to the general public that if I 1 \nget a vaccine I'm good to go, I'm not going to get sick --   2 \nA Right.   3 \nQ -- I'm not going to die.  And while it's very accurate that you're way less 4 \nlikely to die --  5 \nA Right.   6 \nQ -- it's not accurate to say you are not going to die.   7 \nA Yeah.  8 \nQ I mean, generally, do you think people need to be more wise with their 9 \nwords when discussing these things?  10 \nA Yeah, I mean, I think it would be more accurate to say that if you get 11 \nvaccinated there's an overwhelmingly less chance that you're going to get sick or die.   12 \nBut I think the President very likely meant that, but he said it in a way that seemed 13 \na little bit more absolute.  I don't think he was -- in fact, I'm fairly certain that he wasn't 14 \ntrying to fool anybody.   15 \nQ No, no.  And I'm not accusing him of trying to fool anybody.   16 \nAll I'm saying is that we've seen people -- and I'm -- everybody is guilty of it on this 17 \nside of the table, and some on that side of the table too -- of parsing out statements and 18 \nnitpicking certain things.  And how we say things, especially in a public health crisis, 19 \nespecially when talking about, you know, it's a vaccine, it's a very minor medical 20 \nprocedure, it's still going to the doctor, it's still getting a shot  -- that we should be honest 21 \nwith Americans and -- 22 \nA Yeah.  23 \nQ -- that words from the President of the United States matter.   24 \nA Yeah.  25 \n  \n  198 \nQ And I can, like, feel my colleagues on the other side wanting to bring up 1 \nbleach, and I will say that words matter in that situation too.   2 \nA Yeah.  3 \nQ But -- I think this will be my last question on this -- like, do you think it 4 \ncould've been reframed -- 5 \nA Yeah.  6 \nQ -- to be more accurate?  7 \nA But, again, you used a word, Mitch, that I would just push back on.  I don't 8 \nthink the President was being dishonest with the American public.   9 \nI think, as a layperson, he was talking more in generalities than in, 100 percent, 10 \nthis is sure.  He was saying that because, in his mind, vaccines work really, really well in 11 \npreventing you from getting infected and dying.  I don't believe for a second that there 12 \nwas any degree of dishonesty in that.   13 \nQ Thank you.   14 \nI want to -- maybe not properly serving to the process of approving the vaccine, 15 \nbut -- skip through the full approvals.  I imagine that was mostly FDA?  Is --   16 \nA Right.   17 \nQ -- that fair?  And move on to some of the policies that were implemented 18 \nafter the vaccines got their full biologics approval.   19 \nDid you have any conversations with any schools, universities, or other 20 \neducational institutions regarding mandating vaccinations?  21 \nA I didn't go out to universities and say, \"You should be mandating 22 \nvaccinations.\"  But I would occasionally get a phone call from a university president 23 \nsaying, you know, \"We really want to keep these kids safe.  We're thinking of making 24 \nsure that they get vaccinated.  Do you think that would be a reasonable idea?\"  And I 25 \n  \n  199 \nwould say, \"I think that would be a reasonable idea.\"   1 \nBut I wouldn't all of a sudden, you know, go on a speaking tour -- 2 \nQ Uh-huh.  3 \nA -- to colleges, saying, \"You should be mandating.\"  But when they suggest, 4 \nwould that be a way to safeguard everybody, I would say yes.   5 \nAnd then, also, there's always an out for people who don't want to get vaccinated, 6 \nthat they should wind up getting tested frequently enough to be safe.   7 \nQ The off -ramp?  8 \nA The off -ramp, right.   9 \nQ Same kind of question, and if it's the same answer, just tell me it's the same 10 \nanswer.   11 \nAny conversations with major corporations  -- Amazon, Facebook, others  -- about 12 \nmandating vaccinations for employees?  13 \nA Well, you just gave two -- social media.  I don't talk to social media.   14 \nQ No, not in, like, social media ways.  I mean, did you have conversations with 15 \nmajor corporations about --  16 \nA Yeah, I'm trying to think, and I don't -- I do remember conversations with 17 \nuniversity provosts -- 18 \nQ Uh-huh.  19 \nA -- and presidents, but I don't recall -- it is entirely conceivable that I did, but I 20 \ndon't specifically recall.   21 \nQ You were interviewed for a book written by Michael Specter, and it's just 22 \nentitled \"Fauci.\"  I don't know if you remember that interview.   23 \nA I do.  It wasn't a book; it was an article, wasn't it?   24 \nQ I think it was a -- 25 \n  \n  200 \nA Yeah.  1 \nQ -- book.  You were interviewed by Michael Specter.   2 \nA Yeah.  It was, I think, for The Atlantic or something like that -- or the New 3 \nYork -- New York Magazine.   4 \nQ That might be it.   5 \nThere was a recorded portion of this interview that he released recently, well past 6 \nthe book, or article.  And in the recorded portion -- and I'm happy to play it, but I can 7 \njust read it to you -- 8 \nA Tell me.  9 \nQ -- if that's easier.   10 \nYou said, \"Once people feel empowered and protected legally, you are going to 11 \nhave -- schools, universities, and colleges are going to say, 'You want to come to this 12 \ncollege?  Buddy, you're going to get vaccinated.  Lady, you're going to get vaccinated.'  13 \nBig corporations like Amazon and Facebook and all of those others are going to say, 'You 14 \nwant to work for us?  You get vaccinated.'  And it's been proven that when you make it 15 \ndifficult for people in their lives, they lose their ideological bullshit and they get 16 \nvaccinated.\"   17 \nDo you recall making that statement?  18 \nA No.  I mean, I'm sure you are going to play it, but I don't recall making that 19 \nstatement.  20 \nQ Okay.  I don't have to play it -- 21 \nA Yeah.  22 \nQ -- if it's not going to  --  23 \nA Yeah.   24 \nQ But he recently released the recording.  25 \n  \n  201 \nA Right.  1 \nQ Since you don't recall, I'll skip over what did you mean by \"ideological 2 \nbullshit\"?  I presume it's some of the partisan politics surrounding vaccines.   3 \nA Yeah, I mean, I think if I used -- which I'm sure I did, if you're going to play 4 \nit -- if I used the word \"ideological bullshit,\" it refers to my concern that I mentioned an 5 \nhour or 2 or 3 ago, that it's very painful for me, as a physician, to see somebody who's in a 6 \nRepublican State not get vaccinated and die because they happen to have an ideological 7 \nreason not to get vaccinated, whereas someone who doesn't have an ideological reason 8 \nagainst vaccination gets protected and lives.  I think that's unfair.   9 \nQ Uh-huh.  10 \nA That's what I mean by \"ideological bullshit.\"   11 \nQ Putting aside the ideological reasons, are there reasonable objections to 12 \nreceiving a vaccine?  13 \nA Yeah.  There are medical reasons that people, you know, might have a 14 \ncondition.  For example, a live -attenuated vaccine for someone who's 15 \nimmunocompromised -- 16 \nQ Uh-huh.  17 \nA -- that's a very good reason not to get vaccinated.  18 \nQ We saw -- and I don't have it in front of me, but  -- some mandates that 19 \nbusinesses and stuff didn't have religious exemptions or medical exemptions.   20 \nDo you think those kinds of objections to receiving the vaccine are valid?  21 \nA They're valid if they're not abused.  And there have been a lot of abuses of 22 \nthe exemption by people who have no reason at all and say, I have a medical reason or a 23 \npsychological reason.   24 \nQ Uh-huh.  25 \n  \n  202 \nA I think if you have a broad psychological reason, then there's every reason in 1 \nthe world for you not to get vaccinated.  2 \nQ That's fair.   3 \nOn August 24, 2021, Secretary of Defense Austin announced a policy of mandatory 4 \nvaccination for all servicemembers.  Were you involved in that?  5 \nA No.  6 \nQ On September 9, 2021, the President announced an executive order 7 \nrequiring Federal employees to be vaccinated against COVID -19.  Were you involved at 8 \nall in that?  9 \nA I wasn't involved.  I mean, he was always talking about getting people 10 \nvaccinated.  I wasn't involved in that decision.   11 \nQ And then on November 4, 2021, the President outlined COVID vaccine 12 \nmandates issued by the Occupational Safety and Health Administration and the Centers 13 \nfor Medicare and Medicaid Services.   14 \nWere you involved in either of those?  15 \nA Those were decisions that were above me.   16 \nQ And then on November 30, 2021, the Office of Head Start at HHS required 17 \nCOVID -19 vaccination for all Head Start staff.  Were you involved at all in that?  18 \nA No.  I didn't even know that happened, actually.   19 \nQ We've talked about some of the consequences of vaccine hesitancy.  Do 20 \nyou think mandating vaccines can result in some hesitancy?  21 \nA You know, I -- if I can switch over to -- and I'm not dribbling around the 22 \ncourt --  23 \nQ Uh-huh.  24 \nA -- just to switch over to lessons learned, I think one of the things that we 25 \n  \n  203 \nreally need to do after the fact, now, to -- you know, after -the-game, after -the-event 1 \nevaluation of things that need to be done, we really need to take a look at the psyche of 2 \nthe country, have maybe some social -type studies to figure out, does the mandating of 3 \nvaccines in the way the country's mental framework is right now, does that actually cause 4 \nmore people to not want to get vaccinated, or not?  I don't know.  But I think that's 5 \nsomething we need to know.   6 \nBecause, in general, the mandating of vaccines -- forget all the political stuff, and 7 \nforget COVID, and go back -- that mandating for things in our country were very 8 \nwell-accepted before the mindset that we have right now.  The idea of mandating 9 \nvaccines for children in school was something that was easily and widely -- 10 \nQ Uh-huh.  11 \nA -- accepted.  Now, there's a lot of question about that.   12 \nSo I think you need to at least raise the question of whether or not 13 \nmandating -- with all the positive aspects of controlling an outbreak, which it 14 \ndoes -- whether or not that's something that you need to relook at.  I -- anyway.   15 \nQ Yeah.  No, I appreciate that.  I think that's very important.   16 \nI'm going to touch very briefly on the VAERS system, and then I know the 17 \nchairman has some questions.   18 \nA Sure.   19 \nQ Generally, VAERS is used to track adverse events  --  20 \nA Right.   21 \nQ -- to vaccines?  And I'm not going to ask about -- like, I think there's lots of 22 \nproblems with the VAERS system, that I can go report things.   23 \nA It's very misleading.  24 \nQ It's very misleading.  But, generally  -- and we're going to have, I'm sure, 25 \n  \n  204 \nfurther discussion on reforming VAERS in order to get better for  --  1 \nA Right.   2 \nQ -- tracking this kind of stuff.  And with a baseline of it is misleading and I 3 \nagree with you, is it important to track and monitor adverse effects of vaccines?  4 \nA It is important -- 5 \nQ Okay.  6 \nA -- to track and monitor adverse events, for sure.   7 \nMr. Benzine.   I know the chairman has some questions.   8 \nDr. Wenstrup.   Yeah.  Thank you.  I have quite a few things.   9 \nYou know, I look back at the very beginning of this, and I think the trials were done 10 \ntremendously well.  Thirty - to 40,000 people.  I mean, I applaud the Americans that 11 \nvolunteered themselves, you know, to get into these trials with so many unknowns.  I 12 \nthought that was a great thing.   13 \nIn Cincinnati, I tried to get in Moderna.  When I got there, I had given blood 2 14 \nweeks before, they said, no, you can't get in.  And then when we hit 4 weeks, they said, 15 \nyou know, you're not who we're after, actually.  We want people from higher -risk 16 \ncategories.  And I said, that's fine.  Makes sense to me.  That makes for a better 17 \nstudy.   18 \nYou know, again, I believe you saved hundreds and hundreds of thousands of 19 \nlives.  But it didn't prevent.  And I think that that was one thing -- we knew from the 20 \ntrials that the people that got vaccinated could still get COVID but they were less likely to 21 \nget sick, less likely to get hospitalized.   22 \nI don't think we shared that very well as a country.  I don't think our messaging 23 \nwas good enough.  I mean, I was trying to tell people this all the time.  I was out giving 24 \nvaccinations, especially during emergency use, and what I saw were the people that I 25 \n  \n  205 \nthought looked like they were the high -risk people based on what we knew.   1 \nAnd I do hear, you know, even within this committee, you know, Members saying, 2 \nno, these things are safe, they're effective.  Well, that's up to interpretation.  You even 3 \nsaid, you can't ever say something is completely safe.   4 \nYou know, I'm not violating any HIPAA rules, but Debbie Dingell has told us how, 5 \nyou know, when she got a vaccine when she was younger, she got Guillain -Barre.  So she 6 \nwas very nervous about this one or any one she might get.  That's fair.  She went and 7 \ntalked to her doctor about it, and she ended up getting vaccinated.   8 \nAnd that's the same with effectiveness.  It's not 100 -percent effective, right, 9 \nbecause people still get it.  It's not like the polio vaccine, which has a much greater 10 \neffectiveness of ever getting it with getting vaccinated.   11 \nSo, when Americans do hear, you know, \"Get vaccinated, no ICU, no death,\" that's 12 \ndangerous, because people interpret  -- just like people thought -- I didn't think President 13 \nTrump was serious about injecting bleach.  I thought he was being sarcastic.  But other 14 \npeople interpreted it differently.  You've got to be careful with how we do that.   15 \nAnd, you know, I did a thing with some people that were hesitant, and when I 16 \ntalked to them about the vaccine, explained it to them, explained what their risk might 17 \nbe, explained the benefits of this  -- these were all hesitant people  -- they said, well, we 18 \njust want to be educated, not indoctrinated, okay?  And then they said they were more 19 \ninclined to maybe get the vaccine.   20 \nAnd so, you know  -- and I've said the same thing to Mandy Cohen.  When you 21 \nmake CDC recommendations, please explain why you're making this recommendation so 22 \npeople understand.   23 \nBut you go to the mandates  -- and this is the problem I have, as a physician, with 24 \nmedicine in America.  That mandate was being heard from a politician.  And that, I 25 \n  \n  206 \nthink, was the wrong messenger, all the way across.  And there's no doctor involved.  1 \nIt's, \"Do this, or you're fired.\"  And it's not like, \"Go sit down with your doctor.\"  Every 2 \nother medicine, every drug that runs an ad, they've got to say, \"Talk to your doctor, and 3 \nthese are the side effects.\"  We weren't doing that.   4 \nAmericans don't do well -- to what you were saying, Doctor, the psychology of 5 \nAmerica  -- they don't do well with, \"Because I told you so.\"  They want to be educated.  6 \nThey want to know.  These are the types of things that I think we can do well.   7 \nAnd I think, you know, it's always stoic with patients.  Just say what you don't 8 \nknow.  Be honest with patients, you know?  I know I remember hearing, \"Oh, this may 9 \ngo away in the summer.\"  Well, it didn't.  Well, some people thought that because 10 \nother coronaviruses do.  This one didn't.   11 \nSo that's just my take on that point with vaccines.  And I'd love to offline 12 \nsometime talk to you more -- 13 \nDr. Fauci.   Sure.  14 \nDr. Wenstrup.   -- about it  --  15 \nDr. Fauci.   I'd be happy to.  16 \nDr. Wenstrup.   -- to get a better policy.  17 \nBut I do have another thing I want to bring up.  You pointed out that vaccines 18 \nusually take about 7 years.  And I'm just looking at this -- I was looking back at stuff 19 \ncoming out of China.  Yusen Zhou had a patent for a SARS -CoV-2 vaccine in March of 20 \n2020.  March 19th is the date I have.  Zhengli Shi announced the sequence January 21 \n20th of 2020.   22 \nSo we're saying from January 20th to March, 2 months later, he had a vaccine.  23 \nThat struck me as odd.   24 \nDr. Fauci.   Hmm.  25 \n  \n  207 \nDr. Wenstrup.   Does that strike you as odd?   1 \nDr. Fauci.   Well, I don't know if he had a vaccine.  What I'm hearing --  2 \nDr. Wenstrup.   He was seeking a patent on the vaccine.   3 \nDr. Fauci.   No, he was seeking a patent  -- and, again, I  -- 4 \nDr. Wenstrup.   I could be wrong.   5 \nDr. Fauci.   You might be, and I might be.  But let me -- 6 \nDr. Wenstrup.   Okay.   7 \nDr. Fauci.   But let me tell you, when I heard that, I was trying to figure out what 8 \nthat meant.  And you could have a patent for an idea without even having a vaccine in 9 \nyour hand that you've tested.   10 \nFor example, if there were cases in China at the end of December, which we knew 11 \nthere were, and they isolated the virus  -- they may not have sequenced it yet, but they 12 \nisolated the virus, and they did some simple tests.  Like, they took the virus, they 13 \ninactivated it, they put it in a mouse, and they found out that if you infect the mouse --  14 \nDr. Wenstrup.   Yes. 15 \nDr. Fauci.   And then they get a pattern, which is really  --  16 \nDr. Wenstrup.   I understand --   17 \nDr. Fauci.   -- a conceptual pattern.   18 \nDr. Wenstrup.   I understand the process.   19 \nDr. Fauci.   So I think you can get a patent in March -- 20 \nDr. Wenstrup.   Okay.  21 \nDr. Fauci.   -- for something that you had in December and January.  22 \nDr. Wenstrup.   Well, I think that's something we should look into, but it -- 23 \nDr. Fauci.   Yeah.  24 \nDr. Wenstrup.   -- might not be this subcommittee.  It might be downstairs.   25 \n  \n  208 \nDr. Fauci.   No, actually, it would be a good idea to do that.  Because when I 1 \nheard that and people were saying, understandably, how could you get a pattern so 2 \nquickly  --   3 \nDr. Wenstrup.   Yeah.  4 \nDr. Fauci.   -- it depends on what kind of patent you need.   5 \nDr. Wenstrup.   Okay.  That may be something we have to  look --  6 \nDr. Fauci.   Yeah.  It's a good idea.  7 \nDr. Wenstrup.   -- into through the Intelligence Committee  --  8 \nDr. Fauci.   Well --  9 \nDr. Wenstrup.   -- because I don't think he's going to answer our calls.  10 \nDr. Fauci.   Yeah, no, I don't think so.  11 \nDr. Wenstrup.   Thank you.   12 \nDr. Fauci.   You're welcome.  Thank you.   13 \nBY MR. BENZINE:  14 \nQ I want to, in the time remaining, try to get through our last few topics.  And 15 \nso, if I cut you off or ask for a brief answer, I apologize.   16 \nA I will shoot the jump shot as soon as you give me the ball.   17 \nQ Awesome.  18 \nA Okay.  Right.  19 \nQ I want to talk about natural immunity for a minute.  In general, is natural 20 \nimmunity a real thing?  21 \nA Well, if you mean, \"natural immunity,\"  the immunity that you get after you 22 \nget infected  --  23 \nQ Yes, sir.   24 \nA Let's establish that's what we mean.  25 \n  \n  209 \nQ Yes, sir.   1 \nA Because natural immunity could also be innate immunity -- 2 \nQ Oh, no, no.  3 \nA -- that has nothing to do  --  4 \nQ The infection -acquired immunity.  5 \nA Natural immunity post -infection, got it.  Okay.  6 \nQ Yes. 7 \nA It's a real thing.  8 \nQ All right.   9 \nAnd my understanding of the way out of a pandemic is through what -- it's now 10 \nbeen kind of villainized  -- but herd immunity, either via infection -acquired or 11 \nvaccine -acquired immunity.  Is that generally right?   12 \nA It is generally right depending on the pathogen.  And this is critical, Mitch.  13 \nIt's critical.  So -- and I've written about this, okay?   14 \nQ Uh-huh.  15 \nA If you have a vaccine or an infection in which you're dealing with a pathogen 16 \nthat does not change  -- and I'm really not dribbling.  I think -- 17 \nQ No, no.  18 \nA -- it is important for the committee to hear this.   19 \nFor example, I got infected with measles when I was a child because I'm old 20 \nenough not to have been vaccinated for measles, okay?  The post -infection natural 21 \nimmunity from measles -- you're dealing with measles.  The same measles that infected 22 \nme is exactly the same measles that's infecting children in the developing world.  The 23 \nvirus has not changed.  Point number one.   24 \nPoint number two, that the immunity that you get from either infection or 25 \n  \n  210 \nvaccination is measured minimally in decades and generally for a lifetime.  So, when you 1 \nhave an infection like measles or, in some respects, polio and you get infected, natural 2 \nimmunity is as good as it gets, because you have as good protection as you can get from 3 \nanything.  4 \nQ Uh-huh.  5 \nA When you have a pathogen where the infection itself gives you immunity 6 \nthat does not last more than months to a year, and you have a pathogen that starts off as 7 \nthe initial strain and then becomes Alpha, Beta, Gamma, Delta, Omicron, and then 8 \nsubgroups of Omicron, the whole concept of natural immunity is the same problem we 9 \nhave with vaccination.  It doesn't last forever.   10 \nSo that, I think, is the question -- 11 \nQ Yes. 12 \nA -- you're going to get to  --  13 \nQ Yeah.   14 \nA -- is that, when people have been infected, why would you want to vaccinate 15 \nthem?  Because a vaccinated infected person is better off than just an infected person.   16 \nQ And I agree.  And I think studies have come out that hybrid is, like, kind of, 17 \nthe best.  But, of course  -- 18 \nA The best.   19 \nQ -- you don't want to go out and, like, go out and get sick.   20 \nA No, you don't want to get infected just for the sake of getting protected.  21 \nThat's sort of a little backwards.  22 \nQ What you just said, kind of -- a little bit of it struck me.  So we've 23 \nseen -- and you've mentioned it today -- kind of, the vaccine -induced immunity waning 24 \ntoo, so that's why boosters have come out.   25 \n  \n  211 \nA Right.   1 \nQ So that phenomenon, the mutating virus harms vaccine -acquired immunity 2 \nin the same way that it harms -- 3 \nA Exactly.  4 \nQ -- infection -acquired immunity.   5 \nA Exactly.  6 \nQ Okay.  7 \nI'm not going to introduce it, and I'm going to go through it quickly because I think 8 \nyou've talked about it before.  You're generally familiar with the Great Barrington 9 \nDeclaration?  10 \nA I am.  11 \nQ Dr. Collins sent you an email calling the authors \"fringe epidemiologists\" and, 12 \nin essence, requesting, I think he used, \"devastating takedown\" of the Great Barrington 13 \nDeclaration.  14 \nA Yes. 15 \nQ To your knowledge, did NIAID publish anything or act on that instruction?  16 \nA Act on the instruction to take it down?   17 \nQ Uh-huh.   18 \nA No.  No.  19 \nQ Are you aware of the Federal Government publishing any papers that was an 20 \nintentional takedown of the Great Barrington Declaration?  21 \nA You know, they may have, but I don't think so.  I mean, I'd be happy to talk 22 \nto you about the Barrington Declaration if you'd like.   23 \nQ If I had some more time, I would, but -- 24 \nA No, I could even do it with a quick jump shot.   25 \n  \n  212 \nQ No, well, we'll move on.  I'm more worried -- 1 \nA Okay.  All right.  2 \nQ -- about, kind of, the debate process in this.  3 \nA Okay.  4 \nMr. Benzine.   I know -- sir, do you want to ask treatment questions, or do you 5 \nwant --  6 \nDr. Wenstrup.   Yeah, if we can.  Thank you.   7 \nI mean, I think we recognize that the golden standard of things is to have a 8 \ndouble -blind study to support any treatment or before any approval of treatments.   9 \nYou know, look, there were no golden standards of treatment when we really had 10 \nno tests and we had no definitive treatment, we had no vaccines.  I mean, I think golden 11 \nstandards are ideal, but when nonexistent, it isn't always real.   12 \nAnd, you know, in war, you don't always have everything you want.  You know, I 13 \nspent a year in Iraq.  A lot of times, you don't have everything you want.  The 14 \nequipment may break.  You may be out of certain medicines.  You try something else.  15 \nWhatever you do.  And I think February 2020 felt like we were at war, that's for sure, at 16 \nleast on the medical front.   17 \nSo I'm curious, before we had approved COVID tests, what tests did you order to 18 \ntry and diagnose a COVID patient?  With COVID, that is.  19 \nDr. Fauci.   Before there were any tests?   20 \nDr. Wenstrup.   Yeah.     21 \nDr. Fauci.   I think the clinical situation would be pretty easily identifiable.   22 \nDr. Wenstrup.   Yeah.  23 \nDr. Fauci.   And I'm sure you've taken care of and I've taken care of COVID 24 \npatients.  If you have somebody that comes in that doesn't have influenza and doesn't 25 \n  \n  213 \nhave everything else and you're in the middle of a COVID outbreak, it's pretty easy to 1 \nmake a diagnosis.  2 \nDr. Wenstrup.   Well, yeah, just by the symptoms.   3 \nDr. Fauci.   Yeah.  4 \nDr. Wenstrup.   There were other things, too, that I thought were interesting.   5 \nDr. Fauci.   Yeah.  6 \nDr. Wenstrup.   An increase in IL -6.  Of course, all the inflammatory markers --  7 \nDr. Fauci.   Loss of taste and smell.  8 \nDr. Wenstrup.   All those things, yeah.   9 \nDr. Fauci.   Okay.   10 \nDr. Wenstrup.   So that's where we were at that time.  And so, you know, there 11 \nweren't necessarily double -blind studies, but these were the things we were picking up 12 \nand employing into our thought process.   13 \nSo, I mean, when you were bedside -treating COVID patients, especially, you know, 14 \nones that were really failing, you know, what did you prescribe?   15 \nDr. Fauci.   What did we prescribe?   16 \nDr. Wenstrup.   Yeah.  17 \nDr. Fauci.   We prescribed just supportive care.  18 \nDr. Wenstrup.   Like what?   19 \nDr. Fauci.   Supportive care.   20 \nDr. Wenstrup.   What?   21 \nDr. Fauci.   Maintaining fluids, maintaining  blood pressure, maintaining oxygen 22 \nflow.  That's what we did.   23 \nDr. Wenstrup.   Yeah.  [Inaudible.]  24 \nDr. Fauci.   Yeah.   25 \n  \n  214 \nDr. Wenstrup.   And it turned out that wasn't necessarily the best for everybody.  1 \nDr. Fauci.   Right.  2 \nDr. Wenstrup.   And did your treatments vary depending upon, I guess, the level 3 \nof symptoms?   4 \nDr. Fauci.   Yeah.  Yeah.  I mean, obviously, you'd be very aggressive if you had 5 \nsomebody with a pulse ox that's in the 70s.   6 \nDr. Wenstrup.   I guess what I'm saying is, I'm trying to feel for those that were in 7 \nthat situation  --  8 \nDr. Fauci.   Yeah.  No, I understand what you're saying.   9 \nDr. Wenstrup.   -- caring for patients, and, like, holy cow -- 10 \nDr. Fauci.   Right.  11 \nDr. Wenstrup.   -- you know, what else can we do?   12 \nAnd, you know, I think as we move forward, maybe there's other things we can do 13 \nthat maybe could be better next time, especially with a similar type of thing.   14 \nLike, you mentioned earlier, we talked about the furin cleavage site and how furin 15 \ncleaves the site and subsequently makes SARS -CoV-2 more infectious to humans.  I think 16 \nwe agree on that, right?  And this was the first SARS virus published or known that had a 17 \nfurin cleavage site.  18 \nDr. Fauci.   Yeah.   19 \nDr. Wenstrup.   So I just wonder, have we scientifically established what patients 20 \ntypically have higher furin levels?  Because it seems to me, the more furin you have, the 21 \nmore infectious this can become.   22 \nYou know, was it diabetics?  Is it obesity?  Age?  COPD?  CHF?  I mean, have 23 \nwe scientifically looked into this?   24 \nDr. Fauci.   I don't know if they've looked in furin levels, but I know there's a lot of 25 \n  \n  215 \nsystem biology looking at what's going on  -- not only with COVID, but with long COVID, as 1 \nto what's going on.   2 \nYou mentioned a couple of them.  Like, what does the D -dimer do?  What does 3 \nIL-6 do?  What does some of the other inflammatory markers do?  Yeah.  That really 4 \ndoes need -- it's being done, but it's still a mystery.  5 \nDr. Wenstrup.   Yeah.  From the beginning with some of our colleagues, 6 \ncardiologists were really interested in D -dimers --  7 \nDr. Fauci.   Yeah.   8 \nDr. Wenstrup.   -- and what's going on there.   9 \nSo, I mean, what occurs to me  -- and I'm just seeking an opinion on this.  I know 10 \nthere is some research.  Maybe we can accelerate treatment sometime, like Operation 11 \nWarp Speed.  12 \nDr. Fauci.   Right.  13 \nDr. Wenstrup.   It was accelerated.  We accelerated treatments because people 14 \nstill got COVID and they were going to need treatment.   15 \nSo what if we were testing furin  inhibitors or something along that line?   16 \nDr. Fauci.   Yeah.  17 \nDr. Wenstrup.   Does that seem a reasonable thing to pursue?   18 \nDr. Fauci.   Well, I'm not an expert in what other implications furin  has in the 19 \nsystem, because you've got to be careful -- 20 \nDr. Wenstrup.   Yeah.  21 \nDr. Fauci.   -- that if furin is involved in an enzymatic involvement of a lot of good 22 \nbody functions, you don't want to get too much or too little furin, so -- 23 \nDr. Wenstrup.   You don't want to rob Peter to pay Paul, right?   24 \nDr. Fauci.   Exactly.  Exactly.   25 \n  \n  216 \nDr. Wenstrup.   And there are studies I want to dig into a little bit more because 1 \nI'm curious.  2 \nDr. Fauci.   Yeah.  3 \nDr. Wenstrup.   Just trying to think of, you know, what kind of process we can 4 \nhave to enable  -- like you were just saying, maybe some things besides just the crisis can 5 \nwe look into, and maybe do the public -private partnerships.  You know, you mentioned 6 \nmonoclonal antibodies, antivirals.  You know, zinc was being recommended, vitamin D.  7 \nI got on it.   8 \nDr. Fauci.   There's a lot of things that you're alluding to.  But one of them I think 9 \nyou'd be interested in, I'm sure, is that one of the really concerning things was that, when 10 \nyou didn't identify after -- remember, when you were taking patients -- when we were, 11 \npatients would go 6 or 7 days deteriorating slowly, slowly, slowly, and then they would 12 \ncrash and then they would go to the ICU.   13 \nRaul, I know you know that.  You're an emergency medicine person.   14 \nThat would happen, and then there would be no identifiable virus.  And you 15 \nwould say, why are they having such problems in their lungs and in their kidney and in 16 \ntheir brain?   17 \nWe now know that -- there is a study that just came out that, if you look at 18 \nautopsies, there's evidence of virus in multiple organ systems, which means it is not just 19 \nconfined to the upper airway.   20 \nDr. Wenstrup.   Uh-huh.  21 \nDr. Fauci.   Even when you look in the lung and you don't see virus, there's likely 22 \nremnants of virus there that are triggering an immunologic and inflammatory response 23 \nthat's responsible for the pulmonary failure, which we're just finding out now, like, years 24 \nafter the beginning of the outbreak.   25 \n  \n  217 \nDr. Wenstrup.   Just a couple other thoughts in the line of treatments.   1 \nYou know, I know, early on, we were making the call, \"If you had COVID and you 2 \nrecovered, donate your plasma.\"  And patients in Cincinnati, I know, were getting 3 \nconvalescent plasma and doing pretty well.  I think we could've maybe continued to 4 \nhype that a little bit, when other things weren't working especially.   5 \nAnd, you know, the natural immunity is interesting to me, because I got Pfizer, 6 \nboth doses, in early -- what was it  -- January or February.  August, I got COVID.  And the 7 \nonly reason I knew?  I was cooking and I couldn't smell garlic salt.  Okay?  And that 8 \nwas the only way that I knew.   9 \nDr. Fauci.   That's a tragedy, if you can't smell garlic.   10 \nDr. Wenstrup.   I know.  I'm Italian, too.  Anyway.   11 \nSo I said to my wife, I said, I had COVID.  Remember last week I had a chill, right?    12 \nSo then I was going to Germany, and they said, well, you've got to get a booster 13 \nbefore we go.  I said, can we check my antibodies and T cells first?  They said, well, we 14 \ncan do antibodies here.  So I got my results, and it said a strong number was 40, and my 15 \nnumber was 821.  So I questioned whether I should be getting a booster.   16 \nAnd what I'm saying is, we need to get back to personalizing medicine so you have 17 \na conversation with your doctor.  This is a time where who knows who was saying I had 18 \nto have a booster to do this.   19 \nSo -- and I think those are the things that are twisting people's minds in America.  20 \nThey want that personal medicine.  I think we've got to keep that in mind going forward.   21 \nAnd then just one other thing with the vaccines.  I've been doing some reading 22 \non mucosal vaccines, and I think, for this, this may be the next step.  Would you agree?   23 \nDr. Fauci.   Absolutely.  I mean, to get the virus blocked at its point of entry, now 24 \nyou're really talking about preventing infection.   25 \n  \n  218 \nDr. Wenstrup.   Yeah.  1 \nWell, listen, I thank you.  My points I'm trying to make are:  a more organized 2 \nmessage, a better message, more clarity, we can do better in those regards and pursue 3 \nevery one of those avenues.   4 \nDr. Fauci.   Right.  I agree.  5 \nDr. Wenstrup.   Thank you.   6 \nDr. Fauci.   Thank you.  7 \nBY MR. BENZINE:   8 \nQ We have about 5 minutes left in our hour, I think, and I want to ask one, kind 9 \nof, very high -level question on royalties before concluding.   10 \nI know you have said that you've donated your royalties, and I'm not going to ask 11 \nabout individual royalties.   12 \nA Right.  13 \nQ But current NIH policy is that royalties are just part of your income and, 14 \ntherefore, it doesn't need to be disclosed?   15 \nA Yeah.  16 \nQ I think we've heard some concerns that, because of the things NIH 17 \nemployees are working on and then possibly advising on, that not having public disclosure 18 \nof royalties could hide, for lack of a better word, a conflict of interest.   19 \nA Yeah.  20 \nQ Do you think that that needs to be changed?  21 \nA You know, I don't know if you want to change it, but it just goes -- Mitch, I've 22 \nsaid every time and I'll say it again for the record:  I'm always in favor of a great deal of 23 \ntransparency, always.   24 \nQ Thank you.   25 \n  \n  219 \nA Yeah.  1 \nQ My last, kind of, conclusory statement is, like I said, I worked for Mr. Scalise 2 \nwhen he was ranking member of this committee.  You testified a few times back then.  3 \nAnd I actually remember, the first hearing in the Oversight Committee on the pandemic 4 \nwas, like, late February or something.  You testified on that too.   5 \nAnd you actually had to -- you and Dr. Redfield and, I think it might've been 6 \nAdmiral Giroir at the time, had to leave halfway through because you got called to the 7 \nWhite House, and then you came back the next day.  And that's just kind of engrained in 8 \nmy memory.   9 \nA Right.   10 \nQ But at one of these hearings, you were asked by Mr.  Jordan about, kind of, 11 \nthe threshold that would need to be met in order for mitigation measures to be lessened.  12 \nAnd I have your answer, but the answer doesn't really matter.   13 \nAt the time, you were being filmed by PBS in part of the documentary that -- 14 \nA Yes. 15 \nQ -- they released on \"American Masters.\"  And I want to read what you said 16 \nafter you got back in your car after that hearing.   17 \n\"One of the things I've learned from hearings like this, even though in some 18 \nrespects it's a show, the fact is, I found, even when people act like jerks, sometimes there 19 \nis a kernel of truth in what they say.  And it may be advantageous to say, okay, should 20 \nwe be a little bit more flexible in telling people, okay, fine, here's the recommendations 21 \nthat we say, where you can go and what you can do after you've been vaccinated.  22 \nHowever, if you want to take the risk, take the risk.\"   23 \nTo me, that seems like the path forward here, that in future outbreaks it would be 24 \nbetter to inform the American public of what they can do, what their relative risk is, and 25 \n  \n  220 \nthen let the public make the decision based on that risk profile.   1 \nDo you agree, disagree, or have any comments on that?  2 \nA No, I mean, I -- you know, again, just to get back to that, Congressman 3 \nJordan was really -- 4 \nQ Yes.   5 \nA -- pestering me about that, you know?  And, you know, I felt bad, I said -- in 6 \nfact, I said, I think you're ranting.   7 \nAnd I felt badly when I got in the car, because I said that, you know, even though 8 \nhe was acting in a very aggressive way to me -- he wasn't giving me the opportunity to say 9 \na word.  When I got in the car, I said, you know, despite the fact that he was being very, 10 \nvery aggressive  -- 11 \nQ Uh-huh.  12 \nA -- that there was a kernel of truth in what he was saying, and I think that we 13 \nshould keep an open mind to, you know, listening to when people have an objection to 14 \nwhat you're doing.   15 \nI think it just confirms what I told you 4 minutes ago, that I am a transparent type 16 \nof person.  I want to at least honor everybody's opinion enough to at least consider it.  17 \nQ No, I appreciate that.  18 \nMr. Benzine.   And, with that, I want to thank you again for being here voluntarily 19 \nfor both days, 14 hours, potentially, total.   20 \nAnd we can go off the record.  21 \nDr. Fauci.   Thank you.  22 \n[Recess.] 23 \n  \n  221 \n[5:48 p.m.]   1 \n  We can go back on the record.   2 \nBefore we begin this final round of questions, I just want to have Congressman 3 \nDr. Ruiz, Ranking Member Ruiz, who just joined us, introduce himself for the record and 4 \ngive any comments he'd like to.   5 \nDr. Ruiz.   Congressman Dr.  Raul Ruiz, ranking member for the Select 6 \nSubcommittee on the COVID Pandemic.  Nice to meet everybody.   7 \nDr. Fauci.   Thank you.   8 \nMr. Schertler.   Likewise.  9 \nDr. Fauci.   Good to see you.   10 \nDr. Ruiz.   It's always wonderful to see you and even more pleasurable to hear 11 \nyou speak in the interplay between the art and science of medicine and of public health.  12 \nIt is poetry to my ears.  And I appreciate you, your knowledge, your wisdom, and the 13 \nenormous amount of contributions that you have given to our Nation.   14 \nAs I've said before in previous hearings in the Energy and Commerce Committee, 15 \nyou are the doctor's doctor.  And many medical students today still aspire to make such 16 \nan impact not only for our country but for the world as you have done in your career.  17 \nAnd we recognize it, we see it, and we wholeheartedly appreciate it.   18 \nDr. Fauci.   Thank you.   19 \nDr. Ruiz.   I also want to say that I am truly sorry for the incredible negative 20 \nexperience that you have undergone through the intimidation, the threats, the political 21 \nviolence on you and your family.   22 \nI think it's important that we share the humanity and the lack thereof of these 23 \ntype of inquiries and agenda -pursuing crusades that really cause distress, not only for the 24 \nindividual that's being targeted but for their entire family.   25 \n\n  \n  222 \nAnd so I see it, and I empathize.  And I want to make sure that you're okay, your 1 \nfamily is okay, and that you continue to be the wonderful Dr.  Fauci that you are for 2 \nhumanity.  And I appreciate that.   3 \nDr. Fauci.   Thank you.   4 \nDr. Ruiz.   I have some questions that are in the line of health inequities and some 5 \nquestions on the current uptick of COVID -19 cases that we're currently seeing.   6 \nAs you know, the Democrats on our committee have been laser focused on 7 \nputting people over politics and finding real solutions with thoughtful questions that can 8 \nactually lead to preventing and preparing for the next pandemic, which is inevitably going 9 \nto happen.   10 \nAnd so we want to be able to really align ourselves with the true intent of our 11 \npurpose, which is to save lives, and through a lessons learned, and not pursue an extreme 12 \npartisan crusade vilifying individuals like yourself and other public health officials for 13 \npartisan political gain.   14 \nSo looking back on the most severe period of the COVID -19 pandemic, it is 15 \nabundantly clear that the virus took a heavier toll on different communities across our 16 \npopulation.  For example, people of color, people with less income, people with 17 \ndisabilities, LGBTQ+ people, and other marginalized populations experienced greater 18 \nmorbidity and mortality from COVID -19.   19 \nSo I'd like to discuss these health inequities in more detail.   20 \nWhat do we know about the pandemic's disproportionate impact on communities 21 \nof color in the United States?  And how and why was this the case?   22 \nDr. Fauci.   There were two reasons for that.  One was the initial risk of getting 23 \ninfected.  The other  -- well, actually, probably three reasons.  The initial risk of getting 24 \ninfected.  The inequities of access to healthcare.  And the underlying conditions that 25 \n  \n  223 \npeople of poor economic status and people who are in disenfranchised groups, such as 1 \nsome of the minorities.   2 \nIf you take point number one, that if you look at the  -- you know, it's dangerous to 3 \ngeneralize, but this, I think, is a generalization that helps you to understand the situation, 4 \nthat people of color and somewhat more less economically privileged people generally 5 \nhave jobs that necessitate for their economic survival that they are out in the community.  6 \nThey have essential jobs.  They can't sit behind a computer and continue to do their job 7 \nvirtually.  So they are the ones that are out there getting infected more.   8 \nThen, when they do get infected, when you have people of color and other 9 \nindividuals who are less fortunate to have access to healthcare, that when they do get 10 \nsick they don't have the immediate access of getting the kind of care that you would 11 \nexpect them to get, and often they don't get the care until they have an advanced 12 \ndisease.   13 \nThen the third one is that there are underlying conditions that African Americans 14 \nand some Latinos and certainly some Native Americans and others have a higher 15 \nincidence of the underlying conditions, that when you do get infected it makes you 16 \nstatistically more likely that you're going to have a poor outcome with hospitalizations 17 \nand deaths.   18 \nTo name a few, you have obesity, you have hypertension, you have chronic renal 19 \ndisease, you have chronic lung disease, you have cardiovascular disease, all of which 20 \ndisproportionately, due to the social determinants of health, are in individuals not 21 \nbecause of their race or their ethnic origin; it has to do with the social determinants of 22 \nhealth that have not allowed them to have proper diet, to have proper healthcare when 23 \nthey were younger, a whole variety of things.   24 \nSo three compelling and conflating reasons why the results that you talk about are 25 \n  \n  224 \ntrue.   1 \nDr. Ruiz.   And one of those that comes to mind, given that my first home was in a 2 \ntrailer park, is overcrowded housing with multifamilies  --  3 \nDr. Fauci.   Right.   4 \nDr. Ruiz.   -- living due to issues of poverty, et cetera.  And so that increased the 5 \nrisk of transmissions within households of people of lower income.   6 \nAnd so how about, do you have other examples of this disparity in people with 7 \nless income despite race?   8 \nDr. Fauci.   Oh, yeah.  I mean, of an individual with less incomes, I think you 9 \nmentioned one of them, housing.  And you're not going to have somebody that has their 10 \nown apartment with two bedrooms; you're going to have somebody that's living with 11 \ntheir grandparents, with their parents, and with their children.   12 \nAnd that is one of the reasons why when you have a multigenerational home that 13 \nthat's almost like a perfect storm for getting a lot of different people infected.   14 \nAlso, they may not be able to afford tests.  They may not be able to afford any of 15 \nthe things that are not available to be free.  So whenever you get away from 16 \ngovernment supplying things free, you're going to wind up who's going to suffer the most 17 \nfrom them and those who are less economically privileged.   18 \nDr. Ruiz.   Another example that comes to mind is people who cannot afford 19 \ninternet.   20 \nDr. Fauci.   Right.   21 \nDr. Ruiz.   And when you have to register online to get your vaccine dose or for an 22 \nappointment, they're at a disadvantage to get that, those services.   23 \nSo how about people with disabilities, can you discuss some of their barriers and 24 \nrisks?   25 \n  \n  225 \nDr. Fauci.   Yeah.  I mean, disability is just access.  I mean, how do you  have 1 \nsomebody to get you to a drugstore, to get you to a clinic.  Again, it's all part of the 2 \nconstraints on equal access, and people with disabilities, in many respects, don't have 3 \nequal access.   4 \nDr. Ruiz.   And LGBTQ+ people?   5 \nDr. Fauci.   Well, that's stigmatization, and stigmatization is the enemy of public 6 \nhealth.  So the LGBT community suffers from that.   7 \nDr. Ruiz.   By not being  -- can you elaborate more on the stigmatization?   8 \nDr. Fauci.   Yeah.  I mean, there are some physicians, unfortunately, healthcare 9 \nproviders who don't want to treat individuals who are LGBT.  So that makes them often 10 \nnot even wanting to come out and open as to who they are because of the stigma 11 \nassociated with it.   12 \nDr. Ruiz.   Okay.  Are there other marginalized populations who bore the brunt 13 \nof the pandemic that we haven't addressed?   14 \nDr. Fauci.   I think we've covered most of them, yeah.   15 \nDr. Ruiz.   Okay.  And how have COVID -19's disproportionate impacts on 16 \nmarginalized communities compared to those of other outbreaks and pandemics?  So 17 \nhow did this elucidate the disparities in death and morbidity compared to other 18 \npandemics?  Were they similar in previous pandemics, or was this more pronounced?   19 \nDr. Fauci.   You know, I think that this was more pronounced because of the 20 \nmagnitude of it and the issues that are associated with access to healthcare was rather 21 \nalmost a tsunami of that, as opposed to a much less impactful outbreak.   22 \nThere always was an underlying lack of access.  I'll give you an example that I 23 \nknow you're familiar with.   24 \nWhen you were thinking about HIV, where you have, you know, 13  percent of the 25 \n  \n  226 \npopulation is African American and 45  percent of all the new infections are among African 1 \nAmericans, they don't have access for a number of reasons.  2 \nOne, LGBTQ status is not as much accepted in the African American community as 3 \nit is in the general population.  There's an incredible amount of discrimination against 4 \npeople that makes them not seek out healthcare.  They live in  usually an economically 5 \nless privileged group.   6 \nSo I think when you look at AIDS disproportionately affects ethnic groups more, it 7 \nhas a lot more to do than differences in sexual behavior for sure.   8 \nDr. Ruiz.   And so what kinds  -- I know this is a big, big question  -- but what kinds 9 \nof systemic reforms to the U.S. healthcare system are necessary to reduce the threat of 10 \nfuture outbreaks and pandemics to historically marginalized communities?   11 \nDr. Fauci.   Well, I think it's building up of the health  -- the local healthcare 12 \nsystem, particularly in those areas that are populated predominantly by people of color.   13 \nI mean, we were discussing at yesterday and maybe even part of today the 14 \nimportance of the attenuation of the healthcare infrastructure locally.   15 \nAnd many of the neighborhoods that people of color live in, they don't have good 16 \nhealthcare infrastructure to begin with, and when you have an attenuation of healthcare 17 \ninfrastructure it affects that population even more.   18 \nDr. Ruiz.   Can you be a little more specific in terms of healthcare infrastructure 19 \njust for the record?   20 \nDr. Fauci.   I'm talking about health clinics.   21 \nDr. Ruiz.   Clinics.   22 \nDr. Fauci.   I'm talking about clinics, clinics, pharmacies that are in neighborhoods.   23 \nDr. Ruiz.   Okay.   24 \nDr. Fauci.   Yeah.   25 \n  \n  227 \nDr. Ruiz.   Infrastructure can also be interpreted as human capital  --  1 \nDr. Fauci.   Yes.   2 \nDr. Ruiz.   -- the providers and nurses and  --  3 \nDr. Fauci.   When I said infrastructure I mean not only clinics and pharmacies but 4 \nthe people who are out there who go into the community to help.   5 \nDr. Ruiz.   So when people that go out there that go into the community to help, 6 \nyou're referring to community health workers?   7 \nDr. Fauci.   Yes.   8 \nDr. Ruiz.   Okay.  And so how can we incorporate, in your thoughts, how can we 9 \nincorporate community health workers into our healthcare system to prevent the 10 \ndisparities not just in a future pandemic but even now?   11 \nDr. Fauci.   To support them.  To support them.  To give them status that 12 \nwould attract people to that particular avocation as opposed to making it not an 13 \nattractive occupation.   14 \nDr. Ruiz.   Okay.  And now to bring a big question even bigger, what about 15 \nsystem reforms outside of our healthcare system, such as reforms to our economic 16 \nsystems, transportation systems, and more?   17 \nDr. Fauci.   Yeah.   18 \n[Laughter.]  19 \nDr. Fauci.   Yeah, I mean, transportation is one important one.  If you look at the 20 \nability of somebody to get to a doctor's office or to get to a clinic, to get to a testing site, 21 \nit is much less likely that a population that we're referring to now, people of color and 22 \nothers, that they don't have the capability or the resources to get to where they need to 23 \nget to get the proper healthcare.   24 \nDr. Ruiz.   What about the concept of taking the care to the people?   25 \n  \n  228 \nDr. Fauci.   Yeah.  That's what I  -- one of my favorite topics is to go into the 1 \ncommunity and to support financially and resource -wise actually getting clinics and 2 \nphysicians at the community level.   3 \nAnd you can incentivize at multiple levels.  You know that all, but I'll say it for the 4 \nrecord.  You could incentivize from the level of medical school and post -medical school 5 \ntraining to make it much more attractive for people to go into community work as 6 \nopposed to, you know, having an office on K Street.   7 \nDr. Ruiz.   Yeah.   8 \nSo now I'll talk about the uptick in COVID -19 cases, the current one.  As we have 9 \nobserved in the past year, the U.S. is currently experiencing a seasonal uptick in 10 \nCOVID -19 cases.   11 \nCould you explain the reasoning for this trend of higher case numbers during the 12 \nlate fall and winter season?   13 \nDr. Fauci.   Any respiratory infection is always much more likely to occur in a 14 \nsituation where you have cold weather that brings people in together in a room where 15 \nthe ventilation is not particularly good.   16 \nI think, if you superimposed upon that, is that COVID, even without seasonal blips, 17 \nis present all the time.  It's  -- you know, we would've assumed incorrectly that it was a 18 \nseasonal virus from the beginning, expecting that maybe it would go away.  That turned 19 \nout -- the first glimpse of warm weather in April and May proved to be absolutely not the 20 \ncase.   21 \nBut when you start off at a higher baseline and then you go into a winter season, it 22 \ndoes this [indicating].  And if you look at the end of the summer, the number of cases 23 \nper day  -- the number of deaths.  I don't think we can count cases, because the case 24 \ncounts are all off because tests are no longer reported.  So you can measure it from 25 \n  \n  229 \nwastewater for cases and hospitalizations and death.   1 \nThen we had a low level of less than a hundred deaths per day, it was like 70, 50, 2 \nsomething like that.  It's now over 200 as of yesterday.  So here we are in January and 3 \nit's gone way up.   4 \nThankfully, it hasn't gone up to what it was at the peak of the outbreak, when it 5 \nwas 4,000 to 5,000 per day.   6 \nDr. Ruiz.   So I understand the need to coalesce in warmer venues to be out of the 7 \ncold, and therefore the proximity of individuals increases the potential for transmission.   8 \nIs there anything innate in the virus itself that thrives more in cold and wet 9 \nweather?   10 \nDr. Fauci.   Yeah.  Yeah.  I mean, viruses generally, in the survival of the aerosol 11 \nand what have you, do much, much better in cold, dry weather than they do in warm, 12 \nmoist weather.  That's just a function of most respiratory viruses.   13 \nDr. Ruiz.   Okay.  And is this a trend we should continue to expect annually?   14 \nDr. Fauci.   Yes, I think that's the case.  Again, but just with the caveat, Raul, 15 \nthat, yes, you could expect it, but don't expect that in the summer COVID is going to go 16 \naway.   17 \nDr. Ruiz.   Yes, correct.   18 \nDr. Fauci.   Yeah, right.   19 \nDr. Ruiz.   And what steps should the Federal Government be taking annually to 20 \nprepare for the trend of seasonal upticks?   21 \nDr. Fauci.   Yeah.  I think that one is, you know, continue the supply of testing, 22 \nmaking sure that we don't have a diminution in accessibility of testing.   23 \nBut also, as we mentioned yesterday and today, I think we've got to really take 24 \nseriously ventilation, so that when people are indoors in the cold weather there's a 25 \n  \n  230 \ndegree of ventilation, you know.  That's both natural ventilation of getting good air flow 1 \nas opposed to confined, but also things like HEPA filters in places that are classrooms or 2 \nassembly halls or what have you.   3 \nDr. Ruiz.   And what is your assessment of the risk of this current uptick poses to 4 \nAmericans?   5 \nDr. Fauci.   You know, I don't think that you're going to see the kind of 6 \nArmageddon -type approach that we saw back when we were having 5,000 deaths per 7 \nday, but I think you're going to see deaths and hospitalizations that should be 8 \ntroublesome to us.   9 \nOne of the things about COVID or any disease that you have for a long time past 10 \nthe -- we're now in our fifth year of COVID.  I mean, we were talking over the last 2  days 11 \nabout the unprecedented nature of certain things, the speed of vaccines, et cetera.   12 \nIt is unprecedented to have a 5 -year season, is what we've had.  You know, we 13 \nhave influenza seasons, you know, it starts at the end of November, peaks in January, it 14 \ngoes away in March, and then you're good for the rest.  That's not the case.   15 \nSo what I'm concerned at is that there's a complacency around that we're done 16 \nwith COVID.  But when you look at the fact that you have now almost 200 or more 17 \ndeaths per day, and you do the math on that and you compare it, that the mortality is 18 \nmuch greater in COVID than it is with influenza.   19 \nAnd influenza itself, as you know as a physician, is a bane in the existence of the 20 \nelderly, the infirm, et cetera.  You multiply that multiple -fold, and we still have to worry 21 \nthat the vulnerables are going to get into trouble.   22 \nThe other thing is that you always got to factor in long COVID, because people say, 23 \nwell, you know, I'm 30  years old, I'm fine, I can get infected, no problem, I'll get a sore 24 \nthroat, I'll blow my nose, and I'll be okay.  You could still wind up getting long COVID.   25 \n  \n  231 \nSo the idea that we have this much COVID going on right now is troublesome to 1 \nme.   2 \nDr. Ruiz.   So in addition to that, now that the public health emergency has 3 \nconcluded, what adjustments are necessary for the Federal Government to respond to 4 \nthese seasonal upticks?   5 \nDr. Fauci.   Yeah.  You know, that's not my lane as a physician.  But I think the 6 \nthings that disappear when you have an emergency go away, there are still people who 7 \nwere depending on the things that you got from an emergency who still are dependent 8 \non them, drugs, tests, or what have you.   9 \nDr. Ruiz.   Right.  So one of the more apt metaphors I've heard when it comes to 10 \nCOVID -19 mitigation measures are the comparison between a light switch that just turns 11 \non and off and a light switch that brightens and dims, which is to say that there will be 12 \ntimes Americans should consider taking greater precautions, such as masking, to reduce 13 \nthe threat of COVID -19.   14 \nWhen we observe upticks in cases due to changing seasons or new variants, what 15 \nsteps should Americans take to protect themselves and their loved ones?   16 \nDr. Fauci.   I think we're starting to see it right now, as we were having no masks 17 \nthat are required in medical centers until now, if you look across the country, it's sort of 18 \nlike a domino effect of the facilities.  They're requiring, if you're going to come into a 19 \nhealthcare facility with people at risk, you're going to wear a mask.   20 \nAnd I think we need to realize that we're not talking about, you know, draconian 21 \nmeasures, but we're talking about just what you said, as you get an uptick in cases, you've 22 \ngot to adjust accordingly.   23 \nDr. Ruiz.   Thank you.   24 \nDr. Fauci.   Yeah.   25 \n  \n  232 \n  I believe Congresswoman Dingell had a discrete item.   1 \nMrs. Dingell.   I have one question.   2 \nOne of our colleagues tweeted that you've had the best year of your life this last 3 \nyear, after you left here.  And I looked at them and said, \"He's been living in hell.\"   4 \nWould you care to comment?   5 \nMs. Castor.   It was COVID was the best year of your life.   6 \nMrs. Dingell.   Was it COVID?  I didn't even see the actual tweet.  But they said 7 \nyou've been living the best year.   8 \nI think your life has been a living hell.  Do you care to comment on that tweet?   9 \nDr. Fauci.   Are they talking about this past year, or are they talking about the 10 \nyear  -- the COVID year?  Why were they saying it was the best year of my life, because I 11 \nsomehow  --  12 \nMs. Castor.   You got a lot of media attention.   13 \nDr. Fauci.   So that's what they're referring to.   14 \nMs. Castor.   I'm not sure.   15 \nMrs. Dingell.   Is that media attention  --  16 \n  There was a tweet suggesting that your salary increased during 17 \nthe year that COVID -19 took hold, 2020, and that it was the highest it was in 2020, and 18 \nthat that was therefore a predicate for  it being the best year of your life.   19 \nDr. Fauci, do you believe that 2020 was the best year of your life?   20 \nMr. Schertler.   Can you tell us who tweeted?   21 \n  Congressman Michael Cloud.   22 \nMrs. Dingell.   And my actual reaction was, \"His life has been a living hell.\"   23 \nDr. Fauci.   Well, it was.  I mean, 2020 was one of the worst years of my life.  I 24 \nthink it was comparable to the first few years of HIV.   25 \n\n  \n  233 \nMrs. Dingell.   Which I remember.   1 \nDr. Fauci.   Yeah.   2 \nMrs. Dingell.   Why don't you elaborate on that just so we can have it on the 3 \nrecord, so everybody knows what  -- yeah.   4 \nDr. Fauci.   No, I mean, for months and months I was sleeping  4 hours a day.  My 5 \nwife was on me all the time about making sure you drink water and you go to sleep and 6 \nyou eat.   7 \nThat was really tough, because of the burden of seeing this emerging outbreak 8 \nthat you were responsible for developing a vaccine and you had to do it and you had to 9 \ndo it right.   10 \nAnd then I was also  -- my clinical responsibilities was also  -- I didn't see as many 11 \npatients as I used to see when I was more on the wards than as running an institute.  12 \nBut also, we had patients that were, you know, obviously people who were  -- and all 13 \nhealthcare providers were similarly traumatized by that.   14 \nBut then what really put the cap on it is with the point that you brought up, is that 15 \nin the middle of all this, all of a sudden I became the villain number one of the extremists 16 \nin the population.   17 \nSo to say that it was the best year of my life is completely crazy.  And I don't 18 \nknow what they're talking about my salary.  My salary is not determined by me.   19 \nAnd that was another thing that was ridiculous, the attacks that I had on me that, 20 \nyou know, I made money out of the  -- what are they talking about?  Does anybody know 21 \nanything about the government?  How do you make money out of an outbreak?   22 \nSo, yeah, it was one of the worst years of my life.   23 \nMrs. Dingell.   And I do know you.  I first met you  -- I don't want to say how long 24 \nago because it was a long time ago  -- when you were working on HIV/AIDS, and I was 25 \n  \n  234 \nworking at Children's Inn at NIH, and the young patients.  I remember the tears in your 1 \neyes as you were worried about children dying.   2 \nAnd there was  -- you gave people hope when there was no hope.  When I first 3 \nmet you people were dying.  It was a death.  And I remember your reaction.  So I 4 \njust -- and I remember how bad that was.   5 \nSo I wanted you to comment on that.  Thank you.   6 \nDr. Fauci.   A Congress man tweeted that?   7 \nMs. Castor.   Yeah.   8 \nDr. Fauci.   Jesus.   9 \nBY   10 \nQ Dr. Fauci, if you will bear with me, I just want to quickly revisit the topic of 11 \nvaccine requirements and the different kinds of immunity just to make sure the record is 12 \ncomprehensive there.   13 \nOn numerous different occasions the select subcommittee has examined the issue 14 \nof COVID -19 vaccine requirements.   15 \nBriefly, could you just explain for us the premise of COVID -19 vaccine 16 \nrequirements and how they were implemented across the country?  17 \nA How they were implemented?   18 \nQ Yes.   19 \nA I want to make sure I understand your question.   20 \nQ Yes.   21 \nA Could you just say it again?  22 \nQ Yes.  So with respect to vaccine requirements, as I understand it, 23 \noftentimes people were given an opportunity to either get the vaccine or take other 24 \nmitigation measures to ensure that they could reenter common spaces  --  25 \n\n  \n  235 \nA Right.  1 \nQ -- safely and reduce the risk of transmitting the virus.  Is that consistent 2 \nwith your understanding?   3 \nA Yes, that was.   4 \nQ And across the board, as we look at the different vaccine requirements that 5 \nwere put into place in 2021, could you just briefly describe for us how successful those 6 \nwere in encouraging uptake of the COVID -19 vaccine?  7 \nA They were successful.  I mean, a lot of people got vaccinated that perhaps 8 \nwould not have gotten vaccinated.   9 \nQ We've heard suggestions in the select subcommittee that vaccine 10 \nrequirements were not evidence -based and that they were in defiance of the 11 \npatient -physician relationship.   12 \nDr. Fauci, you are a trained physician, and you, yourself, have practiced medicine.  13 \nAs a trained physician, what do you make of the criticism that vaccine requirements 14 \ninterfered with the patient -physician relationship?  15 \nA Well, first, I believe strongly that a patient -physician relationship is very, very 16 \nimportant.  But I think that it's not incompatible with a patient -physician relationship 17 \nunder certain circumstances to require vaccinations.   18 \nI mean, I think, if you look at the success of protecting our children in school 19 \nwhere there's a requirement for vaccination in school, I don't think that every single child 20 \nwho gets vaccinated gets a permission, as it were, from somebody to get vaccinated.  21 \nThe physicians accepted that and accepted it readily, and it led to the saving of a lot of 22 \ndisease in children.   23 \nSo I don't think they're in  -- they're not  -- I mean, it isn't all or none.  It isn't as if 24 \nyou do that then you're destroying the patient -physician relationship.  I don't think that 25 \n  \n  236 \nthat's necessarily the case.   1 \nQ Great.   2 \nIn various cases examining different vaccine requirements, major medical 3 \nsocieties filed briefs demonstrating their support for vaccine requirements.  For 4 \nexample, in BST Holdings v. OSHA, the American Medical Association filed an amicus brief 5 \nwarning that halting enforcement of Federal vaccine requirements would, quote, 6 \n\"severely and irreparably harm the public interest,\" end quote.  And the AMA also filed 7 \nsimilar briefi s in Kentucky v. Biden and Georgia v. Biden.   8 \nDr. Fauci, does the AMA's support for these policies suggest that the physician 9 \ncommunity generally supported vaccine requirements?  10 \nA I believe that it does indicates that, yes.   11 \nQ And would you characterize COVID -19 vaccine requirements as 12 \nevidence -based policies?   13 \nA You know, historically when you require  -- I mean, I just gave you an 14 \nexample of it, so that's for the record, was the school.  I mean, the children are 15 \nprotected.  You don't  -- when the vaccines of a certain disease like measles go down, 16 \nyou have outbreaks and children suffer.  17 \nQ And just quickly on the  --  18 \nDr. Ruiz.   Can I  follow up on that?   19 \n  Of course, please.   20 \nDr. Ruiz.   Are there studies that demonstrate States that had vaccine 21 \nrequirements versus States that don't  -- didn't have vaccine requirements and the 22 \ndifference in reducing transmission and reducing mortality from COVID?   23 \nDr. Fauci.   Yeah, mostly hospitalization and mortality, yeah.  It's a little bit more 24 \ntough to demonstrate", "summary": "Official transcript, Part 2 of Anthony Fauci's transcribed interview before the House Select Subcommittee on the Coronavirus Pandemic.\n\nExcerpt: Cameron asked me to come to the Executive Office Building and was just asking me 12  scientific questions, and I remember that.   13  There may have been other times when I was asked by people in the White  House 14  framework of security.  15  But the one  -- the thing that I do remember is the briefing of Beth Cameron and 16  her team in the Security Council.   17  Q A whistleblower came forward to this committee, and according to him, you 18  visited CIA headquarters and assisted the CIA in their investigation.   19  A Right.  20  Q Have you ever been to the CIA headquarters?  21  A I have been to the CIA headquarters several years ago, I believe during either 22  the anthrax attacks or something.  And I went there, I believe, with one of the other 23  scientists.  I forgot who it…", "source_url": "https://oversight.house.gov/wp-content/uploads/2024/05/Fauci-Part-2-Transcript.pdf", "pdf_url": "/archive-docs/fauci-files/5d2a4d9c67a0adfae432c247137247c2/pdf", "doc_date": "2024-01-09", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "transcribed interview", "house oversight", "select subcommittee", "coronavirus pandemic", "congress", "fauci testimony", "hearing transcript", "testimony-house-2024-jan-part2"], "part_number": 2, "page_count": 246}
{"title": "Fauci Transcribed Interview — House COVID Subcommittee, Part 2 (9 Jan 2024) (Part 3 of 3)", "content": "transmission because you have to have everybody tested, and that 25 \n\n  \n  237 \nwas one of the things.  But clearly in hospitalizations and death.   1 \nDr. Ruiz.   So there was clear evidence  --  2 \nDr. Fauci.   Yeah.   3 \nDr. Ruiz.   -- that vaccination requirements  --  4 \nDr. Fauci.   Right.  5 \nDr. Ruiz.   -- was a protective measure that had population outcomes benefiting 6 \nsaving people's lives?   7 \nDr. Fauci.   I don't  -- I can't quote the studies, but, you know, my recollection is 8 \nthat that's the case.   9 \nDr. Ruiz.   Okay. 10 \n  \n  238 \n 1 \nBY   2 \nQ We have also heard suggestions that vaccine requirements were 3 \nimplemented in a manner that did not appropriately take into account people who had 4 \nacquired immunity via infection.   5 \nAs I understand it, just succinctly, there are different kinds of immunity, including 6 \nvaccine -conferred immunity, infection -acquired immunity, and hybrid immunity.   7 \nIn the last round you discussed this topic, but for the record could you just confirm 8 \nfor us that hybrid immunity, immunity that is conferred both from vaccination and from 9 \nprior infection, offers greater protection to COVID -19 patients than infection -acquired 10 \nimmunity alone?   11 \nA That is true.  For the most part, that's true.  I mean, as a group.  You're 12 \ngoing to find individuals where maybe somebody got a response with natural immunity 13 \nand someone had acquired immunity and they were not as good an immune response.   14 \nBut when you look at a large group of cohort , that hybrid immunity clearly is 15 \nbetter than just immunity from infection, and it's also better than just vaccine.   16 \nQ And in your assessment, did COVID -19 vaccine requirements pose any threat 17 \nto the health of people who had already been infected with COVID -19?  18 \nA No.  No, no.  No evidence at all that vaccinating someone who's been 19 \ninfected and recovered from infection has a negative impact on their health.  20 \nQ Okay.   21 \nBY :  22 \nQ Dr. Fauci, I'm not going to belabor the points that I'm going to make, but 23 \nyou've said throughout the 2 days that we've been here that clear and consistent 24 \ncommunication by public officials is important in addressing the pandemic, correct?  25 \n\n  \n  239 \nA Correct.  1 \nQ And do you think that it can be harmful for public officials to downplay the 2 \nrisks of the virus?  3 \nA Yes.  Yes, of course.   4 \nQ I'm going to go through a couple of statements that were made, and I just 5 \nwant to get your take on them.   6 \nOn January  22nd, 2020, President  Trump said during a CNBC interview, quote, 7 \n\"We have it totally under control.  It's one person coming in from China, and we have it 8 \nunder control.  It's going to be just fine,\" end quote.   9 \nAgain, this was on January  22nd, 2020.   10 \nAt that time, did you agree with that statement from President  Trump?   11 \nA I was concerned about it saying it was under control because of the way 12 \noutbreaks behave.  They start off under the radar screen, and you don't really know if 13 \nyou have it under control.  That's something that was an unknowable at the time.   14 \nQ Similarly, on February 27th, 2020, President  Trump stated, quote, \"It's going 15 \nto disappear.  One  day -- it's like a miracle  -- it will disappear,\" end quote.   16 \nDid you agree with that statement by President  Trump?   17 \nA No.  And I think I  -- that was one of the times when I had to publicly 18 \ndisagree with the President, which started the ball rolling.   19 \nQ Do you think that this statement harmed America's response to the 20 \npandemic by downplaying public concern?   21 \nA Yeah.  I think that if the President had said that, you know, we really have a 22 \nproblem here and we've really got to address it in a reasonable way, you know, by taking 23 \nprecautions, a lot more people would have done things like wear a mask and take 24 \nappropriate precautions.  25 \n  \n  240 \nDr. Ruiz.   And, therefore, would you say a lot more people's lives would've been 1 \nsaved?   2 \nDr. Fauci.   No, I don't want to quantitate that, Raul, because then that gets taken 3 \nout of context in a sound bite, and I don't want to do that.   4 \nBY   5 \nQ My colleague on the Republican side forecasted this one to you.  But on 6 \nApril  23rd, 2020, President  Trump stated, quote, \"I see the disinfectant where it knocks it 7 \nout in a minute, 1  minute.  And is there a way we can do something like that by injection 8 \nor almost a cleaning?  Because, you see, it gets in the lungs and it does a tremendous 9 \nnumber on the lungs, and so it would be interesting to check that,\" end quote.   10 \nDo you agree with President  Trump that injecting disinfectant would've been a 11 \nlegitimate way to treat COVID -19?   12 \nA No.  13 \nQ And if people were to do that, the result could very likely be death, correct?  14 \nA Correct.   15 \nQ I want to compare some of these statements to statements that the 16 \nPresident made more privately.   17 \nOn March  19th, 2020, President  Trump said to Robert Woodward about the risk of 18 \nthe virus, quote, \"I wanted to always play it down,\" end quote.  19 \nDo you think that playing down the risks of a virus is a responsible strategy?  20 \nA I've said that publicly, that that's one of the reasons why I spoke out against 21 \nthat.   22 \nQ At the time, did you feel like the public officials could've been making 23 \nstatements that were more helpful to the response?  24 \nA Well, one of the things I would've hoped was that the President would have, 25 \n\n  \n  241 \none, encouraged people to wear a mask and to do more social distancing.  I think the 1 \nidea of not wanting to wear a mask sent a signal out to people that it's not a good idea to 2 \nwear a mask.  And that's one of the ways I think it could've helped, because leadership 3 \ncounts.   4 \n  And with that, I think that's a great place to end.  Thank you.   5 \nMs. Castor.   So bringing us back to today, in this Congress, thank you very much 6 \nfor, during these long 2  days, going through lessons learned with some recommendations 7 \nfor all of us.   8 \nBut I don't think we can lose sight of COVID -19, 1.4  million American  death s to 9 \ndate are the estimates.  And we just have to do everything we can to prevent that kind 10 \nof epidemic, pandemic again.   11 \nYou've said, you advised us, act now, before the fact.  Don't chase an outbreak.  12 \nAnd even Chairman Wenstrup said, he said that he'd been in a war, and in a war, 13 \nsometimes you don't have what you need to protect yourself.  But that means when our 14 \ntroops come home you surely make sure that they have what's necessary to protect 15 \nthemselves, to protect us for the next war.   16 \nSo right now, there are some debates in Congress over legislation that could help 17 \nprepare us.  One is, we've been trying to work with our Republican colleagues on the 18 \nreauthorization of PAHPA.   19 \nPAHPA is the Pandemic and All -Hazards Preparedness Act.  It's intended to 20 \nimprove the Nation's public health and medical preparedness and response capabilities 21 \nfor emergencies, whether deliberate, accidental, or natural.   22 \nOne of the critical pieces of PAHPA is the authorization of the Strategic National 23 \nStockpile.  Right now, it has expired.  That stockpile, as you're well aware, is intended 24 \nto contain lifesaving supplies, resources, and medicines that can be deployed at the 25 \n\n  \n  242 \nmoment a crisis hits.   1 \nDo you agree that the Strategic National Stockpile is an important part of our 2 \nlarger public health preparedness?   3 \nDr. Fauci.   Yes.   4 \nMs. Castor.   And during the COVID -19 pandemic, the resources and supplies 5 \nwithin the National Stockpile were critical to responding to COVID -19?   6 \nDr. Fauci.   Correct.   7 \nMs. Castor.   Do you agree that it is important that the Strategic National 8 \nStockpile properly be reauthorized and well resourced so that we can ensure that we are 9 \nprepared for future pandemics?   10 \nDr. Fauci.   Yes.   11 \nMs. Castor.   What would the impact of a weakened stockpile, Strategic National 12 \nStockpile, be on our ability to address future emergencies?   13 \nDr. Fauci.   It would hinder our initial response.  If you have to play catchup with 14 \na stockpile then you're behind  the game to begin with.   15 \nOne of the most important reasons that the concept of the stockpile was 16 \ndeveloped years ago was that we could just hit the ground running if you wind up with an 17 \nemergency.  And if you deplete that and the next emergency comes and you don't 18 \nreplete it, then you have a problem.   19 \nMs. Castor.   Failure to reauthorize PAHPA has also meant that the public health 20 \nemergency preparedness grants have also been allowed to expire.  Those are the grants 21 \nthat support our local communities back home and States and territorial health 22 \ndepartments in preparing for and responding to public health emergencies, be it from 23 \ninfectious diseases or natural disasters or other emerging threats.   24 \nAre those kind of resources for States and local communities  -- well, let me first 25 \n  \n  243 \nask, were they vital  --  1 \nDr. Fauci.   Yes, yeah.   2 \nMs. Castor.   -- in the early days of the pandemic?   3 \nDr. Fauci.   Yes, they were, of course.   4 \nMs. Castor.   And why is it important to have consistent, stable resources in 5 \npartnership with State and local jurisdictions to ensure that we're able to tackle a public 6 \nhealth crisis?   7 \nDr. Fauci.   Because, as I mentioned in my previous discussions, that it is very 8 \nimportant to have at the local public health level the capability of responding.   9 \nMs. Castor.   In real time.   10 \nDr. Fauci.   Immediately.   11 \nMs. Castor.   Immediately.  That saves lives.   12 \nDr. Fauci.   Right.   13 \nMs. Castor.   Does it save money if we have those things ready to go?   14 \nDr. Fauci.   Ultimately, it does.  I mean, it's just the same as what we were 15 \ntalking about with the Commonwealth Fund data that showed that if, you know, 3 million 16 \ninfections were prevented  -- excuse me, 3 million deaths were prevented, 18 million 17 \nhospitalizations were prevented, and with that $1.19  trillion was saved.   18 \nMs. Castor.   So this Congress has been marked, people will look back on it by 19 \nshutdowns, threats, and showdowns.  September  30th was the end of the last fiscal 20 \nyear, and here we are in early January and there's no  -- appropriations bills have not been 21 \nfinalized.   22 \nSo there are  -- you're used to these debates over appropriations in the Congress.  23 \nIt would seem that one thing we should be able to come together and agree on in the 24 \nwake of the deadliest pandemic we've ever lived through is making sure not just PAHPA is 25 \n  \n  244 \nreauthorized and we incorporate the lessons learned, but that we make sure that we are 1 \nnot cutting our ability to investigate health concerns.   2 \nI'm concerned that the majority has forced a lot of these cuts on the American 3 \npeople that are going to ultimately cost us money, cost us lives.   4 \nDr. Fauci's former institute, NIAID, received $836  million from the first COVID -19 5 \nsupplemental for COVID -19 research, but cuts that Republicans demanded in the Fiscal 6 \nResponsibility Act rescinded all of those unobligated balances.  In total, the FRA will 7 \nhave the effect of cutting $500  million from NIH's budget.   8 \nWhat would the effect be if this is where we end up, with a budget of $500  million 9 \nof cut to NIH's budget, and specifically NIAID?   10 \nDr. Fauci.   That would really be catastrophic to NIAID.  I mean, if I were the 11 \ndirector now, as I was back, you know, during the pandemic, I would be deeply concerned 12 \nabout a cut at that level.   13 \nBecause when we responded to COVID, while it was full blown, part of the 14 \nresponse was to create the capability  -- and I mentioned this in response to the majority's 15 \nquestion, to Chairman Wenstrup's question about needing to make more drugs.  We 16 \nneed better drugs against these viruses.   17 \nAnd one of the programs was a drug development program that I established 18 \nright, you know, in the middle of the outbreak not only to give us drugs for the current 19 \noutbreak but to have better drugs for future outbreaks.  I don't see how that program 20 \ncan survive if you cut $500  million.   21 \nMs. Castor.   So thank you very much.  You've provided us a long list of lessons 22 \nlearned, and I think it would be the most constructive way for the select committee and 23 \nfor the Energy and Commerce Committee, would be for all of us to come together and 24 \nwork in a bipartisan way on these not just commonsense but just critical investments in 25 \n  \n  245 \nthe public health for the American people.  So thank you for sharing your expertise.   1 \nDr. Fauci.   You're welcome.  2 \nMs. Castor.   And thank you for your years of service.   3 \nDr. Fauci.   Thank you.  Appreciate it.   4 \nDr. Ruiz.   Thank you.  I'd like to close also by thanking you and your family for 5 \nyour incredible sacrifice throughout the years and your support for the population, but 6 \nalso for every patient that you have taken care of, and to the advancements of truth 7 \nthrough science that you have proposed and the advancements in public health that you 8 \nhave helped elucidate that has had real impacts in saving lives and improving lives of the 9 \nAmerican people.   10 \nI want to thank you for your time here.  I want to thank you for enduring and 11 \nbeing resilient during all the attacks and the intimidations and the threats that you and 12 \nyour family have gone through.  And I want to really thank you for your expertise and 13 \ngiving us a lot to ponder in the lessons learned in how we move forward to protect more 14 \nAmericans.   15 \nNow, I want to wish you luck with the storm out there, both literally and 16 \nmetaphorically, and wish you safe travels back home.   17 \nDr. Fauci.   Thank you, Raul.   18 \nDr. Ruiz.   Thank you.  19 \nDr. Fauci.   Appreciate it.   20 \n  And I think with that, we can go off the record.  21 \n[Whereupon, at 6:33 p.m., the interview was concluded.] 22 \n\n  \n  246 \n   Certificate of Deponent/Interviewee  1 \n 2 \n 3 \n I have read the foregoing ____ pages, which contain the correct transcript of the 4 \nanswers made by me to the questions therein recorded.  5 \n 6 \n 7 \n 8 \n     _____________________________  9 \n      Witness Name  10 \n 11 \n 12 \n     _____________________________  13 \n          Date  14 \n 15", "summary": "Official transcript, Part 2 of Anthony Fauci's transcribed interview before the House Select Subcommittee on the Coronavirus Pandemic.\n\nExcerpt: transmission because you have to have everybody tested, and that 25        237  was one of the things.  But clearly in hospitalizations and death.   1  Dr. Ruiz.   So there was clear evidence  --  2  Dr. Fauci.   Yeah.   3  Dr. Ruiz.   -- that vaccination requirements  --  4  Dr. Fauci.   Right.  5  Dr. Ruiz.   -- was a protective measure that had population outcomes benefiting 6  saving people's lives?   7  Dr. Fauci.   I don't  -- I can't quote the studies, but, you know, my recollection is 8  that that's the case.   9  Dr. Ruiz.   Okay. 10       238   1  BY   2  Q We have also heard suggestions that vaccine requirements were 3  implemented in a manner that did not appropriately take into account people who had 4  acquired immunity via infection.   5  As I understand it, just…", "source_url": "https://oversight.house.gov/wp-content/uploads/2024/05/Fauci-Part-2-Transcript.pdf", "pdf_url": "/archive-docs/fauci-files/5d2a4d9c67a0adfae432c247137247c2/pdf", "doc_date": "2024-01-09", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "transcribed interview", "house oversight", "select subcommittee", "coronavirus pandemic", "congress", "fauci testimony", "hearing transcript", "testimony-house-2024-jan-part2"], "part_number": 3, "page_count": 246}
{"title": "Fauci Public Testimony — House COVID Subcommittee Hearing (3 Jun 2024) (Part 1 of 2)", "content": "U.S. GOVERNMENT PUBLISHING OFFICE\nWASHINGTON : 55–830 PDF 2024 A HEARING WITH DR. ANTHONY FAUCI \nHEARING \nBEFORE THE  \nSELECT SUBCOMMITTEE ON THE CORONAVIRUS \nPANDEMIC \nOF THE  \nCOMMITTEE ON OVERSIGHT AND \nACCOUNTABILITY \nHOUSE OF REPRESENTATIVES \nONE HUNDRED EIGHTEENTH CONGRESS \nSECOND SESSION \nJUNE 3, 2024 \nSerial No. 118–114 \nPrinted for the use of the Committee on Oversight and Accountability \n( \nAvailable on: govinfo.gov, \noversight.house.gov or \ndocs.house.gov \n(II) COMMITTEE ON OVERSIGHT AND ACCOUNTABILITY \nJAMES COMER, Kentucky, Chairman \nJIMJORDAN , Ohio \nMIKETURNER , Ohio \nPAUL GOSAR , Arizona \nVIRGINIA FOXX, North Carolina \nGLENN GROTHMAN , Wisconsin \nMICHAEL CLOUD , Texas \nGARY PALMER , Alabama \nCLAY HIGGINS , Louisiana \nPETE SESSIONS , Texas \nANDY BIGGS, Arizona \nNANCY MACE, South Carolina \nJAKE LATURNER , Kansas \nPATFALLON , Texas \nBYRON DONALDS , Florida \nSCOTT PERRY , Pennsylvania \nWILLIAM TIMMONS , South Carolina \nTIMBURCHETT , Tennessee \nMARJORIE TAYLOR GREENE , Georgia \nLISAMCCLAIN , Michigan \nLAUREN BOEBERT , Colorado \nRUSSELL FRY, South Carolina \nANNA PAULINA LUNA, Florida \nNICKLANGWORTHY , New York \nERICBURLISON , Missouri \nMIKEWALTZ , Florida JAMIE RASKIN , Maryland, Ranking Minority \nMember \nELEANOR HOLMES NORTON , District of \nColumbia \nSTEPHEN F. L YNCH , Massachusetts \nGERALD E. C ONNOLLY , Virginia \nRAJAKRISHNAMOORTHI , Illinois \nROKHANNA , California \nKWEISI MFUME , Maryland \nALEXANDRIA OCASIO -CORTEZ , New York \nKATIE PORTER , California \nCORIBUSH, Missouri \nSHONTEL BROWN , Ohio \nMELANIE STANSBURY , New Mexico \nROBERT GARCIA , California \nMAXWELL FROST , Florida \nSUMMER LEE, Pennsylvania \nGREG CASAR , Texas \nJASMINE CROCKETT , Texas \nDANGOLDMAN , New York \nJARED MOSKOWITZ , Florida \nRASHIDA TLAIB, Michigan \nAYANNA PRESSLEY , Massachusetts \nMARK MARIN , Staff Director \nMITCHELL BENZINE , Subcommittee Staff Director \nMARIE POLICASTRO , Clerk \nCONTACT NUMBER : 202-225-5074 \nMILES LICHTMAN , Minority Staff Director \nCONTACT NUMBER : 202-225-5051 \nSELECT SUBCOMMITTEE ONTHECORONAVIRUS PANDEMIC  \nBRAD WENSTRUP , Ohio, Chairman \nNICOLE MALLIOTAKIS , New York \nMARIANNETTE MILLER -MEEKS , Iowa \nDEBBIE LESKO , Arizona \nMICHAEL CLOUD , Texas \nJOHN JOYCE , Pennsylvania \nMARJORIE TAYLOR GREENE , Georgia \nRONNY JACKSON , Texas \nRICHMCCORMICK , Georgia RAUL RUIZ, California, Ranking Minority \nMember \nDEBBIE DINGELL , Michigan \nKWEISI MFUME , Maryland \nDEBORAH ROSS, North Carolina \nROBERT GARCIA , California \nAMIBERA, California \nJILLTOKUDA , Hawaii \n(III) CONTENTS  \nPage \nHearing held on June 3, 2024 ................................................................................. 1 \nWITNESS  \n* Anthony Fauci, M.D., Former Director, National Institute of Allergy and \nInfectious Diseases \nOral Statement ........................................................................................................ 11 \nWritten opening statements and the written statements of the witnesses are \navailable on the U.S. House of Representatives Document Repository at: docs.house.gov. \nI\nNDEX OF DOCUMENTS  \n* Letter, May 31, 2024, Public Health Associations; submitted by Rep. \nRuiz. \n* Article, The Hill , ‘‘Let’s honor Anthony Fauci and his 50 years of advanc-\ning public health’’; submitted by Rep. Ruiz. \n* Interim Report, June 2024, the Minority staff, ‘‘Republican’s Fauci Flop: \nSelect Subcommittee’s Fifteen-Month Probe Fails to Find Evidence of Extreme Claims Linking Dr. Fauci to COVID–19’s Origins’’; submitted by Rep. Castor. \n* Letter, May 31, 2024, Association of State and Territorial Health Offi-\ncials; submitted by Rep. Ruiz. \nDocuments are available at: docs.house.gov. \n(1) A HEARING WITH DR. ANTHONY FAUCI \nMonday, June 3, 2024 \nHOUSE OF REPRESENTATIVES  \nCOMMITTEE ON OVERSIGHT AND ACCOUNTABILITY  \nSELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC  \nWashington, D.C. \nThe Subcommittee met, pursuant to notice, at 10:01 a.m., in \nroom 2154, Rayburn House Office Building, Hon. Brad R. Wenstrup (Chairman of the Subcommittee) presiding. \nPresent: Representatives Wenstrup, Malliotakis, Lesko, Cloud, \nJoyce, Greene, Jackson, McCormick, Ruiz, Dingell, Mfume, Ross, Garcia, Bera, and Tokuda. \nAlso present: Representatives Comer, Griffith, Raskin, and Cas-\ntor. \nDr. W\nENSTRUP . The Select Subcommittee on the Coronavirus \nPandemic will come to order. \nI want to welcome everyone this morning. Pursuant to Committee on Oversight and Accountability rule \n7(d), Members of the Committee may participate in today’s Select Subcommittee hearing for purposes of questions. \nAt the discretion of the Chair and pursuant to an agreement \nwith the Committee on Energy and Commerce, the Chairman and Ranking Member of the Committee on Energy and Commerce, Sub-committee on Oversight and Investigations, Mr. Morgan Griffith and Ms. Kathy Castor, are permitted to participate in today’s hear-ings for the purposes of questions and give 3-minute opening state-ments. \nWithout objection, pursuant to clause 4(a)(iii)(a) of House Resolu-\ntion 5 and clause 2(j)(ii)(c) of House rule XI, the Chair may recog-nize staff of the Select Subcommittee for questions for equal peri-ods of time, not to exceed 30 minutes. \nPursuant to rule 7(d) of the Committee on Oversight and Ac-\ncountability, Mr. Jordan and Mr. Moskowitz, Members of the Full Committee, may participate in today’s hearing for the purposes of questions. \nI would like to remind Members that the issues we are debating \ntoday are important ones and Members feel deeply about them. While vigorous disagreement is part of the legislative process, Members are reminded that we must adhere to established stand-ards of decorum in debate. \nThere is a reminder that it is a violation of House rules and the \nrules of this Committee to engage in personalities regarding other Members or to question the motives of a colleague. Remarks of that \n2 \ntype are not permitted by the rules and are not in keeping with \nthe best traditions of our Committee. \nThe Chair will enforce these rules of decorum at all times and \nurges all Members to be mindful of their remarks. \nFinally, without objection, the Chair may declare a recess at any \ntime. \nI now recognize myself for the purpose of making an opening \nstatement. \nGood morning. And welcome, Dr. Fauci. First, I want to thank you for your dec-\nades of public service. You served your country through multiple epidemics, pandemics, and health crises. \nI do want to say I’m sorry about the threats that you have re-\nceived. As someone who’s been shot at and received threats as well, my heart goes out to you. This should never happen in America. \nRegardless of any disagreements we may have, you chose to \nserve, and I want to extend our appreciation and gratitude. I want to thank you publicly for working with our Doctors Caucus during Operation Warp Speed and the time you spent with us and Dr. Col-lins. \nI also want to thank you for your willing cooperation with the Se-\nlect Subcommittee. You have voluntarily sat for more than 14 hours of testimony and are appearing voluntarily today. This is more than we can say about other witnesses we have called, and we appreciate it. \nDr. Fauci, we’re here to investigate the COVID–19 pandemic and \nto explore lessons learned, positive or negative, and to better pre-pare for future pandemics. Simply put, America cannot move for-ward, though, without looking back. We must know what went right and what went wrong in order to best engrain proficiencies and remedy deficiencies. \nIn 15 months, the Select Subcommittee has sent more than 115 \ninvestigative letters, conducted 30 transcribed interviews, resulting in hundreds of hours of testimony; held, including today, 27 hear-ings or briefings; and reviewed more than 1.5 million pages of doc-uments. \nWe aren’t here to throw the baby out with the bath water. That’s \nnot the intent. We are following the facts, holding wrongdoers ac-countable, and planning for a better, more prepared future. \nBeginning early in 2020, you became the figurehead of public \nhealth. There were drinks named after you. You got bobbleheads made in your likeness. You were on the cover of Vogue. You threw out the first pitch at a Washington Nationals game. Almost over-night, you became a celebrity and a household name in addition to being a public health official. \nAmericans from coast to coast and beyond listened to your words. \nAnd this is where I think we could’ve done better. And this goes to both sides of the aisle. We should’ve been more precise. We should’ve used words and phrases that are accurate and not mis-leading. And we should’ve been honest, especially about what we didn’t know. \nDr. Fauci, I’m not a virologist, but I am a physician. And, like \nmost physicians, we are constantly learning, which is why we do continuing medical education, and we always seek new informa-\n3 \ntion. We learn new things, based on new data. And we want to give \nour patients the best possible care, based on new findings and im-provements in science. \nAt a time when you were prompting the ‘‘Proximal Origin’’ paper, \nwhose focus was to, quote, ‘‘disprove the lab leak theory,’’ end quote, I was in lockdown, researching with another physician in Ohio to try and understand the pathology, the affected physiology, and what treatments worked, and even how to diagnose COVID be-fore we had specific COVID tests. My friend even made a phone call to an infectious disease doctor in China, looking for help. \nAs well during that time, we discovered the Baric-Shi 2015 arti-\ncle on creating a chimera using gain-of-function-type technology. \nWhile policy decisions should’ve been based on scientific data, \nsome, frankly, were not. The burdensome six-foot social distancing rule did not have sufficient scientific report. In your words, it just sort of appeared. Distancing made sense, but the six feet was arbi-trary. Even Dr. Collins said he still hasn’t seen any empirical evi-dence to support the six-foot rule—a rule that shut down schools and businesses, a rule that will have negative ramifications for dec-ades. \nAs the pandemic wore on, more mandates also just sort of ap-\npeared, but the American public didn’t get to see the scientific data to support these mandates. \nAmericans were aggressively bullied, shamed, and silenced for \nmerely questioning or debating issues such as social distancing, masks, vaccines, or the origins of COVID. \nMany Americans were willing to comply with the 15 days to slow \nthe spread and understood the necessity of banning travel from cer-tain countries in an attempt to slow down the virus, but many Americans became very frustrated when components of those 15 days stretched into years. \nAnd it should not have been the case that Americans were forced \nto comply with oppressive mandates when those who chose to ille-gally cross our southern border were not, or when Governor Newsom, or Governor Whitmer, were throwing parties at nice res-taurants. Not a good look. Americans do not hate science, but Americans know hypocrisy when they see it. \nDr. Fauci, under your leadership, the United States health agen-\ncies adopted specific policy aims as a single dogmatic truth, with-out the benefit of debate, out of a desire for a single narrative. \nDr. Fauci, you once said, ‘‘If you disagree with me, you disagree \nwith science.’’ Science doesn’t belong to any one person. I was never taught that science turns a blind eye to hypotheses. They serve to be proven or disproven, and done so with irrefutable facts, if able. \nIt was interesting that you chose not to pursue an aggressive and \ntransparent scientific investigation of both natural spillover and lab leak. We have been investigating both hypotheses. \nYou testified before the Select Subcommittee in your transcribed \ninterview that the lab leak theory was not a conspiracy theory. You \nembraced the ‘‘Proximal Origin’’ letter—it wasn’t necessarily a full peer-reviewed research paper—but you embraced ‘‘Proximal Origin’’ letter, and you shared it with the public from the White House lawn. \n4 \nYou stated during your transcribed interview that you did not re-\nview published articles that considered a potential lab leak of COVID–19. This is especially concerning if the works in question were conducted at a more risky and less safe BSL–2 lab. \nNevertheless, any dissent from your chosen scientific position \nwas immediately labeled as anti-science. Anything less than com-plete submission to the mandates could cost you your livelihood, your ability to go into public, your child’s ability to attend school. Families were thrown off planes and shamed when their 2-year- olds struggled to wear a mask. \nChildren with disabilities lost access to therapy that they and \ntheir families depended on. Students were out of the classroom and told to attend school remotely, even when the science clearly dem-onstrated it was safe for them to go back in the classroom. This harmed low-income students the most. And how were single-parent households supposed to teach their own children and work at the same time? \nDr. Fauci, you oversaw one of the most invasive regimes of do-\nmestic policy the U.S. has ever seen, including mask mandates, school closures, coerced vaccinations, social distancing of six feet, and more. \nWe’ve learned many lessons. Our early fear and confusion was \nunderstandable. COVID–19 was clearly a novel virus. \nUnder your leadership, NIAID allowed disgraced characters like \nDr. Peter Daszak to use millions in taxpayer dollars to conduct risky gain-of-function experiments in Wuhan, China. The actions of EcoHealth and Dr. Daszak call into question the integrity of NIAID’s policies and procedures as a whole, as well as your role, Dr. Fauci, as NIAID’s Director. You did sign off on his research grant. \nWe need to know why Dr. David Morens, your direct report for \nmore than two decades, assisted Dr. Daszak in avoiding oversight and scrutiny and said that you were involved. Your senior advisor and seemingly your chief of staff repeatedly attempted to evade transparency laws to shield information from public scrutiny. \nWe have senior officials from your office, in their own writing, \ndiscussing breaking Federal law, deleting official records, and shar-ing private government information with grant recipients. The of-fice you directed and those serving under your leadership chose to flout the law and bragged about it. \nWhy did you allow your office to be unaccountable to the Amer-\nican people? You were the highest paid person in the government. This makes you more accountable to the people, not less. \nDr. Fauci, whether intentional or not, you became so powerful \nthat any disagreements the public had with you were forbidden and censored on social and most legacy media, time and time again. This is why so many Americans became so angry—because this was fundamentally un-American. \nIf I make a mistake, I answer to the people of Ohio who elected \nme and to my own conscience. When you and your agency made mistakes, Dr. Fauci, what happened? \nWe all need to be held accountable. Sometimes it’s as simple as \nsaying, ‘‘We were wrong.’’ \n5 \nYou took the position that you presented the science. Your words \ncame across to so many people as final and as infallible in matters pertaining to the pandemic. But such rigid demands of an ideologi-cally diverse people like Americans shattered public trust in Amer-ican health institutions. ‘‘Because I said so’’ has never been good enough for Americans, and it never will be. \nIt’s built into the American spirit: We have a thirst for informa-\ntion, a drive for advancement. Americans were first in flight. We landed on the Moon. We’ve cured diseases. You’ve been part of that. And we’ve made enumerable discoveries and explorations that forever changed humanity. \nAmericans do not want to be indoctrinated; they want to be edu-\ncated. And they prefer to make their health decisions in conjunc-tion with the doctor that they know and trust. \nTo be successful, our Federal public health institutions must be \naccountable to the people again. To be successful, our health orga-nizations must do what they are supposed to do: protect Americans. \nI look forward to a robust and on-topic discussion. I thank you. I would now like to recognize Ranking Member Ruiz for the pur-\npose of making an opening statement. \nDr. R\nUIZ. Thank you, Mr. Chairman. \nHello, Dr. Fauci, and thank you for being here. When I was named Ranking Member of the Select Subcommittee \nlast February, I made a commitment to follow the facts in objec-tively analyzing the origins of the COVID–19 pandemic. I made a promise to keep an open mind about how the pandemic started, be-cause understanding whether the novel coronavirus emerged from a lab or from nature is essential to better preventing and preparing for future public health threats and to better protecting the Amer-ican people. \nAnd as the origins of the novel coronavirus still remain inconclu-\nsive, I stand by these commitments to this day. \nBut nearly a year and a half into House Republicans’ extreme \nand chaotic majority, I believe we need to take stock of what the Select Subcommittee has accomplished and whether it has mean-ingfully improved our preparedness for the next public health threat in our Nation. \nUnder the guise of investigating the pandemic’s origins, House \nRepublicans have abdicated their responsibility to objectively exam-ine how COVID–19 came to be and, instead, weaponized concern about a lab-related origin to fuel sentiment against our Nation’s scientists and public health officials for partisan gain. \nThey have done so with one particular public health official in \nmind: Dr. Anthony Fauci. And they have done so in an effort to de-flect blame and anguish for the damage the pandemic inflicted on our society away from the former President, whose stumbling pan-demic response, by some estimates, led to 400,000 unnecessary COVID–19 deaths, and onto Dr. Fauci, who worked tirelessly to stem the crisis. \nOver the past 15 months, the Select Subcommittee has pored \nover more than 425,000 pages of documents provided to us by gov-ernment agencies, universities, and private citizens. We have con-ducted more than 100 hours of closed-door interviews with 20 cur-rent and former Federal officials and scientists. \n6 \nAnd what we have found is the following: Dr. Fauci did not fund \nresearch through the EcoHealth Alliance grant that caused the COVID–19 pandemic. Dr. Fauci did not lie about gain-of-function research in Wuhan, China. And Dr. Fauci did not orchestrate a campaign to suppress the lab leak theory. \nAfter 15 months, the Select Subcommittee still does not possess \na shred of evidence to substantiate these extreme allegations that Republicans have levied against Dr. Fauci for nearly 4 years. \nNow, I want to make something very clear. In the past month, \nthe Select Subcommittee has held hearings where we have exam-ined various serious issues of misconduct. \nIn following the facts, Select Subcommittee Democrats uncovered \ntroubling misconduct by Dr. Peter Daszak and EcoHealth Alliance, including potential efforts to mislead the Federal Government about the nature of its work through the evasion of reporting and transparency requirements. \nAnd less than 2 weeks ago, we heard from Dr. David Morens \nabout his flagrant violation of the Freedom of Information Act’s transparency requirements and the potential destruction of Federal records. \nBoth Dr. Daszak and Dr. Morens deserve to be held accountable \nfor betraying the public’s trust. To hold them accountable is not anti-science; it is the defense of our Federal scientific and research institutions’ decades-long legacy of advancing the scientific enter-prise to safeguard human health. \nBut baselessly suggesting, without evidence, that these discrete \ninstances of misconduct are equivalent to our Nation’s scientists and public health officials causing the COVID–19 pandemic, which has killed more than 1 million Americans and inflicted an immeas-urable toll on our society, is also a betrayal of the public’s trust, which each of us are stewards of as elected Members of this body. \nToday’s hearing comes at a pivotal moment for our Nation’s pub-\nlic health. With the darkest days of the COVID–19 pandemic be-hind us, thanks to the Biden administration’s leadership, we are now faced with a crisis of declining confidence in the very science and public health interventions that lifted our society from one of the most challenging periods in our Nation’s history. \nAnd as we look to the future, we find ourselves at a fork in the \nroad: We can go down the path of fueling mistrust in the interven-tions that saved us, like vaccines, masking, and social distancing, and the public health officials, like Dr. Fauci, who worked tirelessly and with extremely limited and evolving information about a novel virus to save lives during one of the greatest crises of our time, or we can work constructively on the forward-looking policies and so-lutions that we know are necessary to prevent and better prepare us for the public health threats that are yet to come. \nSince my first day as Ranking Member, I set out to take the lat-\nter path—the path of putting people over politics and prioritizing solutions to better prepare us for the next pandemic. And it has been my hope that Republicans would join Democrats in the for-ward-looking work that will better protect our constituents. \nStrengthening oversight of potentially risky research, domesti-\ncally and abroad, is an essential part of this conversation. And so is closing pathways for zoonotic transfers of viruses in nature and \n7 \ninvesting in our public health infrastructure to ensure that when \nfuture viruses arrive, we are ready. \nWhen Democrats were in the majority, we made important \nstrides in these objectives by passing the Consolidated Appropria-tions Act of 2023, which strengthened the protections against undue influence in our biomedical research, improved training and transparency for the handling of select agents, paved the way for the interagency collaboration to fortify zoonotic disease prevention, invested in our infectious disease work force, and enhanced our supply chain preparedness and ability to rapidly develop and de-ploy medical countermeasures. \nAnd ahead of today’s hearing, more than 90 health and medical \norganizations, including the American Public Health Association, the American College of Physicians, the American Academy of Family Physicians, the Infectious Disease Society of America, the Association of State and Territorial Health Officials, and the Na-tional Association of County and City Health Officials, wrote to the Select Subcommittee, urging us to, quote, ‘‘stand against efforts to weaken the ability of the Nation’s public health agencies to protect the Nation’s health’’ and to take additional action to fortify our Na-tion’s public health work force and infrastructure. \nI seek unanimous consent to enter this letter into the hearing \nrecord. \nDr. W\nENSTRUP . Without objection. \nDr. R UIZ. As we sit here today, I have not lost hope that in the \nremaining months of the Select Subcommittee we can work to-gether to build on this legacy and make objectively examining the origins of the novel coronavirus a part of this forward-looking work. I stand by my commitments I mentioned earlier to take a serious, balanced look at all possibilities for the origins of the COVID–19 pandemic. And I stand ready to work with every Member of the Se-lect Subcommittee on this critically important mission so that we can save future lives. \nAnd I believe I still have some time left, so, at that, I would like \nto recognize Mr. Raskin with the remaining time. \nMr. R\nASKIN . Thank you, Dr. Ruiz. \nPublic health is a matter of urgent and comprehensive public \nconcern. \nUnder Donald Trump, when the COVID–19 pandemic began and \nspun out of control, we came close to becoming a failed state, which the political scientists define as a state that cannot deliver the basic goods of existence to its people. \nAccording to Dr. Deborah Birx, Donald Trump’s own COVID–19 \nadvisor, America unnecessarily lost hundreds of thousands of peo-ple because of the recklessness and indifference of Donald Trump and his administration. \nNow the people who brought you the political big lie, claiming \nabsurdly that Trump won the 2020 election, which he lost by more than 7 million votes, now bring you the medical big lie, making the \noutlandish claim that Dr. Fauci was responsible for causing COVID–19. \nUsing the Select Subcommittee as a platform for this \ndisinformation, House Republicans now find themselves in the fa-\n8 \nmiliar position where their own investigation debunks their run-\naway political rhetoric. \nJust like the broader Committee’s impeachment drive proved \nonly that there were no Presidential crimes, much less high crimes and misdemeanors, attributable to Joe Biden, the investigation of Dr. Fauci shows he is an honorable public servant who has devoted his entire career to the public health and the public interest and he is not a comic book super-villain. \nHe did not fund research to create the COVID–19 pandemic. He \ndid not lie to Congress about gain-of-function research in Wuhan. And he did not organize a lab leak suppression campaign. \nToday, Dr. Fauci’s testimony, along with the thousands of pages \nof documents and dozens of closed-door testimony provided to House Republicans as part of the COVID origins investigation, will dispel these hysterical claims and reveal that the people bowing down to a twice-impeached convicted felon who told Americans to inject themselves with bleach now want you to believe not only a big political lie but a big medical lie too. \nI hope that this Committee will be able to correct all of the prop-\naganda and disinformation today and we will be able to actually re-turn to what the good Ranking Member has said, which is an au-thentic investigation of the origins of the pandemic. \nAnd I will yield back to the gentleman. Dr. R\nUIZ. And I yield back. \nDr. W ENSTRUP . I now recognize Mr. Griffith for a 3-minute state-\nment. \nMr. G RIFFITH . Good morning. I want to again thank the leader-\nship of this Committee for including the Energy and Commerce Committee in this hearing. \nDr. Fauci, the recent revelations that Dr. Morens, a senior advi-\nsor, and your chief of staff, Greg Folkers, routinely evaded Federal records laws, including the Freedom of Information Act, or FOIA— and those were a shock. That was a shock. I’ve been doing over-sight now for over 14 years, or right at 14 years, and the scale of the effort to evade FOIA by some at the National Institute of Al-lergy and Infectious Diseases, or NIAID, has surprised even me. \nThese men were among your most senior and trusted staff at an \nagency you led for nearly 40 years. They worked for you for dec-ades. Your calendars show that you met with them multiple times a week during the pandemic. You co-authored dozens of papers with Dr. Morens. He directly implicates you. Even the head of the NIAID FOIA office was apparently in on some of this conspiracy. \nAnd I know that my colleagues on the other side love to say \nwe’re always talking conspiracy, but when the facts lead you there—whether you knew about it or not, when the facts lead you to that your agency was involved in some form of a conspiracy re-lated to COVID origins, we have to follow those facts. It is hard to believe that all of this occurred without your knowledge and/or approval. \nIn civil law, when one party has destroyed or refuses to produce \nevidence that’s within its possession, a jury is allowed to draw an adverse inference, that the information destroyed or not produced was unfavorable. \n9 \nTherefore, until we get a full accounting of all of the communica-\ntions among NIAID’s leadership, it’s reasonable for us to assume that missing information would mirror the private doubts ex-pressed by so many virologists and other scientists related to your public positions. \nWhile telling the public, the media, and Congress that COVID– \n19 almost certainly emerged from nature, experts you convened as a team privately worried that a research-related incident was a possible, if not the probable, origin of the virus. \nDr. Kristian Andersen even said in February 2020, quote, ‘‘I \nthink the main thing still in my mind is that the lab escape version of this is so friggin’ likely to have happened because they were al-ready doing this type of work and molecular data is fully consistent with that scenario.’’ \nFurther, while you and other NIAID officials were assuring us \nthat the virus could not have come from the Wuhan Institute of Vi-rology, NIAID didn’t actually have an idea as to what the full scope of Wuhan’s coronavirus research was or even the trajectory of its gain-of-function research. Now, that may be because EcoHealth wasn’t giving you the reports, I grant that. But this joint investiga-tion has shown just how little oversight NIAID does of risky experi-ments involving potential pandemic pathogens. \nNIAID set up a system designed to green-light potentially risky \nexperiments while avoiding HHS Department-level review. The same program officers who act as advocates for their scientific area are responsible for assessing whether an experiment is too dan-gerous. That creates a conflict of interest. \nI think that means that when we’re taking—when an agency is \ntaking the final approval, we ought to take that final approval away from the agencies like NIAID that fund it. \nThank you, Mr. Chairman. I yield back. Dr. W\nENSTRUP . I now recognize Ms. Castor for a 3-minute state-\nment, and I will oblige you an extra 30 seconds as well. \nMs. C ASTOR . Well, thank you, Dr. Fauci, for your appearance \ntoday and for your decades of service to our country. \nDuring your 39 years at the helm of America’s leading health re-\nsearch institute, the National Institute of Allergy and Infectious Diseases, you tackled some of the most serious health threats, in-cluding AIDS, Zika, Ebola, SARS-CoV–1, and COVID–19. Your leadership and service to Republican and Democratic administra-tions and all Americans saved countless lives and resources. We owe you a debt of gratitude. \nWhile the evidence to date points to COVID–19 having originated \nfrom an animal market in China, the Chinese Communist Party has blocked access to important information that could help con-firm the origin of the virus. \nThis Committee should be doing more to fight for those answers \nbut, instead, has wasted significant time and taxpayer money fuel-ing conspiracy theories and ignoring the importance of preparing \nfor the next deadly pandemic. \nSome GOP Members falsely claimed you secretly broke into CIA \nheadquarters and coerced analysts. Others claimed that you com-mitted crimes. \n10 \nAmerica’s adversaries, like China, Russia, and Iran, love it when \nAmericans are divided and distracted. It provided fertile ground for the spread of misinformation about COVID–19 by our adversaries. \nAnd, unfortunately, fringe, far-right conspiracy theories have \npermeated even mainstream media outlets, and some Republican Members of Congress have played along. \nI regret that many of the conspiracies have smeared you, Dr. \nFauci, as you and our top scientists did everything to keep Ameri-cans safe during the deadly days of COVID–19. \nOver 1.1 million Americans lost their lives to COVID–19, and \ntoday it’s still more deadly than the flu. \nAs we learned from Zika and Ebola, the ways viruses are trans-\nmitted are not obvious at first, and the development of treatments and vaccines takes time. \nWhat you and your team did to speed the development of the \nsafe and effective COVID–19 vaccine was remarkable. That fast timeline was only possible due to years of Federal investment in the National Institutes of Health and support for medical research in the United States. \nSo one of the lessons learned from the pandemic is the need to \ncontinue to invest in medical health research in the U.S.—for can-cer, for heart disease, for diabetes, but also to prepare for the next pandemic. We must learn from the past so that we can keep Ameri-cans safe. \nThat’s why Democrats have worked hard to update America’s \npandemic preparedness law, the Pandemic and All Hazards Pre-paredness Act, to shore up public health and make us more pre-pared to tackle the next pandemic threat. \nIt’s not too late for Republicans to join us and turn the least pro-\nductive Congress in modern history into one where we are all fo-cused on solutions for the American people to make our country safer and stronger. \nDemocrats were able to prevent harmful rollbacks in medical re-\nsearch last year, and I urge my GOP colleagues to join us and move away from threatening and undermining American medical research at every turn. \nPublic health threats are constantly emerging. In the past month \nalone, we have been tracking new strains and variants of H5N1, Mpox, and SARS-CoV–2. \nDr. Fauci, I’m sorry for the personal attacks you have received \nand may have to deal with today. But while you are here, I want you to know that the vast majority of Americans appreciate your work over the years. \nI look forward to continuing to learn from you, to learn every-\nthing possible about how we can take the pandemic lessons learned and put them to use to help keep our communities safe and healthy. \nThank you, and I yield back my time. Dr. W\nENSTRUP . Thank you. \nOur witness today is Dr. Anthony Fauci. Dr. Fauci was the Di-\nrector of the National Institute of Allergy and Infectious Diseases from 1984 to 2022 and Chief Medical Advisor to President Joe Biden from 2021 to 2022. \n11 \nPursuant to Committee on Oversight and Accountability rule \n9(g), the witness will please stand and raise his right hand. \nDo you solemnly swear or affirm that the testimony that you are \nabout to give is the truth, the whole truth, and nothing but the truth, so help you God? \nDr. F\nAUCI . I do. \nDr. W ENSTRUP . Thank you. \nLet the record show that the witness answered in the affirma-\ntive. \nThe Select Subcommittee certainly appreciates you for being here \ntoday, and we look forward to your testimony. \nLet me remind the witness that we have read your written state-\nment, and it will appear in full in the hearing record. As requested, please limit your oral statement to 6 minutes. \nAs a reminder, please press the button on the microphone in \nfront of you so that it is on, and the Members can hear you. When you begin to speak, the light in front of you will turn green. After 5 minutes, the light will turn yellow. And when the red light comes on, your 6 minutes has expired, and we would ask that you please wrap up. \nI now recognize Dr. Fauci to give an opening statement. \nSTATEMENT OF ANTHONY FAUCI, M.D., \nFORMER DIRECTOR \nNATIONAL INSTITUTE OF ALLERGY \nAND INFECTIOUS DISEASES \nDr. F AUCI . Mr. Chairman, Ranking Member Ruiz, Members of \nthe Subcommittee, thank you for this opportunity to testify. \nPrior to my retirement from Federal service in December 2022, \nI had been at the NIH for 54 years and Director of NIAID for more than 38 years. In those posts, I was deeply involved in the sci-entific and public health response to several infectious diseases outbreaks, including HIV/AIDS, pandemic, flu, Ebola, and Zika. And so, under my leadership, we were well positioned to respond to COVID–19. \nFor at least two decades prior to the COVID outbreak, we at \nNIAID had invested billions of dollars in research on mRNA tech-nology and immunogen design, both of which led to the swift devel-opment of COVID vaccines. Less than 11 months after the identi-fication of this new virus, safe and highly effective vaccines were widely available—an unprecedented accomplishment in the history of vaccinology that saved tens of millions of lives worldwide. \nI will now use my remaining time to directly address certain \nissues that have been seriously distorted concerning me. \nThe first issue concerns my actions regarding the possibility that \nSARS-CoV–2 might’ve resulted from a lab leak. \nOn January 31, 2020, I was informed through phone calls with \nJeremy Farrar, then-director of the Wellcome Trust in the U.K., and then with Kristian Andersen, a highly regarded scientist at Scripps Research Institute, that they and Eddie Holmes, a world- class evolutionary biologist from Australia, were concerned that the genomic sequence of SARS-CoV–2 suggested that the virus could’ve been manipulated in a lab. \n12 \nI participated in a conference call the next day with about a \ndozen international virologists to discuss this possibility versus a spillover from an animal reservoir. The discussion was lively, with arguments for both possibilities. Two participants have testified be-fore this Subcommittee that I did not try to steer the discussion in any direction. \nIt was decided that several participants would more carefully ex-\namine the genomic sequence. After this further examination, sev-eral who at first were concerned about lab manipulation became convinced that the virus was not deliberately manipulated. \nThey concluded that the most likely scenario was a spillover from \nan animal reservoir, although they still kept an open mind. They appropriately published their opinion in the peer-reviewed lit-erature. \nThe accusation being circulated—that I influenced these sci-\nentists to change their minds by bribing them with millions of dol-lars in grant money—is absolutely false and simply preposterous. I had no input into the content of the published paper. \nThe second issue is a false accusation that I tried to cover up the \npossibility that the virus originated from a lab. In fact, the truth is exactly the opposite. \nI now quote from an email that I sent to Professor Farrar on \nFebruary 1, 2020. \nQuote, ‘‘Jeremy, I just got off the phone with Kristian Andersen, \nand he related to me his concern about the furin site mutation in the spike protein of the virus. I told him that as soon as possible he and Eddie Holmes should get a group of evolutionary biologists together to carefully examine the data to determine if his concerns are validated and they should report it to the appropriate authori-ties. I would imagine that in the USA this would be the FBI and in the U.K. it would be MI5. In the meantime, I will alert my U.S. Government official colleagues of my conversation with you and Kristian and determine what further investigation they rec-ommend. Let us stay in touch. Best regards, Tony,’’ unquote. \nIt is inconceivable that anyone who reads this email could con-\nclude that I was trying to cover up the possibility of a lab leak. I have always kept an open mind to the different possibilities. \nAnother issue is that of Dr. David Morens, who has the title of \nSenior Advisor to the NIAID Director and who recently began—has been investigated for conduct unbecoming a government official. Naturally, given his title, a connection is made to me. \nWith respect to his recent testimony before this Subcommittee, \nI knew nothing of Dr. Morens’s actions regarding Dr. Daszak, EcoHealth, or his emails. \nIt is important to point out for the record that, despite his title \nand even though he was helpful to me in writing scientific papers, Dr. Morens was not an advisor to me on Institute policy or other substantive issues. \nAt NIAID, we had weekly Executive Committee meetings of the \nInstitute leadership and daily morning meetings of my immediate staff, and, to the best of my recollection, he attended neither of these. Furthermore, his office is located in a different building from that of the NIAID Director. \n13 \nFinally, in a Majority Staff memorandum of May 22, 2024, there \nis this statement: Quote, ‘‘Dr. Fauci may have conducted official business via personal email,’’ unquote. \nLet me state for the record that, to the best of my knowledge, \nI have never conducted official business using my personal email. \nThank you for listening. I would be happy to address these and \nany other issues in the discussion period. \nDr. W\nENSTRUP . Thank you. \nI now recognize myself for as much time as I may consume for \nquestions, with equal time being afforded to the Ranking Member. \nDr. Fauci, on February 1, 2020, you were on a call with Dr. \nFarrar, Dr. Collins, and other scientists regarding the potential that COVID–19 was engineered. \nWas CDC Director Redfield on that call? Dr. F\nAUCI . No, he was not. \nDr. W ENSTRUP . OK. \nDr. Fauci, you’ve said that you had to rely on virologists and evo-\nlutionary biologists regarding origins because you are not an ex-pert. \nIs Dr. Redfield a virologist? Dr. F\nAUCI . I believe he is. \nDr. W ENSTRUP . He is. \nPrior to the pandemic, NIAID awarded at least three grants via \nthe New York Blood Center to Dr. Zhou Yusen. \nAre you aware of these? Dr. F\nAUCI . I’m sorry? To Dr.—— \nDr. W ENSTRUP . Yusen Zhou. Are you aware of those grants? \nDr. F AUCI . I’m sorry. The name of the person? \nDr. W ENSTRUP . Dr. Yusen Zhou. \nDr. F AUCI . [Inaudible.] \nDr. W ENSTRUP . Your microphone is not on, Doctor. \nDr. F AUCI . Excuse me? \nDr. W ENSTRUP . Your microphone is not on. \nDr. F AUCI . I’m not familiar with that name. \nDr. W ENSTRUP . OK. Well, NIAID awarded at least three grants \nvia the New York Blood Center to that scientist. \nHe was a high-ranking Chinese PLA official and director of a lab \nat the Chinese Academy of Military Medical Sciences. \nDoes it concern you if U.S. taxpayer dollars are funding someone \nlike this? \nDr. F AUCI . Grants that are submitted to the NIAID go through \na very—— \nDr. W ENSTRUP . Does it concern you—I’m not talking about the \nprocess right now. \nDr. F AUCI . Well, I don’t know anything—— \nDr. W ENSTRUP . Does it concern you that U.S. taxpayer dollars \nwould be going to someone who’s a high-ranking Chinese PLA offi-cial? Yes or no? \nDr. F\nAUCI . I would have to know more about that, Mr. Chair-\nman—— \nDr. W ENSTRUP . OK. \nDr. F AUCI [continuing]. Because I don’t even—— \nDr. W ENSTRUP . Well, it concerns me. \nDr. F AUCI [continuing]. Know the person you’re talking about. \n14 \nDr. W ENSTRUP . Are you or were you ever aware that the U.S. \nState Department in 2005 issued warnings that the Chinese Gov-ernment was working on the creation of bioweapons? \nDr. F\nAUCI . I was not aware of that. \nDr. W ENSTRUP . Thank you. \nDid you ever discuss the Chinese bioweapons program with any-\none in the intelligence community? \nDr. F AUCI . I have never discussed the Chinese bioweapons pro-\ngram, to my knowledge, with anybody. \nDr. W ENSTRUP . Before, during, or after the COVID–19 pandemic, \ndid you speak to the FBI, CIA, DIA, or any U.S. intelligence agency concerning viral research of any kind? \nDr. F\nAUCI . What timeframe are you talking about, sir? Be-\ncause—— \nDr. W ENSTRUP . I said, before, during, or after the COVID–19 \npandemic, did you speak to the FBI, CIA, DIA, or any U.S. intel-ligence agency concerning viral research of any kind? \nDr. F\nAUCI . I can’t give you the specifics of it, but back in the time \nof the anthrax attacks, we certainly had a number of briefings by agencies that were intelligence agencies—I don’t remember who they were; it could’ve been any of the above that you mentioned— about the possibility that there were bioweapons that had fallen into the hands of bad actors, i.e., terrorists, that might have been used potentially as a bioterror attack. \nThat was at a time when we had thought that the anthrax—— Dr. W\nENSTRUP . So, I appreciate—I appreciate that. I appreciate \nyour expertise in that. But—— \nDr. F AUCI . Well, that’s the answer. \nDr. W ENSTRUP . But did you at any time talk to—concerning viral \nresearch of any kind? \nDr. F AUCI . Again I say that, at the time that there was concern \nabout the fact that al-Qaida may have been using or potentially using bioweapons, we had discussions with intelligence agencies about that—— \nDr. W\nENSTRUP . Sure. \nDr. F AUCI [continuing]. Possibility. \nDr. W ENSTRUP . But not as related to, say, COVID–19? \nDr. F AUCI . Not, to my knowledge—— \nDr. W ENSTRUP . OK. \nDr. F AUCI [continuing]. About COVID—now, well, let me just \nmake sure we get the facts. \nAfter the investigations began about COVID, I was briefed by in-\ntelligence agencies about possibilities of there being activities going on in different laboratories. I was briefed by intelligence—— \nDr. W\nENSTRUP . Yes. \nDr. F AUCI [continuing]. Agencies. \nDr. W ENSTRUP . Thank you. \nScience is always open to debate, and that’s a benefit. The \nscience supported restricting travel from certain countries at the beginning of the pandemic, and after these orders went into effect, the President was called racist and xenophobic. \nDr. Fauci, you said in your transcribed interview that you sup-\nported those orders. Dr. Fauci, were those orders racist and xenophobic? \n15 \nDr. F AUCI . No, they were not. \nDr. W ENSTRUP . Thank you. \nThe vaccine saved millions of lives, and I want to thank you for \nyour support and engagement on that. \nHowever, despite statements to the contrary, it did not stop \ntransmission of the virus. \nDid the COVID vaccine stop transmission of the virus? Dr. F\nAUCI . That is a complicated issue, because, in the beginning, \nthe first iteration of the vaccines did have an effect—not 100 per-cent, not a high effect—they did prevent infection and, subse-quently, obviously, transmission. \nHowever, it’s important to point out, something that we did not \nknow early on that became evident as the months went by is that the durability of protection against infection, and hence, trans-mission was relatively limited, whereas the duration of protection against severe disease, hospitalization, and deaths was more pro-longed. \nWe did not know that in the beginning. In the beginning, it was \nfelt that, in fact, it did prevent infection and, thus, transmission, but that was proven, as time went by, to not be a durable effect. \nDr. W\nENSTRUP . Yes, it definitely had positive effect for many peo-\nple, especially those that were vulnerable. But we knew from the trials that people that got vaccinated still were subject to getting COVID. \nSo, was the COVID vaccine 100 percent effective? Dr. F\nAUCI . I don’t believe any vaccine is 100 percent effective. \nDr. W ENSTRUP . I now recognize the Ranking Member, Dr. Ruiz \nfrom California, for 5 minutes of questions. \nDr. R UIZ. Thank you. \nOver the past year and a half, my colleagues on the other side \nof the aisle have relentlessly vilified Dr. Fauci under the guise of investigating the origins of the COVID–19 pandemic. \nBut after reviewing nearly half a million pages of documents, \nconducting 20 closed-door interviews, and receiving testimony from nearly a dozen witnesses brought before the Select Subcommittee for public hearings, they have come up empty-handed for evidence of their extreme allegations that Dr. Fauci lied about gain-of-func-tion research at the Wuhan Institute of Virology and caused the COVID–19 pandemic. \nSo, I’d like to address both of the Republican claims in turn. Throughout the Majority’s investigation, the Select Sub-\ncommittee has heard three definitions for ‘‘gain-of-function’’ re-search. \nOf the three, Republicans have relied heavily on an overly broad \ndefinition that has no regulatory significance. Let me repeat that: no regulatory significance. In fact, their definition is so broad that it would include the manufacture of flu vaccines as gain-of-func-tion. \nBecause it is so broad, the National Institutes of Health does not \nuse that definition when assessing whether proposed research is or is not, quote/unquote, ‘‘gain-of-function’’ research. For those assess-ments, NIH has instead appropriately used the definitions provided in regulations. \n16 \nAnd, to be clear, the Select Subcommittee has been reminded by \nwitnesses after witness that NIH at all times referred to regula-tions for the definition of ‘‘gain-of-function’’ research and not to a nebulous, expansive definition with no legal bearing that is so broad it could apply to, again, the manufacturing of flu vaccines. \nDr. Fauci, according to the regulatory definitions, for example, in \nP3CO, that NIH applied to proposed research, did NIH ever fund gain-of-function research in Wuhan, China? \nDr. F\nAUCI . As you said, Congressman Ruiz, according to the reg-\nulatory and operative definition of P3CO, the NIH did not fund gain-of-function research at the Wuhan Institute of Virology. \nDr. R\nUIZ. Thank you. And despite my Republican colleagues’ ef-\nfort to fit a square peg into a round hole, it seems to me that you’ve been consistent on this issue from the beginning of the pandemic. And they know this, but they still use the term ‘‘gain-of-function’’ loosely. \nAnd with respect to NIAID’s staff assessments of whether pro-\nposed research was or was not gain-of-function research, were you personally involved in those assessments, or were those assess-ments made several levels removed from you and by subject-matter experts? \nDr. F\nAUCI . Those assessments were done by highly qualified and \nexperienced program people several levels below me. \nDr. R UIZ. Thank you. \nAnd your public statements that NIH did not fund gain-of-func-\ntion research in Wuhan reflected the assessments made by NIAID subject-matter experts applying a definition found in the regulation known as the P3CO framework. \nIs that correct? Dr. F\nAUCI . That is correct. \nDr. R UIZ. Thank you. And thank you for clarifying that. \nIn fact, all of that is abundantly clear in your 2021 Senate testi-\nmony on this matter. When asked by the Senate about gain-of-func-tion research, you testified, quote, ‘‘That is why we have commit-tees, we have a P3CO committee.’’ \nYou also testified in 2021, quote, ‘‘’Gain-of-function’ is a very neb-\nulous term. We have spent—not us, but outside bodies—a consider-able amount of effort to give a more precise definition to the type of research that is of concern that might lead to a dangerous situa-tion. You are aware of that. That is called P3CO.’’ \nThat was back in 2021. At the time of your May 2021 testimony, \nP3CO had been the operative definition of gain-of-function research for several years, correct? \nDr. F\nAUCI . That is correct. \nDr. R UIZ. So I will note that, at your transcribed interview in \nJanuary, the Majority conceded that NIH did not fund research in Wuhan that met the criteria of P3CO. \nI encourage the audience to read the transcript of that interview \nso you can evaluate the merit of the Majority’s claims for your-\nselves. \nSo, now, if we could quickly turn to the irresponsible and false \naccusation that you created SARS-CoV–2, the virus responsible for the COVID–19 pandemic. \n17 \nSo this accusation centers on a grant NIAID awarded to \nEcoHealth Alliance, with a sub-award to the Wuhan Institute of Vi-rology. And we have been entertained earlier about the suggestion that this funding could’ve possibly gone to a bioweapons research capacity as well. \nSo, I want to be clear: No evidence provided to the Select Sub-\ncommittee demonstrates that the work performed under NIH fund-ing, including at the Wuhan Institute of Virology, led to the cre-ation of SARS-CoV–2. \nThe Majority has failed to demonstrate or even credibly suggest \nthat any of the viruses studied under the grant could even possibly have been the progenitor virus. \nDr. Fauci, could you briefly explain why none of the viruses stud-\nied under the EcoHealth Alliance grant could’ve been the pro-genitor virus of the SARS-CoV–2? \nDr. F\nAUCI . When you’re talking about the evolution of a virus \nfrom one to another, the viruses that were studied under the sub- award to the Wuhan Institute that have been reported in progress reports and the literature and published papers, those viruses were phylogenetically so far removed from SARS-CoV–2 that it is molec-ularly impossible for those viruses to have evolved or been made into SARS-CoV–2. \nIt’s just a virological fact. They were so far removed that it could \nnot possibly be a progenitor of SARS-CoV–2. \nDr. R\nUIZ. So I want to be very clear on this point: that the fund-\ning and the research conducted by EcoHealth Alliance did not produce SARS-CoV–2. \nThat doesn’t negate that this lab could’ve—another lab could’ve \nbeen doing research and it could’ve leaked from a lab. That still is a possibility. But it was not directly—or it was not funded by NIAID or NIH. \nAnd, just for the record, this information was provided by NIH \nto then-Oversight Ranking Member James Comer nearly 3 years ago, in October 2021. \nSo, despite the clear evidence that Dr. Fauci and his agency did \nnot fund gain-of-function research under the P3CO regulatory defi-nition and that the viruses studied under the federally funded EcoHealth Alliance grant could have not have been the progenitor virus for SARS-CoV–2, Republicans have levied these unsubstan-tiated allegations, knowing very well that they are not true. And they have done so to push their extreme, partisan narrative that Dr. Fauci and our Nation’s public health officials caused the COVID–19 pandemic. \nDr. W\nENSTRUP . Do you yield back? \nDr. R UIZ. Yep. \nDr. W ENSTRUP . I now recognize the Chairman of the Full Com-\nmittee, Mr. Comer from Kentucky, for 5 minutes of questions. \nMr. C OMER . Thank you. \nDr. Fauci, in your opening statement, you attempt to distance \nyourself from your previous senior advisor, Dr. Morens. You say that Dr. Morens’ title was just made up, that he was not an advisor to you, and that his office was in a different building. \nSo, Dr. Fauci, did Dr. Morens report directly to you? \n18 \nDr. F AUCI . Actually, I’m not sure exactly what the on-paper re-\nport is. He is Senior Advisor to the Director, but it is conceivable— we can get that information—he might have reported through someone lower, like my deputy. \nMr. C\nOMER . So your senior advisor did not report directly to you? \nDr. F AUCI . There were very few people who report directly to me. \nMr. C OMER . OK. \nDr. Morens testified that he could walk into your office anytime \nhe wanted to. Is that true? \nDr. F AUCI . No. That’s not true. You don’t just walk into the of-\nfice. I mean, he’s there. I mean, it’s conceivable that he—— \nMr. C OMER . Did he ever walk into your office? \nDr. F AUCI . I would say he did occasionally, but the idea—can I \nfinish the answer to you, sir? \nMr. C OMER . No, because I’ve got a lot of questions. \nDr. F AUCI . OK. \nMr. C OMER . Dr. Fauci, did you ever delete an official record? \nDr. F AUCI . No. \nMr. C OMER . Dr. Fauci, did you ever conduct official business via \nemail? \nDr. F AUCI . To the best of my recollection and knowledge, I have \nnever conducted official business via my private email. \nMr. C OMER . So, there’s a troubling pattern of behavior from your \ninner circle, not just Dr. Morens but also your chief of staff, Mr. Folkers. \nDo you agree that it violates NIAID policy to use personal email \nfor official purposes? \nDr. F\nAUCI . The Dr. Morens issue that was discussed by this Com-\nmittee violates NIH policy, yes. \nMr. C OMER . But does using official email—using a personal email \nfor official business, does that violate policy? \nDr. F AUCI . Using a personal email for official business violates \nNIH policy. \nMr. C OMER . Does it violate NAID—NAI—NA—NIAID policy to \ndelete records to intentionally avoid FOIA? \nDr. F AUCI . Yes. \nMr. C OMER . OK. \nOn April 28, 2020, Dr. Morens edited an EcoHealth press release \nregarding the grant termination. \nDoes that violate policy? Dr. F\nAUCI . That was inappropriate, for him to be doing that for \na grantee, as a conflict of interest, among other things. \nMr. C OMER . So, on March 29, 2021, Dr. Morens edited a letter \nthat Dr. Daszak was sending to NIH. \nDoes that violate policy? Dr. F\nAUCI . Yes, it does. \nMr. C OMER . On October 25, 2021, Dr. Morens provided Dr. \nDaszak with advice regarding how to mislead NIH on EcoHealth’s \nlate progress report. \nDoes that violate policy? Dr. F\nAUCI . That was wrong and inappropriate and violated pol-\nicy. \n19 \nMr. C OMER . On December 7, 2021, Dr. Morens wrote to the chair \nof EcoHealth’s board of directors to, quote, ‘‘put in a word,’’ end quote, for Dr. Daszak. \nDoes that violate policy? Dr. F\nAUCI . He should not have done that. That was wrong. \nMr. C OMER . And that violates policy? \nDr. F AUCI . Well, I’m not sure of a specific policy, but I imagine \nit does violate policy. He should not have been doing that. \nMr. C OMER . In addition to all those actions, Dr. Morens wrote to \nDr. Daszak, quote, ‘‘Peter, from Tony’s numerous recent comments to me, they are trying to protect you,’’ end quote. \nDid you ever talk to Dr. Morens about Dr. Daszak or EcoHealth \nAlliance? \nDr. F\nAUCI . I can tell you, regarding what you said, I never spoke \nabout protecting him. I mean, obviously, we knew that Daszak was a grantee, so I may have mentioned and discussed Dr. Daszak be-cause he’s a grantee—— \nMr. C\nOMER . So he just made that up? \nDr. F AUCI [continuing]. But I never spoke about—— \nMr. C OMER . You’re testifying—— \nDr. F AUCI [continuing]. Protecting him. \nMr. C OMER [continuing]. That he just made that up? \nDr. F AUCI . Excuse me? \nMr. C OMER . You’re testifying that Dr. Morens just made that up? \nDr. F AUCI . I don’t know where he got that, but that’s not true. \nMr. C OMER . So, by this point, Dr. Fauci, when these emails were \nwritten, you should’ve known that Dr. Daszak was more than 2 years late on a required progress report with his grant, Dr. Daszak conducted an experiment that resulted in a novel virus showing ex-cess growth, that Dr. Daszak failed to report that experiment, that Dr. Daszak was protecting the Wuhan lab in not sharing its lab notebooks, and that Dr. Daszak failed to disclose obvious conflicts of interest. \nSo why were you trying to protect Dr. Daszak and EcoHealth Al-\nliance? \nDr. F\nAUCI . I repeat on the record, I have not tried to protect Dr. \nDaszak. And that’s No. 1. \nNo. 2, you said something that’s not true, because I did not know \nabout the compliance issues until well after the fact, when I was being briefed for going before a congressional committee. So it wasn’t that as these things were going on I knew that he was with-holding—— \nMr. C\nOMER . Well, did you know about Dr. Morens’ close relation-\nship with Dr. Daszak? \nDr. F AUCI . Dr. Morens made it clear that Dr. Daszak was his \nfriend. I did not engage in any of that interaction between them. \nMr. C OMER . And, just last, if I might, Mr. Chair, you testified \nand answered the Chairman’s question that you never had any communication with the intelligence community throughout all of COVID? Did I understand that correctly? \nDr. F\nAUCI . No, you heard wrong. I said I did have communica-\ntion. I was briefed by the intelligence community multiple times during the COVID issue. \nMr. C\nOMER . And you never—— \n20 \nDr. W ENSTRUP . The gentleman’s time has expired. \nMr. C OMER . All right. \nDr. W ENSTRUP . I now recognize the Ranking Member of the Full \nCommittee, Mr. Raskin from Maryland, for 5 minutes of questions. \nMr. R ASKIN . OK. \nFirst, Dr. Fauci, thank you for your testimony and your extraor-\ndinary service to the American people. \nLet me just start, was there anything you wanted to clear up in \nthat last exchange that—where you were interrupted? \nDr. F AUCI . No, I think I made it clear. I mean, they were talking \nabout my knowing about a lack of compliance. That became clear, Congressman Raskin, well after the fact. It isn’t as if they were not complying and I was not monitoring their noncompliance. I didn’t know about it until it was a done deal. \nMr. R\nASKIN . Gotcha. \nYou’ve been a scientist and a scientific administrator for 54 \nyears; is that right? More than a half-century? \nDr. F AUCI . That’s correct. \nMr. R ASKIN . And you were Director of the National Institute of \nAllergy and Infectious Diseases for more than three decades. Is that right? \nDr. F\nAUCI . Thirty-eight-plus years. \nMr. R ASKIN . Thirty-eight years. OK. \nAnd I assume that you’ve never been accused of trying to start \na disease before. Is that right? \nDr. F AUCI . That is correct. \nMr. R ASKIN . You have devoted your life to fighting infectious dis-\neases for the American people. Is that right? \nDr. F AUCI . That is correct. \nMr. R ASKIN . I want to go back to this email that you cited in \nyour opening, because I think it goes right to the heart of this cam-paign of character assassination against you. \nThe claim was, essentially, that you tried to cover up the possi-\nbility of there having been a laboratory leak—which, of course, is perfectly possible, and if this Committee were doing its job, we could actually be working to advance the investigation of that. But they would rather assert that you tried to cover up this possibility. \nHere’s the email that you sent on February 1 at 12:38 a.m. to \nKristian Andersen—with a copy to Kristian Andersen, but you sent it to Professor Jeremy Farrar. \n‘‘Jeremy, I just got off the phone with Kristian Andersen, and he \nrelated to me his concern about the furin site mutation in the spike protein of the currently circulating 2019 nCoV. I told him that as soon as possible he and Eddie Holmes should get a group of evolu-tionary biologists together to carefully examine the data to deter-mine if his concerns are validated. He should do this very quickly. And if everyone agrees with his concern, they should report it to the appropriate authorities. I would imagine that in the USA this would be the FBI and in the U.K. it would be MI5. It would be im-\nportant to quickly get confirmation of the cause of his concern by experts in the field of coronaviruses and evolutionary biology. In the meantime, I will alert my U.S. Government official colleagues of my conversation with you and Kristian and determine what fur-\n21 \nther investigation they recommend. Let us stay in touch. Best re-\ngards, Tony.’’ \nWas this the email where you were putatively trying to cover up \nthe possibility of a lab leak? \nDr. F AUCI . Yes, Congressman Raskin. And that’s the reason why \nI mentioned in my opening statement that it is inconceivable that anyone could get out of that that I was covering anything up. \nMr. R\nASKIN . Would you have any reason to cover up any new sci-\nentific evidence relating to the origins of the COVID–19 virus? \nDr. F AUCI . Absolutely not. And that’s the reason why it was im-\nportant to get people together to discuss this in a transparent way. \nMr. R ASKIN . Have you spent your whole life trying to determine \nthe causes of infectious diseases and then to stop them to protect the American people? \nDr. F\nAUCI . Yes, I have. \nMr. R ASKIN . Well, Dr. Fauci, I want to join my colleague from \nFlorida in apologizing to you that some of our colleagues in the U.S. House of Representatives seem to want to drag your name through the mud. \nThey’re treating you, Dr. Fauci, like a convicted felon. Actually, \nyou probably wish they were treating you like a convicted felon. They treat convicted felons with love and admiration. Some of them blindly worship convicted felons. \nIs there anything else you would like to say to the American peo-\nple about your service to America during the course of the COVID– 19 pandemic? \nDr. F\nAUCI . My main job during the COVID pandemic was to play \na role with my team at the Vaccine Research Center to develop a safe and effective vaccine. And we did that in an unprecedented short period of time never seen before in the annals of vaccinology. \nAs we all know, that vaccine and those vaccines have resulted in \nsaving of hundreds of thousands of lives in the United States and millions of lives throughout the world. \nMr. R\nASKIN . Well, you have fought AIDS and HIV, you have \nfought COVID–19, and you are fearless in doing so. \nDo you have any reason to be afraid of scientific evidence or data \nor the truth? \nDr. F AUCI . Not at all. \nMr. R ASKIN . Thank you. \nI will yield back to you, Mr. Chairman. Dr. W\nENSTRUP . I now recognize Mr. Griffith from Virginia for 5 \nminutes of questions. \nMr. G RIFFITH . Thank you, Mr. Chairman. \nIt’s good to see you, Dr. Fauci. So take a deep breath, because my questions change sometimes \nbased on things that happen in the hearing, and I want you to fol-low the bouncing ball with me. And there’s no ‘‘gotcha’’ at the end of this; I’m just trying to figure this out. \nYou told Dr. Ruiz in his questioning that it was absolutely im-\npossible for any of the viruses that you all were funding—I get that—to—it was impossible for SARS-Covid–2, or SARS-CoV–2, known as COVID–19, to have come from any of the work that was being done at Wuhan. \n22 \nAt the same time, you told Mr. Comer that you didn’t know \nabout the noncompliance by EcoHealth until after the fact and when the virus is already out there, however it got there. \nIn light of the fact that part of that noncompliance was a report \nwhere we uncovered—and I believe that Dr. Daszak was untruthful to this Committee—in one of his reports to NIAID, and, further, that in the two most sensitive years related to the humanized mice experiments, we never got lab notebooks from Wuhan Institute of Virology, can you understand, following the bouncing ball, why some of us doubt that—not that you had some hand in it or that you knew about it, but doubt that you can state with certainty that it was impossible because they might’ve been doing stuff you didn’t know about? Isn’t that true? \nDr. F\nAUCI . Actually, it’s not incompatible at all, Congressman, \nwhat I said. \nThe viruses that were studied, whether you did or did not give \na 5-year report on time, were still the viruses that phylogenetically would be impossible to be the precursor of SARS-CoV–2. \nSo it was completely compatible with the statement that I \nmade—— \nMr. G\nRIFFITH . And is that—— \nDr. F AUCI [continuing]. To Dr. Ruiz. \nMr. G RIFFITH [continuing]. Is that accurate as well, knowing that \nthey had worked on adding a furin cleavage site to MERS? \nDr. F AUCI . But, sir, there’s a difference between the viruses that \nwere funded by the NIH sub-award versus anything else anybody else in China might be doing. \nMr. G\nRIFFITH . Excellent. \nDr. F AUCI . We were talking about, did the NIH—— \nMr. G RIFFITH . You were talking about what you funded. \nDr. F AUCI . What we funded. And—— \nMr. G RIFFITH . All right. \nDr. F AUCI [continuing]. That’s the point. \nMr. G RIFFITH . And that goes to my next question, because I \nthought you might go there. And I appreciate that. \nDr. F AUCI . Right. \nMr. G RIFFITH . Because, in an off-the-record Member-level brief-\ning in February 2022, I asked about the likelihood in nature of a SARS-related coronavirus to have a furin cleavage site, particularly since it takes the 12-nucleotide change in there to make it so—to make it as viral as this was going on. \nAnd, at the time, you said to me pretty much what you just \nsaid—and I want you to just confirm it for the record—‘‘Well, that wasn’t us. If that was being done, it wasn’t us.’’ \nDr. F\nAUCI . Yes. \nMr. G RIFFITH . And you confirmed that for the record, yes? \nDr. F AUCI . No, what I’m—— \nMr. G RIFFITH . It wasn’t you? It wasn’t what you were funding? \nDr. F AUCI . What I’m saying is that I cannot account, nor can \nanyone account, for other things that might be going on in China, which is the reason why I have always said and will say now, I keep an open mind as to what the origin is. \n23 \nBut the one thing I know for sure is that the viruses that were \nfunded by the NIH phylogenetically could not be the precursor of SARS-CoV–2. \nMr. G\nRIFFITH . And I appreciate that, because I’ve never thought \nthat NIH or NIAID went out to create this thing. But I am a be-liever that it came out of the lab. \nAnd I think you’ve just made it clear—and sometimes people \nmiss this, Dr. Fauci—one side says one thing, one side says the other, and the actual fact may be that, at some time, working on that, maybe they used some of our money to get started, maybe they didn’t, but a group of scientists getting together might very well at Wuhan have said, ‘‘Hey, let’s see what happens if we go over here and do this’’—not that NIH funded it, but they, on their own, went off and did something. \nIsn’t that accurate? Isn’t that possible? Dr. F\nAUCI . Well, I actually would also want to say that one thing \nwe should put out on the table, that you were talking about a $120,000-a-year grant in a $6 billion budget. So, I mean, if they were going to do something on the side, they had plenty of other money to do it. They wouldn’t necessarily have to use a $120,000 NIH grant to do it. \nMr. G\nRIFFITH . And I appreciate that, because it means something \ncould happen, and I’m glad you kept an open mind. \nI would ask this one final thing, though. Do you think they \ncould’ve done it without the humanized mice that we gave them? \nDr. F AUCI . Could’ve done what, sir? \nMr. G RIFFITH . Could they have done any other research with the \nhumanized mice that we gave them? Would they be successful? China didn’t have the humanized mice before we gave them to Wuhan. Isn’t it accurate that they might’ve been able to do extra stuff with our mice? \nDr. F\nAUCI . That’s a hypothetical that I can’t really answer, what \nthey could or could not—— \nMr. G RIFFITH . But you can’t say it couldn’t have happened either. \nDr. F AUCI . Well—— \nMr. G RIFFITH . I yield back. \nDr. F AUCI [continuing]. You want me to prove a negative. \nDr. W ENSTRUP . I now recognize Ms. Castor from Florida for 5 \nminutes of questions. \nMs. C ASTOR . Thank you, Mr. Chairman. \nYou know, these special investigative committees are intended at \nthe outset to bring light to difficult matters, and I think, unfortu-nately, this Select Committee has brought more heat than light to things. \nAnd one example is, nearly 5 months ago, Dr. Fauci sat for a 14- \nhour voluntary interview with the Subcommittee—I was there for that interview—which included exchanges on many important questions on research safety, long COVID, vaccine development, \nand the importance of strong public health systems in our local communities. And also, we discussed pandemic preparedness, like stockpiling supplies for our hospitals in advance of the next pan-demic. \n24 \nBut I want the public to know that for 5 months the Republicans \nsat on that transcript. They could have released it at any time. It was released last Friday. \nIf the public had seen it 5 months ago, they would know that \nthey—the Republicans failed to find a shred of evidence of their far-fetched conspiracy linking Dr. Fauci to a cover-up of the origins of the pandemic. Instead, the Republicans contorted and mischaracterized Dr. Fauci’s words over Twitter to gin up conspir-acies about NIH’s role in the origins of the pandemic. \nIn the lead-up to this hearing, parts of that interview have again \nbeen cherry-picked and distorted in press releases and tweets. \nSo, Dr. Fauci, I want to make sure that you have an opportunity \nto publicly clear anything up. Does anything come top of mind right off the bat in how they cherry-picked parts of your 14-hour tran-script? \nDr. F\nAUCI . I don’t want to be casting stones at the distortions of \nwhat was said in that, but, you know, there are a couple of things that come to mind. \nYou know, one I’m sure is going to come up later is the issue of \nthe six-foot distance, and I made the statement that it ‘‘just ap-peared.’’ And that got taken like, ‘‘I don’t know what’s going on. It just appeared.’’ \nIt actually came from the CDC. The CDC was responsible for \nthose kinds of guidelines to schools, not me. \nSo, when I said that it just appeared, it appeared. Was there any \nscience behind it? What I meant by ‘‘no science behind it’’ is that there wasn’t a controlled trial that said, compare 6-foot with 3 feet with 10 feet. So there wasn’t that scientific evaluation of it. \nWhat I believe the CDC used for their reason to say six feet is \nthat studies years ago showed that when you’re dealing with drop-lets—which, at the time that the CDC made that recommendation, it was felt that the transmission was primarily through droplet, not aerosol, which is incorrect, because we know now aerosol does play a role. \nThat’s the reason why they did it. It had little to do with me, \nsince I didn’t make the recommendation. And my saying there was no science behind it means there was no clinical trial that proved that. \nThat’s just one of the things that got a little distorted in the re-\nsponse to that. \nMs. C\nASTOR . And I’ve learned and watched you over the years. \nI have to go back to the Zika outbreak, where we didn’t know how exactly it was being transmitted. And, at one point, we weren’t aware that some of the—some of it was sexually transmitted. \nThat’s an example of why, with these public health threats, that \nyou learn—you learn, unfortunately, as we go along. \nTalk a little bit about the Zika health threat and how that—we \ndidn’t know what was happening in early days. \nDr. F\nAUCI . Well, Congresswoman—— \nMs. C ASTOR . Your microphone. \nDr. F AUCI [continuing]. I’m glad you brought that up, because it \nreally is also reflective of what went on in the early months of COVID. \n25 \nWhen you’re dealing with an outbreak that’s a novel outbreak— \nthe Zika outbreak that caused microcephaly was novel. We had never seen that before. COVID was novel. We’d never seen that be-fore. When you’re dealing with a new outbreak, things change. The scientific process collects the information that will allow you, at that time, to make a determination, a recommendation, or a guide-line. \nAs things evolve and change and you get more information, it is \nimportant that you use the scientific process to gain that informa-tion and perhaps change the way you think of things, change your guidelines, and change your recommendation. \nAnd that really goes across the board, because you’re dealing \nwith something that needs to be modified because it’s a moving tar-get. Zika was a moving target. COVID was a moving target. \nMs. C\nASTOR . Well, thank you very much. \nAnd I want to thank the Democratic staff for your Minority re-\nport. \nAnd if it’s not already submitted for the record, I’d like to ask \nunanimous consent to offer into the record the Democratic staff re-port, just completed, ‘‘Republicans’ Fauci Flop: Select Subcommit-tee’s Fifteen-Month Probe Fails to Find Evidence of Extreme Claims Linking Dr. Fauci to COVID–19’s Origins.’’ \nDr. W\nENSTRUP . Without objection. \nMs. C ASTOR . And thank the staff. This is an outstanding report \nthat folks should read. \nThank you. Dr. W\nENSTRUP . I now recognize Ms. Malliotakis from New York \nfor 5 minutes of questions. \nMs. M ALLIOTAKIS . Thank you, Mr. Chairman. \nI think many of us on the Committee are really disturbed by rev-\nelations to this Committee that there were officials at NIH that de-leted government records, that deleted personal—or they used per-sonal information—personal emails to communicate and cir-cumvent freedom-of-information laws. So, I just had a couple ques-tions about that. \nDr. Fauci, did you delete any emails or records related to the \nWuhan lab or the origins of the virus? \nDr. F\nAUCI . No, I did not. \nMs. M ALLIOTAKIS . OK. \nDr. Morens said in a May 2021 email—he indicated that he was \nconnecting people to you in a, quote, ‘‘secret backchannel.’’ \nDo you know what he was referring to? Dr. F\nAUCI . I don’t have any idea what he’s talking about. There \nis no backchannel at NIAID. \nMs. M ALLIOTAKIS . OK. \n‘‘There is’’—he also said in another email that ‘‘there is no worry \nabout Freedom of Information Act. I can send stuff to Tony on his private email.’’ \nDid you communicate with anyone relating to anything regarding \nNIH or with Dr. Morens on a private email? \nDr. F\nAUCI . I do not do government business on my private email. \nMs. M ALLIOTAKIS . OK. So have you communicated with Dr. \nMorens via private email, even if it was not necessarily your defini-tion of government business? \n26 \nDr. F AUCI . It might have been—because, as I mentioned in my \nopening statement, one of his functions is to write chapters, med-ical scientific chapters, with me. So it is conceivable that I commu-nicated with him on my private email when we were writing a chapter, and that was not official business. \nMs. M\nALLIOTAKIS . What about Peter Daszak? \nDr. F AUCI . No. \nMs. M ALLIOTAKIS . OK. \nI just want to clarify for the record, because today you testified \nthat you did not suppress the lab leak theory, yet in the past you have said, quote, ‘‘It is a distortion of reality,’’ unquote. You’ve said, quote, ‘‘I’ve heard these conspiracy theories, and, like all conspiracy theories, they’re just conspiracy theories.’’ That’s what you told the American people. \nAnd so would you like to clarify, what science were you following \nthen versus now? \nDr. F\nAUCI . Yes. No, I—actually, I’ve also been very, very clear \nand said multiple times that I don’t think the concept of there being a lab leak is inherently a conspiracy theory. \nWhat is conspiracy is the kind of distortions of that particular \nsubject. Like, it was a lab leak, and I was parachuted into the CIA like Jason Bourne and told the CIA that they should really not—— \nMs. M\nALLIOTAKIS . OK. \nDr. F AUCI [continuing]. Be talking about a lab leak. \nMs. M ALLIOTAKIS . Thank you. \nDr. F AUCI . That’s the conspiracy. \nMs. M ALLIOTAKIS . Appreciate that. \nDr. Fauci, how much have you earned from royalties from phar-\nmaceutical companies since the pandemic began in 2021? \nDr. F AUCI . Zero. \nMs. M ALLIOTAKIS . It says, ‘‘NIH scientists made $710 million in \nroyalties from drug makers.’’ \nYou’re saying that you did not receive any of the $710 million? Dr. F\nAUCI . On COVID? I received I think $122 for a monoclonal \nantibody that I made 27 years ago—— \nMs. M ALLIOTAKIS . OK. So, just in general, though, how much \nhave you received—not related to COVID, just in general, how much have you received in royalties between 2021 and 2023? \nDr. F\nAUCI . I think none. \nMs. M ALLIOTAKIS . OK. So somebody received the $710 mil-\nlion—— \nDr. F AUCI . Somebody did, but not me. \nMs. M ALLIOTAKIS . You didn’t receive any royalties? OK. \nDr. F AUCI . I see no royalties associated with COVID. I men-\ntioned—— \nMs. M ALLIOTAKIS . Yes, I said—— \nDr. F AUCI . No, I want to—— \nMs. M ALLIOTAKIS . No, I just said—— \nDr. F AUCI . I’m on the record, and I want to make sure that this \nis clear: that I’ve developed a monoclonal antibody about 25 years ago that’s used as a diagnostic that has nothing to do with COVID, and I receive an average of about $120 a year from that patent. \nMs. M\nALLIOTAKIS . OK. \n27 \nBut the bottom line here is that scientists at NIH did receive \n$710 million in royalties. And I guess my question is, don’t you think that if these experiments are made using American tax dol-lars, that any of those royalties, this nearly billions of dollars, should be going back to the American taxpayer, not in the pockets of the scientists? Do you believe that’s a law that we should con-sider changing? \nDr. F\nAUCI . If you want to change the patent laws and the Bayh- \nDole Act, then go ahead. \nMs. M ALLIOTAKIS . OK. \nDr. F AUCI . But that’s not for me to say. \nMs. M ALLIOTAKIS . Well, I’m asking your opinion. OK. \nWell, anyway, moving on, I just want to say that, you know, we \nknow billions of dollars have been funding these animal experi-ments, both here domestically and in foreign lands. I’m very trou-bled by the animal—the cruel, horrific animal research that has been done on U.S. land and in foreign laboratories of—taxpayers are footing the bill for billions of dollars. These beagle puppies that have their throats slit. They are being injected with ticks. They are murdered after just a few months. Piglets, rabbits, you name it. \nFDA is saying we no longer need to be testing human medica-\ntions on animals, that there’s other ways to achieve this. \nCan you comment on that, if it’s time for the United States of \nAmerica to be moving on from these cruel animal and horrific cost-ly tests? \nDr. F\nAUCI . I’d be happy to comment, but I’m puzzled as to what \nthat has to do with the origins of COVID. \nMs. M ALLIOTAKIS . Well, I have a question about it, and—— \nDr. F AUCI . OK. I’d be happy to answer it. \nMs. M ALLIOTAKIS [continuing]. You’re before this Committee, and \nit has to do in general—— \nDr. F AUCI . Yes. \nMs. M ALLIOTAKIS [continuing]. With the amount of waste of tax \ndollars that NIH is using. \nDr. F AUCI . Well, the animal experiments that are conducted by \nand funded by NIH go through strict regulations of the proper use of animals in research. \nSo, I’m not—Congresswoman, with all due respect, I’m not trying \nto be confrontative. I’m not sure what you’re talking about, but the experiments that the NIH funded go through strict regulatory proc-esses of the treatment of animals, the humane treatment of ani-mals. \nMs. M\nALLIOTAKIS . Well, they’re not very humane. And I will say, \nas the former Director, you signed off on these experiments. \nAnd so my time has expired, and we will—— Dr. F\nAUCI . Well, I signed off on them because they were ap-\nproved by a peer-review process. \nDr. W ENSTRUP . I now recognize Mrs. Dingell from Michigan for \n5 minutes of questions. \nMrs. D INGELL . Thank you, Mr. Chairman. \nYou know, instead of actually taking a serious look at the various \nways by which this virus could’ve emerged in a lab or in nature, my Republican colleagues and friends have spent the last 15 \n28 \nmonths trying to pin blame on NIH, NIAID, and specifically Dr. \nFauci for the COVID–19 pandemic. \nAnd now—and just, you know, let’s bring everything in. Look, I \nwant to have a discussion about animal testing too, but I’m really not sure how that comes into here. \nBut I want to be perfectly clear, though, that the Select Sub-\ncommittee has seen no evidence of this. However, allegations by my Republican colleagues, amplified in the media, have led to real, tangible consequences for Dr. Fauci in his personal life in a way that should be unacceptable to all Americans. \nDr. Fauci, you and I have known each other for a long time, and \nI’m not even going to admit how long. But, during that time, I’ve seen your commitment not just to science but to advancing the greater good. \nAnd I know that this isn’t a topic you enjoy discussing, and I’m \nsorry I’m going to have to ask you about it, but I think the Amer-ican people need to know what we are doing to those who are serv-ing the common good and public health. I think it’s important to make clear the harms that you and your loved ones have suffered because of these deeply irresponsible accusations. Because you know what? You’re human, just like the rest of us. \nSo, Dr. Fauci, can you please share with us the nature of the \nthreats you have received since the start of the COVID–19 pan-demic? \nDr. F\nAUCI . Yes. There have been everything from harassments by \nemails, texts, letters, of myself, my wife, my three daughters. There have been credible death threats, leading to the arrests of two indi-viduals. And ‘‘credible death threats’’ means someone who clearly was on their way to kill me. And it’s required my having protective services essentially all the time. \nIt is very troublesome to me. It is much more troublesome be-\ncause they’ve involved my wife and my three daughters. \nMrs. D\nINGELL . At these moments, how do you feel? \nDr. F AUCI . [Inaudible.] \nMrs. D INGELL . Keep your mic on. \nDr. F AUCI . Terrible. \nMrs. D INGELL . Do you continue to receive threats today? \nDr. F AUCI . Yes, I do. Every time someone gets up and says I’m \nresponsible for the death of people throughout the world, the death threats go up. \nMrs. D\nINGELL . It’s unacceptable that you’ve been treated this \nway, especially after you’ve dedicated your life to science and re-search for the public interest. You deserve better. Every human being deserves better. \nAnd I’m afraid that the treatment you’ve received will also have \nfar-reaching consequences for the future of science, particularly when done for the public good. \nDr. Fauci, how do you think the threats toward you and other \npublic health officials have received will impact bright young schol-ars thinking about going off into science or public service? Do you think as many people will want to follow in your footsteps as they did when I first met you? \nDr. F\nAUCI . You know, Congressman Dingell, I think this is a \npowerful disincentive for young people to want to go into public \n29 \nhealth and maybe even science and medicine in the public arena, \nbecause it’s very clear that not only I, because I’m very much of a public figure, but many of my colleagues who are less visible than I, whenever they speak up in defense of the kinds of things that we’re trying to do to protect the American public, they too get threats. \nAnd when they see that their colleagues get threats, they say to \nthemselves, ‘‘I don’t want to go there. Why should I get involved in that?’’ And you have some potentially very good talent that would be important to maintain the integrity and the excellence of the public health enterprise in the United States—we’re not getting the best people coming in, because they’re reluctant to put them-selves and their family through what they see their colleagues being put through. \nMrs. D\nINGELL . Well, you’re right, you’re not alone in feeling that \nway. In fact, ahead of today’s hearing, the Select Subcommittee re-ceived a letter from the Association of State and Territorial Health Officials, which represents public health officials in communities of all political persuasions, detailing the surge of harassment, intimi-dation, hate speech, threats of violence, and deaths threats that their members faced during the pandemic. \nCan I just—I’m going to ask to insert the—into the letter, but I \nwanted to just make the point before I close, Mr. Chairman, that as many as 40 percent of public health workers have been bullied, threatened, or harassed. And I think we all need to take that on as a public health issue. \nI’d ask to enter the letter into the record, and yield back. Dr. W\nENSTRUP . Without objection. \nMrs. D INGELL . Thank you, Mr. Chairman. \nDr. W ENSTRUP . I now recognize Mrs. Lesko from Arizona for 5 \nminutes of questions. \nMrs. L ESKO . Thank you, Mr. Chair. \nDr. Fauci, did the National Institute of Health fund the poten-\ntially dangerous enhanced potential pandemic pathogens gain-of- function research at the Wuhan Institute of Virology? \nDr. F\nAUCI . I would not characterize it the way you did. \nThe National Institutes of Health, through a sub-award to the \nWuhan Institute of Virology, funded research on the surveillance of and the possibility of emerging infections. \nI would not characterize it as ‘‘dangerous gain-of-function re-\nsearch.’’ I’ve already testified to that effect—— \nMrs. L\nESKO . So—— \nDr. F AUCI [continuing]. A couple of times. \nMrs. L ESKO . So you’re saying no, correct? \nIn his May 16—— Dr. F\nAUCI . I’m saying no because I’ve said no multiple times—— \nMrs. L ESKO . Thank you. \nDr. F AUCI [continuing]. Including in the transcribed interview. \nMrs. L ESKO . In his May 16, 2024, testimony, the NIH Deputy Di-\nrector Tabak said, and I quote, ‘‘I can tell you that the failure of the Wuhan Institute of Virology to provide us with the data that we requested and the lab notebooks that we requested certainly im-peded our ability to understand what was really going on with the experiments that we have been discussing this morning.’’ \n30 \nMy question to you, Dr. Fauci: If the NIH didn’t inspect the \nWuhan Institute of Virology and NIH didn’t receive the lab books and data from China and the required reports from EcoHealth Alli-ance were not submitted—in fact, they were late—how can you de-finitively say that the NIH did not fund the dangerous gain-of-func-tion research? \nDr. F\nAUCI . I go back to what I said, that the gain-of-function re-\nsearch by the operative and regulatory definition of P3C0 does not include, at all, the viruses that were studied under the sub- award—— \nMrs. L\nESKO . How do you know that, sir, if there were no lab \nbooks—— \nDr. F AUCI . Because we—— \nMrs. L ESKO [continuing]. Nothing from China? \nDr. F AUCI [continuing]. Know what viruses they were studying. \nMrs. L ESKO . How? How do you know? You never went there. \nDr. F AUCI . By their—but you—I’m telling you that the NIH fund-\ned research on these viruses. If someone else somewhere in China was doing something else, that is not—— \nMrs. L\nESKO . Well, that’s the problem, because NIH didn’t go \nthere, you didn’t get the reports that were needed. How in the world would you know? \nI’m going to go on to—— Dr. F\nAUCI . Well—— \nMrs. L ESKO [continuing]. The next question. \nDr. F AUCI . And you’re not hearing what I’m saying. \nMrs. L ESKO . Dr. Morens, your senior advisor for over 20 years, \nsaid in an email dated February 24, 2021, ‘‘I learned from your FOIA lady here now how to make emails disappeared when I am FOIA’ed but before the search starts, so I think we are all safe. Plus, I deleted most of these earlier emails after sending them to Gmail.’’ \nIn another email, dated 4/21/21, Dr. Morens said, ‘‘I forgot to say, \nthere is no worry about FOIAs. I can either send stuff to Tony,’’ meaning you, ‘‘on his private email or hand it to him at work or at his house. He is too smart to let colleagues send him stuff that could cause trouble.’’ \nDr. Fauci, were you ever engaged in attempts to obstruct the \nFreedom of Information Act and the release of public documents? \nDr. F\nAUCI . No. \nMrs. L ESKO . Did you—did Dr. Morens communicate with you \nabout official business using his private email? \nDr. F AUCI . Official business? No. \nMrs. L ESKO . Did you ever encourage Dr. Morens to use his pri-\nvate email address for official business? \nDr. F AUCI . No. \nMrs. L ESKO . My next question, sir, is: On February 1, 2020, you, \nyourself, Dr. Fauci, the NIH Director Collins, and at least 11 other scientists were on a conference call to discuss the origins of \nCOVID. A number of the scientists said that they were concerned that COVID was the result of a lab leak at the Wuhan Institute of Virology and were concerned that a revelation of the lab leak theory would hurt their relationship with China. \n31 \nThe CDC Director Redfield testified that he was not invited on \nthis conference call, and he believes it’s because he believed the lab leak theory was possible. \nThree days later, on February 4, 2020, four participants on the \nconference call authored a paper, ‘‘Proximal Origin,’’ which was sent to you for editing. ‘‘Proximal Origin’’ pushed the natural origin theory. \nOn April 16, 2020, the NIH Director, Dr. Collins, emailed you, \nexpressing dismay that the Nature Medicine article, which was based on ‘‘Proximal Origin,’’ didn’t suppress the lab leak theory and asked you for more public pressure to suppress the lab leak theory. \nThe very next day, in response to Dr. Collins’ request to suppress \nthe lab leak theory, you cited the Nature Medicine article, which discounted the lab leak theory, from the White House podium. \nMy question to you, sir: Did you cite this article at the White \nHouse because the NIH Director asked you to suppress the lab leak theory? \nDr. F\nAUCI . No. I did not do that in response to anybody’s sugges-\ntion to suppress anything. It was in response to a question that someone asked at the podium. \nAnd I did not edit any paper, as shown in my official testimony. So you said about four or five things, Congressman, that were \njust not true. \nMrs. L\nESKO . Well, we have emails to prove it. \nDr. F AUCI . No, you don’t. \nMrs. L ESKO . Thank you, and I yield back. \nDr. W ENSTRUP . I now recognize Mr. Mfume from Maryland for 5 \nminutes of questions. \nMr. M FUME . Thank you very much, Mr. Chairman. \nAnd, by the way, no, we don’t have it. So I get tired of hearing \n‘‘we’ve got it,’’ and then when we ask for it, it’s not there. We do not have it, Dr. Fauci, and for everyone watching this. That’s just incorrect. \nNow, let me just say a couple of things. If I sound a little out-\nraged, it’s because, you know, we sit here and we watch one con-spiracy theory after another get debunked. \nAnd, if I might, on a point of personal privilege, to the gentle-\nwoman from New York who wanted to argue that we should be worrying about testing of human medicines on animals, if this Committee really wants to do something, let’s talk about the most infamous biomedical research study in the United States, the Tuskegee study, where 400 Black men in this country were injected deliberately with syphilis and allowed to die slowly over a 40-year period without any attempt to help them at all. It was condoned by the U.S. Public Health Service. And if we want to talk about testing, let’s talk about that as well. \n[Disturbance in the hearing room.] Mr. M\nFUME . I’m going to talk about COVID right now. \nMr. Chairman, point of—I have the floor, Mr. Chairman. \nI want to say to you, Mr. Chairman—— Dr. W\nENSTRUP . If the gentleman would suspend, please. \nI want to remind the audience of decorum. I recognize Mr. Mfume. \n32 \nMr. M FUME . Thank you, Mr. Chairman. I want to thank you and \nRanking Member Ruiz for this opportunity. \nDr. Fauci, we owe you an apology for the way we have raked you \nthrough the mud, and none of us have said to you, here’s where you go to get your good name and your reputation back. It’s the most unfair thing I have seen. \nIf there were evidence, if there were facts that supported the \ncharges, I, like everybody else, would be interested. But we haven’t seen a damn thing to suggest that these accusations are accurate. \nYou’ve been a hero to many for 54 years, five-plus decades. You \nhelped lead this country through the anthrax scare, through AIDS, through Zika, through Ebola, through SARS, and through COVID– 19, pandemics and epidemics. We owe you a collective ‘‘thank you.’’ \nYou are a world-renowned scientist and an American patriot. \nAnd whether or not people want to believe that, that’s on them, but those facts are undisputable. \nFor a year and a half, the Republican Majority on this Com-\nmittee has sought to weaponize genuine scientific questions over COVID–19 and to vilify—vilify—our public health officials and our Nation’s scientists with unsubstantiated, with baseless, with—alle-gations that just can’t stand the light of day. And so they’ve tried to do that with COVID–19, and we are here now as a result of the aggregated amount of foolishness that has taken place. \nAnd I’ve always said to this Committee every time I’ve had a \nchance to speak, let’s go back to when we were in the heart of the pandemic, when our family members and friends and coworkers were dying left and right, when we were afraid to get near any-body, when we wanted to wash down our groceries before we brought them into the house, where we were willing to put on masks or headgear if it would keep us from being infected. \nAnd we turned to our leaders and the public health officials and \nscientists for answers. And we got some, but then we didn’t get some. And then we got some later, like Dr. Deborah Birx, who was Donald Trump’s expert on the virus, who said, ‘‘No, bleach won’t do it, don’t inject yourself with it,’’ and who also said publicly on the record that thousands of American lives could have been spared—spared—if we had done what we were being told to do by the scientific community. \nAt least one thing is clear: Those 1 million people who died as \na result of these conspiracy theories will never come back, and those families have empty seats at the table year after year. And we do a disservice if, at the very least, we don’t acknowledge their deaths and the harm and the hurt that has been done to their fam-ilies and learn—learn—how to find a way to trust science going for-ward in this country. \nDr. Fauci, you’ve been accused over and over again of going to \nthe CIA headquarters and sitting down and having a meeting with the CIA to construct a way to make sure that COVID raged in this country. \nIs that correct? Dr. F\nAUCI . That is incorrect. \nMr. M FUME . Dr. Fauci, have you been to the CIA office in the \nlast 20 years, or headquarters? \n33 \nDr. F AUCI . I went to the CIA decades ago during the anthrax at-\ntacks to discuss the possibility of terrorist attacks. \nMr. M FUME . Thank you. I wanted to get that on the record, be-\ncause that’s just the latest theory now, that you and the CIA Direc-tor conspired. This is foolishness. \nPeople are not going to agree with you, I understand that. But \nwe take and besmirch somebody’s good name? Think about if it were one of us. We’d be jumping up and down, trying to find a way to get justice. \nAnd so, on behalf of those of us who are thankful, who are part \nof many in a grateful Nation, thank you for your service, sir. \nI yield back. Dr. W\nENSTRUP . I now recognize Mr. Cloud from Texas for 5 min-\nutes of questions. \nMr. C LOUD . Thank you, Mr. Chairman. \nThank you for being here. And I do want to echo some of what Mr. Mfume said, because \nI do think we need to focus on the people. And I think that’s really what—the angst that’s left with the American people. It’s what they had to walk through during this time. \nI’m going to go down a list of mitigation measures that you sup-\nported over the course of the pandemic and ask you just to give a ‘‘yes’’ or ‘‘no’’ as to whether you still believe these measures were justified. \nBusiness closures? Dr. F\nAUCI . Congressman, I’m not hearing you at all. Could you \nplease speak louder into the mic? \nMr. C LOUD . Sure. I’m going to go through a list of COVID mitiga-\ntion measures that you supported over the course of the pandemic and ask you to give me a ‘‘yes’’ or ‘‘no’’ as to whether you believe these measures were justified. \nBusiness closures? Dr. F\nAUCI . Early on, when 5,000 people were dying a day, yes. \nMr. C LOUD . Church closures? \nDr. F AUCI . Same thing. \nMr. C LOUD . School closures? \nDr. F AUCI . Again—— \nMr. C LOUD . Stay-at-home orders? \nDr. F AUCI . These were important when we were trying to stop \nthe tsunami of deaths that were occurring early on. How—— \nMr. C LOUD . Early on. \nDr. F AUCI [continuing]. Long you kept them going is debatable. \nMr. C LOUD . Mask mandates for adults? Mask mandates for chil-\ndren? Mask mandates for children under 5? \nDr. F AUCI . And going back to what I said before, all of that is \nin the context of, at the time, 4,000—— \nMr. C LOUD . Mask mandates for children under 5, there—— \nDr. F AUCI [continuing]. To 5,000 people a day were dying. \nMr. C LOUD [continuing]. Was scientific evidence for that? \nDr. F AUCI . Excuse me? \nMr. C LOUD . Mask mandates for children under 5, there was sci-\nentific evidence supporting that? \nDr. F AUCI . There was no study that did masks on kids before— \nyou couldn’t do the study. You had to respond—— \n34 \nMr. C LOUD . Right. \nDr. F AUCI [continuing]. To an epidemic that was killing 4,000 to \n5,000 Americans—— \nMr. C LOUD . Vaccine—— \nDr. F AUCI [continuing]. Per day. \nMr. C LOUD [continuing]. Mandates for employees? Vaccine man-\ndates for students? Vaccine mandates for military? \nDr. F AUCI . Vaccines save lives. It is very, very clear that vaccines \nhave saved hundreds of thousands of Americans and—— \nMr. C LOUD . I’m not debating—— \nDr. F AUCI [continuing]. Millions of people worldwide. \nMr. C LOUD . We’re talking about COVID–19. Did or do the vac-\ncines, the COVID–19 vaccines, stop anyone from getting COVID? \nDr. F AUCI . I have answered that question to the Chairman. Early \non, it became clear that—— \nMr. C LOUD . They did? \nDr. F AUCI . No, actually, no. In the beginning—— \nMr. C LOUD . They did not? \nDr. F AUCI [continuing]. It clearly prevented infection in a certain \npercentage of people, but the durability of its ability to prevent in-fection was not long. It was measured in months—— \nMr. C\nLOUD . And they didn’t stop you from spreading it either, \ncorrect? \nDr. F AUCI . Early on, it did if it prevented infection. But what be-\ncame clear, that it did not prevent transmission when the ability to prevent infection waned. \nMr. C\nLOUD . All right. \nI think what’s troubling is when the American people look at the \ncertainty and the case at which people lost jobs, they lost liveli-hoods. I had rural hospitals in my area that did not have a single case of COVID in their rural community that had to shut down and people not get care that they did need for cancer, and some passed away because of those kind of things. And, time after time, we had people’s lives that are destroyed, and we have not seen the same sort of—once the new data came available, we did not see a change of course. \nAnd you’ll point out, for example, on the schools, that the CDC, \nyou know, put out the guidelines, for example. But we know that those guidelines end up being protection from lawsuits. It’s, ‘‘If you don’t want to be sued, you’d better follow the guidelines.’’ So they are not mandates, de facto mandates, but they turn out to be such a mandate. \nAnd when the science began to change—we all understand that \nin the first couple weeks, first few weeks, even a couple months, we were all trying to figure it out. I think there’s a lot of grace for that. \nThe concern is that, as the science became available, there wasn’t \nlike a, ‘‘Oh, maybe we should consider the lab leak theory,’’ ‘‘Oh, maybe we should consider natural immunity.’’ We never heard this messaging coming from you or from anyone else who stood on the sidelines talking about these things. And it’s left the American peo-ple with a tremendous distrust. \nI want to talk a little bit about the grant process. My under-\nstanding from your testimony to us—it says that the NIH process \n35 \nfor awarding grants is that, basically, a research proposal goes to \na peer-review committee to receive a priority score. Then it goes to an advisory council for NIH personnel. It receives a final—basi-cally, the group votes on it. And then eventually it ends up on your desk for signature, right? \nNow, you said in that that sometimes, if I recall correctly, those \ngrants are often approved en bloc, en masse, when they’re voted on, and then you sign off on them. \nDr. F\nAUCI . That’s correct. \nMr. C LOUD . This is one of the things that’s really troubling to the \nAmerican people. Because they look at their lives being destroyed, and there’s no one to hold accountable, because these systems of accountability have become systems of plausible deniability. \nAnd so your name is on every single grant, but yet you absolve \nyourself of any sort of responsibility by saying, well, you know, it goes to this Committee that’s, you know—that has a number of people on it, and they’re approved en bloc. And so there’s no ac-countability for anything, any of the taxpayer dollars that are going forth. \nDr. F\nAUCI . I disagree with you, Congressman. Because, if you \nlook at the number of grants, we fund thousands of grants. It would be physically impossible for me to go through every single grant in a detailed way to understand it. That is true not only for me but for virtually every institute at the NIH. \nMr. C\nLOUD . Then why does your signature go on it? \nDr. F AUCI . Because somebody has to sign off on it, and you trust \nthe expertise and the competence of the staff that go over—— \nMr. C LOUD . And what is the mechanism—— \nDr. F AUCI [continuing]. It very carefully. \nMr. C LOUD [continuing]. For holding people accountable? \nDr. W ENSTRUP . The gentleman’s time has expired. \nI now recognize Ms. Ross from North Carolina for 5 minutes of \nquestions. \nMs. R OSS. Thank you, Mr. Chairman. \nI want to thank you, Dr. Fauci, for your voluntary testimony \ntoday; also, for so much grace in your 14 hours of testimony. \nAnd I again want to thank you for your service and your pa-\ntience. It’s truly remarkable. Because it bears repeating, let me just remind everyone that, after 15 months, my Republican colleagues’ extreme allegations against you remain unsubstantiated. Unsub-stantiated. \nAnd, now, during your 2-day closed-door interview in January, \nyou discussed a number of topics regarding the public health re-sponse to the COVID–19 pandemic, some of which we’ve touched on briefly, but I just want to dive in a little bit deeper here. \nFor example, you discussed, both then and here with Congress-\nwoman Castor, the recommendation that we maintain six feet of distance between one another to reduce the spread of COVID–19. And you discussed how social distancing recommendations were de-veloped, that you yourself didn’t pick this six feet, and it was just really kind of a guideline in the moment. \nIn your view, though, do social distancing recommendations and \nother public health measures to reduce transmission save lives? \nDr. F\nAUCI . Definitely. \n36 \nMs. R OSS. OK. \nI’d also like to go back and take a deeper dive into the COVID– \n19 vaccine discussion that we just had, and you were also asked about that during your interview in January. \nIn the Select Subcommittee, we’ve heard suggestions that the \nvaccine was ineffective because of breakthrough infections that occur after vaccination. We just heard about that right here. \nBut, as I understand it, perhaps the strongest measure of \nCOVID–19 vaccines’ effectiveness is the reduction of severe disease and death, not necessarily getting a milder form of COVID. \nCould you talk about that a little bit? Dr. F\nAUCI . Yes. It’s very clear that, when you’re dealing with \nmany vaccines but particularly when you’re looking at COVID, as I mentioned—and I’ll repeat it quickly for you—that, early on, there was a degree, not as much as against severe disease, of pro-tection against infection. Unfortunately, that protection against in-fection, which is related to transmissibility, waned rather rapidly, in a matter of months. \nWhat has stood firm well, much better than transmission and \nmuch better than infection, is the ability to prevent someone from hospitalizations and deaths. \nAnd, in fact, the curves, Congresswoman, are stunning. When \nyou look at the deaths and hospitalizations of people who are unvaccinated, it’s like this. \n[Indicating.] When you look at the deaths and hospitalizations \nfor people who are vaccinated and boosted, it’s like this. \n[Indicating.] The difference is profound. When you’re dealing \nwith infection, again, less so, because of the waning of protection against infection. \nMs. R\nOSS. Well, and that was also confirmed by a Common-\nwealth Fund December 2022 report, which came out 2 years after the Biden administration’s effort to get COVID–19 vaccines in arms, and your effort too, that it prevented more than 3 million deaths and averted 18 million hospitalizations. And that came out in 2022, but it seems to corroborate what you’re saying. \nDr. F\nAUCI . Indeed. And $1.15 trillion in healthcare costs. \nMs. R OSS. Thank you for that add. \nOne pillar of the vaccine requirements was to have an increased \nuptake in the COVID–19 vaccines. And that, at the time, was sup-ported by leading physicians, including the American Medical Asso-ciation, the American Academy of Family Physicians, the American Academy of Pediatrics, and more. \nWere the vaccine requirements a clinically sound tool for improv-\ning uptake of a safe and effective vaccine? \nDr. F\nAUCI . Yes. You would like people to get vaccinated volun-\ntarily, realizing the important effect on it, but the fact that people were vaccinated by whatever the motivation was clearly saved many, many lives. \nMs. R\nOSS. And just with the 17 seconds I have, what steps can \npublic health officials take to bolster confidence in these life-saving interventions, since there has been so much misinformation circu-lating? \nDr. F\nAUCI . That’s going to be very difficult, Congresswoman, be-\ncause there is so much mis-and disinformation around that we’ve \n37 \ngot to do a better job of reaching out and trying to get the correct \ninformation. But that’s difficult when you have a very energetic group of people continually spreading mis-and disinformation about vaccines. We’ve got to be more proactive in putting out the facts and the data and the information that’s correct. \nMs. R\nOSS. Thank you very much for your testimony. \nAnd I’ll yield back. Dr. W\nENSTRUP . I now recognize Dr. Joyce from Pennsylvania for \n5 minutes of questions. \nDr. J OYCE . Thank you, Chairman Wenstrup, for convening this \nimportant hearing. \nAnd thank you, Dr. Fauci, for testifying. Dr. Fauci, one of the controversial regulations of the pandemic \nwas the six-foot distancing rule. This rule became an important policy consideration in subsequent regulations. However, you testi-fied recently, and I’m quoting, this six-foot rule ‘‘sort of just ap-peared.’’ \nDo you think that a rule that ‘‘sort of just appeared’’ is substan-\ntial justification for the regulations that we saw based on that six- foot rule? \nDr. F\nAUCI . Congressman, thank you for that question. I an-\nswered that, but I’ll summarize it briefly for you. \nWhen saying it ‘‘just appeared,’’ it came from the CDC—— Dr. J\nOYCE . OK. You stated that earlier. \nWhat was your relationship with the CDC when you saw a regu-\nlation which was not based in the current science? \nDr. F AUCI . Well, when I say it was not based in science, I meant \na prospective clinical trial to determine whether 6-foot was better than 3, was better than 10. What—— \nDr. J\nOYCE . But once we realized that the virus was not spread \nby droplets and was aerosolized, did you feel an indication to go back to the CDC and say, let’s base this on science, let’s get rid of this six-foot rule? \nThis six-foot rule crippled businesses. Dr. F\nAUCI . Right. \nDr. J OYCE . It allowed students to stay at home and not learn. \nAmericans suffered. And that suffering continues, because the frac-ture of trust in American scientists continues to this day. \nDid you not feel an obligation, for something that just sort of ap-\npeared, not to go back to the CDC and say, let’s base this on what we know? \nDr. F\nAUCI . It was a CDC decision, and it was clear—— \nDr. J OYCE . Were you dialoguing with the CDC? \nDr. F AUCI . Excuse me? \nDr. J OYCE . Were you in communication with the CDC? \nDr. F AUCI . CDC was part of the coronavirus response team, yes. \nDr. J OYCE . And you didn’t feel an obligation to go to them and \nsay, look, Americans aren’t going to trust—— \nDr. F AUCI . Yes. \nDr. J OYCE [continuing]. Us, we’re providing them with misin-\nformation? \nDr. F AUCI . We had discussions at the White House about that. \nWe did. But the CDC’s decision—and it was their decision to make, and they made it. \n38 \nDr. J OYCE . And you didn’t feel an obligation, as the lead scientist \nat the NIH, to challenge that? \nDr. F AUCI . I’ve challenged the CDC multiple times—— \nDr. J OYCE . Publicly on this regard? \nDr. F AUCI . Excuse me? \nDr. J OYCE . Publicly you challenged them on this six-foot \ndistancing rule? \nDr. F AUCI . It is not appropriate to be publicly challenging a sister \norganization. \nDr. J OYCE . Do you agree that Americans now have lost their \ntrust in science, in lead science, from government because of misin-formation like this? \nDr. F\nAUCI . Well, I—you know, when you talk about misinforma-\ntion, I think that you have to be careful. That’s not disinformation. It was information that ultimately proved, when you put the aerosolization in, that—— \nDr. J\nOYCE . That it was not an effective rule—— \nDr. F AUCI . All right. \nDr. J OYCE [continuing]. To have six feet of distancing. \nDr. Fauci, let’s move on. On April 21, Dr. Morens wrote to Dr. \nDaszak in an email that ‘‘there is no worry about FOIAs. I can ei-ther send stuff to Tony on his private Gmail, hand it to him at work, or at his house. He is too smart to let colleagues send him stuff that could cause trouble.’’ \nDo you realize that this impact still considers today? This is your \nlead, trusted researcher who works with you, your advisor. Do you realize the impact of that? \nDr. F\nAUCI . It was a terrible thing, it was wrong, and it was inap-\npropriate, and he—— \nDr. J OYCE . Thank you. I think we—— \nDr. F AUCI [continuing]. Should not have said that. \nDr. J OYCE . I think we all agree it was incredibly inappropriate. \nRecently, in an op-ed that Senator Roger Marshall published just \nyesterday, he raised concern about HHS FOIA compliance following your testimony in front of the Senate HELP Committee. \nDr. Fauci, what involvement did you have in HHS not respond-\ning to FOIA requests following your testimony in the Senate in 2021? \nDr. F\nAUCI . I had no role whatsoever in anything to do with the \nrequest. When FOIA is made, it doesn’t go directly to a person like me. It goes to a department, which then takes care of it. So, I don’t have any role, one way or the other, in FOIA. \nDr. J\nOYCE . Let’s go on. \nWere you aware that NIAID employees conducting official work \non unofficial emails and inappropriately assisting grantees during your time as the Director? \nDr. F\nAUCI . I was not aware of that as it was occurring. It, obvi-\nously, came out during the Committee hearings. But I was not aware of that as it was occurring. \nDr. J\nOYCE . And I think that you put an exclamation point on how \nimportant these hearings are. \nDr. Fauci, would you agree that this demonstrates the need for \nmore accountability and increased oversight of NIAID? \n39 \nDr. F AUCI . What you saw, I believe, with Dr. Morens was an ab-\nerrancy and an outlier. The individuals at the NIH and NIAID are a very committed group of individuals, and this one instance that you point out is an aberrancy and an outlier. That does not—— \nDr. J\nOYCE . From your senior advisor for 20 years. \nDr. F AUCI . Well, he is—well, the title is senior advisor. We wrote \nscientific papers together. He didn’t advise me, as I mentioned—— \nDr. J OYCE . Are your senior advisors not trusted staff? \nDr. F AUCI . Again, I told you that his title was senior advisor, but \nhe is not an advisor on policy. He writes—— \nDr. J OYCE . That’s very confusing to have someone’s title—— \nDr. F AUCI . Right. \nDr. J OYCE [continuing]. And not having that to be their obliga-\ntion. \nDr. F AUCI . But that is the fact, though. \nDr. J OYCE . I think that that supports what we said. There needs \nto be more oversight, and there needs to be more accountability. \nMr. Chairman, my time has expired, but these points are very \nclear to all of us today in this hearing room. \nI yield back. Dr. W\nENSTRUP . I now recognize Mr. Garcia from California for 5 \nminutes. \nOh, he left? I now recognize Ms. Greene from Georgia for 5 minutes of ques-\ntions. \nMs. G\nREENE . Thank you, Mr. Chairman. \nMr. Fauci, you were quoted on CBS’ ‘‘Face the Nation’’ saying, \n‘‘It’s easy to criticize, but they’re really criticizing science, because I represent science.’’ \nDo you represent science, Mr. Fauci? Dr. F\nAUCI . I am a scientist who uses the scientific method to gain \ninformation. \nMs. G REENE . Yes. You said you represent science. \nDo you represent science, Mr. Fauci, yes or no? Dr. F\nAUCI . Again—— \nMs. G REENE . Yes or no? \nDr. F AUCI . No, that’s not a yes or no—— \nMs. G REENE . Yes, it’s a yes or no. \nDr. F AUCI . I don’t think it is. \nMs. G REENE . OK. Well, we’ll take that as a you don’t know what \nyou represent. \nDr Fauci. Oh, I—— Ms. G\nREENE . But this—as Director of the NIH, you did sign off \non these so-called scientific experiments. And as a dog lover, I want to tell you, this is disgusting and evil, what you signed off on, and these experiments that happened to beagles paid for by the Amer-ican taxpayer. And I want you to know Americans don’t pay their taxes for animals to be tortured like this. \nSo the type of science that you are representing, Mr. Fauci, is ab-\nhorrent, and it needs to stop. \nMr. Fauci, you also represent the type of science where you con-\nfess that you made up the COVID rules, including—— \nDr. F\nAUCI . I didn’t hear what you said. \n40 \nMs. G REENE [continuing]. Six feet social distancing and masking \nof children. You just—— \nDr. F AUCI . I never said I made anything up. \nMs. G REENE . You admitted that you made it up, you made it up \nas you went. \nDr. F AUCI . I never said I made it up. \nMs. G REENE . So are you saying this is fake news, Mr. Fauci? \nDr. F AUCI . I didn’t say I made anything up. \nMs. G REENE . What did you say? \nDr. F AUCI . I said that it is not based in science and it just ap-\npeared. \nMs. G REENE . But this is science? \nDr. F AUCI . What do dogs have to do with anything that we’re \ntalking about today? \nMs. G REENE . These are scientific experiments. This is what you \nsigned off on. \nBut you also told the American people they had to distance by \nsix feet, they had to wear masks. \nBut let’s also talk a little bit further about the type of science \nthat you represent. \n‘‘NIH scientists made $710 million in royalties from drug mak-\ners,’’ a fact that’s been hidden. \nLet’s talk about the fact about, is it right for scientists and doc-\ntors getting paid by the American people, government taxpayer paychecks, to get patents where they’re paid millions and hundreds of millions of dollars in royalty fees, especially when the NIH and these government agencies, the most powerful agencies in our country, are recommending medical suggestions and advice and making up guidelines, like six feet distancing and masking of chil-dren? \nDo you think that’s appropriate? Do the American people deserve \nto be abused like that, Mr. Fauci? Because you’re not Dr., you’re Mr. Fauci in my few minutes. \nDr. F\nAUCI . Am I going to be allowed to answer the question? \nMs. G REENE . No, I don’t need your answer. \nI want to talk about this right here. Mr. Fauci—— Mr. R\nASKIN . Mr. Chairman, objection. \nMs. G REENE . I reclaim my time. \nMr. R ASKIN . Objection. \nMs. G REENE . I reclaim my time. I reclaim my time, Mr. Raskin. \nDr. W ENSTRUP . The gentlelady will suspend. \nMr. R ASKIN . Point of order. \nDr. W ENSTRUP . The gentlelady will suspend. \nMr. R ASKIN . Mr. Chairman—— \nDr. W ENSTRUP . Point of order. \nMr. R ASKIN [continuing]. In terms of the rules of decorum, are \nwe allowed to deny that a doctor is a doctor just because we don’t want him to be a doctor? \nMs. G\nREENE . Yes. Because in my time that man does not deserve \nto have a license. As a matter of fact, it should be revoked, and he belongs in prison. \nDr. W\nENSTRUP . The gentlelady will suspend. \nThe gentlelady should recognize the doctor as a doctor. \n41 \nMr. M FUME . Thank you. \nMr. Chairman, is this what we have become? Is this what we \nhave devolved into, no decorum? \nMs. G REENE . You know what, we can do that hearing about the \npoor men that were injected with syphilis, because I support you in that. That’s horrific. \nV\nOICE . I would urge—— \nMs. G REENE . And this government that does things like that to \nAmericans doesn’t have decorum to the American people. \nMr. G ARCIA . Mr. Chairman—— \nDr. W ENSTRUP . The gentleman is out of order. \nMr. G ARCIA . Point of regular order, please. \nDr. W ENSTRUP . The gentleman is out of order. \nMr. G ARCIA . Decorum. \nDr. W ENSTRUP . I recognize a point of order. \nGo ahead with your point of order. Mr. G\nARCIA . No. I mean, I was going to say what Mr. Raskin \nsaid, is that it’s completely unacceptable to deny Dr. Fauci, who’s here, a respected member of the medical community, his title. And that’s actually a personal attack on his character. \nDr. W\nENSTRUP . And I have instructed her—— \nMs. G REENE . He’s not respected. \nDr. W ENSTRUP . I’ve instructed her to address him as doctor. \nThe gentlelady shall continue. Ms. G\nREENE . I’m not addressing him as doctor. \nLet’s talk about—— Mr. M\nFUME . And I would—— \nMs. G REENE . Let’s talk about this—— \nMr. M FUME . Mr. Chairman, I would—— \nMs. G REENE . I’m reclaiming my time. \nMr. M FUME [continuing]. Move that the woman’s—— \nMs. G REENE . I’m reclaiming my time. \nMr. M FUME [continuing]. Words get taken down then. \nMs. G REENE . I’m reclaiming my time. \nVOICE . Point of order. \nDr. W ENSTRUP . Suspend. \nA Member can only move to have words—I’m sorry. The issues \nwe are debating are important ones that Members feel deeply about. And while vigorous disagreement is part of the legislative process, as I said at the beginning, Members are reminded that we must adhere to established standards of decorum in debate. \nThis is a reminder that it is a violation of House rules and the \nrules of this Committee to engage in personalities regarding other Members or to question the motives of a colleague. Remarks of that type are not permitted by the rules and are not in keeping with the best traditions of our Committee. The Chair will enforce these rules of decorum at all times and urges all Members to be mindful of their remarks. \nDoes the gentleman from California have anything further? Mr. G\nARCIA . We should take—we should take her words down. \nMr. M FUME . Yes. I made—I offered that her words be taken \ndown, Mr. Chair. \nMr. G RIFFITH . Point of order, Mr. Chairman. \nMs. G REENE . Mr. Chairman, I’d like to make a point of order. \n42 \nDr. W ENSTRUP . Mr. Griffith is recognized—Mr. Griffith—— \nMs. G REENE [continuing]. Because they accuse us of worshipping \nPresident Trump. \nDr. W ENSTRUP . The gentlelady—— \nMs. G REENE . We don’t worship President Trump. \nDr. W ENSTRUP . The gentlelady will suspend. \nMr. Griffith, you have a point of order. Mr. G\nRIFFITH . Mr. Chairman, while it may not be polite, I believe \nthe rule only applies to Members of this body, the Senate, and the President of the United States. I do not believe that it applies—the rule on taking down words does not apply to a witness. \nAgain, I’m not condoning the words. I’m just relating—or asking \nwhether or not it applies to individuals who just happen to be here in front of us. \nDr. W\nENSTRUP . I agree. The Chair overrules the point of order \nby the gentleman from Maryland but asks that Members please af-ford all other Members the respect they’re entitled, refrain from using rhetoric that could be construed as an attack on the motives or character of another Member or the witness. \nYou may proceed. Ms. G\nREENE . Thank you. \nThis was a time in history where you got to throw out the first \npitch at the Washington Nationals baseball game, while Americans were forced to stay home and watch such events that they love from at home, alone, on their televisions. \nAnd what a hypocrisy this picture shows. Here you are without \nyour mask, with empty seats everywhere. Remember the cardboard cutout fans? That was one of the most insulting things to Ameri-cans, having to watch the games from home where you got to go and enjoy the game and sit right next to people, not following the six feet of distancing, not wearing your mask, and everyone else was forced to stay home and stop enjoying life. \nAnd your science—here your science is displayed perfectly in this \npicture where children, children in school, were put in plastic bub-bles because of your science, your repulsive, evil science. \nAnd let’s go back to your very own email. You said earlier you \ndon’t use email. Oh, you do. Right here, this is your own email where you said, ‘‘The typical mask you buy in the drugstore is not really effective in keeping out virus . . . I do not recommend that you wear a mask.’’ This is your email. This is your own words. \nBut yet children, children all over America were forced to wear \nmasks, healthy children forced to wear masks, muzzled in their schools. And then they were forced to learn from home because of your so-called science and your medical suggestions, while you and all your cronies get paid from Big Pharma. \nYou know what this Committee should be doing? We should be \nrecommending you to be prosecuted. We should be writing a crimi-nal referral because you should be prosecuted for crimes against humanity. You belong in prison, Dr. Fauci. \nMrs. D\nINGELL . Mr. Chairman, I have another point of order. \nDr. W ENSTRUP . I recognize Mrs. Dingell. \nMrs. D INGELL . I just want to make sure the record is clear. \nDr. Fauci testified that he did not use his personal email for offi-\ncial business. He did not say he did not use email. And I think \n43 \ntoday this particular has been full of lies and disregard and dis-\nrespect, and we need to stick to facts. \nDr. W ENSTRUP . Thank you. \nThe gentlelady’s time had expired before the point of order. I now recognize Mr. Garcia from California for 5 minutes of ques-\ntions. \nMr. G\nARCIA . Thank you, Mr. Chairman. \nDr. Fauci, I am so sorry you just had to sit through that. That \nwas completely irresponsible. Quite frankly, some we’re hearing— this might be the most insane hearing I’ve actually attended. I’ve only been in Congress for a year and a half, but I am so sorry that you are subjected to those level of attacks and insanity. \nYour, quote/unquote, ‘‘so-called science’’ that the gentlewoman is \nreferring to has saved millions of lives in this country and around the world, and I want to thank you for that. \nI also think it’s important to note that my opinion is that you are \nan American hero, and your team has done more to save lives than all 435 Members of this body on both sides of the aisle. \nYou guys have worked not just during this pandemic but over \ntime to save millions of lives in this country and across the world. \nWe lost 1.1 million American lives, 1.1 American lives, 7 million \nlives around the world. We were having 9/11-like events, death events, daily in this country, losing 4,000, 5,000 people every single day. \nI was mayor during the time of the pandemic. I remember how \npainful it was to close businesses, to shut down schools. But how quickly we forget the pain and how scared we were as a country. We were washing our groceries as they were coming in. We were keeping seniors at a distance. The tragedy that was happening in our nursing homes. Thousands of people were dying a day. \nAnd you and your team of the best and the brightest scientists \nin this country and the world were doing everything that you could and working night and day to save more and more of those lives. \nA lot of my colleagues know that my mom was a healthcare \nworker during the pandemic. My mom died of COVID. My step-father died of COVID. I lost both of my parents during the pan-demic. \nSo I take this very personally, especially when other Members of \nthis body, who are tasked to be responsible and to actually help the American people, attack medical professionals like you and across the world. \nVaccines. The vaccine that you and your team helped foster has \nsaved millions of American lives. \nThese attacks are ridiculous. Now, even before this Committee started—I want to point a few \nthings out. \nEven before this Committee started, this same Member that just \nwent on this rant introduced the Fire Fauci Act and promoted on \na podcast saying that COVID was a bioweapon. That is how insane some of these comments are. \nAnd I want to quote this. This is a quote from this same Mem-\nber. \n44 \n‘‘I don’t believe in evolution. These viruses were not making peo-\nple sick until they created them. They weaponized these viruses to be able to attach to our cells and make us sick. It’s a bioweapon.’’ \nThe ‘‘they created them,’’ sir, is you. They are attacking you and \nour medical community for actually creating COVID that has caused the deaths of millions. And we know that these extreme comments are targeting public health officials across the country. \nI also want to show you this other comment, same Member who \njust attacked you. \n‘‘The Fauci-funded Wuhan lab created the virus.’’ This is so crazy and irresponsible. In this post, this same Member of this Committee is accusing you \nof orchestrating a global conspiracy to create COVID on purpose just to make people get vaccines, that you’ve done this, sir. \nThis same Member routinely promotes complete misinformation \nabout vaccines and actually has encouraged the routine prevention of vaccinations that even eliminate diseases like the measles. \nDr. Fauci, you brought together our Nation and the world’s best \nand brightest scientists to take on COVID and create a vaccine that works. \nI want to ask you a question. I want to be crystal clear for the \npublic. \nYou brought together the world’s and America’s best scientists. \nDo you believe that the vaccine that you all helped create and en-sure is safe and effective for the public? \nDr. F\nAUCI . Yes, and its track record has proven that. \nMr. G ARCIA . And do you also agree that it saved hundreds of \nthousands and possibly millions of lives in America and across the world? \nDr. F\nAUCI . That is absolutely correct, and it’s very clear that it \nsaved millions of lives here and throughout the world. The Euro-peans have done the same studies that we have, and the data are incontrovertible that they save lives. \nMr. G\nARCIA . Sir, and do you think the American public should \nlisten to America’s brightest and best doctors and scientists or in-stead listen to podcasters, conspiracy theorists, and unhinged Facebook memes? \nDr. F\nAUCI . No. Listening to people who you’ve just described is \ngoing to do nothing but harm people because they will deprive themselves of lifesaving interventions, which has happened. \nAnd, you know, some have done studies. Peter Hotez has done \nan analysis of this and shows that in people who refuse to get vac-cinated for any of a variety of reasons probably responsible for an additional two to three hundred thousand deaths in this country. \nMr. G\nARCIA . Thank you, sir, and your entire team for saving \nlives in this country. And I’m sorry you have to continue going on with these attacks. \nI yield back. [Disturbance in the hearing room.] \nMr. G\nARCIA . Oh, thank you. You’re not allowed. Thank you very \nmuch. \nMr. R ASKIN . Mr. Chairman, can you have her removed from \nthe—please just have her removed. \n45 \nDr. W ENSTRUP . Please, excuse me. I ask the Capitol Police to es-\ncort. \nMr. G ARCIA . Yes. Thank you. She can be removed. \n[Disturbance in hearing room.] Mr. G\nARCIA . You can be removed. Actually you’re not allowed to \nspeak. \nMr. R ASKIN . Take your Starbucks with you. \nDr. W ENSTRUP . Your time has expired, Mr. Garcia. \nMr. Raskin, you’re out of line. Your times have expired. I now recognize Dr. Jackson from Texas for 5 minutes of ques-\ntions. \nDr. J\nACKSON . Thank you, Mr. Chairman. \nDr. Fauci, I have to say I, as so many Americans, am deeply dis-\nappointed in your actions during a critical time in our Nation’s his-tory while you were in key leadership roles as the Director of the National Institute of Allergy and Infectious Disease and as the chief medical advisor to President Biden. \nPut quite simply, you failed miserably, in my opinion. Based on all we have learned during the pandemic and all that \nwe have since learned through this Committee’s work, I believe your failures stem from both an effort of self-preservation mani-fested by a series of lies and cover-up and by a total failure of lead-ership. \nIt was obvious to everyone that you and your organization, NIH, \nhad a lot to lose if the American people were to discover that COVID–19 was most likely leaked from a lab in Wuhan, China, and that you, via EcoHealth Alliance and Peter Daszak, actually funded this research, and that this lab was actively and recklessly conducting gain-of-function research. \nAs such, you did everything in your power to deflect and cover \nup this possibility. You even recruited others to help you in this ef-fort. \nUnfortunately, this cost our country and the world valuable time, \ntime that may have led to answers regarding the origin, may have blunted the spread, and would have almost certainly saved lives. \nWhile I think most of us have known all along what I just de-\nscribed, what I have been appalled to discover through sworn testi-mony to this Committee is the level at which you and those that worked with you went to cover up the obvious. \nJust a few examples, and I know these have been touched on, but \nthey’re important for everyone to hear. \nDr. Lawrence Tabak, former Acting Director of NIH, testified \nthat under the generic definition, that NIH did, in fact, fund gain- of-function research. \nThis was based on a definition that was initially used by NIH \nand a definition that was abandoned and removed from the website in October 2021 and replaced by a new, much more detailed defini-tion with a much higher bar that you have since conveniently used to define gain-of-function testing and to deny what Dr. Tabak has since confirmed. \nHe also said that EcoHealth Alliance failed to properly and \npromptly report that their research violated the terms of the grant, something that went completely unaddressed during your watch. \n46 \nDr. Morens, your senior advisor, who you have tried today to dis-\ntance yourself from, but whose large volume of emails clearly dem-onstrate that you had a very close and personal relationship with and who reported to you directly, has openly bragged about how he subverted FOIA requests. \nI remind you that the law requires you and your former organi-\nzation to comply with Freedom of Information Act requests. It is not optional. \nIf you or your employees or your organization that you oversaw \nwere systemically avoiding transparency and illegally hiding or de-stroying documents that rightfully belong to the American people, then you should be criminally charged and they should be as well. \nIn addition, Dr. Gregory Folkers, your chief of staff, also engaged \nin illegal practices in which he crafted messages using symbols in-stead of letters to avoid FOIA exposure. \nIn an email April 2020 from Dr. Morens to Peter Daszak, he \nsays, quote, ‘‘There are things I can’t say.’’ \nWell, I wonder what he couldn’t say. He also went on to say, quote, ‘‘Except Tony is aware and I have \nlearned there are ongoing efforts within NIH to steer through this with minimal damage to you, Peter, and colleagues, and to NIH and NIAID,’’ end quote. \nAnd then a few days later he said, quote, ‘‘I have reason to be-\nlieve that there are already efforts going on to protect you,’’ end quote. \nIn February 2021, Dr. Morens wrote to Boston University sci-\nentist Gerald Keusch saying, quote, ‘‘I learned from our FOIA lady here how to make emails disappear after I’m FOIA’d but before the search starts, so I think we are all safe,’’ end quote. \nDr. Fauci, I want to know what you were being protected from \nand what you needed to be safe from. \nI’m going to go on because I have little time here. He went on to say, quote, ‘‘Plus I deleted most of the earlier \nemails after sending to gmail.’’ \nOnce again, illegal and an actual crime. Dr. Morens noted in another email to Dr. Keusch saying, quote, \n‘‘I learned the tricks last year from an old friend, Marg Moore, who heads our FOIA office and also hates FOIAs,’’ end quote. \nIt is absolutely amazing to me that Dr. Morens and Marg Moore \nstill have jobs and taxpayers are still paying their salaries. \nDr. Morens wrote to Dr. Daszak in April 2021, quote, ‘‘PS, I for-\ngot to say there is no worry about FOIAs. I can either send stuff to Tony on his private email or hand it to him to work or at his house. He is too smart to let colleagues send him stuff that could cause trouble,’’ end quote. \nApparently, you neglected to surround yourself with equally \nsmart individuals. \nDr. Morens wrote to another collaborator, Peter Hotez, in June \n2021, at Baylor College of Medicine, that he had deleted all of his \nemails related to COVID origin when, quote, ‘‘the shit hit the fan,’’ end quote. He said, quote, ‘‘I feel pretty sure Tony would too. The best way to avoid FOIA hassles is to delete all emails when you learn the subject is pretty sensitive.’’ \n47 \nIn October 2021, Dr. Morens wrote to Peter Daszak, quote, \n‘‘Peter, from Tony’s numerous recent comments to me, and from what Francis has been vocal about over the past 5 years, we are trying to protect you,’’ and they are protecting their own reputa-tions as well, end quote. \nI’ll just jump ahead. The American people can rest assured that we are going to con-\ntinue to pursue answers and we continue to push for full account-ability from you and your colleagues despite continuing efforts to try to cover this up. \nDr. Fauci, history will not be kind to you, and you’ll be known \nas the man who put his personal interests before the interests of the American people, the very people that you were supposed to be protecting. \nYour actions, along with several others we have had before this \nCommittee, have completely eroded America’s trust in our public health system and the agency that you represented for half a cen-tury. \nWith that, I yield back. Dr. W\nENSTRUP . The gentleman’s time has expired. \nI now recognize Ms. Tokuda from Hawaii for 5 minutes of ques-\ntions. \nMs. T OKUDA . Thank you, Mr. Chair, and I hope I’ll have an addi-\ntional 30 seconds like the previous gentleman. \nAnd, Dr. Fauci—— Dr. W\nENSTRUP . I have allowed that today—— \nMs. T OKUDA . Thank you. \nDr. W ENSTRUP [continuing]. On several occasions. \nMs. T OKUDA . Thank you, Mr. Chair. \nDr. Fauci, you deserve better than this. The other side suddenly \ncares about puppies, ironic given recent book publications, versus the millions of people that you have kept safe and alive over your lifelong commitment to public health. \nI’d like to use my time to dispel some of the myths about you \nthat have circulated in right-wing circles. \nWe can all acknowledge that, yes, suspension of in-person activi-\nties during the early days of COVID, it was necessary to save lives and to stop the spread, and it was not without its challenges. It was difficult, particularly for our Nation’s students, like my two sons in public schools, and our business owners. But to completely blame these policies on you, Dr. Fauci, is absolutely ridiculous. \nI would like to make the record clear on something. The decision \nto suspend in-person learning, dining, and other activities, that was not a decision that you were somehow solely responsible for, including in your role as NIAID Director. Is that correct? \nDr. F\nAUCI . Yes. \nMs. T OKUDA . In fact, these decisions were actually made at the \nstate and local level in communities across the country, like my home state of Hawaii which was particularly aggressive, in part as a response to the Trump administration’s early failure to contain the initial outbreak of the virus. Is that not correct? \nDr. F\nAUCI . I’m sorry. I did—ma’am, I’m not really hearing you \nvery well. Could you just put your—— \nMs. T OKUDA . We’ll put it a little bit closer. \n48 \nBut to be clear, the decisions were actually made at the state and \nlocal levels in communities across the country. \nDr. F AUCI . That is correct. \nMs. T OKUDA . OK. Thank you. \nNow I’d like to shift topics and turn to the allegation that you \nsought to suppress opposing viewpoints about the pandemic re-sponse. \nOver the past 15 months, Majority Members of this Sub-\ncommittee have levied the allegation that Federal health officials censored proposals, like the Great Barrington Declaration, which were inconsistent with the overwhelming consensus of the scientific and medical community. \nMuch attention has been paid to an email Dr. Francis Collins \nsent you regarding the Great Barrington Declaration where he called for a quick and devastating published takedown of its prem-ises. \nTo be clear, this was not Dr. Collins suggesting that you sup-\npress or censor the Great Barrington Declaration. Rather, he was suggesting that the points you just explained be memorialized to substantively refute the scientific premises of the Great Barrington Declaration. Is that correct? \nDr. F\nAUCI . Yes. \nMs. T OKUDA . And there was good reason for Dr. Collins to have \nsubstantive concerns. The Great Barrington Declaration proposed lifting mitigation measures for the vast majority of society and pre-serving them only for certain populations, including the elderly and people with underlying health conditions. \nThis was months before a vaccination was available and public \nhealth systems are already being overwhelmed and thousands of Americans were dying daily. \nDr. Fauci, what percentage of the population did we estimate \nneeded to be infected with COVID before we would achieve so- called herd immunity? \nDr. F\nAUCI . Herd immunity was very elusive with COVID. And \nthe Great Barrington Declaration was flawed both conceptually and in practice; conceptually that you could shield vulnerable people as if the only vulnerable people are those in nursing homes. \nWe have tens and tens of millions of vulnerable people that you \ncouldn’t possibly shield. People with underlying conditions, the el-derly, those would be the individuals. So it would be conceptually impossible to do that. \nHerd immunity, as we know, means if you have a virus that \ndoesn’t change and a virus in which when you get infected or vac-cinated you have highly durable, perhaps lifelong immunity. That’s not the case with COVID. We know immunity wanes, and we have multiple variants. \nSo, in practical purposes, the Great Barrington Declaration was \ninvalid, both conceptually and practically. \nMs. T\nOKUDA . Thank you, Dr. Fauci. \nYou’ve answered a few of my other questions in terms of the fact \nthat for many of us that live in multigenerational communities, thousands, hundreds of thousands, millions more lives would have been impacted by this so-called approach. And given the fact that \n49 \nthe virus’ rapid evolution that we have seen since 2020, herd im-\nmunity approaches would be absolutely ineffective against COVID. \nIf you would answer one more question. Considering the mor-\ntality rates at the time, how many more deaths might we have seen, just briefly? \nDr. F\nAUCI . I mean, if we had done that, just let it rip, there very \nlikely would have been another million people would have died, I would imagine. \nMs. T\nOKUDA . Thank you, Mr. Fauci. \nSo, it wasn’t the Federal Government suppressing the Great Bar-\nrington Declaration. Rather, it was about protecting and saving millions of American lives. \nThe COVID–19 pandemic wasn’t some academic exercise. It was \nreal. It was in real time. It was about saving lives in real time. \nTheories like herd immunity may seem plausible on paper, but \nwe have to remember that it is based upon the assumption that enough people would have to be infected, and that would likely have meant that our family members, our friends, our neighbors, our constituents, especially those in our most marginalized multigenerational rural communities, would have died. \nSo, thank you, Dr. Fauci. I want to thank you, not blame you. \nThank you for your science. Thank you for your science that have saved millions of American lives, kept us safe, including my chil-dren, many of our families right here on this dais. \nAnd thank you for clarifying these points for the record and for \nall of your efforts to keep us safe during the pandemic and so many other health crises we have faced over the decades that you have served. \nMahalo, Mr. Chair, and I yield back. Dr. W\nENSTRUP . I now recognize Dr. McCormick for 5 minutes of \nquestions. \nDr. M CCORMICK . Thank you, Dr. Wenstrup, Chairman. \nIt’s been insinuated that politicians—only politicians, only \nbloggers, only conspiracy theorists are disagreeing with you. \nI want to point out that I’m probably the only Member of Con-\ngress that actually treated patients during the pandemic, from the very beginning to the very end of the pandemic, during night shifts in the ER, thousands of patients during that time. \nAnd in 2020, I was censored, my medical license was threatened, \nbecause I disagreed with bureaucrats, literally taken off the inter-net as a person who was treating patients with leading-edge tech-nologies, developing theories, but doing my very best, but being censored by the U.S. Government, for the first time stepping in and taking the place of medical professionals as the experts in healthcare. \nAny dissent surrounding COVID–19 treatments, mask mandates, \nand any public policy surrounding the pandemic was immediately labeled as anti-science. I watched as public health officials and politicians told my patients what treatment options were best for them, regardless of their comorbidities or their medical history. \nDespite my education and my training and my experience, my \nopinions were relegated to conspiracy and misinformation by so- called healthcare experts who had never treated a patient through-out the entire pandemic. \n50 \nThis has been a black eye on medicine and has highlighted why \ngovernment should never, never insert itself in between patients and their healthcare providers. The American people deserve to make medical decisions through conversations with their physi-cians rather than politically motivated mandates. \nDr. Fauci, did you ever treat a patient for COVID during the \npandemic? \nDr. F\nAUCI . I was part of a team that was at the NIH that took \ncare—we didn’t take care of many of them because—— \nDr. M CCORMICK . OK. So not hands on. Got it. Thank you. \nWhy would I be criticized by a bureaucrat for doing my very best \nas a healthcare—this is a rhetorical question. But why? Why would the government, who’s never treated a patient for COVID? You can read all the things you want, but you’re not there. You’re not see-ing patients. You’re not watching people die, intubating patients right there with that disease in your face, watching it happen, watching the development of this disease and actually learning from it. But I’m being told by bureaucrats what’s right and wrong. \nAnd what’s funny is everything I was censored on, I was proven \nto be right. Pretty crazy, isn’t it? \nYou said in your interview that you gave as part of an audio \nbook written by Michael Specter that you believed an institution should make it hard for people to live their lives so they’d feel pres-sured to get vaccinated. \nCould we run the audio clip on that, please? [Audio recording played.] Dr. M\nCCORMICK . Thank you. \nAre all objections to COVID vaccinations ideological bullshit, Dr. \nFauci? \nDr. F AUCI . No, they’re not. \nDr. M CCORMICK . Thank you. \nDr. F AUCI . And that’s not what I was referring to. \nDr. M CCORMICK . Well, in reference to making it hard for people \nto get education, traveling, working, I’d say it very much was in context, and I take great offense to this. \nMs. Allison Williams testified before this Committee about losing \nher job because she sought an exemption for ESPN’s vaccine man-date which came from a recommendation from bureaucrats like yourself. \nShe and her husband were actively working with a fertility ex-\npert, a physician, on how to get pregnant and agreed with the premise that she was young, healthy, wanted to get pregnant, and shouldn’t get the vaccination for medical purposes. \nBut she was fired, because you made it hard, just like you said \nin your statement, because you didn’t want to make sure that the ideological bullshit got in the way of her working, of living her life, of making a medical decision with her healthcare professional. \nI think America should take great offense to this. That’s exactly \nwhat you meant when you said making it hard for people to live without getting a vaccination. You affected people’s ability to work, travel, be educated, to actually flourish in America, in fact to self- determine as well given God-given rights. Shame on you. \n51 \nDr. Fauci, you’ve become Dr. Fear. Americans do not hate \nscience. I don’t hate science. The American people hate having their freedoms taken from them. \nYou inspired and created a fear through mask mandates, school \nclosures, vaccine mandates that have destroyed the American peo-ple’s trust in our public health institutions. \nThis fear you created will continue to have ripple effects over \ngenerations to come. You have already seen its effects in education, in the economy, and everything else. Quite frankly, you said, ‘‘If you disagree with me, you disagree with science.’’ \nDr. Fauci, I disagree with you because I disagree with fear. And with that, I yield. Dr. W\nENSTRUP . I now recognize Mr. Moskowitz from Florida for \n5 minutes of questions. \nMr. M OSKOWITZ . Thank you, Mr. Chairman. \nDr. Fauci, good to be with you here today. I was not here, but I saw a Member of this Committee ques-\ntioned whether or not you represent science and tried to make that in some offensive way. I just want you to know most Americans don’t think she represents Congress. \n[Audio recording played.] Mr. M\nOSKOWITZ . So I hear now double Fauci. \nSo, I don’t want you to be offended by that. I actually, similar to Representative McCormick, who was serv-\ning in the field as a doctor during COVID, I was running the logis-tics operation and the Florida response as the director of emer-gency management for the state of Florida for Governor DeSantis. \nSo, I was deploying masks and gowns and gloves. We were set-\nting up field hospitals, we were setting up testing sites, we were setting up vaccine sites throughout the pandemic. \nAnd the one thing that became clear to me: As a country we were \nnot prepared. In fact, we actually had many preparations for a pan-demic, but both the states collectively and the Federal Government threw that out and kind of was just making it up as we go. \nOne of the things I wanted to ask you—and I understand you’re \nnot in the response field—but do you feel since you’ve left that we are better prepared today than we were several years ago when COVID hit? \nDr. F\nAUCI . In some respects, we are; but in others, I’m still dis-\nappointed. And I think one of the things that was really a problem with the response was the degree of divisiveness that we had in the country about a lack of a coherent response where we were having people, for reasons that had nothing to do with public health or science, refusing to adhere to public health intervention measures. \nWhat I think that we will do better, hopefully, is that the CDC, \nI believe, has now recognized some of the failings of the lack of communication and interaction between the Federal response and the local public health officials. \nOne of the weaknesses that we had in the United States that \nother countries didn’t have was a disconnect between the healthcare system and the public health system, whereas the CDC can’t demand information from local public health individuals, they have to volunteer to give it to them. And it isn’t given to them in real time. So we were at a disadvantage. \n52 \nMr. M OSKOWITZ . Oh, no question. I saw that. I saw how—the \nlack of investment in technology, right? We had states trying to share information with the Federal Government using, you know, Windows 2000. \nDr. F\nAUCI . Or fax machines. \nMr. M OSKOWITZ . Fax machines, exactly. \nDr. F AUCI . Yes. \nMr. M OSKOWITZ . And so, you know, we spent $7 trillion in two \npackages in two administrations. And one of my concerns is, is that I feel that, especially in supply chain, I feel like we’re not that much better off than we were before COVID. Am I wrong in that assessment? \nDr. F\nAUCI . Yes, I don’t think you’re wrong, but I hope that—the \nCDC has made it very clear that they are trying to change that and correct that deficit of a separation between the local and the Fed-eral CDC so that we can get information in real time. \nIt was very frustrating for us that often we had to go to the U.K. \nor South Africa or Israel to get real-time information because they had a connection between what was going on on the ground and their public health system. So they knew right away what was hap-pening. We didn’t. \nMr. M\nOSKOWITZ . Dr. Fauci, you talked about how, you know, we \nlive in partisan times, a lot of misinformation. And, you know, col-leagues on this body said, you know, you should be, you know, charged and found guilty. Of course, the only one that that’s hap-pened to is your former boss. \nBut, you know, the question I have is, when you saw a lot of that \ndisinformation, whether it was, you know, we can use a disinfect-ant to do, like, a cleaning or do light in the body or that, you know, China is working super hard, President Xi’s got it contained, all of the stuff that was being put out, were you concerned—you know, what was your feeling at that time working in the administration seeing that come from the podium? \nDr. F\nAUCI . Well, I was very frustrated by that. It was very clear. \nI was put in a very difficult position that I didn’t like of having to contradict publicly the President of the United States. I took no great pleasure in that, but I felt it was my responsibility to pre-serve—— \nMr. M\nOSKOWITZ . He must have thought you did a great job. He \ngave you a commendation right before he left. \nDr. F AUCI . Well, I felt it was my responsibility, you know, to pre-\nserve my own personal integrity and my major responsibility to the American public to tell them the truth. \nAnd if I could just take this opportunity. When I was saying that \nif you attack me, you attack science, I didn’t mean that I am science. What I meant was that when the data showed that hydroxychloroquine does not work and there are people saying, ‘‘Oh, it does, I’ll give it to people,’’ and we know it can be hurtful to them, then when you’re attacking what I’m saying, that the science shows it doesn’t work and the science shows that bleach doesn’t work, that when you attack that, you really are attacking science, because science has shown that it doesn’t work. That’s what I meant when you’re attacking me, you’re attacking science. \nMr. M\nOSKOWITZ . Thank you, Doctor. \n53 \nThank you, Mr. Chairman. I yield back. \nDr. W ENSTRUP . The gentleman’s time has expired. \nI now recognize Mr. Jordan from Ohio for 5 minutes. Mr. J\nORDAN . Thank you, Mr. Chairman. \nDoctor, why was it so important that the virus not have started \nin a lab? \nDr. F AUCI . We don’t know where it started, and that’s the reason \nwhy I keep an open mind. So I don’t know what you mean by, why was it so important? It wasn’t important. \nMr. J\nORDAN . You still don’t know where it started? The guys you \ngave money to figured it out in 3 days. \nDr. F AUCI . No, no, no. They—— \nMr. J ORDAN . Mr. Andersen said on January 31, 2020, ‘‘Virus \nlooks engineered. Virus not consistent with evolutionary theory.’’ \nThe very next day Dr. Garry said, ‘‘I don’t know how this hap-\npens in nature. It would be easy to do in a lab.’’ \nAnd then 3 days later, shazam, they switch and say it didn’t— \nit has to be nature. \nSo they figured it out in 3 days, but you still don’t know? Dr. F\nAUCI . No. In fact, if you look at what they were saying, Con-\ngressman Jordan, they were saying that it was not a manufactured virus. It still could have evolved out of a lab—— \nMr. J\nORDAN . Let me read something here to you. In our—— \nDr. F AUCI . They’re not incompatible. \nMr. J ORDAN . In our study on the censorship of the Biden admin-\nistration working with Big Tech, I want to read you a WhatsApp message from Mark Zuckerberg. \n‘‘Can we include that the White House put pressure on us to cen-\nsor the lab leak theory.’’ \nSo this is a communication on July 16, 2021, Nick Clegg, Joel \nKaplan, Sheryl Sandberg, Mark Zuckerberg. They’re certainly feel-ing the pressure to downplay any lab leak theory and go with the natural origin theory. \nDr. F\nAUCI . Is there a question there? \nMr. J ORDAN . It’s coming. One’s coming. \nHere’s another email to Mark Zuckerberg. It says, Subject line: \n‘‘COVID misinformation. Wuhan lab leak theory. In response to continued public pressure, intense conversations with the new ad-ministration, we started removing five COVID claims, including the lab leak theory.’’ \nMr. Zuckerberg responds, ‘‘This seems like a good reminder that \nwhen we compromise our standards due to pressure from an ad-ministration, in either direction, we often later regret it.’’ \nWhy was it so important the virus not have started in a lab? Dr. F\nAUCI . It wasn’t so important that the virus not. We don’t \nknow. We know—— \nMr. J ORDAN . Well, it was important to someone in the Biden ad-\nministration, so much so that the top people at Meta, the top peo-ple at Facebook are asking, ‘‘Why are we getting all this pressure \nto downplay the lab leak theory?’’ And we have an email from June of the same year, June 4, 2021, saying the same thing. It was cer-tainly important to somebody. \nDr. F\nAUCI . Well, what does that got to do with me? \n54 \nMr. J ORDAN . I’m asking you because you’re the expert on \ncoronavirus. I’m saying why was the administration—— \nDr. F AUCI . Am I on this email? \nMr. J ORDAN [continuing]. Why was the administration so push-\ning not to have the lab leak theory as something that was viable. \nDr. F AUCI . I can’t answer that. I’ve kept an open mind through-\nout the entire process. \nMr. J ORDAN . You’ve kept an open mind. Dr. Fauci, open mind. \nDr. F AUCI . That is correct. \nMr. J ORDAN . What happened in those 3 days? Why did Dr. An-\ndersen and—excuse me—Mr. Andersen and Dr. Garry, why did they change their mind 180 degrees? Because what Kristian Ander-sen says 3 days later, after he said, ‘‘Virus looks engineered. Virus not consistent with evolutionary theory,’’ 3 days later he says, ‘‘The main crackpot theories going around at the moment relate to this virus being somehow engineered, and that is demonstrably false.’’ \nHow did they figure all that out in 3 days, Dr. Fauci—— Dr. F\nAUCI . You can do that—— \nMr. J ORDAN [continuing]. If you still have an open mind? \nDr. F AUCI . Well, what they did is that—you know, they testified \nbefore this Committee what they did. They went back and looked at the sequences and realized that their initial concern was un-founded about that and it did not look at all like it was manufac-tured. But as they said in their paper, even though they feel it was more likely—— \nMr. J\nORDAN . Three days they figured it out. \nDr. F AUCI . That’s exactly. You could do that in 3 days. \nMr. J ORDAN . OK. \nDr. F AUCI . You can scan sequences in a day. \nMr. J ORDAN . OK. \nDr. F AUCI . You don’t need 3 days. \nMr. J ORDAN . OK. Who’s Robert Redfield? \nDr. F AUCI . The former Director of the CDC. \nMr. J ORDAN . Dr. Redfield, right? And he was also on the \nCoronavirus Task Force. Is that accurate? \nDr. F AUCI . He was a member of the Coronavirus Task Force. \nMr. J ORDAN . Here’s what he said to this Committee. He said— \nRedfield said that Fauci and Collins ‘‘left him out because Redfield suspected that coronavirus had leaked from the Chinese lab.’’ \nIs that accurate? Dr. F\nAUCI . Well, he said that, but that’s not true. \nMr. J ORDAN . You’re saying—— \nDr. F AUCI . That is incorrect, Congressman. \nMr. J ORDAN [continuing]. Dr. Redfield was lying to the Com-\nmittee—— \nDr. F AUCI . No. \nMr. J ORDAN [continuing]. When he sat right where you sat? \nDr. F AUCI . When he said that I kept him out, that is an incorrect \nstatement. The roster who was on the phone—— \nMr. J ORDAN . Was Dr. Redfield in that conference call on Feb-\nruary 1 when you had Mr. Andersen and Dr. Garry on that call? \nDr. F AUCI . He was not. And the conference call was put together \nby Jeremy Farrar. So no one kept him out. He said he was kept out because he felt—— \n55 \nMr. J ORDAN . Did U.S. tax dollars—— \nDr. F AUCI . Do you want me to answer the question? \nMr. J ORDAN . Yes. I just wondered why he wasn’t on the call. It \nseems to me the head of CDC, part of the Coronavirus Task Force which was formed 2 days prior to that call, would have been on the call. \nDr. F\nAUCI . Well, the call was arranged by Jeremy Farrar. You \nshould ask him. \nMr. J ORDAN . OK. Did U.S. tax dollars flow through a grant re-\ncipient to the lab in China? \nDr. F AUCI . I’m sorry? What was—— \nMr. J ORDAN . Did U.S. tax dollars flow through a grant recipient \nto the lab in China. \nDr. F AUCI . Yes, of course. It was a subaward to the Wuhan Insti-\ntute—— \nMr. J ORDAN . And who approved that award. \nMr. F AUCI . Excuse me? \nMr. J ORDAN . And who approved that award? What agency ap-\nproved that award. \nDr. F AUCI . The National Institute of Allergy and Infectious Dis-\neases. \nMr. J ORDAN . Your agency approved that, right. \nDr. F AUCI . Yes, it did, after—— \nMr. J ORDAN . Does that have anything to do with this \ndownplaying of the lab leak theory. \nDr. F AUCI . No. \nMr. J ORDAN . Nothing to do with it? \nDr. F AUCI . Nothing. \nMr. J ORDAN . Do you agree that there was a push to downplay \nthe lab leak theory? \nDr. F AUCI . Not on my part. \nMr. J ORDAN . Really? \nDr. F AUCI . Really. \nMr. J ORDAN . Wow. I think most of the country would find that \namazing. \nI’ve still got 11 seconds. Dr. F\nAUCI . Well, look at the facts. I’ve kept an open mind \nthroughout the entire process. \nMr. J ORDAN . All right. I yield back. \nDr. W ENSTRUP . I now recognize the Majority Staff for no longer \nthan 30 minutes of questions. \nMAJORITY STAFF . Dr. Fauci, it’s good to see you again. I want to \nask a couple of questions about some of the Members’ questions and then get into some follow-ups. \nThe issue of the CIA trip was brought up. That was brought to \nus by a whistleblower. That was not an allegation made by the Committee. It was an allegation made by the whistleblower. \nYou testified at a transcribed interview back in early January. \nDo you recall me asking you about that allegation? \nDr. F\nAUCI . About going to the CIA? \nMAJORITY STAFF . Yes. \nDr. F AUCI . Yes. \n56 \nMAJORITY STAFF . And do you recall—and you denied it then as \nwell, and you denied it here today. Do you recall the Subcommittee publishing that you denied it? \nDr. F\nAUCI . I don’t recall. \nMAJORITY STAFF . We did. \nDr. F AUCI . You did. OK. \nMAJORITY STAFF . We put it out in a press release afterwards that \nyou denied the whistleblower’s allegation. \nDr. F AUCI . OK. \nMAJORITY STAFF . And then today, during the course of the last \ncouple hours, have any Members on the Majority side of the dais asked you about a trip to the CIA? \nDr. F\nAUCI . Yes. \nMAJORITY STAFF . They have? \nDr. F AUCI . No, they have. I’m sorry. Mitch, I’m not hearing you \nso well. Let me turn this off. \nMr. M FUME . I have a point of order, Mr. Chairman. \nDr. W ENSTRUP . What’s the gentleman’s point of order? \nMr. M FUME . I have an inquiry about whether or not I’m hearing \nthings or whether or not you just yielded 30 minutes of Committee time to staff. \nDr. W\nENSTRUP . That is correct, both sides. \nMr. M FUME . And the question that the gentleman just raised \nwas a question that I raised. So apparently he was not listening when I was questioning Dr. Fauci. \nDr. W\nENSTRUP . Thank you for your point of order. \nYou may continue. M\nAJORITY STAFF . What I asked was we asked you about this in \na transcribed interview. You testified that you did not go to the CIA. \nDr. F\nAUCI . Yes. \nMAJORITY STAFF . We published that you refuted that allegation. \nDr. F AUCI . Yes. \nMAJORITY STAFF . And then today no Members of the Republican \nside of the dais have asked you that question. Is that accurate? \nDr. F AUCI . Yes. \nMAJORITY STAFF . Thank you. \nYou’ve been asked a number of times about your former senior \nadvisor, Dr. Morens, and have said—and I want to make sure I characterize it correctly because it goes a little back and forth— that you didn’t conduct official business over a personal email with Dr. Morens. \nHas Dr. Morens emailed to your personal email before on nonoffi-\ncial purposes? \nDr. F\nAUCI . As I mentioned, we wrote scientific papers together, \nso he very well may have used that because that’s the email I use when I write a scientific paper, right. \nM\nAJORITY STAFF . And that’s because NIAID policy allows you to \nwrite, on semi-official time, write papers, but you just have to put a disclaimer that this is not the—— \nDr. F\nAUCI . Yes. In other words, if you’re doing something as offi-\ncial business, you shouldn’t use your emails that are official busi-ness. So in order to be compliant with the regulations, you would use a personal email. \n57 \nMAJORITY STAFF . I appreciate it. \nI want to ask about some of the public health policies enacted \nduring the pandemic. \nDr. Francis Collins, the former NIH Director, recently said at an \ninterview, and I’m quoting, ‘‘You attach an infinite value to stop-ping the disease and saving a life. You attach a zero value to whether this actually totally disrupts people’s lives, ruins the econ-omy, and has kept many kids out of school in a way that they never quite recovered.’’ \nUnderstanding the COVID Task Force had a lot of voices at the \ntable, is that an accurate description of the public health advisors and then you could fit in other advisors along the way? \nDr. F\nAUCI . Yes. You know, Mitch, what I believe that Dr. Collins \nwas saying was that we give a advice based on pure public health issues. \nIt’s very, very clear now, retrospectively, looking at the potential \ncollateral negative effects of things like mandating, it would be im-portant for us now, since the purpose of, I believe, why we’re here, is to how we can do better next time, is to consider the balance. \nI think things that we did in the beginning were in the context \nof a horrible situation of four to five thousand deaths per day. But that doesn’t mean that you don’t go back and look and say: Did ev-erything we do at that point and the duration for which we did it, was that appropriate and do we need to reexamine? \nI believe that’s what Dr. Collins was referring to, and I agree \nwith him on that. \nM\nAJORITY STAFF . And you got to my next question, that we are \nhere trying to figure out how to do better next time, lose fewer lives next time. \nDr. F\nAUCI . Yes. \nMAJORITY STAFF . Would that be a better thought process going \nforward of thinking about the possible unintended consequences of public health measures? \nDr. F\nAUCI . Absolutely. \nMAJORITY STAFF . And you’ve heard from both sides of the dais \ntoday, first weeks, months, novel virus, nobody knew what was going on, called for some drastic measures. \nUnderstanding—once there was a better understanding of who \nthe most affected demographics were, do you think it would be im-portant to more narrowly craft public health measures to specifi-cally favor those demographics? \nDr. F\nAUCI . The answer is yes, but you have to be careful, because \nif you have a certain group that is being predominantly afflicted, if you’re really, really clear that another group is really quite pro-tected, then you should fashion it demographically related. \nBut what often happens with outbreaks is that they’re a moving \ntarget, and you only hear about other vulnerables as you get fur-ther into the outbreak. \nSo, the answer to your question is you’re partially correct, that \nyou need to do that, but you’ve got to be careful when you’re deal-ing with a moving target. \nM\nAJORITY STAFF . And we can appreciate that. \n58 \nYou’ve been asked a little bit again about the theories of natural \nimmunity and herd immunity. Those are both real scientific theo-ries in infectious diseases. Is that correct? \nDr. F\nAUCI . Yes. \nMAJORITY STAFF . And between infection-acquired immunity and \nvaccinated-acquired immunity, did the United States hit herd im-munity? \nDr. F\nAUCI . The answer is no, and I’ve written a paper on that, \nis that when you’re dealing—just let me take 30 seconds. I don’t want to run out the clock on you, but I think it’s important to make this point. \nWhen you talk about herd immunity, it’s predicated on two prin-\nciples: that you’re dealing with a pathogen that’s not changing; and, No. 2, that when you either get infected or vaccinated, the du-ration of the immunity is measured in decades, if not a lifetime. \nSo, that if you have a pathogen that stays the same—like mea-\nsles doesn’t change. So I was infected with measles when I was a child. It’s the same measles that’s infecting people in certain coun-tries in the developing world. \nNo. 2, when you get either infected or vaccinated with measles, \nyou have immunity that’s durable minimally in decades and pos-sibly for life. \nSo, if you get the same pathogen and you get a large percentage \nof the people who have either been infected or vaccinated, then you have herd immunity. We did not ever have that with COVID. \nM\nAJORITY STAFF . And you’ve also been asked a number of times \nabout the vaccine and vaccine mandates. Were you the one that recommended to the President to mandate vaccines for certain indi-viduals? \nDr. F\nAUCI . No. \nMAJORITY STAFF . Do you know who did? \nDr. F AUCI . No. It was more of a—it was a combination of a group \nand just saying that, you know, certain agencies, like the Labor De-partment or what have you, would feel that this were to be done. But it was not like I 1 day said, ‘‘Hey, we should mandate vac-cines.’’ That did not happen. \nM\nAJORITY STAFF . And I want to echo the comments of the Chair-\nman that we agree the vaccine saved hundreds of thousands of lives. And we talked about this a little bit in January, and I think you touched on it a little bit today. \nCould issuing these mandates and removing the notion of in-\nformed consent from some certain sects of the citizenry lead to vac-cine hesitancy? \nDr. F\nAUCI . Yes. I mentioned this, I believe, in the TI, that as a \nmatter of fact that’s something that I think we need to go back now, when we do an after-the-event evaluation, about whether or not, given the psyche of the country and the pushback that you get from those types of things, we need to reevaluate the cost-benefit ratio of those types of things. \nM\nAJORITY STAFF . And then I won’t belabor the point, but we \ntalked about the six-foot distance an awful lot today. \nDo you recall if it was ever suggested to be 10 feet? Dr. F\nAUCI . You know, I don’t recall, Mitch, if it was ever sug-\ngested it was 10 feet. But when I made my explanation of what it \n59 \nwas, I was saying that there was no trial that looked at 10 versus \n6 versus 3 versus not even worrying about it at all. \nMAJORITY STAFF . And you said today that there were discussions \nat the White House about the six-foot rule. You don’t recall if it was discussions about whether or not it should be 3 or should be 10 or should be 6? \nDr. F\nAUCI . You know, I don’t recall, Mitch, what the exact discus-\nsion was. But as I’ve said in response to multiple questions, what we had was it came to CDC was said that on the basis of their evaluation, which was based on the droplet approach, that six-foot would be the go. And since there was no clinical trials going one way or the other, that’s why it was accepted by the group. \nM\nAJORITY STAFF . And then it hasn’t been a large topic today, and \nwe talked about kind of like in the many unknowns in early 2020 schools were closed through the semester, some schools reopened for the fall semester, some remained closed going through into 2021. \nLooking back, were there—are there current academic ramifica-\ntions of remote schooling or kids not being in school? \nDr. F\nAUCI . I think there have been a number of studies—not I \nthink, I know—that there have been a number of studies to show that there are lasting effects, at least up to this point. They tend to attenuate over time. But there have been substantial negative effects on learning and on children when you keep them out of school for a prolonged period of time. \nM\nAJORITY STAFF . Have you seen any studies suggesting physical \nhealth ramifications? \nDr. F AUCI . I haven’t seen physical health ramifications. \nMAJORITY STAFF . Mental health? \nDr. F AUCI . I believe that there are some that show psychological \nissues that relate to keeping kids out of the environment, of the so-cial environment of the school. \nM\nAJORITY STAFF . I’m—and apologize for bouncing around. We \ndon’t have 14 hours with you today. I’ve got 30 minutes. So, I’m going to—— \nDr. F\nAUCI . Yes, I’m so sorry about that. \nMAJORITY STAFF . I’m going to move quickly. \nDr. F AUCI . Yes. \nMAJORITY STAFF . Again, across the dais, both sides of the aisle, \na lot of questions on the origins of COVID and finding out the ori-gins and how that could better lead to both protecting against spill-over and wildlife trade, but also increase biosafety standards. \nAs you sit here today, is it possible that COVID–19 was the re-\nsult of a laboratory-related accident? \nDr. F\nAUCI . Oh, absolutely. And I keep, like I mentioned multiple \ntimes, I keep an open mind. \nI feel, based on the data that I have seen, that the more likely— \nnot definitive—but the more likely explanation is a natural spill-over from an animal reservoir. But since there has not been defini-tive proof one way or the other, we have to keep an open mind that it could be either. \nM\nAJORITY STAFF . And based on that answer, I think, is the hy-\npothesis that COVID–19 accidentally leaked from a lab a con-spiracy theory? \n60 \nDr. F AUCI . No. I mentioned that several times. Conceptually, the \nconcept of it is not a conspiracy theory. \nMAJORITY STAFF . We’ve talked a little bit about ‘‘The Proximal \nOrigin of SARS-CoV–2,’’ the paper authored by Dr. Andersen. It came to two primary conclusions, and I’m quoting. \n‘‘Our analyses clearly show that SARS-CoV–2 is not a laboratory \nconstruct or a purposefully manipulated virus’’ and ‘‘we do not be-lieve that any type of laboratory-based scenario is plausible.’’ \nDo you disagree with those conclusions? Dr. F\nAUCI . I think, Mitch, if I’m not mistaken—I don’t have the \npaper in front of me—I think they also said the possibility of if you passaged it in, you could have done that. \nM\nAJORITY STAFF . And they—— \nDr. F AUCI . And that—and if you passage it, it’s in a lab. So it \nis—I mean, that could be. \nMAJORITY STAFF . And they dispelled that at the end with the ‘‘we \ndo not believe that any type of laboratory-based scenario is plau-sible.’’ \nSo, I’m just—I’ll ask again. Is a laboratory-based scenario plau-\nsible? \nDr. F\nAUCI . Well, I mean, again, I’m not—I don’t want to speak \nfor what they meant in that paper, but I have said multiple times I keep an open mind that it could be either a laboratory leak or it could be what I think the data is leaning toward mostly, which is a natural occurrence from an animal reservoir. \nM\nAJORITY STAFF . And this email was brought up, too, on April \n16, 2020. Dr. Collins wrote to you and said, ‘‘Wondering if there’s something NIH can do to help put down this very destructive con-spiracy,’’ referencing the lab leak. ‘‘I hoped the Nature Medicine ar-ticle on the genomic sequence of SARS-CoV–2 would settle this, but probably didn’t get much visibility. Anything more we can do?’’ \nThe next day, you were at a White House press conference and \ncited Proximal Origin and said that Proximal Origin established that COVID–19, quote, ‘‘is totally consistent with a jump of a spe-cies from an animal to human.’’ \nDr. F\nAUCI . Right. \nMAJORITY STAFF . Did anyone tell you to cite Proximal Origin \nfrom the White House podium? \nDr. F AUCI . No. It was in response, I believe, to a question that \nmight have been asked by a reporter. But I wasn’t stimulated to say that at all. I was responding to a question. \nM\nAJORITY STAFF . At that time back in April 2020, was it also \nyour belief that a lab leak was possible? \nDr. F AUCI . Yes. I’ve always had an open mind about it. \nMAJORITY STAFF . And then I want to correct the record again a \nlittle bit on the drafting and publication of the Proximal Origin paper. \nDid Dr. Andersen send you drafts to review? Dr. F\nAUCI . He sent drafts, but I’m going to jump ahead of you \nif I might dribble around. I did not edit it. \nMAJORITY STAFF . That was—— \nDr. F AUCI . It was mentioned by a few of the Congressmen. \nMAJORITY STAFF . It was. \nDr. F AUCI . I did not edit the paper. \n61 \nMAJORITY STAFF . And I appreciate that. I just wanted to get on \nthe record. \nDr. F AUCI . Right. \nMAJORITY STAFF . I want to talk about Dr. Morens and what you \nwrote in your opening testimony and some of the answers that you gave today. \nAnd just for clarity, you were, in addition to being unaware of \nhis use of personal email and potentially intentionally deleting Federal records, were you also unaware of his actions to assist Dr. Daszak and EcoHealth? \nDr. F\nAUCI . I am—I was aware of his friendship. I was not aware \nof his attempts to assist him to respond to an NIH inquiry. \nMAJORITY STAFF . So not aware of the editing of press releases or \nediting of letters? \nDr. F AUCI . No, I was not. \nMAJORITY STAFF . On November 11, 2021, Dr. Morens wrote in an \nemail to Dr. Daszak that he attempted to discuss the EcoHealth grant with you and you, quote, ‘‘got upset’’ and told him to have no more communications with Peter. \nWhy did you tell Dr. Morens to no longer communicate with Dr. \nDaszak? \nDr. F\nAUCI . Because I think it’s inappropriate to do what he did, \nI mean, and your Committee has called him out very definitively about that. And it was inappropriate to do that. \nM\nAJORITY STAFF . This is back in 2021. What did you know about \nwhat he was doing then? \nDr. F AUCI . I didn’t know exactly what he was doing, but I don’t \nthink it’s appropriate for people to be communicating and helping a grantee in a response. I didn’t know exactly what he was doing, but I didn’t think it was appropriate. \nM\nAJORITY STAFF . When did you—you testified to Chairman Grif-\nfith—or, excuse me, Chairman Comer—that you knew about the compliance issues later on with EcoHealth. \nWhen did you first become aware? Dr. F\nAUCI . I became aware during briefings by my staff in prepa-\nration for congressional hearings well after the fact where the com-pliance issues actually happened. And I didn’t know—as I men-tioned to you in the TI, Mitch—I didn’t even know the grant ex-isted before the outbreak. \nAnd then, finally, when there was this issue about congressional \nhearings, I needed to know, what is this grant, what are we doing with it, and are there any issues? That’s when they said there was a compliance problem of the fourth year versus the fifth year progress report. \nM\nAJORITY STAFF . Some of the other emails from Dr. Morens I \njust want to read into the record and ask you if his recollection is accurate. \nOn April 27, 2020, Dr. Morens wrote, ‘‘I am sure privately he \nwould love to see Peter and EcoHealth fully restored, although he \ndid once make the comment to me that Peter had screwed himself with the late report. I already told him that all that crap wasn’t true.’’ \nThe late report was true, despite what Dr. Morens said. \n62 \nOn April 21, 2021, Dr. Morens wrote that he was sure you would \ndo anything you could to restore the funds to EcoHealth. \nOn June 5, 2021, Dr. Morens wrote that you were working be-\nhind the scenes to undo the damage to EcoHealth. \nOn October 21, 2021, Dr. Morens wrote, ‘‘Peter, I had my regular \nmeeting with Tony this morning. He immediately inquired about you and several times asked how you were doing. He used a lot of colorful language about the situation with attacks on EcoHealth.’’ \nOn October 25, 2021, Dr. Morens wrote that you were trying to \nprotect EcoHealth. \nOn March 22, 2021, Dr. Morens wrote, ‘‘The most important is \nwithin NIH to get the decision reversed and the grant refunded. I believe Tony would like to do this.’’ \nAnd on February 24, 2022, Dr. Morens wrote, ‘‘It will be a small \nconsolation to hear the following, but in my face-to-face meeting with Tony this morning he once again brought up, as he usually does, your plight, Peter.’’ \nDid you ever have any discussions with Dr. Morens about pro-\ntecting EcoHealth or helping restore funding? \nDr. F\nAUCI . Not at all. I don’t know what—to be honest with you, \nMitch, I just don’t know what Dr. Morens is talking about with that. Maybe he’s trying to, as he said, cheer up—he said that in front of this Committee—cheer up Dr. Daszak. But to say that I’m getting involved in trying to help him or protect him, not so. \nM\nAJORITY STAFF . Did you ever have any conversations with Dr. \nMorens about what Dr. Daszak was facing or about the termination of the grant? \nDr. F\nAUCI . You know, I may—he may have mentioned to me \nsomething like Dr. Daszak is going through terrible times. But I don’t recall. It is conceivable that he would have mentioned that to me, because, as he mentioned to you, that Dr. Daszak and he are very good friends. \nSo, it would not be surprising if sometime he had mentioned to \nme, ‘‘Boy, Dr. Daszak’s going through some really tough times.’’ Fine. That doesn’t mean that I say you should help him. \nM\nAJORITY STAFF . No, it absolutely doesn’t. So, that’s why we \nwant to ask the questions—— \nDr. F AUCI . Yes. \nMAJORITY STAFF . [continuing] And get the answers. \nDuring your transcribed interview with us, you were asked about \nwhether or not Dr. Daszak had a conflict of interest in reviewing the origins of COVID–19. \nAnd you testified, ‘‘You know, I hesitate to speculate about what \nsomeone else should do. The only people that I am involved with is my own staff, who we’ve mentioned many times in this discus-sion, who don’t have a conflict of interest.’’ \nWith the benefit of hindsight and the work of this Committee, do \nyou believe Dr. Morens had a conflict of interest regarding EcoHealth? \nDr. F\nAUCI . Well, from what we know now, he definitely had a \nconflict, because he was communicating with a grantee and helping him in response to an NIH issue, which is a conflict of interest. I did not know that at the time when I made your statement. \nM\nAJORITY STAFF . And I appreciate that. \n63 \nDr. F AUCI . Yes. \nMAJORITY STAFF . Sticking with EcoHealth, in April 2020 NIH \nterminated and then subsequently reinstated and then suspended the EcoHealth grant that had the Wuhan Institute as a sub-grantee. \nDo you recall that decision? Dr. F\nAUCI . Yes. \nMAJORITY STAFF . Were you involved at all in that decision? \nDr. F AUCI . No. \nMAJORITY STAFF . You previously testified to House Energy and \nCommerce that you were, in essence, told to cancel the grant. Do you recall who told you? \nDr. F\nAUCI . We got it from a number of—now, retrospectively, we \nfound out how it was. It was the White House told the Department to tell the NIH to cancel the grant. \nM\nAJORITY STAFF . Did you agree with the cancellation? \n[Disturbance in the hearing room.] Dr. F\nAUCI . What is that? Do we need to listen to that? \nMAJORITY STAFF . He was escorted out. \nDr. F AUCI . Yes. OK. Good. \nI’m sorry, repeat the question, Mitch. M\nAJORITY STAFF . Did you agree with the cancellation? \nDr. F AUCI . You know, it wasn’t a question of agreeing or dis-\nagreeing. It was like, ‘‘Can we really do that? I don’t think that you can do that.’’ And as it turned out, I was right, because the general counsel of HHS said, ‘‘By the way, you can’t do that. You’ve got to restore the grant.’’ \nM\nAJORITY STAFF . And that’s why they restored it and then sus-\npended it, pending the compliance review. \nDr. F AUCI . Yes, exactly. \nMAJORITY STAFF . Not to keep reading Dr. Morens’ emails, but on \nJune 24, 2020, Dr. Morens wrote an email. \n‘‘He,’’ referencing you, ‘‘made some additional comments to the ef-\nfect that this came from the White House and he was totally op-posed to it.’’ \nYou weren’t totally opposed to it? Dr. F\nAUCI . Well, see, that’s his—you know, he’s doing a lot of in-\nterpretation, Mitch. His interpretation I was totally opposed to it. It was more of, can we really legally do that? And the answer turned out I was right, no, you can’t. \nM\nAJORITY STAFF . Do you recall the—did the Department ask you \nfirst or Dr. Collins first to terminate the grant? \nDr. F AUCI . I think it went directly to Building 10—excuse me, \nBuilding 1, the Director’s Office. \nMAJORITY STAFF . Is that the NIH Director’s Office? \nDr. F AUCI . Yes, yes. I think it—it went from the Department to \nNIH to us. \nMAJORITY STAFF . OK. Were you, prior to your retirement in De-\ncember 2022, were you involved in any of the compliance actions \nNIH took against EcoHealth? \nDr. F AUCI . I don’t believe so. I think the actual—and, again, I’m \na little unclear about the time—but I think most of the disciplinary actions actually occurred after I left, if I’m not mistaken. \n64 \nMAJORITY STAFF . Yes, the actual suspension and debarment oc-\ncurred after you left, but there were a number of letters requesting lab notebooks or further information—— \nDr. F\nAUCI . Yes, I—— \nMAJORITY STAFF . [continuing] While you were still there. \nDr. F AUCI . Yes. What happened, Mitch, and it’s important to \npoint this out, once it was clear that there was compliance issues while I was still there, we were told at NIAID, stay out of it, com-pliance is going to be handled by Building 1—i.e., the NIH Direc-tor—and Mike Lauer. So the compliance was said, don’t touch it, don’t go near it, just we’ll take care of it. \nM\nAJORITY STAFF . And you just brought this up. Since the original \ntermination, then suspension, NIH found numerous major viola-tions of grant policies, has since debarred the Wuhan Institute of Virology and suspended and proposed for debarment both EcoHealth as an institution and Dr. Daszak", "summary": "Official printed hearing transcript (CHRG-118hhrg55830) of Anthony Fauci's public testimony before the House Select Subcommittee on the Coronavirus Pandemic — his first public testimony since retiring from NIAID.\n\nExcerpt: U.S. GOVERNMENT PUBLISHING OFFICE WASHINGTON : 55–830 PDF 2024 A HEARING WITH DR. ANTHONY FAUCI  HEARING  BEFORE THE   SELECT SUBCOMMITTEE ON THE CORONAVIRUS  PANDEMIC  OF THE   COMMITTEE ON OVERSIGHT AND  ACCOUNTABILITY  HOUSE OF REPRESENTATIVES  ONE HUNDRED EIGHTEENTH CONGRESS  SECOND SESSION  JUNE 3, 2024  Serial No. 118–114  Printed for the use of the Committee on Oversight and Accountability  (  Available on: govinfo.gov,  oversight.house.gov or  docs.house.gov  (II) COMMITTEE ON OVERSIGHT AND ACCOUNTABILITY  JAMES COMER, Kentucky, Chairman  JIMJORDAN , Ohio  MIKETURNER , Ohio  PAUL GOSAR , Arizona  VIRGINIA FOXX, North Carolina  GLENN GROTHMAN , Wisconsin  MICHAEL CLOUD , Texas  GARY PALMER , Alabama  CLAY HIGGINS , Louisiana  PETE SESSIONS , Texas  ANDY BIGGS, Arizona  NANCY MACE,…", "source_url": "https://www.congress.gov/118/chrg/CHRG-118hhrg55830/CHRG-118hhrg55830.pdf", "pdf_url": "/archive-docs/fauci-files/56f54a77471c38cab396bdf8e5980466/pdf", "doc_date": "2024-06-03", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "public hearing", "house oversight", "select subcommittee", "coronavirus pandemic", "congress", "fauci testimony", "hearing transcript", "CHRG", "testimony-house-2024-jun-public"], "part_number": 1, "page_count": 74}
{"title": "Fauci Public Testimony — House COVID Subcommittee Hearing (3 Jun 2024) (Part 2 of 2)", "content": "individually. \nAre you aware of those? Dr. F\nAUCI . Yes, I am. \nMAJORITY STAFF . During previous TIs and hearings, when asked \nif they supported every one of these actions and supported the sus-pension and debarment, both Dr. Collins and Dr. Tabak said yes. \nSitting here today, do you support the suspension and debarment \nof EcoHealth? \nDr. F\nAUCI . Yes. \nMAJORITY STAFF . I want to move on to the kind of, like, ‘‘known \nunknowns’’ of COVID origins, to quote Dr. Lipkin’s paper from early 2020. \nOn October 20, 2021, Dr. Tabak sent a letter to then-Ranking \nMember Mr. Comer that said the bat coronaviruses studied under the EcoHealth Alliance grant could not have been the source of SARS-CoV–2 and the COVID–19 pandemic. You’ve testified simi-larly both back in January and today. \nSome of the things that I believe Chairman Griffith brought up \nwas just kind of that statement results on some things—rests on some things that we just can’t know. \nIn your experience, Dr. Fauci, do researchers publish every virus \nthat they sequence? \nDr. F\nAUCI . No. I mean, I think researchers don’t always publish \nevery single thing they do. \nMAJORITY STAFF . Do they routinely publish every experiment \nthat they conduct? \nDr. F AUCI . I’m sure there are people who don’t publish every sin-\ngle experiment that they do. \nMAJORITY STAFF . And then is there a lag time between the sam-\npling, the analysis, and the publication? \nDr. F AUCI . Yes. I mean, publications often take months before \nthey come out. \nMAJORITY STAFF . Is it possible, if not plausible, that EcoHealth \nand the Wuhan Institute of Virology have samples from between 2020, when they originally published a paper—or, excuse me, 2015, when they originally published a paper with all their samples, and now that are unpublished? \nDr. F\nAUCI . Sure, it’s possible. But, Mitch, I’m—I might just throw \nin there you can’t get away from the fact that the viruses that were \n65 \nstudied, that we—that the NIH gave them a grant to study, don’t \npull back on the fact that, no matter what you did with those vi-ruses, they were phylogenetically so different they could not pos-sibly be the precursor of SARS-CoV–2. \nM\nAJORITY STAFF . And I agree with that. I guess my only point \nis that you don’t know all the viruses they were working with. \nDr. F AUCI . Yes. And let’s make that clear, because Griffith—Con-\ngressman Griffith—asked it, and I answered you quite honestly, that none of us can know everything that’s going on in China or in Wuhan or what have you. And that’s the reason why I say today and I’ve said at the TI, I keep an open mind as to what the origin is. \nM\nAJORITY STAFF . The last thing, last topic I want to touch on is \ngain-of-function. We touched on it in January. You touched on it a little bit today. \nI know the pandemic has resulted, as I’m sure you’re aware, with \na rather large debate, including with the NSABB updating their dangerous research policies surrounding gain-of-function, P3CO, and dual use research of concern. \nAt the—prior to October 2021, the NIH website listed gain-of- \nfunction as a type of research that modifies a biological agent so that it confers new or enhanced activity to that agent. \nAnd the P3CO framework that the U.S. Government uses to fur-\nther regulate a subpart of that research, that it’s more dangerous, specifically that could cause widespread and uncontrolled death or disease in humans. \nPutting aside what’s regulatory—I agree with you, the P3CO def-\ninition is regulatory—are there types of research that could fall under the broad definition but not the P3CO definition? \nDr. F\nAUCI . Well, I believe Members on the Minority side have \nmentioned that. Influenza is a gain-of-function to a virus to make it grow better in eggs. Making an E. coli manufacture insulin is telling the E. coli to do something it wasn’t able to do before by mu-tation. Of course that’s the case. \nM\nAJORITY STAFF . So, in kind of the Venn diagram of this re-\nsearch, something could fall under gain-of-function without falling under further regulation? \nDr. F\nAUCI . I know where you’re going and you’re not going to get \nthere. But go ahead. \nMAJORITY STAFF . According to EcoHealth’s year five progress re-\nport, they facilitated an experiment in Wuhan that had seven mice infected with Wuhan Institute of Virology–1 as the backbone. Five survived. Then eight mice were infected with a chimera of WIV1 and the spike from another virus, and two survived. \nIn EcoHealth’s own words, these results suggest that the patho-\ngenicity of that full-length chimera is higher than others. \nDr. F\nAUCI . Right. \nMAJORITY STAFF . You were asked today and it was read back to \nyou a little bit, but on May 16, just a few weeks ago, Mrs. Lesko asked Dr. Tabak, ‘‘Did NIH fund gain-of-function research at the Wuhan Institute of Virology through EcoHealth?’’ \nAnd Dr. Tabak answered, ‘‘If you’re speaking about the generic \nterm, yes, we did.’’ \nDr. F\nAUCI . Right. \n66 \nMAJORITY STAFF . On May 11, you were asked a similar question, \nand you answered, ‘‘The NIH has not ever and does not now fund gain-of-function research at the Wuhan Institute of Virology.’’ \nI’m going to ask it and you can answer it how you want to an-\nswer it. \nAccording to the broad definition of gain-of-function research and \nthe definition Dr. Tabak was testifying pursuant to, did NIAID fund gain-of-function research via EcoHealth in Wuhan? \nDr. F\nAUCI . The broad definition of gain-of-function, in my mind, \nis not applicable here and does nothing but confuse the situation. \nAnd that is the reason why, after 3 years of deliberation by the \nbodies, including the NSABB as well as the National Academies, it was decided to make an operative and regulatory definition. \nIf you harken back to the original broad definition, it does noth-\ning but confuse people. And that’s why every time I have men-tioned gain-of-function, at the Senate hearing with Senator Paul and the TI and today, the definition that I use is not my personal definition. It’s a codified regulatory and operative definition made by a body that has nothing to do with me. \nM\nAJORITY STAFF . Thank you. \nMr. Chairman, I yield back. Dr. W\nENSTRUP . I now recognize the Minority Staff for not longer \nthan 30 minutes. \nMINORITY STAFF . Dr. Fauci, nice to see you. We’ve covered many \ndifferent topics today. We just want to make sure that you have the opportunity to provide your full perspective on any and all of them. \nIs there anything you’d like to add, clarify, or say about any of \nthe topics we’ve discussed here today? \nDr. F\nAUCI . Actually, I think we’ve covered just about everything, \nbut if you come up with something you want to ask me, I’d be happy to try to fill it in. But I think we’ve been rather extensive today. \nM\nINORITY STAFF . I think that’s great, and I think we agree. \nAnd so, with that, we’ll yield back the remainder of our time. Dr. W\nENSTRUP . I would like to yield to Ranking Member Ruiz for \na closing statement if he would like one. \nDr. R UIZ. Dr. Fauci, I’d like to thank you for your testimony \ntoday. And I would like to thank you for your decades of service to our Nation, especially with the HIV epidemic that our Nation suffered through, the pandemic flu, Ebola, Zika, and COVID–19, and your years of research and investment in—that led to the rapid development of the COVID–19 vaccine that saved millions of lives. Thank you. \nAnd over the past 4 years, you have been personally targeted by \nextreme narratives about the origins of the COVID–19 pandemic and the U.S. Government’s response to it. They began in force in retaliation to wisdom you offered that contradicted the reckless and dangerous therapeutic recommendations by President Trump and have remained part of House Republicans’ political playbook. \nThese extreme narratives have been the bedrock of the Select \nSubcommittee’s Republican-led probe and the untenable inferences they’ve somehow drawn despite the overwhelming evidence that it is inconvenient to those narratives. \n67 \nI want to be clear. The evidence uncovered from more than \n425,000 pages of documents and 20 closed-door interviews of cur-rent and former Federal officials has undermined the extreme nar-ratives behind the Republicans’ own probe. \nAs I alluded to at the beginning of this hearing, my Democratic \ncolleagues and I are committed to speaking objectively and truth-fully about what the evidence shows, and this is what it shows: \nDr. Fauci did not fund research through the EcoHealth Alliance \ngrant that caused the COVID–19 pandemic. \nDr. Fauci did not lie about gain-of-function research in Wuhan, \nChina. \nDr. Fauci did not orchestrate a campaign to suppress the lab \nleak theory. \nThese findings are apparent from the evidence. In fact, this much \nwas clear by the time of Dr. Fauci’s 2-day transcribed interview this past January. \nIn the 5 months since, the Select Subcommittee has conducted \nseveral more closed-door interviews and reviewed several thousand more pages of documents. This additional evidence and Dr. Fauci’s testimony today has only made Republicans’ claims less plausible and more preposterous. \nAnd when I was named Ranking Member of the Select Sub-\ncommittee, I made a commitment to follow the facts in objectively analyzing the origins of the COVID–19 pandemic. \nIf the Select Subcommittee is to meaningfully improve our Na-\ntion’s preparedness for future pandemics, then we must take an ob-jective approach to the factual and scientific evidence available to us. \nThe origins of the COVID–19 pandemic remain uncertain. I \nwould like to remind my Republican colleagues that that uncer-tainty is not an opportunity for them to author fiction for partisan gain. It could have been a lab leak and it could have been an ani-mal transmission. \nAnd, at the cost of meaningfully advancing our understanding of \nCOVID–19’s origins, Republicans have levied extreme allegations of creating SARS-CoV–2 against Dr. Fauci. \nThe result is that Republicans’ own probe has failed to shed any \nadditional light on a central question for our Select Subcommittee. \nIn fact, we are actually entering the fourth quarter of this Con-\ngress and this Select Subcommittee on the Coronavirus Pandemic, and what have we focused on? It’s not an objective investigation on the origin as either a lab leak or animal transmission. \nWe have spent the vast majority of time, like in this hearing, \nwith Republicans trying to prove that Dr. Fauci and Collins funded research through EcoHealth that created the SARS-CoV–2 virus. And in order for that to be true, it is dependent on proving the lab leak theory to be true. \nSo it has not been an objective investigation as to whether or not \nthe virus came from a lab or an animal transmission in order to prevent and prepare for the next pandemic. It has been to push this narrative. And this hearing is their climax, their star witness, to finally prove their narrative. And they did not do so. \nInstead of focusing on solutions, like fortifying our public health \nwork force and infrastructure, securing domestic supply chain of \n68 \nvital public health equipment and medication, or equipping schools, \nchurches, synagogues, mosques, and businesses to safely stay open during the next deadly novel viral pandemic, instead they focused on accusation without evidence. \nAnd it seemed like even though the evidence was there that the \naccusations were false, it didn’t matter. They still accused him on a cover-up, suppressing the truth, that he initiated, prompted, or edited the proximal origins paper, that he funded gain-of-research that created the SARS-CoV–2 virus, even that he received royal-ties. \nYou know, his answers today and his transcribed interviews and \nhis countless emails refuted all of this. They always have. And his testimony today did again. But I guess that doesn’t matter for the Majority. \nThe truth is that there is no evidence to prove this narrative that \nwe’ve spent so much time addressing. Their accusations are with-out evidence. But it doesn’t matter to them. \nIntentionally misleading the public is propagating \ndisinformation, and it’s wrong and dangerous not only because it manufactures distrust in our public health leaders and our public health agencies, but also because it targets Dr. Fauci and other public health officials for violent death threats. \nDr. Fauci just said that any time anybody alludes to the false ac-\ncusation that he created the COVID–19 pandemic, his death threats go up. But irresponsibly and recklessly, Members on this Subcommittee continue to accuse him of that. \nSo, for the remaining months of the Select Subcommittee I reaf-\nfirm my commitment to take a serious, balanced look at the ques-tion and the possibilities of whether the novel coronavirus emerged from a lab or from nature. \nAnd I emphasize to my colleagues that any uncertainty about \nthose origins is an opportunity for us to work constructively to-gether on forward-looking measures to improve our Nation’s readi-ness for future public health threats. \nThank you, Mr. Chairman, and I yield back. Dr. W\nENSTRUP . Thank you again. \nDr. Fauci, I want to thank you for coming here today. I, again, \ntruly appreciate your willingness to come voluntarily before the Se-lect Committee for both your transcribed interview and hearing today. \nYou know, this hearing was an opportunity to learn about our \nCOVID–19 response and how we can improve and do better. And we did some good things during that, and I’ll say Operation Warp Speed is one of them. \nIt’s also an opportunity to more closely examine the office in \nwhich you served, because there seemed to have been some signifi-cant wrongdoings that took place. And I believe that we can make changes and prevent that from happening in the future. That’s my goal. \nIt’s an opportunity to take a close look about the processes and \nthe procedures in place in our health institutions in the United States. That’s our job, is oversight, in Congress. That’s what we’re supposed to do. \n69 \nI don’t know what playbook some are talking about, because it’s \nbeen my goal as Chairman—and I think you’ve seen the staff speaking the same way—to take a hard look at the facts so that we can do better in the future. \nI know that at the end of the transcribed interview, not only dur-\ning the interview, we talked about other types of vaccines we may be able to create, mucosal vaccines, maybe inhibitors of furin, if there’s a furin cleavage site as part of the vaccine. I appreciated that conversation so very much. And at the end, you thanked me for the fairness, and we had the opportunity to share a lot that day. \nI think what I’m most concerned about as we go forward as a \ncountry and from our agencies is that we can be trusted and that we are better in our messaging and talk about clarity. \nDr. McCormick today talked about what it was like actually \ntreating COVID patients day in and day out. I had recommended early on that America needed to hear more from doctors that were treating COVID patients, what they were seeing, what was work-ing, what was not working. \nI compared it to General Schwarzkopf during the Gulf War. Ev-\neryone tuned in every night to hear what General Schwarzkopf had to say, not the politician, but what the general in charge had to say. And I think that was important, the one who was in the trenches. \nBut, look, you know, we’ve gone back and forth on the definition \nof gain-of-function. I think it’s been pretty clear what you said was on your mind. And there were two different definitions, if you will, a generic definition and an operative regulatory definition. \nBut so, you know, when we go through this what America hears \nis that you say NIH did not fund and Dr. Tabak said NIH did fund. Clarity matters. \nI think it would have helped when you were in front of Dr. Paul \nin the Senate if you were clear about what you meant. The Amer-ican people had never heard of gain-of-function until this came about. Clarity matters. \nYou know, we conducted great trials on the vaccines. I thought \nthey were phenomenal. Normally, you have eight to ten thousand people. We had about 40,000 people in each one of the trials. \nAnd what we knew from the trials is that, one, it saved a lot of \nlives. That’s one thing. But we also knew that if you got vaccinated you could still get COVID. We didn’t make that clear to the Amer-ican people, in my mind, and that you could still get sick. \nAnd so, if someone stands up, not you, but if someone stands up \nand says, if you get vaccinated you’re never going to go to the ICU and you’re not going to die, well, it was still happening. \nSo, where was the messaging? I wish you would have corrected \nthat right then and there. \nYou know, the President says, oh, maybe we just inject bleach. \nWell, some people maybe thought that was serious. We made it clear it was not, and that was important. \nBut here we have Operation Warp Speed, which I know firsthand \nyou were working on, and you were kind enough to work with the Doctors Caucus to explain what was going on with Operation Warp Speed. And we have a Presidential candidate who says, ‘‘Well, if \n70 \nthat’s developed, I’m not taking it’’—I’m paraphrasing—and then \ntakes it. \nThe American public deserve a lot better from their government. \nAnd what should have been a 9/11 moment for this country, this pandemic, was turned into a political nightmare. \nWe need to do better. These are agnostic issues, not political. And I think from what we have learned from you in the TI and \nhere today, there’s a lot of things that we can do better, and the grant process being one of them. I mean, if you—look, when I sign a prescription, I’m responsible for it. \nSomebody needs to be responsible. And if you’re signing for \ngrants but not responsible for it, you just sign it, then you’re not responsible for the dollars that are going out. \nAnd then maybe it’s the Advisory Committee that needs to be \nsigning the grant so that there’s some level of responsibility, and responsibility for compliance. I think that’s one of the biggest les-sons learned through all this. \nWe can do better. America is a great country. We can fix our \nproblems. But we have to take a good hard look at what we did, what we didn’t do, be honest with ourselves, be better in our mes-saging to the American people, especially when it comes to health. \nAnd that’s why I felt it was very important that we don’t do \nthings like mandates, but let patients have a conversation with the doctor that they know and trust and make sure that we’re getting the doctors all the information and data that they need, from ad-verse effects of the vaccine, which we’ve always done, adverse ef-fects of the vaccine, to what the vaccine can and can’t do, whether you’re at risk or not at risk, what are your risks. \nThose are personal conversations that need to take place. And I \nlook forward to try and establish the system that does a better job at that. \nI’m going to conclude and just say thank you once again, Dr. \nFauci. As a matter of fact, I’d be glad to have more off-the-record conversations about things we can do in the future, the drugs we may be able to develop, treatments we may be able to provide, and vaccines we may be able to produce. \nAnd so, if you’re amenable, I might reach out to you for that, and \nother scientists as well that may have varying opinions. \nSo, again, thank you again for being the witness today. With that, without objection, all Members will have 5 legislative \ndays within which to submit materials and to submit additional written questions for the witnesses, which will be forwarded to the witnesses for their response. \nIf there’s no further business, without objection, the Select Sub-\ncommittee stands adjourned. \n[Whereupon, at 1:30 p.m., the Subcommittee was adjourned.] \nÆ", "summary": "Official printed hearing transcript (CHRG-118hhrg55830) of Anthony Fauci's public testimony before the House Select Subcommittee on the Coronavirus Pandemic — his first public testimony since retiring from NIAID.\n\nExcerpt: individually.  Are you aware of those? Dr. F AUCI . Yes, I am.  MAJORITY STAFF . During previous TIs and hearings, when asked  if they supported every one of these actions and supported the sus-pension and debarment, both Dr. Collins and Dr. Tabak said yes.  Sitting here today, do you support the suspension and debarment  of EcoHealth?  Dr. F AUCI . Yes.  MAJORITY STAFF . I want to move on to the kind of, like, ‘‘known  unknowns’’ of COVID origins, to quote Dr. Lipkin’s paper from early 2020.  On October 20, 2021, Dr. Tabak sent a letter to then-Ranking  Member Mr. Comer that said the bat coronaviruses studied under the EcoHealth Alliance grant could not have been the source of SARS-CoV–2 and the COVID–19 pandemic. You’ve testified simi-larly both back in January and today.  Some of the…", "source_url": "https://www.congress.gov/118/chrg/CHRG-118hhrg55830/CHRG-118hhrg55830.pdf", "pdf_url": "/archive-docs/fauci-files/56f54a77471c38cab396bdf8e5980466/pdf", "doc_date": "2024-06-03", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "public hearing", "house oversight", "select subcommittee", "coronavirus pandemic", "congress", "fauci testimony", "hearing transcript", "CHRG", "testimony-house-2024-jun-public"], "part_number": 2, "page_count": 74}
{"title": "Fauci Testimony — Senate HELP Committee (20 Jul 2021, CHRG-117shrg46775) (Part 1 of 3)", "content": "U.S. GOVERNMENT PUBLISHING OFFICE\nWASHINGTON : 46–775 PDF 2023 S. H RG. 117–195 \nTHE PATH FORWARD: \nA FEDERAL PERSPECTIVE \nON THE COVID–19 RESPONSE \nHEARING \nOF THE  \nCOMMITTEE ON HEALTH, EDUCATION, \nLABOR, AND PENSIONS \nUNITED STATES SENATE \nONE HUNDRED SEVENTEENTH CONGRESS \nFIRST SESSION \nON \nEXAMINING A FEDERAL PERSPECTIVE ON THE COVID-19 RESPONSE, \nFOCUSING ON THE PATH FORWARD, AFTER RECEIVING TESTIMONY FROM ROCHELLE P. WALENSKY, DIRECTOR, CENTERS FOR DISEASE CONTROL AND PREVENTION, ANTHONY S. FAUCI, DIRECTOR, NA-TIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES, NA-TIONAL INSTITUTES OF HEALTH, JANET WOODCOCK, ACTING COM-MISSIONER OF FOOD AND DRUGS, FOOD AND DRUG ADMINISTRA-TION, AND DAWN O’CONNELL, ASSISTANT SECRETARY FOR PRE-PAREDNESS AND RESPONSE, ALL OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. \nJULY 20, 2021 \nPrinted for the use of the Committee on Health, Education, Labor, and Pensions \n( \nAvailable via the World Wide Web: http://www.govinfo.gov \n(II) COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS \nPATTY MURRAY, Washington, Chair \nBERNIE SANDERS (I), Vermont \nROBERT P. CASEY, JR., Pennsylvania TAMMY BALDWIN, Wisconsin CHRISTOPHER S. MURPHY, Connecticut TIM KAINE, Virginia MAGGIE HASSAN, New Hampshire TINA SMITH, Minnesota JACKY ROSEN, Nevada BEN RAY LUJAN, New Mexico JOHN HICKENLOOPER, Colorado RICHARD BURR, North Carolina, Ranking \nMember \nRAND PAUL, M.D., Kentucky SUSAN M. COLLINS, Maine BILL CASSIDY, M.D., Louisiana LISA MURKOWSKI, Alaska MIKE BRAUN, Indiana ROGER MARSHALL, M.D., Kansas TIM SCOTT, South Carolina MITT ROMNEY, Utah TOMMY TUBERVILLE, Alabama JERRY MORAN, Kansas \nE\nVAN T. S CHATZ , Staff Director \nDAVID P. C LEARY , Republican Staff Director \nJOHN RIGHTER , Deputy Staff Director \n(III) CONTENTS  \nSTATEMENTS \nTUESDAY, JULY 20, 2021 \nPage \nCOMMITTEE MEMBERS  \nMurray, Hon. Patty, Chair, Committee on Health, Education, Labor, and \nPensions, Opening statement .............................................................................. 1 \nBurr, Hon. Richard, Ranking Member, a U.S. Senator from the State of \nNorth Carolina, Opening statement ................................................................... 3 \nWITNESSES  \nWalensky, Rochelle, M.D., MPH, Director, United States Centers for Disease \nControl and Prevention, Atlanta, GA ................................................................. 6 \nPrepared statement .......................................................................................... 7 \nFauci, Anthony, M.D., Director, National Institute of Allergy and Infectious \nDiseases, National Institutes of Health, Bethesda, MD ................................... 14 \nPrepared statement .......................................................................................... 15 \nWoodcock, Janet, M.D., Acting Commissioner, United States Food and Drug \nAdministration, Silver Spring, MD ..................................................................... 23 \nPrepared statement .......................................................................................... 24 \nO’Connell, Dawn, Assistant Secretary for Preparedness and Response, United \nStates Department of Health and Human Services, Washington, DC ............ 34 \nPrepared statement .......................................................................................... 36 \nQUESTIONS AND ANSWERS \nResponse by Rochelle Walensky, to questions of: \nSenator Casey ................................................................................................... 70 Senator Baldwin ............................................................................................... 72 Senator Hassan ................................................................................................. 72 Senator Burr ..................................................................................................... 73 Senator Braun .................................................................................................. 75 Senator Tuberville ............................................................................................ 76 \nResponse by Anthony Fauci, to questions of: \nSenator Burr ..................................................................................................... 78 Senator Braun .................................................................................................. 81 Senator Tuberville ............................................................................................ 82 \nResponse by Janet Woodcock, to questions of: \nSenator Burr ..................................................................................................... 84 Senator Braun .................................................................................................. 86 Senator Scott ..................................................................................................... 87 Senator Tuberville ............................................................................................ 91 \nResponse by Dawn O’Connell, to questions of: \nSenator Baldwin ............................................................................................... 92 Senator Burr ..................................................................................................... 93 Senator Braun .................................................................................................. 96 Senator Tuberville ............................................................................................ 96 \n(1) THE PATH FORWARD: \nA FEDERAL PERSPECTIVE \nON THE COVID–19 RESPONSE \nTuesday, July 20, 2021 \nU.S. S ENATE , \nCOMMITTEE ON HEALTH , EDUCATION , LABOR , AND PENSIONS , \nWashington, DC. \nThe Committee met, pursuant to notice, at 10 a.m., in room 430, \nDirksen Senate Office Building, Hon. Patty Murray, Chair of the Committee, presiding. \nPresent: Senators Murray [presiding], Casey, Baldwin, Kaine, \nHassan, Smith, Rosen, Lujan, Hickenlooper, Burr, Paul, Cassidy, Braun, Marshall, Romney, Tuberville, and Moran. \nOPENING STATEMENT OF SENATOR MURRAY \nThe C\nHAIR . Good morning. Senate Health, Education, Labor, and \nPensions Committee will please come to order. Today we are hold-ing a hearing on our Federal response to the COVID–19 pandemic. Ranking Member Burr and I will each have an opening statement and I will introduce our witnesses. After they give their testimony, Senators will each have 5 minutes for a round of questions. \nWhile we are yet unable to have the hearing fully open to the \npublic or media for in-person attendance, live video is available on our Committee website at help.senate.gov . And if anyone is in need \nof accommodations, including closed captioning, please reach out to the Committee or the Office of Congressional Accessibility Services. \nWe are at a point of great promise and peril in the fight against \nCOVID–19. While I am encouraged by the fact that two-thirds of adults in our Country have received their first dose of vaccine, I am alarmed by how the rate of vaccination has been slowing, and how driven by the delta variant, rates of COVID–19 cases and deaths are once again on the rise. Five counties in my state cur-rently have high levels of transmission according to the Centers for Disease Control and Prevention. For example, in Walla Walla County, cases are up in July from June, and they were up in June from April and May. \nEven though 99 percent of the COVID deaths nationwide last \nmonth were among people who had not gotten vaccinated, we are still seeing fear and misinformation hold people back, huge dispari-ties in vaccination rates among communities of color and rural communities, skepticism about vaccines among some religious and conservative communities, and slow uptake among youth—young adults. Vaccines are safe, effective and free and easy to get. We \n2 \nneed to make sure people know that. And we also need to make \nsure they understand. Choosing not to get vaccinated doesn’t just put themselves at risk, it puts the people around them at risk and including people who are immunocompromised like those fighting cancer and kids who are not yet eligible for vaccines. \nWe also have to remember vaccinations are just one front of this \nfight. Local health departments need the capacity to track emerg-ing outbreaks quickly through contract tracing sequence, virus samples to identify variants, help isolate ill people, and track vac-cination progress. And more experts need to evaluate the longevity of immunity, especially in the face of new variants and the poten-tial value of booster shots. \nResearchers need to study the long term impacts of this disease \nand how to treat long haul COVID–19 or PASC. And perhaps most importantly, we as a Nation need to fully learn the lessons of this pandemic and take action so we are never in this situation again. That is why Senator Burr and I have been working on bipartisan legislation and oversight to build the world class public health and preparedness infrastructure our people deserve. It is my hope that through this work, we will not only address challenges we faced during this pandemic but build on progress we saw in some states across the country. \nIn my home State of Washington, they worked to overcome chal-\nlenges with sharing critical COVID data among health depart-ments, labs, and hospitals to improve how data was used to allo-cate critical medical supplies like respirators and develop a more complete dashboard for demographic data that broke out numbers, for example, for the Pacific Islander community. Michigan created a task force on racial disparities early on in the pandemic to ensure they were reaching communities of color for testing and contact tracing. \nAlaska literally employed every mode of transportation to deliver \nvaccines to hard-to-reach communities. One of the clearest lessons from this crisis is that you should have the same protection from a pandemic, chronic disease, or public health threat, regardless of where you live, who you are, or what your income is. And one of the best ways of providing that level of protection is through strong public health infrastructure. \nThe stronger our health departments are at every level, the more \neffectively they can work to use sequencing technology and modern data systems to track the spread of diseases and monitor the suc-cess of vaccination efforts, stand up testing and contact tracing to stop disease outbreaks, develop science based guidelines to address local needs, build partnerships in hard to reach communities, and build trust as communicators and fight misinformation. There is a saying in health care, an ounce of prevention is worth a pound of cure. We need to have that same mindset when it comes to public health. That is why I have pushed for more funding for public health departments throughout our COVID response packages. \nIt is why earlier this year I reintroduced legislation to end the \ncycle of crisis and complacency in public health funding by pro-viding $4.5 billion in dedicated annual funding and is why I am going to continue pushing for us to make these critical investments. We all want this pandemic to end. And it is clear, despite the in-\n3 \ncredible progress we have made in the last few months, we still \nhave a lot more work to do. But even after we are through this cri-sis, our work won’t be done. We have to make sure we learn from this history and take action, so we never repeat it. \nThis crisis has cost too much, has taken too many lives for us \nto do anything less. I look forward to hearing from all of our wit-nesses today. Thank you for being here. We want to hear about our response to this pandemic so far, the path forward, and how we better prepare for threats like this in the future. With that, I will turn it over to Ranking Member Burr for his opening remarks. \nOPENING STATEMENT OF SENATOR BURR \nSenator B\nURR. Well, thank you, Madam Chair. I am pleased that \nwe are holding this hearing today. Our third panel with members of the Administration, this Congress on COVID–19. To our wit-nesses, welcome. Welcome back. Some of you are old hands at this now and others are relatively new. Dr. Fauci, Dr. Walensky, thank you for returning to the Committee for the third time this year to discuss this pressing matter. Ms., O’Connell, welcome. This is your first hearing before the Committee in your newly confirmed role as the ASPER. \nI am glad that we are able to get you confirmed so quickly. You \nhave a lot of work in front of you and all of us, Republicans and Democrats, are ready to help you and the fine folks at ASPER get the job done. Dr. Woodcock, welcome back to the HELP Committee. The FDA has benefited from your leadership, and you are the right person at the helm as we continue to grapple with the pandemic. \nI hope that we will see you again at another hearing to talk \nabout the great things that you are doing at the FDA, preferably a confirmation hearing. I look forward to hearing from each of you on your perspectives of the current response to COVID–19 and what we—where we should go from here. I have spent the better part of my career in Congress working to prepare our Country for the unthinkable and anticipating what we may need to respond to it. These early efforts had the support and leadership of many of my colleagues here now, including Senator Collins, our Chair, Sen-ator Murray, Senator Casey have all been important partners on preparedness with me, working to reauthorize PAHPRA and con-tinue to keep a focus on these items during peacetime. All of this effort was with the hope that we would never have to act on the authorities we provided. But it was also with an eye to what may be around the corner. Each law we wrote was designed to build on \nthe lessons that we learned from each event, Zika, West Nile, SARS and the anthrax attacks. \nWe tried to anticipate what we didn’t think of last time around \nso that we could be better prepared for when the big one came. This Committee has been holding hearings on COVID–19 response since March 2020, at the very first hearing that raised concerns with our ability to keep pace with the virus, to track its where-abouts, and understand the impact it would have on the lives of the American people. We have the authorities needed, but we were and still are faced with many unknowns. \nEach step of the way, we need to look around the corner and ask \nourselves, what do we need to do today to keep us up with the \n4 \nvirus 30, 60, and 90 days from now? CDC estimated in mid-June \nthe delta virus, the variant accounted for more than 30 percent of all covered infections. As of mid-July, the cases caused by delta variant may be approaching 60 percent of all cases. The good news is the cases are down significantly since the peak. The bad news is the delta virus—variant is surging and vaccines have slowed be-cause of hesitancy of resistance. I can tell you that the next few weeks and months will require us to answer some very difficult questions, especially as we work toward the last few miles of ad-ministering the vaccine in this country. COVID won’t just go away. \nWe need all Americans who can get the vaccine to get the vac-\ncine. If you won’t do it for yourself, do it for your friends, your fam-ilies, for your neighbors, and your local community. Do it for your grandchildren so they can go back to school. Do it for your grand-parents so they can finally go out and eat. Not only is a delta vari-ant a concern, but we need to look around the corner to the next mutation of the disease. \nI would like to know if we are performing enough sequencing to \nbe able to quickly detect the presence of variants. And are we tracking the right metrics to understand the shift and drift of the virus so that we can see in real time what new variants may mean for our response? Last week, one vaccine company announced it was ready to file for FDA emergency use for booster shot. Do we need booster shots, when do we need them? What does this mean for a widely available vaccine? Israel started offering booster shots last week. \nI am worried that American leadership is no longer what it once \nwas when it comes to public health and other countries are out-pacing us. We have the same data as Israel. Why aren’t we making the same decisions? Messages from public health experts won’t be followed if Americans don’t believe in the experts. The White House has the power to shape messaging, but it doesn’t and shouldn’t shape science in any administration. The last Administration lost the attention and trust of the American people with 2 hour press briefings. This Administration shouldn’t lose theirs for the sake of the teachers’ union. We need to know what we are being told by experts is the unvarnished truth. Don’t tell us what you don’t think we can handle. Don’t tell us what the Administration thinks we should hear. Level with us. \nAs we sit here today, we are just months away from flu season. \nHow do we get ready for the colder months ahead of us and the flu and cold season that it will bring along with it? Are the flu shots ready? Will we have enough? These questions should have been thought about weeks ago as they are already on our doorstep. The same is true for our legislative efforts and the long term changes we need to make now. While lessons learned from COVID response are top of our mind, the ASPER must play a more promi-nent role managing the threat landscape in peacetime and com-manding the public health and medical response during the emer-\ngencies with better coordination among Federal agencies, better availability of data and public health surveillance, stronger part-nerships with innovators in the private sector, building on the good work of BARDA, and visibility into our supply chain for critical \n5 \ndrug supplies, which are also—which also need to be more sustain-\nable. \nThe CDC must be reformed to become a more focused, account-\nable, and transparent partner in public health and public health preparedness and learn to adopt and leverage 21st century tech-nologies. The NIH should build on its ability to accelerate basic re-search, leaning on its long expertise in partnering with academia to better understand the pathogens that pose the greatest risk and what tools we may have in the research bench to combat them. And the FDA should build on the great success that we have had, staying the more nimble and creative agency it has become during the COVID–19 response. \nThis is especially important as the agency works to make final \nits user fee agreements and transmit them to Congress for our ap-proval next year. Now is the time to anticipate what is next. I en-courage each of you, in this critical role that you play to engage with this Committee to provide the insight into the COVID re-sponse as you have over the last 18 months, but more importantly, to look ahead. We have a window to update our public health and medical preparedness policies, taking into account the lessons learned from COVID–19 and this Committee intends to act before the attention of Congress turns to other matters. \nIt is hard to believe, but memories will fade. I have had to fight \nto keep funding for pandemic and threat awareness too many times to count. I hope to pass that baton onto one of my colleagues to pro-tect these important programs. But before I leave, I feel a great re-sponsibility to make things better in one final bill. \nI am glad that the Chair is an active and able partner in that \neffort. I appreciate her commitment to this bipartisan concern. And I think we have a real opportunity to make improvements. This ef-fort will be our focus going into the fall. \nWe welcome your feedback, your insight, and most importantly, \nyour expertise. There is nothing more important than the health and security of our Nation. With that, I thank the Chair and I yield. \nThe C\nHAIR . Thank you, Senator. With that, I will introduce to-\nday’s witnesses. We will begin with Dr. Rochelle Walensky. She is the Director of the Centers for Disease Control and Prevention and the Administrator of the Agency for Toxic Substances and Disease Registry. Dr. Walensky, welcome back. Thank you for joining us. \nNext, I would like to introduce Dr. Anthony Fauci, who is the Di-\nrector of the National Institute of Allergy and Infectious Diseases and the Chief Medical Advisor in President Biden’s COVID–19 re-sponse team. Dr. Fauci, it is good to have you back before the Com-mittee. Thank you for joining us. \nOur next witness is Dr. Janet Woodcock, the Acting Commis-\nsioner of the Food and Drug Administration. Dr. Woodcock, thank you for being here. I look forward to your testimony. Finally, we have the Assistant Secretary for Preparedness and Response, John \nO’Connell. It is good to see you, Assistant Secretary O’Connell. \nThank you for joining us. I am pleased to welcome you back to \nthe Committee following your confirmation to this new role. With that. Dr. Walensky, you may begin your opening statement. \n6 \nSTATEMENT OF ROCHELLE WALENSKY, M.D., MPH, DIRECTOR, \nUNITED STATES CENTERS FOR DISEASE CONTROL AND PRE-VENTION, ATLANTA, GA \nDr. W ALENSKY . Good morning. Chair Murray, Ranking Member \nBurr, Members of the Senate Health Committee. I am honored to join you today to provide an update on the COVID–19 pandemic and our four priorities of CDC’s ongoing response, tracking and preventing further spread of COVID, creating access to and con-fidence in vaccines, advancing health equity, and getting our chil-dren back to school. The current data reveal two divergent truths. \nSince the epidemic peaked in January 2021, we have seen large \nreductions in COVID–19 cases, hospitalizations, and deaths. And these trends are a testament to the success of our vaccination pro-gram and the tireless effort of professionals from across health, business, and Government sectors who have come together to re-spond. \nOn the other hand, our progress across the country is not uni-\nform. Vaccine coverage varies by state and by county. Communities where people remain unvaccinated, are most vulnerable and most likely to experience increase in case counts. As of last week, nearly 50 percent of vaccine eligible population in this country is now fully vaccinated. 160 million people and still nearly two-thirds of coun-ties in the United States have vaccine coverage less than 40 per-cent. \nIn areas where vaccine coverage is low, cases and hospitaliza-\ntions are starting to climb again. Over the last week, we have aver-aged 239 deaths per day, an increase of nearly 48 percent over the prior week. Each death is tragic and even more heartbreaking when we know that the majority of these deaths could be prevented \nwith a simple, safe, available vaccine. Areas with limited vaccine coverage are allowing for the emergence and rapid spread of the highly transmissible delta variant. CDC has released estimates of variance across the country and predicted the delta variant now represents 83 percent of sequenced cases. \nThis is a dramatic increase, up from 50 percent for the week of \nJuly 3rd. In some parts of the country, the percentage is even high-er, particularly in areas of low vaccination rates. To date, our data indicates that vaccines are available to neutralize but circulating variants in the United States and provide protection against severe disease, hospitalization, and death. The message from CDC re-mains clear, the best way to prevent the spread of COVID–19 variants is to prevent the spread of disease. And vaccination is the most powerful tool we have. \nWe must continue to expand vaccine coverage by building trust \nand confidence in COVID–19 vaccines. And this is particularly im-portant in communities of color, rural communities, and other pop-ulation groups at risk. CDC is engaging trusted community leaders to reinforce messages about the safety, efficacy, and importance of vaccination. CDC remains committed to ensuring all of our work advances health equity. Thanks to supplemental resources, CDC has provided additional support to health departments to address health disparities and improve health equity among historically un-derserved populations at elevated risk. That includes racial and ethnic minority groups and people living in rural areas. \n7 \nWe are training and integrating community health workers into \ncare teams, collaborating with partner organizations to improve vaccine access, and building vaccine confidence among medically underserved communities and disproportionately affected popu-lations. As the Director of the CDC, it is my priority to get our chil-dren back to school for safe in-person learning. Earlier this month, the CDC released updated guidance to reflect the latest science on COVID–19 and the widespread availability of safe and effective vaccines for those ages 12 and over. \nWe continue to recommend that schools implement layered pre-\nvention strategies to protect those who are not fully vaccinated and encourage vaccination for those who are eligible. Masks continue to be a critical part of these layered prevention strategies. Working together, school administrators and public health workers can care-fully consider community transmission rates, local vaccine cov-erage, and occurrence of outbreaks when deciding what strategies are needed to help prevent the spread of COVID–19 and safeguard in-person education. \nIn summary, the overwhelming majority of deaths from COVID– \n19 are now occurring in unvaccinated people. Vaccines are widely available across the country, and the suffering and loss is simply \nentirely preventable, nearly. \nFor our entire Nation to heal and move forward, we must do all \nour part to get our Country vaccinated. Thank you and I look for-ward to your questions. \n[The prepared statement of Dr. Walensky follows:] \nPREPARED STATEMENT OF ROCHELLE WALENSKY  \nChair Murray, Ranking Member Burr, and distinguished Members of the Com-\nmittee. It is an honor to appear before you again today to discuss the Centers for Disease Control and Prevention’s (CDC) ongoing response to the COVID–19 pan-demic. It is my privilege to represent CDC, America’s health protection agency. We work 24/7 to prevent illness, save lives, and protect America from threats to health, safety, and security. CDC is proud of its key role in preparedness and response to public health concerns here in the United States and abroad. \nCDC Efforts to Date \nSince we last met, COVID–19 cases have decreased from the spring to summer, \nand we have made tremendous strides in getting people vaccinated, which has al-lowed many people to resume their daily activities safely. We are hopeful and have made incredible progress toward controlling this pandemic. However, many states and communities continue to have low vaccination rates, and the threat of variants is growing. We are now witnessing concerning increases in a number of jurisdictions and given the threat of variants, including the increased prevalence of the hyper- transmissible Delta variant, we must remain diligent as we continue to fight this virus. \nOn June 23rd we officially passed the heart wrenching milestone of over 600,000 \ndeaths from COVID–19 in the United States. This tragic reminder is a powerful motivator for us all to continue to push to achieve higher vaccination rates and pre-vent the loss of as many more of our loved ones as possible. \nAs of July 15, about 89 percent of the U.S. population 65 years and older, 68 per-\ncent of those 18 years and older, 65 percent of those 12 years and older, and nearly 56 percent of the total U.S. population received at least one dose of a COVID–19 vaccine. This is good news and demonstrative of continued progress. These gains are thanks to the tireless efforts of professionals from across the public health, medical, business, and multisectoral levels of government who have come together across the country to respond to this pandemic. However, looking state-by-state and county-by- county, it is clear that communities where people remain unvaccinated are commu-nities that remain vulnerable and, in many cases, are experiencing increased num-\n8 \nbers of cases. Preliminary data from a collection of states over the last several \nmonths suggest the overwhelming majority of deaths from COVID–19 in the United States have occurred in unvaccinated people. Any suffering or death from COVID– 19 is tragic. With vaccines available across the country, the suffering and loss are nearly entirely avoidable. \nCurrently, nearly two-thirds of counties in the United States have vaccination cov-\nerage less than 40 percent. We are seeing increasing rates of disease in different areas across the country, primarily in counties with low vaccination coverage. As the Delta variant continues to spread across the country, we expect to see increased transmission in these communities unless we can vaccinate more people. Our au-thorized vaccines provide protection against the variants circulating in this coun-try—including Delta. Vaccination is the key to protecting these vulnerable individ-uals, families, and communities and preventing severe disease, hospitalizations, and death from COVID–19. The scale of this unprecedented public health emergency re-quires unprecedented action—at CDC, 9,300 CDC personnel have been part of our COVID–19 response, both at CDC headquarters and in the field. About 1,700 staff have taken part in over 3,600 deployments to more than 300 locations across the United States and around the world. \nAs we well know and the world has learned from this pandemic, a public health \nthreat anywhere is a threat everywhere. To support the prevention of international spread, CDC is working around the world with global partners and many low-and middle-income countries to support the planning, implementation, and evaluation of COVID–19 vaccine programs. We will continue working to facilitate lesson sharing across countries to increase vaccine access to all, both here and abroad. CDC is working to ensure that public health decisions are based on the highest-quality sci-entific information. Since the start of the pandemic, over 300 COVID–19 studies have been published in the Morbidity and Mortality Weekly Report (MMWR) on top-\nics ranging from health disparities exacerbated during the pandemic, to prevention strategies, including the safety and effectiveness of COVID–19 vaccines, to emer-gence of new variants. CDC has also produced more than 6,000 documents to pro-vide information and guidance for government agencies, businesses, and the public. CDC is actively studying the epidemiology of post-COVID conditions (often referred to as long COVID), including the prevalence, duration, and severity of symptoms fol-lowing acute SARS-CoV–2 infection, as well as risk factors for developing post- COVID conditions. This work will help to establish a more complete understanding of the natural history of SARS-CoV–2 infection and post-COVID conditions, which can inform healthcare strategies, clinical decision-making, and the public health re-sponse to this virus that will be required over the long term. A recent MMWR arti-cle comparing patients who have had COVID–19 with cancer rehabilitation patients and the general adult population found that post-COVID patients had poorer phys-ical health, more pain, and greater difficulty with physical activities. \nCDC has provided new guidance to assist healthcare professionals in evaluating \nand caring for patients with post-COVID conditions. Recognizing and confirming the impact that post-COVID conditions can have on quality of life is important. The goal of managing post-COVID conditions is to help patients function in the best way pos-sible and improve quality of life. \nNow I want to take a moment to give you a more in-depth update on some key \nareas for the COVID–19 response. \nVariants \nCOVID–19 has brought to the forefront how interconnected we are as a global \ncommunity and the importance of our international scientific relationships. \nIn the fall of 2020, several SARS-CoV–2 variants emerged, some of which appear \nto spread more easily than others. The emergence of variants is, of course, con-cerning, and it underscores the critical need for genomic surveillance and increased vigilance in the implementation of public health prevention measures. \nWe are monitoring dozens of variants and conducting ongoing and comprehensive \nrisk assessments through the SARS-CoV–2 Interagency Group comprised of CDC, the National Institutes of Health (NIH), the Food and Drug Administration (FDA), the Biomedical Advanced Research and Development Authority (BARDA), the United States Department of Agriculture, and the Department of Defense. We are also in consultation with many of our international colleagues. Of the emerging variants, four have captured our attention and have the highest risk to public health: B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), and B.1.617.2 (Delta). \n9 \nThe Alpha variant, originally identified in the United Kingdom, was first identi-\nfied in the United States in December 2020, and quickly became the predominant variant. However, based on CDC’s most recent data, the Delta variant is now pre-dicted to be the predominant lineage circulating in the United States. The Delta variant was originally detected in India and the earliest known case in the United States was in February 2021. According to CDC’s Nowcast model for the two-week period ending July 3, the national proportion of the Delta variant is projected to be 51.7 percent of cases, with the Alpha variant being the second-most predominant variant at 28.7 percent. The third most prevalent variant in the United States is the Gamma variant, with a projected national proportion of 8.9 percent for the two- week period ending July 3. The fourth variant of concern, Beta, is projected to be well below 1 percent. \nAvailable data indicate that antibodies elicited shortly after vaccination with the \ncurrently authorized vaccines are able to neutralize the circulating variants, al-though some have a reduced neutralization against the Beta and Gamma variants in laboratory studies. A recent study from the United Kingdom indicated that the Pfizer vaccine was 93 percent effective at preventing symptomatic infection with the Alpha variant and 88 percent effective at preventing symptomatic infection with the Delta variant, and a related study indicated that the Pfizer vaccine was greater than 95 percent effective at preventing hospitalization when infected with either the Alpha or Delta variants. Based on preliminary data from a Johnson & Johnson vac-cine clinical trial in South Africa where the prevalence of the Beta variant was esti-mated to be 95 percent, the vaccine was 64 percent effective in preventing infection and 81.7 percent effective in preventing severe disease. Additional data from among healthcare workers in South Africa vaccinated with the Johnson & Johnson vaccine demonstrate that 94 percent of breakthrough infections are mild, in a setting with a high prevalence of the Delta variant. Studies are currently underway to under-stand the impact on the real-world effectiveness of current vaccines against variants and to better understand the impact of the variants on medical countermeasures. \nSince January 2021, CDC has dramatically built up our domestic genomic surveil-\nlance platforms to monitor circulating variants. While the decline in SARS-CoV–2 \ncases compared to the high peak this past winter means that the number of speci-mens available for sequencing has declined, CDC continues to generate enough se-quences to detect emerging variants through the National SARS-CoV–2 Strain Sur-veillance (NS3) program and contracts with commercial diagnostic laboratories. \nWith the funding provided by the American Rescue Plan Act, we are further in-\nvesting in public health infrastructure to strengthen genomic sequencing and bioinformatics capacity. We have issued 29 awards, totaling approximately $37 mil-lion, as part of the SARS-CoV–2 Sequencing for Public Health Emergency Response, Epidemiology, and Surveillance (SPHERES) Initiative. These awards are intended to fill knowledge gaps and promote innovation in the U.S. response to the COVID– 19 pandemic, and will help integrate next-generation genomic sequencing tech-nologies with bioinformatics and epidemiology expertise across the US public health system. \nOn July 1, to address low vaccination coverage and increasing cases due to spread \nof the Delta variant in some communities, CDC, along with other Federal partners, intensified our efforts to help states prevent, detect, and respond to hotspots among the unvaccinated by launching COVID–19 Surge Response Teams. With this inter-agency initiative, CDC will participate in teams at-the-ready to deploy resources and personnel to communities at higher risk for—or already experiencing—out-breaks due to the spread of the Delta variant and under-vaccination. In collabora-tion with state, tribal, local, and territorial health department partners, interagency teams will define the needs on the ground and work to address these gaps. The most important step we can take to prevent these outbreaks is for everyone eligible to get vaccinated, and we continue to work with communities across the country on that goal. \nHealth Equity \nData continue to show the disproportionate impact of COVID–19 on racial and \nethnic minority populations, as well as other population groups such as people living in rural or frontier areas, people experiencing homelessness, essential and frontline workers, people with disabilities, people with substance use disorders, people who are incarcerated, and non-U.S.-born persons. \nIn June 2021, CDC began providing additional resources to health departments \nto address COVID–19-related health disparities and advance health equity among populations that are underserved and facing conditions that place them at elevated \n10 \nrisk, including racial and ethnic minority groups and people living in rural areas. \nThis funding represents an investment by CDC—$2.25 billion over 2 years—to sup-port communities affected by COVID–19-related health disparities. CDC’s new Na-tional Initiative to Address COVID–19 Health Disparities Among Populations at High-Risk and Underserved Communities, Including Racial and Ethnic Minority Populations and Rural Communities, is providing grants to local and state public health departments to work in partnerships with members of the affected commu-nities to improve testing and contact tracing capabilities; develop innovative mitiga-tion and prevention resources and services; improve data collection and reporting; build, leverage, and expand infrastructure support; and collaborate with partners to advance health equity and address social determinants of health as they relate to COVID–19. \nCommunity Health Workers (CHW) have a demonstrated impact in the commu-\nnities they serve yet persistent barriers have left them underutilized in addressing health disparities. In May 2020, CDC announced $332 million dollars in CARES Act funding for a grant program and evaluation to support Community Health Workers for COVID Response and Resilient Communities. The program will support the training and deployment of CHWs to bolster response efforts and strengthen com-munity resilience to fight COVID–19 by addressing existing health disparities. CHWs are well-positioned to reach communities, especially those disproportionately impacted by COVID–19. CHW interventions can improve uptake and access to health care services, improve communication between community members and health providers, reduce the need for emergency and specialty services, and improve adherence to health recommendations. \nAs of May 2021, CDC has released several publications examining vaccination \nrates in certain population groups to monitor disparities and track progress toward health equity. The first study, Demographic and Social Factors Associated with \nCOVID–19 Vaccination Initiation Among Adults Aged ≤65 Years—United States, \nDecember 14, 2020–April 10, 2021, found that after the first 3.5 months of the U.S. COVID–19 vaccination program, 79.1 percent of adults aged ≤65 years had received \n≤1 dose, with higher vaccination initiation among men. Counties with lower vaccina-\ntion initiation rates had higher percentages of older adults with social vulnerabilities. The second study, Disparities in COVID–19 Vaccination Coverage \nBetween Urban and Rural Counties—United States, December 14, 2020–April 10, 2021 , found that COVID–19 vaccination coverage was lower in rural counties (38.9 \npercent) than in urban counties (45.7 percent) and that disparities persisted among age groups and by sex. A third study, Patterns in COVID–19 Vaccination Coverage, \nby Social Vulnerability and Urbanicity—United States, December 14, 2020–May 1, 2021 , found disparities in county-level vaccination coverage by social vulnerability \nhave increased as vaccine eligibility has expanded, especially in large fringe metro-politan (areas surrounding large cities, e.g., suburban) and nonmetropolitan coun-ties. By May 1, 2021, vaccination coverage among adults was lower among those liv-ing in counties with lower socioeconomic status and with higher percentages of households with children, single parents, and persons with disabilities. \nCollectively, these findings highlight the need to continue monitoring demographic \nand social factors affecting COVID–19 vaccine access; to prioritize efforts to ensure equitable access to COVID–19 vaccine; to tailor public health messaging for local populations and counties with high social vulnerability; and the need for public health practitioners to collaborate with health care providers, pharmacies, employ-ers, faith leaders, and other community partners to identify and address barriers to COVID–19 vaccination in rural areas. \nWhile these data indicate additional work that lies ahead to achieve greater vac-\ncination rates in certain population groups, we know there are communities that have been successful in their vaccination efforts. In June 2021, as part of the Na-tional Month of Action, CDC hosted a webinar as a call to action to increase the number of vaccinated people in Black or African American and Hispanic or Latino communities. The webinar highlighted organizations that have conducted successful mass vaccination activities for Black or African American and Hispanic or Latino people. These organizations shared their successes, challenges, and strategies used to increase vaccine education, awareness, and uptake with the nearly 500 partici-pants from public health, healthcare, clinical, and community organization leader-\nship. This effort is part of CDC’s ongoing work to share best practices around the country to help all communities achieve the highest rates of vaccination possible. \nTo assist decision-makers and researchers, CDC also launched a Health Equity \npage on our COVID Data Tracker. The page catalogs current health equity-related data that align with populations and place-based focus groups identified in CDC’s COVID–19 Response Health Equity Strategy. \n11 \n1https://www.cdc.gov/mmwr/volumes/70/wr/mm7020e2.htm’s-cid=mm7020e2-w . \n2https://www.cdc.gov/mmwr/volumes/70/wr/mm7018e1.htm’s-cid=mm7018e1-w . Vaccines \nVaccination is a critical tool in bringing this unprecedented pandemic to an end. \nAs of May 10, every person aged 12 and over in every state and territory is eligible to get vaccinated. CDC has continued to improve accessibility by increasing distribu-tion of vaccines to medical offices. We have increased the number of medical prac-tices receiving vaccine by nearly 85 percent since early April and now have over 10,000 medical practices served by primary care doctors, administering vaccine alongside other routine medical care. The country exceeded President Biden’s goal of administering 200 million shots in the first 100 days of his Administration. A CDC study\n1reviewing data from 2 months of early vaccinations among health care \npersonnel found that both Moderna and Pfizer vaccines were 94 percent effective in preventing symptomatic SARS-CoV–2 infection, seven or more days after the second dose. In addition, another CDC study\n2found these two vaccines were 94 percent \neffective against hospitalization among fully vaccinated adults aged 65 years and older. These findings demonstrate the high, real-world effectiveness of these vac-cines. \nCDC will continue working with partners to monitor how well COVID–19 vaccines \nwork in real-word conditions through multiple studies looking at vaccine effective-ness in various populations, locations, and settings. Through these studies, CDC can obtain more representative, scientifically valid, and complete information about vac-cine effectiveness, including factors associated with vaccine breakthrough. \nVaccinations are highly effective against severe disease including hospitalizations \nand death, thus protecting even the limited number of people who are vaccinated but still get COVID–19. A recent analysis led by CDC published in the New Eng-land Journal of Medicine found that mRNA COVID–19 vaccines show secondary benefits of vaccination for people who were fully or partially vaccinated and still got COVID–19. Secondary benefits included having shorter and milder illness and po-tentially being less likely to spread the virus to others compared to unvaccinated people with COVID–19. \nCOVID–19 vaccine safety is a top priority for the Federal Government, and we \ntake all reports of health problems following COVID–19 vaccination seriously. Since April 2021, increased cases of inflammation of the heart muscle, called myocarditis, or outer lining, called pericarditis,—have been reported in the U.S. following mRNA COVID–19 vaccination (Pfizer or Moderna). This is a rare condition and reported cases have occurred predominantly in male adolescents and young adults. Following a thorough safety review and meeting of CDC’s Advisory Committee on Immuniza-tion Practices, which found the benefits of mRNA vaccination greatly outweighed the risks, CDC continues to recommend COVID–19 vaccination for everyone 12 years of age and older, given the risk of COVID–19 illness and related, possibly se-vere complications. FDA and CDC also conducted extensive outreach to providers and clinicians to ensure they were made aware of the potential for these adverse events. \nCDC and FDA are monitoring reports of Guillain-Barre ´Syndrome (GBS) after re-\nceiving Johnson & Johnson’s Janssen (J&J/Janssen) COVID–19 Vaccine. GBS is a neurological disorder in which the body’s immune system damages nerve cells, caus-ing muscle weakness or in the most severe cases paralysis. Reports of GBS after receipt of the J&J/Janssen COVID–19 Vaccine in the Vaccine Adverse Event Report-ing System (VAERS) are rare, but do likely indicate a small possible risk of this side effect following this vaccine. Around 100 preliminary reports of GBS, mostly in males, many aged 50 years and older, have been detected in VAERS after 12.8 mil-lion doses of J&J/Janssen COVID–19 Vaccine administered. Available data do not show a similar pattern with mRNA vaccines (Pfizer-BioNTech and Moderna). On July 13, the FDA updated the label of the Johnson & Johnson vaccine to add a new warning suggesting an increased risk of Guillain-Barre ´Syndrome within 42 days \nfollowing vaccination. This issue will be discussed as part of an upcoming meeting of CDC’s Advisory Committee on Immunization Practices (ACIP) later in July. The \ndetection of rare complications, such as myocarditis, thrombosis-thrombocytopenia syndrome (a rare and severe type of blood clot), and GBS, is an important validation of the sensitivity of vaccine safety monitoring systems to be able to pick up even very small numbers of potential vaccine safety concerns. \nBuilding on long-standing relationships with state and local partners, CDC has \nworked tirelessly to ensure that we are getting vaccines to people as quickly, safely, and equitably as possible. As of July 16, 2021, about 389 million doses have been \n12 \ndelivered, and more than 336 million doses of COVID–19 vaccine have been admin-\nistered. About 79 percent of all Americans age 65 years and older were fully vac-cinated by this date, and about 68 percent of adult Americans had received at least one vaccine. This is a whole-of-society effort, and it is inspiring to see people across government, business, and communities coming together to complete this important lifesaving task. \nStrong confidence in vaccines within communities leads to more people getting \nvaccinated, and to fewer COVID–19 illnesses, hospitalizations, and deaths. CDC is working in coordination with national, state, tribal, local, and territorial govern-mental and non-governmental partners to build trust in the vaccine, the vaccinator, and the vaccination system. We will continue to work with these critical partners to address barriers to vaccinations, including in communities of color and disproportionally affected groups. It is important that we continually deliver the message that vaccines are rigorously studied during clinical trials, and there is a vast network of safety systems that monitor vaccines once they are in use and safe-ty protocols to monitor people when they receive the vaccine. In order to address vaccine hesitancy, it is crucial to provide accurate scientific messaging across all sec-tors and multiple platforms, using creative communications approaches such as en-listing trusted community members to help address concerns over COVID–19 vac-cines. Listening to, and patiently addressing concerns, including on an individual basis, is a vital method that should be used to build confidence in vaccines. \nFurther supporting efforts to prioritize equity in our vaccine strategy, in early \nApril CDC awarded $3.15 billion directly to states, territories, and some large cities to support local efforts to increase vaccine access, uptake, and equity. The funding focused on reaching communities hit hardest by the pandemic, including those with a high Social Vulnerability Index, minority communities, and rural areas. \nIn order to enhance vaccine uptake among underserved communities of color and \nto build trust and confidence in the authorized COVID–19 vaccines, CDC has devel-oped a comprehensive program of approximately 20 national organizations that sup-port hundreds of local and community-based organizations to improve both COVID– 19 and influenza vaccination coverage among racial and ethnic groups who have his-torically had, and continue to experience, health disparities. Jurisdictions are also encouraged to consider factors such as the Social Vulnerability Index and current administration rates in local communities when reaching out to enroll providers. Guidance was disseminated to jurisdictions on increasing the proportion of vaccines allocated to providers who are located in socially vulnerable communities. In July, CDC added a new Vaccination Equity tab to display Social Vulnerability Index and vaccination coverage maps to the COVID Data Tracker. Improving access to under-served communities and populations that have historically experienced greater bar-riers to healthcare access is another critical component to prioritizing equity in vac-cine distribution. Improving access also requires a multi-pronged approach. For ex-ample, CDC partners with the Health Resources and Services Administration (HRSA) to provide COVID–19 vaccinations and technical assistance to interested HRSA-funded health centers, with the goal of bringing vaccines to communities and improving access for populations disproportionately impacted by COVID–19. As of June 29, roughly 7 million doses had been distributed to 2,200 HRSA-funded health centers across the Nation. \nThe Federal Retail Pharmacy Program is integral to the work CDC is doing to \nmaximize access to COVID–19 vaccines in all communities, including communities of color and other underserved populations, such as rural communities. CDC partnered with 21 national pharmacy organizations and independent pharmacy net-works that represent over 40,000 locations nationwide—to ensure that the public has access to COVID–19 vaccines in a familiar setting. Almost 90 percent of Ameri-cans live within five miles of a retail pharmacy. These pharmacies continue to reach out to communities, administering almost 3 million doses at nearly 10,000 mobile pop-up clinics, with 58 percent of people vaccinated by pharmacies in the last 2 weeks of June being in a minority group. \nOn May 13th, CDC released new guidance for fully vaccinated people, which said \nthat, anyone who is fully vaccinated can resume activities—indoor or outdoor—safe-ly without a mask or physical distancing, except where required by Federal, state, local, tribal, or territorial laws, rules and regulations, including local business and \nworkplace guidance. This decision was based on three major scientific developments: (1) Our vaccines working in the real world, with studies showing them to be >90 percent effective in the real-world settings in preventing mild and severe disease, hospitalization, and death, (2) Our vaccines proving to be effective against the SARS-CoV–2 variants currently circulating in the country, and (3) Research show-ing that if you are vaccinated, you are less likely to spread the virus. A growing \n13 \nbody of evidence suggests that fully vaccinated people are less likely to have asymp-\ntomatic infection and to be able to transmit SARS-CoV–2 to others. While we hope this was encouraging news for the country, we must remain vigilant in our efforts to continue increasing vaccination if we want to continue returning to normal. At this time, CDC sees no need to change our fully vaccinated guidance; however we will continue to monitor all indicators and data closely. \nSchools \nSince becoming the director of CDC, I have stressed the importance of getting \nchildren back to school for in-person learning. The safest way to open schools is to ensure that there is as little disease as possible in the community. With the wide-spread availability of safe and effective vaccines, we have seen reductions in COVID–19 cases, hospitalizations, and deaths. If vaccination rates continue to in-crease and community transmission rates decrease, the risk in schools is expected to decrease as well. \nCDC began working on guidance, resources, and tools for safe school reopening \nin March 2020 when the first schools closed. As CDC learned more about COVID– 19, we continually updated our guidance, resources, and tools for schools, parents, teachers, and other staff. Earlier this month, CDC released updated guidance to help prevent the spread of COVID–19 and safeguard in-person learning. CDC’s Guidance for COVID–19 Prevention in K–12 Schools is now updated to reflect the \nlatest science on COVID–19, lessons learned from schools implementing COVID–19 prevention strategies, and the widespread availability of safe and effective COVID– 19 vaccines for those aged 12 years and older. Reports suggest that limited in—per-son instruction during the pandemic may have had a negative effect on learning for children and on the mental and emotional well-being of both parents and children. In addition, many K–12 schools globally implemented layered COVID–19 prevention strategies during the 2020–2021 academic year. These schools’ experiences contrib-uted to our knowledge of the nature of SARS-CoV–2 transmission in schools and in-formed updates to the K–12 guidance, which emphasizes the importance of offering in-person learning in K–12 schools. \nCDC recommends schools implement layered prevention strategies to protect peo-\nple who are not fully vaccinated, including students, teachers, staff, and other mem-bers of their households. These strategies include vaccination for children and adults ages 12 and up, the correct use of masks, physical distancing, handwashing and respiratory etiquette, cleaning and maintaining healthy facilities (including proper ventilation), and contact tracing, in combination with screening testing, isola-tion, and quarantine for those exposed and not vaccinated. The guidance emphasizes the need for localities to monitor community transmission, vaccination coverage, screening testing, and occurrence of outbreaks to guide decisions on the level of lay-ered prevention strategies. \nMask use and physical distancing are two key prevention strategies for reducing \nSARS-CoV–2 transmission, but a layered approach that uses several strategies will provide the greatest level of protection. Schools where not everyone is fully vac-cinated should implement physical distancing to the extent possible within their structures, in addition to masking and other prevention strategies. If it is not pos-sible to maintain adequate physical distancing, it is especially important that schools layer multiple other prevention strategies, such as masking and screening testing, to help ensure that no students need be excluded from in-person learning. \nIn April, CDC provided $10 billion to states and jurisdictions to support COVID– \n19 screening testing for K–12 teachers, staff, and students to assist schools in re-opening safely for in-person instruction. In May, CDC also awarded $500 million to jurisdictions to expand the school-based public health workforce, including nurses and other health personnel. Combined, we believe these resources will provide sub-stantial help to schools around the Nation as they open in the fall. \nSARS-CoV–2 is still a relatively new pathogen, and we are learning more about \nit and how it impacts different people and communities all the time. CDC’s Guid-ance for COVID–19 Prevention in K–12 Schools presents recommendations based on the best-available evidence at the time of release. As science and data on SARS- CoV–2 and COVID–19 continue to evolve, we will update our guidance and rec-ommendations to reflect new evidence. CDC stands committed to providing the best, most current data and scientific understanding available to protect the health, safe-ty, and well-being of our communities, including our students, teachers, and school staff. \n14 \nConclusion \nIn closing, I want to emphasize that with increased vaccinations nationwide, we \ncan look forward to seeing more kids in school, more families able to connect with one another safely, and our Nation beginning to move forward and heal. But we have to ensure that we are stamping out COVID–19 in all communities, not just some communities. We cannot risk only keeping parts of the U.S. moving forward safely while other parts of the country continue to see tragic numbers of cases and deaths from COVID–19. This will require sustained efforts from all stakeholders and across all levels of government and most importantly individuals making the decision to get vaccinated to protect themselves, their loved ones, and their commu-nities. \nWe also must address the long-standing vulnerabilities in our public health sys-\ntem and the conditions that led to disproportionate burden of COVID–19 illness and death in some communities. The Fiscal Year 2022 President’s Budget Request in-cludes an increase of nearly $1.7 billion for CDC to invest across the public health system. This is an important first step in building back a better public health sys-tem that can deliver health security to all Americans. \nThe C HAIR . Thank you. \nDr. Fauci. \nSTATEMENT OF ANTHONY FAUCI, M.D., DIRECTOR, NATIONAL \nINSTITUTE OF ALLERGY AND INFECTIOUS DISEASES, NA-TIONAL INSTITUTES OF HEALTH, BETHESDA, MD \nDr. F AUCI . Thank you very much, Madam Chair, Ranking Mem-\nber Burr, Members of the Committee. Thank you for giving me the opportunity to discuss with you again the role of the National Insti-tute of Allergy and Infectious Diseases in the research response ad-dressing COVID–19. As I have mentioned to this Committee on prior hearings, the strategic plan for research for NIAID involves research on fundamental basic knowledge regarding the virus to development of diagnostics, therapeutics, and vaccines. \nFor the purposes of today’s discussion and my presentation, I \nwould like to focus on three vaccines that you know have been ap-proved through the emergency use authorization for use in the United States, and that is the two mRNA vaccines from Pfizer, Bio-genetic, and Moderna, and the J&J vaccine, which is a human adenovirus vector vaccine. As I mentioned to this Committee on prior hearings, the clinical trials that proved the extraordinary effi-caciousness of these vaccines to the tune of 93 and 94 percent are very, very clear right now. \nWhat I would like to emphasize today is what has transpired \nsince the last hearing, and that is the accumulation of data on the real world effectiveness of these vaccines. In a situation we are con-fronted with a historic pandemic. And that is seen not only in the United States, but also in the UK in the form of England and Scot-land, in Israel, Qatar, and other places. \nWhen one looks at the data, and one good example is the cohort \nstudy from Israel in which the mRNA vaccine used in that popu-lation was highly effective in the real world beyond the clinical trial, including among asymptomatic, early symptomatic advanced disease, intensive care, and even deaths, and if one looked across the cohort, you saw that it was effective in essentially every age group from young individuals, middle aged, and even the elderly. That is the good news. The sobering news that you have already heard of is the fact that we are now challenged with a very difficult \n15 \nand problematic variant referred to as the delta variant. It has now \nbeen detected in at least 90 plus countries throughout the world. \nThe reason it is so formidable is the fact that it has the capa-\nbility of transmitting efficiently from human to human in an ex-traordinary manner, well beyond any of the other variants that we have experienced up to now, which has led to its becoming the dominant variant in this country. When I spoke to you last time, it was about 1 to 3 percent of the variance in the population. Right now it has gone to over 80 percent, and in some regions of the country, as high as 90 percent. That is the troubling news. \nThe fact is that, however, and the importance of vaccination is \nthat our vaccines that we are using in this country are very effec-tive against this variant, particularly, I point out, to the situation regarding advanced disease leading to hospitalizations and deaths where it is still well in the 90 percent of effectiveness. I would like to close with just one or two comments that we have been hearing about regarding the situation of booster or an additional third dose superimposed upon the double doses of the mRNA and the single dose of the J&J. \nRight now, we are doing studies to determine whether or not we \nwill need boosters to increase the durability of protection. We don’t want people to believe that when you are talking about boosters, that means that the vaccines are not effective. They are highly ef-fective. We are talking about the durability of that. And we are doing studies now to determine that. \nIn addition, there are individuals who are immunosuppressed, \npeople who are on cancer, chemotherapy, a variety of other individ-uals, transplant individuals who may actually need a boost as part of their initial regimen in the sense of getting them up to the point where they are protected. So in closing, I want to underscore what Dr. Walensky just said a few moments ago, the extraordinary im-portance of getting as many people vaccinated as we possibly can. \nWe have the tools to end this epidemic. It is up to us to utilize \nthose tools to the maximum. Thank you very much, Madam Chair. \n[The prepared statement of Dr. Fauci follows:] \nPREPARED STATEMENT OF ANTHONY FAUCI  \nMadam Chair, Ranking Member Burr, and Members of the Committee: \nThank you for the opportunity to discuss the role of the National Institute of Al-\nlergy and Infectious Diseases (NIAID) in the research response to coronavirus dis-ease 2019 (COVID–19) and its etiologic agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV–2). Within the Department of Health and Human Serv-ices (HHS) and the National Institutes of Health (NIH), NIAID is responsible for conducting and supporting basic and clinical research on emerging and re-emerging infectious diseases, including COVID–19. As the Director of NIAID and the Chief Medical Advisor to the President, I am pleased to discuss NIAID’s research address-ing this pandemic. \nCOVID–19 is a once-in-a-lifetime global infectious disease pandemic requiring an \nunprecedented public-private research effort. NIAID plays a central and important role in the public health response to COVID–19. NIAID has capitalized on decades of investment in fundamental basic research, including groundbreaking structure- based vaccine design at the NIAID Vaccine Research Center (VRC); engaged domes-tic and international research infrastructure; and leveraged highly productive part-nerships with industry and longstanding relationships with community partners. NIAID utilized its existing domestic and international clinical trials infrastructure, originally established to conduct research on HIV and influenza, and worked with partners in the public and private sectors to establish the COVID–19 Prevention Network (CoVPN). The CoVPN has supported multiple COVID–19 vaccine can-\n16 \ndidates to progress in record time from concept to authorization for emergency use \nby the U.S. Food and Drug Administration (FDA). NIAID also has built on its long-standing relationships with community partners to successfully conduct these cru-cial clinical trials. NIAID initiated clinical trials with creative and adaptive designs, allowing the evaluation of multiple new and existing therapeutics for use against COVID–19. Several of these trials provided evidence of safety and efficacy of COVID–19 therapeutics and helped support authorization by the FDA. \nThese successes have helped slow the progression of the pandemic in the United \nStates. Currently, more than 67 percent of U.S. adults have received at least one dose of a COVID–19 vaccine, and we must continue to vaccinate as many people as we can, as quickly as possible. FDA-authorized COVID–19 vaccines meet FDA’s \nrigorous standards for safety and efficacy. The high levels of vaccine efficacy ob-served in the carefully controlled conditions of clinical trials have been subsequently confirmed by their effectiveness in studies of vaccines administered to broad seg-ments of the public in the United States and other countries. Vaccination and ad-herence to public health measures are the proven interventions that will be particu-larly important as we work to address the SARS-CoV–2 Delta (or B.1.617.2) variant and other variants with increased transmissibility or pathogenicity that may emerge. \nWhile we are cautiously optimistic about the future, we know that many chal-\nlenges remain. One of the most concerning developments of the ongoing pandemic is the spread of variants of SARS-CoV–2 such as the Delta (B.1.617.2) variant. So far, scientific evidence suggests that the COVID–19 vaccines distributed in the United States under FDA Emergency Use Authorizations (EUA) continue to be ef-fective against severe disease caused by these variants, but we must remain vigi-lant. NIAID is rapidly conducting research to better understand these emerging variants, how they interact with the immune system, and their implications for COVID–19 therapeutic and vaccine formulations. \nWe also know that our fellow Americans in underserved and minority commu-\nnities have been disproportionally affected by this pandemic. NIAID is committed to continuing to work directly with these communities and partnering with other agencies in the Federal Government, and with industry and academia to ensure that nobody in vulnerable communities is left behind as we move forward toward defeating the COVID–19 pandemic. NIAID also recognizes that while many individ-uals with SARS-CoV–2 infection fully recover after a relatively short time period, some individuals suffer longer-term effects after the initial phase of illness. NIAID is supporting collaborative efforts to study COVID–19 outcomes in patients across all ages, genders, and co-morbid conditions. These studies include people who expe-rienced a broad range of COVID–19 disease severity so we can identify and charac-terize post-acute sequelae of SARS-CoV–2 infection (PASC) and develop effective strategies to address them. \nDeveloping Vaccines and Monoclonal Antibodies to Prevent COVID–19 \nSustained research investments by NIAID in the years prior to the emergence of \nSARS-CoV–2 enabled the unprecedented pace of COVID–19 vaccine development. Two activities in particular predate successful COVID–19 vaccines: the development of versatile vaccine platforms and the adaptation of structural biology tools to design specific proteins (immunogens) that powerfully stimulate the immune system. Long before the pandemic, NIAID VRC scientists and their collaborators made the critical scientific discovery of how to stabilize—in a highly immunogenic form—viral pro-teins that are important for infection. These included the spike protein of Middle East respiratory syndrome coronavirus (MERS-CoV), which was stabilized using a double mutation known as S2P. This key finding facilitated the design of vaccine candidates that generate robust immune responses not only against coronaviruses but also other viruses of public health importance such as respiratory syncytial virus. As soon as the sequence of SARS-CoV–2 was made available in January 2020, VRC researchers rapidly generated a stabilized SARS-CoV–2 spike protein for use in COVID–19 vaccine development. This crucial breakthrough in structure-based vaccine design for coronaviruses led to the development of safe and effective COVID–19 vaccine candidates across a range of vaccine platforms. \nSix candidate COVID–19 vaccines have been or are in the process of being as-\nsessed in large-scale Phase 3 clinical trials in the United States thus far, and three have received EUAs from the FDA. Clinical trials to test COVID–19 vaccine can-didates in pediatric populations are ongoing. On December 11, 2020, based on data from a Pfizer-supported Phase 3 clinical trial, an investigational vaccine developed by Pfizer and BioNTech became the first to receive an EUA from the FDA for the \n17 \nprevention of COVID–19. This vaccine is now authorized for emergency use in indi-\nviduals 12 years of age and older. NIAID has helped to advance five additional COVID–19 vaccine candidates through support for research on the foundational biol-ogy underlying the vaccine concepts, as well as for clinical testing through the CoVPN. Two of these vaccine candidates, those from Moderna, Inc., and Johnson & \nJohnson/Janssen, have received EUAs. \nUtilizing the CoVPN, NIAID is participating in the implementation of harmonized \nprotocols to test investigational vaccines and preventive interventions against SARS-CoV–2. These protocols were developed in collaboration with the Accelerating COVID–19 Therapeutic Interventions and Vaccines (ACTIV) public-private partner-ship, vaccine manufacturers, and the Biomedical Advanced Research and Develop-ment Authority (BARDA). NIAID also supports the underlying critical infrastruc-ture for these clinical trials, such as a common Data and Safety Monitoring Board (DSMB), an independent group that periodically reviews data from the ongoing trials to ensure the safety of study volunteers and to determine whether efficacy has been achieved. The CoVPN has enrolled tens of thousands of volunteers across the United States and internationally in clinical trials testing multiple investigational vaccines and monoclonal antibodies intended to protect people from COVID–19. The CoVPN also has developed an extensive community engagement framework to reach out to the underserved and minority communities disproportionally affected by COVID–19; to better understand their interest in, and concerns about, research par-ticipation; and to partner with them to ensure that their vital input is reflected in the conduct of these clinical studies. \nTo further address the critical challenges of participation in clinical trials as well \nas vaccine acceptance and vaccine hesitancy, NIH established the Community En-gagement Alliance Against COVID–19 Disparities (CEAL) initiative, led by the Na-tional Heart, Lung, and Blood Institute (NHLBI) and the National Institute on Mi-nority Health and Health Disparities. CEAL brings together trusted community leaders to serve as champions who share information about the importance of par-ticipating in COVID–19 research and communicate data on the safety and efficacy of authorized COVID–19 vaccines. \nmRNA–1273 (Moderna) \nAs part of a longstanding collaboration, the NIAID VRC worked with the bio-\ntechnology company Moderna to develop a vaccine candidate designated mRNA– 1273, which uses a messenger RNA (mRNA) vaccine platform to express the sta-bilized SARS-CoV–2 spike protein. Early clinical trials demonstrated that mRNA– 1273 was generally well tolerated and induced robust immune responses in healthy adults. NIAID and BARDA then began working with Moderna on a Phase 3 clinical trial through the CoVPN that showed that mRNA–1273 was 94.1 percent efficacious in preventing symptomatic COVID–19. On December 18, 2020, after a thorough re-view of comprehensive data on mRNA–1273, the FDA issued an EUA for the mRNA–1273 vaccine for prevention of COVID–19 in individuals 18 years of age and older. In subsequent observational studies under ‘‘real-world’’ conditions in broader segments of the population, mRNA-based vaccines continue to display high levels of effectiveness. For example, in an article published in Morbidity and Mortality \nWeekly Report (MMWR) , Centers for Disease Control and Prevention (CDC) re-\nsearchers and their collaborators showed that among health care personnel, first re-sponders, and other essential workers, the mRNA–1273 and the Pfizer-BioNTech mRNA vaccine were 90 percent effective against SARS-CoV–2 infections 14 or more days after receiving a second dose. Other MMWR articles reported that these vac-cines were 94 percent effective at preventing symptomatic COVID–19 among health care personnel and reduced the risk of COVID–19 hospitalization by 94 percent among people 65 years of age and older. Recently, NIAID scientists and their col-laborators demonstrated that anti-SARS-CoV–2 antibodies persist for at least 6 months after the second dose of mRNA–1273. On June 26, 2021, FDA updated the EUAs for the Moderna and Pfizer COVID–19 vaccines to include information on the potential risks of myocarditis and pericarditis, particularly following the second dose. According to CDC, reports of myocarditis and pericarditis following vaccination with mRNA COVID–19 vaccines are rare. Most patients who received care have re-sponded well to treatment and rest, and patients usually can return to their normal daily activities after their symptoms improve. Given the significant potential health risk of COVID–19, the CDC continues to recommend that individuals ages 12 and older be vaccinated with the relevant FDA-authorized COVID–19 vaccine. \n18 \nAd26.COV2.S (Johnson & Johnson/Janssen) \nDecades of NIAID support for basic, preclinical, and clinical research on \nadenovirus (Ad)-based HIV vaccines underpin the development by Johnson & John-son/Janssen of a coronavirus vaccine candidate based on the Ad26-vector, known as Ad26.COV2.S or JNJ–78436735. NIAID is supporting a Phase 3 clinical trial of Ad26.COV2.S through the CoVPN and has provided immunological testing of the candidate using NIAID-funded core laboratory infrastructure. As reported in the New England Journal of Medicine , the one-dose vaccine candidate was 66 percent \neffective overall at preventing moderate to severe/critical COVID–19 occurring at least 28 days after vaccination and 85 percent effective overall in preventing severe/ critical COVID–19 in the Phase 3 trial across several geographical regions, includ-ing areas where emerging viral variants predominate. In the United States, the effi-cacy against moderate to severe/critical disease 28 days after vaccination with Ad26.COV2.S was 72 percent. On February 27, 2021, the FDA issued an EUA for Ad26.COV2.S for prevention of COVID–19 in individuals 18 years of age and older. On April 13, 2021, out of an abundance of caution, the FDA and CDC released a joint statement recommending a pause in the use of Ad26.COV2.S in order to review extremely rare case reports of blood clots in combination with low blood platelets after vaccine administration. Medical and scientific teams at the FDA and CDC found that available data suggest that the chance of this serious adverse event oc-curring is very low. Following their thorough safety review—and in accordance with recommendations from the CDC’s Advisory Committee on Immunization Practices— the FDA and CDC lifted the recommended pause on the use of Ad26.COV2.S on April 23, 2021. On July 12, 2021, FDA announced revisions to the vaccine recipient and caregivers and vaccination providers fact sheets for the Johnson & Johnson/ Janssen COVID–19 vaccine regarding a suggested increased risk of Guillain-Barre ´ \nsyndrome during the 42 days following vaccination. The chance of this occurring fol-lowing vaccination appears to be very low. \nOther COVID–19 Vaccine Candidates \nNIAID, through the CoVPN, is supporting Phase 3 clinical trials of COVID–19 \nvaccine candidates from AstraZeneca (AZD1222) and Novavax (NVX-CoV2373). AstraZeneca’s AZD1222 COVID–19 vaccine candidate uses a chimpanzee adenovirus-vectored vaccine approach developed by researchers at the University of Oxford in collaboration with scientists at NIAID’s Rocky Mountain Laboratories. On March 25, 2021, AstraZeneca announced an updated interim analysis of AZD1222 reporting that the vaccine candidate was 76 percent effective at preventing sympto-matic COVID–19, including 85 percent effective in participants aged 65 years and over. Importantly, the efficacy of AZD1222 against severe COVID–19 disease was reported to be 100 percent. Novavax’s NVX-CoV2373 COVID–19 vaccine candidate uses a protein nanoparticle vaccine approach. On June 14, 2021, Novavax an-nounced that NVX-CoV2373 demonstrated 90.4 percent efficacy in preventing symp-tomatic COVID–19 and 100 percent protection against moderate and severe disease. In addition, the company reported that NVX-CoV2373 showed 91 percent efficacy in preventing symptomatic COVID–19 in people 65 years or older, as well as those with certain comorbidities or those who were identified as being likely to experience regular exposure to SARS-CoV–2. FDA has not yet authorized either of these vac-cine candidates. \nClinical Trials of COVID–19 Vaccine Candidates in Special Populations \nTo effectively end the COVID–19 pandemic, it will be important to vaccinate as \nmany people as possible, including those in special populations, such as pregnant and lactating women, children, and people with immune deficiencies. More than \n130,000 pregnant and lactating women already have received the COVID–19 vac-cines under FDA EUAs, and early data are promising. These data do not dem-onstrate any safety concerns for women who are pregnant or their babies. In addi-tion, protective antibodies against SARS-CoV–2 have been detected in babies born to pregnant women who received mRNA COVID–19 vaccines. On June 23, 2021, NIAID launched an observational study, MOMI-VAX, to evaluate the immune re-sponses generated by COVID–19 vaccines administered to individuals during preg-nancy or up to 2 months postpartum. The study also will assess vaccine safety and evaluate the transfer of vaccine-induced antibodies to infants across the placenta and through breast milk. \nEfforts to evaluate COVID–19 vaccines in pediatric and other special populations \nare ongoing. On March 16, 2021, Moderna, in collaboration with NIAID and BARDA, announced the launch of KidCOVE, a Phase 2/3 study to evaluate the safe-\n19 \nty and efficacy of mRNA–1273 in children ages 6 months to less than 12 years. This \nstudy is in addition to Moderna’s ongoing TeenCOVE study of mRNA–1273 in ado-lescents between the ages of 12 and 17. On May 10, 2021, the FDA expanded the EUA for Pfizer’s COVID–19 vaccine to include adolescents ages 12 to 15 years of age, and Pfizer also is evaluating their vaccine candidate in younger individuals. Other vaccine developers also have begun, or are planning to begin, trials to test their vaccine candidates in children, adolescents, and other special populations. On April 23, 2021, NIAID launched an observational study at the NIH Clinical Center assessing how people with immune system deficiencies or dysregulations respond to COVID–19 vaccination. NIAID investigators also will gather information about COVID–19 illness in these individuals. This study will inform decision-making about COVID–19 vaccination in people with immune deficiencies and dysregulation conditions. \nMonoclonal Antibodies to Prevent COVID–19 \nNIAID, collaborating with Regeneron Pharmaceuticals and Eli Lilly and Com-\npany, also initiated two Phase 3 clinical trials to evaluate whether their investiga-tional monoclonal antibodies, REGEN-COV and bamlanivimab respectively, can pre-vent infection or symptomatic disease in people at high risk of exposure due to their living or working conditions. Regeneron reported in a preprint publication that REGEN-COV prevented symptomatic and asymptomatic infection in household con-tacts of individuals who had recently tested positive for SARS-CoV–2. Bamlanivimab also was reported to prevent symptomatic and asymptomatic infec-tion in residents and staff of skilled nursing and assisted living facilities, and these findings were published in the Journal of the American Medical Association . FDA \nhas not yet authorized the use of either of these drugs for prevention of COVID– 19. Clinical trials to test the safety and efficacy of monoclonal antibody therapies for the treatment of COVID–19 are being tested through the ACTIV partnership, and these are discussed below. \nIdentifying Therapeutics to Treat COVID–19 \nSafe and effective therapeutics are urgently needed to treat patients with COVID– \n19. NIAID has worked quickly from the earliest days of the pandemic to evaluate promising therapeutics for COVID–19 in rigorous, randomized, controlled clinical trials. \nThe Adaptive COVID–19 Treatment Trial \nNIAID launched a multicenter, randomized placebo-controlled clinical trial, the \nAdaptive COVID–19 Treatment Trial (ACTT), to evaluate the safety and efficacy of multiple investigational therapeutics for COVID–19. ACTT–1 examined the antiviral drug remdesivir for treatment of severe COVID–19 in hospitalized adults. Based on positive data from ACTT–1, the FDA approved the use of remdesivir for treatment in adults and children 12 years of age and older and weighing at least 40 kg hospitalized due to COVID–19. ACTT–2 evaluated the anti-inflammatory drug baricitinib in combination with remdesivir, and based on favorable data from ACTT–2, the FDA issued an EUA for the use of baricitinib in combination with remdesivir for treatment of adults and children older than 2 years hospitalized with COVID–19 and requiring supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation. ACTT–3 currently is evaluating treatment of hospitalized COVID–19 patients with remdesivir plus interferon beta–1a, which is used to treat individuals with multiple sclerosis. ACTT–4, a study assessing baricitinib plus remdesivir versus the glucocorticoid dexamethasone plus remdesivir in adults hospitalized with COVID–19, has closed to enrollment because the study met pre-defined futility criteria. \nThe ACTIV Public-Private Partnership \nNIAID, in collaboration with other NIH Institutes, also launched two clinical \ntrials as part of the ACTIV partnership, which utilizes master protocols allowing the addition of other investigational therapeutics as the trials continue. The two studies, ACTIV–2 and ACTIV–3, initially evaluated the use of the monoclonal antibody bamlanivimab to treat COVID–19 in outpatient and inpatient settings, respectively. ACTIV–2, which is focused on outpatients, has since been expanded to evaluate two combination monoclonal antibody therapies—BRII–196 plus BRII–198 and BMS– 986414 plus BMS–986413—as well as four additional investigational therapeutics: SAB–185, a fully human polyclonal antibody produced in cattle; SNG001, an \n20 \ninhalable beta interferon; and AZD7442, an investigational long-acting monoclonal \nantibody combination. Camostat mesilate, an orally administered drug that may block SARS-CoV–2 from entering cells, was evaluated but ultimately not included in ACTIV–2 efficacy studies, as it failed to induce early changes in viral shedding or improvement in symptoms. ACTIV–3 currently is evaluating the AZD7442 monoclonal antibody combination, as well as the small molecule ensovibep, in hos-pitalized patients. Ensovibep binds to several sites on the SARS-CoV–2 spike pro-tein, which may inhibit the virus’s ability to infect human cells. On April 22, 2021, NIAID and NHLBI launched a new trial, known as ACTIV–3 Critical Care, to test Zyesami and remdesivir (alone and in combination), for their safety and efficacy in hospitalized COVID–19 patients who are experiencing acute respiratory distress syndrome, a life-threatening condition. Zyesami is a synthetic version of vasoactive intestinal peptide, which is made naturally in the human body and appears to have lung-protective antiviral and anti-inflammatory effects. \nThree monoclonal antibody therapies currently have FDA EUAs for the treatment \nof COVID–19 in outpatients. Due to concerns of variant resistance to monoclonal antibody therapies, the FDA now includes information on the susceptibility of SARS-CoV–2 variants in its fact sheets for health care providers for each of these therapies. NIAID-supported scientists and collaborators are evaluating the potential impact of emerging SARS-CoV–2 variants on the efficacy of monoclonal antibodies. \nAdditional NIAID-Supported Therapeutics Activities \nOn April 13, 2021, NIAID announced the launch of the COVID–19 anti-CD14 \nTreatment Trial (CaTT) to evaluate the use of a monoclonal antibody known as IC14 in adults hospitalized with COVID–19. IC14 works by binding to and blocking a human protein called CD14 that is associated with the development of severe in-flammatory reactions in some COVID–19 patients. In addition, NIAID completed a Phase 3 trial called, ‘‘Inpatient Treatment with Anti-Coronavirus Immunoglobulin,’’ or ITAC, to evaluate hyperimmune intravenous immunoglobulin (hIVIG) for treat-ment of COVID–19 in hospitalized adults. The study demonstrated that hIVIG plus remdesivir was not superior to remdesivir alone. \nNIAID also launched the ACTIV–5/Big Effect Trial (BET), which is designed to \nstreamline the identification of experimental COVID–19 therapeutics that dem-onstrate the most promise. BET, an adaptive Phase 2 clinical trial, compares dif-ferent investigational therapies to a common control arm to identify treatments with relatively large effects as promising candidates for further study in large-scale trials. BET initially is evaluating two therapeutics: risankizumab, an immunomodulatory monoclonal antibody developed by Boehringer Ingelheim and AbbVie, which is FDA-approved for the treatment of severe plaque psoriasis; and lenzilumab, an investigational immunomodulatory monoclonal antibody developed by Humanigen. \nNIH recently launched the Antiviral Program for Pandemics, a collaboration be-\ntween NIH and BARDA that aims to develop safe and effective antivirals to treat and prevent SARS-CoV–2 infection. The program also will build sustainable plat-forms for targeted drug discovery and development of antivirals directly targeting viruses with pandemic potential. As part of this effort, NIAID will establish Antiviral Drug Discovery Centers for Pathogens of Pandemic Concern. These multi-disciplinary research centers will create platforms that will initially target coronaviruses, and then could be expanded to other viruses with pandemic poten-\ntial—helping to better prepare the Nation for future viral threats. \nThe NIH also has established the COVID–19 Treatment Guidelines Panel to pro-\nvide recommendations to health care providers regarding specific COVID–19 treat-ments based on the best available science. The Guidelines also address consider-ations for special populations, including pregnant women and children. Each Treat-ment Guidelines section is developed by a working group of Panel members with expertise in the area addressed in the specific section; these members conduct sys-tematic, comprehensive reviews of relevant information and scientific literature. The Panel comprises representatives of NIH and five other Federal agencies along with representatives of nine professional organizations, academic experts, and treating physicians including providers from high COVID–19 incidence areas, and commu-nity representatives. The Panel meets regularly to evaluate possible treatment op-tions for COVID–19 and update the Treatment Guidelines as new clinical evidence emerges. \n21 \nResponding to Emerging Variants of SARS-CoV–2 \nNIAID is fully engaged in efforts to mitigate the potential impact of emerging \nvariants of SARS-CoV–2. NIH, including NIAID, participates in the HHS-estab-lished SARS-CoV–2 Interagency Group, along with CDC, FDA, BARDA, the Depart-ment of Defense (DOD), and the U.S. Department of Agriculture to address the po-tential impact of emerging variants on critical SARS-CoV–2 countermeasures. NIH, CDC, and DOD are assessing whether vaccine-induced immunity, or natural immu-nity from prior infection, can be effective in combating the variants. NIH, BARDA, and DOD also are determining the efficacy of certain authorized therapeutics against emerging variants in cell lines in vitro and in animal models. \nNIAID is collaborating with vaccine manufacturers on key areas of research to in-\nvestigate whether vaccines designed for the original strain of SARS-CoV–2 can maintain efficacy against emerging variants. NIAID also is conducting and sup-porting comprehensive studies to understand the ability of vaccine-induced anti-bodies to neutralize the variant viruses. NIAID researchers have analyzed the im-mune responses of individuals who recovered from COVID–19 prior to the emer-gence of variants and demonstrated that their T cells—a key component of the im-mune response to SARS-CoV–2—also were capable of recognizing the three most widespread SARS-CoV–2 variants at the time, Alpha (also known as B.1.1.7), Beta (B.1.351), and Gamma (P1). These findings, published in Open Forum Infectious Dis-\neases , shed new light on the role of T cells in the development of immunity to SARS- \nCoV–2 and suggest that these cells also may help protect against emerging variants of concern. On March 25, 2021, NIAID launched a Phase 1 clinical trial in healthy adults to assess the safety and immunogenicity of second-generation COVID–19 vac-cine candidates developed by Gritstone Oncology, Inc. Gritstone’s COVID–19 vaccine candidates utilize a strategy aimed at inducing both neutralizing antibodies and T cell responses to elicit a broad immune response. This approach could provide pro-tection against emerging SARS-CoV–2 variants by targeting several viral antigens, all of which are highly conserved among viral strains. \nNIAID also plans to test new vaccine formulations that may protect against cer-\ntain variants that show early indications of reduced sensitivity to existing counter-measures. On March 31, 2021, NIAID launched a Phase 1 clinical trial of an inves-tigational Moderna vaccine based on its FDA-authorized COVID–19 vaccine, de-signed specifically to target the Beta (B.1.351) SARS-CoV–2 variant first detected in South Africa. NIAID and Moderna are evaluating this vaccine candidate as a pre-cautionary measure as we gain more data to confirm that current vaccines provide an adequate degree of protection against currently circulating SARS-CoV–2 variants. In addition, NIAID is leading a study in fully vaccinated individuals to de-termine the safety and efficacy of boosting with a COVID–19 vaccine different than the one used for the initial vaccination. The results of this trial are intended to in-form public health policy decisions on the potential use of mixed vaccine schedules \nshould booster doses be needed. \nNIAID, the National Human Genome Research Institute, and the National Li-\nbrary of Medicine are participating in the SARS-CoV–2 Sequencing for Public Health Emergency Response, Epidemiology, and Surveillance (SPHERES) initiative. SPHERES is a national genomics consortium led by CDC that helps to coordinate SARS-CoV–2 sequencing across the United States. NIAID is working with partners to identify, monitor, and calculate the frequency of current variations in the SARS- CoV–2 genome to help predict emerging variants. NIAID also facilitates the use of cutting-edge modeling and structural biology tools to understand how variants might affect interactions between the virus and the immune system or COVID–19 therapeutics. NIAID scientists are helping to inform our understanding of trans-missibility of the variants by studying their stability in the environment of infected individuals and their ability to grow in human lung cells. These efforts add to a growing body of knowledge about SARS-CoV–2 variants and our ability to combat them. \nUnderstanding the Immunology and Pathogenesis of COVID–19 \nNIH is supporting studies to understand the incidence of SARS-CoV–2 infection \nin specific populations, including children, as well as certain aspects of the clinical course of infection, including thromboses, strokes, heart attacks, and other sequelae of infection. NIAID is working with partners to delineate biological and immune pathways responsible for the varied manifestations of COVID–19. NIAID also will examine the quality and durability of the immune response to SARS-CoV–2; this in-formation may be leveraged to develop novel SARS-CoV–2 therapeutics or vaccines and inform public health measures. \n22 \nNIAID, along with FDA, is supporting a National Cancer Institute (NCI) effort \nto determine the sensitivity and specificity of certain SARS-CoV–2 serological tests, which can detect antibodies indicative of a prior exposure to SARS-CoV–2. NCI and NIAID also are working to establish a collaborative network to increase national ca-pacity for high-quality serological testing with rapid return-of-results to subjects. These efforts include the use of serological testing to support clinical trials of con-valescent serum and the establishment of registries for seroprotection studies. \nEarly in the pandemic, the intramural research programs of NIAID, NCI, the Na-\ntional Center for Advancing Translational Sciences, and the National Institute of Biomedical Imaging and Bioengineering partnered to rapidly deploy the SARS-CoV– 2 Pandemic Serosurvey. The study investigated whether adults in the United States \nwithout a confirmed history of SARS-CoV–2 infection have antibodies to the virus, thus indicating prior infection. Findings from the first time point of this longitudinal study suggest that the prevalence of COVID–19 in the United States during the spring and summer of 2020 may have far exceeded the number of cases medically diagnosed. Extrapolating from analyses of blood samples from people who did not have a previously diagnosed SARS-CoV–2 infection, along with socioeconomic, health, and demographic data, the researchers estimate that there may have been an additional 16.8 million undiagnosed SARS-CoV–2 infections through mid-July 2020. Continued analysis of the one-year follow-up data from the study will be very important in better understanding mortality rates, prevalence of immunity, and the impact SARS-CoV–2 has had on various communities in the United States. \nNIAID scientists are participating in leadership of the COVID Human Genetic Ef-\nfort, an international consortium of hospitals and genetic sequencing hubs that aim to discover genetic factors conferring resistance to SARS-CoV–2 infection or predis-posing to severe COVID–19 disease. The consortium has identified a subgroup of pa-tients with severe COVID–19 that have ineffective immune responses to SARS-CoV– 2, some of whom have identifiable mutations in key immune pathways. NIAID also supports efforts to understand the rare, but extremely serious, multisystem inflam-matory syndrome in children (MIS-C) that has been associated with SARS-CoV–2 infection in children and adolescents. NIAID hosted a virtual workshop on MIS-C with scientists and clinicians from academia, NIH, FDA, and industry, and a report of the workshop recommendations was published on November 2, 2020. NIAID also supports the Pediatric Research Immune Network on SARS-CoV–2 and MIS-C (PRISM) to evaluate acute and long-term clinical and immunological effects of MIS- C and SARS-CoV–2 infection in children. In addition, NIAID is collaborating with Children’s National Medical Center to follow 1,000 children with a history of SARS- CoV–2 infection, including those with MIS-C, to determine long-term effects of the illness. NIAID is participating in a trans-NIH effort to coordinate MIS-C research led by NHLBI and the Eunice Kennedy Shriver National Institute of Child Health \nand Human Development. This centralized effort, the Collaboration to Assess Risk and Identify Long-term Outcomes for Children with COVID (CARING for Children with COVID), will permit data to be shared across studies to determine the spec-trum of illness and predict long-term consequences of infection. \nMonitoring the Long-Term Effects of COVID–19 \nMany people who have had COVID–19 experience continued symptoms or other \nsequelae as they transition from the acute to post-acute phases of the disease, and we continue to learn more about the duration and manifestations of COVID–19 as we hear from these patients. In December 2020, NIAID hosted a Workshop on Post- Acute Sequelae of COVID–19 with clinicians, immunologists, virologists, and mem-bers of the patient community to present existing data, identify key knowledge gaps, and explore different perspectives on this heterogeneous condition. A report from this workshop highlighting the key scientific questions and knowledge gaps regard-ing PASC was recently published in the Annals of Internal Medicine . NIH has an-\nnounced the Researching COVID to Enhance Recovery (RECOVER) Initiative, a trans-NIH effort to address PASC, including targeted funding for research in this critical area. The NIH RECOVER Initiative will complement ongoing NIAID studies to better understand the various post-acute manifestations of COVID–19 in various populations. \nNIAID intramural scientists initiated the Longitudinal Study of COVID–19 \nSequelae and Immunity to better understand PASC and determine whether people who have recovered from acute SARS-CoV–2 infection develop an immune response to SARS-CoV–2 that provides protection against reinfection. NIAID-supported inves-tigators also have established the Immunophenotyping Assessment in a COVID–19 Cohort (IMPACC) to determine how immunological markers correspond to, or may \n23 \neven predict, the clinical severity of COVID–19. Since May 1st, 2020, IMPACC re-\nsearchers have collected detailed clinical data along with blood and respiratory sam-ples from more than 1,200 hospitalized COVID–19 patients of diverse race and eth-nicity at approximately 20 hospitals nationwide. The cohort will be followed during hospitalization and up to 1 year after discharge to assess their functional and immunologic recovery. \nConclusion \nNIAID continues to expand efforts to elucidate the biology, pathogenesis, and clin-\nical manifestations of SARS-CoV–2 infection, including emerging variants, and to employ this knowledge to develop safe and effective interventions to diagnose, treat, and prevent SARS-CoV–2 infection and COVID–19. NIAID is focused on developing safe and effective SARS-CoV–2 vaccines and therapeutics and sensitive, specific, rapid point-of-care molecular diagnostic and serological tests. NIAID also is con-ducting early stage research on candidate vaccines that could protect against mul-tiple strains of coronaviruses. All these efforts will improve our response to the cur-rent pandemic and bolster our preparedness for the next, inevitable viral disease outbreak. \nThe C HAIR . Thank you. \nDr. Woodcock. \nSTATEMENT OF JANET WOODCOCK, M.D., ACTING COMMIS-\nSIONER, UNITED STATES FOOD AND DRUG ADMINISTRA-TION, SILVER SPRING, MD \nDr. W OODCOCK . Good morning, Chair Murray, Ranking Member \nBurr and Members of the Committee. Thanks for the opportunity to be here today. I am going to provide a brief update of what the agency has been doing in our COVID–19 response. But first, I want to start by recognizing the thousands of FDA employees who have really been working nonstop for the past year and a half. I really \ncommend their efforts and thank them for their service to the coun-try. It has been extraordinary. \nFrom the earliest days of this public health emergency, there was \na need for reliable diagnostics, as we all know. We began gauging developers in early January 2020. And as of last week, FDA has authorized nearly 400 tests and sample collection devices that pro-vide a wide range of options for testing beyond diagnostics. We have evaluated emergency use requests for ventilators and novel devices such as continuous renal replacement therapy products. We continue to review additional submissions for COVID medical de-vices and rigorously monitor safety signals and reports, including their performance against variance for the products on the market. \nThis is in addition to addressing numerous device shortages that \noccurred during the pandemic and working with our Government partners to prevent counterfeit and substandard PPE and other products from entering the United States because, of course, people take opportunities to try to get substandard products into the coun-try. FDA has also supported development and availability of COVID therapeutics as expeditiously as possible. On March 31st, we announced the creation of an emergency review and develop-ment program, the Coronavirus Treatment Acceleration Program. We reassigned staff from other areas to review the hundreds and hundreds of requests from companies, scientists, and doctors who are working to develop treatments as of June 30th. \nWe have reviewed more than 460 trials for potential COVID \ntherapies. These include antivirals, neutralizing antibodies, cell \n24 \nand gene therapies, and combinations of these products. The diver-\nsity of therapeutic approaches that are being investigated is really critical to increasing our knowledge of this disease in its different stages. And these efforts have led to one approved drug therapy to treat COVID–19 and 10 therapeutics currently authorized for emergency use. \nIn addition, FDA issued EUA, as you know, for three COVID– \n19 vaccines. These vaccines were authorized without cutting cor-ners or sacrificing our rigorous standards. Intensive interactions between FDA and manufacturers minimize the time between dif-ferent ordinary phases of the clinical development process and al-\nlowed for seamless movement through development, manufac-turing, and our rigorous scientific review. \nThroughout the vaccine authorization process, we took steps to \nfacilitate transparency and trust by posting trial data, putting out guidances on what our standards would be, key decisional memo-randa, and we held public advisory committee meetings. These vac-cines have met the standards and quality to support an EUA and are helping, as you have heard, in our fight against the pandemic. Our work did not end with the authorization of these vaccines, though we have to share as much information as we can with the public to help with trust and transparency. We are also deeply in-volved with CDC on the safety surveillance for the vaccines as they go into millions of healthy people to understand what adverse events might be related. And we continue to find that the known and potential benefits of these vaccines far outweigh the known risks, even as additional rare risks have been discovered. \nAll this is in addition to the critical work we do to protect the \nNation’s food supply, which also came into some jeopardy during this, and to interdict substandard medical products at our ports of entry, courier facilities, and international mail facilities. Since March 2020, with coordination with Customs and Border Protection colleagues, we have intercepted and destroyed almost 60,000 illegal and unapproved medical products that were attempting to get into the country. \nFDA has also played a major role in investigating the numerous \nshortages of medical products that have occurred during the pan-demic. Partnering with our sister agencies represented here and far beyond, we have responded quickly and decisively while main-taining our commitment to protecting the health of the American people. We look forward to working with the Committee to address further issues. Thank you. \n[The prepared statement of Dr. Woodcock follows:] \nPREPARED STATEMENT OF JANET WOODCOCK  \nIntroduction \nChair Murray, Ranking Member Burr, distinguished Members of the Committee, \nI am Dr. Janet Woodcock, Acting Commissioner of the U.S. Food and Drug Adminis-tration (FDA or the Agency). Thank you for the opportunity to testify before you today to describe FDA’s coronavirus disease 2019 (COVID–19) response efforts. All of our efforts are in close coordination and collaboration with our partners, both within the Department of Health and Human Services (HHS) and across the Fed-eral Government, to help ensure the development, authorization, licensure, and availability of critical, safe, and effective medical products to address the COVID– 19 public health emergency. \n25 \nI want to note at the outset that this is just a snapshot of some of our recent \nwork and is in the context of efforts across the Agency to address this pandemic. There are thousands of FDA employees who have been working non-stop for the past year-and-a-half. I want to commend and recognize their efforts and thank them for their service. \nFrom the beginning of this public health emergency, FDA has taken an active \nleadership role in the all-of-government response to the COVID–19 pandemic, in-spired by the resiliency of the American people and our great innovators. FDA stood up an internal cross-agency group that continues to ensure we are doing everything possible to protect the American public, help ensure the safety, efficacy, and quality of FDA-regulated medical products, and provide the industries we regulate with the \nguidance and tools to do the same. We continue to focus on facilitating the develop-ment and availability of medical countermeasures to diagnose, treat, and prevent COVID–19, surveilling the medical product and food supply chains for potential shortages or disruptions, and helping to mitigate such impacts, as necessary to pro-tect the public health. \nBiologics and Vaccines \nFDA’s Center for Biologics Evaluation and Research (CBER) uses every tool avail-\nable to help patients access promising biological products while facilitating research to evaluate their safety and efficacy as well as manufacturing efforts. \nCBER is working on multiple fronts to address the COVID–19 pandemic, includ-\ning: \n•Expediting clinical trials for vaccines and certain therapeutic biological \nproducts that hold promise to prevent or treat COVID–19 by providing timely interactions, scientific advice, and recommendations for specific sponsors, and generally through guidance documents; \n•Supporting product development and facilitating the scaling up of manu-\nfacturing capacity for high priority products to treat COVID–19; \n•Expediting the review of Emergency Use Authorization (EUA) requests \nand Biologics License Applications (BLAs) for critical medical products to address COVID–19; \n•Helping to ensure an adequate and safe blood supply; and \n•Providing information to healthcare providers and researchers to help \nthem submit expanded access IND requests to permit the use of inves-tigational products for patients with COVID–19. \nThrough our transparent scientific review process, FDA has issued EUAs for three \nCOVID–19 vaccines. In doing so, we have relied upon the Agency’s rigorous stand-ards for safety, effectiveness, and manufacturing quality. Development of a vaccine generally proceeds sequentially through the various stages of clinical development; ordinarily this process minimizes scientific and financial risk for the manufacturer. Manufacturing scale-up only takes place when the data support the safety and effec-tiveness of a vaccine and it is on track for regulatory approval. These three COVID– 19 vaccines were developed without cutting corners or sacrificing our standards. In-tensive interactions between FDA and manufacturers minimized the time between different studies in the clinical development process; allowed seamless movement throughout the different phases of clinical trials; and simultaneously facilitated manufacturers proceeding with manufacturing scale-up before it was clear whether the safety and effectiveness data for a vaccine would support EUA. \nFor the three vaccines authorized to date, our EUA process not only included a \nthorough evaluation of the data by the Agency’s career staff, but also included input from independent scientific and public health experts through our public advisory committee meetings. Throughout this process, FDA took additional steps to facili-tate transparency, such as posting sponsor and FDA briefing documents and key decisional memoranda. \nThe three authorizations make available COVID–19 vaccines in the United States \nthat have shown clear and compelling efficacy in large, well-designed phase 3 trials. These vaccines have met rigorous standards for safety and effectiveness to support EUA and are helping us in the fight against this pandemic. All the COVID–19 vac-cines that FDA has authorized for emergency use are at least 50 percent effective compared to placebo in preventing COVID–19, which is the expectation we conveyed in our June 2020 guidance document, Development and Licensure of Vaccines to Pre-\n26 \n1https://www.fda.gov/media/139638/download . \n2https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid- \n19/covid-19-frequently asked-questions . vent COVID–19 .1A vaccine with at least 50 percent efficacy, we noted, would have \na significant impact on disease, both at the individual and societal level. \nAs part of our continued efforts to be transparent and educate the public, we have \na wealth of information on our website about the authorized COVID–19 vaccines. The information includes fact sheets for healthcare providers (vaccination providers) and vaccine recipients and caregivers, with important information such as dosing instructions; information about the benefits and risks of each authorized vaccine; and topical Questions and Answers developed by FDA for each authorized vaccine.\n2 \nIt is also important to highlight that, as part of each EUA, we are requiring the \nmanufacturers and vaccination providers to report serious adverse events, cases of Multisystem Inflammatory Syndrome (MIS), and cases of COVID–19 that result in \nhospitalization or death to the Vaccine Adverse Event Reporting System (VAERS), a national vaccine safety surveillance program jointly run by FDA and the Centers for Disease Control and Prevention (CDC). \nThese surveillance efforts have led the Agency to take steps to proactively address \nemerging safety signals. In April, out of an abundance of caution, FDA and CDC recommended a pause in the use of the Janssen COVID–19 vaccine while we inves-tigated reports of thrombosis with thrombocytopenia syndrome. Later that month, after careful evaluation of the data, FDA announced revisions to the vaccine recipi-ent fact sheet to include information about the risk of thrombosis with thrombocytopenia, and the vaccination provider fact sheet to include a warning about the risk of thrombosis with thrombocytopenia syndrome. We concluded that the available data suggest that the chance of this serious adverse event occurring is very low. FDA and CDC determined that the recommended pause regarding the use of the Janssen COVID–19 vaccine in the U.S. should be lifted and use of the vaccine should resume. As with all of the COVID–19 vaccines, we continue to closely monitor the safety of the Janssen COVID–19 Vaccine. \nOn June 25, FDA announced revisions to the vaccine recipient and caregivers and \nvaccination provider fact sheets for the Moderna and Pfizer-BioNTech COVID–19 vaccines regarding the suggested increased risks of myocarditis and pericarditis fol-lowing vaccination. The chance of these adverse events occurring following adminis-tration of either the Moderna or Pfizer-BioNTech COVID–19 vaccine appears to be very low, but the level of potential risk due to vaccination is still under investiga-tion. FDA and CDC are monitoring the reports, collecting more information, and will follow-up to assess longer-term outcomes over several months. \nOn July 12, FDA announced revisions to the vaccine recipient and caregivers and \nvaccination providers fact sheets for the Janssen COVID–19 vaccine regarding a suggested increased risk of Guillain-Barre ´syndrome during the 42 days following \nvaccination. The chance of this occurring following vaccination appears to be very low. \nAt this time, data are not yet available to make a determination about how long \nthese authorized vaccines will provide protection, nor are we certain that the vac-cines prevent transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV–2) from person to person. Additionally, although we do not yet know the full range of SARS-CoV–2 variants that each of the authorized vaccines will protect against, there is evidence that the current vaccines protect against disease caused by variants circulating in the United States. \nFinally, manufacturers whose COVID–19 vaccines have been authorized for emer-\ngency use are expected to continue their clinical trials in order to obtain additional safety and effectiveness information and pursue licensure (approval). \nHaving three vaccines authorized to date that meet FDA’s expectations for safety \nand effectiveness only 1 year after the declaration of the COVID–19 pandemic is a tremendous achievement and a testament to the dedication of developers and FDA’s career scientists and physicians. We are highly engaged in ensuring that all COVID–19 vaccines meet the high quality that Americans expect and deserve and are also actively engaged in ensuring the safety of these vaccines following deploy-ment. FDA is also working with international partners as part of multinational ef-forts to end this global pandemic. We have provided guidance and technical assist-ance, and continue to share information as we evaluate and release vaccine doses for use in other countries. The Agency is very proud of these efforts, and we believe that the vaccines will help bring this pandemic to an end. \n27 \nTherapeutics \nSince the beginning of the COVID–19 pandemic, FDA has been working tirelessly \nto facilitate the development and availability of therapeutics for use by patients, physicians, and health systems as expeditiously and safely as possible. FDA has also accelerated the development and publication of guidance and other information for industry and researchers on developing COVID–19-related treatments. Further, on March 31, 2020, FDA announced the creation of an emergency review and develop-ment program for possible therapies for COVID–19, the Coronavirus Treatment Ac-celeration Program, or ‘‘CTAP.’’ The primary goal of CTAP is to help accelerate the development of therapeutics for patients and consumers. The Agency has supported the program by reassigning staff and working continuously to review requests from companies, scientists, and doctors who are working to develop therapies. Under CTAP, FDA is using every available authority and regulatory flexibility to facilitate the development of safe and effective products to treat patients with COVID–19. As of June 30, 2021, there are more than 630 drug development programs in planning stages and the Agency has reviewed more than 460 trials of potential therapies for COVID–19. These include antivirals, immunodulators, neutralizing antibodies, cell and gene therapies, and combinations of these products. The diversity of therapeutic approaches being investigated is important because it rapidly expands our under-standing of the effect of different categories of potential treatments. \nFDA has approved one drug to treat COVID–19 and eleven therapeutics are cur-\nrently authorized for emergency use. Our goal is to be as transparent as possible about the scientific basis for recommending that a drug or biological product be au-thorized for emergency use under section 564 of the Federal Food, Drug and Cos-metic Act (21 U.S.C. 360bbb–3) or for recommending that an EUA be revised or re-voked. \nFDA also continues to work closely with manufacturers to mitigate and prevent \nshortages as the COVID–19 pandemic evolves. For example, the Agency has issued three EUAs to authorize the emergency use of certain therapeutic products intended to treat serious or life-threatening diseases or conditions (e.g., Acute Kidney Injury, Acute Respiratory Distress Syndrome) caused by COVID–19 after determining that the FDA-approved alternatives to these products were not available in sufficient quantities to fully meet the emergency need. This has helped to alleviate shortages of some therapies that are essential for the care of critically ill COVID–19 patients. FDA is also working with manufacturers to increase supplies to meet current de-mand by expediting review of applications. In addition, the Agency has prioritized the review of generic drug applications for potential treatments and supportive therapies for patients with COVID–19, such as antibiotics, sedatives used in venti-lated patients, anticoagulants, and pulmonary medications. In June 2021, FDA reached a milestone of approving 1,000 original and supplemental generic drug ap-plications since the start of the pandemic to help in the treatment of patients with \nCOVID–19. This supports FDA’s everyday mission of improving access to safe, effec-tive, high-quality treatment options, especially during the COVID–19 pandemic. \nMedical Devices \nThe need for medical devices to respond to the COVID–19 pandemic has far ex-\nceeded what we experienced in any prior Public Health Emergency (PHE). The first EUAs issued for the COVID–19 PHE were for medical devices, and the volume of EUA requests quickly surpassed (by two orders of magnitude) that of any prior PHE or other situation. Further, the emergency use requests included submissions for de-vices that CDRH had never received EUA requests for during prior PHEs. This in-cluded ventilators and novel devices such as continuous renal replacement therapy devices. Since the start of the pandemic, FDA has issued EUAs or granted full mar-keting authorization to almost 1,500 medical devices for COVID–19-related uses. In addition, FDA rigorously monitored safety signals and medical device reports using the information to publish 21 letters to healthcare providers and seven safety com-munications, and FDA completed other pivotal work activities such as addressing supply chain shortages and counterfeit products related to COVID–19. \nDiagnostic tests are the first line of defense in an outbreak, and FDA plays an \nimportant role to ensure they work through EUA review. The EUA pathway expe-dites access to accurate diagnostic tests during emergencies, when information gaps and false results may adversely affect individual patient care and public health deci-sion-making. EUAs enable molecular diagnostic tests to be developed, validated, au-thorized, and deployed within weeks rather than several months to over a year, as is typical for test development and traditional premarket submissions. The Agency has employed its EUA authorities to facilitate availability of tests in each PHE or \n28 \nthreat situation since 2009, when the Secretary of HHS declared that circumstances \nexist justifying the authorization of emergency use of in vitro diagnostics. In PHEs, FDA is generally open to receiving and reviewing EUA request for tests from any developer, including commercial kit manufacturers and laboratories. \nFDA sought to facilitate COVID–19 test evaluation and authorization through the \ndevelopment and availability of templates. The templates provide recommendations for test validation and a fill-in-the-blank form to streamline the paperwork and make it easier for developers to provide information in support of a request for emergency use authorization. Since providing the first template in January 2020, FDA has been in daily contact with test developers to answer questions and help them through the EUA process. This has proved to be a helpful tool for many. FDA has now made nine templates available for a variety of test types. As of July 13, 2021, these nine templates have received 510,725 hits from those visiting FDA’s website. FDA also supported test developers through establishment of a dedicated mailbox, 24–7 toll-free hotline that ran until July 2020, the posting of over 100 fre-quently asked questions on our website, and by hosting weekly virtual town halls for test developers. The Agency has worked with over 1,000 test developers since January 2020. \nSince early 2020, FDA has adopted agile, interactive, and innovative approaches \nto EUA review for all types of devices. For example, FDA developed the umbrella EUA approach to efficiently authorize multiple devices of the same type meeting the same criteria. The Agency has also issued 28 guidance documents (including 17 revi-sions) outlining policies to help expand the availability of medical devices needed in response to COVID–19. For example, developers of certain tests offered their tests, upon validation and notification to FDA prior, to issuance of an EUA during Agency review of the EUA request. Further, FDA made several improvements to our EUA review processes to make the most efficient use of our resources, including es-tablishing a front-end triage process to identify devices that would have the greatest impact on the public health. These improvements incorporate the latest information on device availability and shortages, prioritizing novel or critical devices not yet available on the market or those that would address significant device shortages. \nAs of July 13, 2021, FDA has authorized 397 tests and sample collection devices \nfor SARS-CoV–2. As noted in the graphic below, these include 282 molecular tests and sample collection devices, 85 antibody and other immune response tests, and 30 antigen tests. Among these are 11 diagnostic tests that can be run at home (three molecular and eight antigen tests), seven of which do not require a prescrip-tion. We have also authorized 18 tests for serial screening programs (11 antigen and seven molecular). The volume and variety of available tests is a testament to FDA’s support of innovative test design and our commitment to public health. \n\u0002\u0001\u0003\n\n\u00016\u001e\u0010\u0014>A\u000e(\u0015A*7\u001d/A \u0003 \u0001\u0001?A\n\u001f#$;&\u0016A0\u00171.'1\u0018A8\u001b92A\n\b\u0005A\u0001\u0002\u000b(:\u001f\u001c\u0019(A7\u0018293A\u0001\u0004\u0007\u0001\r\u0011\n\u000b\f\u0011\u0002\u0006\b\u0005\u0003\u0011\u000f\t\u000e\u0010\u000e\u0011\n\u0006\t\u0007A\n@\u0002 \u0004\f+!\u0016\u0012<\"\u000fA7\u0018294A\r)\u0014A\n5\r%-!\u0017A\u0011, \"\"\u001a7 +&A\u0014\u0017=\u001e\u00135A\nFDA has authorized a wide variety of other medical devices for use in combating \nthe pandemic, including a wide range of personal protective equipment (PPE), ven-tilators, and other therapeutic devices. As of July 13, 2021, FDA has authorized 270 PPE devices including 39 surgical masks, and has authorized 205 filtering facepiece respirators (FFRs), 13 systems for PPE decontamination or bioburden reduction at \n29 \n3https://www.fda.gov/news-events/press-announcements/fda-brief-fda-revokes-emergency-use- \nauthorizations-certain-respirators-and-decontamination-systems . the time there was a need for these types of devices due to PPE shortages,3and \n13 EUAs for face shields and other barriers intended to protect the user from bodily fluids, liquid splashes, or potentially infectious materials (see related graphic below). In addition to granting EUAs, FDA has also cleared, through its premarket notification pathway, over 250 PPE 510(k)s. \n\u0005\u0007O\n\u000b\u0013\tDO'8>O(\u0014\u001bOD+- 1\u001dEO\n\u00154\u001dO8H, >O\u0018\u0015>C!>EO\n\u0006\bO\n\u0012MFI!3DO'8>O\u000f\u0010\nO\u001e#95J\u0016.6\u0015J/:6O\n:>O\u001909\u0018K>\u001f\"7O>%L\u001aJ/:6O\u0001\u0002\u0006\u0001\u0016\u001c\u000b\u0010\u0014\u001c\u0004\t\u0015\u0016\u0010\u000f\u0007\r\u001c\u0005\u0014\u0011\u0017\t\b\u0018\f\u001b\n\u001c\u0003\u0013\u001a\f\u0012\u000e\n\u000f\u0019\u001c\n\u0002\u0001\u0003\u0004\nN\u0003\u0003\u0004O\f-2 B6*O)\u0015\u001c</$ O\n?&=.@\u0017;AGO\u0001\r\u000e\u0011F\u0002O\nFDA recognizes that medical devices, particularly tests, will continue to play an \nimportant role in the next phase of the pandemic response. The Agency is con-tinuing to monitor its policies, the marketplace, and national needs, and will con-tinue to adapt as the circumstances of the evolving pandemic warrant. \nHuman and Animal Food \nFood security is national security. Thus, throughout the pandemic, FDA has \nworked with Federal, state, and local partners, as well as industry, to help ensure a safe and adequate food supply for both people and animals. \nWhile SARS-CoV–2 is not transmitted by food, some components of the food sys-\ntem experienced challenges and supply chain imbalances, particularly at the outset of the pandemic. Overall, food production and manufacturing in the U.S. has re-\nmained resilient. We continue to monitor the food supply chain systems closely to efficiently and promptly identify mitigation strategies when necessary. Early on, the pandemic caused a significant shift in where consumers were buying food. We took steps to provide temporary guidance to provide flexibility in packaging and labeling requirements to help industry redirect products manufactured for food service and institutional use to retail grocery stores, or if needed to the animal food industry so the food does not go to waste. \nFDA also recognizes that food supply chain continuity and worker safety are two \nsides of the same coin. Thus, a robust food supply is dependent on the safety and health of the Nation’s food and agricultural workforce. Along with our federal, state and local partners, we have provided best practices for food and agricultural work-ers, industry, and consumers on how to stay safe, and help ensure the continuity of operations in the food and agriculture critical infrastructure sector during the \n30 \npandemic and now as restaurants and other retail establishments resume regular \noperations. \nIn response to the pandemic, FDA’s Office of Food Policy and Response, Center \nfor Food Safety and Applied Nutrition, Office of Regulatory Affairs, and Center for Veterinary Medicine developed 21 Forward , a food supply chain data management \ntool, to help identify where risks for interruptions in the continuity of the food sup-ply due to COVID–19 transmission among workers may be greatest. As part of 21 \nForward , FDA also conducted targeted outreach to the food industry to offer addi-\ntional resources and technical assistance in addressing challenges. \nIn collaboration with HHS, CDC, and US Department of Agriculture (USDA), \ndata from 21 Forward have been made available to assist states with their vaccine \ndistribution efforts for workers in the food and agriculture sectors, including migra-tory and seasonal agricultural workers. \nFDA’s Coordinated Outbreak Response and Evaluation team has been working \nthroughout the pandemic, is fully staffed, and on the job looking for signs of foodborne illness outbreaks and initiating responses as needed. FDA’s Center for Veterinary Medicine is also monitoring the animal food supply and initiating needed responses, working closely with other veterinary diagnostic laboratories in its Vet-erinary Laboratory Investigation and Response Network (VET-LIRN). In terms of inspectional work, FDA investigators continue to conduct mission-critical inspections domestically and abroad, including inspections and investigations in response to foodborne outbreaks during the pandemic. FDA transitioned to standard operations for domestic surveillance inspections in July 2021. Additionally, our import inves-tigators and laboratory analysts continue to work on-site by: \n•Staffing our ports of entry, helping to ensure the efficient distribution \nand safety of the Nation’s imported food supply; and \n•Conducting examinations, sample collections, and laboratory analyses of \nimported and domestic food to ensure the safety of our Nation’s food sup-ply. \nFDA continues to screen every line of every shipment of imported food entering \nthe United States utilizing our Predictive Risk-Based Evaluation for Dynamic Im-port Compliance Targeting (PREDICT) tool. We adjusted the algorithm in PREDICT to place increased scrutiny on shipments from facilities where foreign inspections have been postponed. FDA has made greater use of our Foreign Supplier Verification Program (FSVP) regulation to oversee compliance with FDA Food Safe-ty Modernization Act (FSMA) requirements. The shift to remote FSVP inspections, along with other tools utilized by the foods program, has been critical to ensuring the safety of human and animal food from foreign suppliers during the COVID–19 pandemic. Since March 26, 2020, FDA has conducted 1,888 FSVP inspections. Since March 2020, FDA has refused approximately 8,469 lines of imported food products. FDA will continue to target and refuse human and animal foods that are unsafe, misbranded, or may cause a serious health concern for the public. \nFDA continues to closely monitor the overall safety of the Nation’s food supply, \nin collaboration with CDC, USDA, U.S. Customs and Border Protection (CBP) and our state and local partners, to protect consumers from foods contaminated with pathogens. \nOne year ago, FDA announced the New Era of Smarter Food Safety Blueprint \noutlining the Agency’s plans over the next decade to create a more digital, traceable, and safer food system. We have learned from our response as an Agency to the pan-demic that there is an accelerated need for certain goals in this blueprint, especially those involving supply chain continuity and resilience, modernized inspectional ap-proaches, and strengthening food safety infrastructures with regulatory partners. \nInspections, Compliance, and Protecting the Medical Supply Chain \nSimilar to their work protecting the food supply, import investigators have been \nonsite protecting the medical supply chain at our ports of entry, courier facilities, and the international mail facilities (IMFs) throughout the pandemic. Through con-tinued vigilance, FDA has prevented unsafe and unauthorized pharmaceuticals and other medical products from entering the country. Since March 2020, with the co-operation of and in coordination with CBP, FDA has received and destroyed almost 60,000 products, totaling over 11,093,868 capsules, pieces, and tablets of illegal or unapproved drugs. \nSince March 2020, FDA has refused approximately 94,725 lines of imported viola-\ntive medical products. We have maintained the same level of pre-pandemic screen-\n31 \n4https://www.fda.gov/regulatory-information/search-fda-guidance-documents/remote-inter-\nactive-evaluations-drug-manufacturing-and-bioresearch-monitoring-facilities-during-covid . ing for imported products. However, FDA has focused examinations on COVID–19 \nrelief supplies to ensure compliant products are expedited while maintaining our commitment to refusing imported medical products that are unsafe, misbranded, un-approved, counterfeit, or may cause serious illness or injury to the public. In fact, our import and domestic officers have evaluated donations of shipments destined for the Federal Emergency Management Agency (FEMA) and met the first vaccines (Pfizer Belgium) on their arrival into the United States in December 2020 to ensure proper transport, storage, and reconciliation of products. Our officers also assisted with expediting the importation of other compliant vaccine-related shipments. \nDespite pausing domestic and foreign surveillance inspections in March 2020 to \nsafeguard the health and well-being of our staff, as well as employees at facilities we inspect, our investigators continued to conduct mission-critical inspections both domestically and abroad to ensure FDA-regulated industries were meeting applica-ble FDA requirements. In July 2020, FDA resumed prioritized domestic inspections. To arm our investigators with the most reliable and accurate information, FDA de-veloped a rating system to assist in determining when and where it was safest to conduct prioritized domestic inspections. \nOn May 5, 2021, FDA issued a report titled, ‘‘Resiliency Roadmap for FDA \nInspectional Oversight,’’ outlining the Agency’s inspectional activities during the COVID–19 pandemic and its detailed plan to move toward a more consistent state of operations, including FDA’s priorities related to this work going forward. \nThe report outlines inspections that the Agency was unable to complete during \nthe past year due to travel restrictions or inability to ensure the safety of our work-force or the workforces within the industries the Agency regulates. The report also outlines the number of mission-critical inspections FDA completed during that time, such as inspections of facilities for which there was a drug shortage, inspections needed for the approval of novel drugs or drugs related to the potential treatment of COVID–19, support of pre-market and pre-license applications, and response to foodborne disease outbreaks or other food safety risks such as food contaminated with pathogens. \nOf note: \n•From March 2020 through March 2021, FDA conducted a total of 821 \nmission-critical inspections, including 29 in foreign countries. \n•Additionally, the Agency conducted a total of 777 prioritized domestic in-\nspections since resumption of that work in July 2020. \n•Of the more than 13,500 applications for medical product approval or au-\nthorization received since March 2020, only approximately 68 applica-tions have been delayed due to the inability to conduct inspections—and a majority of these applications are not deemed mission-critical. \nAdditionally, the Resiliency Roadmap Report outlines FDA’s continued, successful \nuse of alternative tools and approaches where inspections were or are not currently feasible, including remote interactive evaluations (e.g., remote livestreaming video of operations, teleconferences, or screen sharing), making record requests to regu-lated establishments, and leveraging information from trusted regulatory partners. For example, FDA made over 1,300 record requests to human and animal drug and biological product manufacturers, to support on-time regulatory decision actions. In \naddition, since March 2020, FDA has added products from 18 firms to import alerts as subject to detention without physical examination, based on records requests in advance or in lieu of inspection that FDA submitted pursuant to section 704(a)(4) of the FD&C Act. \nNotably, FDA’s bioresearch monitoring program staff have conducted more than \n130 remote interactive evaluations that were directly used for application deci-sions.\n4The new tool was incentivized for and supported by industry and continues \nto provide the Agency with valuable information to assist with risk-based targeting for inspections. FDA recognizes that remote approaches do not replace inspections, and that there are situations where only an inspection is appropriate based on risk and history of compliance with FDA regulations. \nThe Resiliency Roadmap Report further outlines the ongoing steps the Agency is \ntaking to resume standard operational levels of inspection activities, including how it intends to prioritize domestic and foreign inspections that were not performed during the pandemic. The plan highlights a variety of possible scenarios given the continued uncertainty of the trajectory of the ongoing COVID–19 pandemic. On July \n32 \n1, FDA activated the base-case scenario (COVID response continues on current \ntrend) to transition to standard operations for domestic inspections and other oper-ational work, as detailed in the report. Inspections considered critical to FDA’s mis-sion will remain the primary focus. When planning routine surveillance inspections, the Agency will prioritize higher-risk establishments. This means that postponed in-spections will be prioritized based on risk and conducted over a longer period of time, ultimately increasing the amount of time between inspections of certain lower- risk facilities in order to focus on products that present the greatest risk to public health. \nThe Agency will also soon begin a multi-year modernization effort to further \ntransform our data enterprise platforms and cross-program interoperability infra-\nstructure to better support innovation related to its regulatory oversight role. This includes adopting technology to support regulatory assessments to improve our re-mote receipt, review, and analysis of industry data and records, and improve remote interactions with industry entities to be easier, more efficient, more consistent, and more secure. This modernization effort will include a review of inspectional ap-proaches using next-generation assessment technologies and improvements. FDA is also establishing an Agency-wide Inspectional Affairs Council that will provide for coordination of inspection approaches and assessment processes. The Agency in-tends to share more information on these efforts as this work progresses. FDA will continue to leverage and maximize every available tool and resource to meet its inspectional responsibilities, while achieving optimal public health outcomes. \nCompliance and Enforcement \nFDA exercises its regulatory authority by, among other things, issuing warning \nletters and pursuing civil and criminal actions against firms and individuals who do not comply with regulatory requirements, including those selling unapproved products with false or misleading claims that the products prevent, treat, mitigate, diagnose, or cure COVID–19. In March 2020, FDA launched Operation Quack Hack, which leverages Agency expertise and advanced analytics to protect consumers from fraudulent medical products, including unproven cures, illegitimate test kits, and substandard or counterfeit respirators. FDA has sent thousands of abuse complaints to domain name registrars and internet marketplaces. The Agency also has sent more than 241 warning letters to sellers of unproven COVID–19 products. Working with the Department of Justice (DOJ), FDA has sought and obtained preliminary injunctions that require defendants to halt the sale of fraudulent products claiming to treat or prevent COVID–19, including one product, ‘‘Miracle Mineral Solution,’’ that, when used as directed, is equivalent to industrial bleach. \nIn addition, FDA’s Office of Criminal Investigations (OCI), working with other \nFederal and local law enforcement agencies, investigated a hospital pharmacist who tampered with COVID–19 vaccine doses at a Wisconsin hospital where he worked. On two successive overnight shifts at the hospital in late December 2020, the phar-macist purposefully removed a box of COVID–19 vaccine vials manufactured by Moderna—which must be stored at specific temperatures for specific time periods to remain viable—from the hospital’s refrigeration unit intending to render the vac-cines inert and no longer effective. The pharmacist acknowledged that after leaving the vaccines out for several hours each night, he returned them to the refrigerator to be used in the hospital’s vaccine clinic the following day. Before the full extent of his conduct was discovered, 57 people received doses of the vaccine from these vials. In January 2021, the pharmacist pled guilty to two counts of attempting to tamper with consumer products with reckless disregard for the risk that another person will be placed in danger of death or bodily injury. He has been sentenced to 3 years imprisonment, followed by 3 years of supervised release, and he must pay approximately $83,800 in restitution to the hospital. \nIn addition, FDA investigators remain on the front lines at ports of entry, quickly \nexamining, reviewing, and sampling import entries, and refusing admission where appropriate. We protect the supply chain in two equally critical ways, by helping to ensure that (1) safe products are coming in; and (2) illegal, dangerous, and fraud-ulent products do not get into the country. These efforts include partnering with CBP in establishing satellite laboratories at selected IMFs with scientists using state-of-the-art screening tools to rapidly identify unapproved, counterfeit and illicit products. \nIn March 2020, OCI, with the help of domestic law enforcement partners and for-\neign counterparts in the United Kingdom, led the investigation of fraudulent COVID–19 ‘‘treatment kits’’ that were falsely declared as ‘‘water treatment.’’ Import examination of these shipments found misbranded ‘‘kits’’ intended to treat SARS- \n33 \n5https://www.fda.gov/media/149616/download . CoV–2. As a result of this investigation, a British national was charged and arrested \nfor shipping mislabeled and unapproved products. Subsequently, in April 2020, FDA intercepted a bulk shipment of hydroxychloroquine coming from China going to a physician in California. The physician was thereafter charged with mail fraud and making a false statement stemming from the allegations that he smuggled hydroxychloroquine from China to make his own pills and concealed the shipment from CBP by mis-declaring it as yam extract. In May 2020, FDA worked with CBP to intercept several shipments of counterfeit facemasks, with the result that they were refused and destroyed before getting into U.S. commerce. \nMore recently, FDA has taken steps to address hand sanitizer products that pose \nsafety concerns, such as products that do not meet the required ethanol or isopropanol levels, or that contain or may contain toxic ingredients like methanol or 1-propanol. Regarding the latter, substantial methanol exposure can result in nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, permanent damage to the nervous system or death. Ingesting 1-propanol can cause central nervous system depression, which can result in death. FDA has tested sev-eral hundred products using field-based and laboratory-based tools, found more than a hundred violative products, issued warnings to consumers not to use contaminated hand sanitizers, and has taken steps to help ensure that these dangerous or sub-potent products do not enter domestic commerce. FDA has coordinated with CBP to identify such products, and we have listed products made by more than 40 manu-facturers on import alert. FDA also placed all alcohol-based hand sanitizers from Mexico on a countrywide import alert to help stop products from entering the United States that appear to be in violation until the Agency is able to review the products. That action marked the first time the FDA has issued a countrywide im-port alert for any category of drug product. \nMedical Product Supply Chain \nFDA monitors and responds to worldwide demand and supply chain disruptions \nfor medical products caused by the COVID–19 pandemic. We work closely with man-ufacturers to help ensure they continue to notify the Agency of any permanent dis-continuance or interruption of drug (human and animal), biological product, and de-vice manufacturing in a timely manner and, as noted in FDA’s fiscal year 2022 budget, we are working to better position the Agency and our health care system to assure a strong domestic supply chain in future emergencies.\n5 \nIn addition to our usual communication with drug manufacturers, we work closely \nwith healthcare and pharmacy systems, hospitals, providers, and others on the frontlines of COVID–19 patient care to identify current or emerging regional short-ages of critical care drugs used to treat COVID–19. \nFDA understands the significant impact shortages can have on patient care and \nis doing everything within our authorities to help prevent and alleviate disruptions. When we identify a shortage, we react swiftly to mitigate the impact to U.S. pa-tients and health care professionals, and quickly share that information with the public. For example, we issued temporary policies for outsourcing facilities reg-istered with FDA and pharmacists in state-licensed pharmacies or Federal facilities, regarding the compounding of certain drugs used to treat hospitalized patients with COVID–19 when approved drugs are not available. The Agency has also published \nguidance to help applicants and manufacturers provide FDA with timely and in-formative notifications about changes in the production of certain drugs (including animal drugs) and human biological products, and urging the submission of these notifications, which may assist in our efforts to prevent or mitigate shortages of such products. \nThe Agency quickly identified the need to help ensure widespread access to hand \nsanitizers as demand spiked, while also continuing our mission to ensure these products are not contaminated by removing adulterated products from the market. FDA has published and continues to update three guidance documents designed to help facilitate the production of alcohol-based hand sanitizer in non-traditional set-tings such as pharmacies or distilleries. The Agency has launched several enforce-ment initiatives and import alerts to help stop adulterated and subpotent hand sani-tizer products from getting into U.S. distribution channels. \nOur experience with COVID–19 demonstrates that a strong domestic supply chain \ndepends on a resilient supply chain for medical devices as well. Indeed, multiple en-tities across the public and private sector have important parts to play in strength-ening the domestic medical device supply chain. FDA can play a critical role in iden-\n34 \ntifying and preventing shortages for devices, because the Agency not only reviews \nand authorizes these products, but also has unique, collaborative relationships that allow direct engagement with device manufacturers, patients, distributors, healthcare organizations and other stakeholders. Even before the pandemic hit the United States, there were already problems in the supply chain due to demand for devices in other nations where COVID–19 was already prevalent. As a result, FDA began shortage mitigation activities for medical devices in January 2020 before the PHE was declared in the U.S., and months before a pandemic was declared world-wide. The Agency took several actions to rapidly respond to supply chain needs, in-cluding reassigning 130 staff to perform shortages work across CDRH and con-tacting over 1,000 manufacturing facilities in 12 countries in just a few weeks’ time to get as much information as possible about critical devices. \nIn addition, FDA has conducted horizon scanning to assess demand for devices \nneeded to respond to the pandemic, including PPE, ventilators, diagnostic supplies, infusion pumps, and non-contact infrared thermometers; and established a rapid re-sponse team, working with field personnel to address fraudulent imports. The Agen-cy has likewise worked to prevent and mitigate shortages of testing supplies. For example, FDA collaborated with U.S. Cotton, one of the world’s largest manufactur-ers of cotton swabs, to develop and produce a polyester-based swab for testing. FDA also collaborated with laboratories and clinical investigators validating potential al-ternative sources of control materials, transport media, and swabs. As individual de-velopers validated these alternative components, FDA requested their permission to share their findings publicly so that others could benefit, and we posted these alter-natives on our website. In this way, FDA has been serving as a clearinghouse for scientific information that the entire community can leverage to mitigate shortages and increase testing capacity. FDA continues to post this information on a rolling basis on an FAQ website so that labs have access to the latest information regard-ing alternative controls, transport media, extraction, instruments, and swabs. \nCongress has acknowledged the importance of this work to our health care sys-\ntem, and we want to continue working with this Committee and others to ensure FDA has the resources and authorities needed to ensure U.S. patients and health care providers have the products they need each day, and especially during public health emergencies. \nConclusion \nFDA continues to advance its mission to protect and promote public health by en-\nsuring the safety of human and animal food, and the safety and effectiveness of medical products. We take our public health mandate very seriously and will con-tinue to work each day to end this pandemic. We continue to communicate with the American public and make regulatory decisions based on data and sound science. I look forward to continuing to work with the Committee on these efforts and thank you again for the opportunity to testify today. \nThe C HAIR . Thank you. \nAssistant Secretary O’Connell. \nSTATEMENT OF DAWN O’CONNELL, ASSISTANT SECRETARY \nFOR PREPAREDNESS AND RESPONSE, UNITED STATES DE-PARTMENT OF HEALTH AND HUMAN SERVICES, WASH-INGTON, DC \nMs. O’C ONNELL . Chair Murray, Ranking Member Burr, and dis-\ntinguished Members of the Committee, I am honored to testify be-fore you today regarding efforts within the Office of the Assistant Secretary for Preparedness and Response to support the ongoing response to COVID–19. First, let me thank you for your support of my confirmation. It was just 6 weeks ago that I was before you as a nominee, and it has been just over 3 weeks since I was confirmed as the ASPER. \nI am honored that you have entrusted me with this important \nrole, and I pledge to do everything I can to maintain your trust and confidence in my abilities to lead this Office with vision, precision, \n35 \nand transparency. While I continue to assess ASPER’s work, one \nthing is abundantly clear. The ASPER team is working tirelessly to end this pandemic, and I am pleased to share some examples of the work that they are leading. As you know, the Strategic Na-tional Stockpile, or SNS, worked to backstop states’ medical supply needs when the pandemic strained global supply chains. \nThe SNS has deployed more than 200 million items including \npersonal protective equipment or PPE, ventilators, Federal medical stations, and pharmaceuticals. ASPER has invested approximately $10 billion from COVID–19 supplementals to replenish the SNS to levels at or above pre-COVID–19 amounts. A new mission ASPER has taken on over the course of the pandemic is securing the med-ical supply chain. This work is complex and challenging and has forced our organization to stretch in new ways. A secure and resil-ient medical supply chain is not only necessary for our current COVID–19 response but will be critical for any nationwide re-sponse that follows. \nASPER is investing in industrial base expansion efforts to reduce \nsupply chain vulnerabilities and generate a domestic warm base for manufacturing that can be leveraged in a crisis. So far, ASPER has supported efforts for domestic manufacturing of PPE, active phar-maceutical ingredients, COVID–19 tests and supplies such as re-agents and resins. \nIn support of this work, ASPER is also leveraging the authorities \ndelegated to the secretary under the Defense Production Act to en-sure that private sector partners making life saving products have the materials they need to deliver their product. So far, ASPER has priority rated 55 contracts to directly and indirectly support the COVID–19 response effort. \nASPER will continue to leverage all of the tools we have at our \ndisposal to ensure the supply chain is secure and that we are never again in this situation we found ourselves in last year. The na-tional disaster medical system has completed nearly 5,400 mission assignments. The teams have brought surge capacity to ICU and emergency rooms, established medical overflow centers, provided mortuary support in places like New York City, established sites to deliver therapeutics, and operated Federal vaccination sites. They are currently standing by to participate in surge teams being stood up by the Administration to respond to recent hotspots. \nThe ASPER’s Biomedical Advanced Research and Development \nAuthority, or BARDA, has supported over 65 medical counter-measure projects for the COVID–19 response. Most notably, BARDA led the vaccine development work for what was then known as Operation Warp Speed and is now known as the Coun-termeasures Acceleration Group and advanced the development of the three vaccines currently authorized by the FDA. \nThis was done, as you know, at historic speed with less than a \nyear between the identification of the virus in the authorization of the first vaccine. ASPER is also working with HHS leadership and the Department of Defense to transition the Countermeasures Ac-celeration Group to a long term sustainable management structure within HHS. Dr. Robert Johnson, a senior leader at BARDA, re-cently assumed the responsibilities as the Chief Operating Officer of the mission. \n36 \nI look forward to using this transition planning period as an op-\nportunity to evaluate gaps and bring in the additional logistical ca-pacity needed at ASPER and HHS to sustain the enduring mission for as long as it is required. As we move forward, I would like to build on this foundation to accelerate and recalibrate the work where needed and continue to do all we can to bring an end to the pandemic as quickly as possible. \nThank you again for inviting me to testify and allowing me to \nshare these examples of the work ASPER is leading on behalf of the Administration wide COVID–19 response effort. I look forward to answering your questions. \n[The prepared statement of Ms. O’Connell follows:] \nPREPARED STATEMENT OF DAWN O ’CONNELL  \nChair Murray, Ranking Member Burr, and distinguished Members of the Com-\nmittee, it is an honor to testify before you today on efforts within the U.S. Depart-ment of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) to support the ongoing response to COVID–19. I am grateful for this opportunity to address this Committee and appreciate your continued support for the ongoing response efforts. \nWhen I first appeared before the Committee in early June as the ASPR nominee, \nI shared my top three priorities for the office, which are reflected in the Fiscal Year 2022 Budget request: \nFirst, I wanted to ensure that ASPR has the resources and support nec-\nessary to continue its critical COVID response work, and help the Nation emerge quickly from the current pandemic. This critical work is in addition to our normal preparedness and response efforts for natural disasters, chemical, biological, radiological, and nuclear incidents, and pandemic influ-enza PI events. \nSecond, I wanted to restore and strengthen capacities that have become \nstrained during the COVID–19 pandemic. Specifically, I wanted to ensure the Strategic National Stockpile (SNS) is appropriately resourced, replen-ished, and ready to respond to future challenges, and that the medical sup-ply chain is resilient and can support our country’s needs. \nFinally, I wanted the organization to increase readiness for future public \nhealth emergencies by working with our colleagues both inside the Depart-ment and across the interagency to prepare for whatever manmade or natu-rally occurring threats may come next. \nA month into the job, these remain my top priorities. Every passing day I am \nawed by the hard work and dedication of the ASPR team. It is clear to me that they are working as hard now to end the pandemic as they did when the outbreak first began. Today, I am pleased to share with you an update on the tireless work they have been doing to respond to COVID–19. \nUpdate on ASPR’s COVID–19 Response Effort \nCountermeasures Acceleration Group \nThe response to the COVID–19 pandemic has required an unprecedented whole \nof government approach. As you are familiar, HHS and the Department of Defense (DoD) forged a partnership formerly called Operation Warp Speed (OWS) that is now known as the Countermeasures Acceleration Group (CAG). This partnership brought together the two Departments to develop, manufacture, and deliver safe and effective vaccines and therapeutics to the American people. ASPR has played a significant leadership and coordination role on behalf of HHS in the effort. This endeavor has delivered nearly 390 million vaccine doses and over a million thera-peutic doses to protect the American people from COVID–19. \nIn addition, the President has committed to sharing 580 million doses of vaccine \nwith the world. This includes half-a-billion Pfizer doses the United States will pur-chase and donate to 100 countries in need—the largest-ever donation of COVID–19 vaccines by a single country, and a commitment to share 80 million doses of our \n37 \nown surplus U.S. supply. The CAG has delivered nearly 40 million vaccines to 25 \ncountries, with millions more en route. \nNow, work is underway to transition DoD’s role in the CAG to HHS for long term \nsustainability and management. Dr. Robert Johnson, the Director of the Influenza and Emerging Infectious Diseases Division of ASPR’s Biomedical Advanced Re-search and Development Authority (BARDA), assumed the responsibilities as the Chief Operating Officer of the CAG earlier this month. Under Dr. Johnson’s leader-ship, ASPR’s role in the response is more apparent than ever. \nBiomedical Advanced Research and Development Authority \nASPR’s BARDA has supported over 65 medical countermeasure projects for the \nCOVID–19 response. All of these contract awards are listed on medicalcountermeasures.gov in detail and include 14 therapeutics, 48 diagnostics, \nand seven vaccine candidates. Notably, BARDA, as part of the then-Operation Warp Speed, accelerated the availability of three vaccines—Moderna, Pfizer, and Johnson & Johnson. This was done at historic speed, with the novel virus identified and the first vaccine authorized in under a year. \nLooking forward, BARDA will leverage the supplemental appropriations provided \nby Congress to continue its work as part of the CAG to support the development of additional vaccines and therapeutics to end the COVID–19 pandemic. There are still populations—like children under the age of 12—that cannot yet receive the vac-cine as we complete careful clinical testing. It is critical that the work continue to \ndevelop vaccines and to establish successful treatments for those who do become in-fected. I look forward to working with this Committee on specific plans toward this effort. \nStrategic National Stockpile and Medical Supply Chain \nThe pandemic has severely strained our public health and medical supply chains. \nAs this Committee is well aware, the medical supply chain ecosystem is complex, with different private sector players and market dynamics across categories of med-ical equipment and supplies. Many vital products are primarily made overseas, and practices like ‘‘just in time’’ inventory management resulted in difficulty surging manufacturing when demand surged last spring. This created significant and dev-astating challenges for states and healthcare systems that needed these key sup-plies. \nOver the course of the COVID–19 response, the SNS has worked to backstop \nStates’ medical supply needs at an accelerated pace. As of June 15, 2021, the SNS deployed more than 200 million items to aid the national response including Per-sonal Protective Equipment (PPE), ventilators, Federal Medical Stations, and phar-maceuticals. Now, ASPR is working to replenish the SNS to levels at or above pre- COVID–19 amounts, so it is prepared for any subsequent wave of additional cases. \nAs of July 9, 2021, the SNS has utilized approximately $10 billion from COVID– \n19 supplemental appropriations provided by Congress to inventory approximately: 517 million N95 respirators (35 times pre-pandemic levels); 272.5 million surgical and procedure face masks (eight times pre-pandemic levels); 11.9 million face shields (two times pre-pandemic levels); 22 million gowns and coveralls (five times pre-pandemic levels); 524.7 million gloves (17 times pre-pandemic levels); and 167,000 ventilators (10 times pre-pandemic levels). \nWhile replenishing the SNS is essential, it is also critical to address the root- \ncauses of why supply chains were so strained in the first place. ASPR is taking on this work as well since ensuring a safe and consistent supply chain for medical ma-terials, ingredients, and supplies is critical for any national response to public health emergencies. \nTo start, ASPR is leveraging the authorities delegated to the Secretary under the \nDefense Production Act (DPA) to ensure that private sector partners making life- saving products are able to acquire raw materials, retool their machinery, scale their production facilities, train their workforces, and ultimately deliver their prod-uct. Throughout the COVID–19 response, ASPR has used the DPA authority to issue 46 priority ratings for U.S. Government (USG) contracts for health resources, eight priority ratings for USG contracts for industrial expansion, 3 priority ratings for non-USG contracts to support the production of resins for both diagnostics and infusion pumps, and the manufacture of closed suction catheters for treatment of patients with COVID–19. Going forward, ASPR will continue to build capacity and partnerships with private industry toward the shared goal of ending the COVID– 19 pandemic. \n38 \nIn addition, ASPR is working to steward Congress’s investment in expanding the \ndomestic industrial base. These industrial base expansion (IBx) efforts seek to re-duce supply chain vulnerabilities and generate a domestic ‘‘warm-base’’ for manufac-turing that can be leveraged in a crisis. So far, ASPR has supported domestic manu-facturing of PPE; active pharmaceutical ingredient manufacturing capacity; and COVID–19 testing, including swabs, tests and kits, and supplies such as reagents and resins. Each of these domestic manufacturing initatives meet current, as well as future COVID–19 needs, and seek to create or sustain high-value domestic jobs. \nHealthcare System Preparedness \nFinally, I want to share more about ASPR’s work to prepare our healthcare sys-\ntem to surge to meet the demands of those being treated for COVID–19, without compromising day-to-day health care needs. \nThrough ASPR’s Hospital Preparedness Program (HPP), the only Federal program \nthat supports preparedness efforts within the healthcare system, ASPR has invested $350 million from supplemental appropriations in the National Special Pathogen System (NSPS). These investments span the 62 HPP funding recipients, their asso-ciated 55 Special Pathogen Treatment Center sub-recipients, 10 Regional Ebola and Special Pathogen Treatment Centers (RESPTC) recipients, the National Ebola Training and Education Center (NETEC) (a consortium of three academic medical centers), and 53 hospital associations, and helped leverage and amplify technical guidance from the Centers for Disease Control and Prevention (CDC). These compo-nents work together to provide a coordinated, national approach to preparing health care systems to surge for public health and medical emergencies. \nDuring the COVID–19 pandemic, the NSPS coordinated national expertise, re-\ngional capabilities, and state and local healthcare capacities across the public and private sectors to support an effective pandemic response. Looking ahead, I look for-ward to examining ways to strengthen investments like these in preparedness to en-sure the healthcare system is ready to surge for future public health and medical incidents. \nFurther, if a public health or healthcare system becomes overwhelmed with pa-\ntients, states can request National Disaster Medical System (NDMS) personnel to provide additional support. During the COVID–19 response, NDMS has completed nearly 5,400 mission assignments so far, and counting. For these deployments, NDMS personnel supported hospital augmentation including emergency room sup-port; hospital decompression; setting up medical overflow centers for patients and mortuary support; establishing monoclonal antibody therapy sites; ICU augmenta-tion; and, operating Federal vaccine sites. With the aid of NDMS personnel and re-sources, communities were able to continue to provide care to those in need of med-ical assistance and treatment. NDMS will continue to support such requests. \nConclusion \nThank you again for inviting me to testify before you on efforts within ASPR to \nsupport the COVID–19 response. I look forward to answering your questions and working with my team at ASPR and our colleagues across HHS to end the COVID– 19 pandemic. \nThe C HAIR . Thank you very much to all of our panelists today. \nWe will now begin a round of 5 minute questions of our witnesses. I ask all of my colleagues, please keep track of your clock. Stay within those 5 minutes. We do have votes starting at 11:30 a.m. and we have many Members in attendance today. My first question is for the whole panel. \nWe are at a pivotal point in this pandemic, and after weeks of \ndeclining rates of cases and deaths, we are now seeing a resurgence of COVID–19 in part due, as you mentioned, to the circulation of variants. Vaccination rates are plateauing and COVID fatigue is setting in around the country. So I want to ask each of you, what is the one thing everyone can do to help keep us from returning to the early days of this pandemic? \nDr. Walensky. \n39 \nDr. W ALENSKY . Get vaccinated and get your neighbors vac-\ncinated. \nDr. F AUCI . \n[Technical problems.] The C\nHAIR . Dr. Woodcock. \nDr. W OODCOCK . Couldn’t say it better. \nThe C HAIR . Ms. O’Connell. \nMs. O’C ONNELL . Get vaccinated. \nThe C HAIR . Thank you to all of you and I hope everyone heard \nthat. Dr. Fauci, the quick development of effective COVID vaccines has been a real success story during this pandemic. People are get-ting vaccinated. It is really key to everyone’s ability to return to normal lives. With the spread of variants, as we all talked about, driving and increases in cases and deaths now, I am encouraged to see public health experts and vaccine developers are now consid-ering the possible need for boosters. You mentioned this a bit in your opening remarks, but I want to ask you, how do you assess the duration of vaccine efficacy and the impact of variants on that efficacy? \nDr. F\nAUCI . Thank you very much, Madam Chair. There are two \nways that are actively being used now to assess the answer to your question. One is there are correlates of immunity which have been established. In other words, you have a level of measurable labora-tory, for example, neutralizing antibody, which is the easiest to measure. There are also areas of immunity that are more difficult to measure, like T-cell responses. But the one that seems to be very well correlated is the antibody level. \nWe know from studies, from the clinical trials, as well as from \nanimal studies that there is a baseline level below which you go, you are much more vulnerable to getting a breakthrough infection. So the first is laboratory data. The second is watching and fol-lowing cohorts of people to see if you have an increase in break-through infections. We know, according to the clinical trial, take for an example, the mRNA, they are 93 to 94 percent effective in pre-venting clinically recognizable disease. \nIf you see a fall below that into the 80’s or even unfortunately \nhope it never happens into the 70’s, then you reached the point where the durability needs a boost. Those studies are ongoing right now. \nThe C\nHAIR . We don’t have any data about whether or not we are \nseeing that? \nDr. F AUCI . No, we don’t. There are some preliminary data that \nwe have heard about from Pfizer, which studies that they did in Israel and in their own studies, which seem to indicate that there is waning immunity. We have a lot of cohorts that we are fol-lowing. The CDC is following at least 20 cohorts that will be able to amplify on that data and give us much more of a basis of mak-ing a decision. \nThe C\nHAIR . How will the Administration determine if booster \nshots are needed? \nDr. F AUCI . Just by those very studies. Just by the following the \ncohort studies and we are waiting. We will be maybe—perhaps Dr. Walensky would like to comment because she has in her domain of the CDC a number of cohort studies that will inform us. In the \n40 \nmeantime, we at NIH are doing studies now to determine when \nyou give a booster, how high up do you get it and what kind of a cushion do you get for antibody responses? \nThe C\nHAIR . Okay. \nDr. Walensky. Dr. W\nALENSKY . Yes. Thank you, Senator. We have numerous co-\nhort studies. They represent tens of thousands of people, and they are represented across the United States. These include data from 14,000 nursing home facilities, long term care facilities. We have a heroes cohort that is essential workers of over 5,000 people that are actually getting weekly PCR testing. We have health care worker cohorts. \nWe have cohorts across the country where we are following these \ndata and really looking at it every several weeks to understand what the vaccine efficacy is. And it is among that, and the labora-tory data will be the decisions that we use. Fortunately, we are an-ticipating that this will wane and not plummet. So as we see that waning, that will be our time for action. \nThe C\nHAIR . Okay, thank you very much. We really appreciate it. \nWe will stay in touch on that. I will reserve the balance of my time because there are many Members here. \nSenator Burr. Senator B\nURR. Thank you, Madam Chair. I have got to say, the \nlast exchange was, oh, my god, we haven’t learned anything. Let me just make this point. I remember early on in this when the question of testing came up, the CDC said we do testing. And CDC demanded to do the test and we lost weeks. And I am not here to evaluate data. Tony, that is your job and Rochelle and others. But to say we are going to make this decision based upon the research we have got going on at CDC, based upon the information that we have put out and only our research counts, and to basically ignore the Israeli data or the Pfizer data—and I am not suggesting that we are totally doing that. \nI guess my question would be, is Israel giving us transparency \ninto their data? If you still lived in a world when we didn’t accept foreign data for applications, which FDA has had the authority to do since 1996 when I changed the law, but it took COVID to actu-ally make that happen. So I realized that we want accuracy. But do we really have to wait for CDC to complete the data? Do you think you are going to come to a different conclusion than Israel did? Share with me. \nDr. W\nALENSKY . Thank you for that question, Senator. Absolutely \nnot. We have to have collaboration across the globe because this is a global problem. So we have already had two conversations with Israel. We have data sharing from our collaboration—from our co-horts as well as from theirs. We have also been in discussions with the UK to see what data they have because, of course, they are sev-eral weeks ahead of us in the delta variants. So we intend to lever-age all of the data we have around the world to share liberally with other countries and the hopes that they will share with us so that we can make the proper decisions here in this country and around the world. \nSenator B\nURR. Is there a reason to believe that the Israeli data \nis flawed? \n41 \nDr. W ALENSKY . I am sorry? \nSenator B URR. Is there reason to believe the Israeli data is \nflawed? \nDr. W ALENSKY . Flawed, we are in discussions, epidemiologic dis-\ncussions. There are numerous cohorts in Israel, those in the Min-istry of Health, those in their health care systems. And we have seen some of their data. They are actually continuing to analyze the data. And so where we are in those active epidemiologic con-versations. \nSenator B\nURR. My point is they have made a decision to do boost-\ner’s based upon their data. And we are saying we are still going to work out through our research to determine. And that is where you begin to lose the trust of the American people in our health care experts. In April, the Biden administration announced a $1 billion commitment for sequencing at CDC. To date, only 844 cases from North Carolina have been sequenced, according to CDC website. We had over a million cases. It seems there is a major problem again at CDC. Let me just ask you, in CDC’s recent up-dated mask guidance for schools, says community should use local outbreak data to make decisions. \nYet I would challenge you that if only 844 cases have been \nsequenced, those local people don’t have the data they need to make that determination as to what the policies are going to be at a local level. Would you agree? \nDr. W\nALENSKY . That discussion is based on cases, not based on \nvariance. So we are actually getting data from around the country based on variance as well, based from the local health departments within North Carolina and with all of the states, as well as aca-demic centers, and commercial labs. And the recommendations for schools was based on test positivity and positive cases, not nec-essarily based on variance. \nSenator B\nURR. But shouldn’t transparency by the local health de-\npartment about the variant in their community be important to their decision as to what they do in the schools? \nDr. W\nALENSKY . Absolutely. And we have data by region for \nvariants that are posted on our website. They have been updated this morning with 83 percent. So not only are we looking at test positivity actually down to the county level, but variants that come in as well from each of the individual states, from the academic partners, from the labs. \nSenator B\nURR. Dawn, I know you have only been there 3 weeks. \nWhat are your plans to address the pressure that the flu is going to cause on the system? \nMs. O’C\nONNELL . Ranking Member, thank you for that question. \nThat has been something that we have been—the ASPER team has been considering and planning for over the last several months. There is now an interagency process set up by the White House Supply Chain Coordinator that ASPER has been actively partici-pating in, working with manufacturers of both flu vaccines and \nCOVID vaccines to make sure that the supplies are there so we have access to both vaccines as we head into the fall. \nBut it is something that we will continue to monitor and recali-\nbrate if needed so we are sure that we can do both at the same \n42 \ntime. At this point, our planning assumption suggests that we can, \nbut I will continue to monitor that. \nSenator B URR. Thank you. Thank you, Chair. \nThe C HAIR . Senator Kaine. \nSenator K AINE . Thank you, Chair Murray and Ranking Member. \nThank you to the witnesses. I want to say a word about disinformation and then have some questions. Former President Trump was on television this weekend and he said one of the rea-sons people won’t get vaccinated is because, ‘‘they don’t trust the election results.’’ And when I heard that, I sort of chuckled at that. I thought that was odd to be connecting a big lie about the election to refusal to get vaccinated. But it caused me to do something that I hadn’t done, which is look at the vaccination rates in all 51 states, including the District of Columbia. \nThe CDC data from yesterday morning shows the following. The \n21 jurisdictions with the highest vaccination rates all vote for Joe Biden. 25 of the 30 jurisdictions with the lowest vaccination rates voted for Donald Trump. There is a difference between causation and correlation. But possibly what the President said on television on Sunday, there may be something to it that repeated disinformation about the election is now connecting in people’s minds with this information about willingness to take the vaccine. \nIt didn’t have to be this way because one of the great things \nabout President Trump and the Trump administration working with partners and funded by Congress was setting a world record in terms of developing really super effective vaccines in record time. President Trump had COVID in October. He decided to get vaccinated in January. He didn’t tout the vaccination. It came out months later. But he could still tout it, he could still say this is a Trump accomplishment and encourage people in these states who are lagging behind the national average to get vaccinated. \nThat won’t solve all of the problem because there are many rea-\nsons people don’t get vaccinated. But I am now convinced, I just came back from Latin America. In Latin America, they are so thrilled at the U.S. donation of vaccines, and they view our vac-cines as state-of-the-art compared to the China and Russia vac-cines. And they appreciate that we are donating them rather than charging them, which China and Russia are doing. So around the world, people are beating a door down to try to get to U.S. vaccines if they can. And here we have near universal availability. \nAgain, I thought it was sort of comical, the President’s comments \nthis past weekend. But as I look at the CDC data, maybe it is not so comical, but it is incredibly serious. Dr. Walensky, I wanted to ask you this question. I think you stated in your opening testimony that the overwhelming majority of deaths now are people who are not vaccinated. Now, when you say overwhelming majority, are you talking about 60 percent, 80 percent, 95 percent, 99 percent? What is the statistic? \nMs. O’C\nONNELL . In a five-month study from January to May and \nnumerous states, five or six states, it was 99.5 percent. \nSenator K AINE . Now, obviously, before the vaccine started, it was \n100 percent. 100 percent of people who died before we were vacci-nating were unvaccinated by definition. And since the vaccine has begun to be deployed, 99.5 percent of people who died are people \n43 \nwho are unvaccinated. Those are very, very powerful statistics. As \nthe Administration has begun to say this is now a pandemic of the unvaccinated. Dr. Walensky, I am very concerned with a CDC press release, I guess, from last week about overdose deaths in the last calendar year. A 29 percent increase in overdose deaths. \nIt appears to be connected to the isolation. Substance use dis-\norders is often a disorder of isolation. It appears to be connected to the intense isolation of the last year. Can you tell us what CDC and other partners are doing to look at this and work together with us to try to combat the resurgence of a scourge which we had seen some positive movement on in the last few years? \nDr. W\nALENSKY . Yes, thank you, Senator. You know, there have \nbeen two things in the last decades that have decreased life expect-ancy in this country. One is COVID–19 and the second is overdose. And so we are now seeing a collision of those two things happening at the same time. And in fact, as you noted, the report dem-onstrated a 29 percent increase in overdose deaths a year over year. \nWe are actively working to not only study this issue and not only \nstudy the overdose deaths, but the overdose hospitalizations, to look at surveillance, to look at the infectious diseases associated with injection drug use, to promote certain services programs, naloxone programs, as well as to provide services and toolkits around the country for not just substance use disorders, but for mental health, Hear Her Now campaigns—Hear Her Now cam-paigns for maternal mortality, toolkits for suicide prevention for youth. Parental toolkits. \nWe are actively not only doing the surveillance and the studying \nof this, but also the—in the communities for the toolkits on the pre-vention side. \nSenator K\nAINE . Right, thank you. I yield back, Chair Murray. \nThe C HAIR . Thank you. \nSenator Paul. Senator P\nAUL. Dr. Fauci, as you are aware, it is a crime to lie \nto Congress. Section 1001 of the U.S. Criminal Code creates a fel-ony and a five-year penalty for lying to Congress. On your last trip to our Committee on May 11, you stated that the NIH has not ever and does not now fund gain of function research in the U.S. Insti-tute of Virology. And yet gain of function research was done en-tirely in the Wuhan Institute by Dr. Xi and was funded by the NIH. \nI would like to ask unanimous consent to insert into the record \nthe human virology paper entitled, Discovery of A Rich Gene Pool of Bats SARS Related Coronaviruses. Please deliver a copy of the Journal article to Dr. Fauci. In this paper, Dr. Xi credits the NIH and lists the actual number of the grant that she was given by the NIH. In this paper she took two bat coronavirus genes, spiked genes, and combined them with a SARS related backbone to create new viruses that are not found in nature. \nThese lab created viruses were then shown to replicate in hu-\nmans. These experiments combine genetic information from dif-ferent coronaviruses that infect animals but not humans to create novel artificial viruses able to infect human cells. Viruses that in \n44 \nnature only infect animals were manipulated in the Wuhan Lab to \ngain the function of infecting humans. \nThis research fits the definition of the research that the NIH \nsaid was subject to the pause in 2014 to 2017, a pause in funding on gain of function. But the NIH failed to recognize this defines in a way, and it never came under any scrutiny. Dr. Richard Ebright, a molecular biologist from Rutgers, described this research in Wuhan as, ‘‘the Wuhan lab used NIH funding to construct novel chimeric SARS related coronaviruses able to infect human cells and laboratory animals. \nThis is high risk research that creates new potential pandemic \npathogens—potential pandemic pathogens that exist only in the lab, not in nature. This research matches,’’ these are Dr. Ebright’s words, ‘‘this research matches, indeed epitomizes the definition of gain of function research done entirely in Wuhan,’’ for which there was supposed to be a Federal pause. \nDr. Fauci, knowing that it is a crime to lie to Congress, do you \nwish to retract your statement of May 11th where you claimed that the NIH never funded gain of function research in Wuhan? \nDr. F\nAUCI . Senator Paul, I have never lied—. \nSenator B URR. Microphone. \nThe C HAIR . The Microphone. \nDr. F AUCI . Senator Paul, I have never lied before the Congress, \nand I do not retract that statement. This paper that you were re-ferring to was judged by qualified staff up and down the chain as not being gain of function. \nSenator P\nAUL. What does—. \nDr. F AUCI . Let me finish—— \nSenator P AUL. You take an animal virus, and you increase its \ntransmissibility to humans. You are saying that is not gain of func-tion? \nDr. F\nAUCI . That is correct. And Senator Paul, you do not know \nwhat you are talking about, quite frankly. And I want to say that officially. You do not know what you are talking about. Okay, you get one person—can I answer your question? \nSenator P\nAUL. From the NIH definition of gain of function—this \nis your definition that you guys wrote. It says that scientific re-search that increases the transmissibility among mammals is a gain of function. They took animal viruses that only occur in ani-mals, and they increased their transmissibility to humans. How you can say that is not gain of function. \nDr. F\nAUCI . It is not. \nSenator P AUL. It is a dance, and you are dancing around this be-\ncause you are trying to obscure responsibility for 4 million people dying around the world from a pandemic. \nThe C\nHAIR . Let’s let—Dr. Fauci. \nDr. F AUCI . I have to—well, now you are getting into something. \nIf the point that you were making is that the grant that was fund-ed as a sub-award from Eco Health to Wuhan created SARS-CoV– 2, that is where you are getting. Let me finish. \nSenator P\nAUL. We don’t", "summary": "Official printed transcript of the Senate Health, Education, Labor & Pensions Committee hearing including Anthony Fauci's testimony and the exchange with Sen. Rand Paul ('you do not know what you are talking about, Senator').\n\nExcerpt: U.S. GOVERNMENT PUBLISHING OFFICE WASHINGTON : 46–775 PDF 2023 S. H RG. 117–195  THE PATH FORWARD:  A FEDERAL PERSPECTIVE  ON THE COVID–19 RESPONSE  HEARING  OF THE   COMMITTEE ON HEALTH, EDUCATION,  LABOR, AND PENSIONS  UNITED STATES SENATE  ONE HUNDRED SEVENTEENTH CONGRESS  FIRST SESSION  ON  EXAMINING A FEDERAL PERSPECTIVE ON THE COVID-19 RESPONSE,  FOCUSING ON THE PATH FORWARD, AFTER RECEIVING TESTIMONY FROM ROCHELLE P. WALENSKY, DIRECTOR, CENTERS FOR DISEASE CONTROL AND PREVENTION, ANTHONY S. FAUCI, DIRECTOR, NA-TIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES, NA-TIONAL INSTITUTES OF HEALTH, JANET WOODCOCK, ACTING COM-MISSIONER OF FOOD AND DRUGS, FOOD AND DRUG ADMINISTRA-TION, AND DAWN O’CONNELL, ASSISTANT SECRETARY FOR PRE-PAREDNESS AND RESPONSE, ALL OF THE DEPARTMENT OF HEALTH…", "source_url": "https://www.govinfo.gov/content/pkg/CHRG-117shrg46775/pdf/CHRG-117shrg46775.pdf", "pdf_url": "/archive-docs/fauci-files/c3b739640296186a5c95fb7d5f0f81a9/pdf", "doc_date": "2021-07-20", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "senate help", "rand paul", "congress", "fauci testimony", "hearing transcript", "CHRG", "you do not know what you are talking about", "testimony-senate-help-2021"], "part_number": 1, "page_count": 100}
{"title": "Fauci Testimony — Senate HELP Committee (20 Jul 2021, CHRG-117shrg46775) (Part 2 of 3)", "content": "know. We don’t know if it did—but all \nthe evidence is pointing that it came from the lab, and there will be responsibility for those who funded the lab, including yourself. \nDr. F\nAUCI . I totally resent—. \n45 \nThe C HAIR . This Committee will allow the witness to respond. \nDr. F AUCI . I totally resent the lie that you are now propagating, \nSenator, because if you look at the viruses that were used in the experiments, that were given in the annual reports that were pub-lished in the literature, it is molecularly impossible—. \nSenator P\nAUL. No one is saying those viruses caused it. \nDr. F AUCI . It is molecularly—. \nSenator P AUL. No one is alleging that those viruses caused the \npandemic. What we are alleging is the gain of function research was going on in that lab and NIH funded it. \nDr. F\nAUCI . That is not—— \nSenator P AUL. You can’t get away from it. It meets your defini-\ntion, and you are obfuscating the truth. \nDr. F AUCI . I am not obfuscating the truth, you are the one. \nThe C HAIR . Senator Paul, your time has expired, but I will allow \nthe witness to—— \nDr. F AUCI . Let me just finish. I want everyone to understand \nthat if you look at those viruses, and that is judged by qualified virologists and evolutionary biologists, those viruses are molecu-larly impossible to result in SARS-CoV–2. \nSenator P\nAUL. No one is saying they are. No one is saying those \nviruses caused the pandemic. We are saying they are going to func-tion viruses—. \nDr. F\nAUCI . They are not—. \nSenator P AUL. Because they are animal viruses that became \nmore transmissible in human, and you funded it. Why won’t you admit the truth? \nDr. F\nAUCI . You are implying—— \nThe C HAIR . Senator Paul, your time has expired, and I will allow \nwitnesses who come before this Committee to respond. \nDr. F AUCI . You are implying that what we did was responsible \nfor the deaths of individual—I totally resent that—. \nSenator P AUL. It could have. \nDr. F AUCI . If anybody is lying here, Senator, it is you. \nThe C HAIR . Senator Smith. \nSenator S MITH . Thank you, Dr. Fauci. And thanks to all of our \npanelists for being here today. And thank you, Chair Murray and Ranking Member Burr. I just want to say, Dr. Fauci, is there any-thing more that you would like to say to counteract these attacks on your integrity that we have all just witnessed? \nDr. F\nAUCI . Well, Senator, thank you. I don’t think I have any-\nthing further to say. This is a pattern that Senator Paul has been doing now at multiple hearings based on no reality. He is talking about gain of function. This has been evaluated multiple times by qualified people to not fall under the gain of function definition. I have not lied before Congress. I have never lied, certainly not be-fore Congress. Case closed. \nSenator S\nMITH . Thank you. So we are 6 months into this pan-\ndemic, and I think we are at a critical moment. Two-thirds of adults have received at least one dose of the vaccine. And at the same time, we are seeing cases rising to about 41,000 a day. As Dr. Walensky has said, we have an epidemic here of the unvaccinated. And—but, of course, this continues to affect every single one of us. So it seems to me that our actions and messages in this moment \n46 \nare going to make a huge difference in whether we move forward \nor backward, not only here in the United States, but everywhere in the world. \nToday, as I was walking into this Committee hearing, for the \nfirst time in months, I saw a line of people waiting outside of a pharmacy for testing and vaccines. And it made me wonder wheth-er the recent surge of the delta variant is getting people’s attention and moving them from indecision to action. What a terrible way for this to happen. But—so I have a few questions just I hope clear up some of the misinformation and misunderstandings. Dr. Fauci, the COVID–19 vaccine protects against the delta variant, is that cor-rect? \nDr. F\nAUCI . It protects against the clinically apparent disease, and \nit protects extremely well against hospitalization and death. \nSenator S MITH . Right. So if you are not vaccinated, given how \ncontagious the delta variant is, I mean, it is—would it be fair to say you are almost—you are very likely to get this variant. To get the COVID–19 variant, would you say? \nDr. F\nAUCI . Well, certainly when you look at the capability of this \nvirus to transmit from people to people. I mean, obviously you have to be in an environment in which the virus is present. So if you are in it, for example—and I believe Dr. Walensky mentioned that in her remarks. If you are in an area, be it a state, a city, a county or what have you, well, you have a high level of infection in the community and a very low level of vaccinated people, the chances in that environment of getting infected are reasonably high. \nSenator S\nMITH . Right. And how do you compare, how do you \nthink about the risks—the side effect risks of the COVID–19 vac-cine compared to the risks of not being vaccinated? Because this is, I think, what people are struggling with. \nDr. F\nAUCI . Right. It refers to the risk benefit ratio of getting a \nvaccination. And every time this has been evaluated, not only with this vaccine, but with so many other vaccines, there is no interven-tion that is without some time getting an adverse event. I mean, I don’t think I can think of one that hasn’t. \nWhen you have that situation, you balance the rarity or the un-\ncommonness of a particular adverse event with the advantage that you would get from protecting yourself against the actual disease against which you are vaccinated. And thus far, whenever this has come up about an adverse event, it has been evaluated, perhaps even a warning has been given, but it is always weighed on the part of saying that the benefit of the protection of the vaccine out-weighs the risk of the adverse event. \nSenator S\nMITH . Thank you. Dr. Walensky I talk with public—I \nhave spoken with a lot of public health experts in Minnesota who tell me that they are still challenged getting especially younger adults who are eligible to be vaccinated, getting them vaccinated. And part of it is the challenge, this perception that COVID is just not that big a deal for younger people, people who consider them-selves healthy and have got a strong immune system and so forth. So let me ask you this. Are there a larger number of younger peo-ple getting hospitalized today versus a year ago or 6 months ago? \nDr. W\nALENSKY . We have seen hospitalizations go up for every \nage bracket recently as cases go up. Proportionally because there \n47 \nare more cases now among younger people, we are seeing more of \nthose people in the hospital. They still get hospitalized at a less fre-quent rate given unvaccinated than elderly patients. But in fact, because there are more of them now that we are seeing more of them in the hospital. \nSenator S\nMITH . Okay. So another good piece of advice there to \nhave, being aware of the risk, even if you are—even if you see yourself as young and healthy. \nDr. W\nALENSKY . Absolutely. \nSenator S MITH . Thank you, Madam Chair. \nThe C HAIR . Thank you. \nSenator Moran. Senator M\nORAN . Madam Chair, thank you. Thank you and Sen-\nator Burr for today’s hearing. Thank you for the witnesses for being here. Let me start with Dr. Walensky, please. Doctor, in May, the CDC announced new guidance for fully vaccinated indi-viduals, that they could resume activities without wearing a mask or staying socially six feet apart. \nAt that time, the CDC further said that they would continue to \nupdate guidance for travel as the science was developing and they would need to collaborate with other agencies regarding a face mask requirement. A month later, a number—me and a number of my colleagues sent a letter to the CDC and the TSA asking for an update regarding the mask requirement during travel. \nWhile we had a response from TSA, we have not had it yet, a \nresponse from CDC. And I wondered if you would tell me where the CDC is in the process of updating the mask requirement for fully vaccinated individuals while traveling. \nDr. W\nALENSKY . Thank you for that question, Senator. Obviously, \nas you know, the discussion about masking on Federal aviation and ships is an interagency process, not simply with CDC. I will say a lot has changed since May 13th. As you heard from Dr. Fauci, we now have a variant circulating in this country that is at the time was less than 3 percent and is now 83 percent and much more transmissible. \nWe are continuing those conversations, working toward a letter \nback to you. Thank you for your patience. And we will continue to revisit that as we learn more about vaccine efficacy, as we learn more about transmission in the context of vaccination, and as we understand more about the delta variant. \nSenator M\nORAN . Are you expecting a change in the expiration \ndate of that continued requirement? \nDr. W ALENSKY . I think we still have more looking to do with \nthat. \nSenator M ORAN . Let me turn to Ms. O’Connell. Ms. O’Connell, \nyou are not the perfect witness from HHS for my statements or questions, but you are my only witness from HHS for my state-ments. It is a bit about the future, which you are fully engaged in. We need a better response to public health emergencies. And I want to talk about—in that regard, I want to talk about the param-eters of the provider relief fund. HHS, in my view, is terribly slow in their release of guidance and on how the funds could be utilized. \nThere has been a lot of confusion by health care providers. They \nhave been reluctant to spend the money. It is—we are incapable of \n48 \nsolving problems if the resources that we provide to those who are \nin the health care field, they are not utilized because they are fear-ful that they don’t know what the guidance is and therefore, if they make a mistake, they have penalties at a later date. \nI guess the question that could be for you, what is the plan to \nget HHS to perform better or more quickly so that providers have the necessary information and comfort level to take the steps nec-essary to prevent the spread of the virus and to care for the health care of Americans and others? \nThe part that doesn’t necessarily involve you, but in hopes that \nHHS is otherwise listening, there is about $24 billion left unspent in the Provider Relief Fund and we have been anxiously awaiting always with the answer that it is in the works about assistance and care for facilities that care for our senior populations. And there is still no answer in that regard. \nI don’t know that you have a comment necessarily on that part \nof my commentary, but again, I would utilize this as an oppor-tunity to try to get more certainty at HHS on the spending of those dollars. \nMs. O’C\nONNELL . Senator Moran, thank you for your question, for \nboth parts of it, and I certainly appreciate how frustrating it has probably been not to have the clarity that you and your constitu-ents have been seeking. \nWe will take the comments that you have made today and bring \nthem back to the secretary and other parts of HHS senior leader-ship to make sure that we understand how important it is that this money is moving quickly, and that the guidance comes out expedi-tiously and that we can do all we can to support. I mean, we really want to do all we can to support your constituents. \nIt is helpful to know that this has been a problem, and I look \nforward to working with you and your staff on it. \nSenator M\nORAN . If you can accomplish that, the purpose of my \ncomment will be satisfied. I would particularly ask that someone from HHS respond to us about the provider relief fund as it relates to senior care living circumstances. \nDr. Fauci, in the 24 seconds I have left, I will just ask a quick \nquestion. What are the necessary steps—you have talked about mental health. What are the necessary steps to mitigate a mental health and drug overdose crisis? What should Congress and Amer-ican institutions be doing today for a future pandemic? \nDr. F\nAUCI . Well, first of all, I think the lesson that we have \nlearned from this, and we would hope in good preparation for what will inevitably be another challenge in the future, can’t predict when, is to realize the important mental health impact that this outbreak has had, not only in the suffering from the disease itself, but from the extraordinary disruption of our society, which I think we are going to have to realize, that even when we get this under control, the mental health effects of this are going to be following this for months if not years afterwards. \nWe can’t forget that. When the outbreak is over, the mental \nhealth effects are not going to be over. They are going to linger. And that is what we really need to address. \nThe C\nHAIR . Thank you. \nSenator Rosen. \n49 \nSenator R OSEN . Thank you, Chair Murray, Ranking Member \nBurr, for holding this vitally important hearing today. And I really want to thank all of the witnesses for helping to get our Country vaccinated. It is so important to every person that we know and love in our community and our personal lives that we do every-thing we can to save them and protect them, and I appreciate your hard work in this regard. \nI just want to speak a little bit about vaccine outreach, because \nour Country—we have made tremendous progress over the past several months in making the vaccine available to most individ-uals, to getting shots and arms. I have had the honor of going to some of the vaccine sites, of course, clinics in my home State of Ne-vada. Our health care heroes, they are pillars of strength in our communities, showing up day after day to be sure that everybody that wants a vaccine can get one. \nWe just can’t lose ground. But unfortunately, Nevada is—our \ncases are growing, and we seem to be getting to the top of the list nobody wants to be in, in the cases of the delta variant. I am ex-tremely concerned about the lag in vaccination rates. In fact, last week, especially a nursing home, Senator Cortez Masto and I sent a letter to Secretary Basara to raise concerns about the low re-ported vaccination rates in Nevada’s nursing homes. And we have to find a solution to protect those most vulnerable who can’t go out to a site and even their loved ones couldn’t take them. \nDr. Walensky, are there any plans for the CDC or in coordination \nwith other agencies to restart the pharmacy partner program that sent teams directly to every nursing home, perhaps, or every facil-ity with less than a 90 percent vaccination rate for residents and staff and I might even say families of staff who they go home to? \nDr. W\nALENSKY . Thank you for that question, Senator Rosen. And \nwe recognize this challenge, and we are with you. And that, in fact, we have 10 CDC people deployed to Nevada right now working to assist. You know, part of the long term plan in terms of working to vaccinate our long term care facilities, not necessarily these stac-cato partnerships with the pharmacies, but to have a longitudinal plan, because, in fact, especially in our long term care facilities, there is quite a bit of turnover of the patients. \nWe want to make sure that there is always vaccine available. \nMany of these long term care facilities have access to pharmacies, and we want to make sure that there is a vaccine actually active in the pharmacies so that they can do vaccination when patients come in. I agree with you and in fact we need to work to get our staff vaccinated as well. In fact, staff in some of these long term care facilities are 20 percent less coverage than the facility mem-bers themselves—the residents themselves. \nWe are working on confidence in those areas, but specifically \nstrike teams in with a long term care facilities to assist in getting vaccine to those places that is not reliant on a one time mass vac-cination, but really has a longitudinal plan to make sure vaccine can be available in the long term. \nSenator R\nOSEN . Yes, and I would hope that you would include \nthe families of the staff, because oftentimes they have a high turn-over, too. They go home to their community and are just going to keep putting out that fire over and over. But I would like to switch \n50 \nnow and talk a little bit about the research in vaccines, because ob-\nviously we are discovering more about COVID every single day. \nI think for years to come, we are going to continue to learn. And \nso now is the time to take those additional steps to say—to see we don’t look back and find gaps in data that could have been pre-vented, those gaps could have been prevented if we had acted soon-er, speaking of longitudinal. And so data like this could save lives. That is why I introduced the Ensuring Understanding of COVID– 19 to Protect Public Health Act. And it is bipartisan legislation that requires long term those longitudinal studies on a variety of COVID patient population with regular public reporting. \nFor example, some of the recent research is showing that \nCOVID–19 vaccine may actually improve symptoms for some pa-tients with long haul COVID. So, Dr. Fauci, how do we—what do we know about this so far and how common is the vaccine to be a strong prevention tool, but also to work therapeutically in this case? And what else should we be studying? \nDr. F\nAUCI . Very good point, Senator. And there has been anec-\ndotal reports of people who have been infected, have developed long COVID, and their symptoms have been improved upon getting the SARS-CoV–2 vaccine. That has not been proven under the scrutiny of a clinical trial. \nRight now, we are looking at individuals who actually have re-\ncovered and seeing if, in fact, vaccination does improve. Right now, although the anecdotal cases suggest that I don’t think we can say anything definitively from a scientific standpoint, but that is some-thing that is being looked at. \nSenator R\nOSEN . Thank you. I see my time is up. Thank you. \nThe C HAIR . Thank you. \nSenator Romney. Senator R\nOMNEY . Thank you, Madam Chair. And thank you to \nthe members of our panel today for being here responding to our questions. Thank you also to the teams of people that you work with. Their tireless work over the last year and a half is something which many of us feel a great deal of gratitude for, for that effort. As we try and understand vaccine hesitancy, I am sure some of that is due to spurious conspiracy theories. \nPerhaps and I don’t know this, but social media may be popu-\nlated in part by enemies of our Country that are putting out theo-ries to try and get people not to take vaccines. But there is also, I believe, another reason why some people who are not prone to be-lieve those conspiracies don’t get vaccinated, and that is because they don’t know what the data really suggests. And they wonder, Okay, is this really a good thing for my 16 year old? \nWhat are, the serious side effects of this vaccine for a 16 year \nold versus the probability of them getting very ill? And I wonder, do we provide or is there a place where people can go to find out what the data show for the side effects of vaccines by age group and how many serious complications there are for people of dif-ferent ages and then compare that perhaps with the serious impli-cations of getting COVID? And I will ask first, Dr. Walensky. \nDr. W\nALENSKY . Yes. Thank you very much, Senator Romney. In \nfact, that is exactly what we are doing. So, one of the things I think that is so important to understand is that when people don’t want \n51 \nto be vaccinated it’s for a whole host of reasons. And until you start \ntalking to them about what is their reason, is it, I can’t take off work tomorrow and I may feel unwell, is it because I don’t under-stand these potential side effects for my 6 year old? \nWe and CDC have what we call vaccine confidence consults. So \nwe have state departments, local health departments who can call into us and say, these are the things that we are hearing on the ground. What is the real data so that we can have trusted mes-sengers for providing that real data in real time to people and mak-ing sure that their answers are—their questions are answered and that we can empower the people who are the trusted messengers on the ground with exactly those data. \nSenator R\nOMNEY . Is that information being collected? Are doctors \nand hospitals actually collecting the data that shows how many people are getting side effects by age group? Are you getting accu-rate information that people can rely upon? Because, again, I see on social media and some broadcasters a sense that somehow this is being hidden, that the side effects are being underplayed, that you have an incentive not to let people know what the kind of side effects might be and the seriousness of those side effects. \nDr. W\nALENSKY . The answer is absolutely. We have numerous \nlarge scale mechanisms by which to collect these data. We have the first ever V-safe monitoring program where people are—given their vaccine, how did they do today? How are they doing in a week? We have the Vaccine Adverse Event Reporting System. That is a pas-sive reporting system. \nEverything gets reported, is supposed to get reported but we rec-\nognize it is passive. Things may get missed. And then we actually also have the vaccine safety data link, which is a link of nine aca-demic centers that were able to get real vaccine data as well as their denominators, which is hard to get in passive reporting so we can check numerators and denominators there and give us real es-timates. We are doing—we are covering the gamut. \nSenator R\nOMNEY . The talk that Senator Burr described with re-\ngards to getting a booster, the suggestion from Israel is it makes sense. There are a number of us that would get in line to get a booster. How long is it going to take before we are able to get suffi-cient information to allow Americans who want to get an additional vaccination to be able to do so? Are we talking weeks, are we talk-ing months? I mean, I guess given the fact that this is being done overseas, can we not use the data that has come from those places to allow people in this country to get a third shot if they want to? \nDr. W\nOODCOCK . The agencies represented here are all monitoring \nthis extremely carefully. As you have heard, 95–99.5 percent of all people are being hospitalized now are unvaccinated. So at the mo-ment, the people that are getting sick are the people who haven’t been vaccinated. \nSenator R\nOMNEY . I understand but I am looking at the data that \nis coming from Israel, and people who have double vaccinations are \nstill susceptible to the delta variant for serious disease and death. And they are showing that if they get a booster, that dramatically is reduced. Why should we not allow people who are elderly or have other compromised conditions to be able to get that booster? \n52 \nDr. W OODCOCK . Certainly. We are looking at all that. Remember \nthis vaccine right now, the vaccines that are under emergency use authorization require an additional authorization for a booster. \nSenator R\nOMNEY . How long is that going to take? That is a ques-\ntion. We have people who want to get that booster, and I am hear-ing that from people who are at risk and concerned. They want to take that booster. They are willing to take the additional risk of something that has not been—they have already had two shots of it. They are saying, give me the third, because I got this over a year ago. I got the vaccination over a year ago. I want to get that protection. Why can’t they? And if—I understand, you won’t let them yet. But when will you let them? \nDr. W\nOODCOCK . Well, Pfizer, at least has announced that it is \ngoing to submit to their EUA data, both Pfizer data and Senator Burr’s early point, other Israelis—other data that they have avail-able to potentially make the case for a booster. So the FDA will be looking at that. \nSenator R\nOMNEY . I am sure you will. I don’t like the timeframe, \nfrankly, given the fact that this is being done elsewhere. My time is up so I will turn back to you, Chair. \nThe C\nHAIR . Dr. Woodcock, for clarification, Pfizer has not re-\nquested FDA to approve a booster? \nDr. W OODCOCK . Well, of course, I can’t talk about that, but Pfizer \nhas publicly announced that they are going to submit an amend-ment to their EUA to request—for a booster dose. \nThe C\nHAIR . Thank you. \nSenator Hassan. Senator H\nASSAN . Well, thank you, Chair Murray and Ranking \nMember Burr. And thank you to all of our witnesses today for the work you do. I want to just start to talk about a recent news item. It is a deeply disturbing report detailing dangerous inequities that USA Paralympians are facing at this year’s Tokyo Paralympics. Becca Myers is a six time Paralympic medalist who won three golds in Rio 5 years ago. She is deaf, blind, but in the past, that hasn’t stopped her from competing and winning at the highest lev-els. \nThis year, though, she and other athletes from Team USA who \nexperienced disabilities are being denied adequate access to per-sonal care assistants, reportedly due to COVID–19 restrictions. In-dividuals who experience disabilities should not be forced to navi-gate the Tokyo Olympics without the support that they need in the midst of a global pandemic. Becca announced on Sunday that she is quitting the team because she is being denied a, and this is her quote, ‘‘reasonable and essential accommodation’’ that would enable her to compete. \nThis is an outrage and a preventable situation that should never \nhave gotten to this point. So I want the U.S. Olympic and Paralympic Committee to work immediately to address this issue, and I want them to ensure that all of our athletes are able to com-\npete safely at this summer’s game, including by providing them the basic supports that they need just to navigate the world. So I do have a question though, Director Walensky, because over the last year and a half, the CDC has provided guidance on how to mitigate \n53 \nthe risk of COVID–19 in various activities, as well as special \nevents, including sports. \nI have a question that you all could answer in writing. You can \ncomment on it now if you would like. But what I am interested in is your best guidance regarding COVID–19 mitigation, taking into account the needs of people with disabilities. So if you would like to comment now you can or we can just do it in writing. \nDr. W\nALENSKY . Maybe I will just comment and say I share your \nconcern. We have dedicated resources specifically to disabled com-munities, especially those who are unable to come out and get vac-cinated. I think probably the details of individual sports, which we can do by writing, but I just want to echo your concerns. \nSenator H\nASSAN . I just want to be clear that for some people \nwith disabilities, the accommodation, the aid they need is another human being. And it really needs to be seen as the same kind of accommodations we would make in other situations. So I appre-ciate having an ongoing discussion with you about it. \nNow, I would like to turn to you, Ms. O’Connell. Last year, many \nstates, hospitals, and First Responders struggled to acquire per-sonal protective equipment, and the Federal stockpile did not con-tain the supplies needed to fulfill their requests for help. The stock-pile also contained many expired and unusable products, which fur-ther limited its effectiveness. \nI recently introduced bipartisan legislation with Senator Cassidy \nthat would improve transparency into the stockpile, authorized transfers of expiring products, and assist states in establishing and maintaining their own stockpiles in order to help avoid the kinds of challenges that we faced last year. \nWhat steps are you taking to improve the stockpile, and will you \ncontinue to work with us on this bipartisan legislation to make fur-ther improvements? \nMs. O’C\nONNELL . Senator Hassan, thank you so much for your \nquestion. This is a place where I intend to spend a lot of time in my new role. I am pleased to report that ASPER has spent and in-vested over $10 billion in supplemental funds to restock the stock-pile. \nWe currently have 35 times the number of N95 respirators we \nhad at the beginning of the pandemic. We have 17 times the num-ber of gloves, 8 times the number of masks, and of the N95 masks, all 12 contracts are with domestic manufacturers. So we are begin-ning to see some progress. \nSenator H\nASSAN . Will you work with us on the bipartisan legisla-\ntion that Senator Cassidy and I have introduced? \nMs. O’C ONNELL . I would look forward to. Thank you, Senator. \nSenator H ASSAN . Thank you. Dr. Fauci, I have a question for you \nabout pediatric vaccines. Many parents and family members are understandably eager for updates on the potential availability of COVID–19 vaccine authorized for use for children under 12. I am encouraged that clinical trials for young children are underway, and I am hopeful that we will see the same safety and efficacy that we have seen from previously authorized COVID–19 vaccines. Doc-tor, when do you believe parents and families can expect trials to yield the type of data needed to pursue authorization for use in children under 12? \n54 \nDr. F AUCI . Thank you for that question, Senator. From the \nstandpoint of the data that would be required to make a decision, that very likely when you do the age de-escalation studies, so we have gone from 12 to 9, 9 to 6, 6 to 2, and then 6 months to 2 years, likely by late fall, early winter, we will have enough data. But that doesn’t mean that then it is all of a sudden going to be allowed to happen. That will be a regulatory decision that the FDA will have to make. \nSenator H\nASSAN . Well, thank you. And I see that I am out of \ntime. I will follow-up with you in writing because I am also inter-ested in what you think we could do now to help boost confidence and uptake for the pediatric population once the approval is au-thorized. \nThe C\nHAIR . Thank you. \nSenator Marshall. Senator M\nARSHALL . Thank you, Madam Chair. My first question \nfor Dr. Walensky. As a physician, we always want to be able to know and discuss the benefits and risk of anything that we are prescribing, including a vaccine. It is estimated that 40, maybe 50 percent of children have already had the COVID virus. What are the additional benefits to the vaccine to a child who has already had the virus? \nDr. W\nALENSKY . I think it very much depends on what that vari-\nant that child might have had, whether they could potentially be infected or reinfected. And one thing I just want to note with the children is I think we fall into this flawed thinking of saying that only 400 of these 600,000 deaths from COVID–19 have been in children. Children are not supposed to die. And so 400 is a huge amount for a respiratory season. \nSenator M\nARSHALL . Thank you. Dr. Woodcock, how many chil-\ndren under the age of 18 without a preexisting condition, a signifi-cant health condition, have died from COVID in this country? \nDr. W\nOODCOCK . I don’t—I don’t have that at my fingertips. I am \nsorry. \nSenator M ARSHALL . Dr. Walensky. \nDr. W ALENSKY . Over 400 \nSenator M ARSHALL . Without a pre-existing—— \nDr. W ALENSKY . That, I don’t know. \nSenator M ARSHALL . The answer is probably zero. So I think if \nyou take a deep dive, most of the children that have died had some type of underlying health condition. Dr. Fauci, in my hand is a three dimensional printing of the COVID spike, something that is certainly a scientific—just baffles me in so many ways. \nIt is composed of two units, as you know. There is an S2 subunit \nand an S1. And I would like for you to talk about the S2 subunit for a second. Can you explain the significance of the furin cleavage side, the double arginine CGG codon, if you would, and how that works clinically for us? \nDr. F\nAUCI . Yes. Thank you for that question, Senator. The furin \ncleavage site is a site of a set of amino acids, which is at the point where the enzyme furin can cleave it so that the virus can then bind to the receptor cell and then enter the cell. So what is seen on a number of viruses, it has been seen on the SARD-CoV–2 and it is also seen on other beta coronaviruses. You asked also about \n55 \nthe double CGG codon that is a codon again, that is unusual, but \nit is also seen on a number of beta coronaviruses. It is not a very common codon for the amino acid in question, but it is seen in coronaviruses. \nSenator M\nARSHALL . Dr. David Baltimore, a Nobel Laureate, I \nwill quote him here, ‘‘when I first saw the furin cleavage side in the viral sequence with this arginine codon I said to my wife, it was the smoking gun for the origin of the virus. These features make a powerful challenge to the idea of a natural origin for SARS–2.’’ And again, this is Nobel Laureate, Dr. David Baltimore saying this. Would you agree or disagree with Dr. Baltimore? \nDr. F\nAUCI . Well, Dr. Baltimore, who is an extraordinarily accom-\nplished scientist, has backtracked on that statement, and says, I wish I had not used the word smoking gun when it was pointed out to him that actually this is seen in a number of coronaviruses, including one of the common cold coronaviruses. So I believe, if you would ask—. \nSenator M\nARSHALL . You disagree with him? \nDr. F AUCI . Well, I agree with his second statement where he \nbacktracked and said he wished he had not—. \nSenator M ARSHALL . You disagree with his first statement \nthough? \nDr. F AUCI . He disagrees with his first statement. \nSenator M ARSHALL . Okay, not going to answer the question. We \nalso have the S1 subunit, and I refer to the timeline behind me here that there was a moratorium placed for viral gain of function in 2014. And I think you will agree with me that the NIH funded research that led to this, an S1 spike that looks very similar, if not exactly to what is on the COVID–19 spike. \nDr. F\nAUCI . What are you referring to, Senator? Can you please \nbe more specific? \nSenator M ARSHALL . Yes. So I am talking about the S1 subunit \nof the current COVID–19 spike. \nDr. F AUCI . What about it? I mean, are you talking about an ex-\nperiment or are you talking about a paper that was published? \nSenator M ARSHALL . I am talking about viral research that was \ndone using NIH funding with the North Carolina lab and Dr. Xi developed this S1 subunit spike that looks exactly like what we have on the current COVID–19 spike. Is that not true? \nDr. F\nAUCI . No, I am not sure exactly what you are referring to. \nAre you referring to the paper of Baric and Xi in Nature Immu-nology? Is that what you are referring—I need to know specifically. \nSenator M\nARSHALL . Yes, Dr. Baric and Xi printed studies on this \nS1 unit that was basically the development of the key to the door that was—specifically took the original SARS virus and made it so it would bind to the human lung cells. \nDr. F\nAUCI . No, there was gain—if you are referring, Senator, to \ngain of function by the definition. \nSenator M ARSHALL . That is not my question. Would you agree \nthat the spike that was developed there is was also on the cur-rent— \nDr. F\nAUCI . Yes, but that is irrelevant to anything until you have \na context in which you are putting it. You are talking about an S1 \n56 \nand a spike in what context? If you are talking about a paper that \nwas written by them. \nSenator M ARSHALL . But would you agree or disagree that it is \nthe same spike? \nDr. F AUCI . I am not sure what you are talking about, Senator. \nI am really not sure what you are talking about. \nSenator M ARSHALL . Okay, thank you. \nDr. F AUCI . Alright. \nThe C HAIR . Thank you. \nSenator Casey. Senator C\nASEY . Thank you, Chair Murray. And I want to thank \nthe panel for being here today and for your public service. A chal-lenging time for the country. I just wanted to make a couple of statements at the top. Assistant Secretary O’Connell, I was—I want to ask you a question, but just wanted to note on page four and five of your testimony about the information about the inven-tory that you have built up. We are happy to read that. I won’t go through it all. \nAlso the statement you made about ensuring, ‘‘ensuring a safe \nand consistent supply chain for medical materials, ingredients and supplies is critical for any national response to public health emer-gencies.’’ I couldn’t—we couldn’t be, I should say, more pleased with that kind of a focus, because we are going to need that in the future. Dr. Walensky, there was an earlier question, I think, by Senator Hassan talking about nursing homes and nursing home workers in particular. \nI want to ask you a question, because I have got a separate ques-\ntion. But the lower vaccination rate for nursing home workers is of concern. We are told by Federal data that there are still 13 states with less than half, less than half of nursing home workers have been vaccinated. So the message about vaccinations couldn’t be more important. \nLast thing I would say, Dr. Fauci, in reference to the questions \nby Senator Paul today and the accusation, I think it is a widely shared view in both houses, in both parties that the integrity that you bring to your work and the knowledge you bring to your work on behalf of the Nation, that I think that sentiment is a broad and deep reservoir, and it is very, very much bipartisan. I want to ask you to comment on that. \nBut I wanted to—I have a question for Dr. Fauci and Dr. \nWalensky about breakthrough infections. We know that even with any—even with the great success of the vaccines, there is no 100 percent effectiveness. So I wanted to ask you about breakthrough infections. I haven’t seen, maybe it is available, but I haven’t seen information about either breakthrough infections or enough infor-mation about cases of long COVID, because—I assume because of a lack of data. \nDr. Walensky, I would ask you, what types of data is CDC col-\nlecting to track breakthrough infections? And how are both CDC and the National Institute of Allergy and Infectious Diseases, Dr. Fauci, using data to monitor outcomes in patients with break-through infections? \nDr. W\nALENSKY . Thank you, Senator. So there are different ways \nthat we are capturing these data. And I think all of them fit to-\n57 \ngether in a puzzle. One is passive surveillance where folks give us \ndata when they break through, the hospital systems provide us data. They know that somebody is hospitalized and has a history of vaccination. We want to know about those cases to the extent possible. We would like to have a sample of the virus so that we can understand the viral load, so that we can sequence it, we can understand their symptoms and their risks that potentially put them in that situation. \nHowever, that is actually limited because it actually doesn’t give \nus the denominator. We don’t know who else would have been re-porting or who we missed in that process. And in order to do real effectiveness studies, we need to have both the numerator of the cases as well as the denominator. So we are doing many of those studies across the Nation. We do have them geographically sam-pled. We have a long term care facility study where we are getting data from over 14,000 long term care facilities. We have a health worker study. \nWe have an essential worker study. That is 5,000 essential work-\ners that are being tested by PCR every single week. And we have numerous other cohorts in 19 academic medical centers, 187 hos-pitals to monitor both the numerator, how many people are break-ing through, how serious is their infection, as well as the denomi-nator, how many people overall were vaccinated, so we can get a really good window as to the breakthrough—the percentage of peo-ple who are breaking through. \nSenator C\nASEY . Thank you. \nDr. Fauci. Dr. F\nAUCI . Well, thank you very much for your prior comment, \nSenator. That is much appreciated. With regard to your question, I think people need to appreciate when you talk about break-through infections, that the original data from the clinical trial, the efficacy data, was based on preventing clinically apparent disease, not preventing infection such as asymptomatic infection. \nWhen you hear about a breakthrough infection, that doesn’t nec-\nessarily mean the vaccine is failing because it is still holding true, particularly with regard to protection against severe disease, lead-ing to hospitalization and deaths. \nAs per your question, what are we doing? We will be following \nfor two-years the people who are in the clinical trials, the 30,000 and 44,000 people, to be able to determine just what percent now in the context of the delta variant are actually breaking through, to determine if it is more than that original that we saw or in the context of delta, if it is actually much more. \nSenator C\nASEY . Thank you, Doctor. Thank you, Chair Murray. \nThe C HAIR . Thank you. \nSenator Cassidy. Senator C\nASSIDY . Thank you all. I will ask—if I cut you off, it \nis not—I am not being rude, I just got 5 minutes. Got to hustle. Ms. O’Connell to follow-up on what Senator Hassan said, thank you for replenishing the strategic national stockpile. The one thing that troubled us is that there was no first in, first out. There was no rotation of material before it expired which was just dumped. What—just yes or no, have inventory management systems been implemented to minimize the wastage? \n58 \nMs. O’C ONNELL . Thank you, Senator. Yes, we are looking at that. \nSenator C ASSIDY . Looking is a very vague term. If you are one \nof my medical students on rounds, I would say, what does that mean? \nMs. O’C\nONNELL . Well, one of the things we are pursuing is the \nmodel of the vendor manage. \nSenator C ASSIDY . Wonderful. Thank you. Second, related to that, \nI am told there is a lot of vaccine that is about to expire. So it is 6 months from being expired in a state which is not completely using it. Unfortunately, my state, is among those. \nIdeally, from my perspective, we rotate that vaccine out to the \nborder for those who are coming across as undocumented or down to Central America and Mexico, which is having these COVID out-breaks. I am told there is contractual issues with that. But is there any effort to rotate out soon to expire vaccine that doesn’t appear as if it is going to be used into a set in which it could be used quite rapidly? \nDr. W\nOODCOCK . We have been working on this, and what we \nhave been advising the states is where they have repositories to hold on to that vaccine because unlike most medical products you are used to, we are making these stability determinations on the fly. \nSenator C\nASSIDY . Dr. Woodcock, that is the news. You are telling \nme that even if it goes beyond the expiration date, that the vaccine can still be used? \nDr. W\nOODCOCK . No, I am saying we are telling people to hold on \nto it, because when the additional stability—because we are doing stability—the companies are doing stability on the fly because we— \nSenator C\nASSIDY . I understand. \nDr. W OODCOCK . Yes, so we have extended the date once already \nfor one of the vaccines. We may be able to keep extending as more stability—as there is longer stability observed. \nSenator C\nASSIDY . But it still seems to me inevitably, sooner or \nlater, you are going to decide you have got to toss it. Now, just an inventory management system. It seems wise to be rotating that to a place where it would be taken up quickly as opposed to a place where it is being taken up quite slowly. Agree, disagree, and if you agree, any thoughts regarding that? \nDr. W\nOODCOCK . Well, that is really for probably ASPER to talk \nabout—— \nSenator C ASSIDY . Maybe for State Department. \nDr. W OODCOCK . Yes. \nSenator C ASSIDY . Are there other contractual obstacles to doing \nthat? Because someone told me that the contracts with the drug companies would not allow the transfer of the product to another setting. We couldn’t give it to Mexico, for example, because it just has to be tossed. Do you know about that? \nDr. W\nOODCOCK . Well, they aren’t FDA’s contract so my under-\nstanding is that it is possible under EUA to do exports and that could be possible. So that—but we can get back to you on that, be-cause it really isn’t an FDA issue. \nSenator C\nASSIDY . Sounds great. Next, as regards Dr. Fauci, \nWalensky, it does seem to me this issue of Dr. Woodcock, of wheth-er or not we need a booster would be ascertainable by whether or \n59 \nnot we can see a response of antibody to re-challenge within the \nwindow period is what, 4 days for the virus between exposure and an onset of infection if the antibodies after exposure to vaccine, if you will, mimicking an infection, shoot up rapidly, we have got pro-tection. Are any studies taking place along these lines? \nDr. W\nOODCOCK . Yes, absolutely, both within the Government and \nwithin the companies. And we certainly are—the Government as a whole, the agencies involved are monitoring this very carefully and we are sharing all the data. And we have heard from—— \nSenator C\nASSIDY . Now these are very simply done in very short— \nand don’t have a lot of timeframe. Obviously, the window period is only 4 days. So, and I have asked about this before, but it doesn’t seem as if there are any answers. What is the delay in knowing this? Because that would answer Senator Romney’s question as re-gards whether or not a booster is required. \nDr. W\nOODCOCK . Well as Dr. Fauci said, there are two things \ngoing on here. One is, when does immunity wane to the point that you need to give a booster? Our populace is not just going to—we can’t just boost them all the time, right. We need to boost them when it is appropriate. \nSenator C\nASSIDY . But isn’t there a subset of people whom you are \nfollowing longitudinally that have negative antibodies? Their anti-bodies are initially positive and now they have gone on either very low or zero. \nDr. W\nOODCOCK . They are waning. I wouldn’t say they are nega-\ntive. Obviously, Senator, Dr. Cassidy, there are going to be people who don’t respond to vaccination primarily because of some immunocompromise. However, what is being followed is the waning of humoral immunity, as Dr. Fauci described, over time. But it is waning. It isn’t vanished. And that is clear because everybody who is getting hospitalized is unvaccinated and they are being exposed to the delta variant. So the vaccination is holding right now in the U.S. \nSenator C\nASSIDY . Good. I thank you all. \nThe C HAIR . Thank you. \nSenator Lujan. Senator L\nUJAN . Thank you so much, Chair Murray, for this im-\nportant hearing, and to all of our witnesses for being here today. While I am encouraged that data shows vaccine rates are increas-ing across America, still less than half of Hispanics have been vac-cinated despite data showing that it is the least vaccine hesitant group. Dr. Walensky, Federal investment in community health cen-ters increased Hispanic vaccination rates. Yes or no, did this in-vestment in this community save lives? \nDr. W\nALENSKY . I am grateful for your collaboration with HRSA \nand the Federal qualified health centers, and I absolutely think that being able to reach out to these communities has saved their lives, some of their lives. \nSenator L\nUJAN . Dr. Walensky, additionally, when Hispanic com-\nmunities has received outreach in Spanish, it increased vaccination rates. What is the plan to build on the success of using culturally appropriate outreach and messaging to boost Hispanic vaccination rates? \n60 \nDr. W ALENSKY . I think we need to use culturally appropriate \nmessaging in all of our vaccination efforts. And not just in our vac-cination efforts, in all of our health care efforts. We have—our vac-cination toolkits are available in more than 20 languages. So it has to work within the vaccination of the Hispanic community, but also many of our other harder to reach communities. \nYes, we are continuing to do outreach by trusted messengers in \ntheir own language and culturally sensitive ways. And in fact, we are seeing that is working. We had a recent NWR in North Caro-lina that demonstrated when we did this outreach, we were able to reach Hispanic communities, increasing vaccination rates from 8 to 19 percent. \nSenator L\nUJAN . Dr. Walensky, the next question I have is along \nthose lines. The Administration has enlisted Black owned barber-shops and beauty salons, as well as faith based community out-reach to promote the shots and even serve as vaccination sites to increase Black vaccine rates. Which is important and I applaud. Does the Administration have plans to employ similar targeted out-reach to the Hispanic community? \nDr. W\nALENSKY . The Administration is working to reach people \nwhere they are and to understand the community by community, what is it that community needs, to understand—to have trusted messengers, whether it is in barbershops, whether it is in faith based organizations, whether it is in grocery stores, that is what we are working to do. \nSenator L\nUJAN . I would be interested if you could submit to me \nor get to me what those plans are for outreach into the Hispanic community, similar to the plans I just described. I wish I could ask the panel similar questions about Native American vaccination rates. IHS is not sharing the data, with the exception of the good work that is happening in Alaska, where Alaska is not depending on IHS to get vaccination rates. \nWe do not have state specific IHS data. Many officials have told \nme they are going to fix this. It has not been fixed. Please fix it. Let’s get IHS on board. Let me ask each of you a yes or no ques-tion, has disinformation on tech platforms negatively impacted the response to the pandemic, Dr. Walensky? \nDr. W\nALENSKY . Yes. And in fact, it has propagated 70 percent \nmore often. \nSenator L UJAN . Dr. Fauci. \nDr. F AUCI . Yes, it has. \nSenator L UJAN . Dr. Woodcock. \nDr. W OODCOCK . Yes, absolutely. \nSenator L UJAN . Ms. O’Connell. \nMs. O’C ONNELL . Yes, it has. \nSenator L UJAN . Assistant Secretary O’Connell, viruses don’t re-\nspect international borders, and for interconnected border states like New Mexico, our physical and economic health depends on international cooperation. I very much appreciate the line of ques-tioning from Dr. Cassidy. We need to do better in this space and look for every available tool that exists to make sure we are help-ing get vaccine out, especially into neighboring countries across the Americas. What can the Federal Government do to decrease COVID infections in border communities? \n61 \nMs. O’C ONNELL . Thank you, Senator, for that question. And, I \ndid want to follow-up on what Senator Cassidy asked and Dr. Woodcock was responding to. It is a question of liability, which is one of the things that we work through in these contracts that need to be worked through when vaccines are shared with other countries. \nThat is the contracting issue that can be an impediment. But it \nis important, I think, that we offer tests and vaccines where we can to prevent the spread of COVID in the border communities. \nSenator L\nUJAN . I recently joined a CODEL to Latin America, and \none of the countries we visited in Ecuador, where I found out that some of the vaccine formularies and samples have not been made available to local regulators to approve the vaccine anticipating if the United States can donate more vaccine or there is more vaccine purchased. \nDr. Walensky and Dr. Woodcock—and I know my time is about \nto expire. Maybe submit this into the record. How can the Federal Government better coordinate internationally to ensure that for-eign regulatory bodies have the data and vaccine supply so they can be approved locally? If you want to give me a quick response so then I can follow-up into the record. \nDr. W\nOODCOCK . We have—we have collaborations with regu-\nlators around the world through EKRA, which is the International Medicines Group, Medicine Regulator Group, as well as other ways. So we are actively reaching out to other foreign regulatory authori-ties to give them information about what we have done to review vaccines and what we know about them. \nSenator L\nUJAN . Thank you. And I want to thank this trusted \npanel. I certainly hope that we can stop the spread of misinforma-tion, that we can listen to the experts, and save more people across America. Thank you for your commitment to saving lives. I yield back. \nThe C\nHAIR . Thank you. \nSenator Braun. Senator B\nRAUN . Thank you, Madam Chair. Questions for Dr. \nFauci. I am a strong believer in First Amendment protections, and we have obviously seen coming from the business world as well, the tech industry carries so much clout. They are monopolies as ones are defined. And when you have markets that you control over 70, 80 percent, that is so much not only economic power, but it is a lot of other power that goes along with it. When you have any case where the Federal Government gets in cahoots in any way with big companies like that, that is almost unheard of. \nGenerally the Government would try to do something about that. \nIn February, Facebook included new criteria for removing misin-formation, and part of it was about the origination of the COVID virus, which now has gone from what they were declaring is misin-formation to maybe the way we think it actually occurred. \nFacebook has said that they have made consultations with lead-\ning health organizations. Was your organization, NIAID, one of the leading health organizations Facebook consulted with when decid-ing what speech to filter through? \nDr. F\nAUCI . To my knowledge, Senator, that is not the case. When \nyou say consulting with my agency regarding what speech to filter \n62 \nthrough, I don’t ever recall or have ever heard of any discussion \nabout filtering speech. \nSenator B RAUN . Did they consult with you on any topics, not nec-\nessarily whether you would filter through it or not? Have you been in contact with them to give them your personal opinion on this or that? \nDr. F\nAUCI . I don’t know what you mean by this or that. There \nwas one communication or two perhaps with Mark Zuckerberg in which he emailed me and wanted to know if there is anything that he could do that I believe it was promoting vaccination or making sure people do the right thing, wear a mask. But it was mostly propagating a public health message. It had nothing to do with the origins of the virus at all. \nSenator B\nRAUN . Then do you, on a very frequent basis, consult \nwith him, either via email or do you have his cell phone number, for instance? \nDr. F\nAUCI . I have exchanged a few emails. You probably know \nthat because you are asking the question. About 10,000 pages of my email have been FOIA’d. And in fact, there is an email ex-change or two between myself and Mr. Zuckerberg. I don’t recall— I can look it up right now and see if I have a cell phone number. I am not sure I do. \nSenator B\nRAUN . Well, you can get back to me on that. I am \nguessing you might. My point is an entity like that, and we have got 190 million users here in the U.S. and they are getting into the fray on so many things. And they are the classic example where there is too much concentration within one entity. And in years past, we have done something about that, not just let it kind of run its course. And we have never had any of the big monopolies get involved with filtering or censoring speech to boot. \nAnother question related to the White House, has recently said \nthat they are wanting to flag problematic posts. And working for the President, would you be one that would try to come up with whatever posts that are out there that need to be flagged as misin-formation? \nDr. F\nAUCI . No, I have not at all been involved, even indirectly, \nin that. \nSenator B RAUN . Do you think there is a risk, even though you \nhaven’t been involved, to the White House wanting to flag stuff that they think is problematic, and then have that same type of communication with entities like Facebook? Just your opinion on that? \nDr. F\nAUCI . No, actually, this is beyond my area of expertise. I de-\nveloped vaccines to save people’s lives. I don’t get involved in flag-ging things, Senator. So, I am sorry. \nSenator B\nRAUN . Let’s then pivot to speaking of vaccines. \nDr. F AUCI . Yes. \nSenator B RAUN . When you entered grade school, there are many \nvaccines that are mandated, and I think accepted over time. Would you, and I would like Dr. Walensky to ask or answer this as well, would you be for mandating ever a vaccine for COVID–19 or any other variants as mandatory for getting into grade school? \n63 \nDr. W ALENSKY . I think first we need to see the data. I hope they \nare efficacious. But first we need to see the data. Understand the risk benefit. So I think that is premature at this point. \nSenator B\nRAUN . What data would you need beyond what we have \ngot to go to that next step of making that a mandate, along with some of the others that have been so for a long time? \nSenator B\nRAUN . We don’t have—we don’t have clinical trial data \nin the grade school age population yet. \nSenator B RAUN . I think that means for you that you might con-\nsidering further down. \nDr. W ALENSKY . I think we need to see what the clinical trial data \nto see the risk benefit and see the long term data. \nSenator B RAUN . Dr. Fauci? \nDr. F AUCI . I think the same thing. You have to make decisions \nbased on data. We don’t have that data right now. When we do, then we could address that decision. \nSenator B\nRAUN . Thank you. \nThe C HAIR . Thank you. \nSenator Baldwin. Senator B\nALDWIN . Thank you, Madam Chair. So I have been en-\ncouraged by this Administration’s use of the Defense Production Act to produce more pandemic supplies in the U.S. And I was proud to be a part of the effort to secure $10 billion in the Amer-ican Rescue Plan to increase the domestic supply of PPP and other medical supplies. In 2020, the U.S. was overly dependent on China, and we did not have sufficient domestic sources of very critical PPE, which was exacerbated by a shortage of raw materials. \nWhen the pandemic hit, there was a bottleneck in the global pro-\nduction of medical grade meltblown material that is essential for N95 masks. Today, Wisconsin manufacturers have the ability to provide the meltblowns to provide surge capacity required to produce billions of N95 respirator masks. This type of American manufacturing is exactly what we need to be supporting. \nMs. O’Connell, I know that ASPER has used significant funding \nto increase its inventory of supplies, but I am concerned that if we don’t focus some of our expenditures on raw materials, we may re-main dependent on China and other countries. How is ASPER working to secure supplies of raw materials like meltblown to make us better prepared for the future? \nMs. O’C\nONNELL . Senator Baldwin, thank you so much for that \nquestion and thank you for the work that you did to get that $10 billion in the American Rescue Plan. We just recently had released by OMB $2 billion of that $10, which is going to go to, among other things, expanding manufacturing for raw materials for vaccines. So that is one of the first efforts that is going to—that money will be used for. It will also go to make sure that we have enough fill-fin-ish capacity, needles and syringes, and it is just the start. \nWe are, of course, very anxious to get these contracts awarded \nand moving. But it is the beginning of that $10 billion going to ex-actly what you had hoped it would go to. Of course, that is not enough. We have got more to go. But I just wanted to share with you, that is where we are right now. We have also spent, as I men-tioned earlier, other supplemental funds on producing, and in the U.S., gowns and other PPE. \n64 \nWe are continuing to do that domestic manufacturing. But we do \nhave this industrial base expansion for vaccine manufacturing ca-pacity right now. \nSenator B\nALDWIN . Okay, thank you. During this Committee’s last \nCOVID–19 hearing, I asked about the Administration’s approach to reducing waste and better targeting vaccines, including by reducing the number of doses in each vial and the number of vials in each package. Experts believe that both of these steps would signifi-cantly aid vaccination efforts as doctors’ offices and community or-ganizations could more easily give interested patient shots without worrying about spoiling additional doses. \nIn that hearing, Dr. Kessler expressed the Administration’s \nstrong desire and efforts to move forward on both of those goals. But recent reporting suggests that this might no longer be the case. Dr. Fauci, can you assure me that the Administration is doing all it can to encourage the production of smaller vials and smaller batches as soon as possible? And what steps are being taken and what is your anticipated timeline for changes like this? \nDr. F\nAUCI . Well, thank you for that question, Senator. That is \nnot really in my area of activity. I believe that is more of an FDA question. \nSenator B\nALDWIN . Well, Dr. Woodcock, please. \nDr. W OODCOCK . Certainly. And between ASPER and FDA, right. \nBasically, to do that, we need to get the manufacturers to change how they are manufacturing the drug and what the storage condi-tions might be and things like that. And I think heroic efforts are being made to try and get a vaccine—get vaccines that don’t re-quire deep freezing storage conditions and that could be then bro-ken up into smaller groups and stored in, say, a pediatrician’s of-fice refrigerator. \nI mean, that is the idea here, that—so that pediatricians and \nothers could—primary care, at the pharmacy, at the nursing home pharmacy, whatever, as new people come in, they could vaccinate them without wasting large amounts of vaccine or having to break into something in the deep freeze. \nThose efforts are arduously going on. They are highly technical, \nthough, and they aren’t simple. And I think the Government and the manufacturers are both united in realizing this is necessary. \nSenator B\nALDWIN . Thank you. \nThe C HAIR . Thank you. \nSenator Tuberville. Senator T\nUBERVILLE . Thank you very much. Thank you for being \nhere today, testifying. Dr. Walensky, you have been in your current post since January. You are in the top position, and you surely have heard critiques of the job the CDC has done so far in each— this Administration, even the last, you usually learn from some things that happened in the past. What would you say to those who look to the CDC and say that change is needed, that perhaps the agency needs a bit of restructuring? \nDr. W\nALENSKY . Thank you for that question. Certainly during— \nSenator T UBERVILLE . What would you do different? \nDr. W ALENSKY . What would I do differently? You know, certainly \nduring the times of pandemic, I came in on January 20th. We had our pedal to the metal, shall we say, moving forward to try and do \n65 \neverything that we could to get us out of the pandemic. We have \nmade a lot of progress. We have had to be humble about what this virus can do. And a lot has changed just in the last 6 months. We need a public health infrastructure in this country that allows CDC and our state and local health departments to be prepared for a pandemic. \nIn that process of restructuring, we need long term disease diag-\nnostic funding that isn’t like a roller coaster that comes with one pandemic and, or one infectious disease threat and disappears when that threat is gone. We are going to be dealing with this— when, God willing, everybody is vaccinated and people are well and the pandemic is largely behind us, we have long COVID, we will have boosters to be thinking about, we will be dealing with mental health issues for a very long time to come and we need the public health infrastructure to do so. That would be my biggest—my big-gest task and change. \nSenator T\nUBERVILLE . Thank you. Dr. Woodcock, FDA currently \nhas emergency use authorization for three COVID vaccines, but they have not yet received the full FDA seal of approval. What would you say to the vaccine hesitant people who don’t feel com-fortable taking a vaccine that hasn’t been fully FDA approved? \nDr. W\nALENSKY . Well, first of all, I would say we did not cut any \ncorners in these 30,000 patient trials and these 44,000 patient trials and all the surveillance you have been hearing about of po-tential rare side effects. So compared to other vaccines they would be looking at, these have really gotten the full court press as far as evaluation and study. \nThey have gone through the FDA process, and they have gone to \nthe ACIP, the CDC’s advisory committee, and strongly rec-ommended that people take them. That said, it is public that one of the companies put a marketing application before us and we are going to do everything we can to review that in a timely manner. But, of course, I can’t say anything more about that. \nSenator T\nUBERVILLE . What kind of timeline, do you think, that \nwe will have full approval? \nDr. W ALENSKY . That is the kind of thing I can’t talk about. \nThank you. \nSenator T UBERVILLE . Thank you. Dr. Fauci, we have made this \nway too political—this has been tough on the American people. We all know that. Everybody has worked hard to try to get through this. Politics has played a huge role in this. We have all watched it from close and afar. \nBut I think people need a unifying message from all of us. Be-\ncause in my State of Alabama, we don’t have everybody taking a vaccine and we are having outbreaks as we speak. We have had Operation Warp Speed General Perna here in a committee hear-ing—not in this Committee, but in other committee. He took a beating saying how poorly a job he did. And the American people saw that. \nA lot of people voted for Donald Trump and a lot of people in the \nSouth, a lot of people in my state, and we have to have a unified message. We can’t be blaming this or that. We have got to go North with this. We can’t go South. We can’t go the other direction. \n66 \nDr. Fauci, can you understand unless this Administration ac-\nknowledges the efforts of the last one, a large part of Americans, they are going to continue to feel like nothing is positive. They are not going to take the vaccine. You understand what I am saying? \nDr. F\nAUCI . I understand exactly what you are saying, Senator. \nAnd thank you. That is a very appropriate question that I would be pleased to answer. Having been present through the last year, which was the year when COVID began, the last year of the former Administration, I can tell you that no doubt that the former Ad-ministration deserves a considerable amount of credit for the effort that was put into Operation Warp Speed that was able to allow not only the rapid development and testing, but also the implementa-tion of the vaccine. \nThere is no doubt in my mind, as someone who has been on both \nsides of the fence, to say that is the case. But with regard to a uni-fying message, if I might, sir, I think what we need to appreciate is that we are dealing with a common enemy and the common enemy is the virus. The virus doesn’t know if you are a Republican, Democrat or Independent. The virus just knows that it makes peo-ple ill and it kills people. \nWe have an extraordinarily efficient tool against that common \nenemy. And what I would hope the message would be, the unifying message is let’s all pull together and utilize that tool, which is vac-cination, to really crush that common enemy. I think we have it within our capability to do it. And I would hope that would be the message. \nSenator T\nUBERVILLE . Positive attitude plus effort equals perform-\nance. And if we keep that positive attitude, we can get through this thing. We just need to quit fighting in the media and get everybody believing in the same thing. We are all on the same team. Thank you very much. \nThe C\nHAIR . Thank you. \nSenator Hickenlooper. Senator H\nICKENLOOPER . Thank you, Madam Chair and Ranking \nMember. Thank you, Coach. I appreciate that. The belief in the positive attitude. As someone who was a part of many scientific de-bates back in my salad days, it just—it makes—it increases my re-spect beyond what I can say in words of how well you have gone through the intense debate, because these are life and death deci-sions you have to make oftentimes where there was conflict among the science, and we were trying to get the facts assembled and sort-ed and prioritized as quickly as we could. \nBefore I even ask any questions, just let me say that my ques-\ntions are always toward a unified future. But I want to make sure I recognized how well you have each served your Country under very difficult circumstances. So, and I don’t know, Dr. Fauci, how many of these types of hearings have you been in so far? \nDr. F\nAUCI . \n[Technical problems.] \nSenator H ICKENLOOPER . Yes. So just to look at the intensity by \nwhich you focus on the answers is remarkably impressive and I want to express my gratitude and our gratitude. I guess first with Dr. Walensky and Dr. Fauci together, we saw yesterday the Pediat-\n67 \nrics Academy talk about kids older than two wearing masks. We \nknow that kids 12 and older should be getting vaccinated. \nWell, just quickly, just to give you a platform to talk about that \nunified message, what should schools be thinking about and who should they be talking to get ready? Obviously, the more kids we can get that are over 12 and older, the more we get them vac-cinated, there can be—they will be fully protected by the time they get to school in the fall, if we start now. \nWhat does that message look like—would be a couple of—Dr. \nWalensky why don’t you start then Dr. Fauci can fill in. \nDr. W\nALENSKY . Thank you for that question, Senator. First of all, \nI want to lean in and say I think it is critically important that our schools be open for full in-person learning in the fall. We have learned enough over the last year to understand what we need to do to keep our children safe. And we believe based on the science, that we can keep them safe in those settings. How are we going to keep them safe? \nThe first and foremost is the best thing would be to have every-\nbody vaccinated who can be vaccinated. Surround unvaccinated children who are no longer—who are not yet eligible, with people who are vaccinated to protect them. So that is the highest and most important thing. For those children who are not able to be vaccinated, they can and should wear a mask in those school set-tings. And we have said that in our guidance. \nI want to also comment on one other thing, and that is that I \nthink is critically important in the school year coming ahead and that is the role of testing. Senator Burr has talked about the im-portance of other viral syndromes, flu, influenza. We are going to see upper respiratory infections in these schools in the fall. These kids have not been in school. \nThey have not been with each other. And I am worried about the \nupper respiratory infections. And we are going to have to under-stand what is COVID and what is a simple cold among children. So those are among the things that I am thinking about. Thank you. \nSenator H\nICKENLOOPER . Great. Thank you. Nothing to add? \nDr. F AUCI . Nothing to add. That was a very good explanation. \nSenator H ICKENLOOPER . You have become a good—an admirable \nteam. Dr. Woodcock, some of the FDA reports on—is it pronounced Adulhelm? Biogen’s new Alzheimer’s drug I think are very con-cerning. Last week, there was an expert panel convened by the In-stitute for Clinical and Economic Review unanimously concluded that it wasn’t—it wasn’t efficacious, it didn’t provide a benefit for patients with Alzheimer’s and certainly wasn’t worth the price tag. And I know that I saw a couple—I was researching or reading my briefs from my remarkable staff last night that it could have been handled differently. How specifically differently should the FDA have looked at this? \nDr. W\nOODCOCK . Well, a lot of the confusion is in some of the con-\ntroversy is simply what you said, this is an accelerated approval. That means it was approved on a surrogate endpoint that we be-lieve is reasonably likely to predict clinical benefit. So the conclu-sion that you just referred to is not surprising, Okay, because they haven’t definitively shown benefit. \n68 \nNow, Congress has urged us to use the accelerated approval \npathway for life threatening diseases that don’t have any effective therapy. Alzheimer’s is one. I think part of the issue was that it was brought to an advisory committee and proposed for traditional approval, not on a surrogate endpoint. The advisory committee more or less conclusively shut that down. And so the agency went back and looked at all the data on the surrogate endpoint, which is clearing out the Alzheimer’s plaque, the amyloid plaque from the brain. \nThey found that correlated with benefit, benefit meaning slowing \na decline of deterioration of thinking, right. And so with Malta looking at other programs with other antibodies to do the same thing, they concluded that this clearing out of a plaque was reason-ably likely to predict clinical benefit, right. But not—doesn’t defini-tively mean that there is a clinical benefit. So I think with such a prevalence—it is very common in cancer. It is well accepted. \nThat is how we approved HIV drugs from the very beginning, al-\nright. And that was a very big success story. That is how we ap-prove many drugs for rare diseases. But this is a common disease and almost everyone probably in this room has had a relative—. \nThe C\nHAIR . Dr. Woodcock, thank you. We do have votes called \nand we have got to finish our hearing. So I appreciate the response. \nDr. W OODCOCK . I am sorry. \nThe C HAIR . Thank you. \nSenator Burr. Senator B\nURR. Thank you, Madam Chair. Let me say, Dr. \nWoodcock, I think the decision that FDA made relative to surrogate endpoints is exactly that forward leaning approach that we envi-sion when we created that expedited pathway. And I applaud the decision. I look back at HIV, who Tony Fauci was very involved in, and had we not done similar things then, we wouldn’t have found the keys that unlock doors that we needed. \nI want to turn to Dr. Walensky for just a second. I just want to \nask a quick follow-up on breakthrough. And Dr. Fauci, I under-stood what you said about the NIH following the clinical trials over a two-year period as it relates to breakthrough. That is important. It is not important from a standpoint of today and the decisions that we make. It is my understanding that CDC is only tracking breakthroughs that result in hospitalization. Is that accurate? \nDr. W\nALENSKY . No, it is not. So that is in passive surveillance, \nwhich is, as I mentioned earlier, not the best way to track these breakthroughs and one of the limitations of our passive surveil-lance system, which is why we are collecting longitudinal data in tens of thousands of people, some of whom are getting PCRs so that we can check each test for asymptomatic breakthroughs as well. \nSenator B\nURR. Okay. I think it is extremely important that we \nbe as specific on breakthrough exposures. One of the last tools that we have is, yes, you may get vaccinated, but you may become in-\nfected, and you are going to have to prove the data that says you probably won’t go to the hospital, and you certainly won’t die. So without that data, you are in a very weak situation. So I would en-courage you to build that data base. I am going to take a couple \n69 \nof minutes to make an editorial, and it really gets to the heart of \nsupply chain. \nMs. O’Connell, this is going to fall in your lap. And this is some-\nthing that the Chair and I and the Committee are going to deal with. You talked about a warm base. I know the target for what we want in the strategic national stockpile. Here is the reality. Federal purchases are 4 percent of PPE. And for us to set up a sus-tainable supply chain, it means that you have to compete with dumping practices of China on N95 masks. You have to compete with competition from around the world. \nI think, I know Janet and Tony understand that the memory \nspan of a Member of Congress is about 18 to 36 months. After that, we sort of forget about the last incident that we went through and where we look at it and say, well, why are we funding to keep the lights on in this N95 mask facility. We don’t need any more N95 masks. And the problem is that the 96 percent of the purchasers providers across the country have now turned to the lowest cost competitor, which is probably not the warm base facilities that we have got. We have got to come up with a solution to this, and I want to work with you. \nI want to work with the White House. Because I have gotten to \na point through a process of elimination as to what won’t work, faced with the realities of Congress’s inability to continue to fund indefinitely things that don’t produce something tangible. We have had to put BARDA on life support three different times because members didn’t see a need for it. Thank God we were able to keep it resuscitated. \nI am not sure that there is a way to do this without creating an \nAmerica’s trading bloc, where we incorporate North and South America together, where we incorporate the low cost, low labor areas of Central America, where textile companies already have a presence, where companies could move automatic N95 masks, and not just warm base them, but actually let them compete with China in the open marketplace and sell to the rest of the world, and invite the EU and invite Australia and invite Africa and India to be part of the America’s trading bloc where we can expand. \nAs Janet knows, we have had problems with Brazilians on \nknocking off pharmaceutical manufacturing down there for years. Let’s turn them into a part of our inventory of assets where we can turn to vaccine production down there, pharmaceutical production down there, raw materials of South America. \nIf not, then show me something that is sustainable without the \ncondition of Congress coming in and funding at the tune of hun-dreds of billions of dollars on an annual basis to keep that supply chain for us as a purchaser of only 4 percent. Somehow we have got to—we have got to present to the other 96 percent a domestic manufacturing capability that makes them competitive against China even with China’s dumping practices. \nI sort of lay that on the table. It won’t be the first time Tony has \nlooked at me and said, you come up with something crazy, but I am in the business of trying to find solutions that are sustainable. And it will only happen if we think outside the box on this. We thought outside the box with surrogate endpoints and Janet, well down the road people don’t die of HIV. They extend their lives. \n70 \nMaybe the keys we find are actually cures in the future, mRNA \ntechnology platform, Tony. We may be curing cancer off of that platform two, three, four years down the road. I wonder what the person who didn’t like mRNA for the vaccine for COVID think when they have got prostate cancer and they have got a cure on an mRNA platform? I think they are going to take it. \nEverything is going in our favor, but this is absolutely crucial to \nour assurance to the American people and to the American econ-omy and manufacturers that we are going to put them somewhere, in a system that is sustainable for the future. I thank you for lis-tening to me and I thank the Chair. I yield back. \nThe C\nHAIR . Thank you, Senator Burr. Appreciate that. That will \nend our hearing for today. And I want to thank all of our col-leagues, our witnesses, Dr. Walensky, Dr. Fauci, Dr. Woodcock, Ms. O’Connell, Assistant Secretary O’Connell, for such a thoughtful dis-cussion about our ongoing response to this pandemic and the path forward. \nWith that, for any Senators who wish to ask additional ques-\ntions, questions for the record will be due in 10 business days, Au-gust 3rd at 5 p.m. The hearing record will also remain open until then for Members who wish to submit additional material for the record. \nThe Committee will next meet tomorrow, July 21st, for an execu-\ntive session to consider the Family Violence Prevention and Serv-ices Improvement Act of 2021 and the nominations of Catherine Lhamon to be Assistant Secretary for Civil Rights at the Depart-ment of Education, Lisa Brown to be General Counsel of the De-partment of Education, Roberto Rodriguez be Assistant Secretary for Planning, Evaluation and Policy Development at the Depart-ment of Education, David Weil to serve as Administrator of the Wage and Hour Division at the Department of Labor, and Gwynne Wilcox and David Prouty to serve as members of the National Labor Relations Board. \nAgain, thank you to all of our witnesses today. With that, this \nCommittee does stand adjourned. \nQUESTIONS AND ANSWERS \nRESPONSE BY DR. ROCHELLE WALENSKY TO QUESTIONS OF SENATOR CASEY , SENATOR  \nBALDWIN , SENATOR HASSAN , SENATOR BURR, SENATOR BRAUN , AND SENATOR  \nTUBERVILLE  \nResponses to the QFRs are accurate as of the date of the hearing . \nSENATOR CASEY  \nQuestion 1 . Even as the vaccination campaign continues—whether it is reaching \npeople who thus far have been reluctant to get vaccinated, or hopefully expanding the campaign soon to include younger children—testing remains an important tool in our fight against COVID–19. Especially given that younger children are not yet eligible for vaccination, and with the rise of the Delta variant, testing continues to be a pressing need to ensure that cases are caught early to break the chain of trans-mission—or to rule out COVID–19 when someone is showing symptoms that are common to different illnesses. How is CDC working with local public health officials, \nhealth care providers, employers and schools to support robust testing regimes, and what do those recommendations look like currently? \nAnswer 1. CDC is actively engaging with our state, tribal, local and territorial \npublic health partners and with K–12 schools to support implementation of robust \n71 \ntesting programs. CDC guidance on testing can be found here: https:// \nwww.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html . \nCDC has provided specific technical assistance (TA) on testing and/or deployed \nteams to jurisdictions and school districts who have requested assistance. Support is provided through technical assistance calls, sharing of resources, and creating connections with their state or local school testing teams at the health department or referrals to other opportunities for Federal testing support, such as the HHS Testing and Diagnostics Work Group. \nCDC is also partnering with jurisdictions interested in exploring various ways to \nexpand access to testing and incentives to test in populations they have identified as likely to benefit from additional testing. This includes factors such as current proximity to testing sites, area percent test positivity or case burden, and other fac-tors such as social vulnerability index scores. Pilot activities have explored expand-ing testing in high density workplaces, using pop-up testing in retail sites in the communities, and event-based testing where testing is offered in conjunction with previously scheduled or well-known events or gatherings. As an example, the Race to End COVID project at the Talladega Superspeedway, sponsored by Talladega Superspeedway, the Alabama National Guard, the U.S. Department of Health and Human Services, the CDC Foundation, and the Alabama Department of Public Health, offered an incentive to drive two laps around the track behind a pace car to all participants who were tested or vaccinated at the pop-up site hosted by the \ntrack. The lessons learned from these pilots will be disseminated to inform other jurisdictions who are seeking ways to expand testing availability and desirability within their populations. \nStarting in mid-May, one-on-one TA calls were held with 46 health departments \nto discuss their testing plans for summer schools and summer camps as well as their plans to offer screening testing to K–12 schools in their jurisdiction using CDC Epidemiology and Laboratory Capacity (ELC) Reopening Schools cooperative agree-ment funds. \nQuestion 2 . Earlier this year, I sent a letter with Senator Wyden, Senator Tim \nScott, and Senator Crapo, calling on CDC to publicly release data that have been provided to the Federal Government by CVS and Walgreens in relation to the Long- Term Care Partnership (LTC Partnership). The LTC Partnership data is the only real time accounting of the COVID–19 vaccine rollout from the beginning, and ex-perts have testified to Congress that it is critical to understanding how the distribu-tion of vaccines proceeded, as well as the racial, economic and geographic equity of the COVID–19 vaccine distribution. As the bipartisan letter noted, releasing such information retrospectively will help researchers and policymakers analyze issues such as the speed and equity of vaccine distribution, and the vaccine’s role in reduc-ing disease and death in nursing homes. One need look no further than your agency for proof of the data’s usefulness—CDC shared the LTC Partnership data with states, and used the data for its own public-facing research. Please provide me with all facility-level vaccination data that has been transmitted to CDC by the LTC Partnership since December 2020. Please provide these data no later than August 20, 2021. \nAnswer 2. CDC has been in communication with your staff regarding this data \nrequest. \nQuestion 3 . There is concern that cases of influenza this coming winter season will \nbe significantly higher than last year. Is there an opportunity to encourage in-creased uptake of both flu and COVID–19 vaccines in the coming months, and what would need to occur to make that happen, in terms of patient and provider edu-cation, vaccine distribution plans, etc.? \nAnswer 3. This influenza (flu) season, CDC will expand education efforts to pro-\nmote flu vaccination, including among groups of people for whom vaccination is es-pecially important, such as people with underlying health conditions, pregnant women, children under 3, and people within racial and ethnic minority groups, which typically have lower vaccine uptake. CDC is investing an additional $150 mil-lion to continue to build community engagement around COVID–19 and flu vaccina-tion among racial and ethnic minority groups. \nIn addition, CDC has planned outreach through social media, press conferences, \nweb page spotlights, radio media tours, op-eds, and other publications. A digital campaign will launch to educate the public and people who are at increased risk from influenza and COVID–19 complications about the importance of vaccination. Finally, CDC will support a special campaign to inform the general population, with a focus on Black/African American and Hispanic/Latino audiences, about the impor-tance of flu vaccination. \n72 \nSENATOR BALDWIN  \nQuestion 1 . The CDC is updating its variant tracker once every 2 weeks. Please \nprovide additional information regarding CDC’s plan to increase the frequency of this reporting, improve the granularity of data provided, and work with state and local health departments to enhance sequencing efforts on the ground. \nAnswer 1. CDC reports variant proportion data on two-week time intervals with \nplans to increase frequency in the coming weeks. CDC developed guidance for state and local public health laboratories to ‘‘tag’’ sequences submitted to public data bases that were generated through state-level baseline genomic surveillance efforts. By tagging these sequences, CDC can incorporate these sequence data into the na-tional analysis of variants. Integration of surveillance across the U.S. maximizes the sequencing capacity, expertise, and available data across the U.S. that is available to inform public health decision-making. \nTo improve the detection, monitoring, and mitigation of COVID–19 variants, the \nAmerican Rescue Plan invested $1.7 billion to help the CDC, states, and other juris-dictions more effectively detect and track variants by scaling genomic sequencing ef-forts. This one-time funding is supporting CDC and state and local public health to increase the use of sequencing in the U.S. public health system. The information from sequencing allows CDC and state and local public health leaders to respond to emerging infectious threats more effectively. Sequencing technology is used not only to help in the detection and prevention of COVID–19, but also with most other infectious disease threats. The CDC Advanced Molecular Detection (AMD) program was established in 2014 and has been funded by Congress at $30 million per year, to incorporate sequencing and relevant technologies into public health and has been applied to food safety, emerging infections, biosecurity, antimicrobial resistance, and many other pathogens. CDC has also funded 29 universities to conduct genomic sur-veillance research in collaboration with public health agencies. The studies are meant to provide deeper insights into viral genomics and molecular epidemiology within the various regions across the country. \nSENATOR HASSAN  \nRecently, deeply disturbing reports have been published detailing dangerous in-\nequities that USA Paralympians are facing at this year’s Tokyo Paralympics. \nBecca Meyers is a six-time Paralympic medalist who won three golds in Rio 5 \nyears ago. She is deaf and blind, but in the past that hasn’t stopped her from com-peting—and winning—at the highest levels. \nThis year, though, she and other athletes from Team USA who experience disabil-\nities are being denied adequate access to personal care assistants, reportedly due to COVID–19 restrictions. \nIndividuals who experience disabilities should not be forced to navigate the Tokyo \nOlympics without the support they need in the midst of a global pandemic. \nBecca announced on Sunday that she is quitting the team because she is being \ndenied a, ‘‘reasonable and essential accommodation’’ that would enable her to com-pete. \nThis is an outrage—and an entirely preventable situation. The US Olympic & Paralympic Committee must work immediately to address this \nissue, and ensure that all of our athletes are able to compete safely at this summer’s games—including by providing them the basic supports they need to navigate the world. \nQuestion 1 . Director Walensky, over the last year and a half, the CDC has pro-\nvided guidance on how to mitigate the risk of COVID–19 in various activities, as well as special events—including sports. Understanding that the CDC does not have jurisdiction over specific safety measures taken by the US Olympic & Paralympic Committee, can you please explain how COVID–19 mitigation efforts take into ac-count the needs of people who experience disabilities? \nAnswer 1. We know that most people with disabilities are not more likely to be-\ncome infected with or have severe illness from COVID–19. However, some people with disabilities might be more likely to get infected or have severe illness because of underlying medical conditions, residing in congregate living settings, or systemic health and social inequities. \nCDC is currently providing $93 million to the Administration for Community Liv-\ning (ACL) within HHS to administer grants to aging and disability networks in every state and territory. These funds are providing assistance to older adults and people with disabilities for scheduling vaccine appointments, transportation to vac-\n73 \ncine sites, direct support services needed to attend vaccine appointments, connection \nto in-home vaccination options, and education about the importance of receiving the vaccine to older adults and people with disabilities. This partnership is also pro-viding an additional $5 million in funding to stand-up and maintain a new Dis-ability Information and Access Line (DIAL) to help people with disabilities find vac-cination locations in their communities, assist callers with making vaccination ap-pointments, and connect callers to local services. \nCDC partners with state, territorial, local, tribal partners, and community-serving \norganizations to support communities at higher risk for COVID–19. For example, \nCDC is partnering with FEMA, CDC Foundation, Georgia Tech Center for Inclusive Design and Innovation, University of North Carolina Center for Literacy and Dis-ability Studies, DeafLink, and National Association of State Directors of Develop-mental Disabilities Services, to provide COVID–19 guidance and resources for peo-ple with disabilities and care providers. There is a need for guidance and resources that are tailored for people with disabilities and their care providers. This project aims to compile and develop guidance and tools to help people with disabilities and those who provide services or care for them make decisions, protect their health, and communicate with their communities. The tools and guidance developed in this project reflect what CDC has learned about the needs of people with disabilities and care providers from partners and listening sessions, projects, and research efforts. Following the launch of the CDC Toolkit for People with Disabilities web page (https://www.cdc.gov/coronavirus/2019-ncov/communication/toolkits/people-with- \ndisabilities.html ), we gathered feedback from partners indicating a need for more in-\nformation geared toward people with disabilities related to vaccine access, accessible vaccination sites, and accessible communications products/web resources to develop web content, fact sheets and one-pagers, scheduling language, and a promising prac-tices document on vaccination access for people who have challenges leaving their home. As a result, we began the integration of information related to people with disabilities as well as social media and web-based graphics that reflect varying dis-abilities throughout the CDC sites instead of just on disability-related webpages. \nAnother collaborative project involving CDC Foundation and Georgia Tech Center \nfor Inclusive Design and Innovation is developing accessible materials and culturally relevant messages for people with disabilities. The project focuses on people with disabilities, as well as caregivers of people with disabilities, and organizations serv-ing people with disabilities to deliver essential COVID–19 information. The project helps to ensure that COVID–19 guidance is not only accessible to people with dis-abilities, but also that it is culturally appropriate and relevant to the challenges people with disabilities face during emergency response situations such as COVID– 19. \nSENATOR BURR  \nQuestion 1 . Is CDC tracking the number of individuals who got vaccinated that \nwere previously infected with COVID–19? \nAnswer 1. CDC uses seroprevalence surveys to estimate the proportion of the pop-\nulation that has antibodies as a result of vaccination, infection, or both. Both vac-cination and infection result in production of antibodies. By using a combination of antibody tests and vaccine history, we can distinguish if someone has been infected, vaccinated, or both. \nCDC is working with national blood collection organizations to estimate the num-\nber of vaccinated persons that were previously infected based on vaccine history and antibody testing. We are analyzing these data and working to publish soon. \nCDC is modifying its national commercial laboratory survey to capture similar in-\nformation and hopes to implement this during the upcoming months. \nQuestion 2 . If not, how is CDC estimating the actual level of immunity—both nat-\nural immunity from having COVID–19 and the immunity provided by vaccination— to get a full picture of the road ahead to protect our communities? \nAnswer 2. CDC is currently estimating the level of immunity through the \nseroprevalence studies described above. The type of antibodies detected can deter-mine if the person has antibodies because of past infection or due to vaccination alone. In addition, CDC currently has a manuscript in production that assessed SARS-CoV–2 seroprevalence related to infection and vaccination in the US popu-lation. \nQuestion 3 . Is CDC tracking reinfection rates for those that have been previously \ninfected with COVID–19? \n74 \nAnswer 3. CDC is using several data sources to understand reinfections including \ncohort studies, review of big data from electronic health record systems, and by working with local jurisdictions as they link cases over time. In terms of surveil-lance, CDC is working closely with public health jurisdictions and the Council of State and Territorial Epidemiologists (CSTE) to update the national surveillance case definition of COVID–19 and enable states to count repeat infections in the same individuals over time. This information will be included in the approved posi-tion statement 21-ID–01 titled ‘‘Update to the standardized surveillance case defini-tion and national notification for 2019 novel coronavirus disease (COVID–19).’’ The rate of reinfections depends on both the level of protection by previous infection, for which there is increasing evidence, and the general rate of infections in the popu-lation, which is highly variable. Unlike ascertaining vaccine status, ascertaining prior infection status relies on data systems linking multiple episodes in local juris-dictions or on widespread sequencing. \nQuestion 4 . Can T-cell testing be used to gain better insight in to how COVID– \n19 variants interact with immunity from previous infection or vaccine? \nAnswer 4. SARS-CoV–2 T cell assays are very complex, and therefore are not \nwidely available. Individuals cannot obtain these tests from health care providers. T cell studies can be performed in a research setting. However, we do know that T cells contribute to immunity. Preliminary studies indicate that vaccines generate T-cell immunity, and it is maintained against variants. Ongoing studies are being performed to understand T-cell immunity better. \nQuestion 5 . According to CDC, 74 percent of hospitalized or fatal breakthrough \ninfections occurred in individuals 65 and older. Is CDC tracking how many of these individuals have other conditions that may make them more susceptible to severe illness from COVID–19? \nAnswer 5. The best data for this come from the Coronavirus Disease 2019 \n(COVID–19)-Associated Hospitalization Surveillance Network (COVID-NET), be-cause it has more comprehensive and complete information on underlying medical conditions among hospitalized patients. \nCOVID-NET is a population-based surveillance system that collects data on lab-\noratory-confirmed COVID–19-associated hospitalizations among children and adults through a network of over 250 acute-care hospitals in 14 states covering approxi-mately 10 percent of the U.S. population. Preliminary data from COVID-NET show, among all COVID–19-associated hospitalizations, approximately 29 percent of all vaccinated cases are immunocompromised compared to 11 percent of all unvaccinated cases. Additionally, approximately 68 percent of vaccinated hospital-ized cases have 3 or more underlying medical conditions compared to 52 percent of unvaccinated cases. For adults ages 65 years, 32 percent of all vaccinated hospital-ized cases are immunocompromised compared to 13 percent of unvaccinated hos-pitalized cases. For adults ages 65 years, the proportion of vaccinated hospitalized cases (74 percent) is not significantly different from the proportion seen in unvaccinated cases (69 percent). \nFor national surveillance, 7,525 vaccine breakthrough infections among people \nwho were hospitalized or died were reported as of August 2, 2021. Of those, 2,895 (38 percent) had one or more of the following conditions noted: pregnant, diabetes, renal disease, liver disease, autoimmune disease, immunocompromised, or immuno-suppressive medication. However, another 3,352 (45 percent) were missing data re-garding one or more of these underlying conditions. In addition, national vaccine breakthrough surveillance does not collect information on other underlying medical conditions (e.g., obesity, cardiovascular disease, or pulmonary disease) that have been associated with more severe COVID–19 disease but are not presumed risk fac-tors for a vaccine breakthrough infection. \nOf note, of the 7,525 reported vaccine breakthrough infections among people who \nwere hospitalized or died, 5,557 (74 percent) were aged 65 years, including 3,704 (49 percent) who were aged 75 years. Therefore, a large majority likely have one or more underlying medical conditions that might reduce their response to vaccina-tion and/or increase their risk for severe COVID–19 disease. \nThe number of COVID–19 vaccine breakthrough infections reported to CDC \nthrough national surveillance likely are an undercount of all SARS-CoV–2 infections among fully vaccinated persons. National surveillance relies on passive and vol-\nuntary reporting, and data might not be complete or representative. These surveil-lance data are a snapshot and help identify patterns and look for signals among vac-cine breakthrough cases. \nQuestion 6 . CDC stated that children who are eligible for the COVID–19 vaccine \ncan get their routine vaccinations at the same time as their COVID–19 vaccine. \n75 \nLooking to the fall and a potential need for boosters, can a person receive the flu \nshot and the COVID–19 shot at the same time? \nAnswer 6. COVID–19 vaccine and other vaccines may be administered on the \nsame day, as well as any interval without respect to timing ( https://www.cdc.gov/ \nvaccines/covid-19/downloads/summary-interim-clinical-considerations.pdf ). How-\never, some additional guidance related to co-administration of COVID–19 vaccines and influenza vaccines specifically is under consideration for the upcoming Preven-tion and Control of Seasonal Influenza With Vaccines: Recommendations of the Ad-visory Committee on Immunization Practices (ACIP)—United States, 2021–2022 In-fluenza Season. CDC will provide a further update when available. \nSENATOR BRAUN  \nQuestion 1 . Can you please provide specific updates on your plans to ensure that \nnursing home staff and residents have sufficient point of care molecular diagnostics and access to the most appropriate prophylactics and treatments? \nAnswer 1. Long-term care facilities (LTCF), such as nursing homes, are high-risk \nsettings for residents, staff, volunteers, and visitors. Case and death rates for LTCF staff and residents have declined sharply since mid-December 2020 when vaccine rollout began. Recent outbreaks, including those linked to variants and/or break-through cases, further stress the need to vaccinate residents and staff, including vaccinating new residents and staff given relatively high turnover in both cat-egories, and continue to implement appropriate infection prevention and control (IPC) practices effectively and consistently. \nMore than 80 CDC teams have deployed to LTCFs to investigate outbreaks, as-\nsess staff and supply shortages, and recommend IPC measures. Additionally, CDC maintains guidance specifically for nursing homes and long-term care facilities around IPC practices and the appropriate use of testing which are both essential to quickly detect, identify, and prevent the spread of SARS-CoV–2 infections in LTCFs. \nCDC continues to provide resources and information on our website and for pa-\ntients and healthcare providers regarding the availability of monoclonal antibody treatments and other COVID–19 therapeutics for certain patients at high risk of disease progression. \nCDC is working to rapidly characterize emerging variants to understand the po-\ntential impacts on critical SARS-CoV–2 medical countermeasures (e.g., vaccines, therapeutics, and diagnostics). CDC provides updated information on variant classi-fications and definitions as well as the national prevalence of variants of interest and concern. These data and other clinical considerations are being used by the Of-fice of the Assistant Secretary for Preparedness and Response (ASPR) within HHS and other Federal and state partners to inform decisions regarding distribution and allocation of testing supplies, therapeutics (i.e., monoclonal antibodies), and personal protective equipment (PPE) supplies to help jurisdictions and their nursing homes. CDC continues to update its information and resources as new science becomes available. CDC also continues to work closely with the Centers for Medicare & Med-icaid Services (CMS) within HHS and jurisdictions to provide technical assistance and support to nursing home facilities across the U.S. through current CDC pro-grams and those stood up as part of the ongoing COVID–19 response. This also in-cludes hosting webinars, Clinician Outreach and Communication Activity (COCA) calls, and engaging LTCF partners to provide the latest information. \nQuestion 2 . Due to mandatory lockdowns, limited doctor office, clinics and emer-\ngency room visits, there has been a rapid decline in routine health screenings such as HIV/AIDS. Your agency found that at just one commercial laboratory system, comparing a six-month period in 2019 to 2020, they reported nearly 700,000 fewer HIV screening tests completed and about 5,000 fewer confirmed HIV diagnoses. This is reflective of what has happened across the country: HIV testing is greatly reduced due to patients not accessing healthcare and health departments moving resources to COVID. \nQuestion 2(a) . This is especially troublesome because as we know, early detection \nand getting patients on a treatment plan is critical to limiting the spread of HIV/ AIDS. Will you commit to keeping this Committee updated on HIV screening levels? Will you commit to developing a plan to encourage Americans to visit their local healthcare provider for routine screenings? \nAnswer 2. Yes, and thank you for asking this important question. After an initial \ninterruption of key HIV prevention activities due to the pandemic, jurisdictions rap-idly prioritized surveillance activities and many scaled up self-testing and mobile \n76 \nHIV testing activities. These innovations could help overcome longstanding barriers \nto prevention by providing testing in locations beyond traditional testing venues. Al-though overall HIV testing declined in 2020, 2021 HIV testing year-to-date is back on track. \nAnswer 2(a). CDC will keep the Committee updated on progress related to HIV \nscreening and testing in the U.S. Through CDC’s core HIV programs and our role in the Department of Health and Human Services-wide initiative, Ending the HIV Epidemic in the U.S., CDC is committed to making testing accessible, convenient, and routine by scaling-up self-testing, making HIV screening a regular part of health care, and increasing testing in non-traditional settings, such as correctional facilities and syringe services programs. \nQuestion 3 . Congress has provided a substantial amount of funding for COVID \ntesting—nearly $50 billion in the American Rescue Plan alone, plus tens of billions of dollars more last year. A significant amount of testing money appears to be unspent. This is concerning, given that we are hitting a vaccine wall and cases are on the rise due to the delta variant. We need to ensure that our capacity for testing remains high going into the fall and winter. \nQuestion 3(a) . How much money remains for COVID testing from the American \nRescue Plan? \nQuestion 3(b) . How much money remains for COVID testing appropriated in 2020? \nQuestion 3(c) . What is the Administration’s plan for the remainder of the COVID \ntesting funds? How and when will this money be spent? \nAnswer 3(a), 3(b), 3(c). As of the end of July 2021, of the approximately $95 billion \nidentified by Congress across all COVID supplemental appropriations for testing-re-lated activities, all but $17.5 billion had been allocated to support testing, contact tracing and mitigation activities across HHS. HHS is in the process of allocating the remaining balance for priority activities such as increasing community access to testing and supporting domestic manufacturing capacity of tests and enhancing test-ing capacity in congregate settings. \nIn particular, as of the end of July 2021, the Centers for Disease Control and Pre-\nvention awarded approximately $40 billion of the COVID supplemental funding ap-\npropriated to HHS for broad testing, mitigation and related activities, support for school testing and to address testing-related health disparities in high-risk and un-derserved communities to state, local, and territorial health departments. In addi-tion, CDC had plans in place for additional awards to targeted settings. These funds support a range of activities, including: enhancing testing and mitigation in targeted settings such as correctional facilities, and among homeless populations; expanding the Nation’s disease intervention specialists; supporting infection prevention and control; expanding the Nation’s wastewater surveillance system; and improving lab-oratory data and capacity. \nSENATOR TUBERVILLE  \nQuestion 1 . What would you say to those who look at the CDC and say that \nchange is needed, that perhaps the agency needs restructuring? \nQuestion 2 . What areas or offices specifically do you think could be restructured? \nAnswer 1 & 2. Thank you for the questions. The ability to respond to a public \nhealth emergency requires a strong day-to-day public health system, supported by infrastructure that is not highly segmented by disease, condition, or activity. In ad-dition to the COVID–19 pandemic, over the past 24 months, CDC has also re-sponded to diverse public health threats from E-cigarette or Vaping Product Use- Associated Lung Injuries (EVALI), Ebola, complex multi-state food-borne disease outbreaks, wildfires, and hurricanes. Responding to the unique characteristics of each of these public health emergencies has required deep scientific expertise to de-ploy a specialized approach and called for a robust public health system with world- class infrastructure nationwide to stop disease at its source. Unfortunately, this re-cent history has revealed the effects of an inadequate public health infrastructure. Ongoing health disparities made us as a nation more vulnerable to outbreaks, large- scale public health emergencies, and pandemics as well as burdening large segments of our population with chronic public health concerns. Additional investments in both domestic and global public health and health security infrastructure are need-ed. \nWith investments requested in the fiscal year 2022 Budget, CDC will begin to ad-\ndress mission-critical gaps in public health infrastructure and capacity nationwide. Transitioning from sporadic influxes of supplemental funding tied to a specific emer-gency to flexible funding that can prevent another crisis will strengthen the current \n77 \npublic health system. Flexible, sustainable investments in infrastructure and capac-\nity are critical for saving lives and averting economic losses caused by public health emergencies and chronic public health problems. In fiscal year 2022, CDC will prioritize funding to rebuild the most critical public health infrastructure needed to safeguard the Nation’s health and economic security. \nQuestion 3 . Isn’t it important for CDC to track cases in order to determine the \neffectiveness of the vaccine against COVID? \nAnswer 3. CDC has multiple surveillance systems and ongoing research studies \nto monitor the performance of vaccines in preventing infection, disease, hospitaliza-tion, and death. CDC also collects data on breakthrough infections through outbreak investigations. Examples of CDC’s systems for monitoring performance of vaccines include: The National Healthcare Safety Network (NHSN), HEROES/RECOVER, In-fluenza and Other Viruses in the Acutely Ill (IVY), and the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network (COVID-NET). \nQuestion 4 . Do you consider it misinformation for individuals to share their stories \nof adverse events following vaccination? \nAnswer 4. Millions of people in the United States have received COVID–19 vac-\ncines under the most intense safety monitoring in U.S. history. Communicating timely and transparent information to public health officials, healthcare providers, and the public about the safety of vaccines, including possible adverse events fol-lowing vaccination, continues to be a top priority for CDC. CDC’s communication ef-\nfort will always be based on the scientific evidence and data that we have gathered to-date through different sources, including analyzing our vaccine safety monitoring data and vaccine safety clinical research. \nCDC recommends that individuals who may have experienced an adverse event \nfollowing vaccination speak to their healthcare providers. CDC also encourages any-one experiencing any possible adverse events following vaccination to share this in-formation through CDC and FDA’s vaccine safety monitoring system, Vaccine Ad-verse Event Reporting System (VAERS). When individuals are administered COVID–19 vaccines, they are also given information about the opportunity to reg-ister with CDC’s after-vaccination health checker service, called v-safe. Through v- safe, vaccine recipients can quickly tell CDC if they have any side effects after get-ting a COVID–19 vaccine. \nQuestion 5 . Can you provide the estimated number of reinfections in COVID-re-\ncovered individuals, to the best of the CDC’s understanding? \nAnswer 5. CDC is using several data sources to understand reinfections including \ncohort studies, review of big data from electronic health record systems, and by working with local jurisdictions as they link cases over time. In terms of surveil-lance, CDC is working closely with public health jurisdictions and the Council of State and Territorial Epidemiologists (CSTE) to update the national surveillance case definition of COVID–19 and enable states to count repeat infections in the same individuals over time. This information will be included in the approved posi-tion statement 21-ID–01 titled ‘‘Update to the standardized surveillance case defini-tion and national notification for 2019 novel coronavirus disease (COVID–19).’’ The rate of reinfections depends on both the level of protection by previous infection, for which there is increasing evidence, and the general rate of infections in the popu-lation, which is highly variable. Unlike ascertaining vaccine status, ascertaining prior infection status relies on data systems linking multiple episodes in local juris-dictions or on widespread sequencing. \nQuestion 6 . Can you explain the scientific differences between CDC and WHO rec-\nommendations for masking children under 5 years old? \nAnswer 6. Out of an abundance of caution, CDC recommends masks for children \nolder than age two, carefully weighing the risks and benefits of masking this age demographic. Conversely, most children older than 2 years old do not have any ana-tomic, physiologic, or developmental limitations that should preclude them from wearing a mask safely and effectively. Masks have been shown to be safe in children older than age two. A cohort study among infants and young children in Italy found that the use of facial masks was not associated with respiratory distress or signifi-cant changes in oxygen saturation, including among children age 24 months and younger. In addition, studies suggest that masks are not likely to impact social de-velopment in children. \nAdditional research emerged during the ongoing COVID–19 pandemic with strong \nand consistent evidence demonstrating the effectiveness of mask use among children age 2 years and older in preventing SARS-CoV–2 transmission, especially when it is combined with multiple prevention strategies. \n78 \nQuestion 7 . Can you provide the most recent estimate of the number of COVID \ninfections in children under 18 years old? \nAnswer 7. There were 3,757,699 cases aged 0–17 years during the period, January \n21, 2020—August 17, 2021, based on the aggregate case surveillance system counts, accessed August 18, 2021. \nQuestion 8 . Are you aware of any ongoing studies into the effectiveness of mask-\ning in children under 12 years old? \nAnswer 8. CDC regularly scans the published and pre-print literature as well as \nother sources for research on this topic. CDC uses this information to assess current guidance and whether any amendments are warranted based on that new science. There are data from studies of children, including children under 12 years old, that demonstrate masking provides an additional layer of protection against spread of in-fection in schools. These data are reviewed in this document: https://www.cdc.gov/ \ncoronavirus/2019-ncov/science/science-briefs/transmission-k-12-schools.html . \nQuestion 9 . Funds in part from NIH/NIAID helped build the 12 Regional Bio-\ncontainment Laboratories (RBLs) and 2 National Biocontainment Laboratories (NBL) to support high consequence infectious disease research after 9/11 and the \nanthrax scares in 2001. However, unlike the NBL facilities, the RBL facilities re-ceived no further direct support until last year when Congress provided enhanced investment through NIH/NIAID, targeted specifically to RBL facilities, one of which is at the University of Alabama at Birmingham (UAB) in my state. Nevertheless, it seems as though the RBL infrastructure, most importantly the highly trained staff these facilities maintain and produce is something that falls within the pur-view of the HHS ASPR, considering among other things the UAB RBL has had col-laborations with Altimmune and ImmunityBio for COVID19 vaccine development, and supported BARDA contractors. This type of work strongly aligns with numerous ASPR Strategic Goals, such as Fostering Strong Leadership, and Sustaining Robust and Reliable Public Health Security Capabilities. The RBL infrastructure and per-sonnel is expensive to maintain and operate, and perhaps should not solely rest on either the shoulders of the host University or the NIH/NIAID. \nQuestion 9(a) . Therefore, is support from Assistant Secretary for Preparedness \nand Response (ASPR) something under consideration? \nQuestion 9(b) . If not, why not, and if so what is needed to facilitate that conversa-\ntion? \nAnswer 9(a) & 9(b). CDC defers to our HHS colleagues from NIH and ASPR. \nRESPONSE BY DR. ANTHONY FAUCI TO QUESTIONS OF SENATOR BURR, SENATOR  \nBRAUN , AND SENATOR TUBERVILLE  \nResponses to the QFRs are accurate as of the date of the hearing . \nSENATOR BURR  \nQuestion 1 . Recent reports from the Administration have indicated that, while we \ndon’t need a booster for the COVID–19 vaccine just yet, we will likely need one in the near future. \nQuestion 1(a) . What does the data show us so far about the durability of all three \nauthorized vaccines, particularly against circulating variants, such as Delta? \nAnswer 1(a). At this time, data indicate that all currently authorized COVID–19 \nvaccines remain effective at preventing severe disease and death from COVID–19, including from the Delta variant of SARS-CoV–2 (also known as B.1.617.2). The Na-tional Institute of Allergy and Infectious Diseases (NIAID) is supporting research to assess the duration of protection provided by current COVID–19 vaccination regi-mens and further quantify the protective effect of these vaccines against variants of SARS-CoV–2. Moderna and Pfizer/BioNTech recently reported that immune re-sponses to their respective COVID–19 vaccines remained robust 6 months following vaccination. Johnson & Johnson/Janssen also reported that the durability of im-mune response from vaccination with their COVID–19 vaccine lasts at least 8 months and that the average neutralizing antibody levels were greater at 8 months than at 29 days post-vaccination. In addition, data from both lab studies and clinical effectiveness studies show the effectiveness of all three authorized COVID–19 vac-cines against the Delta variant, particularly against hospitalization. \nQuestion 1(b) . What factors should be considered in determining if or when a \nbooster is needed? Should certain populations be considered for a booster before oth-ers? \n79 \nAnswer 1(b). The National Institutes of Health (NIH), Centers for Disease Control \nand Prevention (CDC), and U.S. Food and Drug Administration (FDA) continue to engage in a science-based, rigorous process to help evaluate whether the durability of immune protection from currently authorized COVID–19 vaccines is waning and whether a booster may become necessary. Current data indicate that all currently authorized COVID–19 vaccines remain highly effective at preventing severe disease and death from COVID–19, including against the Delta variant, and as of the date of the hearing, the CDC and FDA have stated that fully vaccinated people do not need a booster shot at this time. \nWhether a booster is needed in the future will depend on multiple factors, includ-\ning the durability of immune protection, the emergence of a SARS-CoV–2 variant that evades protection from currently authorized vaccines, and the strength of im-mune responses elicited by the initial vaccine regimen in certain populations. For example, data indicate that some immunocompromised individuals, including solid organ transplant recipients and individuals with cancer, have a weak response to the standard vaccine regimen. Emerging data suggest that some of these individuals are able to generate immune responses to an additional dose of COVID–19 mRNA vaccines. Given these data, immunocompromised individuals are likely to be consid-ered for additional doses of the COVID–19 vaccine before other populations. \nNIH is conducting and planning studies to measure and enhance the immune re-\nsponse to COVID–19 vaccines in immunocompromised individuals. In April 2021, \nNIH scientists began two clinical trials to assess how adults and adolescents with certain cancers or immune system deficiencies respond to COVID–19 vaccination. These studies will provide valuable information about the immune responses to COVID–19 vaccines in these individuals. NIAID also plans to launch two additional trials in August 2021 that will assess immune responses to an additional dose of a COVID–19 vaccine in patients taking immunosuppressive medications. One of these trials will enroll participants with one of five autoimmune diseases, and the other will enroll kidney transplant recipients. Each study will enroll participants who have absent or weak antibody responses after an initial course of COVID–19 vaccination. NIAID also plans to launch an additional study that will enroll other solid organ transplant recipients who are receiving immunosuppressive medications. Results from these studies will help us to better understand the immune response to vaccination in immunocompromised individuals and identify approaches to safely enhance their responses to vaccination. These studies may also lead to evidence- based guidelines for safely enhancing responses to COVID–19 vaccination in immunocompromised individuals. \nQuestion 1(c) . What is the status of studies looking at using different types of vac-\ncines together, such as administering doses of both Moderna and Pfizer to someone or using an mRNA vaccine as a potential booster for Johnson & Johnson? \nAnswer 1(c). It is possible that the use of mixed vaccine regimens—in which an \nindividual receives doses of more than one vaccine type—may induce a broader im-mune response, resulting in improved protection against COVID–19. NIAID cur-rently is supporting research to determine the effect of mixed vaccine regimens and on June 1, 2021, launched a study to determine the safety and efficacy of boosting with a COVID–19 vaccine different than the one used for the initial vaccination, such as the Johnson & Johnson/Janssen vaccine followed by one dose of the Moderna COVID–19 vaccine. The study also will evaluate immune responses against SARS-CoV–2 variants. Initial results from this trial are expected in late summer 2021 and may inform public health policy decisions on the potential use of mixed vaccine schedules, should booster doses be needed. \nNIH is committed to supporting further research into the use of mixed vaccine \nregimens. NIAID also is studying the currently available COVID–19 vaccines— which were designed to target the original strain of SARS-CoV–2—to assess the du-rability of protection they provide against SARS-CoV–2 variants. \nQuestion 2 . Given all of the work that we have put into identifying and tracking \nthese new variants as they emerge, once a new variant is detected, how quickly can we determine—in days or weeks—whether our vaccines will continue to protect us from severe illness due to COVID–19? \nAnswer 2. As mentioned in the response to question 1, data indicate that all cur-\nrently authorized COVID–19 vaccines remain effective at preventing severe disease and death from COVID–19, including against known variants of SARS-CoV–2. Once a new SARS-CoV–2 variant of interest or of concern is detected and scientists obtain a sample of the variant or the genetic sequence of the variant, they can assess whether antibodies from individuals who have recovered from COVID–19, or who received a COVID–19 vaccine, can neutralize the variant virus. These experiments, \n80 \nwhich provide an early indication of vaccine efficacy against a new variant, can be \nperformed in a matter of days. However, the process of definitively determining the impact of a variant can take months and can vary based on several factors, includ-ing how widespread, transmissible, and/or pathogenic the variant is. NIAID is fully engaged in efforts to rapidly mitigate the potential impact of emerging variants of SARS-CoV–2. \nNIAID, the National Human Genome Research Institute, and the National Li-\nbrary of Medicine are participating in the SARS-CoV–2 Sequencing for Public Health Emergency Response, Epidemiology, and Surveillance (SPHERES) initiative. SPHERES is a national genomics consortium led by CDC that helps to coordinate SARS-CoV–2 sequencing across the United States. NIAID is working with partners to identify, monitor, and calculate the frequency of current variations in the SARS- CoV–2 genome to help predict emerging variants. NIAID also facilitates the use of cutting-edge modeling and structural biology tools to understand how variants might affect interactions between the virus and the immune system. NIAID sci-entists are helping to inform our understanding of transmissibility of the variants by studying their stability in the environment and their ability to grow in human lung cells. These efforts add to a growing body of knowledge about SARS-CoV–2 variants and our ability to combat them. \nAs part of the ongoing COVID–19 response, NIAID is collaborating with vaccine \nmanufacturers on key areas of research to investigate whether vaccines designed for the original strain of SARS-CoV–2 maintain efficacy against emerging variants. NIAID is conducting and supporting comprehensive studies to understand the abil-ity of vaccine-induced antibodies to neutralize the variant viruses. In addition, NIAID is supporting the development of additional COVID–19 candidate vaccines that seek to induce a broader immune response. On March 25, 2021, NIAID launched a Phase 1 clinical trial in healthy adults to assess the safety and immunogenicity of second-generation COVID–19 vaccine candidates developed by Gritstone Oncology, Inc. Gritstone’s COVID–19 vaccine candidates utilize a strategy aimed at inducing both neutralizing antibodies and T cell responses to elicit a broad immune response. This approach could provide protection against emerging SARS- CoV–2 variants by targeting several viral antigens, all of which are highly con-served among known viral strains. \nQuestion 3 . The Regional and National Biocontainment Laboratories were de-\nsigned to facilitate NIAID-funded research to address biothreats, including emerging infectious diseases. As you know, Duke University is home to one of these regional biocontainment laboratories, and you have previously highlighted some of their promising research, including a pan-coronavirus vaccine candidate that could poten-tially provide increased protection against SARS-CoV–2 and a variety of other coronavirus infections. \nQuestion 3(a) . Could you expand on the role of the Regional and National Bio-\ncontainment Laboratories in the development of medical countermeasures for COVID–19 and other threats? \nAnswer 3(a). NIAID established the U.S. National Biocontainment Laboratories \n(NBLs) and Regional Biocontainment Laboratories (RBLs) to conduct research on biodefense and emerging infectious disease agents and to be available and prepared to assist national, state, and local public health efforts in the event of a bioterrorism or infectious disease emergency. Biocontainment laboratories, including the NBLs and RBLs, are essential for the development of medical countermeasures for emerg-ing and re-emerging infectious diseases. \nThe NBLs and RBLs offer unique resources for the research community, including \nanimal models, imaging services, and specialized equipment. In the case of COVID– 19, research that involves the use of live SARS-CoV–2 is required to take place in high biocontainment laboratories, such as the BSL–3 laboratories within the NBLs and RBLs. The NBLs and RBLs were able to utilize their unique BSL–3 capacity to assist with basic, translational, and clinical research on SARS-CoV–2 and COVID–19. \nOver the past year, the NBLs and RBLs played a critical role in helping to ad-\ndress the COVID–19 pandemic and have been utilized to conduct research with clin-ical samples containing live SARS-CoV–2 to advance the development of COVID– 19 medical countermeasures. The NBLs and RBLs also have been involved in a vari-\nety of pre-clinical research activities to test novel vaccines and therapeutics for COVID–19 and to explore the pathogenesis of, and immune responses to, SARS- CoV–2. This research includes the development of new animal models for COVID– 19 research and the analysis of SARS-CoV–2 variants of concern. \n81 \nQuestion 3(b) . How can these biocontainment laboratories be used in future pre-\nparedness and response efforts? \nAnswer 3(b). As noted in the response to question 3(a), the NBLs and RBLs facili-\ntate the conduct of research that aims to prevent, prepare for, and respond to emerging and re-emerging infectious diseases. NIAID recently published a funding opportunity for facility and building system upgrades for the RBLs, which will facili-tate future research efforts in these laboratories. NIAID will continue to support highly meritorious biomedical research in biocontainment laboratories, including at the NBLs and RBLs, to prepare for and respond to future infectious disease threats. \nSENATOR BRAUN  \nQuestion 1 . Dr. Fauci, what steps are your agency taking to prepare for the in-\ncreased exposure to flu, COVID variants, and other communicable diseases in nurs-ing homes? \nAnswer 1. Older adults, and specifically those in nursing homes and long-term \ncare facilities, are often at higher risk for severe outcomes from infectious diseases, and the Administration is committed to the development and testing of medical countermeasures for this vulnerable population. The Centers for Disease Control and Prevention (CDC), the lead agency for public health, has released guidance on the prevention and management of transmissible diseases in long-term care facili-ties, including nursing homes. This includes specific detailed guidance for COVID- 19, influenza, and other communicable diseases. The National Institute of Allergy and Infectious Diseases (NIAID) conducts and supports basic, translational, and clinical research into infectious diseases, including research into the prevention of infectious diseases. This research encompasses studies in vulnerable populations, such as older adults and individuals living in nursing homes. \nVaccines are the most effective public health tools for preventing infectious dis-\neases, and COVID–19 vaccines currently authorized by the U.S. Food and Drug Ad-ministration (FDA) are well tolerated and effective at preventing severe disease and death, including in older adults. NIAID has played an integral role in the evaluation of COVID–19 vaccines. Early in the pandemic, NIAID supported a Phase 1 clinical trial of Moderna, Inc.’s COVID–19 vaccine, mRNA–1273, which was developed through a collaboration between scientists at the NIAID Vaccine Research Center and Moderna. NIAID included individuals aged 55 and over in this trial to assess the safety and efficacy of mRNA–1273 in older adults. The data from this trial facili-tated progression of mRNA–1273 into more advanced clinical trials that ultimately led to the emergency use authorization (EUA) of this vaccine by the FDA. \nNew viral threats will continue to emerge, and the development of universal influ-\nenza vaccines and pan-coronavirus vaccines, which would protect vaccinated individ-uals against multiple viruses in one shot, can help us be better prepared for future infectious disease threats. NIAID is leading efforts to develop universal influenza vaccines to protect against multiple strains of seasonal and pandemic influenza vi-ruses. NIAID also is conducting early stage research on the development of pan- coronavirus vaccines designed to provide broad protective immunity against mul-tiple coronaviruses, especially SARS-CoV–2 and other viruses with pandemic poten-tial. These vaccines ultimately would be evaluated for use across the age spectrum, including in older adults. NIAID also is investigating the use of therapeutics for pre-vention of COVID–19 in older adults. In collaboration with Eli Lilly and Company, NIAID initiated a Phase 3 clinical trial that demonstrated that the investigational monoclonal antibody, bamlanivimab, could prevent symptomatic and asymptomatic infection in residents and staff of skilled nursing and assisted living facilities. In addition, NIAID is supporting the development of broad-spectrum therapeutics, in-cluding antivirals and antimicrobials, that can be used to treat infections, including in older adults. \nNIAID also conducts and supports research into understanding how the immune \nsystem changes as we age. On October 21, 2020, NIAID announced a new funding opportunity announcement (FOA), ‘‘Cohort Studies To Improve Our Understanding of Influenza Immunity, Vaccine Response and Effectiveness in Older Adults.’’ This FOA will support research to increase understanding of (1) factors that correlate with protection against influenza in older individuals, (2) the impact of influenza ex-posure and vaccination history on protective immune responses, and (3) immunological mechanisms associated with vaccine failure, including potential intra-seasonal waning of protection. Moreover, this research may lead to the identi-fication of risk factors for severe outcomes associated with influenza infection. Ulti-mately, this work will inform efforts to develop durable, broadly protective influenza vaccines across the age spectrum of adults. \n82 \nQuestion 2 . COVID vaccines do not appear to be working as well in \nimmunocompromised individuals or individuals taking immunosuppressants. Could antibody tests be used to greater effect in this population to identify individuals who may need an additional vaccine dose? \nAnswer 2. Immunocompromised individuals are at an increased risk for poor clin-\nical outcomes from COVID–19. While data indicate that some immunocompromised individuals have a weak response to the COVID–19 vaccines available under FDA EUAs, vaccines remain the most effective tool that we have for preventing COVID– 19. As of the date of the hearing, the FDA does not recommend using currently au-thorized SARS-CoV–2 antibody tests to evaluate a person’s level of immunity or pro-tection from COVID–19, including whether an individual may need an additional dose of the COVID–19 vaccine. Antibody tests have not been evaluated to assess the level of protection provided by immune responses to COVID–19 vaccination, includ-ing in immunocompromised individuals. \nNIH is conducting and planning studies to assess and enhance the immune re-\nsponses to COVID–19 vaccines in immunocompromised individuals. In April 2021, NIH scientists began two clinical trials to assess how adults and adolescents with certain cancers or immune system deficiencies respond to COVID–19 vaccination. These studies will provide valuable information about the immune responses to COVID–19 vaccines in these individuals. NIAID also plans to launch two additional trials in August 2021 that will assess immune responses to an additional dose of \na COVID–19 vaccine in patients taking immunosuppressive medications. One of the trials will enroll participants with one of five autoimmune diseases, and the other will enroll kidney transplant recipients. Each study will enroll participants who have absent or weak antibody responses after an initial course of COVID–19 vac-cination. NIAID also plans to launch an additional study that will enroll other solid organ transplant recipients who are receiving immunosuppressive medications. Re-sults from these studies will help us to better understand the immune responses to vaccination in immunocompromised individuals and identify approaches to safely enhance their immune responses to vaccination. These studies may lead to evidence- based guidelines for safely enhancing responses to COVID–19 vaccination in immunocompromised individuals. \nResults from these studies will help us to better understand the immune re-\nsponses to vaccination in immunocompromised individuals and may better inform the development of meaningful antibody tests or other assessments of immune re-sponse to vaccination for this population. \nSENATOR TUBERVILLE  \nVaccination of Children/Parental Consent \nQuestion 1 . Last November, the District of Columbia passed a bill allowing chil-\ndren 11 years and older to get vaccinated without their parents’ consent. It’s been proven that this virus has an insignificant impact on children under the age of 15 or 16. \nQuestion 1(a) . Do you think minor children should be vaccinated without the con-\nsent of their parents? \nAnswer 1 & 1(a). I cannot comment on legislation passed at the local level. While \nit is true that young children and adolescents are less likely to experience severe symptoms from COVID–19, a portion of these individuals will still experience severe disease and hospitalization. Additionally, children and adolescents who are infected with SARS-CoV–2 can experience a rare, but extremely serious, multisystem inflam-matory syndrome in children (MIS-C). As the Delta variant (also known as B.1.617.2), which appears to be more transmissible, has become the dominant strain of SARS-CoV–2 in the United States, it is critical that as many people as possible are vaccinated against COVID–19. The U.S. Food and Drug Administration (FDA) has authorized the Pfizer/BioNTech COVID–19 vaccine for use in individuals 12 years old and older, and I would encourage everyone who is eligible to receive the vaccine to do so as soon as they can. \nCOVID–19 Origins \nQuestion 2 . Did you have knowledge of safety concerns at the Wuhan lab? \nQuestion 2(a) . If so, when did you become aware of those concerns? \nQuestion 2(b) . Was it before or after you said in May 2020 that the virus was \nmore likely to have emerged naturally? \n83 \nAnswer 2(a) & (b). NIAID was aware of interest on the part of the Wuhan Insti-\ntute of Virology (WIV) to obtain additional information and trained staff as they pre-pared to begin research in a new biocontainment level 4 (BSL–4) facility. \nMy own view, based on the studies I have reviewed and my prior experience, is \nthat it is most likely that SARS-CoV–2 infections in people resulted from zoonotic transmission from animals to humans, based on what occurred with two other coronaviruses—Severe Acute Respiratory Syndrome (SARS) and Middle East Res-piratory Syndrome (MERS)—and many other emerging diseases, as well as what is known about the molecular makeup of SARS-CoV–2. The available scientific evi-dence, including information about the sequence of the virus, does not support the assertion that SARS-CoV–2 was engineered. This view is consistent with an emerg-ing consensus from world-renowned experts in virology, genetics, and evolutionary biology based on currently available data. However, as I have publicly stated, the possibility of a laboratory accident exists. A laboratory accident could include sce-narios where a naturally occurring virus was unintentionally released during re-search activities such as collection of animal samples or examination of virus in a laboratory. I am in favor of a full investigation into the origins of SARS-CoV–2, and I look forward to the findings of the experts in the various disciplines relevant to this discussion. \nQuestion 3 . What is your awareness of Dr. Baric’s collaboration with researchers \nat the Wuhan lab? \nAnswer 3. I am aware of collaborations between Dr. Ralph Baric from the Univer-\nsity of North Carolina and the WIV. Dr. Baric was listed as a collaborator on a 2014 grant ‘‘Understanding Risk of Bat Coronavirus Emergence’’ submitted by EcoHealth Alliance and also was listed as a co-investigator on the corresponding 2019 grant renewal application. Prior to the renewal, this grant had included subawards to the WIV. Based on results published in peer-reviewed papers that include authors from Dr. Baric’s lab and the WIV, I also am aware that Dr. Baric has collaborated with investigators from the WIV on basic coronavirus research. \nQuestion 4 . At what point did you realize that more investigation is necessary to \ndetermine the origins of the virus? \nAnswer 4. Since the beginning of the pandemic, I have been supportive of a full \ninvestigation into the origins of SARS-CoV–2 by qualified experts in the relevant fields. \nQuestion 5 . In May, President Biden asked the Intelligence Community to review \nthe origins of Covid–19. Biden also asked that this effort include work by our Na-tional Labs and other agencies of our government to augment the Intelligence Com-munity’s efforts. Have you participated in this review? \nAnswer 5. The National Institutes of Health (NIH) is supporting and cooperating \nwith the President’s call for a U.S. Intelligence Community (IC) investigation and would refer you to the IC for additional information about their review. \nNIH Grants \nQuestion 6 . The HHS Office of Inspector General (OIG) is conducting a review of \nNIH grants. \nQuestion 6(a) . Have you provided documentation to the OIG? \nQuestion 6(b) . Have you been interviewed as part of this review? \nAnswer 6(a) & (b). I am unable to specifically comment on any ongoing oversight \nengagements; however, I will note that the NIH is fully cooperating with the De-partment of Health and Human Services (HHS) Office of Inspector General. \nCOVID–19 Vaccine Clinical Trials \nQuestion 7 . Members of your staff served as co-investigators on the COVID–19 \nVaccine clinical trials. \nQuestion 7(a) . Have they investigated every report of an adverse event by a trial \nparticipant? \nQuestion 7(b) . If so, what does that investigation entail? \nQuestion 7(c) . Do they evaluate each participant reporting an adverse event? \nAnswer 7(a), (b) & (c). Vaccine clinical trials are designed, in part, to assess the \nsafety of candidate vaccines, and all reported adverse events are investigated by the trial sponsor. The National Institute of Allergy and Infectious Diseases (NIAID) was the trial sponsor for the Phase 1 clinical trial for the Moderna vaccine candidate, and the study recorded all adverse events among the 120 enrollees, including cap-\n84 \nturing any symptoms, new medical conditions, and laboratory abnormalities. While \nNIAID is supporting the underlying critical infrastructure for other clinical trials for COVID–19 vaccines through the COVID–19 Prevention Network (CoVPN), NIAID is not the trial sponsor. \nClinical trial protocols include information surrounding the definition and han-\ndling of adverse events. NIAID would note that most of the trial sponsors for the Phase 3 clinical trials of the COVID–19 vaccines tested through the CoVPN have made the protocols for these trials available online, including for Moderna’s COVE trial, Johnson & Johnson/Janssen’s ENSEMLE trial, and Novavax’s PREVENT–19 trial. The protocol for Pfizer/BioNTech’s Phase 3 clinical trial also is available on-line. NIAID recommends contacting the trial sponsors for further information on COVID–19 vaccine clinical trials. \nMisinformation \nQuestion 8 . Are you involved in the administrations recently revealed efforts to \nflag ‘‘misinformation’’ about COVID–19 for removal by social media companies? \nAnswer 8. No, I am not involved in the described efforts. Question 9 . Do you consider it misinformation for individuals to share their stories \nof adverse events following vaccination? \nAnswer 9. No. I encourage anyone who has experienced an adverse event fol-\nlowing vaccination to report it to the Centers for Disease Control and Prevention and FDA Vaccine Adverse Event Reporting System (VAERS), a national early warn-ing system to detect possible safety issues in vaccines. \nQuestion 10 . Funds in part from NIH/NIAID helped build the 12 Regional Bio-\ncontainment Laboratories (RBLs) and 2 National Biocontainment Laboratories (NBL) to support high consequence infectious disease research after 9/11 and the anthrax scares in 2001. However, unlike the NBL facilities, the RBL facilities re-ceived no further direct support until last year when Congress provided enhanced investment through NIH/NIAID, targeted specifically to RBL facilities, one of which is at the University of Alabama at Birmingham (UAB) in my state. Nevertheless, it seems as though the RBL infrastructure, most importantly the highly trained staff these facilities maintain and produce is something that falls within the pur-view of the HHS ASPR, considering among other things the UAB RBL has had col-laborations with Altimmune and ImmunityBio for COVID19 vaccine development, and supported BARDA contractors. This type of work strongly aligns with numerous ASPR Strategic Goals, such as Fostering Strong Leadership, and Sustaining Robust and Reliable Public Health Security Capabilities. The RBL infrastructure and per-sonnel is expensive to maintain and operate, and perhaps should not solely rest on either the shoulders of the host University or the NIH/NIAID. \nQuestion 10(a) . Therefore, is support from Assistant Secretary for Preparedness \nand Response (ASPR) something under consideration? \nQuestion 10(b) . If not, why not, and if so what is needed to facilitate that con-\nversation? \nAnswer 10(a) & (b). NIAID defers to the HHS Office of the Assistant Secretary \nfor Preparedness and Response to respond to this question. \nRESPONSE BY DR. JANET WOODCOCK TO QUESTIONS OF SENATOR BURR, SENATOR  \nBRAUN , SENATOR SCOTT AND SENATOR TUBERVILLE  \nResponses to the QFRs are accurate as of the date of the hearing . \nSENATOR BURR  \nQuestion 1 . Pfizer and Moderna have both submitted or begun to submit applica-\ntions for full, standard approval of their vaccines. Given FDA’s extensive knowledge and understanding of the vaccine data, are the agency’s review timelines going to be faster than a traditional application? If not, why not? \nAnswer 1. FDA’s review of a Biologics License Application (BLA) is among the \nmost comprehensive in the world. When a BLA is submitted, the Agency evaluates the information supporting safety and effectiveness as well as manufacturing data. FDA also inspects the facilities that are involved in the manufacturing of the prod-uct to ensure that the vaccines that are distributed meet rigorous quality standards. \n85 \nFDA scientists are working around the clock and reviewing the applications, \nwhich include hundreds of thousands of pages of data and other information, as ex-peditiously as possible, in a thorough and science-based manner. \nHaving safe and effective approved COVID–19 vaccines is a top priority for HHS \nand FDA. We firmly believe that those eligible to receive a vaccine under the exist-ing EUAs should get their COVID–19 vaccine now. \nAs you know, FDA first issued an EUA for the use of the Pfizer-BioNTech \nCOVID–19 Vaccine in individuals 16 years of age and older on December 11, 2020. Additionally, two other vaccines are currently available under EUA for the preven-tion of COVID–19. On December 18, 2020, FDA issued an EUA for the use of the Moderna COVID–19 Vaccine, and on February 27, 2021, FDA issued an EUA for the use of the Janssen COVID–19 Vaccine. The Moderna and Janssen COVID–19 vaccines are authorized for use in individuals 18 and older. For additional informa-tion on COVID vaccines, please visit: https://www.fda.gov/emergency-preparedness- \nand-response/coronavirus-disease-2019-covid-19/covid-19-vaccines . \nQuestion 2 . FDA has made great strides in supporting innovative clinical trial de-\nsigns. How do you plan to continue to advance innovative clinical trial designs to expedite the development of novel products, using the creativity and flexibilities ex-ercised during the pandemic response as a roadmap? \nAnswer 2. FDA has a long-standing commitment to supporting innovation in clin-\nical development programs to help bring safe and effective drugs to patients more efficiently. Although the COVID–19 pandemic accelerated the use of innovative trial designs, FDA’s policy development in this area long preceded the current public health emergency. FDA recognizes that there are emerging shifts in how diseases are diagnosed, prevented, and treated, and in the development of therapeutics. FDA is working on multiple fronts to provide guidance on innovative approaches to drug development, such as complex, innovative trial designs, master protocols, decentral-ized trials, trials utilizing real world data and evidence (RWD/RWE), modelling, and simulation. Our engagements with stakeholders have supported innovative trial de-signs as part of the COVID–19 pandemic response. These designs improve clinical trial efficiency and may optimize product development. \nFDA continues to promote innovation in clinical trial design and conduct, and to \nencourage the utilization of advanced technologies. The agency is already working in many ways to facilitate pharmaceutical development and improve the overall clin-ical trial enterprise. We are also leveraging strong national and global partnerships in collectively advancing scientific knowledge to ultimately benefit patients. We are invested in advancing innovations, such as decentralized clinical trials and the use of digital health tools that have the potential of making clinical trials more efficient and may allow for wider inclusivity of diverse populations. Further, recognizing the value of innovative designs, FDA is committed to continuing the Complex Innovative Designs Meeting Program, which provides applicants accepted into the program with additional meetings with FDA to discuss proposed innovative designs. \nQuestion 3 . What has FDA learned from its review of products made using plat-\nform technologies, such as the mRNA and viral vector-based platforms, during the response? How will FDA support the development of products for other disease areas that leverage platform technologies? \nAnswer 3. FDA recognizes that, when scientifically appropriate, certain products \nhave begun sharing manufacturing platform technologies, allowing certain informa-tion from one product to be applicable to future products with similar production strategies. The Agency is interested in finding ways to streamline the development and review of such innovative technologies. Toward this end, FDA hopes to find ways to best leverage knowledge gained from approved products that rely on certain platform technologies and associated manufacturing methods to be applied to subse-quent products that a sponsor may develop. As this is a novel area, FDA continues to work to determine how to best leverage such platform technologies and looks for-ward to working with Congress in this area. \nQuestion 4 . On July 8th, the FDA and CDC said that Americans who have been \nfully vaccinated do not need boosters at this time. Pfizer announced it would file for authorization of a booster with the FDA, and the ACIP has stated that they can-not recommend booster shots for specific groups of individuals without FDA action. What is the timeline for determining whether to authorize a proposed booster, ei-\nther for certain populations or the general public? \nAnswer 4. At the time of the hearing, FDA was closely monitoring data as it be-\ncame available from studies administering a booster dose of the authorized COVID– 19 vaccines to immunocompromised individuals. The Agency is collaborating with the Centers for Disease Control and Prevention and continues to evaluate all poten-\n86 \n1https://www.fda.gov/regulatory-information/laws-enforced-fda/Federal-food-drug-and-cos-\nmetic-act-fdc-act . \n2https://www.fda.gov/media/97321/download . tial solutions to this growing question in the medical community. For more informa-\ntion and updates, please see: https://www.fda.gov/emergency-preparedness-and-re-\nsponse/coronavirus-disease-2019-covid-19/covid-19-vaccines . \nFDA understands the potential importance of booster vaccine doses for control of \nthis pandemic and will promptly review any data submitted to the Agency regarding their use in a thorough and science-based manner. Due to legal and regulatory re-strictions, FDA generally cannot discuss product submissions that may be under re-view, including the timing of any potential FDA action to authorize or approve the use of additional doses of COVID–19 vaccines. Please contact the vaccine manufac-turers directly regarding their plans to submit data for their individual vaccines and the timing of such submissions. \nSENATOR BRAUN  \nQuestion 1 . FDA has authorized large numbers of COVID tests and other products \nusing emergency use authorizations. Without further action from FDA, when the public health emergency comes to an end these products will no longer be available for use. \nQuestion 1(a) . How does the FDA plan to transition products to full approval or \nclearance? What will happen if the public health emergency ends, and critical prod-ucts have not received approval or clearance from FDA? \nAnswer 1 & 1(a). On February 4, 2020, the Secretary of the Department of Health \nand Human Services (HHS) determined, pursuant to section 564 of the Federal Food, Drug and Cosmetic (FD&C) Act,\n1that there is a public health emergency that \nhas a significant potential to affect national security or the health and security of United States citizens living abroad, and that involves the virus that causes COVID–19. Pursuant to Section 564 of the FD&C Act, and on the basis of such de-termination, the Secretary of HHS then declared that circumstances exist justifying \nthe authorization of emergency use of in vitro diagnostics for the detection and/or diagnosis of COVID–19 (February 4, 2020), personal respiratory protective devices (March 2, 2020), other medical devices (March 24, 2020) for use during the COVID– 19 outbreak, and drugs and biological products during the COVID–19 pandemic (March 27, 2020). (Please note that a determination under section 319 of the Public Health Service Act that a public health emergency exists, such as the one issued on January 31, 2020, and subsequently renewed, is insufficient to enable FDA to issue EUAs.) \nThe declarations under section 564 have enabled FDA to authorize unapproved \nproducts and unapproved uses of approved or cleared products when, based on the totality of the scientific evidence available, it is reasonable to believe that the prod-uct may be effective in diagnosing, treating, or preventing the disease or condition and the known and potential benefits of the product’s use outweigh the known and potential risks, taking into consideration the material threat posed by an emergency situation. Irrespective of the status of the public health emergency declaration under section 319 of the Public Health Service Act, FDA is empowered to authorize such uses until the Secretary terminates the declaration of emergency or threat jus-tifying emergency use under section 564(b), the criteria for EUA issuance are no longer met, or revocation is otherwise appropriate to protect the public health. It may be the case that once the public health emergency declaration under section 319 of the Public Health Service Act expires, the benefit-risk justification for issuance of any particular EUA are no longer met or revoking such use is otherwise appropriate. In some instances, manufacturers of certain devices, especially non-conventional manufacturers, may no longer wish to market or distribute these prod-ucts. In other instances, manufacturers may desire to transition to full approval or clearance and the statute directs FDA to communicate with manufacturers regard-ing such transition. \nThe Agency is required to periodically review the authorizations made under sec-\ntion 564 of the FD&C Act. As part of that review, FDA reviews the progress made toward approval, licensure, or clearance of the products authorized. See section 564(g) of the FD&C Act and FDA’s guidance on Emergency Use of Medical Products and Related Authorities.\n2As outlined in FDA’s guidance, Emergency Use Author-\nization for Vaccines to Prevent COVID–19, it is FDA’s expectation that, following submission of an EUA request and issuance of an EUA, a sponsor would continue to collect placebo-controlled data in any ongoing trials for as long as feasible and \n87 \n3 https://www.fda.gov/medical-devices/emergency-use-authorizations-medical-devices/ \ncoronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices . \n4 https://www.fda.gov/medical-devices/emergency-situations-medical-devices/coronavirus- \ncovid19-and-medical-devices#guidance . \n5 https://www.fda.gov/medical-devices/guidance-documents-medical-devices-and-radiation- \nemitting-products/cdrh-proposed-guidances-fiscal-year-2021-fy-2021 . would also work toward submission of a Biologics License Application (BLA) as soon \nas possible. FDA’s recommendations regarding the safety and effectiveness data and information are essential to ensure that clinical development of a COVID–19 vaccine has progressed far enough that issuance of an EUA for the vaccine would not inter-fere with the ability of an ongoing Phase 3 trial to demonstrate effectiveness of the vaccine to support licensure and to continue safety assessments, including inves-tigating the potential for vaccine-associated enhanced respiratory disease (ERD). The ability of a sponsor to accrue this information about a COVID–19 vaccine is critical to ongoing assessment of its benefits and risks. \nFDA is working on a transition plan for devices that have been authorized under \nEUAs\n3or that fall within enforcement policies4issued during the COVID–19 public \nhealth emergency. FDA’s intention is to issue guidance in draft form and request public comment before finalization and implementation. Transition plan draft guid-ance is on CDRH’s Fiscal Year 2021 ‘‘A List,’’\n5meaning that this is a prioritized \npolicy that FDA seeks to publish in a timely fashion. FDA recognizes that it will take time for device manufacturers, healthcare facilities, healthcare providers, pa-tients, consumers, and FDA to adapt and adjust from policies adopted and oper-ations implemented during the public health emergency to normal operations. One of the goals of developing guidance on this topic is to have an orderly transition process and to provide transparency around FDA’s approach to that transition. In addition, FDA is engaging in discussions with individual companies that are inter-ested in obtaining marketing clearance or approval for their devices, and we encour-age companies to initiate those discussions. Note that this proactive engagement is an integral part of FDA’s transition plan. As we shift more resources toward work-ing with sponsors pursuing full marketing status and as more devices achieve this status, there will be a smoother transition away from reliance on products author-ized for emergency use or that fall within enforcement policies issued during the COVID–19 public health emergency. \nSENATOR SCOTT  \nQuestion 1 . Dr. Woodcock, the COVID–19 pandemic has had a disproportionate \nand devastating impact on communities of color. Drivers of this disparate impact correlate directly to social determinants of health, such as health and financial lit-eracy, transportation, housing conditions, employment, safety, and education. I have expressed concerns at a number of hearings on the prevalence of vaccine hesitancy among Black Americans, with a 2020 survey suggesting that only 25 percent of Black adults planned to get vaccinated in the event of a COVID–19 vaccine ap-proval. The pandemic has exposed several disparities that exist within the U.S. healthcare system. One such area is the under-representation of communities of color in clinical trials. Improving the diversity of participants in clinical trials con-tinues to be a challenge due to a number of obstacles, including a lack of racial di-versity in clinical trial investigators, community mistrust and skepticism due to his-toric abuses of racial minorities used as test subjects, as well as a lack of convenient and affordable transportation to clinical trial sites. To improve health outcomes for those most at risk, we must diversify our pool of participants. Our goal should be to include participants from diverse ethnic backgrounds and income levels. It is also imperative investigators make devices and software available to participants in ad-dition to allowing enrollees to participate from diverse settings such as their home, local clinics, and, potentially, skilled nursing facilities. \nQuestion 1(a) . Dr. Woodcock—You have praised the success of the innovations \nmade within clinical trial designs. What is your vision to expand access to clinical trials and how do we get there? \nAnswer 1 & 1(a). Modernizing clinical trials is a priority for FDA and the subject \nof significant policy work in which we are currently engaged. We view modernizing clinical trial designs and conduct and utilizing innovative technologies as an essen-tial area to improve efficiencies and to facilitate the development of drugs, biological products, and devices. \nPrior to the pandemic, the Agency was working on these areas, and the current \npublic health emergency further catalyzed these efforts. There is a wide range of designs, tools, and methods that can be utilized in this area. For example, decentral-\n88 \n6 https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enhancing- \ndiversityclinical-trial-populations-eligibility-criteria-enrollment-practices-and-trial . \n7https://www.fda.gov/media/127712/download . ized clinical trials, hybrid trials, trials embedded in healthcare settings, trials that \nallow for seamless transition between phases, the use of digital health technologies, and supporting efficient, risk-based, approaches to trial conduct are all areas that FDA is currently working on or is planning on addressing. We have recently an-nounced that the Agency will be issuing a draft guidance on the use of digital health technologies in clinical investigations and another draft guidance on decentralized clinical trial designs. \nQuestion 1(i) . What was done during the pandemic to ensure COVID–19 treat-\nment and vaccine trials were clinically diverse? \nAnswer 1(i). FDA published guidance\n6to encourage diversity in clinical trials and \nmake recommendations on how to help increase diversity in trials. \nSponsors who have requested an Emergency Use Authorization have provided \nnumbers, including enrollment numbers about the diverse populations, in the pack-age submitted to FDA for consideration for potential Emergency Use Authorization (EUA). We continue to strongly encourage the companies to improve their enroll-ment diversity and we provide recommendations on how to do so by leveraging mes-\nsaging in local communities, site selection, and other strategies to raise the propor-tion of minorities being enrolled. \nWith regard to COVID–19 vaccines, in the June 2020 guidance, Development and \nLicensure of Vaccines to Prevent COVID–19 , the Agency encourages the inclusion of \ndiverse populations, including those most affected by COVID–19, in all phases of vaccine clinical development. \nFor the three vaccines that FDA has authorized for emergency use, all clinical \ntrials included members of racial or ethnic groups at greater risk from COVID–19. \nFDA, vaccine manufacturers, and other scientists are currently working to try to \nunderstand how long the authorized vaccines will provide protection for the preven-tion of COVID–19. Many studies are well underway to evaluate how long protection from a COVID–19 vaccine lasts and whether there is any variability based on age, race or ethnicity, or comorbidities that disproportionately impact underserved com-munities. These studies are currently being conducted by government agencies, aca-demia, and industry partners. Specifically, these studies are longitudinal patient fol-low-up studies, which usually entail measuring antibody titers in a cohort of individ-uals before and at multiple times after vaccination, and identifying an association between antibody responses below a certain antibody level threshold and vaccine failure/infection. These studies may be designed to demonstrate differences in var-ious groups based on age, race and ethnicity, or comorbidities. \nQuestion 1 . If successful, how can we implement these changes post-pandemic? \nAnswer 1. Advancing innovative and inclusive clinical trials is a key part of FDA’s \nongoing efforts that started prior to the pandemic and will continue post-pandemic. FDA will continue to encourage the inclusion of diverse populations in clinical trials and is committed to continue to work on ensuring that best practices for enhancing diversity in COVID–19 treatment and vaccine trials are sustained beyond the pan-demic. Because clinical trials provide a crucial base of evidence for evaluating whether a medical product is safe and effective, enrollment in clinical trials should reflect the diversity of the population that will ultimately use the product. The op-portunity to participate in clinical research should be available to all eligible pa-tients who are impacted by the disease. \nIn November 2020, FDA issued a final guidance for industry titled, Enhancing the \nDiversity of Clinical Trial Populations; Eligibility Criteria, Enrollment Practices, and Trial Designs .\n7This guidance recommends approaches that sponsors of clinical \ntrials to support a new drug application or a biologics license application can take to broaden eligibility criteria, when scientifically and clinically appropriate, and to increase enrollment of underrepresented populations in their clinical trials. FDA has also published several additional guidances supporting clinical trial diversity, in-cluding, Collection of Race and Ethnicities in Clinical Trials (2016); Pregnant \nWomen: Scientific and Ethical Considerations for Inclusion in Clinical Trials (2018); Clinical Lactation Studies: Considerations for Study Design (2019); Postapproval Pregnancy Safety Studies (2019); and Older Participants-ICH E7 . \nFDA remains committed to increasing the participation of racial and ethnic mi-\nnorities and other underrepresented populations in clinical trials that test new med-ical products for all diseases and conditions through issuing guidance, developing \n89 \n8http://wcms-internet.fda.gov/media/136238/download . \n9https://www.fda.gov/media/127712/download . tools, and encouraging the use of innovative trial designs. In addition, FDA is work-\ning on policies pertaining to the use of decentralized trial designs and digital health technologies. Decentralized clinical trials have the potential to increase diversity of research participants by incorporating, telemedicine and mobile/digital technologies to increase access to under-represented populations and/or communities—rural or remote—that may not have access to major medical and research centers. \nMoving forward, FDA will apply lessons learned from COVID–19 to help support \nthe participation of people in racial, ethnic, and other minority groups in the clinical trials that test new medical products through hosting public meetings, developing tools, and issuing guidance documents. \nQuestion 1(ii) . What are some of the benefits to providing technology to clinical \ntrial participants? For example, mobile glucose monitors or tablets and phones equipped with software to transmit information back to clinical trial investigators. \nAnswer 1(ii). Digital health technologies are among the most promising tools we \nhave for advancing clinical trial innovation and promoting diversity and inclusion. Including digital health technologies in clinical trials may make trial participation less burdensome for participants and expand access to trials by enabling remote data collection and monitoring from the participant’s home instead of traveling to a clinical site. Additionally, providing digital health technologies to participants may enhance a participant’s experience in a clinical trial by promoting engagement and more seamless information sharing between trial participants and clinical investiga-tors. Some of these digital health technologies allow continuous collection of data from trial participants, which could allow round-the-clock monitoring of drug effects. This may improve our ability to understand the safety and efficacy of new drugs in ways that were not previously possible. \nWhen digital health technologies are included in clinical trials, however, FDA rec-\nognizes the crucial importance of maintaining both the safety of trial participants and clinical trial integrity. To promote both, the Agency promptly provided guidance during the COVID–19 pandemic titled Conduct of Clinical Trials of Medical Prod-\nucts during COVID–19 Pandemic\n8that included recommendations regarding the re-\nmote collection of data in clinical trials. \nIn this guidance, FDA explains that sponsors planning to use remote electronic \nassessments as part of a clinical investigation should use appropriate technology and develop procedures for provision of technology and technical support to trial participants, investigators, and/or other trial personnel to facilitate those assess-ments. For example, sponsors could develop a plan to accommodate trial partici-pants who are either already enrolled in a trial or may be enrolled in a trial in the future, but who do not have access to appropriate communication technology (e.g., cell phones or Internet), by providing trial participants with these services. \nFDA encourages the use of digital health technologies in clinical trials that are \nbeneficial to study participants. The Agency issued final guidance in November 2020, entitled Enhancing the Diversity of Clinical Trial Populations—Eligibility Cri-\nteria, Enrollment Practices, and Trial Designs Guidance for Industry .\n9This guid-\nance encourages sponsors to think about reducing visit frequency, when appropriate, in addition to considering whether flexibility in visit windows is possible and wheth-er electronic communications, such as phone, email, social media platforms, or other digital health technology tools, can replace site visits and provide investigators with real-time data. \nIn the above-referenced guidances, FDA provides a few examples of potential ap-\nproaches, and encourages the development of other approaches that can make trial participation less burdensome for participants and foster retention and inclusive-ness. \nQuestion 1 . What statutes need to be changed to allow for this exchange? \nAnswer 1. At this time, FDA has not identified statutory changes that are nec-\nessary to facilitate the use of digital health technologies in clinical trials. The Fed-eral Food, Drug, and Cosmetic Act and the Public Health Service Act provide suffi-cient flexibility to enable use of a broad spectrum of technologies when appropriate to a particular development program. Sponsors are already utilizing digital health technologies in clinical development programs, and FDA is working with sponsors to help facilitate such use consistent with applicable regulatory requirements. \nQuestion 2 . The role of the Food and Drug Administration (FDA) in combatting \nthe COVID–19 pandemic has been critical, and I’d like to thank you for the agency’s \n90 \n10https://www.fda.gov/media/142749/download . \n11 https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019- \ncovid-19/covid-19-frequently-asked-questions#biologics . vital work to support the successful delivery of three vaccines to the American peo-\nple. You have testified in the past before this Committee that no corners were cut in FDA’s evaluation of COVID–19 vaccines in authorizing them under Emergency Use Authorization (EUA), meaning that the FDA’s gold standard review for evalu-ating the safety and efficacy of COVID–19 vaccines was met or surpassed for the vaccines authorized in the United States. Looking to future pandemic preparedness efforts and other biological threats, whether naturally occurring, deliberate, or acci-dental, I would like to better understand the EUA process—not just for vaccines, but also for vaccine manufacturing. Vaccine manufacturers moved at unprecedented speed to develop a product and its manufacturing process while simultaneously scal-ing-up manufacturing capacity—all at a record-breaking pace. These efforts took place in the middle of a pandemic in an environment with serious supply chain con-straints. While not unexpected given the circumstances, our understanding is that there have been a number of challenges with COVID vaccine and therapeutic manu-facturers—with media reports focused on a range of companies, including some of the largest pharmaceutical companies in the world (Merck, Lilly) and some smaller contract manufacturers (Emergent, Texas A&M/Fujifilm DioSynth, Catalent). So, I think explaining the EUA standard for the authorization of the product and the manufacturing process will serve to assure the American public and the world that any product authorized during a public health emergency by the FDA is appro-priate—both for the current pandemic and in preparation for the next. \nQuestion 2(a) . Dr. Woodcock—Can you please briefly explain the standards for \ngranting an EUA for a vaccine candidate? \nAnswer 2 & 2(a). FDA may issue an EUA after FDA has determined that the \nproduct that is the subject of an EUA request meets the statutory requirements under section 564 of the FD&C Act. In determining whether to issue an EUA for a vaccine, FDA evaluates the available evidence to determine, among other things, whether it is reasonable to believe that the vaccine may be effective in preventing COVID–19 and whether the known and potential benefits of the vaccine, when used to prevent COVID–19, outweigh any known and potential risks of the vaccine. Once a manufacturer submits an EUA request for a COVID–19 vaccine, FDA evaluates the request and determines whether the relevant statutory criteria are met, taking into account the totality of the scientific evidence about the vaccine that is available to the Agency. The FDA guidance, Emergency Use Authorization for Vaccines to Pre-\nvent COVID–19\n10provides more information about FDA’s current recommendations \nregarding the data and information needed to support the issuance of an EUA under section 564 of the FD&C Act for an investigational vaccine to prevent COVID–19, including chemistry, manufacturing, and controls information; nonclinical data and information; and clinical data and information, as well as administrative and regu-latory information.\n11 \nQuestion 2(i) . Can you please explain the standards for authorizing a bulk drug \nsubstance manufacturing facility as part of a product EUA in a public health emer-gency? \nAnswer 2(i). As stated in FDA’s Guidance for Industry, Emergency Use Authoriza-\ntion for Vaccines to Prevent COVID–19 , FDA assesses current good manufacturing \npractice (CGMP) compliance for each manufacturing site using all available tools and information. FDA expects manufacturers to submit sufficient data to ensure the quality and consistency of their product, and FDA evaluates the chemistry, manu-facturing, and controls and facility information for the product. FDA uses all avail-able tools and information, including reviews, site visits, inspections, EUA investiga-tions, and previous compliance history, and has utilized the authority under section 704(a)(4) of the FD&C Act to request records and other information from foreign and domestic establishments to assess compliance with CGMP requirements of fa-cilities that are intended to manufacture vaccines to prevent COVID–19 under an EUA. FDA has also used establishment inspection information from capable foreign regulatory authorities under the Pharmaceutical Annex to the U.S. and European Union Mutual Recognition Agreement (MRA), and the Pharmaceutical Annex to the U.S. and United Kingdom MRA, as well as other confidentiality agreements and commitments. \nFDA takes its responsibility for helping to ensure the quality of manufacturing \nof vaccines and other medical products for use during this pandemic very seriously. As outlined above, the Agency is using a variety of tools to help ensure that prod-\n91 \nucts being produced in different facilities meet the high-quality standards that \nAmericans have come to expect. It is important to note that even when companies use contract manufacturing organizations, it is ultimately the responsibility of the company that holds the EUA to ensure that the required quality standards are met. No product can be distributed by manufacturers until FDA authorizes its distribu-tion from the facility that is manufacturing it. FDA will continue to work with com-panies to ensure that the quality standards it expects for products distributed under an EUA are met, and will continue to work diligently to help bring needed medical products in a timely manner to Americans during this public health emergency. \nQuestion 2(ii) . Can you please explain the standards for authorizing a fill/finish \nmanufacturing facility as part of a product EUA in a public health emergency? \nAnswer 2(ii). Please see the response to ‘‘i’’ above. Question 3 . Current data suggests high efficacy rates among the vaccines for \nwhich Emergency Use Authorization was approved, good news for the 85.7 percent of South Carolinian seniors who have received at least one dose and the 77 percent of whom are fully vaccinated. However, as the Delta variant remains extremely con-tagious and the World Health Organization labeling the Lambda version a ‘‘variant of interest,’’ the U.S. cannot remain idle as we work to return students back into the classroom and more adults come back to work. Recently, Pfizer announced it planned to submit COVID–19 booster shot data to the FDA by mid-August 2021. American seniors, their families and caregivers, and stakeholders remain interested in knowing what the Federal Government plans to do regarding the possible author-ization and distribution of booster vaccines. This information is especially timely since the first Americans, including South Carolinian long-term facilities residents, received their initial vaccines in December 2020. \nQuestion 3(a) . Dr. Woodcock—What collaborations are occurring between the Fed-\neral Government, vaccine developers, the states, long-term care facilities, the senior community, and other interested stakeholders regarding information about booster vaccines? When will this information be made public? \nAnswer 3 & 3(a). The COVID–19 vaccines authorized in the United States con-\ntinue to be remarkably effective in reducing risk of severe disease, hospitalization, \nand death, even against the widely circulating Delta variant. Recognizing that many vaccines are associated with a reduction in protection over time, and acknowledging that additional vaccine doses could be needed to provide long lasting protection, we have been analyzing the scientific data closely from the United States and around the world to understand how long this protection will last and how we might maxi-mize it. \nFDA understands the potential importance of booster vaccine doses for control of \nthis pandemic and will promptly review any data submitted to the Agency regarding their use in a thorough and science-based manner. Due to legal and regulatory re-strictions, FDA cannot discuss product submissions that may be under review, in-cluding the timing of any potential FDA action to authorize the use of booster doses of COVID–19 vaccines. Please contact the vaccine manufacturers directly regarding their plans to submit data for their individual vaccines and the timing of such sub-missions. \nSENATOR TUBERVILLE  \nQuestion 1 . Funds in part from NIH/NIAID helped build the 12 Regional Bio-\ncontainment Laboratories (RBLs) and 2 National Biocontainment Laboratories (NBL) to support high consequence infectious disease research after 9/11 and the anthrax scares in 2001. However, unlike the NBL facilities, the RBL facilities re-ceived no further direct support until last year when Congress provided enhanced investment through NIH/NIAID, targeted specifically to RBL facilities, one of which is at the University of Alabama at Birmingham (UAB) in my state. Nevertheless, it seems as though the RBL infrastructure, most importantly the highly trained staff these facilities maintain and produce is something that falls within the pur-view of the HHS ASPR, considering among other things the UAB RBL has had col-laborations with Altimmune and ImmunityBio for COVID19 vaccine development, and supported BARDA contractors. This type of work strongly aligns with numerous ASPR Strategic Goals, such as Fostering Strong Leadership, and Sustaining Robust and Reliable Public Health Security Capabilities. The RBL infrastructure and per-sonnel is expensive to maintain and operate, and perhaps should not solely rest on either the shoulders of the host University or the NIH/NIAID. \nQuestion 1(a) . Therefore, is support from Assistant Secretary for Preparedness \nand Response (ASPR) something under consideration? \n92 \nQuestion 1(b) . If not, why not, and if so what is needed to facilitate that conversa-\ntion? \nAnswer 1(a) & (b). FDA defers to ASPR to respond to these questions. \nRESPONSE BY DAWN O’C ONNELL TO QUESTIONS OF SENATOR BALDWIN , SENATOR  \nBURR, SENATOR BRAUN , AND SENATOR TUBERVILLE  \nResponses to the QFRs are accurate as of the date of the hearing . \nSENATOR BALDWIN  \nQuestion 1 . I was encouraged to hear Assistant Secretary O’Connell’s announce-\nment that $2 billion of the $10 billion that I secured in the American Rescue Plan for domestic manufacturing and utilization of the DPA would be used to support vaccine industrial base expansion for raw materials, consumables, fill/finish capac-ity, needles, vials, and syringes. Please provide additional details on the recipients of this funding, as well as any information that can be shared regarding future obli-gations. \nAnswer 1. With $10 billion received for industrial base expansion, ASPR has been \nestablishing and maintaining domestic capacity for vaccine production and adminis-tration, in addition to a number of other efforts for PPE and pharmaceutical manu-facturing. Specifically, ASPR is executing an acquisition strategy to expand the ca-pacities and surge capabilities for high-speed, reliable sterile filling/packaging oper-ations, domestic conversion of bulk biological drug substance into drug product for distribution, and investments in manufacturing capacities to better avail raw mate-rials and consumables that are commonly used across the commercial sterile biologic products industry for production, delivery and administration (e.g., nucleoside triphosphates (NTPs), enzymes, resins, lipids, and needle and syringe sets). \nQuestion 2 . How is the Administration utilizing this funding to ensure that Amer-\nican companies that shifted and significantly expanded production of raw materials to aid in our pandemic response receive support? How is the Administration work-ing to build on our pandemic response to develop a public health industrial base with the capacity to respond to crises and make us less reliant on", "summary": "Official printed transcript of the Senate Health, Education, Labor & Pensions Committee hearing including Anthony Fauci's testimony and the exchange with Sen. Rand Paul ('you do not know what you are talking about, Senator').\n\nExcerpt: know. We don’t know if it did—but all  the evidence is pointing that it came from the lab, and there will be responsibility for those who funded the lab, including yourself.  Dr. F AUCI . I totally resent—.  45  The C HAIR . This Committee will allow the witness to respond.  Dr. F AUCI . I totally resent the lie that you are now propagating,  Senator, because if you look at the viruses that were used in the experiments, that were given in the annual reports that were pub-lished in the literature, it is molecularly impossible—.  Senator P AUL. No one is saying those viruses caused it.  Dr. F AUCI . It is molecularly—.  Senator P AUL. No one is alleging that those viruses caused the  pandemic. What we are alleging is the gain of function research was going on in that lab and NIH funded…", "source_url": "https://www.govinfo.gov/content/pkg/CHRG-117shrg46775/pdf/CHRG-117shrg46775.pdf", "pdf_url": "/archive-docs/fauci-files/c3b739640296186a5c95fb7d5f0f81a9/pdf", "doc_date": "2021-07-20", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "senate help", "rand paul", "congress", "fauci testimony", "hearing transcript", "CHRG", "you do not know what you are talking about", "testimony-senate-help-2021"], "part_number": 2, "page_count": 100}
{"title": "Fauci Testimony — Senate HELP Committee (20 Jul 2021, CHRG-117shrg46775) (Part 3 of 3)", "content": "China? \nAnswer 2. ASPR is leveraging the authorities delegated to the Secretary under \nthe Defense Production Act (DPA) to ensure that private sector partners making life-saving products are able to acquire raw materials, retool their machinery, scale their production facilities, train their workforces, and ultimately deliver their prod-uct. Throughout the COVID–19 response, ASPR has used the DPA authority to issue 46 priority ratings for U.S. Government (USG) contracts for health resources, 8 priority ratings for USG contracts for industrial expansion, and 3 priority ratings of specific purchase orders for companies manufacturing critical lifesaving health re-sources that have been impacted by COVID–19 response demands. ASPR is also continuing to build capacity and partnerships with private industry toward the shared goal of ending the COVID–19 pandemic. ASPR is also working to support efforts in expanding the domestic industrial base. These industrial base expansion (IBx) efforts seek to reduce supply chain vulnerabilities and generate a domestic ‘‘warm-base’’ for manufacturing that can be leveraged in a crisis. \nSupporting domestic vaccine development and manufacturing efforts, BARDA has \ninvested $1.256B in the advanced research and development of Moderna’s mRNA– 1273 vaccine candidate, supporting clinical trials and manufacturing scale up and validation. The investments in a mRNA vaccine will support new vaccine production platforms in the future that will improve the efficiency and reduce the timeline to develop vaccines for other biodefense threats and emerging infectious diseases. Plat-form technologies, such as the mRNA approach, can provide flexible and rapid re-sponse and have many advantages with potential to revolutionize the way vaccines and therapeutics are produced for known and newly emerging threats. \nQuestion 3 . Will the Administration commit to using some of this funding for the \nraw materials, including medical-grade meltblown, needed to produce N95 and N99 masks so that we are not dependent on countries like China for this material? \nAnswer 3. ASPR has invested over $20.5 million in several companies to increase \nand sustain melt-blown fiber production in the U.S., producing enough raw material to manufacture the equivalent of approximately 171 million N95 or 400 million sur-gical masks a month. In addition, utilizing the $10 billion received via the American Rescue Plan Act to support industrial base expansion, ASPR has been working to establish and maintain domestic capacities for N95 manufacturing. \n93 \nSENATOR BURR  \nQuestion 1 . As we saw during the early stages of the COVID–19 response, quickly \nidentifying and containing the spread of a new pathogen is a significant challenge. In preparing for the next public health threat, how is HHS taking into account addi-tional capacity for testing in health care facilities as a result of health systems’ in-vestments in high throughput instruments during the COVID–19 response? \nAnswer 1. HHS monitors the testing supply chain through collaboration with di-\nagnostic manufacturers. Ten of the major manufacturers send shipment data, install base data, and supply projections on a regular basis. HHS integrates this data into HHS Protect, a platform that overlays epidemiological data, hospital clinical data, COVID–19 testing data, and other public health metrics. Of the three main data reports, the install base data gives HHS visibility into the locations and quantity and utilization of all the high-throughput machines for a specific company. This in-formation allows HHS to monitor how additional capacity for testing has increased since the beginning of the pandemic. \nQuestion 2 . T-cell testing adds a critical dimension to how we measure immune \nresponse. How can these tests be used to inform both individual clinical decisions and a population-based, public health response, and what steps is HHS taking to include T-cell testing in planning for future public health threats? \nAnswer 2. T cells are an important component of the immune response to viruses, \nincluding SARS-CoV–2, the virus that causes COVID–19. Existing T cell testing technologies available for widespread use can be used to aid in identifying individ-uals with an adaptive T cell immune response to a virus, indicating recent or prior infection. For example, the T-Detect COVID Test, which was developed by Adaptive Biotechnologies and received an emergency use authorization (EUA) from the FDA, can help determine if a person previously had COVID–19. This test may be useful for people who have exhibited symptoms previously but have not tested positive for COVID–19 using a molecular or antigen diagnostic test. At this time, the test has only been authorized to detect prior infection by SARS-CoV–2, and cannot be used to indicate the degree of protection induced by COVID–19 vaccination or infection. \nIt is important to note that antibody or serum-based commercial assays are read-\nily available to the public and are easier and less expensive to perform than T cell assays. Antibody or serum-based tests also are generally sufficient to indicate cur-rent or previous infection/vaccination. Techniques to examine T cells are labor inten-sive, relatively expensive, and require specialized equipment and sample collection. Laboratories that perform the T-Detect test for commercial purposes also must be specifically designated by the company and have obtained specialized certification. For these reasons, monitoring of T cell responses to COVID–19—or other infectious disease threats—is only possible on a small scale at this time. Nonetheless, scientific studies of T cells can provide important insights into COVID–19 progression, protec-tion against SARS-CoV–2 variants, and durability of immunity. HHS, through the National Institute of Allergy and Infectious Diseases (NIAID), is supporting re-search to improve understanding of the role of T cells in protecting against COVID– 19 as well as in COVID–19 progression. These efforts may lead to improved T cell tests and help support the public health response to COVID–19. \nNIAID also conducts and supports basic and clinical immune research, including \non T cell responses, to improve understanding of SARS-CoV–2. NIAID supported a collaborative longitudinal study by researchers at Emory University and the Fred Hutchinson Cancer Research Center that demonstrated that T cells were detectable for up to 8 months in patients after mild to moderate COVID–19. NIAID also sup-ported two separate studies—one led by researchers from NIAID and Johns Hopkins Hospital and another by scientists from the La Jolla Institute—that examined the T cell responses in recovered COVID–19 patients and individuals vaccinated against COVID–19 and found robust immune responses to the original strain—as well as multiple variants—of SARS-CoV–2 in both groups. In another NIH-supported study, researchers uncovered features of T cells that distinguish fatal from non-fatal cases of severe COVID–19, which could lead to new treatments for this disease. \nNIAID also is funding a number of basic research studies that will inform how \nT-cell based approaches could be incorporated into future countermeasures. This in-cludes assays that measure the magnitude of T cell responses in individuals who receive the currently authorized COVID–19 vaccines. Understanding how T cells re-spond to SARS-CoV–2 infection and vaccination may help improve protection af-forded by future vaccines. Additional monitoring of T cell responses to SARS-CoV– 2 may also improve our understanding of the extent and longevity of immunological protection against SARS-CoV–2. \n94 \nQuestion 3 . Health systems have experienced a spike in cyber-attacks during the \npandemic. For example, Universal Health Services, Inc. experienced a cybersecurity attack in September 2020, which forced hospital systems offline for weeks. Pursuant to the 2020 National Defense Authorization Act Section 9002, the ASPR was des-ignated as the sector risk management agency for the health care and public health sector. \nQuestion 3(a) . What work does ASPR perform as the sector risk management \nagency? Of this work, what proportion is specific to cybersecurity? \nAnswer 3 & 3(a). This past year has been full of challenges, and HHS has found \nourselves responding to increased quantities and new types of cyber-attacks against the Healthcare and Public Health Sector. In ASPR, the Division of Critical Infra-structure Protection (CIP) serves as the hub for HHS as the sector-specific agency. Based on authorities included in the 2021 National Defense Authorization Act (NDAA), CIP is now the focal point for HHS as the sector risk management agency. The goal of sector risk management agencies is to look at the entire sector—in this case, health care and public health—for all hazards. CIP works closely with govern-ment and private sector partners through the structure of the Critical Infrastruc-ture Partnership Advisory Council to identify and address risks across the sector— working with hospitals, pharmacies, manufacturers, distributors, health IT pro-viders, insurance plans, and mass fatality managers. Over the past 5 years, CIP has been focused on four main areas of risks management: \n1. Identifying risks at facilities across the sector in an objective data driven \nmanner through our Risk Identification and Site Criticality Tool (RISC), currently in development of an enhanced, web-based version. The RISC tool identifies cyber risks alongside natural hazard and other manmade risks, unlike many other tools used in the sector, thus promoting conversation be-tween IT security staff and emergency managers. The tool was released 2 years ago and has been downloaded in all 50 states and utilized by at least 1,400 individuals. \n2. Monitoring supply chain challenges in the health sector, including de-\npendence on foreign sourcing and challenges of just-in-time-distribution; \n3. Overall mitigation of risks before, during, and after disasters—with a \nfocus on planning for and communicating during responses, including Hur-ricane Maria and the WannaCry and Petya/notPetya cyber incidents of 2017, wildfires, hurricanes, and the COVID–19 pandemic; and \n4. Coordinating with the White House, DHS, and the FBI to enhance HHS’ \nability to identify and share cyber hygiene best practices; promote sharing of cyber incident information; engage in discussion and coordination with the private sector on priority education, policy, and communications activi-ties; and exercise existing and new cyber plans among government and pri-vate sector partners. \nAs cybersecurity is such a threat to the Healthcare and Public Health Sector, CIP \nmakes sure to incorporate that risk into a majority of projects to both raise aware-ness and encourage all those involved in the partnership to recognize their potential role in preventing or responding to cyber incidents. \nQuestion 3(b) . How has ASPR been executing its cybersecurity responsibilities as \npart of this role and/or how does ASPR plan to execute these responsibilities? If the latter, what is ASPR’s timeline for putting into place this plan? \nAnswer 3(b). ASPR led the development of a ‘‘strategy for public health prepared-\nness and response to address cybersecurity threats’’ that was required by section 703(a)(1) of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019. This strategy was delivered to the HELP Committee on August 2, 2021 by Secretary Becerra. This strategy identifies duties, functions, preparedness and response goals for which HHS is responsible for the Healthcare and Public Health (HPH) Sector. It also includes strategies to address identified gaps and strengthen public health emergency preparedness and response capabilities. \nASPR will direct and monitor implementation of this strategy through the CIP Di-\nvision, relying on expertise and activity from many HHS Operating and Staff Divi-sions, including the FDA for medical devices, OCR for privacy and security, ONC for health IT, and OCIO for the HC3 and 405d programs. ASPR also manages the Critical Infrastructure Partnership Advisory Council Joint Cybersecurity Working Group, with hundreds of members. The group bases its work on the recommenda-tions of the 2018 Healthcare Industry Cybersecurity Task Force and is currently de-veloping CY2022 joint priorities. \n95 \nASPR CIP has led the development of the HPH sector Incident Response plan, \nwhich will be appended as an annex to the all hazard plan. The plan describes the full spectrum of the USG response to HPH cyber incidents, including coordination of tactical activities among HHS, FBI and CISA; development of an assessment of the effect of cyber incidents on delivery of care, on supply chains, and on system integrity; engagement of ESF–8 as necessary; and development of post-incident re-porting and of after-action plans. \nQuestion 3(c) . How many FTEs and resources are dedicated to cybersecurity at \nASPR? \nAnswer 3(c). For the management of the Sector Risk management Agencies \n(SRMA) role for external HPH Sector Cybersecurity (which excludes internal HHS/ ASPR IT security), ASPR has one dedicated staff member supporting cybersecurity preparedness across the health care and public health (HPH) sector, partial time of a second staffer and two contractor positions currently waiting to be filled. In addi-tion, ASPR staff greatly leverage external resources of HHS, DHS, and the private sector to ensure comprehensive risk management for the HPH Sector. Specific ac-tivities include: \n•Co-chairing the Joint Cybersecurity Working Group comprised of 15 sub-\nject-specific Task Groups and over 300 organizations represented; \n•Leading efforts of Federal, state, local, tribal and territorial entities to de-\nvelop and disseminate Sector-wide recommendations and guidance to pre-\npare and better secure the sector from Cyber threats, to identify risks from cyber threats, lead response efforts to HPH-wide cyber events, and promote mitigation and resiliency strategies; \n•Collaborating with private sector and Federal, state, local, territorial, and \ntribal partners to establish and lead work groups to address rec-ommendations made by the Healthcare Industry Cybersecurity Task Force Report for improving healthcare cybersecurity, released in June 2017; \n•Leading collaborative interagency and other HPH sector efforts to iden-\ntify emerging cyber risks in HPH, including risks associated with emerg-ing technologies such as artificial intelligence and machine learning- based tools, as well as risks associated with new care delivery models such as telehealth; \n•Leading tracking and assessment efforts during the Federal response to \nCyber Incidents; \n•Developing and implementing mitigation strategies as well as incident \nand after action reports to inform and advise on future response oper-ations; and, \n•Creating a bi-weekly bulletin on cybersecurity topics that reaches ap-\nproximately 3,000 subscribers. Topics discussed in the bulletin include in-formation pertinent to understanding and mitigating cybersecurity risks across all critical infrastructure sectors, identification and analysis of trends in cyberattacks and vulnerabilities, best practices for general cyberhygiene, and specific recommendations for addressing significant cyber threats. \nQuestion 3(d) . How does ASPR coordinate with the Cybersecurity and Infrastruc-\nture Security Agency and the Federal Bureau of Investigations? \nResponse: One of the ways ASPR collaborates with CISA is by promoting their \ntools and resources and sharing info that could help our sector partners. ASPR serves as a conduit between the Healthcare and Public Health (HPH) Sector and CISA. Confronting cybersecurity threats requires contributions from across the Fed-eral Government, including CISA, the FBI’s National Cyber Investigative Joint Task Force, and other stakeholders. ASPR participates in weekly calls with CISA col-leagues and our health sector partners. ASPR also works closely with CISA through the Federal Senior Leadership Council Roles and Responsibilities work, through which we have negotiated mechanisms of sharing information between SRMAs, CISA, and the FBI. \nQuestion 3(e) . Please describe ASPR’s coordination with the health care and public \nhealth sector specifically related to cybersecurity. \nAnswer 3(e). As described above, ASPR holds weekly calls with sector partners \nto discuss cybersecurity threats. During these calls, ASPR is able to provide both the specialized knowledge regarding cybersecurity as well as sector-specific knowl-edge to assist partners in preventing and responding to incidents like a ransomware \n96 \nattack. ASPR is also able to create private sector partnerships that have a Federal \nAdvisory Committee Act (FACA) exemption so that we can meet with the same pri-vate sector partners and request consensus advice and recommendations from them in a closed setting. Last, ASPR holds joint sector working groups with private sector and government sector partners to identify topics to work on, analyze best practices, and develop products to release to the private sector. \nSENATOR BRAUN  \nQuestion 1 . Can you please provide specific updates on your plans to ensure that \nnursing home staff and residents have sufficient point of care molecular diagnostics and access to the most appropriate prophylactics and treatments? \nAnswer 1. You should be aware that HHS has and continues to distribute approxi-\nmately 3 million point of care tests to long term care facilities on a weekly basis. In addition, HHS monitors the testing supply chain through collaboration with diag-nostic manufacturers. Ten of the major manufacturers send shipment data, install base data, and supply projections on a regular basis. HHS integrates this data into HHS Protect, a platform that overlays epidemiological data, hospital data, testing data, and other public health metrics. Of the three main data reports, the install base data gives HHS visibility into the locations and quantity of all the high- throughput machines for a specific company. This information allows HHS to mon-itor how additional capacity for testing has increased since the beginning of the pan-demic. \nSENATOR TUBERVILLE  \nQuestion 1 . Funds in part from NIH/NIAID helped build the 12 Regional Bio-\ncontainment Laboratories (RBLs) and 2 National Biocontainment Laboratories (NBL) to support high consequence infectious disease research after 9/11 and the anthrax scares in 2001. However, unlike the NBL facilities, the RBL facilities re-ceived no further direct support until last year when Congress provided enhanced investment through NIH/NIAID, targeted specifically to RBL facilities, one of which is at the University of Alabama at Birmingham (UAB) in my state. Nevertheless, it seems as though the RBL infrastructure, most importantly the highly trained staff these facilities maintain and produce is something that falls within the pur-view of the HHS ASPR, considering among other things the UAB RBL has had col-laborations with Altimmune and ImmunityBio for COVID19 vaccine development, and supported BARDA contractors. This type of work strongly aligns with numerous ASPR Strategic Goals, such as Fostering Strong Leadership, and Sustaining Robust and Reliable Public Health Security Capabilities. The RBL infrastructure and per-sonnel is expensive to maintain and operate, and perhaps should not solely rest on either the shoulders of the host University or the NIH/NIAID. \nQuestion 1(a) . Therefore, is support from Assistant Secretary for Preparedness \nand Response (ASPR) something under consideration? \nAnswer 1(a). NIAID provided funding in 2003 and 2005 for the construction of Na-\ntional Biocontainment Laboratories (NBLs) and Regional Biocontainment Labora-tories (RBLs). The NBLs and RBLs are designed to complement and support the re-search activities of NIAID-funded biodefense and emerging infectious diseases re-search as well as assist national, state, and local public health efforts. The NBLs and RBLs achieve this mission by providing safe and secure state-of-the-art BSL– 3/4 laboratory space to the scientific community to advance research on biodefense pathogens and emerging infectious diseases. NIAID’s mission to support the devel-opment of medical products to counter bioterrorism and emerging and reemerging infectious diseases is part of a larger national strategy that involves many agencies. \nThe majority of Federal oversight of U.S. BSL3/4 labs is done on those conducting \nselect agent research, and falls under the purview of CDC and USDA through the Select Agent Program. Additional certification and oversight responsibilities for BSL3/4 labs is handled at the level of the institution. As such, NIH and ASPR over-sight is generally limited to oversight of funded research. \nQuestion 1(b) . If not, why not, and if so what is needed to facilitate that conversa-\ntion? \nAnswer 1(b). See response to 1(a). \n[Whereupon, at 12:24 p.m., the hearing was adjourned.] \nÆ", "summary": "Official printed transcript of the Senate Health, Education, Labor & Pensions Committee hearing including Anthony Fauci's testimony and the exchange with Sen. Rand Paul ('you do not know what you are talking about, Senator').\n\nExcerpt: China?  Answer 2. ASPR is leveraging the authorities delegated to the Secretary under  the Defense Production Act (DPA) to ensure that private sector partners making life-saving products are able to acquire raw materials, retool their machinery, scale their production facilities, train their workforces, and ultimately deliver their prod-uct. Throughout the COVID–19 response, ASPR has used the DPA authority to issue 46 priority ratings for U.S. Government (USG) contracts for health resources, 8 priority ratings for USG contracts for industrial expansion, and 3 priority ratings of specific purchase orders for companies manufacturing critical lifesaving health re-sources that have been impacted by COVID–19 response demands. ASPR is also continuing to build capacity and partnerships with…", "source_url": "https://www.govinfo.gov/content/pkg/CHRG-117shrg46775/pdf/CHRG-117shrg46775.pdf", "pdf_url": "/archive-docs/fauci-files/c3b739640296186a5c95fb7d5f0f81a9/pdf", "doc_date": "2021-07-20", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "senate help", "rand paul", "congress", "fauci testimony", "hearing transcript", "CHRG", "you do not know what you are talking about", "testimony-senate-help-2021"], "part_number": 3, "page_count": 100}
{"title": "Fauci Testimony — Senate HELP Committee (CHRG-117shrg46765) (Part 1 of 2)", "content": "U.S. GOVERNMENT PUBLISHING OFFICE\nWASHINGTON : 46–765 PDF 2022 S. H RG. 117–185 \nAN UPDATE FROM FEDERAL OFFICIALS \nON EFFORTS TO COMBAT COVID–19 \nHEARING \nOF THE  \nCOMMITTEE ON HEALTH, EDUCATION, \nLABOR, AND PENSIONS \nUNITED STATES SENATE \nONE HUNDRED SEVENTEENTH CONGRESS \nFIRST SESSION \nON \nEXAMINING AN UPDATE FROM FEDERAL OFFICIALS ON EFFORTS TO \nCOMBAT COVID-19 \nMAY 11, 2021 \nPrinted for the use of the Committee on Health, Education, Labor, and Pensions \n( \nAvailable via the World Wide Web: http://www.govinfo.gov \n(II) COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS \nPATTY MURRAY, Washington, Chair \nBERNIE SANDERS (I), Vermont \nROBERT P. CASEY, JR., Pennsylvania TAMMY BALDWIN, Wisconsin CHRISTOPHER S. MURPHY, Connecticut TIM KAINE, Virginia MAGGIE HASSAN, New Hampshire TINA SMITH, Minnesota JACKY ROSEN, Nevada BEN RAY LUJAN, New Mexico JOHN HICKENLOOPER, Colorado RICHARD BURR, North Carolina, Ranking \nMember \nRAND PAUL, M.D., Kentucky SUSAN M. COLLINS, Maine BILL CASSIDY, M.D., Louisiana LISA MURKOWSKI, Alaska MIKE BRAUN, Indiana ROGER MARSHALL, M.D., Kansas TIM SCOTT, South Carolina MITT ROMNEY, Utah TOMMY TUBERVILLE, Alabama JERRY MORAN, Kansas \nE\nVAN T. S CHATZ , Staff Director \nDAVID P. C LEARY , Republican Staff Director \nJOHN RIGHTER , Deputy Staff Director \n(III) CONTENTS  \nSTATEMENTS \nTUESDAY, MAY 11, 2021 \nPage \nCOMMITTEE MEMBERS  \nMurray, Hon. Patty, Chair, Committee on Health, Education, Labor, and \nPensions, Opening statement .............................................................................. 1 \nBurr, Hon. Richard, Ranking Member, a U.S. Senator from the State of \nNorth Carolina, Opening statement ................................................................... 3 \nWITNESSES  \nWalensky, Rochelle, M.D., MPH, Director, United States Centers for Disease \nControl and Prevention, Atlanta, GA ................................................................. 6 \nPrepared statement .......................................................................................... 7 \nFauci, Anthony, M.D., Director, National Institute of Allergy and Infectious \nDiseases, National Institutes of Health, Bethesda, MD ................................... 15 \nPrepared statement .......................................................................................... 17 \nMarks, Peter, M.D., Ph.D., Director, Center for Biologics Evaluation and \nResearch, United States Food and Drug Administration, Silver Spring, \nMD ......................................................................................................................... 23 \nPrepared statement .......................................................................................... 25 \nKessler, David, M.D., Chief Science Officer, COVID Response, United States \nDepartment of Health and Human Services, Washington, DC ........................ 30 \nPrepared statement .......................................................................................... 31 \nADDITIONAL MATERIAL \nStatements, articles, publications, letters, etc. Collins, Hon. Susan: \nA Misleading C.D.C. Number By David Leonhardt, The New York Times . 71 \n(1) AN UPDATE FROM FEDERAL OFFICIALS \nON EFFORTS TO COMBAT COVID–19 \nTuesday, May 11, 2021 \nU.S. S ENATE , \nCOMMITTEE ON HEALTH , EDUCATION , LABOR , AND PENSIONS , \nWashington, DC. \nThe Committee met, pursuant to notice, at 10:04 a.m., in room \n106, Dirksen Senate Office Building, Hon. Patty Murray, Chair of \nthe Committee, presiding. \nPresent: Senators Murray [presiding], Casey, Baldwin, Murphy, \nKaine, Hassan, Smith, Rosen, Hickenlooper, Burr, Paul, Collins, Cassidy, Murkowski, Braun, Marshall, Tuberville, and Moran. \nOPENING STATEMENT OF SENATOR MURRAY \nThe C\nHAIR . Good morning. The Senate Health, Education, Labor, \nand Pensions Committee will please come to order. \nToday, we are hearing the latest update from Federal officials \nabout our efforts to fight the COVID–19 pandemic. Ranking Mem-ber Burr and I will each have an opening statement, and then I will introduce our witnesses, Doctors Walensky, Fauci, Marks, and Kessler. \nI am glad to have you all back before our Committee today, and \nI know we will continue to hear from you as we work to end this pandemic. \nAfter the witnesses give their testimony today, each senator will \nhave 5 minutes for a round of questions. \nBefore we begin, I want to again walk through the COVID–19 \nsafety protocols that are in place today. We will follow the advice of the Attending Physician and Sergeant at Arms in conducting this hearing. We are again grateful to all of our Clerks and every-one who has worked so hard to get this set up and help everyone stay safe and healthy. \nCommittee Members are seated at least 6 feet apart, and some \nSenators are participating by videoconference. And while we are unable to have this hearing fully open to the public or media for in-person attendance, live video is available on our Committee website at help.senate.gov. And if you are in need of accommoda-tions, including closed captioning, you can reach out to the Com-mittee or the Office of Congressional Accessibility Services. \nWhile we are not yet through this pandemic, it is clear we are \nmaking significant progress. We administered well over 200 million COVID–19 vaccines in President Biden’s first 100 days. Over half the adult population has gotten at least one dose; one-third of the \n2 \nCountry is fully vaccinated. Schools, businesses, and communities \nare working to safely reopen. And, the Food and Drug Administra-tion has now authorized vaccines for adolescents. So, we have come a long way in the last few months. \nBut, even as we are encouraged by the progress so far, we are \nall keenly aware more work lies ahead. This pandemic has touched every community in our Country and every corner of the world. To truly end it, vaccines have to be just as widespread. \nWhile some progress is being made, for example in my home \nState of Washington, they have released a dashboard with vaccina-tion data, the latest numbers from which show Washington State has vaccinated over five million people, and we are vaccinating around 50,000 more a day. The data also shows vaccinations are lagging in some areas, especially for Black, Latino, Tribal, and rural communities, and not just in my state, but across the Coun-try. \nIn some states, we are still lacking key data on demographic \ncharacteristics, including race and ethnicity. We have to address systemic inequities and tear down barriers that are making it harder for some people to get vaccines. Everyone must have the op-portunity to get vaccinated regardless of race, zip code, disability, primary language, or internet access. \nWe are also seeing vaccination rates slow. It is a reminder that \nmaking sure people can get vaccines is just half the battle. We need to make sure they do get them. To make that happen, we need to make sure people are getting reliable information about vaccines and hearing from voices they trust about why getting vac-cinated is so important, not just to protect themselves, but to pro-tect those around them and stop this disease from spreading or mutating into new deadly strains. \nI am glad the Biden administration is continuing to release funds \nfrom the American Rescue Plan to help address some of these chal-lenges, including last week when they announced almost a billion dollars to strengthen our response in rural communities, and one- quarter of a billion dollars to develop and support a community- based workforce to help underserved groups get information about vaccines, schedule appointments, arrange transportation, and more. \nAs we work to get our Nation vaccinated, we have to also ac-\nknowledge this is a global fight and do our part to lead on the world stage. The deadly outbreak in India is a heartbreaking re-minder of what can happen when this virus spreads unchecked, when it mutates into more contagious, more deadly strains, and when it overwhelms healthcare systems. It is a reminder this pan-demic will not fully be over for our Country until it is over for the world, which is why I am glad the Biden administration is sending medical support to India, sharing some of our excess doses globally, and even considering other steps to remove barriers to vaccines for countries that need them, including a targeted waiver of COVID– 19 patent protections. \nThese moves will not just save lives in India. They will ulti-\nmately save lives in Washington State, North Carolina, and across the Country. Because people get that when there is a fire down the street, it is in their best interest to put it out before it gets to their \n3 \nfamily’s home, not to mention that helping your neighbor is always \nthe right thing to do. \nI am also hearing from lots of people in my home state who real-\nly feel we cannot simply end this crisis and never look back. We have to learn from it. We have to be better prepared for the next public health emergency so that we are never again in a situation like this, which is why Ranking Member Burr and I plan to develop bipartisan legislation to address and build on lessons learned from the COVID–19 response; ensure robust public health and medical capacity to provide services to those most at risk; improve and sup-ply the supply chain for critical medical supplies; tackle the health disparities that afflict so many of our communities; and strengthen the Nation’s public health infrastructure and medical preparedness and response programs at every level. \nI look forward to having more hearings specific to that work soon \nand hearing what our witnesses today have to say on that subject, as well. \nAs Federal officials on the front lines of this pandemic, you all \nhave an important perspective into the progress we are making today, as well as the lessons we must learn for tomorrow. \nNow, I will turn it over to Ranking Member Senator Burr for his \nopening remarks. \nOPENING STATEMENT OF SENATOR BURR \nSenator B\nURR. Thank you, Madam Chair. I am glad we are hold-\ning another hearing to update us on the status of COVID–19 re-sponse. And, to our witnesses, thank you for the work you have done. More importantly, welcome back to the Committee. \nIt has been almost 18 months since the initial reports of severe \npneumonia in Wuhan, China surfaced. Since that time, we have tragically seen over a half million deaths in this Country from COVID–19. Government-backed shutdowns have jeopardized the livelihood of millions of Americans, and we have spent more tax-payer money than I could have ever imagined in response to this virus and the devastating effect it has had on our economy. \nBut, now, more than ever, there is reason for hope. We are see-\ning the promise of vaccines and treatments in real time. A month ago, the case count in the United States was over 70,000 new cases per day. Today, we are down to roughly 40,000 and headed south. The CDC is projecting continued declines in death and hospitaliza-tion rates. \nBecause of Operation Warp Speed, Dr. Marks, Dr. Fauci, Dr. \nHahn, and the FDA, we have fully vaccinated 115 million Ameri-\ncans, which is roughly 44 percent of adults, and delivered almost 330 million doses to states. Operation Warp Speed and BARDA spent more than $18 billion to make vaccines available to Ameri-cans, manufacturing vaccines at risk, and the American people are benefiting from that today. Manufacturers were able to produce vaccines, enough vaccines, that the United States is now able to help provide vaccines to countries in need, like India. \nBecause of the collaborative efforts over the last year, we are \nready to turn the corner. The partnerships developing in manufac-turing the COVID–19 vaccines have been one of the biggest sci-entific success stories in generations. Industry answered the call at \n4 \nthe start of the pandemic and partnered in an unprecedented way \nto bring us these live-saving products. \nIntellectual property is part of the reason we have these life-sav-\ning products today. If these protections are not in place for innovators of life-saving medicines, we will not have them for the next pandemic. It is that simple. \nWe held a hearing on the threat of China taking intellectual \nproperty from U.S. research, and now the Biden administration has agreed just to hand it over. There is a way to support the manufac-turing of vaccines globally and help countries in need without act-ing in bad faith against innovators who stepped up when the world needed them the most. \nIt is the partnerships we are already seeing today that are sav-\ning lives, not silly ideas about socializing means of production. The action from the Biden administration to support waiving intellec-tual property rights will undermine the innovation we are relying on to bring this pandemic to an end and will leave us with a less- prepared future. \nI am encouraged that some of our European allies cautioned \nagainst this reckless action, and I hope the adults in the Biden ad-ministration will realize that what sounds good in a grad school ivory tower thesis paper does not make sense in the real world. You four are the adults in the room. I urge you to think about the real consequences if we just give away this science and this tech-nology. \nThe next part of our job is going to be the difficult part. I have \nbeen looking to Israel to help predict the challenges that we may be in store for in the U.S. since they are ahead of us on vaccination rates today. Israel was able to vaccinate 40 percent of the adult population by the end of February. Their data shows that uptake stalled once they vaccinated about 60 percent of the adult popu-lation. While there are differences between our countries, we have to use the information we have to best predict our road ahead. \nEvery adult has the opportunity to be vaccinated, and supply is \nstarting to exceed demand. In other words, we have more shots than we have arms to put it in. We need to address vaccine hesi-tancy, and it needs to be done now. \nI know this is the case in my state with recent reports from Wil-\nmington, North Carolina that local officials are changing their ap-proach as vaccine demands slow. We must paint a picture for the American people showing the benefits of both a vaccination and a reopening of our Country. This is a simple message for those in leadership positions. \nI got the vaccine. My wife got the vaccine. My sons got the vac-\ncine. Their wives got the vaccine. I have encouraged all of my staff to take it as soon as it is available to them. And, I have gone through the last 24 hours with a real fear that I had a one-and- a-half year old grandson who might have had COVID. Fortunately, it all came back negative and he will hopefully leave the hospital \nsometime today. \nBut, I would guess that everyone in this room is vaccinated, \nwhich means if we follow the CDC guidelines, we can dispense with masks and social distancing. Tomorrow, I hope that we are going \n5 \nto have a vaccine that is approved for kids over 12, and ones \nyounger hopefully in the not-too-distant future. \nWe must reassure Americans that COVID vaccines are safe. Vac-\ncines save lives. I might have been naive when we started this, be-lieving that staying out of the hospital and not dying might have been motivation enough to get people vaccinated. It clearly was not. And that is why we must reassure Americans that if you get a COVID vaccine, our lives can and will return to normal. But, we cannot assure, without painting that picture for them, what that looks like. Today’s response is preparing us for tomorrow’s threat. \nAs Senator Murray said, we have launched a joint effort to \nstrengthen our public health preparedness programs for the next threat, which we will inevitably face. That threat could be emerg-ing today, or it could be a new virus, another curveball from Moth-er Nature, or the result of deliberate, manmade attacks on our Country. \nOur framework has always been flexible and it needs to stay that \nway. There will always be lessons that we learn from each re-sponse, and our threat landscape is constantly evolving. Our expe-rience with this pandemic has made that even more clear. \nSenator Murray and I look forward to working with each of you \nand the Members of the Committee on this project to take stock of lessons learned and to actually put them into action. \nTo our witnesses today, thank you for all you have done up to \nthis point of the response, but know that the most challenging days may be the next several weeks and months ahead as we attempt to get to a vaccination level that changes the glidepath to one that is permanently in the decline. \nWith that, I thank the Chair. The C\nHAIR . Thank you, Senator Burr, and I look forward to \nworking with you on that, and I wish your grandson well. \nSenator B URR. Thank you. \nThe C HAIR . I will now introduce today’s witnesses. \nDr. Rochelle Walensky is the Director of the Centers for Disease \nControl and Prevention and the Administrator of the Agency for Toxic Substances and Disease Registry. \nDr. Walensky, welcome back. Thank you for joining us today. Next, I would like to introduce Dr. Anthony Fauci, who is the Di-\nrector of the National Institute of Allergy and Infectious Diseases and the Chief Medical Advisor on President Biden’s COVID–19 Re-sponse Team. \nDr. Fauci, good to have you back before the Committee, as well. \nThank you for joining us. \nDr. Peter Marks is the Director of the Center for Biologics Eval-\nuation and Research for the Food and Drug Administration. \nDr. Marks, we are glad to have you here again, as well. Thank \nyou. \nFinally, I would like to introduce Dr. David Kessler. Dr. Kessler \nis the Chief Science Officer of the Biden administration’s COVID– \n19 Response Team. \nDr. Kessler, glad to have you with us, as well. With that, we will begin our witness testimony. Dr. Walensky, \nwe will begin with you for your opening statement. \n6 \nSTATEMENT OF ROCHELLE WALENSKY, M.D., MPH, DIRECTOR, \nUNITED STATES CENTERS FOR DISEASE CONTROL AND PRE-\nVENTION, ATLANTA, GA \nDr. W ALENSKY . Thank you, Chair Murray, Ranking Member \nBurr, and Members of the Committee for the invitation to speak \nwith you today. \nI last testified before this Committee less than 2 months ago. \nSince that time, the dedicated professionals at CDC have been working diligently to provide additional resources to states, local-ities, territories, and tribes thanks to support from Congress. We are updating our guidance based on the latest scientific evidence, and we are working with our partners around the Country and around the globe to reduce the burden of COVID–19. \nI am pleased to report that since January, we have seen a con-\nsistent downward trend with daily averages of new infections drop-ping 76 percent, hospitalizations down 71 percent, and reported deaths decreasing by 75 percent. \nThis progress is also reflected in our data on the county-level \nrisk. Just a few months ago, 85 percent of all counties in the U.S. were experiencing high COVID–19 transmission rates and in-creased community risk. This morning, that is down to 33 percent of counties. \nThese trends give me hope. And, still, I continue to emphasize \nthat we must remain diligent and committed to our surveillance and prevention efforts because the emergence of variants could set us back. \nWith your help, CDC is using the $1.7 billion Congress provided \nto expand nationwide genomic sequencing efforts. Since January, we have dramatically increased sequence output from 3,000 sam-\nples per week to approximately 35,000 samples per week. \nWe are also keeping our commitment to prioritize health equity. \nSince March, we have announced a number of investments that center in health equity. These include $2.25 billion to address COVID–19-related health disparities and advance health equity among high-risk and underserved populations; $3 billion to strengthen vaccine confidence, with a focus on increasing uptake and equity in administration, particularly in communities hardest hit by the pandemic; $332 million in community health workers to support COVID–19 prevention and control; and $250 million to de-velop targeted strategies for vaccine education and outreach for up-take in specific communities. \nIn addition, CDC continues to update our guidance as we learn \nmore. This includes a recent update outlining levels of risk of ac-tivities for fully vaccinated and unvaccinated people. We will con-tinue to update this guidance to be clear that vaccines are a means of returning to activities we stopped as a result of the pandemic. \nI am so proud to report the administration of more than 261 mil-\nlion vaccine doses, including more than 133 million since I last tes-tified before you in March. Over 84 percent of Americans age 65 and older, and over 58 percent of all adult Americans have now re-ceived at least one vaccine dose. \nWith these cases trending down in the United States and more \npeople getting vaccinated, we are cautiously optimistic. However, globally, the pandemic is more severe than ever. India’s surge of \n7 \ncases is tragic and a reminder that the virus can rapidly outstrip \nour efforts to contain it if we are not careful. We will not end this pandemic without working hand in hand with countries around the globe to fight COVID–19. \nI want to take a moment to acknowledge that while we have \nmade great progress over the last few months, more than 579,000 people in the United States have died from COVID–19 during this pandemic. And just since I saw you in March, over 39,000 of our loved ones have died from COVID–19 in the United States. Every death is a stark reminder of why we must remain vigilant and fo-cused to end this pandemic as quickly as possible. \nI want to close with a promise and an appeal to the American \npeople. My promise is that CDC will continue to follow the science as our guide. And, my appeal is to implore everyone to get a COVID–19 vaccine as soon as possible as the fastest way to end this pandemic. \nBut, even with this powerful tool, while we continue to have com-\nmunity transmission, we must also maintain public health meas-ures we know will prevent the spread of this virus—masks, hy-giene, hand hygiene, and physical distancing. \nFinally, as we get through this pandemic, we must work together \nover the months and years ahead to build on the investments, part-nerships, and innovations that we have created during this crisis. This includes achieving sustainable investments in public health infrastructure to be better prepared for whatever comes next. It is one way we can turn tragedy into lasting progress and improved health for all. \nThank you again for the opportunity and invitation to testify \ntoday, and I look forward to answering your questions. \n[The prepared statement of Dr. Walensky follows:] \nPREPARED STATEMENT OF ROCHELLE WALENSKY  \nChairman Murray, Ranking Member Burr, and distinguished Members of the \nCommittee. It is an honor to appear before you again today to discuss the Centers \nfor Disease Control and Prevention’s (CDC) ongoing response to the COVID–19 pan-demic. I am grateful for this opportunity to address this Committee as well as for your partnership and leadership in responding to COVID–19. \nIt is my privilege to represent CDC. CDC is America’s health protection agency. \nWe work 24/7 to prevent illness, save lives, and protect America from threats to health, safety, and security. CDC is proud of its key role in preparedness and re-sponse to public health concerns here in the United States and abroad. Addressing infectious diseases and pandemics, like COVID–19, is central to our mission. CDC’s \nexpertise lies in our ability to study emerging pathogens like SARS-CoV–2, to un-derstand how they are transmitted, and to translate that knowledge into timely public health action. By deploying experts on the ground to support our state, Trib-al, local, and territorial partners, we translate science into guidance that protects individuals, communities, and populations. In our work with other Federal agencies we ensure the safe and appropriate use of medical countermeasures, including vac-cines, and collaborate with the academic sector to further our understanding of new diseases. \nI’ve had the honor of being the Director of this agency for over 4 months, and it \nis clear to me that all of this work is done by expert staff with great dedication to, and pride in, their work. They work tirelessly to respond to the COVID–19 pan-demic, and I am committed to making sure that their efforts to conduct and analyze the data allow science to drive our path forward. \nCDC Efforts to Date \nWhile COVID–19 cases have recently decreased, COVID–19 transmission remains \nwidespread across the Nation. We are hopeful. We have made significant progress \n8 \nin getting shots in arms. But, given that many people around the country are not \nyet fully vaccinated and given the threat of variants, we must remain cautious. \nIt goes without saying, we have been tested over the past nearly year and a half. \nIt has been an extraordinarily difficult time for the United States. And I want to take a moment to recognize the more than 570,000 Americans—mothers, fathers, sisters, brothers, wives, husbands, grandparents, and children—who have died be-cause of the pandemic. Every loss is felt. By grieving families, by friends who are unable to say goodbye because of hospital mitigation strategies, by communities dev-astated by the disparate impact of this virus. We also acknowledge the millions of others who have suffered with this disease and recognize there are so many who will require long-term care and support. \nAs hard as this has been, we can still persevere. If we can just stay the course \na little longer by strengthening and maintaining evidence-based prevention meas-ures while vaccinations continue to ramp up, we can prevent a lot of disease and save a lot of lives. \nRight now, we are in a race to stop transmission. Variants of this virus that have \nslight genetic differences from the initial strain have emerged, and available data suggest some are more transmissible. CDC has expanded sequence surveillance across the United States to improve our understanding about the impact of these variants on vaccine effectiveness, severity of disease, transmission, and mortality. \nWe must continue to use every tool we have to fight this virus: wearing masks, \nsocial distancing, handwashing, and administering vaccines. \nThe scale of this unprecedented public health emergency requires unprecedented \naction—at CDC, more than 8,500 CDC personnel have been part of our COVID–19 response, both at CDC headquarters and in the field. More than 1,500 staff have taken part in over 3,000 deployments to nearly 300 locations across the United States and around the world. \nCDC is working to ensure that public health decisions are based on the highest- \nquality scientific information. \nSince the start of the pandemic, over 250 COVID–19 studies have been published \nin the Morbidity and Mortality Weekly Report (MMWR) on topics ranging from health disparities exacerbated during the pandemic, to prevention strategies, to emergence of new variants. CDC has also produced more than 6,000 documents to provide information and guidance for government agencies, businesses, and the pub-lic. CDC is actively studying the epidemiology of post-COVID conditions (often re-ferred to as long COVID), including the prevalence, duration, and severity of symp-toms following acute SARS-CoV–2 infection, as well as risk factors for developing post-COVID conditions. This work will help to establish a more complete under-standing of the natural history of SARS-CoV–2 infection and post-COVID condi-tions, which can inform healthcare strategies, clinical decision-making, and the pub-lic health response to this virus that will be required over the long term. A recent MMWR article found that among 3,000 adults with COVID–19 who didn’t require a hospital stay, two out of three returned for at least one outpatient visit within one to 6 months after COVID–19 diagnosis; many with recurring symptoms poten-tially related to COVID–19. \nThe new resources provided by President Biden’s American Rescue Plan will \nfurther scale up the public health efforts needed to contain the virus , \nthrough six critical priorities: \n•a strengthened national vaccination program, \n•increased testing to protect at-risk populations, \n•expansion of the public health workforce, \n•protection for vulnerable populations, \n•a commitment to U.S. leadership in the global response, and \n•enhanced surveillance to identify emerging strains. \nNow I want to take a moment to give you a more in-depth update on some key \nareas for the COVID–19 response. \nVariants \nCOVID–19 has brought to the forefront how interconnected we are as a global \ncommunity and the importance of our international scientific relationships. \nIn the fall of 2020, several SARS-CoV–2 variants emerged, some of which appear \nto spread more easily than others. There is also concern with how well the variants \nare neutralized by antibodies elicited through prior infection or vaccination. The \n9 \nemergence of variants is, of course, concerning, and it underscores the critical need \nfor genomic surveillance and increased vigilance in the implementation of public health prevention measures. \nIn anticipation of these ongoing threats, the Department of Health and Human \nServices (HHS) established the SARS-CoV–2 Interagency Group to improve coordi-nation across the CDC, National Institutes of Health, Food and Drug Administra-tion (FDA), Biomedical Advanced Research and Development Authority, United States Department of Agriculture, and Department of Defense. This interagency group is focused on the rapid characterization of the emerging variants of concern and is actively monitoring the potential impact on critical SARS-CoV–2 counter-measures including vaccines, therapeutics, and diagnostics. This group is also en-gaging with international partners to improve global surveillance of variants and identify synergies in our collective assessment of the impact of variants globally. \nWe are monitoring dozens of variants and conducting ongoing and comprehensive \nrisk assessments through the SARS-CoV–2 Interagency Group and in consultation with our international colleagues. Of the emerging variants, five have captured our attention and have the highest risk to public health: B.1.1.7, B.1.351, B.1.427, B1.429, and P.1. \nThe B.1.1.7 variant, originally identified in the United Kingdom, was first identi-\nfied in the United States on December 29, 2020. Data from CDC national surveil-lance project that B.1.1.7 viruses represented 72 percent of the viruses circulating for the two-week period ending April 24. The B.1.1.7 variant is the predominant strain of SARS-CoV–2 in the country now and has likely continued to increase as a proportion of all cases. Importantly, variant proportions are dynamic and are not the same in all parts of the country. \nThe B.1.351 variant, first identified in South Africa, and the P.1 variant, first \nidentified in Brazil, have also been identified in the United States. Data from CDC national surveillance project that B.1.351 viruses represented approximately 0.6 percent of the circulating viruses, and the P.1 variant represented approximately 5.6 percent for the two-week period ending April 24. The proportion of cases attributed to the B.1.427 and B.1.429 variants, which were first identified in California, have decreased in recent weeks. According to data for the two-week period ending April 24, the combined prevalence of B.1.427 and B.1.429 is 2.6 percent. \nAvailable data suggest that antibodies elicited by vaccination with the currently \nauthorized vaccines are able to neutralize the B.1.1.7 variant but have reduced neu-tralization against the B.1.351 and P.1 variants. Based on preliminary data from a Johnson & Johnson vaccine clinical trial in South Africa where the prevalence of the B.1.351 variant was estimated to be 95 percent, the vaccine efficacy was 64 per-cent and had 81.7 percent efficacy in preventing severe disease, and promising effi-cacy data have been released from the Pfizer clinical trial in South Africa. Studies are currently underway to understand the impact on the real-world effectiveness of current vaccines against the B.1.351 variant and other variants of concern. Efforts are ongoing to better understand the impact of the variants on medical counter-measures. \nSince January, CDC has dramatically built up our domestic genomic surveillance \nplatforms to monitor circulating variants, increasing the Nation’s sequencing output 75-fold, with over 36,000 specimens now sequenced weekly. With support from the funding the Administration announced in February as well as the resources pro-vided by the American Rescue Plan Act, we’re contracting with several large com-mercial diagnostic laboratories to get viral sequence data from around the country. These laboratories are providing data on over 22,000 virus samples per week. In ad-dition, public health laboratories around the country are sending CDC samples from 750 cases each week. These samples will allow us to both get the viral sequences and isolate the viruses so that we can do additional laboratory testing to better un-derstand virulence, transmissibility and the potential impacts on diagnostic tests, therapeutics, and vaccines. Moreover, U.S. state and local public health laboratories are also sequencing approximately 7,000 specimens per week and using the data to better understand the local epidemiology and to control outbreaks. In addition, U.S. academic institutions and industry are also sequencing another 7,000 viruses per week. These efforts are coordinated through CDC’s SPHERES collaboration, which is a national genomics consortium to coordinate large-scale SARS-CoV–2 sequencing across the country. In all, the United States is sequencing about 10 percent of the roughly 350,000 weekly cases. These partnerships with commercial labs, state and local health departments, and academic and research institutions will continue to grow. We are on our way to sequencing an even higher percentage of cases, a tre-mendous accomplishment. CDC is working with state and local public health de-\n10 \npartments to use these sequencing data as part of their COVID–19 response strat-\negy. CDC has also made significant strides to make our genomic surveillance data more accessible to the public through an interactive dashboard on our COVID Data Tracker website. This site is updated regularly with the prevalence of SARS-CoV– 2 variants at the national, regional, and state levels. \nEach new variant can present different challenges. But each can be stopped by \nthe same methods: rigorous and increased compliance with public health prevention strategies such as vaccination, physical distancing, use of masks, hand hygiene, and isolation and quarantine. \nHealth Equity \nCOVID–19 has highlighted long-standing systemic health and social inequities. \nData repeatedly show the disproportionate impact of COVID–19 on racial and ethnic minority populations, as well as other population groups such as people living in rural or frontier areas, people experiencing homelessness, essential and frontline workers, people with disabilities, people with substance use disorders, people who are incarcerated, and non-U.S.-born persons. Inequities in social determinants of health, such as poverty, housing, and healthcare access, have influenced a wide range of health and quality-of-life outcomes for these groups experiencing dispropor-tionate impacts. \nThese factors and others are associated with more COVID–19 cases, hospitaliza-\ntions, and deaths. Not surprisingly, they intersect with higher rates of some medical conditions in these same populations that increase one’s risk of severe illness from COVID–19. \nHealth equity must be a cornerstone of our public health work. CDC’s Chief \nHealth Equity Officer has been leading implementation of our Health Equity Strat-egy to accelerate progress in reducing COVID–19 disparities. The strategy outlines an approach to expand evidence-based approaches to reduce disparities in COVID– 19 hospitalizations and deaths; increasing testing, contact tracing, isolation options, and healthcare access in populations at increased risk for COVID–19; prioritizing equity in distribution and administration of COVID–19 vaccines; reducing stigma and bias; and expanding a diverse workforce, equipped to address the needs of a diverse population. We are engaging with community-based organizations and di-verse leaders to conduct outreach that is culturally and linguistically responsive to the needs of populations at increased risk of getting sick and dying from COVID– 19. \nTo operationalize the Health Equity Strategy, CDC is supporting activities and \ninterventions with organizations across multiple sectors, including community-and faith-based organizations that have been able to provide more insight about the challenges and needs of the populations they serve. They have also helped us craft and convey tailored prevention messages about COVID–19 to these important popu-lations across the country. With their guidance, CDC has developed toolkits and other resources to address the unique needs of, and to help, communities that have been disproportionately impacted by COVID–19. \nWe know we need the best possible data to more clearly understand these chal-\nlenges and measure our progress as we implement solutions. While we have seen big improvements over the last year, we know that there are still critical gaps in these data. For example, race and ethnicity data continue to be missing from almost 40 percent of the COVID–19 cases reported to CDC. Progress has been slow because there are many data requisition forms and data interfaces in the data exchange \npathway that must be updated. Moreover, public health data systems are not set up in a way that captures the underlying drivers for which race and ethnicity are markers. Those drivers include social determinants of health such as occupation, housing, education, access to healthcare and other factors that are the underlying causes for the disparities we see by race and ethnicity. There are multiple barriers to collecting some of these data elements, including at the state and individual level—including reticence to report income or other socio-economic factors. \nThis pandemic response has illustrated the long-standing need for improvements \nin the public health data network. Congress has been supportive of CDC and has responded to our partners’ concerns about antiquated public health data systems by providing resources to CDC for the data modernization initiative, the first com-prehensive strategy to modernize public health data, technology, and workforce ca-pabilities—together and at once. CDC is collaborating with our partners in the field to improve data collection and sharing. \n11 \n1https://www.cdc.gov/mmwr/volumes/70/wr/mm7005a3.htm?s-cid=mm7005a3-w . \n2https://www.cdc.gov/mmwr/volumes/70/wr/mm7015e2.htm?s-cid=mm7015e2-w . In the last few months, data continue to document ongoing health disparities. In \nFebruary, CDC’s National Center for Health Statistics (NCHS) released data that \nhighlighted disparities in life expectancy between 2019 and 2020, demonstrating the impact of COVID–19 on Black and Hispanic/Latino communities. Additional CDC data\n1released in February noted that racial and ethnic minority groups have expe-\nrienced disparities in mental health and substance use disorder related to access to care, psychosocial stress, and social determinants of health, exacerbated by the pan-demic. Hispanic/Latino adults reported a higher prevalence of psychosocial stress re-lated to not having enough food or stable housing than did adults in other racial and ethnic groups. And more recently, in April, we published a report\n2that found \nracial and ethnic disparities in hospitalization rates during the early months of the pandemic, with rates being highest for Hispanic or Latino patients, although these disparities generally declined later in 2020 as the proportion of cases in White pa-tients increased. \nWhile it is important to document these disparities, we do not need further docu-\nmentation to take action, and we are making strides toward change using the data we have. These data compel us to do what we do best at CDC—to turn our research and science into policy and action to improve the health of all. CDC, in collaboration with other components of HHS, has made historic investments in the last month to address COVID–19 health disparities and promote health equity. \nIn March, CDC announced plans to invest $2.25 billion over 2 years to address \nCOVID–19 related health disparities and advance health equity among populations that are at high-risk and underserved, including racial and ethnic minority groups and people living in rural areas. This funding represents CDC’s largest investment to date to support communities affected by COVID–19-related health disparities. CDC’s new National Initiative to Address COVID–19 Health Disparities Among Pop-ulations at High-Risk and Underserved Communities, Including Racial and Ethnic Minority Populations and Rural Communities, will offer grants to public health de-partments to improve testing and contact tracing capabilities; develop innovative mitigation and prevention resources and services; improve data collection and re-porting; build, leverage, and expand infrastructure support; and mobilize partners and collaborators to advance health equity and address social determinants of health as they relate to COVID–19. \nCDC is also investing $300 million over 3 years in jurisdictions for community \nhealth worker services to support COVID–19 prevention and control, and an addi-tional $32 million for training, technical assistance, and evaluation related to this effort. This funding will be used to address disparities in access to COVID–19 re-lated services, such as testing, contact tracing, and vaccinations, and it will help ad-dress factors that increase risk of severe COVID–19 illness. This effort will benefit populations with increased prevalence of COVID–19 and disproportionately im-pacted by long-standing health disparities. \nThrough this funding CDC is committed to addressing these gaps, not only for the \nCOVID–19 response, but across public health. And as we do this work, we will si-multaneously take action on what we know—that these disparities exist, and they are unacceptable; addressing them is critical in ensuring success against COVID– 19 and future pandemics. \nVaccines \nVaccination is a critical tool in bringing this unprecedented pandemic to an end. \nIn the year since SARS-CoV–2 infections were first identified, the FDA has issued Emergency Use Authorizations for vaccines that meet the expectations for safety and effectiveness for emergency use that are being distributed and administered as we speak. We should all take a moment and acknowledge that this is a remarkable accomplishment and appreciate how vaccine efficacy helps prevent serious illness, hospitalization, and death from COVID–19. As of April 19, every person aged 16 and over in every state and territory is now eligible to get vaccinated, and 90 percent of Americans now have a vaccine site within 5 miles of their home. The country has \nexceeded President Biden’s goal of administering 200 million shots in the first 100 days of his Administration. \nA CDC study reviewing data from the first 3 months of vaccinations among health \ncare personnel, first responders, and other frontline and essential workers found that both Moderna and Pfizer vaccines were 90 percent effective in preventing COVID–19 infection, two or more weeks after full vaccination. In addition, another \n12 \n3https://www.cdc.gov/mmwr/volumes/70/wr/mm7018e1.htm?s-cid=mm7018e1-w . recent CDC study3found these two vaccines were 94 percent effective against hos-\npitalization among fully vaccinated adults aged 65 years and older. These findings \ndemonstrate the high, real-world effectiveness of these vaccines. \nCOVID–19 vaccine safety is a top priority for the Federal Government, and we \ntake all reports of health problems following COVID–19 vaccination seriously. On April 23, following a thorough safety review, including two emergency meetings of the CDC’s Advisory Committee on Immunization Practices, the FDA and CDC deter-mined that the previously recommended pause regarding the use of the Janssen (Johnson & Johnson) COVID–19 Vaccine in the United States should be lifted and use of the vaccine should resume. The pause had been recommended after reports of six cases of a rare and severe type of blood clot in individuals following adminis-tration of the Janssen COVID–19 Vaccine. During the pause, medical and scientific teams at the FDA and CDC examined available data to assess the risk of throm-bosis involving the cerebral venous sinuses (large blood vessels in the brain), and other sites in the body (including but not limited to the large blood vessels of the abdomen and the veins of the legs) along with thrombocytopenia, or low blood plate-let counts. The teams at FDA and CDC also conducted extensive outreach to pro-viders and clinicians to ensure they were made aware of the potential for these ad-verse events and could properly manage and recognize these events due to the unique treatment required for these blood clots and low platelets, also known as thrombosis-thrombocytopenia syndrome. The identification of this rare complication is an important validation of the sensitivity of vaccine safety monitoring systems to be able to pick up even very small numbers of vaccine safety concerns. \nBuilding on long-standing relationships with state and local partners, CDC has \nworked tirelessly to ensure that we are getting vaccines into arms as quickly, safely, and equitably as possible. As of May 6, about 325 million doses have been delivered, and more than 251 million doses of COVID–19 vaccine have been administered. Over 70 percent of all Americans age 65 years and older were fully vaccinated by this date, and about 57 percent of adult Americans had received at least one vac-cine. This is a whole-of-society effort, and it is inspiring to see people across govern-ment, business, and communities coming together to complete this important life-saving task. \nI would like to touch on four core areas that drive CDC’s vaccine work: safety, \nconfidence, access, and equity. As shown during the recent Janssen (Johnson & Johnson) vaccine pause, our commitment to safety remains paramount to our work. Vaccines are rigorously studied during clinical trials and there is a vast network of safety systems that monitor vaccines once they are in use and safety protocols to monitor people when they receive the vaccine. It is important that we continually deliver the message that these vaccines are safe. \nStrong confidence in vaccines within communities leads to more people getting \nvaccinated, and to fewer COVID–19 illnesses, hospitalizations, and deaths. CDC is working in coordination with national, state, tribal, and local governmental and non-governmental partners to build trust in the vaccine, the vaccinator, and the vac-cination system. We will continue to work with these critical partners to address barriers to vaccinations, including in communities of color and disproportionally af-fected groups. \nFurther supporting efforts to prioritize equity in our vaccine strategy, CDC an-\nnounced an investment of $3.15 billion to support local efforts to increase vaccine access, uptake, and equity. In early April, these funds were awarded directly to states, territories, and some large cities, enabling them to support local health de-partments and community-based organizations in launching programs and initia-tives intended to increase vaccine access, acceptance, and uptake. The funding will focus on reaching communities hit hardest by the pandemic, including those with a high social vulnerability index, minority communities, and rural areas. \nIn order to enhance vaccine uptake among underserved communities of color and \nto build trust and confidence in the authorized COVID–19 vaccines, CDC has devel-\noped a comprehensive program of approximately 20 national organizations that sup-port hundreds of local and community-based organizations to improve both COVID– 19 and influenza vaccination coverage among racial and ethnic groups who have his-torically had, and continue to experience, health disparities. \nImproving access to underserved communities and populations who have histori-\ncally experienced greater barriers to healthcare access is another critical component to prioritizing equity in vaccine distribution. Improving access also requires a multi- pronged approach. To that end, CDC is working closely with the Federal Emergency \n13 \nManagement Agency (FEMA) and the Health Resources and Services Administra-\ntion (HRSA) on two critically important programs with the goal of bringing vaccines to communities and improving access for populations disproportionately impacted by COVID–19. CDC partners with FEMA on the implementation of their Community Vaccination Centers. CDC also partners with HRSA to support COVID–19 vaccina-tions in select HRSA-funded health centers. \nThe Federal Retail Pharmacy Program is integral to the work CDC is doing to \nmaximize access to COVID–19 vaccines in all communities, including communities \nof color and other underserved populations, such as rural communities. CDC is partnering with 21 national pharmacy organizations and independent pharmacy networks that represent over 40,000 locations nationwide—including 45 percent in highest-need neighborhoods—to ensure that the public has access to COVID–19 vac-cines in a familiar setting. Almost 90 percent of Americans live within five miles of a retail pharmacy. The retail pharmacy program was also instrumental in attain-ing the goal of prioritizing Pre-K through 12th grade educators, school staff, and childcare workers for COVID–19 vaccination in the month of March. As a result of this effort, our estimates show that approximately 80 percent of these essential frontline workers across the United States received at least one shot in March and more than 2 million teachers, school staff, and childcare workers were vaccinated through the Federal Retail Pharmacy Program in March. More than 52 million doses of vaccine in total have been administered through this program. \nLast month, CDC also announced a new partnership with certain clinics to pro-\nvide COVID–19 vaccinations to people receiving dialysis, as well as health care per-sonnel working in these clinics. Dialysis patients are disproportionately affected by COVID–19 and are at high risk for severe illness and death from COVID–19. It is estimated that 34 percent of people receiving dialysis are Black and 19 percent are Hispanic; and that 22 percent of staff in dialysis clinics are Black. People on dialysis who get COVID–19 have a 50 percent hospitalization rate and a 20 to 30 percent mortality rate. This effort is another important step in making sure that vaccines reach the most medically vulnerable communities and that prioritizing equity in vaccination continues to anchor our efforts to end the COVID–19 pandemic. \nLooking to the future, we are optimistic that, in collaboration with our state, Trib-\nal, local, and territorial partners, we have built a vaccine implementation infrastruc-ture that will expand vaccination coverage to allow our communities to resume some aspects of a normal life. Active investigations will continue to determine how much vaccines reduce asymptomatic infection and transmission, how long vaccine protec-tion lasts, and to what extent vaccines protect against emerging SARS-CoV–2 variants. CDC recently released updated guidelines for fully vaccinated people, pro-viding guiding principles on how to assess their own risk for COVID–19 and deter-mine what prevention measures, including masks, should be used. We look forward to revising this guidance as the science develops and as more of the population is protected through vaccination. \nSchools \nSince becoming the director of the CDC, I have stressed the importance of getting \nchildren back to school for in-person learning. The safest way to open schools is to ensure that there is as little disease as possible in the community. The lower the amount of disease in the community, the less likely it is that cases will be intro-duced into the school environment. This means that all community members, stu-dents, families, teachers, and school staff should take actions to protect themselves and the community where they live, work, learn, play and worship. \nCDC recommends that, among community institutions, schools should be the first \nto open and the last to close. Because of the benefits of in-person learning and the key support services schools offer, it is critical for K–12 schools to open, and stay open, as safely and as soon as possible. This is especially true in low-resourced com-munities, which may include large representations of racial and ethnic minority groups and students with disabilities. CDC began working on guidance, resources, and tools for safe school reopening in March 2020 when the first schools closed. As CDC learned more about COVID–19, we continually updated our guidance, re-sources, and tools for schools, parents, teachers, and other staff. \nIn February of this year, CDC released new science-based resources and tools to \nhelp schools safely reopen and stay open for in-person learning. Specifically, CDC conducted an in-depth review of the science and released the Science Brief: Trans-\n14 \n4https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/transmission-k-12- \nschools.html. \n5https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/operation-strat-\negy.html. mission of SARS-CoV–2 in K–12 Schools,4which informed CDC’s Operational Strat-\negy for K–12 Schools through Phased Prevention.5In developing the K–12 Oper-\national Strategy, CDC gathered input from school superintendents, school officers \nand nurses, national associations with a focus on education, organizations that rep-resent elected officials, and others. These resources complement CDC’s existing guidance and tools for K–12 schools, including a toolkit to assess risks and imple-ment prevention strategies to reduce the spread of SARS-CoV–2 in schools, a quick guide to assist teachers in modifying the layout of their classroom in a way that reduces the risk of virus spread, and updated materials about ventilation strategies in school and child-care settings. In March, CDC updated its school guidance reflect-ing the latest evidence to recommend that, with universal masking, students should maintain a distance of at least three feet in classroom settings. However, middle school students and high school students should be at least six feet apart in commu-nities where transmission is high, if cohorting (or podding) is not possible. CDC will continue to collaborate closely with our colleagues at the U.S. Department of Edu-cation to make sure that all schools have access to the latest guidance, as well as tools and best practices about how to apply this guidance. \nEvidence indicates that many K–12 schools that have implemented prevention \nstrategies to reduce the spread of SARS-CoV–2 consistently and correctly have been able to safely open for in-person instruction and remain open. Regardless of the level of SARS-CoV–2 spread in the community, CDC recommends using a combina-tion of five key strategies to reduce the spread of SARS-CoV–2 in schools and help protect teachers, students, and staff. These strategies are universal and include the correct use of masks, physical distancing, handwashing and respiratory etiquette, cleaning and maintaining healthy facilities (including proper ventilation), and con-tact tracing, in combination with isolation and quarantine, in collaboration with the health department. We also point to the added layers of prevention to be gained from regular testing and vaccination. \nUniversal and correct use of masks and physical distancing are two prevention \nstrategies that are most essential to reducing SARS-CoV–2 transmission, but a lay-ered approach that uses all five of these strategies will provide the greatest level of protection. \nIn April, CDC provided $10 billion to states and jurisdictions to support COVID– \n19 screening testing for K–12 teachers, staff, and students to assist schools in re-opening safely for in-person instruction. In addition to ensuring diagnostic testing of symptomatic and exposed individuals, serial screening testing will help schools identify infected individuals without symptoms who may be contagious so that prompt action can be taken to prevent further transmission. With this funding, states can support the critical testing and testing supports schools need to imple-ment screening testing programs. Recognizing that establishing a testing program is new for many schools, CDC and state and local health departments will support technical assistance to assist states and schools in standing up and implementing these programs. A recent article in CDC’s MMWR found participation in a free, in- school COVID–19 testing program within Utah elementary schools was higher among students belonging to a racial or ethnic minority group and among students living in areas with higher rates of COVID–19. In-school testing could help reach underserved populations and reduce the spread of COVID–19 across the community. \nSARS-CoV–2 is still a relatively new pathogen, and we are learning more about \nit and how it impacts different people and communities all the time. CDC’s K–12 Operational Strategy presents recommendations based on the best-available evi-dence at the time of release. As science and data on SARS-CoV–2 and COVID–19 \ncontinue to evolve, we will update our guidance and recommendations to reflect new evidence. CDC stands committed to providing the best, most current data and sci-entific understanding available to protect the health, safety, and well-being of our communities, including our students, teachers, and school staff. \nLooking to the Future \nAs I’ve said before, I’m cognizant that over the last 12 years, the United States \nhas faced four significant emerging infectious disease threats—the H1N1 influenza pandemic, Ebola, Zika, and COVID–19. While urgency demanded rapid and unique \n15 \nresponses to each of these threats, none resulted in the sustained improvements \nneeded in our Nation’s public health infrastructure. \nThis lack of preparation continues to present significant challenges in our ongoing \nfight to tackle COVID–19. These experiences have proven that public health emer-gencies and, specifically, infectious disease threats are here to stay. \nLooking to the future, I want to work within the Administration and with you to \naddress long-standing vulnerabilities in our core public health infrastructure, in-cluding data, workforce, laboratory, domestic preparedness, and global health secu-rity. \nTo avoid the substantial economic costs associated with both large-scale emer-\ngencies and chronic public health concerns, we must be willing to make investments in our public health system. We also must offer up our technical expertise to sup-port efforts to advance global health security. \nConclusion \nIn closing, I want to emphasize that, while COVID–19 cases remain widespread, \nthere are reasons to be hopeful. I am looking forward to seeing more kids in school, more families able to connect with one another safely, and our Nation beginning to move forward and heal. We are committed to continuing to advance the science around COVID–19; moving more vaccines into more communities—especially those communities most at-risk for COVID–19 infection—and working to improve health equity. \nEnding this pandemic requires more equitable access to affordable and timely \ntesting, treatment, and vaccination. Looking forward, we will continue to take a health equity approach, not only in future emergency responses, but in everything we do at CDC. And even when this crisis is over, we will still need a strong public health system. The COVID–19 pandemic has illuminated long-standing inequalities in health among racial and ethnic minority groups; demonstrated the need for resil-ient, fast, and accurate data systems; and showed the essential role a robust, skilled, and diverse public health workforce plays in protecting Americans. \nThe next few weeks and months will be critical, and we need everyone to continue \nto wear masks properly, practice social distancing and handwashing, and get vac-cinated. I recognize that everyone is fatigued after a very long year. It is as critical as ever to continue these lifesaving efforts. \nI look forward to working together to address both the immediate challenges \nahead in our fight against COVID–19, along with the weaknesses in our public health infrastructure that left our country vulnerable to this pandemic. CDC is grateful for your support. \nWe cannot strengthen the public health infrastructure our Nation needs to combat \npublic health emergencies—like pandemics and other infectious disease threats— overnight or in the middle of an emergency crisis. We must work together over the months and years ahead to reinforce the foundations, partnerships, modernizations, and innovations that we have initiated during this pandemic—ensuring robust pub-lic health systems continue to be grounded in science. It is one way we can turn tragedy into lasting progress and improved health outcomes for all. Thank you again for the invitation to testify today and I look forward to answering your ques-tions. \nThe C HAIR . Thank you. \nDr. Fauci. \nSTATEMENT OF ANTHONY FAUCI, M.D., DIRECTOR, NATIONAL \nINSTITUTE OF ALLERGY AND INFECTIOUS DISEASES, NA-\nTIONAL INSTITUTES OF HEALTH, BETHESDA, MD \nDr. F AUCI . Madam Chair, Ranking Member Burr, Members of \nthe Committee, thank you for giving me the opportunity to discuss \nwith you this morning the role of the National Institute of Allergy and Infectious Diseases and the NIH and research addressing the COVID–19 pandemic. \nAs I had mentioned to this Committee during the last hearing \nthat we attended, we have a strategic plan that has four major \n16 \ncomponents—fundamental knowledge of the virus, diagnostics, \ntherapeutics, and the development of safe and effective vaccines. For the purpose of today’s discussion, I will focus on the issue of vaccines. \nWe often get asked how it could be possible that the virus was \ndiscovered in January 2020 and we had doses of vaccine going into the arms of individuals, a vaccine that was highly efficacious and safe, 11 months later in December 2020. Well, the story behind that has been the decades of investment in basic and clinical, bio-medical research that has led to our ability to accomplish this ex-traordinary feat. \nJust some examples. The basic preclinical and clinical research \nin developing vaccine platform technology, particularly the highly successful MRNA platform. \nIn addition, scientists at the Vaccine Research Center at NIAID, \nas well as grantees and contracts—contractors throughout the Country developed the optimal immunogen, which is the confirmationally correct spike protein, which is used by virtually all the vaccines that are being tested right now. \nFinally, the utilization of a clinical trial network that we had set \nup decades ago for influenza and for HIV. \nWhen one thinks of efficacy, it really is what are the results of \na clinical trial. Often, when you get into the real world, the effec-tiveness of vaccines falls short of the original efficacy. That is not at all the case with the vaccines for COVID–19 because the real- world effectiveness is even more impressive than the results of the clinical trial. \nOne example, the University of Texas looked at 23,000 of their \nemployees and found that the incidence of infection was 0.05 per-cent, markedly lower than unvaccinated individuals. \nThe CDC has multiple MMWRs reporting on various aspects of \nthe real-world effectiveness. Importantly, a recent paper in The Lancet reported on the experience in Israel, which, as Senator Burr had mentioned, has done an extraordinary job of getting their citi-zens vaccinated. And, what we have seen is a remarkable diminu-tion in the number of infections that reached a critical turning point when they reached a certain percentage of the individuals who were vaccinated. \nIt was not only limited to Israel. Another recent paper in the \ncountry of Qatar showed a similar type of result in which, not only was the MRNA vaccine highly effective in over 300,000 individuals tested in preventing the original wild-type virus, but it also had a very interesting capability of protecting against mild to moderate disease of a problematic variant from South Africa, the 351, and protected virtually 100 percent from severe disease, including hos-pitalization and death. \nWhen the President makes the goal of 70 percent of adults re-\nceiving at least one vaccine by the 4th of July, we believe that is an attainable goal. The reason we feel it is important is that I be-\nlieve that we are about at that critical turning point when we get a certain percentage—we do not know exactly what it is, but clear-ly the majority of individuals in the Country vaccinated, we will see a sharp turning point and a marked diminution in cases. \n17 \nAs I said the last time I testified before you, we are in a race \nbetween the vaccine and the virus, if left to its own devices will \ncontinue to surge. Based on experience thus far in this Country and globally, I feel confident that if we continue to vaccinate people at the rate that we are doing, that we will very soon have a situa-tion where we will have so few infections in this Country, we will begin to return to normality that all of us desire so much. \nThank you very much. [The prepared statement of Dr. Fauci follows:] \nPREPARED STATEMENT OF ANTHONY FAUCI  \nMadam Chair, Ranking Member Burr, and Members of the Committee: \nThank you for the opportunity to discuss the role of the National Institute of Al-\nlergy and Infectious Diseases (NIAID) in the research response to coronavirus dis-\nease 2019 (COVID–19) and its etiologic agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV–2). Within the Department of Health and Human Serv-ices (HHS) and the National Institutes of Health (NIH), NIAID is responsible for conducting and supporting basic and clinical research on emerging and re-emerging infectious diseases, including COVID–19. As the Director of NIAID and the Chief Medical Advisor to the President, I am pleased to discuss NIAID’s research address-ing this pandemic. \nCOVID–19 is a once-in-a-lifetime global infectious disease pandemic requiring an \nunprecedented public-private research effort. NIAID plays a central and important role in the public health response to COVID–19. NIAID has capitalized on decades of investment in fundamental basic research, including groundbreaking structure- based vaccine design at the NIAID Vaccine Research Center (VRC); engaged domes-tic and international research infrastructure; and leveraged highly productive part-nerships with industry and longstanding relationships with community partners. NIAID utilized its existing domestic and international clinical trials infrastructure, originally established to conduct research on HIV and influenza, and worked with partners in the public and private sectors to establish the COVID–19 Prevention Network (CoVPN). The CoVPN has supported multiple COVID–19 vaccine can-\ndidates to progress in record time from concept to authorization for emergency use by the U.S. Food and Drug Administration (FDA). NIAID also has built on its long-standing relationships with community partners to successfully conduct these cru-cial clinical trials. NIAID initiated clinical trials with creative and adaptive designs, allowing the evaluation of multiple new and existing therapeutics for use against COVID–19. Several of these trials provided evidence of safety and efficacy of COVID–19 therapeutics and helped support authorization by the FDA. \nThese successes have helped slow the progression of the pandemic in the United \nStates. Currently, we are vaccinating approximately 2.5 million people per day, and we must continue to vaccinate as many people as we can as quickly as possible. FDA-authorized COVID–19 vaccines are safe and highly effective. The high levels of vaccine efficacy observed in the carefully controlled conditions of a clinical trial setting have been subsequently confirmed by their effectiveness in studies of vac-cines administered to broad segments of the public. Vaccination and adherence to public health measures are the fundamental tools that will help us head off another COVID–19 surge. \nWhile we are cautiously optimistic about the future, we know that many chal-\nlenges remain. One of the most concerning developments of the ongoing pandemic is the spread of genetic variants of SARS-CoV–2, some of which appear to be more transmissible than the original virus, more virulent, and/or less responsive to cer-tain therapeutic agents and vaccine formulations. So far, scientific evidence suggests that the COVID–19 vaccines distributed in the United States under FDA Emer-gency Use Authorizations (EUA) continue to be effective against these variants, but we must remain vigilant. NIAID is rapidly conducting research to better understand these emerging variants of SARS-CoV–2, how they interact with the immune sys-tem, and their implications for COVID–19 therapeutic and vaccine formulations. \nWe also know that our fellow Americans in underserved and minority commu-\nnities have been disproportionally affected by this pandemic. NIAID is committed to continuing to work directly with these communities, as well as partnering with other agencies in the Federal Government, and with industry and academia, to en-sure that individuals in underserved and vulnerable communities are not left be-hind as we move forward toward defeating the COVID–19 pandemic. NIAID also \n18 \nrecognizes that while many individuals with SARS-CoV–2 infection fully recover \nafter a relatively short time period, some individuals suffer longer-term effects after the initial phase of illness and after the virus is cleared from the body. NIAID is supporting collaborative efforts to study outcomes in patients across all ages, gen-ders, and co-morbid conditions, who have experienced a broad range of severity of original disease, to identify and characterize these post-acute sequelae of SARS- CoV–2 infection (PASC) and develop effective strategies to address them. \nDeveloping Vaccines and Therapies to Prevent COVID–19 \nSustained research investments by NIAID in the years prior to the emergence of \nSARS-CoV–2 enabled the unprecedented pace of COVID–19 vaccine candidate devel-opment. Two activities predate successful COVID–19 vaccines: the development of versatile vaccine platforms and the adaptation of structural biology tools to design agents (immunogens) that powerfully stimulate the immune system. Long before the pandemic, NIAID VRC scientists and their collaborators made the critical scientific discovery of how to stabilize in a highly immunogenic form viral proteins that are important for infection, including the spike protein of the Middle East respiratory syndrome coronavirus (MERS-CoV), using a double mutation known as S2P. This key finding facilitated the design of vaccine candidates that generate robust immune responses against coronaviruses and other viruses of public health importance such as respiratory syncytial virus. As soon as the sequence of SARS-CoV–2 was made available in January 2020, VRC researchers rapidly generated a stabilized SARS- CoV–2 spike protein for use in COVID–19 vaccine development. This crucial break-through in structure-based vaccine design for coronaviruses has led to the develop-ment of safe and effective COVID–19 vaccine candidates across a range of vaccine platforms. \nFive candidate COVID–19 vaccines have been assessed in large-scale Phase 3 clin-\nical trials in the United States thus far, and three have received EUAs from the FDA. Clinical trials to test COVID–19 vaccine candidates in pediatric populations are ongoing. On December 11, 2020, based on data from a Pfizer-supported Phase 3 clinical trial, an investigational vaccine developed by Pfizer and BioNTech became the first to receive an EUA from the FDA for the prevention of COVID–19 in indi-viduals 16 years of age and older. NIAID has helped to advance four additional COVID–19 vaccine candidates through support for research on the foundational biol-ogy underlying the vaccine concepts, as well as for clinical testing through the CoVPN. Two of these vaccine candidates, those from Moderna, Inc. and Johnson & Johnson/Janssen, have received EUAs. \nUtilizing the CoVPN, NIAID is participating in the implementation of harmonized \nprotocols to test investigational vaccines and preventive interventions against SARS-CoV–2. These protocols were developed in collaboration with the Accelerating COVID–19 Therapeutic Interventions and Vaccines (ACTIV) public-private partner-ship, vaccine manufacturers, and the Biomedical Advanced Research and Develop-\nment Authority (BARDA). NIAID also supports the underlying critical infrastruc-ture for these clinical trials, such as a common Data and Safety Monitoring Board (DSMB), an independent group that periodically reviews data from the ongoing trials to ensure the safety of study volunteers and to determine whether efficacy has been achieved. The CoVPN has enrolled thousands of volunteers across the United States and internationally in clinical trials testing multiple investigational vaccines and monoclonal antibodies intended to protect people from COVID–19. The CoVPN also has developed an extensive community engagement framework to reach out to the underserved and minority communities disproportionally affected by COVID–19; to better understand their interest in, and concerns about, research participation; and to partner with them to ensure that their vital input is reflected in the conduct of these clinical studies. \nTo further address the critical challenges of participation in clinical trials as well \nas vaccine acceptance and vaccine hesitancy, NIH established the Community En-gagement Alliance Against COVID–19 Disparities (CEAL) initiative, led by the Na-tional Heart, Lung, and Blood Institute (NHLBI) and the National Institute on Mi-nority Health and Health Disparities. CEAL brings together trusted community leaders to serve as champions who share information about the importance of par-ticipating in COVID–19 research and communicate data on the safety and efficacy of authorized COVID–19 vaccines. \nmRNA–1273 (Moderna) \nAs part of a longstanding collaboration, the NIAID VRC worked with the bio-\ntechnology company Moderna to develop a vaccine candidate designated mRNA– \n19 \n1273, which uses a messenger RNA (mRNA) vaccine platform to express the sta-\nbilized SARS-CoV–2 spike protein. Early clinical trials demonstrated that mRNA– 1273 was generally well tolerated and induced robust immune responses in healthy adults. NIAID and BARDA then began working with Moderna on a Phase 3 clinical trial through the CoVPN that showed that mRNA–1273 was 94.1 percent efficacious in preventing symptomatic COVID–19. On December 18, 2020, after a thorough re-view of comprehensive data on mRNA–1273, the FDA issued an EUA for the mRNA–1273 vaccine for prevention of COVID–19 in individuals 18 years of age and older. In subsequent observational studies under ‘‘real-world’’ conditions in broader segments of the population, mRNA-based vaccines continue to display a high level of effectiveness. In an article published in Morbidity and Mortality Weekly Report (MMWR), Centers for Disease Control and Prevention (CDC) researchers and their collaborators showed that among health care personnel, first responders, and other essential workers, the mRNA–1273 and the Pfizer-BioNTech mRNA vaccine were 90 percent effective against SARS-CoV–2 infections 14 or more days after receiving a second dose. In another MMWR article, these vaccines reduced the risk of COVID– \n19 hospitalization by 94 percent among people 65 years of age and older. Recently, NIAID scientists and their collaborators demonstrated that anti-SARS-CoV–2 anti-bodies persist for at least 6 months after the second dose of mRNA–1273. \nAd26.COV2.S (Johnson & Johnson/Janssen) \nDecades of NIAID support for basic, preclinical, and clinical research on \nadenovirus (Ad)-based HIV vaccines underpin the development by Johnson & John-son/Janssen of a coronavirus vaccine candidate based on the Ad26-vector, known as Ad26.COV2.S or JNJ–78436735. NIAID is supporting a Phase 3 clinical trial of Ad26.COV2.S through the CoVPN and has provided immunological testing of the candidate using NIAID-funded core laboratory infrastructure. As reported in the New England Journal of Medicine, the one-dose vaccine candidate was 66 percent effective overall at preventing moderate to severe/critical COVID–19 occurring at least 28 days after vaccination and 85 percent effective overall in preventing severe/ critical COVID–19 in the Phase 3 trial across several geographical regions, includ-ing areas where emerging viral variants predominate. In the United States, the effi-\ncacy against moderate to severe/critical disease 28 days after vaccination with Ad26.COV2.S was 72 percent. On February 27, 2021, the FDA issued an EUA for Ad26.COV2.S for prevention of COVID–19 in individuals 18 years of age and older. On April 13, 2021, out of an abundance of caution, the FDA and CDC released a joint statement recommending a pause in the use of Ad26.COV2.S in order to review extremely rare case reports of blood clots after vaccine administration. Medical and scientific teams at the FDA and CDC found that available data suggest such blood clots are very rare events. Following their thorough safety review—and in accord-ance with recommendations from the CDC’s Advisory Committee on Immunization Practices—the FDA and CDC lifted the recommended pause on the use of Ad26.COV2.S on April 23, 2021. \nOther COVID–19 Vaccine Candidates \nNIAID, through the CoVPN, is supporting Phase 3 clinical trials of COVID–19 \nvaccine candidates from AstraZeneca (AZD1222) and Novavax (NVX-CoV2373). AstraZeneca’s AZD1222 COVID–19 vaccine candidate uses a chimpanzee adenovirus-vectored vaccine approach developed by researchers at the University of Oxford in collaboration with scientists at NIAID’s Rocky Mountain Laboratories. On March 25, 2021, AstraZeneca announced an updated interim analysis of AZD1222 reporting that the vaccine candidate was 76 percent effective at preventing sympto-matic COVID–19, including 85 percent effective in participants aged 65 years and over. Importantly, the efficacy of AZD1222 against severe COVID–19 disease was reported to be 100 percent. \nClinical Trials of COVID–19 Vaccine Candidates in Special Populations \nTo effectively end the COVID–19 pandemic, it will be important to vaccinate as \nmany people as possible, including those in special populations, such as pregnant and lactating women, children, and people with immune deficiencies. Tens of thou-sands of pregnant and lactating women already have received the COVID–19 vac-cines under FDA EUAs, and available data indicate that these vaccines are safe and effective in these populations. In addition, protective antibodies against SARS-CoV– 2 have been detected in babies born to pregnant women who received mRNA COVID–19 vaccines. NIAID-supported investigators plan to continue to monitor the safety and further study the immune responses to these vaccine candidates in preg-\n20 \nnant and lactating women. Efforts to evaluate COVID–19 vaccines in pediatric pop-\nulations are ongoing. On March 16, 2021, Moderna, in collaboration with NIAID and BARDA, announced the launch of KidCOVE, a Phase 2/3 study to evaluate the safe-ty and efficacy of mRNA–1273 in children ages 6 months to less than 12 years. This study is in addition to Moderna’s ongoing TeenCOVE study of mRNA–1273 in ado-lescents between the ages of 12 and 17. Other vaccine developers also have begun, or are planning to begin, trials to test their vaccine candidates in children, adoles-cents, and other special populations. On April 23, 2021, NIAID launched an observa-tional study at the NIH Clinical Center assessing how people with immune system deficiencies or dysregulations respond to COVID–19 vaccination. NIAID investiga-tors also will gather information about COVID–19 illness in these individuals. This study will inform decision-making about COVID–19 vaccination in people with im-mune deficiencies and dysregulation conditions. \nMonoclonal Antibodies to Prevent COVID–19 \nNIAID scientists, collaborating with Regeneron Pharmaceuticals and Eli Lilly and \nCompany, also initiated two Phase 3 clinical trials to evaluate whether their inves-tigational monoclonal antibodies, REGEN-COV and bamlanivimab alone and in combination with etesevimab respectively, can prevent infection or symptomatic dis-ease in people at high risk of exposure due to their living or working conditions. Each company recently reported promising initial results. These studies have com-pleted enrollment and further analysis of the data from the trials is ongoing. Due to the sustained increase of SARS-CoV–2 viral variants that are resistant to bamlanivimab—when administered alone—the FDA revoked the EUA for bamlanivimab alone for the treatment of mild-to-moderate COVID–19 on April 16, 2021. In light of these concerns of variant resistance, the use of bamlanivimab alone is no longer being pursued for the prevention of COVID–19. The FDA now includes information on the susceptibility of SARS-CoV–2 variants in its fact sheets for health care providers for each of the monoclonal antibody therapies currently avail-able through an EUA (REGEN-COV and bamlanivimab in combination with etesevimab). In separate studies, NIAID-supported scientists and collaborators are evaluating the potential impact of emerging SARS-CoV–2 variants on the efficacy of monoclonal antibodies. \nIdentifying Therapeutics to Treat COVID–19 \nSafe and effective therapeutics are urgently needed to treat patients with COVID– \n19. NIAID launched a multicenter, randomized placebo-controlled clinical trial, the Adaptive COVID–19 Treatment Trial (ACTT), to evaluate the safety and efficacy of multiple investigational therapeutics for COVID–19. ACTT–1 examined the antiviral drug remdesivir for treatment of severe COVID–19 in hospitalized adults. Based on positive data from ACTT–1, the FDA approved the use of remdesivir for treatment in adults and children 12 years of age and older and weighing at least 40 kg hospitalized due to COVID–19. ACTT–2 evaluated the anti-inflammatory drug baricitinib in combination with remdesivir, and based on favorable data from ACTT–2, the FDA issued an EUA for the use of baricitinib in combination with remdesivir for treatment of adults and children older than 2 years hospitalized with COVID–19 and requiring supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation. ACTT–3 is currently evaluating treatment of hospitalized COVID–19 patients with remdesivir plus interferon beta–1a, which is used to treat individuals with multiple sclerosis. ACTT–4, a study assessing baricitinib plus remdesivir versus the glucocorticoid dexamethasone plus remdesivir in adults hospitalized with COVID–19, has closed to enrollment because the study met pre-defined futility criteria. \nNIAID, in collaboration with other NIH Institutes, also launched two clinical \ntrials as part of the ACTIV partnership, which utilizes master protocols allowing the addition of other investigational therapeutics as the trials continue. The two studies, ACTIV–2 and ACTIV–3, initially evaluated the use of the monoclonal antibody bamlanivimab to treat COVID–19 in outpatient and inpatient settings, respectively. ACTIV–2, which is focused on outpatients, has since been expanded to evaluate a combination monoclonal antibody therapy, BRII–196 and BRII–198, as well as four investigational therapeutics: SAB–185, a fully human polyclonal antibody produced in cattle; SNG001, an inhalable beta interferon; AZD7442, an investigational long- acting antibody combination; and camostat mesilate, an orally administered drug that may block SARS-CoV–2 from entering cells. ACTIV–3 currently is evaluating the AZD7442 monoclonal antibody combination in hospitalized patients. On April 22, 2021, NIAID and NHLBI launched the ACTIV–3 Critical Care study to test \n21 \nZyesami and remdesivir (alone and in combination), for their safety and efficacy in \nhospitalized COVID–19 patients who are experiencing acute respiratory distress syndrome, a life-threatening condition. Zyesami is a synthetic version of vasoactive intestinal peptide, which is made naturally in the human body and appears to have lung-protective antiviral and anti-inflammatory effects. \nOn April 13, 2021, NIAID announced the launch of the COVID–19 anti-CD14 \nTreatment Trial (CaTT) to evaluate the use of a monoclonal antibody known as IC14 in adults hospitalized with COVID–19. IC14 works by binding to and blocking a \nhuman protein called CD14 that is associated with the development of severe in-flammatory reactions in some COVID–19 patients. In addition, NIAID completed a Phase 3 trial called, ‘‘Inpatient Treatment with Anti-Coronavirus Immunoglobulin,’’ or ITAC, to evaluate hyperimmune intravenous immunoglobulin (IVIG) for treat-ment of COVID–19 in hospitalized adults. The study demonstrated that IVIG plus remdesivir was not superior to remdesivir alone. \nNIAID also launched the ACTIV–5/Big Effect Trial (BET), which is designed to \nstreamline the identification of experimental COVID–19 therapeutics that dem-onstrate the most promise. BET, an adaptive Phase 2 clinical trial, compares dif-ferent investigational therapies to a common control arm to identify treatments with relatively large effects as promising candidates for further study in large-scale trials. BET initially is evaluating two therapeutics: risankizumab, an immunomodulatory monoclonal antibody developed by Boehringer Ingelheim and AbbVie, which is FDA-approved for the treatment of severe plaque psoriasis; and lenzilumab, an investigational immunomodulatory monoclonal antibody developed by Humanigen. \nThe NIH also has established the COVID–19 Treatment Guidelines Panel to pro-\nvide recommendations to health care providers regarding specific COVID–19 treat-ments based on the best available science. The Guidelines also address consider-ations for special populations, including pregnant women and children. Each Treat-ment Guidelines section is developed by a working group of Panel members with expertise in the area addressed in the specific section; these members conduct sys-tematic, comprehensive reviews of relevant information and scientific literature. The Panel comprises representatives of NIH and five other Federal agencies along with representatives of nine professional organizations, academic experts, and treating physicians including providers from high COVID–19 incidence areas, and commu-nity representatives. The Panel meets regularly to evaluate possible treatment op-tions for COVID–19 and update the Treatment Guidelines as new clinical evidence emerges. \nResponding to Emerging Variants of SARS-CoV–2 \nNIAID is fully engaged in efforts to mitigate the potential impact of emerging \nvariants of SARS-CoV–2. NIH, including NIAID, participates in the HHS-estab-lished SARS-CoV–2 Interagency Group, along with CDC, FDA, BARDA, the Depart-ment of Defense (DOD), and the U.S. Department of Agriculture to address the po-tential impact of emerging variants on critical SARS-CoV–2 countermeasures. NIH, CDC, and DOD are assessing whether vaccine-induced immunity, or natural immu-nity from prior infection, can be effective in combating the variants. NIH, BARDA, and DOD also are determining the efficacy of certain authorized therapeutics against emerging variants in cell lines in vitro and in animal models. \nNIAID is collaborating with vaccine manufacturers on key areas of research to in-\nvestigate whether vaccines designed for the original strain of SARS-CoV–2 can maintain efficacy against emerging variants. NIAID also is conducting and sup-porting comprehensive studies to understand the ability of vaccine-induced anti-bodies to neutralize the variant viruses. NIAID researchers have analyzed the im-mune responses of individuals who recovered from COVID–19 prior to the emer-gence of variants and demonstrated that their T cells—a key component of the im-mune response to SARS-CoV–2—also were capable of recognizing the three most widespread SARS-CoV–2 variants, B.1.1.7, B.1.351, and P1. These findings, pub-lished in Open Forum Infectious Diseases, shed new light on the role of T cells in the development of immunity to SARS-CoV–2 and suggest that these cells also may help protect against emerging variants of concern. On March 25, 2021, NIAID launched a Phase 1 clinical trial in healthy adults to assess the safety and immunogenicity of second-generation COVID–19 vaccine candidates developed by Gritstone Oncology, Inc. Gritstone’s COVID–19 vaccine candidates utilize a strategy aimed at inducing both neutralizing antibodies and T cell responses to elicit a broad immune response. This approach could provide protection against emerging SARS- \n22 \nCoV–2 variants by targeting several viral antigens, all of which are highly con-\nserved among viral strains. \nNIAID also plans to test new vaccine formulations that may protect against cer-\ntain variants that show early indications of reduced sensitivity to existing counter-measures. On March 31, 2021, NIAID launched a Phase 1 clinical trial of an inves-tigational Moderna vaccine based on its FDA-authorized COVID–19 vaccine, de-signed specifically to target the B.1.351 SARS-CoV–2 variant first detected in South Africa. NIAID and Moderna are evaluating this vaccine candidate as a pre-cautionary measure as we gain more data to confirm that current vaccines provide an adequate degree of protection against currently circulating SARS-CoV–2 variants. \nNIAID, the National Human Genome Research Institute, and the National Li-\nbrary of Medicine are participating in the SARS-CoV–2 Sequencing for Public \nHealth Emergency Response, Epidemiology, and Surveillance (SPHERES) initiative. SPHERES is a national genomics consortium led by CDC that helps to coordinate SARS-CoV–2 sequencing across the United States. NIAID is working with partners to identify, monitor, and calculate the frequency of current variations in the SARS- CoV–2 genome to help predict emerging variants. NIAID also facilitates the use of cutting-edge modeling and structural biology tools to understand how variants might affect interactions between the virus and the immune system or COVID–19 therapeutics. NIAID scientists are helping to inform our understanding of trans-missibility of the variants by studying their stability in the environment of infected individuals and their ability to grow in human lung cells. These efforts add to a growing body of knowledge about SARS-CoV–2 variants and our ability to combat them. \nUnderstanding the Immunology and Pathogenesis of COVID–19 \nNIH is supporting studies to understand the incidence of SARS-CoV–2 infection \nin specific populations, including children, as well as certain aspects of the clinical course of infection, including thromboses, strokes, heart attacks, and other sequelae of infection. NIAID is working with partners to delineate biological and immune pathways responsible for the varied manifestations of COVID–19. NIAID also will examine the quality and durability of the immune response to SARS-CoV–2; this in-formation may be leveraged to develop novel SARS-CoV–2 therapeutics or vaccines and inform public health measures. \nNIAID, along with FDA, is supporting a National Cancer Institute (NCI) effort \nto determine the sensitivity and specificity of certain SARS-CoV–2 serological tests, which can detect antibodies indicative of a prior exposure to SARS-CoV–2. NCI and NIAID also are working to establish a collaborative network to increase national ca-pacity for high-quality serological testing with rapid return-of-results to subjects. These efforts include the use of serological testing to support clinical trials of con-valescent serum and the establishment of registries for seroprotection studies. NIAID, NCI, the National Center for Advancing Translational Sciences, and the Na-tional Institute of Biomedical Imaging and Bioengineering are partnering on a study, called the Serological Sciences Network or SeroNet, to investigate whether adults in the United States without a confirmed history of SARS-CoV–2 infection have antibodies to the virus, thus indicating prior infection. The study is evaluating the durability of the immune response and aspects of the immune response that contribute to protection against COVID–19. \nNIAID scientists are participating in leadership of the COVID Human Genetic Ef-\nfort, an international consortium of hospitals and genetic sequencing hubs that aim to discover genetic factors conferring resistance to SARS-CoV–2 infection or predis-posing to severe COVID–19 disease. The consortium has identified a subgroup of pa-tients with severe COVID–19 that have ineffective immune responses to SARS-CoV– 2, some of whom have identifiable mutations in key immune pathways. NIAID also supports efforts to understand the rare, but extremely serious, multisystem inflam-matory syndrome in children (MIS-C) that has been associated with SARS-CoV–2 infection in children and adolescents. NIAID hosted a virtual workshop on MIS-C with scientists and clinicians from academia, NIH, FDA, and industry, and a report of the workshop recommendations was published on November 2, 2020. NIAID also supports the Pediatric Research Immune Network on SARS-CoV–2 and MIS-C (PRISM) to evaluate acute and long-term clinical and immunological effects of MIS- C and SARS-CoV–2 infection in children. In addition, NIAID is collaborating with Children’s National Medical Center to follow 1,000 children with a history of SARS- CoV–2 infection, including those with MIS-C, to determine long-term effects of the illness. NIAID is participating in a trans-NIH effort to coordinate MIS-C research \n23 \nled by NHLBI and the Eunice Kennedy Shriver National Institute of Child Health \nand Human Development. This centralized effort, the Collaboration to Assess Risk \nand Identify Long-term Outcomes for Children with COVID (CARING for Children with COVID), will permit data to be shared across studies to determine the spec-trum of illness and predict long-term consequences of infection. \nMonitoring the Long-term Effects of COVID–19 \nMany people who have had COVID–19 experience continued symptoms or other \nsequelae as they transition from the acute to post-acute phases of the disease, and we continue to learn more about the duration and manifestations of COVID–19 as we hear from these patients. In December 2020, NIAID hosted a Workshop on Post- Acute Sequelae of COVID–19 with clinicians, immunologists, virologists, and mem-bers of the patient community to present existing data, identify key knowledge gaps, and explore different perspectives on this heterogeneous condition. A report from this workshop highlighting the key scientific questions and knowledge gaps regard-ing PASC was recently published in the Annals of Internal Medicine. NIH has an-nounced a trans-NIH effort to address PASC, including targeted funding for re-search in this critical area. The NIH PASC Initiative will complement ongoing NIAID studies to better understand the various post-acute manifestations of COVID–19 in various populations. \nNIAID intramural scientists initiated the Longitudinal Study of COVID–19 \nSequelae and Immunity to better understand PASC and determine whether people \nwho have recovered from acute SARS-CoV–2 infection develop an immune response to SARS-CoV–2 that provides protection against reinfection. NIAID-supported inves-tigators also have established the Immunophenotyping Assessment in a COVID–19 Cohort (IMPACC) to determine how immunological markers correspond to, or may even predict, the clinical severity of COVID–19. Since May 1, 2020, IMPACC re-searchers have collected detailed clinical data along with blood and respiratory sam-ples from more than 1,200 hospitalized COVID–19 patients of diverse race and eth-nicity at approximately 20 hospitals nationwide. The cohort will be followed during hospitalization and up to 1 year after discharge to assess their functional and immunologic recovery. \nConclusion \nNIAID continues to expand efforts to elucidate the biology, pathogenesis, and clin-\nical manifestations of SARS-CoV–2 infection, including emerging variants, and to employ this knowledge to develop safe and effective interventions to diagnose, treat, and prevent SARS-CoV–2 infection and COVID–19. NIAID is focused on developing safe and effective SARS-CoV–2 vaccines and therapeutics and sensitive, specific, rapid point-of-care molecular diagnostic and serological tests. NIAID also is con-ducting early stage research on candidate vaccines that could protect against mul-tiple strains of coronaviruses. All of these efforts will improve our response to the current pandemic and bolster our preparedness for the next, inevitable viral disease outbreak. \nThe C HAIR . Thank you. \nDr. Marks. \nSTATEMENT OF PETER MARKS, M.D., PH.D., DIRECTOR, CEN-\nTER FOR BIOLOGICS EVALUATION AND RESEARCH, UNITED \nSTATES FOOD AND DRUG ADMINISTRATION, SILVER SPRING, MD \nDr. M ARKS . Chair Murray, Ranking Member Burr, distinguished \nMembers of the Committee, thank you for the opportunity to testify \nbefore you again to describe FDA’s continued COVID–19 response efforts, and particularly our efforts on vaccines. \nFirst, yesterday evening, the FDA announced the expansion of \nthe emergency use authorization for the Pfizer-BioNTech COVID– 19 vaccine to include adolescents down to age 12 years. We know that this is a big step for our Country as vaccinating a younger \n24 \npopulation can bring us closer to a sense of normalcy and to ending \nthis pandemic. \nTo look at the safety of the vaccine, the FDA evaluated a clinical \ntrial of more than 2,000 adolescents age 12 through 15. Half of the participants received the Pfizer-BioNTech vaccine, and half re-ceived a saline placebo. The side effects experienced by those age 12 through 15 were similar to those experienced by individuals age 16 and older. \nTo look at effectiveness, the FDA evaluated data about how par-\nticipants’ immune systems responded to the vaccine, comparing 190 individuals, age 12 through 15, to 170, age 16 through 25. \nThe FDA also evaluated data on cases of COVID–19 among ado-\nlescents age 12 through 15, 7 days after the second dose of vaccine was given. And no cases of COVID–19 occurred among 1,005 ado-lescents who received the vaccine, compared to 16 cases in 978 pla-cebo recipients, thus indicating the vaccine was completely effective in preventing COVID–19 in the trial that was symptomatic. \nParents and guardians can rest assured that the Agency under-\ntook a rigorous and thorough review of all available scientific data, as we have with all of our COVID–19 vaccine authorizations, and the CDC’s Advisory Committee on Immunization Practices will next review the data tomorrow. \nAlso, as we announced yesterday, we intend to convene a virtual \nmeeting of the Vaccines and Related Biological Advisory Committee on June 10, 2021, during which we will provide a status update on our approach to emergency use authorization in individuals age 12 through 17 years of age. And, we will also discuss the data needed to support an emergency use authorization and a biologics license application in children less than age 12. \nSecond, as COVID–19 vaccination expands into adolescents, we \ncontinue to work diligently with CDC and other partners on safety surveillance of the authorized vaccines. We are grateful to Con-gress for the American Rescue Plan funds, which are supporting expanded vaccine safety surveillance, among other critical prior-ities. We have seen that our safety surveillance systems are doing what they are supposed to do in detecting important adverse events. \nRecently, our surveillance systems detected a safety signal for \nrare blood clots and low blood platelets, known as thrombosis thrombocytopenia syndrome, with the Janssen or Johnson & John-son COVID–19 vaccine. Following a brief pause taken to evaluate the situation and educate providers, based on the rare but in-creased risk of this adverse event, mainly in women age 18 through 50 years of age, FDA modified the fact sheet for healthcare pro-viders to include a warning pertaining to the risk of thrombosis with thrombocytopenia, and the fact sheets for recipients and care-givers was also updated. \nWe will continue to diligently monitor the safety of all of these \nvaccines. \nThird, the CDC and FDA are working closely together to track \nthe emergence and the spread of COVID–19 variants. Currently available evidence suggests that the three available FDA-author-ized vaccines adequately address COVID–19 variants circulating in the United States. However, we are working with manufacturers \n25 \nand government partners to plan the composition of the vaccine so \nthat we can administer booster vaccinations if necessary of an ap-propriate composition. \nFourth, the FDA recently completed an inspection of Emergent \nBioSolutions, the proposed manufacturing facility for the Janssen COVID–19 vaccine. At the close of the inspection of Emergent Bio-Solutions, FDA investigators cited several observations concerning whether the facility’s practices met our regulatory requirements and standards. We are now working with Emergent BioSolutions to address the conditions identified. It has been made public that no product has been released from this facility for use in the United States, and we will not agree to the release of any product from this facility until we are truly confident that it meets our ex-pectations for quality. \nAdditionally, moving forward, the Agency is refining how to opti-\nmally evaluate the manufacturing quality during this and any fu-ture public health emergency. We are committed to maintaining the trust of the public in the vaccines and hope that every eligible individual will consider getting vaccinated to help end this pan-demic. \nThank you. [The prepared statement of Dr. Marks follows:] \nPREPARED STATEMENT OF PETER MARKS  \nIntroduction \nChair Murray, Ranking Member Burr, distinguished Members of the Committee, \nI am Dr. Peter Marks, Director of the Center for Biologics Evaluation and Research \n(CBER) at the U.S. Food and Drug Administration (FDA or the Agency). Thank you for the opportunity to testify before you today to describe FDA’s coronavirus disease 2019 (COVID–19) response efforts. All of our efforts are in close coordination and collaboration with our partners, both within the Department of Health and Human Services (HHS) and across the Federal Government, to help ensure the develop-\nment, authorization, licensure, and availability of critical, safe, and effective medical products to address the COVID–19 public health emergency. \nWhile my testimony will focus on FDA’s work regarding COVID–19 vaccines, I \nwant to note at the outset that this is in the context of the breadth of work FDA is doing across the Agency to address this pandemic, including our efforts on diagnostics and therapeutics. \nWith the urgency called for during this pandemic, FDA, through our transparent \nscientific review process, has issued Emergency Use Authorization (EUA) for three COVID–19 vaccines. In doing so, we have relied upon the Agency’s rigorous stand-ards for safety, effectiveness, and manufacturing quality. Vaccine development is a highly de-risked process that generally proceeds sequentially through the various stages of clinical development, and manufacturing scale-up only takes place when the data support the safety and effectiveness of a vaccine and is on track for regu-latory approval. These vaccines were developed without cutting corners or sacri-ficing our standards. Intensive interactions between FDA and manufacturers mini-mized the time between different studies in the clinical development process; al-lowed seamless movement throughout the different phases of clinical trials; and si-multaneously proceeded with manufacturing scale-up before it was clear whether the safety and effectiveness data for a vaccine would support emergency use author-ization. \nFor the three vaccines authorized to date, our EUA process not only included a \nthorough evaluation of the data by the Agency’s career staff, but also included input from independent scientific and public health experts through our public advisory committee process. Throughout this process, FDA took additional steps to facilitate transparency, such as posting sponsor and FDA briefing documents and key decisional memoranda. \nThe three authorizations make available COVID–19 vaccines in the United States \nthat have shown clear and compelling effectiveness in large, well-designed phase 3 \n26 \n1https://www.fda.gov/media/139638/download. \n2https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid- \n19/covid-19-frequently-asked-questions. trials and that meet rigorous standards for safety and effectiveness to support emer-\ngency use authorization. Vaccines are helping us in the fight against this pandemic, which has claimed almost 600,000 lives here in the United States alone. All the \nCOVID–19 vaccines that FDA has authorized for emergency use have far surpassed being at least 50 percent more effective than placebo in preventing COVID–19, which was recommended in our June 2020 guidance document, Development and Li-\ncensure of Vaccines to Prevent COVID–19.\n1A vaccine with at least 50 percent effi-\ncacy would have a significant impact on disease, both at the individual and societal level. \nAs part of our continued efforts to be transparent and educate the public, we have \na wealth of information on our website about the authorized COVID–19 vaccines. The information includes fact sheets for healthcare providers (vaccination providers) and vaccine recipients with important information such as dosing instructions; infor-mation about the benefits and risks of each authorized vaccine; and topical Ques-tions and Answers developed by FDA for each authorized vaccine.\n2 \nIt is also important to highlight that, as part of each EUA, we are requiring the \nmanufacturers and vaccination providers to report serious adverse events, cases of Multisystem Inflammatory Syndrome (MIS), and cases of COVID–19 that result in hospitalization or death to the Vaccine Adverse Event Reporting System (VAERS), a national vaccine safety surveillance program jointly run by FDA and the Centers for Disease Control and Prevention (CDC). \nAt this time, data are not available to make a determination about how long these \nauthorized vaccines will provide protection, nor are we certain that the vaccines pre-vent transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV– 2) from person to person. Additionally, although we do not yet know the full range of SARS-CoV–2 variants that each of the authorized vaccines will protect against, there is evidence that the current vaccines protect against disease caused by variants circulating in the United States. \nFinally, manufacturers whose COVID–19 vaccines have been authorized for emer-\ngency use are expected to continue their clinical trials in order to obtain additional safety and effectiveness information and pursue licensure (approval) through the submission of a Biologics License Application (BLA). \nFDA’s Role Working With COVID–19 Vaccine Manufacturers \nFDA plays a critical role in the development and authorization or licensure of vac-\ncines, spanning the entire product lifecycle. The Agency provides scientific and regu-latory advice to industry, researchers, and other stakeholders across the vaccine de-velopment spectrum. Interactions with product developers begin long before any for-mal regulatory submission is made and continue throughout development under FDA’s investigational new drug application process. FDA is committed to working with all manufacturers developing products to prevent or treat COVID–19 and has had numerous interactions with COVID–19 vaccine manufacturers developing these vaccines and seeking emergency use authorization. \nFDA makes use of all available regulatory tools and expedited programs, as ap-\npropriate, to help advance products critical for public health, including vaccines, from early product development to when a product application is submitted to FDA for our evaluation of safety and effectiveness to support authorization or approval. \nFollowing approval of a BLA or issuance of an EUA request, the Agency uses real- \nworld data to monitor the safety and effectiveness of vaccines through both passive and active post-market surveillance. Passive surveillance involves the submission of adverse event reports by patients, providers, and manufacturers to FDA through the Vaccine Adverse Event Reporting System (or VAERS). The Agency also performs ac-tive post-market surveillance of safety and effectiveness of vaccines through various data bases, including an FDA partnership with the Center for Medicare & Medicaid Services (CMS) to use Medicare data and use of the FDA’s of BEST (Biologics Eval-uation and Safety) system. \nFDA works with manufacturers of approved or authorized products to help ensure \ncontinued supply and availability of critical medical products. The Agency does this by promptly reviewing proposed technical or manufacturing changes and monitoring the continued quality of these products. \n27 \n3https://www.fda.gov/media/142749/download. FDA is committed to providing timely scientific and regulatory advice to support \nrapid COVID–19 response efforts. To assist manufacturers with the development of \nCOVID–19 vaccines, provide scientific and regulatory advice, and outline FDA’s ex-pectations, the Agency issued specific COVID–19 vaccine guidances. In June 2020, FDA issued guidance titled Development and Licensure of Vaccines to Prevent COVID–19. In October 2020, FDA issued guidance titled Emergency Use Authoriza-tion for Vaccines to Prevent COVID–19 and updated it in February 2021 .\n3 \nDuring the COVID–19 public health emergency, FDA is utilizing all available \ntools and sources of information to support regulatory decisions on applications or EUA requests that include manufacturing sites where FDA’s ability to inspect facili-ties is impacted due to COVID–19. During this interim period, we are using addi-tional tools, where available, to determine the need for an onsite inspection and to support the application assessment, such as reviewing a firm’s previous compliance history, and requesting records in advance of or in lieu of onsite inspections or vol-untarily from facilities and sites. Following notice by a sponsor of intent to submit an EUA request, FDA will continue to work with the sponsor regarding resolution of any necessary manufacturing site issues resulting from a site visit or other infor-mation submitted. FDA will assess current good manufacturing practices (CGMP) or CGMP compliance for each manufacturing site using all available tools and infor-mation. \nThe EUA Process for COVID–19 Vaccines \nA determination by the previous HHS Secretary issued on February 4, 2020, de-\nclared that there is a public health emergency that has significant potential to affect national security or the health and security of U.S. citizens living abroad. Declara-tions were issued stating that circumstances exist justifying the authorization of emergency use of unapproved products. These declarations permit FDA to issue EUAs to allow unapproved medical products or unapproved uses of approved med-ical products to be used in an emergency to diagnose, treat, or prevent COVID–19 when there are no adequate, approved, and available alternatives. \nThe issuance of an EUA is different than an FDA approval (licensure) of a vac-\ncine, in that a vaccine available under an EUA is not approved. In determining whether to issue an EUA for a vaccine, FDA evaluates the available evidence to de-termine whether the product may be effective, and assesses any known or potential risks and any known or potential benefits. If there is evidence that convinces us that the vaccine may be effective and the benefit-risk assessment is favorable, it may be made available during the public health emergency. Once a manufacturer submits an EUA request for a COVID–19 vaccine to FDA, the Agency evaluates the request and determines whether the relevant statutory criteria are met, taking into account the totality of the scientific evidence about the vaccine that is available to FDA. \nThe EUA requires fact sheets that provide important information, including dos-\ning instructions and information about the benefits and risks of the COVID–19 vac-cines, be made available to vaccination providers and vaccine recipients. \nEach of the manufacturers of FDA-authorized COVID–19 vaccines submitted a \npharmacovigilance plan to FDA describing their commitment to monitor the safety of their vaccines. The pharmacovigilance plans include plans to complete longer- term safety follow-up for participants enrolled in ongoing clinical trials. The pharmacovigilance plans also include other activities aimed at monitoring the safety profile of the COVID–19 vaccines and ensuring that any safety concerns are identi-fied and evaluated in a timely manner. FDA also expects manufacturers whose COVID–19 vaccines are authorized under an EUA to continue their clinical trials to obtain additional safety and effectiveness information and pursue approval (licen-sure). \nFDA, CDC, Centers for Medicare & Medicaid Services (CMS), Veteran’s Health \nAdministration and Department of Defense are conducting post-authorization safety and effectiveness monitoring in their surveillance systems including VAERS, CMS \nMedicare data, FDA BEST, the CDC Vaccine Safety Datalink and others. \nSpecific updates about each of the authorized vaccines are provided below. \nPfizer COVID–19 Vaccine \nAs Pfizer announced, FDA received the company’s request to amend its emergency \nuse authorization (EUA) to expand the authorized age range for its COVID–19 vac-\n28 \n4https://www.fda.gov/media/144637/download. \n5https://www.fda.gov/media/147762/download. cine to include individuals 12 through 15 years of age. Currently, the vaccine is au-\nthorized for emergency use to prevent COVID–19 in individuals ages 16 and older. While the Agency cannot predict how long its evaluation of the data and information will take, we will review the request as expeditiously as possible using a thorough and science-based approach. Based on an initial evaluation of the information sub-mitted, at this time the Agency does not plan to hold a meeting of the Vaccines and Related Biological Products Advisory Committee (VRBPAC) pertaining to this re-quest to amend the EUA for the Pfizer-BioNTech COVID–19 Vaccine. The original EUA request was discussed at a VRBPAC meeting in December 2020. The VRBPAC voted in favor of the determination that based on the totality of scientific evidence available, the benefits of the Pfizer-BioNTech COVID–19 Vaccine outweigh its risks for use in individuals 16 years of age and older. After considering all the evidence, including the VRBPAC’s advice, FDA issued an EUA for the Pfizer vaccine. As with all FDA-authorized COVID–19 vaccines, we are committed to transparency with this EUA review process. \nModerna COVID–19 Vaccine \nOn April 1, 2021, FDA announced two revisions regarding the number of doses \nper vial available for the Moderna COVID–19 Vaccine. The first revision clarifies the number of doses per vial for the vials that are available, in that the maximum number of extractable doses is 11, with a range of 10–11 doses. The second revision authorizes the availability of an additional multi-dose vial in which each vial con-tains a maximum of 15 doses, with a range of 13–15 doses that can potentially be extracted. The type of syringes and needles used to extract each dose affect the number of doses that can be extracted from the vials. \nBoth of these revisions positively impact the supply of Moderna COVID–19 Vac-\ncine, which will help provide more vaccine doses to communities and permit more people to be vaccinated. Ultimately, more vaccinations administered in a timely manner in the United States and around the world should help bring an end to the pandemic more rapidly. \nDepending on the type of syringes and needles used to extract each dose, there \nmay not be sufficient volume to extract more than 10 doses from the vial containing a maximum of 11 doses or more than 13 doses from the vial containing a maximum of 15 doses. \nTo support these changes to the EUA, FDA evaluated data showing the number \nof doses that could be extracted from the vials and on the fill volumes for both vials that were submitted by ModernaTX, Inc. The Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) and Prescribing Information\n4have \nbeen revised to reflect the new information and are intended to help frontline work-ers administering COVID–19 vaccines understand the number of doses that can po-tentially be extracted per vial. \nJanssen (Johnson & Johnson) COVID–19 Vaccine \nAs part of our regulatory processes for reviewing all manufacturing facilities, FDA \nrecently completed an inspection of Emergent BioSolutions, a proposed manufac-turing facility for the Janssen COVID–19 Vaccine. As Johnson & Johnson an-nounced last month, FDA has not authorized this facility to manufacture or dis-tribute any of the Janssen COVID–19 Vaccine or components and, to date, no \nCOVID–19 vaccine manufactured at this plant has been distributed for use in the U.S. \nFDA’s inspections are thorough, and these assessments review the quality of man-\nufacturing procedures, including records, staff training, facility operations, drug pro-duction and testing, and the systems in place to ensure product quality. At the close of the inspection of Emergent BioSolutions, FDA investigators cited a number of ob-servations concerning whether the facility’s practices met our regulatory require-ments and standards. These observations are outlined in an inspection closeout re-port, also known as an ‘‘FDA Form 483.’’\n5 \nTypically, firms respond to the observations cited on an FDA Form 483, and the \nAgency then works with a company to help identify a path forward to remedy the issues. \nIndeed, it is often in the public’s best interest that FDA work with firms to quick-\nly resolve inspectional observations to ensure that the public has access to medical \n29 \n6https://www.fda.gov/media/146304/download. products that meet the Agency’s high standards for quality, safety, and effective-\nness. \nIn the case of Emergent BioSolutions, we are working with the company to ad-\ndress the conditions identified. At the Agency’s request, Emergent BioSolutions has \nagreed to pause new production while it works with FDA to resolve potential quality issues. For the vaccines already manufactured, the products will undergo additional testing and will be thoroughly evaluated to ensure their quality before any potential distribution. We will not allow the release of any product until we are confident that it meets our expectations for quality. \nWe have notified various health authorities regarding the findings we observed \nat the Emergent facility and are providing additional information as requested. FDA will continue to work closely with its international partners, as it has throughout the pandemic. Additionally, moving forward, the Agency is considering how best to further evaluate manufacturing quality during this and any future public health emergency. \nThese manufacturing actions are unrelated to an ongoing evaluation by FDA and \nCDC of clinical reports of blood clots along with low levels of platelets that have occurred in some people after receiving the Janssen COVID–19 Vaccine, described further below. \nWe are committed to ensuring that the COVID–19 vaccines given to the people \nof this Nation have met the Agency’s high standards for quality, safety, and effec-tiveness. We know that every time a person, including members of our own families, receives a COVID–19 vaccine, they are putting their trust in us. We are committed to maintaining that trust. \nCOVID–19 Vaccine Safety Surveillance \nOn April 13, 2021, FDA and CDC issued a joint statement, announcing that, out \nof more than 6.8 million doses administered as of that date, six reports of a rare and severe type of blood clot combined with low blood platelet levels occurring in people after receiving the Janssen COVID–19 Vaccine had been reported to VAERS. In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia). All six cases occurred among women between the ages of 18 and 48, and symptoms oc-curred 6 to 13 days after vaccination. Treatment of this specific type of blood clot is different from the treatment that might typically be administered. Usually, an anticoagulant drug called heparin is used to treat blood clots. In this circumstance, administration of heparin may be dangerous, and alternative treatments need to be given. \nOut of an abundance of caution, FDA and CDC recommended a pause in the use \nof the Janssen COVID–19 Vaccine while we investigated reports of these serious ad-verse events. This was important, in part, to help ensure that health care providers were made aware of the potential occurrence of these adverse events and could plan for proper recognition and clinical management due to the unique treatment re-quired for thrombosis with thrombocytopenia syndrome. \nFDA and CDC have reviewed all of the available data, and CDC’s Advisory Com-\nmittee on Immunization Practices (ACIP) held emergency meetings to discuss the data on April 14 and April 23, 2021. Those data, plus the deliberations and rec-ommendations of the ACIP, informed our assessment that the known and potential benefits of Janssen COVID–19 Vaccine outweigh its known and potential risks in individuals 18 years of age and older. We concluded that, at this time, the available data suggest that the chance of this serious adverse event occurring is very low. Thus, on April 23, 2021, FDA and CDC determined that the recommended pause regarding the use of the Janssen COVID–19 Vaccine in the U.S. should be lifted and use of the vaccine should resume. However, investigation into the level of poten-tial excess risk due to COVID–19 vaccination is ongoing. \nThe Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Pro-\nviders) has been updated to include a Warning pertaining to the risk of thrombosis with thrombocytopenia.\n6The Fact Sheet for Recipients and Caregivers has also \nbeen updated to include information about these serious adverse events. \nFDA and CDC will continue to closely monitor the safety of these vaccines. We \nwill continue to closely monitor the safety of the Janssen COVID–19 Vaccine. \n30 \nThe pause in the use of this vaccine was an example of our extensive safety moni-\ntoring system working as it is designed to work—identifying even this small number \nof cases. \nAs of May 4, 2021, a total of 23 cases of thrombosis with thrombocytopenia fol-\nlowing post-authorization use of Janssen COVID–19 Vaccine were confirmed, involv-ing cerebral venous sinuses and other sites in the body. These cases have been asso-ciated with three deaths. FDA anticipates these numbers will change over time as additional cases are reported and investigated. \nFDA continues to inform the public of these cases and has noted that a causal \nrelationship with Janssen COVID–19 Vaccine is plausible for thrombosis with thrombocytopenia syndrome. The teams at FDA and CDC also conducted extensive outreach to providers and clinicians to ensure they were made aware of the poten-tial for these adverse events. The outreach also provided information so that they could properly clinically manage and recognize these events due to the unique treat-ment required for these blood clots and low platelets, also known as thrombosis- thrombocytopenia syndrome (TTS). Specific risk factors for thrombosis with thrombocytopenia after vaccination continue to be investigated. \nAs noted earlier, CBER is monitoring the safety of all authorized COVID–19 vac-\ncines through both passive and active safety surveillance systems. CBER is doing so in collaboration with CDC, CMS, the Department of Veterans Affairs, and other academic and large non-government healthcare data systems. In addition, CBER participates actively in ongoing international pharmacovigilance efforts, including those organized by the International Coalition of Medicines Regulatory Authorities and the World Health Organization. These efforts are in addition to the pharmacovigilance efforts being undertaken by the individual COVID–19 vaccine manufacturers for authorized vaccines. A coordinated and overlapping approach using state-of-the-art technologies has been implemented. \nConclusion \nThe process FDA uses to evaluate the safety and effectiveness of medical products \nis respected worldwide and commonly referred to as the ‘‘gold standard.’’ Because of a well-established history, the Agency’s review processes are globally recognized as the most rigorous. \nHaving three vaccines authorized to date that meet FDA’s expectations for safety \nand effectiveness only 1 year after the declaration of the COVID–19 pandemic is a tremendous achievement and a testament to the dedication of developers and FDA’s career scientists and physicians, many of whom have been working tirelessly to con-duct comprehensive and rigorous evaluations of the data submitted for vaccines to prevent COVID–19. We are highly engaged in ensuring that all COVID–19 vaccines meet the high quality that Americans expect and deserve and are also actively en-gaged in ensuring the safety of these vaccines following deployment. The Agency is very proud of these efforts, and we hope that the vaccines will help bring this pan-demic to an end. \nThe C HAIR . Thank you. \nDr. Kessler. \nSTATEMENT OF DAVID KESSLER, M.D., CHIEF SCIENCE OFFI-\nCER, COVID RESPONSE, UNITED STATES DEPARTMENT OF \nHEALTH AND HUMAN SERVICES, WASHINGTON, DC \nDr. K ESSLER . Chair Murray, Ranking Member Burr, distin-\nguished Members of the Committee, thank you for the invitation to \nprovide an update on our COVID–19 response. \nAllow me to succinctly set out what we are focused on today. \nFirst, we have delivered to date 330 million doses of vaccine in the United States and have administered over 260 million of them. The most important thing we all need to do is to get a vaccine to every-one who wants to be vaccinated in the United States. \nThe current vaccine supply exceeds demand. Nothing is more im-\nportant than achieving the President’s goal of having 70 percent of \n31 \nadults with at least one shot before—by July 4. The long-term fate \nof many of our communities depends on getting people vaccinated. \nThere are many reasons why many people have not yet been vac-\ncinated. We need to recognize at the core for many is simply a fear of the unknown. All the data support the basic proposition that these vaccines are safe and effective. Getting vaccinated will pre-vent hospitalization and death. \nSecond, the FDA took a significant step yesterday in the fight \nagainst COVID–19 by expanding the Pfizer EUA to adolescents ages 12 to 15. Pending the recommendation of the ACIP tomorrow, we plan to offer the Pfizer vaccine to all young people ages 12 to \n15. \nRight now, the Pfizer vaccine is available at many local phar-\nmacies and larger health clinics. We are working to make smaller trays available so that the Pfizer vaccine can be administered by more pediatricians, family doctors, and rural healthcare providers. \nBy late fall, we expect to have data on the safety and effective-\nness of vaccines for children under 12. \nThird, we are planning—and I underscore the word planning— \nto have booster doses available if necessary for the American peo-ple. Increased age, the natural waning of antibodies over time, and new variants all increase the probability that booster doses may be needed. \nFourth, it is absolutely essential that we begin sharing doses \nmade in the United States with the rest of the world. Supplying other nations with vaccines is not just the right thing to do for life-saving, humanitarian purposes; it is also in the best interest of the United States to mitigate the risk of viral evolution. \nFifth, we need to hasten our search for an antiviral. I am con-\ncerned that even after we finish vaccinating most of the people who want to be vaccinated by this summer, there will still be a signifi-cant number of cases and an unacceptable number of deaths. Peo-ple who are immunosuppressed, who do not mount an immune re-sponse for a number of reasons, or choose not to be vaccinated will continue to be vulnerable, and we need options for them. The anti-body treatments are one approach, but a simple oral antiviral can add to our armamentarium to bring this epidemic under control. \nLast, we need to build a program for vaccine preparedness for fu-\nture pandemics. This will need to be done in partnership with the private sector and build on all the lessons we have learned to date. \nThank you for the opportunity to testify today, and I look for-\nward to your questions. \n[The prepared statement of Dr. Kessler follows:] \nPREPARED STATEMENT OF DAVID KESSLER  \nIntroduction \nChair Murray, Ranking Member Burr, and distinguished Members of the Com-\nmittee. I am Dr. David Kessler, and I am honored to be serving as the Chief Sci-entific Officer for the COVID–19 Response. Thank you for the opportunity to testify before you today, provide this update, and discuss our planned actions and priorities going forward. \nToday, the United States is in a special position, with three vaccines that have \nmet our standards for safety and effectiveness and are authorized for the prevention of COVID–19. I am privileged to work with colleagues on the COVID–19 Response who coordinate efforts with state and local partners to deliver and administer those \n32 \ndoses. I am pleased to report that more than 83 percent of people over the age of \n65 have received at least one dose and over 70 percent of them are fully vaccinated. As of April 19, 2021, every person aged 16 and over in every state and territory is now eligible to get vaccinated. The country has exceeded President Biden’s goal of administering 200 million shots in the first 100 days of his Administration. \nWe are carefully monitoring the supply chain, raw materials and our manufac-\nturing capacity for vaccines. I am pleased to report that our supply remains strong as we work toward achieving President Biden’s goal of having 70 percent of adult Americans with at least one shot and 160 million Americans fully vaccinated by July 4. \nWe have provided Federal support and Federal personnel for over 1,800 commu-\nnity vaccination centers and mobile sites across the country. We have also launched the Federal Retail Pharmacy Program, a collaboration between Federal Govern-ment, states, and territories, and to 21 national pharmacy networks to expand ac-cess to vaccines for the American public, with over 40 percent of locations in highest need neighborhoods. We increased the number of pharmacies providing vaccines to nearly 40,000. Today 90 percent of all Americans have a vaccination site within 5 miles of where they live. In addition, we have launched a program to directly send vaccine to community health centers, currently reaching over 750 centers who have ordered nearly 6 million COVID–19 vaccine doses for over 2,000 sites. HHS just launched a Rural Health Clinic program and announced expanded COVID–19 Test-\ning and Mitigation funding for small rural facilities and critical access hospitals— to mitigate the spread of the virus in ways tailored to local rural communities. \nI want to stress how important it is that our fellow citizens get vaccinated and \nthat we help ease the minds of those who are considering getting vaccinated. We need to confront the reality of vaccine hesitancy. I have focused my career on study-ing drug safety. We can help people overcome their concerns about vaccines by being transparent with them about the safety of these products. When it comes to the mRNA vaccines, real world data show that they are more than 90 percent effective in preventing infection two or more weeks after the second dose, and that these vac-cines have to date an excellent safety profile. \nI also want to emphasize that we are committed to helping other countries fight \nCOVID–19, most recently India. We delivered 20,000 treatment courses of the antiviral drug remdesivir to India to help treat hospitalized patients. We have redi-rected the United States’ own order of AstraZeneca vaccine manufacturing supplies to India. This will allow India to make over 20 million doses of COVID–19 vaccine. We are also delivering critical supplies to help provide oxygen to patients and addi-tional personal protective equipment for healthcare workers. Supplying other na-tions with vaccines and personal protective equipment (PPE) is not just the right thing to do for life-saving humanitarian purposes, it is also in the best interests of the United States to mitigate the risk of viral evolution. The best way to stop new variants from emerging is to prevent outbreaks that allow mutations to occur. \nToday, I want to provide updates on three topics that we know are vitally impor-\ntant to the overall effort to bring COVID–19 under control in America. \nFirst, we are developing plans to provide booster doses to Americans, if deter-\nmined to be necessary later this year. We know that neutralizing antibodies persist for some time after the second dose of an mRNA vaccine, with a relatively slow de-cline over time. We are supporting research to determine who would benefit from booster doses and when these should be administered. We expect to have more in-formation this summer about the potential benefits that a booster dose could pro-vide, as well as the process and timing for regulatory review of these vaccines. We are also supporting research to evaluate the use of different combinations of booster doses, so that a person’s booster dose might be from a different manufacturer than that person’s initial vaccine regimen. As part of our plans, we will carefully evaluate whether we might need doses that are modified to address variants. As these efforts progress, we will work with manufacturers to make those doses available, as need-ed, to continue to protect Americans from COVID–19. \nSecond, if the Food and Drug Administration (FDA) authorizes vaccines for ado-\nlescents between the ages of 12 and 15, we will make sure those adolescents have access. After a careful review of the data by FDA and the Centers for Disease Con-trol and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP), we plan to have about 20,000 pharmacy sites across the country ready to vaccinate adolescents. We will also work to get vaccines into the offices of pediatri-cians and family physicians so that parents and their children can talk to their doc-tor about vaccines and have an option of receiving their dose from a trusted pro-vider. \n33 \nFinally, I want to talk about our work on therapeutics. Taking a whole of govern-\nment approach, we have worked to accelerate the clinical development and manufac-\nturing scale-up of therapeutic candidates most likely to have a broad public health impact to complement the vaccine effort, with successful therapies at sufficient quantities. There are two monoclonal antibody (mAb) treatments with emergency Use authorization (EUAs) currently available, Regeneron’s cocktail (casirivimab and imdevimab) and Eli Lilly’s combination treatment (bamlanivimab + etesevimab). We have procured almost 3 million monoclonal antibody doses that are being provided to the US healthcare system at no cost, with approximately 980,000 total doses shipped to 5956 (suggest—almost 6000) provider sites. As of April, mAbs were being \nadministered to approximately 1 out of 5 eligible high-risk patients. We continue to support efforts to increase awareness of treatments and expand infusionsites and services to help ensure fair and equitable administration of mAbs. \nOur efforts are also focused on the research and development of antiviral drugs, \nparticularly small molecule oral antivirals to treat individuals who are not vac-cinated or who might become infected after vaccination. These drugs could also help patients in the event of rapidly emerging variant strains. Monoclonal antibodies and other drugs in development target those at high risk of severe disease, but a safe and effective oral drug that demonstrates an endpoint of symptom resolution would be an important treatment option for Americans. We are committed to supporting research and development of antivirals for COVID–19. \nI look forward to working with Members of this Committee as we address the \nissues I have highlighted. Thank you for the opportunity to testify today on our re-cent COVID–19 Response actions. \nThe C HAIR . Thank you to all of our witnesses for being here \ntoday and your testimony. \nWe will now begin a round of 5-minute questions of our wit-\nnesses, and I ask our colleagues to keep track of your clock and \nstay within those 5 minutes. We do have votes starting at 11:30 today. \nDr. Fauci, I am going to start with you. The surge of COVID– \n19 that is devastating India is a painful reminder, really, that we cannot end the pandemic here until we end it everywhere. And I am glad the Biden administration is leading that global fight by re-joining the World Health Organization and funding global vaccine efforts and committing to donate 60 million AstraZeneca vaccines to other countries by July 4th. India’s outbreak really underscores the need for a robust public health infrastructure in the U.S. to re-spond appropriately to this pandemic and future outbreaks, as well. \nI wanted to ask you today, Dr. Fauci, what can we learn from \nIndia’s outbreak that we should apply to our response here in the U.S.? \nDr. F\nAUCI . Well, I think one of the important things is do not \never underestimate the situation. You know, the reason that India is in such dire straits now is that they had an original surge and made the incorrect assumption that they were finished with it. And what happened, they opened up prematurely and wind up having a surge right now that we are all very well aware of is extremely devastating. That is the first thing. \nThe second thing is preparedness with regard to public health \npreparedness, which we, as a lesson learned for future pandemics, have to realize that we need to continue to buildup our local public health infrastructure. Which, over the last decades, we have let ac-tually, in many respects, go into disarray, likely because of our suc-cesses in controlling so many diseases. \n34 \nThe other lesson that is learned, Madam Chair, is that this is a \nglobal pandemic that requires a global response. And, we need to \npay attention to the responsibility that we have, not only for our own Country, but to join with other countries to make sure that we have the access to interventions, particularly vaccines, throughout the world because if it continues to have dynamics of virus any-where in the world, we have a threat here in the United States, particularly with variants. And, there is one variant in India that is also a new variant, number 617B617. \nThose are just a few of the lessons that I believe we can take \nfrom what is going on in India. Thank you. \nThe C\nHAIR . Thank you. \nDr. Marks, I am really encouraged by how the FDA has worked \nboth quickly and carefully to get multiple COVID vaccines author-ized. But, having said that, I am very concerned about the reports involving Emergent BioSolutions. You mentioned it in your re-marks. It is a contractor that received $628 million to manufacture COVID vaccines, and I wanted to ask you to explain FDA’s recent findings. Because after receiving reports of cross-contamination with another vaccine, FDA inspected the Emergent facility, as you said, and asked the contractor to pause manufacturing, and the cross-contaminated vaccine was not distributed for any use. \nBut, Dr. Marks, what steps is FDA taking to make sure the qual-\nity, safety, and effectiveness of all COVID–19 vaccines? \nDr. M\nARKS . Chair Murray, thank you for that question. So, we \nare currently, for the Emergent facility, we are actively working with all of the parties involved to ensure that the facility’s defi-ciencies are all remediated so that before they actually are able to release vaccine, it meets all of our quality standards that Ameri-cans deserve from vaccines. \nAlso, as we move on to other facilities that may be producing \nvaccines, we will take the approach of using all of our inspectional tools to ensure that the quality of those is the highest nature. And, as with all of our biologics license applications, we, for the—gen-erally, will be performing onsite inspections of those facilities to en-sure the quality of those products. \nThe C\nHAIR . Thank you. And I am really deeply concerned about \nwhat happened, and my expectation is in the future, nothing like that happens again. \nDr. Walensky, in my last minute here, let me just ask you. The \nCDC says that while fewer children have been sick with COVID– 19 compared to adults, children can be infected, get sick, and spread the virus. With the authorization of Pfizer yesterday for children 12 to 15, what would you say to parents who are consid-ering getting their kids vaccinated now? \nDr. W\nALENSKY . I would encourage all parents to get their chil-\ndren vaccinated. I know many parents are enthusiastic and have been texting me, cannot wait to get their children vaccinated. I rec-ognize that there—some parents want to sort of see how it goes \nfirst. But, I am encouraging all parents to get their children vac-cinated. Some parents will not want to be first. \nBut, I am also encouraging children to ask for the vaccine. I have \na 16-year old myself, and I can tell you he wanted to get the vac-\n35 \ncine. He wants his life back. These kids want to go back to school. \nThey want to go back to the things they love. \nThe C HAIR . Thank you. \nSenator Burr. Senator B\nURR. Thank you, Chair. \nDr. Kessler, we have shipped 2.7 million doses of AstraZeneca, \nI think, to Mexico. That is the only country we have shipped to. We have additional doses of AstraZeneca in inventory in this Country. We talked about July 4th exporting more. Why have we not taken the AstraZeneca, which is not approved for vaccination in the United States, why have we not mobilized that to other countries of the world today? \nDr. K\nESSLER . Senator, it is a very important question. We have \nshipped a total of four million doses to date, including to Mexico, and I believe 1.5 to Canada. We are ready to ship up to 60 million doses of AstraZeneca. But, as the Chair pointed out, and as my col-league, Dr. Marks, responded, there are issues with Emergent that are under review by the Food and Drug Administration. If and when those issues are resolved and we can say that these are qual-ity doses, we will do just as you say. \nSenator B\nURR. Correct me if I am wrong. I did not think the \nEmergent Baltimore facility had anything to do with AstraZeneca production. Am I wrong, Dr. Marks? \nDr. M\nARKS . Senator Burr, no. The AstraZeneca vaccine was being \nproduced in that facility, and the FDA feels it is imperative that before vaccine can be shipped to any other partner, it has to meet the quality standards that it would meet for any American, as well. \nSenator B\nURR. How long do you anticipate that testing the \nAstraZeneca vaccine that is currently manufactured would take to verify? \nDr. M\nARKS . We are working on that as quickly as we can. We un-\nderstand the imperative here. There is a working group across our Office of Regulatory Affairs and our center and others at FDA that are working together to try to clear that—those doses as quickly as we can. I cannot give you an exact time, but we understand the im-perative to be able to have them available so that Dr. Kessler can arrange for them to be shipped to those in need. \nSenator B\nURR. Okay. Dr. Kessler, one of the reasons we are as \nsuccessful today is that partnerships have been leveraging vaccina-tions around the world, and over 275 partnerships have been cre-ated to scale up vaccine production and manufacturing. \nI guess I am asking you this. If we waive intellectual property \nin the United States, do we not stand the risk of affecting innova-tion in the future when, if we did it to scale up manufacturing ca-pacity, the private sector has done that through partnerships al-ready and that is the reason that we have been so successful? Should we not let the private sector continue to do something that—I think Dr. Fauci and I have said in the past, we never an-ticipated this. This is novel that they would have the relationship to do it. Why mess with a good thing? \nDr. K\nESSLER . I applaud the actions of the pharmaceutical indus-\ntry. Senator, this is a once-in-a-century pandemic. I think we all recognize that extraordinary circumstances call for extraordinary measures. We know—and I agree with you, Senator—that a waiver \n36 \nalone will not result in the scale and speed we need to make \nenough vaccines to end the pandemic. That is why we will continue to ramp up our efforts working with the private sector and all pos-sible partners to expand vaccine manufacturing and distribution around that, around the world. I mean, our job is to do, as you say, to increase that supply. That is what we are focused on. We want to make vaccines available to the world. \nSenator B\nURR. David, here is the reality. When Pfizer went to \nopen up its Kansas plant to produce vaccine, it took them, I be-lieve, 7 months to retool and to get everything done. This belief that you can export intellectual property and you are going to have a standup around the world instantaneously of vaccine production is a joke. Dr. Marks has already expressed concern over the back-logs for inspections and how long would it take for us to inspect foreign sites, if in fact there was a vaccine pool that found its way in and out of the United States. \nLet me just get this before my time runs out. Can anybody give \nme the number? There has been 33 million Americans infected with COVID that have actually tested positive. How many of that 33 million have then been vaccinated? Does anybody know what that number is? \n[Brief silence.] Senator B\nURR. Here is why I make the point, and here is why \nI think it is relevant. If we are looking at a certain number that we do not know exactly what it is, Dr. Fauci, that we want to get to, and we have vaccinated 115 million, it is important for us to know, of the counted vaccine number, how many of those already had protection because they were COVID-positive. \nIf we are trying to reach a number—when the President says 70 \npercent vaccination, if we get to 65 vaccinated and 5 percent got COVID and they had protection, is that not like being at 70? \nI think one of the problems that—the goal post continues to be \ntoo far. And we now have the harder part of how do we take the 40 percent that are not real comfortable with getting vaccinated and at least have a shot at vaccinating 50 percent of that 40 per-cent. And, it may be that our number is higher today on the pro-tected. I know it is. I do not think 33 million have all been vac-cinated that were positive, but I think it is absolutely crucial that we figure out what that number is. I am not sure whose responsi-bility it is that we figure out what that number is and put that into our formula of how many Americans have protections. \nI thank the chair. The C\nHAIR . Thank you, Senator Burr. \nSenator Casey. Senator C\nASEY . Chair Murray, thank you very much. And I want \nto thank our guests, Dr. Fauci, Dr. Kessler, Dr. Marks, and Dr. Walensky. I think I will have at least one question for Dr. Walensky and one for Dr. Marks. \nI am going to start with you, Dr. Walensky. I want to thank you \nfor your leadership and the leadership of the CDC and your efforts to ensure that children and adolescents are up to date on vaccina-tions, particularly as students return to in-person learning. \nYou and others have noted, there are over 11 million doses \nthrough the Vaccines for Children Program that have been missed. \n37 \nThese missed doses could seriously and negatively impact efforts to \nprotect children, their families, and communities from vaccine-pre-ventable diseases and conditions. Of course, we are talking here about diseases other than COVID–19. \nAt the same time, with 12 to 15 year olds now able to get vac-\ncinated against COVID–19, there is an even greater need to ensure parents are aware of all the vaccines, all the vaccines that children should receive in order to remain healthy. The Rescue Plan con-tains funding to build vaccine confidence, and specifically includes provisions to ensure funding is allocated toward increasing vaccina-tion rates throughout the U.S. \nHere is the question, Doctor. In addition to the public awareness \nefforts that you and CDC have already undertaken, will the CDC be releasing the funding to both states and communities to ensure that children and adolescents are caught up on both routine and recommended vaccinations, particularly as children return to in- person learning? \nDr. W\nALENSKY . Thank you, Senator, for that. You raise an issue \nthat is near and dear to my heart and I am very worried about. More than 20 percent of our measles vaccines were not used this year. We have the same issue with meningococcal vaccines, and es-pecially among our adolescents. \nUnfortunately, we actually do not have data on whether we can \nco-administer the COVID–19 vaccine and other routine immuniza-tions and whether we get the same protection from the COVID–19 vaccines and the routine administration of other immunizations. That is one issue that the experts at ACIP are going to address to-morrow as to whether that can safely be done and that we could potentially get adequate protection. \nYou are right. We need to, as we are putting forward these ef-\nforts in vaccine confidence for the COVID–19 vaccine, we need to take this outreach and make sure that we are breaching these com-munities and not only conveying the importance of getting the COVID–19 vaccine, but, if we are not able to co-administer them, to make sure we get back to these children and be able to admin-ister the routine vaccines that they have lost before the school year. \nSenator C\nASEY . In terms of the funding, though, that will be re-\nleased? Do you have any sense of the timing of that? \nDr. W ALENSKY . I do not, but we can get back to you. \nSenator C ASEY . Okay. Thank you. \nDr. Marks, I wanted to start with you regarding Pfizer. We have \nheard a lot this year about emergency use authorization, and we know that Pfizer has recently filed their application for full licen-sure of their COVID–19 vaccine. I think we get a lot of questions at home on a range of these issues, and, in particular, what does it mean? What does it mean? What does full licensure mean? One of the concerns that we have heard a lot about as the vaccines are provided, this emergency use authorization, but what is the next \nstep for a vaccine? Can you explain what it means to get full licen-sure? That is question No. 1. \nSecond, what additional information would a company need to \nsubmit beyond what was required just for so-called EUA? \n38 \nDr. M ARKS . Senator, thanks very much for that question. The full \nlicensure is something that a manufacturer submits with a full \ndata package, which I will go into in a moment. \nBut, I just want to go back to pick up on something that Dr. \nFauci said. These COVID–19 vaccines, they were expedited not by cutting corners, but by going through a development plan in which kind of empty space, space that would have been normally just not stuff happening, was taken away. So, manufacturing was done while the clinical trials were done. \nThe large clinical trial programs were of the size of normally li-\ncensed vaccines in the United States. The one place where we are a little bit short was the duration of safety follow-up. But, we are very confident from the amount of safety follow-up, at least a meet-ing of 2 months safety follow-up on this safety data set for the emergency use authorization, that the large majority of adverse events became apparent. So, we are very confident in recom-mending these vaccines for everyone—our families, all Americans. \nThe difference that will happen with the biologics license applica-\ntion is that the manufacturers will be able to submit additional safety data, perhaps 6 months of safety data rather than just the median 2 months safety data. And, additionally, there are some technical things that will be there that many people may not care a lot about, but we do. That is, manufacturing conformance lots, the formal facilities inspections will occur, and additional ancillary studies will be put in that package. \nI think the main message to the American public is that for all \nintents and purposes, the vaccine that is being used is very close to what we would normally have in a biologics license application. There are some little things around the margins that will go into the biologics license application when we have a formal approval. \nSenator C\nASEY . Thank you. \nThank you, Chair Murray. The C\nHAIR . Senator Paul. \nSenator P AUL. Dr. Fauci, we do not know whether the pandemic \nstarted in a lab in Wuhan or evolved naturally, but we should want to know. Three million people have died from this pandemic, and that should cause us to explore all possibilities. \nInstead, government authorities, self-interested in continuing \ngain-of-function research, say there is nothing to see here. Gain-of- function research, as is juicing up naturally occurring animal vi-ruses to infect humans. \nTo arrive at the truth, the U.S. Government should admit that \nthe Wuhan Virology Institute was experimenting to enhance the coronavirus’ ability to infect humans. Juicing up super viruses is not new. Scientists in the U.S. have long known how to mutate ani-mal viruses to infect humans. \nFor years, Dr. Ralph Baric, a virologist in the U.S., has been col-\nlaborating with Dr. Shi Zhengli of the Wuhan Virology Institute, sharing his discoveries about how to create super viruses. This gain-of-function research has been funded by the NIH. The collabo-ration between the U.S. and the Wuhan Virology Institute con-tinues. Doctor Baric and Shi worked together to insert bat virus spike protein into the backbone of the deadly SARS virus and then used this manmade super virus to infect human airway cells. \n39 \nThink about that for a moment. The SARS virus had a 15 per-\ncent mortality. We are fighting a pandemic that has about a 1 per-\ncent mortality. Can you imagine if a SARS virus that has been juiced up and had viral proteins added to it, to the spike protein, if that were released accidentally? \nDr. Fauci, do you still support funding of the—NIH funding of \nthe lab in Wuhan? \nDr. F\nAUCI . Senator Paul, with all due respect, you are entirely \nand completely incorrect that the NIH has not ever and does not now fund gain-of-function research in the Wuhan Institute of Virol-ogy. \nSenator P\nAUL. Do they fund Dr. Baric? \nDr. F AUCI . We do not fund gain—— \nSenator P AUL. Do you fund Dr. Baric’s gain-of-function research? \nDr. F AUCI . Dr. Baric is not doing gain-of-function research. And, \nif it is, it is according to the guidelines, and it is being conducted in North Carolina, not—— \nSenator P\nAUL. You do not think—— \nDr. F AUCI [continuing]. In China. \nSenator P AUL [continuing]. Inserting a bad virus spike protein \nthat he got from the Wuhan Institute into the SARS virus is gain- of-function? \nDr. F\nAUCI . That is not—— \nSenator P AUL. You would be in the minority because at least 200 \nscientists have signed a statement from the Cambridge Working Group—— \nDr. F\nAUCI . Yes. \nSenator P AUL [continuing]. Saying that it is gain-of-function. \nDr. F AUCI . Well, it is not. And, if you look at the grant and you \nlook at the progress reports, it is not gain-of-function, despite the fact that people Tweet that and—— \nSenator P\nAUL. Do you still—— \nDr. F AUCI [continuing]. Write about it. \nSenator P AUL [continuing]. Support sending money to the Wuhan \nVirology Institute? \nDr. F AUCI . We do not send money now to the Wuhan—— \nSenator P AUL. Do you support—— \nDr. F AUCI [continuing]. Virology Institute. \nSenator P AUL [continuing]. Sending money? We did, under your \ntutelage. We were sending it through EcoHealth. It was a sub- agency and a sub-grant. Do you support that the money from NIH that was going to the Wuhan Institute? \nDr. F\nAUCI . Let me explain to you why that was done. The SARS- \nCoV–1 originated in bats in China. It would have been irrespon-sible of us if we did not investigate the bat viruses and the serology to see who might have been—— \nSenator P\nAUL. Or perhaps it—— \nDr. F AUCI [continuing]. Infected in China. \nSenator P AUL [continuing]. Would be irresponsible to send it to \nthe Chinese government that we may not be able to trust with this knowledge and with these incredibly dangerous viruses. \nGovernment scientists, like yourself, who favor gain-of-function \nresearch—— \nDr. F\nAUCI . I do not favor—— \n40 \nSenator P AUL [continuing]. Maintain—— \nDr. F AUCI [continuing]. Gain-of-function research in China. \nSenator P AUL [continuing]. That the disease arose naturally. \nDr. F AUCI . You are saying things that are not correct. \nSenator P AUL. Government defenders of gain-of-function, such as \nyourself, say that COVID–19 mutations were random and not de-\nsigned by man. But, interestingly, the technique that Dr. Baric de-veloped forces mutations by serial passage through cell culture that the mutations appear to be natural. In fact, Dr. Baric named the technique the no-see-um technique because the mutations appear naturally. \nNicholas Baker of the New York Magazine said nobody would \nknow if the virus had been fabricated in a laboratory or grown in nature. Government authorities in the U.S., including yourself, un-equivocally deny that COVID–19 could have escaped a lab. But, even Dr. Shi in Wuhan was not so sure. \nAccording to Nicholas Baker, Dr. Shi wondered, could this new \nvirus have come from her own laboratory? She checked her records frantically and found no matches. \nThat really took a load off my mind, she said. I had not slept for \ndays. \nThe director of the gain-of-function research in Wuhan could not \nsleep because she was terrified that it might be in her lab. \nDr. Baric, an advocate of gain-of-function research, admits the \nmain problem that the Institute of Virology has is the outbreak oc-curred in close proximity. What are the odds, Baric responded. \nCould you rule out a laboratory escape? The answer in this case \nis probably not. \nWill you, in front of this group, categorically say that the \nCOVID–19 could not have occurred through serial passage in a lab-oratory? \nDr. F\nAUCI . I do not have any accounting of what the Chinese \nmay have done, and I am fully in favor of any further investigation of what went on in China. \nHowever, I will repeat again, the NIH and NIAID categorically \nhas not funded gain-of-function research to be conducted in the Wuhan Institute of Virology. \nSenator P\nAUL. You do support it in the U.S. We have 11 labs \ndoing it, and you have allowed it here. We have a committee to do it, but the committee is granted every exemption. You are fooling with Mother Nature here. You are allowing super viruses to be cre-ated with a 15 percent mortality. It is very dangerous and it was a huge mistake to share this with China, and it is a huge mistake to allow this to continue in the United States. And, we should be very careful to investigate where this virus came from. \nDr. F\nAUCI . I fully agree that you should investigate where the \nvirus came from. But, again, we have not funded gain-of-function research on this virus in the Wuhan Institute of Virology. No mat-ter—— \nSenator P\nAUL. You are parsing words. \nDr. F AUCI [continuing]. How many times you say it, it did not \nhappen. \nSenator P AUL. There was research done with Dr. Shi and Dr. \nBaric. They have collaborated on gain-of-function research where \n41 \nthey enhanced the SARS virus to infect human airway cells, and \nthey did it by merging a new spike protein on it. That is gain-of- function. That was joint research between the Wuhan Institute and Dr. Baric. You cannot deny it. \nThe C\nHAIR . Senator Paul, your time is expired. \nDr. Fauci, I will let you respond to that. We need to move on. Dr. F\nAUCI . Excuse me? \nThe C HAIR . I will allow you to respond to that, and then we will \nmove on. \nDr. F AUCI . Yes. I mean, I just wanted to say, we—I do not know \nhow many times I can say it, Madam Chair. We did not fund gain- of-function research to be conducted in the Wuhan Institute of Vi-rology. \nThe C\nHAIR . Thank you. \nSenator Smith. Senator S\nMITH . Thank you, Chair Murray. And thank you so \nmuch to our panelists for being here today. \nI want to just, following up on that exchange, just ask Dr. Fauci \na question. \nDr. Fauci, what is the impact of conspiracy theories pedaled by \nSenator Rand Paul and others on Americans’ willingness to take this vaccine? A vaccine that, by all accounts, is remarkable for its safety and efficacy. \nDr. F\nAUCI . Well, conspiracy theories certainly are not helpful in \nwhat we are trying to do. I guess I can say that with some degree of confidence. \nSenator S\nMITH . Well, I would agree. And I think, in this moment \nwe are at a critical moment for our response to this pandemic. And, in only 14 months since we—this pandemic started, we are here today to acknowledge that we have 261 million doses of vaccine in people’s arms. We have over 58 percent of Americans with at least one dose. I mean, this is an incredible and—an incredible accom-plishment. \nWe also know that we have more work to do, and it seems to me \nthat we ought to be focused on that work. We have to make sure that our comprehensive strategy that you have been working on, Dr. Fauci, for a long time, and I am so grateful for the support that you are getting from the Biden-Harris administration. A com-prehensive strategy that is around vaccinations, around surveil-lance testing, around treatment, social distancing and masks, and also centering our work around health equity. I mean, this is what we need to be really focused on, seems to me. \nI would like to ask Dr. Walensky a question about how we go \nabout this question on this issue of getting people—getting vaccines into people’s arms now. \nVaccines—an acceptance of vaccines seem to be really a spec-\ntrum, from people that are gung-ho and ready to go to people who have a serious resistance to taking vaccines. And, we are seeing some learning, it seems to me, about what works. \nI have a great example of that in Duluth, Minnesota where pub-\nlic health nurses set up a pop-up vaccine clinic at the Duluth Transportation Center. And, Minnesotans, who were taking their bus home or going to pick up their children at childcare can go to that vaccine pop-up clinic, fill out their paperwork, and get their \n42 \nshot, all in one dose. So, it is breaking down some of the logistical \nchallenges that a lot of Americans and Minnesotans still have, and they are finding just great success. \nThere was a story on Minnesota Public Radio just in the last cou-\nple of days about a woman named Karen Moore, who was waiting to get a vaccine and hoping that she would be able to get it at a convenient location, and was able to do it all in one spot. And that made all the difference in the world to her in terms of overcoming her so-called vaccine hesitancy, which was not hesitancy. It was just the logistics challenges. \nDr. Walensky, can you tell us a little bit about what the CDC \nis doing, working with states and localities, to deploy methods like we are seeing in Duluth, Minnesota to help people get easy access to vaccines? \nDr. W\nALENSKY . Thank you so much, Senator. We have spent $3 \nbillion getting money to states and localities to advance these ef-forts in trying to get vaccines into people and to enrich vaccine con-fidence. \nI would invite all of you to take out your cell phones and to text \nGETVAX, 438829. You put in your zip code. You get a list of all the places where vaccines are available to you. You can do that by an 800 number, or you can go to vaccines.gov and type your zip \ncode and find out which vaccines are available nearby to you. \nWe are trying to make it—we are working to make it easy. We \ndo have to do some of the pivoting, as you discussed, and ensure that—— \nPlaces now have pop-up sites. They have mobile vaccination \nunits; that we are reaching out to rural communities; that we are putting vaccines in federally qualified healthcare centers; that we have a We Can Do This campaign now, a campaign with 5,000 community core members from everyone from NASCAR and NFL to Infectious Disease Society of America, to faith-based organiza-tions, sending our messages, being the trusted messengers. And we are starting to see the effects of this work. \nJust this morning, CDC released new racial and equity data on \nhow we are doing in reaching racial and ethnic minorities with vac-cines. The bar graph now shows not just our overall progress, but what we have done in the last 2 weeks. And, in the last 2 weeks, we have been really successful in reaching racial and ethnic mi-norities in ways we had not up until this time. \nWe have to do more. We recognize we have to do more. We have \nvaccine confidence consults that you can—locals and states can call the CDC and say, we are having a hard time reaching people in this community, what are the things that we can do. \nThis is just a brief list of the many, many activities that we are \nengaged with every single day to get vaccines into people for—and to recognize that all hesitancy is not the same flavor. Some people, it is convenience. Some people want to understand the science more. Some people just need the time off. \nSenator S\nMITH . Thank you so much. \nThank you, Madam Chair. I want to just say I appreciate the \nwork of the CDC and others to support the innovative and strategic efforts of states like mine to overcome some of those barriers. Thank you. \n43 \nDr. W ALENSKY . Thank you so much, Senator. \nThe C HAIR . Senator Collins. \nSenator C OLLINS . Thank you. \nDr. Walensky, I used to have the utmost respect for the guidance \nfrom the CDC. I always considered the CDC to be the gold stand-\nard. I do not anymore, and I want to give you three examples where I think the conflicting, confusing guidance from your agency has undermined public confidence and contradicts the scientific guidance of many experts. \nThe first has to do with school openings, an issue that we have \ntalked about before. The New York Post reported that a powerful teachers’ union, the AFT, successfully secured changes, verbatim, in draft guidance on school reopenings. This came about because of an outside group that did a FOIA request that revealed extensive interactions between the AFT and the CDC. \nThis has been described by Dr. Monica Gandhi, a professor who \nhas written extensively about the coronavirus, as very, very trou-bling. She is referring to the emails back and forth between the CDC and the AFT. And, she says, this is not how science-based guidance should work or be put together. \nMy second example is from a New York Times story that ap-\npeared today. It talks about CDC guidelines on mask wearing, and it—where the CDC announced that less than 10 percent of COVID– 19 transmission was occurring outdoors. The article points out that this is, quote, almost certainly misleading, and goes on to say, there is not a single documented COVID infection anywhere in the world from casual outdoor interactions, such as walking paths, someone on a street, or eating at a nearby table. \nThe third example has to do with new guidance the CDC has \nissued for summer camps, and here are the reactions of two ex-perts. One, a pediatric immunologist at Columbia referred to the recommendations as, quote, senseless. The editor-in-chief of the Journal of the American Medical Association Pediatrics called the guidance, quote, unfairly draconian. \nHere we have unnecessary barriers to reopening schools, exag-\ngerating the risks of outdoor transmission, and unworkable restric-tions on summer camps. Why does this matter? It matters because it undermines public confidence in your recommendations, in the recommendations that do make sense, in the recommendations that Americans should be following. \nI would like you to respond to why the CDC is not following the \nstandard procedures, why it is having offline, secret negotiations with one stakeholder that was revealed only through reporting in a FOIA request, why it is exaggerating outdoor transmission. We know that masks make a big difference indoors. They do not out-doors. \nDr. W\nALENSKY . Thank you for that question. Maybe if I could \ntake each of your examples one by one. \nFirst, the school guidance. As a matter of practice, the CDC en-\ngages with stakeholders, with consumers who take our guidance, who use our guidance, before it is finalized so we can understand whether it addresses their needs. For our school guidance, we did that with 50 different stakeholders. Over 50, actually. I personally engaged with both parents and teachers and many different stake-\n44 \nholders to address what could be done to improve the draft guid-\nance we had. \nOne of those stakeholders recognized that in our guidance we \nhad addressed what you do if you have immunocompromised chil-dren at risk of severe disease, but we had neglected in our draft to address what happens if you have immunocompromised teach-ers—teachers who are getting chemotherapy, who have immunocompromising diseases. \nThe request was that we add some language for what happens \nif you have immunocompromised teachers and how they should be-\nhave in school. That is what we did. We used CDC-based science to make that addition, but the request was to address what hap-pens if you have immunocompromised teachers. And that was an oversight in our initial draft, and we included a science-based re-sponse—or science-based language in our guidance. \nWith regard to the New York Times piece this morning, there is \na meta-analysis from Journal of Infectious Diseases that was pub-lished in November, I believe, where the topline result of all stud-ies that were included in the systematic review said less than 10 percent of cases were transmitted outdoors. It is that meta-analysis that combined science from all sorts of—all different science from many different places. I think over 19 studies were included. The topline result was less than 10 percent, published in the Journal of Infectious Diseases, one of our top infectious disease journals. That is where that came from. It was a published study that syn-thesized studies from many places. \nWith regard to camp, I have a 16-year old. Every day—every \nyear, he comes home from camp and he writes the number of days until he returns to camp the next year. This year, it got to zero and I told him he was not going. I want our kids back in camp. We now have 38,000 new infections on average per day. Last May 11, it was 24,000, and we sent a lot of kids home and camps were closed. The camp guidance is intended to get our kids to camp and allow them to stay there. \nThank you. Senator C\nOLLINS . Madam Chair, I would just ask unanimous \nconsent that the full New York Times story, dated today, be placed in the record because it answers—I realize I am out of time. It an-swers Dr. Walensky’s response. \nThe C\nHAIR . So ordered. \n[The information referred to can be found on page 70] \nThe C HAIR . Senator Kaine. \nSenator K AINE . Thank you, Madam Chair, and thank you to the \nwitnesses for your important testimony. \nSome of you have been before this Committee so often. I can re-\nmember the first time you were before us on January 24, 2020. \nAnd so much has happened since then and there is so much to talk about, but my colleagues have done a good job already in address-ing many of my interests. \nAt the last hearing that we had together, which I believe was in \nMarch, Dr. Fauci, I talked to you a little bit about long COVID. When the day comes where the President declares that the na-tional emergency is over, there is still going to be at least two chal-\n45 \nlenges: Long COVID, and then the mental health challenges that \nhave resulted from a year of such loss. \nI want to ask Dr. Fauci and Dr. Walensky to dig into a little bit \nhow you are using the funds that have been provided to deal with the long COVID issue for folks who are suffering symptoms after they have recovered from COVID. \nDr. F\nAUCI . Thank you very much for that question, Senator. This \nis really an important problem. The NIH has been given $1.15 bil-lion to study this, and we are doing this in collaboration with CDC and other organizations. \nLong COVID is a real issue. Anywhere from 10 to, in one study, \nas high as 30 percent of individuals who recover from the acute manifestations of COVID–19, who have virologically no virus in them at all and they should be on the road to an uneventful recov-ery. But, unfortunately, what we have been able to find out now— and we are going to be putting together a number of cohort studies to determine the extent, the duration, any possible underlying pathogenesis, and any intervention. \nBut, the symptoms are somewhat common. There is a com-\nmonality among them. It is extreme, sometimes debilitating fa-tigue; muscle aches; temperature dysregulation, you feel hot or cold; dysautonomia, which is related to that; unexplained rapid heartbeat, or tachycardia; neurological symptoms and what people refer to as brain fog, or the inability to focus or concentrate over an extended period of time. \nThese are real symptoms, and they can last for a long time. We \nhave people that we have followed now up to 9 months or longer where this occurs. It is a very important problem. We take it very seriously. \nWe have a task force at the NIH. Multiple NIH institutes—not \nonly my own—Heart, Lung, and Blood, Neurology, and Mental Health, all of which are going to be looking at this over the next year or so because it is something that we really do feel we need to find out what is the underlying cause and what we can do about it. \nSenator K\nAINE . Thank you for that, Dr. Fauci. That is going to \nprovide a lot of comfort to people who are grappling with these symptoms. \nDr. Walensky, I want to shift to the second concern that I have. \nAgain, we are not at a point yet where the emergency is over. And, yet, even when we are at that point, the mental health impact of this very, very challenging time on the American public and people all around the world is very significant. \nI have worked closely with colleagues, including Senator Cassidy, \nreally to pinpoint mental health impact on frontline healthcare workers, whose experience of dealing with death and illness at such a massive scale, having to manage end-of-life conversations with people who would normally be having those conversations with their own family members. This is a real significant concern. \nMy colleagues supported inclusion of provisions of the Dr. Lorna \nBreen Act in the recent work that we have done, and I understand that CDC and NIOSH are starting to focus on a public information campaign to frontline healthcare providers to reduce stigma to seeking mental health assistance should they need it. \n46 \nCould you talk a little bit about those efforts, and more broadly, \nthe question of keeping our healers healthy? \nDr. W ALENSKY . Thank you very much for that question, Senator, \nand for the resources. I think it would be hard to overestimate the \ntrauma that our healthcare providers, our frontline workers, have seen over this last year. Having been there before I was here, I can tell you, pulling up to driveways in your hospital that have morgues in the parking lot is really a striking thing to find. \nI am grateful for the resources. We are collaborating—NIOSH is \ncollaborating with our Injury Prevention Center within the CDC to create mechanisms and support tools to do outreach for our healthcare workers. \nI would also mention that we saw mental health challenges \nahead of COVID–19, so these are not just mental health challenges because of COVID–19. Even among our youth, between 2009 and 2019, before COVID ever started, we saw 40 percent increase in mental health challenges. So, we need this not just for our healthcare workers, but through—for the society at large. \nSenator K\nAINE . Thank you very much. \nThanks, Chair Murray. The C\nHAIR . Thank you. \nSenator Cassidy. Senator C\nASSIDY . Doctors, thank you all for being here. I ap-\nproach you now kind of as a physician who has done research in vaccines as much as a—more so than I am approaching you as a Senator. \nI was struck—and, by the way, I am incredibly frustrated, and \nthe American people are frustrated because they hear you are fol-lowing science, but then they just have a sense that the lag time between the implementation of that and recommendations is far too long. It is not just the American people. I will put it this way. Not just the people in my state. \nHere is a Stat Article, CDC’s Slow Cautious Messaging Seems \nOut of Step with the Moment. \nWant to Go Back to the Office? Don’t Wait on the CDC. That is \nfrom the Wall Street Journal. \nThe Liberals Who Can’t Quit Lockdown from The Atlantic. First, I was struck when Senator Burr suggested that previous \nimmunization actually confers immunity. Do any of you agree with that? Dr. Fauci? \nDr. F\nAUCI . Does previous immunization confer—— \nSenator C ASSIDY . Does previous infection confer immunity? \nDr. F AUCI . It does. We do not know what the durability of it is, \nbut—— \nSenator C ASSIDY . Okay. \nDr. F AUCI [continuing]. It certainly does confer immunity. \nSenator C ASSIDY . Now, so, but we still recommend that they be \nvaccinated? \nDr. F AUCI . Yes, we do. \nSenator C ASSIDY . That seems out of step. \nDr. F AUCI . No, actually—actually, Senator, a study has shown \nvery clearly that if you vaccinate someone who has previously got-ten infected and recovered, the level of neutralizing antibodies and T cells are extraordinarily high not only against the wild type—— \n47 \nSenator C ASSIDY . Let me—— \nDr. F AUCI [continuing]. Virus, but also against—— \nSenator C ASSIDY . Let me interrupt. \nDr. F AUCI [continuing]. The variants. \nSenator C ASSIDY . I am aware of that research. I pulled some of \nthe research that refers to that. \nDr. F AUCI . Right. \nSenator C ASSIDY . My concern is that would happen if you had \nanother infection. All the immunization does is mimic a pre-exist-\ning infection. That is very well established with other viruses. No one has not established it for this virus. And, indeed, some of this research shows that within 4 days, which is the window period, if you will, for an infection to become an illness, those antibodies rise quite precipitously. \nBut, we still recommend that they get two doses, even though \nthe same literature shows that there is an increase in side effects when someone gets a second dose and they have been previous im-munized. So—now, not life threatening, but, nonetheless, an in-crease in side effects. But, nowhere do I see a recommendation that, well, do not get the second dose because the literature shows that after one dose, you have topped out your immunologic re-sponse and you are at an increased risk with the second dose. \nWould anybody like to speak to that? Dr. M\nARKS . There are studies ongoing to look at the first versus \nsecond dose. I agree with you, it is a very reasonable proposition for study. But, the purpose of immunizing somebody who has been infected previously is to develop higher antibody titers. Those high antibody titers are what is so critical in preventing a—— \nSenator C\nASSIDY . If I may, again, the studies of other viruses \nshow—hopefully we have research showing here, but it appears to that a second—that a re-immunization merely mimics what would happen if somebody were exposed to the virus. All it does is kind of mimic that which would occur. \nDr. M\nARKS . Senator, this is a different virus. Each virus—— \nSenator C ASSIDY . It is a different virus. \nDr. M ARKS [continuing]. Has its unique—— \nSenator C ASSIDY . Dr. Marks, is there research going to explore \nthat which I am referring to? Because the research so far shows that within 4 days, you get a significant increase in antibody titer. \nDr. M\nARKS . There is research that has been done to show that \nafter the vaccination, the nature of the immune response gives a sufficiently high titer antibodies that the post-—— \nSenator C\nASSIDY . That is with every virus. \nDr. M ARKS [continuing]. Vaccination immune response—— \nSenator C ASSIDY . That is with every virus. That is not unique to \nthis. \nDr. M ARKS . It is likely superior to natural infection in this case \nin preventing against some of these variants, and I think that is \nwhat Dr. Fauci was getting to. \nSenator C ASSIDY . I also point out that the vaccines themselves, \nand presumably the previous infection, is also effective against the variants. \n48 \nBy the way, can people go back to work if they have been vac-\ncinated and not wear a mask, assuming they are not \nimmunocompromised? \nDr. W ALENSKY . We have about a third of people in this Country \nwho are vaccinated. We have about a third of counties in this Country that still have over 100 cases per 100,000. We are working to review our guidance and to update our guidance. We have put out three different guidances. \nSenator C\nASSIDY . I am sorry. Let me just ask again. If I am vac-\ncinated and I have antibody and I am exposed to somebody else, what is my risk of coming down with symptomatic infection? \nDr. W\nALENSKY . Five percent. \nSenator C ASSIDY . Five percent if I am—no, that is overall. Not \nif I have been vaccinated and if I have antibody. That is if I am vaccinated overall, correct. If I have antibody—— \nDr. W\nALENSKY . We do not have—I do not think we have data on \nwhat you are looking at. We did not check antibodies on everybody who was vaccinated. \nSenator C\nASSIDY . But, we could. \nDr. W ALENSKY . We absolutely could, but—— \nSenator C ASSIDY . Absolutely could. \nDr. W ALENSKY [continuing]. To date, we only have information \nabout—— \nSenator C ASSIDY . We do know that if we are in a—if we know \nthat critical mass or if we know that herd immunity is somewhere north of 60 or 70 percent, if we go into a workplace where, within that workplace, there is 100 percent immunization, such as here, we have achieved herd immunity. Yes, there is somebody in here that may not be responding to the vaccine, but because everybody else has, they are protected. That is nowhere reflected. And right now, we have Federal agencies, which we have had employees not working for a year, because the union says that they have to have special workplace precautions for them to return to work. There is consequence to this kind of delay, as the Stat article shows, of the kind of updating of these recommendations. \nThe American people are incredibly frustrated. And, as Senator \nCollins said, they are beginning to disregard what you say that is true", "summary": "Official printed transcript of a Senate HELP Committee COVID-19 response hearing featuring Anthony Fauci's testimony.\n\nExcerpt: U.S. GOVERNMENT PUBLISHING OFFICE WASHINGTON : 46–765 PDF 2022 S. H RG. 117–185  AN UPDATE FROM FEDERAL OFFICIALS  ON EFFORTS TO COMBAT COVID–19  HEARING  OF THE   COMMITTEE ON HEALTH, EDUCATION,  LABOR, AND PENSIONS  UNITED STATES SENATE  ONE HUNDRED SEVENTEENTH CONGRESS  FIRST SESSION  ON  EXAMINING AN UPDATE FROM FEDERAL OFFICIALS ON EFFORTS TO  COMBAT COVID-19  MAY 11, 2021  Printed for the use of the Committee on Health, Education, Labor, and Pensions  (  Available via the World Wide Web: http://www.govinfo.gov  (II) COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS  PATTY MURRAY, Washington, Chair  BERNIE SANDERS (I), Vermont  ROBERT P. CASEY, JR., Pennsylvania TAMMY BALDWIN, Wisconsin CHRISTOPHER S. MURPHY, Connecticut TIM KAINE, Virginia MAGGIE HASSAN, New Hampshire TINA SMITH,…", "source_url": "https://www.govinfo.gov/content/pkg/CHRG-117shrg46765/pdf/CHRG-117shrg46765.pdf", "pdf_url": "/archive-docs/fauci-files/267fc8d97d27fd1ee26548bb1824cedf/pdf", "doc_date": "2021-03-18", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "senate help", "congress", "fauci testimony", "hearing transcript", "CHRG", "testimony-senate-help-2021b"], "part_number": 1, "page_count": 77}
{"title": "Fauci Testimony — Senate HELP Committee (CHRG-117shrg46765) (Part 2 of 2)", "content": "because what you—so much of what you say is patently not true. I have to wear a mask when I am outside and the wind is blowing at 20 miles an hour. That has been changed, but it was only changed recently. They seek not to believe those things which are true. You have got to realize. You have got to be more real time. \nLet me finish with this. I think—I do not know if it was the Stat \narticle or the New York Times that pointed on the HIV epidemic. The recommendations were much more kind of calibrated to real life. Listen, we know people are going to do this. If you are going to do it, please accept this recommendation. \nThis is a blanket. Walk outside and wear a mask. You are vac-\ncinated and everybody else in the room is vaccinated, but you are wearing a mask. \nThe American people have just lost patience with us, with you \nguys. I just ask you just kind of be aware of their frustration and get a little real time into updating these things. \n49 \nI am sorry to be so frustrated. I respect you all and thank you \nfor your service. I yield back. \nThe C HAIR . Senator Baldwin. \nSenator B ALDWIN . Thank you, Madam Chair. \nDr. Walensky, as I led the effort to ensure that the American \nRescue Plan included funding for CDC’s work to address variants \nof the coronavirus, specifically through genomic sequencing. I am really encouraged to hear from your testimony that we are now se-quencing 10 percent of our Nation’s weekly cases, and this is up from about—well, less than half of 1 percent in February when I introduced my Tracking COVID–19 Variants Act. \nA couple questions about what we are finding. Last month, the \nWhite House announced that it would provide initial funding to ju-risdictions so that health departments could conduct, expand, and improve activities to sequence genomes and identify mutations of the coronavirus. I would like to have you describe how health de-partments are making use of this funding and how this investment will improve our response to future public health threats. But, also, any new variants that we should know about that—particularly anything troubling from the perspective of eluding the therapeutics and vaccinations that we have produced? \nDr. W\nALENSKY . Thank you so much, Senator. I am—we are so \ngrateful for those resources and our ability to scale up. As you note, we are now sequencing about 35,000 virus samples per week. That is a broad collaboration with commercial labs, with public health labs, with academic partners, and then with public health labs sending samples to CDC so we can address them more completely. \nIn terms of moving forward, I am looking forward to bolstering \nthe infrastructure to be able to do these sequences at the local level; to producing the infrastructure within CDC to be able to fol-low these in a pandemic-related way, not just for this pandemic, but for future public health threats; and then, further, to expand our ability and our workforce in genomic sequencing and analytics and bioinformatics to be able to not just address COVID–19, but these are longstanding things that we are going to need to address antimicrobial resistance and other infectious threats. \nThank you. Senator B\nALDWIN . Thank you. Last week, the Administration an-\nnounced support for the waiver of intellectual property protections on COVID–19 vaccines to help end the pandemic. I believe that this news is the beginning of our work to restore America’s public health leadership on the world stage. But, there is more to be done when it comes to addressing COVID–19 worldwide. \nDr. Fauci, can you explain how increases in new cases of \nCOVID–19 worldwide threaten the progress that we have made here in the United States? And how can we avoid repeating history when it comes to combatting infectious diseases worldwide? \nDr. F\nAUCI . Thank you for that question, Senator. Yes, indeed, as \nwe have said so often, and it is true, that a global pandemic re-quires a global response. And, even if we successfully vaccinate our population and get the level of infection down to a very low level, as long as there is a dynamic of infection spread throughout the world, any place in the world, there always is the danger that variants will be generated and ultimately will come to the United \n50 \nStates because of the travel that we know makes no place in the \nworld separate completely from any other place in the world. \nThat is something that we really need to pay attention to, and \nit is for that reason that I keep saying, and many of my colleagues keep saying, we really do have a responsibility to the United States first. We do, for sure. \nBut, we also need to take part in an effort, whatever effort, and \nit is going to be multifaceted effort, to make sure that the rest of the world contains the outbreak. And that could be from some of the things we are doing right now with India by giving them imme-diate help with oxygen and drugs and PPEs, but also to provide for the availability of doses of vaccine that we can make available to them. Not alone, not just the United States, but the rest of the de-veloped world. \nSenator B\nALDWIN . Thank you. One quick last question to Dr. \nKessler. In its first few months, the Biden administration has sur-passed every goal and expectation it has set in terms of getting shots in arms. Because of this effort, we are moving into the next phase of our vaccination effort in which the focus is less on mass vaccination sites and more about meeting folks where they are to get shots to hesitant and hard-to-reach individuals. \nAs these vaccines come with certain logistical challenges and lim-\nitations, including cold storage and use-by requirements, as well as specific numbers of doses in each vial. \nAs we shift to a more individualized effort, how will the Adminis-\ntration work to ensure that we are using our existing vaccine sup-plies effectively and maximizing the potential—and minimizing the potential for wasted doses? \nDr. K\nESSLER . Senator, a very, very important question. Because, \nas everyone on this Committee has recognized and has been part of this heroic effort, initially certain decisions were made on how to maximize the number of doses produced. \nThe decision—in order to get the hundreds of millions of doses \nthat we have already administered, we have had to make certain tradeoffs, and that is why you see the packaging the way it is, which is in a considerable number of doses, and we have to reduce that packaging. \nBut, every day, Senator, I am in awe of the contributions that \nmany of our local community health professionals, community lead-ers, ordinary citizens are taking to be able to bridge the barriers that people are having. \nI would like to get this eventually down into very small indi-\nvidual doses, but that is going to take time. And right now, we are going to do everything possible to speed that up. \nThe C\nHAIR . Thank you. \nSenator Murkowski. Senator M\nURKOWSKI . Thank you, Madam Chair. Thank you all \nfor being here. \nA lot of frustration this morning, and I think, as Senator Cassidy \nmentioned, it kind of reflects the frustration that Americans have with where we are. We are all tired with COVID. We are done with COVID. But, as many have said, COVID is not yet done with us. But, how we are able to make sense of the guidance that comes out of CDC is critically important. \n51 \nAlaska was very early on in making sure that the vaccine was \navailable to all very quickly, and, as a consequence, we are pretty \nproud of the fact that our numbers of vaccination were strong and we were No. 1 in the Country. But, when you start out first, you also then are the forerunner in demonstrating what it means to really see this vaccine hesitancy, and we are seeing that play out in different ways and different shapes. \nI appreciated your comments, Dr. Walensky, to Senator Smith \nabout the ways that we can address the concerns that have been raised, whether it is where can I get the vaccine, is it safe, who do I look to for guidance. \nThe State of Alaska did a survey that was released on Thursday \nthat indicated that people are not looking to you all for guidance. They are not looking to our chief medical officer in the State of Alaska. They are looking to see what their friends and their neigh-bors do. They do not care what their Senator or the folks from CDC do. So, we have a lot more work to be doing with regards to that. \nI want to speak to my particular frustrations, which you have \nhad the benefit of multiple conversations with me, and that is how we can get our tourist sector back to work for even a small sliver of the season. \nOne point three million tourists come to the State of Alaska on \na cruise ship. There were 48 tourists that came to Alaska on a cruise ship last year. And, right now, it does not look much better. \nWe have been working back and forth with CDC, trying to deal \nwith these—this conditional sail order. After many months of re-quests, we finally get to a place where we think we have some guidance out there. I just, at 11:30, got new information that the CDC’s last traunch of guidance still requires additional guidance to be published. And, I say, yes, it is minor, but the fact of the matter is it is still yet one more gate that has to be gone through. Our reality is if you cannot get ships turned north now, there is no sea-son, whether it is for 1 week or 1 month. \nI guess, Dr. Walensky, I am going to ask you one more time, can \nyou give Alaskans any guidance at all with regards to the ability to finally get this guidance fully resolved? You have cruise lines that are saying, we are going to require everybody be vaccinated. All of our crews will be 100 percent vaccinated. We will require that those who want to sail on our ships this summer be vac-cinated. Those in the communities who are welcoming them are also equally committed to the vaccine. \nShould I just tell folks back home do not even bother ramping \nup your seasonal operations because it is just not coming, we can-not get that guidance from the CDC? \nDr. W\nALENSKY . First of all, Senator, let me congratulate you and \nAlaskans for getting vaccines into arms because you have been a role model in being able to do that. \nWith regard to sail, I was here in March. We were waiting on \n2A guidance. That 2A guidance of working with ports has since \ncome. We have been now engaging, as I noted we do with schools, with our consumers, with our key stakeholders. We have had twice- weekly calls now with the cruise ship industry to understand what—how they are interpreting their guidance and what they \n52 \nneed in order to be able to get boats back in the water. That is our \ngoal for this season. Mid-summer was our goal. \n2A has been released. 2B has been released. Our guidance on \nhow we get conditional—how we get trial voyages into the water, as well as Step 3 released, how you get conditional sail certificates. All three of those have been released. \nThey have—we have been in this dialog with the industry so that \nwe can understand what are the challenges in the current guidance that are hard to be met. And, we are actually having these con-versations and then going back and addressing those challenges. We had a dear colleague’s letter that went out after 2A, and we have others that are in the works. \nWe are working with those in the industry to do our best to get \nships back in the water this season, and we have actually agreed to a 5–day turnaround when those proposals come to us. \nSenator M\nURKOWSKI . Well, it was news to me to, again, just see \nthat there is yet another thing that has come up just this morning, so I would ask you to take a look at that. \nMy time is expired here, but I must raise this fishing mask man-\ndate. If you think about those mandates that really do not make sense, the fact that the Coast Guard is requiring, because they— it is Federal law out there that persons traveling on a conveyance or at a transportation hub wear a mask for the duration of their travel. \nI have fishermen, commercial fishermen, that are out there in \nthe water. I have crabbers and salmon fishermen and cod fisher-men that are trying to deal with a mask because they are con-cerned about failure to comply. This is more of a safety hazard than anything else. You are out on a boat. The winds are howling. Your mask is soggy wet. \nTell me, tell me, how anybody thinks that this is a sane and a \nsound policy to do. So, I—we have a situation right now where the fishermen are more concerned about the liability in failing to have the mask on rather than prudent marine safety protocols. This is absolutely, absolutely a crazy policy. \nI just do not understand. I do not understand how we put our \nCoast Guard men and women in a situation where they know that safety is at issue, a broader safety issue, than the fear of trans-mission when you are outdoors, in the elements, and you are now being required to wear a mask. So, I would hope that the CDC would reconsider this quickly, quickly, quickly. \nDr. W\nALENSKY . We are in the process of finalizing industry-spe-\ncific guidance for exactly this reason. Thank you. \nSenator M URKOWSKI . Thank you. \nThank you, Madam Chair. The C\nHAIR . Thank you. We will turn to Senators Murphy, Mar-\nshall, and Hassan. A vote has been called. I am going to go over to the floor and vote. Senator Burr will preside, and I will be back as quickly as possible. We will go to Senator Murphy. \nSenator M\nURPHY . Thank you, Chair Murray. Thank you all for \nthe fantastic work you do to protect the Country. \nJust a quick word on this frustration you are hearing regarding \nguidance from the CDC. I mean, listen, our witnesses today could sit here and claim that we have definitive information on risks or \n53 \nmeans of transmission or asymptomatic transmission, but they \nwould not be telling the truth. We suffered through 4 years with a president who literally made things up about this virus; who sim-plified the story over and over and over again because he thought simplifying things and being definitive would make him look good, including giving free medical advice to Americans on what thera-pies they should take; making claims that the virus would dis-appear after a matter of weeks. \nThat was not good for the Country. It did not help us fight this \ndisease. We still have a lot to learn. And, so, I frankly appreciate the fact that we have leaders today who recognize that we still have gaps in information, who occasionally may err on the side of caution in order to save lives. And I share the frustration, but the frustration is rooted in the fact that we are still less than a year and a half into a virus that we are still beginning to understand. \nTo that end, Dr. Walensky, on this question of outdoor trans-\nmission. So, Senator Collins was asking you about a paper you put out suggesting that it could be 10 percent of cases. There are other folks that say it could be 1 percent of cases. There are some epi-demiologists who say that it could be .1 percent of cases. That is a really important difference, and I assume the difference between 5 percent and .1 percent would likely educate decisions you would make about what recommendations you make to summer camps. \nHow do we, on this question, close the gap in information that \nwe have? Given that there are so many competing analyses out there of outdoor transmission, what do we do to try to make sure, especially heading into this summer, that we have the best infor-mation possible? How do we solve this problem? \nDr. W\nALENSKY . Thank you, Senator, for that question. I think it \nis important for—to realize that we, at CDC, are responsible for putting out guidance for individuals, as well as for populations, for public health. We are responsible for putting out guidance for coun-ties that have less than five cases per 100,000 and for counties that have greater than 100 cases per 100,000, as well as for counties that have less than 10 percent of people vaccinated and counties that have more than 50 percent of people vaccinated. Our guidance has to be science-based for all of these situations. \nIn our last iteration of what vaccinated people can do, safely do, \nwe did update our guidance not only for not wearing masks out-doors, but also for not wearing masks outdoors in certain settings for people who are unvaccinated. In those situations, we also said if people are gathered with other unvaccinated people dining with their masks off and close by, there may be a risk to that if they are dining close by. \nCertainly, this meta-analysis that was put forward that dem-\nonstrated the top line result of less than 10 percent transmission occurring outdoors was helpful scientific evidence, and we are fol-lowing the science as it continues to emerge. \nI think it is also really important to recognize that now, with \nvaccination of 12 to 15 year olds, our summer camp guidance is \nprobably going to have to change in those settings, and we plan to do so. \nSenator M\nURPHY . Great. \n54 \nDr. Kessler, question for you on booster shots. You have got—you \nincluded in your testimony an expectation that we may be in the \nbusiness of purchasing and distributing booster shots, maybe as soon as later this year. \nI asked a question at the last hearing about the transparency of \ncontracts with the companies that are supplying vaccines. I still think that we could do better in terms of letting the American pub-lic know and policymakers know about the financial terms of these contracts. \nBut, what do we expect when it comes to contracting for booster \nshots? Are we going to go back to the same companies that pro-vided the vaccine, or are we going to open that tender up to a broader set of companies? How do we expect the process of pro-curing booster shots to work, and how do we make sure that it ade-quately protects taxpayer dollars? \nDr. K\nESSLER . Senator, thanks for the question. Very important. \nWe are in that process now. In order to plan, because that is really what we are doing, if we want a vaccine, let’s say both the duration of immunity increasing age so there is less antibodies, and the variants, we have to take all of those things into consideration. And if we want vaccine end of the year, we have to do that now, and we are, in fact, in those negotiations. \nThe best science to date—I mean, the data we have, and I do not \nwant to get too technical, but the question is are we dealing with homologous boosts or heterologous boosts. Basically, are you going to boost with the same vaccine or are you going to—can you switch that out and do mix and match? And that requires data. We are collecting that data, and it is going to be the data that drives what we boost with. \nBut, for planning purposes, I think the simplest and safest as-\nsumption—and I underline the word assumption—is that it may be for, at least the short term, the homologous boost with the same type of vaccine makes the most scientific sense. But, I need a cou-ple of more months in order to give you definitive answer, but I have to plan now. \nSpecifically to answer your question, we are dealing with the \nsame companies because we want to continue with the safety and efficacy that we have seen in those vaccines. Down the road, that may change as we get other, for example, protein-based vaccines available, Senator. \nSenator M\nURPHY . I was just going to say this. I hope that this \nCommittee is actively involved with the Administration on the con-struction of those contracts, to make sure that we are adequately protecting our taxpayers’ investment. \nThank you, Mr. Chairman. Senator B\nURR. [Presiding] Senator Braun. \nSenator B RAUN . Thank you, Senator Burr. \nDr. Walensky, I think from the get-go, there has been an uncer-\ntainty of when we arrive at the moment when many of us feel that this is truly in the rearview mirror. And, from the early conversa-tions I have had being on this Committee, it has always been inter-esting to understand, I think, if and when that comes with clarity, that is the only way I think we get true comfort back into the Country. \n55 \nSenator Murphy, others, have mentioned how things have \nchanged, goal posts have moved. I think that is inherently con-\nfusing to people, especially ones that might have other reasons for not getting vaccinated, and I think that is so important that we get there, everyone vaccinated. \nMy question is, I think, on the education side of it, more empha-\nsis and resources need to be put into rural America, I think along with the logistics, that have seen some effort made there to im-prove it. I think it is inherently more difficult to get vaccines in the arms when it is spread out in areas like that. \nI would like you to zero in on it was 3 feet, or 6 feet and then \n3 feet, indoors and outdoors. So many things have evolved. And I think with something as uncertain as this, it is natural to have that dynamic. \nWhere in time, and does natural infection go along with vaccina-\ntion to have some weight in that point in time where cases really start to fall off the chart? \nDr. W\nALENSKY . Thank you so much for that—those questions, \nSenator. Maybe I will start briefly with the rural and say in our efforts over this last several weeks, resources have gone broadly to rural communities. We are now funding federally qualified healthcare centers, getting vaccines into areas in those centers. Over five million vaccine doses have been given through federally— FQHCs. So, we know we need to do that outreach, and that is part of this next chapter. \nIn terms of the 6 versus 3 feet, I think from the school guid-\nance—I know from the school guidance, the first iteration that was put out in February, the biggest challenge to getting children back to school was the 6 foot guidance. What happened soon thereafter is science emerged. And because 6 feet proved to be such a chal-lenge, within a month, we had three studies that demonstrated that 3 feet and 6 feet were equivalent for younger children. And, so, it was based on the science. I would really like to say that we are in a static situation here and that the science is not changing, but we are changing our guidance with—as the science evolves and as the science emerges, and we have to remain humble to that science. \nWith regard to your question regarding natural immunity, we \nhave several challenges there. The CDC on its website has a map of presumed seroprevalence by state as to how much—how many people out there have antibodies. And, of course, we do not know all of the infection that has happened, right, because much of this infection has been asymptomatic. \nAs Dr. Fauci has said, that prior infection likely confers some im-\nmunity. It might confer full immunity for some period of time. \nBut, I will say that we are still learning and being humble here. \nThis past week, our genomic surveillance data demonstrated that 72 percent of our sequences are now the B117 variant. What do we know about how long prior infection will last with regard to new infection and a B117 variant if you are not vaccinated? We do not have all of those data yet. We are doing studies. We are evaluating it. But, I do think that we should continue to encourage vaccination of people who have had disease before. \nSenator B\nRAUN . Thank you. \n56 \nDr. Fauci, the J&J vaccine, which I think for many people was \na preference in terms of just being one shot and had a high efficacy \nrate to boot. Do you think it was a mistake in that we pulled it when statistically the rate of an incident was so, so low—lower than I think on many other drugs out there that seemingly have much higher side effect consequences? Was that a setback that put us in a place that has really hurt us, or have we recovered from it? \nDr. F\nAUCI . I do not believe it was a setback, Senator, and I think \nif it was, we certainly have recovered from it because we now know. When you ask people, there is a lot of people who really want to get a one-dose vaccine, who are waiting for the availability of this. \nWhat I do think it did that you do not fully appreciate is that \nit really underscored how seriously we take safety. Because to call a pause on an adverse event that, as you mentioned correctly is really quite rare, because at the time, there were six cases in about seven million people, which is less than one per million, which is really a very, very low amount. \nThe FDA and the CDC looked at the data. They wanted to find \nout if there were any more. They wanted to alert the physicians who might be out there seeing patients about what is the proper way to treat them, because there is one general way to treat that people might use that would actually be contraindicated, namely with heparin. \nIn the long run and the big picture, when all is said and done, \nI do not believe it was a setback. I think it really underscored how seriously we all take safety. \nDr. B\nRAUN . How many vaccinations do we need to get fully in the \narms to be at what the theoretical herd immunity would be and cases crash? Anybody? \nDr. F\nAUCI . Yes. I think that is going to be a difficult number to \ngive because herd immunity as a concept means you get enough people vaccinated, enough people infected, so that you have a core of protected people that is a blanket of protection over even the vulnerables who cannot. The threshold of herd immunity is a num-ber we do not know yet for this particular virus. We know it for measles, but we do not know yet what that is. We can—— \nSenator B\nRAUN . I think that—— \nDr. F AUCI [continuing]. Guess it is somewhere between—— \nSenator B RAUN . That uncertainty is probably the thing that is \ngoing to be the hardest thing to grapple with to get this fully in the rearview mirror. So, thank you. \nSenator B\nURR. Thank you, Senator Braun. \nSenator Hassan. Senator H\nASSAN . Well, thank you, Ranking Member Burr, and I \nthank the Chair for holding this hearing. And, really, thank you to all of our witnesses today for not only being here, but for your serv-ice. \nBefore I get to a question, Dr. Walensky, I just want to second \nwhat Senator Murkowski said about getting the guidance to the fishing industry out as quickly as you can. I just met with my fish-ermen at the Yankee Fishermen’s Co-op in New Hampshire this week, and we have boats of fishermen who are fully vaccinated who \n57 \nsee the Coast Guard coming, telling them they have to keep their \nmasks on. Not only is a wet mask dangerous out on the open water, but because of the noise, both the wind and the equipment, these guys are used to relying on kind of sign language on the boat. And with the mask on, they really cannot, and it is a real safety issue. So, I hope you will take this under advisement and get the guidance out as quickly as you can. \nDr. Fauci, I wanted to follow-up a little bit. We have been talking \nabout the very good news of the Pfizer authorization for 12 through 15 year olds, and it looks like they may be seeking at least emer-gency authorization for 2 to 11 year olds in September. And that is really welcome news, but many families are still looking for guid-ance about how to protect children under the age of 12 from the virus until a vaccine is authorized for them, especially as public health restrictions are being lifted around the Country. And I am hearing some from parents that the schools are mostly reopened, or hybrid reopened, but they are kind of nervous about sending their children to school. \nWhat advice do you have for families about what steps they can \ntake to protect their children from the virus while we await FDA authorization for use of the vaccine for kids? \nDr. F\nAUCI . My recommendation, Senator, would be really to fol-\nlow the CDC guidelines. I mean, what both—when the children are in the home with vaccinated individuals, the guidelines are clear what needs to be done. When they are outside, many things you can do without a mask outside. But, if you are not vaccinated and you are interacting with people outside of the home from different locations, you want to be careful and have the children have masks. \nI think a good following of the CDC guidelines, which, as Dr. \nWalensky says, continue to evolve in real time as they get more data. The guidelines get updated and upgraded. So, that would be my recommendation. \nOne other thing that I think is important is that there is a lot \nof work that we are doing now in clinical trials to get vaccinations for children younger than 12. So, a bunch of companies, several of them, are doing what is called age de-escalation studies where we are looking at children from 12 to 9, 9 to 6, 6 to 2, and then 6 months to 2 years. We think by the time we get to the end of this year that we will have enough information to vaccinate children of any age. \nSenator H\nASSAN . Well, that would be very welcomed news to a \nlot of parents. \nDr. F AUCI . Right. \nSenator H ASSAN . Thank you. \nDr. Kessler, I want to follow-up on a line of questioning that Sen-\nator Murphy was following. We have heard encouraging news, cer-tainly, that the protections from the COVID–19 vaccines remain strong for at least 6 months and likely longer, but, also, that Amer-icans will need booster shots, as you all—may need booster shots, as you all just discussed. It is going to be really critical that these vaccines remain accessible and that their price reflects the large in-vestments that American taxpayers made in the research and de-velopment of the technology. \n58 \nWhat steps should Congress take to ensure that COVID–19 vac-\ncines, including booster shots if needed, remain available to Ameri-\ncans even after the end of the public health emergency? And how can we ensure that pharmaceutical companies price these vaccines in a way that account for taxpayer investment? \nDr. K\nESSLER . Senator, a key question. Let me assure you that be-\ncause of what this Committee has done and your colleagues on Ap-propriations, we do have the funds to purchase the next round, again, if, if they are necessary. So, we will be able to purchase the next round and to assure that if there are boosters, they are free, just as the last round. I think you raise a very good question. \nBeyond that, beyond 2022, I mean, I look to your guidance and \nyour colleagues on at what point do you transition back to a com-mercial market. But, I think for this coming round, we are going to proceed as we have proceeded, and you have made those funds available. \nSenator H\nASSAN . Well, I look forward to continuing the discus-\nsion. I see that I am almost out of time here, but I did want to just ask Dr. Walensky quickly. Can you speak to the importance of con-tinued access to COVID–19 testing even as we work to distribute the vaccine and people are getting—we are building up our commu-nity and herd immunity? \nDr. W\nALENSKY . Yes. Thank you very much for that question. \nFirst of all, we recognize that right now we have done an extraor-dinary job in getting vaccine to one-third of Americans, and yet two-thirds of Americans do not yet have vaccine. And, in fact, our young children will not have access to vaccine for the rest of this year. We have put out $10 billion toward states to be able to do testing programs within schools. Some higher ed have been able to successfully engage in this past semester through testing programs on their college campuses. We are going to need to continue testing through our long-term care facilities, as well as our correctional fa-cilities, our dense industries. And, so, yes, I think there has to be a huge corner of what we are doing that is related to testing. \nAlso, surveillance water testing, sewage testing, to look for out-\nbreaks. So, we are doing a lot in the testing area. We are really grateful for the resources to be able to do so. \nOnce we have vaccine in the majority of people, we are still going \nto have disease out there and we are going to need to rapidly be able to detect it. Thank you. \nSenator H\nASSAN . Thank you very much. \nThank you, Madam Chair. The C\nHAIR . [Presiding] Senator Marshall. \nSenator M ARSHALL . Thank you, Madam Chair. \nDr. Fauci, do you think it is possible that COVID–19 arose from \na lab accident at a lab in Wuhan, and should it be fully inves-tigated? \nDr. F\nAUCI . That possibility certainly exists, and I am totally in \nfavor of a full investigation of whether that could have happened. \nSenator M ARSHALL . Great. Is it possible COVID–19 is not natu-\nrally occurring? \nDr. F AUCI . Again, that is a possibility. I do not know if we are \never going to be able to prove that. But, you always need to open up and leave all possibilities, which is the reason why I and so \n59 \nmany of my colleagues are very much in favor of what the WHO \nsaid, that they want to go back again and take another look in there and see what was going on in that lab. \nSenator M\nARSHALL . Will you commit to get this Committee all \nthe records, anything to do with any type of viral experiments, say from 2013 to the present so we can review those? \nDr. F\nAUCI . Certainly. I would comply with any request of the \nCommittee. \nSenator M ARSHALL . Do you and others at NIH have a conflict of \ninterest when determining if the labs and lab work you help fund should be investigated and how it is investigated? \nDr. F\nAUCI . No. I do not think it is a conflict of interest. We are \nvery open and wanting to make sure that everything that has any question is looked into, at all. I have no problem with that. \nSenator M\nARSHALL . Okay. In 2013, President Obama placed a \nmoratorium on viral gain-of-function studies with some loopholes, which you were able to use at certain times. I know we disagree— I do not know if we disagree. We can discuss what is viral gain- of-function and what is not. But, in 2017, you had a long process, and I assume it was you that decided to lift this moratorium, and during this review—my question is this. \nDuring the review, did you consider the risk of dual applications \nby military, terrorists, or other foreign actors? \nDr. F\nAUCI . I am not sure what you mean by that, Senator. Did \nI consider applications from dual actors? \nSenator M ARSHALL . Yes. I will say it again. Did you consider the \nrisk of dual application, that there might be other folks that would use some of the—— \nDr. F\nAUCI . Sure. \nSenator M ARSHALL [continuing]. Function of discoveries, that \nthey might be used by a military—— \nDr. F AUCI . Sure. \nSenator M ARSHALL [continuing]. Terrorist, or other foreign ac-\ntors? \nDr. F AUCI . Well, in any research that we do, we publish the re-\nsearch. It is available for anyone to use it in any manner in which they can. That is the modus operandi of the NIH. We fund re-search. The research is—— \nSenator M\nARSHALL . Is there not a—— \nDr. F AUCI [continuing]. Made public. \nSenator M ARSHALL . Is there a national security consideration, \nthough, in that type of decision with—thinking the viral gain-of- function could be more powerful than the nuclear weapons to—— \nDr. F\nAUCI . No, but—— \nSenator M ARSHALL [continuing]. Share that information with a \ngovernment—— \nDr. F AUCI . Right. \nSenator M ARSHALL [continuing]. Foreign actor may be consid-\nered—been like trying to do the Manhattan Project in nuclear en-\nergy, nuclear weapons, doing it with, say, Hitler or the Soviet Union? \nDr. F\nAUCI . I am not sure what you are getting at, Senator, but \nwe do not fund research. We have committees that look at that to \n60 \nmake sure that research that is of any potential danger is not fund-\ned. So, I am not exactly sure what your point is. \nSenator M ARSHALL . My point is, is there national security impli-\ncations with something as theoretically lethal as viral gain-of-func-tion? \nDr. F\nAUCI . Sure, there is. That is why we have committees. We \nhave a P3CO committee, which is the Potential Pathogen—Pan-demic Pathogen Care and Observation—and Oversight, excuse me. And that is a committee separate from the NIH that looks at these types of grants to see if they need to be funded. So, there is a con-siderable amount of oversight to make sure grants that are doing research that would obviously be of danger is not performed. \nSenator M\nARSHALL . When you make a decision to stop the mora-\ntorium on gain-of-function, was—were there national security advi-sors in the room? Was there State Department? Was there Defense Department? Who were those people that might have been part of that decision? \nDr. F\nAUCI . First of all, I did not make the decision to stop, to \npause the gain-of-function. If one looks at what actually happened, we put a pause on, and I was the one that was very much in favor of that pause. In 2013—— \nSenator M\nARSHALL . You are talking the 2013 pause? \nDr. F AUCI . In 2014—— \nSenator M ARSHALL . Okay. \nDr. F AUCI [continuing]. To 2017, the pause was lifted because we \nestablished a committee that looked at what we called P3CO. \nSenator M ARSHALL . I am familiar with it. \nDr. F AUCI . Right. Exactly. And when that committee then was \nable to make decisions about granting, apart from the NIH so that we would not have any decision and it would be a decision—— \nSenator M\nARSHALL . I have one last question I wanted to sneak \nin. I still do not know that you answered was there national secu-rity people in the room when you—when that process—someone made the decision. I think you led that decision, but we will come back to that. \nHere is my last question. If COVID–19 is indeed a product of lab \nmanipulation, can you sit here and unequivocally say the viral studies that NIH funded—helped fund, could not be indirectly or directly related to this final COVID–19 virus? \nDr. F\nAUCI . Yes. Looking at the experiments that were done that \nwe funded, there would not be that possibility. \nSenator M ARSHALL . Unequivocally? \nDr. F AUCI . Well they are talking about a hybrid virus of a mouse \nvirus that was adapted to a mouse that anyone that knows any-thing about virology would realize that is not something that would infect a human, much less be pathogenic and transmissible. \nSenator M\nARSHALL . But we helped make the mouse that had the \nHLA receptor that this COVID–19 was specific for, and you were— NIH was involved in the development of—— \nDr. F\nAUCI . Yes. \nSenator M ARSHALL [continuing]. Humanized mouse? \nDr. F AUCI . Yes, but as I mentioned in response to Senator Paul, \nthe NIH and NIAID did not fund gain-of-function research to be conducted at the Wuhan Institute of Virology. \n61 \nSenator M ARSHALL . But that is not my question. You know, the \nquestion is, could some of the—some of the funding you did—you \ncan call it gain-of-function or not, developing the HLA receptor with the mouse. I am not sure if you are going to call that gain- of-function or not. Probably not. \nBut, could some of the funding indirectly ended up to the con-\ntribution of this—of COVID–19? \nDr. F\nAUCI . I am not sure exactly where that question is going. \nYou could do research on something as benign as looking at some-thing that has nothing to do with it and it could indirectly, some-day, somehow, be involved. So, if you want to trap me into saying yes or no, I am not going to play that game. \nSenator M\nARSHALL . But we need to look at that very deeply and \nconsider exactly—that is why you committed earlier to make shar-ing all the viral—— \nDr. F\nAUCI . I would be happy to share any information you would \nlike with the Committee. \nSenator M ARSHALL . Thank you so much. I yield back. \nThe C HAIR . Thank you. \nSenator Rosen. [Brief silence.] The C\nHAIR . Senator Rosen, I believe you are on mute. \n[Brief silence.] The C\nHAIR . We are going to hold 1 second for Senator Rosen’s \nmute function to work. \n[Brief silence.] The C\nHAIR . I believe they are trying to undo Senator Rosen’s \nmute function from the studio. \nSenator Rosen, if you can just be patient with us for a minute \nwhile we get that fixed. \nI am going to go ahead and ask a question, and if—Senator \nRosen, if you can just hold for just a minute. \nI wanted to ask Dr. Walensky. There are variant strains of \nCOVID–19 that threaten to disrupt progress made toward ending the pandemic, and the CDC reports that the B117 variant is now the predominant strain in the United States. We need to know which variants are out there and how they are spreading and why they—and who they are spreading to, which is why we approved $1.75 billion in the American Rescue Plan to help CDC shore up its genomic sequencing and surveillance activities. \nDo you have enough data? Do you have the right data and the \nright data systems to be able to track these variants as they spread? \nDr. W\nALENSKY . Thank you, Senator. We are—we have scaled up \nour sequencing dramatically, as I have noted, and every 2 weeks or so, we get an update on data and we look at the—where these sequences are. Just yesterday, I believe, we had the most recent update that demonstrated 72 percent of our cases are now B117. Six percent are now P1. And, we are grateful for the resources to be able to do so. \nGenerally, our ballpark was to have 10 percent of viral sequences \nable—10 percent of all circulating virus to be able to be sequenced. And, so, with cases coming down and our sequencing rising up, we have been able to reach about that 10 percent mark right now. \n62 \nThat has required a lot of collaboration across government, across \ncommercial labs, and whatnot. \nThe function is a—and the impact of these, whether they are \nvariants of concern, variants under investigation, how we under-stand these, is related to an interagency collaboration with BARDA, NIH, and CDC in terms of seeing how transmissible they are, as well as how well they function against monoclonal anti-bodies and our vaccines. \nThe C\nHAIR . Thank you for that. \nSenator Rosen, do we have you back? Senator R\nOSEN . I think we are back. Can you hear me now? \nThe C HAIR . Yes, we do. \nSenator R OSEN . Oh, very good. Sometimes that Zoom happens. \nThere you go. \nWell, thank you, Chair Murray. I appreciate your patience. I ap-\npreciate you calling this hearing. It is extremely important. And, so, for you, for all the scientists, the medical personnel, the front-line workers, I am so grateful for what everyone has been doing to be sure that we can keep the American people, really, people around the world, safe, healthy, and informed. \nDr. Fauci, when we last spoke in March, you shared that NIH \nhad just launched a billion-dollar initiative to study the long-term effects of COVID–19 and identify potential prevention and treat-ment measures for the long-haulers. Because COVID–19, of course, is a novel virus, there are so many gaps in our research and un-knowns for the people who have been affected and are still suf-fering. And that is why I introduced bipartisan legislation that will ensure that NIH will continue to be able to work with the CDC on comprehensive and longitudinal studies of a diverse group of COVID–19 patients. I know some of the research has already been done. It is going to go forward. \nYou shared earlier some updates on long COVID. Could you \nspeak to the research gaps that remain for learning more about the long-term effects, such as lung capacity, heart function, some of the things that people really seem to be struggling with once they have recovered from their initial symptoms? \nDr. F\nAUCI . Well, thank you very much for that question. Yes, we \nhave initiated a series of studies, first of all, building up cohorts so that we can get enough individuals in the cohort to be able to do the kinds of studies that you are going to do. \nAs I mentioned in response to a prior question, it is a multi-insti-\ntute endeavor involving multiple NIH institutes with differences— different interests in different organ systems, just as you said. The National Institute of Heart, Lung, and Blood is one that is looking at some of the issues that you raised in your question, the National Institute of Neurological Diseases and Stroke, the National Insti-tute of Mental Health, and my institute, the National Institute of Allergy and Infectious Diseases. \nWe have also just now started the request for applications to be \nable to gather the cohorts and do those types of studies. So, there \nis a considerable amount of interest in this and a major commit-ment on the part of the NIH to study this thoroughly to fill in some of the gaps that still remain as to what the pathogenesis of this \n63 \nparticular syndrome is because it is a real syndrome that is very \ntroubling to a large number of patients. \nSenator R OSEN . Thank you. I would like to move to the other \npart of this equation, which is the therapeutic research and devel-opment. Because even though people are getting vaccinated, of course, there are still people getting sick and there are people, like we said, still suffering chronic pain, chronic illness, as a result of COVID–19. And, so, we have to be sure that we have those tools to continue to treat any cases that come forward. \nCould you give us any updates about what therapeutics might be \nin the pipeline? And do you think is there a potential for any of these treatments to help some of the long haulers? You know, maybe it can treat acute and chronic illness as a result of this func-tion of COVID? \nDr. F\nAUCI . Senator, it is an excellent question but it is almost \nimpossible to talk about treatment when you do not know what the underlying pathogenesis is. So, that is the reason why the studies are starting off by gathering the cohorts and trying to find out if there is a mechanism for some of the symptomatology—the pro-found fatigue, the muscle aches, the temperature dysregulation, the sleep disorder, the brain fog, as they call it. \nWe do not know exactly what the mechanism of this symptoma-\ntology is and, for that reason, it becomes very difficult to do any-thing other than symptomatic treatment for these individuals. That is why it is so important to do the studies that we are planning to do, so that hopefully when we understand the mechanisms, we will be able to have some therapeutic intervention. \nSenator R\nOSEN . Well, thank you. I appreciate that because it is \nreally going to be important moving forward. It is going to be im-portant to our healthcare workers, to our surging of hospital capac-ities, and actually globally around the world. \nI just thank you for that. I look forward to reconnecting with you \nas we begin to see more results of this really important longitu-dinal research and the progress that it is making. \nThank you, Madam Chair. I yield back. Dr. F\nAUCI . Thank you. \nThe C HAIR . Thank you very much. \nI wanted to ask, the pandemic’s deadly impact on communities \nof color shows we have a long way to go to address systemic racism and health inequities in this Country. Black and Latino people are receiving vaccinations at disproportionately low rates, and some of the systems that are designed to make vaccinations easier, like on-line registration for appointments, have actually made it harder for some, like our native Hawaiian and Pacific Islander elders. Addi-tionally, AAPI communities have experienced higher rates of dis-crimination and violence, as we know, since the start of this pan-demic. \nDr. Kessler, I wanted to ask you, how is the Federal Government \nworking to decrease COVID–19-related health inequities? \nDr. K\nESSLER . Senator, thank you for the question. Enormously \nimportant. There is some at least initial good news. You know, we have seen that deaths are down dramatically since January, and we all know that they are down 80 percent among seniors. But, they also include—that drop includes a drop among Hispanics of 80 \n64 \npercent, and among African Americans of about 70 percent. And, \nin the past 2 weeks, 55 percent of the people vaccinated were White, but 45 percent were non-White. That compares to the gen-eral population that is about 60 percent White and 40 percent non- White. \nWe have much more to do, especially in the area of confidence. \nWe do see that people’s confidence in the vaccine is increasing. Black Americans’ confidence increased by 24 points since January, and Latino Americans’ confidence increased by 22 points since Jan-uary. \nBut, outreach access is absolutely critical. These vaccines are \nfree. Every adult in America is eligible in about 80,000 locations. But, we have a lot more work to do, and we are keeping equity at the center of the response, and we will not leave anyone behind. \nThe C\nHAIR . Okay. Thank you so much for that effort, and I ap-\npreciate it. \nSenator Burr, do you have any closing questions or comments? Senator B\nURR. Madam Chair, thank you. Yes, I do. I have a little \nbit of cleanup if I can. \nWhat I have been able to piece together since we started—and \nthis is to you Dr. Marks and maybe Dr. Kessler. BARDA signed a contract for $1.2 billion for 300 million doses of AstraZeneca vac-cine. That is currently authorized in 70 countries around the world; its manufacturing capacity in 15 countries and 25 sites. In addition to the Baltimore Emergent facility, two sites in the U.S. manufac-turing, in Ohio and New Mexico, of AstraZeneca vaccine. \nHere is my question. Of the stock that we currently have on \nhand, which I estimate to be about 60 million doses, is all of that being held because it came from Emergent? Or, in that 60 million inventory that we have today, is some of that either foreign manu-factured and/or Ohio or New Mexico and would not have to be held up because of the current inspection concerns at Baltimore? \nDr. K\nESSLER . Senator, I have been talking to AstraZeneca, even \nlast night. I have been talking to them regularly over the last sev-eral weeks. I—to answer your question very specifically, the 60 mil-lion that you reference, all of that drug substance was made at Emergent. \nThere is another facility at Catalent that manufactures drug sub-\nstance, but we are not—we have not contracted and we are not in-volved, and that is for global. \nThere are two other facilities, one in West Chester that you ref-\nerenced, that is for drug product. \nBut, everything that we have involvement in is that 60 that has \nbeen produced for that first initial hundred, and they stopped at 60 when—because of the problems at Emergent were—are all being reviewed by our colleagues at FDA because of issues at Emergent. \nSenator B\nURR. Follow-up question. Of the over two million doses \nthat went to Mexico, a million and a half doses that went to Can-ada, have there been any indications from those vaccines if they have—one, I assume they have been used. Is there any reason to believe that they are reporting any adverse effects? \nDr. M\nARKS . Senator Burr, no, and in—and those came from a \ntime when that facility was not being used for more than one vac-cine, to produce more than one vaccine, sir. \n65 \nSenator B URR. The fact that they produce not only AZ, but J&J, \nnow makes them susceptible? \nDr. M ARKS . It is a matter of public record that the problem that \noccurred at the facility involved a contamination event between two \nvaccines. \nSenator B URR. Okay. \nDr. M ARKS . That was the issue that we are dealing with. But, \nI just should add that you have our commitment that we are going to work as quickly as we possibly can to get both clearance of the doses that are currently being held—because we do not have clear-ance of the safety of those doses yet—and also to get that plant back up and running in a manner that is fully consistent with what Americans expect from their pharmaceutical products. \nSenator B\nURR. Okay. This question, I am going to go to Dr. \nFauci, Dr. Marks, and Dr. Walensky. \nWhat percentage of the employees in your institute, your center, \nor your agency, of your employees, has been vaccinated? \nDr. F AUCI . I am not 100 percent sure, Senator, but I think it is \nprobably a little bit more than half. Probably around 60 percent. \nSenator B URR. Dr. Marks. \nDr. M ARKS . I cannot tell you the exact number, but it—it is prob-\nably in the same range. Some people vaccinated at our facility and others outside of the facility. \nSenator B\nURR. Dr. Walensky. \nDr. W ALENSKY . We are encouraging our employees to get vac-\ncinated. We have been doing town halls and education seminars. We have—our staff have the option to report their vaccination sta-tus. But, as you understand, the Federal Government is not requir-ing it, so we do not know. \nSenator B\nURR. Okay. And, listen, you are the face of why people \nshould get vaccinated, and no one—and promoting and confidently giving numbers, percentages, I think is really, really important as we go into this last part. \nNow, if you tell me that there is some statute that says you can-\nnot require somebody to tell you, imagine being the parent of a school age kid who for generations has been required to have their kids vaccinated before they could start school. And, the fact that, even within our health organizations, we cannot require that of people, we are going to have tough decisions to make. \nEmployers are going to make those decisions. There have been \ndecisions already made by colleges around the Country that said if you are on faculty or you are a student, you are not coming next year if you are not vaccinated. Now, they have the ability to do that. \nThese are tough questions with even tougher answers. But, if we \nare going to get that last mile coverage, we are going to have to start portraying that we are willing to do to ourselves what we are asking the American people to do. \nDr. Walensky, I think it is safe to say that the 21st Century is \nsomething that the CDC has not totally entered, but I am confident \nthat you are going to take them there, and especially as it relates to science and technology. \n66 \nMy question is simple. Do you believe the CDC director should \nmeet with private industry and innovators who have new tech-\nnologies that can help modernize the CDC? \nDr. W ALENSKY . Thank you. I think I have an extraordinary op-\nportunity as being the director of the CDC during this period of time. I think that much of what we are going to need to do in pub-lic health is going to take collaboration with academia, with gov-ernment, with private sector, with non-profits. And I am looking forward to engaging in those in a transparent, open way so that we can have that dialog and create those collaborations. \nSenator B\nURR. Let me go back and ask you one more time. Do \nyou believe that the CDC director should meet with private indus-try and innovators that have new technologies? \nDr. W\nALENSKY . I believe that we should—I should be encour-\naging all of those collaborations, and I am relying on my senior leadership team, my subject matter experts, to engage in many of those conversations. \nSenator B\nURR. But not you? \nDr. W ALENSKY . If it is a subject matter where I am an expert, \nI would be happy to, absolutely. \nSenator B URR. I think in a question to your staff, they suggested \nthat you could not, but I will revisit that through my staff to yours. \nI have to say that I am little bit confused on the issue of CDC \nguidance after hearing my colleagues, Senator Collins and Senator Cassidy, about exactly who is involved in content and language. So, I sent to CDC an oversight letter, and I got your response to it on 22 April, and I will just highlight a few things. \nCDC uses its emergency response clearance protocol to clear \nitems during emergency responses. This emergency response clear-ance is applicable to all CDC-authored, CDC-branded information products with content related to an active or ongoing response, such as COVID–19 response. \nThe clearance process consists of a series of formal reviews, ap-\nprovals, by relevant CDC subject matter experts, SMEs, and Agen-cy clearance officials. This typically consists of content, develop-ment, and review by CDC’s relevant COVID–19 Response Task Force or SMEs, followed by additional review coordinated by CDC’s Joint Information Center. \nAt no point, given the opportunity, did the letter mention any-\nthing about people outside of government. It could be parents. It could be the National Education Association. It basically said this all happens within government. \nNow, that is not what I heard my colleagues say as it related to \nthe guidance on schools, that there was input provided by outside entities. And, as a matter of fact, I went ahead and pulled all the email chains that I think was accessed by the media outlets that made them write this story. \nI will just say that it is a little bit alarming because it is all done \non a timeline, and it suggests that AFT leadership—not sure what the issue was they raised, but they certainly changed the language of the guidance because there is actually email that thanked them for the language that they provided. \nWhen you look at the timeline between that and White House \nannouncement, one would have a hard time believing that every-\n67 \nthing went through a clearance process that was described in the \noversight response letter to me. So, I would ask you clear it up for me, if you would. \nDr. W\nALENSKY . Thank you. Thank you for that question. So, as \nI mentioned to Senator Collins, prior to our putting our guidance through a formal clearance process, we do an enormous amount of stakeholder engagement to ensure that the guidance can actually address the questions asked. In fact, I can tell you, on the other side, when I was a healthcare provider at Massachusetts General Hospital, I would frequently call my colleagues at the CDC and say, we need guidance on X, it needs to address X, Y, and Z. \nIn the stakeholder engagement for the schools, we did outreach \nwith over 50 organizations. We spoke to teachers. We spoke to par-ents. We spoke to superintendents. We spoke to many different stakeholders to understand what it is that they needed from our guidance. \nAs I mentioned previously, in doing so, we recognized, in meeting \nwith the teachers, that we had actually failed to comment on what happened if teachers were immunosuppressed, if teachers were un-dergoing chemotherapy, if they had a family member with a trans-plant at home, how we were going to engage and provide guidance to those. It was the CDC scientists that provided the guidance, that provided the science around what we should do. It was the request from teachers to say, you did not address this issue, and we had not. \nSenator B\nURR. The first contact by AFT with your staff was on \nFebruary 1st, Monday, February 1st. And your staff person—we were able to review a copy of the draft guidance or—excuse me. \nTroutner with the AFT. We were able to review draft guidance \ndocuments over the weekend. We are able to provide some initial feedback to several staff this morning about possible ways to strengthen the document. \nThat is on February 1st in the morning. On February 2nd, your \nstaff emailed to you that they had followed-up with suggested lan-guage on accommodations per exchange. \nOn February 3rd at a White House press conference, you say \nschools can open, reopen without teachers being vaccinated. \nWould one reading this be concerned with this timeline and what \nthe oversight letter told me was the protocol that you went through to have guidance signed off on? \nDr. W\nALENSKY . In the February 3rd press—first of all, in the \nFebruary 3rd press conference, that was before our guidance was released. That was speaking to science and studies that dem-onstrated that schools had effectively reopened without teachers being vaccinated and keeping students and children safe. February 3rd pre-dated our guidance release, which I believe was February 12th, although I would have to confirm. \nYou may recall at the time that in the media I took quite a hit \nfor commenting on that from teachers themselves. They were not \nhappy with me at the time. \nSenator B\nURR. With the success of AFT, the NEA engages you, \nand you actually committed to do an NEA town hall meeting. Is that right? \n68 \nDr. W ALENSKY . We were engaging at the time with over 50 orga-\nnizations—teachers, superintendents, parents alike—at the time \nwhen our school guidance came out as a matter of practice and in an unbiased fashion. \nSenator B\nURR. Well, Madam Chair, I am going to ask that the \nletter and the emails be included as part of the record. \nThe C HAIR . Without objection. \n[The information referred to follows:] Senator B\nURR. I want to make this observation, that I hope you \ncan understand why Members express frustrations on guidance, that there is a chain of information that suggests people had a pre-ferred access to not only advice, but actual language that went into the guidance. \nI know what your answer to my last question is going to be be-\ncause I have stated it in one of the emails. \nShould CDC guidance suggest that all states should require \nteachers to be vaccinated? \nDr. W\nALENSKY . I would encourage all teachers to be vaccinated. \nWe spent the month of March providing vaccines through our Fed-eral pharmacy programs and we got over 80 percent of our teachers and educators vaccinated as a—through that process. So, I am cer-tainly encouraging that all teachers be vaccinated. \nI think that the guidance with regard to mandatory vaccination \nin schools is going to have to be done at the local level. \nSenator B\nURR. Would you provide guidance that suggested to \nschools that they vaccinate teachers? \nDr. W ALENSKY . We have been encouraging vaccination of teach-\ners—— \nSenator B URR. All teachers. \nDr. W ALENSKY . We have been encouraging vaccination of all \nteachers, of all educators, of all parents, of all students. \nSenator B URR. Is that in guidance? \nDr. W ALENSKY . I would have to confirm because I do not know \nwhether our most recent updated guidance for schools actually had widespread availability of vaccine. \nSenator B\nURR. Okay. The Chair has been awfully kind to me, \nand I am not trying to pick. \nAs I said when I started, the next several months are going to \nbe extremely tough at getting people vaccinated. I do not want any of us to lose focus on what the mission is out there. I know for all of you, I am stating the obvious, that we have to stay focused on vaccines. \nBut, the confidence the American people have in you is a lot of \nwhat is going to make us successful. As Dr. Fauci and I have talked many times about, thank God we had in place an architec-ture that we perfected over the last 20 years that allowed things to happen organically, like EUAs and this type of thing. \nIt was not because we experienced anything. We went through \nlittle red flags, H1N1, SARS, Ebola, where we looked at it and said, boy, if this had been the big one, what would we have changed, and collectively, we went through and changed them. We were much better prepared a year ago architecturally, and 80 percent of what we did was following the statute that is out there and the authori-ties that were given to many of your institutes or agencies. Or, in \n69 \nDr. Marks’ case, to the FDA. And, I have to tell you that I believe \nwhat the FDA has accomplished, I never dreamed they could do. \nMy goal now is to make sure we do not roll back. Because as we \nmove into technology platforms, that is not something that is easy to go back and do clinical trials on again if you are just looking for a new indication. But, I have to tell you that I believe that schools going back in person in the fall is absolutely crucial to getting a majority of the parents who have yet to be vaccinated, vaccinated. And knowing that at least by the end of this month, if we are not already there, every adult that wants to be vaccinated can be vac-cinated. \nIt is time for us to start setting the stage and paint the picture \nfor what the fall looks like; that people can go on vacation this year and they can eat in a restaurant, in the Outer Banks of North Carolina, preferably; that they can plan their summer vacation; hopefully, in a few more weeks or days, maybe they can go to camp; that in the fall, we expect every school to be in person, short of some drastic change in the infection glidepath; and next Thanks-giving, you ought to plan to have Thanksgiving with your family and extended family; and Christmas, you ought to be able to enjoy. \nIf we paint that type of picture, I believe, David, we are going \nto get people vaccinated. But, if we continue to fail at the trust that they have in us making the calls that are appropriate at the time, feeling like they are influenced in any way, feeling like we are not out there where we need to be interpreting the science, we are going to fail, and we are going to fail for the American people. But, more importantly, we are going to fail for the world because the world right now is relying on us getting to that number and us pro-viding the technology and the manufacturing capacity for them to be vaccinated. So, we have a big step ahead of us. \nI am delighted that all four of you are here today. I thank you \nfor the work that you have done up to this point and, more impor-tantly, for the work you are going to do in the future. \nI thank the Chair. The C\nHAIR . Thank you. That will end our hearing today. \nI want to thank all of our colleagues who are here. I especially \nwant to thank all of our witnesses today. Thank you all, Doctors Walensky, Fauci, Marks, and Kessler, for joining us to update on this fight against this pandemic, and to tell you thank you to all of those who work for you and have been diligent and trying to make tough decisions in a difficult time to help protect all Ameri-cans. So, thank you very much to you and to all the people that work with you. \nFor any Senators who wish to ask additional questions, questions \nfor the record will be due in 10 business days, on Tuesday, May 25th, at 5 p.m. The hearing record will remain open until then for Members who wish to submit additional remarks and materials for the record. \nThe Committee will next meet tomorrow, Wednesday, May 12th, \nto mark up the nominations of Jocelyn Samuels to be a member of the Equal Employment Opportunity Commission, Jennifer Abruzzo to serve as General Counsel of the National Labor Relations Board, and Seema Nanda to serve as Solicitor for the Department of Labor. \n70 \nWith that, the Committee stands adjourned. \n71 \nADDITIONAL MATERIALS \nA Misleading C.D.C. Number \nBy David Leonhardt \nThe New York Times \nPublished May 11, 2021 When the Centers for Disease Control and Prevention released new guidelines \nlast month for mask wearing, it announced that ‘‘less than 10 percent’’ of Covid– \n19 transmission was occurring outdoors. Media organizations repeated the statistic, and it quickly became a standard description of the frequency of outdoor trans-mission. \nBut the number is almost certainly misleading. \nIt appears to be based partly on a misclassification of some Covid transmission \nthat actually took place in enclosed spaces (as I explain below). An even bigger issue \nis the extreme caution of C.D.C. officials, who picked a benchmark—10 percent— so high that nobody could reasonably dispute it. \nThat benchmark ‘‘seems to be a huge exaggeration,’’ as Dr. Muge Cevik, a virol-\nogist at the University of St. Andrews, said. In truth, the share of transmission that has occurred outdoors seems to be below 1 percent and may be below 0.1 percent, multiple epidemiologists told me. The rare outdoor transmission that has happened almost all seems to have involved crowded places or close conversation. \nSaying that less than 10 percent of Covid transmission occurs outdoors is akin \nto saying that sharks attack fewer than 20,000 swimmers a year. (The actual world-wide number is around 150.) It’s both true and deceiving. \nThis isn’t just a gotcha math issue. It is an example of how the C.D.C. is strug-\ngling to communicate effectively, and leaving many people confused about what’s truly risky. C.D.C. officials have placed such a high priority on caution that many Americans are bewildered by the agency’s long list of recommendations. Zeynep Tufekci of the University of North Carolina, writing in The Atlantic, called those recommendations ‘‘simultaneously too timid and too complicated.’’ \nThey continue to treat outdoor transmission as a major risk. The C.D.C. says that \nunvaccinated people should wear masks in most outdoor settings and vaccinated people should wear them at ‘‘large public venues’’; summer camps should require children to wear masks virtually ‘‘at all times.’’ \nThese recommendations would be more grounded in science if anywhere close to \n10 percent of Covid transmission were occurring outdoors. But it is not. There is not a single documented Covid infection anywhere in the world from casual outdoor interactions, such as walking past someone on a street or eating at a nearby table. \nToday’s newsletter will be a bit longer than usual, so I can explain how the C.D.C. \nended up promoting a misleading number. \nThe Singapore Mystery \nIf you read the academic research that the C.D.C. has cited in defense of the 10 \npercent benchmark, you will notice something strange. A very large share of sup-\nposed cases of outdoor transmission have occurred in a single setting: construction sites in Singapore. \nIn one study, 95 of 10,926 worldwide instances of transmission are classified as \noutdoors; all 95 are from Singapore construction sites. In another study, four of 103 \ninstances are classified as outdoors; again, all four are from Singapore construction sites. \nThis obviously doesn’t make much sense. It instead appears to be a misunder-\nstanding that resembles the childhood game of telephone, in which a message gets garbled as it passes from one person to the next. \nThe Singapore data originally comes from a government data base there. That \ndata base does not categorize the construction site cases as outdoor transmission, Yap Wei Qiang, a spokesman for the Ministry of Health, told my colleague Shashank Bengali. ‘‘We didn’t classify it according to outdoors or indoors,’’ Yap said. ‘‘It could have been workplace transmission where it happens outdoors at the site, or it could also have happened indoors within the construction site.’’ \nAs Shashank did further reporting, he discovered reasons to think that many of \nthe infections may have occurred indoors. At some of the individual construction sites where Covid spread—like a complex for the financial firm UBS and a sky-\n72 \nscraper project called Project Glory—the concrete shells for the buildings were large-\nly completed before the pandemic began. (This video of Project Glory was shot more than 4 months before Singapore’s first reported Covid case.) \nBecause Singapore is hot year-round, the workers would have sought out the \nshade of enclosed spaces to hold meetings and eat lunch together, Alex Au of Tran-sient Workers Count Too, an advocacy group, told Shashank. Electricians and plumbers would have worked in particularly close contact. \nAre schools outdoors? \nHow, then, did the Singapore cases get classified as they did? \nWhen academic researchers began collecting Covid data from around the world, \nmany chose to define outdoors spaces very broadly. They deemed almost any setting \nthat was a mix of outdoors and indoors to be outdoors. \n‘‘We had to settle on one classification for building sites,’’ Quentin Leclerc, a \nFrench researcher and co-author of one of the papers analyzing Singapore, told me, ‘‘and ultimately decided on a conservative outdoor definition.’’ Another paper, pub-lished in the Journal of Infection and Public Health, counted only two settings as indoors: ‘‘mass accommodation and residential facilities.’’ It defined all of these set-tings as outdoors: ‘‘workplace, health care, education, social events, travel, catering, leisure and shopping.’’ \nI understand why the researchers preferred a broad definition. They wanted to \navoid missing instances of outdoor transmission and mistakenly suggesting that the outdoors was safer than it really was. But the approach had a big downside. It meant that the researchers counted many instances of indoors transmission as out-doors. \nYet even with this approach, they found a minuscule share of total transmission \nto have occurred outdoors. In the paper with 95 supposedly outdoor cases from Singapore, those cases nonetheless made up less than 1 percent of the total. A study from Ireland, which seems to have been more precise about the definition of out-doors, put the share of such transmission at 0.1 percent. A study of 7,324 cases from China found a single instance of outdoor transmission, involving a conversation be-tween two people. \n‘‘I’m sure it’s possible for transmission to occur outdoors in the right cir-\ncumstances,’’ Dr. Aaron Richterman of the University of Pennsylvania told me, ‘‘but if we had to put a number on it, I would say much less than 1 percent.’’ \nBritain’s Scientific Approach \nI asked the C.D.C. how it could justify the 10 percent benchmark, and an official \nthere sent this statement: \nThere are limited data on outdoor transmission. The data we do have sup-ports the hypothesis that the risk of outdoor transmission is low. 10 percent is a conservative estimate from a recent systematic review of peer-reviewed papers. CDC cannot provide the specific risk level for every activity in every community and errs on the side of protection when it comes to recom-mending steps to protect health. It is important for people and communities to consider their own situations and risks and to take appropriate steps to protect their health. \nErring on the side of protection—by exaggerating the risks of outdoor trans-\nmission—may seem to have few downsides. But it has contributed to widespread \npublic confusion about what really matters. Some Americans are ignoring the C.D.C.’s elaborate guidelines and ditching their masks, even indoors, while others continue to harass people who walk around outdoors without a mask. \nAll the while, the scientific evidence points to a conclusion that is much simpler \nthan the C.D.C.’s message: Masks make a huge difference indoors and rarely matter outdoors. \nThe health authorities in Britain, notably, seem to have figured this out. They \nhave been more aggressive about restricting indoor behavior, locking down many businesses again late last year and requiring masks indoors even as most of the country is vaccinated. Outdoors, however, masks remain rare. \nIt certainly doesn’t seem to be causing problems. Since January, daily Covid \ndeaths in Britain have declined more than 99 percent. \n73 \n[Whereupon, the hearing was adjourned at 12:42 p.m.] \nÆ", "summary": "Official printed transcript of a Senate HELP Committee COVID-19 response hearing featuring Anthony Fauci's testimony.\n\nExcerpt: because what you—so much of what you say is patently not true. I have to wear a mask when I am outside and the wind is blowing at 20 miles an hour. That has been changed, but it was only changed recently. They seek not to believe those things which are true. You have got to realize. You have got to be more real time.  Let me finish with this. I think—I do not know if it was the Stat  article or the New York Times that pointed on the HIV epidemic. The recommendations were much more kind of calibrated to real life. Listen, we know people are going to do this. If you are going to do it, please accept this recommendation.  This is a blanket. Walk outside and wear a mask. You are vac- cinated and everybody else in the room is vaccinated, but you are wearing a mask.  The American people have…", "source_url": "https://www.govinfo.gov/content/pkg/CHRG-117shrg46765/pdf/CHRG-117shrg46765.pdf", "pdf_url": "/archive-docs/fauci-files/267fc8d97d27fd1ee26548bb1824cedf/pdf", "doc_date": "2021-03-18", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "testimony", "sworn", "senate help", "congress", "fauci testimony", "hearing transcript", "CHRG", "testimony-senate-help-2021b"], "part_number": 2, "page_count": 77}
{"title": "Read the Documents (Part 1 of 2)", "content": "From:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:FW: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019Date:Wed, 10 Oct 2018 16:31:24 -0400Importance:NormalI will explain.,From: Barton Haynes, M.D. <@duke.edu>Sent: Wednesday, October 10, 2018 3:34 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Subject: Re: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019You bet!!!Let’s do itBest  bSent from my iPhoneOn Oct 10, 2018, at 11:23 AM, Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov> wrote:Thanks, Bart.   There is another one that looks possible for me if you are willing to do it.  As usual, I will supply all of thematerial.   It is the Dan David Prize. I will send you their e-mail separately in a minute.From: Barton Haynes, M.D. <@duke.edu>Sent: Wednesday, October 10, 2018 12:56 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Fwd: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019Here you go!Best bartSent from my iPhoneBegin forwarded message:From: The Shaw Prize <@shawprize.org>Date: October 10, 2018 at 10:47:35 AM MDTTo: Barton F Haynes <@mc.duke.edu>Subject: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019Released by Chairman Rand Paul\nThe ShawPrize logoThe Shaw PrizeDear Professor Barton F Haynes,This letter is to confirm that we have received your nomination for The Shaw Prize in LifeScience and Medicine 2019. The nomination cannot be edited any further but if you haveany concerns or if an amendment is essential, you can contact us at any time on@shawprize.org.Thank you for your support,The Shaw Prize Secretariat.\nReleased by Chairman Rand Paul\nFrom:\"Barton Haynes, M.D.\" <@duke.edu>To:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>Cc:Kelly Soderberg <@duke.edu>Subject:RE: Heinz AwardDate:Mon, 10 Dec 2018 14:09:21 -0500Importance:NormalInline-Images:~WRD153.jpg; image001.png; image002.jpgO they never did that I saw. Will ask Kelly? Kelly did the Heinz folks get back to us? Tony I am home all day today (we are snowed in andduke closed )  so I am available all day to day if you want to talk. Best bart From: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Sent: Monday, December 10, 2018 1:26 PMTo: Barton Haynes, M.D. <@duke.edu>Subject: Heinz Award Bart:    Did the Heinz Award people ever get back to you about the requirements for nomination?  Also, some time in the next week or so, we shouldcatch up on a few things.Best,Tony From: Fauci, Anthony (NIH/NIAID) [E]Sent: Sunday, October 14, 2018 4:03 PMTo: 'Barton Haynes, M.D.' <@duke.edu>Cc: Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>Subject: RE: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019 Thanks, Bart.   When you find out from them exactly what material we need for the nomination, please let me know and I will provide it.Best,Tony From: Barton Haynes, M.D. [mailto:@duke.edu]Sent: Sunday, October 14, 2018 2:57 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Cc: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>; Shannon Devine <@duke.edu>; Kelly Soderberg<@duke.edu>Subject: RE: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019 Yep will do this straightaway.   This is a good one I think for you. Best bart From: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Sunday, October 14, 2018 2:53 PMTo: Barton Haynes, M.D. <@duke.edu>Cc: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>Subject: FW: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019 Bart:    Another possible award would be the Heinz Award.  The category would be  for “The Human Condition” .  Paul Farmer has gotten this in thepast.  We can use the PEPFAR  piece in addition to the science and NIAID leadership issue.   We obviously will take care of all of that on my end.The only minor glitch is that in order to nominate me you need to write to them, send your CV and indicate that you want to serve as anominator.   They do this because they do not want just anyone nominating anyone.   If you do not mind, could you write to them with your CVand indicate that you would like to be a nominator (see below for explanation).  I got this from their website.  Let me know what you think. Many thanks.Best,TonyReleased by Chairman Rand Paul\n     \n    \n   \n    \n   \n     \n      \n     \n    \n       \n      \n     \n \n  \n       \n        \n               \n            \n               \n               \n      \n   \n   \n  \n   \n           \n     \n           \n From: Fauci, Anthony (NIH/NIAID) [E]Sent: Sunday, October 14, 2018 2:14 PMTo: 'Barton Haynes, M.D.' <@duke.edu>Cc: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>Subject: RE: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019 Bart:    I just realized as I was going through the details of the nomination for the Dan David Prize that the themes  for the 2019 awards are notscience/medicine.   That was last year.   And so we will hold off on this until medicine/science returns as a theme.   Thanks anyway.Best regards,Tony From: Barton Haynes, M.D. <@duke.edu>Sent: Wednesday, October 10, 2018 3:34 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Re: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019 You bet!!! Let’s do it Best  bSent from my iPhoneOn Oct 10, 2018, at 11:23 AM, Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov> wrote:Thanks, Bart.   There is another one that looks possible for me if you are willing to do it.  As usual, I will supply all of the material.   It is the DanDavid Prize. I will send you their e-mail separately in a minute. From: Barton Haynes, M.D. <@duke.edu>Sent: Wednesday, October 10, 2018 12:56 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Fwd: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019 Here you go!Released by Chairman Rand Paul\n   Best bartSent from my iPhoneBegin forwarded message:From: The Shaw Prize <@shawprize.org>Date: October 10, 2018 at 10:47:35 AM MDTTo: Barton F Haynes <@mc.duke.edu>Subject: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019\nThe Shaw PrizeDear Professor Barton F Haynes,This letter is to confirm that we have received your nomination for The Shaw Prize in Life Science andMedicine 2019. The nomination cannot be edited any further but if you have any concerns or if an amendmentis essential, you can contact us at any time on @shawprize.org.Thank you for your support,The Shaw Prize Secretariat.\nReleased by Chairman Rand Paul\nTo:\"Barton Haynes, M.D.\" <@duke.edu>Subject:RE: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019Date:Wed, 10 Oct 2018 13:00:14 -0400Importance:NormalThanks, Bart.   There is another one that looks possible for me.   It is the Dan David Prize.  I nominated Zeke Emanuel (forEthics work) last year and he won From: Barton Haynes, M.D. @duke.edu>Sent: Wednesday, October 10, 2018 12:56 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Subject: Fwd: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019 Here you go! Best bartSent from my iPhoneBegin forwarded message:From: The Shaw Prize <@shawprize.org>Date: October 10, 2018 at 10:47:35 AM MDTTo: Barton F Haynes <@mc.duke.edu>Subject: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019\nThe ShawPrize logoThe Shaw PrizeDear Professor Barton F Haynes,This letter is to confirm that we have received your nomination for The Shaw Prize in LifeScience and Medicine 2019. The nomination cannot be edited any further but if you haveany concerns or if an amendment is essential, you can contact us at any time on@shawprize.org.Thank you for your support,The Shaw Prize Secretariat.\nReleased by Chairman Rand Paul\nTo:\"charles dinarello\" < @aol.com>Subject:RE: Fauci nomination for Dan David PrizeDate:Wed, 16 Dec 2020 16:45:31 -0500Importance:Normal  From: charles dinarello < @aol.com>Sent: Monday, November 16, 2020 9:48 AMTo: Folkers, Greg (NIH/NIAID) [E] < @niaid.nih.gov>Subject: Re: Fauci nomination for Dan David Prize Yes, I suspected for you and all who work in tony's office. But there is a clear internal  satisfaction in our work and now withthe Moderna vaccine, you can take pride in long days and endless weekends.  Please let me read the draft of the narrative.-----Original Message-----From: Folkers, Greg (NIH/NIAID) [E] <@niaid.nih.gov>To: charles dinarello <@aol.com>Sent: Mon, Nov 16, 2020 7:44 amSubject: RE: Fauci nomination for Dan David PrizeCOB does not exist for any of us  From: charles dinarello <@aol.com>Sent: Monday, November 16, 2020 9:43 AMTo: Folkers, Greg (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Re: Fauci nomination for Dan David Prize Thursday is a very good day. Please tell Tony that the announcement this morning of the success of the second mRNAvaccine for Covid-19 should be emphasized since it was Tony and NIAD that took the risk and put the money  where it wasneeded. It should be in the long narrative (He is writing this). Tell him also that I have papers using mRNA vaccine againstcytokines in mice for several years and they work and  so I was thrilled that Tony took on this technology. As far as I know,mRNA vaccines have not been used previously in human trials. This abbreviation (COB) I think must mean Close ofBusiness but COB really does not exist for me nor for Tony. Please let me read the draft of the long narrative. We haveplenty of time.-----Original Message-----From: Folkers, Greg (NIH/NIAID) [E] <@niaid.nih.gov>To: charles dinarello <@aol.com>Sent: Mon, Nov 16, 2020 6:01 amSubject: RE: Fauci nomination for Dan David PrizeThis should be done by COB Thursday unless TF’s calendar evolves/devolves From: charles dinarello <@aol.com>Sent: Monday, November 16, 2020 12:07 AMTo: Folkers, Greg (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Fauci nomination for Dan David Prize How are you doing? We still have plenty of time.Released by Chairman Rand Paul\nFrom:\"Folkers, Greg (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Schneider, Johanna (NIH/NIAID) [E]\" < @niaid.nih.gov>, \"Johnson, Martin S.(NIH/NIAID) [E]\" < @niaid.nih.gov>Cc:\"Folkers, Greg (NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:johanna, martin do u haveDate:Tue, 17 Nov 2020 11:31:54 -0500Importance:NormalAttachments:Fauci_nomination_for_Dan_David_award_2020-11-16_1330.docxI am working on thus nomination for the dan david award for asf Need to beef up the covid part – Do u have language in the can  (CJ, other) that u could share that delineates how we responded in many ways tocovid? I would tweak and fold a few key things into this   Disclaimer:  Any third-party material in this email has been shared for internal use under fair use provisions of U.S. copyrightlaw, without further verification of its accuracy/veracity.  It does not necessarily represent my views nor those of NIAID, NIH,HHS, or the U.S. government. Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:charles dinarello < @aol.com>Cc:\"Folkers, Greg (NIH/NIAID) [E]\" < @niaid.nih.gov>, \"Grady, Christine(NIH/CC/BEP) [E]\" < @cc.nih.gov>Subject:RE: Dan David Prize SubmittedDate:Tue, 24 Nov 2020 15:24:42 -0500Importance:NormalCharles:     Many thanks and love from the Fauci family.   Happy Thanksgiving to you and Edward.  Please stay safe and well.Warm regards,TonyAnthony S. Fauci, MDDirectorNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesda, MD Phone: FAX: E-mail: @niaid.nih.govThe information in this e-mail and any of its attachments is confidential and may contain sensitive information.  Itshould not be used by anyone who is not the original intended recipient.  If you have received this e-mail in errorplease inform the sender and delete it from your mailbox or any other storage devices.  The National Institute ofAllergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender'sown and not expressly made on behalf of the NIAID by one of its representatives.  From: charles dinarello < @aol.com>Sent: Tuesday, November 24, 2020 1:16 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Folkers, Greg (NIH/NIAID) [E] < @niaid.nih.gov>Subject: Dan David Prize Submitted What an ordeal to use the submission form when one cannot save it. It all must be done at once and no mistakes.Fortunately, I found a file with Tony's home and cell and NIH telephone numbers. These  days, once communicates withthe internet. But it's submitted and thank you Greg and Tony for doing most of the work.  Each year the Dan David Prizecommittee asks me for nominees. I am on a lot of Israeli lists because I am on the Board of the Weizmann Institute andhave an honorary degree from the Weizmann. This year, it was Public Health Present and Tony was the Obvious Nominee.Released by Chairman Rand Paul\nFrom:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>To:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Cc:\"Schwetz, Tara (NIH/OD) [E]\" < @nih.gov>Subject:RE: Draft for your reviewDate:Fri, 29 Jan 2021 17:26:55 -0500Importance:NormalEmbedded:RE:_Dan_David_PrizeDisregard my request to talk, pls. I believe the better approach is for you to write Gretchen and ask her to review the package she has (NAM) and the others(AAAS (re-review), CDC and Dan David) once her office receives them.  We discussed that approach last evening.  Fromme, Gretchen knows Tony wants final decisions and is pressing you to go to HHS to get them.  Pls contact her first.  Upuntil now, OGC has not been the reason for the delay.  (I said last night that NAM’s delay lies mostly with me.)  PerhapsGretchen only needs a reason to ask for a revised prioritization of her work.  To clarify: NAM is pending with Gretchen.  Once Randy gets it, he may agree with us and then there is no need for it to go to OGE. Marilyn gave us comments on AAAS on Jan 7.  We asked AAAS for more information on Jan 12, and pinged them on Jan27.     CDC will go to OGC on Monday and it will be approved.  (I misspoke before.  We needed something from NIAID prior toforwarding the package to OGC, and we got that today.)  Dan David was reviewed in 2011 (Gretchen sent me the attached email), so if we can confirm a few things with Dan David– it’s very likely we can, that should be approved too.  Re: GA Tech and Vanderbilt, we’re in agreement that those are closed?  Tony was told that he could not receive the moneyfrom GA Tech.  He has not been told our conclusion re:  Vanderbilt.  (I attempted that in my draft status email thismorning.)  I briefly discussed both awards with Gretchen and she also agrees, but has not seen the paperwork.  Heragreement was based on their grantee status. If you still want to go to HHS, pls see below. From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Friday, January 29, 2021 1:36 PMTo: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Cc: Schwetz, Tara (NIH/OD) [E] <@nih.gov>Subject: Draft for your reviewImportance: High Draft -  let me know what you think. I would send to HHS C-O-S, his counselor Dawn O’Connell, and Anne Reid. With apologies for adding to your very full plate. I am writing to you in my role as NIH Deputy Ethics Counselor to ask forhelp in expediting OGC’s review of a number of awards for Dr. Anthony Fauci. I am told (and appreciate) that OGC staff are now working on ethics clearance for new appointees, but several awardsneed (or soon will need) OGC’s attention. Given the visibility of Dr. Fauci and the visibility of these prestigious awards it isbecoming increasing uncomfortable for him to explain why no decision has been reached. This will be furthercompounded by the latest award that Dr. Fauci has been notified about (the Dan David prize from Israel) which they wishto announce on Feb 15. To be clear, Dr. Fauci knows he can accept the honor of these awards, but each also comes with aReleased by Chairman Rand Paul\nsignificant monetary award. The sponsors are eager for information as to whether he can accept the cash prizes.  [Tony’sassistant routinely tells the sponsors as soon as NIAID is notified that Tony is an award recipient that the cash prizes needheighten review.  And we don’t just want to say no; we want to try to get to yes.  Yes takes time.] Would it be possible to elevate the priority of the review of these awards by OGC please:National Academy of Medicine Gustav O. Lienhard awardCDC Foundation Fries Prize AAAS Philip Abelson PrizeThe Dan David Prize lat    Released by Chairman Rand Paul\nFrom:\"Weaver, Gretchen (NIH/OD) [E]\" < @od.nih.gov>To:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>Subject:RE: Dan David PrizeDate:Fri, 29 Jan 2021 15:17:35 -0500Importance:NormalHolli:  Here is discussion from 2011.  If you can confirm that nothing has changed, including the “attendant events” thatare now mentioned on the web site, this should be helpful.  I did all of the leg work.  Ed took this information to OGE andOGE accepted the award as bona fide even though the subject area to be recognized changes, etc.:  The Dan David Foundation awards three $1 million Dan David Prizes each year (since 2002), recognizing past, present, andfuture achievements.  For each time dimension, a field is chosen, and one or more recipients are selected.  If more thanone recipient is selected in a field, the cash prize is shared.  The categories for 2012 are:  Past – History/Biography; Present– Plastic Arts; and Future – Genome Research.  Notably, laureates donate 10% of their prize money to graduate studentsof their choice.   NASA and DOE employees are among the prior recipients (they received the award in 2007). International panels of experts in each of the fields to be recognized evaluate the nominees based upon the description ofeach field of recognition posted on the web site and submit reports to the Dan David Prize Board (an international panelselected by the Dan David Foundation Board).  The DDP Board makes the final determination as to which nominee(s) ineach category have achieved that which the prize is intended to recognize (as described in the category descriptions). More information is available at: http://www.dandavidprize.org/, including the composition of the DDP Board. After reviewing the web site, other publicly available information, and the materials our NASA colleagues were able toprovide, I made contact with the Chair of the Dan David Foundation Board, Professor Itamar Rabinovich, and theadministrative Director of the Prize, Ms. Smadar Fisher.  Based on all of the information I have been able to obtain , itappears that the Prize program is “owned” by the Dan David Foundation, although there is a relationship between it andTel Aviv University pursuant to which Tel Aviv provides space and administrative support for the award program. Professor Rabinovich was the President of Tel Aviv University when Dan David began his Foundation and an agreementwas reached.  Professor Rabinovich confirmed that the Foundation could opt to move the administrative headquarters ofthe Prize out of the University. Upon review of the web site, you may also notice reference to French Collaboration.  The Dan David Foundation enteredinto an agreement with the French Government in 2006.  Professor Rabinovich has said that this was intended to furtherthe international outreach efforts of the Foundation.  In alternating years the Prize ceremony is held in France.  Inexchange, two or three seats on the Dan David Prize Board “belong” to the French.  The current composition of the Boardis at:  http://www.dandavidprize.org/about/about-the-board.html.  Based upon the available information, and in light of OLC’s opinions (particularly the more recent award opinion coveringthe President’s Nobel Prize), I do not think the Dan David Prize implicates the Emoluments Clause or the Foreign Gifts andDecorations Act. Although Tel Aviv University is an NIH grantee, I do not think the Dan David Prize implicates our Supplemental Standardbecause the Prize appears to be from the Dan David Foundation, a separate entity that does not appear to be a grantee orotherwise have any business dealings with the NIH. Moreover, although the recipient is expected to give a lecture (at a symposium, and in addition to acceptance remarksduring the presentation ceremony), the Dan David Prize appears to be a bona fide award made as part of an establishedprogram of recognition that an NIH employee, including Dr. Collins, might be permitted to accept (assuming no change inthe program or other individualized issue).  Again , the award appears to be from the Dan David Foundation.  I have foundno record of any business interactions between NIH and the Dan David Foundation, so OGE’s source limitation is not anissue.  Although there is a symposium at which the recipients are expected to give a presentation, I have been told theyReleased by Chairman Rand Paul\ngive talks about their work over the course of their careers, rather than current science and theory, and $1 million is faroutside of the range of typical honoraria paid for individual presentations.  From videos available on the internet (at sitesnot presently blocked by NIH security measures), it appears that the Prize ceremony is quite elaborate, well-attended, andin keeping with what we expect such an event to “look like.”  Press reports that coincide with the announcement of eachyear’s winners appear to reflect that this is a significant award/honor.   Gretchen H. Weaver, J.D.Supervisory/Senior NIH Ethics CounselDHHS/OGC/Ethics Divisionphone: fax:  NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Jaffe, Holli Beckerman (NIH/OD) [E] @od.nih.gov>Sent: Friday, January 29, 2021 2:16 PMTo: Weaver, Gretchen (NIH/OD) [E] < @od.nih.gov>Subject: FW: Dan David Prize My quick thoughts From: Jaffe, Holli Beckerman (NIH/OD) [E]Sent: Friday, January 29, 2021 11:40 AMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Cc: Schwetz, Tara (NIH/OD) [E] @nih.gov>Subject: Dan David Prize I’m lost as to what Tony wants you to raise with HHS at this VERY early time.  It’s not a pending HHS matter yet, thoughonce we transmit the package, HHS could be helpful in telling OGC that this is a top priority (and not clearing otherOPDIVs’ appointees).  NEO needs time to assemble the package.  From a quick review of the website, I know we’ll need to contact the awardsponsor for additional information.  For example:     Laureates in each selected field are chosen by the Dan David Prize Board, based on the recommendations ofInternational Review Committees comprised of world-renowned experts in the relevant fields.  Will need to confirmthat both the Review Committee and the DD Board used written selection criteria, either the same or different.  Alsoneed to know who makes up the Committee and Board (so can likely prove both are independent of Tel Aviv U.) Nomination requirements include:  “A detailed description of the nominee’s work (1-2 pages), stipulating reasonswhy the nominee merits the Dan David Prize. Reference should be made to the importance of the work, its impactand its projected influence in the relevant field.”  Might be able to use “importance of the work, its impact and itsprojected influence in the relevant field,” are selection criteria.  Would need sponsor to confirm that selections arebased on these factors. Released by Chairman Rand Paul\nPrize winners are required to participate in the Award Ceremony and the Attendant Events.  Will need to know whatthe details of the Award Ceremony and get a list of the Attendant Events.  From the website, seems attendant eventsinclude a symposia. Also, we need clarification of Tel Aviv University’s involvement.  The University’s involvement could be consequential ifNIAID has any projects with it.  My guess is that the University is NOT involved in the recipient selection process; itappears to host the symposia.  The latter involvement likely will not affect the determination.  How can I help? Holli Beckerman JaffeDirector, NIH Ethics Office @od.nih.gov Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nTo clarify: NAM is pending with Gretchen.  Once Randy gets it, he may agree with us and then there is no need for it to go to OGE. Marilyn gave us comments on AAAS on Jan 7.  We asked AAAS for more information on Jan 12, and pinged them on Jan27.     CDC will go to OGC on Monday and it will be approved.  (I misspoke before.  We needed something from NIAID prior toforwarding the package to OGC, and we got that today.)  Dan David was reviewed in 2011 (Gretchen sent me the attached email), so if we can confirm a few things with Dan David– it’s very likely we can, that should be approved too.  Re: GA Tech and Vanderbilt, we’re in agreement that those are closed?  Tony was told that he could not receive the moneyfrom GA Tech.  He has not been told our conclusion re:  Vanderbilt.  (I attempted that in my draft status email thismorning.)  I briefly discussed both awards with Gretchen and she also agrees, but has not seen the paperwork.  Heragreement was based on their grantee status. If you still want to go to HHS, pls see below. From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Friday, January 29, 2021 1:36 PMTo: Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Cc: Schwetz, Tara (NIH/OD) [E] <@nih.gov>Subject: Draft for your reviewImportance: High Draft -  let me know what you think. I would send to HHS C-O-S, his counselor Dawn O’Connell, and Anne Reid. With apologies for adding to your very full plate. I am writing to you in my role as NIH Deputy Ethics Counselor to ask forhelp in expediting OGC’s review of a number of awards for Dr. Anthony Fauci. I am told (and appreciate) that OGC staff are now working on ethics clearance for new appointees, but several awardsneed (or soon will need) OGC’s attention. Given the visibility of Dr. Fauci and the visibility of these prestigious awards it isbecoming increasing uncomfortable for him to explain why no decision has been reached. This will be furthercompounded by the latest award that Dr. Fauci has been notified about (the Dan David prize from Israel) which they wishto announce on Feb 15. To be clear, Dr. Fauci knows he can accept the honor of these awards, but each also comes with asignificant monetary award. The sponsors are eager for information as to whether he can accept the cash prizes.  [Tony’sassistant routinely tells the sponsors as soon as NIAID is notified that Tony is an award recipient that the cash prizes needheighten review.  And we don’t just want to say no; we want to try to get to yes.  Yes takes time.] Would it be possible to elevate the priority of the review of these awards by OGC please:National Academy of Medicine Gustav O. Lienhard awardCDC Foundation Fries Prize AAAS Philip Abelson PrizeThe Dan David Prize lat    Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Cc:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @OD.NIH.GOV>Subject:RE: Update on awardsDate:Sat, 30 Jan 2021 11:18:01 -0500Importance:NormalLarry:    Thanks for the note and many thanks to Holli for the effort she has put in.   I understand completely aboutthe Vanderbilt and Georgia Institute of Technology.   I was not expecting to be able to accept the cash on these.I will accept the honor and they can give the cash to charities of their choosing.   I am very pleased to hearabout the “good” news, particularly about the Dan David Prize.   I knew that we had previously (2011) reviewedit favorably and when I spoke to the Israeli person who informed me of the Award, he mentioned thateverything was the same with this award as it was for the past 20 years, and so I am certain that nothing haschanged, but you can check this.   I told them that I will accept the award.   They want to keep this confidential,but they will announce it to the world on February 15.   I will send  the official invitation to Holli as soon as Ireceive it in the mail.   I really appreciate you and Holli helping out on this.Best regards,Tony From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Saturday, January 30, 2021 10:53 AMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Jaffe, Holli Beckerman (NIH/OD) [E] @od.nih.gov>Subject: Update on awards Tony, I certainly understand your frustration about the time that it has taken to reach decisions on a number of awards thathave been pending for too long. I too am frustrated because my goal is to support you in the strongest possible way. I hadextensive discussions with Holli Friday, and as we unpacked things, I realized that more progress has been made than Iwas aware of. Here is the current status of each award: First the good news:Partnership for Public Service’s Service to America Award – approved. Smithsonian Institution’s Great American Medal Gold Medal – approved.The Dan David Prize – Holli raised this prize with Gretchen (HHS OGC) yesterday and Gretchen shared thatthe Dan David Prize was reviewed in 2011 and it was determined to meet the regulatory requirements. Weneed to confirm that certain aspects of the award have not changed since 2011 – Holli’s quick review ofwebsite does not show any changes – and then most likely, you will be able to receive the cash prize. Pleaseforward to Holli the letter notifying you of your selection, and any other written materials you receive fromDan David as soon as you receive them.  CDC Foundation’s Fries Prize – this package is complete and will be transmitted to HHS OGC for final reviewon Monday. We expect a quick approval. As you may know, Harvey Alter received this prize in 2015 and hewas approved to accept the cash prize. AAAS’ Philip Abelson Prize – HHS OGC reviewed the package and requested that we ask AAAS for additionalinformation. Our request for the supplemental documentation is pending with AAAS. We will remind AAASof this need this week, and I remain hopeful that this award will ultimately be approved. It will, however,take more time to get a final decision.Next, the unknown:Released by Chairman Rand Paul\nNAM’s Gustov Lienhard Award – this is the most challenging package. After receiving additional informationfrom NAM (I personally made the request to Victor in November), the completed package was submitted toHHS OGC in December. They determined that you cannot receive the cash prize based on a broad reading ofan applicable regulation. We propose to appeal that interpretation to the US Office of Government Ethics(OGE) but we have arrived at a strategy that we think maximizes our chance at succeeding. We think ourargument is reasonable, but the USG OGE still may reject it if they take a more conservative approach. Ifthey do, we have no other recourse.  In addition, the USG OGE is neck deep in vetting appointments for thenew administration and once it gets to USG OGE it may get hung up for some time. So to get “two turns atbat”, we are first trying to convince the acting HHS OGC DAEO, Randy Hall, who serves as the HHS’ subjectmatter expert and is the POC for the USG OGE, to agree to our interpretation. If he does it won’t have to goto the USG OGE. If he doesn’t, we can still appeal directly to the USG OGE as a final attempt. Now the bad news:Vanderbilt University’s Nichols-Chancellor Medal and GA Institute of Technology’s Ivan Allen Jr. Prize forSocial Courage – unfortunately, you will not be able to accept the cash prizes associated with either of theseawards because both award sponsors (Vanderbilt and GA Tech) are NIAID grantees. We did consider askingfor an exception for these awards; however, neither award appears to comport with the exception forawards which “confer an exceptionally high honor in the fields of medicine or scientific research.” Vanderbilt’s Nichols-Chancellor’s Medal is awarded “to those persons who define the 21st centuryand exemplify the best qualities of the human spirit.” Previous winners were Caroline Kennedy, VenusWilliams, Amal Clooney and Ken Burns.GA Tech’s Ivan Allen Jr. Prize for Social Courage “shines a light on those around the world who bravelyact to improve the human condition, often in the face of seemingly insurmountablechallenges.” Previous winners were Hamilton E. Homes and Charlayne Hunter-Gault, Andrew Youngand Jimmy and Rosalynn CarterAs neither award focuses on achievements in medicine or scientific research we must unfortunately denythe request to accept these awards’ cash prizes. As you know you can accept the honor of being theseawards’ 2021 recipients, and I understand that you are proceeding along those lines. Also, the awardsponsors may donate the cash prizes in your honor to charities of their choosing. I understand GA Tech isproceeding with such a designation and we will inform Vanderbilt of that option.  Holli plays the seminal role in assembling of the award packages, drafting follow-up correspondence with the awardsponsors, and legal discussions with OGC. She will continue to monitor the developments with respect to each packageand keep me informed of any change in status.  Please let me know if you have any questions. Larry  Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @OD.NIH.GOV>, \"Tabak, Lawrence(NIH/OD) [E]\" <@nih.gov>Cc:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:RE: Update on awardsDate:Sun, 31 Jan 2021 08:45:23 -0500Importance:NormalThanks, Holli! From: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Sent: Sunday, January 31, 2021 8:30 AMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>; Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Subject: RE: Update on awards Good morning, Late Friday we received a response from AAAS regarding the Abelson Prize.  My staff sent the additional information toOGC last evening, and I sent a follow-up email this morning.  I expect a decision on this award shortly, and I remainoptimistic that it will be a positive outcome. Holli From: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Saturday, January 30, 2021 11:18 AMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Cc: Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Subject: RE: Update on awards Larry:    Thanks for the note and many thanks to Holli for the effort she has put in.   I understand completely aboutthe Vanderbilt and Georgia Institute of Technology.   I was not expecting to be able to accept the cash on these.I will accept the honor and they can give the cash to charities of their choosing.   I am very pleased to hearabout the “good” news, particularly about the Dan David Prize.   I knew that we had previously (2011) reviewedit favorably and when I spoke to the Israeli person who informed me of the Award, he mentioned thateverything was the same with this award as it was for the past 20 years, and so I am certain that nothing haschanged, but you can check this.   I told them that I will accept the award.   They want to keep this confidential,but they will announce it to the world on February 15.   I will send  the official invitation to Holli as soon as Ireceive it in the mail.   I really appreciate you and Holli helping out on this.Best regards,Tony From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Saturday, January 30, 2021 10:53 AMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Cc: Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Subject: Update on awards Released by Chairman Rand Paul\nTony, I certainly understand your frustration about the time that it has taken to reach decisions on a number of awards thathave been pending for too long. I too am frustrated because my goal is to support you in the strongest possible way. I hadextensive discussions with Holli Friday, and as we unpacked things, I realized that more progress has been made than Iwas aware of. Here is the current status of each award: First the good news:Partnership for Public Service’s Service to America Award – approved. Smithsonian Institution’s Great American Medal Gold Medal – approved.The Dan David Prize – Holli raised this prize with Gretchen (HHS OGC) yesterday and Gretchen shared thatthe Dan David Prize was reviewed in 2011 and it was determined to meet the regulatory requirements. Weneed to confirm that certain aspects of the award have not changed since 2011 – Holli’s quick review ofwebsite does not show any changes – and then most likely, you will be able to receive the cash prize. Pleaseforward to Holli the letter notifying you of your selection, and any other written materials you receive fromDan David as soon as you receive them.  CDC Foundation’s Fries Prize – this package is complete and will be transmitted to HHS OGC for final reviewon Monday. We expect a quick approval. As you may know, Harvey Alter received this prize in 2015 and hewas approved to accept the cash prize. AAAS’ Philip Abelson Prize – HHS OGC reviewed the package and requested that we ask AAAS for additionalinformation. Our request for the supplemental documentation is pending with AAAS. We will remind AAASof this need this week, and I remain hopeful that this award will ultimately be approved. It will, however,take more time to get a final decision.Next, the unknown:NAM’s Gustov Lienhard Award – this is the most challenging package. After receiving additional informationfrom NAM (I personally made the request to Victor in November), the completed package was submitted toHHS OGC in December. They determined that you cannot receive the cash prize based on a broad reading ofan applicable regulation. We propose to appeal that interpretation to the US Office of Government Ethics(OGE) but we have arrived at a strategy that we think maximizes our chance at succeeding. We think ourargument is reasonable, but the USG OGE still may reject it if they take a more conservative approach. Ifthey do, we have no other recourse.  In addition, the USG OGE is neck deep in vetting appointments for thenew administration and once it gets to USG OGE it may get hung up for some time. So to get “two turns atbat”, we are first trying to convince the acting HHS OGC DAEO, Randy Hall, who serves as the HHS’ subjectmatter expert and is the POC for the USG OGE, to agree to our interpretation. If he does it won’t have to goto the USG OGE. If he doesn’t, we can still appeal directly to the USG OGE as a final attempt. Now the bad news:Vanderbilt University’s Nichols-Chancellor Medal and GA Institute of Technology’s Ivan Allen Jr. Prize forSocial Courage – unfortunately, you will not be able to accept the cash prizes associated with either of theseawards because both award sponsors (Vanderbilt and GA Tech) are NIAID grantees. We did consider askingfor an exception for these awards; however, neither award appears to comport with the exception forawards which “confer an exceptionally high honor in the fields of medicine or scientific research.” Vanderbilt’s Nichols-Chancellor’s Medal is awarded “to those persons who define the 21st centuryand exemplify the best qualities of the human spirit.” Previous winners were Caroline Kennedy, VenusWilliams, Amal Clooney and Ken Burns.GA Tech’s Ivan Allen Jr. Prize for Social Courage “shines a light on those around the world who bravelyact to improve the human condition, often in the face of seemingly insurmountablechallenges.” Previous winners were Hamilton E. Homes and Charlayne Hunter-Gault, Andrew Youngand Jimmy and Rosalynn CarterAs neither award focuses on achievements in medicine or scientific research we must unfortunately denythe request to accept these awards’ cash prizes. As you know you can accept the honor of being theseawards’ 2021 recipients, and I understand that you are proceeding along those lines. Also, the awardsponsors may donate the cash prizes in your honor to charities of their choosing. I understand GA Tech isproceeding with such a designation and we will inform Vanderbilt of that option.  Holli plays the seminal role in assembling of the award packages, drafting follow-up correspondence with the awardsponsors, and legal discussions with OGC. She will continue to monitor the developments with respect to each packageReleased by Chairman Rand Paul\nand keep me informed of any change in status.  Please let me know if you have any questions. Larry  Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @OD.NIH.GOV>Cc:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>, \"Conrad, Patricia(NIH/NIAID) [E]\" < @niaid.nih.gov>, \"Billet, Courtney (NIH/NIAID) [E]\"< @niaid.nih.gov>Subject:FW: Dan David PrizeDate:Sun, 31 Jan 2021 08:44:45 -0500Importance:NormalAttachments:AnthonyFauci.pdfHolli:     I just received the official notification of my winning the Dan David Prize (see attached).   As you can see,they will be announcing it on February 15.   Larry asked me to forward this to you as soon as I received it so thatyou can proceed with the official clearance.   Many thanks.Best regards,Tony From: Charlotte Halle @tauex.tau.ac.il>Sent: Sunday, January 31, 2021 4:39 AMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>Subject: Dan David Prize Dear Dr. Fauci, Attached please find the notification letter informing you that you have been selected as a 2021 Dan David PrizeLaureate. The original letter will be sent to you by post. Please confirm receipt of this email. Best wishes, Charlotte Hallé   Charlotte HalléDirectorDan David PrizeOffice: Mobile: Email: @tauex.tau.ac.ilWebsite: www.dandavidprize.org  Released by Chairman Rand Paul\nFrom:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>To:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Subject:RE: Dan David PrizeDate:Sun, 31 Jan 2021 16:18:06 -0500Importance:NormalYes, thankfully.  I’ll contact Gretchen tomorrow on Dan David to clarify what we need from the organization.  I want tokeep this package moving. From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Sunday, January 31, 2021 9:27 AMTo: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Subject: Re: Dan David Prize We appear to be back to a more normal approach From: \"Jaffe, Holli Beckerman (NIH/OD) [E]\" <@od.nih.gov>Date: Sunday, January 31, 2021 at 9:05 AMTo: Anthony Fauci <@niaid.nih.gov>Cc: \"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>, \"Conrad, Patricia (NIH/NIAID) [E]\"<@niaid.nih.gov>, \"Billet, Courtney (NIH/NIAID) [E]\" <@niaid.nih.gov>Subject: RE: Dan David Prize Thanks Tony, and congratulations on this tremendous honor.  Please also forward the invitations to the Prize’s online eventsonce you receive them, and any other correspondence you receive from Dan David. I will share this confidential information with OGC, and proceed to process the award.  As Larry noted, the analysis for theaward was completed several years ago, so do not expect any difficulties with reviewing and approving your awardpackage.  I’ll keep you posted on our developments. Holli From: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Sunday, January 31, 2021 8:45 AMTo: Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Cc: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>; Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>;Billet, Courtney (NIH/NIAID) [E] <@niaid.nih.gov>Subject: FW: Dan David Prize Holli:     I just received the official notification of my winning the Dan David Prize (see attached).   As you can see,they will be announcing it on February 15.   Larry asked me to forward this to you as soon as I received it so thatyou can proceed with the official clearance.   Many thanks.Best regards,Tony Released by Chairman Rand Paul\nFrom: Charlotte Halle <@tauex.tau.ac.il>Sent: Sunday, January 31, 2021 4:39 AMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Cc: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Dan David Prize Dear Dr. Fauci, Attached please find the notification letter informing you that you have been selected as a 2021 Dan David PrizeLaureate. The original letter will be sent to you by post. Please confirm receipt of this email. Best wishes, Charlotte Hallé   Charlotte HalléDirectorDan David PrizeOffice: Mobile: Email: @tauex.tau.ac.ilWebsite: www.dandavidprize.org  Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Charlotte Halle\" < @tauex.tau.ac.il>Cc:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>, \"Dan David Prize\"< @tauex.tau.ac.il>, \"Billet, Courtney (NIH/NIAID) [E]\" < @niaid.nih.gov>,\"Greg Folkers (@niaid.nih.gov)\" <@niaid.nih.gov>, \"Jaffe, HolliBeckerman (NIH/OD) [E]\" < @OD.NIH.GOV>Subject:RE: Dan David PrizeDate:Mon, 01 Feb 2021 21:29:30 -0500Importance:NormalCharlotte:   I will accept the 2021 Dan David Prize.   My Chief-of-Staff, Greg Folkers (copied here)  will provide you with theinformation that you have requested below.   The people in my Institute who can assist you with PR matters areCourtney Billet and Patricia Conrad, both of whom are copied on this e-mail.  Please let me  know if you haveany questions.  Many thanks.Best regards,TonyAnthony S. Fauci, MDDirectorNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesda, MD Phone: FAX: E-mail: @niaid.nih.govThe information in this e-mail and any of its attachments is confidential and may contain sensitive information.  Itshould not be used by anyone who is not the original intended recipient.  If you have received this e-mail in errorplease inform the sender and delete it from your mailbox or any other storage devices.  The National Institute ofAllergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender'sown and not expressly made on behalf of the NIAID by one of its representatives.    From: Charlotte Halle < @tauex.tau.ac.il>Sent: Monday, February 1, 2021 4:01 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>; Dan David Prize < @tauex.tau.ac.il>Subject: FW: Dan David Prize Dear Dr. Fauci, We keenly await confirmation that you will accept the 2021 Dan David Prize. In the meantime, we write to you with some urgent requests regarding the announcement of the 2021 DanDavid Prize laureates, scheduled for Monday February 15 at 1800 (Israel-time); in parallel we plan to notify theinternational and Israeli media that you are among those honored. Should we be in touch directly with someone else regarding these requests?   We ask that within 2 days, you send us the following:Released by Chairman Rand Paul\n 1)    A high resolution photo (at least 1 MB in size; it will be blown up and printed in a large format so thequality of the photo is key). If you can send more than one option, that would be best. Please indicate ifthe photo requires a credit. 2)    A short bio in layman’s terms. 3)    A short paragraph about your work and significant achievements, in laymen’s terms. 4)    A quote from you of up to two paragraphs in length, which includes a statement of reaction to yourselection. Alternatively We would be happy to telephone you for a brief conversation to ask you a couple of questions, includingabout your reaction to being selected. If you prefer this, please send us your telephone number and atime you can be reached over the next few days. 5)    Additionally we ask you to provide us with the name and contact information of a professional at yourinstitution who can assist us with PR matters. I will also mention that your photograph is the most urgent item on this list for us. Thank you very much in advance for your cooperation and we look forward to further contact. Yours sincerely, Charlotte Charlotte HalléDirectorDan David PrizeOffice: Mobile: Email: @tauex.tau.ac.ilWebsite: www.dandavidprize.org   From: Charlotte HalleSent: Sunday, January 31, 2021 11:39 AMTo: ' @niaid.nih.gov' <@niaid.nih.gov>Cc: ' @niaid.nih.gov' <@niaid.nih.gov>Subject: Dan David Prize Dear Dr. Fauci, Attached please find the notification letter informing you that you have been selected as a 2021 Dan David PrizeLaureate. The original letter will be sent to you by post. Please confirm receipt of this email. Best wishes, Charlotte Hallé Released by Chairman Rand Paul\n  Charlotte HalléDirectorDan David PrizeOffice: Mobile: Email: @tauex.tau.ac.ilWebsite: www.dandavidprize.org  Released by Chairman Rand Paul\nFrom:\"Weaver, Gretchen (NIH/OD) [E]\" < @od.nih.gov>To:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Cc:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>, \"Hall, Randall (HHS/OGC)\"< @hhs.gov>Subject:RE: Request for concurrence -Gustav O. Lienhard Award -A. FauciDate:Tue, 16 Feb 2021 11:01:52 -0500Importance:NormalWith apologies; I meant “now,” not “not.” Gretchen Gretchen H. Weaver, J.D.Supervisory/Senior NIH Ethics CounselDHHS/OGC/Ethics Divisionphone: fax:  NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Weaver, Gretchen (NIH/OD) [E]Sent: Tuesday, February 16, 2021 10:46 AMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Cc: Jaffe, Holli Beckerman (NIH/OD) [E] < @OD.NIH.GOV>; Hall, Randall (HHS/OGC) ( @hhs.gov)< @hhs.gov>Subject: RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Dr. Tabak: Good morning.  As a quick update on the status of this item, Randy and I talked and we have forwarded your note to OGEwith a request that they consider the questions presented.  We will keep you apprised of what we hear.  That said, wehave no idea when to expect a response given that OGE is heavily involved in working to bring the Biden team memberson board across the entire Executive Branch.  We will, however, be checking in. I am not turning to focus on the Dan David Prize. Best, Gretchen Gretchen H. Weaver, J.D.Supervisory/Senior NIH Ethics CounselDHHS/OGC/Ethics DivisionReleased by Chairman Rand Paul\nphone: fax: NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Friday, February 5, 2021 5:51 AMTo: Hall, Randall (HHS/OGC) <@HHS.GOV>Cc: Weaver, Gretchen (NIH/OD) [E] <@od.nih.gov>; Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Subject: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Mr. Hall, I write to request your concurrence that the exception to the gift prohibition at section 2635.204(d) does not prohibit Dr.Anthony Fauci from accepting the cash prize associated with the National Academy of Medicine’s (NAM) 2020 Gustav O.Lienhard Award.  Specifically, I ask you to find that: 1) the National Academies of Sciences (NAS), the umbrellaorganization under which NAM was established, is not a “person” under the regulations, and similarly, neither is NAM; or2) if NAS is a “person,” NAM and NAS are different “persons” because of NAM’s independence from NAS; and/or 3) NAS isnot a “person who can be substantially affected by the performance or nonperformance of [Dr. Fauci’s NIH] duties.”  If youdo not concur, I ask that you forward this discussion to the Office of Government Ethics for their consideration anddetermination of the applicability of the gift rule to the NAM Lienhard Award. As you likely know, Dr. Fauci is the Director of the National Institute of Allergy and Infectious Diseases (NIAID).  He wasawarded the Lienhard award from NAM on October 19, 2020.  The Lienhard award – a medal and $40,000 – recognizesindividuals for outstanding achievement in improving health care services in the United States.  NIAID currently funds twoCongressionally-mandated studies as well as six other projects including an Action Collaborative, a Board, two Forums anda Roundtable.  NIAID contributes to the latter projects typically as one of several NIH Institutes and Centers.  It is ourunderstanding that due to a restructuring of NAS, all the business interactions between the Academies and Federalagencies go through NAS.  Thus, NIAID has no current financial, contractual, or similar dealings with NAM.  In order for Dr. Fauci to accept the cash prize, we reviewed the exception to the gift rules for meritorious public service orachievement at section 2635.204(d) (emphasis added): (1) An employee may accept a bona fide award for meritorious public service or achievement and any itemincident to the award, provided that: (i) The award and any item incident to the award are not from a person who has interests that may besubstantially affected by the performance or nonperformance of the employee's official duties, or froman association or other organization if a majority of its members have such interests; The definition of “person” is found at section 2635.102(k) and is:  (k) Person means an individual, corporation and subsidiaries it controls, company, association, firm, partnership,society, joint stock company, or any other organization or institution, including any officer, employee, or agent ofsuch person or entity. For purposes of this part, a corporation will be deemed to control a subsidiary if it owns 50percent or more of the subsidiary's voting securities. The term is all-inclusive and applies to commercial venturesand nonprofit organizations as well as to foreign, State, and local governments, including the Government of theReleased by Chairman Rand Paul\nDistrict of Columbia. It does not include any agency or other entity of the Federal Government or any officer oremployee thereof when acting in his official capacity on behalf of that agency or entity. The “National Academy of Sciences (in this chapter, the “corporation”) is a federally chartered corporation.”  36 USC §150301.  Pursuant to its Mission statement, NAS “is a private, non-profit society [and is] charged with providingindependent, objective advice to the nation on matters related to science and technology.”  The Act to Incorporate theNational Academy of Sciences (aka the Academy Charter) states “the Academy shall, whenever called upon by anydepartment of the Government, investigate, examine, experiment, and report upon any subject of science or art . . . .” Academy Charter at §3. While a corporation is a “person” under section 2635.102(k), I argue that the type of corporationthat NAS is – a federally chartered corporation, with its exceptional mission to advise the Federal Government – is not thetype of corporation that OGE intended to include in the definition.  First, OGE could have, but did not include in thedefinition of “person” any discussion of federally chartered corporations, perhaps because of their uniqueness.  And it’sthis uniqueness which makes the application of section 2635.204(d) unnecessary.  NIAID works with NAS because it isdirected to do so by Congress and because NAS offers NIAID an expertise that cannot be found elsewhere.  NAM did not“return the favor” to NIAID when it selected Dr. Fauci as its 2021 Lienhard awardee.  Its relationship with NIAID is rootedin legislation and will continue regardless of an unrelated award to NIAID’s Director. Last, OGE stated that “[‘person’] doesnot include any agency or other entity of the Federal Government . . . .”  I concede that NAS is not a part of the FederalGovernment.  However, in 1997, Congress amended the Federal Advisory Committee Act (FACA) to include the NationalAcademy of Sciences under some of FACA’s provisions.  See Congressional Research Service report, CongressionallyChartered Nonprofit Organizations (\"Title 36 Corporations\"): What They Are and How Congress Treats Them (July 14,2008).  There, CSR noted that the FACA amendment was: [T]he first instance in which Congress has made [federally chartered corporations] subject to the provisions of ageneral management law, and while the action may be supportable on public policy grounds, it does, to theextent of the applicable provisions, diminish the private character of the affected organizations.  As such, itconstitutes a precedent with implications. CSR Report at 7.  FACA’s partial application to NAS further supports viewing NAS as a different kind of corporate entity thatis outside of the regulatory definition of “person.”  Therefore, if NAS is not a “person,” NAS’ non-person status extends toNAM, an entity established under NAS’ charter.  Consequently, the pending NIAID-NAS matters do not make a gift fromNAM a prohibited gift for Dr. Fauci under the applicable regulations.   In the alternative, if you find NAS to be a “person” under 2635.102(k), then you should not find it to be the same “person”as NAM.  Even though NAM was established in 1970 under the charter of the National Academy of Sciences, the definitionof “person” supports a finding that NAM is not a subsidiary of corporate parent NAS.  The regulation explains that “forpurposes of [Part 2635], a corporation will be deemed to control a subsidiary if it owns 50 percent or more of thesubsidiary's voting securities.”  NAM does not issue voting securities, so NAS cannot control such securities; accordingly,NAM is not a subsidiary of NAS, but rather an independent entity.  Furthermore, pursuant to NAM’s Articles ofOrganization (AoO), adopted May 19, 2015 (copy attached), “the governance of [NAM] shall reside in the President andCouncil to be elected from among the membership,” AoO Art. III, § 1, “NAM shall be solely responsible for the content ofreports on projects that it undertakes, and such reports may be issued in its own name.”  AoO Art. VI, § 2.  NAM’sgoverning documents repeatedly show NAM’s independence from NAS.  Last, NAM’s AoO gives it its own authority toestablish awards.  AoO Art. V.  Thus, the Lienhard award and its associated cash prize are from NAM and NIAID’scommissioned studies and other projects from NAS do not make the award an impermissible gift under section2635.204(d).    Finally, if NAS and NAM are a “person,” then they are not persons who are substantially affected by the performance ornonperformance of Dr. Fauci’s duties because both “compensation” in NAS’ charter as well as “substantially” in section2635.204(d) must have meaning.  NAS’ charter states:  “[NAS] shall receive no compensation whatever for any services tothe Government of the United States.”  This is consistent with NAS’ status as a not-for-profit entity. NAS’ charter wascodified in Title 36 at Sections 150301-150304, and Section 150303 reiterates that NAS “may not receive compensationfor services to the Government, but the actual expense of the investigation, examination, experimentation, and reportshall be paid by the Government from an appropriation for that purpose.”  If the statutory language means that NAScannot receive any compensation for its investigations, examinations, experiments or reports commissioned by FederalReleased by Chairman Rand Paul\nagencies, but rather only reimbursement of expenses, then NAS is not substantially affected by NIAID’s projects. Furthermore, two of NIAID’s projects with NAS were mandated by Congress.  One project was started by another NIHInstitute which NIAID later joined.  Other collaborations were formed at the agency or department level, and not from thedirect action of NIAID.  Most importantly, every NAS project in which NIAID is involved is a large-scale project withnumerous members.  Being one of many means that NIAID’s proportional contribution does not affect NAS substantially. For all of these reasons, Dr. Fauci would not be accepting an award from a person (NAS and/or NAM) who has interestthat may be substantially affected by the performance or nonperformance of his official duties.  For the reasons provided above, a finding should be made that Dr. Fauci may accept the Lienhard Award and the cashprize associated with it from NAM.  If you have any questions, please contact Holli Beckerman Jaffe, cc’d above. Thank you for your consideration. With best wishes,Larry Lawrence A. Tabak, DDS, PhDPrincipal Deputy Director, NIHDeputy Ethics Counselor, NIHReleased by Chairman Rand Paul\nFrom:\"Schwetz, Tara (NIH/OD) [E]\" < @nih.gov>To:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Subject:Re: Request for concurrence -Gustav O. Lienhard Award -A. FauciDate:Fri, 19 Feb 2021 00:58:45 -0500Importance:NormalInline-Images:image001.pngIt was worth a try… Best, Tara A. Schwetz, PhDAssociate Deputy Director, NIHA: P:  | M: \ncidimage001.png@01D639B9.FBF92330 From: Larry Tabak <@nih.gov>Date: Thursday, February 18, 2021 at 6:48 PMTo: Tara Schwetz <@nih.gov>Subject: FW: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Not surprising…but not a good conversation to have with ASF…. From: \"Hall, Randall (HHS/OGC)\" < @HHS.GOV>Date: Thursday, February 18, 2021 at 4:47 PMTo: \"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Cc: Gretchen Weaver < @od.nih.gov>Subject: RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci  Dr. Tabak: Good afternoon.  This is to let you know that OGE has responded to our request to consider whether the gift ruleexception for awards applies in the case of the Lienhard Award the NAM presented to Dr. Fauci.  Unfortunately, OGE hasconcluded that the NASEM/NAM is/are a “person” under the government-wide rules restricting gifts from outside sourcesand that they are a person that can be “substantially affected by the performance or non-performance” of Dr. Fauci’sduties.  As a result, we are unable to change our prior determination that he cannot accept the $40,000 cash giftassociated with the Lienhard Award. Please let us know if you have any questions. Randy  Randall J. HallActing Associate General Counsel for EthicsReleased by Chairman Rand Paul\nAlternate Designated Agency Ethics OfficialEthics DivisionDepartment of Health and Human Services   NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Weaver, Gretchen (NIH/OD) [E]Sent: Thursday, February 18, 2021 3:40 PMTo: Hall, Randall (HHS/OGC) (@hhs.gov) <@hhs.gov>Subject: Final note to Dr. Tabak RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Randy – Did you want to respond to Dr. Tabak?  I had forgotten that I rote to him on Tuesday to let him know we had sentthe question to OGE (see below).  This is what I would send, but let me know if you want to send and want somethingdifferent.  Thanks, Gretchen  Dr. Tabak: Good afternoon.  It is sooner than I expected, but I am writing because OGE has responded to our request.  Unfortunately,OGE has concluded that the NASEM/NAM is/are a “person” under the government-wide rules restricting gifts fromoutside sources and that they are a person that can be “substantially affected by the performance or non-performance”of Dr. Fauci’s duties.  As a result, we are unable to change our prior determination that he cannot accept the $40,000 cashgift associated with the Lienhard Award. Please let us know if you have any questions.  Gretchen H. Weaver, J.D.Supervisory/Senior NIH Ethics CounselDHHS/OGC/Ethics Divisionphone: fax:  NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Weaver, Gretchen (NIH/OD) [E]Sent: Tuesday, February 16, 2021 10:46 AMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Released by Chairman Rand Paul\nCc: Jaffe, Holli Beckerman (NIH/OD) [E] <@OD.NIH.GOV>; Hall, Randall (HHS/OGC) (@hhs.gov)<@hhs.gov>Subject: RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Dr. Tabak: Good morning.  As a quick update on the status of this item, Randy and I talked and we have forwarded your note to OGEwith a request that they consider the questions presented.  We will keep you apprised of what we hear.  That said, wehave no idea when to expect a response given that OGE is heavily involved in working to bring the Biden team memberson board across the entire Executive Branch.  We will, however, be checking in. I am not turning to focus on the Dan David Prize. Best, Gretchen Gretchen H. Weaver, J.D.Supervisory/Senior NIH Ethics CounselDHHS/OGC/Ethics Divisionphone: fax:  NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Friday, February 5, 2021 5:51 AMTo: Hall, Randall (HHS/OGC) <@HHS.GOV>Cc: Weaver, Gretchen (NIH/OD) [E] <@od.nih.gov>; Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Subject: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Mr. Hall, I write to request your concurrence that the exception to the gift prohibition at section 2635.204(d) does not prohibit Dr.Anthony Fauci from accepting the cash prize associated with the National Academy of Medicine’s (NAM) 2020 Gustav O.Lienhard Award.  Specifically, I ask you to find that: 1) the National Academies of Sciences (NAS), the umbrellaorganization under which NAM was established, is not a “person” under the regulations, and similarly, neither is NAM; or2) if NAS is a “person,” NAM and NAS are different “persons” because of NAM’s independence from NAS; and/or 3) NAS isnot a “person who can be substantially affected by the performance or nonperformance of [Dr. Fauci’s NIH] duties.”  If youdo not concur, I ask that you forward this discussion to the Office of Government Ethics for their consideration anddetermination of the applicability of the gift rule to the NAM Lienhard Award. As you likely know, Dr. Fauci is the Director of the National Institute of Allergy and Infectious Diseases (NIAID).  He wasawarded the Lienhard award from NAM on October 19, 2020.  The Lienhard award – a medal and $40,000 – recognizesindividuals for outstanding achievement in improving health care services in the United States.  NIAID currently funds twoCongressionally-mandated studies as well as six other projects including an Action Collaborative, a Board, two Forums anda Roundtable.  NIAID contributes to the latter projects typically as one of several NIH Institutes and Centers.  It is ourReleased by Chairman Rand Paul\nunderstanding that due to a restructuring of NAS, all the business interactions between the Academies and Federalagencies go through NAS.  Thus, NIAID has no current financial, contractual, or similar dealings with NAM.  In order for Dr. Fauci to accept the cash prize, we reviewed the exception to the gift rules for meritorious public service orachievement at section 2635.204(d) (emphasis added): (1) An employee may accept a bona fide award for meritorious public service or achievement and any itemincident to the award, provided that: (i) The award and any item incident to the award are not from a person who has interests that may besubstantially affected by the performance or nonperformance of the employee's official duties, or froman association or other organization if a majority of its members have such interests; The definition of “person” is found at section 2635.102(k) and is:  (k) Person means an individual, corporation and subsidiaries it controls, company, association, firm, partnership,society, joint stock company, or any other organization or institution, including any officer, employee, or agent ofsuch person or entity. For purposes of this part, a corporation will be deemed to control a subsidiary if it owns 50percent or more of the subsidiary's voting securities. The term is all-inclusive and applies to commercial venturesand nonprofit organizations as well as to foreign, State, and local governments, including the Government of theDistrict of Columbia. It does not include any agency or other entity of the Federal Government or any officer oremployee thereof when acting in his official capacity on behalf of that agency or entity. The “National Academy of Sciences (in this chapter, the “corporation”) is a federally chartered corporation.”  36 USC §150301.  Pursuant to its Mission statement, NAS “is a private, non-profit society [and is] charged with providingindependent, objective advice to the nation on matters related to science and technology.”  The Act to Incorporate theNational Academy of Sciences (aka the Academy Charter) states “the Academy shall, whenever called upon by anydepartment of the Government, investigate, examine, experiment, and report upon any subject of science or art . . . .” Academy Charter at §3. While a corporation is a “person” under section 2635.102(k), I argue that the type of corporationthat NAS is – a federally chartered corporation, with its exceptional mission to advise the Federal Government – is not thetype of corporation that OGE intended to include in the definition.  First, OGE could have, but did not include in thedefinition of “person” any discussion of federally chartered corporations, perhaps because of their uniqueness.  And it’sthis uniqueness which makes the application of section 2635.204(d) unnecessary.  NIAID works with NAS because it isdirected to do so by Congress and because NAS offers NIAID an expertise that cannot be found elsewhere.  NAM did not“return the favor” to NIAID when it selected Dr. Fauci as its 2021 Lienhard awardee.  Its relationship with NIAID is rootedin legislation and will continue regardless of an unrelated award to NIAID’s Director. Last, OGE stated that “[‘person’] doesnot include any agency or other entity of the Federal Government . . . .”  I concede that NAS is not a part of the FederalGovernment.  However, in 1997, Congress amended the Federal Advisory Committee Act (FACA) to include the NationalAcademy of Sciences under some of FACA’s provisions.  See Congressional Research Service report, CongressionallyChartered Nonprofit Organizations (\"Title 36 Corporations\"): What They Are and How Congress Treats Them (July 14,2008).  There, CSR noted that the FACA amendment was: [T]he first instance in which Congress has made [federally chartered corporations] subject to the provisions of ageneral management law, and while the action may be supportable on public policy grounds, it does, to theextent of the applicable provisions, diminish the private character of the affected organizations.  As such, itconstitutes a precedent with implications. CSR Report at 7.  FACA’s partial application to NAS further supports viewing NAS as a different kind of corporate entity thatis outside of the regulatory definition of “person.”  Therefore, if NAS is not a “person,” NAS’ non-person status extends toNAM, an entity established under NAS’ charter.  Consequently, the pending NIAID-NAS matters do not make a gift fromNAM a prohibited gift for Dr. Fauci under the applicable regulations.   In the alternative, if you find NAS to be a “person” under 2635.102(k), then you should not find it to be the same “person”as NAM.  Even though NAM was established in 1970 under the charter of the National Academy of Sciences, the definitionReleased by Chairman Rand Paul\nof “person” supports a finding that NAM is not a subsidiary of corporate parent NAS.  The regulation explains that “forpurposes of [Part 2635], a corporation will be deemed to control a subsidiary if it owns 50 percent or more of thesubsidiary's voting securities.”  NAM does not issue voting securities, so NAS cannot control such securities; accordingly,NAM is not a subsidiary of NAS, but rather an independent entity.  Furthermore, pursuant to NAM’s Articles ofOrganization (AoO), adopted May 19, 2015 (copy attached), “the governance of [NAM] shall reside in the President andCouncil to be elected from among the membership,” AoO Art. III, § 1, “NAM shall be solely responsible for the content ofreports on projects that it undertakes, and such reports may be issued in its own name.”  AoO Art. VI, § 2.  NAM’sgoverning documents repeatedly show NAM’s independence from NAS.  Last, NAM’s AoO gives it its own authority toestablish awards.  AoO Art. V.  Thus, the Lienhard award and its associated cash prize are from NAM and NIAID’scommissioned studies and other projects from NAS do not make the award an impermissible gift under section2635.204(d).    Finally, if NAS and NAM are a “person,” then they are not persons who are substantially affected by the performance ornonperformance of Dr. Fauci’s duties because both “compensation” in NAS’ charter as well as “substantially” in section2635.204(d) must have meaning.  NAS’ charter states:  “[NAS] shall receive no compensation whatever for any services tothe Government of the United States.”  This is consistent with NAS’ status as a not-for-profit entity. NAS’ charter wascodified in Title 36 at Sections 150301-150304, and Section 150303 reiterates that NAS “may not receive compensationfor services to the Government, but the actual expense of the investigation, examination, experimentation, and reportshall be paid by the Government from an appropriation for that purpose.”  If the statutory language means that NAScannot receive any compensation for its investigations, examinations, experiments or reports commissioned by Federalagencies, but rather only reimbursement of expenses, then NAS is not substantially affected by NIAID’s projects. Furthermore, two of NIAID’s projects with NAS were mandated by Congress.  One project was started by another NIHInstitute which NIAID later joined.  Other collaborations were formed at the agency or department level, and not from thedirect action of NIAID.  Most importantly, every NAS project in which NIAID is involved is a large-scale project withnumerous members.  Being one of many means that NIAID’s proportional contribution does not affect NAS substantially. For all of these reasons, Dr. Fauci would not be accepting an award from a person (NAS and/or NAM) who has interestthat may be substantially affected by the performance or nonperformance of his official duties.  For the reasons provided above, a finding should be made that Dr. Fauci may accept the Lienhard Award and the cashprize associated with it from NAM.  If you have any questions, please contact Holli Beckerman Jaffe, cc’d above. Thank you for your consideration. With best wishes,Larry Lawrence A. Tabak, DDS, PhDPrincipal Deputy Director, NIHDeputy Ethics Counselor, NIHReleased by Chairman Rand Paul\nFrom:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>To:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Cc:\"Schwetz, Tara (NIH/OD) [E]\" < @nih.gov>Subject:RE: Request for concurrence -Gustav O. Lienhard Award -A. FauciDate:Mon, 22 Feb 2021 16:03:11 -0500Importance:NormalI asked before I wrote you.  No good news, but no bad news either.  Gretchen reviewed the Dan David package and hassome follow up questions about the events surrounding the prize, i.e., award ceremony and symposia.  If they are the sameas in past years (likely yes except this year’s events will be virtual), then approval should be forthcoming.  From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Monday, February 22, 2021 3:57 PMTo: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Cc: Schwetz, Tara (NIH/OD) [E] <@nih.gov>Subject: Re: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Yes please.Have we received any good news to temper this with? From: \"Jaffe, Holli Beckerman (NIH/OD) [E]\" <@od.nih.gov>Date: Monday, February 22, 2021 at 3:41 PMTo: \"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Cc: \"Schwetz, Tara (NIH/OD) [E]\" <@nih.gov>Subject: FW: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Gretchen shared that OGE disagreed with our argument, and upheld OGC’s determination that Tony cannot receive thecash prize associated with NAM award.  Do you want me to draft an email to Tony for you? From: Weaver, Gretchen (NIH/OD) [E] <@od.nih.gov>Sent: Monday, February 22, 2021 3:27 PMTo: Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Subject: FW: Request for concurrence -Gustav O. Lienhard Award -A. Fauci My apologies; I thought you were copied on Randy’s note to Larry.  Please see below.  I am forwarding the string thatwent. Let me know if you have any questions. Thanks, Gretchen Gretchen H. Weaver, J.D.Supervisory/Senior NIH Ethics CounselDHHS/OGC/Ethics Divisionphone: fax:  Released by Chairman Rand Paul\nNOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Hall, Randall (HHS/OGC) <@hhs.gov>Sent: Thursday, February 18, 2021 4:47 PMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Cc: Weaver, Gretchen (NIH/OD) [E] <@od.nih.gov>Subject: RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Dr. Tabak: Good afternoon.  This is to let you know that OGE has responded to our request to consider whether the gift ruleexception for awards applies in the case of the Lienhard Award the NAM presented to Dr. Fauci.  Unfortunately, OGE hasconcluded that the NASEM/NAM is/are a “person” under the government-wide rules restricting gifts from outside sourcesand that they are a person that can be “substantially affected by the performance or non-performance” of Dr. Fauci’sduties.  As a result, we are unable to change our prior determination that he cannot accept the $40,000 cash giftassociated with the Lienhard Award. Please let us know if you have any questions. Randy Randall J. HallActing Associate General Counsel for EthicsAlternate Designated Agency Ethics OfficialEthics DivisionDepartment of Health and Human Services NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Weaver, Gretchen (NIH/OD) [E]Sent: Tuesday, February 16, 2021 10:46 AMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Cc: Jaffe, Holli Beckerman (NIH/OD) [E] <@OD.NIH.GOV>; Hall, Randall (HHS/OGC) (@hhs.gov)<@hhs.gov>Subject: RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Dr. Tabak: Good morning.  As a quick update on the status of this item, Randy and I talked and we have forwarded your note to OGEwith a request that they consider the questions presented.  We will keep you apprised of what we hear.  That said, weReleased by Chairman Rand Paul\nhave no idea when to expect a response given that OGE is heavily involved in working to bring the Biden team memberson board across the entire Executive Branch.  We will, however, be checking in. I am now turning to focus on the Dan David Prize. Best, Gretchen Gretchen H. Weaver, J.D.Supervisory/Senior NIH Ethics CounselDHHS/OGC/Ethics Divisionphone: fax:  NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Friday, February 5, 2021 5:51 AMTo: Hall, Randall (HHS/OGC) <@HHS.GOV>Cc: Weaver, Gretchen (NIH/OD) [E] <@od.nih.gov>; Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Subject: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Mr. Hall, I write to request your concurrence that the exception to the gift prohibition at section 2635.204(d) does not prohibit Dr.Anthony Fauci from accepting the cash prize associated with the National Academy of Medicine’s (NAM) 2020 Gustav O.Lienhard Award.  Specifically, I ask you to find that: 1) the National Academies of Sciences (NAS), the umbrellaorganization under which NAM was established, is not a “person” under the regulations, and similarly, neither is NAM; or2) if NAS is a “person,” NAM and NAS are different “persons” because of NAM’s independence from NAS; and/or 3) NAS isnot a “person who can be substantially affected by the performance or nonperformance of [Dr. Fauci’s NIH] duties.”  If youdo not concur, I ask that you forward this discussion to the Office of Government Ethics for their consideration anddetermination of the applicability of the gift rule to the NAM Lienhard Award. As you likely know, Dr. Fauci is the Director of the National Institute of Allergy and Infectious Diseases (NIAID).  He wasawarded the Lienhard award from NAM on October 19, 2020.  The Lienhard award – a medal and $40,000 – recognizesindividuals for outstanding achievement in improving health care services in the United States.  NIAID currently funds twoCongressionally-mandated studies as well as six other projects including an Action Collaborative, a Board, two Forums anda Roundtable.  NIAID contributes to the latter projects typically as one of several NIH Institutes and Centers.  It is ourunderstanding that due to a restructuring of NAS, all the business interactions between the Academies and Federalagencies go through NAS.  Thus, NIAID has no current financial, contractual, or similar dealings with NAM.  In order for Dr. Fauci to accept the cash prize, we reviewed the exception to the gift rules for meritorious public service orachievement at section 2635.204(d) (emphasis added): (1) An employee may accept a bona fide award for meritorious public service or achievement and any itemincident to the award, provided that:Released by Chairman Rand Paul\n (i) The award and any item incident to the award are not from a person who has interests that may besubstantially affected by the performance or nonperformance of the employee's official duties, or froman association or other organization if a majority of its members have such interests; The definition of “person” is found at section 2635.102(k) and is:  (k) Person means an individual, corporation and subsidiaries it controls, company, association, firm, partnership,society, joint stock company, or any other organization or institution, including any officer, employee, or agent ofsuch person or entity. For purposes of this part, a corporation will be deemed to control a subsidiary if it owns 50percent or more of the subsidiary's voting securities. The term is all-inclusive and applies to commercial venturesand nonprofit organizations as well as to foreign, State, and local governments, including the Government of theDistrict of Columbia. It does not include any agency or other entity of the Federal Government or any officer oremployee thereof when acting in his official capacity on behalf of that agency or entity. The “National Academy of Sciences (in this chapter, the “corporation”) is a federally chartered corporation.”  36 USC §150301.  Pursuant to its Mission statement, NAS “is a private, non-profit society [and is] charged with providingindependent, objective advice to the nation on matters related to science and technology.”  The Act to Incorporate theNational Academy of Sciences (aka the Academy Charter) states “the Academy shall, whenever called upon by anydepartment of the Government, investigate, examine, experiment, and report upon any subject of science or art . . . .” Academy Charter at §3. While a corporation is a “person” under section 2635.102(k), I argue that the type of corporationthat NAS is – a federally chartered corporation, with its exceptional mission to advise the Federal Government – is not thetype of corporation that OGE intended to include in the definition.  First, OGE could have, but did not include in thedefinition of “person” any discussion of federally chartered corporations, perhaps because of their uniqueness.  And it’sthis uniqueness which makes the application of section 2635.204(d) unnecessary.  NIAID works with NAS because it isdirected to do so by Congress and because NAS offers NIAID an expertise that cannot be found elsewhere.  NAM did not“return the favor” to NIAID when it selected Dr. Fauci as its 2021 Lienhard awardee.  Its relationship with NIAID is rootedin legislation and will continue regardless of an unrelated award to NIAID’s Director. Last, OGE stated that “[‘person’] doesnot include any agency or other entity of the Federal Government . . . .”  I concede that NAS is not a part of the FederalGovernment.  However, in 1997, Congress amended the Federal Advisory Committee Act (FACA) to include the NationalAcademy of Sciences under some of FACA’s provisions.  See Congressional Research Service report, CongressionallyChartered Nonprofit Organizations (\"Title 36 Corporations\"): What They Are and How Congress Treats Them (July 14,2008).  There, CSR noted that the FACA amendment was: [T]he first instance in which Congress has made [federally chartered corporations] subject to the provisions of ageneral management law, and while the action may be supportable on public policy grounds, it does, to theextent of the applicable provisions, diminish the private character of the affected organizations.  As such, itconstitutes a precedent with implications. CSR Report at 7.  FACA’s partial application to NAS further supports viewing NAS as a different kind of corporate entity thatis outside of the regulatory definition of “person.”  Therefore, if NAS is not a “person,” NAS’ non-person status extends toNAM, an entity established under NAS’ charter.  Consequently, the pending NIAID-NAS matters do not make a gift fromNAM a prohibited gift for Dr. Fauci under the applicable regulations.   In the alternative, if you find NAS to be a “person” under 2635.102(k), then you should not find it to be the same “person”as NAM.  Even though NAM was established in 1970 under the charter of the National Academy of Sciences, the definitionof “person” supports a finding that NAM is not a subsidiary of corporate parent NAS.  The regulation explains that “forpurposes of [Part 2635], a corporation will be deemed to control a subsidiary if it owns 50 percent or more of thesubsidiary's voting securities.”  NAM does not issue voting securities, so NAS cannot control such securities; accordingly,NAM is not a subsidiary of NAS, but rather an independent entity.  Furthermore, pursuant to NAM’s Articles ofOrganization (AoO), adopted May 19, 2015 (copy attached), “the governance of [NAM] shall reside in the President andCouncil to be elected from among the membership,” AoO Art. III, § 1, “NAM shall be solely responsible for the content ofreports on projects that it undertakes, and such reports may be issued in its own name.”  AoO Art. VI, § 2.  NAM’sgoverning documents repeatedly show NAM’s independence from NAS.  Last, NAM’s AoO gives it its own authority toReleased by Chairman Rand Paul\nestablish awards.  AoO Art. V.  Thus, the Lienhard award and its associated cash prize are from NAM and NIAID’scommissioned studies and other projects from NAS do not make the award an impermissible gift under section2635.204(d).    Finally, if NAS and NAM are a “person,” then they are not persons who are substantially affected by the performance ornonperformance of Dr. Fauci’s duties because both “compensation” in NAS’ charter as well as “substantially” in section2635.204(d) must have meaning.  NAS’ charter states:  “[NAS] shall receive no compensation whatever for any services tothe Government of the United States.”  This is consistent with NAS’ status as a not-for-profit entity. NAS’ charter wascodified in Title 36 at Sections 150301-150304, and Section 150303 reiterates that NAS “may not receive compensationfor services to the Government, but the actual expense of the investigation, examination, experimentation, and reportshall be paid by the Government from an appropriation for that purpose.”  If the statutory language means that NAScannot receive any compensation for its investigations, examinations, experiments or reports commissioned by Federalagencies, but rather only reimbursement of expenses, then NAS is not substantially affected by NIAID’s projects. Furthermore, two of NIAID’s projects with NAS were mandated by Congress.  One project was started by another NIHInstitute which NIAID later joined.  Other collaborations were formed at the agency or department level, and not from thedirect action of NIAID.  Most importantly, every NAS project in which NIAID is involved is a large-scale project withnumerous members.  Being one of many means that NIAID’s proportional contribution does not affect NAS substantially. For all of these reasons, Dr. Fauci would not be accepting an award from a person (NAS and/or NAM) who has interestthat may be substantially affected by the performance or nonperformance of his official duties.  For the reasons provided above, a finding should be made that Dr. Fauci may accept the Lienhard Award and the cashprize associated with it from NAM.  If you have any questions, please contact Holli Beckerman Jaffe, cc’d above. Thank you for your consideration. With best wishes,Larry Lawrence A. Tabak, DDS, PhDPrincipal Deputy Director, NIHDeputy Ethics Counselor, NIHReleased by Chairman Rand Paul\nFrom:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>To:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Cc:\"Schwetz, Tara (NIH/OD) [E]\" < @nih.gov>Subject:FW: Request for concurrence -Gustav O. Lienhard Award -A. FauciDate:Tue, 23 Feb 2021 10:43:34 -0500Importance:NormalHad you sent Tony a copy of the request to OGE?  If not, do you think it is worth sharing it with him now?  While it wasn’tsuccessful, it was a big and difficult effort.  Perhaps he’ll appreciate it.  I suggested language with and without forwardingyour email to Randy. Tony, I write to inform you of the final decision regarding the cash prize associated with NAM’s Lienhard Award.  Unfortunately,we were not successful in our appeal.  While you can accept the honor of being named the 2020 Lienhard awardee, youmay not receive the cash.  1)  For you information, below is the lengthy and detailed argument . . .  or 2) We presented alengthy and detailed argument first to HHS’s Office of the General Counsel (OGC) and then to the independent US Officeof Government Ethics (OGE) to persuade them that NAM’s relationship with Government agencies is unique, and thus, anaward from NAM should be viewed differently than one bestowed by other non-profit corporations.  However, neitherOGC nor OGE felt it was necessary to change their previous determination regarding NAM so that you would be permittedto accept the cash prize under the applicable regulations.  I’m disappointed that we did not get a different decision.  You are deserving of the additional recognition. LAT From: Hall, Randall (HHS/OGC) <@hhs.gov>Sent: Thursday, February 18, 2021 4:47 PMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Cc: Weaver, Gretchen (NIH/OD) [E] <@od.nih.gov>Subject: RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Dr. Tabak: Good afternoon.  This is to let you know that OGE has responded to our request to consider whether the gift ruleexception for awards applies in the case of the Lienhard Award the NAM presented to Dr. Fauci.  Unfortunately, OGE hasconcluded that the NASEM/NAM is/are a “person” under the government-wide rules restricting gifts from outside sourcesand that they are a person that can be “substantially affected by the performance or non-performance” of Dr. Fauci’sduties.  As a result, we are unable to change our prior determination that he cannot accept the $40,000 cash giftassociated with the Lienhard Award. Please let us know if you have any questions. Randy Randall J. HallActing Associate General Counsel for EthicsAlternate Designated Agency Ethics OfficialEthics DivisionDepartment of Health and Human Services Released by Chairman Rand Paul\nNOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Weaver, Gretchen (NIH/OD) [E]Sent: Tuesday, February 16, 2021 10:46 AMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Cc: Jaffe, Holli Beckerman (NIH/OD) [E] <@OD.NIH.GOV>; Hall, Randall (HHS/OGC) (@hhs.gov)<@hhs.gov>Subject: RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Dr. Tabak: Good morning.  As a quick update on the status of this item, Randy and I talked and we have forwarded your note to OGEwith a request that they consider the questions presented.  We will keep you apprised of what we hear.  That said, wehave no idea when to expect a response given that OGE is heavily involved in working to bring the Biden team memberson board across the entire Executive Branch.  We will, however, be checking in. I am not turning to focus on the Dan David Prize. Best, Gretchen Gretchen H. Weaver, J.D.Supervisory/Senior NIH Ethics CounselDHHS/OGC/Ethics Divisionphone: fax:  NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Friday, February 5, 2021 5:51 AMTo: Hall, Randall (HHS/OGC) <@HHS.GOV>Cc: Weaver, Gretchen (NIH/OD) [E] <@od.nih.gov>; Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Subject: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Mr. Hall, I write to request your concurrence that the exception to the gift prohibition at section 2635.204(d) does not prohibit Dr.Anthony Fauci from accepting the cash prize associated with the National Academy of Medicine’s (NAM) 2020 Gustav O.Released by Chairman Rand Paul\nLienhard Award.  Specifically, I ask you to find that: 1) the National Academies of Sciences (NAS), the umbrellaorganization under which NAM was established, is not a “person” under the regulations, and similarly, neither is NAM; or2) if NAS is a “person,” NAM and NAS are different “persons” because of NAM’s independence from NAS; and/or 3) NAS isnot a “person who can be substantially affected by the performance or nonperformance of [Dr. Fauci’s NIH] duties.”  If youdo not concur, I ask that you forward this discussion to the Office of Government Ethics for their consideration anddetermination of the applicability of the gift rule to the NAM Lienhard Award. As you likely know, Dr. Fauci is the Director of the National Institute of Allergy and Infectious Diseases (NIAID).  He wasawarded the Lienhard award from NAM on October 19, 2020.  The Lienhard award – a medal and $40,000 – recognizesindividuals for outstanding achievement in improving health care services in the United States.  NIAID currently funds twoCongressionally-mandated studies as well as six other projects including an Action Collaborative, a Board, two Forums anda Roundtable.  NIAID contributes to the latter projects typically as one of several NIH Institutes and Centers.  It is ourunderstanding that due to a restructuring of NAS, all the business interactions between the Academies and Federalagencies go through NAS.  Thus, NIAID has no current financial, contractual, or similar dealings with NAM.  In order for Dr. Fauci to accept the cash prize, we reviewed the exception to the gift rules for meritorious public service orachievement at section 2635.204(d) (emphasis added): (1) An employee may accept a bona fide award for meritorious public service or achievement and any itemincident to the award, provided that: (i) The award and any item incident to the award are not from a person who has interests that may besubstantially affected by the performance or nonperformance of the employee's official duties, or froman association or other organization if a majority of its members have such interests; The definition of “person” is found at section 2635.102(k) and is:  (k) Person means an individual, corporation and subsidiaries it controls, company, association, firm, partnership,society, joint stock company, or any other organization or institution, including any officer, employee, or agent ofsuch person or entity. For purposes of this part, a corporation will be deemed to control a subsidiary if it owns 50percent or more of the subsidiary's voting securities. The term is all-inclusive and applies to commercial venturesand nonprofit organizations as well as to foreign, State, and local governments, including the Government of theDistrict of Columbia. It does not include any agency or other entity of the Federal Government or any officer oremployee thereof when acting in his official capacity on behalf of that agency or entity. The “National Academy of Sciences (in this chapter, the “corporation”) is a federally chartered corporation.”  36 USC §150301.  Pursuant to its Mission statement, NAS “is a private, non-profit society [and is] charged with providingindependent, objective advice to the nation on matters related to science and technology.”  The Act to Incorporate theNational Academy of Sciences (aka the Academy Charter) states “the Academy shall, whenever called upon by anydepartment of the Government, investigate, examine, experiment, and report upon any subject of science or art . . . .” Academy Charter at §3. While a corporation is a “person” under section 2635.102(k), I argue that the type of corporationthat NAS is – a federally chartered corporation, with its exceptional mission to advise the Federal Government – is not thetype of corporation that OGE intended to include in the definition.  First, OGE could have, but did not include in thedefinition of “person” any discussion of federally chartered corporations, perhaps because of their uniqueness.  And it’sthis uniqueness which makes the application of section 2635.204(d) unnecessary.  NIAID works with NAS because it isdirected to do so by Congress and because NAS offers NIAID an expertise that cannot be found elsewhere.  NAM did not“return the favor” to NIAID when it selected Dr. Fauci as its 2021 Lienhard awardee.  Its relationship with NIAID is rootedin legislation and will continue regardless of an unrelated award to NIAID’s Director. Last, OGE stated that “[‘person’] doesnot include any agency or other entity of the Federal Government . . . .”  I concede that NAS is not a part of the FederalGovernment.  However, in 1997, Congress amended the Federal Advisory Committee Act (FACA) to include the NationalAcademy of Sciences under some of FACA’s provisions.  See Congressional Research Service report, CongressionallyChartered Nonprofit Organizations (\"Title 36 Corporations\"): What They Are and How Congress Treats Them (July 14,2008).  There, CSR noted that the FACA amendment was: Released by Chairman Rand Paul\n[T]he first instance in which Congress has made [federally chartered corporations] subject to the provisions of ageneral management law, and while the action may be supportable on public policy grounds, it does, to theextent of the applicable provisions, diminish the private character of the affected organizations.  As such, itconstitutes a precedent with implications. CSR Report at 7.  FACA’s partial application to NAS further supports viewing NAS as a different kind of corporate entity thatis outside of the regulatory definition of “person.”  Therefore, if NAS is not a “person,” NAS’ non-person status extends toNAM, an entity established under NAS’ charter.  Consequently, the pending NIAID-NAS matters do not make a gift fromNAM a prohibited gift for Dr. Fauci under the applicable regulations.   In the alternative, if you find NAS to be a “person” under 2635.102(k), then you should not find it to be the same “person”as NAM.  Even though NAM was established in 1970 under the charter of the National Academy of Sciences, the definitionof “person” supports a finding that NAM is not a subsidiary of corporate parent NAS.  The regulation explains that “forpurposes of [Part 2635], a corporation will be deemed to control a subsidiary if it owns 50 percent or more of thesubsidiary's voting securities.”  NAM does not issue voting securities, so NAS cannot control such securities; accordingly,NAM is not a subsidiary of NAS, but rather an independent entity.  Furthermore, pursuant to NAM’s Articles ofOrganization (AoO), adopted May 19, 2015 (copy attached), “the governance of [NAM] shall reside in the President andCouncil to be elected from among the membership,” AoO Art. III, § 1, “NAM shall be solely responsible for the content ofreports on projects that it undertakes, and such reports may be issued in its own name.”  AoO Art. VI, § 2.  NAM’sgoverning documents repeatedly show NAM’s independence from NAS.  Last, NAM’s AoO gives it its own authority toestablish awards.  AoO Art. V.  Thus, the Lienhard award and its associated cash prize are from NAM and NIAID’scommissioned studies and other projects from NAS do not make the award an impermissible gift under section2635.204(d).    Finally, if NAS and NAM are a “person,” then they are not persons who are substantially affected by the performance ornonperformance of Dr. Fauci’s duties because both “compensation” in NAS’ charter as well as “substantially” in section2635.204(d) must have meaning.  NAS’ charter states:  “[NAS] shall receive no compensation whatever for any services tothe Government of the United States.”  This is consistent with NAS’ status as a not-for-profit entity. NAS’ charter wascodified in Title 36 at Sections 150301-150304, and Section 150303 reiterates that NAS “may not receive compensationfor services to the Government, but the actual expense of the investigation, examination, experimentation, and reportshall be paid by the Government from an appropriation for that purpose.”  If the statutory language means that NAScannot receive any compensation for its investigations, examinations, experiments or reports commissioned by Federalagencies, but rather only reimbursement of expenses, then NAS is not substantially affected by NIAID’s projects. Furthermore, two of NIAID’s projects with NAS were mandated by Congress.  One project was started by another NIHInstitute which NIAID later joined.  Other collaborations were formed at the agency or department level, and not from thedirect action of NIAID.  Most importantly, every NAS project in which NIAID is involved is a large-scale project withnumerous members.  Being one of many means that NIAID’s proportional contribution does not affect NAS substantially. For all of these reasons, Dr. Fauci would not be accepting an award from a person (NAS and/or NAM) who has interestthat may be substantially affected by the performance or nonperformance of his official duties.  For the reasons provided above, a finding should be made that Dr. Fauci may accept the Lienhard Award and the cashprize associated with it from NAM.  If you have any questions, please contact Holli Beckerman Jaffe, cc’d above. Thank you for your consideration. With best wishes,Larry Lawrence A. Tabak, DDS, PhDPrincipal Deputy Director, NIHDeputy Ethics Counselor, NIHReleased by Chairman Rand Paul\nFrom:\"Tabak, Lawrence (NIH/OD) [E]\" < @nih.gov>To:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>Subject:Re: Dan David Prize winners include Fauci and RosenbergDate:Tue, 16 Feb 2021 08:58:30 -0500Importance:NormalOk - thanks From: \"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>Date: Tuesday, February 16, 2021 at 8:36 AMTo: \"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Subject: RE: Dan David Prize winners include Fauci and Rosenberg The first I heard about Steve’s selection was when I checked the website last evening for Tony’s announcement.  I wroteNCI Ethics and they knew about it from Steve but had not yet filed an award form.  They will do so shortly. From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Tuesday, February 16, 2021 7:33 AMTo: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Subject: FW: Dan David Prize winners include Fauci and Rosenberg So did we know about Rosenberg’s award? From: \"Gottesman, Michael (NIH/OD) [E]\" <@mail.nih.gov>Date: Tuesday, February 16, 2021 at 7:23 AMTo: Francis Collins <@od.nih.gov>, NIH Director's Executive Committee <@mail.nih.gov>Subject: Re: Dan David Prize winners include Fauci and Rosenberg Wow!  A twofer. Michael  From: \"Collins, Francis (NIH/OD) [E]\" <@od.nih.gov>Date: Tuesday, February 16, 2021 at 6:12:50 AMTo: \"NIH Director's Executive Committee\" <@mail.nih.gov>Subject: Dan David Prize winners include Fauci and Rosenberg https://apnews.com/article/joe-biden-donald-trump-science-pandemics-israel-25c3a68083ce77652a4330e944cced73Released by Chairman Rand Paul\nFrom:\"Tabak, Lawrence (NIH/OD) [E]\" < @nih.gov>To:Francis Collins < @od.nih.gov>Bcc:\"Schwetz, Tara (NIH/OD) [E]\" < @nih.gov>Subject:FW: Decision on Gustav O. Lienhard AwardDate:Tue, 23 Feb 2021 22:08:07 -0500Importance:NormalFyi; I don’t think Tony will raise the issue, but just in case. We went all out, and failed…Larry From: Anthony Fauci < @niaid.nih.gov>Date: Tuesday, February 23, 2021 at 10:06 PMTo: \"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Cc: \"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>Subject: RE: Decision on Gustav O. Lienhard Award Larry:   Many thanks to you and Holli for trying so hard on my behalf.   It is much appreciated.Best regards,Tony From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Tuesday, February 23, 2021 1:54 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Subject: Decision on Gustav O. Lienhard Award Tony, With much credit to Holli, we presented a detailed argument first to HHS’s Office of the General Counsel (OGC) (pastedbelow, reading bottom up) and then to the independent US Office of Government Ethics (OGE) to try to persuade themthat NAM’s relationship with Government agencies is unique, and thus, an award from NAM should be viewed differentlythan one bestowed by other non-profit corporations. Unfortunately, neither OGC nor OGE was convinced to change theirprevious determination regarding NAM so that you would be permitted to accept the cash prize under the applicableregulations.  I am very disappointed that we did not get a different decision. You are most deserving of the additional recognition. Larry From: Hall, Randall (HHS/OGC) <@hhs.gov>Sent: Thursday, February 18, 2021 4:47 PMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Cc: Weaver, Gretchen (NIH/OD) [E] <@od.nih.gov>Subject: RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Dr. Tabak: Released by Chairman Rand Paul\nGood afternoon.  This is to let you know that OGE has responded to our request to consider whether the gift ruleexception for awards applies in the case of the Lienhard Award the NAM presented to Dr. Fauci.  Unfortunately, OGE hasconcluded that the NASEM/NAM is/are a “person” under the government-wide rules restricting gifts from outside sourcesand that they are a person that can be “substantially affected by the performance or non-performance” of Dr. Fauci’sduties.  As a result, we are unable to change our prior determination that he cannot accept the $40,000 cash giftassociated with the Lienhard Award. Please let us know if you have any questions. Randy Randall J. HallActing Associate General Counsel for EthicsAlternate Designated Agency Ethics OfficialEthics DivisionDepartment of Health and Human Services NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Weaver, Gretchen (NIH/OD) [E]Sent: Tuesday, February 16, 2021 10:46 AMTo: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Cc: Jaffe, Holli Beckerman (NIH/OD) [E] <@OD.NIH.GOV>; Hall, Randall (HHS/OGC) (@hhs.gov)<@hhs.gov>Subject: RE: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Dr. Tabak: Good morning.  As a quick update on the status of this item, Randy and I talked and we have forwarded your note to OGEwith a request that they consider the questions presented.  We will keep you apprised of what we hear.  That said, wehave no idea when to expect a response given that OGE is heavily involved in working to bring the Biden team memberson board across the entire Executive Branch.  We will, however, be checking in. I am not turning to focus on the Dan David Prize. Best, Gretchen Gretchen H. Weaver, J.D.Supervisory/Senior NIH Ethics CounselDHHS/OGC/Ethics Divisionphone: fax:  NOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE USE OF THE RECIPIENT(S)NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD NOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES. Released by Chairman Rand Paul\nIF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR,PLEASE NOTIFY THE SENDER IMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERALETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON THE PRIOR ADVICE OF ANYAGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT CIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLYSUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND RELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL ININTERPRETING THE SCOPE OF SUCH STATUTES IS A FACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIALDISCRETION.  EMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY ATTORNEY-CLIENTPRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO THE OFFICE OF THE INSPECTOR GENERAL. From: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Sent: Friday, February 5, 2021 5:51 AMTo: Hall, Randall (HHS/OGC) <@HHS.GOV>Cc: Weaver, Gretchen (NIH/OD) [E] @od.nih.gov>; Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Subject: Request for concurrence -Gustav O. Lienhard Award -A. Fauci Mr. Hall, I write to request your concurrence that the exception to the gift prohibition at section 2635.204(d) does not prohibit Dr.Anthony Fauci from accepting the cash prize associated with the National Academy of Medicine’s (NAM) 2020 Gustav O.Lienhard Award.  Specifically, I ask you to find that: 1) the National Academies of Sciences (NAS), the umbrellaorganization under which NAM was established, is not a “person” under the regulations, and similarly, neither is NAM; or2) if NAS is a “person,” NAM and NAS are different “persons” because of NAM’s independence from NAS; and/or 3) NAS isnot a “person who can be substantially affected by the performance or nonperformance of [Dr. Fauci’s NIH] duties.”  If youdo not concur, I ask that you forward this discussion to the Office of Government Ethics for their consideration anddetermination of the applicability of the gift rule to the NAM Lienhard Award. As you likely know, Dr. Fauci is the Director of the National Institute of Allergy and Infectious Diseases (NIAID).  He wasawarded the Lienhard award from NAM on October 19, 2020.  The Lienhard award – a medal and $40,000 – recognizesindividuals for outstanding achievement in improving health care services in the United States.  NIAID currently funds twoCongressionally-mandated studies as well as six other projects including an Action Collaborative, a Board, two Forums anda Roundtable.  NIAID contributes to the latter projects typically as one of several NIH Institutes and Centers.  It is ourunderstanding that due to a restructuring of NAS, all the business interactions between the Academies and Federalagencies go through NAS.  Thus, NIAID has no current financial, contractual, or similar dealings with NAM.  In order for Dr. Fauci to accept the cash prize, we reviewed the exception to the gift rules for meritorious public service orachievement at section 2635.204(d) (emphasis added): (1) An employee may accept a bona fide award for meritorious public service or achievement and any itemincident to the award, provided that: (i) The award and any item incident to the award are not from a person who has interests that may besubstantially affected by the performance or nonperformance of the employee's official duties, or froman association or other organization if a majority of its members have such interests; The definition of “person” is found at section 2635.102(k) and is:  (k) Person means an individual, corporation and subsidiaries it controls, company, association, firm, partnership,society, joint stock company, or any other organization or institution, including any officer, employee, or agent ofsuch person or entity. For purposes of this part, a corporation will be deemed to control a subsidiary if it owns 50percent or more of the subsidiary's voting securities. The term is all-inclusive and applies to commercial venturesand nonprofit organizations as well as to foreign, State, and local governments, including the Government of theDistrict of Columbia. It does not include any agency or other entity of the Federal Government or any officer oremployee thereof when acting in his official capacity on behalf of that agency or entity. The “National Academy of Sciences (in this chapter, the “corporation”) is a federally chartered corporation.”  36 USC §150301.  Pursuant to its Mission statement, NAS “is a private, non-profit society [and is] charged with providingReleased by Chairman Rand Paul\nindependent, objective advice to the nation on matters related to science and technology.”  The Act to Incorporate theNational Academy of Sciences (aka the Academy Charter) states “the Academy shall, whenever called upon by anydepartment of the Government, investigate, examine, experiment, and report upon any subject of science or art . . . .” Academy Charter at §3. While a corporation is a “person” under section 2635.102(k), I argue that the type of corporationthat NAS is – a federally chartered corporation, with its exceptional mission to advise the Federal Government – is not thetype of corporation that OGE intended to include in the definition.  First, OGE could have, but did not include in thedefinition of “person” any discussion of federally chartered corporations, perhaps because of their uniqueness.  And it’sthis uniqueness which makes the application of section 2635.204(d) unnecessary.  NIAID works with NAS because it isdirected to do so by Congress and because NAS offers NIAID an expertise that cannot be found elsewhere.  NAM did not“return the favor” to NIAID when it selected Dr. Fauci as its 2021 Lienhard awardee.  Its relationship with NIAID is rootedin legislation and will continue regardless of an unrelated award to NIAID’s Director. Last, OGE stated that “[‘person’] doesnot include any agency or other entity of the Federal Government . . . .”  I concede that NAS is not a part of the FederalGovernment.  However, in 1997, Congress amended the Federal Advisory Committee Act (FACA) to include the NationalAcademy of Sciences under some of FACA’s provisions.  See Congressional Research Service report, CongressionallyChartered Nonprofit Organizations (\"Title 36 Corporations\"): What They Are and How Congress Treats Them (July 14,2008).  There, CSR noted that the FACA amendment was: [T]he first instance in which Congress has made [federally chartered corporations] subject to the provisions of ageneral management law, and while the action may be supportable on public policy grounds, it does, to theextent of the applicable provisions, diminish the private character of the affected organizations.  As such, itconstitutes a precedent with implications. CSR Report at 7.  FACA’s partial application to NAS further supports viewing NAS as a different kind of corporate entity thatis outside of the regulatory definition of “person.”  Therefore, if NAS is not a “person,” NAS’ non-person status extends toNAM, an entity established under NAS’ charter.  Consequently, the pending NIAID-NAS matters do not make a gift fromNAM a prohibited gift for Dr. Fauci under the applicable regulations.   In the alternative, if you find NAS to be a “person” under 2635.102(k), then you should not find it to be the same “person”as NAM.  Even though NAM was established in 1970 under the charter of the National Academy of Sciences, the definitionof “person” supports a finding that NAM is not a subsidiary of corporate parent NAS.  The regulation explains that “forpurposes of [Part 2635], a corporation will be deemed to control a subsidiary if it owns 50 percent or more of thesubsidiary's voting securities.”  NAM does not issue voting securities, so NAS cannot control such securities; accordingly,NAM is not a subsidiary of NAS, but rather an independent entity.  Furthermore, pursuant to NAM’s Articles ofOrganization (AoO), adopted May 19, 2015 (copy attached), “the governance of [NAM] shall reside in the President andCouncil to be elected from among the membership,” AoO Art. III, § 1, “NAM shall be solely responsible for the content ofreports on projects that it undertakes, and such reports may be issued in its own name.”  AoO Art. VI, § 2.  NAM’sgoverning documents repeatedly show NAM’s independence from NAS.  Last, NAM’s AoO gives it its own authority toestablish awards.  AoO Art. V.  Thus, the Lienhard award and its associated cash prize are from NAM and NIAID’scommissioned studies and other projects from NAS do not make the award an impermissible gift under section2635.204(d).    Finally, if NAS and NAM are a “person,” then they are not persons who are substantially affected by the performance ornonperformance of Dr. Fauci’s duties because both “compensation” in NAS’ charter as well as “substantially” in section2635.204(d) must have meaning.  NAS’ charter states:  “[NAS] shall receive no compensation whatever for any services tothe Government of the United States.”  This is consistent with NAS’ status as a not-for-profit entity. NAS’ charter wascodified in Title 36 at Sections 150301-150304, and Section 150303 reiterates that NAS “may not receive compensationfor services to the Government, but the actual expense of the investigation, examination, experimentation, and reportshall be paid by the Government from an appropriation for that purpose.”  If the statutory language means that NAScannot receive any compensation for its investigations, examinations, experiments or reports commissioned by Federalagencies, but rather only reimbursement of expenses, then NAS is not substantially affected by NIAID’s projects. Furthermore, two of NIAID’s projects with NAS were mandated by Congress.  One project was started by another NIHInstitute which NIAID later joined.  Other collaborations were formed at the agency or department level, and not from thedirect action of NIAID.  Most importantly, every NAS project in which NIAID is involved is a large-scale project withnumerous members.  Being one of many means that NIAID’s proportional contribution does not affect NAS substantially. Released by Chairman Rand Paul\nFor all of these reasons, Dr. Fauci would not be accepting an award from a person (NAS and/or NAM) who has interestthat may be substantially affected by the performance or nonperformance of his official duties.  For the reasons provided above, a finding should be made that Dr. Fauci may accept the Lienhard Award and the cashprize associated with it from NAM.  If you have any questions, please contact Holli Beckerman Jaffe, cc’d above. Thank you for your consideration. With best wishes,Larry Lawrence A. Tabak, DDS, PhDPrincipal Deputy Director, NIHDeputy Ethics Counselor, NIHReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nFrom:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:FW: Dan David Prize - Information Letter PASSPORT COPYDate:Mon, 19 Apr 2021 11:27:23 -0400Importance:NormalAttachments:InformationLetter2021Fauci.docx; InformationLetter2021Fauci(1).docx; Fauci_passport.pdf  From: Conrad, Patricia (NIH/NIAID) [E]Sent: Monday, March 1, 2021 9:48 AMTo: Dan David Prize < @tauex.tau.ac.il>; Charlotte Halle < @tauex.tau.ac.il>Cc: Greg Folkers ( @niaid.nih.gov) < @niaid.nih.gov>; Billet, Courtney (NIH/NIAID) [E]< @niaid.nih.gov>; Awwad, David (NIH/NIAID) [C] < @niaid.nih.gov>; Fauci, Anthony (NIH/NIAID) [E]< @niaid.nih.gov>; Kimberly (NIH/NIAID) Barasch [C] (@nih.gov) <@nih.gov>Subject: FW: Dan David Prize - Information Letter Good afternoon: Dr. Fauci asked that I respond to your letter on his behalf.  I will be the overall point of contactfor Dr. Fauci’s participation in your event – I very  much look forward to working with your teamon this exciting honor. Below are the responses to your questions: 1. We are holding May 9, 2021 for the event.  Please send us a run of show/timeline at yourearliest convenience.  If Dr. Fauci will be expected to make any remarks, please do let usknow how long his remarks should be and any details related to his participation. 2. Symposia events the week of – please send any and all details as to what Dr. Fauci’s rolewill be so that we can begin to make the appropriate preparations. 3. Monetary Award:  Attached is a copy of Dr. Fauci’s government passport as well as theinformation below in case it is hard to read:Passport Number:Passport Issue Date:08/08/2019Passport Expiration Date:08/07/2024 4. PR/Press related inquiries: Courtney Billet is our Communications Director -please feel freeto contact her regarding any media/social media questions or concerns. Again, thank you and please let us know if you have any additional questions for us. Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nFrom:\"Mascola, John (NIH/VRC) [E]\" < @mail.nih.gov>To:\"Erbelding, Emily (NIH/NIAID) [E]\" <@nih.gov>, \"Embry, Alan(NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:FW: -Date:Mon, 01 Mar 2021 21:38:21 -0500Importance:NormalAttachments:ME_DW_FDA_3_1_21_.pdfFYSA I will review with Barney, Karin and Julie at VRC to get some input of what this may mean. From: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Sent: Monday, March 1, 2021 6:07 PMTo: Mascola, John (NIH/VRC) [E] < @mail.nih.gov>Cc: Lane, Cliff (NIH/NIAID) [E] < @niaid.nih.gov>Subject: FW: - Let us discuss. Anthony S. Fauci, MDDirectorNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesda, MD Phone: FAX: E-mail: @niaid.nih.govThe information in this e-mail and any of its attachments is confidential and may contain sensitive information.  Itshould not be used by anyone who is not the original intended recipient.  If you have received this e-mail in errorplease inform the sender and delete it from your mailbox or any other storage devices.  The National Institute ofAllergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender'sown and not expressly made on behalf of the NIAID by one of its representatives.  From: Weissman, Drew <@pennmedicine.upenn.edu>Sent: Monday, March 1, 2021 5:21 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Re: - Tony, Here is the human dose IM studies in pregnant mice. We still have some concern over the data and are talking to all of theappropriate people. Congratulations on the Dan David Prize Hope you and your family are doing well. Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nFrom:\"Erbelding, Emily (NIH/NIAID) [E]\" <@nih.gov>To:\"Bok, Karin (NIH/VRC) [E]\" < @nih.gov>Subject:RE: -Date:Tue, 02 Mar 2021 09:32:38 -0500Importance:NormalThanks Karin.I don’t know what Drew Weismann is trying to accomplish with this.Ultimately this is an FDA decision. From: Bok, Karin (NIH/VRC) [E] < @nih.gov>Sent: Tuesday, March 2, 2021 8:51 AMTo: Erbelding, Emily (NIH/NIAID) [E] <@nih.gov>Subject: FW: - I am sure you are also dealing with this, my answer to John below if helpful. Karin John, Thank you for sharing. I have no comments or concerns about this study, this is typically what you would see in mice withother types of vaccines as well, and it makes sense that mRNA is present in other sites as well, including placenta, etc.As a side note, I was part of the deliberation with CDC (ACIP/ACOG) that led to the permissive recommendation inpregnancy, and the assumptions from the authors below are very incorrect: Assumption that all of mRNA-LNP degraded at injection site Balancing perhaps differential risk/benefit ratio for maternal health vs fetal health  The SMEs on that call (especially obgyns) were aware that mRNA might reach the fetus. The only discussion was aroundthe possibility of that mRNA to integrate into the nuclear DNA. And the second main concern was the fever caused by thevaccine, especially during the first trimester, but they went around that by recommending the administration ofacetaminophen after vaccination. Needless to say both mom and baby’s health are important. CDC recently provided a nice overview of the over 30,000 pregnant women who have been vaccinated so far, with morethan 200 deliveries with no safety concerns. All vaccines administered to pregnant women historically have been foundsafe for mother and baby, so when we recently discussed pregnancy and the J&J vaccine, there was no concern, theyrecommended its use also unanimously. Let me know if you would like us (Emily, myself) to get a second opinion from the obgyns in the special populationsworking group (mainly Rich Beigi and Flor Muñoz) Thanks!Karin.  Karin Bok, MS, PhDSenior Advisor, Vaccine DevelopmentOffice of the Director, Vaccine Research CenterNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthReleased by Chairman Rand Paul\nphone: | mobile: | email: @nih.govhttps://www.niaid.nih.gov/about/vrc   From: \"Mascola, John (NIH/VRC) [E]\" <@mail.nih.gov>Date: Monday, March 1, 2021 at 9:37 PMTo: \"Koup, Richard (NIH/VRC) [E]\" <@mail.nih.gov>, \"Graham, Barney (NIH/VRC) [E]\"<@mail.nih.gov>, \"Ledgerwood, Julie (NIH/NIAID) [E]\" <@nih.gov>, Karin Bok@nih.gov>Cc: \"Sitar, Sandra (NIH/VRC) [C]\" <@mail.nih.gov>Subject: FW: - FYI.  We should each review and then discuss.  Thanks,John  From: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Monday, March 1, 2021 6:07 PMTo: Mascola, John (NIH/VRC) [E] <@mail.nih.gov>Cc: Lane, Cliff (NIH/NIAID) [E] <@niaid.nih.gov>Subject: FW: - Let us discuss. Anthony S. Fauci, MDDirectorNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesda, MD Phone: FAX: E-mail:@niaid.nih.govThe information in this e-mail and any of its attachments is confidential and may contain sensitive information.  Itshould not be used by anyone who is not the original intended recipient.  If you have received this e-mail in errorplease inform the sender and delete it from your mailbox or any other storage devices.  The National Institute ofAllergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender'sown and not expressly made on behalf of the NIAID by one of its representatives.  From: Weissman, Drew <@pennmedicine.upenn.edu>Sent: Monday, March 1, 2021 5:21 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Re: - Tony, Here is the human dose IM studies in pregnant mice. We still have some concern over the data and are talking to all of theappropriate people.Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nPhiladelphia, PA  Released by Chairman Rand Paul\nFrom:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>To:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>Cc:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>Subject:Dan David PrizeDate:Thu, 04 Mar 2021 17:05:02 -0500Importance:NormalHi Tony, I write regarding an invitation to suggest candidates the referenced Prize.  As I’m sure you know, Steve Rosenberg, NCI,was also selected as a Dan David Prize winner.  Below is an excerpt from an email Steve received from Dan David invitinghim to suggest candidates for its scholarship program.  I assume you received a similar invitation.  I discussed this withGretchen Weaver in OGC, and it was determined that making such recommendations is impermissible under ourregulations.  Since this is an optional activity, I expect this won’t cause any problems.  Please let me know if you have anyquestions. Doctoral / Postdoctoral ScholarshipsPlease note that you are welcome to suggest doctoral and postdoctoral researchers for the Dan David Prizescholarship. The candidate should submit an application through our website www.dandavidprize.org, adhering toall the relevant requirements. An ad-hoc committee headed by the Vice Rector of Tel Aviv University and membersfrom the relevant departments will review the applications. Students recommended by the laureates will have highpriority. Please note that the deadline for submitting an application is March 10, 2021. Holli Holli Beckerman JaffeDirector, NIH Ethics OfficeBethesda, MD @od.nih.gov Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @OD.NIH.GOV>Cc:\"Tabak, Lawrence (NIH/OD) [E]\" <@nih.gov>, \"Conrad, Patricia(NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:RE: Dan David PrizeDate:Thu, 04 Mar 2021 17:43:09 -0500Importance:NormalHolli:   I received a similar notice about the option of suggesting candidates for the scholarship program.   I will tellthem that they should choose whom they wish without any suggestions from me.Thanks,Tony From: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Sent: Thursday, March 4, 2021 5:05 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Subject: Dan David Prize Hi Tony, I write regarding an invitation to suggest candidates the referenced Prize.  As I’m sure you know, Steve Rosenberg, NCI,was also selected as a Dan David Prize winner.  Below is an excerpt from an email Steve received from Dan David invitinghim to suggest candidates for its scholarship program.  I assume you received a similar invitation.  I discussed this withGretchen Weaver in OGC, and it was determined that making such recommendations is impermissible under ourregulations.  Since this is an optional activity, I expect this won’t cause any problems.  Please let me know if you have anyquestions. Doctoral / Postdoctoral ScholarshipsPlease note that you are welcome to suggest doctoral and postdoctoral researchers for the Dan David Prizescholarship. The candidate should submit an application through our website www.dandavidprize.org, adhering toall the relevant requirements. An ad-hoc committee headed by the Vice Rector of Tel Aviv University and membersfrom the relevant departments will review the applications. Students recommended by the laureates will have highpriority. Please note that the deadline for submitting an application is March 10, 2021. Holli Holli Beckerman JaffeDirector, NIH Ethics OfficeBethesda, MD @od.nih.gov Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Barasch, Kimberly (NIH/NIAID) [E]\" <@nih.gov>Subject:FW: Dan David PrizeDate:Thu, 04 Mar 2021 17:43:36 -0500Importance:NormalPlease print this out and put into the Dan David Prize folder.   Thanks. From: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Sent: Thursday, March 4, 2021 5:05 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Tabak, Lawrence (NIH/OD) [E] @nih.gov>Subject: Dan David Prize Hi Tony, I write regarding an invitation to suggest candidates the referenced Prize.  As I’m sure you know, Steve Rosenberg, NCI,was also selected as a Dan David Prize winner.  Below is an excerpt from an email Steve received from Dan David invitinghim to suggest candidates for its scholarship program.  I assume you received a similar invitation.  I discussed this withGretchen Weaver in OGC, and it was determined that making such recommendations is impermissible under ourregulations.  Since this is an optional activity, I expect this won’t cause any problems.  Please let me know if you have anyquestions. Doctoral / Postdoctoral ScholarshipsPlease note that you are welcome to suggest doctoral and postdoctoral researchers for the Dan David Prizescholarship. The candidate should submit an application through our website www.dandavidprize.org, adhering toall the relevant requirements. An ad-hoc committee headed by the Vice Rector of Tel Aviv University and membersfrom the relevant departments will review the applications. Students recommended by the laureates will have highpriority. Please note that the deadline for submitting an application is March 10, 2021. Holli Holli Beckerman JaffeDirector, NIH Ethics OfficeBethesda, MD @od.nih.gov Released by Chairman Rand Paul\nFrom:\"Jaffe, Holli Beckerman (NIH/OD) [E]\" < @od.nih.gov>To:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:RE: Dan David PrizeDate:Thu, 04 Mar 2021 17:47:19 -0500Importance:NormalThanks Tony From: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Sent: Thursday, March 4, 2021 5:43 PMTo: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Cc: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>; Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>Subject: RE: Dan David Prize Holli:   I received a similar notice about the option of suggesting candidates for the scholarship program.   I will tellthem that they should choose whom they wish without any suggestions from me.Thanks,Tony From: Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Sent: Thursday, March 4, 2021 5:05 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Cc: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Subject: Dan David Prize Hi Tony, I write regarding an invitation to suggest candidates the referenced Prize.  As I’m sure you know, Steve Rosenberg, NCI,was also selected as a Dan David Prize winner.  Below is an excerpt from an email Steve received from Dan David invitinghim to suggest candidates for its scholarship program.  I assume you received a similar invitation.  I discussed this withGretchen Weaver in OGC, and it was determined that making such recommendations is impermissible under ourregulations.  Since this is an optional activity, I expect this won’t cause any problems.  Please let me know if you have anyquestions. Doctoral / Postdoctoral ScholarshipsPlease note that you are welcome to suggest doctoral and postdoctoral researchers for the Dan David Prizescholarship. The candidate should submit an application through our website www.dandavidprize.org, adhering toall the relevant requirements. An ad-hoc committee headed by the Vice Rector of Tel Aviv University and membersfrom the relevant departments will review the applications. Students recommended by the laureates will have highpriority. Please note that the deadline for submitting an application is March 10, 2021. Holli Holli Beckerman JaffeDirector, NIH Ethics OfficeBethesda, MD @od.nih.gov Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Barasch, Kimberly (NIH/NIAID) [E]\" <@nih.gov>Subject:FW: Dan David PrizeDate:Thu, 04 Mar 2021 17:49:59 -0500Importance:NormalInto folder, please From: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov>Sent: Thursday, March 4, 2021 5:47 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Subject: RE: Dan David Prize Thanks Tony From: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Thursday, March 4, 2021 5:43 PMTo: Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Cc: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>; Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>Subject: RE: Dan David Prize Holli:   I received a similar notice about the option of suggesting candidates for the scholarship program.   I will tellthem that they should choose whom they wish without any suggestions from me.Thanks,Tony From: Jaffe, Holli Beckerman (NIH/OD) [E] <@od.nih.gov>Sent: Thursday, March 4, 2021 5:05 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Cc: Tabak, Lawrence (NIH/OD) [E] <@nih.gov>Subject: Dan David Prize Hi Tony, I write regarding an invitation to suggest candidates the referenced Prize.  As I’m sure you know, Steve Rosenberg, NCI,was also selected as a Dan David Prize winner.  Below is an excerpt from an email Steve received from Dan David invitinghim to suggest candidates for its scholarship program.  I assume you received a similar invitation.  I discussed this withGretchen Weaver in OGC, and it was determined that making such recommendations is impermissible under ourregulations.  Since this is an optional activity, I expect this won’t cause any problems.  Please let me know if you have anyquestions. Doctoral / Postdoctoral ScholarshipsPlease note that you are welcome to suggest doctoral and postdoctoral researchers for the Dan David Prizescholarship. The candidate should submit an application through our website www.dandavidprize.org, adhering toall the relevant requirements. An ad-hoc committee headed by the Vice Rector of Tel Aviv University and membersfrom the relevant departments will review the applications. Students recommended by the laureates will have highpriority. Please note that the deadline for submitting an application is March 10, 2021. HolliReleased by Chairman Rand Paul\n Holli Beckerman JaffeDirector, NIH Ethics OfficeBethesda, MD @od.nih.gov Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Collins, Francis (NIH/OD) [E]\" < @od.nih.gov>Subject:FW: -Date:Tue, 16 Mar 2021 06:14:29 -0400Importance:NormalAttachments:ME_DW_FDA_3_1_21_.pdfFrancis:   I texted you to call me last night, but it was probably too late.   Please give me a call about this at yourconvenience.Thanks,Tony From: Fauci, Anthony (NIH/NIAID) [E]Sent: Monday, March 15, 2021 9:35 PMTo: Erbelding, Emily (NIH/NIAID) [E] <@nih.gov>Subject: FW: - Here are the Weissman data. From: Weissman, Drew <@pennmedicine.upenn.edu>Sent: Monday, March 1, 2021 5:21 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Re: - Tony, Here is the human dose IM studies in pregnant mice. We still have some concern over the data and are talking to all of theappropriate people. Congratulations on the Dan David Prize Hope you and your family are doing well. Take care. Drew From: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Date: Monday, February 8, 2021 at 9:12 PMTo: Weissman, Drew <@pennmedicine.upenn.edu>Subject: [External] RE: -Drew:    Thanks for sending this.  Looks like you have touched all the bases of informing people of your results.   Itwould be interesting to see what human dose levels given IM do.   I hope that all is well with you.  Congratulations on the Rosenstiel Award!Best regards,Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n Tami NoamProject CoordinatorDan David PrizeOffice: @tauex.tau.ac.ilEmail: www.dandavidprize.orgWebsite:     From: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Tuesday, March 16, 2021 1:55 PMTo: Charlotte Halle <@tauex.tau.ac.il>Cc: Dan David Prize <@tauex.tau.ac.il>; Barasch, Kimberly (NIH/NIAID) [E] <@nih.gov>; Awwad,David (NIH/NIAID) [C] <@niaid.nih.gov>; Folkers, Greg (NIH/NIAID) [E] <@niaid.nih.gov>Subject: RE: Quick request re Dan David Prize Please fed ex to the address below to the Attention of Kim Barasch as Dr. Fauci’s mail isdelayed.  I will ask Kim – cc’d here to track its arrival and make sure we send you an iphonepicture when it arrives.  Thank you.  National Institute of Allergy and Infectious DiseasesThe National Institutes of HealthBethesda, Maryland office  From: Charlotte Halle <@tauex.tau.ac.il>Sent: Tuesday, March 16, 2021 7:45 AMTo: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>Cc: Dan David Prize <@tauex.tau.ac.il>Subject: Quick request re Dan David Prize Dear Patti, We are preparing a framed certificate and getting ready to mail it to Dr. Fauci. (We are hoping to get a photo or film of himholding the certificate, which we would use to represent him receiving the award during our online ceremony in May.)  Please provide the postal address where it would be most convenient for him to receive this certificate.  Many thanks,Charlotte Charlotte HalléDirectorDan David PrizeOffice: Mobile: Released by Chairman Rand Paul\nEmail: @tauex.tau.ac.ilWebsite: www.dandavidprize.org  Released by Chairman Rand Paul\nFrom:Charlotte Halle < @tauex.tau.ac.il>To:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>Cc:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>, Dan David Prize< @tauex.tau.ac.il>Subject:RE: Dan David Prize - FauciDate:Tue, 13 Apr 2021 09:03:58 -0400Importance:NormalDear Patty,The prize money will be sent via bank transfer. We will ask for the account details next week. We hope to make thetransfer the week after the award ceremony.Best wishes,Charlotte  From: Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>Sent: Saturday, April 10, 2021 6:58 PMTo: Dan David Prize < @tauex.tau.ac.il>Cc: Charlotte Halle < @tauex.tau.ac.il>; Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Subject: Dan David Prize - Fauci Good morning: We have just received notice that Dr. Fauci is approved for payment for the Dan David Prize.  Iam adding Dr. Fauci here as well.  Please let us know what you require to transfer payment to Dr. Fauci.  Thank you in advance foryour response. Best regards, Patricia L. ConradPublic Health Analyst and  Special Assistant to the DirectorNational Institute of Allergy and Infectious DiseasesThe National Institutes of HealthBethesda, Maryland  office   From: Dan David Prize <@tauex.tau.ac.il>Sent: Wednesday, March 24, 2021 7:25 AMTo: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>; Barasch, Kimberly (NIH/NIAID) [E]Released by Chairman Rand Paul\n<@nih.gov>Cc: Charlotte Halle <@tauex.tau.ac.il>; @niaid.nih.gov' <@niaid.nih.gov>; Awwad, David(NIH/NIAID) [C] <@niaid.nih.gov>Subject: Posting Dan David Prize Award Certificate Dear Patti and Kim, Dr. Fauci’s Dan David Prize laureate certificate has been shipped and is on its way to you. For your convenience, I am attaching the number of the DHL delivery. We would appreciate it if you let us know once youhave received it. Best wishes,Tami Tami NoamProject CoordinatorDan David PrizeOffice: @tauex.tau.ac.ilEmail: www.dandavidprize.orgWebsite:     From: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Tuesday, March 16, 2021 1:55 PMTo: Charlotte Halle <@tauex.tau.ac.il>Cc: Dan David Prize <@tauex.tau.ac.il>; Barasch, Kimberly (NIH/NIAID) [E] <@nih.gov>; Awwad,David (NIH/NIAID) [C] <@niaid.nih.gov>; Folkers, Greg (NIH/NIAID) [E] <@niaid.nih.gov>Subject: RE: Quick request re Dan David Prize Please fed ex to the address below to the Attention of Kim Barasch as Dr. Fauci’s mail isdelayed.  I will ask Kim – cc’d here to track its arrival and make sure we send you an iphonepicture when it arrives.  Thank you.  National Institute of Allergy and Infectious DiseasesThe National Institutes of HealthBethesda, Maryland  office  From: Charlotte Halle <@tauex.tau.ac.il>Sent: Tuesday, March 16, 2021 7:45 AMTo: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>Cc: Dan David Prize <@tauex.tau.ac.il>Subject: Quick request re Dan David Prize Dear Patti,Released by Chairman Rand Paul\n We are preparing a framed certificate and getting ready to mail it to Dr. Fauci. (We are hoping to get a photo or film of himholding the certificate, which we would use to represent him receiving the award during our online ceremony in May.)  Please provide the postal address where it would be most convenient for him to receive this certificate.  Many thanks,Charlotte Charlotte HalléDirectorDan David PrizeOffice: Mobile: Email: @tauex.tau.ac.ilWebsite: www.dandavidprize.org  Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nFive of the 16 people mentioned above are probably Israeli and none of them has anysignificant connection to the Israeli government.Comment by Israel A. CohenTel Aviv, Israelinactive member of the Florida Barcc: Editor, Spectator      Barbara Gastel (Texas A&M)      NIAID news room      Ariel Porat, president, TAU      Dan David Prize emailReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nI think it is fair to say that the occurrence of the Covid pandemic significantly increasedthe likelihood of Dr. Fauci becoming the sole recipient of one of the 3 Dan David Prizesawarded this year. The pandemic brought into sharp focus his contribution to this andother serious health crises during his career. The reasons for his visibility are cogentlyexplained athttps://theconversation.com/10-reasons-why-anthony-fauci-was-ready-to-be-the-face-of-the-us-pandemic-response-150596 It is not fair to say that he received the $1 million prize \"as a payoff from Israel\". The DanDavid Foundation is a private charitable organization similar in concept to theorganization that awards the Nobel prizes. The Dan David Prizes are almost as large butdefinitely not as well-known as the Nobelprize.  https://en.wikipedia.org/wiki/Nobel_Prize  However, the method of determining who receives them is similar.There are 12 members on the board of the Dan David Foundation. They are listed at https://www.dandavidprize.org/about/the-boardFour seem to be US citizens, including Henry Kissinger who was the US Secretary ofState.Four seem to be Israeli, including Ariel David (son of the founder) and Ariel Porat(president of Tel Aviv University).Four seem to be French, including Emmanuel Roman who spent 18 years at GoldmanSachs.There were 4 members on the Review Committee who evaluated potential recipients ofthe prize that Dr. Fauci received. They are listed athttps://www.dandavidprize.org/about/review-committees1 - Prof Elizabeth Miller of the Faculty of Epidemiology & Population Health in London,UK.2 - Prof Philip Greenland at Northwestern University in Chicago, IL.3 - Prof. Fred Binka at the University of Health and Allied Sciences in Ghana.4 - Prof. Daniel Cohen, Head of the School of Public Health at Tel Aviv University in Israel.Five of the 16 people mentioned above are probably Israeli and none of them has anysignificant connection to the Israeli government.Comment by Israel A. CohenTel Aviv, Israelinactive member of the Florida Barcc: Editor, Spectator      Barbara Gastel (Texas A&M)      NIAID news room      Ariel Porat, president, TAU      Dan David Prize emailReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nNIH Ethics:  Summary of Analysis – Award with Cash PrizeSUMMARY OF ANALYSIS – AWARD WITH CASH PRIZE \nREVIEW REQUIRED  NEAC ($2,500 or Above)  NEAC Subcommittee (Below $2,500) \nNEO Specialist Receipt Date  \nRECIPIENT  \nEmployee Name IC \nEmployee has been counselled not to cash the check or accept an electronic transfer \nof funds until approval is received? Page # YES NO \nCan the employee’s performance or non-performance of their official responsibilities have any effect on \nthe donor ( 5 CFR 5501.111 )? YES NO \nConfirmation of 5 CFR 5501.111 must be included with package.  Page # \nAWARD DETAILS  \nAward Name \nSponsor Name \nTOTAL CASH VALUE ASSOCIATED WITH AWARD  $ Page # \nAWARD ANALYSIS  \nThe award has been made on a regular basis orfunded to ensure its continuation if it is a \nfirst-time award? Page # \nUnder which selection of award recipient is made pursuant to written standards? Page #\nIs the recipient expected to present a lecture? Page # \nNEO Specialist Summary Analysis \nBased on the analysis above, this award meets the regulatory requirements of a bona fide award under 5 CFR 2635.204(d) \nNEO Specialist Supervisory Ethics Specialist \nDirector, NEO \nNEAC Subcommittee Co-Chairs 4Linda Simmons 2/17/2021\nAnthony Fauci NIAID445-6\n2021 Dan David Prize\nDan David Foundation\n900,000 3\n16\nThe award has been given on a regular basis consistently since 2002.\n11\nAccording to the Dan David Foundation website, The Dan David Prize covers three-time dimensions - Past, Present and \nFuture - that represent realms of human achievement. Each year the International Board chooses one field within each \ntime dimension since 2002.  Nominees are evaluated by reviewing the importance of the work, its impact and its \nprojected influence in the relevant field. https://www.dandavidprize.org/about/about-the-prize.  It has been confirmed \nthat the Review Committees are indeed independent from the Tel Aviv University and chaired by international experts.\n31\nExpected to attend the award ceremony and  virtual symposium at which recipients are expected to give a presentation. \nPresentations are talks about their work over the course of their careers, rather than current science and theory.\nThe award was found to comply with 2635.204(d). Also confirmed that the organization is not seeking official action from \nthe employee, subordinate, or agency under the employee’s official responsibility (5501.111). The gifts associated with the \naward include a $900,000 cash prize which have been found to be permissible and are not prohibited under the \nEmoluments Clause, nor the Foreign Gifts and Decorations Act. The Dan David Foundation and the website confirm that \nthe 2021 Review Committee (See page 24-27) selected by the Dan David Foundation and the Foundation’s Board (See \npages 24-27) is responsible for the selection the Laureates. All of which act independently and not part of a foreign \ngovernment.Linda D. \nSimmons -SDigitally signed by Linda D. \nSimmons -S \nDate: 2021.03.25 15:12:23 \n-04'00'Sherri L. Park \n-SDigitally signed by Sherri L. Park -S Date: 2021.03.25 15:17:38 -04'00'Holli B. Jaffe -SDigitally signed by Holli B. Jaffe -S \nDate: 2021.03.25 15:25:33 -04'00'Released by Chairman Rand Paul\n AWARD REVIEW WORKSHEET\nDate Received EMIS ID # \nEthics Official IC \nEmployee Name\nFull Name of Award \nAward Sponsor \nEvent Date Event Location \nSponsor’s Contact \nPhone Number Email \nALL GIFTS ASSOCIATED WITH AWARD: \nCash/stipend/cash equivalent $ \nTangible gift (e.g., trophy, crystal bowl, sculpture) $ \nOther Gifts being offered: \nAward Ceremony Dinner, reception, entertainment $ \nCan be accepted under WAG mechanism? Yes No \nTravel expenses (e.g., meal, lodging, transportation, waived \nregistration) $ \nCan accept under Sponsored Travel? Yes No \nList other items \nTotal value of other items $ \nIs Award on NEO’s Approved List? Yes No If Yes, date approved: \nIf Yes, confirm no changes to:  \nCash Prize Amount Lecture Requirement Selection Process New Gifts Offered \nCan the employee’s performance or non-performance of their official responsibilities have any effect on the \ndonor (5 CFR 5501.111)? \nYes  No Documentation of confirmation must be included with package\n12/1/21Jeremy R. TamNIAIDAnthony FauciDan David PrizeExpected to attend the award ceremony and  virtual symposium at which recipients are expected to give a presentation  Presentations are talks about 5/9/2021VirtualCharlotte Halle@tauex.tau.ac.il9000001400\n444444Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n Tel Aviv  Israel. Tel:  \n Email: @tauex.tau.ac.il  \nwww.d andavidprize.org The official announcement of the 2021 Dan David Prize laureates will likely \nbe held on Monday, Feb. 15, 2021 at 6:00 p.m. Israel time, and will be \nbroadcast live on our Facebook page and website. Please note that we will \nconfirm the date of the announcement closer to the time.  \nOur office will be in contact with you shortly regarding PR activities and \nmaterials.   \nOn behalf of the Dan David Prize, we wish to once again extend our sincere \ncongratulations on your receiving this honor.\n  \nBest wishes,\n \n        \nProf.  Ariel Porat   Ms. Charlotte Hallé \nPresident, Tel Aviv University  Director \nChairperson, Dan David Prize Board  Dan David Prize \nDan David Prize \n \n5Released by Chairman Rand Paul\nFrom: Bennett, Arthur (NIH/NIAID) [E]\nTo: Simmons, Linda (NIH/OD) [E]\nCc: Tam, Jeremy (NIH/NIAID) [E]\nSubject: FW: Dan David Prize documentation\nDate: Wednesday, February 17, 2021 1:52:46 PM\nHi Linda,\nPlease see Dr. Fauci’s 5501.111 responses for the Dan David prize below.\nThanks,\nArt\nFrom:  Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov> \nSent:  Wednesday, February 17, 2021 1:51 PM\nTo: Bennett, Arthur (NIH/NIAID) [E] < @niaid.nih.gov>\nCc: Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>\nSubject:  RE: Dan David Prize documentation\nArt:\n   The answer to each of the 3 questions below is “false”.\nBest regards,\nTony\nAnthony S. Fauci, MD\nDirector  \nNational Institute of Allergy and Infectious Diseases  \n \n \nNational Institutes of Health  \nBethesda, MD  \nPhone:  \nFAX:  \nE-mail: @niaid.nih.gov\nThe information in this e-mail and any of its attachments is confidential and may contain sensitive\ninformation.  It should not be used by anyone who is not the original intended recipient.  If you\nhave received this e-mail in error please inform the sender and delete it from your mailbox or any\nother storage devices.  The National Institute of Allergy and Infectious Diseases (NIAID) shall not\naccept liability for any statements made that are the sender's own and not expressly made on\nbehalf of the NIAID by one of its representatives. \nFrom:  Bennett, Arthur (NIH/NIAID) [E] < @niaid.nih.gov > \nSent:  Wednesday, February 17, 2021 1:33 PM\nTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov >\nSubject:  Dan David Prize documentation\n 5501.111\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nNOTICES\nFINANCIAL DISCLOSURE\nAwards, including cash, cash equivalents, meals, lodging, \ntransportation, reimbursements, entertainment, free attendance, \nor other benefits incident thereto, received for the personal use, \ndisposition, or retention by the employee valued individually in \nexcess of $134 and which aggregate $335 or more must be \ndisclosed by employees who file a financial disclosure report.  \nIncumbent and termination filers of the SF-278 Public Financial \nDisclosure Report include this information on Schedule B, Part II \nof the form. Confidential Financial Disclosure Report (OGE-450) \nfilers  include these  items in Part IV. (Note that the reporting \nthreshold is determined every 3 years; check the financial \ndisclosure requirements for the current amount.)  Travel funds \naccepted by the agency under the sponsored travel (HHS-348) \nmechanism are gifts to the agency, rather than to the individual, \nand are not reported as personal gifts on the SF-278 nor on the \nOGE-450. \nTAX CONSEQUENCES\nAward recipients should consult their personal attorney, \naccountant, or other financial advisor concerning the treatment \nof awards and the benefits incident thereto for tax purposes.  \nEthics officials and government attorneys do not provide tax or \nother personal financial advice to government employees.    Note \nthat, pursuant to section 4941 and 4946 of Title 26 of the U.S. \nCode, awards and other payments received from private \nfoundations, as defined under Section 509 of the Internal \nRevenue Code, may be prohibited for Presidential appointees, \nSchedule C employees, or other individuals compensated at pay \nlevels at or above the lowest rate of basic pay for the Senior \nExecutive Service under section 5382 of Title 5, United States \nCode, unless the recipients of the award are selected from the \ngeneral public and consideration is not confined to government \nemployees.   \nAGENCY GIFT ACCEPTANCE\nIf approval is obtained in advance, tangible items intended for \ndisplay at and retention by the NIH that are accepted on behalf \nof the employee’s component pursuant to an applicable agency \ngift acceptance authority statute are not reportable as personal \ngifts on the SF-278.  Employees should consult their employing \noffice, ascertain the availability of this option, and comply with \napplicable procedures.  Travel reimbursement authorities \ncontained in Section 1353 of Title 31 of the U.S. Code, as \nimplemented by Part 304-1 of Title 41 of the Code of Federal \nRegulations, permit the Department to accept where \nappropriate, travel costs tendered by non-federal sources in \nconnection with the recognition of federal employees for \nmeritorious public service that is related to official duties. \nCERTIFICATION\nThe signature of the employee on this form certifies that the \nstatements made and information provided on this form are true, \ncomplete, and correct to the best of the individual’s knowledge. PRIVACY ACT STATEMENT\nSection 7301 of Title 5 of the U.S. Code and Executive Order \n12674, as implemented by Sections 2635.204(d) and 5501.111 \nof Title 5 of the Code of Federal Regulations, authorize the \ncollection of this information.  Disclosure of this information is \nmandatory for employees seeking authorization from an agency \nethics official to accept awards, pursuant to Sections \n2635.204(d)(1)and 5501.111  of Title 5 of the Code of Federal \nRegulations.   Failure to provide the requested information will \nresult in the denial of the request for approval. Falsification of \nthe information required to be reported for this purpose may \nsubject the employee to disciplinary action by the employing \nagency or other appropriate authority.  Knowing and wilful \nfalsification of information required to be reported may also \nsubject the employee to criminal prosecution. The primary use \nof this information is to allow HHS supervisors and ethics \nofficials to make necessary determinations concerning \nemployee requests to receive awards. The information is also \nrequested, pursuant to 5 C.F.R. §§ 2638.203(b)(9), (10), and \n(11), for the purpose of evaluating ethics program \nadministration, as well as the Department’s supplemental ethics \nregulations, to determine their continued adequacy and \neffectiveness in relation to current agency responsibilities and to \nensure that prompt and effective action is taken to remedy \nviolations or potential violations, or appearances thereof, of \nconflict of interest and related ethics provisions. Additionally, this \ninformation may be disclosed to: (1) the Office of Personnel  \nManagement, Office of Government Ethics, Merit Systems \nProtection Board, Office of the Special Counsel, Equal \nEmployment Opportunity Commission, Federal Labor Relations \nAuthority, Federal Service Impasses Panel, Federal Mediation \nand Conciliation Service, and an arbitrator, in carrying out their \nfunctions; (2) a Federal, State, or local  agency charged with \ninvestigating  or prosecuting violations of, or implementing, the \nlaw, in the event there is an indication of a violation or potential \nviolation of civil, criminal or regulatory law; (3) a Federal, State, \nor local agency  maintaining enforcement records or other \npertinent records, such as current licenses, if necessary to \nobtain a record relevant to an agency decision concerning the \nhiring or retention of an employee, the issuance of a security \nclearance, the letting of a contract, or the issuance of a license, \ngrant or other benefit; (4) the National Archives and Records \nAdministration or the General Services Administration in records \nmanagement inspections; (5) the Office of Management and \nBudget during legislative coordination on privacy relief \nlegislation; (6) Federal agencies with power to subpoena other \nFederal agencies’ records; (7) a court or party in a court or \nFederal administrative proceeding if the Government is a party \nor in order to comply with a judge-issued subpoena; (8) private \nfirms with which the Department may contract for the purpose of \ncollating, analyzing, aggregating or otherwise refining records; \n(9) a Member of Congress or a Congressional office, pursuant to \nan inquiry made at the request of the individual who is a subject \nof the record; (10) the Department of Justice in defense of \nlitigation; and (11) contractors and other non-Government \nemployees working for the Federal Government to accomplish a \nfunction related to an Office of Government Ethics \nGovernment-wide system of records. This form will not be \ndisclosed to any requesting person unless authorized by law. \nSee the OGE/GOVT-1 Government-wide executive branch \nsystem of records. \nNIH����� �Rev ������ Page �of�Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReview Committees 2021\nhttps://www.dandavidprize.org/about/review-committees/review-committees-2021[3/2/2021 11:41:53 AM]Prof. Philip Greenland\nCenter for Arrhythmia Research\nFeinberg School of Medicine\nNorthwestern University\nChicago, IL\nUSA\n \nProf. Fred Binka\nSchool of Public Health\nUniversity of Health and Allied Sciences\nHohoe, Ghana\n \nProf. Daniel Cohen  \nHead of the School of Public Health\nSackler Faculty of Medicine \nTel Aviv University\nIsrael\n \nMOLECULAR MEDICINE \nProf. Mary-Claire King - Chairperson\nDivision of Medical Genetics\nDepartment of Medicine\nUniversity of Washington\nSeattle, WA\nUSA\n \nProf. Dominique Stoppa-Lyonnet\nHead of the Genetics Department\nInstitut Curie\nParis, France\n \nProf. Huda Zoghbi\nMolecular and Human Genetics\nBaylor College of MedicineReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nFrom: Weaver, Gretchen (NIH/OD) [E]\nTo: Simmons, Linda (NIH/OD) [E]\nCc: Gross, Avraham (NIH/OD) [E] ; Park, Sherri (NIH/OD) [E]\nSubject: RE: 204(d) Review Request\nDate: Tuesday, March 23, 2021 9:45:08 AM\nAttachments: image001.png\nThanks, Linda.  I agree that this can be approved.\nGretchen\nGretchen H. Weaver, J.D.\nSupervisory/Senior NIH Ethics Counsel\nDHHS/OGC/Ethics Division\nphone: \nfax: \nNOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE\nUSE OF THE RECIPIENT(S) NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD\nNOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES.  IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION,\nDISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR, PLEASE NOTIFY THE SENDER\nIMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERAL\nETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON\nTHE PRIOR ADVICE OF ANY AGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT\nCIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLY SUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND\nRELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL IN INTERPRETING THE SCOPE OF SUCH STATUTES IS A\nFACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIAL DISCRETION. \nEMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY\nATTORNEY-CLIENT PRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO\nTHE OFFICE OF THE INSPECTOR GENERAL.\nFrom:  Simmons, Linda (NIH/OD) [E] < @nih.gov> \nSent:  Tuesday, March 23, 2021 7:12 AM\nTo: Weaver, Gretchen (NIH/OD) [E] < @od.nih.gov>\nCc: Gross, Avraham (NIH/OD) [E] < @nih.gov>; Park, Sherri (NIH/OD) [E]\n<@ n i h . g o v >\nSubject:  204(d) Review Request\nHello Gretchen,\nAttached is the final award package for Dr. Fauci for the Dan David Prize.  I followed up with\nAvraham and Sherri and we have determined that the Dan David Prize is the sole sponsor for the\nprize and all of their virtual events and not the Tel Aviv University.  The Dan David Prize also\nconfirmed that their relationship between them and the Tel Aviv University has not changed since\n2011.  Since the Dan David Prize is the type of entity which merely issues prizes, it would not be\naffected by Dr. Fauci’s official responsibilities.  Dr. Fauci responses of the 5501.111 included in the\npackage will suffice because there are no other subcomponents which need to be evaluated since\nthe sponsor which merely give out prizes would not likely have any CRADAs, grants, or other\nbusiness which could be affected by Dr. Fauci.  I’ve also attached his updated 2854 with theReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nFrom: Charlotte Halle\nTo: Simmons, Linda (NIH/OD) [E]\nSubject: RE: Dan David Foundation\nDate: Thursday, March 4, 2021 3:41:33 AM\nHi Linda,\nYes, the Dan David Foundation funds both the event and the symposium.\nBest,\nCharlotte\n \nFrom:  Simmons, Linda (NIH/OD) [E] < @nih.gov> \nSent:  Wednesday, March 3, 2021 10:08 PM\nTo: Charlotte Halle < @tauex.tau .ac.il>\nSubject:  Re: Dan David Foundation\n \nThanks for getting back to me.  When I say sponsor, I'm talking about who provides the funds to organize the event for the award ceremony and the\nsymposium? In this case it's the Dan David Foundation, correct?\nFrom:  Charlotte Halle < @tauex.tau.ac.il >\nSent:  Wednesday, March 3, 2021 2:52 PM\nTo: Simmons, Linda (NIH/OD) [E] < @nih.gov >\nSubject:  RE: Dan David Foundation\n \nHi Linda,\nEverything is scaled down this year because of the pandemic and no on-the-ground visit.\nTherefore, this year, the attendant events include an online award ceremony for laureates and a symposium, which the Prize organizes. I’m not sure what you mean by\nthe word sponsor. Might it be easier to speak by telephone, so we can clarify? \nI am largely available tomorrow if that would suit you.\nBest wishes,\nCharlotte\n \n \n \n \n \n \nFrom:  Simmons, Linda (NIH/OD) [E] < @nih.gov > \nSent:  Tuesday, March 2, 2021 7:48 PM\nTo: Charlotte Halle < @tauex.tau.ac.il >\nSubject:  RE: Dan David Foundation\n \nHello Charlotte,\n \nI just wanted a little clarity on the events being scheduled virtually surrounding the prize.  We are asking for a list of events and sponsors so that we can determine the\nDan David Foundation is sponsoring all of the events that Drs. Fauci and Rosenberg are required to attend.\n \nLinda D. Simmons\n \n \n \n \nFrom:  Charlotte Halle < @tauex.tau.ac.il > \nSent:  Monday, March 1, 2021 9:17 AM\nTo: Simmons, Linda (NIH/OD) [E] < @nih.gov >\nCc: Dan David Prize < @tauex.tau.ac.il >\nSubject:  RE: Dan David Foundation\n \nDear Ms. Simmons,\nThank you for your email.\nFirst I will confirm that there have been no changes to the Prize since 2011, when the Dan David Prize was previously approved. To answer your specific questions:\n1. The attendant events include an award ceremony for laureates and a symposium in the laureate’s field of expertise, attended by experts in the field, students\nand members of the general public.  This year, due to the pandemic, the events will be online/virtual.\n2. Participation in these events is requested by the Dan David Foundation and is a condition stipulated by the founder of the Prize.\n3. There have been no changes in the relationship between the Dan David Foundation and Tel Aviv University since 2011 in relation to the Prize and the information\non our website is correct. \nReleased by Chairman Rand Paul\n4. The Review Committees are indeed independent from the university and are chaired by leading international experts in their field. The names of the 2021 Review\nCommittees can be found on our website here .\n5. The guidelines outlined on our website are indeed the guidelines that the Dan David Prize Board uses to select all our laureates.  \nPlease let us know if you have any further questions.  \nBest wishes,\nCharlotte Hallé\n \nCharlotte Hallé\nDirector\nDan David Prize\nOffice: \nMobile: \nEmail: @tauex.tau.ac.il\nWebsite: www.dandavidprize.org\n \n \nFrom:  Simmons, Linda (NIH/OD) [E] @nih.gov > \nSent:  Wednesday, February 24, 2021 11:31 PM\nTo: Dan David Prize < @tauex.tau.ac.il >\nSubject:  Dan David Foundation\n \nAriel Porat and Charlotte Halle\n \nMy name is Linda Simmons and I represent the National Institutes of Health (NIH) Ethics Office.  I am assigned to review the 2021 Dan David Prizes for the Future Time\nDimension in the Field of Molecular (Dr. Rosenberg) and the Present Time Dimension in the field of Public Health (Dr. Fauci).  The federal ethics regulations require that\nthey receive an ethics clearance to accept the gifts associated with this award.  Previously in 2011, our Office of General Counsel (OGC) approved the award(s) from the\nDan David Foundation Prizes recognizing past, present, and future achievements and I have been given the task of confirming that the information the organization\nprovided in 2011 is still the same.\n \n1)      What are ALL of the attendant events mentioned on the web site (i.e. the “couple of online events surrounding the prize” mentioned in the letters to Drs. Fauci\nand Rosenberg)? Can you provide a list of all of the virtual events mentioned in your letters.\n \n2)      The letter Drs. Fauci and Rosenberg received indicates that “we” (e.g. the letter authors) will be asking them to participate in a couple of online events.  We\nneed to confirm that the award donor only (Dan David Foundation) was requesting they attend these online events and not the Tel Aviv University?\n \n3)      We need to confirm whether anything has changed in the relationship between the Dan David Foundation and the Tel Aviv University in relation to the prize. \nAs of 2011, we were able to confirm that the prize is \"owned” by the Foundation and the university “merely” provides support. It states on your website\nhttps://www.dandavidprize.org/about/about-the-prize  that the Dan David Prize is an international award, endowed by the Dan David Foundation and\nheadquartered at Tel Aviv University.  Is this information still accurate?\n \n4)      Regarding the review panels, the members of the panels for the 2021 awards are not listed on the web site.  We need this information (for both NIH recipients)\nin order to, hopefully, confirm independence from the university.  Can you provide us a list of the members of the review committee for 2021 and their\naffiliation that was responsible for reviewing the Present Time Dimension in the field of Public Health for Dr. Fauci and the Future Time Dimension in the field of\nMolecular Medicine for Dr. Rosenberg?\n \n5)      Regarding the selection criteria, the web site indicates that the Board makes the final decision, based on the recommendations, as to which nominee(s) have\nachieved the purpose the selected “dimension” is intended to honor. Are the guidelines for selection as stated on the web site about being considered on merit\nand impact in their relevant field are the same and were considered", "summary": "Watcher-discovered document from paul-readingroom (7.24.2026_Fauci-Awards_FINAL_REDACTED.pdf), auto-indexed 2026-07-27.\n\nExcerpt: From:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:FW: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019Date:Wed, 10 Oct 2018 16:31:24 -0400Importance:NormalI will explain.,From: Barton Haynes, M.D. <@duke.edu>Sent: Wednesday, October 10, 2018 3:34 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Subject: Re: Confirmation of your nomination for The Shaw Prize in Life Science and Medicine 2019You bet!!!Let’s do itBest  bSent from my iPhoneOn Oct 10, 2018, at 11:23 AM, Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov> wrote:Thanks, Bart.   There is another one that looks possible for me if you are willing to do it.  As usual, I will supply all of thematerial.   It is the Dan David…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/7.24.2026_Fauci-Awards_FINAL_REDACTED.pdf", "pdf_url": "/archive-docs/fauci-files/40cab29ba63b8c91a97fdb3bdbca6494/pdf", "doc_date": "2026-07-27", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "7-24-2026-fauci-awards-final-redacted"], "part_number": 1, "page_count": 136}
{"title": "Read the Documents (Part 2 of 2)", "content": "for Drs. Fauci and Rosenberg.  https://www.dandavidprize.org/prize/prize-nominations\nLinda D. Simmons\n \nNIH Ethics Office (NEO)\nNational Institutes of Health\nBethesda, MD \n@nih.gov\n (NEO)\n (direct)\nhttps://ethics.od.nih.gov\n \n Released by Chairman Rand Paul\nFrom:  Weaver, Gretchen (NIH/OD) [E] < @od.nih.gov > \nSent:  Friday, January 29, 2021 3:18 PM\nTo: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov >\nSubject:  RE: Dan David Prize\n \nHolli:  Here is discussion from 2011.  If you can confirm that nothing has changed, including the\n“attendant events” that are now mentioned on the web site, this should be helpful.  I did all of the\nleg work.  Ed took this information to OGE and OGE accepted the award as bona fide even though\nthe subject area to be recognized changes, etc.:\n \n \nThe Dan David Foundation awards three $1 million Dan David Prizes each year (since 2002),\nrecognizing past, present, and future achievements.  For each time dimension, a field is chosen, and\none or more recipients are selected.  If more than one recipient is selected in a field, the cash prize is\nshared.  The categories for 2012 are:  Past – History/Biography; Present – Plastic Arts; and Future –\nGenome Research.  Notably, laureates donate 10% of their prize money to graduate students of\ntheir choice.   NASA and DOE employees are among the prior recipients (they received the award in\n2007).  International panels of experts in each of the fields to be recognized evaluate the nominees\nbased upon the description of each field of recognition posted on the web site and submit reports to\nthe Dan David Prize Board (an international panel selected by the Dan David Foundation Board).  The\nDDP Board makes the final determination as to which nominee(s) in each category have achieved\nthat which the prize is intended to recognize (as described in the category descriptions).  More\ninformation is available at: http://www.dandavidprize.org/ , including the composition of the DDP\nBoard.\nAfter reviewing the web site, other publicly available information, and the materials our NASA\ncolleagues were able to provide, I made contact with the Chair of the Dan David Foundation Board,\nProfessor Itamar Rabinovich, and the administrative Director of the Prize, Ms. Smadar Fisher.  Based\non all of the information I have been able to obtain , it appears that the Prize program is “owned” by\nthe Dan David Foundation, although there is a relationship between it and Tel Aviv University\npursuant to which Tel Aviv provides space and administrative support for the award program. \nProfessor Rabinovich was the President of Tel Aviv University when Dan David began his Foundation\nand an agreement was reached.  Professor Rabinovich confirmed that the Foundation could opt to\nmove the administrative headquarters of the Prize out of the University.\nUpon review of the web site, you may also notice reference to French Collaboration.  The Dan David\nFoundation entered into an agreement with the French Government in 2006.  Professor Rabinovich\nhas said that this was intended to further the international outreach efforts of the Foundation.  In\nalternating years the Prize ceremony is held in France.  In exchange, two or three seats on the Dan\nDavid Prize Board “belong” to the French.  The current composition of the Board is at: \nhttp://www.dandavidprize.org/about/about-the-board.html . \n Released by Chairman Rand Paul\nBased upon the available information, and in light of OLC’s opinions (particularly the more recent\naward opinion covering the President’s Nobel Prize), I do not think the Dan David Prize implicates\nthe Emoluments Clause or the Foreign Gifts and Decorations Act.\nAlthough Tel Aviv University is an NIH grantee, I do not think the Dan David Prize implicates our\nSupplemental Standard because the Prize appears to be from the Dan David Foundation, a separate\nentity that does not appear to be a grantee or otherwise have any business dealings with the NIH.\nMoreover, although the recipient is expected to give a lecture (at a symposium, and in addition to\nacceptance remarks during the presentation ceremony), the Dan David Prize appears to be a bona\nfide award made as part of an established program of recognition that an NIH employee, including\nDr. Collins, might be permitted to accept (assuming no change in the program or other individualized\nissue).  Again , the award appears to be from the Dan David Foundation.  I have found no record of\nany business interactions between NIH and the Dan David Foundation, so OGE’s source limitation is\nnot an issue.  Although there is a symposium at which the recipients are expected to give a\npresentation, I have been told they give talks about their work over the course of their careers,\nrather than current science and theory, and $1 million is far outside of the range of typical honoraria\npaid for individual presentations.  From videos available on the internet (at sites not presently\nblocked by NIH security measures), it appears that the Prize ceremony is quite elaborate, well-\nattended, and in keeping with what we expect such an event to “look like.”  Press reports that\ncoincide with the announcement of each year’s winners appear to reflect that this is a significant\naward/honor.\nGretchen H. Weaver, J.D.\nSupervisory/Senior NIH Ethics Counsel\nDHHS/OGC/Ethics Division\nphone: \nfax: \nNOTICE:  THIS E-MAIL MESSAGE FROM THE OFFICE OF THE GENERAL COUNSEL (OGC), ETHICS DIVISION IS INTENDED FOR THE EXCLUSIVE\nUSE OF THE RECIPIENT(S) NAMES ABOVE AND MAY CONTAIN PROTECTED, PRIVILEGED, OR CONFIDENTIAL INFORMATION THAT SHOULD\nNOT BE TRANSMITTED TO UNAUTHORIZED ADDRESSEES.  IF YOU ARE NOT THE INTENDED RECIPIENT, ANY DISSEMINATION,\nDISTRIBUTION, OR COPYING IS STRICTLY PROHIBITED.  IF YOU HAVE RECEIVED THIS E-MAIL IN ERROR, PLEASE NOTIFY THE SENDER\nIMMEDIATELY AT THE ABOVE ADDRESS.  EMPLOYEE RECIPIENTS ARE COUNSELED THAT DISCIPLINARY ACTION FOR VIOLATING FEDERAL\nETHICS REGULATIONS MAY NOT BE TAKEN AGAINST ANY EMPLOYEE WHO HAS ENGAGED IN CONDUCT IN GOOD FAITH RELIANCE UPON\nTHE PRIOR ADVICE OF ANY AGENCY ETHICS OFFICIAL, PROVIDED THAT THE EMPLOYEE HAS MADE FULL DISCLOSURE OF ALL RELEVANT\nCIRCUMSTANCES.  IF EMPLOYEE CONDUCT IS POTENTIALLY SUBJECT TO CRIMINAL SANCTIONS UNDER CONFLICT OF INTEREST AND\nRELATED STATUTES, RELIANCE OF THE ADVICE OF AN AGENCY ETHICS OFFICIAL IN INTERPRETING THE SCOPE OF SUCH STATUTES IS A\nFACTOR THAT MAY BE TAKEN INTO ACCOUNT BY THE DEPARTMENT OF JUSTICE IN EXERCISING PROSECUTORIAL DISCRETION. \nEMPLOYEES ARE CAUTIONED THAT DISCLOSURES TO AN OGC ATTORNEY ARE NOT PROTTECTED WITHIN THE DEPARTMENT BY\nATTORNEY-CLIENT PRIVILEGE.  ALL EMPLOYEES, INCLUDING AGENCY ATTORNEYS, ARE REQUIRED TO REPORT CRIMINAL VIOLATIONS TO\nTHE OFFICE OF THE INSPECTOR GENERAL.\nFrom:  Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov > \nSent:  Friday, January 29, 2021 2:16 PM\nLectureReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nFrom:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>Cc:\"Folkers, Greg (NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:FW: DECISION: Anthony FAUCI's NIH 2854 approvedDate:Sat, 10 Apr 2021 11:52:15 -0400Importance:NormalCongratulations....you're rich!-----Original Message-----From: Bennett, Arthur (NIH/NIAID) [E] < @niaid.nih.gov>Sent: Friday, April 9, 2021 4:44 PMTo: Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>Subject: FW: DECISION: Anthony FAUCI's NIH 2854 approvedAt last!!!!!!!-----Original Message-----From: NIHNEES < @mail.nih.gov>Sent: Friday, April 9, 2021 4:43 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>; Bennett, Arthur (NIH/NIAID) [E]< @niaid.nih.gov>Cc: Bennett, Arthur (NIH/NIAID) [E] < @niaid.nih.gov>Subject: DECISION: Anthony FAUCI's NIH 2854 approvedSYSTEM-GENERATED MESSAGE; PLEASE DO NOT REPLY TO THIS MESSAGE VIA EMAIL.The  NIH 2854 for  Dan David Prize has been approved.Please go to https://nees.nih.gov and log in as employee/filer. Choose View the report, then click on the View/Print tab toopen the pdf  Request.Remember, you are recused from all specific party matters where the award donor organization is a party to the matter, forone year following the date you will receive the award. This means that you may not participate in any official Governmentmatter (e.g., grant or contract) in which the award donor is also a party (e.g., the grantee or contractor) until one yearfollowing the date you receive the award. If anyone attempts to discuss a Government matter involving the donororganization, please stop the discussion and refer the individual to your supervisor. If you have questions, contact your IC'sethics office. Contact information is available at http://ethics.od.nih.gov/coord.pdf. Released by Chairman Rand Paul\nFrom:\"Folkers, Greg (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:RE: DECISION: Anthony FAUCI's NIH 2854 approvedDate:Sat, 10 Apr 2021 11:58:34 -0400Importance:NormalI want my 15% Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>Subject:RE: DECISION: Anthony FAUCI's NIH 2854 approvedDate:Sat, 10 Apr 2021 16:43:40 -0400Importance:Normal -----Original Message-----From: Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>Sent: Saturday, April 10, 2021 11:52 AMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Folkers, Greg (NIH/NIAID) [E] < @niaid.nih.gov>Subject: FW: DECISION: Anthony FAUCI's NIH 2854 approved Congratulations....you're rich!   -----Original Message-----From: Bennett, Arthur (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Friday, April 9, 2021 4:44 PMTo: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>Subject: FW: DECISION: Anthony FAUCI's NIH 2854 approved At last!!!!!!! -----Original Message-----From: NIHNEES <@mail.nih.gov>Sent: Friday, April 9, 2021 4:43 PMTo: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>; Bennett, Arthur (NIH/NIAID) [E]<@niaid.nih.gov>Cc: Bennett, Arthur (NIH/NIAID) [E] <@niaid.nih.gov>Subject: DECISION: Anthony FAUCI's NIH 2854 approved SYSTEM-GENERATED MESSAGE; PLEASE DO NOT REPLY TO THIS MESSAGE VIA EMAIL.  The  NIH 2854 for  Dan David Prize has been approved.  Please go to https://nees.nih.gov and log in as employee/filer. Choose View the report, then click on theView/Print tab to open the pdf  Request.  Released by Chairman Rand Paul\nRemember, you are recused from all specific party matters where the award donor organization is a party to thematter, for one year following the date you will receive the award. This means that you may not participate inany official Government matter (e.g., grant or contract) in which the award donor is also a party (e.g., thegrantee or contractor) until one year following the date you receive the award. If anyone attempts to discuss aGovernment matter involving the donor organization, please stop the discussion and refer the individual to yoursupervisor. If you have questions, contact your IC's ethics office. Contact information is available athttp://ethics.od.nih.gov/coord.pdf.Released by Chairman Rand Paul\n  Released by Chairman Rand Paul\nFrom:Dan David Prize < @tauex.tau.ac.il>To:\" @niaid.nih.gov'\" < @niaid.nih.gov>Subject:Dan David Prize - Bank TransferDate:Tue, 11 May 2021 06:13:57 -0400Importance:NormalAttachments:Watch_the_ceremony.3.pdf; Anthony_Fauci_-_Swift.pdfDear Dr. Fauci, I am attaching a copy of the bank transfer. Please confirm that you have received the funds. I am also attaching a flyer, with a link to ceremony screening. Best wishes,Tami Tami NoamProject CoordinatorDan David PrizeOffice: @tauex.tau.ac.ilEmail: www.dandavidprize.orgWebsite:   Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Dan David Prize\" < @tauex.tau.ac.il>Subject:RE: Dan David Prize - Bank TransferDate:Sat, 15 May 2021 13:54:55 -0400Importance:NormalI have received the funds.   Many thanks.Best regards,A.S. FauciAnthony S. Fauci, MDDirectorNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesda, MD Phone: FAX: E-mail: @niaid.nih.govThe information in this e-mail and any of its attachments is confidential and may contain sensitive information.  Itshould not be used by anyone who is not the original intended recipient.  If you have received this e-mail in errorplease inform the sender and delete it from your mailbox or any other storage devices.  The National Institute ofAllergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender'sown and not expressly made on behalf of the NIAID by one of its representatives.  From: Dan David Prize < @tauex.tau.ac.il>Sent: Tuesday, May 11, 2021 6:14 AMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Subject: Dan David Prize - Bank Transfer Dear Dr. Fauci, I am attaching a copy of the bank transfer. Please confirm that you have received the funds. I am also attaching a flyer, with a link to ceremony screening. Best wishes,Tami Tami NoamProject CoordinatorDan David PrizeOffice: @tauex.tau.ac.ilEmail: www.dandavidprize.orgWebsite:   Released by Chairman Rand Paul\nFrom:\"Fauci, Anthony (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Folkers, Greg (NIH/NIAID) [E]\" < @niaid.nih.gov>Cc:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>, \"Auchincloss, Hugh(NIH/NIAID) [E]\" <@niaid.nih.gov>, \"Barasch, Kimberly (NIH/NIAID) [E]\"<@nih.gov>Subject:RE: Dinarello has a questionDate:Mon, 23 Aug 2021 16:25:22 -0400Importance:NormalInline-Images:image002.jpgI did not want Bart  to nominate me for the Shaw Prize.   If Charles wants me to nominate himfor the Shaw Prize, I would be happy to do so.   He would have to write the nomination as hehas done in the past. Anthony S. Fauci, MDDirectorNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesda, MD Phone: FAX: E-mail: @niaid.nih.govThe information in this e-mail and any of its attachments is confidential and may contain sensitive information.  Itshould not be used by anyone who is not the original intended recipient.  If you have received this e-mail in errorplease inform the sender and delete it from your mailbox or any other storage devices.  The National Institute ofAllergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender'sown and not expressly made on behalf of the NIAID by one of its representatives.  From: Folkers, Greg (NIH/NIAID) [E] < @niaid.nih.gov>Sent: Monday, August 23, 2021 3:25 PMTo: Fauci, Anthony (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>; Auchincloss, Hugh (NIH/NIAID) [E]<@niaid.nih.gov>; Barasch, Kimberly (NIH/NIAID) [E] <@nih.gov>Subject: RE: Dinarello has a question This came to BartHe asked you if you wanted him to nominate you Don’t know where that stands, nor what to do re: charles  From: Barton Haynes, M.D. <@duke.edu>Sent: Sunday, November 15, 2020 10:01 PMTo: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>; Anthony Fauci [E] <@gmail.com>; Fauci, Anthony(NIH/NIAID) [E] <@niaid.nih.gov>Cc: Kelly Soderberg <@duke.edu>Subject: Fwd: Final Reminder to Nominate a Candidate for The Shaw Prize in Life Science and Medicine 2021Released by Chairman Rand Paul\n   Hi TonyHave you won this yet? Want me to nominate you? Best bSent from my iPhone  From: The Shaw Prize <@shawprize.org>Date: November 15, 2020 at 9:50:51 PM ESTTo: \"Barton Haynes, M.D.\" <@duke.edu>Subject: Final Reminder to Nominate a Candidate for The Shaw Prize in Life Science and Medicine 2021\nThe Shaw PrizeDear Professor Barton F Haynes,This letter serves as our renewed invitation to you to nominate a candidate for The Shaw Prize in Life Science andMedicine.Please click on the link below to start the nomination process. If this is your first visit to this new round of 2021, you willbe invited to set a password before you begin.BEGIN NOMINATIONPlease treat this invitation and nomination as highly confidential and kindly do not transfer the invitation for nominationto any other individual.Thank you for your support and please note that all nominations must be received by the Shaw Prize on or before 30November 2020. Sincerely yours,Peggy NgThe Shaw Prize Secretariat   From: Fauci, Anthony (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Monday, August 23, 2021 11:39 AMTo: Folkers, Greg (NIH/NIAID) [E] <@niaid.nih.gov>Cc: Conrad, Patricia (NIH/NIAID) [E] <@niaid.nih.gov>; Auchincloss, Hugh (NIH/NIAID) [E]<@niaid.nih.gov>; Barasch, Kimberly (NIH/NIAID) [E] <@nih.gov>Subject: Re: Dinarello has a question Greg: I believe I have been asked by the Shaw prize people to nominate someone. However because I have been so busy Ijust discarded the request and no longer have the forms. I am not sure whether I can get another copy since I believe thatCharles wants me to nominate him. Let us discuss. Thanks, Tony Released by Chairman Rand Paul\nOn Aug 23, 2021, at 11:25 AM, Folkers, Greg (NIH/NIAID) [E] <@niaid.nih.gov> wrote:Do u know? From: charles dinarello <@aol.com>Sent: Monday, August 23, 2021 11:24 AMTo: Folkers, Greg (NIH/NIAID) [E] <@niaid.nih.gov>Subject: Dinarello has a question I thoroughly enjoyed Tony's acceptance speech for the Dan David Prize and again I thank you for your essential  role inthe nomination process.  Can you find out if Tony has been asked by the Shaw Prize committee to nominate someone.Thanks. CharlesReleased by Chairman Rand Paul\nFrom:\"Miller, Katherine (NIH/NIAID) [E]\" < @niaid.nih.gov>To:\"Auchincloss, Hugh (NIH/NIAID) [E]\" <@niaid.nih.gov>Cc:\"Holland, Steven (NIH/NIAID) [E]\" < @niaid.nih.gov>, \"Shaffer, Meredith(NIH/NIAID) [E]\" <@nih.gov>Subject:RE: Nominate Anthony Fauci as an exceptional candidate in infectious diseases for the 2022John J. Carty Award for the Advancement of ScienceDate:Fri, 17 Sep 2021 09:50:23 -0400Importance:NormalThank you! From: Auchincloss, Hugh (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Friday, September 17, 2021 9:40 AMTo: Miller, Katherine (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Holland, Steven (NIH/NIAID) [E] < @niaid.nih.gov>; Shaffer, Meredith (NIH/NIAID) [E]<@nih.gov>Subject: RE: Nominate Anthony Fauci as an exceptional candidate in infectious diseases for the 2022 John J. Carty Awardfor the Advancement of Science You could ask Laurie Glimcher     @dfci.harvard.edu and Larry Corey  @fredhutch.org From: Miller, Katherine (NIH/NIAID) [E] <@niaid.nih.gov>Sent: Thursday, September 16, 2021 4:55 PMTo: Auchincloss, Hugh (NIH/NIAID) [E] <@niaid.nih.gov>Cc: Holland, Steven (NIH/NIAID) [E] <@niaid.nih.gov>; Shaffer, Meredith (NIH/NIAID) [E]<@nih.gov>Subject: FW: Nominate Anthony Fauci as an exceptional candidate in infectious diseases for the 2022 John J. Carty Awardfor the Advancement of Science Hi HughHow are you?  I hope you are doing well in these extraordinary times. Steve has asked that I help with the nomination of Dr. Fauci for the Carty award.  The timeline is tight and the mostimmediate concern is the need for two reference letters from outside NIH (highlight below).  I am happy to solicit theletters – have referees been identified?I will also draft a letter and citation to send through the usual channels for review and I’ll reach out to Greg for theabbreviated CV and top 12 publications unless you advise an alternative course.Thank you and take care.Best,Katherine  From: Estes, Mary Kolb <@bcm.edu>Sent: Monday, September 13, 2021 11:55 AMTo: Collins, Francis (NIH/OD) [E] <@od.nih.gov>Subject: Nominate Anthony Fauci as an exceptional candidate in infectious diseases for the 2022 John J. CartyAward for the Advancement of Science  Dear Francis,Released by Chairman Rand Paul\n I am chairing the committee to review nominees for the 2022 John J. Carty Award for the Advancementof Science that will be presented at the National Academy of Sciences meeting next spring. The committee easily identify Dr. Fauci as an exceptional candidate for this award.  I am writing ask ifyou would be willing and able to nominate him for this Award. The 2022 John J. Carty Award recognizes noteworthy and distinguished accomplishments in infectiousdiseases. The award is presented with a medal and a $25,000 prize. Additional information, includingpast recipients, eligibility requirements, and more, can be found at http://bit.ly/NASCartyAward. All nominations must be submitted online. Unless otherwise stated, the following materials must besubmitted: 1. A letter from the nominator describing the candidate's work and why he or she should be selected forthe award. No more than three (3) pages.2. Curriculum vitae. No more than two (2) pages (similar to CVs included with NSF proposals but other 2page formats are acceptable).3. Bibliography listing no more than twelve (12) of the nominee's most significant publications.4. Suggested citation. A 50-word summary stating why the nominee should be considered for thisaward. Citation examples»5. Two letters of support. Support letters must be written by individuals from institutions outside boththe nominator's and the nominee’s institution. Nominations accepted through Monday, October 4, 2021. Please let me know if your office can do this or if you have another suggestion for who I might contact.   Thank you and I look forward to hearing from you. Sincerely, Mary Mary K. Estes, PhDThe Carty Award Selection Committee Distinguished Service ProfessorDepartment of Molecular Virology and MicrobiologyBaylor College of MedicineHouston, Texas  cell Released by Chairman Rand Paul\nFrom:\"/O=EXCHANGELABS/OU=EXCHANGE ADMINISTRATIVE GROUP(FYDIBOHF23SPDLT)/CN=RECIPIENTS/CN=DF38103D75134F658AE2D356F0396B94-AFAUCI\" < @niaid.nih.gov>To:\"Conrad, Patricia (NIH/NIAID) [E]\" < @niaid.nih.gov>, \"Bennett, Arthur(NIH/NIAID) [E]\" < @niaid.nih.gov>Cc:\"Barasch, Kimberly (NIH/NIAID) [E]\" <@nih.gov>Subject:RE: Draft info - Dr. Fauci annual financial disclosure reportDate:Wed, 23 Mar 2022 11:20:59 -0400Importance:NormalInline-Images:image001.pngArthur:    Some corrections to you e-mail regarding gifts, awards, etc.:1. The Dan David prize that was deposited in my bank account was $899,960. 00, not $901,400.2) The Elliot Richardson Prize was officially $25,000.00; however, I only received $12,500since they automatically gave $!2,500 of the $25,000 to charity.   That was a condition of theaward. 3) My wife and I never attended the Amethyste at the French Ambassador’s home.  We were invited, but we did not attend.Thanks,Tony Anthony S. Fauci, MDDirectorNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesda, MD Phone: FAX: E-mail:@niaid.nih.govThe information in this e-mail and any of its attachments is confidential and may contain sensitive information.  Itshould not be used by anyone who is not the original intended recipient.  If you have received this e-mail in errorplease inform the sender and delete it from your mailbox or any other storage devices.  The National Institute ofAllergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender'sown and not expressly made on behalf of the NIAID by one of its representatives.  From: Conrad, Patricia (NIH/NIAID) [E] < @niaid.nih.gov>Sent: Wednesday, March 23, 2022 11:11 AMTo: Bennett, Arthur (NIH/NIAID) [E] < @niaid.nih.gov>Cc: Barasch, Kimberly (NIH/NIAID) [E] <@nih.gov>; Fauci, Anthony (NIH/NIAID) [E]< @niaid.nih.gov>Subject: Re: Draft info - Dr. Fauci annual financial disclosure report Thanks u. Adding ASF Sent from my iPhoneReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul", "summary": "Watcher-discovered document from paul-readingroom (7.24.2026_Fauci-Awards_FINAL_REDACTED.pdf), auto-indexed 2026-07-27.\n\nExcerpt: for Drs. Fauci and Rosenberg.  https://www.dandavidprize.org/prize/prize-nominations Linda D. Simmons   NIH Ethics Office (NEO) National Institutes of Health Bethesda, MD  @nih.gov  (NEO)  (direct) https://ethics.od.nih.gov    Released by Chairman Rand Paul From:  Weaver, Gretchen (NIH/OD) [E] < @od.nih.gov >  Sent:  Friday, January 29, 2021 3:18 PM To: Jaffe, Holli Beckerman (NIH/OD) [E] < @od.nih.gov > Subject:  RE: Dan David Prize   Holli:  Here is discussion from 2011.  If you can confirm that nothing has changed, including the “attendant events” that are now mentioned on the web site, this should be helpful.  I did all of the leg work.  Ed took this information to OGE and OGE accepted the award as bona fide even though the subject area to be recognized changes, etc.:     The Dan…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/7.24.2026_Fauci-Awards_FINAL_REDACTED.pdf", "pdf_url": "/archive-docs/fauci-files/40cab29ba63b8c91a97fdb3bdbca6494/pdf", "doc_date": "2026-07-27", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "7-24-2026-fauci-awards-final-redacted"], "part_number": 2, "page_count": 136}
{"title": "HERE", "content": "Released by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nPhotos\n#Preview\n1.\n2.\nDate of Birth\n1.DASZAK, PETERPlace of Birth\n1.Place of Birth:DUKINFIELD\nUNITED KINGDOM GB/GBR\nCity:DUKINFIELD\nCountry:United Kingdom (GB/GBR)\n2.Country:United Kingdom (GB/GBR)\nCitizenship\nUnited States (US/USA)\nDisposition\n1.Disposition Category:\nDisposition: ActionUNCLASSIFIED//LES\nUNCLASSIFIED//LES \nReleased by Chairman Rand Paul\nDisposition Reason\n1.Remarks:Referred to .  FBI requested not to stop subject.  No further \nNTC action\nRecords\n#Person Record Name S\nubtype Record ID Code\n1.\n2.PNR\n3.PNR\n4.TECS\nConveyances\n1.MOT:Air-Commercial\nEst Departure:01/12/2021 01:00:00 EST\nEst Arrival:01/12/2021 13:15:00 EST\nFlight No:704\nCarrier:QATAR AIRWAYS (QR)\nF\nrom Port:John F Kennedy International Airport (JFK)\nTo Port:Hamad International Airport (DOH)\nItinerary Description: John F Kennedy International Airport(JFK)-Hamad International Airport(DOH)\n2.MOT:Air-Commercial\nEst Departure:02/04/2021 13:00:00 EST\nEst Arrival:02/04/2021 21:30:00 EST\nFlight No:945UNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nCarrier:QATAR AIRWAYS (QR)\nFrom Port:Singapore Changi Airport (SIN)\nTo Port:Hamad International Airport (DOH)\nItinerary\nDescription:Singapore Changi Airport(SIN)-Hamad International Airport(DOH); Hamad \nInternational Airport(DOH)-Singapore Changi Airport(SIN); Hamad \nInternational Airport(DOH)-John F Kennedy International Airport(JFK)\n3.MOT:Air-Commercial\nEst Departure:01/12/2021 18:10:00 EST\nEst Arrival:01/13/2021 01:55:00 EST\nFlight No:946\nCarrier:QATAR AIRWAYS (QR)\nF\nrom Port:Hamad International Airport (DOH)\nTo Port:Singapore Changi Airport (SIN)\nItinerary\nDescription:Singapore Changi Airport(SIN)-Hamad International Airport(DOH); Hamad \nInternational Airport(DOH)-Singapore Changi Airport(SIN); Hamad \nInternational Airport(DOH)-John F Kennedy International Airport(JFK)\n4.MOT:Air-Commercial\nEst Departure:02/05/2021 00:15:00 EST\nEst Arrival:02/05/2021 14:25:00 EST\nFlight No:701\nCarrier:QATAR AIRWAYS (QR)\nF\nrom Port:Hamad International Airport (DOH)\nTo Port:John F Kennedy International Airport (JFK)\nItinerary\nDescription:Singapore Changi Airport(SIN)-Hamad International Airport(DOH); Hamad \nInternational Airport(DOH)-Singapore Changi Airport(SIN); Hamad \nInternational Airport(DOH)-John F Kennedy International Airport(JFK)\n5.MOT:Air-Commercial\nEst Departure:01/04/2021 21:00:00 EST\nEst Arrival:01/05/2021 09:15:00 EST\nFlight No:QR 702\nCarrier:QATAR AIRWAYS (QR)\nF\nrom Port:John F Kennedy International Airport (JFK)\nTo Port:Hamad International Airport (DOH)\nItinerary\nDescription:John F Kennedy International Airport(JFK)-Hamad International Airport(DOH); \nHamad International Airport(DOH)-Singapore Changi Airport(SIN); Singapore \nChangi Airport(SIN)-San Francisco International Airport(SFO); San Francisco \nInternational Airport(SFO)-Newark Liberty International Airport(EWR)\n6.MOT:Air-Commercial\nEst Departure:01/05/2021 12:30:00 EST\nEst Arrival:12/31/1969 20:45:00 EST\nFlight No:QR 942\nCarrier:QATAR AIRWAYS (QR)\nF\nrom Port:Hamad International Airport (DOH)\nTo Port:Singapore Changi Airport (SIN)\nItinerary\nDescription:John F Kennedy International Airport(JFK)-Hamad International Airport(DOH); \nHamad International Airport(DOH)-Singapore Changi Airport(SIN); Singapore \nChangi Airport(SIN)-San Francisco International Airport(SFO); San Francisco \nInternational Airport(SFO)-Newark Liberty International Airport(EWR)\n7.MOT:Air-Commercial\nEst Departure:02/04/2021 21:00:00 EST\nEst Arrival:01/01/1970 11:35:00 ESTUNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nFlight No:UA 2\nCarrier:UNITED AIRLINES (UA)\nFrom Port:Singapore Changi Airport (SIN)\nTo Port:San Francisco International Airport (SFO)\nItinerary\nDescription:John F Kennedy International Airport(JFK)-Hamad International Airport(DOH); \nHamad International Airport(DOH)-Singapore Changi Airport(SIN); Singapore \nChangi Airport(SIN)-San Francisco International Airport(SFO); San Francisco \nInternational Airport(SFO)-Newark Liberty International Airport(EWR)\n8.MOT:Air-Commercial\nEst Departure:02/05/2021 13:45:00 EST\nEst Arrival:01/01/1970 19:23:00 EST\nFlight No:UA 1900\nCarrier:UNITED AIRLINES (UA)\nF\nrom Port:San Francisco International Airport (SFO)\nTo Port:Newark Liberty International Airport (EWR)\nItinerary\nDescription:John F Kennedy International Airport(JFK)-Hamad International Airport(DOH); \nHamad International Airport(DOH)-Singapore Changi Airport(SIN); Singapore \nChangi Airport(SIN)-San Francisco International Airport(SFO); San Francisco \nInternational Airport(SFO)-Newark Liberty International Airport(EWR)\nActivity Reason\nGLOBAL TACTICAL OPERATIONS BRANCHUNCLASSIFIED//LES\nUNCLASSIFIED//LES \nReleased by Chairman Rand Paul\nActivity Remarks\nRe\nm\nar\nk\nTy\npeRemark\nRE\nMA\nRK* DASZAK was asked publicly by NIH to retrieve the original type-specimen used by WIV for \ngenetic analysis, and return it to the United States.  He was also asked to explain several \naspects of their collaboration, including related to cell phone data.  DASZAK called the \nrequirements \"outrageous\" and does not appear to intend to comply with them \n(https://www.sciencemag.org/news/2020/08/nih-imposes-outrageous-conditions-resuming-coronavirus-\ngrant-targeted-trump)\n* DASZAK and EcoHealth has been awarded a number of contracts and grants from the U.S. \nfederal government.  These include contracts with the DHS Chemical and Biological Threat \nDivision.  Many items that EcoHealth studies are likely to be subject to serious non-disclosure \nagreements with the U.S. government and/or be export controlled. \nMore background information in the kind of research that DASZAK is heavily involved in.  A lot of \nthe funding DASZAK receives is put towards \"gain of function research\" also known as biological \nweapons research.  This research involves experimentation that aims or is expected to increase \nthe transmissibility and/or virulence of pathogens. Such research, when conducted by responsible \nscientists, usually aims to improve understanding of disease causing agents, their interaction \nwith human hosts, and/or their potential to cause pandemics. The ultimate objective of such \nresearch is to better inform public health and preparedness efforts and/or development of medical \ncountermeasures.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996883/  In gain of function \nresearch, genome sequences are reconstructed/reformulated and are inserted into human/animal \ncells to be studied on how the \"new\" sequence effects humans and/or animals.  There is a lot of \ncriticism on gain of function research in regards to ethics and if the science is worth the risks \nof creating a potentially harmful virus or disease.  \nIn 2013, DASZAK was a coauthor of publication \"Isolation and characterization of a bat SARS-like \ncoronavirus that uses the ACE2 receptor\" with Zhengli SHI and Ralph BARIC.  This paper is of \nsignificance due to the first reporting of a SL-CoV-WIV1 (SARS-like coronavirus WIV1) binding to \nhuman cells and infecting them.  https://www.nature.com/articles/nature12711#Sec2  Essentially, \nDASZAK and collaborators at WIV created a bat coronavirus capable of directly infecting humans. \nA follow up article published in Nature magazine on 12/12/2015 titled \"Engineered bat virus stirs \ndebate over risky research, Lab-made coronavirus related to SARS can infect human cells\" debates \n\"whether engineering lab variants of viruses with possible pandemic potential is worth the \nrisks.\" https://www.nature.com/news/engineered-bat-virus-stirs-debate-over-risky-research-\n%201.18787 \nDuring the inspection, it is hard to say if DASZAK will be forthcoming with information.UNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nRe\nm\nar\nk\nTy\npeRemark\nRE\nMA\nRKFrom: CBP.DHS.GOV> \nSent: Tuesday, February 2, 2021 10:18 PM\nTo: cbp.dhs.gov>\nCc:  REFERRALS cbp.dhs.gov>; S\n@cbp.dhs.gov>\nSubject: Re: Subject Event 3  P. DASZAK C\n10-4, thanks. We'll send it out in the morning.\nCharlie \nSent from my iPhone\nOn Feb 2, 2021, at 10:11 PM, cbp.dhs.gov> wrote:\n \n \nGood evening , \n \n***FYSA - NTC has rescinded previous inspection request; however, subject may be of interest to \nthe FBI ***\n \n \nPeter DASZAK  (DOB:  is scheduled to travel from DOH to JFK on \n02/05/2021, aboard QR #701 ETA 1425 EST- Event has been created for additional \ninformation.\n \n*** Reference event for notable publications and news articles.***\n \n \nBackground\nPeter DASZAK (DOB: is the President of EcoHealth \nAlliance; a US science-based non-profit that conducts research and outreach on the causes of \nemerging pandemic diseases, and their links to environmental change and conservation (Link).  \nDASZAK's scientific research is focused on understanding the drivers of emerging diseases to \ninclude: evidence that emerging disease, chytridiomycosis, causes global amphibian declines; the \nfirst ever map of emerging disease 'hotspots'; and the identification of bats as a reservoir for \nSARS.  DASZAK's goals are to understand what drives disease emergence develop innovative ways to \nstop emerging diseases in wildlife, livestock and people; and promote conservation of wildlife.  \n \nDASZAK, is part of the World Health Organization (WHO) team that is investigating the origins of \nSARS-CoV-2, the virus that causes COVID-19 (Link).  DASZAK is also affiliated with Zhengli SHI \n(Bat Woman) - the lead Virologist and Researcher at the Wuhan Institute of Virology (WIV), \nChinese Academy of Sciences (CAS) Link. SHI's areas of study include:  Bats, Viral Ecology, Viral \nEntry, Virus Discovery, Zoonotic Diseases, Virology, Ecology of Pathogens (Link). EcoHealth\n \nAlliance and DASZAK have been working with Shi Zhengli for more than 15 years.\n \nDASZAK is listed as the Principal Investigator (PI) on National Institute of Health (NIH) \nNational Institute of Allergy and Infectious Diseases (NIAID) grants:  1U01AI151797-01 - \nUnderstanding Risk of Zoonotic Viruses Emergence in EID Hotspots of Southeast Asia, and  \n#2R01AI110964-06:  Understanding the Risk of Bat Coronavirus Emergence, dated  6/01/2014-\n06/30/2024.  SHI listed grant R01AI110964 on her resume (Link), although SHI is not listed as a \nPI.  A search of the grant revealed 19 publications (Link), many of which were written by SHI.  \n \nAdditional information\n* DASZAK was asked publicly by NIH to retrieve the original type-specimen used by WIV for \ngenetic analysis, and return it to the United States. He was also asked to explain several UNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\n\nRe\nm\nar\nk\nTy\npeRemarkaspects of their collaboration, including related to cell phone data. Link \n* DASZAK and EcoHealth has been awarded a number of contracts and grants from the U.S. \nfederal government. These include contracts with the DHS Chemical and Biological Threat Division. \nMany items that EcoHealth studies are likely to be subject to serious non-disclosure agreements \nwith the U.S. government and/or be export controlled.  \n \n* Much of the funding DASZAK receives is put towards gain of function research.  This \nresearch involves experimentation that aims or is expected to increase the transmissibility\n \nand/or virulence of pathogens. The ultimate objective of such research is to better inform public \nhealth and preparedness efforts and/or development of medical countermeasures. Link  \n \n* In 2013, DASZAK was a coauthor of publication \"Isolation and characterization of a bat \nSARS-like coronavirus that uses the ACE2 receptor\" with Zhengli SHI and Ralph BARIC. This paper \nis of significance due to the first reporting of a SL-CoV-WIV1 (SARS-like coronavirus WIV1) \nbinding to human cells and infecting them. Link  \n \n* A follow up article published in Nature magazine on 12/12/2015 titled \"Engineered bat \nvirus stirs debate over risky research, Lab-made coronavirus related to SARS can infect human \ncells\" debates \"whether engineering lab variants of viruses with possible pandemic potential is \nworth the risks.\" Link\n \nRespectfully, \n \nNational Targeting Security Specialist\nNational Targeting Center (NTC)\nTactical Targeting \n \n \n \n \n \nWARNING:  This document is LAW ENFORCEMENT SENSITIVE and is designated for OFFICIAL USE ONLY.  It \ncontains information that may be exempt from public release under the Freedom of Information Act \n(5USC552). This document is to be controlled, handled, transmitted, distributed, and disposed of \nin accordance with DHS policy relating to FOUO information, and is not to be released to the \npublic or personnel who do not have a valid \"need-to-know\" without prior approval from OFO \nNational Targeting Center - Passenger at 571-468-1000.UNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nRe\nm\nar\nk\nTy\npeRemark\nRE\nMA\nRKFrom: cbp.dhs.gov> \nSent: Tuesday, February 2, 2021 8:55 PM\nTo: cbp.dhs.gov>; J bp.dhs.gov>; NY\nREFERRALS cbp.dhs.gov>\nCc: NTC-P cbp.dhs.gov>; P\n@cbp.dhs.gov>\nSubject: RE: Referral Event 3  P. DASZAK C\n10/4\nSupervisory Officer- TTRT\nUS Customs and Border Protection\nFrom: cbp.dhs.gov> \nSent: Tuesday, February 2, 2021 8:49 PM\nTo: cbp.dhs.gov>; N REFERRALS < bp.dhs.gov>\nCc: NTC-P NatSec Group cbp.dhs.gov>; P\n@cbp.dhs.gov>\nSubject:  Referral Event 3  P. DASZAK C\nGood afternoon,\nPlease consider the following subject for a TTRT Exam.\nPeter DASZAK  (DOB:  is scheduled to travel from DOH to JFK on \n02/05/2021, aboard QR #701 ETA 1425 EST- Event has been created for additional \ninformation.\n*** Reference event for notable publications and news articles.***\nBackground\nPeter DASZAK (DOB: is the President of EcoHealth \nAlliance; a US science-based non-profit that conducts research and outreach on the causes of \nemerging pandemic diseases, and their links to environmental change and conservation (Link).  \nDASZAK's scientific research is focused on understanding the drivers of emerging diseases to \ninclude: evidence that emerging disease, chytridiomycosis, causes global amphibian declines; the \nfirst ever map of emerging disease 'hotspots'; and the identification of bats as a reservoir for \nSARS.  DASZAK's goals are to understand what drives disease emergence develop innovative ways to \nstop emerging diseases in wildlife, livestock and people; and promote conservation of wildlife.  \nDASZAK, is part of the World Health Organization (WHO) team that is investigating the origins of \nSARS-CoV-2, the virus that causes COVID-19 (Link).  DASZAK is also affiliated with Zhengli SHI \n(Bat Woman) - the lead Virologist and Researcher at the Wuhan Institute of Virology (WIV), \nChinese Academy of Sciences (CAS) Link. SHI's areas of study include:  Bats, Viral Ecology, Viral \nEntry, Virus Discovery, Zoonotic Diseases, Virology, Ecology of Pathogens (Link). EcoHealth\n \nAlliance and DASZAK have been working with Shi Zhengli for more than 15 years.UNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nRe\nm\nar\nk\nTy\npeRemark\nDASZAK is listed as the Principal Investigator (PI) on National Institute of Health (NIH) \nNational Institute of Allergy and Infectious Diseases (NIAID) grants:  1U01AI151797-01 - \nUnderstanding Risk of Zoonotic Viruses Emergence in EID Hotspots of Southeast Asia, and  \n#2R01AI110964-06:  Understanding the Risk of Bat Coronavirus Emergence, dated  6/01/2014-\n06/30/2024.  SHI listed grant R01AI110964 on her resume (Link), although SHI is not listed as a \nPI.  A search of the grant revealed 19 publications (Link), many of which were written by SHI.  \nAdditional information\n* DASZAK was asked publicly by NIH to retrieve the original type-specimen used by WIV for \ngenetic analysis, and return it to the United States. He was also asked to explain several \naspects of their collaboration, including related to cell phone data. Link \n* DASZAK and EcoHealth has been awarded a number of contracts and grants from the U.S.\n \nfederal government. These include contracts with the DHS Chemical and Biological Threat Division. \nMany items that EcoHealth studies are likely to be subject to serious non-disclosure agreements \nwith the U.S. government and/or be export controlled.  \n* Much of the funding DASZAK receives is put towards gain of function research.  This \nresearch involves experimentation that aims or is expected to increase the transmissibility \nand/or virulence of pathogens. The ultimate objective of such research is to better inform public \nhealth and preparedness efforts and/or development of medical countermeasures. Link  \n* In 2013, DASZAK was a coauthor of publication \"Isolation and characterization of a bat \nSARS-like coronavirus that uses the ACE2 receptor\" with Zhengli SHI and Ralph BARIC. This paper \nis of significance due to the first reporting of a SL-CoV-WIV1 (SARS-like coronavirus WIV1) \nbinding to human cells and infecting them. Link  \n* A follow up article published in Nature magazine on 12/12/2015 titled \"Engineered bat \nvirus stirs debate over risky research, Lab-made coronavirus related to SARS can infect human \ncells\" debates \"whether engineering lab variants of viruses with possible pandemic potential is \nworth the risks.\" Link\nNTC Requests\n* TTRT exam to include review of media (search level determined by POE).\n* Why was DASZAK chosen to be on the WHO investigative team?\n* Where in China did DASZAK go?\n* Where did DASZAK stay while in China?\n* Who was the POC? \n* Did the team visit WIV? If so, what areas did they inspect? Who did the team meet with?\n* Did the team visit the Chinese Center for Disease Control and Prevention? If so, what \nareas did they inspect? Who did the team meet with?\n* Did the team meet with any other officials from the Chinese government?\n* Did DASZAK collect any biological samples during the trip?\n* Is DASZAK traveling with any biological samples?\n* Did he mail any samples back to the US?\n* Did he take any materials with him to China?\n* Has DASZAK maintained contact with anyone at the WIV? If so, whom and how often would he \ncommunicate?  What do they communicate about?\n* What was the purpose of DASZAK's travel from 01/04/2021-01/07/2021?\nRespectfully, \nNational Targeting Security Specialist\nNational Targeting Center (NTC)UNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nRe\nm\nar\nk\nTy\npeRemarkTactical Targeting \nUNCLASS:  \nHSDN:  \nJWICS:  \nPhone: \nWARNING:  This document is LAW ENFORCEMENT SENSITIVE and is designated for OFFICIAL USE ONLY.  It \ncontains information that may be exempt from public release under the Freedom of Information Act \n(5USC552). This document is to be controlled, handled, transmitted, distributed, and disposed of \nin accordance with DHS policy relating to FOUO information, and is not to be released to the \npublic or personnel who do not have a valid \"need-to-know\" without prior approval from OFO \nNational Targeting Center - Passenger at 571-468-1000.UNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nRe\nm\nar\nk\nTy\npeRemark\nRE\nMA\nRKHey ,\nDo you have additional information besides this?\nPeter DASZAK\n* President of EcoHealth Alliance - US based non-profit organization that conducts research \nand outreach programs on global health, conservation and international development//collaborates \nwith scientists around the world to discover new viruses in wildlife \nhttps://www.scientificamerican.com/article/how-chinas-bat-woman-hunted-down-viruses-from-sars-to-\nthe-new-coronavirus1/ // https://www.ecohealthalliance.org/ \n* Listed as the Principle Investigator on National Institute of Health (NIH) National \nInstitute of Allergy and Infectious Diseases (NIAID) grant #2R01AI110964-06 \"Understanding the \nRisk of Bat Coronavirus Emergence\" data indicates project dates 06/01/2014-06/30/2024 (Shi listed \nthis grant on her resume and is not a PI)\n*\nA search this grant revealed 19 publications  https://www.ncbi.nlm.nih.gov/pubmed?\nterm=R01+AI110964/AI/NIAID+NIH+HHS/United+States[Grant+Number] \no Articles of interest \n* Origin and evolution of pathogenic coronaviruses Nature Reviews Microbiology volume 17, \npages181-192(2019) Authors - Jie Cui, Fang Li & Zheng-Li Shi This work was jointly funded by the \nStrategic Priority Research Program of the Chinese Academy of Sciences (XDB29010000), the \nNational Natural Science Foundation of China (31621061) and the US National Institutes of Health \n(NIH) National Institute of Allergy and Infection Diseases (R01AI110964) to Z.-L.S; NIH grants \n(R01AI089728 and R01AI110700) to F.L.; the CAS Pioneer Hundred Talents Program to J.C.; and the \nWuhan Institute of Virology (WIV) \"One-Three-Five\" Strategic Program (WIV-135-TP1) to J.C. and \nZ.-L.S\n* Discovery of Novel Bat Coronaviruses in South China That Use the Same Receptor as Middle \nEast Respiratory Syndrome Coronavirus Journal of Virology Jun 2018, 92 (13) e00116-18 Authors - \nChu-Ming Luo, Ning Wang, Xing-Lou Yang, Hai-Zhou Liu, Wei Zhang, Bei Li, Ben Hu, Cheng Peng, Qi-\nBin Geng, Guang-Jian Zhu, Fang Li, Zheng-Li Shi This study was jointly funded by the Scientific \nand Technological Basis Special Project (2013FY113500) from the Ministry of Science and \nTechnology of the People's Republic of China to Z.-L.S., a USAID Emerging Pandemic Threats \nPREDICT project grant (Cooperative Agreement no. AID-OAA-A-14-00102), NIH grants (R01AI110964 to \nZ.-L.S.; R01AI089728 and R01AI110700 to F.L.), and the National Natural Science Foundation of \nChina (31727901) to Z.-L.S.\n* Cross-neutralization of SARS coronavirus-specific antibodies against bat SARS-like \ncoronaviruses Science China Life Sciences volume 60, pages 1399-1402 (2017) Authors -Lei-Ping \nZeng, Xing-Yi Ge, Cheng Peng, Wanbo Tai, Shibo Jiang, Lanying Du & Zheng-Li Shi  In the \nacknowledge section \"This work was supported by the National Natural Science Foundation of China \n(81290341, 31621061 to Zheng-Li Shi), the Strategic Priority Research Program of the Chinese \nAcademy of Sciences (XDPB0301 to Zheng-Li Shi), National Institute of Allergy and Infectious \nDiseases of National Institutes of Health grant (R01AI110964 to Zheng-Li Shi), the National Key \nResearch and Development Program of China (2016YFC1201000 to Shibo Jiang) and NIH grant \n(R01AI098775 to Shibo Jiang and Lanying Du)\"\n* Discovery of a rich gene pool of bat SARS-related coronaviruses provides new insights \ninto the origin of SARS coronavirus PLoS Pathog. 2017 Nov; 13(11): e1006698 Authors - Ben Hu, \nLei-Ping Zeng, Xing-Lou Yang, Xing-Yi Ge, Wei Zhang, Bei Li, Jia-Zheng Xie, Xu-Rui Shen, Yun-Zhi \nZhang, Ning Wang, Dong-Sheng Luo, Xiao-Shuang Zheng, Mei-Niang Wang, Peter Daszak, Lin-Fa Wang, \nJie Cui, Zheng-Li Shi\n* Serological Evidence of Bat SARS-Related Coronavirus Infection in Humans, China \nVirologica Sinica volume 33, pages104-107(2018) Authors - Ning Wang, Shi-Yue Li, Xing-Lou Yang, \nHui-Min Huang, Yu-Ji Zhang, Hua Guo, Chu-Ming Luo, Maureen Miller, Guangjian Zhu, Aleksei A. \nChmura, Emily Hagan, Ji-Hua Zhou, Yun-Zhi Zhang, Lin-Fa Wang, Peter Daszak & Zheng-Li Shi This \nstudy was jointly funded by the National Natural Science Foundation of China Grant (81290341) to \nZLS; the National Institute of Allergy and Infectious Diseases of the National Institutes of \nHealth (Award Number R01AI110964) to PD and ZLS, United States Agency for International \nDevelopment (USAID) Emerging Pandemic Threats PREDICT project Grant (Cooperative Agreement No. UNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nRe\nm\nar\nk\nTy\npeRemarkUS Customs and Border ProtectionUNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nRe\nm\nar\nk\nTy\npeRemark\nRE\nMA\nRK \n \nDASZAK@ECOHEALTHALLIANCE.ORG\nLinkedin: https://www.linkedin.com/in/peter-daszak-93987665/ \nEco Alliance: https://www.ecohealthalliance.org/\nSHI Bio: https://www.ws-virology.org/dt_team/zhengli-shi/ \nSHI CV: https://www.ws-virology.org/wp-content/uploads/2017/11/Zhengli-Shi.pdf \nRelevant News articles\nhttps://www.scientificamerican.com/article/how-chinas-bat-woman-hunted-down-viruses-from-sars-to-\nthe-new-coronavirus1/ \nhttps://childrenshealthdefense.org/defender/conflicts-of-interest-taint-investigations-covid-\norigins/\nhttps://www.sciencemag.org/news/2020/08/nih-imposes-outrageous-conditions-resuming-coronavirus-\ngrant-targeted-trump\nGain of Function Research: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996883/ \nhttps://www.telegraph.co.uk/global-health/science-and-disease/exclusive-mission-really-big-step-\nforward-understand-covid-19/ \nhttps://www.nature.com/news/engineered-bat-virus-stirs-debate-over-risky-research-%201.18787\nhttps://www.scmp.com/news/china/science/article/3111314/who-names-line-international-team-\nlooking-coronavirus-origins\nhttps://www.nature.com/articles/d41586-020-02473-4\nhttps://www.pressreader.com/uk/the-mail-on-sunday/20210110/281831466368322\nArticles of interest\n* Origin and evolution of pathogenic coronaviruses Nature Reviews Microbiology volume 17, \npages181-192(2019) Authors - Jie Cui, Fang Li & Zheng-Li Shi This work was jointly funded by the \nStrategic Priority Research Program of the Chinese Academy of Sciences (XDB29010000), the \nNational Natural Science Foundation of China (31621061) and the US National Institutes of Health \n(NIH) National Institute of Allergy and Infection Diseases (R01AI110964) to Z.-L.S; NIH grants \n(R01AI089728 and R01AI110700) to F.L.; the CAS Pioneer Hundred Talents Program to J.C.; and the \nWuhan Institute of Virology (WIV) \"One-Three-Five\" Strategic Program (WIV-135-TP1) to J.C. and \nZ.-L.S\n*\nDiscovery of Novel Bat Coronaviruses in South China That Use the Same Receptor as Middle \nEast Respiratory Syndrome Coronavirus Journal of Virology Jun 2018, 92 (13) e00116-18 Authors - \nChu-Ming Luo, Ning Wang, Xing-Lou Yang, Hai-Zhou Liu, Wei Zhang, Bei Li, Ben Hu, Cheng Peng, Qi-\nBin Geng, Guang-Jian Zhu, Fang Li, Zheng-Li Shi This study was jointly funded by the Scientific \nand Technological Basis Special Project (2013FY113500) from the Ministry of Science and \nTechnology of the People's Republic of China to Z.-L.S., a USAID Emerging Pandemic Threats \nPREDICT project grant (Cooperative Agreement no. AID-OAA-A-14-00102), NIH grants (R01AI110964 to \nZ.-L.S.; R01AI089728 and R01AI110700 to F.L.), and the National Natural Science Foundation of \nChina (31727901) to Z.-L.S.UNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nUNCLASSIFIED//LES\nUNCLASSIFIED//LES\nReleased by Chairman Rand Paul", "summary": "Watcher-discovered document from hsgac-newsroom (2026.07.17_Daszak-CBP-Package_-1-1.pdf), auto-indexed 2026-07-27.\n\nExcerpt: Released by Chairman Rand Paul Released by Chairman Rand Paul Released by Chairman Rand Paul Released by Chairman Rand Paul Released by Chairman Rand Paul Photos #Preview 1. 2. Date of Birth 1.DASZAK, PETERPlace of Birth 1.Place of Birth:DUKINFIELD UNITED KINGDOM GB/GBR City:DUKINFIELD Country:United Kingdom (GB/GBR) 2.Country:United Kingdom (GB/GBR) Citizenship United States (US/USA) Disposition 1.Disposition Category: Disposition: ActionUNCLASSIFIED//LES UNCLASSIFIED//LES  Released by Chairman Rand Paul Disposition Reason 1.Remarks:Referred to .  FBI requested not to stop subject.  No further  NTC action Records #Person Record Name S ubtype Record ID Code 1. 2.PNR 3.PNR 4.TECS Conveyances 1.MOT:Air-Commercial Est Departure:01/12/2021 01:00:00 EST Est Arrival:01/12/2021 13:15:00 EST…", "source_url": "https://www.hsgac.senate.gov/wp-content/uploads/2026.07.17_Daszak-CBP-Package_-1-1.pdf", "pdf_url": "/archive-docs/fauci-files/13c5671ea377de971a2a4ba965505c5c/pdf", "doc_date": "2026-07-27", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "hsgac-newsroom", "2026-07-17-daszak-cbp-package-1-1"], "part_number": 1, "page_count": 23}
{"title": "LIVE: Dr. Fauci testifies on COVID-19 pandemic before House subcommittee", "content": "LIVE: Dr. Fauci testifies on COVID-19 pandemic before House subcommittee\nYouTube video by House Oversight Committee (YouTube) (https://www.youtube.com/watch?v=qCsEbq9SpsM). Committee-livestream captions of Fauci's 3 June 2024 public testimony before the House Select Subcommittee on the Coronavirus Pandemic. Auto-caption ASR — the certified transcript is CHRG-118hhrg55830 (also archived).\n\ne the select subcommittee on the Corona virus pandemic will come to order I want to welcome everyone this morning pursuant to committee on oversight and accountability rule 7D members of the committee May particip ipate in today's select subcommittee hearing for purposes of questions at the discretion of the chair and pursuant to an agreement with the committee on Energy and Commerce the chairman and ranking member of the committee on Energy and Commerce subcommittee on oversight investigations Mr Morgan Griffith and Miss Kathy Caster are permitted to participate in today's hearings for the purposes of questions and give three minute opening statements without objection pursuant to Clause 4 a3a of house resolution 5 and Clause 2 j2c of house rule 11 the chair May recognize staff of the select subcommittee for questions for equal periods of time not to exceed 30 minutes pursuant to rule 7D of the committee on oversight and accountability Mr Jordan and Mr moscowitz members of the full committee May participate in today's hearing for the purposes of questions I would like to remind members that the issues we are debating today are important ones and members feel deeply about while vigorous disagreement is part of the legislative process members are reminded that we must adhere to established standards of decorum in debate there is a reminder that it is a violation of house rules and the rules of this committee to engage in personalities regarding other members or to question the motives of a colleague remarks on that remarks of that type are not permitted by the rules and are not in keeping with the best traditions of our committee the chair will enforced these rules of decorum at all times and urges all members to be mindful of their remarks finally without objection the chair May declare a recess at any time I now recognize myself for the purpose of making an opening statement good morning and welcome Dr C first I want to thank you for your Decades of Public Service you served your country through multiple epidemics pandemics and health crises I do want to say I'm sorry about the threats that you have received as someone who's been shot at and received threats as well my heart goes out to you this should never happen in America regardless of any disagreements we may have you chose to serve and I want to extend our appreciation and gratitude I want to thank you publicly for working with our doctor scotus during operation warps speed and the time you spent with us and Dr Collins I also want to thank you for your willing cooperation with the select subcommittee you have voluntarily sat for more than 14 hours of testimony and are appearing voluntarily today this is more than we can say about other Witnesses we have called and we appreciate it Dr fouchy we're here to investigate the covid-19 pandemic and to explore Lessons Learned positive or negative and to better prepare for future pandemics simply put America cannot move forward though without looking back we must know what went right and what went wrong in order to best ingrain proficiencies and remedy deficiencies in 15 months the select subcommittee has sent more than a 115 investigative letters conducted 30 transcribed interviews resulted in hundreds of hours of testimony held including today 27 hearings or briefings and reviewed more than one and a half million pages of documents we aren't here to throw the baby out with the bath water that's not the intent We are following the facts holding wrongdoers accountable and planning for a better more prepared future beginning early in 2020 you became the figure head of Public Health there were drinks named after you you got bobbleheads made in your likeness you were on the cover of Vogue throughout the first pitch at a Washington Nationals game almost overnight you became a celebrity in a household name in addition to being a public health official Americans from coast to coast and Beyond listen to your words and this is where I think we could have done better and this goes to both both sides of the aisle we should have been more precise we should have used words and phrases that are accurate and not misleading and we should have been honest especially about what we didn't know Dr fouchy I'm not a virologist but I am a physician and like most Physicians we are constantly learning which is why we do continuing Med medical education and we always seek new information we learn new things based on new data and we we want to give our patients the best possible care based on new findings and improvements in science at a time when you were prompting the proximal origin paper whose Focus was to quote disprove the lab leak Theory end quote I was in lockdown researching with another physician in Ohio to try and understand the pathology the affected physiology and What treatments worked and even how to diagnose Co before we had specific covid tests my friend even made a phone call to an infectious disease doctor in China looking for help as well during that time we discovered the baric shei 2015 article on creating a chimera using gain of function type technology while policy decisions should have been based on scientific data some frankly were not the burdensome six-foot social distancing rule did not have sufficient scientific report in your words it just sort of appeared distancing made sense but the six feet was arbitrary even Dr Collins said he still hasn't seen any empirical evidence to support the six-foot rule a rule that shut down schools and businesses a rule that will have negative Ram ramifications for decades as the pandemic wore on more mandates also just sort of appeared but the America American public didn't get to see the scientific data to support these mandates Americans were aggressively bullied shamed and silenced for merely questioning or debating issues such as social distancing masks vaccines or the origins of covid many Americans were willing to comply with the 15 days to slow the spread and understood the necessity of banning travel from certain countries in an attempt to slow down the virus but many Americans became very frustrated when components of those 15 days stretched into years and it should not have been the case that Americans were forced to comply with oppressive mandates when those who chose to illegally cross our Southern border or not or when Governor Nome or Governor Whitmer were throwing parties at nice restaurants not a good look Americans do not hate science but Americans know hypocrisy when they see it Dr fouchy under your leadership the United States Health agencies adopted specific policy aims as a single dogmatic truth without the benefit of debate out of a desire for a single narrative Dr fouchy you want said if you disagree with me you disagree with science science doesn't belong to any one person I was never taught that science turns a blind eye to hypothesis they serve to be proven or disproven and done so with irrefutable facts if able it was interesting that you chose not to pursue an aggressive and transparent scientific investigation of both natural spillover and lab leak we have been investigating ating both hypotheses you testified before the select subcommittee in your transcribed interview that the lab Lake theory was not a conspiracy theory you embrac the proximal origin letter it wasn't necessarily a full peer-reviewed research paper but you embraced proximal origin letter and you shared it with the public from the White House lawn you stated during your transcribed interview that you did not review published articles that considered a potential lab leak of covid-19 this is especially concerning if the works in question were conducted at a more risky and less safe bsl2 lab nevertheless any descent from your chosen scientific position was immediately labeled as anti-science anything less than complete submission to the mandates could cost you your livelihood your ability to go into into public your child's ability to attend school families were thrown off planes and shamed when their 2-year-olds struggled to wear a mask children with disabilities lost access to therapy that day and their families depended on students were out of the classroom and told to attend school remotely even when the science clearly demonstrated it was safe for them to go back in the classroom this harmed low-income students the most and how were single parent households supposed to teach their own children and work at the same time Dr Fouch you oversaw one of the most invasive regimes of domestic policy the US has ever seen including mask mandates school closures coer vaccination social distancing of 6 feet and more we've learned many lessons our early fear and confusion was understandable covid-19 was clearly a novel virus under your leadership niid allowed disgraced characters like Dr Peter daik to use millions in taxpayer dollars to conduct risky gain of function experiments in Wuhan China the actions of Ecco health and Dr daic call into question the Integrity of ni ni these policies and procedures as a whole as well as your role Dr fouchy as ni Aid's director you did sign off on his research Grant we need to know why Dr David Moren your direct report for more than two decades assisted Dr daik in avoiding oversight and scrutiny and said that you were involved your senior advisor and seemingly your Chief of Staff repeatedly L attempted to evade transparency laws to Shield information from public scrutiny we have senior officials from your office in their own writing discussing breaking federal law deleting official records and sharing private government information with Grant recipients the office you directed and those serving under your leadership chose to flout the law and bragged about it why did you allow your office to be unaccountable to the American people you were the highest paid person in the government this makes you more accountable to the people not less Dr fouchy whether intentional or not you became so powerful that any disagreements the public had with you were forbidden and censored on social and most Legacy Media time and time again this is why so many Americans became so angry because this was fundamentally an American if I make a mistake I answer to the people of Ohio who elected me and to my own conscience when you and your agency made mistakes Dr fouchy what happened we all need to be held accountable sometimes it's a simple as saying we were wrong you took the position that you presented to science your words came across so many people as final final and as infallible in matters particular paining to the pandemic but such rigid demands of an ideologically diverse people like Americans shattered public trust and American Health institutions because I said so has never been good enough for Americans and it never will be it's built into the American Spirit we have a thirst for information a drive for advancement Americans were First in Flight we landed on the moon we've cured diseases you've been part of that and we made innumerable discoveries and Explorations that forever changed Humanity Americans do not want to be indoctrinated they want to be educated and they preferred to make their health decisions in conjunction with the doctor that they know and trust to be successful our federal Public Health institutions must be accountable to the people again to be successful our health organizations must must do what they are supposed to do protect Americans I look forward to a robust and on-topic discussion I thank you I would now like to recognize ranking member Ruiz for the purpose of making an opening statement thank you Mr chairman hello Dr foui and thank you for being here um when I was named ranking member of the select subcommittee last February I made made a commitment to follow the facts and objectively analyzing the origins of the covid-19 pandemic I made a promise to keep an open mind about how the pandemic started because understanding whether the novel Corona virus emerged from a lab or from nature is essential to better preventing and preparing for future Public Health threats and to better protecting the American people and as the origins of the novel Corona virus still remain inconclusive I stand by these commitments to this day but nearly a year year and a half into House Republicans extreme and chaotic majority I believe we need to take stock of what the select subcommittee has accomplished and whether it has meaningfully improved our preparedness for the next public health threat in our nation under the guise of investigating the pandemic's origins House Republicans have abdicated their responsibility to objectively examine how covid-19 came to be and instead weaponized concerned about a lab related origin to fuel sentiment against our nation scientists and public health officials for partisan gain they have done so with one particular Public Health official in mind Dr Anthony fouchi and they have done so in an effort to deflect blame and anguish for the damage the pandemic inflicted on our society away from the former president whose stumbling pandemic response by some estimates led to 400,000 unnecessary covid-19 deaths and on to Dr fouchi Who worked tirelessly to stem the crisis over the past 15 months the select subcommittee has poured over more than 425,000 pages of documents provided to us by government agencies universities and private citizens we have conducted more than 100 hours of closed door interviews with 20 current and former Federal officials and scientists and what we have found is the following Dr fouchi did not fund research through the Echo Health Alliance grant that caused the co 19 pandemic Dr foui did not lie about gain and function research in Wuhan China and Dr foui did not orchestrate a campaign to suppress the lab leak Theory after 15 months the select subcommittee still does not possess a shred of evidence to substantiate these extreme allegations that Republicans have levied against Dr now I want to make something very clear in the past month the select subcommittee has held hearings where we have examined various serious issues of misconduct in the in following the facts select subcommittee Democrats uncovered troubling misconduct by Dr Peter daak and Echo Health Alliance including potential efforts to mislead the federal government about the nature of its work through the evasion of reporting and transparency requirements and less than two weeks ago we heard from Dr David Ms about his flagrant violation of the Freedom of Information acts transparency requirements and the potential destruction of federal records both drors Z daak and Dr morren deserve to be held accountable for betraying The public's trust to hold them accountable is not anti-science it is the defense of our federal scientific and research institution's decades long Legacy of advancing the scientific Enterprise to safeguard human health but baselessly suggesting without evidence that these discreet instances of misconduct are equivalent to our nation scientists and public health officials causing the covid-19 pandemic which has killed more than 1 million Americans and inflicted an immeasurable toll on our society is also a betrayal of the Public's trust which each of us are stewards of body today hearing comes at a pivotal moment for our nation's Public Health with the darkest days of the covid uh 19 pandemic behind us thanks to the Biden administration's leadership we are now faced with a crisis of declining confidence in the very science and public health interventions that lifted our society from one of the most challenging periods in our nation's history and as we look to the future we find ourselves at a fork in the road we can go down the path of fueling mistrust in and the interventions that saved us like vaccines masking and social distancing and the public health officials like Dr fouchy Who worked tirelessly and with extremely limited and evolving information about a novel virus to save lives during one of the greatest crisis of our time or we can work constructively on the forward-looking policies and solutions that we know are necessary to prevent and better prepare us for the public health threats that are yet to come since my first day as ranking member I set out to take the latter path the path of putting people over politics and prioritizing solutions to better prepare us for the next pandemic and it has been my hope that Republicans would join Democrats in the forward-looking work that will better protect our constituents strengthening oversight of potentially risky research domestically and abroad is an essential part of this conversation and so is closing Pathways for zoonatic transfers of viruses in nature and investing in our Public Health infrastructure to ensure that when future viruses arrive we are ready when Democrats were in the majority we made important strides in these objectives by passing the Consolidated Appropriations Act of 2023 which strengthen the protections against undue influence in our biomedical research improve training and transparency for the handling of Select agents pave the way for the inter agency collaboration to fortify zoonotic disease prevention invested in our infectious disease Workforce and enhanced our supply chain preparedness and ability to rapidly develop and deploy medical counter measures and ahead of today's hearing more than 90 health and medical organizations including the American Public Health Association the American College of Physicians the American Academy of family physicians the Infectious Disease Society of America the associate ation of state and territorial Health officials and the National Association of County and City Health officials wrote to the select subcommittee urging us to quote stand against efforts to weaken the ability of the nation's Public Health agencies to protect the nation's health and to take additional action to fortify uh of n our nation's Public Health Workforce and infrastructure I seek unanimous consent to enter this letter into the hearing record without objection as we sit here today I have not lost hope that in the remaining months of the select subcommittee we can work together to build on this Legacy and make objectively examining the origins of the novel Corona virus a part of this forward-looking work I stand by my commitments I mentioned earlier to take a serious balanced look at all possibilities for the origins of covid-19 pandemic and I stand ready to work with every member of this select subcommittee on this critically important Mission so that we can save future lives and I believe I still have some time left uh so at that I'd like to recognize uh uh Mr Rasin with the remaining time thank you Dr Ruiz public health is a matter of urgent um and comprehensive public concern under Donald Trump when the covid-19 pandemic began and spun out of control we came close to becoming a failed state which the political scientists Define as a state that cannot deliver the basic Goods of existence to its people according to Dr Deborah Burks Donald Trump's own co9 adviser America unnecessarily lost hundreds of thousands of people because of the recklessness and indifference of Donald Trump and his administration now the people who brought you the political big lie claiming absurdly that Trump won the 2020 election which he lost by more than million votes now bring you the medical big lie making the outlandish claim that Dr fouchy was responsible for causing covid-19 using the select subcommittee as a platform for This disinformation House Republicans Now find themselves in the familiar position where their own investigation debunks their runaway political rhetoric just like the broader committee's impeachment Drive proved only that there were no uh presidential crimes much less High crimes and misdemeanors attributable Joe Biden the investigation of Dr fouchy shows he is an honorable public servant who has devoted his entire career to the public health in the public interest and he is not a comic book super villain he did not fund research to create the covid-19 pandemic he did not lie to Congress about gain of function research in Wuhan and he did not organize a lab leak suppression campaign today Dr F's testimony along with the thousands of pages of documents and dozens of closed door testimony provided to House Republicans as part of the covid origins investigation will dispel these hysterical claims and reveal that the people bowing down to a twice impeached convicted felon who told Americans to inject themselves with bleach now want you to believe not only a big political a big political lie but a big medical lie too I hope that this committee will be able to correct all of the propaganda and disinformation today and we will be able to actually return to uh what the good ranking member has said which is an authentic investigation of the origins of the pandemic and I will yield back to the gentleman and I yield back I now recognize Mr Griffith for three minute statement good morning I want to again thank the leadership of this committee for including the Energy and Commerce Committee in this hearing Dr fouchy the recent Revelations that that Dr moren's a senior adviser and your Chief of Staff Greg fulkers routinely evaded Federal records laws including the Freedom of Information Act or Foya and those were a shock that was a shock I've been doing oversight now for over 14 years or right at 14 years and the scale of the effort to evade Foya by some at the National Institute of allergy and infectious diseases or niad has surprised even me these men were among your most senior and trusted staff at an agency you led for nearly 40 years they worked for you for decades your calendars show that you met with them multiple times a week during the pandemic you co-author dozens of papers with Dr morens he directly implicates you even the head of the niad Foya office was apparently in on some of this conspiracy and I know my colleagues on the other side love to say we're always talking conspiracy but when the facts lead you there whether you knew about it or not when the facts lead you that your agency was involved in some form of a conspiracy related to co Origins we have to follow those facts it is hard to believe that all this occurred without your knowledge Andor approval in civil law when one party has destroyed or refuses to produce evidence that's within its possession a jury is allowed to draw an adverse inference that the information destroyed or not produced was unfavorable therefore until we get a full accounting of all of the communications among nad's leadership it's reasonable for us to assume that missing information would mirror the private doubts expressed by so many virologists and other scientists related to your public positions while telling the public the media and Congress that covid-19 almost certainly emerged from nature experts you convene convened as a team PR ly worried that a research related incident was a possible if not the probable origin of the virus Dr Christian Anderson even said in February of 2020 quote I think the main thing still in my mind is that the Lab Escape version of this is so freaking likely to have happened because they were already doing this type of work and molecular data is fully consistent with that scenario further while you and other niad officials were assuring us that the virus could not have come from the Wuhan Institute of orology Ni didn't actually have an idea as to what the full scope of wuhan's coronav virus research was or even the trajectory of its gain of function research now that may be because Eco Health wasn't giv you the reports I grant that but this joint investigation has shown just how little oversight niad does of risky experiments involving potential pandemic pathogens niad set up a system designed to Greenlight potentially risky experiments while avoiding HHS Department level review the same program officers who act as advocates for their scientific area are responsible for assessing whether experiment is too dangerous that creates a conflict of interest I think that means that when we're taking when an agency's taking the final approval we ought to take that final approval away from the agencies like niad that fund it thank you Mr chairman I yield back I now recognize Miss caster for a three minute statement and I will oblig you an extra 30 seconds as well well uh thank you Dr fouchy for your appearance today and for your Decades of service to our country during your 39 years at the helm of America's leading health research institute the National Institute of allergy and infectious diseases you tackled some of the most serious health threats including AIDS zika Ebola SARS K1 and covid-19 your leadership and service to Republican and Democratic administrations and all Americans save countless lives and resources we owe you a debt of gratitude while the evidence to date points to covid-19 having originated from an animal Market in China the Chinese Communist party has blocked access to important information that could help confirm the origin of the virus this committee should be doing more to fight for those answers but instead has wasted significant time and taxpayer money fueling conspiracy theories and ignoring the importance of preparing for the next deadly pandemic some GOP members falsely claimed you secretly broke into CIA headquarters and cohered analysts others claim that you committed crimes America's adversaries like China Russia and Iran love it when Americans are divided and distracted it provided fertile ground for the spread of misinformation about covid-19 by our adversaries and unfortunately con Fringe far-right conspiracy theories have permeated even mainstream media outlets and some Republican members of Congress have played along I regret that many of the conspiracies have smeared you Dr fouchy as you and our top scientists did everything to keep Americans safe during the deadly days of covid-19 over 1.1 million Americans lost their lives to covid-19 and today it's still more deadly than the flu as we learned from zika and Ebola the ways viruses are transmitted are not obvious at first and the development of treatments and vaccines takes time what you and your team did to speed the development of the safe and affected covid-19 vaccine was remarkable that fast timeline was only possible due to years of federal investment in the National Institute of Health and support for medical research in the United States so one of the lessons learned from the pandemic is the need to continue to invest in medical health research in the US for cancer for heart disease for diabetes but also to prepare for the next pandemic we must learn from the past so that we can keep Americans safe that's why Democrats have worked hard to update American pandemic preparedness law the pandemic and all hazards preparedness act to short public health and make us more prepared to tackle the tackle the next pandemic threat it's not too late for Republicans to join us and turn the least productive Congress in modern history into one where we are all focused on solutions for the American people to make our country safer and stronger Democrats were able to prevent harmful roll backs in medical resarch last year and I urge my GOP colleagues to join us and move away from threatening and undermining American Medical Research at every turn Public Health threats are constantly emerging in the past month alone we have been tracking new strains and variants of h5n1 andox and SARS K2 Dr fouchy I'm sorry for the personal attacks you have received and may have to deal with today but while you are here I want you to know that the vast majority of Americans appreciate your work over the years I look forward to continuing to learn from you to learn everything possible how we can take the ne can take the pandemic Lessons Learned uh and put them to use to help keep our community safe and healthy thank you and time thank you our witness today is Dr Anthony fouchy Dr fouchy was the director of The National Institute of allergy and infectious diseases from 1984 to 2022 and chief medical advisor 2022 pursuant to committee on oversight and accountabil rule 9g the witness will hand do you solemnly swear or affirm that the testimony that you are about to give is the truth the whole truth and nothing but the truth so help you gu thank you let the record show that the witness answered in the affirmative the select subcommittee certainly appreciates you for being here today and we look forward to your testimony let me remind the witness that we have read your written statement and it will appear in full in the hearing record as requested please limit your oral statement to 6 minutes as a reminder please press the button on the microphone in front of you so so that it is on and the members can hear you when you begin to speak the light in front of you will turn green after 5 minutes the light will turn yellow and when the red light comes on your six minutes has expired and we would ask that you please wrap up I now recognize Dr fouchy to give an opening statement Mr chairman ranking member Ruiz members of the subcommittee thank you for this opportunity to testify prior to my retirement from federal service in December 2022 I had been at the NIH for 54 years and director of niid for more than 38 years in those posts I was deeply involved in the scientific and public health response to several infectious diseases outbreaks including HIV AIDS pandemic flu Ebola and zika and so under my leadership we were well positioned to respond to covid-19 for at least two decades prior to the covid outbreak we at niid had invested billions of dollars in research on mRNA Tech technology and imen design both of which led to the Swift development of covid vaccines less than 11 months after the identification of this new virus safe and highly effective vaccines were widely available and unprecedented accomplishment in the history of vinology that saved tens of millions of lives worldwide I will now use my remaining time to directly address certain issues that have been seriously distorted concerning me the first issue concerns my actions regarding the possibility that s K2 might have resulted from a lab leak on January 31st 2020 I was informed through phone calls with Jeremy Farah then director of the welcome trust in the UK and then with Christian Anderson a highly regarded scientist at scrips Research Institute that they and Eddie Holmes a worldclass evolutionary biologist from Australia were concerned that the genomic sequence of s K2 suggested that the virus could have been manipulated in a lab I participated in a conference called the next day with about a dozen International virologists to discuss this possibility versus a spillover from an animal Reservoir the discussion was Lively with Arguments for both possibilities two participants have testified before this subcommittee that I did not try to steer the discussion in any direction it was decided that several participants would more carefully examine the genomic sequence after this further examination several who at first were concerned about lab manipulation became convinced that the virus was not deliberately manipulated they concluded that the most likely scenario was a spillover from an animal Reservoir although they still kept an open mind they appropriately published their opinion in the peer-reviewed literature the accusation being circulated that I influenced these scientists to change their minds by bribing them with millions of dollars in grant money is absolutely false and simply Preposterous I had no input into the content of the published paper the second issue is a false accusation that I tried to cover up the possibility that the virus originated from a lab in in fact the truth is exactly the opposite I now quote from an email that I sent to Professor Ferrar on February 1 2020 quote Jeremy I just got off the phone with Christian Anderson and he related to me is concern about the furing sight mutation in the spike protein of the virus I told him that as soon as possible he and Eddie Holmes should get a group of evolutionary biologists together to care carefully examine the data to determine if his concerns are validated and they should report it to the appropriate authorities I would imagine that in the USA this would be the FBI and in the UK it would be MI5 in the meantime I will alert my US government official colleagues of my conversation with you and chrisan and determine what further investigation they recommend let us stay in touch such best regards Tony unquote it is inconceivable that Anyone who reads this email could conclude that I was trying to cover up the possibility of a lab leak I have always kept an open mind to the different possibilities another issue is that of Dr David morrens who has the title of senior advisor to the ni ID director and who recently began has been investigated for conduct Unbecoming a government official naturally given his title a connection is made to me with respect to his recent testimony before this subcommittee I knew nothing of Dr moren's actions regarding Dr deac Eco health or his emails it is important to point out for the record that despite his title and even though he was helpful to me in writing scientific papers Dr morrens was not an advisor to me on Institute policy or other substantive issues at niid we had weekly executive committee meetings of The Institute leadership and daily morning meetings of my immediate staff and to the best of my recollection he attended neither of these furthermore his office is located in a different building from that of the ni director finally in a majority staff memorandum of May 22nd 2024 there is a statement quote Dr fouchi may have conducted official business via personal email unquote let me State for the record that to the best of my knowledge I have never conducted official business using my personal email thank you for listening I would be happy to address these and any other thank you I now recognize myself for as much time as I may consume for questions with equal time being afford afforded to the ranking member uh Dr fouy February 1 2020 you were on a call with Dr Ferrar Dr Collins and other scientists regarding the potential that covid-19 was engineered was CDC director Redfield on that call no he was not okay Dr fouy you've said that you had to rely on biologists and evolutionary biologists regarding Origins because you're not an is prior to the pandemic niid awarded at least three grants via the New York blood center to Dr Z eus are you aware of these I'm sorry to Dr H Zhao your microphone is not on Doctor your microphone is not on I'm not familiar with that name okay well ni ID awarded at least three grants via the New York blood center to that that that scientist he was a high-ranking Chinese pla official and director of a Lab at the Chinese acad Academy of military medical Sciences does it concern you if US taxpayer dollars are funding someone like this grants that are submitted to the niid go through very ex does it concern you I'm not talking about the process right does it concern you that the U that US taxpayer dollars would be going to someone who's a high-ranking Chinese pla official yes or no I would have to know more about that Mr chairman because I don't even know the talking about are you or were you ever aware that the US state department in 2005 issued warnings that the Chinese government was working on the creation of bioweapons I was not aware of that thank you did you ever discuss the Chinese bioweapons program with anyone in the intelligence Community I've never discussed the Chinese bioweapons program to my knowledge with anybody before during or after the covid-19 pandemic did you speak to the FBI CIA Dia or any us intelligence agency concerning viral kind what what time frame are you talking about sir I said before during or after the covid-19 pandemic did you speak to the FBI CIA Dia or any us intelligence agency concerning viral I can't give you the specifics of it but back in the time of the anthrax attacks we certainly had a number of briefings of um by agencies that M that were intelligence agencies I don't remember who they were it could have been any of the above that you mentioned about the possibility that there were bioweapons that had fallen into the hands of Bad actors I.E terrorists that might have been used potentially as a biot terror attack that was at a time when we had thought that the anthrax appreciate I appreciate that I appreciate your expertise in that well that's the answer but but did you at any time talk to concerning viral research of any kind again I say that at the time that there was concern about the fact that alqaeda may have been using or potentially using bioweapons we had discussions with with intelligence agencies about that possibility but not as related to say covid-19 not to my knowledge about Co now but let me just make sure we get the facts after the um investigations began about covid I was briefed by uh intelligence agencies about possibilities of there being uh activities going on in different Laboratories I was briefed by intelligence agencies thank you science is always open to debate and it's a benefit the science supported restricting travel from certain countries at the beginning of the pandemic and after these orders went into effect the president was called racist and xenophobic Dr fouchy you said in your transcribed interview that you um supported those orders Dr fouchi were those orders racist and xenophobic no they were not thank you the vaccine saved millions of lives and I want to thank you for your support and engagement on that however despite statements to the contrary I it did not stop transmission of the virus did the covid vaccine stop transmission of the virus that is a complicated issue because in the beginning the first iteration of the vaccine did have an effect not 100% not a high effect they did prevent infection and and and subsequently obviously transmission however it's important to point out something that we did not know early on that became evident as the months went by is that the durability of protection against infection and hence transmission was relatively limited whereas as the duration of protection against severe disease hospitalization and deaths was more prolonged we did not know that in the beginning in the beginning it was felt that in fact it did prevent infection and thus transmission but that was proven as time went by to not be a durable effect yeah definitely had positive effect for many people especially those that were vulnerable but we knew from the trials that people that got vaccinated still were subject to getting covid so was the covid vaccine 100% effective I don't believe any vaccine is 100% effective I now recognize the ranking member Dr ree from California for five minutes of questions thank you U over the past year and a half my colleagues on the other side of the AL have relentlessly vilified Dr fouchi under the guise of investigating the origins of the covid-19 pandemic but after reviewing nearly half a million pages of documents conducting 20 closed door interviews and receiving testimony from nearly a dozen Witnesses brought before this elect subcommittee for public hearings they have come up empty-handed for evidence of their extreme allegations that Dr foui lied about gain of function research at the Wuhan Institute of virology and caused the covid-19 pandemic so I'd like to address both of the Republican claims in turn through the majority's investigation the select subcommittee has heard three definitions for gain of function research of the three Republicans have relied heavily on an overly broad definition that has no regulatory significance let me repeat that no regulatory significance in fact their definition is so broad that it would include the manufacture of flu vaccines as gain a function because it is so Broad the National Institute of Health does not use that definition when assessing whether proposed research is or is not quote unquote gain of function research for those assessments NIH has instead appropriately used the definitions provided in regulations and to be clear the select subcommittee has been reminded by Witnesses after witness that NIH at all times refer to regulations for the definition of gain of function research and not to a nebulous expansive definition with no legal bearing that is so broad it could apply to again the manufacturing of flu vaccines Dr fouchi according to the regulatory definitions for example in P3 Co that NIH applied to proposed research did NIH ever fund gain of function research in Wuhan China uh as you said uh um uh Congressman Ruiz according to the Regulatory and operative definition of P3 Co the NIH did not fund gain of function research at the Wuhan Institute of Urology thank you and despite my Republican colleagues effort to fit a square peg into a round hole it seems to me that you've been consistent on this issue from the beginning of the pandemic and they know this but they still use the terms gain of function Loosely and with respect to niad staff's assessments of whether proposed research was or was not gain of function research were you personally involved in those assessments or were those assessments made several levels removed from you and by subject matter experts those assessments were done by highly qualified and experienced programed people several levels below me thank you and your public statements that NIH did not fund gain of function research in Wuhan reflected the assessments made by IAD subject matter experts applying a definition found in the regulation known as the P3 Co framework is that correct that is correct thank you and thank you for clarifying that in fact all of that is abundantly clear in your 2021 Senate testimony on this matter when asked by the senate about gain of function research you testified quote that is why we have committees we have a P3 Co committee you also testified in 2021 quote gain of function is a very nebulous term we have spent not us but outside bodies a considerable amount of effort to give a more precise definition to the type of research that is of concern that might lead to a dangerous situation you are aware of that that is called P3 Co that was back in 2021 at the time of your May 2021 testimony P3 Co had been the operative def definition of gain of function research for several years correct that is correct so I will note that at your transcribed interview in January the majority conceded that NIH did not fund research in Wuhan that met the criteria of P3 Co I encourage the audience to read the transcript of that interview so you can evaluate the Merit of majority's claims for yourselves so now if we could quickly turn to the irresponsible and false accusation that you created SARS kv2 the virus responsible for the covid-19 pandemic so this accusation centers on a grant NAD awarded to Echo Health Alliance with a sub awward to the Wuhan Institute of v virology and we have been entertained earlier about the suggestion that this funding could have possibly gone to a bioweapons research capacity as well so I want to be clear no evidence provided to the select SubCom committee demonstrates that the work performed under NIH funding including at the Wuhan Institute of iology led to the creation of SARS K2 the majority has failed to demonstrate or even credibly suggest that any of the viruses studied under the grant could even possibly have been the progenitor virus Dr fouchi could you briefly explain why none of the viruses studied under the Echo Health Alliance Grant could have been the progenitor virus of the SARS K2 when you're talking about the evolution of a virus from one to another the viruses that were studied under the subaward to the Wuhan Institute that have been reported in progress reports in the literature and published papers those viruses were phenetically so far removed from so from from SARS CO2 that it is molecularly impossible for those viruses to have evolved or being made into SS K2 it's just a virological fact that was so far removed that it could not possibly be a progenitor of ss K2 so I want to be very clear on this point that the funding and the research conducted by Echo Health uh did not produce SARS CO2 that doesn't negate that this lab could have another lab could have been doing research and it could have leaked from a lab it still is a possibility but it was not directly or it was not funded by niad or NIH and just for the record this information was provided by NIH to then oversight ranking member James comr nearly three years ago in October 2021 so despite the clear evidence that Dr fouchi and his agency did not fund gain of function research under the P3 Co regulatory definition and that the virus is studied under the federally funded Grant Echo Health Alliance Grant could not have been the progenitor virus for SARS kov 2 Republicans have levied these unsubstantiated allegations knowing very well that they are not true and they have done so to push their extreme partisan narrative that Dr fouchi and our nation's Public Health pandemic yep now recognize the chairman of the full committee Mr comr from Kentucky for five minutes a question thank you Dr Fouch in your opening statement you attempt to distance yourself from your previous senior adviser Dr moren's you say that Dr Moran's title was just made up that he was not an adviser to you and that his office was in a different building so Dr fouchy did Dr Moran's report directly to you um actually I'm not sure exactly what the onp paper report is he is senior advisor to the director but it is conceivable we can get that information he might have reported through someone lower like my Deputy so your senior advisor did not report directly to you there are very few people who report directly to me okay Dr Dr BRS testified that he could walk into your office anytime he wanted to is that true no that's not true you don't just walk into the office I mean he's there I mean it's conceivable that he did he ever walk into your office I would say he did occasionally but the idea can can I finish the answer to you sir because I've got a lot of questions Dr fouchy did you ever delete an official record no Dr fouchy did you ever conduct official business via email to the best of my recollection and knowledge I have never conducted official business via my private email so there's a troubling pattern of behavior from your interner circle not just Dr morens but also your Chief of Staff Mr fulkers do you agree that it violates ni niid policy to use personal email for official purposes the the Dr moren's uh issue that was discussed by this committee violates NIH policy yes but does using official email using a personal email for official business does that violate policy using a personal email for official business violates NIH policy it violate niid uh nii Na niid policy to delete records to intentionally avoid fo you yes okay on April 28th 2020 Dr moren's edited an Ecco Health press release regarding the grant termination does that violate policy that was inappropriate for him to be doing that for a grante as a conflict of interest among other things so on March 29th 2021 Dr Ms edited a letter that Dr dassk was sending to NIH does that violate policy yes it does on October 25th 2021 Dr Mar provided Dr dasic with advice regarding how to mislead NIH on Ecco Health's late progress report does that violate policy that was wrong and inappropriate and violated policy on December 7th 2021 Dr morand wrote to the chair of Eco Health's board of directors to to quote put in a word in quote for Dr Dass does that violate policy should not have done that that was wrong and that violates policy well I'm not sure if a specific policy but I imagine it does violate policy he should not have been doing that in addition to all those actions Dr Marin wrote to Dr dassit quote Peter from Tony's numerous recent comments to me they are trying to protect you end quote did you ever talk to Dr Moren about Dr dassk or eco Health Alliance um I I can tell you regard to what you said I never spoke to about protecting him I mean obviously we knew that do desac was a grande so I may have mentioned and discussed Dr desac because he's a grande but I never spoke testifying that he just made that up excuse me you're testifying that uh Dr Mor just made that up I don't know where he got that but that's not true so by this point Dr fouchy when these these emails were written you should have known that Dr dassk was more than two years late on a required progress report with his Grant uh Dr dassk conducted an experiment that resulted in a novel virus showing excess growth that Dr dasic failed to report that experiment that Dr dasic was protecting the Wuhan lab and not sharing its lab notebooks and that Dr dasic failed to to disclose close obvious conflicts of interest so why were you trying to protect Dr dasik and Eco Health Alliance I repeat on the record I have not tried to protect Dr desc and that's number one number two you said something that's not true because I did not know about the compliance issues until well after the fact when I was being briefed for going to before a congressional committee so it wasn't as as the things were going on I knew that he was with did you know about Dr moren's close relationship with Dr dassk Dr morance made it clear that Dr desk was his friend I did not engage in any of that interaction between them and and just lastly if I REM Mr chair you you testified and answered uh the Chairman's question that you never had any communication with the intelligence Community throughout all of Co did I understand that correctly no you heard wrong I said I did have communication I was briefed by the intelligence Community multiple times during the covid issue and you never gentleman's time is expired I now recognize the ranking member of the full committee Mr Rasin from Maryland for five minutes of questions okay first Dr fouchy uh thank you for your testimony and your extraordinary service to the American people let me just start was there anything you wanted to clear up in that last exchange that where you were interrupted no I think I made it clear I mean they were talking about my knowing about uh a lack of compliance that became clear Congressman Rasin well after the fact it isn't as if they were not complying and I was not monitoring their non-compliance I didn't know about it until it was a done deal gotcha you've been a scientist and a scientific administrator for 54 years is that right more than a half century and correct you were director of the National Institute of of allergies and infectious diseases for more than three decades is that right 38 plus years 38 years okay and I assume that uh uh you've never been accused of trying to uh start a disease before is that right that is correct um you have devoted your life to fighting infectious diseases for the American people is that right that is correct I want to go back to um this email that you cited in your opening because I think it goes right to the heart of this uh campaign of character assassination against you the claim was essentially that you tried to cover up the possibility of there having been a laboratory leak which of course is perfectly possible and if this committee were doing its job we could actually be working to advance the investigation of that but they would rather assert that you tried to cover up this possibility um here's the email email that you sent uh on February 1st uh at 12:38 a.m. um to Christian Anderson um with a copy to Christian Anderson but you sent it to Professor Jeremy Ferrar Jeremy I just got off the phone with Christian Anderson and he related to me his concern about the furing sight mutation in the spike protein of the currently circulating 2019 ncov I told him that as soon as possible he and Eddie Holmes should get a group of evolutionary biologist together to carefully examine the data to determine if his concerns are validated he should do this very quickly and if everyone agrees with this concern they should report it to the appropriate authorities I would imagine that in the USA this would be the FBI and in the UK it would be M MI5 it would be important to quickly get confirmation of the cause of his concern by experts in the field of Corona viruses and evolutionary biology in the meantime I will alert my US government official college of my conversation with you and Christian and determine what further investigation they recommend let us stay in touch best regards Tony was this the email where you were peely trying to cover up the possibility of a lab leak uh yes uh Congressman Rasin and that's the reason why I mentioned in my opening statement that is it inconceivable that anyone could get out of that that I was covering anything up would you have any reason to cover up uh any new scientific evidence relating to the origins of the covid-19 virus absolutely not and that's the reason why it was important to get people together that to discuss this in a transparent way have you spent your whole life trying to determine the causes of infectious diseases and then to stop them to protect the American people yes I have well Dr fouchy um I want to join my colleague from Florida in apologizing to you uh that some of our colleagues the United States House of represent resentatives seem to want to drag your name through the mud uh they're treating you Dr fouchy like a convicted felon actually you probably wish they were treating you like a convicted felon they treat convicted felons with love and admiration some of them blindly worship convicted felons um is there anything else you would like to say to the American people about your service to America during the course of the co9 pandemic my main job during the covid pandemic was to play a role with my team at the vaccine Research Center to develop a safe and effective vaccine and we did that in an unprecedented short period of time never seen before in the annals of vaccinology as we all know that vaccine and those vaccines have resulted in Saving of hundreds of thousands of lives in the United States and millions of lives throughout the world well you have fought uh AIDS and HIV you have fought covid-19 um and you are fearless in doing so do you have any reason to be afraid of scientific evidence or data or the truth not at all thank you I will yield back to you Mr chairman now recognize Mr Griffith from Virginia for five minutes of questions thank you Mr chairman it's good to see you Dr fouchy so take a deep breath because my questions change sometimes based on things that happened in the hearing and I want you to follow the bouncing ball with me um and and there's no gotta at the end of this I'm just trying to figure this out you told Dr Ruiz in his questioning that it was absolutely impossible for any of the viruses that you all were funding I get that it was impossible for SARS covid 2 or SARS CO2 known as covid-19 to have come from any of the work that was being done at Wuhan at the same time time you told Mr comr that you didn't know about the non-compliance by Eco Health until after the fact and when the virus is already out there however it got there in light of the fact that part of that non-compliance was a report where we uncovered and I believe that Dr dashak was untruthful to this committee and one of of his reports to niad and further that in the two most sensitive years related to the uh humanized mice experiments we never got lab notebooks from Wuhan Institute of biology can you understand following the bouncing ball why some of us doubt that not that you had some hand in it or that you knew about it but the doubt that you can say state with certainty that it was impossible because they might have been doing stuff you didn't know about isn't that true um actually it's not incompatible at all Congressman what I said the viruses that was studied whether you did or did not give a five-year report on time was still the viruses that phenetically would be impossible to be the precursor of sarce K2 so it was completely compatible with the statement that I made to Dr is that accurate as well knowing that they had worked on uh adding a fur and cleavage site to uh Ms but sir there's a difference between the viruses that were funded by the NIH sub award versus anything else anybody else in China might be doing excellent we were talking about did the NIH you were talking about what you funded what we funded and that's the point and and that goes goes to my next question because I thought you might go there and I appreciate that because in an off the reccord member level briefing in February of 2022 I asked about the likelihood nature of a SARS related Corona virus to have a fur and cleavage site particularly since it takes the 12 uh nucleotide change in there to make it so to make it as viral as this was going on and at the time you said to me pretty much what you just said and I want you to just confirm it for the record well that wasn't us if that was being done it wasn't us and you conf confirm that for the record yes it wasn't you it wasn't what you were funding what I'm saying is that I cannot account nor can anyone account for other things that might be going on in China which is the reason why I have always said and will say now I keep an open mind as to what the origin is but the one thing I know for sure is that the viruses that were funded by the NIH phenetically could not be the precursor of SAS to and I appreciate that because I've I've never thought that that NIH or niad went out to to create this thing but I am a believer that it came out of the lab and I think you've just made it clear and sometimes people miss this Dr fouchy one side says one one side says one thing one side says the other and the actual fact may be that at sometime working on on that maybe they used some of our money to get started maybe they didn't but a group of scien is getting together might very well at Wuhan have said hey let's see what happens if we go over here and do this not that NIH funded it but they on their own went off and did something isn't that accurate isn't that possible well I actually would also would want to say that one thing we should put out on the table that you were talking about a $120,000 a year Grant in A6 billion doll budget so I mean if they were going to do something on the side they have plenty of other the money to do it they wouldn't necessarily have to use a $120,000 NIH Grant to do it and and I appreciate that because it means something could happen I'm glad you kept an open mind I would ask this one final thing though do you think they could have done it without the humanized mice that we gave them yeah could have done what sir I could have done could they have done any other research with the humanized mice that we gave them would they be successful China didn't have the humanized mice before we gave them to Wuhan isn't it accurate that they might have been able to do extra stuff with ir mice sorry sir that's a hypothetical that I can't really answer what they could have you can't say it couldn't have happened either I go back well you want me to prove a negative now recognize Miss Caster from Florida for five minutes of questions thank you Mr chairman you know these special investigative committees are are intended at the outset to bring light to difficult matters and I think unfortunately this select committee has brought more heat than light to things uh and one example is nearly five months ago Dr fouchy sat for a 14-hour voluntary interview with the subcommittee I was there for that interview which included exchanges on many important questions on Research safety long covid vaccine development and the importance of strong Public Health Systems in our local communities also we discussed pandemic preparedness uh like stockpiling supplies for our hospitals uh in advance the next pandemic but I want the public to know that for five months the Republicans sat on that transcript they could have released it at any time it was released last Friday if the public had seen it five months ago they would know that they the Republicans failed to find uh a shred of evidence of their far-fetched conspiracy uh linking Dr fouchy to a coverup of the origins of the pandemic instead the Republicans contorted and mischaracterized Dr Fouch uh words over Twitter uh to Jin up conspiracies about nih's role in the origins of the pandemic in the leadup to this hearing parts of that interview have again been cherry-picked and distorted in press releases and tweets so Dr Fouch I want to make sure that you have an opportunity to publicly clear anything up um does anything come top of mine right off the bat and and how they transcript I I don't want to be casting stones at the distortions of what was said in that but you know there were a couple of things that come to mind you know one I'm sure is going to come up later is the issue of the six- foot distance and I made the statement that it just appeared uh and that got taken at like I don't know what's going on it just appeared it actually came from the CDC the CDC was responsible for those kinds of guidelines for schools not me so when I said that it just appeared it appeared was there any science behind it what I meant by no science behind it is that there wasn't a control trial that said compare 6 foot with three feet with 10 feet so there wasn't that scientific evaluation of it what I believe the CDC used for their reason to say six feet is that studies years ago show that when you're dealing with droplets which at the time that the CDC made that recommendation it was felt that the transmission was primarily through droplet not aerosol which is incorrect because we know now aerosol does play a role that's the reason why they did it it had little to do with me since I didn't make the recommendation and my saying there was no science behind it means there was no clinical trial that proved that that's just one of the things that got a little distorted in the response to that and and I've learned and and watched you over the years I I have to go back to uh the zika outbreak where we didn't know uh how exactly it was being transmitted and um and at one point we weren't we weren't aware that some of the some of it was sexually transmitted that's an example of of why with these Public Health threats that you learn you learn unfortunately as we go along talk a little bit about about the zika health threat and how that we we didn't know what was happening in the early days your microphone all right I'm glad you brought that up because it really is also reflective what went on in the early months of covid when you're dealing with an outbreak that's a novel outbreak the zika outbreak that caused microsil was novel we have never seen that before covid was novel we'd never seen that before when you're dealing with a new outbreak things change the scientific process collects the information that will allow you at that time to make a determination or a recommendation or a guideline as things evolve and change and you get more information it is important that you use the scientific process to gain that information and perhaps change the way you think of things change your guidelines and change your recommendation and that really goes across the board because you're dealing with something that needs to be modified because it's a moving Target zika was a moving Target Co was a moving Target well thank you very much and I I want to thank the uh Democratic staff for your Minority Report and if um if it's not already submitted for the record I'd like to ask unanimous consent to offer into the record the the Democratic staff report just completed Republicans fouchy flop select committee's 15-month probe fails to find evidence of extreme claims linking Dr fouchy to co 19's Origins and thank the staff this is an outstanding report that that folks should read thank you now recognize Miss malakas from New York for five minutes a questions thank you Mr chairman uh I think many of us in the committee are really disturbed by re Revelations to this committee um that there were officials at NIH that deleted government records they deleted personal or they used personal information personal emails to communicate and circumvent Freedom of Information laws um so I I just had a couple questions about that Dr fou did you delete any emails or records related to the Wuhan lab or the origins of the virus no I did not okay uh Dr morens said in a 2020 May 2021 email he indicated that uh he was connecting people to you in a quote secret back channel do you know what he was referring to I don't have any idea what he's talking about there is no back Channel at niid okay there is uh he also said in another email that there is no worry about Freedom of Information uh act I can send stuff to Tony on his private email did you communicate with anyone uh Rel relating to anything regarding NIH or with Dr morren on a private email I do not do government business on my private email okay so was there so have you communicated with Dr morrens Via private email even if it was not necessarily your definition of government business it might have been because as I mentioned in my opening statement one of his functions is to write chapters medical scientific chapters with me so it is conceivable that I communicated with him on on my private email when we were writing a chapter and that was not official what about Peter daic no okay um I just want to clarify for the record because today you testified that you did not suppress the lab leak Theory yet in the past you have said quote it is a distortion of reality unquote you've said quote I've heard these conspiracy conspiracy theories and like all conspiracy theories they're just conspiracy theories that's what you told the American people and so would you like to clarify what science were you following then versus now yeah no I actually I've also been very very clear and said multiple times that I don't think the concept of there being a lab leak is inherently a conspiracy theory what is conspiracy is the kind of distortions of that particular subject like like it was a lab leak and I was parachuted into the CIA like Jason Bourne and told the CIA that they should really not be talking about a lab lek that's the conspiracy appreciate that Dr fouchy um how much have you earned from royalties from pharmaceutical companies since the pandemic began in 2021 zero it says NIH scientists made 710 million in royalties from drug M makers uh you're saying that you you did not receive any of the $710 million on covid I received I think $122 for an for an monoclonal antibody that I made 27 years ago okay so just in general though how much have you received not not related to covid just in general how much have you received in royalties between 2021 and 2023 I think none okay so somebody received the $710 milon somebody did but not me you didn't receive any royalties okay Ian I see no royalties associated with Co I mentioned I said know I I want I'm on the record and I want to make sure that this is clear that I've developed a monoclonal antibody about 25 years ago that's used as a diagnostic that has nothing to do with covid and I receive an average of about $120 a year from that pent okay but the bottom line here is that scientists at ni uh did receive 71010 million in royalties and I guess my question is don't you think that if these experiments are made using American tax dollars that any of those royalties this nearly billions of dollars should be going back to the American taxpayer not in the pockets of the scientists do you believe that's a law that we should consider changing uh if you want to change the patent laws and the and and and The Bu Dole act then go ahead okay but that's not for me to say I'm asking your opinion okay well anyway um moving on I just want to say that uh you know we know billions of dollars have been funding these animal experiments both here domestically and in foreign uh lands I'm very troubled by the uh animal the cruel horrific animal research that has been done on us land and in foreign Laboratories of taxpayers are footing the bill for billions of dollars these beagle puppies that have their uh these their throats slit uh they're being injected with ticks they are murdered after just a few months um piglets rabbits you name it FDA is saying we no longer need to be uh testing uh human medic indications on animals that there's other ways to achieve this um can you comment on that if it's time for the United States of America to be moving on from these cruel animal and horrific costly tests I'd be happy to comment in but I'm puzzled as to what that has to do with the origins of covid well I have a question about it before this committee and it has to do in general with the amount of waste of tax dollars that NIH is using well the animal experiments that are conducted by and funded by NIH go through strict uh uh regulations of the proper use of animals in research so I'm not Congressman with all due respect I'm not trying to be confrontive I I'm not sure what you're talking about but the experiments that the NIH funded go through strict regulatory processes of the treatment of animals The Humane treatment of animals well they're not very Humane and I will say as the former director you you you you you signed off on these experiments and so my time has expired and we will well I signed off on them because they were approved by a peer review now recognize Miss Dingle from Michigan for five minutes of questions thank you Mr chairman you know um instead of actually taking a serious look at the various Ways by which this virus could have emerged in a lab or in nature my Republican friend colleagues and friends have spent the last 15 months trying to pin blame on NIH niad and specifically Dr fouchy for the covid-19 pandemic and now and just you know let's bring everything in look I want to have a discussion about animal testing too but I'm really not sure how that comes into here so but I want to be perfectly clear though that the select subcommittee has seen no evidence of this however allegations by my Republican colleagues Amplified in the media have led to real tangible consequences for Dr kouchi in his personal life in a way that should be unacceptable to all Americans Dr foui you and I have known each other for a long time and I'm not even going to admit how long but during that time I've seen your commitment not just to science but to advancing the greater good and I know that this isn't a topic you enjoy discussing and I'm sorry I'm going to have to ask you about it but I think the American people need to know what we are doing to those who are serving the common good and public health I think it's important to make clear the harms that you and your loved ones have suffered because of these deeply irresponsible accusations because you know what you're human just like the rest of us so Dr fouchi can you please share with us the nature of the threats you have received since the car start of the covid-19 pandemic um yes there have been um everything from harassments by emails texts letters uh of myself my wife my three daughters uh there have been credible death threats leading to the arrests of two individuals and credible death threats mean someone who clearly was on their way to kill me um and it's required my having uh Protective Services uh essentially all the time uh it is very Troublesome to me um it is much more Troublesome because daughters at these moment how do you feel keep your mic on terrible do you continue to receive threats today yes I do every time someone gets up and says I'm responsible for the death of people throughout the world the death threats go up it's unacceptable that you've been treated this way especially after you've dedicated your life to science and research for the public interest you deserve better every human being deserves better and I'm afraid that the treatment you've received will also have far-reaching conse consequences for the future of science particularly when done for the public good Dr fer how do you think the threats towards you and other public health officials have received will impact Bright Young Scholars thinking about going off into science or public service think as many people want to follow in your footsteps as they did when I first met you you know Congressman um Dingle I I think this is a powerful disincentive for young people to want to go into public health and maybe even science and medicine in the public Arena because it's very clear that not only I because I'm I'm a very much of a public figure but many of my colleagues who are less visible than I whenever they speak up in defense of the kinds of things that we're trying to do to protect the American public they too get threats And when they see that their colleagues get threats they say to themselves I don't want to go there why should I get involved in that and you have some potentially very good talent that would be important to maintain the integrity and the Excellence of the public health uh Enterprise in the United States we're not getting the best people coming in because they're reluctant to put themselves and their family through what they see their colleagues being put through well you're right you're not alone and feeling that way a fact ahead of today's hearing the select subcommittee received a letter from the association of state and territorial Health officials which represents Public Health officials in communities of all political Persuasions detailing The Surge of harassment intimidation hate speech threats of violence and death threats that their members faced during the pandemic can I just I'm going to ask to insert the into the letter but I wanted to just make the point before I close Mr chairman that as many as 40% of Public Health work workers have been bullied threatened or harassed and I think we all need to take that on as a public health issue I'd ask to enter the letter into the record and yield back without objection thank you Mr and now recognize Miss Lesco from Arizona for five minutes a question thank you Mr chair uh Dr foui did the National Institute of Health fund the poten potentially dangerous enhanced potential pandemic pathogens gain of function research at the Wuhan Institute of orology I would not characterize it the way you did the National Institutes of Health through a subaward to the Wuhan Institute of Urology funded research on the surveillance of and the possibility of of emerging infections I would not character ciz it as dangerous gain of function research I've already testified to that effect a couple of times so you're saying no correct um in in his May 16 I'm saying no because I've said no multiple times including on the transcribed in his May 16th 2024 testimony the NIH deputy director tabic said and I quote I can tell you that the failure of the Wuhan Institute of orology to provide us with the data that we requested and the lab notebooks that we requested certainly impeded our ability to understand what was really going on with the experiments that we have been discussing this morning my question to you Dr fouchi if the NIH didn't inspect the Wuhan Institute of biology and NIH didn't receive the lab books and data from China and the required reports from Eco Health Alliance were not submitted in fact they were late how can you definitively say that the NIH did not fund the dangerous gain of function research I go back to what I said that the gain of function research by the operative and Regulatory definition of P3 Co does not include at all the viruses that was studied under the sub how do you know that sir if there was no lab books nothing from China we know what viruses they were studying how how do you know you never went went there by the but you I'm telling you that the NIH funded research on these viruses if someone else somewhere in China was doing something else well that's the problem because NIH didn't go there you didn't get the reports that were needed how in the world would you know I'm going to go on to the next question well you're not hearing what I'm saying Dr moren's your senior adviser for over 20 years said in an email dated February 24th 2021 I learned from your Foya lady here now how to make emails disappeared when I am foyer but before the search starts so I think we are all safe plus I deleted most of these earlier emails after sending them to Gmail in another email dated 42121 Dr Moren said I forgot to say there is no worry about foas I can either send stuff to Tony meaning you on his private email or hand it to him at work or at his house he is too to let colleagues send him stuff that could cause trouble Dr fouchi were you ever engaged in attempts to obstruct the Freedom of Information Act and the release of public documents no did you did Dr Moren communicate with you about official business using his private email official business no did you ever encourage Dr Moren to use his private email address for official business no my next question question sir is on February 1st 2020 uh you yourself Dr foui the NIH director Collins and at least 11 other scientists were on a conference called to discuss the origins of covid a number of the scientists said that they were concerned that covid was the result of a lab leak at the Wuhan Institute of rology and were and were concerned that a revelation of the lab leak Theory would hurt their relationship with China the CDC director read field testified that he was not invited on this conference call and he believes because he believed the lab leak theory was possible three days later on February 4th 2020 four participants on the conference call authored a paper proximal origin which was sent to you for editing proximal origin pushed the natural origin theory on April 16 2020 the NIH director Dr Collins emailed you expressing dis May that the nature medicine article which was based on proximal origin didn't suppress the lab leak Theory and asked you for more public pressure to suppress the lab leak Theory the very next day in response to Dr Collin's request to suppress the lab leak Theory you cited the nature medicine article which discounted the lab leak Theory from the White House Podium my question to you sir did you cite this article at the white white house because the NIH direct director asked you to suppress the lab leak Theory I did not do that in response to anybody's suggestion to suppress anything it was in response to a question that someone asked at the podium and I did not edit any paper as shown in my uh official testimony so you said about four or five things Congressman that were just not true well we have emails to prove it well you back I now recognize Mr infu from Maryland for five minutes of questions thank you very much Mr chairman and by the way no we don't have it so I get tired of hearing we've got it and then when we ask for it it's not there we do not have it Dr fouchy and for everyone watching this that's just incorrect now let me just say a couple of things if I sound a little outraged just because you know we sit here and we watch one conspiracy theory after another get debunked and if I might on a point of personal privilege to the gentle woman from New York who wanted to argue that we should be worrying about testing of human medicines on animals if this committee really wants to do something let's talk about the most infamous biomedical research study in the United States the Tuskegee study where 400 black men in this country were injected deliberately with syphilis and allowed to die slowly over a 40-year period without any attempt to help them at all it was condoned by the US Public Health Service and if we want to talk well I'm going to talk about Co right now Mr chairman point I have the floor Mr chairman I want to say to you Mr chairman suspend please I want to remind the audience of dorum recognize Mr amum thank you Mr chairman uh I want to thank you and ranking member Ruiz for this opportunity um Dr fouchy we owe you an apology for the way we have wrecked you through the mud and none of us have said to you here's where you go to get your good name and your reputation back it's the most unfair thing I have seen if there were evidence if there were facts that supported the charges I like everybody else would be interested but we haven't seen a damn thing to suggest that these accusations are accurate you've been a hero to many for 54 years five plus decades you help lead this country through the anthrax scare through AIDS through zika through Ebola through SARS and through covid-19 pandemics and epidemics we owe you a collective thank you you are a world-renowned scientist and an American Patriot and whether or not people want to believe that that's on them but those facts are undisputable for a year and a half the Republican majority on this committee has sought to weaponize genuine scientific questions over covid-19 and to vilify vilify our Public Health officials and our nation scientists with unsubstantiated with baseless with allegations that just can't stand the light of day and so they've tried to do that with covid-19 and we are here now as a result of the aggregated amount of foolishness that has taken place and I've always said to this committee every time I've had a chance to speak let's go back to when we were in the heart of the pandemic when our family members and friends and co-workers were dying left and right when we were afraid to get near anybody where we wanted to wash down our groceries before we brought them into the house where we were willing to put on mask or headgear if it would keep us from being infected and we turned to our leaders and our Public Health officials and scientists for answers and we got some but then we didn't get some and then we got some later like Dr Deborah Burks who was Donald Trump's expert on the virus who said no bleach won't do it don't inject yourself with it and who also said publicly on the record that thousands of American lives could have been spared spared if we had done what we were being told to do by the scientific community at least one thing is clear those 1 million people who died as a result of these conspiracy theories will never come back and those families have empty seats at the table year after year and we do a diser if at the very least we don't acknowledge their deaths and the harm and the hurt that has been done to their families and learn learn how to find a way to trust science going forward in this country Dr FY you've been uh accused over and over again of going to the CIA headquarters and sitting down and having a meeting with the ca to construct a way to make sure that covid raged in this country is that correct that is incorrect Dr foui have you been to the CIA office in the last 20 years or headquarters I went to the CIA uh decades ago during the anthrax attacks to discuss uh the possibility of terrorist attacks thank you I want to um I wanted to get that on the record because that's just the latest Theory now that you and the CIA director conspired this is foolish people are not going to agree with you I understand that but we take and bmer somebody's good name think about if it were one of us we'd be jumping up and down trying to find a way to get Justice and so on behalf of those of us who are thankful who are part of many in a Grateful Nation thank you for your service sir I yeld back and I'll recognize Mr cloud from Texas for five minutes of questions thank you Mr chairman thank you for being here and uh I do want to Echo some of what Mr inum said because I do think we need to focus on the people and I think that's really what um The Angst that's left with the American people it's what they had to walk through uh during this time um I'm going to go down a list of mitigation measures that you supported over the course of the pandemic and ask you just to give a yes or no as to whether you still believe these measures were Justified business closures not hearing you at all could you please speak louder sure uh I I'm going to go through a list of Co mitigation measures that you supported over the course of the pandemic and ask you to give me a yes or no as whether you believe these measures were Justified business closures early on when 5,000 people were dying a day yes Church closers same thing school closures again stay at home orders these were important when we were trying to stop the tsunami of deaths that were occurring early on how long you kept them going is debatable Mas mandates for adults Mas mandates for children mask mandates for children under five and going back to what I said before all of that is in the context of at the timeand for children under five scientific evidence for that excuse me mask mandates for children under five there's scientific evidence supporting that there was no study that did masks on kids before you couldn't do the study you had to respond to an epidemic that was killing four to 5,000 Americans per vacine mandates for employees vaccine mandates for students vaccine mandates for military vaccines save lives it is very very clear that vaccines have saved hundreds of thousands of Americans and millions I'm not we're talking about 19 uh did or do the vaccines the covid-19 vaccinees stop anyone from getting covid I answered that question to the chairman early on it became clear that they didn't no actually no in the beginning it clearly prevented infection in a certain percentage of people but the durability of its ability to prevent infection was not long it was measured in months and they didn't stop you from spreading it either early on it did if it prevented infection but what became clear that it did not prevent transmission when the ability to prevent infection w i I think what's troubling is when the American people look at the um certainty and the the case at which people lost jobs they lost livelihoods I had rural hospitals in my in my area that did not have a single case of covid in their rural community that had to shut down and people not get care that they did need uh for cancer and and some passed away because of those kind of things uh and and Time After Time Again people's lives are destroyed and we have not seen the same sort of once the new data came available we did not see a change of course and you'll point out for example in the schools that the CDC you know put out the guidelines for example but uh but we know that those guidelines end up being protection from lawsuits it's if you don't want to be sued you better follow the guidelines so they're not mandates de facto mandates but they turn out to be such a mandate um and and when the science began to change be we all understand that in the first couple weeks first few weeks even a couple months we were all trying to figure it out I think there's a lot of Grace for that the concern is that as the science became available there wasn't like a oh maybe we should consider the lab leak Theory oh maybe we should consider um natural immunity we never heard this messaging coming from you or from anyone else El who stood on the sidelines talking about these things and it's left the American people with a a tremendous distrust I want to talk a little bit about the grant process my understanding from your testimony to us it says that the nah process for rewarding grants is that basically research proposal goes to peer review committee to receive a priority score then it goes to an advisory Council for NIH Personnel it receives a final basically the group votes on it and then eventually it ends up on your desk for Signature right now you said in that that sometimes if I recall correctly it's those grants are often approved in Block in Mass when they're voted on and then you sign off on them that's correct I I this this is one of the things that's really troubling to the American people because they look at their lives being destroyed and there's no one to hold accountable because these systems or of of accountability have become systems of plausible deniability and so your name is on every single Grant but yet you you absolve yourself of any sort of responsibility by saying well you know it goes to this committee that's you know that has a number of people on it and they're approved in block and so there's no accountability for anything any of the taxpayer dollars that are going forth I disagree with you Congressman because if you look at the number of Grants we fund thousands of Grants it would be physically impossible for me to go through every single Grant in a detailed way to understand it that is true not only for me me but for virtually every Institute at the NIH then why does your signature go on it because somebody has to sign off on it and you trust the expertise and the competence of the staff that go over meis gentleman's time has expired I now recognize Miss Ross from North Carolina for five minutes of questions uh thank you Mr chairman I want to thank you Dr fouchi for your voluntary testimony today also for um so much great in your 14 hours of testimony and I again want to thank you for your service and your patience it's truly remarkable um because it Bears repeating let me just remind everyone that after 15 months my Republican colleagues extreme allegations against you remain unsubstantiated unsubstantiated and now during um during your two-day closed door interview in January discussed a number of topics regarding the public health response to covid-19 pandemic some of which we've touched on briefly but I just want to dive in a little bit deeper here um for example you you discussed both then and here with congresswoman Caster the recommendation that we maintain six feet of distance between one another to reduce the spread of covid-19 and you discussed how um social distancing recommendations were developed that you yourself didn't pick this six feet um and it was just really kind of a guideline in the moment in your view though do social distancing recommendations and other public health measures to reduce transmission save lives definitely okay um I'd also like to go back and take a deeper dive into the covid-19 vaccine discussion that we just had and you were also asked about that during your interview in January in the select subcommittee we've heard suggestions that the vaccine was ineffective because of breakthrough infections that occur after vaccination we just heard about that right here but as I understand it perhaps the strongest measure of covid-19 vaccines effectivess is the reduction of severe disease and death not necessarily getting a milder form of covid could you talk about that a little bit yes it's very clear that when you're dealing with many vaccines but particularly when you're looking at covid the as I mentioned and I'll repeat it quickly for you that early on there was a degree not as much as against severe disease of protection against infection unfortunately that protection against infection which is related to transmissibility waned rather rapidly in a matter of months what has stood firm well much better than transmission and much better than infection is the ability to prevent someone from hospitalizations and deaths and in fact the curves congresswomen are stunning when you look at the deaths and hospitalizations of people who are unvaccinated it's like this when you look at the deaths and hospitalizations for people who were vaccinated and boosted it's like this the difference is profound when you're dealing with infection again less so because of the waning of protection against infection well and that was also confirmed by a commonwealth fund December 2022 um report that um which came out two years after the Biden administration's effort to get covid-19 vaccines in arms in your effort too that it prevented more than three million deaths and averted 18 million hospitalizations and that came out in 2002 but it seems to corroborate what you're saying indeed and $1.15 trillion dollar in health care costs thank you for that ad um one pillar of the vaccine requirements was um was to have an increased uptake in the n in the covid-19 vaccines and that that at the time was supported by Leading Physicians um including the American Medical Association the American Academy of family physicians the American Academy of Pediatrics and more were the vaccine requirements a clinically sound tool for improving uptake of a safe and effective vaccine yes you would like people to get vaccinated voluntarily and realizing the important effect on it but the fact that people were vaccinated by whatever the motivation was clearly saved many many many lives and just with the 17 seconds I have um what steps can Public Health officials take to bolster confidence in these life-saving interventions since there has been so much misinformation circulating that's going to be very difficult congresswoman because there is so much Miss and disinformation around that we've got to do a better job of reaching out and trying to get the correct information but that's difficult when you have a very energetic group of people continually spreading Mis and disinformation about vacines we've got to be more proactive in putting out the facts and the data and the information that's correct thank you very much for your testimony and I'll yield back now recognize Dr Joyce from Pennsylvania for five minutes of questions thank you chairman winstrip uh for convening this important hearing and thank you Dr fouchy for testifying Dr fouchy one of the controversial regulations of the pandemic was the six-foot distancing role this role became an important policy consideration in subsequent regulations however you testified recently and I'm quoting this six-foot role sort of just appeared do you think that a role that sort of just appeared is substantial justification for the regulations that we saw based on that six-foot role Congressman thank you for that question I I answered that but I'll summarize it briefly for you when saying it just appeared it came from the CDC okay you stated that earlier what was your relationship with the CDC when you saw a regulation which was not based in the current science well when I say was not based in science I meant a pro prospective clinical trial to determine whether 6 foot was better than three was better than 10 but once we realize that the virus was not sped by droplets and was aerosolized did you feel an indication to go back to the CDC and said let's base this on science let's get rid of this six-foot rule this six-foot rule crippled Bill businesses it allowed students to stay at home and not learn Americans suffered and that suffering continues because the fracture of trust in American scientists continues to this day did you not feel an obligation for something that just sort of have appeared not to go back to the CDC and say let's base this on what we know it was a CDC decision and it was clear will you dialoguing with the CDC excuse me were you in communication with the CDC CDC was part of the Corona virus response team and you didn't feel an obligation to go to them and say look Americans aren't going to trust us we're providing them with misinformation we have discussions at the White House about that we did but the cdc's decision and was their decision to make and they made it and you didn't feel an obligation as the lead scientist at the NIH to challenge that I've challenged the CDC multiple times publicly on this regard excuse me publicly you challenged them on the six foot distance it is not appropriate to be publicly challenging a sister organization do you agree that Americans now have lost their trust in science in lead science from government because of misinformation like this well I you know when you talk about misinformation I think that you have to be careful it's not disinformation it was information that ultimately proved when you put the aiz in that that it was not an effective role to have six feet of distancing Dr fouy let's move on on April 21st Dr morrens wrote to Dr dasik in an email that there is no worry about foas I can either send stuff to Tony on his private Gmail hand it to him at work or at his house he is too smart to let colleagues send him stuff that could cause trouble do you realize that this impact still considers today do you this is your lead trusted researcher who works with you your advisor do you realize the impact of that it was a terrible thing it was wrong and it was inappropriate thank you I think we all agree it was incredibly inappropriate recently in an oped that Senator Roger Marshall published just yesterday he raised concern about HHS foyer compliance following your testimony in front of the Senate help committee Dr fouchy what involvement did you have in HHS not responding to foyer request following your testimony in the senate in 2021 I had no role whatsoever in anything to do with the request when foyer is made it doesn't go directly to a person like me it goes to a department which then takes care of it so I don't have any role one way or the other in Foya let's go on were you aware that niad employees conducting official work on unofficial emails and inappropriately assisting grantees during your time as a director I was not aware of that as it was occurring it obviously came out during the commission the the committee hearings but I was not aware of that as and I think that you put an exclamation point on how important these hearings are Dr fouchy would you agree that this demonstrates the need for more accountability and increased oversight of niyad what you saw I believe with Dr morens was an Aber bareny and an outlier the individuals at the NIH and niid are of a very committed group of individuals and this one instance that you point out isn't a bareny and an outlier that does not from your senior advisor for 20 years well he was well the title is senior advisor we wrote scientif ific papers together he didn't advise me as I mentioned are your senior advisers not trusted staff again I told you that his title was senior advisor but he is not an advisor on policy he WR that's very confusing to have someone's title right and not having that to be their obligation but that is the fact though I think that that supports what we said there needs to be more oversight and there needs to be more accountability Mr chairman my time has expired but these points are very clear to all of us today in this hearing room I yield back I now recognize Mr Garcia from California for five minutes oh he left I now recognize Miss Green from Georgia for five minutes of questions thank you Mr chairman Mr fouchy you were quoted on CBS Face the Nation saying it's easy to criticize but they're really criticizing science because I represent science do you represent science Mr fouchy I am a scientist who uses the scientific method to gain information yes you said you represent science do you represent science Mr fouchi yes or no yes or no no that's not a yes or no answer yes it's a yes or no I don't think it is okay well we'll take that as a you don't know what you represent oh I but this as director of the NIH you did sign off on these so-called scientific experiments and as a dog lover I want to tell you this is disgusting and Evil what you signed off on and these experiments that happened to beagles paid for by the American taxpayer and I want you to know Americans don't pay their taxes for animals to be tortured like this so the type of science that you are representing Mr fouchy is abhorent and it needs to stop Mr fouchy you also represent the type of science that you where you confess that you made up the covid rules including six feet social distancing and masking of children I never said I made anything up you admitted that you made up you made it up say I made it up so are you saying this is fake news Mr I didn't say I made anything up what did you say I said that it is not based in science and it just appeared but this is science what does dogs have to do with anything that we're talking about today these are these are scientific experiments this is what you signed off on but you also told the American people they had to Distance by six feet they had to wear mask but let's also talk a little bit further about the type of science that you represent NIH scientists made $710 million in royalties from drug drug makers a fact that's been hidden let's talk about the fact about is it right for scientists and doctors getting paid by the American people government taxpayer paychecks to get patent where they're paid millions and hundreds of millions of dollars in royalty fees especially when the NIH and these government agencies most powerful agencies in our country are recommending medical uh suggestions and advice and making up guidelines like six feet distancing and masking of children do you think that's appropriate do the American people deserve to be abused like that Mr fouchy cuz you're not doctor you're Mr fouchy in my a few minutes no I don't need your answer I want to talk about this right here Mr I reclaim my time I reclaim my time Mr R Lady M Mr chairman order just in terms of the rules of decorum are we allowed to deny that a doctor is a doctor just because we don't want him to be a doctor yes because in my time that man does not deserve to have a license as a matter of fact it should be revoked and he he belongs in prison suspend the gentle lady should recognize the doctor as a doctor thank you Mr chairman is this what we have become is this what we have devolved into no Decor you know what we can do that hearing about the poor men that were injected with syphilis because I support you in that that's horrific and this government that does things like that to Americans doesn't have decorum to the American people gentlemen is point of regular order theorum recognize the point of order go ahead with your point of order you got it no I mean I I was going to say what what representative Raskin said that's completely unacceptable to be able to to deny Dr fouchi uh who's here a respected member of the of the medical community his title and that's actually a personal attack on on his character and I have instructed her he's not respected and I instructed her to address him as Doctor I'm not addressing as Doctor let's talk about let's talk about this I I reclaim time I'm reclaiming my time words get taken down I'm reclaiming my right a member can only move to have words I'm sorry the issues we are debating are important ones that members feel deeply about while vigorous disagreement is part of legislative process as I said at the beginning members are reminded that we must adhere to established standards of decorum and debate this is a reminder that it is a violation of house rules and the rules of this committee to engage in personalities regarding other members or to question the motives of a colleague remarks of that type are not permitted by the rules and are not in keeping with the best traditions of our committee the chair will enforce these rules of decorum at all times and urges all members to be mindful of their remarks does the gentleman from California have anything further well she should take her we should have to take her words down yeah I made it I I offered that her words be taken down Mr chair point of order Mr chairman uh Mr chairman I'd like to make a point of order Mr Griffin accused using president Trump we don't worship president Trump gent lady will suspend Mr Griffin you have a point of order Mr chairman while it may not be uh polite I believe the rule only applies to uh members of this body the Senate and um the president of the United States I do not apply believe that it applies the rule on taking down words does not apply to a witness again I'm not condoning the words I'm just relating or asking whether or not it applies to individuals who are just just happen to be here in front of us I agree the chair over rules point of order by the gentleman from Maryland but ask that members please afford all other members the respect they're entitled refrain from using rhetoric that could be construed as an attack on the motives or character of another member or the witness you may proceed thank you this was a time in history where you got to throw out the first pitch at the Washington Nationals baseball game while Americans were forced to stay home and watch such events that they love from at home alone on their tele visions and what a hypocrisy this picture shows here you are without your mask with empty seats everywhere remember the cardboard cutout fans that was one of the most insulting things to Americans having to watch the games from home where you got to go and enjoy the game and sit right next to people not following the six feet of distancing not wearing your mask and everyone else was forced to stay home and stop enjoying life and you're science here your science just displayed perfectly in this picture we're children children in school were put in plastic bubbles because of your science your repulsive evil science and let's go back to your very own email you said earlier you don't use email oh you do right here this is your own email where you said the typical mask you buy in the drugstore is not really effective in keep keeping out virus I do not recommend that you wear a mask this is your email this is your own words but yet children children all over America were forced to wear masks healthy children forced to wear masks muzzled in their schools and then they were forced to learn from home because of your so-called science and your medical suggestions while you and all your cronies get paid from Big Pharma you know that what this committee should be doing we should be recommending you to be prosecuted we should be writing a criminal referral because you should be prosecuted for crimes against humanity you belong in prison Dr fouchi Mr chairman I have another point of order uh I recognize M Dingle just want to make sure the record is clear Dr fouchi testified that he did not use his personal email for official business business he did not say he did not use email and I think today this particular has been full of lies and disregard and disrespect and we need to stick to facts thank you the gentle L's time had expired before the point of order I now recognize Mr Garcia from California for five minutes of questions thank you Mr chair Dr Fouch I am so sorry you just had to sit through that that was completely irresponsible uh quite frankly some we're hearing this might be the most insane hearing I've actually attended I've only been in Congress for a year and a half but I am so sorry that you are subjected to those level of attacks and Insanity uh your quote unquote so-called science that the gentle woman is referring to has saved millions of lives in this country and around the world and I want to thank you for that I also think it's important to note that is my opinion is that you are an American hero and your team has done more to save lives than all 400 35 members of this body on both sides of the aisle you guys have worked not just during this pandemic but over time to save millions of lives in this country and across the world we lost 1.1 million American lives 1.1 million American lives 7 million lives around the world we were having 911 like events death events daily in this country losing 4,000 5,000 people every single day I was mayor during the time of the pandemic I remember how painful it was to close business businesses to shut down schools but how quickly we forget the pain and how scared we were as a country we were washing our groceries as they were coming in we were keeping seniors at a distance the tragedy that was happening in our nursing homes thousands of people were dying a day and you and your team of the best and the brightest scientists in this country in the world we're doing everything that you could and working night and day to save more and more of those lives a lot of my colleagues know that uh my mom was a healthcare worker during the pandemic my mom died of covid my stepfather died of covid I lost both of my parents during the pandemic so I take this very personally especially when other members of this body who are tasked to be responsible and to actually help the American people attack medical professionals like you and across the world vaccines a vaccine that you and your team helped Foster have saved millions of American lives these attacks are ridiculous now even before this committee started I'm going to point a few things out even before this committee started this same member that just went on this rant introduced the fire fouchy act and promoted on a podcast seeing that Co was a bioweapon that is how insane some of these comments are and I want to quote this this is a quote from the same member I don't believe in evolution these viruses were not making people sick until they created them they weaponized these viruses to be able to attach to ourselves and make us sick it's a bioweapon the they created them sir is you they're they are attacking you and our medical community for actually creating Co that has caused the deaths of of millions and we know that these extreme commas are targeting Public Health officials across the country I also want to show you this other comment same member who just attacked you the fouchy funded Wuhan lab created the virus this is so crazy and irresponsible in this post the same member of this committee's accusing you of orchestrating a global conspiracy to create covid on purpose just to make people get vaccines that you that you've done this sir the same member routinely promotes complete misinformation about vaccines and actually has encouraged the routine prevention of vaccinations that even eliminate diseases like the measles Dr fi you've brought together our nation and world's best and brightest scientists take on covid and create a vaccine that works I I want to ask you a question I want to be crystal clear for the public you brought together the world and America's best scientists do you believe that the vaccine that you all helped create and ensure is safe and effective for the public yes and it's track record has proven that and do you also agree that it saved hundreds of thousands and possibly millions of lives in America and across the world that is absolutely correct and it's very clear that it's saved millions of lives here and throughout the world the Europeans have done the same studies that we have and the and the the data are incontrovertible that they save lives sir and do you think the American public should listen to America's brightest and best doctors and scientists or instead listen to podcasters conspiracy theorists and unhinged Facebook memes no I'm listening to people who you just described is going to do nothing but harm people because they will deprive themselves of life-saving interventions which has happened and you know some have done studies Peter Hotes has done an analysis of this and shows that in people who refuse to get vaccinated for any variety of reasons probably responsible for an additional two to 300,000 deaths in this country thank you sir and your entire team for saving lives in this country and I'm sorry you have to continue going on with these attacks I yield back oh thank you you're not allowed to speak you thank you very much Mr chairman could you ever a removed from the thank you removed excuse me I ask escort yep thank you she can be removed yeah you can be removed actually you're not allowed to speak your time take your Starbucks with you Mr Garcia Mr Raskin you're out of line your times now recognize Dr Jackson from Texas for five minutes of questions thank you Mr chairman Dr fouchy I have to say I as so many Americans am deeply disappointed in your actions during a critical time in our nation's history while you were in key leadership roles as the Director of the National Institute of allergy and infectious disease and as the chief medical adviser to President Biden put quite simply you failed miserably in my opinion based on all we have learned during the Pand mic and all that we have since learned through this committee's work I believe your failures stem from both an effort of self-preservation manifested by a series of lies and cover up and by a total failure of leadership it was obvious to everyone that you and your organization NIH had a lot to lose if the American people were to discover that covid-19 was most likely leaked from a lab in Wuhan China and that you via Ecco Health Alliance and Peter daik actually funded This research and that this lab was actively and recklessly conducting gain of function research as such you did everything in your power to deflect and cover up this possibility you even recruited others to help you in this effort unfortunately this cost our country and the world valuable time time that may have led to answers regarding the origin may have blunted the spread and would have almost certainly saved lives while I think most of us have known all along what I just described what I have been appalled to discover through sworn testimony to this committee is the level at which you and those that worked for you went to cover up the obvious just a few examples and I know these have been touched on but they're important for everyone to hear Dr Lawrence tabac former acting director of NIH testified that under the generic definition that NIH did in fact fund gain of function research this was based on a definition that was initially used by NIH and a definition that was abandoned and removed from the website in October of 2021 and replaced by a new much more detailed definition with a much higher bar that you have since conven veniently used to define gain of function testing and to deny what Dr tabac has since confirmed he also said that Eco Health Alliance fa to properly and promptly report that their research violated the terms of the grant something that went completely unaddressed under your watch Dr Moran your senior adviser who you have tried today to distance yourself from but whose large volume of emails clearly demonstrate that you had a very close and personal relationship with and who reported to you directly has openly bragged about he how he subverted foyer request I remind you that the law requires you and your former organization to comply with Freedom of Information Act request it is not optional if you or your employees or your organization that you oversaw were were systemically uh avoiding transparency and illegally hiding or destroying documents that rightfully belong to the American people then you should be criminally charged and they should as well in addition Dr Gregory fulkers your Chief of Staff also engaged in illegal practices in which he crafted messages using symbols instead of letters to avoid Foy exposure in an email April 2020 from Dr morans to Peter daik he says quote there are things I can't say well I wonder what he couldn't say he also went on to say quote except Tony is aware and I have learned there are ongoing efforts within NIH to steer through this with minimal damage to you Peter and colleagues and to NIH and niid end quote and then a few days later he saide I have reason to believe that there are already efforts going on to protect you end quote in February of 2021 Dr Moran wrote to uh Boston University scientist Gerald k saying quote I learned from our Foy lady here how to make emails disappear after I'm foed but before the search starts so I think we are all safe end quote Dr fouchy I want to know what we being protected from and what you needed to be safe from I'm going to go on because I have a little time here he went on to say quote plus I deleted most of the earlier emails after sending to Gmail once again illegal and an actual crime Dr morans noted in another email to Dr K saying quote I learned the tricks of the I learned the tricks last year from an old friend Marge Moore who heads our Foya office and also hates foas end quote it is absolutely amazing to me that Dr morans and Marg Moore still have jobs and are taxpayers are still paying their salaries Dr morans wrote to Dr daik in April of 2021 quote PS I forgot to say there is no worry about foas I can either send stuff to Tony on his private email or hand it to him to work or at his house he is too smart to let colleagues send him stuff that could cause trouble appar end quote apparently you neglected to surround yourself with equally smart individuals Dr morans wrote to another collaborator Peter hotit in June 2021 at Baylor College of Medicine that he had deleted all his emails related to co origin when qu the hit the fan end quot he said I feel pretty sure Tony were too the best way to avoid for hassles is to delete all emails when you learn the subject is pretty sensitive in October 2021 Dr Mor wrote to Peter daik quote Peter from Tony's numerous recent comments to me and from what Francis has been vocal about over the past five years we are trying to protect you and and they are protecting their own reputations as well end quote I'll just jump ahead the the American people can rest assured that we are going to continue to pursue answers and we continue to push for full accountability from you and your colleagues despite continuing efforts to try to cover this up Dr fouchy history will not be kind to you and you will be known as the man who put his personal interest before the interest of the American people the very people that you were supposed to be protecting your actions along with several others we have had before this committee have completely eroded America's trust in our public health system in the agency that you represented for half a century with that I Y back gentleman's time has expired and now recognize Mr Cuda from Hawaii for five minutes of questions thank you Mr chair and I hope I'll have an additional 30 seconds like the previous gentleman and Dr fouchi I have allowed that today on several occasions thank you Mr chair Dr fouchi you deserve better than this the other side suddenly cares about puppy ironic given recent book Publications versus the millions of people that you have kept safe and Alive over your lifelong commitment to Public Health I'd like to use my time to dispel some of the myths about you that have circulated in right-wing circles we can all acknowledge that yes suspension of in-person activities during the early days of covid it was necessary to save lives and to stop the spread and and it was not without its challenges it was difficult particularly for our nation students like my two sons in public schools and our business owners but to completely blame these policies on you Dr fouchi is absolutely ridiculous I'd like to make the record clear on something the decision to spend inperson learning dining and other activities that was not a decision that you were somehow solely responsible for including in your role as niad director is that correct in fact these decisions were actually made at the state and local level in communities across the country like my home state of Hawaii which was particularly aggressive uh in part as a response to the Trump administration's early failure to contain the initial outbreak of the virus is that not correct I'm sorry I didn't ma'am I'm not really hearing you very well could you just put your we'll put it a little bit closer but to be clear that the decisions were actually made at the state and local levels in communities across the country that is correct okay thank you now I'd like to shift topics and turn to the allegation that you sought to suppress opposing viewpoints about the pandemic response over the past 15 months majority members of the subcommittee have levied the allegation that federal health officials censored proposals like the great barington declaration which were inconsistent with the overwhelming consensus of the scientific and medical community much attention has been paid to an email Dr Francis Collins sent you regarding the great barington declaration where he called for a quick and devastating publish takedown of its premises to be clear this was not Dr Collins suggesting that you suppress or censor the great barington declaration rather he was suggesting that the points you just explained be memorialized to substantively refute the scientific premises of the great barington declaration is that correct yes and there was good reason for Dr Collins to have substantive concerns the great barington declaration proposed lifting mitigation measures for the vast majority of society and preserving them only for certain populations including the elderly and people with underlying health conditions this was months before a vaccination was available and public health systems were already being overwhelmed uh and thousands of Americans were dying daily Dr fouchi what percentage of the population did we estimate needed to be infected with covid before we would achieve so-called herd immunity herd immunity was very elusive with covid and the great barington decoration was flawed both conceptually and in practice conceptually that you could Shield vulnerable people as if the only vulnerable people are those in nursing homes we have tens and tens of millions of vulnerable people that you couldn't possibly Shield people with underlying conditions the elderly those would be the individuals so it would be conceptually impossible to do that her immunity As We Know means if you have a virus that doesn't change and a virus in which when you get infected or vaccinated you have highly durable perhaps lifelong immunity that's not the case with covid we know immunity wains and we have multiple variants so in practical purposes the great barington Declaration was invalid both conceptually and practically thank you Dr F you've as answered a few of my other questions in terms of the fact that for many of us that live in multigenerational communities uh thousands hundreds of thousands millions more lives would have been impacted by this so-called approach and given the fact that the virus's rapid Evolution that we have since seen since 2020 uh her immunity approaches would be absolutely ineffective against covid um if you would answer one more question considering the mortality rates at the time how many more deaths might we have seen just briefly I mean if we had done that just let it rip they very likely would have been another million people would have died I would imagine thank you Dr foui so it wasn't the federal government suppressing the great barington declaration rather it was about protecting and saving millions of American lives the covid-19 pandemic wasn't some academic exercise it was real it was in real time it was about saving lives in real time theories like herd immunity may seem plausible on paper but we have to remember that it is based upon the assumption that enough people would have to be infected and that would likely have meant that our family members our friends our neighbors our constituents especially those in our most marginalized multi-generational rural communities would have died so thank you Dr Fouch I want to thank you not blame you thank you for your science thank you for your science that have saved millions of American lives kept us safe including my children many of our families right here on this dis and thank you for clarifying these points for the record and for all of your efforts to keep us safe during the pandemic and so many other Health crisises we have faced over the decades that you have served Mahalo Mr chair and I yield back now recognize Dr McCormack for five minutes of questions thank you Dr winstrip chairman it's been insinuated that politicians only politicians only bloggers only conspiracy theorists are disagreeing with you I want to point out that I'm probably the only member of Congress that actually treated patients during the pandemic from the very beginning to the very end of the pandemic during night shifts in the ER thousands of patients during that time and uh in 2020 I was censored my medical license was threatened because I disagreed with bureaucrats literally taking off the internet as a person who is treating patients with Leading Edge Technologies developing theories but doing my very best but being censored by the United States government for the first time stepping in and taking the place of medical professionals as the experts in healthcare any dissent surrounding covid-19 treatments Mass mandates and any public policy surrounding the pandemic was immediate labeled as anti-science I watched as public health officials and politicians told my patients what treatment options were best for them regardless of their comorbidities or their medical history despite my education and my training and my experience my opinions were relegated to conspiracy and misinformation by so-called Healthcare experts who had never treated Tre a patient throughout the entire pandemic this has been a black eye in the medicine and has highlighted why government should never never insert itself in between patients and their health care providers the American people deserve to make medical decisions through conversations with their Physicians rather than politically motivated mandates Dr fouchy did you ever treat a patient for covid during the pandemic I was part of a team that was at the NIH that took care we didn't take care of many of them okay so not hands on got it thank you why would I be criticized by a bureaucrat for doing my very best as a healthcare this is a rhetorical question but why why would the government who's never treated a patient for covid you can read all the things you want but you're not there you're not seeing patient you're not watching people die intubating patients right there with that disease in your face watching it happen watching the development of this disease and actually learning from it but I'm being told by bureaucrats what's right and wrong and what's funny is everything I was censored on I was proven to be right pretty crazy isn't it you said in an interview that you gave as part of an Audi book written by Michael Spectre uh that you believed an Institutional should make it hard for people to to live their lives so they'd feel pressured to get vaccinated could we uh run the audio clip on that please you think can be done about it I have to say that I don't see a big solution other than some sort of mandatory vaccination I know Federal officials don't like to use that term once people feel empowered and protected legally you were going to have schools universities and college is are going to say you want to come to this college buddy you're gonna get vaccinated lady you're GNA get vaccinated yeah big corporations like Amazon and Facebook and and and all of those others are gonna say you want to work for us you get vaccinated and it's been proven that when you make it difficult for people in their lives they lose their ideological and they get vaccinated thank you are all objections to covid vaccinations ideological Dr pouchy no they're not and that's not what I was referring to well in reference to making it hard for people to get education traveling working I'd say it very much was in context and I take great offense to this Miss Allison Williams testified before this committee about losing her job because she sought an exemption for ESPN's vaccine mandate which came from recommendation from bureaucrats like yourself she and her husband were actively working with a fertility expert a physician on how to get pregnant and agreed with the premise that she was young healthy wanted to get pregnant and shouldn't get the vaccination for medical purposes but she was fired because you made it hard just like you said in your statement because you didn't want to make sure that the ideological got in the way of her working of living her life of making a medical decision with her health care professional I think America should take great offense to this that's exactly what you meant when you said making it hard for people to live without getting a vaccination you affected people's ability to work travel be educated to actually flourish in American to self-determined as we're all given god-given rights shame on you Dr Fouch you've become doct fear Americans do not hate science I don't hate science the American people hate having their freedoms taken from them you inspired and created fear through Mass mandates school closures vaccine mandates that have destroyed the American people's trust in our Public Health institutions this fear you created will continue to have Ripple effects over generations to come you have already seen its effects in education in the economy and everything else quite frankly you said if you if you disagree with me you disagree with science Dr fouchy I disagree with you because I disagree with yield I now recognize Mr moscowitz from Florida for five minutes of questions uh thank you uh Mr chairman uh Dr fouchy good to be with with you uh here today um I was not here uh but I saw a member of this committee questioned whether or not you represent science and try to make that in some offensive way I just want you to know most Americans don't think she represents Congress so one of the things I've learned so so uh I hear now you double double fouchy um so I don't want you to to to be offended uh offended by that uh I actually similar to uh representative McCormack who was serving in the field as a doctor during covid I was running the logistics operation and the Florida response as the Director of Emergency Management for the State of Florida for governor D santis so I was deploying masks and gowns and gloves we were setting up field hospitals we were setting up testing sites we were setting up vaccine sites uh throughout uh throughout the pandemic and the one thing that became clear to me as a countryes we were not prepared in fact we actually had had many preparations for a pandemic but both the states collectively and the federal government threw that out and kind of was just um uh making it up a as we go one of the things I wanted to ask you and I understand you're not in the response uh field but do you feel since you've left that we are better prepared today than we were uh several years ago when Co hit some respects excuse me in some respects we are but in others I'm still disappointed um and I think one of the things that was really a problem with the response was the degree of divisiveness that we had in the country about a lack of a coherent response where we were having people for reasons that had nothing to do with public health ass science refusing to adhere to Public Health intervention measures what I think that we will do better hopefully is that the CDC I believe is now recognized some of the failings of the lack of communication and and interaction between the federal response and the local public health officials one of the weaknesses that we had in the United States that other countries didn't have was a disconnect between the Health Care system and the public health system where where is the CDC can't demand information from local public health individuals they have to volunteer to give it to them and it isn't given to them in real time so we were at a disadvantage oh no question I saw that I saw how the the lack of investment in technology right we had states trying to share information with the federal government using you know Windows 2000 well fax machines fax machines exactly yeah so and so you know we spent $7 trillion in two packages and two administrations and one of my concerns is is that I feel that especially in supply chain I feel like we we're not that much better off than we were before covid am I wrong in that assessment yeah yeah I don't think you're wrong but I I hope that the CDC has made it very clear that they are trying to change that and correct that deficit of a separation between the local and the federal CDC so that we can get information in real time it was very frustrating for us that often we had to go to the UK or South Africa or Israel to get realtime information because they had a connection between what was going on in the ground and their public health system so they knew right away what was happening we didn't Dr fter you talked about how you know we live in partisan times a lot of misinformation uh and you know colleagues on on this body said you know you should be you know charged and and found guilty of course the only one that's that's happened to is your former boss uh but you know the question I have is when you saw a lot of that disinformation whether it was you know we can use a disinfectant to do like a cleaning or do light in the body or that you know China's working super hard president she's got it contained all of the stuff that was being put out were you concerned you know what was your feeling at that time uh working in the administration seeing that come from the podium well I was very frustrated by that it was very clear I was put in a very difficult position that I didn't like of having to contradict publicly the president of the United States I took no great pleasure in that but I felt it was my responsibility to preserve he must have thought you did a great job he gave you a commendation right before left well I felt it was my responsibility you know as to preserve my own personal integrity and my major responsibility to the American public to tell them the truth and if I could just take this opportunity when I was saying that if you attack me you attack science I didn't mean that I am science what I meant was that when the data showed that hydroxy chloroquin does not work and there are people saying oh it does I'll give it to people and we know it can be hurtful to them then when you're attacking what I'm saying that the science shows it doesn't work and the science shows that bleach doesn't work that when you attack that you really are attacking science because science has shown that it doesn't work that's what I meant when you attacking me you're attacking science thank you doctor thank you Mr chairman i y back gent times expired now recognize Mr Jordan from Ohio for five minutes thank you Mr chairman doctor why was it so important that the virus not have started in a lab uh we don't know where it started and that's the reason why I keep an open so I don't know what you mean by why was it so important it wasn't important you still don't know where you still don't know where it started the guys you gave money to figured out in three days no no no they Mr Anderson said on January 31st 2020 uh virus looks engineered virus not consistent with evolutionary theory the very next day Dr Gary said I don't know how this happens in nature it'd be easy to do in a lab and then three days later Shazam they switch and say it didn't it has to be nature so they figured out in three days but you still don't know no in fact if you look at what they was saying Congressman Jordan they were saying that it was not a manufactured virus it still could have evolved out of a lab let me read something here to you in our they're not incompatible in our study on the censorship of the Biden Administration working with big Tech I want to read you uh WhatsApp message from Mark Zuckerberg can we include that the White House put pressure on us to censor the lab leak Theory so this is a communication on July 16th 2021 Nick Cay Joel Kaplan Cheryl Samberg Mark Zuckerberg they're certainly feeling the the pressure to downplay any lab leak theory is there a question there there's coming there one's coming here's another email to Mark Zuckerberg it says subject line Co misinformation Wuhan lab League theory in response to continued public pressure and tense conversations with the new Administration we started removing five Co claims including the lab leak Theory Mr Zuckerberg responds this seems like a good reminder that when we compromise our standards due to pressure from an Administration in either direction we often later regret it why was it so important the virus not have started in a lab wasn't so important that the virus not we don't know we know what was important to someone in the Biden Administration so much so that the top people at meta the top people at Facebook are asking why are we getting all this pressure to to to downplay the lab League Theory and we have an email from June of the same year June 4th 2021 saying the same thing it was certainly important to somebody well what hases that got to do with me I'm asking you because you're the expert on the coron virus I'm saying why was the administration why was the administration so pushing not to have the lab leak Theory as something that was viable I can answer that I've kept an open mind throughout the entire proc an open mind Dr fouchy open mind that is correct what happened in those three days why did Dr Anderson and uh excuse me Mr Anderson and Dr Gary why did they changed their mind in 180 degrees because what what Christian Anderson says 3 days later after he said virus looks engineered virus not consistent with evolutionary theory three days later he says the main crackpot theories going around at the moment relate to this V virus being somehow engineered and that is demonstrably false how did they how did they figure all that out in three days Dr Fouch you can do still have an open mind well what they did is that that you know they testified before this committee what they did they went back and looked at the sequences and realized that their initial concern was unfounded about that and it did not look at all like it was manufactured but as they said in their paper even though they feel it was more likely three days they figured it out that's exactly you could do that in three days you can scan sequences in a day you don't need three days okay uh who's Robert Redfield the former director of the CDC Dr Redfield right and he was uh and he was also in the coronavirus task force is that accurate he was a member of the coron virus task force here's what he said to this committee he said Redfield said that fouchy and Collins left him out because Redfield suspected that Corona virus had leaked from the Chinese lab is that accurate well he said that but that's not true that is incorrect Congressman Dr redfield's lying to the committee when he sat right where you sat when he said that I kept him out that is an incorrect statement the the the the roster who was on the phone was Dr Redfield in that conference call on February 1st when you had Mr Anderson and Dr Gary on that call he was not and the conference call was put together by Jeremy Farah so no one kept him out he said he was kept out because did US tax dollars you want me to answer the question yeah I I would just wonder why it wasn't on the call it seems to me the head of CDC part of the coronavirus task force which was formed two days prior to that call would have been on the call well the call was arranged by Jeremy Farah you should ask him okay uh did US tax dollars flow through a grant recipient to the lab in China I'm sorry what was did US tax dollars flow through a grant recipient to the lab in China yes of course it was a sub awward to the Wuhan instit and who approved that award excuse me and who approved that award what agency approved that award National Institute of allergy and infectious diseases your your agency approved that right yes it did after did that have anything to do with this downplaying of the lab leak Theory no nothing to do with it nothing what do you do you agree that there was a push to downplay the lab leak Theory not on my part really really wow wow I think I think most of the country find that find that amazing I still got 11 seconds we got but look at the facts I've kept an open mind throughout the entire process all right I you back I now recognize the majority staff for no longer than 30 minutes of questions Dr fou Dr fouchy it's good to see you again I want to ask a couple questions about um some of the members questions and then get into some follow-ups um the issue of the uh CIA trip was brought up that was brought to us by a whistleblower that was not an allegation made by the committee it was an allegation made by The Whistleblower um you testified at a transcribed interview back in early January do you recall me asking you about that allegation about the going to the CIA yes um and do you recall and you denied it then as well and you denied it here today uh do recall the subcommittee publishing that you denied it I I don't recall uh we did we did okay we put it out in a press release afterwards that you denied the whistleblower's allegation um and then today during the course of the last couple hours have any members on the majority side of the dis asked you about a trip to the CIA yeah they have no they have I'm sorry Mitch I'm not hearing you so m i I have a point of order Mr chairman gentleman's point of order what's the gentleman's point of order um I have an inquiry about whether or not I'm hearing things or whether or not you just yielded 30 minutes of committee time to staff that is correct both sides and the question that the gentleman just raised was a question that I raised so apparently he was not listening when I was questioning Dr FY thank you for your point of order you may continue um what I what I asked was we asked you about this in a transcribed interview you testified that you did not go to the CIA we published that you refuted that allegation and then today no members of the Republican side of the dis have asked you that question is that accurate thank you um you've been asked a number of times about uh your former uh senior adviser Dr morrens um and have said and I want to make sure I characterize it correctly because I it goes a little back and forth um that you didn't conduct official business over a over a personal email with Dr morrens has Dr morren emailed your personal email before on non-official purposes as I mentioned we wrote scientific papers together so he very well may have used that course that's the email I use when I write a scientific paper right and that's because niad policy allows you to write on semiofficial time write papers but you just have to put a disclaimer that this is not the in other words if if you're doing something as official business you shouldn't use your emails that are official business so in order to be compliant with the regulations you would use a personal email I appreciate it um I want to ask about some of the public health policies enacted during the pandemic uh Dr Francis Collins the former NIH director recently said at an interview and I'm quoting uh you attach an infinite value to stopping the disease and saving a life you attach a zero value to whether this actually totally disrupts people's lives ruins the economy and has kept many kids out of school in a way that they never quite recovered um understanding the co task force had a lot of voices at the table is that an accurate description of the public health advisers and then you could fit in other advisers along the way yeah you know Mitch what what I believe that Dr Collins was saying was that we give a advice based on pure public health issues it's very very clear now retrospectively looking at the potential collateral negative effects of things like mandating it would be important for us now since the purpose of I believe why we're here is to how we can do better next time is to consider the balance I think things that we did in the beginning were in the cont text of horrible situation of four to 5,000 deaths per day but that doesn't mean that you don't go back and look and say did everything we do at that point and the duration for which we did it was that appropriate and do we need to reexamine I believe that's what Dr Collins was referring to and I agree with him on that and you got to my next question that we are here trying to figure out how to do better next time lose fewer lives next time um would that be a better thought process going forward of thinking about the possible unintended consequences of Public Health measures absolutely yeah um and you've heard from both sides of the dis today first weeks months novel virus nobody knew what was going on called for some drastic measures um understanding or I once there was a better understanding of who the most affected demographics were um do you think it would be important to more narrowly track uh craft Public Health measures to specifically favor those demographics the answer is yes but you have to be careful because if you have a a certain group that is being predominantly a Afflicted if you're really really clear that another group is really quite protected then you should fashion it demographically related but what often happens with outbreaks is that there are moving Target and you only hear about other vulnerables as you get further into the outbreak so the answer to your question is you're partially correct that you need to do that but you've got to be careful when you're dealing with a moving Target and uh we can appreciate that and you've been asked a little bit again about the theories of natural immunity and herd immunity those are both real scientific theories and infectious disease is that correct yes and between uh a in infection acquired immunity and vaccinated acquired immunity did the United States hit her immunity the answer is no uh and I've written a paper on that is that when you're dealing and just let me take 30 seconds I don't want to run out the clock on you but I think it's important to to make this point when you talk about herd immunity it's predicated on two principles that you're dealing with a pathogen that's not changing and number two that when you either get infected or vaccinated the duration of the immunity is measured in decades if not a lifetime so that if you have a pathogen that stays the same like measles doesn't change so I was infected with meagles measles when I was a child it's the same measles that's infecting people in certain countries in the developing world number two when you get either infected or vaccinated with measles you have immunity that's durable minimally in decades and possibly for life so if you get the same pathogen and you get a large percentage of the people who have either been infected or vaccinated then you have hert immunity we did not ever have that with covid um and you've also been asked a number of times about the vaccine and vaccine mandates uh were you the one that recommended to the president to mandate vaccines for certain individuals no do you know who did no it was it was more more of a it was a combination of of a group and just saying that you know certain agencies like the labor department or what have you would feel that this would to be done but it was not like I one day said hey we should mandate vaccines that did not happen um and I want to Echo the comments of the chairman that we agreed the vaccine saved hundreds of thousands of lives um and we talked about this a little bit in January and I think you touched on it a little bit today could issuing these mandates and removing the notion of informed consent from some certain sect of the citizenry lead to vaccine hesitancy yeah I I mentioned this in I believe in in the ti that as a matter of fact that's something that I think we need to go back now when we do an an after the event evaluation about whether or not given the psyche of the country and the push back that you get from those types of things we need to re-evaluate the cost benefit ratio of those types of things um and then I won't belabor the point but we talked about the six foot distance an awful lot today um do you recall if it was ever suggested to be 10 feet you know I don't recall Mitch if it was ever suggested it was 10 feet but I when I made my explanation of what it was I was saying that there was no trial that looked at 10 versus 6 versus 3 versus not even worrying about it at all um and you said today that there were discussions at the White House about the 6-foot rule you don't recall if it was discussions about whether or not it should be three or should be 10 or should be you know I I don't recall Mitch what the exact discussion was but as I've said in response to multiple questions what we had it was it came the CDC was said that on on the basis of their evaluation which was based on the droplet approach that 6 foot would be to go and there was no clinical trials going one way or the other that's why it was accepted by the group um and then it hasn't been a large topic today and we talked about kind of again the the many unknowns in early 2020 schools were closed through the semester some schools reopened in the in the for the fall semester some remained closed going through into 2021 um looking back uh were there are there current academic ramifications of remote schooling or kids not being in school I think there have been a number of St not I think I know that there have been a number of studies to show that there are lasting effects at least up to this point and they tend to attenuate over time but there have been substantial negative effects on learning and on children when you keep them out of school for a prolonged period of time have have you seen any studies suggesting physical health ramifications I haven't seen physical health ramification mental mental health um I believe that there are some that show psychological issues that relate to keeping kids out of the environment of the social environment of the school um I'm and apologize for bouncing around we don't have 14 hours with you today I've got 30 minutes so I'm going to I'm so sorry about that I'm going to move quickly um uh again across the Das both sides of the aisle a lot of questions on the origins of Co and finding out the origins and um how that could better lead to both protecting against spillover and Wildlife uh trade but also increased biosafety standards um as you sit here today is it possible that covid-19 was the result of a laboratory related accident oh absolutely and I keep like I mentioned multiple times I keep an open mind I feel based on the data that I have seen that the more likely not definitive but the more likely explanation is a natural spillover from an animal Reservoir but since there has not been definitive proof one way or the other we have to keep an open mind that it could be either and I'm based on that answer I think is the hypothesis that covid-19 accidentally leaked from a labba conspiracy theory no I mentioned that several times conceptually the concept of it is not a conspiracy theory um we've talked a little bit about the proximal origin of uh SARS kovy 2 the paper authored by Dr Anderson uh it came to two primary conclusions and I'm quoting our analysis clearly show that SARS K2 is not a laboratory construct or a purposefully manipulated virus and we do not believe that any type of laboratory based scenario is plausible um do you disagree with those conclusions I think Mitch if I'm not mistaken I don't have the paper in front of me I think they also said the possibility of if you passaged it and you could have done that and they and that and if you passage it it's in a lab so it is I mean that could be and they they dispelled that at the end with the we do not believe that any type of laboratory based scenario is plausible um so I'm just I ask again is a laboratory based scenario plausible well I mean again I'm not I I don't want to speak for what they meant in that paper but I have said multiple times I keep an open mind that it could be either a laboratory leak or it could be what I think the data is leaning towards most which is a natural occurrence from an animal Reservoir and this email was brought up too on April 16th 2020 Dr Collins wrote to you and said wondering if there's something NIH can do to help put down this very destructive conspiracy referencing the lab leak I hope the nature medicine article on the genomic sequence of SARS K2 would settle this but probably didn't get much visibility anything more we can do the next day you were at a White House Press Conference and cited proximal origin and said uh that proximal origin established that covid-19 quote is totally consistent with a jump of a species from an animal to human um did anyone tell you to cite proximal origin from the White House Podium no it was in response I believe to a question that might have been asked by a reporter but I wasn't stimulated to say that at all I was responding to a question at that time back in April of 2020 um was it also your belief that a la leak was possible yeah I always had an open mind about it and then I want to correct the record again a little bit on um the Drafting and publication of the proximal origin paper did Dr Anderson send you drafts to review he sent drafts but I'm going to jump ahead of you if I might dribble around I did not edit it it was mentioned by a few of the it was congressmen I did not edit the paper and I appreciate that I just wanted to get on the record right um I want to talk about Dr moren's and what you wrote in your opening testimony and some of the answers that you gave today and just for clarity you were uh in addition to being unaware of his use of personal email and potentially intentionally deleting Federal records were you also unaware of his actions to assist Dr daik and Eco health I I am I was aware of his friendship I was not aware of his attempts to assist him to respond to an NIH inquiry so not aware of the editing of press releases or editing of letters no I was not on November 11th 2021 Dr Moren wrote in an email to Dr daic that he attempted to discuss the Eco Health Grant with you and you quote got upset and told him to have no more Communications uh with Peter why did you tell Dr Moren to no longer communicate with Dr D because I think it's inappropriate to do what he did I mean and your committee has called him out very definitively about that and it was inappropriate to do that th this is back in 2021 what did you know about what he was doing then I didn't know exactly what he was doing but I don't think it's an appropriate for people to be communicating and helping a Grande in a response I didn't know exactly what he was doing but I didn't think it was appropriate um when did you you testify to uh chairman Griffith or excuse me chairman comr um that you knew about the compliance issues later on with Eco Health when did you first become aware I became aware during briefings by my staff in preparation for Congressional hearings well after the fact where compliance issues actually happened that mean I didn't know as I've mentioned to you in the ti I didn't even know the grant existed before the outbreak and then finally when there was this issue about Congressional hearings I needed to know what is this grant what are we doing with it and are there any issues that's when they said there was a compliance problem of the fourth year versus the fifth year uh progress report um some of the other emails from Dr Moren I just want to read into the record and ask you if his recollection is accurate on April 27th 2020 Dr menen wrote I am sure privately he would love to see Peter and Eco Health fully restored although he did want to make make the comment to to me that Peter had screwed himself with the late report I already told him that all that crap wasn't true the late report was true despite what Dr Moren said on April 21st 2021 Dr menen wrote that he was sure you would do anything you could to restore the funds to Eco Health on June 5th 2021 Dr menen wrote that you were working behind the scenes to undo the damage to Eco Health on October 21st 2021 Dr Moren wrote Peter I had my regular meeting with Tony this morning he immediately inquired about you and several times asked how you were doing he used a lot of colorful language about the situation with attacks on eco Health on October 25th 2021 Dr menen wrote that you were trying to protect Eco Health on March 22nd 2021 Dr Moren wrote the most important is within NIH to get the decision reversed and the grant refunded I believe Tony would like to do this and on February 24th 2022 Dr Moren wrote it will will be a small consolation to hear the following but in my face-to-face meeting with Tony this morning he once again brought up as he usually does your plight Peter did you ever have any discussions with Dr Moren about protecting Eco health or helping restore funding not at all I don't know what I to be honest with the MIT I just don't know what Dr Moren is talking about with that maybe he's trying to as he said cheer up he said that in front of this committee cheer up Dr desich but to say that I'm getting involved in trying to help him or protect him not so did you ever have any conversations with Dr Moren about what Dr daik was facing or about the termination of the grant you know I may he may have mentioned to me something like Dr dayc is going through terrible times uh but I don't recall it is conceivable that he would have mentioned that to me because as he mentioned to you that Dr desac and he are very good friends so it would not be surprising if sometime time he had mentioned to me boy Dr des's going through some really tough times fine that doesn't mean that I say you should help him no absolutely doesn't so that's why we want to ask the questions and get get get the answers um during your transcribed interview with us uh you were asked about whether or not Dr dazak had a conflict of interest in reviewing the origins of covid-19 and you testified you know I hesitate to speculate about someone else should what someone else should do the only people that I'm involved with is my own staff who we've mentioned many times in this discussion who don't have a conflict of interest with the benefit of hindsight and the work of this committee do you believe Dr Moren had a conflict of interest regarding Eco Health well from what we know now he definitely had a conflict because he was communicating with a grantee of helping him in response to an NIH issue which is a conflict of interest I did not know that at the time when I made your statement and I appreciate that that's yeah um sticking with Eco Health in April 2020 NIH terminated and then subsequently reinstated and then suspended the Eco Health grant that had the Wuhan Institute as a subgrantee do you recall that decision yes were you involved at all in that decision no uh you previously testified to house Energy and Commerce that you were in essence told to cancel the grant do you recall who told you um we got it from a number of now retrospect effectively we found out how it was it was the White House told the department to tell the NIH to cancel the cancellation what is that do we need to listen to that okay he he was he was escorted out yeah okay good um I'm sorry repeat the question Mitch did you agree with the cancellation you know I I it wasn't a question of agreeing or disagreeing it was like can we really do that I don't think that you can do that and as it turned out I was right because the general counsel of HHS said by the way you can't do that you've got to restore the Grant and that's why they restored it and then suspended it pending the compliance review exactly um not to keep reading Dr moren's emails but on June 24th 2020 Dr Moren wrote an email he referencing you made some additional comments to the effect that this came from the White House and he was totally opposed to it you weren't totally opposed to it well see that's his in you know he's doing a lot of interpretation Mitch his interpretation I was totally opposed to it it was more of can we really legally do that and the answer turned out I was right no you can't um do you recall the did the department ask you first or Dr Collins first to ter I think it went directly to building 10 uh excuse me building one the the director's is that the NIH director yeah I think it it went from the Department to NIH to us okay um were you prior to your retirement in December of 2022 were you involved in any of the compliance actions NIH took against Eco health I don't believe so I think the the act and and again I'm I'm a little unclear about the time but I think most of the disciplinary actions actually occurred after I left if I'm not mistaken the yes the actual suspension and debarment occurred after you left but there were a number of letters requesting lab notebooks or further information while you were still there but what happened mention it's important to point this out once it was clear that there was compliance issues while I was still there we were told at niid stay out of it compliance is going to be handled by building one I.E the NIH director and Mike laow so the compliance was said don't touch it Don't Go Near it just will take care of it and you just brought this up since the original termination then suspension NIH found numerous major violations of Grant policies has since debarred the Wuhan Institute of orology and suspended and proposed for debarment both Eco Health as an institution and Dr daic individually are you aware of those yes I am um during previous TI and hearings when asked if they supported every one of these action and supported the suspension in dearment uh both Dr Collins and Dr tabac said yes sitting here today do you support the suspension and Department of Eco Health yes I want to move on to the kind of like known unknowns of covid Origins to quote Dr lipkins paper from early 2020 um on October 20th 2021 Dr tabek sent a letter to uh then ranking member Mr comr that said the bat Corona viruses studied under the Eco Health Alliance Grant could not have been the source of SARS K2 and the covid-19 pandemic you've testified similarly both back in January and today um some of the things that uh I believe chairman Griffith brought up was just kind of that statement results on some things rests on some things that we just can't know um in your experience Dr fouchi do researchers uh publish every virus that no I mean uh I think researchers don't always publish every single thing they do um do they routinely publish every experiment that they conduct uh I'm sure there are people who don't publish every single experiment that they do and then is there a lag time between the sampling the analysis and the publication yeah I mean Publications are often months before they come out is it possible if not plausible that Eco health and the Wuhan Institute of rology have samples from between 2020 when they originally published a paper or excuse me 2015 when they originally published a paper with all of their samples and now that are unpublished sure it's possible but Mitch I'm I might just throw in there you can't get away from the fact that the viruses that were study that we that the NIH gave them a grant to study don't pull back on the fact that no matter what you did with those viruses they were phenetically so different they could not possibly be the precursor of s kobe2 and and I agree with that I guess my only point is that you don't know all the viruses they were working with yeah and let's make that clear because uh Griffith Congressman Griffith asked it and I answered you quite honestly that none of us can know everything that's going on in China or in Wuhan or what have you and that's the reason why I say today and I've said it the ti I keep an open mind as to what the origin is um the last thing last topic I want to touch on is gain of function we touched on it in January you touched on it a little bit today I know um the pandemic has resulted as I'm sure you're aware with a rather large debate and including with the nsbb updating their uh dangerous research policies surrounding gaina function P3 Co and dual use research of concern um at the prior to October of 2021 the NIH website listed gain of function as a type of research that modifies a biological agent so that it confers new or enhanced activity to that agent and the P3 Co framework the U that the US government uses to further regulate a sub a subpart of that research that is more dangerous specifically that could cause widespread and uncontrolled death or disease in humans um putting aside what's what's regulatory I agree with you the P3 Co definition is regulatory are there types of research that could fall under the broad definition but not the P3 Co definition well I believe members on the minority side have mentioned that influenza is a gain a function to a virus to make it grow better in eggs making an eoli manufacture insulin is telling the eoli to do something it wasn't able to do before by mutations of course that's the case um so in kind of the ven diagram of This research something could fall under gain a function without falling under further regulation I know where you're going and you're not going to get there but go ahead um according to Ecco Health's year five progress report they facilitated an experiment in Wuhan that had seven mice infected with Wuhan Institute of rology one as the backbone five survived then eight mice were infected with a chimera of wiv one and the spike from another virus and two survived in Ecco House's own words these results suggest that the pathogenicity of that fulllength Chimera is higher than others right um you were asked today and uh it was read back to you a little bit but on May 16th uh just a few weeks ago Miss leco asked Dr tabac did NIH fund gain a function research at the Wuhan Institute of rology through Ecco health and Dr tabac answered if you're speaking about the generic term yes we did right on May 11th you were asked a similar question and you answered the NIH has not ever and does not now fund gain of function research at the Wuhan Institute of I'm going to ask it and you can answer it how you how you want to answer it according to the broad definition of gain of function research and the definition Dr tabac was testifying pursuant to uh did niad fund gain of function research via Eco Health in Wuhan the broad the broad definition of gain of function in my mind is not applicable here and does nothing but confuse the situation and that is the reason why after to three years of deliberation by the bodies including the nsbb as well as the national acmy it was decided to make an operative and Regulatory definition if you hearken back to the original broad definition it does nothing but confuse people and that's the why every time I have mentioned gain of function at the Senate hearing with senator Paul and the TI and today the definition that I use is not my personal definition it's a codified regulatory and operative definition made by a body that has nothing to do with me thank you Mr chairman I yield back I now recognize the minority staff for not longer than 30 minutes Dr fouchy nice to see you we've covered many different topics today we just want to make sure that you have the opportunity to provide your full perspective on any and all of them is there anything you'd like to add clarify or say about any of the topics we've today we've covered just about everything but if you come up with uh something you want to ask me i' I'd be happy to try to fill it in but I think we've been rather rather extensive today I think that's great and I think we agree and so with that we'll yield back I would like to yield to the ranking member Ruiz for a closing statement if he would like one Dr Fouch I'd like to thank you for your testimony today and I would like to thank you for your Decades of service to our nation uh especially with the HIV um epidemic that our nation suffered through the pandemic flu Ebola zika and covid-19 and your years of research and investment in that led to the rapid development of the covid-19 vaccine that saved millions of lives thank you and over the past four years you have been personally targeted by extreme narratives about the origins of the covid-19 pandemic and the US government's response to it they began in force in retaliation to wisdom you offered that contradicted The Reckless uh and dangerous uh therapeutic recommendations by President Trump and have remained part of House Republicans political Playbook these extreme narratives have been the Bedrock of the select subcommittee's republican-led probe and the untenable inferences they've somehow drawn despite the overwhelming evidence that it is inconvenient to those narratives I want to be clear the evidence uncovered from more than 425 th000 pages of documents and 20 closed door interviews of current and former Federal officials has undermined the extreme narratives behind Republicans own prob as I alluded to at the beginning of this hearing my Democratic colleagues and I are committed to speaking objectively and truthfully about what the evidence shows and this is what it shows Dr fouchi did not fund research through the Echo Health Alliance grant that caused the co9 pandemic Dr Dr fouchi did not lie about gain and function research in Wuhan China Dr foui did not orchestrate a campaign to suppress the lab leak Theory these findings are Apparent from the evidence in fact this much was clear by the time of Dr fouche's two-day transcribed interview this past January and the five months since the select subcommittee has conducted several more closed door interviews and reviewed several thousand more pages of documents the the this additional evidence in Dr fouche's testimony today has only made Republicans claims less plausible and more Preposterous and when I was named ranking member of the select subcommittee I made a commitment to follow the facts and objectively analyzing the origins of the covid-19 pandemic the select subcommittee is to meaningfully improve our nation's preparedness for future pandemics then we must take an objective approach to the factual and scientific evidence available to us the origin of the covid-19 pandemic remain uncertain I would like to remind my Republican colleagues that that uncertainty is not an opportunity for them to author fiction for partisan gain it could have been a lab league and it could have been an animal transmission and at the cost of meaningfully advancing our understanding of Co 19's Origins Republicans have levied extreme allegations of creating SARS K2 against Dr fouchi the result is that Republicans own Pro has failed to shed any additional light on a central question for our select subcommittee in fact we're actually entering the fourth quarter of this Congress and this select subcommittee on Corona's pandemic and what have we focused on it's not an objective uh investigation on the orig origin as either lab leak or animal transmission we have spent the vast majority of time like in this hearing with Republicans trying to prove that Dr funded research through Echo Health that created the SARS K2 virus and in order for that to be true it is dependent on proving the labak theory to be true so it has not been an objective investigation as to whether or not the virus came from lab or or an animal Transmission in order to prevent and prepare for the next pandemic it has been to push this narrative and this hearing is their climax their star witness to finally prove their narrative and they did not do so instead of focusing on Solutions like fortifying our Public Health Workforce and infrastructure securing domestic Supply chain of vital public health equipment and medications or equipping schools churches synagogues mosques businesses to safely stay open during the next deadly novel viral pandemic instead they focused on accusations without evidence and it seemed like even though the evidence was there that the accusations were false it didn't matter they still accused him on a cover up suppressing the truth that he initiated prompted or edited the proximal Origins paper that he funded gain of research that created the SARS K2 virus even that he received royalties you know his answers today and his transcribed interviews and his countless emails refuted all of this they always have and his testimony today did again but that I guess that doesn't matter for the majority the truth is that there is no evidence to prove this narrative that we spent so much time addressing their accusations are without evidence but it doesn't matter to them intentionally misleading the public is propagating disinformation and it's wrong and dangerous not only because it manufactures distrust in our Public Health leaders and our Public Health agencies but also because it targets Dr fouchy and other public health officials for violent death threats Dr fouchy just said that anytime anybody alludes to the false accusation that he created the covid-19 pandemic his death threats go up but irresponsibly and recklessly members on this subcommittee continued to accuse him of that so for the remaining months of the select subcommittee I reaffirm my commitment to take a serious balanced look at the question and the possibilities of whether the novel Corona virus emerg from a lab or from nature and I emphasize to my colleagues that any uncertainty about those Origins is an opportunity for us to work constructively together on forward-looking measures to improve our nation's Readiness for future Public Health threats thank you Mr chman and I yield back thank you again Dr fouchy I want to thank you for coming here today I again truly appreciate your willingness to come voluntarily ly before this Select Committee for both your transcribed interview and hearing today um you know this hearing was an opportunity to learn about our covid-19 response and how we can improve and do better and uh we did some good things during that and I'll I'll site operation warpspeed is is one of them it's also an opportunity to more closely examine the office in which you served because there seemed to me some significant wrongdoings that took place and I believe that we can make changes and prevent that from happening in the future that's my goal it's an opportunity to take a close look about the processes and the procedures in place in our health institutions in the United States that's our job as oversight in Congress that's what we're supposed to do I don't know what Playbook some are talking about because it's might been my goal as chairman and I think you've seen the staff be in the same way to take a hard look at the facts so that we can do better in the future I know that at the end of the transcribed interview not only during the interview we talked about other types of vaccines we may be able to create mucosal vaccines maybe Inhibitors of furin if there's a fur and cleavage site as part of the vaccine I appreciated that conversation so very much and at the end you thanked me for your for the fairness and we had the opportunity to to share a l lot that day I think what I'm most concerned about as we go forward as a country and from our agencies is that we can be trusted and that we are better in our messaging and talk about Clarity Dr McCormick today talked about what it was like actually treating covid patients day in and day out I had recommended early on that America needed to hear more from doctors that were treating covid patients what they were seeing what was working what was not working I compared it to General schwarzkoff uh during the golf War everyone tuned in every night to hear what general Schwarz kov had to say not the politician but what the general in charge had to say and I think that was important the one who is in the trenches but look you know we we've gone back and forth on the definition of gain of function I think it's been pretty clear what was uh you said was on your mind and there's there were two different definitions if will a generic definition and an operative regulatory definition but so you know when we go through this when America hears is that you say NIH did not fund and Dr tabach said NIH did fund Clarity matters I think it would have helped when you were in front of uh Dr or Paul Dr Paul in the Senate if you were clear about what you meant the American people had never heard of gain of function until this came about Clarity matters you know when we we conducted great trials on the vaccines I thought they were phenomenal normally you have 8 to 10,000 people uh we had about 40,000 people in each one of the trials and what we knew from the trials is that one it saved a lot of lives that's one thing but we also knew that if you got vaccinated you could still get covid we didn't make that clear to the American people in my mind and that and that you could still get sick and so if someone stands up not you but if someone stands up and says if you get vaccinated you're never going to go to the ICU and you're not going to die well that was still happening so where was the messaging I wish you would have corrected that right then and there you know uh President says oh maybe we just inject bleach well some people maybe thought that was that was serious we made it clear it was not and that was important but here we have operation warp speech which I know firsthand you were working on and you were kind enough to work with the doctor's caucus to explain what was going on with operation warp speed and we have a presidential candidate who says well if that's developed I'm not taking it I'm paraphrasing and then takes it the American public deserve a lot better from their government and what should have been a 911 moment for this country this pandemic was turned into a political nightmare we need to do better these are agnostic issues not political and I think from what we have learned from you in the TI and and and here today there's a lot of things that we can do better and the and the grant process being one of them I mean if you look when I when I sign a prescription I'm responsible for it somebody needs to be responsible and if you're signing for Grants but not responsible for it you just sign it then you're not responsible for the dollars that are going out and and then maybe it's the advisory committee that needs to be signing the grant so that there's some level of responsibility and responsibility for compliance I think that's one of the biggest Lessons Learned uh through all this we can do better America is a great country we can fix our problems but we have to take a good hard look at what we did what we didn't do be honest with ourselves be better in our messaging to the American people especially when it comes to health and that's why I felt it was very important that we don't do things like mandates but let patients have a conversation with the the doctor that they know and trust and make sure that we're getting the doctors all the information and data that they need from adverse effects of the vaccine adverse effects of the vaccine to what the vaccine can and can't do whether you're at risk or not at risk what are your risks those are personal conversations that need to take place and I and I look forward to try and establish a system that does a better job at that I'm going to conclude and just say thank you once again Dr fouchy matter of fact I'd be glad to have more off- the reccord conversations about things we can do in the future uh drugs we may be able to develop treatments we may be able to provide and vaccines we may be able to produce and uh so if you're amenable I might reach out to you for that and other scientists as well that may have varying opinions so again thank you again for being the witness today with that and without objection all members will have five legislative dat within which to submit materials and to submit additional written questions for the witnesses which will be forwarded to the witnesses for their response if there's no further Business Without objection [Music]", "summary": "e the select subcommittee on the Corona virus pandemic will come to order I want to welcome everyone this morning pursuant to committee on oversight and accountability rule 7D members of the committee May particip ipate in today's select subcommittee hearing for purposes of questions at the discretion of the chair and pursuant to an agreement with the committee on Energy and Commerce the chairman and ranking member of the committee on Energy and Commerce s…", "source_url": "https://www.youtube.com/watch?v=qCsEbq9SpsM", "source_name": "House Oversight Committee (YouTube)", "doc_date": "2024-06-03", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["testimony", "sworn", "public hearing", "house oversight", "select subcommittee", "coronavirus pandemic", "congress", "fauci testimony", "fauci", "covid", "covid-19", "2024"]}
{"title": "Testimony of Anthony Fauci — Senate HSGAC Hearing (Rand Paul), 29 July 2026", "content": "Testimony of Anthony Fauci — Senate HSGAC Hearing (Rand Paul), 29 July 2026\nYouTube video by News livestream (YouTube kT5xuodO6BY) (https://www.youtube.com/watch?v=kT5xuodO6BY). Whisper (large-v3) ASR of a full news-channel livestream of the 29 July 2026 Senate HSGAC hearing 'Testimony of Anthony Fauci' (Chairman Rand Paul). At this hearing Fauci repeatedly invoked his Fifth Amendment right and declined to answer questions. This is an uncertified auto-transcript pending the official GPO/committee transcript; the verbatim decline-to-answer repetitions are the actual record, not transcription errors.\n\nThe committee will now come to order. One million Americans died from COVID-19. Some estimate as many as 15 million people died worldwide from COVID-19. Publicly, Anthony Fauci promoted the theory that the virus arose naturally, while privately he was well aware of a mountain of evidence suggesting the virus originated in the lab. The American people deserve answers. The American people deserve to know why dangerous research was funded by NIAID in a totalitarian country, in a lab that lacked acceptable safety standards. The decision to fund dangerous gain of function research in Wuhan, China, will likely go down in history as perhaps one of the worst public health decisions. Frankly, the American people deserve an apology. I hope today Dr. Fauci will come clean, admit it was a mistake to fund dangerous research in China, admit it was a mistake to fund dangerous research in China, and admit it was a mistake to fund dangerous research in China, and admit that the risk of this dangerous research exceeded any possible benefits. Ask forgiveness and pledge to help our government devise safeguards so a man-made epidemic never happens again. Instead of an apology, you have for years avoided responsibility. Regarding the lockdowns, you argue that you did not personally issue every lockdown order, close every school, or impose every mandate. But officials across the country invoked your authority to justify these decisions. And you presented your recommendations not as judgments open to debate, but as dictates of science itself. Your own words demonstrate that you understood the influence you exercised. On March 14, 2020, you wrote that the task force recommendations were driven by me, yourself, Deb, and CDC. The next day you wrote that you had convinced Mayor Bill de Blasio to close the New York City schools, so you were involved. The next day you wrote that you had convinced Mayor Bill de Blasio to close the New York City schools, so you were involved. That same night, Governor Gavin Newsom's chief of staff told you that the governor had decided to close California schools, bars, and restaurants after watching you on television. Presidents, governors, mayors, school boards, corporations, and Congress all bear responsibility for the decisions they made. The COVID lockdown, however, could never have been inflicted without you aiding and abetting the crime. Children lost years of education. Small businesses built over a lifetime disappeared. Patients delayed cancer screenings and other medical care. Families were separated from dying relatives. Workers were ordered to accept a medical procedure or lose their jobs. Worship assembly, employment, education, and travel were restricted in the name of science. While you did not impose every restriction, you used your public authority to justify them. While you concluded publicly that COVID occurred naturally, your private record tells a different story. While you concluded publicly that COVID occurred naturally, your private record tells a different story. While you concluded publicly that COVID occurred naturally, your private record tells a different story. While you concluded publicly that COVID occurred naturally, your private record tells a different story. In early 2020, your hand-picked virologist warned that the virus appeared to have been manipulated in the lab. In early 2020, your hand-picked virologist warned that the virus appeared to have been manipulated in the lab. In early 2020, your hand-picked virologist warned that the virus appeared to have been manipulated in the lab. In early 2020, your hand-picked virologist warned that the virus appeared to have been manipulated in the lab. In early 2020, your hand-picked virologist warned that the virus appeared to have been manipulated in the lab. In early 2020, your hand-picked virologist warned that the virus appeared to have been manipulated in the lab. In early 2020, your hand-picked virologist warned that the virus appeared to have been manipulated in the lab. concerning the origin of the virus, all but two of the participants believed deliberate insertion was possible. Your concern was not merely theoretical. That same week, you led an urgent effort to determine whether your own agency had funded the research related to these experiments that were now under suspicion. Hours later, your assistant reported that the Wuhan experiments had indeed been reviewed and approved by the NIH. Those were not the actions of officials who believed that a research related to origin was an absurd conspiracy theory. They were the actions of officials urgently trying to determine whether their agency funding was connected to the research under discussion, connected to the pandemic. You could not hide that your agency had funded the Wuhan research or your long history of defending gain-of-function research. The only alternative left was to argue that COVID-19 did not originate from the Wuhan lab. You were not a detached observer. You had an institutional interest in the public believing that federally funded research had nothing to do with the pandemic. It was a conflict of interest from the very beginning. The authors of the proximal origin of SARS-CoV-2 privately had serious doubts about a natural origin. Within days, though, they flipped and they all wrote in proximal origin that the virus was almost certainly not a laboratory. The authors of the proximal origin of SARS-CoV-2 privately had serious doubts about a natural laboratory construct. That paper was then used by the government and the media and you to discredit Americans who were asking the same questions that you and the authors were asking yourselves privately. You even cited proximal origin from the White House podium. You held it out as evidence that the virus could not have been engineered, but you didn't disclose your role in the discussions that preceded the writing of the paper. You did not disclose the author's original concerns. You did not reveal that you had been part of the paper, that you had read and offered editorial comments on the paper before it was published, before you began using it as evidence that it couldn't have originated in the lab. You did not disclose that you had immediately investigated yourself whether NIAID funding might be connected to the research. You did not tell the American people the full story. Duly released private messages indicate that the doubts with the authors and others were not directly connected to the research. You did not tell the American people the full story. You did not tell the American people the full story. You did not say publicly that you had written a report right on the paper talked at his office, that the lecturers didn't disappear after the publication. So while this was being waved at the White House to show that it couldn't come from the lab, the authors were still privately continuing to assign a meaningful probability to a laboratory origin, one thing in public and another in private. You did not disclose prés полаг badmez como evalúa el video en la E Даile, réduciendo Wisconsin throughNucleosis. The less intense changes in quality and efficiency, the more четыplo Gold Dimensions information affects the application of Niaidos. It is important to avoid the ordeal of intentions of those who change authors, rather than evaluating foci transitioning from the existing data. Ultimately, for liberalism, the sibling can actually go to the lab. The pattern is straightforward. Privately, there was alarm, then an immediate inquiry to see if NIAID's possible exposure to funding, then a rapid public declaration of certainty, continued private doubt, and then years of resistance to disclosure. The question is why? The only logical answer is that your primary concern was avoiding culpability. Your primary concern was hiding the fact that you had approved the funding for this dangerous research. Your support of gain-of-function research is extensive and longstanding. In 2011, your agency funded Ron Fouchier's laboratory when it mutated the avian flu until it could spread through the air between mammals. This was the tipping point. This is when others became worried. You funded this. You advocated for this. The federal government's own biosecurity board, though, recommended withholding the details of these experiments because of this. This is the danger the research posed. People were concerned that publishing it was publishing a road map to creating bioweapons around the world. But you sided with the gain-of-function scientist, Fouchier, and argued that the benefits of publishing the research far outweighed the risks. You defended this avian flu transmissibility experiment as critical research. You wrote that even if a scientist became infected and triggered a pandemic, the benefits of the research have been zeroed out. The benefits of the research have been zeroed out. benefits of the gain-of-function experiments outweighed the risk. In 2014, your agency, NIAID, began funding the Wuhan bat coronavirus work. In 2015, Ralph Baric and the Chinese scientist Shi Zhengli published NIAID-supported research combining a bat coronavirus spike protein with a SARS backbone. The resulting virus could infect human airway cells. It's a novel virus that now can infect human cells. It gained transmissibility. It gained function. In 2018, the same group of scientists, EcoHealth, Baric, Shi, and their collaborators submitted the Diffuse proposal, which involved the insertion of a furin cleavage site into the coronavirus. DARPA rejected it as too dangerous. When COVID was sequenced, though, early on in January of 2020, within days, scientists discovered that, lo and behold, it had a novel furin cleavage site just as had been proposed in the Diffuse project. This was either an extraordinary coincidence or a smoking gun, evidence that the Chinese had created COVID-19. It made the laboratory origin question more legitimate, and it made your categorical public denials indefensible. On May 11, 2021, you told the Senate, We were then told that only the government's narrowest regulation of definition counted here, that you could define gain-of-function in one way in which this wasn't gain-of-function, in which all of the common sense of the world would be thrown out, all of the ideas that the mice were dying and the virus was more transmissible didn't matter because you had a technical definition that allowed you to fund it. But the real question is, was it dangerous? Was it a wise decision to fund this? And you haven't deviated from that. You've never admitted that it could have been a mistake funding this research in China. The American people weren't asking for a semantics debate over what is gain-of-function. They were asking, does common sense say this research was dangerous in Wuhan? They wanted to know whether there are money-funded experiments in Wuhan that made bat coronaviruses better able to infect humans. The answer is yes. They wanted to know whether NIAID adequately supervised their work. The answer is no. When you defended this research, you described its benefits in the broadest terms, but when Congress demanded accountability, you hid behind the narrowest possible definition. You can't have it both ways. Your conduct concerning federal records raises further questions. It is a crime to destroy federal records. Yet our investigation reveals your assistant diligently reported that she deleted tons of emails. In 2024, you testified that you did not delete federal records. Who's telling the truth? You or your assistant? The committee has obtained repeated instructions from you telling federal officials to delete communications. On February 2nd, 2020. One day after. Your origins call, you told Francis Collins, please delete this email after you read it. The committee asked for your voluntary cooperation to come today. Your appearance had to be compelled by subpoena. You're here today under duress. You were here today because of the court ordering it. President Biden issued you a sweeping pardon extending back to 2014. The same pardon he gave to his son Hunter. A pardon may protect a person from criminal prosecution. A letter from their superiors. A letter from their superiors. Your past has been put to the press. You're here today because of the public's protection. Your past is a test of your name, your history and your loyalty. You need to be tried. There's no guarantee that your history will get edited and you won't rewrite history. It does not erase documents. It does not convert a misleading statement into a truthful one. It does not prevent Congress from establishing what happened. There will be another pandemic. government officials cannot be questioned because questioning them would undermine public trust. They have it backwards. It is secrecy that destroys trust. It is arrogance that destroys trust. It is censorship that destroys trust, and it is the refusal to admit error that destroys trust. That loss of trust may be your most damaging legacy. Trust can't be ordered. It has to be earned. No scientist is above scrutiny. No government official is beyond accountability, and no public servant has the right to treat the suffering of millions of Americans as a footnote to his preferred version of history. I now recognize Senator Peters for his opening remarks. Thank you, Mr. Chairman. The Senate Homeland Security and Governmental Affairs Committee has a long and a very proud history of conducting serious oversight on behalf of the American people. When this committee has been at its best, Democrats and Republicans have worked together to investigate complicated issues, to follow the facts wherever they may lead, and produce recommendations that actually strengthen our nation's security and improve government functions. That bipartisan tradition has produced meaningful work following Hurricane Katrina. The January 6th attack on the U.S. Capitol, failures at the Secret Service, and countless other matters. Unfortunately, today's hearing is the latest step in the Chairman's sharp departure from that long tradition. This hearing appears to be a culmination of months of biased and selected efforts by the majority under the guise of a committee investigation to basically legitimize a role of security in the U.S. economy. Senate Chairman Hathaway has been on the call for a number of days in the EMB assing the chairman'sword to be raised in a hastily averaged blast over the chairman's conclusion that was reached years ago. In 2021, the Chairman has called for today's witness to be fired, to be arrested, accused him of leading cover ups and conspiracies. He has even featured the witness prominently in fundraising emails and on the cover of his book. He has also called for the cancellation of the witness's security detail despite the fact the witness and his family have received suing. numerous credible death threats. When I served as chairman, Senator Paul and I launched a bipartisan biosecurity investigation that included oversight of risky research and the origins of COVID-19. Because we agreed that the committee's work would be stronger if we did it in a bipartisan manner and just followed the facts. That was and continues to be an area of legitimate and certainly needed oversight. As chairman, Senator Paul has taken the opposite approach. He has abandoned longstanding practice by blocking minority participation in committee oversight actions and has chosen to selectively release committee records that the minority has never had any access to in order to support his pre-drawn conclusions. The chairman has repeatedly excluded committee's minority and withheld documents and evidence from members that are entitled to receive them. Disregarding longstanding Senate rules and committee precedent that have preserved the credibility of our oversight in this committee for decades. I have raised these concerns directly with the chairman. Because it's not just what we investigate that matters. But how we conduct that investigation. That also matters. One-sided investigations designed to validate and control the truth of the public view of the committee. And the second is that the chairman's pre-determined conclusions do not serve the American people. Who sent us to actually undercover the truth and to solve problems. I wrote to the chairman requesting that he adhere to committee rules. But instead of addressing concerns that I raised, he removed part of the committee's website from the public view. This move not only prevented the public from being able to view those questions about the desire for transparency and legitimate oversight of this matter. But what makes today's hearing particularly disappointing is not simply the chairman's actions. But what we could be using this committee's true and time oversight responsibilities to accomplish. This committee has not held its annual threats hearing at all in this Congress. We have not held a budget hearing for the Department of Homeland Security. There are important hearings that we would have the opportunity to discuss as to how to strengthen our Homeland Security across the board. No hearings on those topics. Instead of focusing on the national security challenges that we are facing in our country right now, today's hearing looks backwards. Revisiting questions this committee has already examined, including through bipartisan work that Senator Paul and I conducted together when I served as chairman of this committee. But rather than building on that work to strengthen our preparedness against future disasters, we are instead relitigating the past. COVID-19 exposed serious deficiencies in our nation's public health infrastructure. We know that. More than one million Americans lost their lives. And this committee should absolutely continue to examine how we can better prepare our nation against future biological threats. Those are the kinds of forward-looking, life-saving questions that will help our nation be better prepared to protect the health and the safety of Americans when the next emergency occurs. Unfortunately, at this precise moment, we should be strengthening our capabilities. The Trump administration seems to be doing everything in their power to actually weaken our capabilities. The administration has hollowed out the public health workforce. They have fired. Pushed out. And cut funding for public health personnel. Shrinking the CDC workforce by a quarter. Thousands of experienced scientists have left government service. And with them has gone critical institutional knowledge that cannot be easily replaced. Certainly not quickly replaced. The administration, thanks to political operatives like Russell Vogt, has slashed or illegally withheld funding for life-saving medicines and cutting-edge technologies. That let us rapidly develop them during an emergency. Mr. Vogt is now further politicizing the federal grant-making process, proposing to subject all federal grants, including those for disaster relief, housing development, and cancer research, to the whims of political appointees, not non-partisan experts. All of this has left the American people more vulnerable to infectious disease threats. And we are already tragically sick. We are seeing the consequences. Staffing and funding cuts have slowed the federal, state, and local response to ongoing outbreak of a food-borne parasite, which has sickened thousands in my home state of Michigan, as well as across the country. At the same time, the administration cuts to global health programs and international partnerships have greatly reduced our ability to contain dangerous diseases like Ebola before they spread to our shores. We should be examining whether our federal health agencies are able to respond to these threats. Whether our federal health agencies have the personnel and the resources they need to effectively prevent, detect, and respond to these threats. We should be asking how to strengthen our biodefense efforts to deter our adversaries and prevent biological attacks against our country, and how our government can better coordinate and communicate during public health emergencies. These are the kinds of forward-looking matters that are worthy of the committee's time. Instead, we are here continuing the chairman's year-long focus on one individual. History tells us, unfortunately, another pandemic is all but inevitable. The question is whether Congress and this committee will work to better prepare our country for it or continue looking backward while our public health infrastructure crumbles around us. That is the hearing that we should be having today. Unfortunately, I fear the intent of this hearing is only meant to further a purely partisan agenda and will not, it will not make Americans safer. Thank you, Mr. Chairman. The accusation that the committee has denied access to the minority to records is categorically false. This is the most transparent investigation in the history of Congress. We actually created a website and we put all of the information on the website. It continues to operate. The reason it hasn't been accessed is no Democrat ever signed up for it. Not one Democrat. We told them the access. They never asked for the access code. They haven't been on the website because they have not cared about the investigation. It's a practice of this committee to swear in the witness. Dr. Fauci, please stand and raise your right hand. Do you swear that the testimony you will give before this committee will be the truth, the whole truth, and nothing but the truth? So help you God. Dr. Anthony Fauci, you are recognized for five minutes for your opening statement. Thank you, Member Peters, members of the committee. I served at the NIH for over 54 years, 38 of those as director of the National Institute of Allergy and Infectious Diseases. Over that period, I proved that I believe in and respect the value of legitimate congressional oversight. In fact, I testified before and or briefed Senate and House committees well over 200 times over those 38 years. During and after the COVID pandemic, I have appeared multiple times for hearings in the Senate and the House, usually under oath, and sat for several days long. I have also been among transcribed sworn interviews answering questions about the very issues that are now the subject of this hearing. However, given Senator Paul's obvious obsession with calling for my prosecution, his repeated slanderous comments about me, and recently his publicly releasing my unredacted, unconfirmed, and unresolved personal diary aimed at embarrassing and intimidating me, the only conclusion I can reach is that the sole reason he is calling me before this committee is to get me to say something, anything that could vindicate his repeated public pledges that I end up, in his words, quote, behind bars, unquote. Any reasonable person who has followed his unhinged obsession with me would readily come to the same conclusion. Therefore, although it pains me to do so because of the respect I have for the legislative branch of government and my decades-long record of cooperating with the government, I am not going to be able to do that. I am not going to be able to do that. I am not going to be able to do that. I am not going to be able to do that. I am not going to be able to do that. I am not going to be able to do that. I am not going to be able to do that. I am not going to be able to do that. I am not going to be able to do that. I am not going to be able to do that. I am not going to be able to do that. Under the advice of my attorneys, I will invoke my right under the Fifth Amendment of the Constitution to refrain from answering your questions. Thank you. We will now begin a round of questioning. Dr. Fauci, your testimony today is compelled by a lawful subpoena. As you know, it's a crime under 18 U.S.C. Section 1001 to knowingly make a material false statement to Congress. with a penalty up to five years of imprisonment understanding that you are under oath the american people would like to understand your reasoning your rationale for why you chose to fund the research in wuhan there have been um you know intelligence agencies the cia the fbi the doe have all come to the conclusion that more likely than not the virus came from the lab in wuhan and we'd like to know what was the rationale what was the discussion how you know what went behind the decision to fund the research uh in wuhan um how did you come to the conclusion that a totalitarian country would be capable of doing this in a bsl2 lab a lab that lacked the security what was the reasoning and are you are you sorry basically for making the decision would you you know like given a another chance say well gosh circumstances now as i know it maybe it wasn't a wise thing can you explain to the committee why you chose to fund this dangerous research in china on the advice of counsel i respectfully declined to answer based upon my rights under the fifth amendment of the constitution in the red folder on your table is a copy of section 192 of title ii of the u.s code your council has been provided a copy as well that's a copy of the u.s code that section makes it a crime for a witness appearing under subpoena to refuse to answer any questions pertinent to the question under inquiry do you have that in front of you on the advice of counsel i respectfully declined to answer based upon my rights under the fifth amendment of the constitution let the record record that the witness has refused to answer whether there's a folder in front of him based on his fifth amendment right it is true that you're appearing under direction of our office and i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry i'm sorry to provide testimony on matters under consideration by the committee including the origins of covet 19 risky life sciences research and your tenure as a federal government employee additionally you've been provided a full and unconditional pardon dated january 19th 2025 for any offenses against the united states which may have been committed or taken part from january 1st 2014 through the date of the pardon for a 10-year period arising from or in any manner related to your service as director of the national institute for allergy and infectious diseases as a member of the white house coronavirus task force or the white house covet 19 response team or as chief medical advisor to the president have you refused this pardon or do you have any reason to believe this full and unconditional pardon this grant of immunity would somehow require you to plead the fifth amendment on the advice of council i respectfully the client and the client and the client and the client and the client and the client to answer based upon my rights under the fifth amendment of the constitution based on the facts presented i'm going to direct you to answer the questions the committee has issued a valid subpoena they have requested your presence here the questions are very pertinent to your decision making as head of niaid as well as uh as a chief advisor to the president do you still refuse to answer the questions on the advice of council i respectfully decline to answer based upon based upon my rights under the fifth amendment of the constitution dr falchi were you ever made aware of gain of function research on monkey pox being conducted at the national biodefense analysis and countermeasure center and back at fort diedrich on the advice of council i respectfully declined to answer based upon my rights under the fifth amendment of the constitution dr falchi hours on the most important committee in this senate debate we back to doctor turkitt Dr. Fauci, did the CIA ever transfer funds to NIH under an inter-agency agreement? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment of the Constitution. Dr. Fauci, did the NIH ever conduct research for or in coordination with any element of the intelligence community, CIA, ODNI? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. The reason why these questions are important is, you know, President Trump has done a ban, and we're glad that he did a ban on gain-of-function research. So we're better off than we were when we had an advocate serving as head of NIAID, an advocate for gain-of-function research. There is still, though, a question, though, whether or not the intelligence community is adhering to the law. In that order, there's a question of whether or not gain-of-function research is still ongoing. And these are important questions the American people deserve to know. Dr. Fauci, have you been read into any classified Department of Homeland Security program, any prospective special access program concerning gain-of-function research? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment of the Constitution. When we look at the research in China, the gain-of-function research that you've denied was gain-of-function. One of the things that startled the scientists when they saw COVID in the first couple of weeks was when they looked at the sequence of it, they said, oh, my God, there's a furin cleavage site in it. And in this particular family of coronaviruses, the sarvicoviruses, they'd never seen this before. They were also startled to look at it and see how it was coded for, what the codons were, and to discover that the codons used, out of 36 different possibilities, turned out to be the one that was commonly used in gene manipulation by scientists. Dr. Fauci, were the scientists at the Wuhan Institute of Virology capable of inserting a furin cleavage site into a coronavirus? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment of the Constitution. So one of the experiments that was pretty common was they would take the backbone of a SARS virus, and this would be a SARS virus that the backbone itself wasn't that dangerous, but then they would dig through guano, 300 feet underground, back guano. They'd find other viruses, unknown viruses. They'd take the S protein off of an unknown virus and stick it on a backbone. And then they would infect mice that have humanized cells. And they were trying to discover if they could create a virus that infects humans. Now, many people would say, well, gosh, that doesn't sound like a really good idea to create viruses. That don't exist in nature to see if they'll infect human cells. What if one escaped? What if you keep infecting this and do serial passage? You actually adapt the virus to be infectious to humans. So the question is, is whether or not Dr. Fauci, the Wuhan Institute of Virology was combining an S protein with one virus with the backbone of others. And could this lead to a virus? Maybe it wasn't even predicted, but could it lead to viruses that gained in function? And then could lead to a pandemic? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment of the Constitution. One of the arguments that you and others have made against this virus coming from the lab is it couldn't have come from the viruses that have been published. And nobody's really arguing that. I think from the very beginning, people acknowledged that the viruses that have been published are too far evolutionarily distant from. A virus that could have become COVID-19. But what has never been acknowledged by the side who tries to call the other side of conspiracy theory, which is really something you don't usually see in a scientific debate. This is the first time I've ever seen an article printed in Lancet by your friends who called this a conspiracy theory. You know, these are the kind of things you see as a screed on a political, you know, website. You don't really see this in science, but when they they released this as being a conspiracy theory. You know, we're wondering that when you do this, when you combine these viruses and are able to grow them in humanized cells, whether or not this kind of risky research, whether or not, whether you call it gain of function or not, whether you use the definition of gain of function, whether this kind of research should have had more scrutiny. I think in your house testimony, you testified that you never traveled to China and that you were unaware that anybody in NIH ever examined. The labs that you trusted the Chinese scientists. I think you've said that even recently that with your discretion, you trusted the Chinese scientists. The problem is, is that even in our country, we trust our scientists. They're good. American scientists probably doing the right thing for America. But at the same time, we oversight to make sure it's not dangerous research. But we also investigate the lab. I believe Fort Detrick was one of our main labs was closed down in the last year or two because of, you know, Research Institute. A research incident that was dangerous with dangerous pathogens. And so the American people would want to know how could you approve this dangerous research in China? Say that you trusted the Chinese scientists. And then in the end, you had to admit that you'd never been there. None of your inspectors had ever been there. Dr. Fauci, at any of the labs where this dangerous research was occurring, were any American lab oversight or lab investigators today? Ever? Or appear in these labs to make sure that they were safe labs? On the advice of Council, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. So one of the main theories for those who have looked at this being created in the lab was the idea that could have come from a virus not previously published. Dr. Fauci, are you aware that Dr. Shi, who worked for the Wuhan Institute of Virology, was said to, and I think in her own words, to have over 100 viruses that had not been previously published that could have been close enough relative to create COVID-19. Are you aware of that? On the advice of Council, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Under your testimony previously when you denied ever having funded gain of function in China, it was so adamant as to be striking to leave no room for any interpretation of what is or isn't the virus. Dr. Fauci, I'm sorry. Dr. Shi, are you aware of that? On the advice of Council, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. But there's another important question. Did you fund gain of function research in other biolabs around the world? On the advice of Council, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. The one research project that we do know you did fund is the one that Ron Fucchi did. It's important to talk about because this sort of was the beginning of the debate over gain of function. This wasn't just me. I wasn't even aware of the debate 10 years ago. 10 years ago, this was other scientists, over 200 scientists at the Cambridge Working Group signed a protest because they didn't think you should fund the research and they didn't think it should even be published because it was sort of a roadmap as to how to make a bioweapon. So what they did was the avian flu, and this is important. It may be the most important question we get to here today. The avian flu has about 50% mortality for humans. The good news, though, about animal viruses is they don't infect humans very well. It will infect humans, but doesn't go human to human very well. Ron Fouchier, with the money that you provided to him, did an experiment where he caused purposeful mutations to create a new virus, an avian flu that didn't just infect birds well, but actually infected mammals well, went ferret to ferret in an aerosolized manner. People saw this and were aghast at the decision-making process that you decided to fund this. But this is when, you know, the Department of Health and Human Services debate came about, and you wrote in support of this in the Washington Post, and you said, even if a scientist is bitten, even if a pandemic should occur, the knowledge is worth the risks. Do you still stand by that? Would you like to qualify at all whether or not the knowledge of gain-of-function is worth the risks, particularly in this case, since we now know 15 million people died worldwide? Many people believe this came from the lab. Do you think that the risks really are worth the benefits for gain-of-function research? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Yeah, all right. We're going to finish with this question, and it's based really on that statement, that general statement in your support for gain-of-function, the idea that the benefits outweigh the risks. So there are many other people who disagree, and they aren't politicians or not. I don't know what party they're in. David Relman is probably one of the most esteemed, and he, you know, I think he's one of the most esteemed, you know, he is a scientist at Stanford. He, I think, has classified clearance. He's been a consultant to our government probably for a decade or more. And he's written about this publicly. He says the opposite. He said that the risks of this research do not outweigh the benefits. He said the risks, we shouldn't do it. Richard Ebright, who's been involved in this debate for two decades, says the same thing. Does he really, we really shouldn't be doing this at all. There's a question. There's a quote also by the Kevin S. Felt quote. Is that at the very end? Kevin S. Felt, who's a CRISPR scientist at MIT, also wrote about this gain of function. I implore every scientist, funder, and nation working in the field, please stop. No more trying to discover or make pandemic-capable viruses. No more experiments likely to disseminate blue prints for plagues. Dr. Fauci, would you like to at least answer this one question for us today? And let us know whether or not you have changed your mind on whether or not the benefits of gain-of-function research outweigh the risks. On the advice of counsel, I respectfully decline to answer based upon my rights under the fifth amendment to the Constitution. The chairman has denied your assertion of privilege and directed you to answer, but you nonetheless refuse, and stay silent for two minutes. I masquerade as might be approved. No response is smoke-ifiers. If you're gonna show down a celebrecoming fire ngh next week, on privilege despite the existence of the pardon. The committee will have to consider after this hearing what appropriate action should be taken against you for the failure to testify after being directed to do so. It's against the law to obstruct an investigation of Congress. There will be repercussions to your refusal to testify today. Senator Peters. You're not recognized. You're not recognized. If you are unruly you will be removed from the proceeding. You are not recognized and you you are not recognized sir. Sir, you are not recognized. You are not recognized. Security will hold off. But you will respect these proceedings. You were told not to sit at the table. You insist on sitting at the table, and we told you you would not be recognized you are not invited here for testimony. Sir, you are being disruptive. Would you behave this way? in a courtroom no because the judge would put you in jail i can't do that today but i can have you escorted from the premises so i would say sir sit quietly and don't say another word i said sit quietly you are not recognized another word and you're gone so mr chairman i'd like to hear uh what the the attorney has to say he is not recognized by the committee or the chair if he speaks again he will be removed from the room this testimony is from anthony fauci this is not a game with his lawyers he can advise his lawyers can give him advice he's got a half dozen here they're all allowed to talk to him yes all right but the attorneys are not recognized in fact the attorney was told not to sit at the table and he's not obeying that recommendation there's a row behind you sir that's where you were told to sit and you're not and now you're disrupting the proceedings and so look this is the way anthony fauci wants to be remembered for a lawyer not listening to the rules that's the way you want to be remembered and that's what you're going to do you are not recognized sir security please remove him from the room let the record state that dr fauci will still have the advice of the other half a dozen attorneys that he brought along today senator peters thank you mr chairman the uh the coved 19 pandemic is not the first or the last public health crisis to impact our nation in december 2020 2022 i released a report that identified significant failures in our federal government's preparedness and initial response to covid 19. this report contained 17 key findings it's a very large report which i have right here it contains 17 key findings and corresponding recommendations including the need to invest in sustainable domestic manufacturing capabilities for critical medical supplies build the infrastructure for the health care of our people and the health care of our people and the health care of our people and the health care of our people and the health care of our people needed to surge testing capacity for infectious diseases and robustly fund public health emergency preparedness and responses across all levels of government unfortunately multiple administrations including the current trump administration have failed to fund or to reform our health preparedness this is something that i would hope the committee in the future would investigate it needs to be taken a look at it also feels like a new public health threat is hitting us every month there's a foodborne parasite affecting thousands of people in michigan and across the country and our federal agencies still haven't fully pinned down the source of that outbreak measles cases in this country are the highest they've been in 35 years more children are getting sick and even hospitalized from this preventable disease over a thousand people have died from the ebola virus in africa and we don't know how widespread this crisis actually is we have a hunter virus scare on a cruise ship and though it hasn't made headlines in the way that the screw worm threatening our food security has i remain concerned about bird flu that is also spreading and could one day cause a pandemic this is also something this committee should be investigating and holding hearings on since january 2020 the trump administration has taken a number of actions to drastically weaken our ability to fight infectious diseases and biological threats that endanger americans these actions are both incomprehensible and are also inexcusable they include slashing funding for public health and infectious disease research canceling contracts for cutting-edge vaccine technology shutting agencies responsible for tackling infectious diseases around the world firing thousands of federal employees with keeping our communities and our medicines and our food supply safe and injecting political appointees in what should be non-political grant-making functions that is something this committee should be looking at i could go on i could go on on all the topics that we need to be looking at moving forward to protect this country we're not doing that in this committee that's what this committee was designed to do it's what it has done throughout history it has done it in a bipartisan way we should get back to that and think about the future of this country and keeping this country safe when a crisis like covet 19 strikes we have an obligation to examine what went right and what went wrong to provide accountability for the american people congress certainly has done that between the house and senate nearly 20 different committees 20 different committees including this committee as i mentioned have conducted oversight of the covet 19 pandemic conducting transcribed interviews holding dozens of hearings and released more than 10 cases today's exercise unfortunately is a stark departure from those largely bipartisan legitimate efforts the chairman has shut the minority out of participating equally in these efforts withheld information selectively released documents actions that completely undermine the credibility of this investigation i will enter a record without objection mr chairman a letter that i sent to you that detailed all of those areas that we have concerned with and where we were shut out without objection we'll provide a other details as well i think today's hearing unfortunately does real damage it's turning tempting to turn one person into the scapegoat for a crisis that hundreds of officials across both the trump and the biden administration were responsible for handling it does so in a way that people that are facing death threats this is only going to unfortunately deter other scientific experts from public service to understand that this is what they would have to go through as they provide their advice to us we're not going to make our nation safer and i hope that we can restore the by doing these kinds of activities and i hope that we can restore our legitimate bipartisan oversight that's going to help strengthen our public health and pandemic preparedness and other homeland priorities that's what this committee needs to focus on it hasn't the last year and a half let's hope it does in the future thank you mr chairman senator johnson thank you mr chairman uh dr fauci i hope the american people listened very carefully to chairman paul's opening statement i think it's a stunning indictment of the actions you've taken that have been so destructive to global health i certainly understand why you needed a pardon i certainly understand why on the advice of counsel you're not answering any questions because i think it'd be almost impossible for you to answer the questions truthfully without really demonstrating what you did your culpability self-incriminating we have all of us has prepared a lot i've been deluged with questions to ask dr anthony fauci that there are so many legitimate questions that deserve answers and now you're not willing to provide those answers so with with my limited time i'm going to talk about things that my investigation revealed that have not been adequately answered and quite honestly having been adequately covered by the legacy media i'll do i'll kind of combine the the questions into kind of one but you know i certainly let's let's put up the last uh covert chart uh i was warned pretty early on about the day i'm going to be on the dangers of the experimental gene therapy that you've called a vaccine, but it really falls under the definition of gene therapy. So I was going to ask you, I mean, were you carefully monitoring the safety surveillance systems like VAERS and V-SAFE that literally were deluged with complaints? Currently, worldwide, there have been almost 1.7 million adverse events reported to the VAERS system. Of those, over 39,000 were deaths. And of those deaths, 24% occur on the day of vaccination within one or two days. 24%, which, by the way, just happens to be the same percentage that a Rasmussen poll pointed out, the American public believe they, 24% of the American public believe they know somebody who died of the experimental gene therapy. So again, I was certainly interested in asking you whether or not you were following this as carefully as I was. It was not my responsibility to follow safety surveillance systems, but I did. And by the way, when I published, this is actual government information. When I published it and people had me on their shows, they would be censored by Facebook. They would be deplatformed. I think largely at the behest of the actions you took to make sure that disinformation wasn't spread. This wasn't disinformation. This was the truth. So I was going to ask you whether you knew Dr. Marks. I think you do know him. He's the head of CBER. He's the man who is in charge of approving vaccines and surveilling for the safety. My investigation shows that on March 1st of 2021, less than three months after the emergency use authorizations, he was warned by Dr. Anna Sharsman, data mining expert, that the algorithm they were using to analyze VAERS data was going to hide in mass safety systems. So I was a little confused at first. Because at the very beginning of the day, we had all these new data. Now we had this new algorithm that gathered and set up all these new safety signals. 26 days later, in three months consecutively after that, they did data runs with a new algorithm that unmasked those safety signals. They show dozens of safety signals including sudden cardiac death, cerebral artery occlusion, basal ganglia stroke, agonal rhythm, Bell's palsy, and pulmonary infarction. Your diaries now show that you actually suffered. Pulmonary infarction. in I think probably June 2021 I was just wondering I was just wondering whether ever went through your mind but maybe that injection all those boosters you took might have caused that you know in the question I was gonna and I'll ask this question were you ever made aware of the fact that Peter Marks was warned that the algorithm is gonna hide the safety signals and were you told that senior FDA officials were given dozens shown dozens of safety signals associated with the covert injection on the advice of counsel I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution next day I want to go through is in that same month of March 2021 an employee at NIH dr. Nath led a team of researchers who were diagnosing a patient who had been diagnosed with COVID-19 in the United States and the and treating individuals who'd never had COVID or severely injured by the genetic therapy injections dr. Nath told those individuals stay quiet you know we want to make sure that you know we get all gather all the information and then release it to doctors so they can treat people like yourself there was a concerted effort and I'll enter this in the record it appears inside NIH to quash dr. Nath's publishing publishing that study it finally was put on a pre-print server with telling no one and I think about May of 2022 I think what's noteworthy about this is dr. Nath told the injured participants that early treatment early intervention was crucial for them to be treated and yet within the NIH they were questioning what was dr. Nath doing they didn't want to publish that because I want to take time searching for it because publishing it would create vaccine hesitancy which is what we continue to hear time and time again is the reason they didn't promote you they lied about the safety signals they were seeing throughout the pandemic I always push early treatment you know we've got things in in here where you know you you were really concerned about remdesivir because it was it was untested but hydroxychloroquine yeah it was an approved drug you know maybe some safety issues but we had a great deal of experience with it all of a sudden you had the Surgisphere study those retracted within two weeks because it completely false totally blew up the use of hydroxychloroquine and then when it comes to ivermectin which by the way because I had those contact by so many people I referred them to doctors actually had the courage and compassion to treat vaccine injured individuals it works but I was going to ask you whether you involved in the FDA attack on ivermectin you had a interview on CNN on August 29th of 2021 where again I just don't want to take time to find the exact quote but you know so there's no evidence there's no evidence that ivermectin is helpful on that exact same day and I've got the studies right here there was a website it was tracking the random controlled studies they're here they are showing 60 70 percent efficacy of ivermectin the same thing you say there's no evidence there was all kinds of evidence loved ones had to go to hospitals had to sue hospitals just would you try it so I would want to know you know to what extent were you involved in sabotaging hydroxychloroquine ivermectin and and did you do that because you knew the only way you get an emergency use authorization for these drugs these experimental gene therapy was if there was no effective treatment you couldn't get the emergency use authorization so is that is that why you help sabotage these cheap generic drugs in favor of remdesivir which by the way nurses are you are the fact that nurses called it run death is near on the advice of a council I respectfully declined to answer based upon my rights under the fifth amendment to the constitution but let me end on this note because this this just came to light you know we've got 11 million pages documents we also have other people who were in the room but now when you actually lied to you you lied to your you lied to your own diary on march 27 2020 you wrote in your diary to my surprise yesterday the POTUS sent a letter to governors to reopen county by county while monitoring the spread of virus in low-risk counties this was half-baked and never shown to Deb or I before it was sent out so we have evidence that in fact you know you were fully aware of it and certainly approved if not authored it so I just simply ask you means that is that true I mean did you literally lie to your own diary did did did you know of that letter sent out to governors about reopening county by county Mr. Chairman I'd ask you to ask the witness just answer that one simple question on the advice of council I respectfully declined to answer based upon my rights under the fifth amendment to the constitution famous chairman Senator Hassan thank you Dr. Fauci I want to start by thanking you for more than 50 years of service to this country at the National Institutes of Health. How um something that is so solemn I think you must be very very fortunate that you have been put in the position that you are in today. And it must be enormously frustrating to know that this hearing is designed to entrap you It must be very frustrating for your attorneys to hear the chairs mischaracterization of the legal issues and posture that impact your decisions at the witness table today. things that are relevant right now to the people of the United States about the state of public health in this country. Since President Trump took office in 2025, more than 4,500 cases of measles have been reported. That is more cases in the year and a half since Donald Trump has been president than were reported from 2000 to 2024 combined. Children are dying because there has been increased vaccine hesitancy fueled by Robert F. Kennedy Jr., the Secretary of Health and Human Services, and frankly, his entire administration. Thousands of people in the United States of America have been sickened by a foodborne parasite, and the outbreak is nowhere near under control as staffing at the FDA and other critical public health entities has been slashed by Russell Vogt and Elon Musk. Last year, the National Institutes of Health awarded 201 fewer grants compared to the previous years. 207, I am corrected. Compared to previous years. As those grants were either canceled or delays, especially at the beginning of the Trump administration, I can tell you, I can tell my colleagues what the impact was on people in New Hampshire, on scientists in New Hampshire, on clinical trials in New Hampshire where people's cancer treatment was interrupted because Elon Musk and Russell Vogt know better, they say, than the people at NIH about what to fund. And because they did some sort of word search, it seems, to some of the grants, and boy, oh boy, if you were studying rural health in New Hampshire and trying to understand how to better engage people who need health care in rural America, was off the table. America is losing researchers and scientists to other countries because researchers and scientists highly trained, highly qualified, invested in often by the American taxpayer, are finding the hostility from this administration so strong that it interferes with their science and they want to pursue science wherever that science takes them. I also sit on the Health, Education, Labor and Pensions Committee. We have had a number of hearings with nominees recently to fill critical spots. One of those nominees is Dr. Erica Schwartz, a brilliant woman, medical degree, biomedical engineering degree. I think she also told us she has a law degree and a master's in public health. She was a two-star admiral in the United States Navy, an experienced doctor. And yet, when I asked her... When I asked her if she would push back at Secretary Kennedy, if he instructed her to suspend the promotion of the flu vaccine, as he did at some point in the last few months — there's an email to prove it — she couldn't answer that question. She either could not, would not, or had been bullied into evading a question about whether she, as the Director of Health, would push back. The idea that the Director of CDC would stand up to Secretary Kennedy — the most unqualified Secretary of Health and Human Services this country has ever seen, and more than unqualified — somebody who pursues conspiracy theories, degrades people with disabilities, and continues to promote disproved science. That's the state of healthcare. That's the state of healthcare. public health in this country right now, not to mention the trillion dollars or so of cuts to the Medicaid program that is decimating health care in my state and decimating it around the country, not to mention the refusal of my colleagues and this administration to extend critical tax cuts for people who are trying to afford insurance on the Affordable Care Act. I just was at one of my community health clinics, and they are reporting fewer and fewer people coming in for care, disrupting care because they can no longer afford health insurance. And that is impacting, of course, the revenue stream to the community health clinic, their ability to hire and pay people, their ability to take care of their community. That's what I wish we were having hearings about in this committee and in the help committee. That's what I wish we were having hearings about in this committee and in the help committee. That's what I wish we were trying to address in a bipartisan way. But instead we are here. In an attempt to entrap you. Because you had a distinguished career. Trying to put Americans public health first. With that I yield. Senator Blackford. Chairman. Thank you. Thanks for coming today. I know you're invoking your fifth member right, which you have the right to be able to do constitutionally. Thanks for coming. I'd be a part of this. There are a lot of issues and a lot of questions that have come up and hopefully in some day in the future. We'll be able to get all this clarity to be able to pull together. There were over a million Americans that died from Covid. You know that well, you were tracking the numbers literally every single day. Um, those affected and those that died from the earliest days. There are a lot of lessons that we've got to learn from this that we should put into history to be able to determine what happens in the future. How do we respond in the future? How do we deal with something like this again? It was uncharted territory for everyone. But I would tell you countless families, including my own. Watch the loved one died behind glass or through a screen because we couldn't get access to him. Children couldn't get to school. People missed their prom. Or graduation ceremonies. There are lots of things that happened that dramatically changed the future of the country. The mental health issues that we have continued to deal with from the isolation. Have been profound. Even something as simple as Children that wore mass or around adults wearing masks for all that time. Are slower and learning language now because they couldn't watch someone's lips moving. And so they're slower in that. Amazingly enough, churches in places of worship were forced to be closed down. There were even churches that were closed down because they couldn't watch someone's lips moving. And so they're slower in that. Amazingly enough, churches in places of worship were forced to be closed down. There were even churches that were closed down. There were even churches that met. Where the pastor preached in the parking lot, and the tat congregants all met in their cars. With windows up. And police came and scattered them and said you can't be here. The simple act of social distancing became an issue. As everyone guessed, what's there? I distance to be away from someone else. Literacy rates have declined. All these things or results? of lives and the health experiences that have been out there for many americans so there are legitimate questions i want to be able to raise some of those to be able to walk through some of this because it has been very very challenging as we've gone through some of your your notes and your diary and other things that are out there we're trying to be able to pull bits and pieces of things to be able to learn lessons on may the 6th 2020 you wrote at that time i had a conversation with robert redfield as you know well was then the director of cdc about the fact that greater than one million children worldwide have missed their measles vaccination because of the shutdown you stated this is terrible and needs to be addressed since on that basis alone there would be far for far far more excess deaths from measles among children than coronavirus deaths among children i need to bring this up to the team tf the task force did you ever have an opportunity to bring up the potential of measles deaths among children an infection rate going around the world from measles based on the fact that so many children would not get their measles vaccine because of the shutdown i'm sorry senator but on the advice of council i respectfully declined to answer based upon my rights under the fifth amendment to the constitution that is your right to do one of the big issues really coming up is on the lab issue this was greatly discussed about whether this came from a lab or whether this came from nature there are obvious issues and differences between the two to be able to know this you had a lot of conversation on this scientists around the world were in we're in conversation on this there are different statements that you even made in your private notes and your public notes on it in january the 26th of 2020 this is before we had our even our first tragic death of coronavirus in the united states you wrote it now appears using epi data that the genomic data the first infection was in early december and was not connected to the market which was the big rumor that was out there as this wet market in china we know the market was not the source it was the amplifier on january the 31st you wrote about a phone call you wrote the people in the phone on the phone felt the mutations around the furin cleavage site of the spike protein could not have occurred naturally since it would require an evolutionary jump that they found no way to prevent the spread of the virus and that's why we're in bat isolates they bring up the possibility this could have been deliberately inserted and either accidentally released or deliberately released by a crazy person in the lab the former being the most likely february the first same year 2020 this is again still before our first death there was not total agreement about the likelihood of deliberate insertion ron said he was he was sure that this could occur naturally and we should not waste our time and divert our effort to pursue this this is expected of him since he was the original gain of function person with yoshi also christian was withdrawn the rest felt deliberate insertion was possible and given the fact that dr jingling she at the university of wuhan has been working for years and gain a function in coronaviruses to allow adaptation of the spike protein to bind to the human ace 2 receptor we could not let this go that's a remarkable statement for february the 1st of 2020 when there hadn't even been the first death here but we knew something was moving you knew well that something was moving you identified february the 1st before any of us had ever heard of the wuhan lab not only the wuhan lab in the conversation but literally the scientist that you named in your own notes the lead scientist that was there it's interesting to me on that and the questions i was going to ask you was just your background and knowledge about the wuhan lab and and dr shi and and all the details and i'm going to ask you a couple of questions first and then i'm going to ask you an answer to the follow-up i also want you to know that i know i'm aware of where you have been on trying to be able to lead your fifth minute right which is your right to be able to do but i also want to be able to find out some facts to be able to help us for the future on this the lawrence livermore national laboratory in may of 2020 put out a classified document that has only been recently unclassified on this that had this statement we assess all the necessary conditions for an accidental release of a laboratory modified coronavirus adapted to recognize human cell receptors were present at the Chinese Wu on Institute of Virology in mid to late 2019 now the question that I have for you is this is May the 27th of 2020 this is the report that most people will see is this I have I have clearance I serve on the Intelligence Committee I've actually read this complete document unredacted my concern is were you given the ability to see this document unredacted based on your position were you able to see this and to be able to get this information I could I could see it and I know what's here everybody else just has their conclusion at the beginning of it not this my question to you was going to be did you have access because it's important for the future that people in your position do have access to this kind of information and insight is there any way you could answer that question were you able to give it you could answer that question were you able to give it access to this data on the advice of counsel I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution you wrote on January the 26th of 2020 we should be allowed to send our CDC epidemiologists to China to work with them so you could so they could see the data firsthand you you also wrote in February 12 2020 that you had great concerns about the World Health Organization because there depends greatly on China and as you stated often bows to them this is a really important issue that we've got to resolve for the future it's not just our cooperation with Chinese scientists it's our acknowledgement that China covered up their data wouldn't allow our scientists to be able to come in they cleaned up the wet market they cleaned up the other areas they wouldn't allow you to get access to all the other scientists are there including their health records their medical records their medical records records, what happened to them, or even all the sequencing that they had done in advance. For the future of our research and our cooperation with any scientists around the world, I think it's really important that we resolve, if we're going to fund research and cooperate with you, we've got to have certain things from you. If things go sideways, we've got to have access to all information in all places. You were noting not only that China was affecting the World Health Organization and that China was bending them to their will, and so the World Health Organization was putting out data that you saw, at least at that point, as being from a Chinese perspective covering up what was going on, but you also noted we weren't able to get access to all this information. We've got to be able to figure this out for the future to be able to make sure that research that is done, we have access to all information. If something goes sideways at some point, which clearly it did at the Wuhan Institute of Virology, and that being, as was noted by many people, the only the only thing that we can do is to get access to all the information that we have. We have access to all the information that we have. We have access to all the information that we have. There was only one lab in the world that was doing research like this that had a lower standard of actually their security standards there than many other labs around the world, yet they were doing this very dangerous research. What can we gain, and what advice could you give us to say in a future setting we've got to make sure that we actually get information from people and we can be guaranteed that we're going to get that insight? Yes, sir. On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment. I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. I yield back. Senator Blumenthal. Thank you, Mr. Chairman. I want to go back to the dark days of the coronavirus pandemic, one of the darkest days or times in our history. Hospitals were overflowing. Navy medical ships were docked in the Hudson River. Emergency rooms were forced into unprecedented triage. During the worst week of the pandemic, which happens to have been the last week of President Trump's first term, more than 25,000 Americans died of COVID-19. Easy to forget those dark days. But for the past 18 months, the Trump administration has been engaged in a campaign to rewrite this history. And today's proceeding, I fear, is part of that effort. One of the darkest days. The Trump administration has launched a baseless set of smears against vaccines that help pull us out of that public health crisis, vaccines that are undoubtedly President Trump's greatest accomplishment. It has slashed funding to local public health departments that were on the front lines of the pandemic. And those health care workers are. Heroes. It has disparaged those heroes as woke. Or wasteful. And it has used a politicized Department of Justice. To target the researchers who helped us track and understand. The novel virus. Today's hearing is another page in that playbook. Sadly, tragically. Dr. Fauci, you've spent five decades in public health. In public service. Including nearly four decades in leadership at the National Institutes of Health. Helping to conquer COVID-19. But also HIV. Swine flu, Zika, Ebola and other epidemics with real life results, saving human lives. Put aside all the. Flowery rhetoric that we hear in the United States Senate. Dr Fauci has saved lives. As have public health officials. In the United States and throughout the world. And today. We are demeaning and degrading. Their lifesaving service. Republicans are eager to rebrand. You as a villain. In order to distract from their own failure to protect Americans from soaring health care costs. And to protect our own health. And to protect our own health. And to protect our own health. And to protect our own health. And to protect our own health. And to protect our own health. They've been rising astronomically in the last couple of years. And from unsafe food. And to protect our own health. From unsafe food. Which has caused cyclospora to spread. Which has caused cyclospora to spread. And resurgent measles. As a result of the anti-vaccine policy. This hearing is the culmination. Of a years long crusade. Which started more than six years ago. When Dr Fauci dared. To contradict. President Trump. The campaign to vilify you, Dr. Fauci, is just one part of this larger campaign against science and facts, a campaign that has made Americans less safe. It is shameful that in a country like ours, a dedicated public service like Dr. Fauci has experienced persistent threats to his life since the pandemic because of the lies that are told about him. His attorney has been gagged, thrown out of this hearing room, but he has written a letter to the chairman that is an explanation for the reasons why Dr. Fauci is, in fact, invoking his constitutional right. It is a right, and I would ask that this letter from David Shurtler and Danny Onato be made part of the record if there's no objection. His attorney has also issued a statement within the last half hour, I believe, that sets forth, again, the reasons that he is here to help protect his client's rights, and I would ask that that statement be made part of the record as well, Mr. Chairman. Without objection. Let's be very clear. The Fifth Amendment is a right of everyone. And the job. It is a right. I would ask that this letter be made part of the record as well, Mr. Chairman. Without objection. you purport to seek information he has been thoroughly transparent and consistent in providing factual information to congress and he is deeply familiar with the processes and protocols of sharing information with the legislative branch and then referring to the chairman this year's long public crusade against dr fauci makes one thing clear this is not a serious effort to seek information from dr fauci in a transcribed interview for a valid legislative purpose you are single-mindedly fixated on dr fauci seeing dr fauci prosecuted for imaginary crimes and you are so invested in that outcome that you have created a personal brand around it those are the words of his attorney and he cites as well the statements of the chairman which indicate a clear intent that the result of this proceeding be a prosecution quote the power of some of us must be used for good like putting fauci in jail that's from december 23 2025. i want to give him a subpoena and a jail cell also from december of 2025 the first was 2024. those kinds of statements by the chairman of a committee in tweets certainly provide a well-founded fear that the proceeding underway is simply an effort to trap dr fauci in some kind of criminal wrongdoing that is not the purpose of a congressional hearing not the valid purpose of a congressional hearing during some of the dark days in this body under senator joe mccarthy it became standard operating procedure to seek that kind of prosecutorial objective we should not be part of a rerun of that kind of effort this attempt to rebrand one of the most challenging times in our nation's history is a short-sighted act of desperation that will leave us less prepared to face the consequences of this act of desperation that will leave us less prepared for the next pandemic it is an insult to the memory of more than one million americans who died from covet 19. if there are valid scientific questions about the origins of this pandemic covet 19 about the kinds of steps that were taken to counter it about the need for more preparation they should certainly be addressed but not in a show trial not as part of a continuing vendetta against a single individual and unfortunately i fear that is what we are seeing today america deserves better thank you mr chairman in no courtroom in america can you have your witness plead the fifth amendment then your attorney gets to testify that's what that letter is the attorney's complaining and and testifying saying he didn't do it the prosecution's unfair you don't get to do that that's one thing you give up when you take the fifth amendment you say i'm not going to testify i'm not going to give you any information you don't then get to put your lawyer forward to justify it he can do it in the press but you can't come and testify he was not invited to testify and he was out of order and it was appropriate to have him injected senator chairman paul thank you for doing this i think i know in my state people have been asking questions about Dr. Fauci for years. So, Dr. Fauci, your entry has made clear that you love being a hero, a celebrity, and you're having the eyes of the world upon you. You loved every newspaper profile, every photo shoot, every fancy dinner with the elites. To many Americans who lost family members, who lost trust in our federal government, you're not a hero. Unfortunately, you're a villain. You made yourself the story and abandoned the American people to serve your own ego. To begin, I'd like to talk about your relationship with David Marins. He was the senior advisor in the NIAID, Office of the Director, your office, for 16 years. He was your friend. He was a frequent guest at your house. You reportedly co-authored over 50 scientific articles with him. You turned to him first right after COVID-19 first occurred. Earlier this year, the Department of Justice charged him with conspiracy against the United States. In addition to other charges, as part of a conspiracy, he was also charged with conspiracy to conceal information and falsify records to suppress alternative theories about the origins of COVID-19. Now, you've publicly ticked this man to the curb, saying, Dr. Marins was not an advisor to me on institute policy or other substantive issues. So let's start with the use of personal Gmail accounts in David Marins' relationship with Peter Daszak. David Marins tells Peter Daszak, president of Equal Alliance, and you've got this in front of you, it's Exhibit 1, and it's already in the record as part of this. It says, quote, P.S. I forgot to say that there is no worry about FOIA. I can either send stuff to Tony on his private Gmail or hand it to him at work or as house. He is too smart to let colleagues send him stuff that could cause trouble. Dr. Fauci, did Dr. Marins' relationship with Peter Daszak concern you? Yes or no? On the advice of counsel, I respectfully decline to answer. Dr. Fauci, did Dr. Marins' relationship with Peter Daszak concern you? Yes or no? On the advice of counsel, I respectfully decline to answer. Based upon my rights under the Fifth Amendment to the Constitution. Did David Marins ever bring documents to your house? On the advice of counsel, I respectfully decline to answer. Based upon my rights under the Fifth Amendment to the Constitution. Did you ever receive a text about your work at NIAID to your personal cell phone? On the advice of counsel, I respectfully decline to answer. Based upon my rights under the Fifth Amendment to the Constitution. Did any text about your work at NIAID to your personal cell phone? ID that went to your personal cell phone ever become part of federal records? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Did you maintain a personal email account while serving as director? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Did you ever receive work-related communications on that Gmail account from David Marins? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Did you preserve any work-related communications on that Gmail account from David Marins? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Did David Marins ever provide you with documents outside of those two ways that would violate NIH policy for four year compliance? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. declined to answer based upon my rights under the Fifth Amendment to the Constitution now let's look at two other communications you emailed Dave Moran's on January 26 2020 quote it is important that I speak with you tonight please call me at home this is the part of exhibit 2 that you have in front of you this email is sent the same day the exact same day you write in an internal document quote now we know the market was not the source it was the amplifier unquote would you call the origins of Code 19 a substantive issue on the advice of counsel I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution did you discuss code 19 origins with them or ants on this phone on this phone call on the advice of counsel I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Now let's take a closer look at the last time you testified before Congress. This is part of what you have in front of you is exhibit four, which is part of the record. In June 2024, you testified to Dr. Moran's quote, was not an advisor to me on institute policy or other substantive issues. Furthermore, his office is located in a different building from that of the NIAID director, unquote. Is that still your testimony today? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. So today under oath, your testimony remains that Dr. Moran's was not an advisor to you on institute policy or substantive matters. On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. I've got exhibit five, which you have in front of you. On October 24, 2021, David Moran's texted you to provide information about an advocate for the Constitution. He has a controversial EcoHealth Alliance grant. You thank him and tell him you will check the information. Would you agree that this shows an advisory relationship between David Moran's and yourself? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Would you agree that you two were discussing a substantive issue? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. If documentary evidence establishes that Dr. Moran's advise you regarding EcoHealth Alliance COVID origins or grant policy, then your June 2024 testimony would have been inaccurate, correct? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Is there any document in your possession today that would contradict your prior congressional testimony? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Have you deleted, destroyed, or instructed anyone to destroy records after learning Congress is investigating these matters? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Are you aware of anyone who did? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. As you know, Dr. Moran still faces charges related to destroying records while you distance yourself from him. Is that fair to a decades-long frat? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. When is the last time you spoke to him? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. In hindsight, are you disappointed how you handled COVID? Do you have any regrets? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. to the Constitution. Dr. Fauci, I want to close with this. Here's how you impacted my family and people close to me. I have daughters with children. You can't imagine the questions they had around vaccines for their kids and themselves and the pressure, the unbelievable pressure to make the right decision for their health. I can tell you pregnant women who worked with me were so scared because every time they went to the doctor, they were told something different about taking the vaccine and you caused this. Imagine being a mom trying to protect their kids or an expectant mother trying to figure out what to do. Every three weeks, a doctor tells you a new set of guidance on a vaccine. The haphazard information you released and pushed on the American people with little research is appalling and why there's so much distrust in our institutions today. That trust is crucial to public health and you more than any person or event in my lifetime have destroyed that trust for millions of Americans. You lied to hundreds of millions of people amid the worst public health crisis in this century. You failed to follow your own guidance. You forced people to watch their loved ones die alone over the phone. It's disgusting. You destroyed the federal government's credibility when it comes to public health. We have entire generations of Americans who rightfully so do not trust your institution to keep people safe because of you. This has destroyed decades of progress and lifetimes of work because you wanted to fuel your own ego and be the center of attention. What would you do differently knowing what you know today, Dr. Fauci? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. All the evidence is right here and you still can't bring yourself to tell the truth or apologize because you received an auto-pinned pardon from a staffer in the Biden White House. If we have another pandemic tomorrow, millions could die because of what you did, what you did to make Americans lose trust in their government when it comes to medicine and health care. How many families have you apologized to had to watch their loved ones die alone? You breached public trust and now you're hiding behind a fraudulent pardon. Your legacy will not be as a man who has saved America from COVID, but as a man who destroyed the public trust in America's public health institutions in exchange for five minutes of fame. This is how history will remember you. I yield back. Senator Kim. Thank you, Dr. Fauci, for coming on out in front of this committee. I know it's not what you would want. It's not what you deserve. I just want to say and start by just saying thank you to you for your service to this nation. I didn't know much about you prior to the pandemic. I came to learn about you from how many Americans did, but I also had the opportunity to talk to you and engage with you as someone who is a member of the Select Committee on the Coronavirus Crisis over in the House of Representatives. When I learned about. Your background 38 years as the director of the National Institute of Allergy and Infectious Disease, appointed by President Reagan, served under seven presidents, four Republicans and three Democrats. I admire that greatly. I myself had a chance to serve in the executive branch, serving government under both a Republican president and a Democratic president. And I believe that we need more of that. More of that type of work. A place where we can understand our jobs, not as coming from a place of partisanship and politics, but that of just public service. And right now I feel the hyper partisanship growing in this country in dangerous ways. I feel it much more present here on the Hill than I did back when I served as a nonpartisan career public servant at the State Department. And I worry about it. I worry about what kind of trajectory we're on as a country and what this causes when it comes next for public service and those willing to step up for our nation. And it's not just in the attacks, but we see it brought out with the cuts to funding, to the firing of federal workers, to the demonization of their motivations. People calling our public servants criminals. Thinking that they are there solely to undermine others that are trying to engage. I look at it right now. You know, it's not just that the people are being attacked, our public servants being attacked, but that it's undermining the very nature of the work of governance. You know, these cuts to HHS funding, to NIH funding, to the grants, cuts to the researchers doing the critical work. To find cures and medicines. These firing, these cuts, they're creating a chilling effect. Honestly, a chilling effect for the next generation of people who might consider stepping up to serve our nation. To be the next generation of researchers who now are wondering whether this is the right thing for them to do at a time when they see some of their colleagues, those that they looked up to being attacked. Their funding. being cut. Researchers that I talked to who are now either leaving the country or considering leaving the country to do their work because of the sheer unpredictability of America. That this nation so great, so powerful, has now been crippled with this sense of unpredictability and unreliability. That is not the type of country that I hope we strive to be. I've raised this because these attacks upon Dr. Fauci, it's not just about him. It's sending signals to others. Others who are thinking about serving our country, our scientists, our doctors, our healthcare professionals, our researchers. Trying to show to them that if you don't get in line with the politics that you will also potentially be subject to attacks. And from the work that he has done from HIV, AIDS, to Ebola, to COVID, you know, we've seen him try to engage in these crises. They're not easy. Especially when it's a novel disease, when you don't know what comes next. A lot of unknowns. Having to make decisions without the full breadth of knowledge we always wish we had in hindsight. But there is nothing perfect, no perfect clarity when it comes to pandemics, when it comes to crises. I worked in national security in wars and crises. I made judgment calls, gave my best information, and I was able to do it. I was able to do it. I was able to do it. I was able to do it. I was able to do it. I was able to do it. I was able to do it. I was able to do it. I was able to do it. So I dust that I have to give this advice to generals, to ambassadors, even to a president. Did I get it all Right? No. Did I do my best? I did everything I thought I could with the information that I had. The public servants, they do this work because they love this country, and that they strive to improve it. It's not an easy job, but it is because there is so much at stake in our country. But these public servants do it because they are in the arena i just want to end by just reading a portion of this because i think it's important as we're thinking about how to be able to treat public servants through this country to think through this and in the words of teddy roosevelt saying it's not the critic who counts not the man who points out how the strong man stumbles or where the doer of deeds could have done them better the credit belongs to the man who is actually in the arena whose face is marred by dust and sweat and blood who strive valiantly who errors becomes short again and again who spends himself in a worthy cause who at the best knows in the end the triumphs of high achievement and who at the worst if he fails at least he fails while daring greatly so that his place shall never be with those cold and timid souls who neither know victory nor defeat thank you for your service dr fauci i yield back senator holling thank you mr chairman well nothing says honesty like taking the fifth huh doc let's try something what day of the week is it today on the advice of council i respectfully declined to answer based upon my rights under the fifth amendment to the constitution what color tie you're wearing on the advice of council i respectfully declined to answer based upon my rights under the fifth amendment to the constitution what color is the carpet in front of you on the advice of council i respectfully declined to answer based upon my rights under the fifth amendment to the constitution let's just get one thing straight you don't have any rights under the fifth amendment because you've been pardoned as you very well know as a supreme court has been clear for a century and more brown versus walker 1896 when he has been pardoned he may not stand upon his privilege you know that your lawyers sitting behind you now shifting nervously in their chairs they know it this isn't about the constitution this isn't about the law this is about contempt contempt for this body and contempt for the american people but i think i know why you're doing it it's because you don't want to answer questions it's because you did all kinds of terrible things it's because during the pandemic you got rich didn't you you got rich while people were dying hundreds of thousands of americans over a million in the end and you were getting rich and not only were you doing that you were using federal employees with taxpayer money to apply for and solicit cash prizes for you personally cash prizes totaling over a million dollars you did all of that during the pandemic didn't you that's a question on the advice of counsel i respectfully declined to answer based upon my rights under the fifth amendment to the constitution you remember greg fulkers who was that on the advice of counsel i respectfully declined to answer based upon my rights under the fifth amendment to the constitution your chief of staff is the answer do you remember patricia conrad who was that on the advice of counsel i respectfully declined to answer based upon my rights under the fifth amendment to the constitution uh-huh she was your personal assistant and what were these individuals doing in the depth of the pandemic in november of 2020 when millions of americans were suffering from covid what were they doing i tell you what they're doing fokers was on your behalf soliciting and gathering information for a cash award let's look at it we've got his email right here right over my shoulder foker says i'm working on this nomination for the dan david award for fauci we need to beef up the covid part do you have language in the can that you could share that delineates how we responded in new ways to covet he sends this to multiple federal employees what was the dan david award do you remember doc on the advice of counsel i respectfully declined to answer based upon my rights under the fifth amendment to the constitution it was a 900 000 cash award 900 thousand dollar cash award and he got it because he used federal employees to get it and this wasn't the only award was it dr fauci in fact you applied for and received at least eight other federal cash prizes on federal time using federal employees and federal resources here they are over my shoulder besides the dan david award you've got the partnership for public service you've got the adelson prize you've got the Smithsonian Award. You've got the National Academy of Medicines Award. You've got the CDC Foundation. In fact, you turned your staff into a full-time application machine. You actually wrote to people and said, do you think maybe I'd qualify? And you got cash for all of this. And it wasn't just one or two employees, was it? In fact, you used eight separate federal employees on federal time using federal resources to solicit cash awards. Isn't that true? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Here they are right over my shoulder. Here's all of them. The people that you use, federal employees, so that you could go and get cash money. And the most hilarious part is that you weren't content to even dragoon them into applying for all of these cash awards. You then had them go out to the ethics agencies and ethics watchdogs and demand that you be able to get the money. That's right. We've got it in your hands. We've got it in your hands. We've got it in your hands. We've got it in your hands. We've got it in your hands. We've got it in your hands. We've got it in my hands. Wait a minute. Instead of you they need staff and clean staff in order to get access to all the technology available and then the general security just gives their staff time to check that. You don't just look and search emails, search through your emails. Your staff and employees on federal time using federal resources being paid with federal dollars are soliciting cash for you and then they're turning around and saying to the agency, We don't want just an answer. We want to get to yes, because Fouchy wants the money. He wants it. We want to get to yes. And yes takes so that you could get money, so that you could get rich. And it violated the law, didn't it, Dr. Fauci? Didn't it? It violated the law, didn't it? It is a question. You can answer. Go ahead. On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Federal law, as you very well know, prohibits the solicitation of cash awards or other personal benefits for federal employees. And it certainly prohibits using your own employees to do this. 5CFR Section 2635205B, it says it right there in black and white. You cannot use federal resources, federal dollars, federal employees, federal offices, federal email, federal time to solicit cash awards. And you did all of it. And the worst part is thousands of people were dying while you were doing it. You were supposed to be the nation's doctor, and you're playing. You're the one on TV. But this is what you were doing with your time. Isn't that true? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Yeah. Yeah, I can see why. I can certainly see why. You know what I can't quite figure out is that why you were so obsessed with it, because you're already rich. I mean, and your scheme worked here. I mean, your net worth now is north of $12 million. You got over a million dollars in cash. You got over a million dollars in cash awards during COVID, during a 12-month, 24-month span during COVID. A million bucks you knocked down in cash money using federal resources. Now you're worth more than $12 million. You've got a pension that in its first year paid out north of $400,000 a year. A million people dead, you're getting rich. A million people dead, you're using federal employees to get cash awards for you. A million people dead, and you're here taking the fill. A million people give to you. You're telling us this because you don't want to admit that what really happened in all that time was a multi-month, multi-year course of self-dealing. Isn't that true, Dr. Fauci? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Yeah, well, silence is admission. And here's the real thing. At the end of the day, it wasn't just about the money, really, was it? It was really about a power trip. I mean, through all of this, you, you want to be the most famous scientist in the world the world. You were so focused on getting every award and every drop of cash that you could all because you wanted to be on TV. You wanted to be the sun God of science. You wanted to be the guy who was in charge of it all. You wanted to blam bass Trump. You wanted to make sure that nobody else stole your spotlight. You wanted to be the guy you had time to sit for in style magazine. Here's what you were doing with your time. You could sit for in style magazine, but you can't answer questions for the American people. You could sit for in style magazine, but you're here taking the fifth. You could sit for in style magazine and get a million bucks in cash awards, but now the cat's got your tongue. I bet he does. I tell you what, here's my conclusion from all of this. This was really all about you the whole time. Somewhere along the way, you lost your way. You may have been a good public servant at one time. I don't know, but what I can tell you from reading your emails now, from listening to your emails, from listening to your emails, from listening to your emails, from looking at what you did, how you used your employees, somewhere along the line, it became all about you. You became a narcissist and a megalomaniac and a liar. And you've lied to the American people and you've lied to this body. And you've disgraced your profession by doing it. You called yourself the most famous scientist in the world. You've done more to harm science than anybody in my lifetime. And I hope you'll go home and write that in your diary. Thank you, Mr. Chairman. Senator Fetterman. Thank you, Mr. Chairman. Uh, Dr. Fauci, I'm not here to perhaps attack you or defend or anything. It's really just, just more, uh, honestly, I'm just want to acknowledge I have had members of my family die from COVID. And now I also grieve for people that I've met that have lost their business through the pandemic and they'll never been the same. Now, as during the pandemic, I was the last person to die from COVID. I was the last person to die from COVID. I was the last person to die from COVID. I was the last person to die from COVID. I was the last person to die from COVID. I was the last person to die from COVID. Lieutenant governor. So we were in the middle of, of all of that maelstrom trying to find the right balance between protect life and protect the economics and for all of it. And I'm not sure if we got it all right or wrong. Um, but without a doubt, I can continue to question myself, but one that I, it's not about much more your regrets, but I have one. And that is early on that there was the theory that the virus could have emerged from the lab and early on that became like a right wing kinds of theory. And I thought it seemed to make sense. Now there was a really advanced lab that was close by. And then you have this unknown virus, uh, out. So, uh, but that became a very partisan thing. And now, uh, it seems now it's more and more emerging theory that that would have caused the virus to emerge from the lab. So, uh, but that became a very partisan thing. And now, uh, it seems now it's more and more emerging theory that that would have caused the virus to emerge from the lab. So, uh, but that became a very partisan thing. And now, uh, it seems now it's more and more emerging theory that that would have caused the virus to emerge from the lab. come from from the lab. Now, you know, I hope I think that the next time our nations facing something like this, we are not become, you know, as I might have been blinded by the partisan idea that maybe the truth might come from a side that's different than than you are. But I think we should really be willing to pursue truth, no matter where that may have emerged, you know, after for all of that. So and I now see the the remain back to the chair. Thank you. Senator Moreno. Thank you, Mr. Chairman, and I will echo Senator Johnson's comments about your opening statements. Chairman, I think it was it was dead on very, very well done. Mr. Fauci, do you know who David shirtler is? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Fifth Amendment, Fifth Amendment of the Constitution. What is the Fifth Amendment of the Constitution say? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. On the advice of counsel, I respectfully declined to answer based upon my rights on the Fifth Amendment of the Constitution. No, I'm just asking you what it says. On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. I'm going to give the Constitution to my aid. He'll bring it over to you so you can have it for future reference. I think it's something that every American should know what the Constitution says. Do you know who wrote the Fifth Amendment? On the advice of counsel, I respectfully declined to answer. Based upon my rights on the Fifth Amendment of the Constitution. So you're invoking a right that you don't know who wrote it or what it says, is that correct? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Wow. Well, let me tell you who David shirtler is for the audience because he was ejected by the chairman. He's a high profile criminal attorney. He's represented some really great people like Senator Bob Menendez. Maybe that's. Somebody who my Democrat colleagues may remember took gold bars as bribes from the Egyptians. And there's an article here in the Washington Free Beacon that talks about. Why you would hire guy like Denver shirtler and the comment is if you're in deep shit, that's who you call. Do you feel like you're in deep shit? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Clearly. What you think today is that somehow you're above reproach. Somehow you feel like you. Don't need to be treated like a normal American. Can you do me a favor in the audience and stand up if during the time of the covert pandemic, you were called the racist. For calling the virus a Wuhan virus or the China virus. If you thought the six foot rule was total crap. If you thought the virus. The vaccine wasn't something that you should take if you thought it was outrageous the way the mass policy was rolled out if you were fired from your job for not taking that vaccine, including members of the military. If you thought closing schools was catastrophically stupid and that you thought that during these times saying these things made you somehow a lesser human being. Dr Frederick, you just turn around and look at the people behind you. You're not willing to do that. That's not a question. It's not a question. To your lawyers, not a question. It's a request. All you have to do is look up from your lawyers. And look at the people who were absolutely shamed for saying what we know now to be the truth. You can't even look at them? That's a question. Are you able to look at them? You can sit down in the audience. There was a mom. In Ohio. In the middle of the coronavirus pandemic. Decided to go to her high school football game for her son. They hadn't been out much. The kids had been learning at school. And then the school got shut down. They hadn't really gotten much out of that education. As any parent knew, that remote learning was no learning at all. But it was a Friday night. Her son wanted to go watch. Her buddy go play football. So they went to the stadium. They sat alone. Far from everybody else. Just a mom, a dad. A few kids. They didn't feel they needed to wear masks. Because it was stupid. Because they were outside. They all lived together. They're not near anybody. Dr. Fauci, do you know what happened to that mom and that family? That's a question. On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. They were dragged out of that stadium. And arrested. Those policies were put in place because you had moronic politicians that listened to the words of a megalomaniac who was more interested in having met a Kardashian than the suffering of the American people. And that is you. Your advice to communities like that, to idiotic politicians who enforce those rules, arrested that mom for watching a football game with her own family outside. When that story broke, I said to myself, I cannot stand I. Lee on this. I cannot stand I. Lee on the side and watch this happen. It was about six years ago today that I decided I'm going to give up my businesses, sell them all, run for office, run for the United States Senate. Here I am sitting in front of you six years later saying, who the fuck do you think you were for doing that? It is a total disgrace what you did to this country. And if my Democrat colleagues are standing there defending you, I hope the voters of the United States of America watch the clips of every one of you doting on a guy who was more interested in being a celebrity than saving American people. I will make it my mission to make certain that every single one of those Democrats who did that will see that clip over and over and over again. Because defending, there is no defense of what you did. You may have had a 50-plus year legacy of public service, but it ends in total and complete disgrace. So let me ask you an opportunity to answer one question. Will you apologize, just apologize, to the people who you harmed through your actions? Will you say, do you have the dignity to just say you're sorry? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. So you won't apologize to the military members who Joe Biden summarily dismissed from the military for not taking the vaccine? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Will you apologize to the business owners that lost their business, shattered their lives, and they'll never recover? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Will you apologize to the moms who had to force their infant children, two, three, four-year-olds, to put masks on, and what that did and how that traumatized those kids? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Will you apologize to the family members or the people who died because they took your advice and not only got the first vaccine but the five, six other boosters that they did not need? To answer based upon my rights under the Fifth Amendment to the Constitution. Will you apologize to that mom from Ohio for being arrested for watching a football game with her family? Fifth Amendment to the Constitution. So you didn't know who wrote the Fifth Amendment. It's James Madison. Lived in this town. I can only wonder what he would think of somebody like you invoking his writings to shield culpability. For the actions that you took. It's no secret why you have to hire the biggest dirtbag attorney on the planet. Because of what you did. I hope you're paying him well. And I hope that one way or the other, somewhere, sometime, you answer for your crimes. Senator Ernst. Thank you, Mr. Chairman, for holding this important hearing today. Dr. Fauci, Americans haven't forgotten the tragic stories of people who lost loved ones during COVID and those that were denied a chance to say goodbye to their family members that were in hospitals or residing in nursing homes because of the COVID-19 protocols. Americans haven't forgotten the mandates, the adverse reactions to vaccines, the government misinformation, social media censorship, hotlines to tattle on their neighbors, the forced school closures, the tragic rise in suicides, or those businesses that were forced to close during lockdowns. Americans haven't forgotten the hundreds of billions of dollars spent by taxpayers for COVID relief stolen by fraudsters who bought Royals, excuse me, Rolls-Royces and yachts. These were taxpayer dollars. Americans have lost trust in science and government after the COVID response. Trust which will be incredibly difficult for us to gain back. Dr. Fauci, you said that the science was evolving and that your recommendations evolved with it. But Americans remember you as the public face of the coronavirus response. As one of the nation's most trusted voices, you urged policies you said were absolutely necessary even when those policies came at an enormous human and economic cost. And Americans deserve answers about reports that you may have worked with others to pressure the president into adopting the slow the spread strategy and why you later sought an unconditional pardon for crimes you may have committed dating back to 2014. Dr. Fauci, in 2022, you had a taxpayer-funded salary of $480,000 a year. You were, in fact, the highest paid federal employee in the entire federal government, even making more than the NIH director and the president of the United States. According to now public documents, that was due in large part to your work on biodefense. Unreported is how NIAID spent over $1 billion from 2009 to 2026 in biodefense and influenza federal contracts and subcontracts. My office uncovered records on usaspending.gov that show from 2015 to 2020, NIAID paid out $515,418 in subcontracts to Harvard Veterinary Institute in Harbin, China, including $100,000 a few days after it opened a BSL-4 biolab in 2018. That very same institute was criticized for doing gain-of-function bird flu research in 2013. And yet you were funding them for years after that, sending U.S. taxpayer dollars to China. These contracts, which we also traced to NIAID, show U.S. taxpayers funded gain-of-function researchers in the Netherlands and in Wisconsin, funding the same folks whose controversial work led President Obama to pause this exact type of dangerous pandemic research. Dr. Fauci, did you know that the NIH's billion-dollar Sears contract programs were funding gain-of-function researchers in China, the U.S., and in the Netherlands? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Dr. Fauci, Dr. Deborah Birx wrote in her book that you and President Obama's former CDC director were at a Saturday, March 14, March 14, we're at a Saturday, March 14, yes, 2020 meeting at her home two days before the president announced his 15 days to slow the spread effort. Your now-released diary said the meeting was a week before that. Dr. Birx said you all were trying to trap the president into having no other options. She wrote, your plan was to, quote, block any of the president's escape routes, so, quote, he'd have no choice but to agree to our flatten-the-curve measures. Yes or no, Dr. Fauci, did you try to block or trap President Trump into the slow-the-spread flatten-the-curve measures in March 2020? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. When the COVID-19 virus broke out in Wuhan, China, you, Dr. Fauci, knew pretty much right away that NIH had funded Chinese labs, including those doing coronavirus research. There's email traffic from early January 2020 where your staff was flagging for you that NIH funded coronavirus research at the Wuhan lab through EcoHealth Alliance. Yet few Americans knew we funded the Wuhan lab because the funding went through a sub-award, and was not reported to the public database like usaspending.gov as it should have been. Also, EcoHealth violated federal law by failing to report in its research papers how much taxpayer funding it spent on that research. At my request, the Government Accountability Office helped track down that $1.4 million of U.S. taxpayer money that was sent to the Wuhan Institute of Virology, both by U.S. and by you, Dr. Fauci, and through USAID. But first, it passed through EcoHealth Alliance, which I helped to get defunded through the NDAA. Dr. Fauci, did you intentionally use sub-award funding to obscure NIH funding of Chinese bio labs and coronavirus research? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. NIAID awarded multimillion-dollar grants to a number of scientists shortly after they wrote publicly in the Proximal Origins paper that the COVID virus likely came from nature. The documents Chairman Paul released last week show in private those same scientists were much more open to the virus being from a lab. In 2023, Representative Jordan insinuated that you basically gave a $9 million bribe in the form of an NIH grant to NIH-funded virologists to say the virus likely was from nature. Dr. Fauci, yes or no, did you reward the Proximal Origins authors by giving them NIAID grants or contracts? I absolutely decline to answer based upon my rights under the Fifth Amendment to the Constitution. Dr. Fauci, we have learned that U.S. coronavirus researchers at UNC shipped, quote, humanized or transgenic mice to China by around 2017 for use in their dangerous coronavirus work. Under your NIAID coronavirus, researchers also used aborted baby body parts in mice research, and taxpayers paid for them to do that. NIH-funded coronavirus researcher Dr. Ralph Baric and his colleagues at UNC put parts of livers, thymuses, and chunks of human fetal lung that they got from aborted almost five-month-old human babies. They put those parts in their research mice. They disgustingly named them BLT-L mice and wrote they had created a, quote, sandwich of aborted body parts in the mice. Get it, folks? BLT. A BLT sandwich. Your RML lab employees in Montana also ordered and used aborted baby body parts in their taxpayer-funded research, and emails show how they planned to use those mice for post-COVID work. NIH-funded putting aborted babies' fingers and scalp off the heads of aborted babies and putting them into the backs of research mice. The scalps later grew fine baby hair in the mice. They even included those disgusting photos in their research paper that you funded. Not all of those were research on coronaviruses, but some were. Thankfully, the current NIH director has said no more of this. Dr. Fauci, yes or no? Do you think that human aborted parts should be put into mice for coronavirus research? The advice of counsel I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Mr. Chairman, would you direct the witness to answer the questions that we have been asking? You probably would if he was here, but I can direct it. But I think we understand his answer. We do. We do understand that Americans are asking for accountability, Dr. Fauci, and your silence is very telling. Thank you, Mr. Chair. Senator Moody. Thank you, Mr. Chairman. You know, I'm the most junior member of the Senate here, showing from where I sit. I just got here last year. Many of you may remember I was the attorney general in Florida who fought back against the lockdowns, the school closures, the church closures, everything to embrace sanity and science. We fought back. We got ridiculed for it. And we didn't just call people names. We actually empaneled a grand jury of people of all walks of life, all political persuasions. So that's how I came here, fighting for a free state amongst states that had locked their own people down. We are now called the free state of Florida. And I believe our responsibility here is to make sure that government remembers the people are our bosses, that we report to them, that we're accountable to them. Government shouldn't operate for itself. Government operates on behalf of and for the American people. And anytime we get close to reporting back to our bosses about what government has done or how it's been abused or how individuals that are employed by the government had acted in their own self-interest or against the interests of the American people, every time we get close, if we start uncovering outrageous fraud, we'll have a hearing. And the tactics have been to not show up. So you'll have all of us over here trying to drill down on why we've been given money that actually works against American citizens, and no one shows up. Today there's... Well, nobody's here at the moment. Today there seems to be a different tactic. Today we have Democrats showing up and trying to spin why we shouldn't even be having this hearing to report back to our bosses. One said, today's hearing does damage. It will deter others from public service. Another said, this hearing is designed to entrap you. Another said, oh, one fell all over himself, flattering you, thanking you for your service multiple times, quoting man in the arena. Another said that we are demeaning first responders, and today is a sad play in a repeated playbook. Or we're going after one man. I mean, all of their time was used on why we should not be having the hearing to report back to our bosses and give the people accountability. So I would like to talk about that, because I believe that trust, the trust the American people place in our public health institutions and what happened to that trust during COVID is important. Because in a public health emergency, they are asked to make extraordinary sacrifices based on advice given to them by the government that is supposed to be working for them. And for that system to work, the public has to be able to trust them, trust the people giving them instructions. That trust depends on candor. Would you agree with that, Dr. Fauci? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. And when the evidence is uncertain, officials need to say so. When recommendations are based on assumptions rather than hard data, they need to say so. And when they get something wrong, they need to own it. And when the trust is lost and the consequences extend far beyond any single pandemic, the next time public health officials genuinely need Americans to listen, millions of people may simply ignore them or not believe them. And Dr. Fauci, you were undeniably the face of the federal government's COVID response. You said so yourself in your diary. You said it's not hyperbole to say I've become the most famous and talked about person in the country. So I want to understand how we got here. Let's start at the beginning. On March 8th, 2020, you appeared on 60 Minutes to discuss the spread of COVID-19. You were specifically asked to clear up the confusion and misinformation surrounding masks. You told the American people, right now in the United States, people should not be walking around with a mask. The interviewer immediately stopped you and said, are you sure of it? Because people are listening really closely to this. And instead of walking back or qualifying your statement in any way, you doubled down. There's no reason to be walking around with a mask. When you're in the middle of an outbreak, wearing a mask might make people feel a little better. It might even block a droplet, but it's not providing the perfect protection that people think it is. And often there are unintended consequences. People keep fiddling with their masks. They keep touching their face. Just a few weeks later, the CDC released its guidance recommending that Americans wear masks in public. You were asked to explain your original recommendation. You emphasized a very different consideration. You said, well, back then, the critical issue was to save the masks for the people who really needed them because it was felt there was a shortage of masks. So I want everybody to sit with that. The critical issue driving your initial recommendation to the American public was scarcity, logistics, not medical evidence. So when you told the American people there was no reason to wear a mask, what was your principal objective, giving them an honest assessment of the medical evidence or discouraging them from consuming a scarce supply of masks? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Well, unfortunately, that was just the beginning of a broader pattern. Let's talk about the six-foot distancing rule. In April 5th, 2020, interview on CBS said, every time I get to that podium in the White House briefing room, I always essentially plead with people, please take a look at those very simple guidelines of physical separation. And they're very simple. They're very, very clear. Physically separate six feet away. Yet when Congress finally asked you in 2024 what science supported that evidence, six-foot distance rule for COVID, you admitted you were not aware of any studies supporting it. Incredibly, you said the six-foot rule sort of just appeared and described it as an empiric decision that wasn't based on data. That rule had real consequences. Schools didn't open back up. Businesses didn't open back up. Churches didn't open back up. I could go on and on and on. And Americans were kept physically separated from one another during the most difficult moments of their lives. Many lost loved ones during that time. So Dr. Fauci, did you have any evidence to support a six-foot separation rule when you gave that advice to Americans? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. All right, well, let's look at the lockdowns then. By 2022, the consequences of prolonged COVID lockdowns on our children were clear, from delayed development to social isolation, which is probably why you were asked in July 2022 whether you would recommend locking down schools again. And you said, first of all, I didn't recommend locking anything down. But now we have your diary, and it tells a very different story from the one you told the public. And I will quote, I spoke with Bill de Blasio, the mayor of NYC, and convinced him based on what I was saying publicly in my conversation tonight to close the NYC schools. He had already decided based on what I was saying on TV. I went on to tell him he should close the bars and restaurants in NYC. And he said he would do this based on my recommendation. You even said that you told the president we should shut the whole country down. So Dr. Fauci, how do you square telling the American people publicly that you didn't recommend locking anything down with your own diary entry based on federal government equipment, saying that your recommendation is what convinced the mayor and the president to lock things down? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Now, I just want to make clear that when in Florida, we were pleading with people to give us advice based on scientific evidence, that we were getting these conflicting statements by you that didn't match science. That didn't match scientific data. And in fact, when we impaneled a grand jury, the grand jury's conclusion, not surprising to anyone, and by the way, we're still the only state to have impaneled a grand jury. I was the only attorney general to do this. We did this in 2023. That conclusion was the lockdown mask and social distancing advice administered by federal agencies and implemented by certain local, state, and federal agencies was not based on the best available scientific data. In fact, many recommendations and their accompanying mandates departed significantly from available research. Again, people from all walks of life, all political persuasions, that is what they found. And yet, during that time, while you were giving those statements, knowing there was no scientific basis for it, and we know now you knew it because we have your diary entries, you called the governor to fight to keep Washington and D.C. out of our state so that we could indeed respect the rights of our citizens. You called our governor, Governor DeSantis, and I'm going to quote this so I get it right, right out of your journals, a total jerk, that he is a complete disgrace, that he is blocking local authorities from mandating masks in various locations, including schools. And you were very concerned and upset that we were actively, and I'm going to quote, criticizing you, and we talked virtually every day about being wrong on everything. And what is astounding is that you wrote you feared because of that, because we were questioning our government, because we were fighting back for the truth from our government, from scientifically based recommendations, because we were pushing for that. You said you feared that our democracy is in dire danger. Thank goodness we have people up here that I work with that understand our role, which is to report to our bosses, the people, because they are in charge, calling for our government to be honest with us and transparent with us and accountable to us. That is a democracy. What you did is the opposite. And I cannot believe I have to explain this to someone who represented our government and some of the most important issues for so long. And before I conclude, if I can just put up our pardon. This is the pardon you have heard so much about. And Dr. Fauci, the only other person that got a pardon like this, I believe, had a last name of Biden. This pardon goes back to, and if you'll see, January the 1st of 2014. Did you talk to President Biden and ask for this pardon? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Who did you talk to in the White House about this pardon? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Did you specifically ask that it be dated back to the beginning of 2014? On the advice of counsel, I respectfully declined to answer based upon my rights under the Fifth Amendment to the Constitution. Did you do that so that you would be given immunity going back to the beginning of 2014 on the advice of counsel I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution I'm just very interested why it was this date did it have anything to do with the fact that 2014 was also the year that the NIAID or NIH began funding eco health alliances understanding the risk of bat coronavirus emergence grant on the advice of counsel I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution and this is the same grant that funded the work on bat coronaviruses at the Wuhan Institute on virology millions of Americans are questioning what happened during COVID why we were getting given misleading information misleading advice why you gave conflicting statements based on I guess how you were feeling that day and Americans rightfully we lost over a million Americans they should be insulted when the Democrats insult our chair that he's doing this because he is on an obsessive mission to go after one man could his obsession obsessive mission be to find out why American a million Americans died and who might be responsible for that and where that started could that be his mission dr. Fauci on the advice of counsel I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution and after everything we have just walked through can you sit here today and tell the American people our bosses that you bear no responsibility for their collapse and trust of their government it's based upon my rights under the Fifth Amendment to the Constitution time has expired we're going to do another quick round for those who remain about five minutes any questions that haven't come up that are pressing let's try not to re go over territory that's already been done I'll begin by asking unanimous consent to insert into the record documents show that show that the CIA transferred funds to NIAID through interagency agreement hearing no objection so ordered we had hoped to hear testimony from Anthony Fauci today we haven't but I think it's important that we do hear from him so we will have a video we'll play in a moment for years Anthony Fauci has been the public leader of the United States and the United States has been the public leader of the United States and the United States has been the public leader of the United States and the United States has been the public face of saying this in all likelihood came from nature he kept saying it's the marketplace it's the marketplace it's a marketplace he's been saying that on television up until recently but what we find is that what he was saying in public is different than what he was saying in private in January in private he wrote that looks like the wet market was a super spreader event it didn't originate there we know that some of the earliest deaths and sickness came from somewhere else but then for years and years we got dishonest so let's play the video so we can see a little juxtaposition of the problem we're dealing with Fauci's journal entries contradict what he said publicly about the origins of COVID-19 Fauci admitted in January 2020 that the initial outbreak of COVID did not occur at a wet market take a really good look at the animal-human interface and the fact that animals from the wild are being brought into wet markets you have animals that come out of the wild that are sold and sold at these open what they call them wet markets wet markets where you bring animals in from the wild who have these viruses the wet markets in Asia where people bring animals from the forest into a market there are wet markets in Wuhan that are ample opportunity for a virus to jump from an animal the origin was from a bat to an intermediate host to a human very likely in a wet market and those animals should not have been in the Wuhan market they knew that those animals should not have been in the market and they immediately cleaned out the market put restrictions on the kinds of animals that come into these wet markets I think they should shut down those things right away I mean it just it boggles my mind so repeatedly saying in public different something different than what he believed in private now this is interesting because you know the first SARS in 2003 was traced to a wet market to animals there but interestingly they had evidence they had evidence that the animals had the disease they also had evidence that the handlers had a disproportionately high number of antibodies to the disease so there was evidence and the evidence was presented so when this came out the same thing happened again they did look at the wet market they looked at the wet market and tested I think 80 000 animals and didn't find any animals that had that had covered 19. when they did find COVID-19 and trace samples there they found that the DNA or the RNA was consistent with human spread this was known not later on didn't take years to develop was known in January of 2020 and so Dr Fauci says privately he knows it's it didn't come from the wet market but as you saw those were over a multi-year period one of the other discussions I've had with Dr Fauci over the years about natural immunity so uh most infections you get a degree of immunity not perfect some fairly perfect smallpox you just don't get again George Washington knew this he had his wife get vaccinated but he didn't because he'd already had smallpox but there's one particular story that a man came up to me and lost his wife to covid he said we all got it we all got sick and my wife ended up getting sick enough to the hospital but they we'd recovered two weeks she was still alive two to three weeks later we'd all recovered and they wouldn't let us be with her and to this day it's one of the saddest things and it just you know it I think all of us should think about this they were not allowed to visit their mom he wasn't allowed to visit his wife in the hospital but based on this misunderstanding of natural immunity that for some reason two weeks later they were a problem but this was all promulgated by you we had the workers in the uh you know the meat factories they were essential they had to keep working most of them got COVID they got it in the first couple weeks most of them were younger the reassurance should have come from public health the reassurance should have said congratulations you've recovered it also should be acknowledged what's the number one thing we can do before another pandemic before we have a vaccine before we have monoclonal antibodies it would be to utilize natural immunity so instead of the advice you were giving to Cuomo and others in New York that led to the deaths of hundreds of thousands of people or tens of thousands of people you could have been saying well maybe the nurses taking care of the elderly should be people who are two weeks out from covet infection we could have used natural immunity as somewhat of a block of protection imperfect but the only protection we had and the only thing we could have done instead the nursing homes were seated seated with people had covet so I think the discussion of natural immunity is one where there wasn't sufficient honesty humility there wasn't enough presentation to encourage people that was the only encouraging thing we had for a while is you've got it you're very very if not impossible close to impossible chance that you'll die if you get it again everybody could have been reassured nobody was reassured like well we don't know we just don't quite understand natural immunity my favorite quote from that is from Martin Kulldor from from uh Harvard you called him one of the people he had to take down the fringe epidemiologist which I've never ever heard a scientist call another scientist that but uh he jokingly said on Twitter he said yeah we knew about natural immunity from 486 BC from the time of the Athenian plague we lost all knowledge of it in 2020. the good news is it's slowly coming back 24 to 20 20 25 we're beginning to understand what natural immunity is again not something perfect but a useful tool that could have been used but also something that could have helped people by telling the public my goodness you're not going to die now you have a chance if you've already had it you're 85 years old you're at risk for it you're wanting to feed your wife and they're telling you to wear four masks and not be around your wife when you've already had it it made no sense I visited with a man whose mom was 83 and she was dying from covid they go to the hospital in Orange County they won't admit her to the hospital till she's vaccinated because we have a policy that everybody in the hospital must be vaccinated she's got covid and they wanted to vaccinate her again at one point in time the CDC understood this they told people don't get vaccinated if you've had covid within three months why because it may give you a heightened immune response when you've already got a heightened immune response but giving a person very sick and many of the people who died from covid died from soda this this uh storm of uh of of response this immune storm the the answer wouldn't have been to try to stir up their immune response more by giving them a vaccine the answer was actually steroids and good old-fashioned steroids 37 percent reduction in death it turned out to be way more value than remdesivir way more valuable than any of the other treatments but I don't remember ever hearing a complimentary word on natural immunity or steroids or anything else and you know I wish we could have done more today I would have been willing to accept an apology today I'm sorry I made mistakes we all made mistakes and you know at the time I thought the risk was you know the risks of it were worth the benefits but um but I've reassessed since 15 million people died people say well gosh these things never happen we know it happened in 1977 we know with a hundred percent certainty a virus escaped in 1977 there's something called the Russian flu nobody's exactly positive how it got out but when they sequenced it they found out that a flu in 1977 had exactly the same RNA as a 1954 one that they had in the lab and they'd created a virus in fact turns out anybody born before 1954 was immune and the only people got it were people who had been born between 1954 and 1977 but it was identical the the genetic sequence was identical to this vaccine or the virus from 1954 and that doesn't happen because these respiratory viruses are always mutating to be identical means it had to have leaked from the lab proof positive that it had so we know this happens uh a author by the name of Young wrote a book and said there was 1200 cases of significant accidents that have occurred we knew all of this and yet it was completely discounted because I think you were worried that if it was seen that you funded dangerous research to start the pandemic you'd get blamed and it was a concerted effort wasn't just you anybody associated with the funding decided we needed to protect ourselves Senator Johnson Mr Chairman you mentioned that we lost knowledge of natural immunity I didn't Dr Fauci did I suppose I had an asymptomatic case of covid because of the very faulty PCR tests I never got vaccinated there's or injected there's no way I would have done that because I found out enough about the mRNA gene therapy but you also brought up the issue of hospital protocols I'm going to be holding a public event on hospital protocols we've already received a couple hundred testimonies they are heart-wrenching they are heart-wrenching here's an excerpt from the testimony of a staff surgeon very experienced you know doctor for decades at Providence Regional Medical Center Everett Washington quote after our hospital was given remdesivir by the CDC we were provided misleading slash inaccurate information about the drug biomedical leadership when I had a young trauma patient who was a perfect candidate for remdesivir the infectious disease doctor on call told me to not give it to her because quote she seemed like a nice girl he concludes it was early there I'm desperate kills I said nurses referred to it as run death is near so again I've always been you know because I was never made sense to me that we put all of our eggs in the experimental gene therapy um if you knew anything about it would have you would have avoided it like a plague and we didn't we sabotaged early treatment but the only treatment we really approved monoclonal antibodies which I think basically worked pretty well but those weren't particularly available they were I had an awful lot of patients it was all remdesivir based on a study that the NIH changed the end point from mortality because it had no impact on mortality today's recovery a drug that the who recommended against its use in covid in November of 2020 but a drug that cost over three thousand dollars for a course of treatment versus things like ivermectin hydroxychloroquine who even Dr Fauci and I should have got that one out because I want to take some time to end things in the record so you know we need to have a very tight protocol on remdesivir because it's unknown but hydroxychloroquine I mean that's approved some side effects but we have a long history of it let's put up my latest chart again I was tracking adverse events on on the experimental injection but I I use this chart as a comparison so you've got ivermectin Hydroxychloroquine again a virus doesn't improve causation but you know there's correlation it's there it's safety signal so ivermectin over 30 years of fda reports 17 deaths per year hydroxychloroquine over 38 years of reporting 142 deaths per year remdesivir over five and a half years 546 deaths per year the covert injection almost 7 000 deaths per year what which is safest what what did the fda freak us out about ivermectin hydroxychloroquine when they turn a complete blind's eye toward the injections injury so i want to enter the quote from the surgeon by the way here's here's the answer uh cheryl atkinson in an interview said that when it comes to money we check financial ties among experts on the government panel devising coronavirus treatment guidelines which had the effect of dialing back hydroxychloroquine use and giving an edge to remdesivir we found the 11 members reporting links to a drug company nine of them named relationships to remdesivir's maker gilead seven more including two of the committee leaders have ties to gilead beyond the 11 months they had to disclose two were on gilead's advisory board others were paid consultants who received research support in honor area by the way within the study i think one of the study participants was an employee of gilead a bunch also had conflicts with gilead so gee i wonder why you know their conflicts of interest gilead made billions of dollars off remdesivir and people died in terms of ignoring safety signals you can probably put that down now this has come to light this is dr drew weissman who got the nobel prize for the mrna platform he wrote to dr fauci on february 8th of 2020. tony i wanted to alert you to some new data we generated with our mrna lmp vaccine now it was a higher fold dose but that mrna lmp go to the placenta and fetus measured by translation of the mrna and cause of immune response in an amniotic fluid so that same day dr foucher responds it'd be interesting to see what human dose levels given in her muscular do so about a month later dr weisman replies he said we still have some concerns over the data after they tested at im now again there's there's more documentation in terms of the fda blew it off it's like ah don't worry about that there was a whole thing that's that's what peter marx did when he was shown that uh his uh l serotonin Filter 3 device you've seen the results basically man's Russians and other people's men I'd give them a brief summary like a� algorithms going to mass safety signals the last thing I want to enter in the record here is and I want to make the point you know why is this important that they buried the treatment of severely injection injured the fact that we have an acknowledges injection injuries these people can't get treatment they're being gaslit by their doctors so it's all in your head the rate of the injection injured of suicides is increasing because they've given up hope because our medical establishment federal health agencies completely failed him failing to acknowledge it so again dr. Nath was treating diagnosing treating injection injured in March of 2021 this concerned people so you had dr. Walter Koro shits writes dr. Fauci one of the points he made there's been a steady slow stream of reports to me of post-vaccination neurological conditions dr. Nath has been collecting a bunch he has reports saying that there's been a steady slow stream of reports to me of post-vaccination neurological conditions that we're seeing and I've seen this kind of information everywhere online on the Internet and is now a constantly increasing number of reports are going to get sent out to publish well that alarmed everybody boy you can't let the public know what's actually happening you can't actually let the public know what the science is showing so on April 29th a email from crancid Collins had an i-h to that to dr. Korch at's says I find this approach troubling and dr lawrence tabek writes to francis collins i don't understand what walter why walter does not shut this thing down why don't you shut down that dr nath who's actually treating injection injured why because of vaccine hesitancy and because we haven't acknowledged that and the reason i've been advocating for this is because i know the injection injured i know people who lost love lost loved ones within days of the injection and we've turned our backs on them they deserve acknowledgement they deserve to be heard seen and believed so they can get treatment i also know the doctors whose careers were destroyed because you denigrated things like ivermectin and denied ivermectin to people in hospitals who got their kidneys knocked out by the rendesivir but got put on ventilators never got to hug their loved ones goodbye because those hospital protocols that's what your science did to people so dr fauci my only question is based on your lack of testimony here today uh based quite honestly on our our investigation into the cover-up of safety signals and injection injuries we have issued letters to a number of former fda officials to come in for transcribed interviews you'll be getting a letter today asking for a volunteer tri-school and transcribed interview so i'd be asking will you comply or will i have to subpoena you on the advice of council i respectfully declined to answer based upon my rights under the fifth amendment to the constitution expected subpoena thank you senator scott dr fauci did you personally receive any royalty payments connected to covet related intellectual property on the advice of council i respectfully declined to answer based upon my rights under the fifth amendment to the constitution given the NIH receives royalty payments from certain pharmaceutical companies why would any american believe these financial ties did not influence decisions about which treatments were promoted or restricted on the advice of council i respectfully declined to answer based upon my rights under the fifth amendment to the constitution why doesn't niaid publicly disclose these payments on the advice of council i respectfully declined to answer based upon my rights under the fifth amendment to the constitution did you partner with bill gates on cannabis funding nomination challenges proposed fund funding program so there we had some evacuation in senator fain's establishment to carry out the meddling efforts in order to fund meddling另外 um members of medicine are obliged to take American rollout these applications amendment to the Constitution. Specifically, dual use research such as countermeasures or gain of function? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Do you know if Bill Gates entities partnered with U.S. government classified programs? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Do you know if Bill Gates maintains an active national security clearance? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Did you advocate or request for Bill Gates to receive a security clearance? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Do you have any knowledge that NIAID or NIH, through HHS, sponsored or requested a security clearance for Bill Gates? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Around 2010, my understanding is that the government shifted its approach to biodefense. Did NIAID, under your leadership, partner with the Obama White House or any other U.S. government classified entities on sensitive countermeasures research? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Did your office take steps to drive biological research investments? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. What was private industry's take on the type of research in the 2010 timeframe? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Was it considered too dangerous to conduct? Any industry was hesitant to take this on and invest in? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Why did you take steps to mature the government's approach to biodefense? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. specific lines of effort or actions you felt were needed during this time to improve the research development and fielding model? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. How was dual use and gain-of-function incorporated or accounted for in maturing biodefense countermeasures? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Did you ever discuss moving gain-of-function countermeasures research out of government space to private industry space? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. How were these private organizations regulated through government oversight while conducting risky research, including gain-of-function or gene-editing technology? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Did the Obama White House or any government entities take steps to inject funding into private industry? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. How do you ensure that our national security and public health is protected when private organizations work with foreign countries of concern and have the no government oversight such as the EcoHealth Alliance research grant you funded in a CCP military lab? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Given the culture of the pay to play at NIAID, did you or anyone acting on your behalf make any payment or enter any arrangement in any way or fashion to secure or influence the broad pardon you received from President Biden? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Thank you, Mr. Chairman. I'd like to ask unanimous consent to enter into the record a letter from the Department of Energy that confirms during Anthony Fauci's tenure that Bill Gates was given Q security clearance from 2014 to 2021. Without objection, that will be entered into the record. I'd also ask unanimous consent to enter into the record the contents of the folder of authorities provided to Dr. Fauci, including the pardon. Let's be clear today, you know, what we've seen. I really did want to hear from Dr. Fauci. I wanted to hear perhaps an apology. Perhaps some semblance of being sorry for what happened or that judgment errors were made. We didn't hear any of that. But he was subpoenaed here to testify, refused to answer any questions even after being directed by the chair and being advised of the law requiring him to do so. He has cited a privilege that is unsupported because of his blanket pardon and because he waived the privilege by testifying at the start. I'm going to give you one more opportunity to comply with that. I'm going to give you one more opportunity to comply with the law. Limited to the period of your pardon, at any point between January 1, 2014 and January 19, 2025, did you destroy any federal record or tell anyone else to? Under the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Given that you have an unlimited presidential pardon, what is your specific objection that you are making? On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. My question was limited to the period of your pardon only. I find your objection unsupported and direct you to answer the question. On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution. Because you refused to answer, citing a privilege that is unsupported because of your pardon, and after being denied to do so, this committee has scheduled a vote next week on arrest on arrest. You will be given a resolution certifying your contempt. I think we have another question or two from Senator Lankford. Mr. Chairman, really this is a question for you, and it's a question to try to figure out how do we get a good answer on this? Because clearly Dr. Fauci's attorneys are saying that he has a Fifth Amendment right. We've also subpoenaed him to be able to compel his testimony to be able to be here. I happen to be in the committee as we're also dealing with Lois Lerner. came and testified gave an opening statement and then took the Fifth Amendment the committee then held her in contempt for that saying you can't do both you can't both testify and say I'm not gonna answer questions so the parliamentary question that I think we've got to be able to deal with is is this consistent with Lois Lerner what she also did when she came before Congress gave an opening statement testimony so made a statement and then refused to answer questions are we dealing with the same issue here where someone is make you can't make a statement and say I'm not gonna make statements at the same time I think it's a very good question I think that's something all of us will examine over the next week we're gonna have a vote next week on contempt I think there's another legal question that the courts may have to decide upon and that is whether or not a presidential pardon that offers you complete immunity that you can still claim that you need protection from immunity when you've been protected because dr. Fauci isn't liable for anything as long as he tells the truth even if he admits that he destroyed records on a routine basis his assistant said she destroyed a ton of emails I think was a routine thing I think he destroyed throughout his career there are probably thousands of emails even if he did that as long as he answered truthfully yes I did I didn't think that was important I I made a mistake you can't be prosecuted for many of the things are outside the statute of limitations as well all he had to do today if he wanted to be honest as long as he was honest even about committing a crime he would have no jeopardy but I think the pardon does has given him more immunity than most people would ever get if you offer a witness immunity in exchange for testimony he has blanket immunity the president gave him blanket immunity for virtually anything he could have possibly done you know while at NIH so I think we all have to individually answer this question we welcome you to be part of helping us with this question thank you Mr Chairman today will be the capstone to Anthony Fauci's 40 years of abuse of power at NIH in the end must imagine Fauci believes he got away with it but still late at night even the guilty must become anxious rerunning the scenarios through his mind wondering latching on to lingering doubts and worrying did his actions lead to the largest man-made pledge given to Fauci for the suivest sentence on a mandatory leg in human history. Are the millions dead the result of his experiments or experiments that he approved that increased the pathogenicity of deadly viruses? History will judge, but the facts as we now know them paint a sordid tale of dishonesty, misjudgment, and ultimately the hubris the likes of which the world has rarely seen. If everyone will remain seated for a few minutes, we're going to let Dr. Fauci exit. Thank you.", "summary": "The committee will now come to order. One million Americans died from COVID-19. Some estimate as many as 15 million people died worldwide from COVID-19. Publicly, Anthony Fauci promoted the theory that the virus arose naturally, while privately he was well aware of a mountain of evidence suggesting the virus originated in the lab. The American people deserve answers. The American people deserve to know why dangerous research was funded by NIAID in a totali…", "source_url": "https://www.youtube.com/watch?v=kT5xuodO6BY", "source_name": "News livestream (YouTube kT5xuodO6BY)", "doc_date": "2026-07-29", "doc_kind": "proceeding", "case": "covid-19-origins", "sub_case": "congressional-testimony", "tags": ["testimony", "sworn", "hearing", "hsgac", "rand paul", "fifth amendment", "pleaded the fifth", "fauci testimony", "fauci", "covid", "covid-19", "congress", "pending-official-transcript", "2026"]}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 1 of 10)", "content": "670while being filmed.   Also, Jenny was worried about the anxiety this might cause Megan.   \nIt all worked out well as they were individually interviewed by Janet 1-on-1.  Janet was \nterrific.  \nI am starting to collect Cacti in my home office. \nDec. 30, 2019 – Over the years I have helped Dionne Warwick to find physicians for \nherself and her colleagues.   I have done this sometimes through as intermediary, Guy \nDraper, who is well-known sould song wsriter and agent for many groups .   Guy \ncalled me up today and asked for a referral for a peripheral vascular physician at Hopkins \nfor one of Dionne’s friends.   I recommended in Medicine Dr. Elizabeth Virginia \nRatchford and in Surgery Dr. James Hamilton Black.   Also, Guy wanted me to put on \nmy calendar for June 13, 2020 a ceremony at Bowie State University where they are \ndedicating a building to Dionne.   They want me there as their guest.\nAlso, Jon laPook was interviewed on CBS Morning News and mentioned me several \ntimes since he e-mail me over the weekend to prep him for his interview on Universal Flu \nvaccine and HIV vaccines.\nJan. 2, 2020 – Met in my office with Dr. Olivier Tshiani who was and is a main player \nin our PALM trial in DRC.   Also present were Cliff lane, Rick Davey and Lori Dodd.  \nOlivier was right there on site when the Mai Mai burned the ETUs at Katwa and \nButembo and his car was stoned as he was travelling at night from the ETU to his \ncompound where he was living in Butembo.   He related stories of the very difficult \nsecurity issues while doing the PALM study.   He is a real hero.   He had also previously \nspent 5 years in Nancy Sullivan’s lab. Here at VRC.\nDid TV interview with Cox TV this year’s influenza situation.   Interviewed by \nSamantha Manning\nJan. 3, 2020 – Influenza is heavy in the media.   Did an interview with Elizabeth Cohen \nof CNN for her Blog.   Also, did a live radio interview with John Catsimatidis for his \n“Cats Roundtable” from NYC.\nAlso, yesterday the US via a precise drone strike in Iraq outside of Baghdad airport \nkilled the leader of the Iranian Quds Force General Quassim Souleimani.   There has \nbeen over the past few days attacks on the US Embassy by Iranian backed Iraqi militia as \na result of the fact that the US armed forces attacked and killed 25 Iranian backed Iraqi \nmilitia who had killed a USA contractor and wounded several USA soldiers in Iraq.  This \nwill certainly lead to major escalation of tension and even retaliation from Iran.\nAlso 44 unusual cases of pneumonia in Wuhan, China opver the past couple of days.   \nEtiology still unknown.   Said to be a “viral pneumonia’ of unknown etiology.   Flu ruled \nout.   Cases linked to a seafood market.  No human-to-human transmission documented at \nthis time.\nReleased by Chairman Rand Paul\n671Jan. 6, 2020 – Chris and I went to a book party for our friend Ruth Marcus \n(Washington Post columnist), fo her book “Supreme Ambition” about Justice Brett \nKavanaugh.   Party at the home of David and Katherine Bradley at 2211 30th Street, NW.   \nElegant home.   Super A list at party: Senator Mark Warner, Kellyanne Conway, Andrea \nMitchell, David Ignatius, David Frum, Zeke Emanuel, etc., etc.  Rafe Sagalyn is Ruth’s \nagent and was there.   Also, ran into Sylvia Burwell.   Really great to see her. Realized \nhow much I miss working with her.  Nice evening. \nJan. 7, 2020 -   Just because of the sudden preduction of 1-3 inches of snow, OPM shut \ndown the USG at 1:00 PM and everyone rushed to get off campus at the same time that \nWalter Reed personnel are trying to leave.   This has created a total nightmare traffic jam \non campus.   It is taking almost 1 hour to get off campus from time you get in your car.\nDid TV interview with Canadian TV (CTV) on the viral outbreak in Wuhan, China.  \nDid interview (print) with HealthDay on the influenza season  \nJan. 10, 2020  (Friday)– Infleunza is hot and heavy.   Vaccine match is OK for H1N1, \nbut not so good for B and H3N2.   Did WUSA local TV on flu as well as interview with \nElizabeth Cohen of CNN that went on her blog with multiple references to our \nconversation.\nAppeared on Voice of America to discuss the new Wuhan virus documented to be a \nnovel coronavirus.  Interesting that ovewr the past several years we have had 3 emerging \nnovel coronaviruses that have caused serious disease in humans: SARS, MERS, and now \nthe Wuhan virus.\n \nChinese publish sequence of the virus on public data base\nJan. 11, 2020 (Saturday) – Barney Graham ordersd the constructs using credit \ncards.\nJan. 13, 2020 – Went to a function at the National Cathedral where David Rubenstein  \nwas interview in the naïve (similar to my interview a few years ago) by the Dean of the \nCathedral in association with David’s book – “The American Story”.  David was his \nusual hilarious self.\nJan. 14, 2020 –  Barney Graham’s team starts work on GMP vaccine in \ncollaboration with Moderna\n Did taped interview for the Islam Radio Breakfast Show about anti-vaxx movement.   \nVery good interview.\nAlso, did another interview with Eileen Reilly of Axios\nReleased by Chairman Rand Paul\n672Apparently, CDC is upset because I am saying that this is on a course to be as bad a year \nas 2017-2018 and 2014-2015.  In fact, the flu infection “numbers” are exactly on tract \nwith those years.   However, there are less total deaths and hospitalizations.   This is due \nto the fact that Influenza B has predominated early that this hits kids more severely.  \nSince the elderly account for most of the deaths and hospitalizations, the total of these are \ndown; however for this time compared to other years, the number of pediatric deaths is \nway up.   And so it depends what you mean by a ‘bad’ season.  I say it is a bad season \nand CDC says no. There was a discussion between Azar and Nancy Messonnier of CDC \nabout this and about my statements, but no one thought of getting me on the conference \ncall.   Not good.   Typical CDC!\nJan. 15, 2020 -  Did interview on WTOP Radio on the number of pediatric flu deaths.   \nI explained the issue of predominance of Influenza B and children and the poor match of \nthe vaccine to circulating virus with Influenza B Victoria.\nJan. 16, 2020 – The situation in Wuhan, China continues.   Now have 2 deaths and 2 \ncases in Thailand and 1 in Japan.   Was in on a PCC meeting via the NIH SCIF with the \nNSC chaired by Anthony Ruggiero.  CDC and DHS have decided to do entry screening at \n3 USA airport in people coming directly and indirectly from Wuhan: Kennedy in NYC, \nLAX, and SFO.   Tomorrow night at 10:00 PM a 747 from Wuhan will arrive at Kennedy \nand will be the first to get screened.\nnCoV_PCC_SOC_FIN\nAL.docx\nI appeared this evening on a PBS NewsHour segment on Ebola with considerable \nexposure in the piece.\nJan. 17, 2020 – appeared on radio with NPR “Here and Now” on the pediatric \nInfluenza B situation.   Influenza B predominating yet the Victoria B in the vaccine is \nonly a 58% match and so children are getting a double whammy with B \npredominating early in the year and continuing and the vaccine is not well matched.   In \nthis regard, there are more pediatric deaths (39) thus far at this point in the season \ncompared to most other years.   The infection slope is high for all infections yet the total \ndeaths and hospitalization are not that high, likely because there is little H3N2 and that is \nthe virus that affects the elderly the most and the elderly accound for most of the \nhospitalizations and deaths.\nJennifer Ashton of ABC World News Tonight called me in a panic about 15 minutes \nbefore she is to go on the air about the Wuhan virus (2019nCoV).   She wanted to get my \ntake on the airport screening and the potential seriousness of the situation.   I emphasized \nthat we need to take this seriously and the airport screening is entirely appropriate.\nWe are now doing entry screening at JFK, LAX and SFO of flights from Wuhan.   There \nare a couple of direct flights per week from Wuhan to JFK and SFO\nReleased by Chairman Rand Paul\n673Jan. 18, 2020 – Situation starting toheaten up re: 2019nCoV.  There are now 17 more \ncases in Wuhan and the LSTMH has estimated that there may actually be several \nhundreds of cases that have not yet been recognized.   It is starting to look like there is \nsome low grade close contact transmission person to person.   I appeared on CNN \nNewsroom with Fredricka Whitfield to discuss the 2019 nCoV situation and the recent \nscreening at 3 airports.\nJan. 19, 2020 – Things evolving rapidly with the 2019 nCoV.   Now there are 198 \nconfirmed cases, all in China except for 2 in Thailand and 1 in Japan.  Cases now in \nGuangdong Province with suspected cases in Beijing and Shanghai.  \nDid TV interview (pre-taped) for CNN International at 10:00 PM to be shown \ninternationally through the night and tomorrow,\nJan. 20, 2020 – Now there are >220 cases of n-CoV with a travel case in South Korea \nand 14 transmissions to health care providers.  Clearly, this is a rapidly expanding \nsituation with no question about person-to-person transmission.\nDid print interview for Caixin Media Company, which is the most influential political \nand business news organization in China.\nAlso did interview for CBS Evening News and for FOX 5 Local TV\nAlso, conversation with Elizabeth Cohen of CNN.  Problem with her is that she tends to \ndramatize things, which can get me in trouble not matter how many caveats I give her.\nJan. 21, 2020 – n-CoV situation continues to evolve.   Now 298 cases with 6 deaths.  \nVery fluid.\nDid ointerview with Eileen O’Reilly for Axios\nInterview with Chinese Radio Free Asia\nCDC announced today that the first case of n-CoV has been identified in Seattle.   A \n35 year old otherwise healthy Chinese man visited Wuhan, came to USA on January 15 \n(before airport screening), developed sxs on Jan. 16, tested on Jan. 19, test sent to CDC \nand positive on Jan. 20.   He walked into a clinical with fever and respiratory sxs and was \nsmart enough to mention that he just came from Wuhan.\nOther press today – VOA News; WSJ with Betsy MacKay; WCBS Radio; TV \nNewsMAX; TV FOX Business with Lou Dodd; Biocentury with Steve Usdin; \nBloomberg Law with Jeannie Baumann; Washington Times; Time Magazine (Alice \nPark)\nWe are having daily PCCs with Anthony Ruggierro.   He is his usual prickly self.\nReleased by Chairman Rand Paul\n674Jan. 22, 2020 – Now 400 cases and 9 deaths.  Chicago ORD and Atl airports added to \nentry screening with JFK, LAX, and SFO.   Soon to funnel all flights with people from \nWuhan (indirect) through these 5 airports.\nAnother PCC with Anthony being hostile that the orgs (CDC, DHS, CBP) have not \nworked out how to get 100% of people coming from Wuhan screened.  We are in Phase 1 \n(Screening at JFK, LAX, SFO).   We are almost fully ready for Phase 2 (add ORD and \nATL).  Phase 3 is to funnel people who originate at Wuhan and want to go to USA \nthrough one of the 5 airports.  Phase 4 is to screen individuals coming from many cities in \nChina.   Big argument between CDC (Redfield) and CBP/DHS regarding have 5 versus \n12 USA airports do the screening.   Marty Cetron was trying to explain how difficult \ndoing 12 USA airports would be since CDC does not have staff in a few of these cities.\nTo complicate it all, while we were in the PCC, China announced that it is cutting off all \npublic transportation  (air, ferries, train, buses, out of Wuhan City)  Essentially a \nquarantine of the entire city of 11 million people except for absolute emergencies.   This \ncomplicates the USA airport screening strategy since people will not be able to get out of \nWuhan and to the USA easily. May try other means.   Some confusion about what the \nbest way to prevent establishment of infection in the USA.   Anthony (with his attitude) is \nmaking matters worse.   \nPhase I—Current Posture\n•Description: Foreign nationals who have been in China within 14 days prior to their \nactual or attempted entry into the United States are ineligible for admission under \nSection 212 (f) of the Immigration and Nationality Act (INA).  Departments and \nagencies may exercise certain exemptions.  Any person, but specifically U.S. \ncitizens and legal permanent residents (LPRs) who have been: (1) in Hubei \nprovince within the past 14 days may be subject to 14 day mandatory quarantine; \nand (2) in China (outside Hubei province) within the past 14 days may be subject \nto screening and self-isolation for 14 days.  All direct and indirect flights from \nChina are funneled to 11 airports with enhanced CDC medical screening.  CDC is \ncoordinating with state and local health care clinicians to identify domestic cases, \nisolate cases, and conduct appropriate contact tracing.\noTriggers: Already being implemented.\n•Objectives: (1) Contain the outbreak at its source, (2) minimize domestic \nimportation of additional cases, (3) limit potential for domestic epidemic, and (4) \nprepare the domestic response mechanisms.\n•Messaging: Daily HHS and CDC briefings and on camera task force briefings as \nappropriate.\nOn the interview below (FOX Business with David Asman) one of the panel asked me to \ncomment of a clip he played where Trump said that everything is under control.   Xi \nJinping told him everything is under control.   I had to answer that we are taking this very \nReleased by Chairman Rand Paul\n675seriously and that Americans should not be frightened or worry, but we are taking it \nseriously.   Let us see if this pits me against the POTUS.\n552 cases – 17 Deaths   Cases now in Hong Kong and Macao\nWTOP Radio on Seattle case;  The Morning Goods (local radio talk show); TRT \nWorld Turkish TV; Reuters TV; Fox Business (Cavuto); Bloomberg print; FOX \nBusiness with David Asman; Italian TV (Mediaset);  Taped CNN in the VRC \ntalking about the vaccine; Hong Kong Phoenix TV; Univision TV (Spanish-\nAmerican TV); Bloomberg TV Asia; 24 NEWS Israeli TV over the phone\nJan. 23, 2020 – China shuts down public transportation in 3 additional smaller cities – \nHuanggang, Ezhou and Chibi.  \nAfter 2nd Advisory Committee meeting WHO still does not declare PHEIC.   Very \ncontroversial decision.   They are getting some criticism about this.   On several of the \nmedia that I did (see below) I was asked my opinion of this.   I said I did not want to \noutguess the WHO and demurred.\nPress still heavy.   Did FOX Business TV (Varney and Company); FOX News \n(Sandra Smith); CBS Radio;Shanghai Media TV via Skype; Politico (Sarah \nOwermohle); Shanghai Media TV; Science News print; CNN Newsroom (clip shown \nby Sanjay Gupta); FOX News Rundown (Radio); COX Media TV; John \nCatsimatidis Radio Show – Cats Roundtable; CNBC Asia Squawk Box; BBC radio; \nFOX Business News (Lou Dobbs);Canadian Broadcasting System (Kelly Crowe).\nJan. 24, 2020 – More cities shut down by the Chinese.   Now >800 cases and 26 deaths.  \nState Department issued Level 4 (no travel at all) for Wuhan.\nHad meeting at EEOB381 (Anthony’s office) to discuss the evolving siautaion with \n2019-nCoV.  Derek Kan (Deputy Director, OMB) was there with other OMB folks to \ndetermine what the budgetary needs would be for our response.   I will put together some \nbudget numbers.  I was supposed to be on this coming weekend (it is now Friday) This \nWeek With George Stephanopoulos and Face the Nation; however, these were bumped \nbecause of impeachment trial that is onging.   \nCall from Lena Sun (Washington Post) trying to verify (I said I knew nothing of this) \nthat people in the USG were saying that the Chinese got to Tedros to convince him not to \ndeclare a PHEIC since it would harm their reputation.   I told her that was nonsense and I \nprobably stopped her from writing the story.   She said since I am in all the important \nmeetings that I would know.\nCNBC Squawk Box; CBS Radio New York;  Massive press interactions prior to and \nafter my briefing of the Senators;  Clip of me on CBS This Morning from the \nbriefing\nReleased by Chairman Rand Paul\n676Jan. 25, 2020 – now more than1400 cases and 42 deaths.   President Xi Jinping \nessentially sutting down the entire country.   Schools closing in Beijing.   Suspicion that \nthe Chinese are telling us everything that is going on in China.   Why are the Chinese \nreacting so dramatically by essentially shutting down the entire country?\nState Department evacuating all USA personnel from consulate in WUHAN\nNew York Times interview; CNN International\nJan. 26, 2020 – GAME ON!!!   Things are changing rapidly.  Dr. Ma Xiaowei, the \nChinese Minister of Health gave a press statement saying that the incubationperiod of \nnCoV is 1 to 14 days and that the virus is being transmitted when people are \nasymptomatic!   This has enormous implications for how we handle people from Wuhan \n(like our diplomats who are now on the way back from WUHAN, having been ordered to \nevaculate).   Should we quarantine them.   I am very skeptical about the Chinese \ninterprepation of their data.  I spoke with Mike Ryan (WHO) from Geneva and he and \nTedros are going to Wuhan soon.   Mike is very skeptical that aymptomatic spread is \npresent or at worst is a major driver of spread.   Mike Osterholm also feels this way.  \n    I spoke with Nancy Messonnier and Bob Redfield this AM to coordinate our \nresponses.   Bob and I feel (and I told Elizabeth Cohen this) that we should be allowed to \nsend our CDC epidemiologists to China to work with them so that we see the data first \nhand since we will base important response activities and strategies based on whether this \nis true.   It would require our quarantining for a period of time even asymptomatic people \nwho arrive from Wuhan.\nIt now appears using epi data and genomic data that the first infection was in early \nDecember and was not connected to the market.   The infections spread among people \nweeks before the Chinese reported that they were dealing with a new infection and that \ngave the virus time to establish itself in multigenerational (sustained) spread.   \nRemember, early on the Chinese were saying that there is no human to human \ntransmission and all the original 27 cases were from the market.   Now we know the \nmarket was not the source, it was the amplifier.   Having said that, somewhere the virus \njumped from animals to humans.\nThere is complete chaos in China now with president Xi Jinping declaring an emergency \nsituation.   The Chinese are building within days 1000 and 1300 bed hospitals and flying \nin hundreds of medical personnel from military.  They have shut down travel within most \nof the country and have called off many Lunar New Year events.   Schools closed at least \nuntil mid-February.   Running out of supplies such as PPE.\nHad 8:00 PM call with Anthony Ruggiero, Phil Ferro, and Bob Redfield about the \nevolving situation.  The deputiers and White House are pushing to close the borders for \nany traffic from China.   Bob and I are against that.   Anthony said that he heard that I wa \nin favor of that.   Will have 11:00 AM meeting tomorrow from SCIF with Deputy \nNational Security Advisor Matthew Pottinger regarding possibly closing borders from \nChina entry.\nReleased by Chairman Rand Paul\n677CNN phone interview with Elizabeth Cohen; CBC Canadian TV; CNN with \nFredricka Whitfield (cancelled because of tragic accidental death of Kob Bryant in \nhelicopter crash in LA); NewsHour from UK\nJan. 27, 2020 – Packed day today.  Council and multiple important non-corona-virus \nmeetings.\nBusy day – two meeting with White House via SCIF.   First at 11:00 AM led by Deputy \nDirector NSC Matt Pottinger who still wants to stop all incoming from China.   Bob \nRedfield, Phil Ferro, Mart Cetron, Peter Marks etc.\nSecond White House meeting via SCIF was on same subject withMick Mulvaney \nChairing and visit to meeting by VP Pence. Still discussing the pros and cons of shutting \noff China.   I tried to squeeze in my opinion, but it was touch since I was remote.   I \nbriefed Azar beforehand by phone as to the down side (historically) in shutting out a \ncountry.  Also at the meeting were Joe Grogan, Matt Pottinger, Alex Azar, DHS\nMultiple print media including Washington Post,  Maggie Fox, Los Angeles; NPR \nMorning Edition with Rachel Martin; WTOP radio; John LaPook with CBS – \ntaped interview to run with face to face interview tomorrow with Norah O’Donnell; \nVOA; CNN International; Bret Baier FOX; WTOP again; Sean Hannity (FOX);  \nJan. 28, 2019 – Big day at White House.   Major discussions at Deputies on how to \nhandle the 200 US Citizens (diplomats and families and  others) who are being air-\nevaculted form Wuhan.   They are on a plane from China to Alaska to California.  \nConcern about whethernor not to quarantine them for 14 days when we did not and do \nnot quarantine Chinese who pass screening on entry.   Marty Cetron had argued that the \nAmerican were very recently in the “hot zone” whereas the chines who are coming in \nnow are not really coming from Wuhan since Wuhan has been shut down by the Chinese.  \nAlso, political concern of what it looks like to quarantine or “imprision” US citizen \nversus what happens if we let them in and they start infecting people.   Finally decide to \ndo a sft verion of bringin them in to a military airbase – the March Air reserve Base in \nRiverside County. CA, and consider them all not a low risk.   They are either medium or \nhigh risk based on their exposure.   They all will be tested (nasal swab PCR) and detained \nat the base for up to 72 hours until the tests come back and then released.   The “high” \nrisk people majr get more intense investigation Discussed for hours in the Situation \nRoom.  The meeting was chaired by Mick Mulvaney and most Deputies were present \ntogether with Matt Pottinger, Kellyanne Conway, Ken Cucinelli, Dr. Navarro, Biegun, \nBlair, Eisenberg, Szabat, Lidell, Foret (CBP)John Wilson, John Mark (?).\nChinese scientists are saying that the epidemic is much worse than is being reported.   Dr. \nYuan say that 50% of the infections are asymptomatic.   However, this is confusing \nReleased by Chairman Rand Paul\n678people since he does not say what percent of these are spreading while asymptomatic.   A \nlot of confusion and misinformation while the outbreak accelerates.\nAzar wanted the POTUS to be briefed by me in the Oval office after the Sit Room, but a \nfluke prevented this.   Brian Harrison called me into a side room for a few questions and \nAzar was looking for me and could not find me and so he and Redfield went to the Oval \nwithout me.   Innocent screwup.\nPress conference with Azar – multiple media reporting with several clips of me; Lou \nDobbs FOX; Marc Siegal FOX; CBS This Morning;\nJan. 29, 2020 -  Got a call this AM from Lou Dobbs who told me that President Trump \nwill be calling me.  Lou spoke with the POTUS andf told him that I was the “smartest \nperson” around  and he should speak with me.\nAmazing day today!  \nBob Kadlec, Bob Redfield, Karin King (State), Ken Cuccinelli (DHS), Jonathan Fritz \n(State) briefed the House members led by Nancy Pelosi who was her usual self with me \n(big hug, kiss and telling everyone how great I am -  little embarrassing.   Diane DeGette \ndid the same thing.\nAt the Deputies Meeting in the Situation Room (4:00 to 5:15 PM) – big surprise.   Mick \nMulvaney led the meeting and after about 1 hour the President came in and the first \nthing he said as he looked at me was: “Anthony, you are really a famous guy.   My good \nfriend Lou Dobbs (see above) told me that you were the one of the smartest, \nknowledgeable and outstanding persons he knows.   He then stayed for 20 minutes and \nasked most of his questions of me.  I was surprised and very pleased and the Deputies \nwere clearly stunned and impressed.   When Trump finally left, he said: “Anthony, are we \nOK?”   I said: “We are good”.   He smiled and as he walked out of the room, he said \n“Thanks, again, Anthony.   We are counting on you”. \nThe arrival of the US passengers at March base was a total success.  They arrived on a \nKalitta Air Boeing 747.(NPR)   The passenegers were extatic to be home.   The real issue \nnow is how do we get out the 200,000 US citizens who are in China if they want to leave.   \nIt will be a logistical challenge.\nCases 7700 with 170 deaths\nReleased by Chairman Rand Paul\n679Clips of HHS press conference showing on different TV networks; NPR “On Point”;\nJan. 30, 2020 – Another amazing and difficult day.  Briefed the House Energy and \nCommerce Committee members in Rayburn 2123.   All my friends kept saying I was a \nnational hero and they “….felt safe in my arms (Eschoo)”.   Testifying with me were Bob \nredfield, Bob Kadlec and denise Hinton (FDA).\nThe chaos:   We had 2 PCCS led by Ruggiero and one Deputies lead by Mick Mulvaney \nwith the usal cast of characters.   Case in point.  Mart Cetron who was listening in on the \nWHO call said that the epidemic was accelerating that this is was clear that the \nincubation period was shorter (2-5 days than was previously felt and that asymptomatic \ntransmission was occurring.   Thus, it was agreed to present to the POTUS a revised plan \nfor containment:   The 200 people at March Base would be quarantines for 15 days.   \nAnyone coming in from Wuhan would be quarantined for 15 days.   Anyone from any \npart of China would be voluntarily isolated for 15 days with monitoring by public health \nofficials (State/Local).      Azar would declare a Public Health Emergency and the State \nDepartment level alert would be level 4.\nThe number of cases today are: 9480 with 213 deaths.   It is increasing by about 25% per \nday.   In 1 month it has surpassed SARS for 1 year (8000).\nWHO Declares a PHEIC\nPolitico (Dan Diamond) is coming out with an article bashing badly Azar.   HHS COMS \nhad me speak to Dan and I greatly praised Azar.\nThe POTUS announced the Coronavirus Task Force today (see below):\nMembers of the President’s Coronavirus Task Force:\nSecretary Alex Azar, Department of Health and Human Services\nRobert O’Brien, Assistant to the President for National Security Affairs\nDr. Robert Redfield, Director of the Centers for Disease Control and Prevention\nDr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases \nat the National Institutes of Health\nDeputy Secretary Stephen Biegun, Department of State\nReleased by Chairman Rand Paul\n680Ken Cuccinelli, Acting Deputy Secretary, Department of Homeland Security\nJoel Szabat, Acting Under Secretary for Policy, Department of Transportation\nMatthew Pottinger, Assistant to the President and Deputy National Security Advisor\nRob Blair, Assistant to the President and Senior Advisor to the Chief of Staff\nJoseph Grogan, Assistant to the President and Director of the Domestic Policy Council\nChristopher Liddell, Assistant to the President and Deputy Chief of Staff for Policy \nCoordination\nDerek Kan, Executive Associate Director, Office of Management and Budget\nPRESS: FOX – “Fox and Friends”; ABC TV local; NBC TV local; PBS NewsHour; \nWTOP radio X2\nJan. 31, 2020 – Another truly amazing day.   Sequested in the White House essentially \nall day working out a proposal to put before the POTUS that would restrict travel from \nChina.  The proposal was driven largely by CDC (Marty Cetron) who felt that given the \nvolume of people coning in from China by direct and even more importantly indirect \nflights it would be logistically impossible to effectively screen people at many, many \nairports and the diversion of people from their place of origin to selective airports would \nfurther complicate things.   Also, the cases continue to sharply rise with 12000 cases and \n259 deaths.   Also, a NEJM report from Germany indicated that a Chinese woman came \nfrom Shanghai visited a colleague in Stockdorf Bavaria.  She infected him when she had \nno sxs, returned to China and got sik on the plane.  The german man then got sick and \ninfected 2 other Germans.   This would have bn the first truly documented case of \ntransmission from an asymptomatic person, thus, adding to the concern about the \naccuracy of screening at airports.  In addition, the WHO declared a PHEIC yesterday \nprompting Azar to declare a Public Health Emergency here in the USA.   I disagreed with \nthe latter since there were only 7 infections (6 travel) at the time.   All this led to the \nconclusion of travel restriction.   This was late in the afternoon  - around 1:30-2:00 PM.   \nThe entire task force (above) plus Kellyanne Conway, Jessica Zitto (WH Coms) and a \nvariety oof senior WH officials gatherd in the Roosevelt Room to hammer out how we \nwould present this to the POTUS.   The policy decision was:  1) Ban travel to the USA of \nall non-citizens who have been to China within the past 14 days.   If you were in China, \nyou need to go somewhere else (Paris, UK, etc.) until 14 days pass from the time you \nwere in China. 2) If you are a citizen and were in the Hubei Province (includes Wuhan) \nReleased by Chairman Rand Paul\n681and you return to USA, you are institutionally quarantined for 14 days. 3) If you come \nfrom any other part of China other than Hubei, you have voluntary isolation for 14 days.\nWe wanted to present this to the POTUS befor the Stock Market closed so that we do not \nlook like we held off to avoid bad effects.   We went into the Oval Office at about 3:00 \nPM.   We had been scheduled to go in at 2:30 PM but things backed up.  Presentation was \nmade to the POTUS by Azar, Bob Redfield and me.   Trump as he did a couple of ddays \nago posed many questions to me making sure that I thought it was a good idea.   I said \nthis was an imperfect process, but the best choice we have right now.   He questioned me \nabout what the difference was between this and flu.   He somewhat brashly suggested \neven more stringent restrictions and was dyswaded by Kellyanne.   She clearly has \ninfluence over the POTUS.\nPotus agreed and we immediately went out to the WH Press Briefing room that was \npacked.   Azar led the presentation, but many questions were ansered by me.   Interesting \nthat impeachment was going on and the senate did not get the 4 GOP votes to allow \nwitnesses to be called.   This also dominated the news.   We thought this would get us on \nthe Sunday Talk Shows, but impeachment bumped us.  White House is now fully \nconvinced that I be the science/health spokesperson for the USG.   Bob Redfield just does \nnot come across very weel.   He takes forever to say something and it is usually \nwondering.   This drives the WH and HHS comms people crazy and so they are putting \nme out on all the requests.\nWhen I got back to my office, got call from Jeremy Farrar who sounded very concerned \nand conferenced me in with Kristian Anderson, an evolutionary biologist from Scripps.  \nThey had also been talking with Eddie Holmes, another evolutionary biologistfrom \nSidney Australia.   There have been conspiracy theories that the virus was given GOF by \ninserted mutations and deliberately or accidentally released in Wuhan.   One theory was \nwritten by Indian investigators that HIV sequences were inserted by a Chinese person in \nCanada and released in Wuhan.   Everyone thinks that is crazy, but the Farrar phone call \nwas different.   The people on the phone felt that the mutations around the furine \ncleavage site of the spike protein could not have occurred naturally since it would require \nan evolutionary “jump that they found nowhere in bat isolates.   They bring up the \npossibility that this could have been deliberately inserted and either accidentally released \nor deliberately released by a crazy person in the lab, the former being the most likely.   \nJeremy was calling me for advice.   I suggest that we get a larger group of qualified \nevolutionary biologists/virologists together under the auspices of a convening body and \ncarefully look at this.  We agreed to convene by phone the next day.   I called Brian \nHarrison and Garrett Grigsby who arranged for a call with Azar to decide what to do.   \nReleased by Chairman Rand Paul\n682Azar did not like the idea of WHO as convener because he feels (somewhat unfairly, I \nbelieve) that Tedros would immediately tell the Chinese and they would crush the \nattempt and/or think we are attacking them.   We decided to have a 2-pronged approach \nstrongly suggested by Kadlec who felt we had security responsibilities to investigate this \nourselves.  He would do this through OSTP and NAS.   Meanwhile I would pursue a \nmultinational approach with Jeremy.   I decided to now bring in Francis.\nPRESS: The Today Show NBC; Lou Dobbs Fox; many print\nFeb. 1, 2020 -  Conference call at 2:00 PM with Jeremy, Francis and several other \nscientists gathered by Jeremy (see below).\nParticipants in the Feb., 2020 call included:\n•Francis Collins, Director of the U.S. National Institutes of Health, U.S.;\n•Anthony Fauci, Director of the U.S. National Institute of Allergy and Infectious \nDiseases, U.S.;\n•Jeremy Farrar, Director of the Wellcome Trust;\n•Patrick Vallance, U.K. Chief Scientific Adviser and Head of the Government \nScience and Engineering; \n•Kristian Anderson, Director of Infectious Disease Genomics, Scripps Research \nTranslational Institute, CA, U.S.; \n•Christian Drosten, Director of Human Virology at the German Center for \nInfection Research at Charité – Universitätsmedizin, Germany; \n•Edward Holmes, Professor of Viral Evolution at University of Sydney;  \n•Andrew Rambaut, Professor of Molecular Evolution, University of Edinburgh’s \nInstitute of Evolutionary Biology, U.K.; \n•Ron Fouchier, Deputy Head of Department of Viroscience, Erasmus Medical \nCenter, NL; \n•Robert Garry, Professor of Virology, Tulane University School of Medicine, \nLouisana, U.S. ;  \n•Mike Ferguson, Professor of Life Sciences at University of Dundee, U.K.; and\n•M.P.G. Koopmans, Head of Department of ViroScience, Erasmus Medical \nCenter, NL.\nThere was not total agreement about the likelihood of deliberate insertion.   Ron Fouchier \nsaid he was sure that this could occur naturally and we should not waste our time and \ndivert effort to pursue this.   This is expected of him since he was the original GOF \nperson with Yoshi Kawaoka.   Also, Christian Drosten was with Ron; the rest felt that \ndeliberate insertion was possible and given the fact that Dr. Zheng-Li Shi  at the \nUniversity of Wuhan has been working for years in GOF in coronaviruses to allow \nadaptation of the spike protein to bind to the human ACE2 receptor, we could not let this \nReleased by Chairman Rand Paul\n683go.  We decided to have Jeremy with Francis to contact Tedros with Stewart Simonson’s \nhelp (I arranged this) to see if Tedros would convene experts.\nMeanwhile, the DHS and DOT and FAA are working hard on the logistics of diverting \nplans to selected airports that are associated with the capability of screening with \nquestions and quarantining or moving to voluntary isolation.\nAirports are: LAX, SFO, Seattle, ATL, ORD, Hawaii, Newark, IAD, Detroit, DFW\nJFK, and Seattle\nPRESS:  CNN (truck came to my house since I was so busy with wall-to-wall \nconference calls and hundreds of e-mails.; \nFeb. 2, 2020 – Call from Sylvia Burwell asking for clarification of the new policy \nregarding AU students who are returning fom China.   Apparently, the policy is not up on \nthe CDC website.\nHad daily Task Force call.  Discussed the difficult logistics of airport funneling and \nquarantine/isolation at land crossings with Canada and Mexico.\nCases now 14,551 and 304 deaths\nNow 3 aditional cases in USA = 11\nKansas City Chiefs beat SF  49ers – Patrick Mahomes stars abd comes back from 10 \npoint deficit in the 4th quarter.\nPRESS:  MSNBC; Fox Local TV; NBC Nightly News; CNN with Anna Cabrera\nFeb. 3, 2019 – Task Force meeting daily.    Repatriated people from Wuhan 150 tested \nnegative; no positives thus far.  Cases = 17,205 with 361 deaths; 26 countries have 180 \ninternational cases and within that there are 20 human to human transmission \ntransmissions with no sustained transmission yet.\nComplicated issue with border crossings of Chinese at Canada and Mexico. Many come \nover, but screening capabilities are not like we have at airport.\nTravis AFB, Miramar, Lackland AFB are landing destinations for US Citizens coming \nfrom Wuhan so that we can implememnt institutional quarantines and medical care if \nneeded.\nSpoke with George Gao tonight in China.   George is the Director General of the Chinese \nCenters for Disease Control and Prevention.   He confirmed that infected people can be \nasymptomatic and that asymptomatic people can transmit.   This is important since the \nrecent NEJM paper that said that a Chinese woman who went from Shanghai to Germany \nand infected a business associate while she was asymptomatic was in fact mildly \nReleased by Chairman Rand Paul\n684symptomatic and so the NEJM paper is incorrect.   However, the fact is still true.   Also, \nGeorge was very sensitive and understandably defensive since he was the one who said \nearly on that there was no human to human transmission and that the original 27 cases in \nthe wet market reported on December 31, 2019 were animal to human when actually \nhuman to human transmission was occurring weeks before.   The Wuhan health officials \ndid not tell him this and he thus gave out false information.   This lapse likely allowed the \noutbreak to take hold since Wuhan went about their business with 40,000 pot luck \nfestivals without social distancing.\nFailure of HIV vaccine trial HVTN-702 (Uhambo) conducted in South Africa  >5000 \nparticipants showed no efficacy at all.   DSMB stopped trial due to futility\nPRESS:  WTOP Radio; CNBC; TRT Turkish TV (x2); CGTN Chinese TV; On \ncamera interview with Jennifer Ashton in VRC – ABC News; Lou Dobbs FOX \nNews.\nJan. 4, 2020 -  20,680 cases and 27 deaths.   No sign of diminishing.   We are hearing the \nobvious conflicting opinions of the benefit or harm of travel restrictions.\nA lot of interest in the revealing that the NEJM paper claiming in one Chinese to German \ntransmission that it was symptomatic transmission, when it probably was not.   I quoted \nthat paper (now flawed) in the WH presser.\nOne death in Hong Kong (total of 2 with Phillippines for non-China deaths)\n20,680/426 – 2% mortality\nContinuing to evacuate USC from Wuhan.   4 individuals from Hubei Province under \nquarantine (2 LAX, 1 ORD, 1 NY)\nChinese officials criticizing USA for travel restrictions.  WHO also adding muted \ncriticism.\nGot urgent e-mail from Lindsey Baden from NEJM to review in 2 hours a pape from \nGermany showing that an asymptomatic person can harbor replication competent virus in \nnasal passages.\nState of the Union address tonight and vote on conviction after impeachment tomorrow – \nweird!\nPRESS:  Bloomberg Radio;Vox print; Marc Siegal Doctor Radio – Sirius; NPR – \n“All Things Considered”- Richard Harris; Good Morning America – ABC;  Yahoo \nFinance TV; NY Times – Roni Caryn Rabin; Reuters print; Israeli TV – i24 LIVE; \nPicture in Washington Post; BBC Radio interview\nReleased by Chairman Rand Paul\n685Feb. 5, 2000 – Spenty the day on the Hill as part of the President’s Coronavirus Task \nForce led by Alex Azar and Mick Mulvany to brief first the Senators in the Dirksen \nBuilding led by Lamar Alexander and Patty Murray and then the House led by Rosa \nDeLauro and Tom Cole in the Capitol Visitor’s Center.  Also, spent time in the SCIF \nplanning for tomorrow when we may be briefing the POTUS again.\n25,000 cases/479 deaths.\nPresident was acquitted today by the Senate on a partisan vote.\nMuch print press about every aspect of nCoV, particularly the controversy about \nasymptomatic transmission. In the Washington Post today, Nancy Pelosi, when asked \nwhether she feels the administration is doing a good job, said the following:\nPost – Feb. 5, 2020:\nExiting the briefing, House Speaker Nancy Pelosi (D-Calif.) praised Anthony \nFauci, director of the National Institute of Allergy and Infectious Diseases who is \nalso on the administration task force, saying she had worked with him for years. \nFauci was among those briefing lawmakers on Wednesday.\n“He has confidence in what is happening at CDC, so again, my confidence is in \nhim,” Pelosi said. “I think we have to be appropriately alert but not \nfearmongering on this, and I think that’s the right tempo.”\nAsked about Azar’s leadership, Pelosi said: “I don’t know that much about Azar \nbut I know Fauci. All I know about Azar is he used to work for a pharmaceutical \ncompany. I don’t know that much about his experience with disease but Dr. Fauci \nis a doctor, and this is his life’s work.”\nTragic news – Eric Scorce (my nephew) found dead in his apartment.   Likely \nsudden heart attack.\nPRESS:  KCBS Radio – San Francisco; MSNBC; Radio Free Asia (TV); Wed MD; \nWashington Post\nFeb. 6, 2020  - Cases continue to soare with 28,018/563.  Another packed day mostly at \nHHS and White House.   Conspiracy theories still abound.   The NAS group with OSTP \nmet (see above) and decided that there was no clear evidence of malfeasance, but it \nshould be looked into (see attachement below):\nNASEM Response \nto OSTP re Coronavi   \nReleased by Chairman Rand Paul\n686Briefed the Asia/East Asia Ambassadors on nCoV in Room EEOB-350. Then had long \nmeeting of Coronavirus Task Force is Sit Room of WH chaired by Mick Mulvany at \n4:00- 4:45PM when the core group of Task Force were called to Oval Office to brief \nPOTUS.   When we walked in the POTUS was not yet in the room.   When he walked in \nwith Melania, the first thing he did was say“\"Anthony, come here and say hello to \nMelania”.   Then, to my embarrassment in front of everyone (Kellyanne, Mick, Bob \nO’Brien and many in Cabinet) he told Melania that I was the smartest person in the \nworld.   We then sat down and briefed him and Melania.  He asked what he could do and \nwe said that since he would be calling Chinese President Xi Jinping late this evening, he \ncould ask him to approve the WHO delegation of scientists that include CDC and NIH \npeople.   He did what he did last time and directed most of the questions to me, again \nending with asking me if I thought that we were on the right track.\nDuring the task Force meeting, the issues came up of cruise ships (one in Yokohama, \nJapan, and one in New Jersey/New York) that had infected Chinese from Wuhan on them \nand discussion of how to handle quarantine for the rest of the passengers. \nPRESS: India TV; Podcast with Newt Gingrich; Podcast with Howard Buchner at \nJAMA (well-received by NYT and WSJ reporters.\nFeb. 7, 2020 – Started with 7:00 AM with a multi-party call hosted by WHO.  Got good \ninformation. See below.\n31,211/637.  61 infections on Japanese cruise ship. Chinese are starting to see a slight \ndowntrend in cases.   Perhaps we are turning things around in China?   I warn on the call \nthat we need to give developing countries the resources to do contact tracing and isolation \nor else as we decrease China, another country will become like China.   Also, need \nserologies to determine extent of asymptomatic and minimally symptomatic infection so \nthat we can determine the true case fatality rate among other things.\nCancelled trip to Florida for Chris’s birthday.  So sorry.\nPRESS: Press conference at HHS with Azar, Redfield, Cuccinnelli, Biegun, Szabat; \nCNN; interviewed with: USA Today,   Bloomberg Law (Jeannie Beaumann), \nArizona republic, NY Times (Denise Grady), Bloomberg News (Bob Langreth; \nWJLA TV ABC7 (Local); CNN with Lou Dobbs.\nFeb. 8, 2020 – Numbers today: 34,867/724.  First USCit died in Wuhan.   Much press \nabout this and the cruise ships in Japan and Bayonne.   Infections and quarantine of the \nJapan ship (61 so far, including some USCits.  10 people under quarantine from airport \nscreening at the 11 airports.   People on Japanese ship getting cabin fever with \nReleased by Chairman Rand Paul\n687quarantine.  People on Bayonne ship have all been released and the Chinese nationals on \nthe ship are going home.\nTom Frieden called me this AM and we discussed various aspects of the outbreak.   He \nand I are on the same page in thinking tht this is acting like a bad influenza in its \ntransmissibility and that the denominator is much greater than 34,867 (above) making the \ncase fatality rate (CFR) more like 0.2-0.3 % rather than 2.0%.\nPRESS:  FOX and Friends; WTOP Radio; MSNBC\nFeb. 9, 2020 – Sunday, but it goes on.   37,593/814.   People on the Japanese cruise ship \nare being released from quarantine.  Outbreak still raging in China.   Still only 12 cases in \nUSA (9 travel from Wuhan and 2 spouses of 2 of the 9).\nBriefed the Governors at the Governors convention at the DC Convention Center\nPRESS:  CNN International (good interview)\nFeb. 10, 2020 – 40,625/910.   Outbreak still progressing.  I will list below the quarantine \ncenters associated with the various funneled airports:\nJB Pearl Harbor-Hickam, Hawaii (HNL)\nGreat Lakes Training Center Navy Base, Illinois (ORD)\nNaval Air Station Joint Reserve Base, Texas (DFW)\nMarch ARB, California (LAX)\nTravis AFB, California (SFO)\nDobbins ARB, Georgia (ATL)\nFort Hamilton, New York (JFK)\nNaval Base Kitsap, Washington (SEA)\nJoint Base Anacostia, Washington DC (IAD)\nJoint Base McGuire-Dix-Lakehurst, New Jersey (EWR)\nFort Custer Training Center, Michigan (DTW)\nReleased by Chairman Rand Paul\n688The Department of Defense already has quarantine centers at Fort Carson in \nColorado, Travis Air Force Base and Marine Corps Air Station Miramar in \nCalifornia, and Lackland Air Force Base in Texas.\nKen Cucinnelli sends e-mail to Task Force saying that we should be much more \naggressive in “mitigation” right now and not wait until outbreak in USA occurs.  \nThis triggers calls at HHS since it might look like HHS is not doing things \ncorrectly.   Had a vigorous Task Force call at 4:00 PM to discuss merssaging and \nthe fact that we need to prepare for mitigation.   Ken Cuccinelli wants to prepare \nfamilies and businesses to how they would respond to an outbreak.   I pushed back \nsaying that my experience with anthrax and the “duct tape” incident made me feel \nthat this would inspire unnecessary panic or ridicule.   We should prepare more \nforward-looking at the state and local health levels, not the family level.\nInfections on the Japanese Cruise ship up to 136.   Sick people taken off and rest \nquarantined on ship.   Question raised whether aerosol spread through ventilation \nsystem similar to spread of SARS in 2004 in Amoy Garden Apartment Complex \nin Hong Kong.\n97 people die in China yesterday – most for a single day.\nCDC wants the airlines give them the contact information of passangers so that \nthey can be tracked.\nBob Redfield having trouble clearly articulating the process of converting from \ncontainment to mitigation.   He is a good guy, but Bob is Bob.   Azar/HHS/and \nWH are all putting me out there to explain things within our group and to the \npress.   Bob seems OK and modestly wants to learn.   I like him.\nPRESS: CNN (Jim Sciutto); Diane Rehm Podcast; Sean Hannity Radio Show; \nCNN International.\nFeb. 11, 2020 – 13th American infected (San Diego).   One of the people air-\nevacuated by State to Miramar from Wuhan.   Minimal sxs.\n43,138/1018\nBob Kadlec offers the Japanese help in providing remdesivir in a compassionate \nuse protocol to the people on the Diamond Princess cruise ship in Yokohama.   \nReleased by Chairman Rand Paul\n689Now 131 people infected and the rest are quarantined.   I offer Cliff Lane to help \nwith the protocol.\nA PCC document that I just read is proposing that even in Phase IV (see below) \nwe should continue INA 212 (f) travel restrictions.   I disagree with this since \ntravel restrictions are to delay the entry of disease into your country.   Once you \nhave sustained transmission in your country, it is a waste of resources to try to \nkeep out travelers.   I cannot be on the PCC call this AM (on a panel at the Aspen \nInstitute in DC) and so I called Bob Redfield and asked him to respresent me and \nmy reservations about this:\nPhases of U.S. Government Response to the 2019 Novel Coronavirus (2019-nCoV)\nPhase I—Current Posture\n•Description: Foreign nationals who have been in China within 14 days prior to their \nactual or attempted entry into the United States are ineligible for admission under \nSection 212 (f) of the Immigration and Nationality Act (INA).  Departments and \nagencies may exercise certain exemptions.  Any person, but specifically U.S. \ncitizens and legal permanent residents (LPRs) who have been: (1) in Hubei \nprovince within the past 14 days may be subject to 14 day mandatory quarantine; \nand (2) in China (outside Hubei province) within the past 14 days may be subject \nto screening and self-isolation for 14 days.  All direct and indirect flights from \nChina are funneled to 11 airports with enhanced CDC medical screening.  CDC is \ncoordinating with state and local health care clinicians to identify domestic cases, \nisolate cases, and conduct appropriate contact tracing.\noTriggers: Already being implemented.\n•Objectives: (1) Contain the outbreak at its source, (2) minimize domestic \nimportation of additional cases, (3) limit potential for domestic epidemic, and (4) \nprepare the domestic response mechanisms.\n•Messaging: Daily HHS and CDC briefings and on camera task force briefings as \nappropriate.\nPhase II—Aggressive Containment\n•Description: Expand the scope of the travel ban to account for additional states or \nterritories.  Apply quarantine measures above to people not covered by the travel \nban, including U.S. persons, but who have traveled to these additional states or \nterritories within the time frames described above.  All direct and indirect flights \nfrom these additional states or territories will be funneled to the 11 airports with \nenhanced CDC medical screening.  Consider reducing the number of airports to \nconcentrate screening resources. CDC further coordinates with state and local \nhealth care clinicians to identify domestic cases, isolate cases, and conduct \nappropriate contact tracing.\noTriggers: Sustained human to human transmission and exportation of cases \nwithout nexus to China.\nReleased by Chairman Rand Paul\n690•Objectives: (1) Limit the outbreak to the source and additional outbreak areas, (2) \nminimize importation of additional cases, (3) limit potential for domestic epidemic, \n(4) additional preparation of the domestic response mechanisms and in some cases \nexecuting those plans, and (5) begin outreach to state and local authorities to \nprepare for Phase III and Phase IV.\n•Messaging: XYZ.\n•Specific Department and Agency Activities: XYZ.\nPhase III—Partial Mitigation\n•Description: Travel restrictions put in place by active INA 212(f) proclamations \nremain in place.  Those not covered by any active travel bans, including U.S. \npersons from identified countries are allowed to travel to their final destination and \nmay then be subject to self-isolation for 14 days, as coordinated by state and local \nauthorities.  Individuals who travel to the affected domestic areas or live in those \nareas may be subject to self-isolation for 14 days, as coordinated by state and local \nauthorities.  \noTriggers: Sustained human to human transmission without nexus to China \nin two or more domestic locations.\n•Objectives: (1) Implement the national response, (2) reacting to the first domestic \nepicenters, and (3) mitigating and minimizing the impact of the disease.\n•Messaging: XYZ.\n•Specific Department and Agency Activities: XYZ.\nPhase IV—Mitigation\n•Description: Travel restrictions put in place by active INA 212(f) proclamations \nremain in place.  Limit non-essential domestic travel, cancel public gatherings, \nsocial distancing, execute private sector and government continuity of operations.\noTriggers: Wide-spread domestic human to human transmission, could be in \ncities or regional.\n•Objectives: (1) Preserve the functioning of critical infrastructure and mitigate \nimpact to the economy and functioning of society, and (2) support community \nresponses to the extent possible to mitigate illness, suffering, and death.\n•Messaging: XYZ.\n•Specific Department and Agency Activities: XYZ.\nWHO officially names the 2019-nCoV as “COVID19”.   Was on Panel at Aspen Institute \nchaired by Helen Branswell and with Nancy Messonnier and Ron Klain as co-panelists.   \nReminisced with Ron about the Ebole-White House days\nPRESS:  NPR Radio 1A (Todd Zwillick); WTOP Radio; Press at the Aspen \nInstitute (2300 N Street); FOX News (Lou Dobbs) \nReleased by Chairman Rand Paul\n691Feb. 12, 2020 – 45,172/1115  Individual reports are coming out about various \nclinical characteristics.   Unreviewed report now of virus in saliva of infected \npeople.   Let us see what kind of reponse that gets.\nVery busy day today with 4 Congressionald briefings!   Also, complicated by \nwake of Eric Scorce today and funeral tomorrow.   Much stress.\nFirst we briefed House members at Rayburn led by Rosa DeLauro, Nita Lowey \nand Tom Cole.   Then we went to the Senate Dirksen to brief senators led by \nLamar Alexander.   Then to Capitol Visitors center to brief House members led by \nEliot Engel.   Then to Majority hosue leader Steny Hoyer’s office to brief \nmembers.   Steny was profuse in his praise for me, which was  a little \nembarrassing\nOn my way out of White House from the 4:00 to 5:00 PM Task Force meeting, ran \ninto Larry Kudlow, who has become my new best friend.   He joked about how \nmany years I have been doing this and he has been following my career.   His \nmain question was when is this COVID19 going to crash the economy, i.e. when \ndoes he need to start worrying about it.   It told him that we are OK for now but \nthis could change rapidly if we start seing sustained person-to-person \ntransmission.   He asked me to keep him informed when in my opinion things are \nstarting to go bad \nHaving our second big multipeson conference call this AM with Mike Ryan, \nTedros and WHO, Bruce Aylward (Canadian) called from China.  He is part of \nWHO multi-national advance team in China.  Still no invitation for US \nrepresentation from China to be part of group. Azar getting very angry and \nblaming Tedros for not pushing with China to get us on the group.  Azar feels that \nTedros in bowing to Xi Jinping who does not want USA.  Tough situation since \nTedros and WHO depends greatly on China and often bows to them.\nPRESS:  WTOP Radio; Bloomberg TV (by phone;\nFeb. 13, 2020 – 60,349/1369    Sharp increase in that they are not using just lab \ntest for DX; they are using chest x-rays and CT scans of lung.\nMeeting at White House with Chairs and Ranking members of big 4 committees \nwith  Anne Schuket, General Paul Friedrichs, Bob Kadlec in Roosevelt Room.  \nReleased by Chairman Rand Paul\n692Kevin McCarthy, Steve Scalise, Greg Walden.   Chaired by Mick Mulvaney.   \nAlso, Eric Ueland of WH Lewg there.   Good questions.   Many compliments\nPRESS:  CBS This Morning (for showing tomorrow); FOX News (Lou \nDobbs)\nFeb. 14, 2020 – 64,460/1384   Making plans to deal with Americans on Princess \nDiamond Cruise ship in Yokohama harbor.   Cliff flying to Japan to help design a \nclinical trial to treat infected people with remdesivir.   Then he is off to China as \npart of the WHO-sponsored delegation.\nAzar, Redfield, Kadlec and I briefed the entire Cabinet on a teleconference this \nAM\nPRESS:  FOX  Business; Spectrum News TV; Fox News with Dana \nperino;CBS This Morning ; CNBC\nFeb. 15, 2020 – 67,178/1527.  Had White House Task Force conference call at \n12:00 noon (Saturday).   Big issue was the plan to get Americans off the Diamond \nPrincess in Yokohama harbor.   State will charter planes to get them to Lackland \nand Travis AF bases.   Sick people will stay in Japanese hospitals.   Uninfected \nand people whoise status is not clear will be flown out with the proper PPE for \nthose who are thought to be at roisk of being infected.\nAlso, discussed on the call the persistent problem of cruise ships in general, which \ncould derail all polasn for containment since they scatter people from all over the \nworld to all over the world.\nImportant conference call chaired by Bob Kadlec with the ASPR and CDC people \nwho are on the ground with the Diamond Princess Cruise ship in Yokohama.  The \nconditions apper to be dreadful with major transmission on the boat.   Many crew \nmembers getting infected.   Japanese are not adhering to the required PPE.  It \nseems that they are unaware of the potential transmissibility of the virus.  The \nCDC people say the ship is like an “incubator” for the virus.   One called it a \ncesspool of virus.  This conversation makes it clear that we need to get US citizens \noff that ship.  James Lawlor (Nebraska) and Michael Callahan (Mass. General) \nwere on the call.\nReleased by Chairman Rand Paul\n693PRESS:  FOX News with Molly Line; \nFeb. 16, 2020 – 69,275/1670  (Sunday)  Big discussion on phone with Kadlec, \nAnne Schuchat and Kevin (ASPR) on whether to remove a person from the \nevacuation plane who recently showed to be positive.  Original plan was that \nanyone who was infected would not board plane evacuating people from the \nDiamond Princess.  Now Kadlec and Kevin want to board them since people on \nthe bus waiting to board have already been exposed on the bus to several people \nwho are infected.\nWashington Post story by Jasmeen Abutaleb has me defending Azar against slurs \nagainst him (covertly by administration officials).   I also say that w need to be fair \nto the POTUS (see below):\n\"In fairness to the president, someone told him something that has a basis in \nreality. ... There is some validity in saying respiratory viruses like flu and \ncoronavirus are seasonal,\" Fauci said. \"The only thing is when you're dealing \nwith a pandemic-type virus that is brand new, there's no way of knowing what's \ngoing to happen when the weather gets warm.\"\nSome officials have complained that Trump's comments about the virus emanate \nfrom his briefings with Azar, who they say has been overly controlling in the \nresponse and has told other doctors not to get too far into the details of the virus \nand the outbreak with Trump. Azar is disliked by many in the White House, four \nadministration officials say.\nFauci, however, said Azar has brought medical professionals with him to nearly \nevery briefing and insisted they be part of Oval Office meetings.\nAzar \"always defers to the scientists. That's the reason why whenever we're in \nthe Situation room and the president would like some briefing, Alex always takes \nme and (CDC director) Bob Redfield in with him,\" Fauci said. \"He always wants \nus to give the straight scientific information to the president.\"\nPRESS: Face the Nation (Margaret Brennan);\nReleased by Chairman Rand Paul\n694Feb. 17, 2020 – 71,438/1775.   454 infected on Diamond Princess cruise ship.  \nHeated discussion last evening (see above) with Bob Kadlec, Will Walters (State \nMed), Anne Schuchat, Kevin (ASPR) about whether to board people on the \nevacuation 747 plane who were originally scheduled to come home as \n“uninfected” after they just found out that 14 of them are in fact infected.   The \nwritten agreement is that no documented infected people should get on the evac \nplane.   Walters, Kevin and to some extent Bob Kadlec (he was complicit) insisted \nthat since they were already on the bus, we should allow them on the plane.  They \nsaid that we would not know what to do with them if they stayed since we could \nnot leave them on the ship and the Japanese did not have facilities to take care of \nthem (I do not believe the latter).  Anne Schuchat vehemently argued that they \nshould not be allowed to board since the public and written agreement was that \nthey would be put on a plane WITHOUT infected people and this would be \nbreaking that agreement.   Nonetheless, Walters pushed and Kadlec (ASPR) caved \nand went along.   Of note, later on (today) Walters said that he checked with me \nand I was OK with the boarding – a lie!   On the call today Azar was upset since \nthe entire Cabinet was questioning why we let them board and when he asked our \nstance, he heard that we (HHS) disagreed.   He was upset that we did not speak \nwith one voice and this looked bad.   On the call today, I told him that State \n(Walters) was going to do what he wanted to do anyway no matter what we said.   \nOf note, on these issues in foreign countries, State has the last word.\nSeveral of the 14 infected people from ship who were evacuated went to Nebraska.  \nAlso 3 additional people were notified while on the plane that they were infected.   \nWe air evacuated 328 people from Diamond Princess.  61 Americans elected to \nstay in Japan on the ship, but the Japanese want them off the ship because \ntransmission is occurring on the ship.  There are now 800+ non-China cases, 365 \nof which are on Diamond Princess.   Now 28 countries have cases and within these \nthere are 183 human to human transmissions.   Singapore is problem with 68% of \ntheir cases are human to human\nPRESS: WTOP Radio; FOX (Caputo) TV; FOX Business TV; CNN (Wolf \nBlitzer Situation Room).\nFeb. 18, 2020 – 73,335/1876.  More infections appearing on Diamond Princess.   \nGood thing we got our people off the ship.\nDirector of a major Wuhan hospital dies of COVID-19.  Liu Zhiming, 51yo \nneurologist \nReleased by Chairman Rand Paul\n695Did panel at the Council on Foreign Relations chaired by Fran Townsend.  Bob \nKadlec was other panelist.\nMuch discussion about Cruise ship issues.\nOur planes land in Lakeland and Travis with evacuated Americans.   Infected \npeople shipped to University of Nebraska for containment; remainder of the \nuninfected go into 14 day quarantine\nPRESS: CNN New Day (Jim Sciutto and Alisyn Camerota); BBC Radio; \nCNN International; FOX America Newsroom; CNBC; FOX News (Laura \nIngraham)\nFeb. 19, 2020 – 75,201/2012.  On WHO weekly call with Mike Ryan. 1700 health \ncare workers have been infected.  Starting to discuss the role of environmental \n(surfaces) spread of virus, particularly in the context of the Diamond Princess.  \nMike Ryan makes good point that the stringent control efforts of China are putting \npressure on the virus not to spread.  This is somewhat artificial.   He is concerned \nthat the virus in other countries that cannot be so draconian in control we might \nsee a resurgence of the virus that is being artificially controlled in China.\nCDC Comms concerned that I am being too hard on the Japanese by sayng \npublicly that their quarantine failed.   They contacted Courtney.   Too bad.  I tell it \nlike it is.   They completely messed up the infection control on the Diamond \nPrincess.   They had over 500 people infected on the ship.  Problem is that \nJapanese are releasing people into the community from the ship without the \ncomplete 14 day quarantine.   They consider being on the ship as quarantine when \nit is not.  We have “do not board” orders on the people who have left the ship until \nthey are off the ship for 14 days.\nPRESS:  NPR “Morning Edition”; KCBS Radio (San Francisco); FOX \nBusiness News; Siriusx Radio – Michael Smerconish; Nextstar TV; Wall \nStreet Journal Pocast; NBC Nightly News (did not show – may show in AM); \nPBS NewsHour (William Brangham); FOX News (Lou Dobbs)\nFeb. 20, 2020 – 75,752/2130.  Had major discussions last evening among the HHS \nteam.   Some disagreement that we had to sort out between ASPR (Kadlec) and \nReleased by Chairman Rand Paul\n696CDC (Cetron/Redfield) regarding when to trigger the transition from containment \nto mitigation.   Kadlec wanted to do it if only 1 location (city, etc) had more than 3 \nrounds of transmission, whereas CDC wanted to trigger to be >3 rounds in more \nthan one non-contiguous location (city, etc.) .   After much conference call \ndiscussion we came to a compromise.\nAzar pissed off at a story in the Washington Post by Lena Sun.   Someone leaked \nthe story about the disagreement between CDC and State/ASPR regarding \nallowing infected Americans to board the evacuation plane taking people from the \nDiamond Princess back to the USA.   Now this is a big story:  “Infected patients \nput on plane against CDC advice”\nPRESS:  Radio Free Asia (TV); The Doctors TV Show; Home Care Radio \n(HCR); NBC Nightly News (from yesterday)\nFeb. 21, 2020 – 76,775/2247.   1st patient to die from being on Diamond Princess.   \nHad intense “Table Top”=like exercise with the WHTF in the Situation Room \nfrom 3:00to 5:00 PM.   Discussed the plans and triggers of going from \ncontainment to mitigation.   Lots of good discussion.   Led by Mick Mulvaney.\nCNBC interview wa slightly hostile questioning the “controversial” decision of \nputting the infected evacuees from the Diamond Princess on the plane back to \nUSA.   After my explanation and after I was off the air, Mike Osterholm and Scott \nGottlieb got on and starting spewing forth about the idea that we might be missing \npeople in the UA who are infected.   The hosts seemed to be pitting me against \nthem.  Typical media \nPRESS: BBC World Radio Show; NBC News print; WJLA Local TV by phone; \nCNBC (Meg Terrell)\nFeb. 22, 2020 – 77,932/2363.  Seeing  sustained transmissions in Japan and Korea.   \nCDC issuing travel alert 2 – “consider postponing non-essential travel”.  This is a bad \nsign and could be the beginning of the transition to a pandemic.\nPress (see MSNBC below) still folucing on the decision to board infected people on the \nplane from the Diamond Princess\nReleased by Chairman Rand Paul\n697PRESS: MSNBC; CNN with Michael Smerconish; \nFeb. 23, 2020 (Sunday) – 78,804/2463.  Cases of community spread now increasing \ngreatly in Japan, South Korea, Italy.\nBob Kadlec called me this AM with emerging problem.   We need to house some of the \nevacuees from the Diamond princess who are continuing to convert to virus positive in a \nplace where we can isolate them and have them ready for acute medical care if they \nbecome ill.  There are about 30 people thus far negative for infection who may soon \nconvert, mostly elderly and frail about whom Kadlec is concerned.  It is projected that 1 \nof 10 will convert and likely will get seriously ill as has been the case with other elderly \npeople from the Diamond Princess who got ill in Japan and went to Japanese hospitals.   \nThey are now at air force bases Lakeland and Travis, but the military does not want to \nhave responsibility for them if they are infected since they are concerned about “force \nprotection”.  Also, and importantly, Bob Kadlec tried to get the people housed at \nAnniston, AL.  Congressman Mike Rogers (R-AL) got furious and reemed out Kadlec \nsaying he was going to destroy him.   He got on the phone to President trump who was on \na plane going to India and badmouthed Azar.  Apparently, the POTUS called up Azar and \nwas very pissed off.   He told Azar he had to fix it or else, since the POTUS was \noriginally angry that we even brought back infected Americans from the Diamond \nPrincess.   Azar then came to me asking me to help him “fix it”.   And so that is the \norigina of this saga.\nThe suggestion is to ship them to the NIH Safra Lodge so that they have access to NIH \nSCSU.  This would be disruptive to NIH, but there does not seem to be many \nalternatives.  Had discussions with Francis (boarding a plane to Grand Cayman) and \nLarry while on my C & O canal walk with Chris  about how to address this difficult and \nfrustrating issue.  Francis on way to Grand Cayman for vacation.  This leave it to Larry \nand I to “fix”.\nHad important conference call with NIH Clinical Center people – Jim Gillman, Tara \nPalmore, Rick Davey, etc.   Tara makes good point that we realy cannot use the Safra \nlodge since even one infected person would nullify keeping uninfected people there.   \nDecision was to skip the Lodge and put everyone in the Clinical Center.  Gillman, Tara \nand Rick now huddling to figure out how to do this. \nI visit the Clinical Center group (Gillman, Tara, Rick, Henry Masur, David Henderson, \nnursing, etc in Clinical Center Room 6-3551 where they are convening to work this out.   \nThey present to me that they can make 11 beds available in the CC for evacuees who may \nconvert.  If they did the full 30 (i.e. +19), it would be dangerous for our staff since we \ncannot retrofit that many rooms with negative air flow and proper room for don/doff.   \nWe decide on 11 in CC and Rick works with Lauren Sauer at Hopkins for an additional 8 \nfor a total of 19.   We go with that.   I contact Azar who contacts POTUS who is on plane \nReleased by Chairman Rand Paul\n698to India with Melania.  And so, it is “fixed”.   Azar called me to thank me for “saving his \nass”.\nFeb. 24, 2020 – 79,524/2626.  Situation getting worse in Italy, Korea, Japan, Iran.   More \nreports of transmissions by asymptomatic people.   Lots of discussions of when the WHO \nwill declare this a “pandemic”.   WHO is saying that they are no longer using the \nterminology “pandemic”\nStock Market plunging today about 1000 points as a result of coronavirus reports.\nMick Mulvaney called my office today to give me the cell number of Larry Kudlow \nwho wanted to speak with me.   I called and Larry wanted my take on what is evolving \nwith COVID-19 since it is critical to him in his assessment of the potential impact on the \neconomy.   He said he trusts my opinion over anyone else.\nOMB will release the Supplemental Request to the Congress tonight and I have a \nCongressional briefing with AZAR and the HHS team tomorrow AM. They did not \nrequest any for NIAID even though I put in for $145 million.   Spoke with Azar a few \ndays ago and he said that OMB and he would not be upset if the Congress added to the \nSupp request for money for me.   Problem is thsat until then, I may need to defend why I \nam not getting or do not need additional money.\nHad dinner over mansion  of Adrienne Arst.  Chris Liddell and his wife Renee were also \nguests.\nPRESS: CBS Radio (NYC); AP TV; FOX Business (Lou Dobbs)\nFeb. 25,2020 -  80,277/2705  Major concern ove other countries surging in cases – Italy, \nSouth Korea, Iran.   Stock Market staring to crash due to COVID-19.   Supply chain \nconcerns.\n1st patient evacuated from Diamond Princess to Lackland supposedly will come to NIH \nsince patient has since converted to virus positive.\nBig explosion of media.  On the usual CDC press briefing, Nancy Messonnier made the \ncomment that a pandemic and community spread in the USA is not a matter of IF, but a \nmatter of WHEN and we should prepare to do things like close schools and do telework.   \nThis caused a firestorm of media frenzy around the world.  The Stock Market tanked by \n1000 points; the POTUS called up Azar asking what the hell is going on.   I went into the \nmedia to try to calm the waters (see press below).  Also, the press was zinging the \nPOTUS and Larry Kudlow for saying right before Nancy made her statement that \neverything is under control in the USA (which it is for now – 14 cases with no \ncommunity spread) while CDC officials (Messonnier) were saying that a USA outbreak \nwas inevitable.   Also, zinging the POTUS who is saying that a vaccine is imminent \nReleased by Chairman Rand Paul\n699(soon).   He is obviously confusing the initiation of a phase 1 trial and having a vaccine \nready. \nPRESS:  WTOP Radio; CBS Radio (NYC); FOX with Bret Baier; CNN Situation \nRoom with Wolf Bitzer; CNN International; CNN with Chris Cuomo; MSNBC; \nBBC Radio x2\nFeb.26, 2020 -  81,187/2768.  Should be a big day with the POTUS back from India and \ngoing to give a press conference this afternoon.\nBig day today!   POTUS returned from India and wanted to clear up the issue of Nancy \nMessonnier’s statement that sent the Stock Market crashing.  The Task force, particularly \nAzar, me, Redfield, added Anne Schuchat,  Mick M. met with Trump in the Oval \nOffice  and updated him on coronavirus situation.   \n(Of note, we have 1st case of community acquired COVID-19 in a woman from Solano \nCounty, CA who had no epidemiologic link to anyone weith COVID-19. This could be \nthe beginning of something bad)\nAfter we briefed POTUS in the White House, we went into the Cabinet Room and the \nother members of the Task Force briefed the POTUS a bit more.   Then we went into the \nWhite House press Room which was more packed than I had ever seen it.   People \nstanding on chairs in the isles.   POTUS made comments, then Azar, then Anne, then me \non vaccines and therapy.   The POTUS stayed for a long time (45 minutes) answering \nquestions. He called Nancy Pelosi “Incompetent” in answer to a question  For the most \npart he was OK, but tended a little bit to underplay the situation.   After that we went \nback to the Oval Office with the POTUS to do a “post-mortem” on the press \nconference .   Everyone felt good about the presser.  \nThere was much speculation that the POTUS would either get rid of AZAR or appoint a \nCzar.   The press was geared for that.   However, POTUS asked VP Pence to do overall \ncoordination of the coronavirus effort.    Clearly this was a compromise to not make Azar \nlook bad since he is friends with Pence and at the same time silence/satisfy those who \nwant a Czar and/or to get rid of Azar.\nAnother interesting twist was that they announced that Debbie Birx would be the new \n“coronavirus coordinator” in the NSC.   Apparently, she may have been fired from \nPEPFAR where there was considerable discontent about her leadership style (very \ndogmatic and inflexible)\nFinally, we all adjourned to VP Pence’s office to discuss his new role  in coordinating \ncoronavirus activities.\nWhite House had us cancel all press briefing commitments since they wanted all the news \nto be the POTUS.   This led to the impression that I was being “muzzled” and led to a \nreal twitter forestorm\nReleased by Chairman Rand Paul\n700PRESS:  CNN New Day with John Berman and Alisyn Camerota; FOX News; \nCNBC Squawk Box;\nFeb. 27, 2020 – 82,446/2808.  Very interesting things evolving.   Got phone call from \nAzar this AM (while in Building 31 cafeteria).  Azar is frustrated with the operational \nincompetence of the CDC and asked me to start thinking abou a possible replacement for \nRedfield at CDC in case Azar needs to replace him.  He prefers a woman, and someone \nwho is not an obvious anti-Trump person.  Azar admits that regardless of all the PR, the \nfact is that Pence is now in charge.  Also, Azar told me that Pence ordered the lockdown \nof all press by everyone including Azar.   Azar is trying to turn this around since it is \nobviously a bad idea.\nGot phone call fom Tom Bossert (former Deputy National Security Advisor to Bush and \nNational Security Advisor to Trump until John Bolton forced him out).   Tom saw the \npress briefing on TV last night and was appalled by the denialism of the problem by \nTrump.   He wanted to know if I was trying to bring in some reality testing.  I told him \nthat this was difficult.  I emphasized that we should be testing thousands of people and \nnot just a few hundred.   With the 1st community case in CA, it is clear that there are \nother infected  people out there in the USA.  Also, there is a 2nd community case in \nCalifornia.  Turned into an amazing day .  Chris Cuomo calls me up and says that he \nwants me on his show since he is going to rip apart the CDC for not having enough tests \navailable to screen for community spread cases (i.e. no known geographic connection).   \nHe says that people from NYC and elsewhere are calling us saying that they have \nsuspicious cases and they cannot get test kits from CDC.   Actually, this is for at least 2 \nreasons: 1) the CDC has not worked out the glitches in their kits and the criteria for \ntesting a PUI (person under investigation) included their having an epidemiologic \nconnection to a case.   This is crazy since by definition, a community-based case (which \nwe are trying to screen for) does not have any recognizable epi link.   I realize that we \nhave to fix the CDC problem and I call Brian Harrison and we both walk into Azar’s \noffice and explain that we need to get CDC, FDA together to loosen the regulatort \nconstraints on getting tests out.  It was my pushing that did it.  They come up with a \nsolution of regulatory relaxation of QC.  \nStock Market crashing!  Also the issue of “muzzling Fauci” is going wild.  See above: It \nstarted when the VP took over the Task Force and his Chief of Staff (Mark Short) and his \ncomms person Katie Miller wanted to re-assess the communications.  This was really \ntriggered by the Nancy Messonnier’s statement.  I had agreed to a number of TV hits and \nwe got word from the VP office to Bill Hall that we need to stand down on all media for \nthe time being so that we can re-submit clearances.   This got interpreted that Fauci was \nbeing muzzled and triggered an amazing twitter storm that was widely and virally \ntweated to not suppress the “great Fauci”.   I was getting hundreds and hundreds of e-\nmails of support.  There is even a #freeFauci out there.\nReleased by Chairman Rand Paul\n701Big surprise was at 10:35 PM tonight I got a phone call at home from President Trump \nwho wanted to chat about the coronavirus situation in general.   We spoke for about 20-\n25 minutes.   I encouraged him not to underplay the seriousness of the situation since if it \nturns out bad, it would look like he is covering up.   I even spoke to him from a political \nstandpoint that his chances for re-election might be more damaged if he downplayed the \npotential spread of virus in the USA than if he said we may face serious problems and \neven if the Stock Market goes down further, he was at least honest and the country would \nrespect him for it.   I thought that he heard what I said, but the next day, he again \nunderplayed it.\nFeb. 28, 2020 – Much community spread in South Korea, Italy, Iran, Japan.\nBriefed the All House Membership at the Capitol Visitor Center.   Question came up of \nwhether I am muzzled and I explained that this was not the case.\nPRESS:  MSNBC – Chris Matthews Hardball; FOX Business with Gregg Jarrett;\nFeb. 29, 2020 – 86,000/2941.  \nImportant Day – Went to Situation Room  for a Saturday AM (10:00 AM task force \nmeeting) when it became clear that there was several new cases of “community spread”   \nThere were already 14 cases (12 from Wuhan and 2 spouses).   Then we learned a few \ndays ago that there were 2 cases in California that were community based and both were \nnow on respirators.   The NEW information from yesterday is that there are now 6 \nadditional cases – 1 in Oregon of a 45 yo who is now in the ICU and 5 cases near Seattle \nWashington, one of whom died last night; another one is hospitalized; and a 73 yo in long \nterm care is now in an ICU; one just returned from Korea and so that might be a link for \nthat person, but the others are unknown source .   A new chapter in the outbreak.  \n6 hour meeting in the White House Situation Room.  We increased travel alert to Italy \nand Korea and no travel to Iran.   Level 3 for Italy and Level 4 to Northern Italy.   Level 3 \nfor Korea and Level 4 for Daegu in Korea.   I suggest and it is accepted as the “Fauci \nRule” of asking these countries to do exit screening on people coming from their country \nto USA.\nMeeting led by VP Pence.   Trump joins meeting and we decide to make \nannouncement at press briefing in WH press Room of new findings (plus the fact that \nthey signed an agreement with the Talaban to end the war in Afghanistan).   Pence and \nMick Mulvney want me standing right next to the POTUS on the podium so that I can be \nseen on TV, and I make remarks about the recent community cases.   POTUS speaks, \nthen VP Pence, the Azar, then me, and then Redfield.  They wanted just me, but I pushed \nto have Redfield also make remarks.\nDuring the question period, the issue again comes up about whether I am muzzled.  I go \nto microphone and say I am not nor have I ever been muzzled.\nVP Pence and Azar to be on Sunday Morning Shows tomorrow\nReleased by Chairman Rand Paul\n702PRESS:  NBC Today Show; MSNBC; \nMar. 1, 2020 – 87,137/2977.  Bob Redfield and Nancy Messonnier telling me that there \nare now more cases in Chicago, Rhode Island, Florida, Massachusetts.   Nancy is \nfrustrated that Bob is not sounding the alarm to start social distancing.   She is asking for \nmy help.   I will bring it up at the AMA call and the Task Force call.\nGot call at home this AM (Sunday) from Gov. Andrew Cuomo (NY) asking advice how \nhe should handle the COVID-19 siutation in NYC.   Had long conversation in which he \nstressed a few times, how much his father (and mother) loved me and used to tell Chris \nand Andrew how much they respected me and how proud they were that I was an Italian-\nAmerican.\nSylvia Burwell appeared on Fareed Zakaria GPS show.   I was supposed to be on with \nher, but it was one of the shows that got cancelled for me.   She called me this AM while \nChris and I were on our walk and asked advice and fact checking for her interview.\nOn several of the Sunday Shows my name kept coming up by people in interviews and \npanels (Chuck Todd – Meet the Press) saying that “we should have Dr. Tony Fauci out \nthere speaking to the American people.   He has a decades long history of giving the truth \nin a calming way to the public.”\nSunday conference call with AMA followed by VP Pence and Task Force.   We are \nmoving to mitigation in Santa Clara section of California where there are cases and in the \nSeattle area of Washington State.  Reason – we have sustained community transmission \nin those areas.\nPRESS: FOX and Friends; \nMar. 2, 2020 – 89,197/3038.  2nd death in the USA (Washington State man).   Several \nmore community based cases plus a NYC case that returned from Iran.   We will need to \nmove to mitigation + containment in Washington State, which has declared state of \nemergency.\n89 cases in USA with more cases each day.  6 deaths in USA\nDeb Birx on board.   Had a slight run in with her when she told me that the WH was \npissed at me for sayng on n NBC interview today that we have an outbreak and “likely a \npandemic”.   It all go cleared up after I spoke with Katie Miller who is now running the \nComms shop for COVID-19.   She is the VP’s Comms person.\nSomeone trying the hurt Azar by leaking to press (Politico and WSJ)that on a phone call \nwher we discussed the contamination problem with the CDC test that Azar and Brian \nHarrison said to send the tests out anyway even though they are defective.   The leaker \nsaid that I was on the call and tried to persuade them not to do this.   The entire story was \na fabrication and Brian Harrison, Redfield and Steve Hahn talked the reporter out of it.\nReleased by Chairman Rand Paul\n703Met in the Cabinet Room with POTUS, VP and multiple CEOs of PHARMA to discuss \ncontribution on industry to treatment and vaccine effort.  POTUS very deferential to me \nat meting.  Getting many, many e-mail and press writing about my role helping the \ncountry.   Much press exposure (daily WEH briefing from press room)\nHaving a daily Task Force meeting at 4:00 PM will destroy my schedule to do anything \nelse.\nPRESS:  CNN New Day with Alisyn Camerota; CNN with Chris Cuomo;  Daily \npress conference from WH press room.  Mutliple spinoffs\nMar. 3, 2020 – 91,320/3118.    POTUS and VP visit NIH today.\nAmazing day!   Testified with Steve Hahn, Anne Schuchat, Bob Kadlec before Senate \nHELP Committee chaired by Lamar Alexander.   Patty Murray complaining about lack of \ntesting availability in Washington State where there is increased community spreading \nnow with 6 deaths most in nurtsing home.  In the middle of the hearing Sen Keane asked \nme why I was disinvited to the Democratic caucus lunch.  It was scheduled that after the \nHearing, Hahn, Birx and I should make comments first at the GOP Senate caucus lunch \nand then the Dem.  In reality someone in the VP’s office screwed up and felt that I would \nnot get to the NIH in time to greet the POTUS who was coming up on Marine One.  They \ndid not know that I was supposed to ride in the motorcade with Pence.   Anyway when \nthe VP’s office heard about the outrage of Keane, they immediately re-invited me.   \nKeane thought that this wa another example of them “muzzling me”.   A real cluster.   \nHowever,  the VP spoke so long at the Dem lunch that it was clear that the POTUS would \narrive before me, who was supposed o greet him.  Finally Azar and I raced up in his car \nwith no motorcade to NIH.   Amazing that the POTUS got to VRC/NIH before me and \nAzar and actually waited in the holding room for me. Yikes!  We did our thing; I made a \npresentation, we had a press conference in the VRC.  Graham and Kizzmetia Corbett \nmade presentation on 2nd floor and then the POTUS invited me and Azar to return to \nWhite House with him on Marine One.   After we got off Marine One, the POTUS and I \nheld a press conference on the lawn.  Amazing.  \nWe then had our Task Force meeting followed by another press conference.  \nImportantly, I have been pushing for blanket testing throughout the country on \nsymptomatic and asymptomatic people to get some data.   CDC and FDA are promising \nthis now, but I doubt if they can deliver.  I am beginning to quedtion the competency of \nCDC and the innocent inexperience of Steve Hahn and FDA\nIn the middle of this, Larry Corey calls me up and mentions that they did in Seattle a \nscreening of people presenting with Flu like sxs in 4 emergency rooms, and of 380 \npeople, 4 were positive for Coronavirus.   This is bad since this is 1%.   I told Larry to \ncall Bob Redfield and let him know.    This may be the beginning of a major outbreak in \nthe USA \nReleased by Chairman Rand Paul\n704PRESS:  Good Morning America with George Stephanopoulos; multiple press \nconferences, including one on White House Lawn after getting off Marine One with \nthe POTUS\nMar. 4, 2020 – 95,125/3254 Countriesd with cases – 77.   South Korera -5328 cases; \nItaly – 2502.  In USA 22 cases travel related + 38 person-to-person (10 deaths) = 60 \ncases + 3 Wuhan and 45 Diamond Princess repatriated – 48 .  total – 108.\nTestified with my NIH colleagues at the House Approps Subcommittee chaired by Rosa \nDeLauro and present was Full committee Chair Nita Lowy.  Again much praise for my \nrole in coronavirus.\nMany senators want to speak individually to me.   Today spoke with Senators Manchin \n(D-WV), Gary Powers (D-MI), and Pat Toomey (R-PA) clarifying point about testing, \nwhich is the big topic since the CDC and FDA lagged behind.\nMore briefings today of House GOP and Dem caucus in Capitol Visitor Center.   Totally \nstanding room only.   Kevin McCarthy ran GOP and Nancy Pelosi ran Dem. Much praise \nfor me.   VP came with Birx and then took me with them to return to WH in his \nmotorcade, which was really fun – driving at 50 miles/hour down usually crowded streets \nthat are now all blocked off.\nDaily task force meeting – I presented to group the 4 cases of community spread in \nSeattle (Corey phone call).  VP and Steve Mnuchin pownplayed and VP bought it saying \nthat 1% is a small number.   I tried to explain to them that 1% reflects the situation a few \nweeks ago givin incubation and the real number is probably hundreds of infections.   I \nwanted to have them do social distancing.   Birz looking like she wants to tell the VP \nwhat he wants to hear.   Not looking good.  Sean Conley appropriately questions the VP \ngoing to Seattle.   \nI call up Marc Short tonight and express my concern that they are downplaying the 4 \npatients.   He understands and will relay this to VP.\nGovernor Cuomo wants me (texts) to go to NYC and do a press conference with him.  I \ntold him that this is unlikely.   He texts me back: “You are doing the important work!  I \nam in the cheap seats.  God Bless.   Whenever works”.\nPRESS:   Press conference after the Task Force meeting.   I stress difference \nbetween risk of infection and risk of complication.\nMar. 5, 2020 – 97,381/3348   Now have 12th death in USA – another of the Seattle \nnursing home.   Total cases in the USA = 152.  Seattle seeing community spread (see \nabove).   \nReleased by Chairman Rand Paul\n705Did Full Senate and Full House briefings in the Capitol Visitor Center with Azar, and \nsome members of Task Force.   Some hostility between Azar and Congressman for Texas \nregarding the issue of the Congressman questioning whether CDC people were properly \nPPE’d when they brought expatriated people from Diamond Queen.  \nFollowing the briefings, we did a press conference.   Many hostile questions regarding \nwhat the POTUS said that AM on Hannity.   He said that most people who get infected \nand do very well and can go back to work.   He obviously misunderstood the briefing of \nhim that most people whore infected (>80%) do well and do not need hospitalization.   \nHe also quoted a modeling study from CDC (Spoken by Brett Giroir) that the real CFR \nwas between 0.1% and 1.0%.   The press asked me how this could differ from the WHO \nnumber of 2-3%.   I explained that the WHO only counts cases that come to the attention \nof the medical community (and this was pure arithmetic of numerator (deaths) and \ndenominator (number of recognized infected people) and the CDC model was making \nassumptions about the actually number of infected people who might be asymptomatic or \nminimally symptomatic and not get noticed.\nDid a Podcast with Alan Alda (really wonderful guy).  \nCongress passed a $8.3 billion supplement for coronavirus.   NIAID gets $826 million\nGovenor Inslee of Washington State called me even though the VP was on his way to \nvisit the Govenor and asked me my opinion about mitigation, i.e. should they start it.   I \ntold him a definitely yes.   He said that he trusts me and no body else in the \nadministration.   I also answered a number of questins from him and his staff.\nSomeone still is planting stories to discredit Azar.   Judy Steckler (HHS) has asked me on \na couple of occasions (see above) to call the reported and give the other side of the story \nwhich I have done.\nPress stories that the White House did not like the Profile of me in Politico since it is off \nmessage (Really???).  Yet everyone in the WH is congratulating me on the piece (watch \nyour back, Tony).  I am pretty safe, I believe since the public adulation of me has been \namazing with every young intern as well as seasoned veteran in the WH coming over to \nme congratulating me and thanking me for my work and even asking for selfies.\nBad news with another cruise ship – Grand Princess.   A person was on the ship, did not \nfeel well, got off in a port in California, then was hospitalized, tested positive for \nCOVID-19 and died.   Now the cruise ship wants to dock in SF.   Not being allowed   \nSeveral people on board have respiratory sxs.   Flying tests in to see if there is infection \non the ship.   If there is, we will have to quarantine the entire population of the ship OFF \nthe ship to avoid a Diamond princess situation.   Problem is that logistically we have no \neasy way to quarantine 4000 people.   More tomorrow when we get results of tests.\nPRESS:  FOX Business with Lou Dobbs; CNN Town Hall with Anderson Cooper.\nReleased by Chairman Rand Paul\n706Mar. 6, 2020 – Nancy Messonnier calls me asking for help in getting the message out \nthat we must protect the vulnerable (elderly with co-morbidities).   She wants to say it but \nshe says the VP’s staff are pushing back.   I promise to bring up at TF meeting.   I do and \nget support to announce it, which I do at the WH press conference this afternoon.   I say \nthat people with underlying conditions, particularly the elderly, should start to practice \nsome form of social distrancing as well as avoiding any non-essential travel, particularly \nairplanes.\nDuring task force meeting it became clear that there were at least 21 infections on the \nGrand Princess out of the 46 tested.   All but 2 were in the crew.   I and others strongly \npush to get these people off the ship to avoid another Diamond Princess fiasco.   Leave \ncrew on ship and test everyone and put inot holding facility (March or Travis) and then \nsend the California passengers to self-isolation at home, provide charter flights for the \nnon-Californians to their home, and have the UK, Canada and other countries come and \nmake decisions for their citizens as to their disposition.\nPOTUS in Florida tells VP that he would keep the people on the vessel, but if Fauci and \nothers feel it is better to take them off, then take them off.   Yet, when he does a press \nconference in Florida, he says does not favor taking them off ship.   I am beset with \nhaving to deal with always being asked if I disagree with the POTUS.\nContinually being pressed about the lack of availabioity of tests when Hahn at FDA is \nsaying that 750,000 tests are distributed and 1.5 million more are on the way next week.\nPRESS:  NBC Today Show with Savannah Guthrie; JAMA Podcast with Howard \nBauchner; Tape CBS 60 minutes for airing on Sunday March 8);\nMar. 7, 2020 – 102,969/3511.  Meeting at Deb Birx home to hash out issues in \npreparation for TF meeting today (Saturday) at 4:00 PM.   Tom Frieden comes down \nfrom NYC, Joe Grogan, Steve Redd (now detailed from CDC to Deb), Matt Pottinger, \nOlivia Troye.\nWe make decision to recommend that staff of all nursing homes and extended care \nfacilities act as if they are infected and wear masks, wash hands, etc. in dealing with \nclients.   Also, limit visits of family members, and if they do visit, they should do as the \nstaff does. \nStill have not made decision about whether to ban all embarkment s of cxruise ships for \nUSA.   We want to do this, since we do not have the facilities to quarantine thousands of \npeople on a single ship when we know from DOT that at any given time there are 99 \ncruise ships out there with >300,000 people that are planning on disembarking at USA \nports.\nAnnounced last night that Mick Mulvaney is out as Chief of Staff to POTUS and will \nnow be Special Envoy to Northern Ireland (Yikes!)\nReleased by Chairman Rand Paul\n707At Deb house we learm that 2 people from the AIPAC (American Israel Public Affaitrs \nCommittee) meeting are infected and one who has now actually gotten sick has hugged \nMark Meadows, the new Chief of Staff to POTUS.   I speak with Sean Conley, Physician \nto POTUS, and tell him that Meadows needs to be isolated at home now; he needs to be \ntested now;   if negative, then OK, but still isolate 14 days’ if positive, we have a real \nproblem sine he has made contact with many public Figures, possibly the POTUS \nalready.   VERY INTENSE TIMES.   Meadows test is negative.  Will isolate for 14 \ndays.\nGov. Cuomo calls my cell and wants me to help him get masks from the WHO supply \nsince the SNS does not have enough to service New York.   I give him Stewart \nSimonson’s cells phone and they connect.\nHad important TF meeting in Sit Room.   VP phones in from Mar a Largo.  At least 4 \ncruise ships with crew members who were on the Grand Princess are out there.   Could be \na logistic nightmare.   I propose that we urge seniors with co-morbidities to avoid crowds, \nunnecessary travel, particularly on planes and absolutely on cruises as part of my \ncampaign (see above) to protect the vulnerable.   I write (handwritten at the Table) a \nstatement for the State Department to publish with DHS that this is our recommendation.   \nVP loves it (on phone) and says let us call it the Fauci doctrine.\nMar. 8, 2020 – 105,427/3583.   2 cases in DC and at least 3 in Montgomery County.   I \nam going to start social distancing myself – am 7 monhs shy of 80 years old.   Today is \nthe Sunday show day.   I emphasized on FOX (Chris Wallace) and Meet the Press that \npeople with underlying conditions, particularly the elderly with such conditions should do \nsocial distancing, avoid all by absolutely essential travel, do not take long plane trips and \nabsolutely avoid cruise ships.\nThe meetingof the TF today emphasized getting people off the ship.   There has been a \ndelay with the union of longshoreman somewhat passive aggressing the USG.   Pence to \nCall Gov. Newsom.   Pence tasks Deb and I to put together some “Doctor Talk” \nstatements in clear language.\nPence clearly very happy the way I handled the 2 Sunday Shows that I did.\nNice Profiles of me in Politico and NY Times today.\nAmazing outflow of thanks from hundreds of people!!\nArticle from Denise Grady:\nNot His First Epidemic, Dr. Anthony \nFauci Sticks to the Facts\nReleased by Chairman Rand Paul\n708Where politicians fumble and other government health officials step back, he steps up to \nexplain.\nDr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, \nspeaking before the House Appropriations Committee on Wednesday.Credit...Anna \nMoneymaker/The New York Times\nBy Denise Grady\n•March 8, 2020, 3:04 p.m. ET\n•  •  Dr. Anthony Fauci, the nation’s leading expert on infectious diseases, is widely \nrespected for his ability to explain science without talking down to his audience — and \nlately, for managing to correct the president’s pronouncements without saying he is \nwrong.\nPresident Trump said that drug companies would make a coronavirus vaccine ready \n“soon.” Dr. Fauci has repeatedly stepped up after the president to the lectern during \ntelevised briefings or at White House round tables to amend that timetable, giving a more \naccurate estimate of at least a year or 18 months.\nMr. Trump said a “cure” might be possible. Dr. Fauci explained that antiviral drugs were \nbeing studied to see if they might make the illness less severe. The president also said the \nReleased by Chairman Rand Paul\n709disease would go away in the spring. Dr. Fauci said maybe so, but because it was caused \nby a new virus, there was no way to tell.\nExperts like Dr. Fauci should be the ones who speak to the public during epidemics, said \nRepresentative Donna E. Shalala of Florida, who was his boss during the Obama \nadministration, when she led the Department of Health and Human Services.\n“I think Tony is playing the same exact role that he has in the past — to make sure the \nscience is accurate and clear,” Ms. Shalala said. “During a health emergency, it’s the \nscientists and physicians that are the credible people to the American public, not \npoliticians.”\n“I used to make him wear his white coat when talking to the public,” she added. “I used \nto make them all wear their white coats so people were reassured that they are real \ndoctors.”\nOn Sunday, Dr. Fauci appeared on at least two television news shows, warning that as the \nvirus spread — there were more than 450 cases in at least 33 states — some stricter \nmeasures to isolate the infected might be considered. He also offered advice for older \nadults and those with underlying health conditions who are most at risk, saying they \nshould avoid cruises, flights and large gatherings of people.\nAt a recent Congressional subcommittee hearing, one representative asked Dr. Fauci if he \nhad a twin, because he seemed to be everywhere lately. Another offered medical advice: \nlemon, honey and bourbon for his voice, which has been hoarse for weeks from endless \nrounds of talking to lawmakers, scientists, health officials and reporters.\nIf Dr. Fauci has become the explainer-in-chief of the coronavirus epidemic, it is in part \nbecause other government scientists have left a vacuum, avoiding the news media \nspotlight or being reined in by the Trump administration and accused of exaggerating the \nthreat from the virus. When reporters call Dr. Fauci, he calls them back.\nDr. Robert Redfield, director of the Centers for Disease Control and Prevention, is \nfamous for being unknown: He has given few interviews or public talks outside those \nrequired by administration news conferences. Dr. Nancy Messonnier, director of the \nC.D.C.’s National Center for Immunization and Respiratory Diseases, who warned on\nFeb. 25 that the coronavirus was likely to spread  in the United States, and that “this could\nbe bad,” came under fire from the administration and has toned down her advisories.\n“Nancy Messonnier told it like it is,” said Dr. Thomas Frieden, the former director of the \nC.D.C. “And she was 100 percent right, and they silenced the messenger.”\nThe C.D.C. has made few of its other scientists available for interviews about the \ncoronavirus. And it is now facing sharp criticism for long delays in providing states with \nkits to test for the virus, and for setting such tight limits on the tests performed at its \nReleased by Chairman Rand Paul\n710headquarters in Atlanta that some diagnoses were delayed or missed, possibly leaving \ninfected people to spread the virus to others.\nDr. Fauci, 79, does not seem to be in the cross hairs. Although he was recently told he \nmust clear his many TV, radio and print interviews through the White House, he has said \nthat he has not been muzzled.\n“You don’t want to go to war with a president,” Dr. Fauci told Politico. But he thinks the \npublic needs solid, understandable medical information, especially during crises. He \nmakes a point of not trying to “razzle-dazzle” audiences with his knowledge, he told an \ninterviewer in 2015, adding that his education at a Jesuit high school and college taught \nhim intellectual rigor and the value of public service. As director of the National Institute \nof Allergy and Infectious Diseases since 1984, Dr. Fauci has lasted through six \npresidents, and has declined multiple requests to lead his agency’s parent organization, \nthe National Institutes of Health. He has led federal efforts to combat diseases caused by \nemerging viruses, including H.I.V., SARS, the 2009 swine pandemic, MERS, Ebola and \nnow the new coronavirus.\nHe was an architect of the President’s Emergency Plan for AIDS Relief, started in 2003 \nby President George W. Bush, to fight H.I.V. globally.\nIn 2001, after anthrax was mailed to Senator Tom Daschle of South Dakota, the Bush \nadministration tried initially to minimize the threat, but Dr. Fauci was characteristically \nblunt.\n“This is material that is quite formidable, that is infecting people with inhalation anthrax, \ninfecting them in the absence of direct contact,” he said. “You can call it whatever you \nwant to call it with regard to grade and size or weaponized or not weaponized. The fact \nis, it is acting like a highly efficient bioterrorist agent.”\nPrevious disease outbreaks have kept him on the lookout for new pathogens, and in \nJanuary, reports of unexplained pneumonia cases in Wuhan, China, set off alarms in his \nhead.\n“Even before we knew it was a coronavirus, I said it certainly sounds like a coronavirus-\nSARS type thing,” he said. “As soon as it was identified, I called a meeting of top-level \npeople and said, ‘Let’s start working on a vaccine right now.’”\nHe is among the most highly paid federal employees, earning about $400,000 a year, \nmore than the vice president or the chief justice of the Supreme Court. He oversees a \n2020 budget of $4.75 billion, which is $769 million less than last year’s after being cut by \nthe Trump administration.\nUnflappable though Dr. Fauci may seem, the new coronavirus worries him, especially its \nspread in the Seattle area and the toll it is taking in a nursing home there. He said he \nReleased by Chairman Rand Paul\n711thought it was still possible to stop the disease, but health authorities would have to know \nwhere it was to do that, and he said the lack of testing capacity was a huge obstacle.\nTest kits sent by the C.D.C. to states were flawed, and it has taken weeks to begin \nreplacing them. And strict regulations from the Food and Drug Administration hampered \noutside labs’ efforts to begin to do their own tests.\nBut Dr. Fauci declined to join the chorus of blame against the C.D.C.\n“It’s so easy to play Monday morning quarterback,” he said. “Every element of the \nfederal government was working full-speed to try to get this out and get things going.”\n“What I really want to concentrate on is the idea of getting enough tests out there to get \nan evidence-based foundation of where we are in this country,” he said. “Seattle is of \nconcern. We need to know the extent of the community spread.”\nAt times in the past, Dr. Frieden said, Dr. Fauci may have over-promised a bit in his \nenthusiasm for projects of his that have yet to pan out — an H.I.V. vaccine, and a \nuniversal flu vaccine that would provide long-lasting immunity to multiple strains so that \npeople would not need another shot every year.\n“It’s the role you have to play to get money from the Hill, and the role of a researcher to \nbe eternally optimistic about a cure being around the corner,” Dr. Frieden said. “He’s \nvery effective at asking for money from Congress.”\nHe is also a fair-minded colleague, Dr. Frieden added. During West Africa’s Ebola \nepidemic in 2014, after two nurses treating a patient who had traveled to the United \nStates became infected, the C.D.C. was harshly criticized for not having helped hospitals \nto prepare better. Dr. Fauci did not pile on.\n“Not everything we did was perfect,” said Dr. Frieden, who then headed the C.D.C. \n“There are many people in similar roles as Tony who might have taken advantage of that \nfor the interest of their institution, and Tony was always honorable.”\n“If we did something wrong he was frank about that,” he continued. “When we were \ngetting attacked unfairly, he defended us. That’s very unusual behavior in the \nbureaucratic situation you see in Washington sometimes. I think that’s why Tony is so \nrespected.”\nDuring the early years of the AIDS epidemic, the U.S. government and its health \nagencies were a frequent target of criticism and protests, blamed for inaction on potential \ntreatments and inadequate funding for research and medical care.\nWhen AIDS activists demonstrated outside his institute in 1988, demanding a chance to \ntry experimental drugs, Dr. Fauci surprised the leaders by inviting them into his office. \nHe wound up working with them to develop new ways to expand access without \nReleased by Chairman Rand Paul\n712compromising the clinical trials that were urgently needed to determine which drugs \nworked — an approach that was later applied to research in other diseases as well.\n“There are a lot of world class scientists, but Tony has a special set of skills,” Ms. Shalala \nsaid. “An ability to communicate, high integrity and an understanding of politics — and \nto know to stay out of politics in order to protect scientists.”\nDr. Fauci acknowledged that his age puts him in one of the groups at highest risk for \nbecoming severely ill from a coronavirus infection. But it has not slowed him down. He \nsleeps only about five hours a night, works most of his waking hours and jumps on the \nMetro to get around the Washington, D.C., area, from his office to the Capitol and the \nWhite House. Most days, he runs or power walks 3.5 miles.\n“I’m not worried about myself,” he said. “I’m worried about the job I have to do.”\nAndrew Jacobs contributed reporting. Alain Delaqueriere contributed research.\nDisclaimer:  Any third-party material in this email has been shared for internal use under fair use \nprovisions of U.S. copyright law, without further verification of its accuracy/veracity.  It does not \nnecessarily represent my views nor those of NIAID, NIH, HHS, or the U.S. government.\nPRESS:  FOX Sunday with Chris Wallace; Meet the Press with Chuck Todd;  \nAppeared on 60 Minutes (CBS) Special on coronavirus\nMar. 9, 2020 – 111,354/3892.  Stock market really crashing.  \nEven though we are saying that 1.1 million tests are out there, and millions (4 mill this \nweek) to follow, we still do not know how many tests have been performed and whether \nanyone can get a test who needs it.  hate to say it, but some incompetence at CDC/FDA.  \nWe are  geeting killed publicly by this vulnerability.   Am now told by CDC that we only \nhave 1 million nasal swabs to collect the specimens.   And so now we have more tests \nthan swabs!   And the limiting factor is the swabs.\nGov.  Cuomo calls me up and asks my advice on whether to close schools in the orthodox \nJewish section of Westchester where they have 90 cases (more than rest of NYC).   I tell \nhim yes.   He also asks about closing subways.   I tell him not yet, but let us stay tuned.\nI will push for more surveillance testing.  Lab Corps and Quest\nOn phone call with VP and all the Govenors. I talk about protecting the vulmerables with \nco-morbidities, particularly among the elderly   I bring Cliff into the group on an almost \nfulltime basis.\nCases in 35 states.   >500 cases with 22 deaths\nPriority 1 is to get people off the Grand Princess.\nReleased by Chairman Rand Paul\n713Had press conference.   POTUS came.  Had good conversation with him.   He is getting \nvery crummy with me.   I sarcastically answered one of the persistent questions about the \ncruise ship issue by saying I personally would never get on a cruise ship.\nPRESS:   CNN New Day with Alisyn Camerota and John Berman; FOX and \nFriends. \nMar. 10, 2020 – 116,588/4090.  USA cases now 712. Deaths 29\nJust signed off on a Level 3 State (“Reconsider Travel”) and a Level 3 CDC (“Avoid \nnon-essential travel) for the European Schengen Area   This measn that all travelers from \nthis area are required to enact a 14 day voluntary quarantine after arriving to USA.  Also \nwill consider an INA Section 212(f) Proclamation banning travel to USA bu any foreign \nnational, with limited exceptions,  who has been physically present in Italy in the last 14 \ndays\nI  push hard with Jerome Adams to expand community mitigation.  One topic was \nwhether there should be campaign rallies.   I insiste that we say all large crowds should \nbe avoided.   Marc Short pushes back since the POTUS will be doing rallies.   Jerome and \nI continue to push.   I will say that the degree of stopping depends on the area of the \ncountry – Washingotn State (bad); Nebraska (probably OK).\nChris Liddell becoming a friend and encourages me to stick by my guns – good guy.\nFor better or worse, I am becoming an international celebrity.  Calls from all over the \nworld.   \nAm concerned a bit about my health.   Having total body pain and will again stop Crestor\nReports from Italy are really bad.   Running out of equipment and just letting the elderly \nand frail die without intervention.\nKatie Miller defending my saying what is my opinion  based on good  public health \nprinciples despite others in the  VP’s staff wanting me to be a bit more politically \nsensitive, particularly around campaign rallies.  Katie wants to have me do ther “Fauci 5” \nthis coming Sunday.\nChatted with Govenor DeSantis (R-FL) who was concerned that I said at Press \nconference today that Florida had community spread, when in fact Florida just had a big \ncluster.   He was correct, was nice on the phone call arranged by WH after he \ncomplained.   We came out with a statement correcting.\nSpoke together with (Bob Redfield)with Nancy Pelosi at the request of VP to convince \nher to pass a bill to indemnify companies who make the surgical masks.   There are 2 \ncategories of masks: 1) medical, and 2) industry.   They are really the same with some \nvery minor differences.  We do not have enough medical and so we want to sell the \nReleased by Chairman Rand Paul\n714industrial ones to medical use. The PREP act allows indemnification   The companies \nwant indemnification to sell the industrial ones to medical.\nPRESS:  NPR Morning Edition; FOX  Hannity\nMar. 11, 2020 – 121,098/4366.    >1000 cases in USA – 29 deaths (WHO numbers).\nCongressional House Energy and Commerce Oversight and Reform Hearing today – \nCarolyn Maloney (D-NY) Chair\nAMAZING DAY!!  Before Hearing we were told that the POTUS wanted me at the \nWhite House at 12:30 PM for a meeting about travel restrictions that we had been \ndiscussing and the Hearing was supposed to end at 12;30PM ..  I obviously had to leave \nat 11:45 AM.   I left. The chair and committee was very annoyed.   The twitter feed \nblasted that since I was being very forceful in saying that :”Things were going to get \nworse before they got better” and gave a very serious warning about what was ahead, that \nthe POTUS yanked me out of the hearing (Amazing).. Multiple TV cameras and \nhundreds of camera clicks followed me out of the Rayburn Building as I had a car \nwaiting for me to take me to the Oval Office.\nThe days discussions were historic.   I, Bob Redfield, Deb Birx and Azar argued and \ndiscussed for a couple of hours that we should retrict all travel from the Schengen \ncountries (the 26 European countries) similar to what we did with China (see above).  \nUSCITS can come back but will be funneled through 1 of 13 airports and when they get \nhere, they must self isolate fo 14 days.   Non-USCITs can only come if they had spent the \nlast 14 days outside of the Schengen.   Reason was that 70% of all new global infections \nwere in Europe (particularly Italy and France) and 30 of the 35 US States had infections \nthat originated in Europe.   Level 3 travel to Europe – only essential travel\nSteve Mnuchin and Larry Kudlow were against this since they felt it would cause a \ndepression, not just a recession.   We went back and forth multiple times.   Jared Kushner \nand Bob O’Brien (NSC) weighed in with me and Bob/Deb.    \nWe went in and presented to the POTUS and he asked good questions, many of them to \nme.   He agreed and was clearly concerned more about the health of the American people \nthan he was about the economy, which he said would recover.\nWe then went and asked the opinion of the CEOs of the major banks who were waiting \nfor POTUS in the Cabinet room.  We did not them what we had alredy decide, but we \nasked them what they thought about travel restrictions.  They were favorably disposed.\nSpeech written mainly by Steve Miller with help from Jared Kuschner.  I helped in \nreviewing of the Speech which the POTUS gave at 9:00 PM from the Oval. POTUS \nwriters took out some good stuff that I wanted in and kept in some stuff I did not like.   \nHowever, in all it was a good speech.\nReleased by Chairman Rand Paul\n715The VP and I called Pelosi, Schumer, Mitch McConnel, and Kevin McCarthy to give \nthem a heads up\nAfter I went home and watched on TV, the CNN commentators (Chris Cuomo, Anderson \nCooper, David Gergon, David Gregory) all discussed me as the adult in the room and the \nperson wew should all trust.  \nFinally, Nancy Pelosi called me at home and was enraged and yelled at me for about 25 \nminutes saying that we left out the UK because of Trumps relationship with Boris \nJohnson.   She is completely incorrect.   UKwas not part of Schengen.   She did not care.   \nShe said that I have lost all of my credibility now by saying that I said this was a public \nhealth decision when it really was a political decision.   Terrible phone call!!!   I called up \nOlivia Troye (Assistant to VP) after the call and explained.   We will try to address this \ntomorrow.   Probably should get Steve Beigen (State) to explain Schengen to her.\nPRESS:  WTOP Radio;   Clips of me all over all the news on multiple \nnetworks/cable.\nMar. 12, 2020 – 129,846/4931.  1267 cases in USA, 38 deaths.   Cases in 44 states.   \nItaly continues to surge\nHas House briefing in Capitol and Senate briefing in Dirksen.  Then continuation of \nHouse Energy and Commerce Hewaring from the other day with Malonet as Chair.   \nAgain, they hammered us about testing.  The Senators and Congressperrdsons were \nenraged, especially Patty Murry (D-WA).   Steve Redd during the briefings and Bob \nRedfield during the Hearing continued to be incoherent in explaining about the difficulty \nregarding testing the “Public health” system that the CDc set up works well in individual \nsmall numbes of patient/physician related requests.   However, it is not suited to mass \nscreening.\nCalls with Se. Joe Munchin (x2); Gov. Cuomo; Sen. Rick Scott (R-FL)\nVery flattering article abpout me in the Washington Post by Karen Tumulty (see below) \nthat explains the above:\nAnthony Fauci fights outbreaks with the \nsledgehammer of truth\nReleased by Chairman Rand Paul\n716Dr. Anthony Fauci, the director of the \nNational Institute of Allergy and Infectious Diseases at the National Institutes of Health, \non Capitol Hill on Thursday. (Joshua Roberts/Reuters)\nBy \nKaren Tumulty \nColumnist\nMarch 12, 2020 at 5:32 p.m. EDT\nA virus that is deadly and little understood. An administration in deep denial. Anthony S. \nFauci has been here before.\nAs the coronavirus epidemic escalates, the director of the National Institute of Allergy \nand Infectious Diseases (NIAID) has become a familiar media presence.\nFauci’s expertise and credibility shine against the contradictory and false messages \ncoming out of President Trump. The administration has at times sounded more concerned \nwith protecting the president politically than stopping the spread of a potentially lethal \ndisease.\nWhile Trump tries to play down the severity of a public health crisis that might affect his \nreelection prospects, Fauci has laid out the best assessment of the true danger in stark \nterms.\nIn testimony Wednesday on Capitol Hill, he warned that the coronavirus has a mortality \nrate 10 times as great as that of the flu, and refuted Trump’s rosy promise that a vaccine \nwill be ready “in a fairly quick manner.” Fauci also said flatly that the government is \n“failing” when it comes to the urgent imperative of making widespread testing available.\nThe latest updates on the coronavirus\nAfter federal officials gave lawmakers a briefing on Thursday, a frustrated Rep. Anna G. \nEshoo (D-Calif.) told me: “Everything was wrapped in confusion. The only one who \nReleased by Chairman Rand Paul\n717answers the questions — he not only gives the science, but then he says, let me explain \nthis in pedestrian language — is Dr. Fauci.”\nThen again, this is not the first time Fauci has found himself in the position of having to \nnavigate a public health crisis fraught with political land mines. A renowned international \nexpert on the immune system, Fauci took over NIAID in 1984, barely a year and a half \nafter scientists had identified a mysterious retrovirus that was killing thousands of people.\nIt would be nearly another year before President Ronald Reagan would publicly utter the \nname of the disease it produced: AIDS. Reagan’s sluggish handling of the epidemic left \none of the deepest scars on his legacy.\nIn 1986, Reagan’s surgeon general, C. Everett Koop, produced a report that described in \ngraphic terms the potential toll of AIDS, projecting that 270,000 Americans might \ncontract it by 1991. The report used explicit language, explaining that the disease was \ntransmitted through “semen and vaginal fluids” and during “oral, anal and vaginal \nintercourse.”\nConservatives approved of some of what was in Koop’s document: It warned against \n“freewheeling casual sex,” and asserted that the surest means of preventing AIDS were \nthrough abstinence and monogamy. But they weren’t so happy with the surgeon general’s \nrecommendation that condoms be used as a fallback.\nKoop was concerned that his findings were being buried by the Reagan administration, so \ntwo years later, he and Fauci cooked up a bold idea: mailing an abridged version of his \nreport to every single one of the 107 million households and postal boxes in the country.\nThe problem, however, was that the surgeon general lacked the budget to do it. As Fauci \nrecounted to me during a 2018 interview, he told Koop: “You know, there is a \nmechanism called an interagency transfer.” Fauci had the authority to provide funds to \nget the project off the ground, because combating AIDS related to his own agency’s core \nmission.\nCongress picked up the idea and ordered the largest mass mailing in U.S. history. It also \nstipulated that the seven-page brochure be “distributed without necessary clearance of the \ncontent by any official, organization or office” — in other words, that it not be edited to \nsuit anyone’s political agenda.\nIn addition to being printed in English and Spanish, “ Understanding AIDS” went out in \nChinese, Portuguese, Haitian-Creole, Vietnamese, Laotian, Cambodian and Braille. It \ndebunked many myths about the disease, for instance stating unequivocally that AIDS is \nnot spread by mosquitoes, and could not be caught through casual contact with saliva, \nsweat or toilet seats.\nReleased by Chairman Rand Paul\n718Subsequent surveys found that nearly 87 million adults perused part or all of the booklet \n— making it the most widely read publication in the country in July 1988, with Reader’s \nDigest coming in a distant second with 48.5 million readers. \nOf course, there are many differences in scale and severity between the AIDS epidemic \nand the coronavirus threat. While most who contract coronavirus will recover, AIDS \nduring the 1980s was a death sentence wrapped in stigma.\nBut as Fauci well understands, all infectious diseases have something in common: \nAccurate information is one of the most powerful weapons for fighting them.\nFauci has already shown how important it is to hit a microscopic enemy with a \nsledgehammer of truth. A yet-untold number of Americans will be betting their lives on \nhim to do it again.\nLooks like I may have Polymyalgia Rheumatica or really bad Crestor myalgia\nPRESS:  On Pebble Beach at the White House after the TF meeting:   ABC Evening \nNews; CBS Evening News; NBC Evening News;   Then, I did a gaggle of 5 questions \non Pebble Beach;  CNN Coronavirus Town Hall with Sanjay Guptya and Anderson \nCooper;\nMar. 213, 2020 – 132,382/4981    USA 1694    Deaths.  Primary health care facilities.   \nHot areas – WA, CA, MA, NYC\nI thought that it would be a quiet day since the TF meeting was called off.  However, at \n2:00 PM, I was called down to the White House since the POTUS wanted me next to him \nat the podium of the Rose Garden as he made the announcement of deckaring at \n“National Emergency” which would give him and the Secretary of HHS the power to \nremove many constraints in  response to a national emergency. Also on the podium were \nthe CEOs of the major private sector companies that would make tests readily available – \nCVS, Target, Walmart, etc.  I was at the posium and answered many questions of the \npress in the Rose Garden.   I will be on the 5 Sunday Showes  2 days from now (The \n“Fauci Five”).  Prior to that, I was involved in helping to proof the speech he would give.   \nThere were some glaring errors in the speech that I corrected.   Got to meet Hope Hicks \nwho was very nice.   Jared is playing a major role in all of this.\nAfter the presser the White House people showe me a minute by minute graph of the \nstock markert from the time the POTUS went to the podium and it went down to the 45 \nminutes of the speech and questions.   The DOW went up in 45 minutes 1980 points, \nwhich was the greatest single increase in the market in history.   The POTUS signed a \ncopy of the graph for me and several of the CEOs\nMy tooth crown fell out in flossing this AM and Dr. Eric Hosaka so nicely fixed it for me \nright away 2 hours after I called him Also, got and MRI for my leg pain.\nReleased by Chairman Rand Paul\n719Alex Azar is obviously being pushed aside as he played a very minor role in the Rose \ngarden Presser.\nPRESS:  MSNBC Morning Joe; GMA (ABC);CBS The Morning; FOX and Friends;  \nBBC World News; Rose Garden Presser with many cameras.\nMar. 14, 2020 (Saturday)  -  CDC numbers (less than WHO numbers.  142,320/5388.   \n129 countries involved.   China numbers going way down – only 11 new infections.   \nKoreaa flattening out.   USA – 2226 cases, 50 deaths, 532 new cases.\nPOTUS came into the TF meeting with “USA” baseball cap on.   We spent a lot of time \ntalking about “ratings’ of yesterday’s press conference and its effect on the stock market.   \nHe dwelled on doing more press conferences and how the ratings would be even better \nthan the best fake news TV ratings.   He made the right decisions about now doing travel \nrestrictions in UK + Ireland and so what I ma seeing is someone who actually makes \ndecision that are bestr for the public health since he follows what the TF recommends \n(driven by me and Deb and CDC) but his public expression and even private expression \nis related to the fluff of ratings and publicity.   And so he wants us to do 2 press \nconferences/day – one in AM and one in PM.  Really interesting.  We now will have no \ntime to do work.\nHope Hicks seems as uncomfortable with this as I am.  I see her as a future ally.  POTUS \nDid press conference and Alex Azar was not invited in  order to make room for \n“diversity” on the podium with Ben Carson and Jerome Adams.   Death by a 1000 cuts \nfor Azar.   I volunteered to Alex that in my introduction I would mention that the \nDeclaration of Natuonal Emergency gacve Azar as Secertary enormous powers and \nflexibility to unshackle our response.   I did so.\nMahor positive profile of me in The Atlantic yesterday (03/13/2020)  \nhttps://www.theatlantic.com/notes/2020/03/time-capsule-2-exceptional-dr-\nfauci/607957/?utm_campaign=share&utm_medium=email&utm_source=a  (see below):\nAs of today, March 13, 2020—three-plus years into the current \nadministration, three months into public awareness of the \ncoronavirus spread, seven-plus months until before the next \nelection—Anthony Fauci is playing a role in which no previous \nTrump-era figure has survived.\nOne other person has been in the spot Fauci now occupies. That is, of \ncourse, James Mattis, the retired four-star Marine Corps general and \nformer secretary of defense for Trump. Former  is the key word here, \nand the question is whether the change in circumstances between \nMattis’s time and Fauci’s—the public nature of this emergency, the \nReleased by Chairman Rand Paul\n720greater proximity of upcoming elections, the apparent verdict from \nfinancial markets and both international and domestic leaders that \nDonald Trump is in deep over his head—will give Fauci the greater \nleverage he needs, not just to stay at work but also to steer policy \naway from the abyss.\nWhy is Anthony Fauci now, even more than James Mattis before him, \nin a different position from any other publicly visible associate of \nTrump’s?\n1.Pre-Trump credibility, connections, and respect . Fauci has been \nhead of the National Institute of Allergy and Infectious \nDiseases, at the National Institutes of Health, since Ronald \nReagan’s first term, in 1984. (How can he have held the post so \nlong? Although nothing in his look or bearing would suggest it, \nFauci is older than either Bernie Sanders or Joe Biden. He \nrecently turned 79.)\nThrough his long tenure at NIH, which spanned the early days \nof the HIV/AIDS devastation and later experience with the \nSARS and H1N1 epidemics, Fauci has become a very familiar \n“public face of science,” explaining at congressional hearings \nand in TV and radio interviews how Americans should think \nabout the latest threat. He has managed to stay apart from any \nera’s partisan-political death struggles. He has received a raft of \nscientific and civic honors, from the Lasker Award for health \nleadership, to the Presidential Medal of Freedom, awarded by \nGeorge W. Bush.\nThus, in contrast to virtually all the other figures with whom \nTrump has surrounded himself, Fauci is by any objective \nstandard the best person for the job — and is universally seen \nas such . This distinguishes him from people Trump has favored \nin his own coterie, from longtime consigliere Michael Cohen to \nlongtime ally Roger Stone to longtime personal \nphysician Harold Bornstein; and from past and present \nmembers of his White House staff, like the departed Michael \nFlynn and the returned Hope Hicks and the sempiternal Jared \nKushner; and fish-out-of-water Cabinet appointees, like (to \npick one) the neurosurgeon Ben Carson as Secretary of Housing \nand Urban Development.\nReleased by Chairman Rand Paul\n721Put another way: Very plainly, Trump needs Fauci more than \nFauci needs Trump. This is not a position Donald Trump has \never felt comfortable in— witness the denouement with Mattis.\n  \n2.The ability not to abase himself before Trump . The first Cabinet \nmeeting Donald Trump held, nearly three years ago, was unlike \nany other conducted in U.S. history, and very much like \nsubsequent public appearance of Trump in company with his \nappointees.\nIn that meeting, on June 12, 2017, as TV cameras were rolling, \nTrump went around the table and one-by-one had his \nappointees gush about how kind, wise, and far-sighted he was—\nfailing only to compliment him on his humility. (Tina \nNguyen described the meeting at the time in Vanity Fair .) After \npraising himself, Trump called on others to praise him, starting \nwith the reliable Mike Pence. “It is the greatest privilege of my \nlife to serve as the vice president to a president who is keeping \nhis word to the American people,” Pence began. All the others \nfollowed his example—with the prominent exception of Mattis. \nHe spent his “praise” time instead complimenting the men and \nwomen in uniform he led.\nNo public event like that Cabinet meeting had happened before \nin the United States, simply because no other president has \nbeen as needy for in-public  adulation as Trump is. Of course \nmost politicians and all presidents are needy; you could not run \nfor the presidency if you had a normal temperament. \n(Background reading on this point, while you’re “socially \nisolating”: Robert Penn Warren’s All the King’s Men.)  Every \npolitical leader eats up the praise in private—“Wonderful job \ntoday, Mr. President—you were really connecting!”, not to \nmention Veep —but all the rest of them have been savvy enough \nto know how tacky this looks in public. The modern exception-\nillustrating-the-rule might have been Lyndon Johnson, with \nenough of the Sun King in his makeup to enjoy having \npeople humble themselves before him. But holding a public \nadulation-fest? If George W. Bush had heard, say, Karl Rove \nstart in that way, he would likely have said, “OK, Turd Blossom, \nwhat are you angling for?” Barack Obama—or John F. Kennedy, \nor Jimmy Carter— would have arched an eyebrow as if to ask, \nReleased by Chairman Rand Paul\n722“Hey, did you think you were still playing in the minors?”\nBut what we saw in that Cabinet meeting, we have seen again \nand again from those around Trump. The most humiliating \nrecent examples come from the people in charge of the \ncoronavirus response: Pence again; Alex Azar, head of Health \nand Human Services; Robert Redfield, head of the Centers for \nDisease Control; and Seema Verma, in charge of Medicare and \nMedicaid. The beginnings and endings of their public \nstatements, and the answers to many questions, are larded with \npraise for Trump and his “decisive and visionary action.” (For \nthe latest example, see Verma under questioning from Martha \nMacCallum of Fox News. Verma repeatedly dodges \nMacCallum’s direct question about whether hospitals have \nenough ventilators and other supplies (as Fred Barbash laid \nout in the Washington Post . MacCallum makes one last try—\nand Verma seeks refuge in saying, “And that’s why the \npresident has taken such a bold and decisive action.” That claim \nmade no logical sense to MacCallum or the listeners, but it \nreflected the inescapable logic of what is expected from \nmembers of the Court of Trump.)\nThere is one exception: Anthony Fauci. He has occasionally said \nthat he agrees with aspects of the administration’s or the \npresident’s policies, but he has avoided the ritual self-\nabnegation. Of course Fauci held his job long before Trump \ncame to town, and is not part of the normal round of high-level \nappointments each new administration makes. (To the best of \nmy knowledge, though, directors of NIH institutes, like Fauci, \nserve “at the pleasure of the president” and so could be \nremoved. If I’m wrong on that, will update. Update: Several \nNIH veterans have written in to say that Fauci’s position is \nofficially different from that of the NIH director, and is not \ndirectly a presidential-political appointment. Recent history \nteaches that a vindictive president can make things difficult \neven for career civil servants. But I am grateful for the \nclarification. )\nBut Fauci’s polite but consistent reluctance to grovel cannot \nhave gone unnoticed by the audience-of-one for all the other \nappointees: Trump himself.\n  \nReleased by Chairman Rand Paul\n7233.Daring to contradict Trump, in public . This is a step beyond \nanything Mattis attempted. Through the first two years of the \nadministration, background-sourced stories and reports based \non “those in a position to know the Secretary’s thinking” laid \nout the increasing distance between Mattis’s view of American \ninterests and what Trump was saying and doing.\nBut there is no precedent, from Mattis or anyone else, for what \nwe have seen these past few weeks from Fauci at the podium. Is \nthe coronavirus problem just going to go away (as Trump had \nclaimed)? No, from Fauci. It is serious, and it is going to get \nworse.  Is the testing system “perfect” (as Trump had \nclaimed)? No, it is not working as it should . Is the U.S. once \nagain the greatest of all nations in its response to the \nthreat? No, it is behind in crucial aspects, and has much to \nlearn from others.\nFauci is saying all these things politely and respectfully. As an \nexperienced Washington operator he knows that there is no \nreason to begin an answer with, “The president is wrong.” You \njust skip to the next sentence, “The reality is...” But his \nmeaning—“the president is wrong”—is unmistakable.\nAnthony Fauci has earned the presumption-of-credibility for \nhis comments. Donald Trump has earned the presumption that \nhe is lying or confused. A year ago that standoff—the realities, \nversus Trump-world obeisance—worked out against James \nMattis. Will the balance of forces be different for Fauci? As of \nthis writing, no one can know.\nPRESS: Press conference in WH press room; The Atlantic (see above)\nMar. 15, 2020 (Sunday) – BIG DAY!\n142,539/       USA = 2888 with 58 deaths and 662 new\nI did all 5 Sunday Shows today (my 3rd Fauci 5”) with This Week on ABC, Meet the \nPress on NBC, Face the Nation on CBS, FOX with Chris Wallace and CNN.   All went \nvery well\nHad press conference at White House.  POTUS made intro and then left for us to take \nQuestions.  Brett Giroir brought a bunch of USPHS officers with their dark blue work \nuniforms and told the press how great they are.   I spent an hour before the press briefing \nReleased by Chairman Rand Paul\n724in the VP’s office.   In preparing for the briefing which was geared to rolling out the high \nthroughput tests in collaboration with the States and the private sector that will be \noperational in the next day or so, they wanted to spin it that this was unprecedented that \nno one has ever done this so quickly.   Deb did not speak up which shows me that she is \nreally inhibited by her Presidential appointee status.   A little shame on her.   I spoke up \nand said that several countries have already done what we are talking about, i.e. China, \nSouth Korea and so why not stop bragging and just say that we are entering a new phase \nof our response to COVID-19, i.e. a much more expansive testing capability.  Hope Hicks \nand Jared Kuschner were my allies in this and both seem to now want to make sure that I \nam involved in everything and approve everything.\nThe POTUS came in and misunderstood thinking that we (the USG) would be \nimplementing the testing.  He was pissed.  Brett and VP corrected him.   However, he \nremained in a bad mood.  He then said that he wanted to show his face and make some \nremarks without Qs and As at the briefing.   Hope felt this was dangerous and said he \nshould not do it.   He started to berate Hope in front of everyone say that he became \npresident because he was good and dealing with the public and was pissed that Hope was \ntrying to tell him what he could or could not do.\nI spoke with Bill de Blasio (Mayor – NYC) and convinced him based on what I was \nsaying publicly and my conversation tonight to close the NYC schools (he had already \ndecided based on what I was saying on TV).   I went on to tell him he should close the \nbars and restaurants in NYC.   He said that he would base this on my recommendation.\nI had a similar call with Ann O’Leary, the COS of Gov. Gavin Newsom of California.   \nAnn said that based on my TV appearances today and yesterday, the Governor has \ndecided to close the schools in California as well as the bars and restaurants.\nWhen I left the WH and crossed Pennsylvania and 17th Street, several cars honked their \nhorns and shouted “thank you” out the window.\nCongress (Blount) call and wants to give us a lot more in a 2nr supplement.\nMar. 16, 2020 – Came out with the guidelines that reflected my pushing for a more \naggressive mitigation 15 day strategy →  If you are elderly, self-isolate; do not \ncongregate in groups >10 people; stay away from bars, restaurants, theaters, sporting \nevents;  if a community has community spread CLOSE the bars, restaurants and places of \ncongregation; close schools where there is community spread; no visitors to nursing \nhomes; if family member is  sick, others in family should take extra percautions; only \nnecessary travel, telework as much as possible.\nPress conference after was highly attended.   Stock market dropped byu 3000 points, the \nbiggest percentage drop in history.\nPRESS: ABC 20/20 coronavirus special with David Muir;\nReleased by Chairman Rand Paul\n725Mar. 17, 2020 – 168,000/6700; 151 countries; USA 4529 cases (903 news); 84 deaths \n(16 new).   At TF discussed supply chain issues; also testing still somewhat of an issue.\nPress conference with POTUS.   He is now coming around (largely through my efforts) to \nsay thatr this is really a serious problem, but he still always brags about how well we are \ndoing as opposed to emohasizing the challenges ahead.   I gave some support to Gov. \nCuomo during a question of me.  \nIssue arising of clains from France that hydroxychloroquine is effective in decreasing \nthe duration of viral shedding and also is used as a prophylaxis in exposed people.   All \nuncontrolled studies.\nPRESS: Press conference after TF.   I was featured heavily in the presser; FOX with \nLaura Ingraham;  Sean Hannity Radio; Barstool Sports Podcast\nMar. 18, 2020 – WH wanted me to not wear myself out.   Have had private car and \ndriver since Mar. 13 (Friday).   I will stay at NIH today and do some press tonight from \ntruck at home.   Very positive press with Laura Ingraham on FOX last night\nMy diagnosis of PMR really bothering me.  Will start on prednisone today.\nOn WHO call, Dale Fisher (Australian working in Singapore) gave warning to other \ncountries that after you lift the lock down, be prepared for a rebound and use the lock-\ndown period to stock up on supplies, prepare alternative hospitals (gyms, schools, etc.) \npreserve PPE and not use them for unnecessary things.   Also, from Italy, 12% of ICU \npatinets were 19-50 years od and ~30% were 50-70 yo; 50% of French patienets in ICU \nare under 60 yo.\nBloomberg report on March 18 (Tommaso Ebhardt et al) said that in Italy 99% of thois \nwho died had “othe illness”.   However, 75% of these had hypertension.   These latter \nmust have been on anti-hypertensive meds and so the issue of ACE inhibitors absolutely \nmust be pursued.\nOn TF call we discussed the Defense Production Act and a possible EO.   Also, the VP \nsaid over the phone that he wanted me at the Pressor today and Katie (good for her) \npushed back and said that I should stay at NIH.   VP looked surprised.   Probably will \nhear more about this.   \nAlso, at TF meeting they decided to fully embrace FEMA and make a big announcement \nabout that with the POTUS today.\nNew York City and State are facing a “Sophie’s Choice” regarding PPE.   They are very \nlow and they have to make a decision of using PPE for testing versus giving to HCWs \nwho are taking care of patients.   Obviously, it goes to HCWs, but that will interfer with \ntesting.   This was related to me by phone call with Peter Staley, Mark Harrington, and \nJames Krellerstein.\nReleased by Chairman Rand Paul\n726Also, had phone call with Major de Blasio who wants to go to “shelter in place for the \nentire city.   He is asking my advice since Gov. Cuomo is pushing back.   I advised \nDeBlasio to go ahead and do it.   I will try to speak with Cuomo.\nPOTUS called me up from Oval.   He has Alex Azar, Steve Hahn, Bob Redfield Scott \nGottlieb, and Deb Birx in the office with the usual WH crowd.   They want me in on the \ndiscussion.   A friend of POTUS (Tom Ellison of Ellison Foundation ?) said that he \nheards that someone gave Hydroxychloroquine (HC) to 51 people and 51 got better. \nPOTUS has heard similar stories, including Remdesivir (R) about other drugs and wants \nto make these available.   To my amazement and dismay, Azar said that he could approve \nHC and Remdesivir now with the powers that he has.   Steve Hahn and to some extent \nDeb and Bob started to chime in that this would give people hope.   I took a deep breath \nand said that this was wrong and should not be done.   If you want expanded access (EA) \nof HC which is an approved drug, you can do it in an EA protocol and still get wide \ndistribution and possibly learn something.   I stated that with R it is different since this \nwas not approved.   In the chorus of eeveryone agreeing with the POTUS that we need to \ngive hope to people, I insisted that we can do both, but in the context of a trial.   To his \ncredit, POTUS agreed with me as long as we get the drugs out there.   They wanted to \nannounce this today, but I convinced them to do so tomorrow when I am there.   Below is \nan e-mail that I sent right after the conversation:\nFrom: Fauci, Anthony (NIH/NIAID) [E] \nSent: Wednesday, March 18, 2020 2:27 PM\nTo: Redfield, Robert R. (CDC/OD) <olx1@cdc.gov>; Stephen Hahn \n<SH1@fda.hhs.gov>; Birx, Deborah L. EOP/NSC <Deborah.L.Birx@nsc.eop.gov>\nCc: clane@niaid.nih.gov; Troye, Olivia EOP/NSC <Olivia.Troye@nsc.eop.gov>; Short, \nMarc T. EOP/OVP <Marc.T.Short@ovp.eop.gov>; Miller, Katie R. EOP/OVP \n<Katie.R.Miller@ovp.eop.gov>; Hicks, Hope C. EOP/WHO <Hope@who.eop.gov>; \nkellyanne conway <Kellyanne.e.conway@who.eop.gov>\nSubject: Follow-up of today's conversation\nFolks:\n     When we put together the proposal for the protocols/distribution of \nHydroxychloroquine (HC) and Remdesivir, I feel that it is important that we \ndo not make the program the same for each.   We need to link Remdesivir to \na much more strict protocol as opposed to HC which is an approved drug \nand although it has some adverse events, we have tons of experience with \nit.  I am comfortable with the HC plan as discussed in the Oval.    In \ncontrast, we know much less about the unapproved drug Remdesivir.   I have \nmore concern about the potential toxicities of this unapproved, \ninvestigational drug in the context of COVID-19 as well as the need to prove \nthat it works before we widely distribute it.   The bulk of the data that we \nhave with Remdesivir is in Ebola where it did not have a clear benefit.  We \nshould consider leading with HC in a flexible distribution protocol and \nReleased by Chairman Rand Paul\n727accelerating the clinical trial aspect of Remdesivir.   Also, we clearly need to \nhave a discussion with Gilead about drug supply and the plan for any \naccelerated study.  Finally, and importantly, the Chinese already have a \nclinical trial of Remdesivir with more than 200 people enrolled in the \nadvanced disease arm of the study.   Someone should directly contact the \nChinese investigators (Bin Cao, et al) and find out if they have any \npreliminary data on efficacy and safety.  In my mind it is imperative that we \nfind out what they know before we launch any distribution program. Happy \nto discuss.\nThanks,\nTony\nAnthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nPRESS: Dave Webb Radio Show; Mike Gallagher Show; FOX Tucker Carlson; \nCNN Cuomo Prime Time;\nMar. 19, 2020 - >200,000/~10,000; USA – 9026/150; 2900 new.   Italy >31,000 \nIn the USA testing:  ~70,000 tests with ~10% positive\nMet yet again with POTUS right before the press conference, which did not include me \nsince it was predominantly an FDA issue with Steve Hahn.  POTUS excited about \nmaking drugs (Chloroquine, Remdesivir, etc.) more accessible.  Therapy was the theme \nof the day.  They actually were going to go too far (see above) and make them all \navailable on compassionate use.  I convinced them not to.   POTUS was hot to give out \nchloroquine or hydroxychloroquine since Jeff Ellison thinks that it is a great drug.  Steve \nHahn did a good job in stressing the need for safety and efficacy data.\nKatie Miller and Kelly Love are trying to not overload me and particularly Katie is \nsensitive to my time.\nReleased by Chairman Rand Paul\n728Call with Gilead regarding remdesivir studies and supply\nPRESS:  Marc Levin Radio; PBS NewsHour with Judy Woodruff; Facebook with \nMark Zuckerberg and Priscilla Chan; CNN Town Hall with Anderson Cooper and \nSanjay Gupta; NBC Evening News with Lester Holt\nMar. 20, 2020 – Another day at the WH.   Important TF meeting and press conference.   \nDuring the day, Gov. Cuomo had a press conference that he wanted me on to join him, \nbut I could not since I did not want to do a press conference outside of USG and the \nWGH would not let me do it anyway.   Cuomo took a gigantic step forward.  90% of \nthe new infections in the USA are now coming from NYC and Westchecter, but mostly \nNYC.   Cuomo is essentially shutting down all non-essential activity in the city..  100% \nof non-essential workers must stay at home and not intermingle.  I strongly praised \nCuomo for doing this at the Presser after the TF.\nWe met with the POTUS (as usual) in the Oval.   The theme of the presser will be the fact \nthat we are now having only essential travel to Canada and Mexico, and \nIMPORTANTLY, no aliean/immigrants can enter the countrywithout proper papers from \nCanada or Mexico, although the order is clearly aimed at Mexico.   The rationale is that \nwe are shutting down entry to USA from China, South Korea, Iran, Europe and \nUK/Ireland and yet people from these same countries are crossing over from Mexico.   If \nsome are infected and we take them in, we put them in facilities including with \nunattended children, we could have another cruise ship situation.   The decision relly was \na public health decision.\nLAST NIGHT, Katie and Steve miller called me up and explained why the CDC order to \ndo this was given (CDC was essentially told by state and DHS to do it).  They wanted my \nsupport to emphasize that this was a pubic health decision and not an anti-immigrant \ndecision.   I believe that they have a good point.\nDuring the presser, the reporters continued to ask me about the free distribution of \nHyrdoxycholorquine (HC) , which the POTUS wants, and my statements that the \nevidence to do this is purely anecdotal and there is no convincing evidence by an RCT \nthat either HC ro remdesivir works.   After the presser the press went wild saying how I \nagain contradicted the POTUS and I received hundreds of e-ails of people thanking me, \neven though I did not intend to or like the idea of contradicting POTUS, but I need to \nstick with the science.  They also had a tweet that went viral of me holding me head \nseemingly in disgust as the POTUS was talking.   That wa not my intention.\nMost important part of the day and disturbing was my conversation with Mark Meadows \nand Marc Short together with Deb Birx   Meadows praised me for a while and then got to \nthe point.   He wants me to consider the tone that I say that HC has no evidence of \nefficacy.   I told him that I cannot compromise my scientific principles.   Tough \nconversation.   He wa being a gentleman, but he wanted me to go to a place that I would \nnot go.\nReleased by Chairman Rand Paul\n729Even more disturbing was the conversation where he wanted me to support the idea of \nlifting the mitigation restrictions after the 125 dya periods since if we do not do this, \nMark fees thatwe will trigger a depression (not just a recession).   Mark Short agreed with \nhim, but seemed much more sensitive to the fact that I did not want to get into that kind \nof situation that would use my credibility to sell an economic and a political issue.   After \nI left the office, Mark Meadows called my cell and said that afterhe looks at some \nmodelling, he would like to sit down with me and figure out how we can resolve this \nissue.   He did ask me directy, if I thought we needed to extend the mitigation program \nbeyond 15 days and I said yes.   He seemed to accept that.   There certainly is more \nahead.   I called a meeting at my house with Cliff lane, Chrsitine and me to discuss how \nto handle this as we go forward.   I cannot and will not compromise  acting on my good \njudgment.   However, I can understand Marks dilemma with the economy.   There will be \nmore discuss.\nAlso, had conversation by phone with Governor John Bell Edwards of Louisiana who has \n~400 cases in NOLA and wants my advice about how aggressive he should be and maybe \ncopy NYC.   He has already closed all the bars and restuarants.  I told him to look at the \ninflection of the curve over the next day or so and contact his Commissione of Health.   It \nthe curve is steep, he should consider mandating only essential work and everyone else \nstays homw, but not quite yet.\nAlso, Petrer Staley, Mark Harrington, James Krellenstein and others called late at night \nand told me that they had a bad situation in NYC where the desire to do many tests was \neating up PPEs that were needed by HCWs who were taking care of COVID-19 patients.   \nThe implored me to speak out that ony necessary testing should be done, i.e. on \nhospitalized patient and those with sxs not in hospital, and not just anyone who wants a \ntest.   They sounded desparate that NYC would un out of PPEs within the next 7 days.   I \nwill bring this up to TF tomorrow.\nPRESS:  CBS Evening News with Norah O’Donnell; FOX with Bill Hemmer;  WH \nPress Conference; Major Washington Post Profile on me\nMay 21, 2020 – Global 234,100 – new 24,200; deaths 9800\nItaly 3,400 deaths, now surpassed China\nUSA – 19,300; new 5300; deaths 272 (73 new)\nAt task force meeting I stressed the problem about the PPEs being diverting to testing as \nopposed to HCWs.  I also emphasized this strongly at the subsequent press conference.   \nAgain, we met with POTUS after the TF meeting and in preparation for the presser.   \nVery good press conference.\nBig front page article abut me appeared in the Washington Post.   Very flattering.   The \nsituation with my national and international fame is explosive and really unimaginable.   \nIt is not hyoperbole to say that today I am the most famous and talked about person in the \nReleased by Chairman Rand Paul\n730country and one of the most recognizable peson in the world.   Countless profiles on me \nin multiple media.  I cannot even read all the things that are written abuyt me since I am \nso busy….seriously. POTUS seems to be enamored of me even though I am taking the \nspotlight away from him.   We are developing a very unique and interesting relationship.  \nThe entire secret service corps is coming over to me and chatting.   They let me into the \nfirst gate without even checking ID.   Everyone is worried about my health and welfare, \nprobably because it is all over the place that I am almost 80 years old.\nPRESS:  WH press conference picked up by many outlets.  Many print profiles and \nfeatures on me.   Ridiculous – too numeous to count!\nMar. 22, 2020 (Sunday)– Cases continue to soar. 30,000 in USA with 400 deaths;   Italy \nstill escalating.   My please to the TF regarding needing desparately to get PPEs and other \nsupplies to NYC seems to be working since FEMA in pusing stuff to them.  \n250,000 tests now done not counting those from hospitals and medical centers\nPress is going wild with me.   Front page in Washintgton Post  yesterday and Op Ed by \nMaureen Dowd in NY Times today about me and my relationship with the POTUS.   \nProfile by Peter Nicholas on me in The Atlantic .  I am trying in several articles and on TV \nto clarify that the POTUS is tsalking about hope for therapies although there are no good \ndata, while I must stick to the science and so fundamentally we are approaching this from \ndifferent, but not conflicting standpoints.   The press are crucifying the POTUS for “not \nlistening to me and making crazy statements about “game-changing” therapies and \npraising me fot stivking to my guns.\nORACLE (Larry Ellison – a bit of a loose cannon) .   Mark Meadows wants CDC, FDA \nand me to help put together by 5:00 PM tomorrow an on line site for tracking availability \nof drugs like Hyroxychloroquine and Remdesivir and making these drugs available via a \nphysician.   Bad idea, but it will happen.  I will go with this as long as it does not interfere \nwith the conduct of RCTs.   Cliff Lane helping out but employing NLM and NCATS \npeople.  I am giving him full authority since I have absolutely no extra time given what I \nam doing already.\nAlso, Jared and Mark are very skeptical about the CDC modesl about the trajectory of the \noutbreak and what can be predicted regarding timing of modification of the mitigation.   \nThey want to see the data before they believe the models and get CDC out of the business \nof doing this alone and making policy – good for them – it is about time.   I am getting \nCliff to get MIDAS people in on this.\nPress conference  (I did not attend) after the virtual TF meeting.   POTUS went into detail \nwith very granular numbers of all the things USG (mostly FEMA) is doing regarding \nsending masks, PPE, other equipment to high risk locations (Washingto State, CA, NYC, \netc.)   On TV programs, FEMA Pete Gaynor did not look good since he did not have any \nidea how many ventilators and other equipment was available.  POTUS went on and on \nReleased by Chairman Rand Paul\n731about all the things that we are doing. Very rambling and disorganized as he ad libs his \nspeech  I would have advised against this, since we are still getting calls that many \nlocations do not have enough of anything.   Also, they are talking about the now hundreds \nof thousands of tests that are out there  and being done.   However,as I have always said, \ntesting for the sake of testing without  reason only consumes PPEs of the people \nadministering the tests.\nLooking at the presser from home on computer has made it clear how self-congratulatory \nthe POTUS, VP and others appear on the stage.\nTitle 42 enacted – use of National Guard to help.\nRole out of telemedicine without reguations so that people do not have to leave the house \nto interact with their physician.\nA lot of promises – I hope we can back them up.\nPRESS:  CBS Face the Nation with Margaret Brennan; Multiple print features\nMay 23, 2020 – Global 292,000/12,800; new cases – 26,000;  USA 33,300/391;  new \ncases 6800.  Cases in USA went up overnight by 20%.   Bad news.\nGot copy of proposed POTUS press conference speech for this afternoon.   I objected \nsharply to the ststament that the ORACLE system (see above) will be able to follow \nevery coronavirus patient in the country starting in 2 days (Wed).   This is logistically \nimpossible and I surely will clash with WH people, particularly Mark Meadows.   He is a \ngood guy, but wedded to this.\nThey are pushing to get HC out and we really need to do it under and IND and a protocol.   \nMuch tension between me (also Steve Hahn, Cliff Lane) and the White House (Meadows \net al)\nApparently the WH is very upset that I am being profiled and it looks like I am putting \ndown the POTUS and becoming a star that outshines him.   The press is playing into this \nas is the tweet storm.   Very stressful!!\nHad improatnt and good meeting with Marc Short (VP- COS) and explained that 3 of the \n5 profiles of me were without even interviewing me.   The others started as inteviews and \nwound up as Profiles (Science – Jon Cohen, The New York Times - Maureen Dowd).  The \nprofiles always pit me (the good guy) against the POTUS (the bad guy).   I explained to \nMardc that I have no desire to conflict with, embarrass or show up the POTUS.  He \ncompletely understood the situation that I was in and was very sympathetic.   I told him \nthat I would not do anymore profiles.\nVery important meeting in the Oval Office with the POTUS, Deb Birx, Jared Kushner, \nMark Meadows, the VP and Marc Short about the timing of liftinbg the mitigation \nReleased by Chairman Rand Paul\n732guidelines and telling people to come back to work since if we go much longer, the \neconomy will definitely will tank and more damage to health might occur not to mention \ncivil violence.   He wnted to lift everything by Easter Sunday (April 12).   I pushed back \nheavily saying we need to model out how to do this in segments and not just declare \n“Opening Day”.\nPOTUS at press conference has essentially said he is going to open up the country.   Did \nnot say when, but hinted it was a few weeks at most.  Getting calls at home from  many \npeople wanting tomknow what I think.   I am nit anwering most.   Spoke with Gov. \nCuomo who is concerned about me and the position I am in.   Also, spoke with Chris \nCuomo who feels the same.\nAmazing firestorm about me on TV tonight with Chris Cuomo, Don Lemon and \nothers, wanting to know why I was not at the presser.   Chris is being wonderful about \nsaying that the press should not use Fauci as a foil against the POTUS.   We need Fauci \nand we are putting him in a terrible position by pitting him against the POTUS. \nPRESS: Several print profiles;   Mentioned all night on TV (see above)\nMar. 24, 2020 – 392,000/17,000; 45,000/550 in USA.  Cases still soaring in NYC.\nCOVID Cases \n3.24.20 powerpoint \nIncredible intrigue going on with people (likely WH staff) feeding total lies to media \nabout the frayed relstionship between me and the POTUS.  This is really bad stuff.   I am \ngetting calls from media (Reuters) saying that a source told them that the POTUS was \nscreaming at me and being abusive about the issue of HC treatments.   Total nonsense.\nSee below.   Typical of many aryicles over the past few days:\nIn order to save Dr. Fauci, we must \ndestroy him\nDr. Anthony Fauci, director of the National Institute of \nAllergy and Infectious Diseases, is a study of calm and \ncompetence in the middle of a pandemic. Which makes \nhim an endangered species, working as he does for a \nReleased by Chairman Rand Paul\n733boss who is notoriously insecure and made his name \nshouting “You’re fired!” on a reality TV show.\nBy Kevin Cullen Globe Columnist,Updated March 23, 2020, 5:25 p.m.\n209\nDr. Anthony \nFauci’s calm, reassuring competence in response to the coronavirus pandemic is placing \nhim at serious risk of hearing the words that made his boss famous: You’re fired.Jabin \nBotsford/The Washington Post\nDr. Anthony Fauci  is a bum.\nA quack, a snake oil salesman.\nHe got his degrees online, not from Holy Cross and Cornell .\nHe watches Wheel of Fortune but not Jeopardy.\nHe’s a Yankees fan.\nSuch character assassination is unsavory but necessary because Fauci’s calm, reassuring \ncompetence in response to the coronavirus pandemic is placing him at serious risk of \nhearing the words that made his boss famous: You’re fired.\nPresident Trump is watching and listening to the same thing we are, i.e., Fauci going to \nthe podium to rebut with facts the latest outbreak of paranoid anxiety or the president’s \nregularly reckless statements .\nReleased by Chairman Rand Paul\n734Fauci is an oasis of rigor and reason in a barren desert of confusion and fear.\nWhich, given who he works for, makes him an endangered species.\nDuring the Vietnam War, some US Army officer supposedly suggested that in order to \nsave a village from the Vietcong they had to destroy it.\nAnd so, to save Dr. Fauci, we must destroy him — at least in Trump’s eyes.\nNow that might sound crazy, but we’re dealing with a crazy president in crazy \ncircumstances.\nIt’s not as if there’s no relevant precedent here.\nTwo words: Bill Bratton.\nTwo other words: Rudy Giuliani. Who happens to be Trump’s BFF.\nBefore Giuliani grew old, deranged, and more qualified to be a spokesman for Miracle \nEar than the president’s lawyer, he was the reform-minded mayor of New York City.\nRudy rode into Dodge, which is what Times Square resembled at the time, and vowed to \nclean it up. His hand-picked sheriff was Dorchester’s own Bill Bratton.\nAs police commissioner, Bratton did much to stem violent crime in the nation’s biggest \ncity, but even more remarkably got his cops to reduce the incidence of more minor, so-\ncalled quality of life crimes that had made New York less livable, from the tony sections \nof Manhattan to the Tony Fauci sections of Brooklyn.\nBratton did his job too well. He ended up on the cover of Time magazine, hailed as the \nguy who pulled the worm out of the Big Apple. He became more popular than the mayor.\nThis drove Giuliani nuts. Rudy had to be the smartest guy in the room, had to get all the \ncredit. Sound familiar?\nSo Bratton had to go .\nThat wasn’t Bratton’s first rodeo. Long before he landed in New York, he became the \nface of progressive, modern policing in his hometown, the youngest-ever Boston Police \nsuperintendent. Police Commissioner Joe Jordan resented his overly-ambitious No. 2 so \nhe busted Bratton .\nThe point is, insecure bosses don’t like being shown up by smarter, more competent \nsubordinates. Small men make big mistakes.\nReleased by Chairman Rand Paul\n735It may be too late  to save Fauci. He just got the star treatment from Maureen Dowd  \nin The New York Times.\nThere used to be a thing called the Sports Illustrated curse, that after an athlete appeared \non its cover his or her career tanked.\nSimilarly, being in the Trump administration and getting praised by The New York \nTimes is the kiss of death.\nNow, normally, you could print something in the Times and chances were the president \nwouldn’t read it. He routinely dismisses the Gray Old Lady as fake news, except when \nhis and his family’s lousy books are mass-bought onto the newspaper’s bestsellers \nlist. He is not fond of polysyllabic words and prefers to get his news from “Fox & \nFriends” or whatever white nationalist website  his aide Stephen Miller might \nrecommend.\nBut Trump reads Mo Dowd because they have known each other forever and she writes \nabout him at a nuanced, personal level that drives him especially cuckoo.\nWe’re way past the theoretical  here.\nTony Fauci is in real danger, and by extension so are the rest of us who expect — nay, \npray for — one person in the White House to be trustworthy and competent in a time of \nunprecedented crisis.\nSo, again, repeat after me, Dr. Anthony Fauci is a bum.\nLong live the bum.\nKevin Cullen is a Globe columnist. He can be reached at kevin.cullen@globe.com . \nSearch many other similar articles from today (Wash Post, etc.)\nTF meeting today at 3:00.   Met with Joe Grogan and importantly with Jared Kushner \nabout the strategy to get Trump to be more flexible instead of sticking to his desire to lift \nthe mitigations by Easter Sunday.   Then met with Trump in the Oval.   As usual he was \nwondeful to me, asking me most of the questions.   He fixed on easter and I pushed back \nand said we need more data that we would get with testing to be able to inform policy \nabout mitigation.   He ent back and forth, but agreed.   He fixed on the increase in the \nstock marhet by 2000 points (biggest increase in nistory); hweoevr, wew recently had the \nbiggest drop in history.   He also focuse on his approval rating for how he is handleing \nthe outbreak.   It is all polls, ratings, and image.   In some ways he is endearing, but he \nReleased by Chairman Rand Paul\n736really is far from “Presidential”.   At the press conference, the reporters were glad that I \nwas there and “not fired or dead”.   Twitter fed still exploding about me.   I explained at \nthe presser that we need flexibility in the date about when to “open up”.   Easter is \n“aspirational for the POTUS, but he is flexible in looking at all the data.   Good \nconference.   No conflicts.   Keep getting calls from people wanting me to steer the \nPOTUS in one direction or another.   Gov. JB Pritzker (Illinois); Ken Langone of NYU, \nLindsey Graham, etc.\nPRESS:  WMAL Radio; Chris Stigali Radio (Philly); FOX Laura Ingraham\nMar. 25, 2020 – 435,000/20,000; USA – 54,622/749.   On WHO weekly call.   China \nremoving restrictions – critical to watch this closely to determine what happens in light of \nwhat POTUS is trying to do in reducing restrictions by Easter .   Giuseppe Ippolitto \nreporting from Italy – major restrictions of non-essential industries.   Good control in \nCentral and Southern Italy.   Lombardy still very bad.  People moving from North to \nSouth bringing cases to South.  Contact tracing impossible in major outbreak areas.  \nDeaths mostly in older (>60 yo) people.   From Italy – no evidence of bad effects of ACE \ninhibitors on COVID-19, hence no need to change meds.   CHINA – in regions where \nthey have gone doen to no cases, they are seeing reintroductions from imported travel \ncases.  Big problem.   Also, need to get infected people out of the homes since they are \nsecondarily infected the rest of the family → family clusters.  Discussed the issue of loss \nof sense of smell as an early sign of COVID-19. \nAt TF meeting, Jared still throwing barbs at CDCbecause they did not nail down the \nrecommendations for returning critical infrastructure (CI) people to work after an \nexposure where they did not kno if they were infected, but were asymptomatic.\nMetagain with POTUS in Oval.   He really acting like he is very fond of me, always \ndeferring to me.   His staff definitiely notices this (Hope Hicks, Kellyanne Conway).  I \nbelieve that the mole who does not like me is Alexa, the Comms person.   Hogan is OK.   \nDevin is getting better and Katie Miller is great (tough, smart,but great).   Interesdting \ncouple with Steve Miller.\nAt press conference, it went well as I fashion a new slant for each presser.   I apologized \nto reporter Philip Wegmann for answering him sharply when he asked what I thought \nabout Tedros favoring the Chinese.  He wrote me a nice note afterwards.  \nBig issue from the appearance on CNN Cuomo Prime Time was when I answered the \nquestion about the timeline to re-open the USG, I said “we do not determine the timeline, \nthe virus determines the timeline”.  That will not play well among some of the POTUS \nstaff.\nPRESS:  Bob Rose Radio (Gainesville, FL); WABC Radio (NYC) Bernie and Sid \nShow; CNN Cuomo Prime Time\nReleased by Chairman Rand Paul\n737Mar. 26, 2020 – Global - 414,000/18,400; USA - 68,600/1000; NYC 20,000/280.  \nContinued pressure regrding POTUS aspitational goal of wanting to open up on Easter \nSunday.  Cases now coming into NIH with several staff infected.   Admissions to the \nSCSU\nReceived another of now several calls from Gov. Andrew Cuomo wanting guidance on \ninterpreting the trend of new cases/day and what this means to predictions of where the \noutbreak is going in NYC.   Had the usual good and warm/friendly conversation.   He and \nChris Cuomo are becoming friends.   Also, we discussed his and my relationship with \nTrump.\nCRAZY, CRAZY – donuts are being named after me; T shirts have my picture on them \nand are being sold;  San Francisco radio is dedicating a song to me – Curtis Mayfield \nsinging “Keep on Pushing”; coloring pictures with crayons for my picture, face time with \nTrevor Noah; Instagram with Steph Curry\nColor me \nFauci.docx\nReleased by Chairman Rand Paul\n738Steph Curry Had An Instagram Live \nChat With Dr. Fauci About Coronavirus \nThat Was Super Informative\nBarack Obama and Justin Bieber posted some emojis.\nTasneem NashrullaBuzzFeed News Reporter\nPosted on March 26, 2020, at 3:04 p.m. ET\n•  Tweet\nReleased by Chairman Rand Paul\n739•  Share\n•  Copy\nThe journalists at BuzzFeed News are proud to bring you trustworthy and relevant \nreporting about the coronavirus. To help keep this news free, become a \nmember and sign up for our newsletter, Outbreak Today.\nReleased by Chairman Rand Paul\n740Instagram: @https://www.instagram.com/stephencurry30/?hl=en\nThousands of people tuned in to NBA star Stephen Curry's Instagram live Q&A \nwith Dr. Anthony Fauci about the coronavirus on Thursday because 2020 \ncontinues to be surreal.\nMar. 27, 2020 – USA now has more cases than any country in the world\nGlobal – 542,788/24361\nTo my surprise yesterday, the POTUS sent a letter to Governors outlining a plan to \nreopen county by county while moniroring the spread of virus in the low risk \ncounties.   This was half-baked and never shown to Deb or I before it was sent out.   \nIt was derived by Jared and Kevin Hassett (modeler) and I cannot see how it can \nReleased by Chairman Rand Paul\n741be implemented.   I am surprised at Jared, who is usually very measured.   This is \nreckless since it would require monitoring with much testing by CDC and they do \nnot even know about it.   Poor Bob Redfield is totally out of it.\nIMPORTANT DAY – There has been a disconnect between what we in the TF \nhave been saying about the availability of PPE (particularly masks) and ventilators \nand whether the people in the trenchs (ICUs) sare actually getting them.   We keep \nsaying that the equipmen is out there and the medical centers just need to get them \nand the medical centrers are saying that they are trying to get them and either they \ndo not know how or the USG is outbidding them for the equipment.\nI got on the phone via Cliff’s treatment guidelines committee that he is organizing \nand listened to ICU docs from all over the country.  The are very fearful of \nrunning out of PPEs within days to a weeks.  Ventilators are mostly a NYC issue; \nthey may fall behing and still there is this tension of Cuomo asking for 30,000 \nvents and USG (us) sayng that the vents are in the warehouses; they just need to \nget them.  I promise the group I would try to fix this nonsense.\nAt the TF meeting, I took over and said we really have to stop this shit and fix this.   \nWe are acting like these people have everything they need and the fact is they do \nNOT.   I was very empnatic and the VP (good for him) listened.   We had FEMA \n(Pete   ) and Adm Pete on the screen and the Adm acted like a rigis navy officer \nsaying thsat they did their job and got the vents and PPEs to the warehouse and \nnow it is up to the locals to get it distributed.   I essentially said that this is bullshit \nand we need to communicate to them how they can actually get the material.   I \nasked is it our job to just check our own boxes or are we trying to actually get the \njob done in real life.   Clearly, Adm Pete is not happy with me, but so what!\nHope Hicks, Kellyanne Conway strongly agree with me as does Marc Short and \nthe VP.   The VP order to make this happen.   Also, the POTU finally invoked the \nDPA to have GM make ventilators and we are stopping (via me) saying that NYC \nhas enough.   Just give them what they ask for and if it is overkill, they they can  \nreturn them and give to others.\nImportant discussion with  Deb Birx that I have some concern about.   She is using \na model from Chris Murray to plot out how to delay the POTUS from pulling the \nplug for at least 2 weeks more.   Critical issue that I feel strongly about and \ndiscussed with Cliff is that if we are going to lift restraints on certain areas, we \nmust have the capability of flooding the system with people to do identification, \nisolation (out of the home) and contact tracing.   Otherwise, we will precipitate a \nsurge as is NYC, NOLA, and other locales.   Big discussion coming over the \nweekend.\nReleased by Chairman Rand Paul\n742POTUS signed $2.2 Trillion (uo to $6.2 trillion) relief package for the economy to \ngive aid to laid off workers and other vulnerables.   POTUS signed bill in the \nOVAL and actually delayed the signing until I wsa called from the lower West \nWing lobby to be there for the signing.   When I entered the OVAL the POTUS \nsaid, “Anthony, come here with us.   I cannot sign this without you being here”.   \nThe entire crowd in the OVAL including several Senate (McConnell) and House \n(McCarthy) leaders and Cabinet members present applauded me as I entered.   \nVery embarrassing.   I am not comfortable with this attention.   After the signinf, \nthe POTUS asked me and others to make comments before the many TV cameras \nthat were let into the OVAL\nVery laborious press conference where the POTUS rambled on.  He wasted the \nopportunity to just focus on the relief package and went inot his diatribe against \nprevious administrations.\nSECURITY ISSUES – Threats on the “dark web” abainst me, Chris and the girls.   \nThey know everything about us including where my daughters live and work.  \nStrange people hanging around my house and taking photos of the house.   DC \npolice now stationed at my house in addition to ISG agents with me all the time.  \nHHS is giving me heavy security with ISG agents (Lonetto et al) guarding me 24 \nhrs.   Agent George Adams assigned to me.\nPRESS:  Bloomdaddy Radio Show – Pittsburgh; Morning News with Brian \nHaldane Radio Baton Rouge – both right wing radio shows; Press in the \nOVAl with the signing; some press at the Presser.\nMAR. 28, 2020 (Saturday) – 509,000/23300; USA 104,200/1700; NYC – \n26700/450.   Cases still escalating.  First day with full sceurity\nLindsey Graham trying to help.   Will go on TV and opush my message of holding \noff the POTUS to pull the plug too soon.\nGov. J.B. Pritzker called with report of death of a 9 month old from COVID-19 in \nChicago.   Prtiztker concerned that this will generate panic in mothers throughout \nthe USA.   May be 1st infant in USA to die of COVID-10\nThe USNS Comfort taking off from Norfolk, VA to NYC to supply beds and \ntreatment for non-COVID-19 patients in order to free up on shore beds for \nCOVID.  Also, the USNS Mercy has already arrived in LA for same purpose\nReleased by Chairman Rand Paul\n743The “swag” around me is getting really ridiculous.   You can but Fauci T-shirts, \nmugs, donuts, sweat shirts, candles, pillows, etc.  Geeeez!!   I do not like this one \nbit.\nAMAZING interaction with POTUS.  Today Trump tweeted that he was considering \nquarantining the NY tri-state area (NYC, NJ. CN).  This triggered a major news buzz.   \nGov. Cuomo called me ; I was in my NIH office getting ready to do the Saturday TF \nmeeting from the NIH SCIF.  Cuomo asked me to help dissuade the POTUS since he \n(Cuomo) would have to forcibly push back on this and would defy National Guard troops \nsent to enforce the Q.\nAt the TF meeting we had major discussions lead by VP.   I helped convince people that \na quarantine was not tenable and that we should recommend to POTUS to do a “strong \ntravel advisory” that the governors would strongly support instead of having the Feds \nenforce a quarantine.\nI thought that I was finished for the night and would go home to an evening off when the \nVP said I should come down to his office and we should, together with Deb, Chad Wolff, \nSteve Mnuchin, Mark Meadows, Marc Short meet with the POTUS to tell him our \nrecommendation to announce tomorrow.\nWe met with the POTUS in the living quarters (not the OVAL) for about 1 hour.  I led \nthe discussions since the POTUS kept referring to me.   It was a disturbingly rambling \ndiscussion since he kept talking about TV ratings, and HC, and influenza and virtually \neverything else as I was trying to keep him on track (with the help of the VP).\nFinally, we got him to agree to “travel advisory” and not quarantine.   We wanted to \nannounce tomorrow, but he wanted to tweet this tonight.   He also said he wanted to get \nthe Governors on board and so he wanted to call Gov Cuomo (NY), Gov Murphy (NJ), \nGov. Ned Lamont (CN).   And so, we adjourned to the Lincoln Study and finalized the \nlanguage for the Advisory right at the Lincoln desk where the Emancipation \nProclamation was signed.   I kept insisting that they do not slip and let the CDC (from \nwhom the Advisory must come) to use their words of “DO NOT TRAVEL”.   Also, I \ninsisted through the rambling and lack of attention span that the POTUS explicitly say \nthat this is NOT a quarantine.   Finally, he individually called the 3 Governors starting off \nby saying “I am here with Tony and a few other people…..”   Cuomo was OK but \nquestioned to be explicit as to just what “Advisory” meant.   We go it straightened out \nand before he went to the other Govs, he called up Sean Hannity to schmooze about TV \nratings (I am not kidding).   Finally, he got to the other Governors and we stopped for the \nnigh.   Marc Short will work with CDC to get the right language out and the POTUS will \ntweet this later.\nI texted Cuomo saying that I had pushed back and we had avoided the quarantine.  He \nresponded: “I know that.   It wasn’t his conscience.   He would have made a terrible \nmistake for the nation.   I would have had to organize the Governors to rebel.   Last thing \nwe need.  Thank you….on behalf of all of us.”\nWHAT A NIGHT!!! \nReleased by Chairman Rand Paul\n744PRESS:  Desus and Mero Showtime TV; \nMar. 29, 2020 (SUNDAY) – Cases continue to soar.   BIG DAY AT WHITE \nHOUSE    Spent several hours with the POTUS.   Bottom line.  Deb and I pushed \nhard to have the POTUS extend the 15 day guidelines for another 30 days to end \nof April even though Mark Meadows and Kevin Hassett were against this. They \nwanted to just go to 15 days extra and then re-evaluate.   We pushed and said that \nwe would leave to the POTUS.     \nWe met with the POTUS in OVAL and Deb and I presented the case for 30 days.   \nHe accepted that right away (he really trusts me very much).   He decided that he \ndid not want to wait three days to Tuesday to announce and so we Chaotically and \nquickly wrote into his speech the announcement that it would be 30 days.  We had \na press conference in the Rose Garden (RG) and he called several times of me and \nDeb to explain the rationale behind the decision.   It was another of the painfully \nrambling press conferences that lasted on a beautiful evening the RG for 2 hours.   \nPOTUS kept on mentioning the potential 1.5 to 2.0 million deaths in the USA due \nto Coronavirus, which is actually the worst case scenario of a flawed model; \nhowever, he felt that if he keeps mentioning that, then the people will take what \nwe are saying seriously.   He is incorrigible.   At the end of the day it was a good \noutcome since we convinced him to go with 30 day instead of ending the \nmitigation prematurely, which I feel would be a disaster.   At the presser, I \nemphasized that we must pay attention to the cities/states/areas with relatively few \ncases since they could explode just like NYC and NOLA and other cities.\nCRAZY PRESS – the fringe far-right crazies are cooking conspiracy theories that \nI am a Hilary Clinton mole trying to destroy Trump. See NY Times – Sunday \nMarch 29, 2020 “Chief Scientist Draw Venom From the Right” by Davey Alba \nand Sheera Frankel.  Also, article in NY Times on “Testing Blunders….” By \nMichael Shear et al.\nGOOD ARTICLE: March 29, 2020 article by Jenny Jarvie\nAIDS crisis shaped Anthony Fauci, disease expert at front lines of \ncoronavirus pandemic \nLos Angeles Times \nYou're making me feel guilty,” President George W. Bush said in 2008 when he awarded Fauci , the \nlongtime director of the National Institute of Allergy ...\nFlag as irrelevant \nReleased by Chairman Rand Paul\n745Great areticle in WSJ by Ben Cohen – March 29, 2020: WSJ: Dr. Fauci Was a \nBasketball Captain. Now He’s America’s Point Guard.  \nhttps://on.wsj.com/33TOug3\nPRESS:  CNN State of the Union with Jake Tapper; big exposure at Rose \nGarden press Conference after announcing the 30 day extension of guidelines \nfor mitigation.\nMar. 30, 2020 – Cses still soaring.  Spent another entire day at the WH.   Met with \nthe POTUS and had Press conference in Rose Garden.   Today most attention o \nCEOs and companies coming to indicte that they would help in any way.   \nDiscussion at theTF meeting about Ad Bax (I brought it up) and the issue of \naerosol merely by speaking and whether we should now seriously think about \nrecommending that everyone wear a mask.   More to come.   Also, I am \ncontinuing to push that we onnect the dots about how we are going to handle the \ninevitable flares that we will soon see in other smaller cities.   There needfs to be \nthe capasbility of testing, identification, isolations and contact tracing.   No one \nseems to be in charge. CDC is their usual lack of stepping up.  I love Bob \nRedfield, but he relly is not the right perdon for this job and this time.   Joe Grogan \ntrying to get things organized in this regard.\nPRESS: ABC Good Morning America with George Stephanopoulos; CNN \nNew Day; Rose Garden Press Conference\nMar. 31, 2020 – Perhaps some early indication of leveling of new admissions in \nNYC.   Careful.\nComplete craziness with this Fauci cult hero stuff.   See below in Washington Post \ntoday:\nFauci socks, Fauci doughnuts, Fauci fan \nart: The coronavirus expert attracts a cult \nfollowing\nReleased by Chairman Rand Paul\n746Doughnuts bearing the likeness of Anthony S. \nFauci, director of the National Institute of Allergy and Infectious Diseases, rest on a plate \nat Donuts Delite in Rochester, N.Y., on March 25. (Shawn Dowd/Rochester Democrat & \nChronicle/AP)\nBy \nAntonia Noori Farzan \nMarch 31, 2020 at 5:15 a.m. EDT\nEarly last week, Nick Semeraro wanted to find a way to honor Anthony S. Fauci. As the \nowner of a small doughnut shop in Rochester, N.Y., he had been closely tracking the \nlatest news about the coronavirus pandemic. And night after night, he’d been impressed \nby how Fauci, the director of the National Institute of Allergy and Infectious Diseases, \napproached the crisis in a calm, knowledgeable manner.\nSo, as a tribute, Semeraro put the renowned immunologist’s face on a doughnut. \nExpecting to sell a few hundred, he was shocked when the store sold out day after day, \nwith thousands flying off the shelves. Donuts Delite was besieged with requests to ship \nthe buttercream-frosted creations all over the country, and one Fauci fan drove three \nhours just to pick up a dozen. Soon, bakeries in Wisconsin and Pennsylvania  followed \nsuit, using edible paper to decorate pastries with Fauci’s likeness.\n“We had no idea it was going to blow up this big,” Semeraro told CNN. “We didn’t know \neveryone else felt the same way we did.”\nWhile Fauci was already a respected scientist before the outbreak, his appearances during \nWhite House press briefings have made him a household name and an unlikely celebrity. \nWith his straightforward demeanor and willingness to contradict President Trump, he’s \nbegun to develop the same kind of cult following as Supreme Court Justice Ruth Bader \nGinsburg and former special counsel Robert S. Mueller III, who inspired countless \n“Plank like RBG” tank tops  and a bizarre illustrated children’s book, respectively.\nEven as whole swaths of the global economy collapse, the pandemic has created a robust \ncottage industry of Fauci-themed merchandise, including bottle openers, magnets and \nmugs. On Etsy, you can buy “Honk for Dr. Fauci” bumper stickers, prayer candles \ndepicting “St. Fauci” and socks printed with Fauci’s face. Graphic T-shirts bear slogans \nsuch as “I Need a Hero”  and “In Dr. Fauci We Trust.”\nReleased by Chairman Rand Paul\n747If so inclined, you can even decorate your home with an “I Heart Dr. Fauci” throw \npillow , or purchase a replica of Fauci’s jersey from the time he captained the basketball \nteam at Manhattan’s Regis High School. Lingua Franca, which sells cashmere sweaters \nembroidered with resistance-friendly slogans for $380 and up, recently began taking \norders for an army-green “Dr. Fauci Fan Club” knit.\nIn honor of Fauci’s Italian heritage, a clam bar in Long Island named  a linguine dish after \nhim this week. (Available for pickup only, “the linguine with white clam sauce shares \norigins with Fauci, as the sauce itself was invented in the Fauci Family’s native Sciacca, \nItaly,” the restaurant claimed in a statement.)\nAs countless Americans remain glued to the news while trying to stay indoors, a robust \nFauci fandom has flourished online. On Facebook, the “Dr. Anthony S. Fauci Fan Club” \nhas over 32,000 members. Thousands more congregate in groups with names such as \n“Dr. Anthony S. Fauci, the Man, the Myth, the Legend,” “Dr. Fauci Speaks, We Listen” \nand “Dr. Fauci Memes for Social Distance Teens.”\nAn unassuming 79-year-old public servant who has advised six presidents, Fauci has \nbecome  a “reliable", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: 670while being filmed.   Also, Jenny was worried about the anxiety this might cause Megan.    It all worked out well as they were individually interviewed by Janet 1-on-1.  Janet was  terrific.   I am starting to collect Cacti in my home office.  Dec. 30, 2019 – Over the years I have helped Dionne Warwick to find physicians for  herself and her colleagues.   I have done this sometimes through as intermediary, Guy  Draper, who is well-known sould song wsriter and agent for many groups .   Guy  called me up today and asked for a referral for a peripheral vascular physician at Hopkins  for one of Dionne’s friends.   I recommended in Medicine Dr. Elizabeth Virginia  Ratchford and in Surgery Dr. James Hamilton Black.   Also, Guy wanted me to put on  my calendar for June 13, 2020 a ceremony at…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 1, "page_count": 1141}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 2 of 10)", "content": "constant in a time of uncertainty,” The Washington Post’s Ellen \nMcCarthy and Ben Terris reported. But his admirers — and there are a lot of them — \nworry that it’s only a matter of time before he’s sidelined by Trump.\nWhen Fauci missed a White House news conference earlier this month, panic erupted on \nTwitter, along with speculation that he could be sick. There was palpable relief when he \nresumed his regular position at the podium the following day and appeared to hide some \nexasperation as Trump referenced “the deep state.”\nFauci later explained that he had simply been trying to dislodge a lozenge from his throat. \nBut the much-analyzed “Fauci facepalm” had already become a meme, deployed by \nliberal members of what’s known as the resistance .\nFauci’s newfound fame can be partially attributed to his willingness to engage with all \nforms of media — in recent weeks, he’s gone on a Barstool Sports podcast, chatted with \nbasketball star Steph Curry on Instagram Live as Barack Obama listened in, and appeared \non “The Daily Show With Trevor Noah.”\nBut it also undoubtedly helps that his fans tend to take social distancing seriously and \nconsequently have ample spare time to produce fan art or perform songs written (or \nmodified) in his honor.\nOn social media, Fauci’s virtual fan clubs peruse old photos of the infectious disease \nexpert in search of “comfy turtleneck vibes,” stitch his face on embroidery hoops and \ndiscuss erecting statues as tribute. They frost his name on cookies and joke about \nconstructing shrines in his honor. Prominent activists and entertainers confess to wanting \nto marry him, or have him tuck them into bed.\nReleased by Chairman Rand Paul\n748Fauci has remained characteristically modest about his new status as a cult figure. “Well, \nthat’s very nice,” he responded when McCarthy and Terris mentioned that people all over \nthe country were praying for him. Of course, that means that his fan base has only \ncontinued to grow.\n“I never met a guy that, worldwide, he is so loved,” Semeraro, the Rochester doughnut \nshop owner, told CNN. “And a month ago, we never knew his first and last name.”\nDisclaimer:  Any third-party material in this email has been shared for internal use under fair use \nprovisions of U.S. copyright law, without further verification of its accuracy/veracity.  It does not \nnecessarily represent my views nor those of NIAID, NIH, HHS, or the U.S. government.\nChris Cuomo has COVID-19.  \nBig issue today is whether w should be recommending masks for everyone.   We \nprobably were too strong in saying masks do not work.   I mentioned this on CNN \n(Sciutto) this AM.\nStill local issues regarding availability of ventilators and PPE and tests.   TF \ndiscussions still make it seems like they are out there, I I have no confidence that \nthey are really getting to the people who need them.\nImportant phone call tonight organized by David Barr with many ICU and other \ndocs throughout the country.   They calim that PPE is running out, vents are \nneeded and teting that takes several days to get results are essentially useless to \nthem.   I promisedto bring their concerns to the TF.\nTrump continues to become more and more enamored of me.  \nJoe Grogan organizing small group of me, Deb. Redfield, Hahn, Giroir to solve \npractical issues.   I am concerned that we are not really connecting the dots from \nTF to the trenches.   Is Giroir really up to this.  Means well.  I also have doubts \nabout Pete and FEMA\nWe shocked the public when Deb and I mentioned at the Press Conference \nthat there could be 100,00- to 240,000 deaths in the USA even with maximal \nmitigation.   I explained that this is the “model”, but we can definitely get the \ndeaths down below that since it is the data that always trumps the model\nPRESS:  CNN Newsroom with Jim Sciutto; White House Press conference.\nReleased by Chairman Rand Paul\n749April 1, 2020 -  Cases still going up.  USA - 188,000/3700.   Global – \n751000/36400\nNYC- 43100/1100\n Some very early signs in NYC that the number of “new cases’ in starting the \nstabilize.   However, the deaths always lag and these will continue to increase over \nthe next week or two.\nDid major briefing of the GOP House leadership organized by Liz Cheney and \nKevin McCarthy\nContinued crazy stuff:   Petition to name me “Sexiest Man Alive”; videos games \nnamed after me; Fauci Bobblehead; dishes in redstaurants named after me, and on \nand on.\nHad good conversation with Bill Gates  tonight who wants the BMGF to partner \nwith me (NIAID) and BARDA in the advanced development and scaleup of \nvaccines, therapeutics.   Also, wanted to discuss a strategy for opening up the \ncountry after the wave subsides.\nReally very fine podcast with Sanjay Gupta – personal, but very informative\nWashington Post for tomorrow:\nMedia\nPerspective\nDr. Fauci symbolizes everything \nabout the Trump-era media \nclimate\nReleased by Chairman Rand Paul\n750Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, \nattends a White House briefing. (Jabin Botsford/The Washington Post)\nBy \nMargaret Sullivan \nMedia columnist\nPress is over the top.   My picture and stories about me are in the national news \nvirtually every day.  Today and yesterday and tomorrow was flooded with stories.  \nToo much; impossible to even read all of the stories\n \nPRESS:  Fox Radio NYC – Rosanne Scotto; CBS Norah O’Donnell taped for \ntonight; NY Times Daily Podcast; White House Press conference\nApril 2, 2020 –  USA – 215500/4600; NYC – 47400/1400\nReleased by Chairman Rand Paul\n751Global – 824000/41000;\nWashington Post now reporting that I have a security detail (George Adams).   \nAlso, DC police now guarding my house 24 hrs/day.\nGave briefing to the GOP Senators for 45 minutes similar to House briefing \nyesterday.\nTerrific Sirius XM – Coach K podcast – wonderful person who was so generous \nand complimentary in his comments to me.   He called me “the point guard for the \nworld”  \nSpoke with Gov. Phil Murphy of New Jersey who wanted to run by me his \napproach to COVID and see if I thought that he was doing all the right things.  He \nwas.   He is frustrated that some people still do not adhere to Guidelines even \nthough he is pushing hard and slappiung penalties on people.\nPRESS: CBS This Morning;  NBC Today Show with Savannah Guthrie; \nCNNTown hall with Sanjay Gupta and Anderson Cooper;\nApril 3, 2020 – Global - 879000/46000; USA 245000/5500;  (real numbers are \nprobably more;  these are CDC numbers – global is 1,000,000/50,000)  Deaths and \ncases still soaring.  \nMeeting today virtually (Francis Collins leading) with the Public Private \nPartnership to address research and development for COVID-19.  Mikael Dolstien  \n(Pfizer); Paul Stoffels (J & J), etc.\nIntense media blitz on me continues.   Mentioned by all Late Night TV Shows.\nQuestion of universal wearing of masks dominating conversation\nPress conference today:   I was originally supposed to be sitting on the side for \nquestions and at the last minute, they told me that I was not needed.   This was not \nunreasonable since the presser was about masks and Jerome Adams had been \npushing this and CDC released the guidelines about masks and so it made sense \nthat I did not need to be there.   I mentioned this to Jim Acosta (CNN) and he \nmade a story that I was excluded from the prsser.   This created a firestorm where \nCNN made it a story saying that I wa excluded since I had said last night 9CNN \nTownhall) and this AM (Fox and Friends) that all states should practice “stay at \nhome’, and the POTUS has refused to “mandate that”.   They painted it as an \nexclusion of Fauci since he disagreed with the POTUS, which was not the case.   \nReleased by Chairman Rand Paul\n752WELCOME TO WASHINGTON.    I believe that the White House (mostly \nPOTUS staff) are starting to get really pissed off at me.\nThe press conference turned out to be a shit-storm since Jared Kushner got up and \ntrie to explain things and the press killed him.   Also, the POTUS said he would \nnot wear a mask, which undermined what Jerome and Bob had just said.   Glad \nthat I was not there.\nThe ridiculous attention to me continues; fan clubs, Swags, am constantly on TV; \ncountless profiles of me.   For example:\nT heThe Anthony Fauci Fan Club Twitter account wants you to know one \nthing: “If you don’t have a crush on this man, do you even care about public health?”\nThe account, which quickly skyrocketed to over 13,000 followers in just \nthe past few days, was launched by three Maryland-based microbiologists \nwho, at first, created a group chat to “gush over” Fauci in private. “We can’t \nbe the only ones who are feeling this way,” one said of the esteemed \nimmunologist.\n“Did I mention he’s easy on the eyes?” said another.\nThe microbiologists aren’t alone. Over the last few weeks, Dr. Fauci stands \nhave created Facebook fan clubs, TikTok videos, donuts, browser \ngames and even prayer candles in celebration of the scientist leading the \nTrump administration’s novel coronavirus response. A 79-year-old career \nscientist isn’t usually the type of person the internet feverishly stans over. \nBut under these extreme circumstances, Fauci has emerged as the \ncomforting leader the internet, and the US, needs now more than ever.\nAnthony Fauci Fan Club@FauciFan\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n754“It is the moment to exercise and practice fandom,” Abigail De Kosnik, \ndirector of the Berkeley Center for New Media and a fandom specialist, \ntold The Verge. De Kosnik says fandom around Fauci is thriving right now \nbecause it’s one of the only ways we can “connect to the outside world” \nand interact with strangers since we can’t see anyone physically. “Fandom \nis what remains.”\nFor years, political figures — like Fauci — who have spoken truth to power \nin tumultuous times in history have become the ideal breeding ground for \nfandom. According to Know Your Meme, Ruth Bader Ginsburg’s rise to \ninternet celebrity stardom corresponded with the creation of a Tumblr \nblog entitled Notorious R.B.G., invoking the name of the famous hip-hop \nartist, The Notorious B.I.G. The blog launched in celebration of Ginsburg’s \nlauded 2013 dissent in the Shelby County v. Holder case that struck down \nparts of the Voting Rights Act. That dissent paired with the blog’s memes \nwas just the flint in creating a fire of RBG fan content and merch that \ncontinues today. The excitement around Fauci is creating a similar \ncommunity, focused around bringing hope and joy to one another during \nthis pandemic.\nThe fandom has grown rapidly with stans posting a slew of memes and \nmerch all across the internet. Etsy and Amazon are littered with T-shirts \nthat feature the scientist. One asks “What would Fauci do?” Another Etsy \nseller has made prayer candles featuring Fauci depicted as an angel with a \nhalo around his head. Pastry shops across the country are selling donuts \nwith Fauci’s face surrounded in red, white, and blue buttercream. Fauci’s \nconstant status in American life amid the pandemic has made it even more \nnoticeable when he’s absent. When Fauci did not make an appearance at a \nWhite House press briefing last month, the hashtag #WhereisFauci went \nviral on social media, as though Fauci stood up the internet.\nAndrew Banas\n✔@AndrewWHAM\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n756The fandom is cross-generational, too. On Facebook, the Dr. Anthony Fauci \nFan Club group touts nearly 40,000 members of all ages. They post news \narticles to keep each other informed, but they also share memes honoring \nFauci. In one, Fauci appears on the front page of People magazine as the \n“sexiest man alive.” In another, Fauci’s face is photoshopped onto the body \nof Captain America. One user posted a Trump-like campaign sign, but \ninstead of featuring the president’s own infamous slogan, it reads, “Fauci: \nMake Science Great Again 2020.”\n“Just saw this, and thought I’d share,” the poster wrote. “Humor helps me \nendure.”\n“HUMOR HELPS ME ENDURE”\nOn TikTok, influencers like celebrity blogger Perez Hilton have posted \nvideos featuring Fauci’s viral press briefing facepalm from earlier this \nmonth. “This is how I feel right now,” Hilton wrote in the video’s caption. In \nanother, Coldplay’s “The Scientist” plays as images of Fauci dissolve into \none another beneath the caption, “BREAKING NEWS: Dr. Fauci has been \nhospitalized from carrying the entire nation on his back.”\nFauci fandom has also provided comic relief and emotional support for \npeople struggling through this unprecedented crisis. On the Facebook page \nearlier this week, one member made a plea for reassurance. “Will we ever \nbe able to go back to ‘normal’? My anxiety is telling me this is going to last \nforever...” The post received over 100 replies, a majority of them offering \noptimistic statistics or messages of support reassuring the user that they \nweren’t alone — valuable messages at a time when large swaths of the US’s \npopulation are stuck indoors with their lives entirely uprooted from what \nthey were before.\nIn a moment like this, Fauci has become a comforting figure for those who \nare struggling. “He’s kind of like this kind, old, wise mentor figure that \nwe’re thirsty for right now,” Scott T. Allison, a professor of psychology who \nspecializes in heroism and leadership at the University of Richmond, \ntold The Verge. “He’s the grandfather who will tell it to you straight and tell \nit to you lovingly.” And Americans agree. According to Business Insider, \nAmericans trust Fauci more than President Trump and Treasury Secretary \nSteven Mnuchin to handle the COVID-19 pandemic.\nReleased by Chairman Rand Paul\n757No one knows how long this pandemic will last, as Fauci mentions at \nnearly every briefing. As it continues, today’s circle of Fauci stans could \nchange the face of fandom in the future, De Kosnik said. “We could see a \ndifferent fandom arise around this calmer, more rational and more ‘square’ \ncelebrity or performer,” she said. The appeal of a whimsical or “bad boy” \ntype celebrity could taper out if uncertainty in daily life continues to grow. \nA nerdy pragmatist could become the new focal point for fandom.\nOr maybe it’ll just redefine who we see those traits in. “You might say that \nDr. Fauci is a badass — a person who does his job, and does it well, and to \nhell with the consequences and to hell with what the boss might think,” \nAllison said. “We should all have such courage.”\nPRESS:  Fox and Friends; PBS NewsHour with Judy Woodruff\nApril 4, 2020 – Global 972600/50300; USA 277200/6600;\nGov. Greg Abbott of Texas – questions about my statements recently that all states \nshould do stay at home.   He was vey nice ad wanted clarification of what that \nmeant forTexas and was he already doing what I was saying.   In fact, he was for \nthe most part.\nAlso, spoke with Gov. Ned Lamont of Connecticut.  Same issues as Gov. Abbott\nWashington Post had article ridiculing Jared for his appearance at the Press \nconference.   They are being a bit unfair.   Thick politics going on fueled by \nPOTUS ridiculous behavior of blaming people for things.   He keeps talking about \nTV ratings of the press briefings, which fuels the press backlash at him.\nIn Task Force meeting had a big (unusual) argument with Peter Navarro who \nhanded out a folder that he says shows studies that Hydroxychloroquine is \neffective in COVID.   I strenuously objected and he then attacked me saying that I \nwas the one who was against blocked travel from China when in fact I pushed the \nPOTUS to do so.   Weird guy!!  VP and Marc Short acted like Peter was nuts.\nSee below Axios description of the “confrontation between Navarro and me:  \nReleased by Chairman Rand Paul\n758Scoop: Inside the epic White House \nfight over hydroxychloroquine\nJonathan Swan\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n760Photo: Drew Angerer/Getty Images\nThe White House coronavirus task force had its biggest fight yet on Saturday, pitting economic adviser Peter Navarro against infectious disease expert Anthony \nFauci. At issue: How enthusiastically should the White House tout the prospects of an antimalarial drug to fight COVID-19?\nBehind the scenes: This drama erupted into an epic Situation Room showdown. Trump's coronavirus task force gathered in the White House Situation Room on \nSaturday at about 1:30pm, according to four sources familiar with the conversation. Vice President Mike Pence sat at the head of the table.\n• Numerous government officials were at the table, including Fauci, coronavirus response coordinator Deborah Birx, Jared Kushner, acting Homeland \nSecurity Secretary Chad Wolf, and Commissioner of Food and Drugs Stephen Hahn.\n• Behind them sat staff, including Peter Navarro, tapped by Trump to compel private companies to meet the government's coronavirus needs under \nthe Defense Production Act.\nToward the end of the meeting, Hahn began a discussion of the malaria drug hydroxychloroquine, which Trump believes could be a \"game-changer\" against the \ncoronavirus.\n• Hahn gave an update about the drug and what he was seeing in different trials and real-world results.\n• Then Navarro got up. He brought over a stack of folders and dropped them on the table. People started passing them around.\n• \"And the first words out of his mouth are that the studies that he's seen, I believe they're mostly overseas, show 'clear therapeutic efficacy,'\" said a \nsource familiar with the conversation. \"Those are the exact words out of his mouth.\"\nNavarro's comments set off a heated exchange about how the Trump administration and the president ought to talk about the malaria drug, which Fauci and other \npublic health officials stress is unproven to combat COVID-19.\n• Fauci pushed back against Navarro, saying that there was only anecdotal evidence that hydroxychloroquine works against the coronavirus.\n• Researchers have said studies out of France and China are inadequate because they did not include control groups.\n• Fauci and others have said much more data is needed to prove that hydroxychloroquine is effective against the coronavirus.\n• As part of his role, Navarro has been trying to source hydroxychloroquine from around the world. He's also been trying to ensure that there are \nenough domestic production capabilities inside the U.S.\nFauci's mention of anecdotal evidence \"just set Peter off,\" said one of the sources. Navarro pointed to the pile of folders on the desk, which included printouts of \nstudies on hydroxychloroquine from around the world.\n• Navarro said to Fauci, \"That's science, not anecdote,\" said another of the sources.\nNavarro started raising his voice, and at one point accused Fauci of objecting to Trump's travel restrictions, saying, \"You were the one who early on objected to the \ntravel restrictions with China,\" saying that travel restrictions don't work. (Navarro was one of the earliest to push the China travel ban.)\n• Fauci looked confused, according to a source in the room. After Trump imposed the travel restrictions, Fauci has publicly praised the president's \nrestriction on travel from China.\n• Pence was trying to moderate the heated discussion. \"It was pretty clear that everyone was just trying to get Peter to sit down and stop being so \nconfrontational,\" said one of the sources.\n• Eventually, Kushner turned to Navarro and said, \"Peter, take yes for an answer,\" because most everyone agreed, by that time, it was important to \nsurge the supply of the drug to hot zones.\n• The principals agreed that the administration's public stance should be that the decision to use the drug is between doctors and patients.\n• Trump ended up announcing at his press conference that he had 29 million doses of hydroxychloroquine in the Strategic National Stockpile.\nBetween the lines: \"There has never been a confrontation in the task force meetings like the one yesterday,\" said a source familiar with the argument. \"People \nspeak up and there's robust debate, but there's never been a confrontation. Yesterday was the first confrontation.\"\n• In response to a request for comment on Axios' reporting, Katie Miller, a spokesperson for the vice president, said: \"We don't comment on meetings \nin the Situation Room.\"\nThe bottom line: The way to discuss the drug's potential has become a fraught issue within the Trump administration.\n• Most members of the task force support a cautious approach to discussing the drug until it's proven.\nReleased by Chairman Rand Paul\n761• Navarro, on the other hand, is convinced based on his reading that the drug works against the coronavirus and speaks about it enthusiastically.\n• Some of Trump's favorite TV hosts, including Fox's Sean Hannity, and friends including Rudy Giuliani, have also been touting the malaria drug for the \ncoronavirus. Trump has made no secret who he sides with.\n• \"What do you have to lose? Take it,\" the president said in a White House briefing on Saturday. \"I really think they should take it. But it's their choice. \nAnd it's their doctor's choice or the doctors in the hospital. But hydroxychloroquine. Try it, if you'd like.\"\nPOTUS continues to ramble at presser.   Prior to the presser, POTUS invited me \nand Deb into his inner office at the OVAL and started telling me that as a Catholic \nhow much of a shame it would be if we did not do a classical Easter and Good \nFriday and Palm Sunday.   He wanted to figure out how to do a version of it like \noutdoor mass or stay in car and do drive in theater-like mass.  Hope Hicks and I \nconvinced him to essentially put Easter on hold for this year.  Then he went on and \non (almost pleading) with Me (mostly) and Deb saying that he cannot keep the \ncountry closed beyond the 30-day extension.   He rambled on and on that we are \ndestroying this great country and started rattling off the names of various sports \ncommissioners (NBA, MLB, NHL, etc.) who said that their sports would be \ndestroyed if we did not open up.  Also, he said industry (all the industrial giants) \nwould be forever destroyed.   He said that he understood where Deb and I were \ncoming from, but he could not let the country die and so one way or another, he is \nopening up in 30 days.   He went on and emphasized this over and over at the \npress conference, which immediately followed his conversation with me and Deb. \nPRESS:  White House Press Conference – 1hr 25 minutes.   I had the \nopportunity to push mitigation sayin that it was our ony weapon right now \nand I praised the HCWs saying they were true heroes.\nApril 5, 2020 – (Sunday) – Major news-outlets (Wash Post, NY Times) starting \nto write detailed stories of how the USG (esp. Trump) dropped the ball in response \nto COVID-19.  CDC getting bashed (in some respects rightly so).  Much Monday \nmorning quarterbacking.   Thus far, I am coming out OK, but the response in \ngeneral in being bashed.\nGlobal – 1,100,000/57000; USA – 311000/7700; Cases predicted to continue to \nrise and deaths increase over next week.\nNice article in Washington Post on the relationship between Deb Birx and me.\nBeautiful profile of me on BBC audio featuring Chris and Peter Staley.\nI was sitting on steps of EEOB on a conference call reviewing countermeasure \nportfolio (BARDA) when a photographer from across the landscape (on Pebble \nReleased by Chairman Rand Paul\n762beach) shot me and focused on my pokadot socks.   It got tweeted around the \ncountry.  “Birx has her scarfs and Fauci has his socks”   Geeeez.\nVery amusing and notable dynamics at the TF meeting today.   It is Sunday and \nwe were supposed to have a relatively low-key meeting without a subsequent press \nconference.   HOWEVER, as we began the TF meeting, we learned that the \nPOTUS was joining us.   He came in and in his usual rambling self starting going \nall over the lot and then said that we should have a press conference in 30 minutes \nsince he wanted to give “good news’.   Deb had been saying that the cases were \nstarting to stabilize in NYC and in a couple of days we could speak about it.   \nJared wanted to talk about some good stuff regarding supply chain tomorrow.  \nPOTUS would have none of it.   He wanted a press conference now.   Everyone \nstarted scrambling to prepare.   Of note, ADM John Polowczwk (“Adm P”)  gave \nsome data on supply chain.  The POTUS loved and told John to get over to the \nWH for the press conference.   John was dressed in his Combat Fatigues and \nclearly was terrified of appearing on TV when the rules are that you should wear \nthe standard formal dress (not dress level) for TV appearances out of the combat \nzone.   He felt that he would be reprimanded by superiors at the Pentagon.   It was \nclear that he was very nervous and almost frozen.   When people in the room \nexplained to POTUS what was going on, POTUS said “Last time I looked, I was \nCommander in Chief and so get your ass down here now”.  Then POTUS said: \n“Get Gen. Milley (Chair of the Joint Chiefs) on the phone and clear this up.   Just \nthen a Deputy Chair General go on the phone (not sure who it was) and said: \n“John, you are good to go.   Get over to the White House in your combat fatigues.”   \nAll ended well, although Joh was still clearly nervous as he stood before the \ncameras at the WH briefing Room.\nPress:  Face the Nation with Margaret Brennan;   Press briefing in the White \nHouse press room after the TF meeting.\nApril 6, 2020 – Global – 1,100,000/63,000; USA – 338,000/10,000; \nToday did call with Governors (me, Deb, Redfield, Giroir et al).  Turned out it was \nmostly Governors’s staff and health people as opposed to actual Governors.\nIndividual Calls with Gov. Ricketts (NE) and Gov. Reynolds (IOWA).   They \nwere concernced about my comment that “I cannot understand why all states have \nnot done stay at home orders”.   They are really already doing as much or more \nthan some states that have officially issued stay at home orders and they are being \ncriticized as a result of my comments.   We worked it out over the phone.   I will \nsupport them and clarify where I can to support them.\nReleased by Chairman Rand Paul\n763At the Press Briefing today, I took the opportunity to say that the Govs of NE and \nIowa are doing an excellent job ad are functionally doing exactly what those states \nthat have stay-at-home orders are doing.   Trump dud his usual rambling stream of \nconsciousness show at the briefing.\nIntense publicity about me continues with stories of granmothers who have \ncrushes on men.  Petitions to vote me “Sexiest Man Alive”.   Major stories about \nmy basketball career at Regis.\nJanet Tobias pushing to get footage and access to TF workings with me.   I am \nvery reluctant since the optics are bad.   My main goal is to stop this outbreak, not \nto participate in a documentary.   She can do her thing as long as it is not intrusive \nto our work.\nI am concerned that we really do not have a clerar plan to “open up” the country at \nend of April.   No one is really in charge or even knows what they are doing.   This \nis not my area and so I can only provide 40,000 foot perspective, which is not \ngood.\nPRESS: Appeared at the White House Press Briefing.  \nApril 7, 2020 -  Global – 1,200,000/68000; USA – 369,000/11,000\nPress still hot and heavy about me.  Multiple stories per day directly or indirectly \ninvolving me.  The debate about the use of HC still dominating the discussion.  \nBig article in the Washington Post about the long relationship between Deb Birx \nand me.\nBig challenge today is to firm up a plan on how to approach to re-opening of the \ncountry.   I am concerned that there really is no plan and no one is really in charge.   \nOff-hand mention of “another task force”.   Jared is getting involved with us.   Deb \nsupposedly leading it.   Deb unhappy with Brett Giroir and bad-mouthing him a bit \nas he goes his way continually reporting about how many “tests” are out there.   I \ndo not have a good felling about this.\nHowever, the meeting that we had in the Roosevelt Room tonight made me feel \nbetter.  The entire team gathered after the Press conference for 2 hours starting at \n7:30 PM.  Paul Mango provided a framework for “re-opening” delineating all \nthe things that need to be in place.   Again, much depends on the easy availability \nof testing.   Present were:  Joe Grogan, Kellyanne Comway, Jared Kushner, Bob \nRedfield, Steve Hahn, Seema Verma, Deb Birx, Brian Harrison.\nReleased by Chairman Rand Paul\n764At presser I discussed the issue of greater pecent of deaths among African-\nAmericans dues to the health disparities (hypertension, diabetes, obesity, asthma) \nthat predispose to poor outcome (pneumonia and death).\nAfter all this, at night 9:30 PM Cliff Lane came over my house and we went over \nthe Guidelines document that he and the group prepared.   I will brief Azar on \nThursday and then officialy submit it as a “workstream”.\nThis is an example of the type of articles that are appearing.   This appeared in The \nAtlantic today (April 7, 2020):\nWhy America Is Thirsty for \nAnthony Fauci\nDuring the pandemic, a 79-year-old immunologist is \nbecoming as crushable as a pop star.\nKAITLYN TIFFANY\n6:30 AM ET\nEnjoy unlimited access to The Atlantic for less than $1 per week.\nSign in\nSubscribe Now\nReleased by Chairman Rand Paul\n765ALICIA TATONE / THE ATLANTIC\n•\n•\n•Link Copied\n•\n“If you don’t have a crush on this man, do you even care about public health?”\nIt’s a question that wouldn’t have made even the slightest bit of sense before the \ncoronavirus pandemic, and it doesn’t make a ton of sense during it either. Still, it \nwas posed, above a headshot of Anthony Fauci, by the Twitter account @FauciFan, \nwhich was created three weeks ago and has amassed more than 15,000 followers.\nAll day, Americans go online to fess up about crushing on Fauci, the director of the \nNational Institute of Allergy and Infectious Diseases. They dig up his college yearbook \nphotos and evidence that he once played basketball in short-shorts. They edit his \nWikipedia page, swapping the main photo with one taken 13 years ago, then one from 17 \nyears ago. In my upstate-New York hometown, you can buy donuts with his face on \nthem. More than 10,000 people have signed a petition to make Fauci People  magazine’s \nnext “Sexiest Man Alive.”\nReleased by Chairman Rand Paul\n766Fauci has had the same job since 1984, and he’s earned national recognition before for \nhis handling of the HIV/AIDS crisis. But during this epochal natural disaster, as a leading \nmember of the federal government’s coronavirus task force, he’s more akin to an actual \ncelebrity, famous for the contrast between his calmly stated expertise and Donald \nTrump’s contradictory messaging during White House press briefings. Doodling hearts \nall over his face may seem irrational, but times of crisis often breed infatuation with \nauthorities who can provide guidance and soothe anxiety.\nMORE STORIES\n•\nThere’s No Zoom Party Like a College Zoom Party\nKAITLYN TIFFANY\n•\nYou Have a Moral Responsibility to Post Your Boring Life on Instagram\nKAITLYN TIFFANY\n•\n•\nWhat You Need to Know About the Coronavirus\nHALEY WEISS\nAt this moment, smooching anyone is verboten, even reckless, but in isolation and in \ndaydreams, lots of Americans are thinking about planting one on a 79-year-old \nimmunologist.\nRead: When keeping your distance is the best way to show you care\nThe @FauciFan Twitter account—which last week featured a photo of a young Fauci \nexplaining how HIV interacts with the immune system, captioned “#tbt #thirsttrap”—was \ncreated by Sarah Alexander, Tiffany Zarrella, and Leann Zhou, three friends and \nmicrobiologists who work together in Bethesda, Maryland. They are not joking about \ntheir crush.\nReleased by Chairman Rand Paul\n767The trio had been talking about their thirst for Fauci over text, and decided to take it \npublic in hopes that it would be entertaining to other bored and freaked-out people. Zhou, \n22, told me that she thinks people are drawn to Fauci’s “cute Brooklyn accent.” She \nwouldn’t have been able to guess his age, she added, pointing out that he’s an avid \nrunner, and has serious light-up-the-room energy. “He’s very knowledgeable and expert, \nbut he speaks in a really approachable way,” Zarella, 33, told me. “Everyone wants to \nknow what’s going on, and he delivers.”\nAlexander, 25, agrees, saying, “I do personally think that he actually is attractive, and it’s \nnot unheard of for people to be attracted to older men. Look at Jeff Goldblum.” I \nproposed to her that Goldblum is an actual Hollywood star, and that there might be \nsomething strange about presenting Fauci as one. “We’re not trying to prop him up and \nmake him a celebrity,” she told me. “It’s just an appreciation of him. He’s working 16-\nplus-hour days.”\nAmericans have had plenty of political crushes before. There have been more durable \nones on presidents such as John F. Kennedy, Ronald Reagan, and, more recently, Barack \nObama. By the time Obama became a public figure, the internet was ready to amplify \nconversations about thirsting over handsome and competent men: In 2007, one of \nYouTube’s first mainstream viral hits was a comedy music video called “ Crush on \nObama,” starring the actress Amber Lee Ettinger as a young woman in booty shorts who \nwants to make out with the then-senator from Illinois.\n“I did develop a crush on Obama,” Ettinger told me. (Today, she’s an Instagram \ninfluencer who posts mom-related lifestyle content.) “He was this young, sauve, \nhandsome fellow. People felt a personal connection with him when he spoke.” For Fauci, \nshe speculated, the incentives for crushing are a little bit different. “No. 1, his little New \nYork accent. He feels like a voice of reason, someone you can trust. He has a calming \npresence about him. Supersmart. I think he’s adorable.”\nThe more obvious precedent for Fauci’s newfound celebrity is another flavor-of-the-week \npublic figure, Special Counsel Robert Mueller, who became a superhero and stoic \nboyfriend to the left during his investigation of Russian interference in the 2016 election. \nThat in itself was not entirely novel: For a brief period after 9/11, then-Secretary of \nDefense Donald Rumsfeld was treated as a sex symbol—as Salon put it, a “hot \nRepublican war dad.”\nMueller, like Fauci, became crushable because of the perception that he was unflappable, \nsoberly sifting through facts and ignoring irrelevant clangor during a tense situation. One \nwoman told the Associated Press last year, “I admire [Mueller’s] mystique. I admire that \nI haven’t heard his voice.” But although lots of Americans are making these men into \nheartthrobs—whether as a joke or sincerely—it doesn't mean we actually want them to \nact like celebrities. We just want to be taken care of, and we don’t want anything to \nshatter the illusion that they can save us.\nReleased by Chairman Rand Paul\n768There are other crushes of the coronavirus crisis, most notably New York Governor \nAndrew Cuomo, whose daily press conferences in state-branded attire have become \nappointment television for people living in the epicenter of the country’s \noutbreak. Vogue has praised his competence and “imaginary boyfriend” potential, while \nthe New York Post spoke with moms on Long Island who gushed about eating ice cream \nin bed, watching him speak calmly and convincingly of New York’s ability to overcome \nthe pandemic.\nWhile descriptions of Fauci dwell on how “adorable” he is, Americans’ fascination with \nCuomo is openly grimier. Last week, for instance, Twitter was abuzz with speculation as \nto whether a strange-looking wrinkle under the governor’s polo was, in fact, a nipple \nring. A fake dating profile written for the governor by City & State didn’t mention \nsweetness or charm, but interests such as “fishing” and “yelling,” as well as the \npersonality type “laid-back, loose dude, who is always in a cool mood.”\nIn a recent blog post titled “Help, I Think I’m in Love With Andrew Cuomo??” \nthe Jezebel writer Rebecca Fishbein ran down the list of things she despises about him \npolitically, then confessed, “When I stream his presser on the governor’s website—every \nday around 11:30 a.m., complete with a PowerPoint presentation—I feel comforted. I feel \nalive. I feel protected. I feel ... butterflies.” She’s heard from plenty of New York women \nwho agree. “A lot of women who are older than me have been emailing me being like, \nNo I really love him; he has all of his hair,” she told me.\nFishbein lived in New York City during 9/11, and she remembers people feeling similarly \nabout then-Mayor Rudy Giuliani. And after Hurricane Sandy in 2012, she said, she knew \npeople who thought that then-New Jersey Governor Chris Christie was heroic enough to \nfeel gooey over. “It [does] not last long, but I think there’s this feeling that somebody is \ntelling you, in what seems like a straightforward manner, what’s going on,” she said. This \ncan mutate into a crush with ease. “It’s just your mind playing tricks on you.”\nRead: Why people are confessing their crushes right now\nThis is literally true, says Helen Fisher, a biological anthropologist who studies dating \nand relationships at Indiana University’s Kinsey Institute. “In times of crisis, people have \na fight-or-flight response. That drives up the testosterone in the brain,” she told me. \n“Testosterone triggers various brain systems that can trigger sexual arousal. Testosterone \nalso has a positive correlation with dopamine, and dopamine is linked with feelings of \nromantic love.”\nYou don’t need me to explain that the past month has been saturated with \nfeelings, or that your nerves can only tap-dance for so long before your \nbrain starts to do strange and shocking things. Similar hormones are \ninvolved in both crushing and panicking, and rushes of adrenaline can \nlead to attraction, which is presumably why The Bachelor involves so much \nbungee jumping and helicopter travel.\nReleased by Chairman Rand Paul\n769Crushing on a public official is not particularly fruitful, but it’s hard to \nthink of a reason not to indulge in it a little bit. Even in normal \ncircumstances, a crush is a diversion from everything we’re worried about. \nPointless crushes may be, if anything, even more necessary during a \npandemic, when the only other stimuli are horrifying. Crushes spike up \nand surprise us—uncomfortable but fun, sweet but nauseating.\nThirsting over Fauci won't stop the pandemic, but at least it can keep us \nbusy. I recently stumbled across a video of a woman named Jill playing \nguitar and singing, in a school-teacher voice, a love song for him. “Please \nstay safe doctor,” the song ends, “you’re our only hope.”\nWe want to hear what you think about this article. Submit a letter to the editor or \nwrite to letters@theatlantic.com.\nKAITLYN TIFFANY  is a staff writer at The Atlantic, where she covers technology.\nConnectTwitter\n   ALSO, see article today in The Nation by Jeet Heer entitled “Dr. Anthony Fauci \nhas a target on his back”.   The story says that the right wing, including Rudy \nGiuliani, is out to get me because of my stance on HC and because I am \nresponsible for shutting down the government and ruining the economy.\nFrom today regarding deaths:\nThe fatality rate remains unclear, estimates of the proportion of people contracting the \nvirus who never show symptoms ranges from 25 to 50 percent and there is no clear \nexplanation for why it proves so deadly for some people who are relatively young and \npreviously in good health.\nReleased by Chairman Rand Paul\n770PRESS: Local Radio hits – Jason Rantz Show KTTH Seattle;  The John and \nKen Show (California – KFI AM640 Los Angeles); Multiple local (from \naround the country) TV hits in EEOB;  White House press conference.\nApril 8, 2020 – Global – 1,300,000/73,000; USA – 398,000/13,000\nAs we predicted, yesterday was the most deaths in single day in USA.   However, \nindications from NYC aree that cases, hospitalizations, intensive care and \nintubations have been down for past few days.   Remember – deaths always lag by \nabout 2 weeks behind new cases.   Could be first clear sign of turnaround.        \nNow focusing on how to “re-open” the country safely (see meeting last night)\nBobblehead raising money:\nFauci bobblehead raises $100,000 for American \nHospital Association\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n772Growing concern about fact that African-Americans are dying much more than \nother racial/ethnic groups.   Certainly due largely to the increase in underlying \nconditions among them such as hypertension, diabetes, obesity, asthma\nPRESS: FOX TV – America’s Newsroom; Eric Bolling Sinclair TV; White \nHouse Press Conference.\nApril 9, 2020 (Thursday) – Global -1,400,000/80,000;   USA– 430,000/15,000; \nGetting ready to submit the COVID-19 Treatment Guidelines that Cliff led.  \nBriefed AZAR by phone he liked it but wanted to make sure that Nancy \nMessonnier was OK with it since we did not want CDC to be coming out with \nobjections.  I called Nancy and found out in a poignant call that she no longer is \ninvolved in the COVID response.  I do not believe that Azar knows this.   Who \nremoved her???   Tim Uyeki is representative for CDC on the Guidelines Panel.\nTF Conference call with Senate GOP and Dems – usual questions about when to \nre-open the country\nAnother example of craziness.   This below in the New Yorker:\nBy Andy Borowitz \nApril 8, 2020\nReleased by Chairman Rand Paul\n773Photograph by Lo Scalzo / Bloomberg / Getty\nWASHINGTON (The Borowitz Report)—In what he described as a “potentially major \nbreakthrough,” Dr. Anthony Fauci has convinced Donald Trump  to attack COVID-19 as \nif it were an inspector general.\nFauci, who has been frustrated in his efforts to get through to Trump, compared the \nglobal pandemic to an inspector general while in a closed-door meeting with the \nPresident on Wednesday.\n“What do you hate more than anything, Mr. President?” Fauci asked.\n“Jim Acosta,” Trump immediately replied.\n“O.K., fine. But, besides Jim Acosta,” Fauci said, “it would be an inspector general, \nright?”\n“You’re right, Tony,” Trump agreed. “I hate those losers.”\n“Well, think of COVID-19 as the worst inspector general in the world,” Fauci continued. \n“It’s overseeing everything you do and making you follow the law. It’s keeping you from \nspending taxpayer money on anything you want. You wouldn’t stand for that, would \nyou?”\nReleased by Chairman Rand Paul\n774Reportedly, Trump appeared shaken by Fauci’s analogy. “Damn it, Tony, when you put it \nthat way, we’ve got to do something about COVID-19,” he said.\nSpeaking to reporters, Fauci said that he was “cautiously optimistic” that his inspector-\ngeneral analogy would finally spur Trump to action, but added, “Jared could still screw \nthis up.”\n……………………………………………………………………………………….\nAgain, countless print press stories about me directly or indirectly.   Far, far too \nmany for me to even think about reading.   Some day, maybe, go back and read.\nEveyone asking about the plasn for re-opening the ountry\nPRESS:  ABC -Good Morning America with George Stephanopoulos; NBC \nToday Show with Savannah Guthrie; CBS This Morning;   WH Press \nConference coverage\nApril 10, 2020 – Global – 1,440,000/85,000;  USA – 465,000/17,500\nConcern building about the economy and when we can open the country.   17 \nmillion jobs lost within the past 4 weeks.   Larry Kudlow and Steve Mnuchin are \nconcerned that even with the massive infusion of relief dollars that we may o \nirreparable damage to the economy if we do not open soon.\nCall with Randell Stephenson – CEO of ATT wanting counsel on how to get his \nworkforce back towork safely\nCall with Gov. Asa Hutchinson of Arkansas – doing a good job in AR; want \ncounselon retunring to normal\nCall with Gov. Mark Gordon of Wyoming – same discussion.   What advice and \ncounsel of returning to normal.\nCall with Gov. Doug Burgum of North Dakota\nAll these Governors are calling me because of my credibility and reputation to run \ntheir plans by me and ask for my opinion and help (message back to TF and \nPOTUS).   Unfortunately, I really cannot do much but get their messages back.   \nVery frustrating\nReleased by Chairman Rand Paul\n775POTUS actually joined the TF meeting right at the beginning andstarting talking \nabout ratings of the press conferences being the best ratings on all of TV.   Yikes!\nPOTUS was again rambling at the press conference with stream of consciousness \nnot really answering questions and spouting how well we are doing. Press \nfocusing on whether we are prepared to re-open.   Press keeps dwelling on fact \nthat we likely do not have enough testing capability.\nPOTUS mentioned (to my and Birx’s surpise) that he has already asked some \npeople to be on another Task Force to help him decide on re-opening.   He even \nmentioned that there would be prominent physicians on the call.   Deb is worrie d \nabout this.   I am not surprised.\nDuring press briefing reporter asked PTUS a question about Gov. DeSantis (R-\nFL) wanting to open his schools in May and would not that endanger lives of \npeople since there are many cases in Florida.   He did not answer and then the \nreporter asked what my opionion was.   I spoke generically saying I am not aware \nof the situation in Florida, but in general, if there are active cases in community, \nchildren in school could spread the virus.   Later that afternoon DeSantis called my \ncell and explained that he wa evaluating the situationon a week by week basis and \ndid not make any definitive decisions and the districts that he was considering \nopening the schools were districts with very few infection.\nPRESS:  CNN New Day with Alisyn Camerota and John Berman; Sirius \nDoctor Radio – Marc Siegal; Press conference (see above); FOX Martha \nMcCallum; FOX Jesse Watters; Brian Williams - MSNBC\nApril 11, 2020 – Light day.   TF, but no press conference.   Important discussion \nabout the fact that the sensitivity of the Abbott ID Now (15 minute test) machine \nis queationable.   We have not had a single positive at the WH with press and \nsecret service and staff.   We will bring a machine to NIH to use on people with \ndocumented COVID-19.\nI am still concerned about our ability to dothe tsting that we keep reassuring the \npublic that we can do.   Deb very much suspicious and restrained hostile towards \nBrett Giroir whom she does not trust.\nGave extra copies of the HHS Guidelines to Marc Short.   They plan to have me \npresent it to POTUS on Monday, April 13.\nReleased by Chairman Rand Paul\n776April 12, 2020 (Easter Sunday) – Global – 1,800,000/110,000; USA \n500,000/20,000.   In general, early indications of leveling off.   \nPrint news (NY Times especially) writing multiple articles about howTrump was \nlate to respond/slow to act even thugh he was given warnings by many people.   I \nlook good to neutral in the reports.   Big article in New YorkTimes today by Eric \nLipton, David Sanger, Maggie Haberman, Michael Sherar, Mark Mazzetti and \nJulian Barnes.\nI was spoofed last night on Saturday Night Live (SNL).   Media buzz in my \nanswer to Tapper’s question whether lives would have been saved if we had shut \ndown earlier.   I said yes with a lot of qualifiers; however, the press is not \nreporting the qualifiers.  Such is life…..\nPRESS:  CNN State of the Union with Jake Tapper; MSNBC TV with Rev. \nAl Sharpton\nApril 13, 2020 – Potential big problem (we shall see).  NY Times reporting on an \nanswer to a question that I gave on CNN yesterday (see above).   Jake Tapper \nasked me if we had closed down earlier, whould that have saved lives.   I said it is \ncomplicated; he persisted and I said obviously, if you close earlier there would \nhave been lives saved, but the decision was complicated.   I could have answered \nthe question better and with more clarity, but the Times is now saying that I was  \nimplying that the POTUS was to blame for additional deaths according to me.   \nThe far right is tweeting to fire me. The POTUS even re-tweeted the tweet that \nsaid to fire me.  We shall see how the day goes…….\nI called up Marc Short and explained that I was answering a hypothetical question \nand I told the truth.   Marc was very supportive and said the POTUS was not upset \nand understood.   I met with VP – he called me to his office 15 minutes befor the \nTF meeting and we discussed this.   He was terrific.   I said I was angry at having \nbeen put into this position, I am completely apolitical, and I am loyal to the people \nthat I work with.   I offered to explain to the press at the daily White House press \nconference.  Right before I walked in, I huddled with the POTUS and told him \nwhat I would do.   He was very relieved and grateful saying that his right wing \nbase is causing a lot of trouble and he was total OK with me.   I went out and \nexplained that I was being hoest in my answer to Jake, but that I was not implying \nReleased by Chairman Rand Paul\n777that anyone was responsible for more deaths.   I explained that the 2 times I \nrecommended to the POTUS to go to ‘mitigation” (15 day, then 30 day) he took \nmy (and Deb’s) advice and started to mitigation guidelines despite the fact that \nsome people were pushing back (did not mention any names)\nRight after that, he went on an anti-media rage showing a filiming recently put \ntogether that day by staff showing how he was on top of everything and responded \nswiftly.   Again, repetitive stream of consciousness.   I was uncomfortable sitting \nthere.\nPhone call with Jake Tapper.   Jake wanted to make sure the interview did not \ncause me any problems.\nGlobal – 1,700,000/106,000; USA – 560,000/22,000; \nPRESS: C-SPAN TV; \nApril 14, 2020 -   Press buzz still continues.   Feature story in today’s Washington \nPost: “Despite assurances, debate over Fauci’s fate continues” by Toluse \nOlorunnipa, Seung Min Kim and Josh Dawsey.  Also, Mike Gerson wrote an \neditorial in the Post attacking Trump for attacking me (re-tweet that energized \nTrump’s right wing fringe to attack me.\nGlobal -  1,800,000/112,000;    USA – 580,000/24,000.   Daily cases starting to \nlevel off over past couple of days.\nDid not do Presser today.   Topic was economic.  He rambled on in typical \nmanner.   He reversed himself from yesterday when he said that he has “absolute \npower” to tell the Governors what to do in the “re-opening”.   He stunned the press \nwith that announcement and people like Caitlin Collins pushed him on saying that \nsince it is not true.   He blew it off yesterday.  Today he said that he leaves it to the \nGovernors\nPress still buzzing about the tension between me and the POTUS – multiple \narticles. \nIt is clear after a meeting that I was called to with the VP at 10:30 AM with Deb. \nJared, Brett, and some from Jared’s team thsat they have salready decidedthat they \nwill “re-open” the country on May 1 no matter what I or Deb say.   Deb (as \nexpected) is totally bought in on this.   I am quite skeptical that they have a \nReleased by Chairman Rand Paul\n778program in place to respond to a rebounbd.   CDC certainly in incapable and Bob \neven admits that his team is mor “academically oriented” as opposed to pandemic \nemergency oriented.   Also, testing is still an issue.\nPRESS: Good Luck America Snapchat Interview (Skype); Bobby Bones \nCountry Music DJ Skype interview; NBC CoronavirusSpecial tsaped for \ntomorrow AM\nApril 15, 2020 – Global – 1,900,000/120/000;  USA – 603,000/25,000\nPrint media still pitting everything I say as contradicting POTUS.   They are also \ndigging into what I said it February indicting that I said the virus would not be a \nproblem; however, when you read my entire sentence, I said at this time (when \nthere were a couple of cases in the USA) there is not a serious threat, but this \ncould change very rapidly and so we need to be prepared. They leave out the last \npart of the sentence.  \nPeter Nicholas of The Atlantic  (Peter Nicholas)wrote a piece saying I was \nhumiliated and “shamed” by getting in front of the cameras and backing off the \nCNN interview with Tapper.   Fuck you, Peter.\nHas discussion with Chris this AM (in bed) about my considering resigning from \nthe Task Force.   The CDC/FEMA, etc in my mind have no idea what they are \ndoing.  There really is no plan.   Deb is secretive and worried about her job \nwanting to please the VP asnd POTUS and the press briefings are a total Shit \nShow with POTUS rambling.   I am afraid that if I resign it will be a global \nexplosion and might also look to my many admirers like I am deserting the cause, \nbut this is getting very tough. \nPhone call with Bill Gates and Trevor Mundel  regarding working together on \nvaccines and therapeutics.  Bill, like I, is very skeptical about serologic tests – \ncould be misleading is saying that someone is protective if Ab is positive.  He is \nconcerned as I am.  He feels that there are ethical considerations.\nDeb Birx last night put together the plan to re-open based on a combination of \nthe plans put forth by Tom Frieden, Scott Gottlieb, Zeke Emanuel.   I edited it \ntoday with her.  VP asked me to leave the TF and work with her.   I edited what \nshe had already done.   It was really a done deal before she showed it to me.   I \nemphasized that what was missing was guidelines about what to do if there is \nrebound.   It was almost as if she had not even thought of that.   She said she \nwould do this tonight.  This is really seat-of-the-pants stuff with patching together \nReleased by Chairman Rand Paul\n779overnight a plan that has enormous implcations for the health and safety of the \nnation.   I will hang in there to help as much as I can.  \nMarc  Short is becoming a good rriend.   He shuffled me out of the WH before \nthey started asking me to hang around for the endless press conference.   I ha told \nMarc that it would be great if I could go nly to those pressers where I was really \nneeded.   He got the message and the VP agreed.   And so, I am off today.   \nClearly the press will ask where I am.\nAmazing profile of me today on Nightline: https://bit.ly/2VvC0HP \nMultiple editorials (print news Washington Post, etc.) and opinion pieces \n(Newsweek) written about me.   Cannot keep up or even read all of them.   \nCountry needs someone to look up to in the face of Trump presidency. Interesting \npsychodynamics.   \nBrewery in Georgia named a beer after me “Fauci Spring”\nCartoon in thee Boston Globe:\nReleased by Chairman Rand Paul\n780Apr. 15, 2020 1:30 PM EDT\nItalian Virus Hospital Offers Fauci Work If Trump Fires \nHim\nBy NICOLE WINFIELD\nAssociated Press\nPRESS: Good Day FOX TV NYC – Rosanna Scotto; Cox TV; WSJ story on \nmy relationship with Shelly Wolff; ABC TV – David Muir; CBS Evening \nNews – Norah O’Donnell\nApril 16, 2020: Global – 2,000,000/125,000;  USA – 640,000/32,000.\nToday is day when newe Guidelines for re-opening will be announced.  \nI was shocked last night when she e-mailed me and said that all my edits had been \naccepted by the “Comms people”.   However, they wanted to take out the part \nabout recommending masks.   I wrote back (see bold below): \nOkay.  Great.   If we explicitly say follow CDC guidelines regarding use of masks and \nuse during mass transit, then I cannot see how there can be any objection.\nFrom: Birx, Deborah L. EOP/NSC <Deborah.L.Birx@nsc.eop.gov> \nSent: Wednesday, April 15, 2020 9:52 PM\nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nSubject: Re: WH Comms kept all of our words\nHaven’t done rebound yet. Will do early am. Pushing back on mask saying follow cdc \nguidance and wear during mass transit. \nSent from my iPhone\nReleased by Chairman Rand Paul\n781On Apr 15, 2020, at 9:49 PM, Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> \nwrote:\n \nWe should push back a bit on the masks.  I think that it is important.   Since when \ndo comms people dictate public health suggestions?  Walk out of the streets and \npeople are wearing them anyway.   We should be on board with them.    I would be \nhappy to do that tomorrow.   We are meeting with the VP tomorrow morning.   Can \nyou arrange for you and I to meet with the relevant person so I can give it a \npitch?  Also, let me see the part that I did not see regarding what one does when \nrebound of virus occurs in the midst of a diminution of current mitigation.\nThanks,\nTony\n \nFrom: Birx, Deborah L. EOP/NSC <Deborah.L.Birx@nsc.eop.gov> \nSent: Wednesday, April 15, 2020 9:43 PM\nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nSubject: WH Comms kept all of our words\n \nExcept took out the mask in public – kept all the thresholds.  What do you think?  I am OK if \ncovered in CDC guidelines I guess.  Deb\n………………………………………………………………………………………………….\nIn private conversation with Marc Short, I explained to him my concern about being brought into \nthe writing of the guidelines that they wanted me to endorce, and yet I only saw them for the first \ntime last night.   Marc said that Deb told him she had run them by me and Bob Redfield.   Bob \nsaid that the first time he saw them was last night.   I gently confronted Deb with this and she \ngarbled an embarrassed response.\nSen. Joe Manchin (D-WV) called my cell concerned about whether his state is ready to re-open.   \nHis consitutuents are frightened about coming out since they realize there is no treatment and \nthey could die from the disease.\nWorked on the guidelines a bit and now got them right.   POTUS, VP Deb and I presented these \nat the Presser.   Generally well-received, everyone still fixated on the issues with testing\nAfter my Laursa Ingraham hit, Jake Tapper (CNN) texted me saying sarcastically: “Hard to beliee \nPaura Ingraham went to Dartmouth, isn’t it.   All of us alumni are very proud.\nAlso, if I did not mention it above, I now have OIG security portal to portal car with armed \nguards.   Still getting death threats and obscene calls to my daughters and Chris.   US Marshalls \ngoing after these idiots.   DC Police continually patrolling my home.\nPRESS: White House Press Conference releasing :Opening Up America \nAgain” guidelkines; FOX TV Laura Ingraham.\nReleased by Chairman Rand Paul\n782April 17, 2020 – Global –  2,000,000/132,000;     USA -660,000/34,000;  \nDid briefing with the VP and Deb and Steve Hahn and BobRedfield and Brett \nGiroir to the Dem Senate Caucus led by Chuck Schummer.   Very hostile.  Kept \ncoming at us abut testing and how inadequate it is.   I have been telling the TF that \nthis is an issue that will not go away.   Angus King (Maine) tee-ed off on VP about \nthe fact that we are unprepared.   Patty Murray was her old self wanting a testing \nplan, etc. etc.   This rompted us to devope the entire TF to testing and decided to \ndo a presser.  I took over and chided the group that we cannot be telling people \nthat we have more test and materials than we need since this would be insulting to \nthem.   We cannot blame anyone and we must admit that the supply (which we \nclaim is adequate) is not “connected to” nor does it reach the people who are \ndemanding it.   Bottom line is that they are not getting what they want and ewe \nneed to fix the fact that it really is a distribution problem.   Also, Senators (and the \npress and the public) are under the impression that we should test everyone for the \nvirus. Hope Hicks, Katie Miller, the VP came over to me qnd said and indicated \nby their expression “Thank God that you are in the room!”\nWe explained this at the presser\nAnother indication of the craziness in the world.   This came out today:\nFrom: Billet, Courtney (NIH/NIAID) [E] \nSent: Friday, April 17, 2020 1:32 PM\nTo: Burklow, John (NIH/OD) [E] < BurklowJ@OD.NIH.GOV>; Myles, Renate \n(NIH/OD) [E] <mylesr@mail.nih.gov>; Mcgraw, Michael (NIH/OD/ORS) [E] \n<mcgrawm@ors.od.nih.gov>\nCc: Harper, Jill (NIH/NIAID) [E] <JHarper@niaid.nih.gov>; Folkers, Greg \n(NIH/NIAID) [E] <GFOLKERS@niaid.nih.gov>; Conrad, Patricia (NIH/NIAID) [E] \n<conradpa@niaid.nih.gov>; Routh, Jennifer (NIH/NIAID) [E] \n<jennifer.routh@nih.gov>; Stover, Kathy (NIH/NIAID) [E] <kathy.stover@nih.gov>\nSubject: FW: Media request - Fauci sexual assault allegation / possible smear\nJust when you thought life couldn’t get any crazier, we are now getting media inquiries \nabout this “press release” from a firm we can find no trace of online.  The address they \nprovide for their “press conference” is the Chinese Embassy.  \nI have a call in to Dr. Fauci to let him know about this, but he is at the White House and \nnot answering his cell phone.  \nLt. McGraw, can you help get to the bottom of who these people are?  There is a phone \nnumber at the very bottom.  Should we also be sending this to OIG?\nReleased by Chairman Rand Paul\n783Can you please advise on how to respond to inquiries?  Do we respond, or refer them to \nNIH?  We would propose to say something like:\n“The allegations are preposterous and the press release is apparently a hoax.  We can find \nno firm by this name, and the address provided for the “press conference” is the Chinese \nEmbassy.  We are referring the matter to appropriate authorities for follow-up.”\n \nFrom:  William Sommer\nSent: Friday, April 17, 2020 12:48:52 PM (UTC-05:00) Eastern Time (US & Canada)\nTo: NIAID NEWS (NIH/NIAID)\nSubject:  Media request - Fauci sexual assault allegation / possible smear\nHi, \nMy name's Will Sommer, I'm a reporter with The Daily Beast in DC. There's a press \nconference scheduled for next week that's supposed to detail sexual assault allegations \nagainst Dr. Fauci — it has all the hallmarks for me of a smear campaign from some GOP \noperatives, but wanted to flag if the Fauci office has any comment or if this has been \nreferred to law enforcement for investigation. Attaching the press release below. \nThanks for your time\nWill Sommer\nReporter, The Daily Beast \n(703) 863-1148\nwilliam.sommer@thedailybeast.com\n@willsommer\nFOR IMMEDIATE RELEASE\nReleased by Chairman Rand Paul\n784CONTACT:\nRhonda Abramson\nVice President, Whitley, Moran, Telander LLP\nhttp://linkedin.com/in/rhonda-abramson-349413199\n(310) 893-3545\n \nDr. Anthony Fauci, World Renowned COVID-19 Figure, \nAccused of Sexual Assault – Press Conference Planned with \nVictim       \n____________\nConference line established for those unable to attend / wish to respect \nsocial distancing guidelines\nFamed immunologist accused of assaulting 20-year old at Four Seasons \nInner Harbor Hotel in Baltimore\n \nWHAT:                                               Anthony Fauci Assault Allegation Media Q&A\nWHEN:                                               TUESDAY, APRIL 21, 2020 – 1 p.m. ET\nWHERE:                                             In Person: 3505 International Place, Washington \nD.C., 20008\n                                                            Conference Line: (712) 775-7100 Passcode: \n654321#\nBACKGROUND:\nUPDATE: A conference line has been established for reporters who wish to adhere to \nsocial distancing guidelines. Diana will still be at the physical location, along with \nRichard Whitley and Rhonda Abramson. The press conference will also be simulcast \nvia the above phone line.\nInterested media members should RSVP for the in-person or conference call by \nMonday at 6 p.m. ET.\nOn December 6, 2014, former television intern Diana Rodriguez alleges that she met Dr. \nAnthony Fauci, director of the National Institute of Allergy and Infectious Diseases, at \nthe Four Seasons Hotel in Baltimore.\nReleased by Chairman Rand Paul\n785Rodriguez, who was 20 at the time, had several drinks with Dr. Fauci at the bar and \nproceeded to accompany him to his suite overlooking the harbor.\nThe following is Ms. Rodriguez’s accounting of the night.\nHe looked rich and powerful, and I love smart men with grey hair. He told me all \nabout his fantastic career in medicine, so I went upstairs.\nHe made it clear that he expected sex once we got to the room and by then I was \nso drunk the room was spinning. He threw me on the bed and pulled up my dress. \nI was too drunk to resist, but I begged him not to. He only said, “don’t you know \nwho I am, you little bitch?”\nHe became angry when he failed to get an erection - he looked like he was in his \nmid-70s - so he got up and popped two Cialis pills. He then told me to stay on the \nbed while he returned a call. I was so scared I obeyed.\nAbout 15 minutes later, he returned to the bed and shoved me down again. Now \nhe was erect, and I was defenseless. Suddenly, I had the presence of mind to grab \na pen from the nightstand, with which I jabbed him in the shoulder. I then ran out \nof the room and out of the hotel, never to return.\nIt was the most harrowing and terrifying experience of my life.\nNow, when I see him on TV touted as some kind of hero, I want the nation to know \nthe truth.\nThis is my truth. This is my story.\nCONTACT:\nRhonda Abramson\nVice President, Whitley, Moran, Telander LLP\nhttp://linkedin.com/in/rhonda-abramson-349413199\n(310) 893-3545\nStory in “The Daily Dot”:\nReleased by Chairman Rand Paul\n786Someone is spreading a sketchy \nsexual assault claim against Dr. \nFauci\nThe people behind it seem to not exist.\nApr 17, 2020, 5:56 pm*\n \nTech\n  \nClaire Goforth\nThe White House/Flickr\nThe coronavirus outbreak has made Dr. Anthony Fauci, longtime director \nof the National Institute of Allergy and Infectious Diseases, a household \nname.\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n7884:57 PM - Apr 13, 2020\nTwitter Ads info and privacy\n64 people are talking about this\nLast month, as the threats escalated, Fauci was assigned a security detail.\nThe latest attack on him comes in the form of an accusation of sexual \nassault.\nEarlier this week, the Daily Dot received a press release from a woman \nclaiming that Fauci sexually assaulted her in 2014. The release included \nthe details of the allegation and said she and her representatives plan to \nhold a press conference on Tuesday in Washington, D.C.\nAll allegations of this nature are given equal consideration. But the more \nthe Daily Dot looked into the details, the more things didn’t add up. The \naccuser didn’t respond to multiple requests to speak with her.\nThe woman, whose name is not reported here because it couldn’t be \nconfirmed, claims to be represented by Rhonda Abramson and Richard \nWhitley of Whitley, Moran, Telander LLP. The Daily Dot could find no \nrecord of any business by that name.\nThe email, which came from the accuser’s Gmail, included Abramson’s \nLinkedIn account and phone number. There she claims to live in the \nWashington, D.C. area and to have worked for two companies.\nUnlike Whitley, Moran, Telander, those companies’ existence was readily \nconfirmed. However, both told the Daily Dot that they have no record of \nAbramson’s employment.\n“We have never employed her, have never heard of her, and have been \nfielding calls and emails on this for a couple of days,” said Dave Seman, \nmanaging principal of Paladin Political Group, which Abramson claims to \nhave worked at until last month. “We have requested LinkedIn flag her \nprofile for fraud.”\nReleased by Chairman Rand Paul\n789A human resources representative at the second company, where \nAbramson claims to have worked from 2007 to 2011, said that the position \nshe lists doesn’t exist.\nAbramson herself seems to also not exist. Reverse image searches for her \nLinkedIn profile picture turn up nothing.\nAn initial search for her picture on Have They Faked Me was negative, but \nbarely; a second search a day later was positive. This means either that \nfake photos have likely been made using this image, or that the image \nitself is fake.\nAbramson did not respond to numerous messages via voicemail, text, and \nLinkedIn. All calls went to voicemail.\nAlthough she’s not responding to inquiries, Abramson did find time to post \nthe press conference details on LinkedIn yesterday.\nRichard Whitley is similarly impossible to find. The Daily Dot found no one \nby that name, or any of the variations of Richard, in Washington, D.C on \nLinkedIn or Facebook.\nEven the location of the press conference is strange. According to the \nassault allegation, it took place at the Four Seasons in Baltimore in 2014, \nwhich is on International Drive.\nThe address for the press conference is also given as an International \nDrive, but in Washington, D.C. That address most closely matches that of \nthe Chinese Embassy.\nHowever bizarre, it is possible this location was chosen because the \ncoronavirus originated in China.\nGiven the nature of the allegation and his history, the Daily Dot contacted \nfar-right pundit Jacob Wohl to ask if he knew anything about it. Wohl has \npreviously been involved with leveling often far-fetched sexual allegations \nagainst various individuals Republicans consider their enemies: Sen. \nReleased by Chairman Rand Paul\n790Elizabeth Warren (D-Mass.), Pete Buttigieg, and Robert Mueller. Each \nallegation was later resoundingly discredited.\nPlus, sham press conferences in the D.C. area are kind of his thing.\nWohl said he had nothing to do with the accusation against Fauci.\n“This is the first I’ve heard of it,” he said.\nHe also said that his frequent co-conspirator and right-wing lobbyist Jack \nBurkman isn’t involved and that no one had contacted him with allegations \nagainst Fauci. Wohl said that he’s presently in California and has no plans \nto be in D.C. this Tuesday.\nIt’s beginning to seem unlikely that anyone, least of all Abramson or \nWhitley, will attend the press conference.\nAs of press time, Fauci had not responded to questions sent to the \nNational Institute of Allergy and Infectious Diseases press office. This story \nwill be updated if a response is received following publication.\n…………………………………………………………………………………….\nThis is really pissing me off.   They threaten my life, harass Chris, send obscene texts to \nmy children and now this bullshit!\nPRESS: The Breakfast Club NYC Radio (D.J. Evy, Angela Yee, and \nCharlamagne tha God; Podcast with Will Smith; White House Press \nConference (Testing)\nApril 18, 2020 – Global 2,100,000/140,000; USA – 700,000/36,000\nFar right agitating to get back to work.   Much agitation!  Daily articles involving \nme continue to appear. Article  in Today’s Washington Post. Talks about my one \nhour call with the Congressional Black Caucus and how they trust me,but do not \ntrust Trump to help them.   They are afraid that I will be fired.\nI am getting worn down with all this PLUS my PMR, prednisone and now I have \nlost 8 lbs over the past couple of months\nMary McNamara column in Los Angeles times:\nReleased by Chairman Rand Paul\n791Column: Is Anthony Fauci the Sexiest Man \nAlive? Who the hell cares?\nDr. Anthony S. Fauci speaking at the White House Friday.\n(Carolyn Kaster / AP)\nBy MARY MCNAMARACULTURE COLUMNIST AND CRITIC \nAPRIL 18, 2020\n6 AM\nFor the love of God, can someone please tear up the petition to make Dr. \nAnthony Fauci People magazine’s Sexiest Man Alive?\nIf not, can we please at least stop talking about it?\nI get that it’s a compliment; for some, heaven help us, the ultimate \ncompliment. Fauci’s unflappable and highly competent demeanor has \nbeen a beacon of strength and surprise amid the squishy, tweet-driven, \nass-covering, daily-contradictory triumph of personal feelings over \nirrefutable facts that has been the Trump administration’s reaction to this \npandemic.\nLet others voice outrage about churches closing down, or sputter about the \nindignity of wearing masks; express concern about the Dow Jones or \nexplain why it is now perfectly safe for Floridians to go back to the beach \n(which they only recently vacated) because, well, just because.\nADVERTISEMENT\nDr. Fauci will continue to stand in front of microphones talking only about \nthe things he knows. Not what he wants, wishes, thinks or feels. What he \nknows.\nNo matter how blatantly Fox News anchors attempt to shift his on-air \nnarrative, no matter how often the president contradicts him in public and \nto his face, Dr. Fauci quietly but firmly sticks to the facts.\nReleased by Chairman Rand Paul\n792So now expert is the new sexy, from the specs to the striped socks — \nimmunology the new rock ’n’ roll. We all feel it, that swoon of relief when \nFauci begins to speak, but here’s an idea: Let’s not succumb.\nLet’s all take a deep, socially distanced breath and choose to resist \ncomplimenting the person who very possibly stands between 328 million \nAmericans and complete disaster by granting him an accolade he would \nshare with Chris Hemsworth  (no offense, man).\nResist the desire to “humanize” the head of the National Institute of Allergy \nand Infectious Diseases by asking him for dating advice or make him more \n“accessible” by tarting him up with some pop culture makeover.\nYou think I’m overreacting? There’s already a bobblehead , a late-night fan \nclub, a prayer candle and socks; can a reality show be far behind?\nBecause that’s how it works when you start slinging around the term \n“sexy.” Sexy sells and this economy is going to need some fast, hot sales in \nthe near future. Who wouldn’t tune in to see Fauci judge which contestant \ncomes up with the best COVID-19-preventing protocols?\nBut if life is really going to look different in the coming months, let’s begin \nwith this.\nLet’s not make Anthony Fauci a rock star. Because he doesn’t need to be a \nrock star. He needs to be what he is — a physician and expert \nimmunologist who emerged from the AIDS crisis with a unique \nunderstanding of the relationship among science, humanity and public \npolicy. A man with the near-miraculous power to separate his ego from his \nmission, to bring science to an avowedly anti-science presidential \nadministration, to express expertise in front of a president who doesn’t \nbelieve in experts.\nLet’s not destroy that highly delicate balance by dragging sexy into it. \nUnlike his late-night fans, or his president, for that matter, Fauci does not \nneed to be concerned with television ratings. Wouldn’t it be nice if it \nstayed that way?\nReleased by Chairman Rand Paul\n793As scientific fact forces the culture to shift away from desire to reality, we \nhave a chance to honor the line between pop culture influence and genuine \nexpertise. We know what life looks like when we blur that line. It looks like \nDrs. Oz, Phil  and Drew, men who became media personalities because they \nwere often willing to tweak facts for the sake of ratings and are now being \nslammed for their inability to stay silent about things they do not \nunderstand. Like COVID-19, because, guess what? None of them are \nimmunologists or epidemiologists, and “Dr. Phil” doesn’t even have a \nmedical degree. “We need our mojo back,” Oz said recently on “Hannity,” \nbefore suggesting that getting kids back in school was worth raising the \nCOVID-19 mortality rate. As if some bizarre form of national swagger was \nworth making schoolchildren canaries in a coal mine. (He has since walked \nback his remarks after overwhelming criticism.)\nWe have a chance to return expert culture to actual experts.\nThe emergence of personal testimony as a valuable social force — whether \nthrough memoir, daytime talk show or the blogosphere — was a \ndemocratizing triumph of popular culture. Millions of people, ignored by \nor refused entrance to traditional means of disseminating information, \nwere suddenly being heard. And it changed the world.\nIt also made everyone an expert.\nBut the personal is a complement to, not a replacement for, the empirical; \nfeelings can stem from or help create facts, but facts exist apart from \nfeelings. So while many of us may have felt  that COVID-19 was just a form \nof the flu, Fauci and others knew, through their expert ability to analyze \ndata, that it was not.\nWith any luck, Fauci’s expertise will not just save us from the pandemic, \nbut it will also remind us that there are times when expertise is the most \nimportant commodity. Not strong branding, social-media influence, \nlikability or audience connection. In our rush to become the next \nYouTube/social media/”America’s Got Talent” star, some of us have \nforgotten the importance of skill sets that have less to do with personality \nand more to do with perseverance. Dr. Fauci is 79 years old; he has served \nas the director of the NIAID since 1984. He knows what he’s talking about \nReleased by Chairman Rand Paul\n794not because he’s cool (which he very well may be) but because he’s been \ntalking about it for a very long time.\nFauci has become a star by repeatedly telling the truth even when it’s a \ntruth no one wants to hear.\nThat’s not sexy. That’s astonishing. But I don’t think People magazine has a \ncategory for that.\n……………………………………………………………………………………………………………\nE-mail from Holy Cross:\nMy Fellow Classics Major,\nI'm sure you've already received numerous emails about Holy Cross's Giving \nDay today -- BUT have you received one especially for you as a Classics \nMajor?\nAround the nation, people have deemed Fridays to be #Faucifriday in \nappreciation for our very own Dr. Anthony Fauci. If you weren't aware, Fauci \nwas, in fact, a Classics major at Holy Cross!!!\nSo, in support of Fauci Friday and the college's giving day, let's show the \nPower of Purple by giving back to our beloved school. You can even designate \nyour gift towards the lovely Classics Department if you so desire.\nTo make your gift, please visit:  https://www.givecampus.com/4vai5d\nThank you all for your support as alums. Stay safe and healthy!\nAJ Wells\nClass of 2018 Class Chair\n………………………………………………………………………………\nPRESS:Greta Van Sustern TV Show – “Full Court Press”  to air tomorrow\nReleased by Chairman Rand Paul\n795April 19, 2020 – Global – 2,200,000/150,000; USA – 725,000/38,000\nMuch agitation (spurred by the POTUS’s stupid “Liberate Michigan, VA, etc) \nabout people wanted to open up.   Rallies with chants of “Fire Fauci”\nHad conversation with Jake Tapper who is asking where the 27 million tests by \nend of March came from (Brett Giroir).   Fact is I have no idea how he got that \nnumber.  Deb Birx has no confidence in Giroir, nor do I.   We are saying that we \nhave 1.5 to 2.0 Million tests per week available.   I hope so.   Still there is the \nreality and perception that we do not have enough tests.\nSunday shows kept focusing on testing, testing, testing\nMark Meadows approved our putting out Guideliens for Clinical Management \n(Cliff Lane’s groups) after he made some simple, good suggestions that did not \nimoact integraty of the document.   It will come out under the NIH instead of the \nTask Force or HHS (Alex Azar afraid the POTUS would be upset at the HC \nguideline (no evidence for or against its use) because of the POTUS hailing it.\nApril 20, 2020 – Global – 2,250,000/153,000; USA – 745,000/35,000\nGoodday for me since for the 3rd day in a row, I do not need to be at press \nconference and stand (or sit) there and listen to his stream of consciousness.\nI had a major pushback (raising my voice) to Deb and Bob and Steve and Joe \nGrogan in the Sit Room before the TF meeting (mostly Deb) that we are relying \non numbers from from Bret and Deb has absolutely no confidence in Brett.   \nEveryone in the country and the world is saying that we do not have enough \ntesting and Brett keeps saying that we do when the people in the trenches all so no.  \nWe are looking like idiots and I told the group that.   Deb is weak!! She says that \nshe has gone to to VP 3 times saying that Brett is a disaste and the VP “cannot do \nanything about it”.   Deb claims that this is because Brett is backed by Jared and \nthe VP does not want to go there.   Holy Shit!!!!!   Anmother example:   There are \nnumber for projected tested over the next few months that Brett is going to put \ninfront of the POTUS.   Deb does not believe them and says they are overinflated.   \nI told her to take them out since she is the “Coronavirus Coordinator”.   Agains \nshe balked until someone in the room (? Works with staff secretary) said that they \nhave a screening process that they rarely use with Trump since there are so many \nways into him (Hope, Jared, etc), but thye might use that process to block this \nfalse information from getting to the POTUS.\nReleased by Chairman Rand Paul\n796Article online in Washington Post (tomorrow in print) giving the history of Brett \nand how he was fired from his job in Texas as heard of a vaccine initiative since \nhe “over-promised and did not deliver”.\nGeorgia and South Carolina starting to open us even though they do not even \nfulfill the criteria for gating, much less going into Phase 1.   I predict that this will \nresult in major rebound and said that on GMA (see below).\nPRESS:  ABC Good Morning America with George Stephanopoulos; YES \nRadio Yankees Network with Jack Curry; NFL PSA\nApril 21, 2020 – Global – 2,300,000/158,000;      USA – 780,000/41,000;\nVP is travelling and so no TF meeting today.   Big stir on TV shows last night \nabout some states wanting to open and violating the guidelines for “Opening \nAmerica Again”.   POTUS making things worse by hiscrazy pronouncing \n“Liberate Michigan, Liberate Virgina”.   Really crazy – he himself and us (me, \nDeb) are stressing to abide by the guideliens and he is rabble-rousing by his \nstatements.   Typical Trump.   Stir a lot of “Fire Fauci\n out there among the far right.\nCall from Sem Lindsey Graham saying that he spoke with POTUS today and \nGraham is afraid that POTUS will not push back against what Georgia Governor \nis doing by “opening up” the state and he wants me to do so.   I do not need him to \ntell me to do that.   I told him that I would.\nCall from Ari Emanuel (he calls often) asking when I thuink this will end.  He has \nalready lost several hundreds of millions of dollars on cancelled bookings for \ntheater, concerts and other events that he runs.\nReceived call from Dionne Warwick who received an e-mail from a friend asking \nwhether vaccuines developed for dog corna virus could help with vaccine \ndevelopment for SARS-CoV-19.   Not a stupid question.\nSpoke by phone with Governor of Puerto Rico Wanda Vasquez Garced together \nwiyh her Secretary of State.   They wanted to know if I approved of what they \nwere doing to mitigate in PR and they had some good questions.\nWoman who claimed that I raped her (see above) never materialized.\nReleased by Chairman Rand Paul\n797April 22, 2020 – Interesting day -  Rick Bright has gone rogue.   Due to his \npoor performance as head of BARDA, Alex (+/-) Kadlec removed him from his \npost.   We (Francis and I) thought that he would stay at BARDA and spend 50% of \ntime at NIH in order to coordinate BARDA with NIH vaccine activities,   We all \nhad always felt that he was making bad decisions in his giving hundreds of \nmillions of dollars to Phartma companies without any requirements to coordinate \nwith NIH and his choices were poor to begin with.   HOWEVER, in what turned \nout to be the most incompetent and botched HR move, they fired him by just \ntaking his name and picture off the HHS/BARDA website without even telling \nhim.   They then assigned him to be an NIH employee under Francis taking with \nhim from BARDA $1 Billion to work on diagnostics with Bruce Trumberg of \nNBIB.    Rick reacted by going public, hiring a lawyer, claiming whistleblower \nstatus and saying he was fired because he was pushing back against HHS and \npolitical pressure to fund bad science and certain companies and that he objected \nto pushing HC.   In fact, there are e-mails and memos showing that he himself was \npushing HC and giving millions to get it out there.   He is an abject LIAR!\nI  have been calling Chris Cuomo on his cell (he is sick at home with COVID-19) \nevery night (usually after 10:00 PM when his show ends) for the past 2 weeks.   \nHis fever lingers and his wife Christina and son Mario are both infected, less \nsevere than he.   They both have loss of taste and smell and sinusitis.\nGeorgia Governor Kemp is actually ignoring the guidelines for “Opening Ameica \nAgain” by skipping to phase 2 and opening beaches, massage parlors, tatoo shops.   \nCrazy!.   A couple of days ago Deb waffled about condemning it, but today she \nconvinced the POTUS to back off in supporting Gov. Kemp (R-GA).   During the \npresser, I came out unambiguously saying that Kemp was wrong and if I were his \nadvisor, I would tell him not to do that since it risks a rebound.\nIt seems that the WH is putting me out to the press much less than usual over the \npast week to week and ½.   We shall see.   The relationship between me and Katie \nand Hogan and Devin seems really good and so I do not know what is going on.   \nCould be just a coincidence.\nMy PMR is under control – starting to slowly taper the 15 mg prednisone.   Have \nbeen on pred. for 36 days\nPRESS:  White House Presser\nReleased by Chairman Rand Paul\n798April 23, 2020 – Global – 2,500,000/170,000;   USA – 827,000/47,000;\nInteresting day.   Was asked to come to Pentagon (with Deb Birx) by Chairman of \nJoint Chiefs of Staff Mark Milley.   He had Deb and I brief him and his immediate \nstaff on how the Armed Forces could best prepare for the future wave (in the Fall \nand beyond) of COVID-19.   All about “force protection”.   We did this in the \nfamous “Tank”.   Howver, before we did that he wanted to take a bunch of photos \nwith him, his wife, and Vice Chair Gen. John Hyten and Gen.Paul Friedrichs.   \nAlso, he had me sign his surgical masks and a basketball that was originally \nsigned by Coach K of Duke.   I had a wondeful time!!\nTF was uneventful.   I was not at presser…..\nHOWEVER, the presser was a disaster for the POTUS.   All he did was fight with \nthe press   Someone from DHS presented data showing that sunlight, heat and \nhumidity “kills’ the virus.   Actually, they presented this at the TF meeting and the \nPOTUS did not even know about it.   When the DHS guy presented it, the press \ntore it apart as a gimmick from the POTUS. Also, the POTUS incredibily made \nthe comment that one should consider injecting or swallowing these disinfectants \n(including chlorax-like substances) as a “cure”.   Deb almost fainted on stage,  \nThank God I was not there,  After the presser, CNN with Erin Burnett presented a \nsegment of the clash between the scientists (almost exclusively me) and the \nPOTUS.   They showed a point-by-point contrast of me versus the POTUS.  Let us \nsee what the reaction is tomorrow at the TF meeting. \nAfter the presser (about 1 hour) Deb Birx texted and then called me saying it was \ngood that I was not there since after the presser, the POTUS called her into the \nOval and started yelling at her saying “You and Fauci have destroyed the country \nand the economy.   I should never have listened to you.   You have completely \ndestroyed us.”   He kept saying this over and over again and was yelling at her.   I \nencouraged her that we are OK and at the end of the day she and I will be loved by \nthe people we care about.   She was relieved and after wrote me a text sincerely \nthanking me.   \nPRESS: None\nApril 24, 2020 – Global – 2,600,000/177,000; USA – 860,000/49,000.\nReleased by Chairman Rand Paul\n799Press having a field day trashing the POTUS for his statement about “drinking \nbleach”.  Consuming the press.\nWill brief Governors today with the POTUS.   Governor talk went well.  Cuomo \nstated what I had been saying all along that we need a “partnership” between USG \nand States.   Note the POTUS goes back and forth and has often said that the \nStates are on their own and when I say “partnership” there was some concern that \nI was contradicting POTUS.\nFir first time the POTUS had a presser and walked out without answering any \nquestions.   \nAxios wrote that he may greatly diminish pressers.  He used to love them due to \nthe “ratings” of viewers.   However, his people are now telling him that it is \ngreatly hurting his approval ratings.\nApril 25, 2020 – (Saturday) – Very brief TF at the WH today.   No press \nconference.  \nMuch discussion about the plasn of the states to open.\nA lot of buzz in the media about Azar very likely getting fired.   Reuters wrote a \nsmear piece on him and attacked Brian Harrison (his COS) for be a dog breeder \nsince he raised labradoodles at some ime in his life.   Very unfair.\nAlso, it is clear that theyare gradually keeping me off the press conferences with \nthe POTUS and not allowing me on TV/radio nearly as much.   NBC reported that \nof the last 7 press confercens, I was at 1 and I usually get 2-3 media hiots per day \nand I have only done 2 last week – FOX with Laura Ingraham and GMA with \nStephanopoulos.  Katie Miller no longe doing press assignments.   Now it is \nKayleigh McEnany and Alyssa FarahAlexa.\nSee below from April 24:\nFauci's absence from recent coronavirus \nbriefings draws notice\nThe national health expert was in attendance for just one of this week's seven briefings.\nReleased by Chairman Rand Paul\n800President Donald Trump reacts as Dr. Anthony Fauci steps away from the podium after \nspeaking and answering questions at the daily coronavirus task force briefing at the \nWhite House on April 22, 2020.Jonathan Ernst / Reuters\nApril 25, 2020, 3:22 PM EDT / Updated April 25, 2020, 4:14 PM EDT\nBy Monica Alba, Kristen Welker and Carol E. Lee\nWASHINGTON — Until this week, Dr. Anthony Fauci was a near-constant presence at \nthe daily coronavirus task force briefings at the White House. As the head of the National \nInstitute of Allergy and Infectious Diseases for 35 years, his expertise on the global \npandemic has been a reassuring force for millions of Americans concerned about how \nCOVID-19 has uprooted their lives.\nOf the roughly 50 press conferences on the health crisis so far, Fauci had only missed a \nhandful. But now, for the first time since regular press conferences began on the topic, \nFauci was only present for one of seven briefings this week.\nWhile Fauci gave media interviews throughout the week, his absence at the podium \nFriday was notable given the president’s controversial remarks a day earlier about using \nlight and disinfectants to possibly treat the deadly respiratory illness.\nAnd though Fauci regularly shares his decades-long infectious disease knowledge \npublicly, one administration official suggested there’s a preference that Fauci do more of \nthat behind closed doors so it doesn’t appear he’s on such a different page from the \npresident.\n“You are here in a certain role, you’ve got to give advice privately,” this official said.\nMembers of the president’s task force have taken notice of Fauci’s diminished public \nprofile, as well. There is mounting frustration among some of them with Fauci, who has, \nat times, publicly contradicted President Trump. Adding to the tensions, some officials \ncomplain they feel caught off guard by some of Fauci’s media interviews.\nWhen asked why he was only at the briefing once this week, an administration official \ntells NBC News that Fauci \"does have other responsibilities at NIH. Just because he is \nnot at the briefing does not mean he’s not actively involved in task force meetings and \nbriefings.\"\nReleased by Chairman Rand Paul\n801White House Deputy Press Secretary Judd Deere was more direct, telling NBC News that \n\"despite the media’s ridiculous efforts to somehow create distance between the president \nand his top health experts, it is simply fake news.\"\n\"President Trump has relied on and consulted with Dr. Adams, Dr. Birx, Dr. Fauci, Dr. \nHahn, Dr. Redfield, and many others,\" Deere added, \"as he has confronted this \nunforeseen, unprecedented crisis and put the full power of the federal government to \nwork to slow the spread, save lives, and place this great country on a data-driven path to \nopening up again.\"\nThe most recent example of discord came on Thursday when an interview with “TIME” \nrevealed the doctor had a dismal view of the country’s testing capability.\n“We absolutely need to significantly ramp up, not only the number of tests but the \ncapacity to actually perform them,” Fauci said. “I am not overly confident right now at all \nthat we have what it takes to do that.”\nWhen asked later in the day if he agreed with Fauci, the president said: “I don't agree \nwith him on that, no, I think we're doing a great job on testing.”\nOn Wednesday, the only day Fauci joined for the briefing this week, he refuted the \npresident’s assertion that coronavirus “may not come back at all” this year and, if it does, \nit would just be “embers” or “pockets.” Minutes later, Fauci took to the lectern to state \ndefinitively: “We will have coronavirus in the fall. I am convinced of that.”\nWhile Fauci has appeared on most Sunday shows through March and April, he did not \nappear last weekend and is not currently slated to be on any of the political programs in \nthe coming days.\nGiven Fauci’s absence from the briefings this week, several of the president’s aides and \nallies have started to wonder what it means about their relationship. Officials close to the \ntask force, however, insist Fauci’s role is seen as critical to the pandemic response and \nmaintain his job is safe.\nAnd, the decision to skip the briefings may be Fauci’s own, given that he called the \nsometimes two-hour, marathon events “really draining” recently. Aides also said Fauci is \na regular attendee at the closed-door meetings that often take place right before the \ntelevised pressers.\nExperts agree Fauci’s storied career in the industry means he seeks little praise and \ndoesn’t need the president’s approval to perform his duties.\n“If you’re somebody who aspires to have impact in public health as a physician or \nprovider, you should look no further than Dr. Fauci or Dr. Birx, which spans \nadministrations,” said Dr. Vin Gupta, a pulmonologist and global health policy expert \nReleased by Chairman Rand Paul\n802who is an NBC News medical contributor. “I think at the end of the day, the president \nneeds Fauci more than Fauci needs any of this.”\nHis job is considered the “ultimate balancing act,” according to Dr. Kavita Patel, also an \nNBC News contributor. Watching the president continue to ad-lib medical advice from \nthe White House briefing room “has to be frustrating” for Fauci, whose day job entails \nresearch on a potential vaccine, but he is likely aware that the pandemic response will \ntake months and months so he takes a longer view. “He is a runner, and I am sure part of \nthis is viewing COVID-19 task force as a marathon not a sprint,” she said.\nBesides the president and Vice President Pence, the only coronavirus task force member \nwho has appeared at more briefings is coordinator Dr. Deborah Birx. Neither doctor \nattended Friday’s briefing, which was the shortest to date. And, in a first at these kinds of \nnewsers, Trump and Pence took no questions.\nWhite House officials provided no explanation for the abbreviated appearance and lack of \nmedical professionals like Birx and Fauci.\nEarlier this month, the president elevated a tweet that contained the hashtag “FireFauci.” \nAdvisers close to both men denied that was ever under consideration and the two later \nsaid publicly they had a good relationship and will continue to work together.\nEven so, the president does not have the direct authority to dismiss Fauci. The president \ncould, in theory, direct Health and Human Services Secretary Alex Azar to see to it that \nFauci is fired. Azar would then have to direct the NIH head to oust Fauci. As a federal \nemployee, Fauci can only be fired “for cause.”\nIf he were to be removed, however unlikely, it would cause “irreparable harm,” Gupta \nsaid.\nOccasionally in recent weeks, when Fauci hasn’t been seen among the group of aides \nemerging from the bright blue doors of the West Wing to start the briefings, observers on \nsocial media have wondered aloud: “Where’s Fauci?”\nThe answer for most of this week, at least: no longer at the president’s side in the daily \nbriefings.\nMonica Alba\nMonica Alba is a political reporter for NBC News.\nReleased by Chairman Rand Paul\n803Kristen Welker\nKristen Welker is a White House correspondent for NBC News.\nCarol E. Lee\nBrad Pitt plays me on Saturday Night Live and thanks me in serious tone \nafter his skit.    https://people.com/tv/brad-pitt-portrays-dr-anthony-fauci-on-snl-at-\nhome/\nSong about me: \nhttps://www.youtube.com/watch?v=Vp5rc8FCR8I&feature=youtu.be&f\nbclid=IwAR1FbjNMK-\nUOiSiDjZLHahjlsZs562qv1ueN6avimgocc0nhlOwoTkIafXQ\nApril 26, 2020 – (Sunday) – Global – 2,750,000/190,000;  USA – 930,000/53,000\nI was not on Sunday shows.   Deb was on CNN with Jake Tapper and did not answer the \nquestion of whether it was a mistake for the POTUS to talk about injecting or swallowing \nbleach.   Jake wrote me a text afterwards and said: “Birx has lost her way I fear.   She has \nchosen to focus on defending the president and attacking the press.   Odd.”\nHad very important teleconference that I called for , but was chaired by Francis \nCollins and Bob Kadlec.  The entire call was to align BARDA with the mission of \nNIH.   Up to now, BARDA did what they wanted as a “parallel” component to \nNIH in HHS without any real consultation or coordination.   They are OK for \ntaking a hand-off from us on a product that we do early concept and development \nand then give to them to fund a company to make a product and oput inot SNS.   \nHowever, when it comes to the emergency of making a vaccine and they (without \neven consulting with us) give hundreds of millions of dollars each to several \nPHARMA companies to go their own way with no stipulations or requirements for \ncoordination with us, then that is unacceptable.   We discussed the need to re-boot \nReleased by Chairman Rand Paul\n804with regard to BARDA and NIH and have them fund companies with the \ncondition that they coordinate (protocol design, lab data, DSMBs, etc.) with NIH.  \nPeter Marks (FDA) will help lead this new approach.   Francis and Bob Kadlec are \ntotally on board.   Now the devil is in the details. \nApril 27, 2020 – Global – 2,800,000/195,000; USA – 955,000/54,000\nStay heads up to a marked decrease in WH Comms allowing me to go on national \nmedia compared to 2 weeks ago.  Let us see what happens.\nBig topics this week is the opening plans of various states and how they align with \nthe “Opening America Again” Guidelines\nBriefed the Governors on the “Blueprint for Testing to Open Ameica Again”.   \nThey all sounded like everything was fine with testing and praised the POTUS (at \nleast the GOPs did), and Brett gave his usual overly optimistic report on how \nmany tests we will have out there.  However, when the press asked the Governors \nabout their ability to test, many (mostly DEMS) still complained.\nBobbleheads of me being made in massive quantities in China: Video: Bobblehead \ndolls of US disease expert Dr Anthony Fauci being made by Chinese factory \nhttps://bit.ly/3eRnRh0 \nGreat news from Emily Erbelding:   The randomized  placebo controlled trial of \nRemdesivir in hospitalized patients with COVID-19 disease has fully enrolled \n1063 patients throughout the world (ACTT-1 Study).   The DSMB met and \nindicated that remdesivir had a 31% higher rate of recovery compared to the \nplacebo group (p < 0.001).   The death rate approached significance (P=0.059).   \nData sets not complete and will likely require a few mored days to tidy up.   \nHowever, the site invrestigators will be notified tomorrow night at 7:00 PM for \nethical reasons – to make sure that those who might be on the placebo limb would \nhave the opportunity to get Remdesivir and all other placebo-controlled trials need \nto consider Remdesivir as now SOC. This information will almost certainly leak \nand so I have decided to ask Mark Meadows if I could announce these preliminary \ndata at a presser at the WH tomorrow (Wednesday).\nPRESS: Telemundo Un Nuevo Dia (TV); \nApril 28, 2020 – Global – 3,000,000/200,000;       USA – 1,000,000/56,000\nReleased by Chairman Rand Paul\n805Meeting with Joe Grogan group in Roosevelt Room.   Joe is pissed that the \nindividual guidances for special situations, i.e. restaurants, Child care centers, etc, \ndo not align with the various phases of re-opening.   Also, CDC again were late \nand off on their own regarding guidelines for surveillance.   CDC is tone deaf to \nhow everyone feels that they are not up to the task.\nBriefed Kayleigh McEnany and Mark Meadows about the Remdesivir trial.   Mark \nand Kaylee agree that I should announce this at a presser tomorrow.   I warn Mark \nthat we cannot allow the POTUS to ad lib and over-promise since I will be very \nconservative.\nCalled up Mersad  Parsey at Gilead out of courtesy to infrom him that I will be \nannouncing this at the Presser.   Amazingly, (or not) he asked me to hold off until \nThursday informing the PIs at the sites tonight so that they can formulate a \nstatement and policy to not allow an unfavorable or too favorable response of the \nStock Market.   I immediately told him that no way do I want to discuss the stock \nmarket with him and this was inappropriate.   He backed off.\nPRESS: Bloomberg News (John Lauerman, print); Economics Club Podcast \nwith David Rubenstein; Ryan Zimmerman Podcast; New York Times Sports \nEditor print interview; CNN “The Lead” with Jake Tapper.\nApril 29, 2020 – Global – 3,000,000/203,000                 USA – 1,100,000/58,000;\nEventful day.   Was supposed to present the Remdesivir findings at the usual 5:00 \nPM press conference at the WH.   Marc Short called me when I was at NIH office \nand said to rush down to Wh since the POTUS was going to have a press \navailability with John Bell Edwards (Democratic Governor of Lousiana).   George \nAdams drove me down to Wh with lights flashing and we got there in 17.5 \nminutes (Yikes).  I present the data to multiple cameras in the Oval Office with \nPOTUS sitting there.   POTUS took me aside and said”Be enthusiastic, Tony.  Be \nOptimistic, we need to open up the economy.   It is very important”.   I told him \nthat I would tell it like it is.   He nodded OK.   I gave ameasure, accurate \npresentation.   Great success.\nIn afternoon, HHS (with Paul Mango, Alex Azar, Bob Kadlec, Peter Marks, Bob \nJohnson, Francis Collins, Bruce Tromberg)  presented our new vaccine strategic \nplan to the TF led by Deb Birx.   Deb immediately tore everything apart \n(somewhat overly done).   Poor Peter Marks took the brunt of it.   She said we \nshould have brought in all the companies that have a track record with their \nplatforms and guided them and funded them to go after COVID-19 instead of \nReleased by Chairman Rand Paul\n806waiting for companies to come in themselves and ask for money.   She does not \nlike “newer technology” such as mRNA, DNA, and even some virasl vectors.   \nShe likes antigens, whole killed, etc.   A bit overdetermined in her prejudice.  \nHowever, she did have a point that btu did not fully realize that this is the problem \nthat I have had with BARDA for years.   They just give out money without \ncoordinating anything.   Very tense meeting!!\nThe rest of the world still pushing that we are not doing enough testing.\nClerarly a trend towards the Comms folks (Kayleaigh and Alyssa) focusing on \neconomic re-entry and trying to hold back to POTUS from his disastrous press \nconfererences and so the pressers are being cut back.   None today; only the above \nOval with Gov. Edwrads\nBecoming rather friendly with Jared.   Clearly, he respects me\nPRESS:  Made presentation at  presser in Oval Office on the ACTT-1 trial.   \nGot picked up by multiple networks/cable.\nApril 30, 2020 – Global – 3,020,000/210,000;  USA – 1,030,000/61,000;\nNew York Times had my picture and front page of Sports Section today with the \nheadline saying that I believe that professional sports may need to be cancelled \nthis season.  That was not what I said.   Like I said clearly in the Ryan Zimmerman \ninterview, it would depend on the status of the virus in any given City.   We could \ndo sports only on TV or we could have the stadiums half full or completely full or \nnot at all.   They headlined the latter.\nThe media frenzy continues on and on with me:\nReleased by Chairman Rand Paul\n807Announcement today that Joe Grogan will resign as Director of the Domestic \nPolicy Council on May 24 (3 weeks).   Another example of the changes that Mark \nMeadows is making along with shaking up the Comms group.\nAmazing story about me in Forbes:\nhttps://www.forbes.com/sites/williammeehan/2020/04/30/anthony-s-fauci-md-part-iii-\nthe-7-principles-of-faucian-leadership/#7b76aef7313d\nReleased by Chairman Rand Paul\n808Had another tense meeting in Roosevelt Room led by Joe Grogan and Deb.   Deb. \nagain attacked (somewhat justifiably) the lack of leaderhip at HHS central.   Steve \nHahn piled on too even obliquely criticizing Azar.   Problem is that we are \nsuffering now from the weakness and complete inadequacy of BARDA.   We \n(NIAID  – particularly John Macola/Cliff and Carl can do the massive master-\nprotocol trial of multiple candiates.   The central leadership is lacking.   Alex has \nfailed to hold Bob Kadlec responsible and Bob has completely delegated BARDA \nto a group of weak people who are fixed in ways that you can get awaywith in \nnormal times, but defimitely not when you are in a global health crisis wher the \ncountry and the world depends on us to develop a vaccine and therapies.   Right \nnow, vaccine is critical.   I will meet tomorrow with Francis, Cliff and John to plan \nhow to handle this.\nDid a Zoom call with a whole host of movie stars and athletes organizef by Kim \nKardashian:\nHere is the list \n1.Michael Kives\n2.Lydia Kives\n3.Nico Mizrahi\n4.Ben Schwerin\n5.Eric Stonestreet\n6.Jamie Schneider Mizrahi\n7.Kate Hudson\n8.Mikey Hess\n9.Katy Perry\n10.Orlando Bloom\n11.Chris Rock\n12.Scooter Braun\n13. Yael Cohen \n14.Chris Paul\n16.Josh Gad\n18.Misha Nonoo\n19.Dwayne Wade\n20.James Corden\n21.Gwyneth Paltrow\n22.Ashton Kutcher \n23.Mila Kunis \n24.Kevin Durant\n25.Kendall Jenner\n26.Kim Kardashian\n27.Ariana Grande\n28.Paula Abdul\n29.2 Chainz\n30.Michael Buble\nReleased by Chairman Rand Paul\n80931.Usher\n32.Demi Lovato \n33.Brad Falchuk\n34.Michael Jordan\nPRESS:  NBC Today Show with Savannah Guthrie; Zoom call with \nHollywood stars; CNN Coronavirus Town Hall with Sanjay Gupta and \nAnderson Cooper\nMay 1, 2020 – Global – 3,090,000/218,000;  USA – 1,100,000/63,000\nMike Caputo is delighted with the event last night.   It is interesting that he is one \nof my greatest fan and he is sincere.   So different from some of the shit I took \nduring the esarly years of the Obama administration with that asshole Jenny \nBacchus who always hesitated to put me on TV until Denis McDonough and Lisa \nMonaco of the White House intervened.\nAnd the media blitz goes on:\nDr. Anthony Fauci And Andrew Cuomo Remain The Most Trusted Leaders \nOn Coronavirus, While Donald Trump And Jared Kushner Are The Least \nTrusted.\nGrace Panetta writes for Business Insider (4/30, 3.67M) that NIAID Director Dr. Anthony \nFauci “and Gov. Andrew Cuomo remain the most trusted leaders Americans look to for \nofficial advice on the coronavirus crisis, while President Donald Trump and White House \nadvisor Jared Kushner still rank at the bottom.” Consumers’ “levels of trust in the top officials’ \nhandling of the crisis [have] remained remarkably steady across...three surveys.” \n……………………………………………………………………………………………………\nHad Zoom talk with Mike Lerner (owner of Nats)and Ted Leonis (Owner of Caps, Mystis, \nWizards).   Long conversation with them about opening up the sports seasons, particularly, \nimminently the Nats.   I gave them the usual discussions.   They want me to throw out the 1st \nball at Nats stadium and drop the puck at the Hockey game, etc.\nMay 2, 2020 – Global – 3,200,000/225,000;   USA – 1,100,000/65,000’\nBig push on the part of states >32 to rush to reopening, some like Texas and \nGeorgia more than others.   Militia-types in Michigan going to the Capitol armed \nand demanding of the Governor to “open up” Michigan.   Much stress about the \neconomy being destroyed.  \nReleased by Chairman Rand Paul\n810White House not allowing me to respond to request from Rosa DeLauro to testify \nbefore the House Committee.   Makes front page news everywhere together with \ntweet storm.   WH will allow me to testify before the Senate Help Committee.  \nSituation very tense:\nEconomic Policy\nWhite House blocks Fauci from testifying \nbefore House panel, committee \nspokesman says\nAn Appropriations subcommittee sought to call the \nhealth official to testify next week\nAnthony S. Fauci in early April. (Jabin Botsford/The \nWashington Post)\nBy \nErica Werner and \nMike DeBonis \nMay 1, 2020 at 5:34 p.m. EDT\nBiden accused of groping a woman (Tara Reade) in his Senate office decaades \nago.\nYesterday Peter Staley called me up and said that some (? how many) members of \nthe scientific and old activist community are disappointed in me for appearing in \nthe Oval Office with the announcement of the Remdesivir results, making it a \npolitical thing used by Trump.   I can see theor point, but  I had not choice (see \nabove).   I rectified that yesterday (later in the day)( when at the TF meeting, Jared \nKushner arranged to have a photo op in the Oval Office celebrating the domnation \nof >1 million doses of Remdesivir to the USG to distribute to people who needed \nit.   They wanted me, Bob Redfield, Deb, and Azar to pose for photos with the \nPOTUS and the CEO of Gilead.   I asked Narc Sort to step out of the Sit Room \nReleased by Chairman Rand Paul\n811and I explained that I could not do this since my colleagues would say (and so \nwould I) that I am seting ovrer the line.   I explained to Marc the aversion \nscientists (of any political persuasion) have for politicizing science.   He \nunderstood completely and we wen back inot the room and I told the VP the same \nthing and he wa very supportive.   Deb and Bob were clearly not happy with what \nI did, likely because they also felt uncomformtable, but had no choice since they \nare political appointees.   Such is life.   I made the correct decision.\nMore  of the constant surrealness.   Here for Mother’s Day\nReleased by Chairman Rand Paul\n812\nReleased by Chairman Rand Paul\n813May 3, 2020  (Sunday) – Global – 3,300,000/230,000;  USA – 1,130,000/66,000\nContinued big push tio re-open despite many states lacking the criteria to do so.\nNot on any Sunday shows.   Washington Post article today states that the \nadministration is cutting down media appearances by Deb and me and giving more \nto the economists, Kudlow, Mnuychin and Hassett.   Theyare cutting me more \nthan Deb.\nFauci-maddness continues with multiple articles and every sort of paraphernalia \nand restaurant and foods named after me.\nAmazing aryicle in USA Today:\nhttps://www.usatoday.com/story/news/nation/2020/05/03/coronavirus-white-house-\nexpert-dr-anthony-fauci-americans-trust/3042991001/\nStraight-talking Dr. Anthony \nFauci is the voice \nAmericans want to hear \nright now. So, who is he?\nMarco della Cava\nUSA TODAY\nAD\n5:37\nDr. Anthony Stephen Fauci didn’t grow up wanting to be famous. Mostly he \njust wanted to make a difference. But now a lifetime of service has flicked on a \nsearing spotlight.\nPerhaps not since the late actor Jack Palance did one-armed push-ups at the \n1991 Oscars at age 73 – YouTube it, millennials – has the nation been this \nseduced by a senior citizen. \nReleased by Chairman Rand Paul\n814By virtue of his calm, Brooklyn-inflected White House briefings \non coronavirus that frequently if diplomatically contradict statements by \nPresident Donald Trump, Fauci, 79, has become a meme, spawned fan clubs \nand been lovingly parodied by Brad Pitt.\nFauci’s longtime official title is director of the National Institute of Allergy and \nInfectious Diseases, a part of the National Institutes of Health. But since \nbecoming the face of this country's COVID-19 pandemic, the career \nimmunologist who has battled everything from AIDS to Ebola \nis increasingly referred to as America’s Doctor.\nAnd he's in the headlines again this week, having been barred by the White \nHouse from addressing House lawmakers Wednesday on the topic of the \nadministration's response to the crisis. Instead, Fauci will meet with a GOP-led \nsubcommittee on May 12.\nSo just who is Tony Fauci?\nReleased by Chairman Rand Paul\n815Interviews with friends and colleagues offer overlapping descriptions of a man \nas dedicated to hard work – endless hours peppered with power walks – as he is \nto his wife, scientist Christine Grady, and three accomplished daughters.\nThey describe a man who takes as much pride in his Bolognese pasta sauce (the \nkey, one friend says, is the long-simmering time) as he does in enduring \nrelationships. He's a burger and beer at the bar guy, but also a public servant \nbuilt for our trying times.\n“Tony’s capable of elevating his game to whatever is needed, and more has \nbeen demanded of him now than in any time in his career,” says Michael \nOsterholm, director of the University of Minnesota’s Center for Infectious \nDisease Research and Policy. “In the eyes of the American public, he’s the \nvoice we need right now, one of credibility.”\nReleased by Chairman Rand Paul\n816Steven Gabbe met Fauci when both were at Cornell Medical College in New \nYork City in the late 1960s, and “the person you see now on TV is the same \nguy I met back then, smart and humble.”\nGabbe, emeritus CEO of The Ohio State University Wexner Medical Center in \nColumbus, lauds his friend’s sense of humor. \"I’m sure he finds it entertaining \nthat there are bobblehead dolls of him now,\" he says. \"But he’s so grounded I \ndon’t think it would go to his head.”\nFauci would be excused it if did. In a recent survey of 1,900 registered U.S. \nvoters, Morning Consult asked respondents whom they would trust \"a lot\" or \n\"some\" to end social distancing. Fauci and the Centers for Disease Control and \nPrevention topped the list among all voters with 71% trust ratings.\nGet the Coronavirus Watch newsletter in your \ninbox.\nStay safe and informed with updates on the spread of the coronavirus\nDelivery: Varies\nYour Email\nThree months in:A timeline of how COVID-19 has unfolded in the US\nSuch a high-profile status inevitably also has generated criticism.\nRight-wing pundits have assailed how shelter-in-place guidelines he supported \nhave impacted the economy, leading conservative internet TV host Bill \nMitchell to tweet “this Dr. Doom Fauci is the most depressing idiot I’ve ever \nlistened to.”\nThat harsh assessment has some grounding in a real issue, says Jonathan Engel, \nprofessor at the Marxe School of Public and International Affairs at Baruch \nCollege, part of the City University of New York system.\nReleased by Chairman Rand Paul\n817“Cost-benefit analysis is not the way Fauci thinks, he’s a physician and \nimmunologist,” says Engel. “So that’s where the frustration in some red states \ncomes from. You’re saving lives, but you’re also destroying lives. Someone \nelse needs to be there to step back and think about the whole picture, but that’s \nnot Fauci’s role.”\nGet daily coronavirus updates in your inbox:Sign up for our newsletter now.\nCritics ask: Did Fauci 'miss it'?\nEven some fellow scientists who praise Fauci’s professional accomplishments \nsuggest not only that he was late sounding the alarm, but that having one \ncelebrated virus point person is dangerous.\n“In January, February and part of March there was one physician on show after \nshow, him, and while he’s great at explaining things, in terms of telling the \ncountry to get prepared, he missed it,” says Marty Makary, professor at the \nJohns Hopkins Bloomberg School of Public Health. “My concern is not with \nAnthony Fauci as much as it is in a media and policy world that puts its faith in \none person.”\nReleased by Chairman Rand Paul\n818If anything, Fauci’s rise highlights the fact that no one person regardless of \ntheir stature – his laurels include almost every scientific accolade short of a \nNobel Prize – should hold all the reins when it comes to national and global \npandemics.\n“Tony’s taken on this big role in part because of the vacuum that exists,” says \nDavid Relman, a Fauci friend and professor of medicine at Stanford University.\n“But what if the next pandemic destroys our food? Or a bioterror attack?” he \nsays. “We need a new leadership system that sits inside the White House, \nwhere people have the authority to tell the Attorney General what to do, or the \nFederal Reserve or the Secretary of Defense, so you can move fast. Tony can’t \ndo that. No one can. The system needs to change.”\nReleased by Chairman Rand Paul\n819Fauci’s current national stature indeed appears unique in U.S. history, says \nhistorian Douglas Brinkley of Rice University in Houston, citing past examples \nthat fall short.\nIn the late 1700s, a yellow fever outbreak in Philadelphia caused President \nGeorge Washington to flee the city, leaving in charge the preeminent doctor \nand fellow Founding Father, Benjamin Rush.\nWhen President Woodrow Wilson got sick while visiting Paris during World \nWar I, many scholars believe his physician and his wife were running the \ncountry for a spell.\n“So you have moments when doctors have become the voice of the country, but \nnothing like this,” says Brinkley. “The straight talking Fauci is what you want \nto hear, much like if you go to a doctor you don’t want spin or blarney.”\nReleased by Chairman Rand Paul\n820Brinkley says after the coronavirus pandemic starts to recede, Fauci is likely to \ngo down in history “as one of few scientists who are now household names.”\nSome suggest Fauci enjoys this new spotlight too much. Although an NIAID \npress officer said Fauci was too busy for an interview, the doctor's media \nappearances are frequent and varied, from network news and comedy shows to \nonline interviews with sports icons such as basketball star Steph Curry.\nFauci Pouchys and 'Docta Fauci'\nAnd yet the public can’t seem to get enough. The Anthony Fauci Fan Club on \nTwitter has 24,000 followers and a pinned tweet that reads: “If you don’t have \na crush on this man, do you even care about public health?”\nReleased by Chairman Rand Paul\n821New York-based singer Missy Modell rewrote the lyrics to Lady Gaga’s \n2008 hit “Paparazzi” to rhyme with “Docta Fauci.” Her Instagram hit includes \nthe line, “Tony, there’s no other superstar except for Andy,” New York \ngovernor Andrew Cuomo.\nFauci’s likeness is splashed on coffee mugs, T-shirts and even donuts. In \nWashington, D.C., the town Fauci calls home, Capo’s Speakeasy teamed up \nwith a real estate company to sell Fauci Pouchy to-go drinks, cocktails in see-\nthrough sealed bags emblazoned with the doctor's image.\nAt Chef Geoff’s in northwest D.C., Fauci and his wife, a nurse bioethicist at the \nNIH, are regulars who in pre-virus times would pull up bar stools and order \nChef Geoff Burgers and beers, says owner Geoff Tracy. He posted a sign \nwarning take-out customers, “Dr. Antony Fauci is a long time guest and he \nwants SIX FEET.”\n“He’s a genuinely nice human being, and I deal with a lot who aren’t \nsometimes,” says Tracy, whose wife, CBS anchor Norah O’Donnell, has \ninterviewed Fauci over the years. Tracy says Fauci’s sudden ascent into the pop \nculture firmament doesn’t surprise him. But he doubts it phases Fauci.\nReleased by Chairman Rand Paul\n822“My father-in-law is an infectious disease doctor, and these guys not about \npicking fights or the limelight,” says Tracy. “They’re about sharing information \nand guiding you. And no one’s better at that than Tony.”\nFauci recently told an interviewer he appreciated the way “classy” actor Brad \nPitt played him on a recent Saturday Night Live stay-at-home broadcast, this \nafter Fauci said in an interview that Pitt would be his top choice for someone to \nimpersonate him on the show. But friends note celebrities don't really phase \nhim.\nStanford professor Relman, who focuses on microbiology and immunology, \nrecalls talking to Fauci about the time U2 singer Bono, who has focused his \nphilanthropy on Africa, wanted to discuss disease issues with Fauci.\nReleased by Chairman Rand Paul\n823“Tony thought it would cause too big a scene at the NIH, so he just told Bono \nto come over to his house,” says Relman. “Bono did, but Tony forgot that that \nmight completely freak out his daughters, which it did. Those are just his \ncircles. His ability to talk honestly about important matters causes people to \nseek him out.”\nStudy:Americans trust Fauci more than Trump or their own governors\nFauci's hoop dreams dashed by height\nFauci grew up in Brooklyn the grandson of Italian immigrants. His parents ran \na pharmacy. He did deliveries on his bicycle, while his older sister Denise ran \nthe register.\nIn past interviews, Fauci hasn’t revealed much about his hard-working \nupbringing except to say that it laid the foundation for a life ultimately devoted \nto science and public service.\nFauci went to Regis High School in Manhattan, which required commuting for \nhours on buses and subways. Although a stand-out basketball player, his height, \n5-foot-7, prompted him to look for a career outside sports.\nFor college, he attended Holy Cross in Worcester, Massachusetts, which like \nRegis was run by Jesuits, whose educational philosophy seeks to meld \nspirituality – Fauci is a lifelong Catholic – with social justice.\nReleased by Chairman Rand Paul\n824The experience was formative, says Eric Goosby, a distinguished professor of \nmedicine at the University of California, San Francisco, who met Fauci in the \n1980s and has been a frequent guest at his friend’s pasta Bolognese dinners. \n(“He’ll call me days before to make sure I’m still coming,” he says with a \nlaugh.)\n“Tony was deeply affected by exposure to the Jesuit order, which fostered in \nhim a self-expectation of service,” says Goosby. “This guy goes to sleep and \nwakes up asking, 'Have I done everything I can do?' It’s in his DNA.”\nAs is a fierce work ethic. In summers during college, Fauci worked \nconstruction. As the story goes, one job found him helping on a new building at \nthe Cornell Medical College. Fauci vowed one day he would be an alum, and \nmade it happen.\n“That story says it all to me,” says his friend Gabbe. “He just has this powerful \ndrive that won’t be stopped. The same thing happened when he graduated and \ntold people he was going to the NIH to study infectious diseases. People told \nReleased by Chairman Rand Paul\n825him they were all conquered, this was a career-killer move. Not long after, \nAIDS hit.”\nFauci’s role in the AIDS epidemic changed him. At first, he tackled the \ngrowing crisis with a measured, data-driven approach to trying to find a \ntreatment. But that methodical tack infuriated gay activists watching friends die \ndaily.\n“Initially, Fauci was very rigid in his approach to AIDS and people like (gay \nrights activist and playwright) Larry Kramer got in his face, calling him the \nworst things,” says Baruch College professor Engel, who wrote “The Epidemic: \nA Global History of AIDS.” “And to Fauci’s credit, he got it and he changed.”\nFauci had been seen as the detached scientific face of an uncaring \nadministration led by President Ronald Reagan, late to understanding the scope \nof the AIDS crisis. Fauci started to meet with members of the gay rights \ncommunity and quickly understood the need to include those who were \nsuffering in finding a solution.\nReleased by Chairman Rand Paul\n826Goosby, who was running of one the nation’s first AIDS clinics in the late ‘80s, \nrecalls attending a meeting with Fauci in Washington, D.C. The gathering was \nattacked by ACT UP activists, who locked the meeting’s attendees, there to \ndiscuss new drugs to fight HIV, inside the hall with chains.\n“A lot of us were nervous and scared of possible violence,” Goosby recalls. \n“But Tony looked at us and said, ‘This is our chance to learn about the \nfrustrations of the community. It’s an opportunity for us to learn and serve.’ I’ll \nnever forget that.”\nFauci turned enemies into allies\nThat shift in attitude – away from the rigidity of scientific pursuits and towards \nan embrace of the human reality – soon turned enemies into lifelong friends, \nsays Matt Sharp, a San Francisco-based AIDS survivor and activist who was \npart of many ACT UP protests in the nation’s capital aimed at calling out \nFauci.\n“What developed was a very interesting mutual respect, where you have a hero \nwho once was an enemy,” says Sharp. “Once we got him to relate to us and our \nreality, trust was established. Today, the AIDS community is glad he’s the one \nleading this effort right now.”\nOver what is now nearly a 50-year career with the NIH, Fauci has worked for \npresidents as philosophically wide-ranging as Reagan, George H.W. Bush, Bill \nClinton, George W. Bush and Barack Obama, helping them through crises that \nincluded the post-9/11 anthrax scares, SARS in 2003, H1N1 in 2009 and Ebola \nin 2014.\nThose who know Fauci marvel at how he keeps his political leanings private.\n“I honestly don’t know if he’s a Democrat or Republican,” says Sharp. “But I \nknow he’s got an amazing grace and an ability to cut through the b-----. That’s \nhis genius.”\nReleased by Chairman Rand Paul\n827That skill is particularly valuable now, as Fauci continues to navigate his truth-\ntelling role for a president whose response to criticism often is dismissal.  \n“He has always had a knack for telling it like it is, and letting the political chips \nfall where they may,” says Stanford’s Relman. “Don’t forget, Tony Fauci is \nproud card-carrying New Yorker. He has a blunt, endearing and no-nonsense \nNew York attitude, and I think Trump kind of gets that.”\nIndeed, a brief #FireFauci firestorm that flared in the wake of Fauci appearing \nto show exasperation at the president’s coronavirus remarks ended with Trump \nsaying Fauci wasn’t going anywhere.\nThat’s probably just fine with Fauci. He may not get much sleep these days, \nand he’s contending with political forces dueling over just how much reopening \nthe country will lead to another coronavirus case spike and then more shut-\ndowns.\nReleased by Chairman Rand Paul\n828But friends insist he’d wouldn’t want to be anywhere other than in this hot seat. \nSays Osterholm of the University of Minnesota: \"I would go so far as to say \nTony's been the right man for the job for several decades now.\"\nThe recipe for that success perhaps can be found in remarks Fauci made around \nthis time in 2016 to the graduating class at Ohio State University.\nFauci started out by telling the graduates – in his trademark Brooklyn patois \nthat made “honor” sound like on-AH and “poverty” like PAW-vaty – that if \nthey’re like him, they’ll soon forget every word their commencement speaker \nsaid.\nThen over the next 12 succinct minutes, Fauci laid out five credos to live by: \nBe a perpetual student, expect the unexpected, embrace public service, lead by \nexample, and, finally, pursue happiness.\nAs prescriptions go, Fauci has taken his own medicine. When he is at that West \nWing lectern, he seems to radiate a sense of satisfaction at simply being of \nservice despite the attendant slings and arrows of the post. \n“Different pursuits provide joy,\" Fauci urged the gradates. \"Find your source of \njoy, and embrace it.”\n……………………………………………………………………………………\n…..\nImportant and somewhat ridiculous issue with Pence wanting to come to NIH \nto thank the people at VRC and show his appreciation.  He got into trouble at \nMayo Clinic last week since he went there and did not wear a mask when \neveryone lse had a mask on and the press killed him.   I had an agreement with \nMarc Short that the VP would come to the VRC on Tuesday , April 5 and go \nupstairs and meet the scientists.   The rules of VRC are that masks must be \nworn in the labs.   Marc said that the VP would wear a mask in the labs, but \nwhen we go downstairs to the lobby to have TF meeting followed by presser, \nthat he would not have to wear a mask since we never wear masks at TF \nReleased by Chairman Rand Paul\n829meetings.  All was well until Olivia Troye called me in a panic today saying \nthat the POTUS does not want the VP to wear a mask since it is a bad optic for \nopening up (I cannot understand this reasoning).   Nonetheless , the VP will not \nwear a mask and so we are saying that he should not come.  I refuse to give in.  \nPoor Olivia is caught in the middle.   We shall see what happens.\nPRESS:  Several articles about me in print papers – New York Times and \nWashington Post among several.\nMay 4, 2020 – Global -  3,350,000/239,000; USA – 1,142,000/67,000\nContinued tension in GOP states wanting to re-open in defiance of many of the \nrecommended guidelines and Dem states  the opposite.   It is almost a political \nand ideological dichotomy\nCNN – Jake Tapper did a segment last night on the inadequate response of the \nTrump administration to the pandemic.   I came out relatively well.\nVP Call with Governors from Sit Room.  Again, it seemed like a lot of happy \ntalk, particularly from GOP governors saying that they are doing well and 40 \nstates have submitted their plans for re-opening.  They seem to indicate that \nmost have what they need regarding tests, etc.   Yet, when you spek to the \nlocals, that is not always the case.  \nReal crazy-town today. VP wanted to come to VRC to thank people in the \nlabs at VRC working on a COVID-19 vaccine.   However, despite the problem \nhe got into at Mayo, his staff (Olivia Troye) told me he would not wear a mask.   \nThis despite the fact that he did wear one at GM and admitted that it was a \nmistake not to wear one at Mayo.   Turns out the reason is that Trump did not \nwant him to wear a mask since it would be a bad signal in his quest to re-open \nthe country (totally crazy!).  Nonetheless, we worked out a compromise \nwhereby he would come to VRC, not go upstairs and would have a Task Force \nmeeting in the first floor conference room.  No one would wear masks, but the \nReleased by Chairman Rand Paul\n830yunger researchers would not present to him.  This defeats the purpose of the \nvisit, which was to thank the young researchers.   We thought that we had it all \nworked out with Francis greeting the VP and I and John Mascola take over.  \nNot so easy.  Francis calls me in distress late that evening and says that he \nlooked at his recent message to NIH community that says everyone should \nwear a mask on campus, every place and at all times.   Therefore, we have to \ndisinvite the VP.   Much stress.  Marc Short came to the rescue with a plan to \ndo this without creating a shit-storm.   We cancelled the visit to VRC, will \nbring John, Barney and Francis to White House and have the TF meeting \nconcentrating on work at the VRC where John and I will explain our vaccine \nefforts for COVID. (WTF???).  All this because the VP listened to the POTUS \nand would not wear a mask.\nThat night I did CNN with Cuomo (see below).   We spoke about the new \nmodels showing 3000 deaths pe day and about 134,000 total deaths if we back \noff on mitigation the way the POTUS is pushing.  During the interview, Chris \ngave a wonderful explanation to viewers how close and good friends we are \nand how I checked in on him every night including weekends for weeks during \nhis COVID illness.  Never saw something like that on TV.  He praised me such \nthat Megan (who was watching live) said it almost brought her to tears.\nPRESS:  CNN with Chris Cuomo\nMay 5, 2020 – Global – 3,500,000/240,000; USA – 1,200,000/69,000\nOMG!   This is really getting nutsy.   Sally Quinn evidently wrote a book some \ntime ago about a character that is me:\nhttps://www.washingtonian.com/2020/05/05/sally-quinn-modeled-the-erotic-hero-of-her-\n1991-bestseller-on-anthony-fauci/  \nThe Maureen Dowd sends me an e-mail:  “I can see it”\nReleased by Chairman Rand Paul\n831Did a TF  meeting today in the Sit Room (see above) displaying the NIH (esp. VRC) \nvaccine effort.   I took Barney Graham, John Mascola (who presented) and Francis \nCollins.   We successfully got VP to understand the NIH intramural and extramural.\nGot call from Paula Reid asking about a story in the New York Times that the WH is \ndisbanding the Task Force.   I told her that this was news to me.   I also made peace with \nher about the “confrontation” at a press conference that we had a few weeks back (see \nabove)\nToday’s USA Today:\nReleased by Chairman Rand Paul\n832Another bit of craziness:  Paula Read of CBS called my cell and said that the NY \nTimes was reporting that WH was going to phase down the TF and was that true.   \nI told her that I had not heard that and it was news to me.   She apparently reports \nthis on CBS and soon after, I get a call from Katie Miller saying that I am \ncontradicting the VP since when reporters asked him (someone leaked it from the \nWH), he admitted that they were going in that direction.   Katie says that I should \nReleased by Chairman Rand Paul\n833not have said to Paula that I had not heard about this.   I should have said I will get \nback to you.   I pushed back strongly.   This is bullshit.  The reporter asks if I had \nheard about this and I said no.  It would have been ridiculous to say anything else.   \nFinally Katie admitted thatr she had not even heard about it before the media \nannounced it.   CRAZY TOWN!!\nThe woman who held the press conference call today (Karen Draper) saying that \nshe worked for me for 2 years and I sexually assaulted  her flopped.   There were \n6 people on the call and the Buzzfeed reporter pointed out that he checked her out \nand there was no record of her ast NIH ever.   Also, he pointed out that she \npronounced my name Dr. Foouchi and so she could not have worked for me for 2 \nyears.   This is the second flopped accusation. (see above).\nMuch press on Trump blocking emfrom testifying before the House while \nallowing me to testify before the Senate.  Also, media frenzy regarding Trump \nplanning to  phase out the TF.   He does say that Deb and I will remain as \nscientific advisors (whatever that means).   My prediction is that Deb will stay in \nthe WH and I will remain at NIH and only do minor peripheral stuff.\n………………………………………………………………….\nTonight I had the usual 8:30 PM weekly “medical community” meeting (this is the \n4th meeting) chaired by David Barr.  He gets on the teleconference the following: \nBalter (LA County); Allison Arwady (Chicago); Demitre Daskalakis (NYC); \nLaQuandra Nesbitt (DC); Jeff Duchin (Seattle).  They have the same issue – \nmostly problem with testing, not enough, shortage of swabs, extraction material, \nmedia, long wait for results.  I keep bringing this up to TF and TF (Giroir and \nJared) do happy talk.\nReleased by Chairman Rand Paul\n834May 6, 2020 – Global – 3,53,000/245,000;   USA – 1,200,000/71,000\nBegin day with uncertainty about the fate of the TF as well as the fact that there is \ngreat discord in the country regarding opening abruptly versus continued careful \nmitigation.   It is clear thsat Trump and advisors are concentrating only on opening \nand saving the economy for the election in November.   To be fair, we should \nconsider that there are unintended consequences in my area of health.   Had \nconversation with Bob Redfield lastr night about the fact that >1 million children \nworld-wide have missed their measles vaccinations because of the shutdown.   \nThis is terrible and needs to be addressed since on that basis alone, there would be \nfar, far more excess deaths from measles among children than coronavirus deaths \namong children.   I need to bring this up at TF meeting.\nTrump does complete turnaround and now says that he will continue the TF \nindefinitely since he has gotten so many call from “good people” who tell him that \nthe TF has do a “great job” and he should not dissolve it.  Katie Miller and I laugh \nat each other in the Sit Room (see above).  \nAt TF meeting VP apologizes to me about the misinformation regarding the \ndissolution of the Tf and how that oput me in an awkward position with the media \n(see above).   He admikts that he was “blindsided” since someone (likely Jared) \nleaked the story without telling Pence (Yikes!).  I also took the opportunity \ntogether with Deb Birx who was there for the conversation that it is clear that Deb \nand I are being blocked from appearing the press (specifically national TV).   I \nexplained to Pence that I was formerly doing 2 TV hits per day and now I am \ndoing 1 and at the most 2 per week with nothing on Sundays.   He was surprised \nand said he would speak with Kayleigh about it.\nAlso, they want to beef up the TF with both economists and some additional \nmedical people.   Marc Short and Pence sked me to ask Francis Collins to join.  I \nspoke with Francis tonight and , as expected, Francis would do it even though it \nwould be an added burden of work piled on an already packed schedule.  A bit \nunusual that they would have 2 NIH people on TF.\nReleased by Chairman Rand Paul\n835Got rather unusual phone call from Larry Horowitz arranged by Anna Eschoo (D-\nCA).   He was asking questions about Rick Bright, likely related to tomorrow’s \nHearing on the Whistleblower issue and his getting fired from BARDA.   I was \ncareful in response.   Larry said he had many e-mails (from January, 2020) where \nRick was calling attention to fact that we needed supplies for the SNS (masks, \nPPE, ets) and Kadlec was not listening.   The e-mail make Kadlec look bad.   \nLarry wanted to know if I knew about these e-mails.   I had never seen them.   \nThey were all e-mails within ASPR/HHS/BARDA.\nTrouble looming with the distribution of the Remdesivir that was donated by \nGilead.   Kadlec with Adm. P given task of distributing the drug equitably and \neithically (Chris was consulted) to the hospitals that needed it.  VP at the end of \nthe TF meeting asked Azar, Kadlec, Adm. P, Deb and then unexpectedly me to get \non the phone tonight and by tomorrow have a solution to what was perceived as a \nmisalignment of distribution.   It was clear from discussion last night that someone \n(likely Kadlec and ASPR) screwed up since in NYC, it was clear (and I picked it \nup right away) that the hospitals such as Cornell and Columbia did not get drug \nwhile Queens Hospital and Lincoln Hospital got drug.  There is a furor about his \nscrewup and Deb is not hesitating to call it out.\nMay 7,2020 – Global – 3,600,000/248,000;  USA – 1,210,000/73,000\nPhone call with Secretary Azar about how to fix this problem.  Cluster in process.   \nDeb does not show up for phone call.   \nFrancis at Hearing today aimed at the Rick Bright issue.   Not much problem for \nFrancis.\nBig Cluster regarding the mis-distribution of Remdesivir.  FEMA dropped the \nball.  They were supposed to distribute through ASPR the drug accoding to need \nof hospitalized patients in states.  Deb Birx made it clear in an e-mail to Pete \nGayno (FEMA Director) that the drug should be distributed according to need.  \nReleased by Chairman Rand Paul\n836Gaynor either did not read the e-mail or blew it off.   What happened was that \nFEMA told ASPR (Kadlec) to distribute the drug to 7 states (at first) according to \npopulation of the  States with indicating any relationship to hospitalized patients.  \nKadlec balked and FEMA (working with Navy Adm. Polowcyzc) said “stand \ndown andsend it”.   Bob caved in and off it went.  And so some hospitals with few \nor no patients got lost of drugs and hospitals like Cornell, Columbia and NYU got \nno drug.   A hospital received drug that was not aware of the cold-chain \nrequirement.   Drug ruined.   People started complaining and the press got hold of \nit and is now reporting about lack of transparency.   FEMA is saying that the plan \nof distribution was an HHS and Task Force plan.  Deb went ballistic and the press \nare buzzing around.\nWashington Post article today:\nSally Quinn Modeled the Erotic Hero of \nHer 1991 Bestseller on…Anthony Fauci\nYes, that Anthony Fauci. In the novel, the character \nromances the first lady. \nWritten by Benjamin Wofford \n| Published on May 5, 2020 \nReleased by Chairman Rand Paul\n837This article appeared in Salon:\nWoman who accused Dr. Anthony Fauci \nof sexual assault now claims Trump \nsupporters paid her to lie\nDiana Andrade claims right-wing provocateur Jacob \nWohl and frequent accomplice Jack Burkman were \nbehind the scheme\nTravis Gettys  \nMay 7, 2020 4:09PM (UTC)\nMedia blitz, stories (mostly good, but some critical) abound with dozens per day.   \nTruly unbelievable.   People naming their dogs after me. Sally Quinn saying that I \nwas the erotic lead male in a book she wrote in 1994.   She had met me at a dinner \nthat year.  And on and on.\nStill press is fixating on my not being allowed to testify before the Dem House but \ntestifying before the GOP Senate\nMay 8, 2020 – Global – 3,670,000/254,000; 1,240,000/75,200;\nCOVID-19 hits the White House!!   Yesterday, it was revealed that the personal \nvalet of the POTUS tested positive for Sars-CoV-2.   However, today it was noted \nthat Katie Miller tested positive.   She was negative yesterday and positive X2 \ntoday!!!   She had sxs in the Sit room yesterday and sat next to Steve Hahn and \nbehind Azar.   I was on the other side of the room from her, but she was coughing \nin the room.  She sat next to Olivia Troye when she was coughing and, in the \nafternoon, yesterday, Olivia sat right next to me in the Ward Room of the West \nWing for 45 minutes. In the room were Deb Birx, Steve Hahn, Bob Redfield, \nReleased by Chairman Rand Paul\n838Tyler Ann, Seema Verma.   Big upheaval in the WH now.   Katie sits next to Mark \nMeadows every morning in the AM meeting; however, she was negative \nyesterday.   I tested negative today as did Olivia and Bob Redfield and Steve \nHahn.   Steve Miller is negative (I spent time next to him in the Sit Room).  \nI spent much time on phone this evening advising Katie and Steve Miller as to \nwhat they should do.   She is 10 weeks pregnant.   I advised that Steve must move \nout of the house into a hotel; he still has to self-isolate for 14 days.   If he stays in \nthe house, whether or not he gets infected, he still must self-isolate for 14 days \nafter Katies tests negative.   His clock will start after he separates from Katie and \nso he should start the clock now.\nWe had our pre-brief for the Senate HELP Hearing on May 12 and we are trying \nto decide whether to call off the Hearing or do it virtually.   There are different \ndegrees of risk for the 4 witnesses: Giroir – no risk – was not in the room; Fauci – \nlow risk – in room but separated; Redfield – Moderate risk – closer to Katie; Hahn \n– a bit higher – sat next to Katie.  And so we will have an issue with consistency \nsince technically, Steve is the only one who should not go to the Hearing.\nIf we postpone hearing, there will be political blowback from the Dems.  If we do \nit, people will say we are violating our own public health recommendation.   \nTough situation.\nIt is my impression that there will be several more infections in the WH over the \nnext few days.   They should do everything virtually.\nMark Meadows wants to delare TF members as essential workers and test us every \nday for 10 days and wear masks, 6 ft distance and come to work.  CDC people \nfirst said that all in the room should quarantine for 14 days.   We are trying to \nwork this out.  I strongly disagree with switching to 10 days.  That would be an \nunforced error as far as PR is concerned.   I am OK with testing every day, \nwearing mask and doing mostly telework for 14 days.  Let us see what happens \ntomorrow.\nReleased by Chairman Rand Paul\n839Crazy Judy Mikovits.   See Science article:\nFact-checking Judy Mikovits, the \ncontroversial virologist attacking \nAnthony Fauci in a viral conspiracy \nvideo\nBy Martin Enserink, Jon CohenMay. 8, 2020 , 6:20 PM\nMay 9, 2020 – Global – 3,760,000/260,000;    USA – 1,270,000/77,000\nTrying to figure out policy for addressing the infection on WH complex.\nBig breaking news tonight!  Steve Hahn who was closest to Katie is going into \nstrict 14 date home quarantine.   Bob Redfield who had a moderate exposure is \nalso saying he is going itnom14 day quarantine (when in fact he will gointo his \noffice).\nJake Tapper called me and asked whether I was going inot quarantine.   I \nexplained to Jake that I would do a “modified quarantine” since I was a low risk \nexposure to Kstie.   Thid merans that I will get tested every day, would wear a \nmask ontinually, and would spend most of my time either alone in my home office \nor alone in my NIH office and would go to White House or Congress with \nprecautions of universal mask wearing and phycial distancing.   I tested negative \nyesterday and will get tested every day for 14 days and then 1 time per week \nafterwards.  \nThis went viral with calls from multiple neywroks to confirm the CNN story and \nfrom people like Dani Bolognesi worried that I was actually infected.\nReleased by Chairman Rand Paul\n840Also, I am calling Katie frequently to check on her couple time per day.  She is \nvery anxious about getting very ill since she is 10 weeks pregnant.   Tonight she \nhad an anxiety reaction.  I calmed her over the phone.   Her pulse Ox is fine and \nshe is afebrile.\nMarc Short and others close to Katie really should do some sort of quarantine \n(even if modified), but they are not even wearing masks.  Not a good metric.\nPRESS:  I am all over the news regarding my “modified quarantine”  (see \nabove)\nMay 10, 2020 – Global – 4,150,000/283,000;    USA – 1,290,000/79,000\nMuch flurry over the press wanting to understand the difference between a \nmodified quarantine and a total quarantine.   I am explaining.  Also, I do not want \nto do the Hearing in person on Tuesday, but Mark meadows is getting pressure \nfrom the POTUS and others in WH to have me do it in person.   It would give \nmixed signals given my statement of Modified Quarantine.   It would be an \nunforced error if I did.   We finally decided that all 4 witnesses (Giroir, Fauci, \nHahn and Redfield would do it virtually.\nPresident Trump called my cell while I was at home to check and see if I was \nOK, having heard that I was in semi-quarantine.\nReports from all over the world including USA of children who are SARS-CoV-2 \ninfected who develop a Kawasaki-like syndrome.   NIH will start to study these \nchildren.   We have heard from UK and Italy.\nMany e-mails from friends concerned about me.   Some misinterpreted and \nthought that I was actually infected (Mike Gerson)\nReports of countries and some states in the USA that are opening up and triggering \nblips and rebounds.  Actually the curve of new infections is flat (at a high level).   \nReleased by Chairman Rand Paul\n841It is flat because cities like NYC and NO are going down while others are going \nup.  Up + Down = Flat\nPRESS:   Heavy TV and print cover of Hahn, Redfield and I going into \nquarantine.\nMay 11, 2020 – Global – 3,930,000/275,000; USA – 1,320,000/79,500\nSome press bugging Courtney as to the precise nature of my “modified \nquarantine”.   This is related to the fact that there is major inconsistency in the \nWhite House.   Marc Short (whom I resally like) practically sits on Katie’s lap and \nhe is vey close to the VP.   Yet he is not even wearing a mask.   He actually should \nbe self-quarantining.   He was at a much greater risk than I.\nGot phone call from Alex Azar as I wa leaving my house with Security to go to \nNIH at ~7:45 AM.   Alex was concerned that the WH wanted him tosit in the \nSituation Room without a mask with the POTUS on the csall with the governors.   \nAlso, they went him to sit next to the POTUS in the Rose Garden later in the day.   \nAlex is a higher risk than I sitting right in front of Katie.   Alex is very \nuncomfortable about this and does not know what to do.   It is tough to say no to \nMark Meadows who is insisting.  (this is why Mark was torn and wanted me to \nappear in person before the HELP Committee Hearing tomorrow - we discussed \nthis by phone over the weekend and finally I convinced him to have all 4 of us  - \nGiroir, Redfield, Hahn and me do the Hearing virtually)  \nCall with Sen. Lamar Alexander regarding tomorrow’s HELP Hearing.   It was a \ncourtesy call and his wanting to know what would be the best questions to ask.   \nHe is set on testing all college students before re-starting school in August.\nHilarious video of Billy Crystal playing me in a Trump dungeon prison:\n. https://www.thedailybeast.com/billy-crystals-dr-anthony-fauci-held-hostage-by-trump-during-feeding-\namerica-comedy-festival.\nReleased by Chairman Rand Paul\n842Continued interest by the press on the “quarantine” of me, Redfield and Hahn \nsince they want to focus on why the VP and POTUS who have as much exposure \nto Katie and we have are not quarantining.\nNote from Barbra Streisand:\nFrom: Kelly Dipaola <kelly@barwoodfilms.com>\nDate: May 11, 2020 at 6:59:11 PM EDT\nTo: \"Fauci, Anthony (NIH/NIAID) [E]\" <afauci@niaid.nih.gov>\nCc: \"Conrad, Patricia (NIH/NIAID) [E]\" <conradpa@niaid.nih.gov>\nSubject: A message from Barbra Streisand\n \nDear Dr. Fauci,\nMs. Streisand asked that I send the below message to you. \nMany thanks, \nKelly\nDear Tony,\nI can't imagine how you're feeling right now, but I hope you are staying \nhealthy and well.\nPlease know I deeply appreciate the important and consistent work you are \ndoing to assist our country during this difficult and challenging time. From \nthe bottom of my heart I thank you and your colleagues for your constant \nguidance, patience and reassurance that we, as a nation, will find answers \nand make it through these times. \nI wanted to share a recent video I put together to honor the heroic efforts of \nessential workers. I hope it brings you a few minutes of calm during this time \nand shows you how grateful I am for the selfless work you, and all those on \nthe frontline, are doing every day to keep us safe. \nYou are in my thoughts and prayers every day. Stay strong and be well.\nBarbra\nMay 12, 2020 – Global – 4,000,000/280,000; USA – 1,350,000/81,000\nReleased by Chairman Rand Paul\n843Mark Meadows called this AM (7:15 AM) before the HELP Hearing \nchecking on how I was and thanking me for “taking flak from both sides”.   \nHe is a good guy, but I think that the call was prompted somewhat by a NY \nTimes story this AM (Sheryl Gay Stolberg) that reported my saying to \nSheryl when she asked what I hope to accomplish at the Hearing, I said to \nlet people know that they must be careful in opening the country and not \ngo too fast or prematurely since we risk the problem of rebound.\nHearing went well by virtual.   I was in my home office.  Had a little scuffle \nwith Rand Paul who said that I am not the end all and be all to close down \nthe country.  I went back at him and tweets said I came out way on top.\nReceived 2 packages of cookies from Joe and Jill Biden with note: “You are \nour hero.  Stay strong and healthy.  We need you”.\nVOX did a mini-history of me: https://bit.ly/2WrCa4w \nMay 13, 2020 – Global – 4,100,000/285,000;  USA – 1,400,000/82,000\nPress today and yesterday afternoon reporting heavily on the Senate Hearing from \nyesterday.   Playing up that I am the voice of reason.   However, I am obviously \ncausing conern among GOP who want to open quickly.  FOX  News blasting me – \nHannity, Carlson, Ingraham.\nSee Politico piece about GOP getting “Fauci Fatigue: \nhttps://www.politico.com/news/2020/05/12/anthony-fauci-republicans-coronavirus-\n251919\nHad a wonderful Instagram discussion organized by the ONE Campaign with \nJulia Roberts.  She was absolutely fabulous.   She embarrassed me somewhat \nwhen I sat down in the chair and appeared on the screen through Zoom, she put \nher hands in front of her mouth and said “Oh my God.   It’s Dr. Fauci, he is here.”  \nThen she went on to say that I was he personal hero and how happy she was to \nhave this conversation with me.   We discussed COVID-19 and its potential \nimpact on the developing world.   I told her that we have a moral responsibility to \nhelp and also we have enlightened self-interest in that if the outbreak continues in \nthe developing world, it will always be a threat to the rest of the world.   Also, we \ndiscussed the importance of including the developing world in the vaccine trials \nand accessibility of vaccine.   She was totally down to earth.  Great experience!!\nReleased by Chairman Rand Paul\n844Dick Cheney called me to thank me for what I was doing and to say that he fully \nsupported me.   I acknowledged and thanked him and his daughter Liz for sticking \nup for me after the Senate Hearing yesterday.   He was muted in his criticism of \nTrump, but he did agree that Trump was living in an alternative universe (I said \nthis and he agreed)\nAfter the TF meeting (which I attended virtually since Natalie Hurst said there was \na crowded field and I should stay at NIH and call in), the VP wanted to chat with \nme.   He kept me on the phone for 25 minutes talking about the meeting that he \nand Deb had (by zoom) with College and University Presidents including Stanford \nand UVA among others.   The presidents had sound plans for opening up in late \nAugust.   I agreed with them that they need to test everyone before they come on \ncampus and weed out (temporarily) those that are infected (both symptomatic and \nsymptomatic) to start off with a zero baseline infections.   Afdter that, they do \nsurveiilance and indentification/isolation/contact tracing on all new cases.    All \nstudents with co-morbidities should do classes by virtual.    Sounds like a good \nplan.   \nDuring the call, the VP said that I was the most visible and trusted asset in the \ncountry.\nTonight, CNN really played up the “feud” between the POTUS and me.   They \nfed him that I said we should not open schools, when in fact, I said that we would \nnot have a vaccine in time to vaccinate the students (mostly college) for the \nAugust/Fall semester.   This was in response to a question from Lamar Alexander.  \nIn an interview, the press kept asking POTUS about my cautoon in opening the \ncountry and my concern about opening the economy.  He obviously got annoyed \nand explicitly criticized me (first time he has done this).   That is when CNN went \nwild and on Erin Burnett, Anderson Cooper, and Don Lemon they had people \nsaying how I was correct and the POTIS was wrong and that they should believe \nme.   I called up Chris Cuomo before his show and told him the truth.   He gave a \nmore measured account on his show.   Now I know why the VP spent so much \ntime with me on the phone talking about his conversation with the college \npresidents about opening the colleges.  VP is a “good guy”.   I think he was trying \nto protect and shield me.  I texted Mark Meadows at 8:51 PM to call me to \nexplain, and he never did.   Let us see what tomorrow brings.\nPRESS:   See above media blitz about my feud with the POTUS\nMay 14, 2020 – Global – 4,170,000/288,000;   USA – 1,380,000/84,000\nReleased by Chairman Rand Paul\n845POTUS on FOX this AM blasting me saying that I disagreed with his decision to \nstop travel from China.\nBig buzz in media about the POTUS feud with Fauci\nI spoke with Mark Short by phone and he is very much OK with me.   He \nsuggested that I speak with the POTUS and explain exactly what I said.   I have \nbeen trying to connect with Mark Meadows by phone and text, but no response \nthus far.\nMoncef Slaoui joins the team as the “Czar” for \nVaccines/Therapeutics/Diagnostics.\nMark Meadows called me back and confirmed that the POTUS is upset with me. \nI explained to him that there  is confusion.   I never said do not open the schools.   \nI said that we would not have a vaccine ready.  Mark said that he would speak \nwith the POTUS and perhaps have the POTUS call me.  Chris Cuomo, and Jake \nTapper are trying to clarify this in my defense on their shows.\nMark Meadows calls me back and says that he spoke with the POTUS and the \nPOTUS understands and all is good.   He appreciates my reaching out to him.\nI went to West Wing for meeting with Deb Birx in her office (lower lobby).   I \nwent upp to say hi to VP staff and  Hope Hick saw me and asked how I was doing.   \nI had printed out the entire transcript from the HELP Hearing and tabbed the parts \nthat indicated that I did not say do not open the schools.   Hope had those pages \ncopied and she will show them to the POTUS.   Hopefully, this ends the “feud”\nGetting many, many e-mail of support from all over the world.   This has made big \nnews!\nIn a column today in the Washington Post, Mike Gerson said: \n“At one level, this is an unfair fight. Trump is a proven and perpetual liar, and his Fox \nNews allies are artless, shameless ideologues. Fauci is one of the greatest humanitarian \nphysicians of our time, whose entire career has been committed to scientific integrity and \ntruth-telling. In a battle of credibility, the duplicitous, conspiratorial demagogues are at a \nserious disadvantage.”\nMay 15, 2020 – Global -  4,200,000/3295,000;  USA – 1,410,000/86,000\nReleased by Chairman Rand Paul\n846IMPORTANT DAY AT WHITE HOUSE:  Wen to White  House as usual, but \ntoday was a Rose garden ceremony announcing the “Operation Warp Speed”, \nwhich is the interagency plan to develop a COVID-19 vaccine by the end of the \nyear and have 100 million doses by November and 300 million by Jan. 2021.  This \nis the plan that we have been working on for some time at NIAID.   In addition, \nthe occasion was to introduce Moncef Slaoui as the “Czar” for the project and \nGeneral Gus Perna as the COO or logistic person for the supply of  vaccine doses.\nImportant event was my meeting with the POTUS in the context of our \nongoing “feud”.   We (those who would be on the stage with him in the Rose \nGarden – Sec. Azar and Sec, Mark Esper (DoD), General Mark Milley (Chair, \nJoint Chiefs); Gen. Gus Perna, Francis Collins, Deb Birx) were all in the Oval \nwaiting for the POTUS.   We all had masks on.  The POTUS walked in from the \nInner Office and immediately caught my eye and opend up his arms.   He gently \npulled my into the outer office where the TV was on giving the economic forecast \nand said.  “Tony, you are losing me trillions of fucking dollars.”   Then he said \nsomething interesting.  Her said: “Tony, you and I are OK.  There is no problem \nbetween us   We are similar is some respects.   You are playing me and I am \nplaying you.   I know you better than you think and I respect you and like you.   \nYou need to do your thing and I need to do mine; as long as you understand tht I \nneed to keep this country alive.”   Then as we were ready to go out, he looked at \nall of us and said: “Do we really need to have those masks on.   It sends the wrong \nsignal”.   I told him that we should keep them on since it would be an unforced \nerror to take them off.   The press would kill us.   His response was “Who gives a \nshit about the press; they will try to kill us no matter what we do.”   Francis and \nDeb looked to me and I said:  “Mr. President, I will not remove the mask.   I must \nwear it.”   He had a look of exasperation on his face and said:  “OK, if you insist” \n(Francis and Deb sighed a sigh of relief as it was clear that Deb was willing to \nromove the mask; Francis was with me).   However, he turned to the generals and \nAzar and Esper and said: “You guys, take you masks off, you hear me?”.   They \ndutifully did and we all walked out to theRose Garden.   After the ceremony when \nwe came back to the Oval and were about to disperse, he came over to me and \nsaid:  “Tony, we are good, right?”   I said: “We are good Mr. President”.\nMay 16,2020 (Saturday) – Global – 4,300,000/298,000     USA – \n1,430,000/87,000\nFront page of Washington Post  headlines: “Trump’s vaccine timeline doubted”.   \nQuotes by good people like Paul Offit and Peter Hotez doubting the feasibility of \nthe announcement yesterday.   This is an example of the problem with the new \nCOMMS people in the WH (Kayleigh et al) absolutely shutting me down \nregarding approvals for the press.  I could have easily explained the plan and put it \nReleased by Chairman Rand Paul\n847into context.  I ewxplained this to Marc Short on the phone this AM.   He said that \nhe and the VP are just as frustrated with the situation.   He thinks things will get a \nlittle better as the new COMMS team gets better organized.   I am not so sure of \nthat.\nPeter Reiss of the Netherlands sent me a clip showing that I was the “Man of the \nWeek” of the leading Dutch newspapers:\nTony, \nAs I was reading through one of our Saturday national newspapers, I suddenly found \nmyself looking at this cartoon of yours, and thought I’ld share:\nhttps://www.nrc.nl/nieuws/2020/05/16/man-van-de-week-anthony-fauci-a3999906  \nThe artist Sigried Woldhek, since the 70’s, every week draws a picture of a man or \nwoman who is in the news. \nReleased by Chairman Rand Paul\n848The accompanying text reads:\nWho\nDr. Anthony Fauci, head of the US National Institute of Allergy and \nInfectious Diseases.\nWhy\nFauci, worldfamous expert in the field of infectious diseases and advisor to \nall US presidents since Ronal Reagan, steadfast continues to provide \nscientific explanation and advice about the coronavirus  and the possible \nconsequences of measures taken and still to be the taken. But president \nTrump is less and less pleased with that. He called some of Fauci’s remarks \nduring the Senate hearing unacceptable, and the pitbulls from Fox News \nsubsequently attacked Fauci full force. \nHow\nWatercolour painting.\nWe’re living through unprecedented times as a medical and public health community, but \nI can only imagine how you and your family must be experiencing these times. \nYou are doing an incredible job, we all stand with you, and I personally send you warm \nregards,\nPeter\nArticle in New York Times today by Aexalander Burns, Maggie haberman, Jonathan \nMartin and Nick Corasaniti – “A President Riles a Nation Amid a Crisis”  mentions that \nTrump is hurting himself by attacking attacking everyone in sight, trashing Obama and \n“distancing himself from a highy poplar Dr. Anthony Fauci”\n………………………………………………………………………………….\nMay 17. 2020 (Sunday) Global – 4,400,000/302,000;   USA – 1,460,000/89,000\nContinued blocking me from appearing on any press .   Also, doing this somewhat \nfor Birx.   Deb getting slammed by many in press as caving in to POTUS and not \nsticking up for her principles.\nReleased by Chairman Rand Paul\n849Sunday shows were all about opening up the economy with Tom Frieden, Tom \nIngelsby, Scott Gottlieb giving their version and mostly agreeing with me.   \nNavarro still spewing his stuff.\nWhat is evolving is that states that are opening thus far are not seeing an increase \nin cases.   In fact, some are seeing decreases.   We need another couple of weeks \nto se what is happening.   Interesting that they might be paying attention more to \nmask use and social distancing as they open.   This is true EXECPT for the young \npeople who are going to the bars (Milwaukee) and beaches (South Carolina, \nGeorgia, Florida).  \nThere are 2 patterns:  Acute outbreaks in nursing homes (1/3 of all dealth are in \nnursing homes), prisons, and meat packing plants, and industries where workers \nare in dormitory-like quarters.   This is easily recognizable and quickly contained.   \nThen there is the more subtle community spread  that gradually accelerates and \nrequires contact tracing.   It is conceivable that we will progress in the next weeks \nwith little to modest community spread and many acute outbreaks as described \naccounting for the spikes that we are seeing and will see.\n~6:00 PM received a call from Jared Kushner.  He wanted to feel me out about a \nfew things.   Primarily he wanted to get my take on Operation Warp Speed.   He \nwanted my perspective on the structure, what it meant, my take on Moncef Slaoui.   \nHe did not fully realize and it was good that I explained to him that the \ndevelopment of the COVID-19 vaccine(s), i.e. the science and implementation of \ntrials is WHAT I DO.   I asked him to make sure that when new people come in \nand new structures are formed that we do not “reboot” and re-invent the wheel.   \nWe are well into the process and I just do not want any person or organization or \nstructure get in my way.   My team is the best that there is.   I believe he got it.   \nHe wanted to know how the military fits into this.   It was clear during the \nconversation that he is the link to the POTUS and his skepticism about HHS and \nAzar came through.   Nowhere was there mention of the VP, which aligns with \nwhat I am witnessing, i.e. the dichotomy between Jared and the POTUS versus \nOVP.   He spoke of the role of the military in logistics and supply.   I emphasized \nthat I do not do that; I develop vaccines and do clinical trials.   I punt to others to \nproduce and distribute.\nAlso, it is clear that he wants to phase out the Task Force and move on the more of \nthe various agencies of government doing their thing.   He will keep Deb Birx, \nwho clearly is in his favor.  It seems to me that there is a lot of “palace intrigue” \ngoing on or about to go on.  We shall see.\nMay 18, 2020 – Global – 4,500,000/308,000; USA – 1,500,000/90,000\nReleased by Chairman Rand Paul\n850The Moderna/VRC data on the high levels of neutralizing  Abs in the two doses \n(25 microgram and 100 microgram) given  in phase 1 trial are being released today \nby Moderna.   I have been asked by Jim Sciutto of CNN to discuss this on his \nshow and have requests from NY Times (Denise Grady), WSJ, and STAT to \ncomment.   We are getting the same stonewall from WH COMMS.   They do not \nanswer our requests for clearance.   This in the background of not allowing me out \nin the press for the past 2 weeks under any circumstances.  Jim Sciutto called the \nWH Comms and they told him no and Jim wrote back to me by text message: \n“Between us, someone in WH told us they’re aware you’re frustrated but \n“don’t care”.\nI called up Marc Short and explained to him.   Good guy that he is, he is going to \nlook into it.   Katie Miller, whom I have been following every day for her COVID-\n19 is feeling better and I mentioned it to her also.   She will be back soon.\nGot call to rush down to White House by Olivia Troye.   They now want me at the \nGovernors teleconference run by POTUS in Sit Room with First Lady Melania.   \nPOTUS very friendly and usual warm to me in the room.  Most states are starting \nto open us and POTUS cheering them on He calls upon me to explain to \nGovernors theModerna announcement.  Govenors are all gushing over the POTUS \nand telling him what a fabulous job he is doing.   He made the call go for almost 2 \nhours since he lover the adoration.\nMarc Short writes me a text saying that since the POTUS was so friendly with me, \nmaybe now the Comms thing will get straightened out.   I doubt it. I am thinking \nof confronting Kayleigh and/or bringing it up with Marc Meadows.\nMay 19, 2020 – Global – 4,600,000/312,000; USA – 1,500,000/91,000\nDespite my being kept out of the press by the Whit House COMMS people, the \nmedia blitz about me continues strong, as well as the gimmick stuff like underwear \n(bikini) with  either my name on the front or Govs. Cuomo or Newsom (D-CA).\nSigns in DC: https://bit.ly/36dKb0f \nI decided to take the bull by the horns and address this muzzling of me and importantly, \nthe fact that the requests that we are sending down for clearance are just being ignored.   \nInstead of going to Mark Meadows and jumping over the head of Kayleigh McEnany, I \ndecided to go straight to Kayleigh.   It worked out beautifully.  I described it in an e-m,ail \nthat I sent to Courtney and Patty tonight after the call with Kayleigh and Alyssa Farah:\nCourtney/Patty:\n    Important breakthrough!   Spoke tonight with Kayleigh McEnany and had good \nconversation.   Although she is copied on all the e-mails, she rarely reads them.   I \nReleased by Chairman Rand Paul\n851explained the problem of lack of any response to our inquiries.  I believe it is now \nfixed.  First, she said that all our correspondences to them should include copies \nto  Lyndee Rose at Lyndee.D.Rose@who.eop.gov .  The she connected me with Alissa \nFarah and with that everything got settled and fixed.   I had a long conversation with \nAlyssa.   Her cell phone # is (202) 809-6071.   I explained that my two contacts are \nCourtney and Patty.   She admitted that they were holding me back , but she feels that this \nhas gotten out of hand.   She was terrific on the phone.   We made a deal.   New \nRules:   For all print press like the 3 requests from NY Times, WSJ and STAT regarding \nthe Moderna data, we DO NOT NEED clearance.   We can respond on the record and we \nmerely need to let her know what we are doing and keep her in the loop.  For podcasts \nand talks to organizations, i.e. Council on Foreign Relations, we DO NOT NEED \nclearance.   We merely need to inform them as an FYI.   For major TV hits, we need \nclearance, but send directly to Alyssa and Lyndee.   She said she will start clearing our \nTV requests tomorrow depending on what the topic is.  She admitted, they definitely \nshould have cleared the requests regarding Moderna.   She says that she trusts that I know \nwhat I am doing and can handle anything,  and will start clearing my TV requests, but \nsaid that with certain really sensitive subjects like the bleach issue, they would rather not \nhave me out there.   It was a great conversation and I believe that we have now fixed the \nproblem.   We can discuss more tomorrow.\nThanks,\nTony\nMay 20, 2020 – Global – 4,700,000/317,000;  USA – 1,530,000/92,000\nThe Fauci craze continues.  Some select examples: \nBrooklyn Artist Jeremy Penn’s Dr. Anthony Fauci Portrait Nets $15K For \nCharity.\nPage Six (5/19, Mohr, 1.6M) reports, “Brooklyn artist Jeremy Penn, who has painted Diane \nvon Furstenberg, Kate Moss, John Galliano and Karl Lagerfeld, sold a portrait of” Anthony \nFauci for $15,000. Penn “s donating all proceeds from the Fauci piece to charities True Hero \nFund and No Kid Hungry.” \nReleased by Chairman Rand Paul\n852Already starting to get clearances for press appearances.   Alyssa is keeing her word.\nReleased by Chairman Rand Paul\n853On Conference call with the OWS group, it is clear that Jared Kushner is inverting \nhimself in the process of decisions about vaccines, therapeutics and diagnostics that \ndisturbs me.  Also, I am concerned that Jared said that after 1 hour and 45 minutes of \nReleased by Chairman Rand Paul\n854discussion, Jared said that we need to run this by Deb Birx.   I have a bad feeling about \nthis.\nHad nice teleconference with the advisory board to Mayor Bowser in helping her to open \nup DC.   Old friends Susan Rice and Mike Chertoff on on the board.   They were very \nappreciative.\n \nMay 21, 2020 -  Global – 4,800,000/320,000; USA – 1,600,000/94,000\nWill start doing print interviews in earnest today starting with Denise Grady and Noah \nWeiland of NY Times.\nAlso, spoke with Sanjay Gupta explaining the Moderna data.   Interesting that despitr \nAlyssa’s promise, they still have not cleared me for Jim Sciutto.   However, I was cleared \nto do the CNN Town Hall.\nCartoon in USA Today:     https://bit.ly/3bQDXVt \nMy instgram interview with Julia Roberts:  https://people.com/movies/julia-roberts-\ncute-reaction-speaking-dr-anthony-fauci/\nDid a Zoom interview and town hall under Boomberg/Harvard moderated by Mayor \nMichael Boomberg  with 190 Mayors of various cities throughout the country\nPRESS:  CNN Town Hall with Anderson Cooper and Sanjay Gupta\nReleased by Chairman Rand Paul\n855May 22, 2020 – Global -4,900,000/325,000; USA – 1,600,000/95,000\nTurmoil in OWS – Peter Marks drops out.  Upset with how he is being treated with the \narrival of Moncef.\nMoncef has met with pharma companies involved in the harmonized protocols and as \nexpected they expressed doubt about the possibility that we (NIAID/USG) could pull the \ntrials off.   Deep down, they want the money and they want to do it on their own.   I will \nset up teleconference next week with Francis, me, Larry Corey, John maslcola, Cliff and \nthe CEIO’s of the companies tomstraighten this out.\nTrump getting out of control in pushing to open up the country and get the economy back \nbefore election day.   He is desparate.   This is all about re-election.\nPRESS:  NPR Morning Edition; Nextstar Interview with Mike Saag; CNBC with \nMeg Tirrell;\nMay 23, 2020 -  Global 5,000,000;328,000; USA – 1,600,000/96,000\nSome states flattening and coming down, while others showing some spiking.   DC still \nnot coming down nor is Chicago or Los Angeles.\nArgument about whether the CDC and other groups are undercounting or overcounting \ndeaths.   At the Senate Hearing 2 weeks ago I said I thought that if anything, we are \nundercounting deaths since people were likely dying at home of COVID-19 and not \ngetting counted since they were not getting to the hospital.\nThe media and magazine craze about me continues.   Here is one from The Atlantic: \n https://www.theatlantic.com/international/archive/2020/05/pandemic-anthony-fauci-\ntrump-ireland-tony-holohan/611890/\nGLOBAL\nThe Faucis of the World\nThrusting once-anonymous health experts into leadership \ncreates a tension when political decisions must be made.\nTOM MCTAGUE\nMAY 22, 2020\nReleased by Chairman Rand Paul\n856ALEX WONG / BRIAN SMIALOWSKI / GETTY / THE ATLANTIC\nMAY 24, 2020 -  \nNot on Sunday shows today despite multiple requests.   DC, MD VA has most cases now \nper capita.  \nNice pick up on Boston TV station of my words to the Holy Cross 202 Graduating Class:\nhttps://www.boston25news.com/news/health/dr-anthony-fauci-surprises-holy-cross-2020-\ngraduates-with-inspiring-message/PHPQQBXP3BFYDPENB4UERGCRXI/\nJennifer Rubin in the Washington Post: \nDistinguished person of the week: He’s \nback!\nReleased by Chairman Rand Paul\n857Anthony S. Fauci, the director of the National Institute of Allergy and Infectious \nDiseases, outside the White House on Friday. (Alex Brandon/AP)\nBy \nJennifer Rubin  \nOpinion writer\nMay 24, 2020 at 7:45 a.m. EDT\nPresident Trump has done his best to muzzle the most trusted voice on the coronavirus \nepidemic. Indeed, until late last week we had not seen much of Anthony S. Fauci, \ndirector of the National Institute of Allergy and Infectious Diseases, recently. Then, on \nThursday, he reemerged for a CNN town hall.\nFauci promised he would be out and about more. “We’ve been talking with the \ncommunications people, and they realize we need to get some of this information out, \nparticularly some of the scientific issues for which I’m predominantly responsible for, so \nhopefully we’ll be seeing more of us, will get the opportunity to talk to you.” Once more, \nhe was a source of common-sense advice: Go for a walk. Wear a mask. Socially distance. \nHe’ll forgo a haircut for now.\nOn Friday, Fauci gave an interview for the Hill. He tempered the president’s unrealistic \nhappy talk about producing a vaccine by the end of the year. He frowned on the \n“Operation Warp Speed” moniker coined by Trump. “I’m a little concerned by that name \nbecause it can imply by warp speed that you’re going so fast that you’re skipping over \nimportant steps and are not paying enough attention to safety, which is absolutely not the \ncase,” he said. “But in this program of hastening the development of the vaccine, it’s \nsomething that we do feel actually is feasible to get the kinds of doses that you would \nneed.” He remained optimistic but measured about our ability to find a vaccine.\nMost important, he warned states to maintain precautions as they began to reopen. “It is \nprudent for states who are at various levels of infection to follow the guidelines that have \ncome out about reopening or opening America again,” Fauci warned. “And that is to get \npast the gateway criteria and then go into the various phases at the rates that are \nReleased by Chairman Rand Paul\n858prescribed by the guidelines. Obviously if some states don’t do that, there is always a risk \nthat you may have a resurgence.”\nFauci remains one of the most trusted people in America precisely because he steers clear \nof divisive partisanship and delivers objective data. A Quinnipiac poll released this week \nshows his approval rating is 68 percent, 26 points higher than Trump’s. Even a majority \nof Republicans (51 percent) approve of the job Fauci is doing. It is easy to figure out \nwhy. As he puts it, he makes certain to “give the best public health advice and guidance \nbased on data, based on science and based on evidence.”\nFauci has conveyed lifesaving information to millions of Americans, avoiding hype and \nhyperbole. Managing to stay in an administration that has consistently demonstrated its \nhostility to science without sacrificing candor is no easy feat. His ability to communicate \nscientific information effectively is reflected in the overwhelming number of Americans \nwho are following his advice (e.g., wearing masks) and in their determination to avoid \nexcessively risky behavior. Fauci has no doubt saved countless lives by encouraging \nAmericans to follow social-distancing measures and by acting as a restraint on the \npresident, who remains a menace to public health. Moreover, Fauci has restored our faith \nthat facts do matter to the vast majority of Americans.\nFor all that we can say, stay healthy and well done, Dr. Fauci.\n……………………………………………………………………\nTeleconference with CDC and others from HHS in anticipation of an MMWR coming \nout on Tuesday showing that there was not widespread infection in the USA that was \nunnoticed (i.e. in Dec. 2019 and early Jan. 2020).   CDC is a bit defensive since some \nhave said that they missed community spread that was going on for some time.\nMay 25, 2020 –  Global - 5,200,000/339,000; USA – 1,650,000/98,000\nWill discuss on today’s group call (Fauci, Corey,Mascola,Lane, Erbelding, Dieffenbach, \nMarston, Conrad) the conference call with Pharma to take place on Wednesday.\nMay 26, 2020 -   Global – 5,300,000/345,000;  USA – 1,660,000/98,000\nStill no clearances for press.   Spoke last night with Chris Cuomo who feels that they do \nnot want me out there since I remind people of the challenge of COVID-19 and the \nadministration does not want that to be the topis.   The topic for them is opening up the \neconomy, no matter what the consequences.   Deb Birx out there losing credibility with \nthe community.\nReleased by Chairman Rand Paul\n859Was  in  Sit Room with the VP doing the Governors call.   As usual, the governors were \nhighly complimenting of the administration.   Having said that, thing do seem to be \nimproving with much more testing going on and several states having tested >5 % of the \npopulations and of those tested, many states have <10% which is the benchmark \nindicating that you are testing enough people.\nWe are waiting to see if there will be rebounds associated with the opening up in certain \nstates.\nPRESS:  Washington Times interview; \nMay 27, 2020 -  Global – 5,400,000/345,000; USA – 1,680,000/100,000\nLarry Kramer dies!   Very, very sad.   Many calls and e-mails\nPRESS: CNN with Jim Sciutto; PBS NewsHour with Judy Woodruff\nMay 28, 2020 – Global – 5,500,000/350,000;  USA – 1,700,000/100,000\nhttps://www.nytimes.com/2020/05/27/health/larry-kramer-anthony-fauci.html\n‘We Loved Each Other’: Fauci \nRecalls Larry Kramer, Friend and \nNemesis\nIn public, the activist berated the infectious disease expert for federal inaction on \nAIDS. But their affection lasted decades and changed the course of the epidemic.\nReleased by Chairman Rand Paul\n860Larry Kramer in 2015. “It was an extraordinary 33-year relationship,” said Dr. \nAnthony Fauci said of his friendship with the activist. Credit...Todd Heisler/The \nNew York Times\nBy Donald G. McNeil Jr.\n•May 27, 2020\n•\no\no\no\no\no\nReleased by Chairman Rand Paul\n861“How did I meet Larry? He called me a murderer and an incompetent idiot on the \nfront page of the San Francisco Examiner magazine.”\nSpeaking as he passed though a fever check on his way into the White House, Dr. \nAnthony S. Fauci, the director of the National Institute of Allergy and Infectious \nDiseases, recalled some of his fondest memories of his friend Larry Kramer, \nwho died early Wednesday morning.\nNearly every anecdote in our brief interview had the same plot: the country’s \nbest-known AIDS activist publicly abusing the country’s best-known AIDS doctor \n— and then privately apologizing afterward, saying he hadn’t meant it, that it was \njust how to get things done.\n“It was an extraordinary 33-year relationship,” Dr. Fauci said. “We loved each \nother. We would have dinner. I would go see him in the West Village, he would \ncome down to Washington.\n“But even recently, when he got pissed at me about something, he said to some \npaper, ‘Fauci’s gone over to the dark side again.’ I called him up and said, ‘Larry? \nWhat the….’ And he’d say, ‘Oh, I didn’t really mean it. I just wanted to get some \nattention.’”\nNobody stirred up attention for a cause quite like Mr. Kramer did.\nAn open letter to the San Francisco Examiner in 1988, Dr. Fauci said, was the \nfirst time he’d heard of Mr. Kramer, a playwright who had founded two activist \ngroups: the Gay Men’s Health Crisis; and Act Up, the AIDS Coalition to Unleash \nPower.\nAddressing Dr. Fauci in the letter, Mr. Kramer wrote: “Your refusal to hear the \nscreams of AIDS activists early in the crisis resulted in the deaths of thousands of \nQueers. Your present inaction is causing today’s increase in HIV infection outside \nof the Queer community.”\n“I thought, ‘This guy, I need to reach out to him,’” Dr. Fauci recalled. “So I did, \nand we started talking. We realized we had things in common.”\nMr. Kramer’s name-calling wasn’t personal, Dr. Fauci explained.\n“I was the face of the federal government. I was the one out there trying to warn \nthe public, and he was, too. That was his way of saying, ‘Hello? Wake up!’ That \nwas his style. He was iconoclastic, he was theatrical — he wanted to make his \npoint.”\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n863In 2001, with Mr. Kramer suffering from both hepatitis B and side effects of his \nH.I.V. medication — he had the disease for at least six years before effective \ntriple-drug cocktails became standard practice — Dr. Fauci became his doctor.\nMr. Kramer had told him he was not doing well, and doctors were baffled.\n“I said, ‘Come to the N.I.H. We’ll work you up.’” Dr. Fauci recalled. “He was really \nat death’s door. We realized he needed a liver transplant.”\nMr. Kramer went on a transplant list. But there was a public debate over whether \nhe should get a scarce donor organ, because patients with H.I.V. had long been \nconsidered less likely to survive, despite the introduction of effective medications.\nAnd at 66, Mr. Kramer was older than a typical transplant candidate. \nNonetheless, he got a new liver that December  at the University of Pittsburgh \nMedical Center.\nThat not only set a precedent for H.I.V. patients and older patients, but also \nabruptly reversed the decline in Mr. Kramer’s health.\n“He really bounced back,” Dr. Fauci said. “It gave him multiple more years of \nlife.”\nThe relationship between the two men played out in Mr. Kramer’s literary works \nas well as in his political activism.\nMr. Kramer’s autobiographical play in 1992, “The Destiny of Me ,” includes a \ncharacter based on Dr. Fauci.\n“He’s named Anthony Della Vida — Tony Of Life,” Dr. Fauci said. “He told me he \nwanted the actor who was playing me to come down to Bethesda and go on \nhospital rounds with me and learn my mannerisms.\n“He made the character a mix of goodness and rigidity. To him, that’s the federal \ngovernment — rigid.”\n“On opening night, he invited my wife and me, and he’s so sensitive about our \nfriendship,” Dr. Fauci added. “I was standing around at the reception afterward \nwith all these activists — Peter Staley, Gregg Gonsalves, Mark Harrington — and \nhe comes up to me sheepishly and says, ‘Do you hate me?’”\n“I said, ‘What, Larry, it was a good play.’”\n“He said, ‘Well, I was a little hard on you.’”\n“I said, ‘Larry, you’re always doing that to me, anyway!’”\nThe Life of Larry Kramer\n…………………………………………………………………………………..\nWhite House Comms back to blocking me.   They even balked at my doing press \nassociated with Larry Kramer’s death……..really????\nReleased by Chairman Rand Paul\n864Kayleigh McEnany coming out at her own orivate press conference saying thsat HC \nactually benefits patients, particular early patients.   POTUS doubling down on his use of \nHC.   Crazy Peter Navarro stops me in the EEOB office where we get our COVID tests \nand tells me that what I am saying about HC is actually causing many deaths (amazing \nasshole!!!).   It seems that my comments on CNN on Wednesday has really stirred up \nthe White House.  They definitiely do not want me out there on the air.\nMike Caputo wants to have a “meal” with me to talk.   \nWe will wait to see what the RCTs show about HC.   The observational studies show no \nbenefit and some significant risk.   I asked Andrea Lerner to review literature on HC for \nme.\nPRESS:  BBC World Service NewsHour; Instagram interview with Sen. Tim Scott \n(R-SC); LA Times video interview; WYNC Radio with Amy Walter on Larry \nKramer; STAT interview with Helen Branswell on vaccines; \nMay 29, 2020 – Global – 5,600,000/354,000;  USA – 1,700,000/102,000\nHad major", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: constant in a time of uncertainty,” The Washington Post’s Ellen  McCarthy and Ben Terris reported. But his admirers — and there are a lot of them —  worry that it’s only a matter of time before he’s sidelined by Trump. When Fauci missed a White House news conference earlier this month, panic erupted on  Twitter, along with speculation that he could be sick. There was palpable relief when he  resumed his regular position at the podium the following day and appeared to hide some  exasperation as Trump referenced “the deep state.” Fauci later explained that he had simply been trying to dislodge a lozenge from his throat.  But the much-analyzed “Fauci facepalm” had already become a meme, deployed by  liberal members of what’s known as the resistance . Fauci’s newfound fame can be partially…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 2, "page_count": 1141}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 3 of 10)", "content": "confrontation with the people from Moderna, mostly Tal Zaks, aandStephane \nBancel who wanted to push backon the collaboration (mostly do their own thing).   \nMoncef, John, Larry and I set them straight.   Also Mikael Dolsten and people from \nPfizer also wanting part of our resoruces (clinical sitesd) without joining the \ncollaboration.   Several conference calls to straighten this out.   It is not going to be easy.\nHad long conversation on “background” with Bob Woodward who is writing a book on \nthe early response to COVID in the USA.   I provided him with some history of our \nresponse in early January and into February.   Will tlak more with him tomorow\nPRESS: Wall Street Journal interview re: Chinese vaccines for COVID; Canadian \nRadio re: Larry Kramer; Young Money Radio – Lil Wayne and Dr. Dre;\nMay 31, 2020 – Global – 5,800,000/363,000;  USA – 1,800,000/104,000\nSunday – as expected, no shows for me.   Also, conditions influenced by widespread \nriots and disruptions  going on in multiple cities in response to a Minneapolis policeman \nwho killed an unarmed black man (George Floyd), which was videotaped by a passerby.  \nThis has dominated the news.\nReleased by Chairman Rand Paul\n865A race horse owner just bought a horse to run in the Belmont Stakes and named the horse \n“Fauci”!\nI made it into a “Doonesbury” cartoon\nJune 1, 2020 – Global – 6,000,000/368,000;  USA – 1,800,000/104,000\nDisruptions continue.  Trump either silent or fueling the problem.  McEnany looking \nmore and more preposterous as she gives single person press briefings.\nRiots getting worse.   Disruption and property destruction around White House and now \ninto my very neighborhood blocks from my home up at Foxhole Center.   Walgren’s and \nVourhius vandalized.  \nDid Zoom interview led by Father Dan Lahart for the Regis High School graduating \nseniors.  Students loved it.\nJake Tapper did a piece on CNN quoting me as saying that I have not seen or spoken to \nthe POTUS in 2 weeks from May 18 (Governors call)  through June 1.   Media picked up \non it and made it a big deal\nPRESS: Interview with London Times for profile of me;  TV interview with Italian \nTV (Sky TV)- Giovanna Pancheri; Washington Times interview on the effect of \ndemonstrations/rioting on containment of COVID-19;\nJune 2, 2020 – Global – 6,100,000/371,000;  USA – 1,800,000/105,000\nRiots continue in several cities.   Washington, DC particularly bad.   There was violence \nearlier yesterday, but then it was a peaceful demonstration.   The POTUS ordered the \npolice to clear the way through Lafayette Park so that he could do a photo op with a bible \nat St. John’s Church across the street.   The police came in and scattered the mostly \npeaceful crowd and injured several with rubber bullets and clubs.   Things getting very \nbad.\nTask Force in Sit Room meeting regarding usual stuff – testing, supply chain,etc.\nMeeting with POTUS in Oval Office re: vaccines.  As usual, POTUS was very warm \nand friendly with me.   When he walked into the Oval with us waiting, I was standing \nnext to the door and he said “I love you, Tony.   I feel like giving you a big hug”.   And \nthroughout the meeting where Moncef described our vaccine activities to him, he kept \nreferring to me.   After it was over, he called me close to the desk and asked how I was \ndoing and said “How are you; you are looking real good”.\nReleased by Chairman Rand Paul\n866Ran into Alyssa Farah outside the White House.   Real strange.  She said that she really \nliked my performance on CNN with Town Hall and also with Jim Sciutto.   She asked \nhow my other hits went.   I told her that I did not have any other hits and that all my \nrequests for clearance over the past week have been turned down.   She acted very \nsurprised and said she would look into this.   Again, she claimed that there was confusion \nand lack of coordination with VP’s Comms staff and theirs.   Something funny here.   I \nam meeting with Michael Caputo tomorrow AM in my house for breakfast.\nPRESS:  Wall Street Journal – Tech Health Interview (ZOOM); Podcast with JAMA \n– Howard Bauchner\nJune 3, 2020 – Global – 6,200,000/378,000; USA – 1,800,000/106,000\nNo TF today.   Only a Governors call on Nursing Homes to which I was not invited. \nProbably mostly Seema Verma.   Also, despite people (including Kellyanne Conway) \nassuring me that we are returning to 3x/week press briefings without the POTUS (i.e. \nwith the VP), nonetheless, the press briefing today was Kayleigh by herself at the \npodium.\nHad breakfast at my house this AM (6:30 – 7:30 AM) on the back deck with Michael \nCaputo  who wanted to discuss with me Comms strategy involving me.   Good \nconversation.   He says that there really is confusion at the level of the WH about putting \nme out.  Clearly Alyssa wants to put me out there (not for every request, but certainly not \n0 for 8 on a given week.   He says that Alexa Hennings is the scheduler who books TV \nappearances in the one blocking me for unclear reasons.   He will try to fix that sine he \nspoke with Alyssa over the phone yesterday (likely as a result of my meeting her outside \nthe WH) and Alyssa wants to get me on more.   Complicated situation.   Also, Michael \nwant me to do more PSAs and even a documentary.   He is trying to establish novel \nparadigms for COMMS involving me.   Also, we spoke a lot about his history with \nRussia and Roger Stone.   He and his family have been greatly harassed by Antifa and he \nunderstands my harassment by the dark web.   He is clearly an unusual guy who has been \noperating “at the edge” for some time.   However, he seems like a pretty good human \nbeing.\nAnthony Fauci namesake is a favorite at \nBelmont Park \nBy Justin Tasch\nJune 3, 2020 | 9:21am | Updated \nReleased by Chairman Rand Paul\n867Dr. Anthony Fauci Getty Images composite \nFauci could be a big winner Wednesday.\nNo, not Dr. Anthony Fauci, the infectious disease expert, but the horse named after him \nwhich will run in the third race at Belmont Park today as racing returns to Elmont, the \nfirst sporting event in New York in 80 days. Fauci, jockeyed by Tyler Gaffalione and \ntrained by Wesley Ward, is a 4-to-5 favorite.\nHad a very difficult experience today.   The POTUS called my cell and screamed at \nme because I had mentioned to the Press (likely on a Howard Bauchner podcast or a \nPolitico interview that the duration of immunity for common coronaviruses was 6 months \nto 1 year and that although we do not know the duration of vaccine immunity, it is \npossible that we may have to use additional boosts.   Apparently the press blew this up \nand said that the vaccine will only protect for a very short time.  The POTUS was very \nangry.   He said I cannot keep doing this to him.   He said he lover me but the country is \nin trouble and I am making it worse.  He said the stock market only went up 600 points \nand it should have gone up 1000 points and so I cost the country $1 trillion.   Quite a \nphone call.\n10:00 PM – Katie Miller called me up and said she had a message from the POTUS and \nthe VP.  Both of them (POTUS and VP) asked Katie to tell me that they both loved me \nand are sorry about what happened.   They understand and feel that the press will \ncontinue to pit me against the POTUS and so please be careful.\nReleased by Chairman Rand Paul\n868PRESS:  Politico interview with Sarah Wheaton\nJune 4, 2020 – Global – 6,300,000/380,000;  USA – 1,850,000/107,000\nHad call with NYC Health Commissioner Oxiris Barbot and Deputy Commissioner \nDemetre Daskalakis to discuss the possibility of doing a multicenter study of the \nMultisystem Inflammatory Sydnrome in Children (MIS-C).   NYC has 140 cases.\nJust today informed that I have been chosen for the: 2020 Sammies Federal Employee \nof the Year award.  The ceremony will take place in September.\nPRESS:  Live Instagram with Jose Andres; Alan Alda Podcast; Did interview with \nJonathan Swan of Axios.   I got off interview quickly since it appeared I would be \npitted against the POTUS with his questions.\nJune 5, 2020 -  Global – 6,400,000/385,000; USA – 1,870,000/108,000\nHad Zoom with activists David Barr, Peter Staley, Mark Harrington, James Kellerstein \nabout community engagement with COVID-19 research and the issue of releasing data \nbefore publication.\nModerna becoming a pain in the ass about the collaboration with mRNA vaccine.   \nWanting to pull back on prior agreements.   We will pull the BARDA money if they do \nso\nDid “Fireside Chat” withn  Brookings Institute with David Rubenstein.\nI made favorable comments today on CNBC about vaccines and decreasing of # of cases \nand the stock market went up by 3%.   I should (but will not) contact the POTUS and say \nthat he told me on Tuesday that my remarks blunted the increase in the Stock Market and \ncost him “one trillion fucking dollars”.    And so now my remarks actually made him “4 \ntrillion fucking dollars”, and so he owes me $3 trillion.\nReleased by Chairman Rand Paul\n869PRESS:  WTOP Radio; Interview with the American Journal of Managed Care on \nthe upcoming virtual IAS 2020 meeting; CNBC with Meg Tirrell; Radio interview \nwith John Catsimatidis (NYC) – Cats Roundtable; Telemundo TV\nJune 6, 2020 – Global -      USA\nFinally got a haircut with Sabine today after 11 weeks!!\nQuiet day.   Catching up on NIH-related Talks.\nJune 7, 2020 – Global – 6,700,000/393,000;  USA -1,930,000/709\nSunday – no health people on Sunday Shows.   Nation gripped with protests, \ndemonstrations and violence over death of George Floyd and other assaults on blacks.  A \ncouple of days ago the POTUS ordered the clearance of Lafayette Park to get to St John’s \nChurch to do a photo op with a bible.   Police crushed a peaceful crowd.   Major PR \nreaction.  Gen Milley and Sec. of Defense Asper being sharply criticized for being there \nand participating in the process.   They were probably taken by surprise of what they \nwere involved in.   Milley wearing combat fatigues (not good).   Protests spreading \nworldwide.\nDisturbing trend over past few days in number of new cases per day with 29,000 today.   \nThis is not rapidly going down regarding new cases, in fact going up.   USG claiming that \nthis is due to doing more testing, but that cannot explain it all.   Could be result of crowds \nduring Memorial Day and if so, we can expect more as country opens, in some cases \nprematurely.   Also, deaths keep coming down.\nJune 8, 2020 – Global – 7,000,000/399,000;  USA- 1,950,000/111,000\nReleased by Chairman Rand Paul\n870PRESS: Univision TV; WRC TV – Doreen Gentzler; NY Times interview; WGN TV \nChicago; iHeart Latino Radio with Enrique Santos; Spectrum News TV; taped Bio \nFireside Chat (for tomorrow);  \nJune  9, 2020 -  \nPhone call with Sen. Richard Burr (R-NC) about “after action” evaluation of our \nresponse.\nBig controversy when the WHO’s Maria Van Kerkhove said that transmission \nfrom asymptomatic person was “very rare”.   She got blasted for this since there was no \ndata to indicate this.   We feel that there is substantial transmission since asytmptomatics \nhave equivalent viral load in nasopharynx as do people with Sxs.   Also data from Teddy \nRoosevelt aircraft carrier and prisons and nursing homes and meat packing plants indicate \nthat transmission occurs a lot from asymptomatics.\n Lovely “thank you” by the Weill Cornell Medicinegraduating students for my sending \nthem a video brief “Commencement Address” for their “virtual graduation”.\nSeveral state are showing increases in number of cases and % of tests that are positive.   \nCoud be the beginning of a rebound.   NYC has opened as had DC.  Other  states getting \n“itchy” to open.   Major sentiment to move forward.   We will soon face the problem that \nif we see blips that are not contained by contact tracing, will the administration say damn \nthe torpedoes, full speed ahead or will they pull bak.   I suspect the former.\nWeill Cornell Medicine Student Thank you Video \nhttps://vimeo.com/426254316\nPassword: wcm\nPRESS: Yahoo Finance TV; Interview with Melissa Healey of LA Times;\nJune 10, 2020 – Global – 7,100,000/405,000;  USA – 1,980,000/113,000\nReports of multiple states including North Carolina, South Carolina, Alaska, Arizona, \nCalifornia, Utah, Tennessee,etc. having the highest single day number of cases reported.   \nCannot just be due to increased testing.   Concern that the opening of states will be \nReleased by Chairman Rand Paul\n871followed by increased infections that will be difficult to contact trace since many are \nasymptomatic.   Spoke with the David Barr group again last night and they feel that they \nwill not be able to adequately contact trace if a uptick occurs.   Also, there is a growing \nurge for peope to “get out”.\nDid a Zoom call with Francis Collins and the activists – Peter Staley, James Krellenstein \nabout PrEP for COVID.\nPRESS:  Good Morning America ABC; NPR – Science Friday with Ira Flatow \n(taped); CBC Canadian TV; Newsy  Documentary; Bill Nye “Science Rules”; Voice \nof America TV with Lesia Bakalets; Interview with the Daily Telegraph;\nJune 11, 2020 – Global  USA\nHad good conversation (having these every 2 weeks) today with Bill Gates on status of \nmAb (Regeneron, Lilly, etc.).  Also, discussing other therapies. Also, discussed vaccines.\nGreat article in Elle magazine about Christine.\nBig issue with companies that we are dealing with for COVID-19 vaccine.   Moderna is \nacting like and asshole in that they want the USG money but are resisting having the \nNIAID network (Larry) control the trial They have the IND and so the trial is really \ntheirs.   Moncef and I and John Mascola had important call where Moncef indicated that \nhe himself is concerned that a single network with one leader can be responsible for  3 \n(Moderna, Astrazeneca, J & J) and possible 5 (Sanofu, Novovax) trials.   Abd so we \ndecided that Moncef would put in writing that the companies can run their own trials in \nour network, but they must harmonize with regard to protocol design (with some \nvariations), single DSMB, consistent lab results, and same primary and secondary \nendpoints.   If they do not agree, then BARDA does not give them money.\nI am still concerned about Deb’s negative opinion and tendency towards EUA.\nSpoke with Gary Bettman, Commissioner of NHL about their plan for a “bubbled” \nseason → test all players and isolate them in a bubble and play the season like a \ntournament.. MLB and NFL considering such a plan.\nPRESS:  CNBC “The Street” with Jim Cramer (interviewed by Katherine Ross); \n“The Stadium” TV Marquis Network.\nJune 12, 2020 -  Global – 7,300.000/415,000;  USA – 2,050,000/114,000\nDid Council on Foreign Relations Zoom meeting; \nReleased by Chairman Rand Paul\n872Crazy situation where WH approved nothing and then after the Podcast with Caputo, he \nsaid “The WH did not want you to do Wolf Blitzer yesterday since it competed with the \nPOTUS on TV and so I asked for today, but they gave no response and so let us just go \nahead and do it.”    Tough to figure out what if any strategy they have about getting me \nout to the media.\nThere is a resurgence of cases in those cities that are opening up and now the model is \nprojecting 1000 deaths per day with total of 170,000 deaths  \nPRESS:   RAI – Italian National TV; Yahoo News TV; ABC News Podcast with \nJonathan Karl;  WAMU Diane Rehm Podcast; Local TV stations in Buffalo, New \nYork City, Los Angeles, Seattle, Portland, Oregon, Atlanta; Podcast with Michel \nCaputo; CNN Situation Room with Wolf Bitzer;\nJune 13, 2020 -  Global – 7,400,000/418,000;  USA – 2,116,000/117,000\nGot call from Alex Gorsky (CEO and Chairman at J & J) expressing concern on the part \nof the company CEOs regarding whether Gen. Gus Perna (as competent as he is supposed \nto be in military matters) can actually pull off the massive distribution of vaccine when it \nis ready including providing needles, syringes, etc.   I have the same issue since Gus \nseems like a good person but every time Alex or Esper says something, he says “Yes sir, \nwe are on it and will get it done”   Seems too over-confident.   Does he really know what \nhe is doing?\nGot call from Gov. Cuomo at 8:00 AM but missed it because I was running on the C & \nO Canal.   When I called him back he as on a helicopter and will call me back later.  \nWhen he called back, he expressed how much in denial the POTUS is.   He speaks with \nthe POTUS regularly and tells him he needs to admit that cases are increasing, and he is \ngoing to help in suppressing them instead of denying them.   NYC is doing well by \ncarefully opening according to my recommendations.   Cuomo says that I am the only \none left in the USG who is speaking truth.   He has given up on Deb and somewhat on \nBob (who actually has been speaking up lately)\nDenial on part of administration saying that increases in case in CA, AZ, TX, NC are \nmerely increases in testing and/or real increases, but mostly Americans returning from \nMexico to get care since Mexico is exploding with infections right now.   Clearly there \nare increases in cases and hospitalizations\nPRESS:  None but many shows are showing recent clips to make points.\nReleased by Chairman Rand Paul\n873June 14, 2020 (SUNDAY) – Global – 7,600,000/425,000; USA – 2,100,000/116,000\nRiots continue with more police killing of African American men, this time in Atlanta \nwith killing of Rayshard Brooks as he was running away after scuffle with police leading \nto firing of officer and resignation of Police Chief Erika Shields.\nBecoming clear that the increase in infections in CA, AZ, TX, NC, etc. are real increases \nin addition to increased testing.\nHad conversation with Fred Hiatt (Washington Post Editor of Editorial Page) about my \nevaluation of the situation.   I indicate that it should n0t be pure public health versus \n“damn the torpedoes, full speed ahead”, i.e. not shut down versus “liberate the state/city”.   \nWe should expect some cases as we open.   It is critical to how we handle these with \nidentification, isolation, and contact tracing.\nPRESS:   No Sunday Shows, but showing clips of my prior comments.\nJune 15, 2020 – Global – 7,700,000/428,000  USA – 2,100,000/116,000;\nGovernor’s call today at WH and I was not invited.\nBARDA requesting FDA to pull back the EUA for Hydroxychloroquine and \nChloroquine,   I was always against the EUA for HC and Ch since I did not believe that it \nfulfilled the criteria (some indication of efficacy) for an EUA:  see link below.   Also, this \nis the issue that Rick Bright has blown the whistle on, i.e. saying that he was pressured \ninto recommending to FDA (when he was head of BARDA) to issue the EUA.\nGot call from Michael Caputo today asking if I thought that the POTUIS should cancel \nhis campaign rally.   I told him definitely yes.\nhttps://www.fda.gov/media/138945/download \nCall from Jeremy Berg at Pitt sending me as Cell Host & Microbe by a Chinese group \nShi-Hui Sun et al:  A mouse model of SARS-CoV-2 Infections and Pathogenesis.  28: 1-\n10, July 8, 2020 (Online first)   indicating that the Chinese were making CRISPR.Cas9 \nknockin mice for ACE-2 that were made 30 weeks ago, which would be August, 2019.   \nWhy would they be doing that last summer???  They could have been studying SARS, \nbut they already had mouse models.   Possible they just wanted to use a better technique \n(CRISPR) OR they knew that SARS-CoV-2 already existed and the outbreak was already \nongoing.\nReleased by Chairman Rand Paul\n874Spoke with Howard Zucker, Commissioner of Health for NY State.   He wanted advice \nabout a possible National Policy for opening up universities.   I referred him to CDC, but \nalso to Silvia Burwell to see what she is doing with AU.\nPRESS:  NEJM Poodcast about our HIV paper in the series for the 50th \nAnniversary of NAM; \nJune 16, 2020 – Global   USA\nLaura Ingraham calls me “Deep State” for asking people to wear masks.\nRECOVERY trial from UK showed good effect of Dexamethasone on COVID-19 \npatients on ventilators or Oxygen, but not on early patients.\nMedia pushing a major breach between me and the White House.   Big issue is that \nPence wrote an OpED in the WSJ saying that there were no increase in cases; the \napparent increase was due to increased testing.  He got blasted since I (and to some extent \nDeb) said that the increase in cases was due to BOTH increase in testing AND actual \nincrease in cases in CA, AZ, NC, TX, AL, etc..   Politico writes:\nWith help from Myah Ward\nVEEP IN THOUGHT — Since February there has been a rift inside the White \nHouse between the scientists and the politicians over how to contain the spread \nof coronavirus. Anthony Fauci has been the consistent advocate of a forceful \nresponse and an opponent of any sugar-coating of the perils Americans face. \nPresident Donald Trump has been the reluctant warrior against the disease who \ntook some major steps early on but soon grew impatient of the stay-at-home \nrestrictions, the masks, and — most of all — the economic calamity that might \njeopardize his re-election.\nVice President Mike Pence, the chair of the president’s coronavirus task force, \noften played the role of bridge between the factions. At the awkward task force \nbriefings that dominated afternoon television in March and April, the three roles \nof the three men played out as theater: Fauci the doomsayer, Trump the \nmisinformed optimist, and Pence the child of a troubled marriage trying to \nsmooth things over during mom and dad’s public fights.\nReleased by Chairman Rand Paul\n875PRESS: Interview with AP (Marilyn Marchione); Nature – Heidi Ledford; WAMU \nRadio 1A;  Wall Street Journal on Dexamethasone study; Jesuit Conference podcast;   \nDaily Beast – Erin Banco; LA Times Bill Shaikin about MLB opening; WCBS Radio, \nNYC – Linda Lopez; Financial Times -Hannah Kuchler \nJune 17, 2020 – Global   USA\nSerius problem emerging with Moderna who are insisting (see discussions above) on \nimplementing the protocol for mRNA in a way that both Larry Corey and John Mascola \nfeel strongly is contrary to the safe followup of people who get infected and also contrary \nto good science in being able to get good end point data.   We have tried, but theyhave a \nCMO who is incompetent (Tal   ).   Their CEO Stephane Bancel has a company that has \nnever made a product or done a trial despite the fact that by somewhat questionable PR \nhave built up a cash ase of billions of dollars.   We may have to threaten them with the \nwithholding of BARDA.  This will be a sticky issue and likely very time consuming.   I \nwill have to work through Francis, Azar, Marc Short, Mark Meadows, POTUS.   Yikes!\nDid virtual meeting with Council on Foreign Relations Independent Task Force on \nPrepring for the Next Pandemic – organized by  Sylvia Burwell\nBorowitz satirist continues to poke fun at Trump, Pence, Kushner by way of making up \nridiculous satires about our relationship:  https://www.newyorker.com/humor/borowitz-\nreport/white-house-staff-seething-with-envy-after-fauci-reveals-he-has-not-spoken-to-\ntrump-in-two-weeks\nWent toTask Force at WH at 4:00 to 5:30 PM.   Depite the fact that I was concerned \nabout all the hevy publicity pitting me against the VP, everyone (including junior to \nmoderate staff) were genuinely glad to see me.   Pence was joking with me from the time \nhe came into the room.   He said he wants to steel my tricks.   He held up the WSJ and \nsaid when they asked me about the second wave, I should have done what Tony did and \nsay “Second wave??   What second wave?   We are still in the first wave”\nPRESS:  Tea Leaves Podcast – Asian Group;\nJune 18, 2020 – Global    USA\nCommuniation between Deb Birx and me on June 18:\nThank you.  I haven’t been sleeping because of this.  What do you think about going into \nMS with Lumina as the diagnostic sequencer and massive tracking molecularly?\nSent from my iPhone\nReleased by Chairman Rand Paul\n876On Jun 18, 2020, at 7:26 AM, Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> \nwrote (read from bottom to top):\nAs you recall, I have always been in favor of massive testing.   Now is the \ntime.   We are swimming in the dark.   Let us discuss at the TF tomorrow.\nAnthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nThe information in this e-mail and any of its attachments is confidential and may contain \nsensitive information.  It should not be used by anyone who is not the original intended \nrecipient.  If you have received this e-mail in error please inform the sender and delete it \nfrom your mailbox or any other storage devices.  The National Institute of Allergy and \nInfectious Diseases (NIAID) shall not accept liability for any statements made that are the \nsender's own and not expressly made on behalf of the NIAID by one of its representatives.  \nFrom: Birx, Deborah L. EOP/NSC <Deborah.L.Birx@nsc.eop.gov> \nSent: Thursday, June 18, 2020 8:00 AM\nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nSubject: Re: 18JUNE2020 Data\nThank you.  I haven’t been sleeping because of this.  What do you think about going into \nMS with Lumina as the diagnostic sequencer and massive tracking molecularly?\nSent from my iPhone\n \nI have been obsessing about the increases in cases that do not seem to be \nrelated to openings or closings or massive crowds.   I believe that ultimately \nwe will see increases related to all of the above; however, right now we may \nbe looking for the lost keys under the light of the lamppost. There is \nsomething inherent here that we are missing and that is insidiously keeping \nthe outbreak alive in the USA, and that is more concerning than anticipated \nspikes associated with identifiable events.\n \nAnthony S. Fauci, MD \nDirector  \nReleased by Chairman Rand Paul\n877National Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nThe information in this e-mail and any of its attachments is confidential and may contain \nsensitive information.  It should not be used by anyone who is not the original intended \nrecipient.  If you have received this e-mail in error please inform the sender and delete it \nfrom your mailbox or any other storage devices.  The National Institute of Allergy and \nInfectious Diseases (NIAID) shall not accept liability for any statements made that are the \nsender's own and not expressly made on behalf of the NIAID by one of its representatives.  \n \nFrom: Birx, Deborah L. EOP/NSC <Deborah.L.Birx@nsc.eop.gov> \nSent: Thursday, June 18, 2020 6:37 AM\nTo: Redfield, Robert R. (CDC/OD) <olx1@cdc.gov>; Hahn, Stephen <SH1@fda.hhs.gov>; \nFauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nSubject: FW: 18JUNE2020 Data\n \nRemain concerned about CA, FL, TX – followed by SC, MS, NC, GA, AL.  Bob let me know \nwhere exactly you went as we need to ensure surge to the next set of States next week.  The \nreason I pushed back on calling it “just reopening”  because it implies it just a thing and \neverything is just cases we expected but I think this is serious and specific populations especially \nthe underdiagnosed Hispanic communities are at enormous risk.  Tony and Bob, I need your \nteams to explore pools of 10 on thermofisher and Roche.  We need to be able to tst 10X right now \nin communities when you get your team on the ground.  We also need creative ways for housing \nand work among asymptomatics – ie working and housing in teams to decrease spread.  Open to \nall discussion.  Hopefully we can meet and strategize tomorrow.  We need a breakthrough in \nmasks.  Pulled 2 paper but maybe we can strengthen guidance.  Also sending the antibody \npaper.  Deb\nAmazing interview with Bobv Cousy who praises me so wonderfully:\nhttp://hoopshd.com/2020/06/17/a-couple-of-crusaders-hoopshd-interviews-bob-cousy-\nabout-dr-anthony-fauci/\nSelected quotes from Cousy: \nDr. Fauci has become even more well-known this year during his \npress conferences as a member of the White House Coronavirus Task \nForce: what is it about him that causes the country to trust him?  He \ngets offstage as quickly as possible, which is an attribute I admire greatly. I am \nnot trying to share his spotlight but over the past few decades when someone \nasked who my heroes were I would say Dr. Tony Fauci. Lately I have added Bryan \nStevenson to the list after reading his book “Just Mercy” about 5 years ago.\nTony spent his career at NIH simply helping people with his \nintellect/knowledge/desire. I think that he is the most unassuming superstar and \nReleased by Chairman Rand Paul\n878just wants to help the world. I would like to think that he was engendered with \nthat philosophy by the Jesuits.\n \nGot call from Chris Wallace at Fox News saying he has been trying to get me on his \nshow for weeks and wanted to know how I was doing.   I told him to keep trying and \nmaybe he will get it.\nMichael Caputo called me and told me that the Comms people in the WH want to keep \nme off TV until next week because of my message that is contrary to the VP and POTUS \n– no kidding.\nOWS meeting today talking about modelling where the infections are going to surge for \nthe vaccine trial. \nMonsaoui met with Pfizer who said that would sell the vaccine for $100/dose.  This is a \nnon-starter.   A price should be ~$25/dose.   During this emergency, we can take over \nPfizer or invoke the Defense Production Act (DFA) and dictate the price, and so we have \na “hammer” with them.\nI have been speaking about the danger of states/cities leap-frogging over the progressive \ncheckpoints in the guidelines to “Open America Again” as well as the danger of those in \nstates who trying to do it right now wearing masks and/or congregating in crowds.   And \nsure enough, we are now having significan increases in cases and hospitalization in FL, \nTX, AZ, OK.   Particukarly problematic in OK where the Trump campaign rally is taking \nplace tomorrow in Tulsa.\nMy comments about the difficulty in getting the football season going this Fall and \nWinter has been very widely overed in the Sports Press\nPRESS: McLatchey print interview – Michael Wilner;  Washington Post  Podcast \nwith Allie Caren; Dan Patrick Sports News – TV; Vice News TV; Correire Della \nSera print interview; Financial Times – HIV compared to COVID-19\nJune 19, 2020 – Global -    USA\nSpoke with Fr. Dan Lahart to give him advice and discussion about whther to open up \nRegis for the Fall term or do it virtually.   I explained that it would depend on the viral \ndynamics at the time of opening.   Their problem is that >95% of the students get to \nRegis by riding on a subway and so they really have a defined daily risk that would be \nreflected by the virus activity in the city.\nReleased by Chairman Rand Paul\n879Last day of my HHS Security Detail.   The whole crew  George Adams, Brett Rowland, \nAndre Jacobs, Greg, Mike, and also Mike Lunetto came over for photos and to brief me \nabout future protection.\nPOTUS tweeted about me today saying that I have nothing to do with the NFL…. “Tony \nFauci has nothing to do with NFL Football.   They are planning a very safe and controlled \nopening.   However, if they don’t stand for our National Anthem and our Grand Ameican \nFlag,  I won’t be watching”.\nSign in Greenwich Village:\nPRESS:  CBS News Radio NYC; WABC Radio NYC video podcast; Global Health \nAffairs Interview with Susan Dentzer\nReleased by Chairman Rand Paul\n880June 20, 2020 – Global   USA\nThings are really heating up.   Someone leaked to media that Deb and I advised against \nthe Tulsa Campaign rally.   We never really discussed it at the TF meeting.   I got text-\npinged by several reporters (Jon Karl, Norah O’Donnell, Jim Sciutto, Jim LaCosta  about \nthis.   I honestly said that I could not conbfirm this since we never discussed thr Tulsa \nrally specifically.   Nonetheless, today papers are saying that this is the case.   Clearly \nsomeone is leaking things without knowing the facts.   Karl told me that the word was out \neven before the TF meeting ended.  And so, someone is leaking even before we finish.\nI am getting progressively disillusioned with Deb Birx.   She is happy talking the \nincreased cases and the VP who is desparately looking for good news listenes to her and \nactually thinks that thngs are going well when, in fact. 13 states are clearly having surges \nof cases.   She makes the case that 37 cases are stable or decreasing and underplays the13 \nthat are “on fire”.   In fact after the TF meeting on Friday (yesterday, the VP wants us to \npresent this to the POTUS who probably hates me by now, even though he says that he \n“loves me”.   He has tweeted about me 3 times yesterday and today.   Deb has ststed that \nwe should noit do clinical trials since “I want to see every infected person in a nursing \nhome get plasma early on and steroids later.   Forget the trial, we need to do this on \nEUAs.    She says the same thing about vaccine trials.   Clearly, she is trying to provide \nTrump with his October surprise. I may need to blow the whistle on her.\nIt is reported that several(6) staff from the WH rally advance team have tested positive \nupon screening.\nKatie Miller called me and asked if she were protected from reinfection since she is in \nTulsa with the Campaign rally and she did not want to wear a mask because of the Trump \ngroup not wearing masks as a symbol of resistance against the scientists.   I told her that \nshe and Steven should wear masks since Tulsa is a hot bed and she needs to think of the \nfact that she is in 2nd trimester of pregnancy.\nDavid Perlman of he SF Chronicle. He was a great science reporters and one who first \ninterviewed me during the earlier years of HIV/AIDS\nTrump-Fauci tension building up by the press.   White House remains friendly, but press \nreports stressing the difference between the POTUS and me.  I am now being ttacked \nmore by the far right.   Higly tense political situations.   I quite frankly do not really care.   \nI will keep doing what I am doing.   Am being constantly pinged (texted) by the press \nasking my opinion of various statements that are coming out.\nKayleigh McEnany essentially saying that I will not be out in the press.  Alyssa Farah is \nthe one hope in Comms since she clearly wants me out their.   Kayleigh constantly lying \nto and insulting the press.   They are all on to her.\nPOTUS makes silly statement at the rally in Tulsa that the more you test, the more cases \nthere will be (implying that testing causes cases) and then said that he told his people to \nReleased by Chairman Rand Paul\n881“slow down the testing”.   This triggered a rash of press calls to me that I answered on \nbackground or off the record.\nNIH Clinical Trial Evaluating Hydroxychloroquine and Azithromycin for COVID-\n19 Closes Early\nThe National Institute of Allergy and Infectious Diseases (NIAID), part of the National \nInstitutes of Health, has stopped enrollment in its clinical trial evaluating whether \nhydroxychloroquine and azithromycin can prevent hospitalization and death from \ncoronavirus disease 2019 (COVID-19). This action was taken because NIAID, the study \nleadership and the independent data and safety monitoring board (DSMB) overseeing the \ntrial determined that the rate of participant enrollment has been inadequate for the trial to \nmeet its objectives in a timely manner. No safety concerns were associated with the trial.\nPRESS:\nJune 21, 2020 (Sunday) – Cases still surging in 13 to 20 states.   Global – \n8,500,000/459,000;  USA – 2,300,000/120,000\nMuch concern about surge of cases, particularly in Florida and South Carolina and \nGeorgia and Oklahoma.   Also, tensions regarding the Tulsa campaign rally.\nJune 22, 2020 – Global – 8,700,000/462,000;  USA – 2,300,000/120,000\nBelowis a very good article in Politico that describes in detail whast the problem has been \nin ther USA response to COVID-19\nHow the U.S. and Italy traded places on coronavirus\nWhile Trump touted America’s reopening and watched infections climb, European \nleaders maintained strict rules and drove cases down.\nReleased by Chairman Rand Paul\n882The historical Piazza della Signoria square in \nFlorence, Italy, in early June. | Andrew Medichini/AP Photo\nBy DAN DIAMOND and SARAH WHEATON\n06/22/2020 04:30 AM EDT\nThree months ago, public health officials feared that America would be swamped \nby Covid-19 like Italy. Today, the U.S. would be lucky to swap its coronavirus \ncrisis for theirs.\nItaly’s sudden surge of coronavirus in March swamped hospitals, pushed the \nnation into a strict lockdown and forced its doctors to ration life-saving \nventilators. About 200,000 Italians were sickened and 29,000 died from the \nvirus by May 1 alone. Global health officials seized on Italy — as the first country \noutside of China to be battered by the virus — as a disturbing case study for the \nrest of the world. In private meetings, White House officials worried that Italy \nwas a preview of the storm about to hit the U.S. health system.\nBut Italy announced just 264 new Covid-19 cases on Saturday — the same day \nthat the United States reported nearly 32,000. The European nation opened its \nrestaurants and stores a month ago, albeit under new, national safety measures, \neven as U.S. states wrestled with inconsistent, hasty reopening efforts that have \nbeen blamed for new virus spikes. And Italy’s outbreak has dramatically ebbed \nfrom its mid-March peak, while America’s new per capita cases remain on par \nwith Italy's worst day — and show signs of rising further, with record \nhospitalizations in states like Arizona, Florida and Texas last week.\n“I think there are going to be states in our country that can replicate Italy,” said \nAshish Jha, head of Harvard’s Global Health Institute, noting that New York has \nmade its own dramatic strides in containing the virus.\n“But I would rather spend this summer in Rome with my family than in Phoenix.”\nItaly is not alone in driving coronavirus down to manageable levels. Its Western \nEuropean neighbors Spain and France grappled with damaging outbreaks that \nkilled tens of thousands and prompted lockdowns, only to drive daily new cases \nbelow 500. Meanwhile, Germany was able to fend off the virus with relatively low \nmortality, which some credit to the nation’s robust test-and-trace strategy. The \ncollective recovery of the European nations — punctuated by Italy’s apparent \nReleased by Chairman Rand Paul\n883turnaround — stands in stark contrast to the muddle facing many parts of \nAmerica, where the death toll has now topped 120,000.\n“I would rather spend this summer in Rome with my family than in \nPhoenix.”\n Ashish Jha, head of Harvard’s Global Health Institute\nJha and other public health experts say that America’s piecemeal, politicized \napproach to fighting coronavirus has left the United States ever-further behind \nthe Western European nations that were similarly threatened by the virus but \nmoved more judiciously to fend it off. They also say that Western Europe is a \nbetter comparison point for the United States than nations like South Korea and \nSingapore, which had been scarred by previous viral outbreaks and were more \nprepared to handle the arrival of Covid-19. After the damaging initial spike in \ncases, European Union members' total daily case count is now about one-\neighth of the U.S. daily cases — despite having roughly the same population.\n“Both we and Western Europe were really slow to act,” said Jeremy Konyndyk of \nthe Center for Global Development, who helped oversee international aid efforts \nduring the Obama administration. “But the worst performers in Europe with the \nbad luck to get hit first, like Italy and Spain … they are now down 85, 95 percent \nin terms of case counts from the peak.”\n“In the US, we’ve struggled to get it down one-third — and in the last few days, it \nlooks like it could rebound again,” Konyndyk added.\nPartisan fights bog down U.S. response\nPublic health experts cited multiple factors for why the fortunes of the United \nStates have differed from Western Europe — starting with the intense \npoliticization that worked against a disciplined response, and the federal \ngovernment’s decision to let individual states take the lead in reopening. The \ndecisions of some states to end their lockdowns as early as possible — at levels of \ninfection considerably higher than those that triggered reopening in Western \nEurope — appear to have consigned the United States to a far longer battle with \nthe virus.\nPresident Donald Trump and some Republican governors have bristled at public \nhealth experts’ advice, questioning predictions on viral spread and pushing back \non recommended lockdowns. GOP-led states like Georgia and Texas reopened \ntheir economies despite requests from public health experts to wait for more \ntesting and fewer cases.\nMeanwhile, Trump’s allies and pundits on Fox News pushed malaria drugs as \npossible Covid-19 cures, despite scant evidence, leading to largely fruitless efforts \nthat consumed the time of senior federal officials — including scientists whose \ntime would have been better spent pursuing other therapies.\nReleased by Chairman Rand Paul\n884“There are plenty of people, on cable TV and elsewhere, who exploited that the \nvirus was primarily in New York and other places to say that it's a blue state \nproblem,” said Harvard’s Jha. “They’d ask, ‘Why are we shutting down Montana \nwhen the problem is Manhattan?’”\nDemocrats, meanwhile, didn’t condemn hundreds of thousands of people for \nviolating restrictions on mass gatherings to protest police brutality this month. \nInstead, governors like New Jersey’s Phil Murphy and Michigan’s Gretchen \nWhitmer broke the lockdown orders that they had extended just days before to \njoin the protests themselves — moves that confused many Americans about the \nneed for social distancing and fueled charges of hypocrisy from conservatives.\nEven basic protections have been politicized in the United States. Trump has \neschewed a mask in public and has sometimes mocked others for wearing face \ncoverings — despite requirements that people wear masks in certain states and \nample science that they work to prevent the virus’ spread.\nThe president also swiped at mask-wearers in a Wall Street Journal interview last \nWednesday, suggesting that some Americans are wearing coverings to signal \ntheir disapproval with him. He has repeatedly voiced his hesitation about the \nwidespread coronavirus testing urged by public health experts, including \ncontroversial remarks at his rally on Saturday.\n\"When you do testing to that extent, you're going to find more people,\" Trump \nsaid during his rally in Tulsa, Okla. \"You're going to find more cases. So I said to \nmy people, slow the testing down please.\" White House officials claimed Trump \nwas joking.\nBut in Italy, there’s been much less disagreement over scientists’ \nrecommendations — including lockdowns that were more restrictive than those \napplied in the United States — particularly after the virus swiftly tore through the \nnation in early March, peaking at 6,557 new cases announced on March 21. \n(Adjusted for population, that would be equivalent to about 35,400 new cases in \nthe United States.) While some protested, residents largely went along with \nrestrictions that effectively banned jogging, instituted one-at-a-time entry \npolicies for grocery stores and saw the Pope livestream his Easter Mass from an \nempty St. Peter’s Basilica.\nThat still wasn’t enough to spare Italy from horrific consequences in the early \nspring: Doctors had to make decisions on the fly about who would get life-saving \ncare when there weren’t enough beds to go around. Dead bodies had to be stored \nin sealed-off rooms until funeral services were available in the worst-hit regions.\n“The Italian crisis provoked by Covid-19 is the most serious event in Italian \nhistory after World War II,” Italian doctors Ciro Indolfi and Carmen \nSpaccarotella wrote in April's Journal of the American College of Cardiology. “It \nis a national human, health, and economic tragedy.”\nReleased by Chairman Rand Paul\n885But the devastation hit home in a way that prompted broad acceptance of \nlockdown measures. Political leaders largely embraced the need for personal \nprotection and have even policed each other. Prime Minister Giuseppe Conte \nregularly wears a mask in public — and when he attempted to remove it to speak \nto his parliament in April, he was heckled by fellow lawmakers.\nPrime Minister Giuseppe Conte regularly wears a mask in public — and when he \nattempted to remove it to speak to his parliament in April, he was heckled by fellow \nlawmakers. | (LaPresse, Pool via AP Photo)\nWhen far-right populist leader Matteo Salvini tried to take a page from the \nTrump playbook, tweeting accusations that the virus came from a Chinese lab \nand occupying the parliament in protest of lockdowns, the move backfired. His \nparty, the League, is still the most popular party in Italy’s polls, backed by about \n25 percent of voters,  but support has dropped since February and its lead over \nthe center-left Democratic party has narrowed considerably.\n“One issue that was amazing about all this: Italians took the quarantine seriously, \nthey collaborated with the central orders and were able to follow the guidelines” \ndespite widespread economic suffering, said Raffaella Sadun, a Harvard Business \nSchool professor who advised Italy’s prime minister on the crisis. “This may be \nthe primary point of difference with what we are seeing in the U.S.”\nNational leadership takes center stage\nThe early wave of coronavirus cases blindsided leaders around the globe — \nalthough those leaders adopted significantly different paths to respond.\n“Whoever the leadership was, we would’ve had an outbreak. Virtually every \ncountry has,” said Jennifer Kates, director of the Kaiser Family Foundation’s \nglobal health policy work. “The United States clearly performed poorly at many \npoints along the way in January, in February, in March.”\nIn the United States, Trump’s deputies struggled to convince the president to take \nnecessary steps to fend off Covid-19 across February and March, ranging from \nmobilizing more parts of the federal government to ensuring the availability of \nadequate testing. Even after Trump recognized the severity of the crisis by mid-\nReleased by Chairman Rand Paul\n886March, the White House largely delegated the subsequent response to states — \nforcing governors to end up bidding against each other for supplies and \nresources, and fueling broader chaos.\nBut in famously fractious Italy, after some initial confusion over who was in \ncharge, national leadership devised a more centralized plan that regional \ngovernors could follow. In Germany, lawmakers gave the federal government \nemergency authority to impose health measures across the 16 states. Likewise, \nthe European Union leaders in Brussels ultimately convinced  national capitals to \nstop hoarding medical supplies, coordinate border closures and start discussing \nthe appropriate standards for ending lockdowns well in advance.\nThe European countries’ response hasn’t been seamless. Spain was initially \nhamstrung by Madrid’s failure to get its fractious regions in line , and German \nChancellor Angela Merkel has faced her own challenges from unhappy regional \nleaders. But up-front coordination and quick decisions paid dividends across the \nmonthslong crisis, experts said.\n“That central cohesive role of a federal government has been lacking in the \nUnited States. In a way, the U.S. has hamstrung itself.”\n Alexandra Phelan of Georgetown’s Center for Global Health Science and \nSecurity\n“One of the strengths about a federation or a nation is that you can centralize \npriorities and goods like acquiring personal protective equipment, or policies like \nwhen to test for coronavirus,” said Alexandra Phelan of Georgetown’s Center for \nGlobal Health Science and Security.\n“That central cohesive role of a federal government has been lacking in the \nUnited States,” Phelan added. “In a way, the U.S. has hamstrung itself.”\nAnother significant difference: how national leaders abroad publicly incorporated \nthe advice of their top health advisers, even as Trump often undermined the \nmessages of experts like infectious disease doctor Anthony Fauci — sometimes as \nthey shared the same stage.\n\"Countries that have had good understanding between political leaders and \npublic health leaders have done the best,” said David Heymann, a professor of \ninfectious disease epidemiology at the London School of Hygiene & Tropical \nMedicine who led the global response to the SARS outbreak in 2003. He pointed \nto Germany as a good example, where its public health institute “has been a \nconstant adviser to the government, and the government has taken the \ninformation and used it.”\nReleased by Chairman Rand Paul\n887No time for American exceptionalism\nEven as the coronavirus situation began to worsen across the winter, Trump \nadministration leaders repeatedly touted the U.S. health system as an advantage \nthat other nations lacked — and, as independent experts acknowledged, for good \nreason.\nA scorecard issued by the Nuclear Threat Initiative and the Johns Hopkins \nCenter for Healthy Security in October 2019 ranked the United States the most-\nprepared nation to face a pandemic, citing ample investments in infectious \ndisease detection and response, led by organizations like the Centers for Disease \nControl. Meanwhile, Italy ranked 31st in preparedness, falling behind nations like \nEstonia and Indonesia.\nBut the all-encompassing faith in the U.S. infrastructure turned out to be \nmisplaced, exemplified by the CDC’s early failure on testing, which contributed to \ncoronavirus’ silent spread. Trump’s own vows in February and March that the \nvirus would simply “disappear” put the United States out of step with other \ndeveloped nations.\n“How much of that was America knows best, America can handle this… that was \ncertainly part of the decision-making,” said Kates of the Kaiser Family \nFoundation. “That turned out to be the wrong call.”\nMeanwhile, the administration’s aggressive, isolationist posture — with Trump \nbashing global health experts and threatening to yank the United States’ funding \nfrom the World Health Organization — has done little to help coordination. And \nnations like Italy, which provide universal health care access to citizens, \nsimplified residents’ efforts to get tested and treated.\nThe insular thinking in the United States has alarmed global health experts, who \nsaid that opportunities to learn from other nations were missed.\n“There was no sound reason to think that a virus capable of overwhelming the \nhealth systems of China and Italy would prove any less dangerous in the United \nStates,” Konyndyk of the Center for Global Development wrote in Foreign \nAffairs this month. “But leaders across American society imagined that somehow \nthe United States would be spared the ravages of the disease.”\nA push to reopen\nIf the United States had waited just a few more weeks to lift lockdowns — or more \nrigorously imposed them in the first place — that could’ve driven cases down \nmuch further, experts agree.\n“We know that a one-week delay in imposing lockdowns, given the exponential \nnature of transmission, could have reduced cases by 50 percent,” said \nReleased by Chairman Rand Paul\n888Georgetown’s Phelan, who acknowledges the downsides of social distancing for \neconomies.\nEuropean countries’ “initial reopening phase was more or less comparable to our \nfull lockdown phase. And they were much more judicious and consistent in how \nthey applied it,” said Konyndyk. “They had a much more hard-nosed and a much \nmore consistent approach to limiting transmission.”\nThe experts acknowledged that Covid-19 has proven to be a fearsome opponent \nand that small flare-ups can quickly mushroom into major outbreaks, changing \nthe calculus on which countries have contained the virus.\nBut for now, the European Centre for Disease Prevention and Control — modeled \non the U.S. CDC — has given European countries a pat on the back last week.\n“Decreasing trends in disease incidence are observed and sustained” in almost all \nEU countries, the European health agency’s latest threat assessment declared. \nWhile no one knows exactly which types of social distancing measures are best, or \njust how intense they need to be, the ECDC said, “such measures appear to have \nbeen associated, at least temporarily, with decreases in the number of newly \nreported cases.”\n“The lesson for the United States, in my opinion, is … the only strategy, in the \nabsence of the vaccine and specific therapy, during the Covid-19 pandemic is \nsocial isolation and the use of masks,” said Indolfi, the Italian cardiologist.\nIndolfi — who lives in Calabria, a southern region of Italy that experts \nworried was at high risk if Covid-19 got a foothold, given its lack of infrastructure \n— noted that his nation’s coronavirus intensive care wards are virtually empty \nand that the pandemic “can be considered practically over.”\n“At the present time, in Italy people consider themselves safer,” he said.\nSeveral experts like Phelan, who also serve as public health professors, said that \nthey’d already begun incorporating the U.S. response into their classes as a lesson \non public health failures.\n“I know for my course, this is pretty much going to be all we’ll talk about,” said \nPhelan, who teaches national and global health law at Georgetown.\nKates, of the Kaiser Family Foundation, concluded, “You would not look to the \nUnited States as a case study of how to do this well. The U.S. has in the past, and \ncould in the future, shown tremendous leadership in health crises. ... The fact that \nwe couldn't do it in this case — it is depressing, as a global health person.”\nHarvard’s Jha, who said he’s long championed some flexibilities in the U.S. \nhealth system compared to nations with socialized health care, said he’s come to \nReleased by Chairman Rand Paul\n889his own grim conclusion about America’s often scattershot response to \ncoronavirus.\n“We may end up being the worst of any country in the world in terms of our \nresponse,” Jha said. “Italy… they're going to do way better than us.”\nContinued press activity around my comment about NFL likely not being able to play in \nthe Fall inless in a bubble.   Causing a big uproar with crazies saying I did this so as to \nhurt Trump since he needs “return to normal” to get re-elected.\nDid a Q and A by Zoom with the Directors of all of the Smithsonian Institutes (>12) on \nCOVID-12.   Good back and forth.\nMark Meadows called me about helping with a friend of his hospitalized in NC with \nCOVID-19 and compliating bacterial pneumonias\nHBO is going to do a scripted series about me:\n‘Outliers’ Anthology Series From Brian \nGrazer & Malcolm Gladwell In Works At \nHBO Max With Dr. Anthony Fauci As \nFirst Subject\nBy Nellie Andreeva\nNellie Andreeva\nCo-Editor-in-Chief, TV\n@DeadlineNellie\nMore Stories By Nellie\n▪NBC Commits To Filming 5 Pilots This Year, Rolls 5 To 2021 As ‘La Brea’ \n& ‘Debris’ Get On Path To Possible Series Orders\n▪‘Perry Mason’ Draws Largest Premiere Night Multi-Platform Viewership \nFor HBO Series In Almost 2 Years\n▪‘The Young And The Restless’ Eyes July Production Restart Date\nVIEW ALL\nJune 22, 2020 9:43am\nReleased by Chairman Rand Paul\n890•Facebook\n•Twitter\n•Print\n•Email\n•Show more sharing options\nSage Grazer/Celeste Sloman/Shutterstock\nEXCLUSIVE: HBO Max has put in development Outliers , an anthology \nseries based on Malcolm Gladwell’s New York Times bestselling book. It \nhails from Brian Grazer, Imagine Television Studios and CBS Television \nStudios. Greg Walker, showrunner of the DC Universe series Titans, will \nwrite and executive produce the series, with Gladwell also executive \nproducing.\nOutliers  will take a detailed look at why people are successful, what \nmakes them successful and at what cost. Part historical drama, part \nbiopic, each season will profile individuals through an unique lens, \nlooking at the specific historical situation which led to their outsized \nimprint on society and what ultimately makes them an Outlier.\nReleased by Chairman Rand Paul\n891Kayleigh continues to make a fool of herself on TV with ridiculous answers to questions.\nPRESS:   Interview with John Lauerman (Bloomberg News – London); WNYC \nNPR Radio with Brian Lehrer; Radiolab Public Radio Interview podcast Jab \nAbumrad; ESPN 98.7 Radio Interview (30 minutes)\nJune 23, 2020 – Global – USA\nBig day today with House Energy and Commerce Hearing on COVID-19.   Me, Redfield, \nHahn, Giroir.   \nVP called me at 10:00 AM when I was driving with Farncois to the Hearing.  He called \nfrom Air Force 2 (on way to Wisconsin) and we spoke for 25 minutes.  He wanted to \nknow if I needed anything.   He is a good guy, but he was really calling (sub-text of his \nwords) to urge me to go lightly in my explanations and to not forget to bring out some of \nthe positive things that are being done.   He still is a guy with the glass half full and not \nhalf empty.   He even admitted this in the conversation.\nHearing was very long (6 hours).  I had some cantankerous exchanges with Rep. \nMcKinley (R-WV)  who was giving me shit about saying early on that we should not \nwear masks to save them for the HCWs at a time when there was a shortage.  I said “Ok, \nwe are going to play that game”   This went viral on social media.   Also, I sqwitched in \nthe middle of the Hearing from a black mask to a Washington Nationals mask, which \nwent viral and 2 days later led to a big photo of me with the Nats mask in the Sports \nSection of the Washington Post.\nPOTUS tweeted about me right before the Hearing:\nReleased by Chairman Rand Paul\n892And so now I am his friend when he sees that I have high approval ratings.   Totally \namazing!!\nPRESS:  Winston Salem State Radio Podcast with Chancellor Elwood Robinson – \nWSSU – Future Focus Now, WSNC 90.5\nJune 24, 2020 – Global – 9,000,000/470,000;  USA – 2,350,000/122,000\nBased on my discussions last night with David Barr and the group he brought together of \npeople in the trenches of COVID-19 in NYC, New Orleans, DC, Seattle and Chicago, it \nis clear that the surge is caused by people opening up and throwing caution to the wind \nleading to community spread.   We (me) say that in orde to contain these increases in \nnfection that will inevitably occur when you open, we need to identify, isolate and \ncontact trace.   They are saying that this doesnot work.   Contact tracing is a sham.   It is \ndone by phone, people do not trust government, there is no isolation after the tracing \nReleased by Chairman Rand Paul\n893when tracing does occur and people go right back into multi-generational homes and \ninfect the vulnerable.   \n     This was confirmed in 2 conversation that I had with Mak Ghaly the Secretary of \nCalifornia HHS.   Here is his e-mailfrom today:\nHi, thanks for talking this morning and including me in on this \nconversation. \nIn Califronia, we have built up a statewide contact tracing platform \ncalled CALConnect and we are on our way to have nearly 10,000 contact \ntracers throughout the state as our phase I program.  This said, \ncontact tracing can be improved by\n1) increasing the availability of disease investigators skilled at \nconducting the initial deep dive into an identified case \n2) hiring an army of contact tracing workers who look like the \ncommunity they work in and speak the same language as those they are \nworking to contact trace and support \n3) must fund and make widely available safe places for supported \nisolation and/or quarantine- underused hotels make sense. \n4) must help fund two weeks of wage replacement so that low income \nindividuals don’t have to make a short term choice between feeding \ntheir families or spreading coronavirus. \nIn my view funding these ideas at the federal level is a way to do both \ncommunity stimulus and response with one single investment strategy. \nI will report this to the TF.   I am afraid that we are not equipped to handle resurgences at \nthe community level.\nDid taped briefing to the US Conference of Mayors.\nDeb and I realize that Bob redfield is over his head and not really mounting an adequate \nresponse.   He is passive.   Good guy, but not fit for the job.\nPRESS:  NPR “Morning Edition” – Rachel Martin;  Front page story and picture of \nme in Washington Post and New York Times about the House Hearing yesterday;  \nNPR Sacramento CapRadio – Sammie Caiola – Facebook Live\nJune 25, 2020 – Global   USA\nCalled Deb this AM trying to figure out how to stop this disaster.   Contact tracing does \nnot work.   We need pooled testing.   She will talk to Jared and I offered to call Mark \nMeadows.  Spoke with Mark for 20 minutes at 7:45 AM.   I laid it on heavy and he \ngets it.   He will call an emergency meeting at the WH and agrees that we need to do \nReleased by Chairman Rand Paul\n894pooled testing.  I told him that our response regarding contact tracing and isolation was a \n“Fucking disaster and an abject failure”   Also, he fully appreciates that the CDC is not \nup to the task.   They cannot respond o a domestic or global pandemic.\nHad good conversation with DeMaurice Smith Director of the NFL Players \nAssociation (NFLPA). I clarified the misunderstanding re: my saying there will not be \nan NFL this Fall/Winter.\nDid 1.5 hour Zoom with CondeNaste led by Anna Wintour.   This is the overarching \norganization of mlost of the major magazines such as Vanity Fair, Wired, Self, Vogue, \nBon Apetit.\nI have been invited to appear on Dancing with the Stars  – no thanks!\nPRESS:  Toronto Radio KISS 92.5; picture of me with my Nats Mask in the Sports \nSection of the Washington Post\nJune 26, 2020 – Global – 9,300,000/480,000;   USA – 2,420,000/125,000.  40,000 new \ncases yesterday, the most for a single day.\nSpoke woth Gary Bettman, Commissioner of the NHL giving advice about their opening.\nMy talk with Mark Meadows yesterday precipitated a major firestorm of \ndisagreement in the WH.   Some elements led by VP and his staff (particularly Katie) \nfelt we should have a TF meeting and then have a Press Conference with me and Deb \nleading and run by the VP.   Apparently, Kayleigh and Alyssa and the POTUS team \n(probably Jared and the economy team) were against this.   Triggered much rancor, but \nfinally we did it.   Clearly, the lines are dividing in the WH.  Clearly, I am precipitating \nthis since Deb still cannot get herself to speak up even though she lives in the WH.   At \nthe Press Conference, unfortunately, the VP continues to stress the bright side about \nhow well we have done when the southern part of the country is on fire.   I came in \nand spoke of the danger to the entire country even though the map looks like there are \nmore good parts than bad parts of the country.   I stressed that we are a heterogeneous \ncountry, but we are not disconnected within the country and an outbreak anywhere is a \ndanger even to those sections that have done well.   I stressed that the young people have \nboth a personal and a societal responsibility.   If they get infected, they are feeding the \ndynamics of the outbreak and are part of the problem, not part of the solution.   It is up to \nthem.\nThe press killed the VP following the press conference saying that he did happy talk \nwhen the country is in serious trouble.   They are correct.   At least the press that I added \na reality check to the story.\nReleased by Chairman Rand Paul\n895Had out Security team over the house for a “separation party” since they are being \nwithdrawn since the death and violent threats have decreased over the past 2 weeks.   \nTeam leader George Adams plus Andre Jacobs, Ken Marty, Brett Rowland, Mike Salva  \nHad a wonderful time.   We had really bonded with these guys over the past few months.\nPRESS:   Much press associated with my remarks at the press conference today.   \nWill spill over to tomorrow;  Meg Tirrell of CNBC will show parts of our interview \ntoday with the Milken Institute; Interview with Elizabeth Cohen (CNN) for the \nAspen Institute and Aspen Ideas – she will use this for CNN tonight.\nJune 27, 2020 – Global – 9,700,000/494,000;  USA – 2,500,000/125,000;   45,000 cases \ntoday – highest amount ever.   Florida is having increased hospitalizations as is Arizona \nand California.   \nClear, there is a SERIOUS PROBLEM.  \nDeb, Bob Redfield, Steve Hahn and I had a Zoom call that Deb and I arranged.   It is \nclear that we need to change strategies and rely (see above) on massive community \ntesting and effective tracing in person and on foot at the community level.   Our efforts \nhave failed for a number of reasons.   Bob still insisting that there were likely these many \ninfections all along, but we were missing them since many were asymptomatic and now \nwe are picking them up.   That is crazy since there are more hospitalizations and the \npercent positives of testing are increased in several states.   The VP saying yesterday that \nwe are doing really well becomes more ludicrous.   There will likely be 100,000 cases per \nday by August.\nCliff and I will try to help out Deb by getting NIH-funded elements to help in the \ncommunity testing.\nReleased by Chairman Rand Paul\n896PRESS:  Stories from yesterday’s disastrous press conference.\nJune 28. 2020 – Global – 9,66,000/492,000;   USA – 2,500,000/126,000;    5th day in a \nrow of new record set for number of daily cases.\nPence (inexplicably) continues on TV to say we have done very well and ours is a \nsuccess story.   He is getting blasted.   I have been completely blocked from TV by the \nComms team at the White House.\nReleased by Chairman Rand Paul\n897Next couple of weeks will be critical as hospitalizations increase.\nVP is finally wearing a mask.    Believe that Deb likely convinced him\nPRESS:   Interview with Apoorva Mandavilli of New York Times on “pooled \ntesting”;  Wolf Blitzer showed an interview of me by Elizabeth Cohen as part of the \nAspen Ideas Festival in a Special Sunday Night Edition of the Situation Room.\nJune 29, 2020 – Global – 10,000,000/500,000;   USA – 2,550,000/127,000\n47,000 new cases yesterday.  50% of all new cases from CA, AZ, TX, FL.   Clearly big \nproblems with resurgences very likely related to young people at bars and in big parties \nrelated to opening, Memorial Day and crowds.   Mostly young people with average 1.5 \ndecades younger than a couple of months ago.\nGovernors’ call in Sit Room with VP leading the call.   Clearly, they get it now and are \nworried.   I spoke about making the public health response to vehicle to re-opening as \nopposed to the obstacle to re-opening, i.e. obey guidelines and always use mask and \nphysical distancing even when opening.\nGov Ray Cooper (D-NC) called me and spoke for 45 minutes on his dilemma about \nwhether to open the Charter Schools that are scheduled to open in 2 weeks, right after 4th \nJuly.   He was agonizing since he wanted to do the right thing.   Since this is the first \ndecision among Governors regarding opening for the Fall term, he feels that he will be \nthe example.   He is seeing an uptick of cases and he is near FL and so is worried that if \nhe opens, he may have to lose again if he gets surge like FL and TX,  I recommended that \nhe delay decision for 2 weeks.   His health officer is Mandy Cohen.\nHad important conversation with Pence  right before the afternoon task Force meeting.   \nI came early and walked up to VP suite and luckily he was sitting in his office with Marc \nShort and ? Natalie.   I told him that I am being blocked from TV and I needed to get on \nTV to give the ‘risk reduction” message and that I would avoid being pitted against him \nor the POTUS merely by not playing that game.   I mentioned the recent interview on \nNPR with Michel Martin where she asked a Fauci versus Pence/Trump question and I \nresponded that this was not helpful and I was there as a health official and not to get into \npolitics.   Michel gracefully backed down.   I also told him about the dangers of having \nme and others on stage with him when he talks happy i.e. glass half full as opposed to \nglass half empty.   He got it, but still wanted to do press conferences with us.   He did \npromise that he would get me out there on TV since he really liked my message.   First \ntime anyone ever spoke that way to VP.  He truly likes me a lot (and vice versa).  Now \nwe have to get the POTUS press people to agree.  Interesting intrigue in the White House.  \nPOTUS people versus VP people.   Katie and Marc are all with me.\nReleased by Chairman Rand Paul\n898PRESS:   FOX Radio and podcast (National)\nJune 30, 2020 – Global – 10,000,000/500;   USA – 2,600,000/127,000.   37,000 cases \nyesterday.   Multiple other states (total of 31) are showing increased cases and several \nshowing increased hospitalizations.\nTestified at the Senate HELP Hearing chaired by Lamar Alexander (R-TN) and \nranking minority  Patty Murray (D-WS).   Focus was on opening schools, but it became \nfree-wheeling.   Elizabeth Warren was her usual muted hostility towards me, probably \nsince she is aiming to by Biden’s VP and she wants to she she is tough on administration.   \nAlso, Rand Paul was his usual self obliquely accusing me of  arrogance and conceit in \nmaking projections without data.   He referred to my discussing whether Sports could \nopen.   Actually my responses won him over and he gave me a big wave and smile when \nhe left the hearing room.   Rest of the hearing went very well.   I predicted that if we do \nnot do something about the recent surge that the entire country is in danger and we could \nreach 100,000 cases in a single day.   This made NY Times immediately online.  I said \n“Bars are bad news”.   Outdoors better than indoors.\nIn a speech today, Joe Biden said that if he is elected POTUS one of the first things he \nwould do in addressing COVID-19 is to reah out to me and ask me to continue my \nleadership role in this effort and “join his administration”.  Clearly, this will piss off \nTrump and the White House.\nReleased by Chairman Rand Paul\n899PRESS:   Much media coverage of the Hearing today.\nJuly 1, 2020 – Global – 10,200,000/504,000;  USA – 2,620,000/128,000.   Most involved \nstates now pulling back on opening and closing bars and cancelling events for the \nupcoming 4th July.   Spoke yesterday with Marc Khaly from California (see above).  He \nis going to cancel all crowding activities over the weekend.   He calls me regularly for \nadvice.\nNews reporting that there is now a schism in the White house with Trump, meadows, \nKayleigh and Hope leaning towards economics and deeply suspicious of me versus the \nVP and his team (Katie, Fevin O’Malley) favoring me and being much  more realistic \nwith the VP for the 1st time wearing a mask regularly.   Media speculating that Penceis \nnow thinking about his own political future and wants to be on the right side of history.   \nMy relationship with Pence getting much stronger.\nReleased by Chairman Rand Paul\n900Laura Ingaham (FOX) is now spreading conspiracy theory (Huff Post) that I am actually \n“Medical Deep State” and am actually going to be Joe Biden’s running mate:\nLaura Ingraham Spews Yet Another \nWild Conspiracy Theory About Anthony \nFauci\nThe Fox News personality called the nation’s top infectious disease expert “Dr. Doom” \nand criticized him for “undermining Trump’s agenda.”\n-------------------------------------------------------------------------------------------------\n------------------------------------------------------------------------------------------\nI reached out to Congressman Joseph Kennedy (D-MA) since we had a garbled \ninterchange at the House Hearing last week  and it looked like he was annoyed with me.   \nI wanted to set the record straight and develop a relationship with him.   I was good \nfriends with great uncle Teddy.   We had a Zoom conversation today for 30 minutes and \nit was terrific.   I believe that this is the beginning of a friendship.   He was very gracious \non the Zoom.\nHad dinner over Jake Tapper and Jen Tapper’s home in DC.   Terrific couple.   \nFriendship building.\nReleased by Chairman Rand Paul\n901PRESS:  Front page Washington Post  story on my statement that we could get \n100,000 cases/day if we do not control the outbreak. NPR – All Things Considered – \nMary Louise Kelly;  BBC Radio Morning Show\nJuly 2, 2020 – Global   USA\nBig problems - >53,000 cases yesterday.   Highest ever for a given day.   I am concerned \nthat we might be on “exponential” increase as we enter into the 4th of July weekend.   \nPOTUS and his people have essentially dropped out and do not even recognize that an \noutbreak is ongoing on.  They are denying all requests for me to appear on any major TV \nprograms.\nCaputo is a con man who is completely full of shit.   He says he wants me out there on \nTV and yet I am being blocked, very likely by him who knows nothing about public \nhealth.  He is a close friend on Roger Stone, for goodness sakes!\nGot call from Ross (POTUS speechwriter) who wants to include in a speech the \nbeneficial effects of remdesivir and dexamethasone in advanced disease and even \nmortality.\nPhone Call with Rev. Jesse Jackson, Sr.       \nPRESS: BBC The World Radio Program; SiriusXM NFL Radio; Multiple outlets \nquoting things that I said on BBC, Harvard Business Review and other podcasts\nJuly 3, 2020 – Global – 10,5000,000/513,000;  USA – 2,750,000/129,000\nMore daily record being broken with cases now at 57,500.\nReleased by Chairman Rand Paul\n902Caputo (sleezebag) and White House comms playing games with me in that they are not \nallowing me to go out on TV as we enter the 4th July weekend to instruct people on how \nto avoind infection.   They do not respond to multiple requests for me to appear.   I spoke \nyesterday to Judy Woodruff (PBS NewsHour) and Andrea Mitchell (NBC News), bot of \nwho want me on their show as does Jim laCosta (CNN).  \nRep. Andy Biggs (R-AZ) and LtGov Dan Patrick (TX) attacking me for what I am saying \nabout how to avoid infection.   Dan Patrick denying that TX skipped over checkpoints in \nopening and accused me of lying about this.   I never specifically said they did.   I said \n“some states” skipped over guidelines”  Guilty conscience??  CNN did a fact check and \ncalled him out as completely incorrect. \nInteresting exchange involving Michael Caputo, me an Alyssa Farah.   Michael is full of \nshit, for sure.   He claims to be trying to ge me on TV saying that the WH is blocking.   \nAnd so   I wrote an e-mail to him with copy to Alyssa today:\nMichael:\n   I am sorry to disturb you on this holiday weekend, but I feel compelled to \nagain reach out to you.   As you are painfully aware, our country is in a very \nserious situation with resurgences of COVID-19 cases in multiple states at \nrecord levels.   I believe that it is our moral responsibility to get out the \npublic health messages about personal and societal responsibility to urge \npeople (particularly young people) to protect themselves and others from \ngetting infected as we enter the holiday weekend.  Messages from public \nhealth officials like myself and my colleagues are critical to this effort and \nwill save lives.   As you know, I have been asked by virtually every network \nReleased by Chairman Rand Paul\n903and cable outlet to get out there and deliver this potentially life-saving \nmessage.   Yet every single one of these requests of late, which we re-submit \nevery day, has been ignored or denied.   We are missing an opportunity to \nsave lives.  Please consider this.\nBest regards,\nTony\nAlyssa immediately texts me with the following:  “Hey, Dr. Fauci, just \ngetting up to speed. WH comms is supportive of you going out, which I’ll \nconvey to Caputo.   What programs do you think make sense?   I think it \nwould make sense to add you into the Sunday shows and then look at \nnetwork TV next week”.  \nI tell her my choices and then she texts back:  “I’ll get with your team and \nlock some of these in.  Apologies for this happeneing again”.  \nI had told her that my choice would be Meet the Press. They then tried toget \nme on MTP, but they were already booked up.   \nJuly 4, 2020 -   Global – 11,000,000/525,000    USA – 2,800,000/130,000\nAndrea Mitchell called my cell very apologetic  about not being able to have me on the \nshow since they already booked a couple of governors who were giving exclusives to \nNBC.   I mentioned to her my concern about them keeping me off the air.   She was \nshocked and thought that when I did not come on after requests that it was because I did \nnot want to go on a show.\nIt is clear that Michael Caputo in totally full of shit.   The WH is now saying that they are \ngiving the ball back to Pence to decide what happens with COVID-19 and that there will \nbe more media appearances from health experts.   We shall see.\nFlorida had 11,000 cases yesterday.   Everything is surging.\nJuly 5, 2020 – Sunday – Hahn on 2 Sunday Shows.   I am blocked (see above).  Surges \ncontinue in multiple states with new records every day.   Particularly FL.   In NY Times \nthis AM, comment about people in some states, particularly TX (Dan Patrick – Lt. Gov as \nan example) are making me the symbol of what they are tired of.   Theyare saying to hell \nwith the outbreak, “we are done with it”, even though people are getting sick and \nReleased by Chairman Rand Paul\n904hospitalized.   POTUS had 4th Juy celebration on South Lawn (I and Chris were invited) \nthat was crowded and no one wearing masks.   I did not attend.\nNot just USA, there are major outbreaks in Brazil, Mexico, Asia (Japan, North Korea, \netc).  \nI have been having several 30 minute deep background conversations with Bob \nWoodward who is writing a book on the Trump response to the outbreak.\nMargaret Brennan on “Face the Nation”  came out and explicitly said that the Trump \nadministration was blocking my appearing onTV including their show where they \ncontinually ask for me and have been refused.  \nThis clearly triggered a response either/or in HHS and the WH because Caputo texted me \nin the afternoon and asked what my priority shows would be for next week.    I said \nNewsHour with Judy Woodruff and Today with Savannah Guthrie.   Savannah would be \non vacation and so we went with CNN Town Hall with Sanjay Gupta and Anderson \nCooper.   We shall see what actually happens.\nJennifer Rubin wrote column in Washington Post:\nDistinguished person of the week: Fauci \nfinally breaks through\nReleased by Chairman Rand Paul\n905Opinion by \nJennifer Rubin\nColumnist\nJuly 5, 2020 at 7:45 a.m. EDT\nIn Senate testimony and interviews, Anthony S. Fauci, director of the National Institute \nof Allergy and Infectious Diseases, sounded the alarm: We are not winning in the battle \nagainst the novel coronavirus. Even more important than that was his insistence that we \nall wear masks in public. Consider what he told the Senate Committee on Health, \nEducation, Labor and Pensions on Tuesday when Sen. Bernie Sanders (I-Vt.) asked if \nmasks should be given away for free: “There’s no doubt that wearing masks protects \nyou,” Fauci said. “Anything that furthers the use of masks, whether it’s giving out free \nmasks or any other mechanism, I am thoroughly in favor of.” \nPresident Trump has been the main impediment to mask-wearing, choosing to turn a vital \npublic health measure into a sign of tribal identity. Fauci nevertheless has persisted in his \nmessage.\nThis is hardly the first time Fauci has tried to get Americans to adopt the simple, \nlifesaving practice. (“Everybody should wear a mask when out [in] public,” he said in \nJune. In late May he told CNN, “I want to protect myself and protect others, and also \nbecause I want to make it be a symbol for people to see that that’s the kind of thing you \nshould be doing.” The advice took on fresh urgency as he warned that the country could \nexperience as many as 100,000 new cases a day.\nThe Post interviewed Fauci and other health experts about wearing masks. He was \nunequivocal. “It dominates everything I do. The only time I don’t wear one is when I am \nalone, when I am home with my wife, or when I am speaking in public — provided there \nis 6 feet between me and the people to whom I am speaking, as was the case when I \nanswered questions at the recent congressional hearings.”\nLast week the rate of infections spiked past 55,000 in a single day, and suddenly \nRepublicans who had pooh-poohed mask-wearing and echoed Trump’s disdain for masks \nwere speaking up. Senate Majority Leader Mitch McConnell (R-Ky.) finally proclaimed, \n“We must have no stigma, none, about wearing masks when we leave our homes and \ncome near other people. Wearing simple face coverings is not about protecting ourselves, \nit is about protecting everyone we encounter.” Too bad he didn’t say that months or \nweeks ago — or tell Trump to stop discouraging mask use.\nWe seemed to reach a tipping point when Texas Gov. Greg Abbott (R) finally put out a \nstatewide order requiring masks. Other states fell into line as the infection and \nhospitalization rate soared. Arizona Gov. Doug Ducey (R) issued a shutdown order and \nReleased by Chairman Rand Paul\n906encouraged mask-wearing as the virus threatened to overwhelm his state’s hospital \ncapacity. Pennsylvania , Oregon and Kansas also implemented state mandates on mask-\nwearing. Even Vice President Pence — who refused to wear a mask when visiting the \nMayo Clinic in late April — during his visit to Arizona called on Americans to wear \nmasks.\nIf only Republicans had listened to Fauci months ago, the U.S. death count  might not be \nroughly 130,000 and the pandemic might not be surging in states where leaders shrugged \noff mask-wearing and prematurely opened. This is, however, a case of better late than \nnever.\nBy successfully cajoling lawmakers and ordinary Americans to wear masks, Fauci will \nsave thousands of lives before a vaccine is ready. For his constant efforts, defying and \nultimately breaking through the deadly fog of the Trump cult, we say, “Well done, Dr. \nFauci.”\nJuly 6, 2020 – Global    USA\nRecords continue to be broken in various states.\nDid a COVID session virtually at the IAS with Slim Karim and Deb Birx.\nTask Force meeting at WH.  VP still focuses on fact that despite the increase in cases, \nthe deaths are still down.   I mentioned to him that I did not think that the deaths will ever \nreach the degree (>2000/day) that it was when NYC was surging, but increased cases will \nand are leading to increased hospitalizations.   Wrong Direction.\nWashington Post : Coronavirus updates: Seven-day \naverage case total in the U.S. sets record \nfor 27th straight day\nBy Derek Hawkins, Marisa Iati  and Ja        cqueline Dupree\nJuly 5, 2020 at 10:14 p.m. EDT\nReleased by Chairman Rand Paul\n907\nReleased by Chairman Rand Paul\n908PRESS:  Profile interview with the Financial Times; Philly Beaumont Radio The \nTimes of London; KCBS Radio San Francisco;  Clips of me on CNN\nJuly 7, 2020 – Global -  11,300,000/532,000;  USA – 2,900,000/130,000\nDid press briefing via Zoom in Alabama with Sen. Doug Jones (D-AL) – went very well.\nHere we go again.   Got call from Francis Collins who got a call from Marc Short who \nsaid the WH is upset with me because I gave the interview with Sen. Doug Jones (see \nabove) and he is a Democratic Senator is a tight race with a Republican and they are \nsuspicious that I am favoring the Dems.  BTW, the interview was approved by HHS Leg \nand ASPA.\nCaputo called saying that the WH was just going to approve the requests for me to appear \non NewsHour and CNN, but because I said that relying on decrease deaths to say that all \nis well with COVID-19 is a “false narrative” and we should not be complacent … I said \nthis on the Sen. Jones interview.  Now the POTUS is also tweeting that I am wrong on \nthis as I have been wrong on many things including masks and closing down travel, \nwhich is complete bullshit.\nPRESS: Interview with Denise Grady of New York Times regarding Moderna \ntension; Corriere della Sera Italina newspaper – Giuseppe Sarcina; ABC News \nFiveThirtyEight Podcast – Anna Rothschild;\nReleased by Chairman Rand Paul\n909July 8, 2020 – Global 11,500,000/536,000;  USA – 3,000,000/131,100\nTF meeting at the Dept. of Education – I was in Sit Room and not part of the press \nconference that followed.   Purpose of the TF was to push for opening of schools.  Good \nthing that I was not part of the press conference (Deb, VP, Sec. DeVos) since much \nnegative public response.  Clearly Trump is pushing to open the schools no matter what.   \nThere is concern about the safety of the children and teachers.   Yet, Trump together with \nRedfield (being pressured) is saying that the CDC guidelines should not stand in the way \nof opening schools (what???).   Glad that I am not involved in that discussion.\nSpent 1 hour on Zoom with Sean Penn and his organization – CORE – coronavirus \nrelief.   Great conversation.  They provide testing in various cities and wanted my opinion \nof how they can optimize their impact.   I strongly advised them to focus on a process \nthat has an impact and endpoint, not just testing to increase the numbers.   I \nrecommended that they work with cities (like LA, Atlanta) that can utilize their efforts to \nactually do effective identification, contact tracing, and isolation.   Sean and his group \nwere very grateful for the time that I spent with them.\nTension building up with the press (especially CNN) stressing Trump versus Fauci. \nTrump tweeting negative things about me.  When asked about my comment of “false \nnarrayive”, he said I am wrong on a lot of things.  He said that I said not to shut down \nChina (this coming from Peter Navarro) (when I actually said to shut it down).  He is also \nsaying that I was against masks before I was for them.   Someone is obviously feeding \nhim this shit.\nCaputo told me that I am being kept off TV (even though they were leaning to approve \nrequests) because of my comment about “false narrative” concerning relying on deaths \ngoing down.\nEven some crazy stuff on the Dark Web about Chris saying that she is Ghislaine \nMaxwell’s sister:\nThe debunking is under way! \nReleased by Chairman Rand Paul\n910PRESS: Wall Street Journal podcast – Kate Linebaugh; Sirius Radio “Doctor \nRadio” – Marc Siegel\nJuly 9, 2020 – Global   USA\n>60,000 new cases yesterday!  Things not going in the right direction at all, yet continued \nhappy talk from the VP and the White House.   Clearly I am the “skunk at the picnic”.\nReleased by Chairman Rand Paul\n911Bob Redfield defending the fact that Trump forced CDC to change guidelines that Trump \nfelt was too strict to open the schools.   Bob is losing a lot of credibility.   Trump wants to \nopen the schools at all costs.   Clearly he does not care about the safety of the chidren,\nReleased by Chairman Rand Paul\n912PRESS:  Hill TV with Steve Clemons – The Future of Healthcare; Press conference \nat IAS on COVID-19; CNN continues to quote me in opposition to Trump and as \nthe ony person telling the truth.\nJuly 10. 2020 – Global – 12,000,000/546,000;    USA – 3,110,000/133,000\nAnother record day with 68,000 cases.   Approaching my prediction of ~100,000. \nImportant meeting with Pence who asked to see for 20 minutes before today’s Task \nForce meeting.   He obviously is concerned over the press making an open conflict \nbetween me and Trump.  He explained how much respect and affection he had for me.   \nHe then asked me for advice about how we are doing.   I said that I would be coldly \nhonest with him.   He agreed to accept that.   I then told him that he is completely losing \ncredibility when we have >60,000 new cases with increased hospitalizations and deaths \nand he starts off at the Pressers saying “We are in a good place”.   I stressed that it would \nbe best to establish credibility first by coming out right off and saying we have a big \nproblem, but we are trying to address it in the Southern states that are involved as well as \nprevent such resurgences in other states.   Then and only then could he say that we are in \na better place and shape to respond than we were before.   BUT, you must admit the \nproblem first.  He agreed and was clearly grateful that I was open and honest with him.   I \nthen told him that 19 years ago in this same room I sat with VP Cheney to discuss the \nAnthrax attacks.  I have a photo of Cheney and me right here   Pence asked where in the \nroom I did this with Cheney and where was the picture taken.   He then called in the WH \nphotographer and took a photo of exactly where Cheney and I were sitting.   He seemed \nto really enjoy that historic context.   At the end of the TF meeting, he again thanked me \nfor his conversation.\nAlso, Mark Meadows called me and asked that we meet next week to straighten out the \nconflict between me and Trump.   We shall see how that meeting turns out.   I see him on \nMonday.\nPRESS:  Podcast with American Dissected; CNN (especially Don Lemon, but also \nseveral others at CNN) hammering away at the Fauci versus Trump issue.\nJuly 11, 2020 – In USA – 3,300,000 cases and 136,000 deaths.   Numbers still soaring \nwith ICU beds filling up in Florida.   \nHeard from Washington Post (Jasmeen Abutaleb) that she is writing a big article for \ntomorrow (Sunday) about the conflict between me and the POTUS.   Yikes!   Let us see \nhow that turns out.\nReleased by Chairman Rand Paul\n913Had call with Marc Ghaly Heath Commissioner from California (Los Angeles) wanting \nadvice about how to respond to the surge of cases in California.\nJuly 12, 2020 – Cases still soring.  Florida >13.500 today\nBig firestorm over the Post article and the fact that unspecified White House officials \nhave compiled a list of things I said that were incorrect.  This is oppositional research \nagsinst one of their own (me).   The blowback has been incredible.   I have been \ncontacted by virtusally every reporter (Post. NY Times, mutiple CNN – Sanjay Gupta, \nJim Sciutto, networks) that I have ever dealt with and they are consistently outraged by \nthe disinformation campaign of the WH against me and the attempt to discredit me .   \nThey all want to help.\nI called up Marc Short (whom I trust) to ask his take on this.   He was “embarrassed” \nand disturbed by this action by the White House.   He believes that it could not have \nhappened without Mark Meadows’s buy in and approval.   This shows the schism \nbetween the VP’s people and the POTUS/Meadows people.   Marc was quite disturbed \nthat this is going on.\nAlso, Brett Giroir tried to throw me under the bus on Sunday TV saying that I am not \nalways correct – playing into the discrediting scheme.\nSign (below) photo sent to me from Sylvia Burwell.\nReleased by Chairman Rand Paul\n914a\nPRESS:  Big deal – Front page story in Washington Post: “White House sidelines an \nincreasingly candid Fauci” by Yasmeen Abutaleb, Josh Dawsey, and Laurie \nMcGingle – much comment about this on the Sunday Shows.\nJuly 13, 2020 – Global   USA\nYesterday Florida had >15,000 infections – most for any state since the beginning\nMet with Mark Meadows.   He denies knowing anything about the WH drive to \ndiscredit me.   This is tough to believe in that multiple nerws outlets (networks and \nCables0 have been given a list of my “mistakes and errors” directly from the White \nHouse.   No way that he did nt knw abut it.   Nonethelerss, he said he will make sure that \nit stops.   Too late, they already did the character assassination.\nMajor, Major show of support for me for multiple and varied sectors.   Most peole \nexpressing outrage that the trump administration woud be so bumbling and incompetent \nto try to discredit the most credible scientist in the world.\nReleased by Chairman Rand Paul\n915Gave Fireside Chat Podcast for Stanford Univerity MC’d by Lloyd Minor, dean of \nStanfod Medical School.\nMet virtually with Mark Lerner and officials from Washinfgton Nationals to discuss \npotential obstacles to their opening at Nats Stadium on July 23.   I will throw out the first \npitch.\nAnother all with Dionne Warwick about COVID-19.   She is advising Biden people.\nChris Cuomo on the top of his show blasts Trump administration regarding trying \ntodiscredit me.\nPeter Staley blasts Trump regarding me on Anderson Cooper 390 (CNN)\nPRESS:  TV and print have flooded the media in support of me and condemnation \nof the Trump administration.\nOpinions\nFauci has been an example of \nconscience and courage. Trump \nhas been nothing but weak.\nReleased by Chairman Rand Paul\n916A sign outside a home in Rockport, Mass., reads \"In Fauci We Trust.\" (Brian \nSnyder/Reuters)\nOpinion by \nMichael Gerson\nColumnist\nJuly 13, 2020 at 5:09 p.m. EDT\nJuly 14, 2020 -   Global -  12,800,000/568,000;  USA – 3,400,000/136,000\nOutbreaks still raging in Florida – records being broken.  >60,000 cases yesterday\nDeep state is going more crazy than ever in attacking me as the academic community is \nmobilizing to defend me.   Real crazy.   See below:\nReleased by Chairman Rand Paul\n917I did a fireside chat online at Georgetown hosted by John Monahan.   It was taken up \nmy multiple press including C-SPAN, which then fed into CNN and other networks.   It \nwas a good venue for my getting the message out.\nPhone call with Alyssa Farah.   She apologized profusely about the “screw up” with her \njunior staff who put out the list of how I got things wrong.  She admits that it only hurts \nthe POTUS to disrespect me and question my credibility.  I told her that the White House \n(either Meadows or the POTUS) need to shut up Stephen Moore and stop his publication \nof “Dr. Wrong” paper.   If he does not the entire academic community will dump all over \nthe POTUS.\nPeter Navarro wrote OpEd in USA Tosday saying everything that I have ever said was \nincorrect.\nI went on a Goergetown Fireside chat (see above) and in ashort sentene I said that the \ncurrent outbreak was “comparable to 1918”.   I did not mean in numbers, but for a \nsensitive person, it could mean that I wa predicting 50 million deaths.  Well, tonight \nFrancis Collins  called me up saying that he just got off the phone with Mark Meadows \nwho was screaming at him about what I said.  Mark wanted this “walked back”.  \nClerly Markis vey sensitive about playing down the pandemic because of the ucoming \nelection and anything that indictes that this is a big problem drives him nuts.   I got on the \nphone with Mark (he was still very angry), but I calmed him down and said that I would \nclarify this on my next TV appearance.   He then indicated that he really liked me very \nmuch and respected me and values ou relationship.   I apologized for what happened and \nhe accepted the apology.   Just an example of the tension that the pandemic in the context \nof the upcoming election is causing.\nPRESS: Trevor Noah https://bit.ly/2CyI0tH ; CNN – see above at Georgetown again \nstrongly pitted me against the POTUS regarding a particular statement when I was \nReleased by Chairman Rand Paul\n918asked about “who can we  trust”.   I said “medical and public health experts who \nspeak based on science and data and who tell the truth”.   I said “trust me”.    CNN \ntook that as strongly implying “do not trust Trump”\nJuly 15, 2020 – Global   USA\nContinue record-breaking numbers of cases with increased hospitalizations and now even \ndeaths.   \nThe press are all over the issue of the White House trying to discredit me.   Alyssa Farah \nput out tweet saying that the USA Tody OpEd by Peter Navarro was never cleared or \napproved.\nAdm. Michael Mullen, former Chairman Joint Chiefs called me to empathize and \ngive me encouragement and support.   Very nice of him since I had never met him.  Very \nnice conversation\nThe Lincoln Project put out a vewry provocative Fauci versus Trump link:\nLincoln Project ad https://bit.ly/2AYJAEy  \nDan Scavino retweated this cartoon mocking me.   This caused outrage among my \nsupporters:\nLetter from Congressman Krishnamoorth to AZAR regarding attackes on me: \nReleased by Chairman Rand Paul\n919\n2020.07.15 Letter \nfrom Krishnamoorth   \nAmazing Day!!   The setting is the extreme tension in the press and in the White House \nabout the USA Today OpEd by Peter Navarro and the “list” of my mistakes sent out by \nWH Comms.   On my way by car to the WH for the TF meeting, I received a call from \nthe POTUS.  He started off by saying that this tension of me versus him is terrible and \nneeds to stop.   He “loves” me and know we have a very special relationship and have \nbonded right from the beginning.   He is furious about the Navarro OpEd and said (as \nMark Meadows walked into the room and he put me on speaker phone):  “I am going to \ntell Navarro if he says or writes one fucking word against you I am going to kick his \nfucking ass out the fucking door.   Mark, make sure Novarro understands, one more word \nand he is out the fucking door and he won’t come back”.  He then started to talk to me \nabout how bad or not things were.   He wanted me to be “positive”.   I took the \nopportunity to say”  “Mr. President, with your permission, can I be absolutely frank with \nyou?   We have a problem and we need to own it.  We need to admit that the situation is \nserious, otherwise we completely lose credibility.   We should own the problem and then \nemphasize how we are going to fix it as opposed to denying the problem”.    He was not \nentirely happy with this but said that he understood the point that I was making.   It was a \nvery good conversation.   \nThen after the TF meeting ended, I got a note from the Sit Room staff that Mark \nMeadows was on the phone from Air Force One and wanted to speak with me.   He had \nseen the interview from The Atlantic and was angry that I had not “walked back” my \nstatement about the 1918 pandemic on that interview.   He was again angry and said he \nthought that I agreed that I would walk back the statement today.   I told him I was going \nto wait until tomorrow when I am on the NewsHour with Judy Woodruff.  That was not \ngood enough for him.   He wanted it done today.   He was also pissed that I had \nmentioned to the press that we had met and I spoke about the nature of our conversation.  \nHe was clearly over-reacting since even he admitted the press knew about our meeting, \nbut I do not think I said anything else to them except that we had met.\nAnyway, on the way back to NIH I called Sanjay Gupta and asked him to quote me \ntonight on his TV hit on CNN and say that I wanted to clarify that on the Georgetown \ninterview, I did not mean to imply that COVID-19 would be as bad (50-100 million \ndeaths) as was 1918.  Sanjay agreed to do this.   I texted this information back to Mark on \nAir Force One and he replied: “Thanks for getting back with me.  We are going to make \nthis work.”\nThe media is totally buzzing about the tension between me and White House.   \nAmazing support for me and blowing off of Navarro and the “list”\nPRESS:  The Atlantic Pulse with Ed Yong; Interview with New Yorker Magazine on \nCOVID vaccine with Dhruv Khullar;\nReleased by Chairman Rand Paul\n920July 16, 2020 – Global    USA     Cases continue to surge.   >67,000 cases yesterday.  \nHospitalizations and deaths going up.\nProblem emerging here.  Mark Meadows is starting to be a problem.   He wanted me \nto “walk back” the statement comparing COVID-19 to 1918.   I was planning to do it on \na schedule appearance on NewsHour today (Thursday).   However, Mark called me \nyesterday and was upset that I did not do it already.   He could not wait 1 day.   I said OK \nand called Sanjay Gupta and asked him to quote me on his show and also  write it on his \nblog that I wanted to clarify.   I thought that he did a good job.   Then this AM I get \nanother angry call from Meadows saying the clarification was not strong enough \n(??really).   Then on the phone he went on that I need to back off  with media since this \ncannot be a “Tony Fauci show”.   He did not like the fact that I did an “In Style” piece \nand did not want any more profiles of me.   If that was not enough, he hung up and then \n120 minutes later called and said he read something where I was reported  to say that the \nincubation period was greater than 14 days and wanted me to retract this.   I do not \nremember ever saying that and so he sent me an article where Chuck Todd mentioned \nthat I said that.   I pushed back and got angry myself saying that I never said that and so I \ndo not know what he wants me to do.  I will try to track down that statement.  I also will \nsee if I can state again the 1918 clarification on my Face Book live chat with Mark \nZuckerberg this evening.   Trouble brewing here.   For the first time, I am seriously \nconsidering resigning from the Task Force.   I cannot tolerate people following my every \nword.   You know he has staff looking up things about what I have said in the past.\nTeleconference with Matt Pottinger and Bob O’Brien to discuss opening the travel \nbetween USA and Europe.  Right now there are exceptions for travel for business, but not \nfor tourism.\nPRESS:  Did terrific FaceBook Live with Mark Zuckerberg – 1.8 million viewers;\nJuly 17, 2020 -    Global – 13,400,000/580,000;  USA – 3,600,000/138,000    \nRecords being broken daily.   Yesterday 74,000 new cases.   Hospitalizations and deaths \nincreasing.  \nBig issue – Despite all the walking back stuff regarding the 1918 comment, Mark \nmeadows in an appearance on FOX News and reported by The Hill, Mark Meadows said \nthat my comment was “irresponsible”.   This is really bad.   He is losing control of \nhimself with the screaming at Francis and me and the demanding walking back on trivial \nissues like my comment on 1918 and the “non-issue” about the incubation period being \ngreater than 12 days (which I never said) and now this comment about “irresponsible”, I \nam thinking about resigning from the Task Force.   I called up Marc Short for advice.   \nMark was on Air Force Two with the VP coming back from Wisconsin and could not \nReleased by Chairman Rand Paul\n921respond but called when he landed at Andrews.   He said that he too is having trouble \ndealing with Meadows who is says can be very difficult.   Mark told me to hang in there \nand not do anything drastic just in response to Meadows.   Short was totally supportive \nand clearly indicated that Meadows was a problem for him also.\nDid Chamber of Commerce live podcast – came out very well.\nDid Medscape Podcast with Eric Topol and Abraham Verghese\nDid WebMD with John Whyte\nConcresswoman Maxime Waters called wanting me to directly address millennials.   \nGood conversation.\nCrazy Michael Caputo says he now has total control of approvals for HHS people for TV, \nbut wants a “murder Board” before each appearance since “if we screw up, his job is in \ntrouble”.   Total bullshit since the 1st “Murder Board” for Francis (CNN) and me \n(NewsHour) was a joke with his staff who know nothing trying to question Francis and \nme.\nSlso, Caputo calls me and says that he is takng over the decision about who goes on TV \nand not the White House.   He wants an organized program of equal distribution among \nthe HHS docs.   He sounds delusional.   He is declaring independence from the WH.   \nSyas that they will decide Sunday Show, but nothing else.\nPRESS: PBS NewsHour with Judy Woodruff; New York Times article by Michael \nGrynbaum refute Navarro’s USA Today OpEd with title: “Newspaper Says Op-Ed \nAttacking Fauci Was Misleading”;   Many clips on CNN drawing from Chamber of \nCommerce podcast\nJuly 18, 2020 – Global – 13,800,000/594,000;    USA – 3,640,000/139,000.\nCases continue to surge.   News cycle dominated  by reports of conflict between me and \nthe Trump insiders (see below)\nPetitions from multiple scientific organizations going around to sign on in support of me.\nComm situation becomes even crazier.   Despite Caputo saying that he is now “calling \nthe shots and not the White House (see above), Alyssa Farah called me and said that Jake \nTapper wants me this week and she will put me on for Tuesday.   I explained to her what \nCaputo said and she told me not to pay attention to him since he is a big problem.   She \neven said that it would be better if he stopped tweeting about Roger Stine and \nconcentrated on his job, things would work better.   Anyway, I am caught in the middle.   \nLet us see how this turns out.\nReleased by Chairman Rand Paul\n922PRESS:  Article in New York Times by Mark Leibowich  - “Whats Happening” to \nDr. Fauci is the Buzz.  – Description of the tension against me and for me;  Long \narticle in Washington Post by Philip Rucker, Laurie McGinley, Josh Dawsey and \nYasmeen Abutaleb “Attacks on Fauci undercut response”.  Also article in CNN blog \nby Vivian Salama, Pamela Brown, Kristen  Holmes and Kate Bennett quite critical \nof Birx for selling out to trump and compatring me and Deb; Also another New York \nTimes Article by Giovanni Russonello “Most Americans Put Their Faith in Fauci”; \nBoston Globe by Kevin Cullen: “The Crusader doctor and the non-crusading judge” \n– comparing me from Holy Cross and Chief Justice John Roberts from Harvard – \ncute article\nJuly 19, 2020 (Sunday) -  Continuing surge\nFrancis Collins on Meet the Press – did well.   They continually ask him if WH has told \nhim to fire me.   Francis responded that this is “unimaginable”.   \nJohn Lewis dies of pancreatic cancer\nMany societies are writing statements in explicit support of me.   It isvery moving and \nhumbling.\nKellyanne Conway called me today saying how angry she was at the unseemly criticism \nof me by some in the White House.  She has spoken to the POTUS about this and he is \nstrongly supportive of me\nMark Mradows and I going back and forth regarding his nitpicking every word of mine \non interviews.   Latest was his concern that I said that NYC did a good job in getting back \nto basline and opening safely.   He says NYC did a terrible job and I should not be setting \nthem as an example.   He is incorrect and misunderstood what I was saying.   I meant that \nthey went down to baseline and are not opening safely.   WEgo back anad forth and \nfinally call a truce.\nReleased by Chairman Rand Paul\n923USA Today piece by Gov. Larry Hogan: \nHogan: Governors like me rely \non experts for COVID facts. Dr. \nFauci has never let me down.\nAs Trump downplayed COVID, Fauci offered clear-eyed views of the \nevidence and what we faced. I shudder to think where our country would be \nwithout him.\nLarry Hogan\nOpinion contributor\nPRESS:  New York Times article by Michael Shear, Noah Weiland, Eric Lipton, \nMaggie Haberman, and david Sanger entitled “Passing off virus burden, White \nHouse fueld crisis” – criticizes Deb Birx a lot.   I comme out well;   Major 3 page \narticle in Washington Post  by Molly Roberts entitled “Anthony Fauci built a truce. \nTrump is destroying it” – very favorable profile\nReleased by Chairman Rand Paul\n924July 20, 2020 –  Global – 14,000,000/598,000;   USA – 3,800,000/140,200;\n•Kentucky, Louisiana, Oregon and South Carolina all set new single-day records \nfor new cases on Sunday. Idaho, Nebraska, Iowa and five other states have seen \ntheir seven-day averages for daily new fatalities rise by more than 40 percent in \nthe past week.\n•More than 100 Florida hospitals have run out of ICU beds for adults. The state has \nreported more than 10,000 new covid-19 cases on 12 different days in July.\nHad call with Bill Gates (usual call every couple of weeks)\nWas on Governors’ call from the Situation Room today.   Made comment about the \nimportance of the “fundamentals” on 1) masks; 2) close bards; 3) limit restaurant \noccupancy; 4) avoid crowds; 5) personal hygiene – wash hands.\nThe Nats mask that Iwore to the Hearing is being put into the Cooperstown MLB Hall of \nFame!\nPRESS:  Nice profile on me in Corriere della Sera -  https://bit.ly/2ZIWDU7 ; Slate \nMagazine “What’s Next” podcast; Podcast/Instagram with Maria Schriver\nJuly 21, 2020 – Global – 14,300,000/604,000;  USA – 3,800,000/141,000.\nSurge continues in Southern States.   Florida in trouble.\nPOTUS had press conference on COVID-19 without having me, Deb, or other TF \nmembers with him\nMeadows and now Rand Paul have been actively criticizing me for saying that NYC got \nit right in that after their peak, they brought the infections down and now have few \nhospitalizations and few deaths.   They are incorrect.   See below numbers for NYC:\nReleased by Chairman Rand Paul\n925\nReleased by Chairman Rand Paul\n926PRESS: NPR Radio – “Morning Edition” Rachel Martin; New York Times interview \nwih Jennifer Senior; Nice article in U.S. News and World Report; CNN with Jake \nTapper – The Lead; Interview with John Casey of The Advocate\nJuly 22, 2020 – Global   USA\nDeath threats are ramping up again and so my security with George Adams is coming \nback.   George will take Christine and meto the game tomorrow night and provide \nsecurity.\nHad a great  Zoom conversation with Ryan Zimmerman (Zim) who gave me tips on \nthrowing out the first ball on Thursday.   He was wonderful.   Very nice man.\nInteresting day at the Task Force.   Called the POTUS   I mentioned to the VP that the \nPOTUS did a good job on the solo press conference yesterday.   I told VP to tell the \nPOTUS that I said so.   The VP told me to call him myself since he has such great respect \nfor me.   Katie Miller gave me the phone number of the POTUS’s personal secretary, \nMolly Michael.   I called her and she ultimately (30 minutes later) connected me.   I told \nhim it was a good idea (like I had told him last Thursday) to own the problem, admit that \nthings are bad and describe how he is going to do something about it.   I also told him \nthat it was good that he did it solo and kept it to 30 minutes.   He was very glad to hear \nfrom me and said it was”a really great call”\nGov. Andrew Cuomo called me asking how I was.  I told him that I was upset that the \nfar right was trying to discredit me.   He strongly suggested that I resign; he does not \nseem to appreciate the difference between resigning from TF and resigning from NIAID.   \nHe said I will lose credibility if I stay and that my legacy needs to be preserved.   He said \nReleased by Chairman Rand Paul\n927if I quit he will make sure that I am hired as an uber-consultant and could do very, very \nwell in the private sector.  Sorry, not for me.\nNearly 3,500 Public Health Experts Signal \nSupport for Fauci\nCurrent and Former Health Officials, Physicians, and \nScientific Experts Sign Letter Denouncing White House \nAttacks on NIAID Director\nJuly 22, 2020\nShareThis\nNearly 3,500 of the nation’s leading public health experts are speaking out against White \nHouse attacks on National Institute of Allergy and Infectious Disease Director Dr. \nAnthony S. Fauci and are calling on President Donald Trump not to sideline science or \nscientists as the country continues to reel from the COVID-19 pandemic. The signers \ninclude two former Commissioners of the Food and Drug Administration, two former \ndirectors of the Centers for Disease Control and Prevention, a former Secretary of the \nDepartment of Health and Human Services, a former Surgeon General, several leading \nmedical journal editors, and hundreds of the nation’s most prominent physicians, \nresearchers, and public health experts.\nReleased by Chairman Rand Paul\n928The open letter to President Trump was drafted by former FDA Associate Commissioner \nDr. Peter Lurie, now President of the Center for Science in the Public Interest, and \nepidemiologist and longtime AIDS activist Gregg Gonsalves, now of Yale School of \nPublic Health, who began circulating the open letter on Friday evening.\n“This week and last, the White House mounted a campaign to discredit one of our \nnation’s leading scientific experts, Dr. Anthony Fauci, the director of the National \nInstitute of Allergy and Infectious Diseases, who has advised six Presidents on epidemics \nfrom HIV to SARS, from Ebola to H1N1 influenza,” the letter reads. “Since the \nbeginning of the pandemic, he has remained one of the world’s most trusted scientists on \nCOVID-19, daily explaining in lay terms the complexity of an illness we still don’t fully \nunderstand. And he has done so by placing science front and center in the public \ndiscourse. Attempting to marginalize highly respected researchers such as Dr. Fauci is a \ndangerous distraction at a time when we most need voices like his.”\nIn mid-July, the White House circulated a set of talking points criticizing Dr. Fauci to \njournalists , and Trump administration trade advisor Peter Navarro penned an op-ed in \nUSA Today claiming that Dr. Fauci was “wrong about everything I have interacted with \nhim on.” USA Today retroactively said that Navarro’s op-ed had claims that were \nmisleading or lacked context, and thus did not meet the paper’s fact-checking standards. \nThough the White House eventually distanced itself from the Navarro op-ed, Dr. Fauci \nwas not invited to participate in yesterday evening’s White House coronavirus briefing, \nthe first since April.\nSignatories to the open letter include former New England Journal of Medicine Editors \nDr. Marcia Angell and Dr. Jerome Kassirer; current New York City Health \nCommissioner Dr. Oxiris Barbot and former Commissioner Dr. Mary Bassett; former \nNBC News science and health correspondent Dr. Robert Bazell, now at Yale; American \nPublic Health Association President Dr. Georges Benjamin; Dr. Luciana Borio, former \nDirector for Medical and Biodefense Preparedness at the National Security Council; New \nYork University bioethicist Dr. Arthur Caplan; former US Surgeon General Dr. Joycelyn \nElders, former HHS Deputy Secretary William Corr, former CDC Director and current \nPresident and CEO of Resolve to Save Lives Dr. Thomas Frieden; former EPA official \nand current Dean of the Milken Institute School of Public Health at George Washington \nUniversity Dr. Lynn Goldman; former FDA Chief Scientist Jesse Goodman, now with \nGeorgetown University; former FDA Commissioners Dr. Margaret Hamburg and Dr. \nJane Henney; Dr. Shelley Hearne of the Johns Hopkins Bloomberg School of Public \nHealth; The Lancet Editor-in-Chief Dr. Richard Horton; Ruth J. Katz of the Aspen \nInstitute and former Dean of the Milken Institute School of Public Health at George \nWashington University; former CDC Director Dr. Jeffrey Koplan of Emory University; \nYale cardiologist Dr. Harlan Krumholz; former HHS Assistant Secretary Dr. Nicole \nLurie; Federation of American Scientists President Dr. Ali Nouri; former HHS official \nDr. Anand Parekh of the Bipartisan Policy Center; former JAMA Deputy Editor Dr. \nDrummond Rennie of the University of California San Francisco; former HHS General \nCounsel William Schultz; former Kansas Governor and HHS Secretary Kathleen \nSebelius; former FDA Deputy Commissioner and current Vice Dean for Public Health \nReleased by Chairman Rand Paul\n929Practice and Community Engagement at the Johns Hopkins Bloomberg School of Public \nHealth Dr. Joshua Sharfstein; and Editor-in-Chief of the Science family of journals Dr. H. \nHolden Thorp.\n“As current and former public health officials, researchers, and public health \nprofessionals, we call on our political leaders, members of the media and all Americans \nto reject the sidelining of science, to speak out against the silencing of scientists, and to \nchampion open and public scientific discussions of the issues facing our country as we \nstruggle to make progress against the SARS-CoV-2 pandemic,” the letter continues. “For \nthat, we need the clear voices of government experts, including Dr. Fauci, to be available \nto the American public without limitation. That is the only path that can bring success in \nour efforts to control the virus.”\n“Science and scientists had been under relentless assault during the Trump administration \nbefore the COVID-19 pandemic, and that assault has not let up,” said Lurie of the Center \nfor Science in the Public Interest. “We must reverse the administration’s hostility to \nscience and certain scientists if we’re to deploy the public health measures and develop \nthe treatments and vaccines that are our only hope for bringing the pandemic under \ncontrol.”\n“We have so much work to do to end the SARS-CoV-2 pandemic in the United States. \nWe’ve seen too much death, too much economic devastation already. Public health and \nscience offer us a way out, a way to vanquish this virus. But to do that we have to \nembrace the best science and scientists this country has to offer, not denigrate the very \nexpertise that is vital to our survival at this moment,” said Gonsalves of Yale School of \nPublic Health.\nTopic: \nCOVID-19 Integrity In Science Anthony Fauci\nContact Info: \nContact Jeff Cronin (jcronin[at]cspinet.org) or Richard Adcock (radcock[at]cspinet.org).\nTelephone call with Marc Ghaly fro CA again asking for advice on how to control the \nsurge in CA.   A problem is that even when you close the bars, people have backyard \nbarbecues that are as bad as bars.   He is also concerne about the upcoming harvest \nseason with migant workers.   75% ofinfection are among LatinX\nPRESS:  Randy Rainbow Pleads for Dr. Fauci's Help to 'Gee, Officer Krupke' \nhttps://bit.ly/3jtogIN;   \nJuly 23, 2020 – Global  - 14,800,000/612,000;   USA – 3,950,000/143,000\nReleased by Chairman Rand Paul\n930Uneventful day with usual NIH meetings.  Did not go down to White House.   Getting \nnervous about throwing out the first ball at Nats stadium tonight in the Opening Day \nceremony of Nats versus Yankees game.\nAmazing night at NATS Stradium where I threw out the first pitch to open the 2020 \nBaseball season with Nats – NY Yankees game.   Unfortunately, I threw a “bouncer” to \nthe right of the plate.   I felt really badly but the overwhelming public reaction to it was \nsympathetic and positive.   Mark Lerner (owner of Nats) had me sign dozens of baseballs \nto be given out to people and one that will go into the Baseball Hall of Fame together \nwith  2 Louisville Slugger bats. I signed a Nats Jersey that will hang on the wall in Nats \nstadium next to a similar shirt signed by President Obama.   Game got rained out in the \n6th inning and we went home.   Yankees were leading 4-1.\nPRESS: Interviewed with David Axelrod for “The Axe Files” podcast; Wall Street \nJournal Article on AIDS activism; \nJuly 24, 2020 – Global – 15,000,000/619,000;    USA – 4,020,000/144,000\nRoutine day.   Went for my “annual” physical with Ted Li.   All is well.\nPRESS:   FOX News with John Roberts; On front page picture of me glove tapping \nwith Sean Doolittle; Podcast with CSIS (Steve Morrison); Interview with Ben Cohen \nof Wall Street Journal;  podcast with Khan Academy; WINS NYC Radio;\nJuly 25, 2020 – Global     USA\nTexas now have to triage who gets into intensieve and who does not (too far gone and/or \ntoo old.   Very difficult situation.   California takes over from NY as state with the most \ncases.  Florida still surging.\nDeaths in the USA up to 1000/day for 4th day in a row.\nThey have created a baseball card with a photo of me throwing out the first pitch.\nJudy Mikovits is planning to be on conspiracy TV shows via Sinclair news network \nsaying that Fauci created the coronavirus in China and brought it to the USA\nOver the past week POTUS has done 3 press conferences alone.   I have commented to \nthe press that I think that this is good since he is now giving a sober message that things \nwill get worse before they get better and that people should wear masks and avoid \ncrowds.   He has cancelled the GOP Convention in Jacksonville Florida.   I commented \nReleased by Chairman Rand Paul\n931that I liked the fact that the pressers were short and concise.   CNN sarcastically \ncommented that I really giving a vailed criticism of his prior pressers.\nJuly 26, 2020 (Sunday) – 5th Day in a row for 1000 deaths/day.   Brett Giroir on Tapper \n(State of the Union) talking bullshit about testing with Jake pressing him.   I gave Jake \nsome questions to ask him.   Mark Meadows on This Week with George Stephanopoulos \nsaying that public health measures are not working and we will have to rely on \ninterventions such as vaccines and therapeutics.   This is his way of backing out of a \nfailure and trying to get an “October Surprise”.   Heads up for him trying to push an early \napproval of vaccine or even influencing the decision about convalescent sera, which \nactually do not look too good right now.\nSpent better part of yesterday and this AM working out the tension between the COVPN \nsites, Larry Corey and Moderna.   Larry acting out since he is angry that Moderna and \nperhaps AstraZeneca  are going with CROs instead of the COVPN sites.   Larry \nunderstandably feels left out and disrespected.   He has a point but he is poisoning the \nrelationship with the companies, which is a bad idea since like it or not, we (Operation \nWarp Speed – OWS) allowed the company instead of NIH to hold the IND and so it is \ntheir trial.   Larry hostility spilled over to the site PIs and they leaked to the press \ndisparaging things about Moderna, which set off a media pickup, etc.   I called Larry, \nthen set up a Zoom yesterday with Moncef Slaoui, Matt Herpburn, John Macola to figure \nout how to fix this.  I volunteered to convince Larry that he is inadvertently becoming the \n“problem”.   Zoom call today with Larry and the above 4 to come to some sort of \nunderstanding:   Larry and COVPNs would not be left out of the action, but Larry must \nstop criticizing the Company.   Tomorrow we have Zoom with all of us + the COVPN \nPIs.\nJake Tapper woke me up at 11:23 AM (I went to bed early) furius at POTUS for tweeting \nabout the fact that Jake severly questioned Brett Giroir on SOTU CNN show today.   Jake \nwas really pissed at the craziness of it all.\nJuly 27, 2020 – Global – 15,800,000/640,000;    USA – 4,200,000/147,000\nToday is launching of Phase 3 trial of Moderna mRNA-1273.   First patient received \nthe vaccine in Savannah Georgia at 6:45 AM.   Fastest ever in the USA from sequence to \nphase 1 and fro sequence to now phase 3\nWe had in Building 1 a virtual press conference at 10:00 AM with me, Francis Collins, \nMatt Hepburn, and Stefan Bancel announcing the start of the Phase 1 trial.\nMet with the POTUS in the Oval Office today briefing him (with Azar, Collins, Gen. \nPerna, Moncef, Jared Kushner) about therapeutics and vaccines.   He was typical stream \nReleased by Chairman Rand Paul\n932of consciousness and rambling on.   It is clear he wants therapeutics quickly.   He \naccepted that the vaccine might not be ready before the election, but he was not happy \nabout it.   He kept pushing about when therapy would be ready.   Francis and I were \nsurprised when some of the WH staff sitting behind us told him that the convalescent \nplasma data looked real good and we would have definitive results tomorrow.   Had no \nidea what they were talking about since we know that the plasma data are a mess and we \nare bringing in statisticians (independent) to look at the data.\nThe baseball card of my opening day pitch by Todd has broken the all time record for \nsales with 51,512 print sales in just 24 hours.   Craziness continues.\nThreats against me are increasing greatly and so George Adams and my “modified” \nsecurity  detail is back\nPRESS:  Press conference re: start of Moderna vaccine trial (mRNA-1273); did \nFace Book Live with Francis Collins and Steve Hoge on the Moderna phase 3 trial; \nCNN Situation Room with Wolf Blitzer; FOX News with John Roberts.\nJuly 28, 2020 -  Global   USA\nOn GMA, George Stephanopoulos brought up that the POTUS has retweeted a tweet \nfrom a Breitbart based group that said that I was misleading the American public and \nthsat I was a fraud.  George asked me to respond and I blew it off saying that I do not \ntweet or even read tweets.   After the interview, George texted me saying: “Thank you, \nTony.  So impressive”.   The POTUS is playing a weird game of acting Okay with me in \nperson and saying that our relationship is fine to the press and then retweeting stuff that \nattacks me.   He is a very strange guy.\nTask Force meeting today.   Continued surge in Florida.   Threats now to yellow states of \nOhio, Kentucky, Indiana, and others sine they are seeing increases in percent positives of \ntheir tests.\nPRESS:   Good Morning America – ABC with George Stephanopoulos; Black \nEntertainment TV – Marc Lamont Hill; Wired print interview with Steven Levy; \nAP Website TV – Mike Stobbe;  Fireside Chat – American Federation of Teachers – \nFaceBook Live\nJuly 29, 2020 – \nTrump bemoaned to the press at a press conference yesterday that my approval ratings \nwere better than his. And he did not understand why.  Amazing!!   He really stepped in it \nyesterday when he endorsed a group of whacko doctors who said that \nReleased by Chairman Rand Paul\n933Hydroxychloroquine cures COVID-19.  Woman (African) doctor named Stella Immanuel \nwho beiieves in alien DNA and demon sperm said you do not need masks and HC cures \nCOVID-19.   Trump not resally knowing much about her, endorses her because she \npushed HC.   Don Lemon (CNN) on his show last night crucified Trump for this.\nAgain the narrative continues of me versus Trump.  CNN and the media in general are \nhaving a field day with this and hammering Trump.\nMet with group of “Doctors” (Deb, Seema, Brett, Bob) in a new format led by Adam \nBoehler and Brad Smith + Morgan Ortagus (Comms) to tighten up policy\nTucker Carlson calls Anthony Fauci a \n“hypocritical buffoon”\nCarlson: “Criticize Fauci, and you will disappear from the internet”\nW R I T T E N  BY  M E D I A  M A T T E R S  S T A F F\nP U B L I S H E D  0 7 / 2 8 / 2 0  8 : 4 7  P M  E D T\nS H A R E\n•\n•\n•\n•\nC O M M E N T\n•\nPRESS:  BBC Radio News; ESPN podcast with Pablo Torre; BBC/PBS World News \nTV with Katy Kay; MSNBC with Andrea Mitchell; 4 local TV stations – \nTelemundo; Univision; 2 others\nJuly 30, 2020 – Global – 16,600,000/565,000; USA – 4,400,000/151,000\nParticipated in a “Call to Action to Donate” ceremony at the American Red Cross \nHeadquarters.   Did tour with Azar and the POTUS and visited with a person giving \nReleased by Chairman Rand Paul\n934blood.   Then had roundtable with POTUS, Azar Hahn, Adams, Collins, Birx. Adam \nSchechter of Quest, Gail McGovernPres and CEO of ARC.\nHad phone conversation with Ted and Annette Lerner (Owners of Washington \nNationals).   They wanted to thank me for all that I am doing for the country and to wish \nme well.   Promised that we will be seating together at a nationals game.\nPRESS:   Press briefing associated with visit to Red Cross; Black Press USA \nFireside Chat Face Book Live; CNN Town Hall with Sanjat Gupta and Anderson \nCooper\nJuly 31, 2020 –  \nStill >1000 deaths per day.  Slight flatteningin AZ, but other states still surging.   Yellow \nstates starting to increase.\nRed states - >10% positive; Yellow states – 5 to 10% positive; Green states - <5% \npositive\nHouse Hearing today – Select Subcommittee on COVID-19 – Chair – James Clyburn – \nRayburn-2154,   Major clash with Jim Jordan (R-OH).   Go to You Tube to see.  I believe \nthat I made him look silly.\nReleased by Chairman Rand Paul\n935Important call form Larry Horowitz who works closely with nancy Pelosi.  \nApparently, There was a meeting in the WH with Steve Mnuchin, Mark Meadows, \nNancy Pelosi and Chuck Schummer.   Steve and Mark told Nancy and Chuck that \nAstraZeneca  will have vaccine in September and that it will be given an EUA.  Theyare \ntalking about the ChADOX vaccine that Adrian Hill is testing in Brazil and South Africa,   \nIt is a 10,000 person trial.  Apparently, Peter Marks does not know anything about this \nand Larry just informed him.   Bottom line is that they are going to pressure Steve Han \n(who likely will cave in in the idea of an EUA) to issue one even though Peter has serius \nissues with this.   An EUA will likely get in the way of completing the RCTs that are \ngoing on.  Clearly. This is politically driven and will be a ploy for Trump to get re-\nelected.\nPRESS:   Much coverage on CNN of my encounter and confrontation with Jim \nJordan.   CNN Jim Sciuttto, Don Lemon and Chris Cuomo dumped all over Jordan.\nAugust 1, 2020 -    Global – 17,400,000/675,000;  USA – 4,500,000/153,000\nUneventful Saturday.   Southern states still surging; >1000 deaths yesterday.   The new \napproach of jumping on the mostly yellow states that are starting to show a slight \nincrease in  percent positive is referred toas the “embers approach”\nHad conversation with Ian Lipkin.   Ian is responsible for the medical/public health \naspects of the Democratic Convention in Milwaukee.  He called me to go over all the \nthings he has put into place – masks, testing everyone, airflow, limit numbers, physical \ndistance, etc. – to ask if he has missed anything.   Seems he has done all he can do.  The \nReleased by Chairman Rand Paul\n936decision to hold the convention or not is up to the politicians.   Since they have decided to \ngo with it, Ian has done his job in making it as safe as possible.\nPRESS: Usual CNN pitting me against the POTUS\nAugust 2, 2020 (Sunday) – Global – 17,700,000/681,000;  USA – 4,600,000/154,000.\nI was not on any Sunday shows despite requests for from them.   Brett Giroir on Meet the \nPress and Deb on SOTU.\nPOTUS continues to tweet that I am incorrect in what I am saying.   He rejects that I say \nthat the USA only shut down by 50+% while EU shut down by 90% and then goes on \nwith the non-sequitur that we have more cases BECAUSE we are testing more.   The \npress in blasting him for supporting the wild woman Stella Immanuel.\nAugust 3, 2020 – Global   USA\nFar right and FOX News continuing to attack me.  Tucker Carlson calling me a “Fraud” \nand a “hypocritical buffoon”.\nFireside Chat  with Dartmouth Medical School faculty.\nPRESS:   Local TV – KDFW-TV – Dallas; KABC-TV – LA; KSNV-TV – Las \nVegas; WTVJ-TV – Miami; KTLA-TV – Los Angeles; WGN-TV- Chicago; KGTV-\nTV – San Diego; Voice of America TV with Greta Van Sustern; JAMA Podcast with \nHoward Bauchner; US News and World Report (Brian Kelly interview); Face Time \nLive Press conference with Gov. Lamont (D-CT)\nAugust 4, 2020 – Global  - 18,000,000/688;  USA – 4,700,000/155,000\nAmazing Day – We were supposed to have a routine TF meeting today.   We were \nwaiting in the Sit Room for a 3:00 PM start and the VP was late at 3:15 PM.   Marc Short \nthen came in and said that the POTUS wanted some of us ogo to the Oval Office.   We \nwe got there, the entire senior staff was there (everyone).  The VP sat the following \naround the Resolute Desk – me, Deb, Redfield, Giroir, Azar.   The POTUS then started \neyeing and throwing around the Fuck word:   “What the fuck are you people doing?   Deb \nyou are saying that the pandemic is now in the rural areas.   First the cities, now the rural \nareas.   Where is it now.   I am saying we have it under control and you say it is \neverywhere.   Tony, you are always contradicting me.  Giroir, you say HC does not work \n(he said this on SOTU on Sunday).   I took it and many good doctors swear by it.The whs \nReleased by Chairman Rand Paul\n937fucking message.   You need to be positive”.   Then he started raving that we are seeing \nmore cases only because we are doing more testing.   The other countries look good \nbecause thery are not testing. At that point, Kellyanne Conway took over and made the \npoint that we can say what we feel is correct, but if it contradicts the pOTUS, they need \nto hear about it in the Oval or Sit Rooms and not hear about it for the first time on TV.   \nEveryone remained silent.   At that point I gifures enough is enough.   I said:  “Okay Mr. \npresident.   We are now in the Oval office and so you need to hear it diretly from me.   \nIncreased testing does not cause cases.   When you increase testing you will of cours pick \nup asynptomatics whm you might otherwise not notice.   However, when you have \nincreased percent positives and increased hospitalization, and increased deaths, that \nmeans that there are truly more cases.  He then changed the subject and started talking \nabout the fact that deaths are down.   After I broke the ice, then Deb, Redfield, and Giroir \nchipped in.   All in all it was a manifestation that he is desparate and still does not \nunderstand the pandemic.   Very interesting encounter.\nAfter that we went to the Doctors Huddle with Brad Smith and Adam Boehler to talk \nabout tesing and schools.   More later.\nPRESS:\n   \nReleased by Chairman Rand Paul\n938\nReleased by Chairman Rand Paul\n1Historical Record of A. S. Fauci – Part 2\nAugust 5, 2020 – Global – 18,100,000/692,000;   USA – 4,750,000/156,000.\nMet with POTUS yesterday in Oval (see part 1).   Photo below:\nHad Peter Navarro discuss HC with NIH Guidelines Panel.   He was his typical \narrogant self and rejected RCTs as being flawed and stuck with the observational \nstudies.  He maintained: “I am wrong, no one is harmed, if you are wrong, \nthousands of people die”.   He denies that HC can have any deleterious effects.   \nHis partner on the call was Mark Hatfill (Yikes!)\nReleased by Chairman Rand Paul\n2PRESS: Did The Forum at the Harvard T.H. Chan School of Public Health – \n“When Public Health Means Business” with Sanjay Gupta moderating – \ncarried live by CNN; Bloomberg TV – David Westin; Brain Pop TV; Politico \npodcast – Dan Diamond; Reuters TV; Interview with Walter Isaacson on \nAmanpour and Company TV\nAugust 6, 2020 –  Global – 18,400,000/698,000;   USA – 4,800,000/158,000\nReleased by Chairman Rand Paul\n3Got semi-agitated call from Mark Meadows at around 7:45 AM saying that he \nis going to keep me off all TV until we sit down and talk.   He admits that I am \nprobably being misquoted, but the press is pitting me against the POTUS.   They \nare trying to drive a wedge between us.   My interview with CNN this AM was \nterrific, and when I saw that it was Mark who was calling I thought that he was \ncalling to tell me that the CNN interview was great.   Apparently, I had said \nyesterday that the virus would not be “eradicated”, which is true (only smallpox).  \nThis is against what the POTUS said.   I explained this to Mark and he seemed to \nunderstand that I was saying that it could not be eradicated, but I emphasized that it \ncould be controlled.   I suggested that he watch the CNN interview.   He stated that \nthe POTUS has a great deal of affection for me and he does not want to see a rift.   \nHe said he would watch CNN New Day and get back to me.  I may be off TV for a \nwhile.\nCall from Sen. Pat Toomey (R-PA) asking about a few things.   Is it a good idea \nto widely test for antibodies in PA to determine penetrance of infection?   I told \nhim yes.   Also, questions about use of saliva POC tests.   Good conversation.\nDiscussion with Don Milton and Kimberly Prather on aerosols.   They are particle \nand aerosol physicists and it is clear that particles larger than 5 um can aerosol \nReleased by Chairman Rand Paul\n4including those up to 50 or 100um.  Important implications for masks and indoor \nventilation and physical distancing.\nDid a briefing with Qs and As to the Congressional Asian Pacific American \nCaucus (CAPAC) led by Rep. Judy Chu and including Mazie Hirono, Grace Meng, \nBobby Scott, Tulsi Gabbard, Brad Sherman, Susan Davis, Mark Takano.   Went \nvery well.\nPRESS:  WVLK Lexington, KY Morning News Radio; CNN New Day with \nJohn Berman; Bloomberg News on Vaccine hesitancy – Anna Edney\nAugust 7, 2020 – Global -    USA\nMade rounds again today (felt really good) – saw Mr. Davis (HIV, IRIS, Steroids \nand Ramsey-Hunt Syndrome);  Also saw Sharon Rockefeller in for Steve Holland \nand will get removal of rectal stump that is chronically infected with fistula due to \nradiation.\nOWS Weekly Call – All 6 companies now have advanced purchase agreements.  \nAlso, Pfizer still not giving any information even though they have adv. Purchase \nagreement.   This is unacceptable and they need to be blasted in my memoir.   \nAlso, we are averaging 800 enrollments/day in the Moderna trial:\n2020-08-07 OWS \nboard briefing Vx &   \nCall from Larry Horowitz (works with Nancy Pelosi) (should have described above).   He had \nwarned me a few days ago about Meadows trying to pressure Hahn and Marks to grant UA (or \neven BLA) prematurely to vaccines (likely AZ) in time for the election.   I called Peter Marks a \ncouple of days ago (together with Collins and Lane) and explained that we would back him if he \nholds the line.   He called the AZ package “a hot mess’ and definitely not in shape for an EUA\nReleased by Chairman Rand Paul\n5Plasma drive on Times Square\nDid Fireside Chat (virtual) at Brown University with Ashish Jha (new Dean at Brown School of \nPublic Health) - \nPRESS: Face Book Live – Brown Fireside Chat (see above)\nAugust 8,2020 – Global – 19,200,000/716,000;  USA – 4,900,000/160,200.\nPOTUS acting even more erratically.   Keeps insisting that increased case numbers \nare due only to increased testing, ignoring the increases in percent positive, \nhospitalizations and deaths (>1000/day).\nInconsistent message to me whether they want me on TV.   David Muir (ABC \nWorld News Tonight) requested me and we accepted and thought that it was \ncleared and then silence.  Same for NBC Morning News with Savannah Guthrie.   \nAnd so, I decided to call Alyssa Farah and straighten things out.   She was her \nReleased by Chairman Rand Paul\n6usual wonderful self when I explained that I needed to know where I stood with the \nWH and being on TV.   She said that she would want me on every day and every \nnight.   However, the POTUS keeps saying that the Doctors are contradicting him \nand he is very impulsive and so when he sees or hears about a contradiction he \nblows up and says either Birx should not be on TV or Fauci should not be on TV.  \nComms people obey and then after a couple of days, they know that he calms \ndown and even forgets and they then get me and Deb back on the air.   Alyssa also \nsaid that Kayleigh McEnany reminds him that I have an 80%  approval rating and \nit is not a good idea to keep me off TV.   They want me on TV, but they have to \nplay to POTUS and Mark Meadows impulsive and mercurial behavior.  Interesting \ncall. \n  \nPRESS:   Appeared in Washington Post:\nAs Fauci battles the pandemic and politics, \nhis grateful neighbors celebrate him as a \nhero\nReleased by Chairman Rand Paul\n7Ida Bergstrom and her sons Lars, 11, left, and Nils, 14, are selling yard signs to show support for \nAnthony S. Fauci, who is the nation's top infectious-disease expert and one of their neighbors. \n(Bill O'Leary/The Washington Post) \nBy \nMarisa Iati\nSpoke with Dr. Patrizia Cavazzoni (Deputy Director and Acting Director of \nCDER/FDA.   She is Acting for Janet Woodcock who is now at OWS.  Larry \nHorowitz (see above) who warned me about Meadows pressuring Hahn and \nultimately Marks to give EUA or even BLA prematurely to vaccines (likely AZ), \nalso said that Patrizia needed some support because Henry Ford hospital has put in \nfor a re-issue of the EUA for Hydroxychloroquine (previously removed by the \nFDA), being pushed by Peter Navarro to do so.   Patrizia had just reviewed all the \ndata (including the Henry Ford data – observational study with many confounders) \nReleased by Chairman Rand Paul\n8and feels strongly that no EUA is justified.   She wrote it up and will officially \nsubmit it and make it oubic.   HOWEVER, she was told by Steve Hahn to wait \nuntil Monday (today) so that he can “speak with Meadows”.   Question is whether \nSteve merely wants to inform Meadows out of courtesy, or he might cave to \nmeadows.   We shall see.  Patrizia is OK.   She will stay strong.\nAugust 9, 2020 – Global – 19,500,000/722,000; USA – 5,000,000/161,000\nBirx gets compared with me in a Guardian  article: \nReleased by Chairman Rand Paul\n9Dr Deborah Birx: voice of scientific reason \nor apologist for Trump?\nThe coordinator of the White House coronavirus taskforce built her reputation fighting Aids but \nis she compromising it by indulging the president’s whims?\nDr Deborah Birx speaks during a meeting in the Oval Office with Trump. Photograph: \nRex/Shutterstock\nTom McCarthy\n@TeeMcSee\nPublished on Sun 9 Aug 2020 05.00 EDT\nMonths of frustration with Donald Trump’s denial of the coronavirus crisis in the United States \nboiled over last week when the Democratic House speaker, Nancy Pelosi, publicly attacked a \ntop member of Trump’s coronavirus team, Dr Deborah Birx, for standing by the US president \ndespite his record of lies and misinformation about the virus.\nHer position contrasts sharply with Dr Anthony Fauci, her former supervisor and current \nscientific peer on the White House coronavirus taskforce, who has clashed more frequently \nwith Trump – but has if anything risen in the public estimation for doing so.\nThe question for Birx is whether, after the current health emergency is past, she will be \nremembered as a Fauci-like figure who was able to work with Trump without becoming \npersonally compromised – or as something else.\nReleased by Chairman Rand Paul\n10We know sooner or later that when EU opens up, there cases will go up if they are \nnot careful, and some of them are not careful:\nFrom an American Artist in Paris”\nReleased by Chairman Rand Paul\n11Whether or not to open schools has been a major topic of discussion as we \napproach the school opening timetable.   I have been saying consistent that we \nshould have as a default position our attempt/intention to open schools because of \nthe psychological effects on children and in some areas, the dependence on schools \nfor breakfast and lunch.   Also, the potential deleterious downstream effects on \nworking parents.   HOWEVER, the primary consideration must be the health, \nsafety and welfare of the children and the teachers, and the potential spreading to \nothers (i.e. family members).   I have stated that one size does not fit all and \ndecisions should be based on the level of infection in the community:\nPRESS:  Front page article in Washington Post blasts Meadows and Trump \nfor ignoring me and Birx and carefully monitoring everything that I say in \norder to keep us on message and when we do not, they do not approve \nrequests for interviews.   Glad that the sources were many and so they do not \nthink that I leaked.\nAugust 10, 2020 – \nReleased by Chairman Rand Paul\n12Important NBC print article (blog) about the difference between Birx and me:\nTrump calls Birx's COVID-19 warnings \npathetic — but the real test is what she \ndoes next\nDoctors like Fauci and Birx find themselves in an unenviable position, as do so many employed \nby the Trump administration. But given our national crisis, there is little room for excuses.\nDr. Deborah Birx, the White House coronavirus response coordinator, arrives for a coronavirus \ntask force briefing in the Rose Garden at the White House on April 27.Jabin Botsford / The \nWashington Post via Getty Images file\nAug. 10, 2020, 4:30 AM EDT\nBy Jalal Baig, oncologist\nDr. Anthony Fauci is, by now, a household name.  But the good doctor's mostly unalloyed \nadvocacy of scientific and public health truths has come with clear political and personal costs.\nAs the coronavirus has spread, Birx has hewed much closer to the White House’s often-\nproblematic pandemic script.\nReleased by Chairman Rand Paul\n13There are constant rumblings of Fauci's firing by President Donald Trump, who excoriates him \nregularly for committing \"a lot of mistakes.\" In addition, the director of the National Institute of \nAllergy and Infectious Diseases has drawn the ire and ridicule of lawmakers like Sen. Rand Paul, \nR-Ky., and Rep. Jim Jordan, R-Ohio, for opining on matters deemed to be beyond his preserve. \nMost bloodcurdling are the \"serious threats\" that have been made  against him and his family.\nFauci's counterpart on the White House coronavirus task force, Dr. Deborah Birx, the response \ncoordinator, is in a different position. House Speaker Nancy Pelosi called Birx \"the worst\" in a \nclosed-door meeting with members of the Trump administration at the end of July. Then during \na follow-up appearance on ABC's \"This Week\" on Aug. 2, Pelosi accused the official of enabling \nTrump's spread of coronavirus misinformation .\nThese concerns are not unfounded. As the coronavirus has spread from raging fires in scattered \nepicenters to a national inferno, Birx has hewed much closer to the White House's often-\nproblematic pandemic script. For months, she stayed publicly mum in the face of Trump's \npoliticized and patently false claims about the contagion, occasionally gushing about his \nnuanced appreciation for science.\nYet, when Birx finally countered some of Trump's conspiracy theories and half-truths this \nmonth, she predictably found herself in his crosshairs.\nShe stated the obvious last week, describing infections as \"extraordinarily \nwidespread\"throughout the nation. This irked Trump, who accused Birx of taking \"the bait\" \nfrom Pelosi and attacking the administration's response.\nBirx, a colonel in the Army who serves at the pleasure of the president, highlights the \nmetamorphosis that seemingly competent and objective individuals undergo inside Trump's \nWhite House. As David Smith wrote in the Guardian , \"Like other White House officials before \nher, she is said to be sacrificing a hard-won professional reputation at the altar of Trump's \nvanity.\"\nNow, as America enters a new, critical coronavirus phase, Birx finds herself at a fork in the \npandemic road. Will she continue to walk the line between truth and the politicized \"truth\" \nTrump desires to hear? Or will she opt to clearly put her medical oath over job security?\nAugust would be an ideal time for Birx to grow a spine. With the protracted first wave of the \nvirus inching closer to the dreaded fall and with schools now reopening, the country remains all \nbut rudderless in its response to the coronavirus pandemic. After the federal government \nabdicated its role to helm a coordinated response, 50 states scrambled to cobble together 50 \ndifferent plans.\nReleased by Chairman Rand Paul\n14Trump, meanwhile, has continued with his dangerous musings on the virus. As physician Dhruv \nKhullar observed in the New Yorker, \"The work of saving lives has been complicated by \nmisinformation, rhetoric, and political calculation.\" Apart from hismuddled messaging on \nmasks, Trump has said COVID-19 would just \"disappear,\" promoted hydroxychloroquine as a \nsafe and effective treatment, ascribed increased cases merely to testing and pronounced 99 \npercent of coronavirus cases  to be \"totally harmless.\" He has also continued to peddle his belief  \nthat kids are \"virtually immune\" from the virus \"and we have to open our schools.\"\nDoctors like Fauci and Birx find themselves in an unenviable position, as do so many employed \nby the Trump administration. They have been tasked with speaking uncomfortable and \ninconvenient truths to those in power. But given the current asphyxiation of scientific and \npublic health expertise in Washington, there is little room for excuses.\nBirx established her profile as a physician-scientist of great repute through work on HIV and \nAIDS since the 1980s. Nowadays, Birx works closely with Vice President Mike Pence, who refers \nto her as his \"right arm.\" With an office located near the Situation Room, she has become a cog \nin the president's team.\nUnfortunately, instead of serving as a firewall in the West Wing against Trump's medical \ndisinformation, Birx has too often been obsequious.\nIn an interview with the Christian Broadcasting Network in March, she praised Trump's ability \nto assimilate data and science: \"He's been so attentive to the scientific literature and the details \nand the data,\" she said, Vox reported. \"I think his ability to analyze and integrate data that \ncomes out of his long history in business has really been a real benefit during these discussions \nabout medical issues.\" In April, she remained mum and unmoved when the president turned to \nher and hypothesized aloud about using disinfectant as a coronavirus treatment.\nThat same month, her rosy outlook on the country's outbreak provided Trump the scientific \ndata he needed to push forward with his plans to reopen the country economically after an \nextensive lockdown. As the New York Times reported  in July, \"Dr. Birx was the chief evangelist \nfor the idea that the threat from the virus was fading.\" Her fervor was based on her erroneous \nassumption that America's trajectory would resemble Italy's and that infections and deaths \nwould crater after reaching a peak in mid-April.\nGiven the president's stance on the Centers for Disease Control and Prevention and school \nreopenings, it is unnerving that Birx has worked to strip the organization of potentially vital \ncoronavirus patient data. She has also worked to create more pliable guidelines for schools, \ndespite the concerns of many medial professionals.\nReleased by Chairman Rand Paul\n15The suddenly beleaguered Birx is not without allies, however. Even as Trump turned on her, the \nNew York Times reported  that others have spoken out in her defense, including Kentucky Gov. \nAndy Beshear and Gov. Tate Reeves of Mississippi. Dr. Carlos del Rio, an infectious disease \nspecialist who helms the scientific advisory board for a State Department AIDS program Birx \nruns, told the New York Times it was Birx who convinced Pence to appear publicly wearing a \nmask, weeks before Trump relented. In the past, even Anthony Fauci has noted that Birx finds \nherself \"in a difficult position\" and that she \"essentially lives in the White House.\"\nA difficult position indeed. But as Fauci told Politico, \"You should never destroy your own \ncredibility. And you don't want to go to war with a president.\"\n\"But you got to walk the fine balance of making sure continue to tell the truth,\" he said.\nUltimately, the looming loss of more American lives as summer turns to fall should give \nDeborah Birx pause. At a moment when science and public health have been criminally \ndevalued, fidelity to Trump — and yes, perhaps her future career prospects — should be \nsuperseded by a simple promise she made many years back as a medical student to \"first, do no \nharm.\"\nJalal Baig\nDr. Jalal Baig is a physician and writer. He is an oncologist in Chicago. His work has appeared in \nThe Washington Post, The Guardian, The Atlantic, Slate, Vice, Salon and elsewhere.\nHad productive talk with particle and aerosol physicists from DHS who confirmed the fact that \nparticles >5 micrometers  do aerosolize.   Leader of group was Matthew nMoe.   His people \nwere Paul Dabisch, Michael Hevey, Justin Taylor, and Marcia Firmani.   Andrea Lerner was with \nme on the call.\nReleased by Chairman Rand Paul\n16Patrizia Cavazonni stood by her guns and Steve Hahn did not over-rule her \nregarding the EUA or Hydroxycholoquine\nPRESS:  ABC TV – David Muir – ABC World News Tonight;\nAugust 11, 2020 – Global    USA\nVery serious e-mail from Deb Birx this AM and my response to her:\nDeb:\n   I am totally with you.  I will, and I trust we all will, continue to give the \nmessage that we have been giving.   This is an historic pandemic and it \nis our responsibility to do everything we can to contain, control and \neliminate it.   We cannot just let the virus do its thing since people will \ndie.   Children get infected and some of them get very sick and they \nalmost certainly play a role in the community spread.  W e should hold \nstrong on this.   Perhaps we can still be value-added, but we need to \ndiscuss that if the POTUS is following Atlas’s advice and not ours, then \nwhat are we doing there?\nReleased by Chairman Rand Paul\n17Best,\nTony\nAnthony S. Fauci, MD \nDirector \nNational Institute of Allergy and Infectious Diseases \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520 \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nThe information in this e-mail and any of its attachments is confidential and may contain \nsensitive information.  It should not be used by anyone who is not the original intended \nrecipient.  If you have received this e-mail in error please inform the sender and delete it \nfrom your mailbox or any other storage devices.  The National Institute of Allergy and \nInfectious Diseases (NIAID) shall not accept liability for any statements made that are the \nsender's own and not expressly made on behalf of the NIAID by one of its \nrepresentatives.  \nFrom:  Birx, Deborah L. EOP/NSC <Deborah.L.Birx@nsc.eop.gov > \nSent: Tuesday, August 11, 2020 6:59 AM\nTo: Fauci, Anthony (NIH/NIAID) [E] < afauci@niaid.nih.gov>; Redfield, Robert R. (CDC/OD) \n<olx1@cdc.gov>; Hahn, Stephen <SH1@fda.hhs.gov >\nSubject: Oval yesterday\nA very dangerous meeting in the OVAL yesterday.  I had been excluded from all oval meetings \nsince 22April until a couple of weeks ago when the President began speaking to Tony and I and \nthus the southern hot pink graphic showing the Southern outbreak.  Since then I am sometimes \nincluded in a brief meeting before his press briefing (approx. 2-3 times total). A couple of weeks \nago a Dr Scott Atlas showed up at the WH with a very different take on the epidemic.  Dr Atlas \nthoughts\n1. No matter what we do it the outcome will be the same – in other words in most places \nthe virus has already run its course.  There is enough herd immunity to protect the rest \nof the population if we protect the vulnerable\nReleased by Chairman Rand Paul\n182. Schools can open and should open everywhere – I countered that this would cause a \nnew round of community spread and eventually lead to new hospitalizations and deaths \n– but I had no impact\n3. Children are not at any risk to infection and do not spread the virus in any manner – the \ndo not transmit the virus\n4. HTN and associated co-morbidities are not that critical – ie all BB, MLB, FB except for \nline backers that are overweight are at no risk as physical fitness overcomes the virus \neffects\n5. Masks are over rated and not needed\n6. Testing is very over rating – thus the source of the President’s call for new testing \nguidance\n7. Case identification is bad for the President’s reelection – testing should only be of the \nsick\nThe president has decided we were wrong about “heat” and the summer and therefore our \nopinions at this point are irrelevant.  (As was discuss by CHOP months ago and all models \npredicted outdoors (thus summer) would decrease R1 by 15-20% due to some increase in social \ndistancing but this could immediately be over come with decreased mitigation such as social \ndistancing and etc and thus the situation we are in.) He noted that it was the task force that got \nus into this ditch by promoting testing and falsely increasing case counts compared to other \ncountries.\nThe conclusion was Dr Atlas is brilliant and the President will be following his guidance now. I \ndon’t know what can be done at this point but I will make another run at this and will continue \nthe state by state approach to try to contain the virus but doubt my abilities to change the \nPresident’s mind concerning what needs to be done – strict mask use, expansion of testing, \nstrict social distancing and limiting access to all public venues where social distancing and \nmasks cannot be used, limit school reopenings where there is uncontrolled community spread – \nthe red counties – until the outbreak can be contained, limiting in yellow counties with strict \nsocial distancing and mask use. \nOpen to all thoughts but I don’t think I can be very effective at this point. Deb\nMet with POTUS in Oval Office together with Collins, Deb, Moncef Slaoui, Gus \nPerna and the entire WH staff with our group sitting in front of the desk.   Meeting \nwas supposed to be our briefing the POTUS on vaccine progress.   However, it \nturned into the free-floating stream of consciousness about vaccines, treatments, \nstock market, Russian vaccine, approval ratings, testing too much, influenza, etc, \netc.   My relationship with him is now back on track as I joked with him a lot \nduring the meeting.   Lasted about 40 minutes.\nReleased by Chairman Rand Paul\n19Had teleconference from my home with Mascola, Dieffenbach, Mike Cohen, Peter \nGilbert, Larry Corey regarding the revealing of the AMP data (Antibody Mediated \nPrevention).   HPTN 703 – Women in Southern Africa and HPTN 704 – MSM and \nTGW in Americas and Switzerland receiving VRC01 infusions every 2 months for \n10 months.   Data are clear:   overall no prevention of HIV infections.   However, \nvery clear from sieve studies that VRC01 prevented acquisition of VRC01 \nsensitive isolates.   Big win!    This is first step in a multi-mAb regimen similar to \ncombination ART\nPRESS:  Terrific Face Book/Instagram with Tiffany Haddish;\nAugust 12, 2020 – Global – 20,000,000/735,000;   USA – 5,120,000/164,000\n4800 items regarding me on sale:\nFauci items on Etsy - n=4804   https://www.etsy.com/search?q=fauci \nDiscussed on a “chat” with Pastor Miller of St. Luke’s Lutheran Church in Silver \nSpring in a session for children.   She also said a prayer for me.\nBets Malone has written a song about me to the words of “You Made me Love \nYou”.   Going viral on you tube.   Totally crazy\nReleased by Chairman Rand Paul\n20Important meeting at Task Force – Trump has brought in a Dr. Scott Atlas, a \nradiation oncologist from Stanford Hoover Institute.   He is a FOX News \nCommentator and Trump has seen him on FOX.   He is against everything we are \nsaying.   He wants to open schools in red Zone, feels that children do not get sick \n(or even transmit when they get infected) and so we should let herd immunity \nform.   He wants to protect the vulnerable but does not realize that we do no do that \neffectively.   He wants to only test symptomatic people.   He obviously does not \nbelieve in community spread.   This is going to be a real problem.   The rightwing \npress is saying that Trup brought him in to counter me and Birx.  Atlas now has an \noffice in the EEOB and he is Special Assistant to the POTUS.   He is also now a \nmember of the Task Force.\nPRESS:  Did Fireside Chat with the “Trilateral Commission” led by Meghan \nO’Sullivan and Juliette Kayyem (Harvard Kennedy School of Government)\nAugust 13, 2020 – ~1500 deaths yesterday – deadliest day of summer.  Global – \n20,200,000/737,000; USA – 5,200,000/165,1000.\nReleased by Chairman Rand Paul\n21Had very nice Zoom conversation with Gov. Raimondo (D-RI) about school \nopening.   RI is in green zone and so it was an easy conversation.\nThe Fauci cult is getting even stronger.   E-mail from  Children’s Hospital at \nNorthwestern in Chicago”\nReleased by Chairman Rand Paul\n22Amazing  surprise:   Irwin Redlener called me.   He is a friend of Joan Baez and \nsaid that Joan is now an accomplished portrait artist and she is a great admirer of \nmine and has painted a portrait of me.   Irwin wanted to know if it was OK for him \nto give Joan my cell phone number.  I said of course and within an hour Joan \ncalled me and we had a wonderful conversation with her calling me an American \nhero.   She texted a copy of the portrait to me.   I gave her my home address and \nshe will send me a print of it.   See below:\nReleased by Chairman Rand Paul\n23\nReleased by Chairman Rand Paul\n24PRESS: Local Radio and TV in North Carolina – 1) 106.1 FM:  KC O’Dea \nShow (Radio); 2) Bo Thompson WBT (Radio); 3) WGHP Fox 8 Brad Jones \nTV Greensboro; 4) WXII TV Davonte McKennith – Winston-Salem.   PBS \nNewsHour with Judy Woodruff.  Instagram Live with Matthew \nMcConaughey.  Pew Trust Podcast\nAugust 14, 2020 – Excess death calculations has us actually at 200,000 deaths \nfrom COVID-19.  Global   USA\nDid Task Force today.   Had brief discussion with Scott Atlas.   He is concerned \nabout being seen as the “anti-Fauci”.   He says that he is not in favor of “let it rip” \nto develop herd immunity.   He believes in herd immunity, but he feels that we \nshould just protect the elderly and vulnerable in nursing homes.  He may be \nbacking off on what he was “supposed” to have said.   Clearly, Deb Birx and to \nsome extent Redfield feel that he is dangerous.   He might be, but I really need to \nhear from him what is position is on a variety of subjects.\nJoan Baez sent me a beautiful note this evening.\nHi Tony,\nJust a thought..\nPeople have told me over and over how important I was I'm their lives..I never \nreally either believed them or paid them much attention.  But maybe too much \nmodesty, false or otherwise, is as silly as blowing ones own trumpet to loudly.\nI wonder if you have any idea (probably not) how important you are to us, our \nhealth, our sense of hope, and that we won’t go under, not just yet.  I am not \noptimistic about the future of our country, or the world for that matter.  But that \ndoesn’t mean I’ve given up.  \nI’m fortunate to paint, and paint well.  Same as I sang well.  I had the blessed luck \nto end my singing career shortly before Covid upended the entertainment \nindustry.  \nReleased by Chairman Rand Paul\n25My first portrait exhibit was called “Mischief Makers”.  It consisted of people who \nhad spoken truth to power, many risking their lives to make change without the \nuse of violence. \nWithout even thinking about it, you are doing nonviolent resistance every time \nyou stand up in front of the cameras with people all around you who are doing \neverything possible to negate common sense and science.. knowing your life \noddly and unexpectedly is more fragile than you’d thought, by the splits and \ndivisions, mistrust and hatred - mostly people by who are encouraged to do evil, \nare now very close by.  \nCorragio Tony!  If I, or anyone from my community of activists and friends can \nhelp you out in any way, please just let us know.  \nMeantime, my British mom used to say, \"Carry on the good works and take care.. \ngood people are scarce.\"\nYours, Joan\nOn rereading  this I see that parts of it might be appropriate to put up on my face \nbook page.  Let me knkw if that makes you uncomfortable in any way.  \nPRESS:\nAugust 15, 2020  \nBrett Giroir getting slammed by the press for saying that we do not need to do \nwidespread testing.   He is acting annoyed with the press (which is a bad idea) \nwhen they push him and mention that all the health experts disagree with him.\nThe Fauci cult continues:\nFauci Bobblehead Raises $200k for Healthcare Workers\nReleased by Chairman Rand Paul\n26Two new Fauci-themed bobbleheads are on preorder. They will also raise money to support \nhealthcare professionals.\nBy Christopher Ruvo\nThe National Bobblehead Hall of Fame and Museum has revealed that a bobblehead it \nproduced of Dr. Anthony Fauci has raised more than $200,000 to aid in the fight against COVID-\n19.\nDr. Anthony Fauci\nThe museum generated the money by donating $5 from every Fauci bobblehead sale to the \nAmerican Hospital Association’s Protect the Heroes Campaign in support of the 100 Million \nMask Challenge and other initiatives that protect healthcare workers on the front lines of the \ncoronavirus pandemic. Other bobbleheads, including one of Dr. Deborah Birx, helped generate \nan additional $70,000 in donations for the cause.\nGiven the success of the Fauci bobblehead charitable initiative, the Milwaukee, WI-based \nmuseum has created two more Fauci bobbleheads that are now available for preorder. The first \ncommemorates the Fauci “facepalm” incident from earlier this year, while the second features \nthe original Fauci bobble design with a red tie. The museum will continue to donate $5 from \nevery purchase to Protect the Heroes.\nReleased by Chairman Rand Paul\n27Dr. Fauci ‘facepalm’ bobblehead\nReleased by Chairman Rand Paul\n28Dr. Fauci red tie bobblehead\n“After releasing the first bobblehead of Dr. Fauci, we received a lot of requests for a facepalm \nversion, and when the original bobblehead sold out, we wanted to give a few options for the \nmany people out there just finding out that a Dr. Fauci bobblehead exists,” said National \nBobblehead Hall of Fame and Museum co-founder and CEO Phil Sklar. “We look forward to \nraising more funds and awareness for the Protect the Heroes Campaign during these \nunprecedented times.”\nFauci, 79, is the executive director of the National Institute of Allergy and Infectious Diseases. A \ncentral figure on global health issues like HIV/AIDS, Ebola and Zika, Fauci has been the medical \nexpert at the forefront of the U.S. battle against coronavirus.\nThe “facepalm” theme of the one new bobblehead arises from a press briefing in March in \nwhich Fauci appeared to chuckle and cover his face with his hand in reference to something \nPresident Donald Trump said. Fauci said he was only covering his face because a lozenge was \nstuck in his throat, but the image went viral.\nReleased by Chairman Rand Paul\n29The problem is that now I am one of the most recognizable and well-known people in the \nworld.   This is very strange; however, it is triggering increased hate mail and threats.   My \nsecurity detail (Brett Rowland, Andre Jacobs, Mike Salva, Ken are getting more careful and \nconcerned.\nOutbreak still roaring:\nReleased by Chairman Rand Paul\n30PRESS: None\nAugust 16, 2020 (Sunday) – No Sunday shows for me.  They are putting out Scott \nAtlas and Brett Giroir.   New emphasis is that we do not need to widely test, we \njust need to protect the vulnerable in Nursing Homes by testing personnel often \nReleased by Chairman Rand Paul\n31and occupants.  They are forgetting about the many vulnerables in the community \n(diabetics, obese, HT, elderly) who will get infected by community spread.\nPRESS:   Glenn Kessler (fact checker for Washington Post) wrote a piece in \ntodays Post indicating that Trump was incorrect in his statements that I was \nwrong on: 1) saying that everything is OK and we do not need to worry; 2) \nthat I opposed China travel ban;  3) that I was against masks.\nAugust 17, 2020 – Global     USA\nReleased by Chairman Rand Paul\n32•Did Fireside chat with Gallaudet University\n•Discussion with Cong. Sanford Bishop (D-GA) – member of CBG – \nparticular interest in Vets.  \n•Gave COVID lecture to ASM Microbe meeting.   Afterwards did fireside \nchat with Peggy Hamburg\nPRESS: Taped interview with J.J. Green, national security correspondent for \nWTOP radio;\nAugust 18, 2020 – Global – 22,000,000/773,000;    USA – 5,400,000/170,000\nI continue to be kept out of the classic press but am getting in through indirect \nways.   Still have >1000 deaths per day.   Scott Atlas now the main person that \nTrump listens to.   I have reached out to Scott to give him a fair chance to explain \nto me exactly how he feels about children getting infected and the issues with \nletting community spread happen.  We obviously differ here.   He and White \nHouse feel that we can let children get infected in schools since they do not get \nsick and we just need to protect the vulnerable in Nursing Homes.   Fallacious \nthinking since there are many not in Nursing Homes who are vulnerable such as \nobese people, diabetics, hypertensives, etc.   ALSO, many reports coming out now \nabout long term cardiovascular and brain effects in younger people who were not \nReleased by Chairman Rand Paul\n33even sick enough to go to the hospital, and who were merely home in bed for a \ncouple of weeks.  ALSO, more younger people dying.\nOf note, I was the only one of the Doctors in the TF who was noit invited to be \npresent in the Sit Room for the Governors’s call today.\nJoan Baez texted me saying that she now has 3,000,000 views on her Face Book \nnote to me.  Her  comment was:  “Over three million views.   Is this fun or what?”\nPRESS: Healthline Town Hall; Commonwealth Club of California Fireside \nChat; Bloomberg Quicktake Live\nAugust 19, 2020   Global – 22,000,000/776,000;    USA – 5,500,000/171,000 \nReleased by Chairman Rand Paul\n34\nReleased by Chairman Rand Paul\n35Interesting that Scott Atlas announced at a Doctor’s Huddle that I was on board in \nseeing the rationale for his statements.\nJoan Baez Face Time now has 4,000,000 views re: my portrait and her words about \nme.\nPOTUS called up Collins and started ranking that Francis and I are hurting him \nby getting in the way of the EUA for convalescent plasma   he was yelling at \nFrancis saying that he and I (and Cliff to some extent) are undermining him.   See \narticle in the NY Times today as well as Politico that said that Trump feels that \nFrancis and I are pushing back on the EUA for “political reasons”.\nPRESS: “60 Minutes – Australia” TV; Radio Lab – NY Public Radio – Tracy \nHunt; Podcast with Frank Sesno – covered on C-SPAN; IDSA Podcast with \nCarlos Del Rio; Interview with Der Spiegel  (German print); New York Times \narticle by Noah Weiland reports that Francis Collins and I and Cliff Lane are \npushing back on the possibility of an EUA for convalescent plasma until more \nReleased by Chairman Rand Paul\n36data come in since we feel the current data does not justify an EUA at this \npoint.   It reports that we are working with the FDA on this.   However, some \nare interpreting that we are pushing back against the FDA, which is not true.   \nPeter marks is on board with us.\nAugust 20, 2020 – Global    USA\n•Surgery today to remove polyp from vocal cord at GWU Hospital by Dr. \nSteven Bielamowicz.\n•Becoming really nice pen pal with Joan Baez.\n•\nPRESS:   Much press coverage of my surgery started by Sanjay at CNN and \nthen went viral\nAugust 21, 2020 – Global   USA\n•Washington Post is writing a story that is intended to be a hit job on Pence \nand Short. Katie Miller asked me to counter with some statements and I did\nReleased by Chairman Rand Paul\n37\nReleased by Chairman Rand Paul\n38PRESS:   Continued coverage of my surgery in press.\nAugust 22, 2020 – Global – 22,800,000/795,000;   USA – 5,600,000/175,000  \nReleased by Chairman Rand Paul\n39•POTUS called my cell at around 7:37 PM while I was outside on back \ndeck with Chris and Jenny.   It was the White House Operator saying the \nPOTUS wanted to speak with me.   I could not speak sine Dr. Bielamowicz \nsaid to not utter a word until tomorrow (Sunday), Chris answered and gave \nmessage to WH operator.  POTUS called back and said he hoped I was \ndoing well.\nI was concerned that he might think I was disrespectful for not answering the \nphone and so I texted Katie Miller ad explained the situation and asked if \nshe or Stephen Miller could get the message to the POTUS and explain why \nI could not speak.  She teted back and said that VP Pence would take care of \nit and tell the POTUS.  I could not figure out why he called.   He could have \nread about my surgery and was checking on me.  Or there is a lot of tension \nagainst Francis Collins ad me in the WH because we have questioned the \ndata supporting an EUA for convalescent plasma.  They re holding it up \nuntil further data are available tomorrow and POTUS is saying the scientists \n(particularly FDA) are “deep state”.   He throws that around a lot.  Katie \nthinks he was calling to thank me for saying in interviews that we can get \nthings back without shutting down again.  We may never know.\nPRESS: Australia “60 Minutes” TV interview to be shown tomorrow (Sunday \nin Australia);\nAugust 23, 2020 (Sunday) – Global    USA\nReleased by Chairman Rand Paul\n40\nReleased by Chairman Rand Paul\n41Very bad and disgraceful day for FDA and Steve Hahn and Alex Azar – They \ncaved to pressure from Trump to issue EUA for Convalescent Plasma (CP).   \nFrancis Cliff and I among others a few days ago looked at the data and since there \nwas no control and the analysis was post hoc with end points that were NOT \npredetermined, we could not say that there was any effect.  When they tortured the \ndata, they came up with a 35% decrease in deaths among people 3 days from dx, \n.80 years old and not on ventilator.  Very narrow group.  We had agreed to wait for \nfurther data from the same Mayo Clinic study to do a predetermined end point \nanalysis to see if it strengthened the original data.   The new data was collected, but \nbefore we could see it, Mark Meadows decided to “break the log jam” and got \nSteve Hahn and Alex to cave in and issue the EUA tonight, the night before the \nbeginning of the GOP convention tomorrow night.   I am afraid that this will \nhappen with the upcoming vaccine trials.\nPRESS:  New York Times and Washington Post coverage of old statements by \nme and Francis and Cliff about our skepticism of the EUA data\nAugust 24, 2020 – Global – 23,300,000/806,000;   USA – 5,700,000/177,000\nReleased by Chairman Rand Paul\n42\nReleased by Chairman Rand Paul\n43•Got call from Albert Bourla (CEO of Pfizer) expressing concern about \nAstraZenica likely trying to get an EUA for their vaccine before the big \ncompanies (Moderna, Pfizer, J & J complete their phase 3 trials.   We \ndiscussed what to do.   He suggested that he ask the companies to sign an \nagreement that they will all strive for completion of phase 3 studies before \ndecisions are made.   I suggested that we get the scientific community \ninvolved who should demand to see the data upon which the FDA would \nmake any decisions.\nThe Nashville, TN Public Defender has established the “Fauci Award”:\n Introducing the Dr. Fauci Award! This Nashville Defenders Award recognizes staff members \nwho embody the admirable qualities and character of the Director of the National Institute of \nAllergy and Infectious Diseases, Dr. Anthony S. Fauci. Amongst the numerous positive \nqualities demonstrated by Dr. Fauci which include a commitment to perseverance in the face \nof adversity, compassion, cleanliness, good health, and concern for the education, protection, \nand welfare of others above his own personal interests. Dr. Fauci has stood in the face of \npower and fought back, maintaining his integrity and keeping his mission in the forefront.\nReleased by Chairman Rand Paul\n44PRESS:  Article (online today, print tomorrow) in Washington Post by Ashley \nParker, Josh Dawsey and Philip Rucker quoting me as defending Pence - \nPolitics\nMike Pence hopes four years of \nsubservience to Trump will lift his \npolitical future\nInterview with Julie Steenhuysen of Reuters on COVID-19 vaccine trials; New \nYork Times – Sheryl Stolberg is doing a profile on me and my recent surgery \nand other things.\nAugust 25, 2020 – Global   USA\nSteve Hahn admits publicly that he “exaggerated” the data showing effect of \nCP on death rate.   He originally said that out of 100 patients, 35 lives were saved, \nwhich is absolutely incorrect.   He now admits that but he does not back down on \ndeclaring a positive effect.  Data analysis from Mike Lauer and Dean Follmann \nshow absolutely no effect.\nReleased by Chairman Rand Paul\n45See Below from Martha’s Vineyard\nReleased by Chairman Rand Paul\n46Spain is starting to “explode:\nReleased by Chairman Rand Paul\n47PRESS:\nAugust 26, 2020 – Global    USA\n•POTUS holding more briefings with Scott Atlas and others (Dr. Jay \nBhattacharya, Dr. Joseph Ladapo, Dr. Martin Kulldorff, and Dr. Cody \nMeissner) to the exclusion of Deb Birx.  Making it very awkward for her.   I \nhave been out of the briefing loop for some time now.\n•We have been seeing surges that follow crowded events – Memorial Day, 4th \nof July, and now with Labor Day coming up, there is concern that we will \nsee another “surge” as people move around, travel and return home from \nbeaches, etc.   We are playing “whack a mole”\nSign in East Village, NYC:\nReleased by Chairman Rand Paul\n48\nReleased by Chairman Rand Paul\n49\nReleased by Chairman Rand Paul\n50•Big shit show today about the change in CDC testing guidelines where they \nsaid if you are exposed to a documented case of COVID-19 you need not get \ntested if you are asymptomatic.   This version was circulated at a TF meeting \na couple of weeks ago and we were asked to look at it and sign on.   I did so \ncursorily, made a change but did not grasp the implications of this change \nthat means we put no emphasis on symptomatic spread.  The guidelines were \nfurther discussed at a Aug 20 TF meeting when I was under general \nanesthesia for vocal cord surgery.   When the shit hit the fan and the public \nhealth community went nuts at these changes, Brett Giroir said at a press \nconference that the TF, explicitly mentioning me, approved this, it got me \nvey upset.  Clearly at the Aug 20 meeting, Deb Birx did not agree (she told \nme so).   Also, I did not give it a lot of attention and I was not in the room \nfor the final discussion when Deb objected.  Sanjay Gupta (CNN) reported \nthe disconnect between me and Brett which caused a bit of a media storm.   \nBehind these changes was Scott Gottlieb\n•Telephone conversation between Peter Marks, Steve Hahn, Francis Collins, \nCliff Lane, Mike Lauer, Dean Follmann, and Rich Forshee (FDA) about the \nbasis of their declaring an EUA on CP.  We (NIH) feel that FDA clearly \ncaved to the White House and we were trying to examine the data that was \nthe basis for their decision.   Clearly Hahn was very defensive and Peter was \n“hurt” because he thought that the NIH was attacking the FDA.   We settled \nit, but it is becoming clear that Steve is a bit more political than we are.  \nSeems to be star struck about being around the White House and likely \ncaved to Meadows. Who is looking for good news before the election.\nReleased by Chairman Rand Paul\n51PRESS:  Shit show about CDC guidelines changing and Brett Giroir saying \nthat I approved them  (see above)\nAugust 27,2020 –\n•I wrote an email to Brett trying to make peace:\n-----Original Message-----\nFrom: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> \nSent: Thursday, August 27, 2020 6:31 AM\nTo: Birx, Deborah (nsc.eop.gov) < Deborah.L.Birx@nsc.eop.gov >; Giroir, Brett \n(HHS/OASH) <Brett.Giroir@hhs.gov>\nCc: Redfield, Robert R. (CDC/OD) < olx1@cdc.gov>\nSubject: RE: Testing \nBrett:\n   I am sorry that there was so much press seemingly pitting you against me \nregarding approval or not of the changes in the CDC guidelines.  I want to make \nsomething clear from my perspective and hopefully we can move on as good \ncolleagues.  According to the press reporting, you stated that the guideline \nchange was \"approved\" by the task Force including and specifically by me.   If \nwhat we did  was the process for \"officially approving\" as important a document \nas the CDC guidelines, then the process is clearly flawed.   There was no official \n\"group discussion\" at any meetings that I was at. The document was passed \naround to us individually before or after a TF meeting and indeed I did quickly \nlook at it.   I considered the document as a done deal that would not change no \nmatter what we said.   To your credit, you did make one minor change that I \nsuggested.   Importantly, had I appreciated that Deb, the Task Force \nCoordinator,  had such a real problem with it (see her e-mail below), I would have \nlooked at it much more carefully and discussed her concerns with her in detail, \nand re-read it in that context.    I understand from Deb that a discussion did occur \nat the Aug 20 meeting (see below) when I was out being operated on at GWU \nhospital.    Upon careful examination of the document now, I see why the \ncommunity is up in arms about it since that change can and is being interpreted \nby many as indicating that we do not believe that asymptomatic spread and thus \nReleased by Chairman Rand Paul\n52community spread is important enough to test for it.   We can argue within the \nconfines of the Situation Room that the intent of the guidelines are clear and crisp \nand helpful.  However, the overwhelming proportion of the public health \ncommunity are baffled by these changes.  This is an unforced error.  I am happy to \ndiscuss with you.   Again, sorry for the misunderstanding.\nBest,\nTony\nPowder Attack!!! – Today, I received a letter at home from Jacksonville, FL looking like the \nvery many letters that I get each day, usually asking me to sign a baseball card or an index card.   \nThe letter had typewritten address as opposed to WORD processor.   It was very thin.  I brought \nit o work and around 10:30 AM started opening the “fan mail”.   I opened this one and took out a \nReleased by Chairman Rand Paul\n53single sheet of white paper that was folder in 1/3s.   As I opened the folding, fine white powder \nessentially shot up for the paper an got on my hands, my tie, shirt ants, face, desk and chair.   I \nimmediately called Kim and told her not to come into the room but to get George and Brett \n(security) who were down the hall.   They came and we put the letter and envelope in a plastic \nbag and called NIH Hazmat.   The entire team came and hade me strip naked to spray me down.   \nI then went downstair to take a long shower and put on my running shots to go home with.   All \nmy closes and everything that I touched went into a plastic bag for forensics.   George and Brett \ntook me home and we waited for the analysis that finally showed no protein (anthrax or ricin).  \nSheet of paper had typewritten statement: “MANDATORY LOCKDOWNS…MEDICATIONS, \nREAP WHAT YOU SOW.   SIC SEMPER MARXUM PRODITORES.  ENJOY    YOUR      \nGIFT”  \nAlan Alda and Anthony Fauci Talk Science \nin Live-Streamed Smithsonian Associates \nEvent\nPRESS:   GOP convention dominating.   Yet, much press around the CDC \nguidelines mess (see above);   New York Times: How Dr. Fauci \nFound Himself Talking to Julia Roberts, Lil \nWayne and Just About Any Podcaster Who \nAsked\nReleased by Chairman Rand Paul\n54By Quoctrung Bui, Margot Sanger-Katz, Sheryl Gay Stolberg , Noah Weil and and Kitty \nBennettAug. 27, 2020\nAugust 28, 2020 – Global   USA\n•Amazing that there were no leaks to the press following the powder attack.\n  \nStill >40,000 cases per day\nReleased by Chairman Rand Paul\n55Email exchange with Kellyanne Conway on the announcement of her \nleaving the WH:\nDear Dr. Fauci – \nWhat a kind and welcome note. Thank you for taking the time. Indeed, it has been a pleasure \nworking with and learning from you over the past 6 months in the face of a global pandemic. \nYou may be “America’s Doctor,”  but you also are accessible and affable. Thank you for your \nmany kindnesses.\nI hope you are feeling better following surgery, and that you will heal quickly and completely. \nGod bless you. Always here for you, if I may help in any way.  \nFondly, \nKellyanne\nReleased by Chairman Rand Paul\n56KAConway@gmail.com\n202-251-9943\nFrom:  Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> \nSent: Monday, August 24, 2020 7:22 AM\nTo: Conway, Kellyanne E. EOP/WHO <KAC@who.eop.gov>\nSubject: miss you\nKellyanne:\n  I was sorry to read in the Post today that you will be leaving the White \nHouse at the end of the month.  However, your reasons appear to be \nquite sound and your usual good judgment seems to have prevailed.   I \nreally will miss seeing you around the Sit Room and the Oval.   You light \nup the room and I always feel a little better when you are \naround.   Take care of yourself and I hope that we continue to run into \neach other in the future.\nWarm regards,\nTony\nAnthony S. Fauci, MD \nDirector \nNational Institute of Allergy and Infectious Diseases \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520 \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n59pandemics, would you want to stay in a role where you were suddenly \nconstantly criticized and undermined by your current administrator and \nwere receiving death threats?\nAl Jazeera TV (UK); \nAugust 29, 2020 –  Global – 24,600,000/834,000;    USA - ,99,000/181,000\nFound out from George Adams and Brett Rowland that similar powdered letters \nfrom the same person (from Jacksonville. FL) also were sent to Nancy Pelosi, \nBernie Sanders, AOC, Bill Gates, among other “liberals”\n.\nAugust 30, 2020  (Sunday) – Global – 25,000,000/840,000    USA – \n5,900,000/182,000\nReleased by Chairman Rand Paul\n60Sunday shows dominated by recent GOP convention and the blatant lies that \nTrump spewed forth during the convention.   Also, to hold a conventin event \ndirectly at the White House is a gross violation of the Hatch Act.\nConcern now about post-labor day (coming up) surge of cases as people \ncongregate.\nSpoke with Joan Baez today – She wants to use the portrait of me to advertise the \nneed for science and adhering to public health messages. In essence, she wants to \nuse the portrait in PSAs.  She really is wonderful.\nAugust 31, 2020 – Global   USA\nTrump stoking violence (racial tensions) in Kenosha, WI and Portland, OR\nQAnon misrepresenting data from CDC that says that about 9000 out of the \n>180,000 deaths reported for COVID-19 had only COVID-19 on the death \ncertificate.   The remainder also had other underlying conditions.   QAnon is \nsaying that all the other deaths had nothing to do with COVID-19.   The", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: confrontation with the people from Moderna, mostly Tal Zaks, aandStephane  Bancel who wanted to push backon the collaboration (mostly do their own thing).    Moncef, John, Larry and I set them straight.   Also Mikael Dolsten and people from  Pfizer also wanting part of our resoruces (clinical sitesd) without joining the  collaboration.   Several conference calls to straighten this out.   It is not going to be easy. Had long conversation on “background” with Bob Woodward who is writing a book on  the early response to COVID in the USA.   I provided him with some history of our  response in early January and into February.   Will tlak more with him tomorow PRESS: Wall Street Journal interview re: Chinese vaccines for COVID; Canadian  Radio re: Larry Kramer; Young Money Radio – Lil Wayne…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 3, "page_count": 1141}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 4 of 10)", "content": "POTUS \nloves this and is tweeting that Fauci and Birx shut down the country for only 9000 \ndeaths.   What an idiot!! \nReleased by Chairman Rand Paul\n61See below:   Cases/day are not dramatically falling.   Looks like they may be \nplateauing again\nGot called down to White House to do the Governors’s call.\nReleased by Chairman Rand Paul\n62PRESS: Washington Post Article indicating that Scott Atlas is pushing for a \n“herd immunity” approach to the outbreak and said he was the “anti-Fauci” \nin the White House. New York Times article will come put today with same \nstory.\nSeptember 1, 2020 – Global 25,300,000/848,000; USA – 6,000,000/184,000\nDid the usual weekly Miami Mayor’s call with Deb and Redfield.   Mayor Suarez \nand Major Jimenez\nReleased by Chairman Rand Paul\n63Another inappropriate explosion by Mark Meadows.  The NUH Treatment \nGuidelines came out in response to the EUA for convalescent plasma (CP).  It just \nrepeated what it had said before saying that there was not sufficient evidence for or \nagainst the use of CP and that clinical trials should continue.   In essence, this is \nwhat the EUA said.   However, the press went nuts saying that NIH contradicted \nthe FDA and the POTUS who said that CP was a “major historic breakthrough”.   \nIn fact, the EUA and the Guidelines were aligned.  It was the POTUS, AZAR, and \nHahn who over-exaggerated.   In any event, Meadows called up Francis Collins \nand started screaming saying that he needs to “fix this”.  Meadows said until he \ndoes, Fauci and you will not get in front of a TV screen “even for a podcast with a \n3rd grader”.   Francis sent out a tweet to explain that there was no difference \nbetween the EUA and the Guidelines and Meadows was satisfied.   Another day in \nParadise…..\nPRESS:  ABC Good Morning America;   Taped Today Show (NBC)  - \nSheinelle Jones – concerning my vocal cord surgery; NBC Nightly News\nSeptember 2, 2020 – Global – 25,600,000/854,000;   USA  - 6,000,000/184\nReleased by Chairman Rand Paul\n64PRESS:   MSNBC with Andrea Mitchell;\nSeptember 3, 2020 – Global – 25,800,000/860,000;    USA – 6,100,000/185,100\nBig concern about a potential upsurge following Labor Day Weekend.   I am \nemphasizing this on TV hits (see below)\nPRESS: CNN with Jim Sciutto; Katie Couric podcast; Marc Siegel Doctor \nRadio; NBC Nightly News\nSeptember 4, 2020 – Global – 26,300,000/864,000;  USA – 6,100,000/186,000\nReleased by Chairman Rand Paul\n65PRESS:  Global News Canada TV; STAT interview – Joseph Andrew; CNN \nSituation Room with Jim Acosta\nSeptember 5, 2020 Global – 26,500,000/871,000;   USA 6,200,000/187,200\nReleased by Chairman Rand Paul\n66PRESS:  New York Times print interview regarding Labor Day weekend and \nCOVID;\nSeptember 6, 2020 – Global    USA\nReleased by Chairman Rand Paul\n67PRESS:  Sunday dominated by election\n \nSeptember 7, 2020 - Global   USA\nReleased by Chairman Rand Paul\n68PRESS:  Spoke with Robyn Ross of the Washington Post Magazine.   She is \nwriting a piece on my “Bobblehead”.\nSeptember 8, 2020 – Global    USA\nReleased by Chairman Rand Paul\n69Had weekly Miami Mayor’s call with Deb Birx and Miami Mayors Gimenez and \nSuarez\nSeptember 9, 2020 –\nReleased by Chairman Rand Paul\n70Bob Woodward’s book “Rage” just came out today causing a media fire \nstorm since it has Trump saying that he knew along along that COVID-19 was \nvery serious, but he played it down to not frighten the American public.   \nReleased by Chairman Rand Paul\n71Some potentially damaging stuff about me.   Woodward always said my \ndiscussions with him were “background” and not “on the record”.   Yet he has \nothers giving quotes by me that sounds like on the record.   For example:\nCNN:  Dr. Anthony Fauci, the administration's top infectious disease expert, is quoted telling \nothers Trump's leadership was \"rudderless\" and that his \"attention span is like a minus \nnumber.\" \n\"His sole purpose is to get reelected,\" Fauci told an associate, according to Woodward. \nWashington Post: The book charts the Trump administration’s failings and missteps on the \npandemic, including the decisions and actions of Pottinger, Centers for Disease Control and \nPrevention Director Robert Redfield, infectious-disease expert Anthony S. Fauci and others.\nFauci at one point tells others that the president “is on a separate channel” and unfocused in \nmeetings, with “rudderless” leadership, according to Woodward. “His attention span is like a \nminus number,” Fauci said, according to Woodward. “His sole purpose is to get reelected.”\nIn one Oval Office meeting recounted by Woodward, after Trump had made false statements in \na news briefing, Fauci said in front of him: “We can’t let the president be out there being \nvulnerable, saying something that’s going to come back and bite him.” Pence, Kushner, chief of \nstaff Mark Meadows and senior policy adviser Stephen Miller tensed up at once, Woodward \nwrites, surprised Fauci would talk to Trump that way.\nWoodward describes Fauci as particularly disappointed in Kushner for talking like a cheerleader \nas if everything was great. In June, as\n•Went on FOX News with John Roberts and unfortunately gave impression \nthat I was defending Trump since I answered John’s question about did I \never see Trup play down COVID.   I answered that we briefed him in the \nOval and he would come out and not really contradict us.   I should have \nsaid that he does play down COVID such as when he said it would \n“disappear like a miracle”.\nPRESS: CBS This Morning; LBC UK Radio; Latin Leaders Magazine; FOX \nNews with John Roberts; Celine Grounder podcast; Instagram with Jennifer \nGarner\nSeptember 10, 2020 – \nReleased by Chairman Rand Paul\n72Did podcast and PSAs with Dennis Quaid\nGave Grand Rounds to the Harvard Hospitals (all of them together).   Much \npositive feedback\nPRESS:  Interview and photo shoot with Alice Park for TIME Magazine \nSeptember 11, 2020 - Global – 28,000,000/905,000;  USA – 6,400,000/191,400\nReleased by Chairman Rand Paul\n73•I corrected with Andrea Mitchell on MSNBC (see below) what I should \nhave said to John Roberts on FOX\n•Had great dinner over my house with Peter Staley (and his dog Stella) with \nChris, Janet Tobias and John….\nReleased by Chairman Rand Paul\n74PRESS:  Interview with Newsweek – Fred Guteri; MSNBC with Andrea \nMitchell; CNN Situation Room with Wolf Blitzer\nSeptember 12, 2020\nSeptember 13, 2020\nImportant Day!! – POTUS called me up at around 11:20 AM (Sunday) and \nstarted a diatribe about my interview on Friday with Andrea Mitchell on MSNBC.   \nHe went on and on about how negative I was on the show.   He said that I was \ngreat on Thursday with John Roberts (FOX) and so “what happened” to make me \nnegative.   I tried to explain to him that the entire message was not all negative.   I \nwas really saying that there is a risk with the upticks in ND, SD, MT and other \nstates for a surge if we do not intensify the public health measures of masks, \ndistance, crowds, etc.   I emphasized that what I was saying is that we can control \nthis without having to shut down.   As soon as I mentioned the word “shut down” \nhe went off saying we will never again shut down as if I was suggesting that we \nwould when I was saying just the opposite.  He then went off on asking about \nReleased by Chairman Rand Paul\n75vaccines and saying that I should take credit for success instead emphasizing \nfailures.   It really was stream of consciousness. We ended the call on a friendly \nnote, but it was clear that he did not want me to do this anymore.   He mentioned \nwhether or not I like Trump, I should not do this.   I told him that I do not dislike \nhim and he knows that.   He agreed.  I will either have to stay off TV or continue to \ndisappoint him since I cannot change my message.\nThis evening when I went up to Chef Geoff’s to pick up carry out hamburgers for \nme and Brett Rowland, every outdoor table serving Chef Geoff and Al Dente was \nReleased by Chairman Rand Paul\n76occupied and every person at the tables gave me a roaring round of applause as I \nleft Chef Geoff’s with my food.   It blew me and Brett away.   Very moving.\nSeptember 14, 2020 – Global – 29,000,000/922,000;  USA – 6,500,000/194,000\nMichael Caputo went crazy.   Article in NY Times has him raving about conspiracy \ntheories;\n“Trump Health Aide Pushes Bizarre Conspiracies and Warns of Armed Revolt” by \nSharon LaFraniere\nReleased by Chairman Rand Paul\n77Europe is starting to surge:\nSeptember 15, 2020 – Global – 29,200,000/927,000;    USA 6,500,000/194,000\nHad virtual press conference with Gov. Phil Scott (R-VT).  They are doing very \nwell with test positivity of 0.2%\nHad call with Miami Mayors (weekly event) with Deb and Bob Redfield\nDid 1 hour briefing of Congressional Progressive Caucus (liberal Dems)\nTask Force meeting.   VP gave me a signed enlarged photo of he and I.\nPRESS: See above press conference in VT; NPR with Joe Palca (pre-recorded \nfor later date); \n \nSeptember 16, 2020 – Global  - 29,400,000; 931,000;   USA – 6,600,000/195,100\nReleased by Chairman Rand Paul\n78Did Congressional Hispanic Caucus Institute Leadership Conference with Sanjay \nGupta moderating\nPRESS:Bloomberg News Podcast – David Rubenstein; Business Insider \ninterview; BMJ Podcast; Wall Street Journal podcast interview; Wall Street \nJournal online event\nReleased by Chairman Rand Paul\n79September 17, 2020 – Global   USA\nWas a panelist on the “CEO Global Perspectives Series Webcast (Oxford, UK) \nwith Michael Earl (Moderator) and Sir John Bell (co-panelist).   Great discussion \ncomparing UK and USA experience.\nPresented to ONE Board on COVID-19 – Bono, Josh Bolten, and Sheryl Sandberg \nwas on the Zoom\nMichael Caputo diagnosed with squamous cell carcinoma metastatic to cervical \nlymph node. – head and neck cancer.\nReleased by Chairman Rand Paul\n80PRESS: WTOP Radio; MSNBC TV – Chris Hayes\nSeptember 18, 2020 – \nReleased by Chairman Rand Paul\n81New cases today at 43,000\nTesting has decreased and so hospitalizations per 100 case has increased since we \nare missing asymptomatics (see note above)\nPRESS:   Interview with La Repubblica; \nSeptember 19, 2020   Global – 30,400,000/950,000;    USA – 6,700,000/198,100\nReleased by Chairman Rand Paul\n82The 4 Presidents from the Washington Nationals came to my house today to \npresent me with the “Sammie” Award as the Outstanding Federal Employee.   Had \nmany cameras filming the event.  \nSeptember 20, 2020 (Sunday)  Global    USA\nYet again, I am not allowed on Sunday Shows while Brett Giroir is doing SOTU.\nSigns in NYC subway stations:\nLot of discussion about the transverse myelitis in a volunteer in the UK Chimp Ad \nOxford trial.   May have had a prior case, but was designated as multiple sclerosis.   \nTrial re-started in UK; not yet in USA (the AZ trial)\nReleased by Chairman Rand Paul\n83Scott Atlas deliberately trying to undermine Deb Birx interpretation of the data\nReleased by Chairman Rand Paul\n84September 21, 2020 – Global   USA\nWas on weekly Governors call via phone.   Explained to them about vaccine \nprotocol, i.e. Data to DSMB to Company to FDA for EUA/BLA to VRPAC \nadvisory committee.   All transparent to scientific community.\n104 million tests performed in the USA\nReleased by Chairman Rand Paul\n85Had wonderful time at Adrienne Asche’s home 2221 – 30th Street, NW.   Outdoor \nconcert with NPO (National Pops Orchestra led by Luke Frazier.   Adrienne called \nme out and Luke Dedicated a song to me (Climb Every Mountain).   Everyone \nmasked and physically distant with champage at each separate table of people \nalone or withspouses.  Present were Ambassadors from Iraq, Mexico, Colombia, \nand UK\nPRESS:   Did a series of YouTube chats with Trevor Noah; Fat Joe; The Onyx \nFamily; and The SloMo Guys;  The Daily Beast – Erin Banco; CNN Jeremy \nDiamond \nStory broke in the Daily Beast:\nA Notorious COVID Troll \nActually Works for Dr. Fauci\nINSIDE JOB\nBill Crews is a PR official at the National Institutes of Health. But he \nalso has another job: an anonymous RedState editor who rails against \nthe agency for which he works.\nLachlan Markay\nSeptember 22, 2020   Global   USA\nReleased by Chairman Rand Paul\n86 \n \nPRESS: CNN Citizen Conference with Sanjay Gupta;  Interview with The \nAtlantic Festival with Alexis Madrigal was carried on CNN and other \nnetworks\nSeptember 23, 2020 – Global – 31,400,000/966,666;   USA – 6,900,000/200,000\nReleased by Chairman Rand Paul\n87For Time Magazine 100 Most Influential People, I was ranked #1 among the \n“Leaders” category\nTHE 100 MOST INFLUENTIAL PEOPLE OF 2020\n BACK TO HOME\nAnthony Fauci\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n89Stefan Ruiz for TIME\nBY JIMMY KIMMEL\nSEPTEMBER 22, 2020 9:34 PM EDT\nA s the COVID-19 pandemic began to spread to the U.S ., there \nwas one person millions of Americans immediately knew we could turn \nto for guidance: Dr. Anthony Fauci . As director of the National \nInstitute of Allergy and Infectious Diseases, Dr. Fauci has advised six \nPresidents over 36 years. When COVID-19 reared its ugly head, he was \namong the first to step forward with facts and only facts .\nDr. Fauci doesn’t sugarcoat his words and refuses to be pressured by \npoliticians . He delivers the truth, as difficult as it may be to hear, \nearnestly and with one goal: to save lives. His courage and candor have \nearned our trust. We are all fortunate to have a man of his wisdom, \nexperience and integrity to help us navigate these difficult waters.\nKimmel is the host and an executive producer of Jimmy Kimmel Live!\nLEADERS \n•Anthony Fauci \n•Kamala Harris \n•Tsai Ing-wen \n•John Roberts \n•Xi Jinping \n•Donald Trump \n•Caesar \n•Angela Merkel \n•Joe Biden \n•Jair Bolsonaro \n•Nancy Pelosi \nReleased by Chairman Rand Paul\n90•Narendra Modi \n•William Barr \n•Anne Hidalgo \n•Tedros Adhanom Ghebreyesus \n•Mary Kay Henry \n•Nemonte Nenquimo \n•Ursula von der Leyen \n•Jung Eun-kyeong \n•Bonnie Castillo \n•Jean-Jacques Muyembe Tamfum \n•Yousef Al Otaiba \nNote of appreciation from Senator Feinstein:\nNote to Dr. Fauci \n9.23.20.pdf\nReleased by Chairman Rand Paul\n91Had Hearing today at the Senate HELP committee Chaired by Sen. Alexander (R-\nTN) and ranking minority Sen. Murray (D-WA).   Had hostile interaction with Se. \nRand Paul.   I really stuffed him as he spouted out bullshit acting like he is a \nexperienced epidemiologist.\nDid Smithsonian sponsored “chat” with Alan Alda.   We are very fond of each \nother. Went very well.   \nInterviewed with Jon Cohen for an HBO documentary that Jon is doing with David \nFrance on COVID-19\nPRESS: Much press about my encounter with Sen. Paul\nSeptember 24, 2020 – Global   USA\nReleased by Chairman Rand Paul\n92Still >40K cases per day:\n•Made major presentation (virtually) to the World Vaccine Congress\n•Given the mixed messages from FDA and CDC (with CDC stumbling all \nover themselves in first saying do not test asymptomatics and then saying \nyes, test them.   Also, first saying aerosol is important and then saying it is \nReleased by Chairman Rand Paul\n93not).   POTUS now saying he may not wait for the 60 day “wait for safety \nrule” following the time 50% of the vaccines receive their last dose for the \nimplementation of an EUA.  FDA (Steve Hahn) says he will listen to his \ncareer scientists and have this be part of the EUA criteria, while the POTUS \nhas hinted he would over-rule this and get an EUA out right away, i.e. before \nthe election.\nPRESS:  Did press conference with Governor Murphy (D-NJ) – appeared live \non ABC; did Face Book LIVE with Francis Collins on Janssen Vaccine; Did \n“Fireside Chat” with Carlos Del Rio moderated by Sanjay Gupta (clearly will \nappear on CNN)\nSeptember 25, 2020  - Global – 32,100,000/980,000;   USA – 6,900,000/292,300\nHave not mentioned this, but threats and harassments of my children continue, \nparticularly of letters and texts to Megan.  These assholes have her home address \nand write to her threatening me, which is quite disturbing to her.   We have sent all \nof this to Brett Rowland (security) who is\nReleased by Chairman Rand Paul\n94PRESS:  Appeared in Newsweek: Herd Immunity Study \nRand Paul Cited Against Fauci Actually \nRefutes Senator's Claim\nBy Hannah Osborne On 9/25/20 at 7:56 AM EDT \nUK Channel 4 TV News; Late, Late TV Show in Ireland by Zoom; Instagram \nwith Peter Staley;   JAMA Podcast (usually gets picked up by networks); USA \nToday Interview; Interview with Donald McNeil of NY Times re: Herd \nimmunity and Scott Atlas\nSeptember 26, 2020 – \nMajor conflict between Deb and Atlas.   See below with Deb’s daily report.   \nAtlas says that we do not need to test for  asymptomatics since the only thing that \ncounts is preventing vulnerable people from dying.   He does not see the \nconnection between asymptomatic young people (without hospitalization and \ndeaths rising  →  older and vulnerable (with later hospitalization and deaths \nrising).   We are heading to a major clash between deb/me/Bob versus Atlas\nReleased by Chairman Rand Paul\n95\nReleased by Chairman Rand Paul\n96Jon LaPook has been wanting to do a 60 Minutes Special focused on me and \nComms has been disking around without responding.  Francis and I sent e-mails to \nAlyssa Farah and she apologized saying that she will approve 90% of requests for \nme and refuse ONLY those that are obviously politically charged.   Up to this \npoint, 95% of requests for me have be refused or ignored by the WH/HHS.   They \ntruly are dysfunctional even though I believe that Alyssa is a good person.\nMedai-Ite\nJoe Biden Promises to Hire Dr. Anthony \nFauci ‘Minutes After The Race Is Called’\nBy Tommy ChristopherSep 26th, 2020, 12:28 pm \n116 Comments\nSeptember 27, 2020 –  Global – 32,700,000/991,000;   USA – 7,060,000/204,000\nReleased by Chairman Rand Paul\n97Things really getting crazy.   Irish thought that I was physically present in Dublin \nfor the Late Late show interview (see above on Sept. 25) and they demonstrated \nagainst me:\nProtesters outside RTÉ last night were \nconvinced top US doctor had flown in for \nthe show\nReleased by Chairman Rand Paul\n98By Sarah Finnan  \nSeptember 26, 2020 at 9:15am\nShare: \nProtestors outside 'fake news HQ RTÉ' last night seemed to think that top US doctor Anthony \nFauci had flown in from DC especially for the show.\nPRESS:  Sunday and still no show appearances – all turned down by HHS \nand/or WH.  \nRAI TV live in Italy;\nSeptember 28, 2020 – Global    USA\nReleased by Chairman Rand Paul\n99Dr. Fauci Top 20 Highly Cited Papers (Based on Web of Science, 09/28/2020)\n1. Roberts AB, Sporn MB, Assoian RK, et al. “TRANSFORMING GROWTH-\nFACTOR TYPE-BETA - RAPID INDUCTION OF FIBROSIS AND ANGIOGENESIS \nINVIVO AND STIMULATION OF COLLAGEN FORMATION INVITRO.” \nProceedings of the National Academy of Sciences of the United States of \nAmerica. 1986;83(12):4167-4171. [2,613 citations]\n2. Hoffman, G. S., G. S. Kerr, R. Y. Leavitt, C. W. Hallahan, R. S. Lebovics, W. D. \nTravis, M. Rottem, and A. S. Fauci. 1992. \"Wegener Granulomatosis: An \nAnalysis of 158 Patients.\" Annals of Internal Medicine 116 (6): 488-498. \ndoi:10.7326/0003-4819-116-6-488. [2,060 citations]\n3. Koenig, S., H. E. Gendelman, J. M. Orenstein, M. C. Dal Canto, G. H. \nPezeshkpour, M. Yungbluth, F. Janotta, A. Aksamit, M. A. Martin, and A. S. \nFauci. 1986. \"Detection of AIDS Virus in Macrophages in Brain Tissue from \nReleased by Chairman Rand Paul\n100AIDS Patients with Encephalopathy.\" Science 233 (4768): 1089-1093. \ndoi:10.1126/science.3016903. [1,663 citations]\n4. Pantaleo, G., C. Graziosi, J. F. Demarest, L. Butini, M. Montroni, C. H. Fox, J. \nM. Orenstein, D. P. Kotler, and A. S. Fauci. 1993. \"HIV Infection is Active and \nProgressive in Lymphoid Tissue during the Clinically Latent Stage of \nDisease.\" Nature 362 (6418): 355-358. doi:10.1038/362355a0. [1,649 \ncitations]\n5. Fauci, A. S., B. F. Haynes, P. Katz, and S. M. Wolff. 1983. \"Wegener's \nGranulomatosis: Prospective Clinical and Therapeutic Experience with 85 \nPatients for 21 Years.\" Annals of Internal Medicine 98 (1): 76-85. \ndoi:10.7326/0003-4819-98-1-76.. [1,646 citations]\n6. Hunder, G. G., D. A. Bloch, B. A. Michel, M. B. Stevens, W. P. Arend, L. H. \nCalabrese, S. M. Edworthy, et al. 1990. \"The American College of \nRheumatology 1990 Criteria for the Classification of Giant Cell Arteritis.\" \nArthritis & Rheumatism 33 (8): 1122-1128. doi:10.1002/art.1780330810. \n[1,609 citations]\n7. Lane, H. C., H. Masur, L. C. Edgar, G. Whalen, A. H. Rook, and A. S. Fauci. \n1983. \"Abnormalities of B-Cell Activation and Immunoregulation in Patients \nwith the Acquired Immunodeficiency Syndrome.\" New England Journal of \nMedicine 309 (8): 453-458. doi:10.1056/NEJM198308253090803. [1,579 \ncitations]\n8. Kehrl, J. H., L. M. Wakefield, A. B. Roberts, S. Jakowlew, M. Alvarez-Mon, R. \nDerynck, M. B. Sporn, and A. S. Fauci. 1986. \"Production of Transforming \nGrowth Factor β  by Human T Lymphocytes and its Potential Role in the \nRegulation of T Cell Growth.\" Journal of Experimental Medicine 163 (5): \n1037-1050. doi:10.1084/jem.163.5.1037. [1,559 citations]\n9. Fauci, A. S. 1988. \"The Human Immunodeficiency Virus: Infectivity and \nMechanisms of Pathogenesis.\" Science 239 (4840): 617-622. \ndoi:10.1126/science.3277274. [1,523 citations]\n10.Leavitt, R. Y., A. S. Fauci, D. A. Bloch, B. A. Michel, G. G. Hunder, W. P. \nArend, L. H. Calabrese, et al. 1990. \"The American College of Rheumatology \n1990 Criteria for the Classification of Wegener's Granulomatosis.\" Arthritis \n& Rheumatism 33 (8): 1101-1107. doi:10.1002/art.1780330807. [1,392 \ncitations]\n11.Chun, T. -W, L. Stuyver, S. B. Mizell, L. A. Ehler, J. A. M. Mican, M. Baseler, \nA. L. Lloyd, M. A. Nowak, and A. S. Fauci. 1997. \"Presence of an Inducible \nReleased by Chairman Rand Paul\n101HIV-1 Latent Reservoir during Highly Active Antiretroviral Therapy.\" \nProceedings of the National Academy of Sciences of the United States of \nAmerica 94 (24): 13193-13197. doi:10.1073/pnas.94.24.13193. [1,317 \ncitations]\n12.Masi, A. T., G. G. Hunder, J. T. Lie, B. A. Michel, D. A. Bloch, W. P. Arend, L. \nH. Calabrese, et al. 1990. \"The American College of Rheumatology 1990 \nCriteria for the Classification of churg-strauss Syndrome (Allergic \nGranulomatosis and Angiitis).\" Arthritis & Rheumatism 33 (8): 1094-1100. \ndoi:10.1002/art.1780330806. [1,287 citations]\n13.Fauci, A. S., B. F. Haynes, and P. Katz. 1978. \"The Spectrum of Vasculitis. \nClinical, Pathologic, Immunologic, and Therapeutic Considerations.\" Annals \nof Internal Medicine 89 (5 I): 660-676. doi:10.7326/0003-4819-89-5-660. \n[1,272 citations]\n14.Arend, W. P., B. A. Michel, D. A. Bloch, G. G. Hunder, L. H. Calabrese, S. M. \nEdworthy, A. S. Fauci, et al. 1990. \"The American College of Rheumatology \n1990 Criteria for the Classification of Takayasu Arteritis.\" Arthritis & \nRheumatism 33 (8): 1129-1134. doi:10.1002/art.1780330811. [1,234 \ncitations]\n15.Kerr, G. S., C. W. Hallahan, J. Giordano, R. Y. Leavitt, A. S. Fauci, M. Rottem, \nand G. S. Hoffman. 1994. \"Takayasu Arteritis.\" Annals of Internal Medicine \n120 (11): 919-929. doi:10.7326/0003-4819-120-11-199406010-00004. \n[1,111 citations]\n16.Pantaleo G, Graziosi C, Fauci AS. THE IMMUNOPATHOGENESIS OF HUMAN-\nIMMUNODEFICIENCY-VIRUS INFECTION. New England Journal of Medicine. \n1993;328(5):327-335. [946 citations]\n17.Fauci AS, Dale DC, Balow JE. GLUCOCORTICOSTEROID THERAPY - \nMECHANISMS OF ACTION AND CLINICAL CONSIDERATIONS. Annals of \nInternal Medicine. 1976;84(3):304-315. [931 citations]\n18.Morens, D. M., G. K. Folkers, and A. S. Fauci. 2004. \"The Challenge of \nEmerging and Re-Emerging Infectious Diseases.\" Nature 430 (6996): 242-\n249. doi:10.1038/nature02759. [899 citations]\n19.Fauci AS, Macher AM, Longo DL, et al. ACQUIRED IMMUNODEFICIENCY \nSYNDROME - EPIDEMIOLOGIC, CLINICAL, IMMUNOLOGICAL, AND \nTHERAPEUTIC CONSIDERATIONS. Annals of Internal Medicine. \n1984;100(1):92-106. [887 citations]\nReleased by Chairman Rand Paul\n10220.Folks TM, Justement J, Kinter A, Dinarello CA, Fauci AS. CYTOKINE-INDUCED \nEXPRESSION OF HIV-1 IN A CHRONICALLY INFECTED PROMONOCYTE CELL-\nLINE. Science. 1987;238(4828):800-802. [872 citations]\nPRESS:   Good Morning America TV; The Netherlands TV – Nieuwsuur; \nCanadian Journalism Foundation World News Day with Brian Stelter (Web \nTV); Steph Curry – State of Inspiration Interview; Aspen Institute – Fireside \nChat with Helen Clark former PM of New Zealand\nSeptember 29, 2020 - Global  - 33,200,000/1,000,000;  USA – 7,100,000/205,000\nCases increasing in certain regions (see below).   Hospitalization starting to creep \nup.  Deaths will follow.   Total deaths have plateaued and so as deaths go down in \ncertain regions, which is true, deaths that increase in other regions result in a net \nflat curve.   Again, today big dispute between Deb (backed by me) and Atlas.   \nAtlas feels that after a city/town/state reach their peak, the turn around has nothing \nto do with any intervention that we apply.   He insists that the city/state has reached \nherd immunity.   He also cherry picks papers on T cell immunity and says that \ncross-reacting T cell immunity accounts for:  the 22% ab positive in NYC + 25 % \nT cell immunity = herd immunity.   He feels that all we need to do in protect the \nvulnerables in nursing homes and we will be OK.   No need to test and no need to \nworry about community spread.\n1st Presidential Debate tonight. Horrible “shit show”.   Trump was \nembarrassing, continually interrupting Biden, bullying all the way, making no \nsense, lying.   Moderator Chris Wallace could not control him.   Trump refused to \ndenounce White Supremacists and when asked about the “Proud Boys”, Trump \nsaid” “Stand down, stand by” essentially endorsing them.   Alos, he misquoted me \nsaying that I am against masks.   He also said that I praised him for saving lives by \nshutting down China travel.   Reporters (Chris Cuomo, Jim Sciutto, Maggie Fox, \netc) continually texting me during the debate wanting me to counter what he said \nabout me and masks\nReleased by Chairman Rand Paul\n103PRESS:  The Texas Tribune Festival – Fireside Chat with Lawrence Wright \n(The New Yorker); Interview with Wall Street Journal – Caitlin McCabe.  \n \nSeptember 30, 2020 – Global   USA\nReleased by Chairman Rand Paul\n104Addressed the Congressional Hispanic Caucus on COVID-19 led by Rep. Joaquin \nCastro (D-TX) and Rep Escobar.\nAddressed State, local and Tribal Officials  on COVID-19\nPresented plenary to American Academy of Pediatrics\nAddressed Quad Caucus together with Francis\nPRESS:   Wired TV with Steven Levy; ABC Podcast; Interviewed with \nWashington Post (Joel Achenbach) regarding anti-Science trend; New Yorker  \nInterview  \nNY Times: Fauci counters Trump for misrepresenting his stance on masks.\nReleased by Chairman Rand Paul\n105Anthony Fauci, director of National Institute of Allergy and Infectious Diseases at NIH, \nattaches his mask before testifying at a Senate Health, Education, and Labor and \nPensions Committee on Capitol Hill.Credit...Pool photo by Graeme Jennings\nDr. Anthony S. Fauci, the country’s leading official on infectious diseases, hit back at Mr. \nTrump on Wednesday for what he called the misrepresentation of Dr. Fauci’s stance on \nmasks to curb coronavirus outbreaks.\nIn the first presidential debate Tuesday, Mr. Trump claimed that Dr. Fauci initially said \nduring the pandemic “masks are not good. Then he changed his mind.” And responding \nto former Vice President Joseph R. Biden Jr.’s assertion that wearing masks could save \ntens of thousands of lives, Mr. Trump also contended that “Dr. Fauci said the opposite.”\n“Anybody who has been listening to me over the last several months know that a \nconversation does not go by where I do not strongly recommend that people wear \nmasks,” Dr. Fauci, the director of the National Institute of Allergy and Infectious \nDiseases, said during an interview on ABC News’s “Start Here” podcast. The full \ninterview can be heard tomorrow, ABC said.\nDr. Fauci explained that “very early on in the pandemic” authorities initially did not \nrecommend masks in the context of concerns over shortages and hoarding of masks. Dr. \nFauci also emphasized that he has clearly been urging people for months to wear masks \nwhen it became clear that asymptomatic transmission was spreading the virus, that \nReleased by Chairman Rand Paul\n106there was no shortage of surgical masks and that masks are effective at stopping the \nspread of the virus.\n“I have been on the airways, on the radio, on TV, begging people to wear masks,” Dr. \nFauci said. “And I keep talking in the context of wear a mask, keep physical distance, \navoid crowds, wash your hands and do things more outdoors versus indoors.”\n— Simon Romero\nOctober 1, 2020\nHope Hicks is infected!!!\nPRESS: The National Press Club – NFID – Influenza Press Conference;  The \nTight Rope with Tricia Rose and Cornell West\nJournalist Michael Specter examines Fauci’s career and the challenges of facing COVID-19 with \nTrump’s White House in his new audiobook “Fauci,” the first biography to be published on the \ndoctor. Specter writes that he first met Fauci in 1986. Even then, Fauci was a mainstay in both \nthe political and medical communities. He has since served with every U.S. president since \nRonald Reagan.\nReleased by Chairman Rand Paul\n107October 2, 2020 –   Global – 34,200,000/1,000,000;   USA – 7,300,000/207,300\nPOTUS is infected with SARS-CoV-2!!!!   I was very close to VP on Tuesday, \nSept. 29.   VP is negative today.   Melania also positive.   Media frenzy!   Much \ndiscussion that WH knew that Hope was positive BEFORE the POTUS went on a \ntrip and could possibly have exposed others. I just got tested via NIH today – \nnegative.\nReleased by Chairman Rand Paul\n108POTUS admitted to Walter Reed with increasing sxs.   Received Regeneron \nmonoclonal antibody.  I had called Sean Conley and told him that this is what I \nwould do.   He agreed.    Later in day received Remdesivir.   I reached out again to \nSean Conley to help again.   No response.  WH really shutting down comms with \noutside world.\nKellyanne Conway, RNC Chair and two senators ( Senator Thom Tillis, \nRepublican of North Carolina and Senator Mike Lee), Republican of Utah) \ninfected plus Bill Stepien (Trump’s Campaign manager); all were at the Rose \nGarden ceremony for Supreme Court Justice Amy Coney Barrett.   It appears that \nthis ceremony was a super-spreading event since all infected people were there and \nthe timing is perfect\nKatie Miller called me last night and this AM.   Stephen Miller has sxs – is getting \ntested now at Walter Reed – he is negative!   I told her to stay physically separate \nfrom Steven even if he tests negative.\nPRESS:   Getting scores of calls from press and request to appear on every \nshow.   White House has indicated no press of any type until further notice.   \nThey do not want me or other government docs out there until further notice.   \nReleased by Chairman Rand Paul\n109Press (CNN) asking on air why Fauci and other TF members are not be able \nto speak.\nOctober 3, 2020 -  Global – 34,500,000/1,000,000;   USA – 7,300,000/208,100\nReleased by Chairman Rand Paul\n110Sean Conley and the WR team are giving mixed messages about how well or not \nthe POTUS is doing.   Conley saying he is doing fine.  Others saying his vital signs \nare troublesome, he is on oxygen and coughing with fever.  His condition could be \ndeteriorating.\nPRESS:  In Science magazine:\nWhy Anthony Fauci is happy being the \n\"skunk\" on the Coronavirus Task Force\nBy Jon Cohen  Oct. 3, 2020 , 1:05 PM\nOctober 4, 2020 – Global   USA\nStill confusion about condition of POTUS.   He came on TV last night \nwearing a blue suit with no tie saying that he felt fine and will be in \nhospital for a few days\nBob Grady texted me last night and said he talked with Chris Christie \n(he is infected and in the hospital) and Chris would like to speak with \nme.   Gave me his cell phone.\nReleased by Chairman Rand Paul\n111I spoke with Christie.   He was extremely grateful and “honored” that I \ncalled.   He is doing fairly well.   Had some fever and aches.   His O2 sat \noff oxygen is 96-98.   He is asthmatic and obese and realizes his risks \nand so he has already started Remdesivir and will start today at 12:00 \nnoon the Lilly mAb.\nMark Meadows called my cell while I was walking on the C & O \nCanal at around 8:30 AM to ask my advice about when the POTUS \ncould go out publicly again.   I mentioned that the CDC guidelines say \n10 days from the onset of sxs.   His sxs started Thrusday, Oct. 1 and so \n10 days would be Saturday, Oct.10.   Mark told me that on Friday his \ntemp was 103 and his O2 sat was in the 80s.   That triggered the \nRemdesivir.   Today (Sunday) he is up and about in his room and is \nafebrile.   O2 sat is improved and he feels much better.   I told Mark to \nsend the POTUS my best wishes.\nHad conversation with Katie Miller who is in hotel separated from \nStephen since he was exposed strongly.   I spoke with Stephen yesterday \nand told him that he should stay away from Katie until he has multiple \nnegative PCRs.   Today was his 4th negative and so I told Katie that she \ncan leave the hotel and go home to Stephen.  Provided that they wear \nmasks.\nAt least seven people besides the president who were there (the Amy Coney Barret \nevent in the Rose Garden) have tested positive in recent days: first lady Melania \nTrump, former White House adviser Kellyanne Conway, former New Jersey \ngovernor Chris Christie (R), University of Notre Dame President John Jenkins, \nSens. Mike Lee (R-Utah) and Thom Tillis (R-N.C.) and an unnamed journalist.\nContacted by Sean Conley.  Got together by conference call with Walter Reed \nmedical team plus Cliff Lane plus Bob Redfield to discuss course of POTUS \ninfection.   Also, discussed possibility of getting infected high level officials out in \npublic with some sort of “filtering device” while they are still infected as opposed \nReleased by Chairman Rand Paul\n112to waiting 10 days.   I told them that this would create a firestorm of pushback \nfrom the press since it would be breaking all the CDC guidelines.   I suggested that \nthey might use the 2 negative PCRs over 24 hours as opposed to the 10 day from \nonset of sxs rule.   Sean said that they gave the POTUS dexamethasone since his \nO2 level dropped into the 80s, but he bounced back quickly with O2 \nadministration.   They started dex just as a precaution.\nWhite House comms (including Alyssa) as well as Sean giving confusing messages \nto the public about the POTUS health.   Mark Meadows was honest and said that \nhis situation was precarious requiring O2 on Friday night and the POTUS got \nangry with Mark sine he did not show a happy face.   Sean was obviously \nintimidated by POTUS and so he sugar-coated the briefing.   Bottom line is that \nPOTUS is doing rather well.   He had a limo drive him up and down Rockville \nPike waving to the crowds of supporters.   He wore a cloth mask instead of a N95 \nand press criticized him for endangering the Secret Service who were in the car.\nOctober 5, 2020 – Global – 35,100,000/1,000,000;  USA – 7,400,000/210,000\n1.The overall picture continues to deteriorate raising concerns across the United \nStates (beyond the improvements across the South that are currently holding) \nthe absolute numbers and the concerning trendlines across the upper North \nWest and Mid West and now the North East – although some of these changes \nReleased by Chairman Rand Paul\n113are subtle when you triangulate them and take into account the changing \nweather conditions in these areas small clusters can rapidly and silently \nspread to large outbreaks – this spread is preventable with aggressive \nmitigation : this is not about shutting down but using the clear evidence based \nmitigation that has worked – attached both states of concern and the stable \nsouthern state\n2.The silent spread among the asymptomatic individuals leads to silent \ncommunity spread that then spreads to the more cautious group including the \nvulnerable members of households : the way to prevent this is to ensure \npersonal mitigation through masks, physical distancing and personal hygiene \ncombine with early identification of community spread and protecting the \nvulnerable individuals in their household.\n3.These data driven laser focused interventions will be essential as we move into \nthe fall : there needs to be a clear recognition of in household, small gatherings \namong neighbors and family events are active spreading events when there is \neven one asymptomatic COVID positive individual – although outdoors are \nsafer both the level of the viral load and closeness of contact can lead to \nincreasing spread\n4.The overarching concern relates to the balance of personal mitigation \nbehaviors and the weather driving more activities indoors with the lower \nhumidity increasing the K value (dispersion factor) with lower humidity the \ndroplets partially evaporate allowing for longer suspension in the air and \ntogether – poor personal mitigation and cooling weather with heating will \nincrease the R value and the clear evidence of aerosol contribution\n5.Any baseline immunity in the population (ranging from <1-10%) in all states \nexcept LA, NY, NJ (where mortality was 3-4X all other states) can be offset and \novercome by this weather element and increased indoor activities – this is the \nconcern about continued spread in states where the weather is changing \n(cooling) and the need for immediate mitigation actions by the leadership and \nthe public collectively : conversely the improved weather across the south with \nmovement outdoors from air conditioning will lower both R1 and decrease \ndispersion (K) – \n6.There also needs to be careful proactive attention to the NE – cases rising in \nNYC and Boston\n7.Will be key to increase testing in the communities and states where test \npositivity is rising to prevent further community spread to prevent increases \nin hospitalizations and fatalities\n8.This first several tranches of BINAX to states should be prioritized to states \nwith high community spread\nWhite House people continue to get infected – latest is Kayleigh McEnany\nReleased by Chairman Rand Paul\n114POTUS called me up from his hospital room at Walter Reed.  1:08 \nPM.  He rambled on about the suite he was in and how expensive it was \nto build it.   Says it is better than the White House.   Asked me if I have \never been there.   I told him about the time I went there to help in the \ntreatment of President Nixon’s pneumonia.   He then commented on my \nvoice and my successful vocal cord surgery.   He then described his \ntherapies (Remdesivir, mAB (Regeneron) and Dexamethasone).   He \npraised Len Schleifer and now the real reason he called.  He said that he \nwas very sick when he came into the hospital and “felt like fucking \nshit”,   However, a few hours after receiving the Regeneron mAB, he \nfelt better than he has felt in years (I believe that DEX is contributing to \nthis as well as to his obvious hyperkinetic state).   Bottom line is that he \nwants me to get the Regeneron mAb out as an EUA.   I explained that \nthe mAb was in clinical trials.   He said the most important clinical trial \nhas been done – i.e. on him the POTUS.   That is all we need to know.   \nHe wants me to get back to him and get it out to millions of people.   He \nsaid it was not about the election, it was about saving lives.   I told him \nthat it was an FDA regulatory issue.   He then said that they would listen \nto me.  He said he was aware of the Lilly mAB,but thinkgs that \nRegeneron is better (Len probably told him so).   POTUS then said get \nboth Reg and Lilly an EUA. We are obviously going to have a problem \nsince there is not enough data for an EUA.\nMark Meadows called me  about what the appropriate PPE would be \nfor others to wear around the POTUS when the POTUS returns (today) \nto the WH.   Also, he wanted my opinion of what PPE the Senators who \nare infected or who will be infected should wear when they vote for \nACA and Supreme Court justice confirmation.\nPRESS:  CNN New Day – discussion of my Sammie Award – Federal \nEmployee of the Year; WTOP Radio; Times Radio UK; CNN with Chris \nReleased by Chairman Rand Paul\n115Cuomo; The New Yorker Festival – Audio – Biography – “Fauci” on \nYouTube livestream with Michael Specter;   The Sammies presentation \nlivestream.   Extraordinary comments by a large number of celebrities: \nhttps://www.facebook.com/rpublicservice/videos/351805602538815/\nOctober 6, 2020 –  Global -  35,300,000/1,000,000;   USA – 7,400,000/210,000\nQUITE A DAY!!\nFauci gets his own action \nfigure\nBY JUDY KURTZ - 10/06/20 12:23 PM EDT 297\n \n \n \n \nReleased by Chairman Rand Paul\n116•Fireside Chat for Cornell (Ithaca) Homecoming – Kate Snow\n•Holy Cross fireside chat\n•Fireside chat with American University Political Union with Sylvia Burwell\nReleased by Chairman Rand Paul\n117Dennis Quaid called to thank me for doing the podcast with him.\nHad long conversation by phone with Chris Christie who is in Morristown \nHospital. I am advising Gov. Christie on his medical course.   He has received \nRemdesivir and is doing fine.   His asthma is acting up, but his O2 is 97-98%.   \nSome docs are recommending that he go home since he is doing well.   I told him \nthat since he is only 4-5 days into his illness and people crash on day 5 to 8, he \nshould stay in hospital instead of going to his beach home.   He should make \nsurethat he walks around and treats the hospital like a hotel and not stay in bed to \navoid thromboembolic phenomenon.   He is really pissed at Trump for his reckless \nbehavior and his disregard for infecting others.   Christie is sure that Trump \ninfected him since Christie helped prepare  Trump for the Presidential debates.   \nChristie want to be the voice opposite to Trump in saying that COVID-19 is \nserious and we should not brag about not dying from it, and we should not \ntrivialize it or brag aboutndefeating it since it is still killing 210,00 people in the \nUSA.   He related that Trump told him that he was surprised that “strong men like \nyou and me got infected”.   Christie told him that it has nothing to do with how \nstrong one is.   The virus can infect anyone.\nStephen Miller is infected!  Very strange.   Stephen was exposed to POTUS, \nHope, others and tested negative by Abbot now, antigen tests and 2 PCR tests over \nthe past 6 days.   I had told him that he could re-unite with Katie who is in a hotel.   \nHe did.   Now he is positive.   In retrospect, he was mildly symptomatic for the \nentire 6 days, but since he tested negative, he felt that he was not infected.   Now \nwe know that he was probably infected but his level of virus was so low that it was \nnot detected (tells you something about the tests).  Spoke multiple times to Katie \nwho is on way to her parents in Florida.   Spoke to her at Houston airport and after \nshe landed.   Told her to get tested again (she was negative today by the Abbott \ntest).   I warned her that in this political scene, the Dems will ask her if she was \nnear the VP (which she was) and whether she is sure that she in not infected from \nStephen.   They will not believe her unless she gets a PCR test.  Otherwise they \nwill say that VP may be a contact who needs to be sidelined for 10 days.   I \nstrongly advised her to get a PCR test tomorrow.  The VP debate is tomorrow.\nScott Atlas crossed a line today.   See e-mail below:\nReleased by Chairman Rand Paul\n118Marc:\n   I am sorry to bother you with this as we approach the important VP \ndebate, but this needs attention.   You had mentioned to me about \ntrying to reconcile differences between the other doctors on the Task \nForce and Dr. Atlas and I told you that I certainly am amenable to doing \nso.   Below is a note that a reporter (Ashley Collman) sent to me asking \nfor my response to an interview that she had with Dr. Atlas that they \nare planning on publishing.   I am not planning to respond publicly since \nthat would be beneath my dignity.  However, a line has been crossed \nhere am I strongly suggest that Dr. Atlas be removed from the Task \nForce and quite frankly from the White House itself.   Not withstanding \nhis outrageous comments about me, which are factually incorrect (I \nnever said that “everyone should wear goggles” and I never “ridiculed” \nSen. Paul and I, by the way,  have actually written the book on natural \nimmunity), what he has been preaching about public health measures \nhas put the POTUS and the White House staff at risk, resulting in the \ninfection of our President and several White House staff and other \ngovernment officials.   As I mentioned, I am not going to address this \npublicly, but it must be addressed internally.   Thank you for listening.\nBest regards,\nTony\nAnthony S. Fauci, MD \nDirector \nNational Institute of Allergy and Infectious Diseases \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520 \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nReleased by Chairman Rand Paul\n119The information in this e-mail and any of its attachments is confidential and may contain \nsensitive information.  It should not be used by anyone who is not the original intended \nrecipient.  If you have received this e-mail in error please inform the sender and delete it \nfrom your mailbox or any other storage devices.  The National Institute of Allergy and \nInfectious Diseases (NIAID) shall not accept liability for any statements made that are the \nsender's own and not expressly made on behalf of the NIAID by one of its \nrepresentatives.  \nFrom:  Ashley Collman <acollman@businessinsider.com> \nSent: Tuesday, October 6, 2020 9:20 AM\nTo: Conrad, Patricia (NIH/NIAID) [E] < conradpa@niaid.nih.gov>\nSubject: Business Insider reporter - request for comment\nHi Patricia, \nMy name is Ashley Collman and I'm a reporter for Business Insider. My colleague Hilary said I \nshould contact you if I'm trying to offer Dr. Fauci the opportunity to comment on a story. \nI spoke to Dr. Scott Atlas yesterday, who had some things to say about Fauci. \nAtlas slammed Fauci for using \"media contacts to make public criticisms of other people out of \ninsecurity.\" \nHe also criticized Fauci for saying \"everyone should wear goggles\" and for \"ridiculing\" Sen. Rand \nPaul for suggesting that some people have a natural immunity to the virus. \n\"To ridicule that statement shows a complete lack of understanding and a lack of the current \nscientific research,\" Atlas said. \nHe added: \"I think a lot of the criticism stems from people who are either politically motivated \nor are interested in maintaining their own stature in the public eye.\" \nLet me know if Fauci would like to say anything in response to these comments from Atlas. \nBest, \nAshley Collman\nReleased by Chairman Rand Paul\n120Senior News Reporter\nAlyssa Farah texted me (at 3:39 PM) and said that Meadows will now prevent Atlas from doing \nany media; however, Atlas appeared on Laura Ingraham (FOX) with misleading statements that \nInfluenza was more dangerous for young people than COVID-19.   What a stupid statement!   \nAnd so, it is OK to have the elderly and the 80 million people in USA with underlying conditions \nget seriously ill from COVID just because young people do well (mostly).   Ridiculous.  Deb Birx \nwent in to see Meadows and apparently Meadows said he will fix the problem with Atlas, but it \nmay take 48 hours.   We shall see.\nPRESS:   Podcast with ESPN 30 on 30 – “Day in the Life of Tony Fauci on \nMarch 11, 2020; \nOctober 7, 2020 – Global   USA\nAlex Azar met yesterday with Atlas and his 3 stooges – Jay Bhattacharya \n(Stanford), Sunetra Gupta (Oxford) and Martin Kulldorff’s (Harvard).    Seems that \nhe is buying into Atlas\nReleased by Chairman Rand Paul\n121VP debate tonight between Pence and Harris.    Much more civil than the POTUS \ndebates.   Pence did not directly answer several questions using the technique that I \nhave seen him use of avoiding answering the questions and talking about \nsomething else in response to the question.  My name was mentioned multiple \ntimes during the debate.   Harris said she would take an OVID-19 vaccine if I said \nso, but not if Trump said so.  Also, Pence mentioned my name saying that I said \nthat Trump saved many lives by shutting down travel from China.\nOctober 8, 2020 – Global 36,000,000/1,000,000;  USA – 7,500,000/211,100\nBelow is really October 8, not October 6\nReleased by Chairman Rand Paul\n122Much discussion centered around the upcoming 2nd POTUS debate.   Issue is \nwhether Trump (recently infected) can safely do it in person.   The Commission \nwants to do it virtually; however, Trump says he will not debate except in person.  \nMark meadows has called me twice for advice about the CDC guidelines of when a \nperson post-infection can safely go out.   The guidelines say 10 days from onset of \nsxs and 2 PCR tests (24 hours apart) that are negative.   His last PCR had a CT of \n28.9.   It needs to be 35 or greater to be considered negative.   More to come.\nGreat podcast with Bill Gates and Rashida Jones\nNow total 34 people infected in the White House super-spreader event in the Rose \nGarden.   Also, Kellyanne and Chris Christie helped him prepare for the debate\nPRESS:  Print interview with Italy’s La Repubblica newspaper; Italy TV Sky \nTG24; MSNBC with Andrea Mitchell; Podcast with Rashida Jones and Bill \nGates; Radio ONE NYC; PBS NewsHour with Judy Woodruff;\nMemphis Commercial Appeal:\nDr. Anthony Fauci: a trusted and \ndependable voice during COVID-19 | \nOpinion\nReleased by Chairman Rand Paul\n123With so much false information about the coronavirus \nbeing thrown at us, Fauci has evolved as a voice we can \ntrust. He speaks truth, gives us the facts, and pulls no \npunches.\nLynn Norment\nColumnist\nOctober 9, 2020 – Global   USA\nWe are clearly seeing resurgences in various parts of USA , esp. the upper mid-\nwest and the Northwest (see below).   This is exactly what we (Deb and I) \npredicted would happen if young people did not abide by public health \nrecommendations (masks, crowds, etc).   It also validates my insisting to the VP \nthat although I did not like being the “skunk at the picnic”, the upticks in case \npositivity clearly predicted the increase incases → hospitalizations → deaths.   \nAlso, shows that Atlas and his 3 stooges are completely incorrect.\nGov. Cuomo called me up.  Deb wanted me to speak with him about the surge in \nNYC since she knows that we are friends.   I asked his brother Chris to have him \ncall me.   Andrew feels that the NYC surge is driven almost exclusively by the \nHasidic Jews who feel that they have “herd immunity”.   Obviously they do not \n(see Atlas).   In the middle of the conversation, the POTUS calls me (see below)\nPOTUS called me this AM at 9:10 AM.   He is still very hyper and is saying that \nthe Regeneron product “cured” him.  He had with him on speaker phone Sean \nConley and the entire Walter Reed team.   He had them say that the drop in viral \ntiter from 10 to the 8 to 10 to the 3 was the fastest they have ever seen.   They \nobviously do not have that much experience.  When I asked what the CT was, they \nsaid it was 33, which means he still has replication virus in his nasopharynx.   \nCould be that Dex is slowing the clearance of virus.   He wants me to help get REG \nmAB an EUA to save hundreds of thousands of lives.   He is clearly hyper.   He \nReleased by Chairman Rand Paul\n124told the crew that I was the best persuader in the world.   He used to think that he \nwas, but he now feels that he is 2nd.   Weird conversation; friendly, but weird.\nReleased by Chairman Rand Paul\n125PRESS: AP video interview with Kelly Daschle; CBS Radio interview; Irish \nNewspaper – Sunday Indepemdent;\nOctober 10, 2020 – \nMultiple calls with Katie Miller, Stephen Mill and Mark Meadows.   Big issues \nis when to get the POTUs back into the public (campaign rallies).   Mark Meadows \ncalled me about this X2 today.   The POTUS has been 10 day since onset of sxs, \nwhich is the CDC guideline for being able to return to public.   However, his CT \nwas less than 35.   Today it is 34.6, but other viral parameters for replication are \nshowing no replication.   I convinced Mark to not allow the POTUS to go to \nFlorida today (Saturday) but to wait until Monday and do a Ehite House balcony \nshow today.\nAlso, Stephen Miller is chomping at the bit to get out in public since the campaign \nis short-handed with so many people infected.   Stephen has crazy numbers.   CT \nwas 27.8 yesterday and 16 today!.   Looks like a lab error.   Will check again \ntomorrow\nGOP campaign put out an ad misleading) having me say that the POTUS did \neverything possible.   The press are calling out the GOP since they know that this \nis totally out of context.   I called Stephen Miller and asked him to look into this.\nPRESS:  Continue to do taping for the NAT/GEO documentary as well as the \n60 Minutes Special that will come up next week.   Crazy situation with Alyssa \nFarah and Jon Karl who rally wants me on “This Week” tomorrow (Sunday).   \nFirst she promised him that there wa a 99.5% chance that he could have me.   \nShe said this on Wednesday.   Jon texted her every day for confirmation and \nshe just ignored his texts until it was too late (Saturday afternoon).   Totally \nincompetent and disrespectful to Jon and ABC, but not atypical for them \n(WH Comms)\nOctober 11, 2020 (Sunday)\nReleased by Chairman Rand Paul\n126See above re: Jon Karl.   They are completely blocking me for Sunday shows.   \nAlso, big stink about the POTUS hiding data regarding how infective he might be \n(see above)\nMultiple conversation with Sean Conley, docs at Walter Reed and me.   Also, \nSavannah Guthrie representing NBC wants assurances that it is safe for the \naudience that the POTUS does a Town Hall on Thursday (Oct.14).  Mark wants us \nat NIH to repeat the PCR and CT values to get an independent voice here since the \npress does not trust Sean Conley or the Walter Reed people since they believe that \nthese folks are afraid of the Commander-in-Chief.   However, Mark does not want \nto admit that we need to go to NIH and so he wants NIH to do the PCR but have \nme not say that it was done at NIH, but only say that I will vouch for the results.   \nReally ridiculous.   Cliff will do the swab on Thursday and run it at NIH.\nI needed to respond to the misrepresentation of my support forTrump by the GOP \ncampaign and so when Kaitlan Collins contacted me about it, I issued a statement \nthat she tweeted:\n \"In my nearly five decades of public service, I have never publicly endorsed any \npolitical candidate. The comments attributed to me without my permission in the \nGOP campaign ad were taken out of context from a broad statement I made \nmonths ago about the efforts of federal public health officials.\"\nIt went totally viral on twitter and several networks and cable reported it.   The \nGOP campaign hit back by giving other quotes from me saying that I did indeed \nsupport what the POTUS was doing.   However, they left out all f my criticisms, \nand besides in none of those quotes did I endorse the POTUS.   Now the GOP \ncampaign is tweeting everything that I ever said positive about our effort trying to \ncall me a liar about denying that I am favoring Trump.   This is turning into an \nongoing war between me and the GOP campaign.   Nate Silver tweeted that the \nGOP campaign is really stupid to pick a fight with Tony Fauci just a couple of \nweeks before the election.\nJon Karl called out Alyssa Farah on “This Week” saying that she would not let me \non the show.   He then asked for any medical or TF person including Redfield, \nReleased by Chairman Rand Paul\n127Birx, Hahn, Giroir, or even Pence.   She ignored that and tweeted that Karl did not \nask for anyone else but me.   Karl got furious and tweeted his tweet to her showing \nher up to be a liar.   She responded and said she must have “missed the text”.\n \nPRESS:  \nOpinions\nDistinguished person of the week: Fauci \ncalls out Trump’s recklessness\nOpinion by \nJennifer Rubin\nColumnist\nOct. 11, 2020 at 7:45 a.m. EDT\nReleased by Chairman Rand Paul\n128October 12, 2020    Global – 37,400,000/1,100,000;  USA – 7,700,000/214,100\nContinued confusion about whether I am allowed on shows.   Jake Tapper was told \nby Alyssa that it is OK to put me on his show.   When Patty and CNN tried to \nmake the arrangements, WH comms said that they did not know anything about \nthis.  Jon Karl and Wolf Blitzer also trying in vain to get me on.\nAll day and evening press dominated by the conflict between me and the GOP \nCampaign regarding their campaign ad featuring me.   The press are making \nTrump look very bad saying that trump is not running against Biden, he is running \nagainst Tony Fauci.\nThe Epi outbreak situation is deteriorating (See below)\nReleased by Chairman Rand Paul\n129\nReleased by Chairman Rand Paul\n130PRESS: CNN Jake Tapper – “The Lead”; CNBC – Shepherd Smith; complete \nfilming for CBS “60 Minutes” for next week with Jon LaPook;\nOctober 13, 2020 Global    USA\nIncreases in cases continue (see map below)\nReleased by Chairman Rand Paul\n131Mark Meadows has asked me to certify that POTUS is not transmittable for \nSARS-CoV-2.  This relates to the fact that NBC (Savannah Guthrie) execs do not \nwant to host the Town Hall with Savannah moderating on Thursday (10/15/2020) \nunless they are sure that POTUS will not infect Savannah or anyone else connected \nwith the Town Hall.   I offered to have a PCR done here at NIH and to go over all \nthe data with Cliff and certify if appropriate.  Cliff went to WH and Sean Conley \ndid nasal swab on POTUS and Cliff brough it back to NIH.   Result was CT of \n34.3.   We then went over all his data including multiple negative cultures and \nmultiple negative antigen tests (see attached document) and clinical course of >10 \nfollowing onset of sxs and we determined that he was not infectious.   I related this \nto Savannah by phone at 10:00 PM tonight\nSummary of \nfindings[3].pdf\nPRESS: Good Day NY TV with Rosanna Scotto; Public Radio – “The World”\nOctober 14, 2020 – Globus   USA\nVery concerned about the uptick of cases throughout the country in ~30+ states, \nwhich is a good predictor of surges.    Important as we enter Fall and Winter \nSeason.   Also, baseline infections are ~40,000 to 50,000/day.  \nA FEW DAYS AGO, Julia Roberts sent me beautiful flower arrangement.   I e-\nmailed her my thanks. \nScott Atlas still causing problems with his “herd immunity” issue.\nContinued press coverage of tension between me and POTUS\n“Barrington Declaration” – Misleading people into thinking that it only measn do \nnot close down country and just protect the vulnerable, when in fact is means go \nfor herd immunity, which will kill many, many people.\nHa long talk tonight with Jared Kushner asking his help in getting rid of Scott \nAtlas.   Much activity in the community asking Deb and I to threaten to resign if \nthe White House does not get rid of Atlas.\nReleased by Chairman Rand Paul\n132\nReleased by Chairman Rand Paul\n133PRESS:  Major article in Washington Post by Yakamura, Dawsey and \nYasmeen Abutaleb discussing tension and “feud” between POTUS and me; \nCBS.com live stream with Norah O’Donnell; CBS Evening News; WABC \nRadio Interview – Conversations in Healthcare;\nOpen discussion of conflict with WH:\nReleased by Chairman Rand Paul\n134Trump’s COVID Task Force Is Now Openly \nRebelling Against Him\nFrom Fauci to Birx to Redfield, the president’s top health officials appear to be at their wits’ \nend. \nErin Banco\nAsawin Suebsaeng\nSam Stein\nOctober 15, 2020 Global    USA\nAs the election nears, the cases increase and surges are inevitable as we enter \ncooler weather.   Trump is on the campaign trail spewing nonsense.   He is really \nout of control.   A true embarrassment.\nI did Face Time and some screen shots with a young boy at Children’s National \nMedical Center who has recurrent brain tumor.   He is from Hollywood, FL.   His \nname is Benjamin.\nChris Christie’s physician called me to ask advice on getting Gov. Christie back \nin circulation following COVID-19.   He still is PCR positive, has been 13 days \nsince onset of sxs.   Do not yet know CT level.   I told them to get it and get back \nto me.\nReleased by Chairman Rand Paul\n135Seems like the POTUS is desperately attacking me.   This from the New York \nPost:\nHere's the Trump quote:\n\"Tony Fauci, he's a nice guy. He said this is not a threat. This is not a problem. Don't worry \nabout this...  he said do not wear a mask. Do not wear a mask under any circumstances. Don't \nwear a mask — don't, don't, don't, right? So we don't wear a mask. Then they say, oh wear a \nmask. I never saw, did you ever see any conflicts? but he's a nice guy so I keep him around, \nright? We'll keep him around.\n\"He is a Democrat. everybody knows that. He's Cuomo's friend. Cuomo did the worst job of any \ngovernor in the United States. Almost 40,000 people died more, and 11,000 at least — and you \nknow I gave him this big convention center, 2,800 beds, he didn't use it. I gave him a ship. I gave \nhim the great hospital ship meant for wars... it's incredible, they didn't use it. Instead they sent \nsick people back into nursing homes, right? It's a disgrace.\"\n-- \nSteven Nelson\nNew York Post\nReleased by Chairman Rand Paul\n136Signal/cell: 202-805-0625\nWhen the POTUS said this to the crowd in North Carolina, as he mentioned my \nname, the crowd booed and he encouraged this.   On the evening cable shows CNN \nAnderson Cooper said this was a terribly childish thing to do to a career public \nservant like me.\nPRESS:  Good Morning America with George Stephanopoulos (ABC) – I blew \naway the Great Barrington Declaration; Yahoo Finance Interview;  PBS \nFiring Line with Margaret Hoover.\nOctober 16, 2020 – Global    USA\nSurges continue.   See Birx slides below\nReleased by Chairman Rand Paul\n137\nReleased by Chairman Rand Paul\n138Cases continue to climb:\nOctober 17, 2020  (Saturday)\nGot call at 5:53 AM from Deb Birx who reported to me about yesterday’s activities \nat the WH.   Atlas did not come to White House.  However, at the “huddle” in the \nReleased by Chairman Rand Paul\n139AM he tried to undermine everything that Deb and I have been saying about how \nto contain the surges.   He explicitly wants to never do contact tracing and never \nisolate any person who is infected.   He feels that this constitutes a “lockdown’ and \nfeels that the POTUS does not want to lock down.   We (Deb and I) have \nrepetitively said that we do not want to lock down.  Atlas has convinced the entire \nWhite House.   My conversation with Jared a couple of days ago obviously did not \nconvince him since he told Deb yesterday that the POTUS likes differences of \nopinion and so we should just work it out. THIS IS VERY REMINISCENT OF \nAIDS DENIALISM WITH THABO MBEKI when it went beyond differences \nof opinion and >300,000 South Africans died without ART because he \nbelieved from Duesberg et al that HIV did not cause AIDS\nCases continue to surge (see graph below).   Could possibly start to overwhelm \nhospitals in some more rural areas.\nReleased by Chairman Rand Paul\n140October 18, 2020 –  Global – 39,600,000/1,100,000;   USA – 8,100,000/218,500\nSurge continues:\nReleased by Chairman Rand Paul\n141Baby Blues\nby Jerry Scott and Rick Kirkman\nHilarious song about mask wearing:  https://bit.ly/37jp8fs \nNot allowed on any shows.   Meet the Press and Face the Nation asked for me.   \nWH gave Alex Azar to Meet the Press\nReleased by Chairman Rand Paul\n142PRESS: (Sunday) –CBS “60 Minutes” with Jon LaPook\nOctober 19, 2020 – Global    USA\nThings getting worse and worse, and still the White House espouses the “herd \nimmunity” nonsense from Scott Atlas.   I am ashamed of Alex Azar for embracing \nthis.\nSee PRESS below.  Trump is on tear trashing me saying that I am a “disaster”, \ngoing on about my throwing arm at the Nats opener, tweeting constantly about me, \nsaying if he had listened to me 500K people would be dead by now.  Calling the \nTask Force people “idiots” He is really sounding totally crazy.  He must have \ndriven over the edge by the incredibly well-received profile of me last night on \nCBS  “60 Minutes”  The response of my supporters with e-mails, texts, and tweets \nhas been overwhelming.   Some examples of hundreds of e-mails and texts:   Text \nfrom Joan Baez – “I hope you’re celebrating.   It’s an honor to be attacked by that \nmiserable fuck”.  Text from Hilary Rosen – “14 more days.   Hang in there.   We \nneed you.  That fuckhead isn’t fit to tie your shoes.  😊 Xo Hilary”\nReleased by Chairman Rand Paul\n143CNN jumped all over zTrump for doing this.\nPRESS:  CBS/KNX Radio – Los Angeles; \nWashington Post article describing situation on the TF\nTrump’s den of dissent: Inside the White \nHouse task force as coronavirus surges\nBy \nYasmeen Abutaleb , \nPhilip Rucker, \nJosh Dawsey  and \nRobert Costa\nOct. 19, 2020 at 6:00 a.m. EDT\nTrump to campaign staff: \"Fauci is a disaster\"\nFrom CNN's Kaitlan Collins\nhttps://twitter.com/realDonaldTrump\nReleased by Chairman Rand Paul\n144October 20, 2020 – Global - 40,300,000/1,100,000;      USA – 8,200,000/220,000\nHad call with “Miami Mayors again (Deb and I).   They are starting to see \nupticks in test positivity in certain groups (younger people – 30-40 y.o.), but not \nthe general population since they are decreasing the number of tests; however, it \nmight not be totally reflective of what is going on.   Gov. DeSantis is legally \npreventing the Mayors from doing what needs to be done.  They cannot close bars \nor restaurants.   DeSantis is preventing them from doing what needs to be done.   \nMayors are frustrated.\nPhone call with Governor Inslee (D-WA).  He wants my help in doing a PSA or an \ninterview to encourage the people of Washington state to abide by public health \nguidelines since they are experiencing a slight surge in cases when they were \npreviously doing very well.\nReleased by Chairman Rand Paul\n145\nReleased by Chairman Rand Paul\n146PRESS:   Front page articles in the Washington Post and the New York Times  \non Trump attacking me.   See NY Times below by Stolberg, Haberman and \nWeiland; CBS Radio NYC\nTrump Calls Fauci ‘a Disaster’ and \nShrugs Off Virus as Infections Soar\nWith two weeks remaining in his re-election campaign, President Trump made the \ncoronavirus his message and Dr. Anthony S. Fauci his foil, dismissing scientific \nadvisers as “these idiots.”\nThe New York Post:\nReleased by Chairman Rand Paul\n147Fauci reportedly quotes ‘The Godfather’ in \nresponse to Trump criticisms \nBy Yaron Steinbuch\nOctober 20, 2020 | 7:00am | Updated \nOctober 21, 2020   Global – 40,500,000/1,100,000;   USA – 8,200,000/220,400\nSe. Patrick Leahy (D-VY) called me to encourage me in light of the POTUS \nattacks on me.   His mother’s side of the family is Italian and he said to me \n“Coraggio” or courage, which his grandmother used to tell him when he was a \nprosecutor in Vermont.\nPRESS:  Article in Washington Post by Molly Roberts – “Why Fauci Won’t \nQuit”;\nReleased by Chairman Rand Paul\n148Article and cover in Washingtonian magazine:\nWashington’s Very Top Top Doctor\nEach November, Washingtonian honors the best \nphysicians in our region. This year, Anthony Fauci \ndeserves special recognition. \nWritten by Sherri Dalphonse  \n| Published on October 20, 2020 \nOctober 22, 2020 – Global – 41,100,000/1,100,000;  USA – 8,300,000/221,400\nSurging continues as does hospitalizations and soon deaths.  Atlas continues to \nspew forth nonsense about letting children and young people get infected and just \nprotect the vulnerable.   How do you protect the vulnerable not in nursing homes, \ni.e. in the community.   He feels that wearing masks are worthless and contact \nReleased by Chairman Rand Paul\n149tracing and isolation is actually locking down.   The WH is letting him do this.   \nBorders on criminal.\nGot call from Mark Meadows from Nashville with the last Presidential debate \ntakes place.   Mark said that they want to put up a plexiglass plate between Trump \nand Biden and Trump feels that this is a distraction.   Mark called me to ask my \nopinion and I confirmed that it is unnecessary.   The POTUS is not infected nor is \nBiden.   Mark thanked me and a few minutes later Dr. Kens Sands (Physician for \nthe debate) called me at Mark’s suggestion to discuss the details of our data that \nthe POTUS is no longer transmissible.   I gave him eth CT number of 34.3 CT and \nthe negative antigen tests and cultures.   He was satisfied.   Amazing → POTUS \ndays I am an “idiot” and a “Disaster” and then counts on me to verify about his \nhealth.\nOctober 23, 2020  Global – 41,600,000/1,100,000;   USA – 8,400,000/222,400\nLast night was final Presidential Debate.  POTUS still insisting that we are \nturning the corner and all parameters are down.   This is completely untrue as per \nthe summary below from Deb Birx.   Also, after the moderator brought up the fact \nthat POTUS called me and  others “idiots”  he continues to say that I am a nice guy \nReleased by Chairman Rand Paul\n150but have been wrong many times.   He brings up the “incomplete” quote where I \nsay that: “…..at this time, we do not need to do anything different”, yet he leaves \nout the second part of the sentence: “……however, it really is an evolving \nsituation, and we have to be prepared for the worst”.  This was a quote from me on \nCNN on January 20, 2020.   On Jan. 21, the 1st travel-related case was detected in \nthe USA.   On  Jan. 24 the 2nd travel-related case was detected and on Jan. 30 the \n1st person-to-person spread of SARS-C0V-2 was confirmed in the USA.   \nTherefore, I was warning that we needed to be prepared for the worst even before \nthe 1st case was detected in the USA.   Also, he said again that I am a Democrat \nand brings up my early (and very brief) statement on masks.   Fact checkers \nshowed he lied dozens and dozens of times during the debate.\n•Did Fireside Chat with the Aspen Group - Sibelius, Thompson.   Very well \nreceived.\nHad dinner at my home with Jake and Jennifer Tapper.   Relaxed, good time.   Jake clearly \nbelieves that Trump is totally nuts.\nHit 83,000 new cases today.   The single day record since the beginning of the outbreak:\nSurge continues:\nReleased by Chairman Rand Paul\n151PRESS:  MSNBC – Chuck Todd – Meet the Press Daily; BBC TV Andrew \nMarr Show; CNN with Erin Burnett\nOctober 24, 2020   Global – 42,100,000/1,100,000;   USA – 8,500,000/223,400\nMuch discussion in the press that the outbreak is out of control as we enter the \ncooler months.  POTUS keeps saying that we are “turning the corner” and this will \nbe under control very soon.   Press pitting this against what I and other credible \nscientists are saying.\nReleased by Chairman Rand Paul\n152Adam Silver, Commissioner of NBA, wrote me a nice letter thanking me for \nhelpingto make the NBA season successful and safe\nOctober 25, 2020 – Global – 42,500,000/1,100,000;   USA – 8,600,000/224,2200\nReleased by Chairman Rand Paul\n153The slide below demonstrates why it is important to test both symptomatic ad \nasymptomatic people. WH (with pushing by Atlas) is saying you only show test \nsymptomatic people,  Colleges are good example  See below:\nReleased by Chairman Rand Paul\n154Marc Short tests positive for COVID-19.  VP continues to campaign despite \nCDC guidelines about quarantine sine VPO is with Marc constantly.   VP and WH \nsaying that VP is “essential personnel” and so an continue his work. Other VP staff \nthat are now infected include political advisor Marty Obst; his personal aide Zach \nBauer, known as a “body man,” who accompanies him throughout his day; and two \nother staff members.\nHad conversation with Marc Shot by phone today.   I reached out to him to offer \nany help or advice that he might require.   He was very appreciative.\nMark Meadows on TV with Jake Tapper on SOTI (CNN- Sunday) saying we \ncannot control the  pandemic, but we will fight it with therapies and vaccines.   \nThis is the Scott Atlas approach.   This is interpreted by many and played up by \nBiden that the administration has essentially “given up” on trying to control the \npandemic and have admitted failure.\nReleased by Chairman Rand Paul\n155Some buzz around my statement on CNN Erin Burnett that I would favor mask \nmandates if people do not voluntarily wear masks.   I clarify with Sheryl Stolberg \nof New York Times that local (state, city, county) mandates (if any) are better than \nnational mandate.\nAdam Silver (Commissioner of NBA) sent me a letter thanking me for helping to \nmake the NBA season successful and safe:\nSKM_C754e2010251\n5200.pdf\nOctober 26, 2020   Global – 43,000,000/1,200,000;    USA – 8,600,000/224,600\nSurging continues:\nReleased by Chairman Rand Paul\n156POTUS insists on having large rallies 1 week before the election.   Crowds are \nclose together, many without masks.   He is desperate and defiant.\nOn Friday, October 23, the FDA’s FDA’s Vaccines and Related Biological \nProducts Advisory Committee (VRBPAC)  held a meeting chaired by Arnold \nMonto of Univ. of Michigan and also member Paul Offit (U Penn) to discuss the \npros and cons of issuing an EUA after 50 events in a 150 event trial (such as with \nModerna and Pfizer).   Thankfully, they weighed heavily on keeping the trial going \nand not unblinding it after the first sign of efficacy, which would negate the further \ngathering of important data.  This is exactly what we had hoped for.  Much \npressure from Trump and Meadows to get an answer quickly or at least promise \nthat an answer will come quickly.  With the VRBPAC recommendation, vaccine \n(if effective) would not begin to be distributed before January, and not \nNovember/December.\nOver the weekend Gil Omenn called me and said that he had a recent meeting \nwith President Obama and the President did not want to contact me directly sine \nhe felt that this might cause me difficulty with the Trump people.   However, he \nwanted Gil to convey to me how proud he was of me for what I have been doing \nand standing for and he wanted to express to me how much he admired me.\n•Went to Clinical Center to visit a young woman (Leslie Adelman) who has \nVon Hipple-Lindau disease and had a hemangioblastoma in her cerebellum \nremoved last week.   Since she was in the hospital she asked her \nneurosurgeon Dr. Kareem Zaghloul if it were possible to meet me.   I, of \nReleased by Chairman Rand Paul\n157course, said yes and went to see her.   Quite a time.  Nurses and physicians \nall wanted pictures with me.   Leslie was delighted.   Made my day.\nSign in Kensington:\n. Dr. Anthony Fauci\nReleased by Chairman Rand Paul\n158PRESS:   Yahoo Finance TV;\nOctober 27, 2020 – Global    USA\nSurges continue:\nReleased by Chairman Rand Paul\n159Great \nGreat Fireside Chat with Sharon Lewin et al (Peter Doherty) at Melbourne, \nAustralia.  Sharon said that I am a “household name” in Australia.  The \nAustralians had zero new infections in the entire city of Melbourne yesterday \nproving that pure public health measures such a mandatory mask wearing \n($1000.00 fine) and avoiding crowds actually works.\nAlyssa Farah and Roma Daravi (White House comms) are continuing to jerk \nme around regarding clearances for TV requests.   I get 20 requests and they \nignore them.   We complain, and then Alyssa says that she has no problem \nwith any of them.   “Go ahead and work with Roma to schedule”.   Roma \ngives us one or two and then we do not hear from them (ignore us) for another \nweek.   All the while they are approving Azar and other docs on the task force \n(Hahn, Redfield, Adams, etc.)    Clearly, they do not want me on Major TV, \nbut are afraid to admit it.   This must be pointed out in the book!\nPRESS:  WAMU podcast with Diane Rehm; Carnegie Endowment for \nInternational Peace – Fireside Chat; Rolling Stone Interview with Jeff \nGoodell\nReleased by Chairman Rand Paul\n160October 28, 2020 – Global   USA\nWent on rounds today with a patient with COVID-19 in the SCSU.   When I \nentered the SCSU nurses’ station, the group of 5 nurses screamed in delight that I \nhad visited and we took a whole bunch of picture.   Brett Rowland (security) was \nthe photographer.\nWhite House still claiming that everything is under control and that all that matters \nis deaths.   That is absurd.   Deaths are in fact increasing; however, they are \ncompletely disregarding the morbidity associated with getting infected and not \ndying, which could be protracted.\nHere’s A Timeline Of President Donald Trump’s And Dr. Anthony Fauci’s \nRelationship.\nUSA Today (10/28, Behrmann, Santucci, 10.31M) reports, “The relationship between President \nDonald Trump and Dr. Anthony Fauci, the nation’s leading infectious disease expert, has \npublicly eroded as the coronavirus pandemic has raged through the United States, with the two \nofficials often disagreeing on issues from what drugs to use and a vaccine timeline to something \nas simple as the fact that COVID-19 isn’t ‘going to disappear.’” According to the article, “over the \ncourse of the virus’ spread, Trump’s relationship with Fauci, who has worked under both \nDemocratic and Republican administrations since 1984, has vacillated from support to disdain.” \nUSA Today provides “a timeline of the pandemic, reports about their relationship, and public \nstatements from the two men regarding the virus and each other.” \nReleased by Chairman Rand Paul\n161PRESS: Marc Siegal “Doctor Radio” Sirius Radio; Interview with Joel \nAchenbach – Washington Post; JAMA Podcast with Howard Bauchner; BBC \nReleased by Chairman Rand Paul\n162Radio; CNBC – Shepard Smith; Chicago Ideas with Brandis Friedman – Brad \nKeywell;\nOctober 29, 2020 – Global – 44,000,000/1,200,000;    USA – 8,800,000/227,000\nPOTUS in complete denial  that there is a raging pandemic and everything is \nspiking.   He keeps insisting that we have “turned the corner” or “rounding the \nturn”.\nSome potentially nefarious stuff going on.   The FDA career scientists are \nhesitant to grant EUAs to Lilly’s and Regeneron’s mAb based on the current data.  \nAlex Azar is really pushing them and furious because he thinks FDA is “slow-\nwalking” the process so as not to have it out before the election in 5 days.   Clearly, \nAlex wants to please the POTUS so that they can say that they have a breakthrough \n(similar to Convalescent plasma nonsense) right before the election.   Azar then \nasked NIH (Collins), CDC (Redfield) and ASPR (Kadlec) to weigh in since the \nlegislation that established the EUA process (dating back to the Anthrax situation \nin 2001) requires the CDC, NIH, and ASPR Directors to weigh in on EUA \ndecisions (even though they have not done so in the past).   Cliff and I had long \nconversation with Francis on his way down to HHS to discuss with Azar.   We \nencouraged Francis to support the career scientists at FDA since they do not want \nto rush this through.   They need more time to gather important information since \nwhat they have now is rather weak. \nOctober 30, 2020 – Global – 44,600,000/1,200,000;   USA -8,900,000/228,100\nReleased by Chairman Rand Paul\n163•Did Fireside chat with Silicon Valley leadership Group Annual Forum\n•Was on Governors call led by Azar.  After call Gov. Greg Abbott called me \nto ask about availability of mAbs\nReleased by Chairman Rand Paul\n164Kelly Ripa throws her support behind coronavirus task \nforce leader Dr. Anthony Fauci by stepping out in a \nsweater bearing immunologist's name\nBy David Lawrance  and Christine Rendon For Dailymail.com \nPublished: 23:12 EDT, 29 October 2020 | Updated: 23:12 EDT, 29 October 2020 \nEarlier this month she had her own brush with COVID-19, when her Live With Kelly And Ryan \nco-host Ryan Seacrest had to be tested for the virus. \nFollowing Ryan's thankfully negative result, Kelly Ripa gave a nod to one of the faces of the U.S. \nGovernment's coronavirus taskforce when she stepped out in New York City in a statement \ngarment on Thursday.\nThe TV personality, 50, donned a white sweater bearing the name 'FAUCI,' an apparent \nreference to the famed immunologist Dr. Anthony Fauci, who has become something of a folk \nhero in the midst of America's coronavirus pandemic.\nReleased by Chairman Rand Paul\n165\nReleased by Chairman Rand Paul\n166PRESS:\nFamiliar Fauci anecdotes, told \nwith a Brooklyn accent\nAnthony Fauci, head of the National Institute of Allergy and Infectious Diseases, \nhas been in the spotlight during the coronavirus pandemic. President Trump \nrecently called him a “disaster”; the same day, Fauci received a leadership award \nfrom the National Academy of Medicine. (Photo by Erik S. Lesser/EPA-\nEFE/Shutterstock)\nBy \nAmy Goldstein\nAmy Goldstein is The Washington Post’s national health-care policy writer. \nDuring her three decades at The Post, her stories have taken her from \nhomeless shelters to Air Force One, often focused on the intersection of \nReleased by Chairman Rand Paul\n167politics and public policy. She is the author of \"Janesville: An American \nStory.\"\nOct. 30, 2020 at 8:00 a.m. EDT\nMonths before travel was hobbled by coronavirus fears, I was returning \nhome one evening from Raleigh-Durham International Airport when I \nnoticed a familiar figure at the gate — slight, bespectacled, hair side-parted \nand gray. Anthony S. Fauci and I have spoken now and then over the years, \nand we began to chat. When it was time to board, it turned out our seats \nwere adjacent. So, I was treated to vivid war stories about the arc of his \nmedical and scientific work in infectious diseases, and about his \ninteractions with a succession of presidents during the AIDS crisis.\nNew York Times – 10/29/2020 – Thomas Kaplan:\nMr. Biden has also signaled that Dr. Anthony S. Fauci, the \ngovernment’s top infectious disease expert, will have a prominent \nrole in a Biden administration. The Biden campaign has said Dr. \nFauci, the longtime head of the National Institute of Allergy and \nInfectious Diseases, “will have full access to the Oval Office and an \nuncensored platform to speak directly to the American people — \nwhether delivering good news or bad.” — Thomas Kaplan and \nAbby Goodnough\nOctober 31, 2020 – Global – 45,400,000/1,200,000;  USA – 9,020,000/229,100\nSurging continues to accelerate 3 days before the election.   Trump out on \ncampaign trail with big crowds, many who do not wear masks.\nReleased by Chairman Rand Paul\n168Almost at the 100,000 per day level that I predicted at the Senate Hearing a \nfew months ago:\nReleased by Chairman Rand Paul\n169Tonight, I virtually received the Leonardo da Vinci Award of the National Italian \nAmerican Foundation at their Virtual Gala online from 6:30 PM to 8:30 PM.  \nHosted by Pat Harrison, Joe Piscopo and Maria Bartiromo.   There was a \nwonderful series of testimonials to me from an amazing group of people: Robert \nDeNiro, Al Pacino, Leonardo DiCaprio, Francis Ford Copolla, President George \nW. Bush, Bono, John Turturro, Neil Sedaka, Dion DiMucci wrote and sang a song \nto me, Maria Tomei (she also grew upon Bensonhurst and commented about that), \nIsabella Rossilini, Mike Piazza, among many others.   Very moving and humbling\nPRESS:  ONLINE version of Washington Post article came out this evening \n(se below).   Firestorm started.   Apparently, the Post called the White House \nto inform them of my “negative towards the WH” interview.   Mark Meadows \ncalled Collins (supposedly he tried to contact me but told Francis I did not \nanswer my phone.   He likely called my office phone that I no longer answer).   \nHe yelled at Francis saying that he has not seen the article yet but he has \nheard that I solicited an interview with the Post and did so without clearance.  \nFrancis called me and ascertained that in fact they called me and I did get \nclearance.   See below (Sunday).\nNovember 1, 2020 – Global – 45,900,000/1,200,000;   USA – 9,110,000/230,000\nReleased by Chairman Rand Paul\n170Big ISSUE!! – Blockbuster situation in Washington Post in an interview that I \ngave on Friday evening to Josh Dawsey and Jasmeen Abutaleb.   I spoke about the \nfact that cases were dramatically increasing throughout the country (see prior days \nabove) and that we needed to do something different like doubling down on public \nhealth measures.   I also strongly blasted Scott Atlas.   In the article, much to my \ndismay, Dawsey (less than Abutaleb) wanted to keep the word “seriously in a \npassage that I thought was off the record, but he said that it was not (I am pissed at \nhim).   Here is the passage: Fauci said former vice president Joe Biden’s campaign “is taking \nit seriously from a public health perspective.” Trump, Fauci said, is “looking at it from a different \nperspective.” He said that perspective was “the economy and reopening the country.”.  \n Also, in the article. Judd Deere blasted me saying I was being political:\nJudd Deere, a White House spokesman, offered blistering criticism of Fauci for his comments in a \nstatement to The Washington Post on Saturday. Deere said Fauci “knows the risks [from the \ncoronavirus] today are dramatically lower than they were only a few months ago.”\n“It’s unacceptable and breaking with all norms for Dr. Fauci, a senior member of the President’s \nCoronavirus Task Force and someone who has praised President Trump’s actions throughout \nthis pandemic, to choose three days before an election to play politics,” Deere said. “As a \nmember of the Task Force, Dr. Fauci has a duty to express concerns or push for a change in \nstrategy, but he’s not done that, instead choosing to criticize the President in the media and \nmake his political leanings known by praising the President’s opponent — exactly what the \nAmerican people have come to expect from The Swamp.”\nI thought that I was in big trouble.   However, some interesting things happened.   Alyssa Farah \ntexted me at 7:00 AM on Sunday and said:  \nI am so sorry that fool Scott Atlas keeps attacking you. I’m even more sorry I’m not \nin a better position of influence to see him out the door. I’m trying to make people \nsee he’s a disaster.\nI immediately called her up and explained that I was not pitting my support for \nBiden over the POTUS.   She understood perfectly and said she totally supported \nme and thanked me for what I do.\nThen, at 9:30 AM, the POTUS called me from Air Force One.  We had a 15 minute \nconversation where he did his usual rambling.  He started by saying that I really \nneed to be positive.  “Tony, I really like you, and you know that, but what the fuck \nReleased by Chairman Rand Paul\n171are you doing?   You constantly drop bombs on me.   Everybody wants me to fire \nyou, but I am not going to fire you, you have too illustrious a career, but you have \nto be positive.   The country cannot stay locked down.  (I never said that we \nshould lock down).   You have got to give them hope.   I like you but so many \npeople, not only in the White House, but throughout the country hate you \nbecause of what you are doing.   I am going to win this fucking election by a \nlandslide.   Just watch.   I always did things my way. And I always win, no matter \nwhat all these other fucking people think.   And that fucker Biden.   He is so \nfucking stupid.   You are 10 times smarter than he is.   I am going to kick his \nfucking ass in this election.  I will win by a landslide.   Just wait and see.  I will win \nFlorida, Pennsylvania, Ohio, all the key states.   Just wait and see. The smallest \ncrowd that I had was 25,000 people.   Biden had 5 people blowing their fucking \nhorns in their cars.   Tony, you have to be positive.  I do not want to keep you off \nTV, but when you are out there, you have to be positive. (I tried to interject some \nwords that I am being positive by telling people what they need to do to avoid \ninfection – he heard none of it and just kept talking over me.   He did not seem \nhostile, but he was just rambling).   Then when he was finished, he said: “OK, \nTony, I will see you in a couple of days.   Take care”. \nAlthough I do not think that I will be fired, I am not out of danger just yet.\nAnother crazy thing.   Scott Atlas did an interview from the White House with \nRussian Television blasting the response of the USA scientists (including me).   \nCNN is jumping all over this.\nPRESS:\n‘A whole lot of hurt’: Fauci warns of covid-\n19 surge, offers blunt assessment of \nTrump’s response\nReleased by Chairman Rand Paul\n172Josh Dawsey  and \nYasmeen Abutaleb\nOct. 31, 2020 at 7:00 p.m. EDT\nPresident Trump’s repeated assertions the United States is “rounding the turn” on the novel \ncoronavirus have increasingly alarmed the government's top health experts, who say the \ncountry is heading into a long and potentially deadly winter with an unprepared government \nunwilling to make tough choices.\nCNN Blog:\nWhite House unleashes on Fauci after \ncriticism of Atlas and Trump's pandemic \nresponse\nBy Kelly Mena\nCartoon pitting me against Trump:  https://www.youtube.com/watch?v= oCS-1w-OdU\nNov. 2, 2020 – Global     USA\nDuring rally in Florida, the crowd started chanting “Fire Fauci” and the POTUS \nsaid: “Don’t tell anybody but let me wait til a little after the election.   I appreciate \nyour suggestion”.   I got dozens of texts immediately following the posting of the \ntweet from people lending me their support and horror about what he is suggesting.  \nInteresting that he told me yesterday that he is not going to fire me.\nMany kids dressed up as me for their Halloween costumes:\nReleased by Chairman Rand Paul\n173\nReleased by Chairman Rand Paul\n174Nice talk with Marc Short today.   He is totally supportive as is (as he says) the \nVP.   I continue to get dozens of e-mails and texts of support from all over the \nworld.  The press is all over this.\nRosa DeLauro just called me and said: “We all love you.   Fuck him.   There is no \nway in the world we are going to let him fire you.”\nPRESS:  Multiple stories running now about the threat to fire me.\nNovember 3, 2020 – Election day!!\nRed hot discussions in press of POTUS firing me.  Dominating the news.  Also, \nsomeone leaked one of Deb’s daily briefing (see right above) making it look like \nshe is bucking the POTUS similar to what I did in the Post on Friday.\nLincoln Project (Republicans against Trump) says: You have a choice on election \nday.   Either fire Fauci or Trump.   Who do you want to fire?  \nUnfortunately, I am right in the middle of the fight for a Presidential election.   \nYIKES!!!\nReleased by Chairman Rand Paul\n175Harrison Ford And Lincoln Project Back \nAnthony Fauci, Advocate Firing Donald \nTrump\nBy Ted Johnson, Dominic Patten\nNovember 2, 2020 5:48pm\nImportant situation evolved today.   White House (meadows) clais that \nWashington Post (Dawsey) told him that I initiated the interview from Friday.   \nNOIT SO!!!    E-mail below is self-explanatory:\nBrian:\n    As per our recent telephone conversation, let me summarize.   Francis Collins \ncalled me this afternoon after his regularly scheduled meeting with the \nSecretary.   Apparently, the Secretary is under the impression (someone related \nthis to him) that I initiated the interview with the Washington Post that is now so \ncontroversial.   That is categorically incorrect and I have proof of that.  The e-mail \nbelow indicate that the reporter Josh Dawsey reached out to me for an \ninterview  (e-mail below dated October 29, 2020 at 11:48 AM).   I did what I \nalways do and requested  clearance.   The e-mails below show that this occurred \nand I was cleared to speak with him.   I would like very much to clear up this \nmisunderstanding that I reached out to the reporter, which I absolutely did \nnot.   Please read the e-mail chain from bottom up.  Many thanks.\nBest regards,\nTony\nFrom:  Conrad, Patricia (NIH/NIAID) [E] <conradpa@niaid.nih.gov> \nSent: Tuesday, November 3, 2020 3:55 PM\nTo: Fauci, Anthony (NIH/NIAID) [E] < afauci@niaid.nih.gov>\nSubject: Fwd: CLEARED - RE: Covid -- WashPost request\nReleased by Chairman Rand Paul\n176Sent from my iPhone\nBegin forwarded message:\nFrom:  \"Conrad, Patricia (NIH/NIAID) [E]\" <conradpa@niaid.nih.gov>\nDate: October 31, 2020 at 4:09:33 PM EDT\nTo: \"Fauci, Anthony (NIH/NIAID) [E]\" <afauci@niaid.nih.gov>\nSubject: Fwd:  CLEARED - RE: Covid -- WashPost request\n \nSent from my iPhone\nBegin forwarded message:\nFrom:  \"Leifman, Laura (NIH/NIAID) [E]\" <laura.leifman@nih.gov >\nDate: October 30, 2020 at 10:21:52 AM EDT\nTo: \"Billet, Courtney (NIH/NIAID) [E]\" <billetc@niaid.nih.gov>, \"Conrad, Patricia (NIH/NIAID) [E]\" \n<conradpa@niaid.nih.gov>, NIAID OCGR NSWB <NIAIDOCGRNSWB@mail.nih.gov>\nCc: \"Routh, Jennifer (NIH/NIAID) [E]\" <jennifer.routh@nih.gov>\nSubject: CLEARED - RE: Covid -- WashPost request\n \nPatty, ASF is cleared to talk with Josh Dawsey.\n-------------------------------------------------------------------------------------------------------------\n-------------------------------------------------------------------------------------------------------------\n-------------------------------------------------------------------------------------------------------------\n----------------------------------------------\nFrom:  \"Lemar, Naweed (OS/ASPA)\" <Naweed.Lemar@hhs.gov>\nDate: October 30, 2020 at 10:19:38 AM EDT\nSubject: Re:  Interview request:  COVID-19 as we head toward winter\n Ok\nV/R,\nReleased by Chairman Rand Paul\n177Naweed Lemar\nU.S. Department of Health & Human Services\nDirect: 202-260-6962\nMobile: 202-816-2427\nEmail: naweed.lemar@hhs.gov\n \nFrom:  Leifman, Laura (NIH/NIAID) [E] <laura.leifman@nih.gov > \nSent: Friday, October 30, 2020 9:19 AM\nTo: Billet, Courtney (NIH/NIAID) [E] < billetc@niaid.nih.gov>; Conrad, Patricia (NIH/NIAID) [E] \n<conradpa@niaid.nih.gov>; NIAID OCGR NSWB <NIAIDOCGRNSWB@mail.nih.gov>\nCc: Routh, Jennifer (NIH/NIAID) [E] <jennifer.routh@nih.gov>\nSubject: RE: Covid -- WashPost request\n \nThis is in clearance now. \n \nFrom:  Conrad, Patricia (NIH/NIAID) [E] <conradpa@niaid.nih.gov> \nSent: Friday, October 30, 2020 6:51 AM\nTo: NIAID OCGR NSWB < NIAIDOCGRNSWB@mail.nih.gov>\nCc: Billet, Courtney (NIH/NIAID) [E] <billetc@niaid.nih.gov>; Routh, Jennifer (NIH/NIAID) [E] \n<jennifer.routh@nih.gov>\nSubject: FW: Covid -- WashPost request\n \nPlease send for asap clearance. Hoping to do today\n \nFrom:  Auchincloss, Hugh (NIH/NIAID) [E] <auchinclossh@niaid.nih.gov> On Behalf Of Fauci, \nAnthony (NIH/NIAID) [E]\nSent: Thursday, October 29, 2020 11:49 AM\nTo: Billet, Courtney (NIH/NIAID) [E] < billetc@niaid.nih.gov>; Conrad, Patricia (NIH/NIAID) [E] \n<conradpa@niaid.nih.gov>\nSubject: FW: Covid -- WashPost request\n \n \nReleased by Chairman Rand Paul\n178 \nFrom:  Dawsey, Joshua <josh.dawsey@washpost.com> \nSent: Thursday, October 29, 2020 11:48 AM\nTo: Fauci, Anthony (NIH/NIAID) [E] < afauci@niaid.nih.gov>\nSubject: Covid -- WashPost request\n \nHi Dr. Fauci,\nJosh Dawsey from the Washington Post again. Hope you are well.\nMy colleague Yasmeen Abutaleb and I are working on a story about what the \npandemic is likely to look like this fall/winter -- and what the administration \nshould be doing about it. Wonder if you could answer a few questions.\n \n1.Have you briefed the president on the spike in cases in recent weeks, and \nhave you prescribed any course of action that you think is best to contain \nthe virus? If so, what is the action?\n2.What are you projecting as far as cases and deaths this fall?\n3.In what ways is the country better prepared to handle this wave of cases? \nIn what ways is the country worse prepared to handle this wave of cases? \nI'd love to get as granular as possible here. \n4.Why does the coronavirus task force meet less frequently than it once did? \nDo you have access to high-level decision makers at the White House as \nyou once did? \n5.What did you think of Mark Meadows comment that we can't control the \nvirus? Was that good public health messaging? What about the president's \ncomments that covid is overblown and that coverage of covid -- and the \ndangers of the disease itself -- will recede after Election Day?\n6.Have you warned the White House or the campaign, besides your public \ncomments, about the dangers of these large rallies?\n7.Have you spoken to anyone on the Biden transition team about controlling \nthe pandemic, should he win?\n8.Do you believe the president is getting good health advice from Dr. Scott \nAtlas? We are told you have repeatedly disagreed with Atlas. Is that true? If \nso, why?\nReleased by Chairman Rand Paul\n1799.We are told that you wanted to appear on television in upcoming weeks to \nwarn the country about the disease this winter, but were scuttled from \ndoing some appearances. Is that true? If so, do you know why?\nIf you have a second, I'm also happy to talk by phone. Just figured you might be \nbusy. I'm at 843-267-6747.\nPRESS:  News of the day dominated by press indicating me versus the \nPOTUS and the story that he is going to do a purge even if he is not re-elected \nand that the purge will start with me.   Front page in Washington Post;\nPolitico: Politics\nTrump threatens to fire Fauci ‘after the \nelection’\nBy Lev Facher @levfacher  \nJimmy Kimmel: [On Trump casually alluding that he is thinking of firing Dr. Fauci] “Firing Dr. \nFauci, that’s a smart move. He’s the only good person in the whole Administration. But go \nahead and fire him, because a group of people who sell nightcrawlers out of their vans started a \nchant.”\nNovember 4, 2020   Global – 47,400,000/1,200,000;     USA – 9,400,000/232,000\nSurging continues.  Predictions that we will have 1000 deaths/day for the next \ncouple of months if things do not change\nReleased by Chairman Rand Paul\n180In the AM, election still too close to call – Biden – 224; Trump – 213 at 5:30 AM\nBiden picking up numbers as the day goes on.  5 critical states.  Trump already \nclaiming fraud.   Wants to stop counting in the “mail-in” states since the counting \nis going against him.   Threatens to bring to Supreme Court even though it was \nagreed upon by the states that all votes would be counted.\nPhoto below from Liz Sabo:\nReleased by Chairman Rand Paul\n181PRESS:\n2020 election results may influence \nTrump's treatment of Dr. Fauci. That \nmatters.\nIf Trump does succeed in silencing Fauci somehow, it would come at a particularly precarious \ntime for America.\nReleased by Chairman Rand Paul\n182Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.Frankie \nAlduino / Redux Pictures\nFauci has spent the past few months speaking up about the stark realities of the pandemic — \nhonesty that is out of step with the White House's messaging and which seems to have resulted \nin his being sidelined. But Fauci's true courage and wisdom are most evident in how he has \nmanaged to strike a difficult balance: avoiding overt political attacks while still speaking truth to \npower. By walking this very tricky line, Fauci has probably avoided getting kicked off the \ncoronavirus task force, ensuring that he could continue working from within the administration. \nThis couldn't have been easy.\nI don't think the Trump administration realizes how much this unassuming and kind man \nembodies scientific excellence. But he's also got backup. There is a legion of citizen scientists, \npublic health experts and medical workers who aren't giving up. Silencing one man, even a \ngiant in the field of infectious diseases, won't silence those in our field. For months, efforts like \nthe Johns Hopkins COVID-19 Dashboard , the COVID Tracking Project and others have been \nproviding the kinds of critical intelligence that should have been coming directly from the CDC. \nOver the last few months, our professional societies have started to become vocal advocates \nfor evidence-based action, calling out this administration's deceptive and false claims. Long-\nstanding and revered scientific publications have come out against Trump for his lack of \nleadership and respect for science.\nReleased by Chairman Rand Paul\n183Nov. 4, 2020, 6:19 AM EST\nBy Dr. Nahid Bhadelia, infectious diseases physician and NBC News/MSNBC medical contributor\nPicture of me in the editorial page with statemen that I should be heeded and not fired.\nNovember 5, 2020 – Global – 47,900,000/1,200,000;     USA – 9,500,000/233,000\nYesterday number of cases in single day hit 100,000 as per my Senate Hearing \nprediction!!\nBiden at 253 electoral votes.   Closing in on victory.   Trump threatening to sue in \nseveral states and let the courts decide.   He has no case, but anything can happen.\nPOTUS on TV tonight saying that all the mailed in ballots that are going Biden’s \nwayare illegal.   He is making no sense.   He wants to stop the counting in \nPennsylvania and Georgia where he is ahead but Biden is rapidly catching up as \nmailed in ballots are being counted.  Trump told his followers to vote in person and \nso that is why he took the early lead.   However, many democrats mailed in and \nthat is why their votes are no turning things around.   Biden is leading in Arizona \nand Nevada and so Trump is OK with continuing the voting there.\nReleased by Chairman Rand Paul\n184Did a Fireside Chat with UCLA Health interviewed by Judith Currier.   Also, big \nsurprise, Karem Abdul-Jabar was on and said “from one basketball player to \nanother” thank you for all you have done.  He kidded me about my errant pitch at \nthe Nats opener.\nSteve Bannon said on his radio show with a guest that someone should behead me \nand FBI Director Wray and put our heads on a spike as an example to Federal \nbureaucrats/\nSteve Bannon and his co-host discuss \nbeheading Dr. Anthony Fauci and FBI \nDirector Christopher Wray \nBannon: “I'd put the heads on pikes, right, I'd put them at the two corners of the White House \nas a warning to federal bureaucrats” \nWritten by Media Matters Staff\n \n Kyle Griffin\n￿@kylegriffin1￿\nTwitter has banned an accoun\nt associated with Steve \nBannon and YouTube removed one of his videos after \nBannon called for the beheadings of two federal \nofficials. nbcnews.com/politics/2020-…\n  \nReleased by Chairman Rand Paul\n18511/5/20, 8:20 PM\n \nGot call from Ron Klain this evening.  Ron mentioned that Biden will give a \nspeech tonight and he wanted to mention in the speech that I am his top person on \nhealth issues and outbreaks.   However, he did not want to cause me trouble with \nTrump and so he asked if it was OK with me.   I told Ron that I likely would be \nfired within 15 minutes of Biden saying that in the speech and so please do not.   \nRon agreed and said that Biden wanted me to know that even though he is not \nsaying it, be assured that I am his point main when it comes to COVID or any \nother infectious diseases issues.   I told Ron that I cannot wait to work with him \nand Biden.   He said they could not wait to have me.\nNovember 7, 2020 – Global - 49,100,000/1, 200,000;   USA – 9,700,000/236,000\nEvery day, a new record is set.\nElection called for Biden!!!\nReleased by Chairman Rand Paul\n186138,000 cases yesterday with >1100 deaths.   My prediction of “A whole lot of \nhurt coming our way as we enter the cooler months of the Fall and colder months \nof the winter”   \nAm getting many calls from the press about whether I have been contacted by \nBiden’s team.   All my responses have been…..”no comment”\nNow you can determine your level of \nFauci with this handy meme\nA public health professor memed Anthony Fauci’s facial \nexpressions to gauge her students’ moods\nBy Kim Lyons  Nov 2, 2020, 1:30pm EST\nShare this story\n• S h a r e  t h i s  o n  F a c e b o o k  ( o p e n s  i n  n e w  w i n d o w )• S h a r e  t h i s  o n  T w i t t e r  ( o p e n s  i n  n e w  w i n d o w )• S H A R E A l l  s h a r i n g  o p t i o n s\nReleased by Chairman Rand Paul\n187Dr. Anthony Fauci says a lot with his facial expressions.  Photo by Al Drago / Pool / Getty Images\nReleased by Chairman Rand Paul\n188Anthony Fauci is probably one of the most recognizable faces  of the \ncoronavirus pandemic in the US. So when a public health expert needed a \nway to measure how her students were coping with all of the stresses of \n2020, she created a chart to gauge their “level of Fauci.”\n“We all kind of need something that’s positive, that makes sense to us,” \nKaren Sautter Errichetti, an assistant professor in public health and \ncommunity medicine at Tufts University School of Medicine, said. She’d \nnoticed that her community of public health and medical professionals was \nfeeling pretty depressed. So to lighten the mood and get the students \ninterested, she and her co-instructor Reece Lyerly start every class with a \nmeme of some sort.\nNothing caught on quite like the Fauci meter, which she introduced to her \nstudents back in September. The hardest photo to find was one of Fauci \nfull-on smiling, she notes.\nPRESS:\nSteve Bannon Loses Lawyer After \nSuggesting Beheading of Fauci\nReleased by Chairman Rand Paul\n189Mr. Bannon, the former adviser to President Trump, said the heads of the F.B.I. director and Dr. \nAnthony Fauci should be put on pikes, leading Twitter to ban one of his accounts.\nNovember 8, 2020 (Sunday) – Global    USA\nCall from Deb Birx concerned (as I am) of the potential dissociation of what we \nwill be doing with the TF until January 20 and what Biden’s people are planning \nvia their Task Force.   Since I am/will be on both, perhaps I can convince them to \nform some sort of collaborative transition to smoothly address the coming 90 days.\nTrump vowing to fight until the end.   He claims that he won.\nAlso, Deb mentioned to me that Jared, Marc Short and the VP are trying to “talk \ndown” the POTUS from attempting to discredit the election and create havoc that \nwill go nowhere.\nReleased by Chairman Rand Paul\n190Cases are now exploding throughout the country.   Every day a new record is \nset!!   Clearly, the Atlas strategy that once an area is hit hard, they are \nprotected against the next surge is utter nonsense.   Areas are surging that got \nhit previously and so no herd immunity with 25% of people infected.\nReceived a call at 7:45 PM from Albert Bourla (CEO of Pfizer) informing me \nthat the DSMB looked at the data of 94 infections (first interim look) from \ntheir mRNA vaccine and the results were 4 infections in vaccine and 90 in \nplacebo for a 95% efficacy!!!!    This will be announced tomorrow.\nReleased by Chairman Rand Paul\n191November 9, 2020 -  Global – 50,300,000/1,300,000;   USA – 10,000,000/238,000\nHas Task Force meeting today.   First one since October 20.   VP Pence seemed in \ngood spirits and stated that we will either be here for an additional 90 days or for 4 \nmore years.  Whichever it is, we will do our job.   He did say that we will make \nReleased by Chairman Rand Paul\n192sure that “every legal vote gets counted”.   I was surprised that there was not even \na hint in Pence’s voice that declaring the vaccine successful a few days AFTER the \nelection was a conspiracy of some sort.   I have not even heard any of that from the \nOval Office.   Let us see over the next couple of days.\nPRESS:   CNN with Wolf Blitzer\nNovember 10, 2020 – Global – 50,500,000/1,300,000;  USA – \n10,000,000/238,000\nReleased by Chairman Rand Paul\n193Patterns are the same.   Weekends see a dip in cases due to lack of weekend \nreporting.   Then we get into the week and we break daily records.   Country still \non fire and getting worse.  122,000 cases yesterday!\nPOTUS still insisting that the GOP won the election.   Completely alternate \nuniverse.   Kayleigh and GOP Senators (Graham, McConnell, Ted Cruz) all \nprostituting themselves by supporting the POTUS’s baseless claims.   Heading \ntowards a constitutional crisis.\nReleased by Chairman Rand Paul\n194See below the states that are increasing:\nReleased by Chairman Rand Paul\n195Janet Tobias interviewed President George W. Bush for her documentary and he \nwas really funny.   He sent me a message “…..hang in there; the country needs \nyou” and he said “…I would have been able to kick your ass in running; the \nsecurity detail used to be not able to keep up.   I hear that you power walk now and \nI damn sure can’t run anymore at 74, let alone 79”. 😊\nI received virtually a citation from Eric Adams Borough President of Brooklyn at a \nceremony on the steps of Borough Hall.   It was called COVID Heroes.    The other \nheroes cheered me on during my acceptance speech.\nHad my every 2 week meeting with the David Barr-organized people in the \ntrenches to talk about the dire situation with >100,000 infections per day and major \nincreases in hospitalizations: LaQuandra Nesbitt (DC), Alison Arwady (Chicago), \nSharon Balter (LA), Jeff Duchin (Seattle), Demetre Daskalakis (NYC), Preetha \nIyengar (NOLA).   Clearly Scott Atlas is dead wrong.\nPRESS: MSNBC with Andrea Mitchell; Connecticut East – NOVA podcast; \nCNN Jake Tapper – “The Lead”; Interview with Sheryl Stolberg (New York \nTimes)\nReleased by Chairman Rand Paul\n196November 11, 2020 – Global    USA\nSteady surges continue with 10 days in a row of>100,000 cases/day.\nTrump fired Sec Mark Esper and several DoD civilian officials (high ranking) have \nresigned.   Fear is that Trump is stacking the DoD with loyalists if he really wants \nto do a coup and steal the election/democratic process.  Very scary times.   The \nGOP leadership that are backing Trump (McConnell, McCarthy, Jordan, Blount) \nare incredibly shameful.   Reminds me historically of Hitler getting duly elected to \nChancellorship and then forcibly taking over the country.   Amazing!!\nScott Atlas criticized me to Politico (see below).   I e-mailed Alyssa Farah and told \nher that this was unacceptable.   She wrote back to me (see below) saying she \nwould take care of this.   Within 30 minutes, Atlas called me up and said that we \nshould stop criticizing each other and that he is extremely qualified and I need to \nrecognize this.   I was gracious and said let us agree to say that we just have \ndifferences in opinion and interpretation of data and stop any personal attacks.   In \nfact, he really does not know what he is talking about, but I am not going to battle.\ncoronavirus\n‘A political animal’: Atlas attacks Fauci, escalating feud \nbetween Trump’s pandemic advisers\nThe remarks represent a continuation of the criticism Trump leveled at Fauci in the run-up to \nlast week’s election.\nReleased by Chairman Rand Paul\n197Dr. Scott Atlas, a top coronavirus adviser to President Donald Trump, is a physician with no \nexpertise in infectious diseases or epidemiology. | Tasos Katopodis/Getty Images\nBy QUINT FORGEY\n11/11/2020 07:47 AM EST\nEmail from Alyssa Farah:\nI Will immediately raise with Dr Atlas. This is unacceptable. He goes rogue and it’s wildly \nunhelpful. I’m so sorry you have to deal with this. I’ve advocated for his dismissal for months to \nno avail.. \nSent from my iPhone\nGot call from VP Pence at 1:10 PM today.  He wanted to tell me how much he \nrespected me as a scientist and as a person.   He heard that I had called Marty Obst \nevery day while he was ill with COVID-19 as well as my calling Marc Short every \nday.   He thought that this was wonderful.   Also, he liked my recent messaging \nReleased by Chairman Rand Paul\n198that “help is on the way with a vaccine” and so we should all hang in there with \npublic health measures.   Very nice call!\nReleased by Chairman Rand Paul\n199PRESS:  Fireside Chat with Financial Times – Hannah Kuchler; interview \nwith INSERM regarding my INSERM Award\nNovember 11, 2020 – Global – 51,800,000/1,300,000;  USA – \n10,300,000/241,100\n140,000 case yesterday; 60,000 hospitalizations; 1300 deaths\nReleased by Chairman Rand Paul\n200PRESS:  Good Morning America with Robyn Roberts; Vice News with Liz \nLanders; Chatham House with Emma Ross and David Heymann; American \nPhilosophical Society Fireside Chat with Mark Thompson; VICE TV \nReleased by Chairman Rand Paul\n201interview; Sinclair TV Broadcasting – Jan Jeffcoat; Reuters healthcare \nForum – Julie Steenhuysen; 2020 Ignatius Forum at the National Cathedral \n(covered by all the TV networks) \nPolitico (see below)\nFauci and Biden team steer clear of each other — for \nnow\nBiden’s transition team must plan for a crisis response without access to essential \ninformation about the nation’s supply chains and testing supplies.\nAnthony Fauci, director of the National Institute of Allergy and Infectious Diseases, testifies on \nCapitol Hill. | Alex Edelman/Pool via AP\nBy SARAH OWERMOHLE, ADAM CANCRYN and DAN DIAMOND\n11/11/2020 06:33 PM EST\nReleased by Chairman Rand Paul\n202November 13, 2020 – Global -  USA – \nPandemic surge continues.   Curve is exponential\nMoving along with the deployment of vaccine, Pfizer is putting in for their EUA.   \nThere should be 20 million doses of vaccine ready to deploy in December.   \nModerna will be doing the initial examination of data within days and likely will \nhave comparable efficacy data to Pfizer.   Their will have 15 million doses for \ndeployment in December.   Thus, 20 + 15 = 40 million doses for 15 - 20 million \npeople in December.   Aim to is get nursing homes (NH) covered quickly.   1.5 \nmillion people in NHs + 1.5 million staff = 3 million people (6 million doses)\n•Did major photo shoot with People Magazine\nRon Klain called me up.   He said that he wanted to ensure me that I have  friend in the COS to \nthe POTUS.   He asked for suggested candidates for CDC.   I recommended: Rochelle Walensky, \nAshish Jha, Rich Besser, Carlos Del Rio, Josh Sharfstein (Ron feels that he would be better  for \nFDA – I agreed).\nPOTUS had press conference today with the OWS people (Slaoui and Perna and Azar) – \nTrump spouted how well we are doing here in the USA.   After that he had Slaoui talk about the \nsuccess of the vaccines (Pfizer and Moderna) which is good news\nPRESS:   CBS This Morning;\nNovember 14, 2020 – Global – 53,200,000/1,300,000;    USA – \n10,700,000/244,000\nStill raging – 184,000 cases yesterday (Friday) and 69,000 hospitalizations; \n>1400 deaths).   Every day is a record.   Hospitals soon to run out of ICU beds and \npersonnel.\nReleased by Chairman Rand Paul\n203Crazy situation of Trump supporters including “Proud Boys” marching on DC to \nprotest that Biden “stole the election”\nDid major photo shoot with Bloomberg News in anticipation of being one of the 50 \nmost influential people in 2020.\nDid the first Saturday morning (10:00 AM) meeting with Janssen, similar to what \nwe did for several weeks with Moderna to help them and encourage them to get \ngood diversity in their clinical trials.  For NIH, it was Francis, Cliff, me, Kim \nTaylor from DMID, Gary Gibbons.   For Janssen, it was Paul Stoffels, Johan van \nHoof, Peter Ronco, Mathai Mammen, Najat Khan, Stacy Hargraves.\nENSEMBLE is the Phase 3 trial for the Janssen candidate.\nPRESS:  \nReleased by Chairman Rand Paul\n204Joe Biden and Dr. Fauci praise \nthe work of Jesuit Refugee \nService\nMichael J. O’Loughlin November 12, 2020\nNovember 15, 2020 – \nSurge continues.   244,000 deaths (1300 yesterday); 10,900,000 infections, \n167,000 cases yesterday.\nBig issue now is the logistics of distribution of the vaccine.   Locals are saying that \nthe USG has not given them enough money (bullions instead of hundreds of \nmillions) to be able to distribute the vaccine.\nCrazy Scott Atlas is out there urging people of Michigan to “rise up” against the \nrestrictions put on by the Michigan Governor Gretchen Whitmer to quell the \noutbreak.   WH Comms still lets him out despite the fact that Alyssa tells me she \nthinks he is destructive.   Clearly someone (POTUS, Meadows) wants him out \nthere:\nTrump coronavirus adviser Scott Atlas urges \nMichigan to 'rise up' against new Covid-19 \nmeasures\nBy Paul LeBlanc and Jeremy Diamond , CNN\nReleased by Chairman Rand Paul\n205\nReleased by Chairman Rand Paul\n206DSMB for Moderna met today!  Wonderful results.   95 events.  5 in the vaccine group and \n90 in the placebo group. Point efficacy = 94.5%; P = 10-15 ;  11 severe events – 11 in \nplacebo, 0 in vaccine.   Effect consistent across all subgroups and ages.  Press \nannouncement tomorrow\nDoing several embargoed interviews this evening.\nPRESS:  CNN State of the Union with Jake Tapper\nNovember 16, 2020 – Global – 54,300,000/1,300,000;  USA – \n11,000,000/246,000\nContinual surge:  138,000 new infections yesterday.   POTUS has no interest at all \nin the Pandemic.   He is focusing on blocking Biden from being POTUS.   He is \nembarrassing the USA.   However, 72,000,000 voted for him.   Difficult to \nunderstand.  Craziness has overtaken part of our country (1/2).\nJared Kushner did call me up right before the press briefing related to the Moderna \nvaccine announcement (see below)\nReleased by Chairman Rand Paul\n207\nReleased by Chairman Rand Paul\n208*******The administration (POTUS, Pence, Meadows, etc) keep emphasizing that we have \nnever been as well prepared to respond to this pandemic.   They refer to hospital beds, \nventilators, PPE, etc.   They are missing the fact that the pandemic is raging and they are really \ndoing NOTHING to stop its spread.   They have essentially given up (see comments above from \nMark Meadows) in stopping it and concentrating on having enough supplies to address the cases \nas they come in.   In fact, smaller states (southwest, northwest) are rapidly running out of ICU \nbeds and personnel.  They are wrong on both accounts.\nFreddy Ford (George W. Bush’s Chief of Staff) emails me and mentions that W. wants to receive \nvaccine publicly to indicate his support for vaccines, and could I help out.\nSir Elton John and husband David Furnish call me up and want to talk about how we can link the \ninterest in COVID-19with sustained interested in ending the COVID pandemic.   Great \nconversation; they are very “proud of me”.   I suggest linking testing for COVID to getting tested \nfor HIV and getting people on PrEP.   They loved the idea.\nPRESS:   NBC Today Show with Savannah Guthrie; CBS with Jon LaPook; \nWTOP Radio;   Press briefing by Francis Collins, me, Stephane Bancel, Matt  \nHepburn; Stephen Hoge, John Mascola related to Moderna announcement\nNovember 17, 2020 – Global – 54,800,000/1,300,000;   USA – \n11,100,000/246,200\nReleased by Chairman Rand Paul\n209The surge continues.   ICU beds in Montana are running out.. Recent (Nov. 13) \nNPR interview of ICU nurse in Billings MT:\nRIHA: We are currently at a critical level of patients in our ICU. So as you mentioned, we're the largest \nhospital operating system in Montana. And under normal operating circumstances, we have a 24-bed \nICU in our hospital. When I left last night at the end of my shift, we currently had 44 ICU patients that \nwere under the care of our service with a very, very full emergency room and likely more ICU patients \ncoming in.\nIn Task Force meeting today, Deb, I (by virtual), Bob sounded the alarm.   Mark \nMeadows blurted out and objected to our call for a consistent message about \nmasks and testing asymptomatics.  He feels that no matter how much you test, you \nstill will have outbreak. He got tested every day and he claims to have been \ninfected while wearing a mask – NONSENSE.   He was not wearing a mask before \nhe got infected.   He has bought into Scott Atlas.   This is disgraceful.  Deb \nsuggested that we have a doctor White House press conference once per week. I \npointed out that we must have a consistent message from the White House.   I was \nnot so subtly referring to Scott Atlas saying that masks do not work.\nReleased by Chairman Rand Paul\n210PRESS:  NPR Morning Edition; New York Times “Dealbook”\nNovember 18, 2020 – Global – 55,100,000/1,300,000;    USA – \n11,300,000/248,000\nStill very much out of control.   Trump is absent when it comes to outbreak.   He \nrecently fired a civil servant Christopher Kreb, cybersecurity official.   This is \nhaving press speculate that he might fire me.\nReleased by Chairman Rand Paul\n211\nReleased by Chairman Rand Paul\n212Exponential spread:\nReleased by Chairman Rand Paul\n213PRESS: BBC World News TV; Elizabeth Rosenthal Kaiser Health Podcast \n(NY Times); USA Today Editorial Board Interview; USA Today interview \nAdrianna Rodriguez\nNovember 19, 2020 - Global   USA\n164,000 cases yesterday; 1900 deaths\nDid Miami Mayors call.   New Mayor of Miami-Dade – Daniella Levine Cava, \nreplaced Mayor Carlos Gimenez who has been elected to Congress.  Mayor Francis \nSuarez is Mayor of Miami City.   Real problem is that the Mayors want to do the \ncorrect thing, but the Governor has ordered that bars and restaurants open at full \ncapacity.  The best that he will give the Mayors is a 2 hour curfew, i.e. close bars at \n10:00 PM.  He is a Trumper and a real problem.  Screw people dying; save the \neconomy.\nMajor staff shortages in hospitals in Midwest and other areas.   This completely \nbelies the stunning denial that Mark Meadows, POTUS, even the VP, certainly \nScott Atlas are manifesting.   They believe that the increase in cases is due to \nincreases in testing.  They just deny that hospitalizations and deaths are increased \ngreatly.   Amazing that even in regions where the virus is surging and hospitals are \noverflowing, the people in the region are calling it “fake news”\nOWS (General Perna) briefs VPOTUS on vaccine distribution.   He is promising a \nlot. \nDid nice podcast fireside chat with The Hastings Center\nReleased by Chairman Rand Paul\n214\nReleased by Chairman Rand Paul\n215Sharon Stone, Dr. Anthony Fauci to be \nHonored During Virtual Research in Action \nAwards\nSharon Stone and her good friend Dr. Anthony Fauci are among the honorees at Treatment Action \nGroup's virtual Research in Action Awards\nPRESS: Nexstar TV; White House Press conference (discussed vaccines and \npublic health measures.   Pence ran it and did not allow questions after the \npresentations.  The reporters in the audience (Kaitlan Collins, Jon Karl and \nothers) went nuts with anger; CNN with Chris Cuomo;\nNovember 20, 2020 – Global – 56,600,000/1,400,000;    USA – \n11,700,000/251,700\nReleased by Chairman Rand Paul\n216Still surging out of control.   Records being broken daily.   1700 deaths yesterday.   80,000+ \npeople in hospital.  198,500 cases today.  Hospitals started to be strained.  Record \nhospitalizations.\nMedia dominated by COVID and Trump clearly trying to overturn the results of the \nelection.   Incredibly he is bringing in State legislators to the White House to try and convince \nthem to cast their electoral votes for him even though the populace voted for Biden and Biden \nwon Michigan.  The GOP leaders are remaining silent with very few exceptions.   They are all \nafraid that TRUMP will target them either as a private citizen or if he runs in 2024.   Shameful \ncowards!!   I am so disappointed in Pence whom I really like.\nGiuliani is babbling incoherently as the top lawyer trying to overturn the election.   It really \nseems that he is mentally decompensating.\nReleased by Chairman Rand Paul\n217PRESS:  MSNBC – Chuck Todd and Meet the Press Daily; Univision TV with \nJorge Ramos; Katie Couric TV Website; Fox TV – “Bill Hemmer Reports”; \nWisconsin TV – ABC – WISN-TV, Adrienne Pedersen Anchor\nNovember 21, 2020 (Saturday) – Global – 57,300,000/1,400,000;    USA – \n11,800,000/253,600\n192,700 cases yesterday.\nContinual trend of worse and worse every day.   Records of hospitalizations and \ndeaths and daily cases continue to surge.   See below.\nTrump and cronies (Giuliani et al) losing each of the court and other attempts to \noverthrow the election\nHad important Webex meeting at 9:00 AM (sunny) with Peter Marks, Cliff Lane, \nFrancis Collins about the data from convalescent plasma that has been basis of \nEUA.   Date are statistically significant, but very unimpressive.   Need to treat 70 \npatients to benefit 1.\nReleased by Chairman Rand Paul\n218Had Zoom with NIH people (Francis Collins, John Mascola, Kim Taylor, Gary \nGibbons, Eliseo Perez-Stable, Cliff Lane) and with the Janssen people (Paul \nStoffels, Mathai Mammen, Stacey Hargraves, Peter Ronco, Macaya Douoguih, et \nal) to review the status of the Janssen trial and to encourage getting greater \ndiversity in the trial.\nGot call from Larry Horowitz tonight telling me that Peter Marks told him that \nTrump called up Steve Hahn today and told him that Alex Azar said that Steve lost \nthe POTUS the election by holding up the news about the Pfizer vaccine.   Trump \nwas cursing Steve on the phone and then hung up.   Steve did not know if he was \ngoing to get fired and told this to Peter who called up Larry.   Still not sure what is \ngoing to happen.\nReleased by Chairman Rand Paul\n219November 22, 2020 – Global – 57,900,000/1,400,000;  USA – 2,000,000/255,100\n200,000 cases yesterday\nSee UK below.  Mitigation (closing bars, gyms; restricting indoor dining; confine \ndinners and activities to immediate households) works as shown in UK and even \nUSA during the summer rise and decline:\nReleased by Chairman Rand Paul\n220Some states may actually be starting to turn around as they start mitigating:\nGot a call from Nancy Messonnier expressing great concern that after the doses get delivered \nby Gen. Perna to the local state locations, that there is confusion in how to get the doses \ndistributed.   She says that the local health departments who have been given this responsibility \neither have no idea what they are doing or they need the resources that they do not have.   She \nReleased by Chairman Rand Paul\n221says her communications with Redfield are rare and she is distraught.   She has more access to \nme than to Redfield.\nPRESS:   Face the Nation (CBS) – with Margaret Brennan;\nNovember 23, 2020 – Global – 58,400,000/1,400,000;   USA – 12,200,000/256,000\n Very concerned that the travel over Thanksgiving will exacerbate the current surge.  Some states \nthat are mitigating (IL, NM) and doing much better than those that are not (IN, SD)\nReally good news in that both Moderna and Pfizer on further analysis of ther data are reporting \nvery good efficacy after first dose and prior to second dose.\nAstraZeneca is reporting today 70% efficacy (on average) with ½ dose prime and full dose boost.   \nStrange that ½ + full did better than full + full\nKatie Miller’s daughter Mackenzie born a few days ago.   Went to NICU due to Transient \nTachypnea of the newborn (TTN).   Katie had strangulated hernia that required surgery.   All is \nwell now.\n•Toronto Goes Into 28-Day Lockdown As COVID-19 Cases Surge.  Remember when \nwe got hit badly early on and Canada did so well people said we did not do it right, but \nCanada did.   We could not figure out what “it” was.   Now with the Fall surge, Canada is \ngetting badly hit as is every place else.\nReleased by Chairman Rand Paul\n222PRESS:  RAI Italian TV; La Stampa/Vatican Radio interview with Paolo Mastriolli; \nHcehinger Boston Radio (NPR); Yahoo Finance TV interview; Washington Post Live with \nRobert Costa; PBS NewsHour with Judy Woodruff; Zoom with Washingtonian Top \nDoctors\nNovember 24, 2020   Global  - 58,700,000/1,400,000 USA – 12,300,000/257,000\nSurge continues.   Europe starting to level off since they are shutting down in many countries. \nDespite CDC saying not to travel over holidays, millions of people, particularly students are \ncrowding airports\nReleased by Chairman Rand Paul\n223Biden tweeted today that he has not spoken to me but his staff has and I have been “very, very \nhelpful”.   I had told he press that I had not heard from the Biden team since my conversations \nwith Ron Klain were supposed to be confidential since over the past several days Ron has \ncontacted me about my advice for CDC Director and FDA Commissioner.   I recommended \nRochelle Walensky for CDC.   Ron called he and liked her.  Also, Ron told me that there was \npush back by some against Josh Sharfstein whom I recommended for FDA. In order not to have \na contradiction with Biden, I have told CNN (Kaitlan Collins, Jim Acosta, etc.) GMA\nPRESS: NBC Radio The Takeaway; Healthline Live Stream; MTV Interview; FOX News \nLocal DC; Yahoo News TV;\nReleased by Chairman Rand Paul\n224November 25, 2020 – Global   USA\n11:00 AM call with Azar regarding the role of ACIP in the recommendation for the \nprioritization of the distribution of vaccine starting in December.  Azar feels (with advice \nfrom Bob Charrow) that ACIP has no statuary authority of being involved in the process.  Azar \nwants to act early to without ACIP involvement get vaccine to both HCWs and nursing home \nand other vulnerables (aged).  This would require using all of the first supply as the prime (and \nnot withholding half the doses for the boost), thus allowing us to vaccinate more of the high \npriority group and depend on the integrity of the supply chain to supply the booster doses.  His \nintent is good, but I point out that this would be a PR disaster since we have been saying all \nalong that an independent body (ACIP) would be very much involved in these recommendations.  \nIt would be interpreted as sidestepping a established process by political influence.   My \nargument turns the tide to get ACIP involved with us from the beginning.   They may agree with \nus (which is great) or they may not whereby we can say we included them in the process, but we \ndo not accept their recommendation\nRon Klain texted me last night after midnight.   I was asleep.   He sent me video of Joe and \nJill giving Thanksgiving message to be careful over Thanksgiving.  I will speak with Ron Today.  \nRon just texted me and said that they decided on  Rochelle Walensky for CDC director on my \nrecommendation!!\nPRESS:  Good Morning America (ABC) with George Stephanopoulos; C-SPAN \nWashington Journal; WINS Radio (NYC); WGN TV (Chicago); Byron Allen and GRIO, \nan African-American online TV interview;  Huffington Post (Jeff Young) – writing a piece \non “A Day in the Life of Dr. Fauci”; McClatchy (Mike Wilner) print interview on vaccines; \nKaiser News Interview (Lauren Weber); Interview with Scientific American (Charles \nSchmidt);\nNovember. 26, 2020 (Thanksgiving) Global – 59,800,000/1,400,000; 12,700,000/261,300    \nUSA\nSurge continues   Trump not addressing the outbreak at all Consumed with blasting sway at \npeople and pardoning people like Gen. Flynn.   Georgia Senate re-run about to occur to \ndetermine control of the Senate.\nWent on walk with Will and Joli to Mall and was “mobbed” by well-wishers who wanted photos \nwith me.   Went to the steps of Lincoln Memorial and read the speech of Lincoln on the opposite \nReleased by Chairman Rand Paul\n225wall of the Gettysburg Address.   Strikingly referable to today:   “Men who worship the same \nGod can be so far apart on fundamental issues….”\nReleased by Chairman Rand Paul\n226PRESS:  \nU.S. News \nNov. 25, 2020 / 8:44 PM \nFauci, Harris top 'Time' 2020 Person of the \nYear nominees\nReleased by Chairman Rand Paul\n227November 27, 2020 – Global – 60, 300,000/1,400,000; USA – 12,800,000/263,000\nNow concerned about the post-Thanksgiving surge\nReleased by Chairman Rand Paul\n228Record number of hospitalizations at >80,000\nNovember 28, 2020 – Global – 61,300,000/1,400,000;  USA – 13,000,000/264,000\nReleased by Chairman Rand Paul\n229Reporting of cases will be inaccurate for the next couple of days due to Holiday.   However, we \ncan expect a post-Thanksgiving surge.\nDid filming with Janet Tobias and John Hoffmann for the NatGeo documentary.   Went to the \nold RFK Stadium/Armory complex to view and film the 250,000 white flags put up by artist \nSusan    in memory of those who died from COBID-19.   Very reminiscent of the HIV/AIDS \nQuilt project.   The crew filmed Chris and I walking through the acres of small white flags.   \nAlso filmed us from above with a drone.\nTrump bringing his argument before the Supreme Court.   He has lost every court case (>30) \nexcept for one.   The Supreme court issue relates to a lower court rejecting his claim that the \nPennsylvania election was rigged.   He and his lawyers (led by Rudy Giuliani) are an extreme \nembarrassment to the GOP and to the country.   The rest of the world is looking at what is going \non here incredulously.   We look like a Banana Republic.   I never would have imagined in my \nwildest dreams that our democracy would be so shook.   It is still amazing how the ZGOP \nleaders do not abandon Trump.   They are just afraid of him and what he can do after he leaves \nthe Presidency to their political careers – Profiles in Cowardice.\nReceived Deo et Patriae Award from Regis High School and President George W. Bush sent a \nletter of congratulations:\nLetter from \nPresident George W                  \nReleased by Chairman Rand Paul\n230Got call from Ron Klain tonight at 5:15 PM.  He wanted to fill me in on recent appointments \n(not announced yet) to make sure that I am OK with them:  Josh Sharfstein (FDA), Vivek \nMurthy (Surgeon General), Rochelle Walensky (CDC), Jeff Zients (COVID-19 Czar), Gina \nRaimondo (Secretary of HHS).   Ron said that Biden wanted to call me soon but he did not want \nto compromise me with the Trump people.   They will clear with Meadows that the transition \nteam can start getting in place and then Biden will call me. \nGot call last night from Mark Ghaly (Deputy Director for Community Health for the LA \nCounty Dept of Health Services).  He has called me several times for advice.  Frantic call \nsaying that they are surging in LA County and very soon hospital beds will be overrun.   He \nwants to do a 3 weeks shutdown of the city to “stop the surge” and wants my support since there \nis a large pushback to locking down.   I agreed to support him. \nNovember 29, 2020 – Global – 61,900,000/1,400,000;    USA – \n13,100,000/266,000\nNow at end of Thanksgiving weekend.   Expect further surges (Birx’s daily report):\nReleased by Chairman Rand Paul\n231Photos below of Fauci making rounds with Clinical Center inpatient and Clinic Staff – from \nOctober 2020\nReleased by Chairman Rand Paul\n232\nFauci makeing \nrounds  with Clinica         \nPRESS: NBC Meet the Press with Chuck Todd; ABC This Week with Martha \nRaddatz\nNovember 30, 2020 – Global – 62,400,000/1,500,000;     USA – 13,300,000/266,100 \nWe will see in the next few weeks whether the travel associated with Thanksgiving leads to a \nsurge upon a surge.  95,000 people are currently hospitalized with COVID-19 – new record for \nthis outbreak.\nBiden putting together his team.  Very diversified with women and people of color.   Trump \nstill flailing about challenging without any hint of evidence that various states were won by him.   \nHe still has his Greek Chorus of people backing him although little by little they are being less \nvocal and explicit about backing him.   The GOP is in a crisis in that many have lost credibility \nby not explicitly condemning Trump.   They are all afraid since he does have almost ½ the \ncountry with him.   He will definitely run in 2024 and they are afraid that they will lose his \nsupport if they come out against him.  Terrible situation for democracy.\nGot call from Gov. JB Pritzker (D-IL) praising me for what I have been doing and asking for my \nbacking for him to keep stringent public health measures (short of lock down).   He is getting \npushback from bars and restaurants and even from hard core people who do not want to wear \nmasks.   He said that I am so credible and respected that he would like to quote what I have said \nas backup for himself.   He liked my statement on Sunday shows of “Close the bars; open the \nschools”.  He is very frustrated with people not wearing masks and told me he would like to just \nsay:  “Wear a fucking mask!”\nReleased by Chairman Rand Paul\n233\nReleased by Chairman Rand Paul\n234Sen. Rand Paul continues to act like an idiot:\nRand Paul says Fauci owes \nparents and students an \napology over pandemic \nmeasures\nBY DOMINICK MASTRANGELO - 11/30/20 12:01 PM EST 488\nSen. Rand Paul (R-Ky.) scolded Dr. Anthony Fauci in a tweet on Sunday, suggesting \nthe nation's leading infectious disease expert apologize for his warnings about the \ndanger coronavirus poses to school-aged children. \n\"Dr. Fauci owes [Rand Paul] an apology,\" one of Paul's Twitter followers said. \nReleased by Chairman Rand Paul\n235Paul responded: \"No, he owes one to every single parent and school-age child in \nAmerica. I told him this multiple times this summer.\" \nFauci and Paul have clashed several times since the pandemic began, with the \nKentucky Republican accusing Fauci of fear-mongering rhetoric and what he says is \nincorrect praise of so-called lockdown measures implemented to stem the spread of \nthe virus. \n“Dr. Fauci, every day we seem to hear from you things we can’t do. But when you’re \nasked, ‘Can we go back to school?’ I don’t hear much certitude at all. ‘Well, maybe.’ \n‘It depends.’ Guess what? It’s rare for kids to transmit this. I don’t hear that coming \nfrom you. All I hear is, ‘We can’t do this, we can’t do that, we can’t play baseball,’” \nPaul said while demanding schools reopen during a Senate hearing in late June. “It’s \nimportant to realize that if society meekly submits to an expert and that expert is \nwrong, a great deal of harm may occur when we allow one man’s policy or one group \nof small men and women to be foisted on an entire nation.\"\nFauci responded to Paul at the hearing, saying he feels \"very strongly we need to do \nwhatever we can to get the children back to school.\" \nDuring the early days of the pandemic, Fauci and other public health officials urged \nlocal school districts to consider all factors before deciding if it was safe to have \nchildren and teachers return to classrooms. \nOn Sunday, Fauci clarified his position on school closures amid a nationwide spike in \ncoronavirus cases this fall. \n\"The default position should be to try as best as possible, within reason, to keep the \nchildren in school, to get them back to school,\" Fauci said on ABC's \"This Week.\" \"If \nyou look at the data, the spread among children and from children is not very big at \nall, not like one would have suspected. So let's try to get the kids back. But let's try to \nmitigate the things that maintain and push the kind of community spread we are \ntrying to avoid. And those are the things you know well. The bars, the restaurants ... \nthose are the things that drive the community spread. Not the schools.\" \n•Did weekly Governor’s call today led by VP Pence.\n•Moderna applied to FDA for an EUA for their mRNA vaccine. Their final data were \nvery impressive.   94% efficacy and 30 severe outcomes, all in placebo, none in vaccine. \nPfizer did this submission last week (Nov. 20)\n•Fireside chat with American Society of Hematology\nReleased by Chairman Rand Paul\n236•Did a nice 60 minute Facebook Live with Mark Zuckerberg\nPRESS:  WUSA TV interview (Gabe Cohen); WTOP Radio; Yahoo News and Sports; \niheart Radio; Cheddar TV; WedMD Magazine interview (I will be one of their public \nhealth “heroes”; Facebook Live with Mark Zuckerberg; BBC World News Radio;\nDecember 1, 2020 – Global – 62,700,000/1,500,000;  USA – 13,400,000/267,300\nMany GOP (such as Roy Blount) still supporting Trump who is becoming more and more \nunhinged.   He is losing every court case that he appeals to overthrow the vote in a number of \nstates.   He rales that it is all a stolen election and that he won by a landslide.   Very \nembarrassing.   Blount refuses to call Biden the President -Elect.\nScott Atlas resigns!    I imagine that is because everything that is happening now with the surges \nhas finally proven him to be incorrect on virtually everything that he has said.   The one area \nwhere he was correct was in saying that school children are not the drivers of the outbreak.   \nHowever, he was dead wrong in saying that mitigation does nothing and that when states peak \nand come down, it is because they have reached herd immunity.   Yet, now we are seeing states \nand cities that peaked high months ago and now are peaking even higher.   So much for heard \nimmunity.\nRand Paul still coming after me saying that I should shut everything down.   The press is \ncontradicting him by showing quotes from me to the contrary.   What a jerk!   I am staying above \nthe fray.\nAlex Azar is becoming more sycophantic towards Trump as we get to the end of the \nadministration.   See below:\nAzar Touts Swift Progress On COVID-19 Vaccine Development.\nFox News (11/30, Nelson, 27.59M) reports that on Monday, HHS Secretary Alex Azar said progress \non the COVID-19 has been unprecedented. He told Fox News, “Think about this: 10 months into this \npandemic hitting our shores, thanks to what President Trump has done, we believe we’re going to \nhave people getting vaccinated, millions of people, before Christmas this year. It’s just unheard of in \nthe history of public health, this accomplishment.” He added that “the vaccine will be ‘shipped’ within \n24 hours of FDA approval and then it would be up to ‘nursing homes, hospitals, and pharmacies to \nget that dispensed.’” \nReleased by Chairman Rand Paul\n237California Governor: State At “Tipping Point” Of Pandemic.\nReuters (11/30, Whitcomb, Caspani) reports California Gov. Gavin Newsom (D) “said on Monday the \nstate was at a ‘tipping point’ in the COVID-19 pandemic that would soon overwhelm hospitals as \npolitical leaders nationwide turn to increasingly aggressive measures to hold back the latest \n•Had important call with Gov Cuomo who called me up.   He was explaining to me why he \nhad an independent panel look at the COVID-19 vaccines.   He said that the skepticism \nabout the FDA already existed (i.e. their doing an EUA for Hydroxychloroquine) and he was \ntrying to ameliorate it.   He also was concerned about managing expectations about how \nquickly the vaccines will make a big and broad difference.  He and I agree that the difference \nwill not be until mid to late summer.   He told me about his conversations with Trump and \nhow Trump wants to mend the fences with Cuomo despite the fact that he has been trashing \nhim.  He wants to change his residence back to NYC saying that it would be good for NYC.  \nCuomo pushed back and told him that he did not agree that it would be good for NYC.  Also, \nTrump apologized for calling Chris Cuomo “Fredo”. Cuomo believes that Trump is a \npsychopath and an evil man who just wants to manipulate for his future, which he knows is \nbleak.    Cuomo also expressed disdain for Azar saying that he is a sycophant  to Trump and \ndoes not understand that black and brown people will not get fair access to vaccines with the \npaltry amount of money that the USG is giving to the states for the implementation of the \nvaccine distribution.   USG gave $200 million to NY, when they really need $1 billion.   \nCuomo told me the best thing that could happen for my legacy would be for Trump to fire me \nand then have Biden re-hire me. \n•Had call with Rob Manfred, Commissioner of MLB – He needed advice about the \ntiming of Spring Training (February for pitchers) vis-à-vis the roll out of vaccines and \nwhen there would be enough people vaccinated so that he can both get his players \nvaccinated and have a degree of herd immunity present so that he can have spectators in \nthe stands.   I told him that by April there could be massive vaccinations IF people uptake \nthe vaccine.   We could have most people vaccinated by early summer which means they \ncan start with half full stadiums and then by the World Series they could conceivably \nhave packed stadiums. He might delay start of Spring Training from February to March.   \nAlso, he wants to offer stadiums and parking lots for massive vaccination programs.   I \ntold him that would be a CDC/local public health department issue.\n•Had Miami Mayors call. – The mayor of Miami-Dade County – Daniella Levine Cava \nnow has COVID-19.   Former Mayor Jimenez has COVID-19.  Still remaining issue that \nGovernor DeSantis is blocking the mayors attempts to mitigate.   For example, he will \nnot allow closing the bars and indoor restaurants.\n•Had call with Gary Bettman (NHL) about the coming hockey season\n•Task Force call – The VP still extracts “happy talk” out of a very sober report from Birx \nabout the surge and the fact that we are perilously close to having our health care system \nReleased by Chairman Rand Paul\n238over-run by the surge upon the surge.   He and the Greek Chorus of the TF just cannot \naccept that we are in serious trouble.   Very frustrating\nSome states starting to plateau while others continue to surge.   See below:\nDanger of hospitals being overrun and lack of adequate staffing (see graphs below):\nReleased by Chairman Rand Paul\n239•Received Lifetime Achievement Award together with Henrietta Fore (Director of \nUNICEF) and David Beasley at elegant “virtual” gala.   Praised by Barbara Bush in an \ninterview and several celebrities\n•Heated discussion at TF meeting regarding the NIH Guidelines not being specific enough \nin its recommendations for mAb and CP.   Typical Deb Birx wanting to push therapies \nmore than the data justify.   In the discussion, Pence was convinced by Deb and others \nReleased by Chairman Rand Paul\n240(with no medical background) chimed in that saying “no evidence for or against the use \nof …….”   Had long conversations with Cliff tonight and he is very reluctant to change \nthe wording.   VP was insistent that we indicate more strongly that the drugs work since \nDeb says that the clinicians are not using the drugs since they do not see a strong \nindication in the guidelines that the drugs work.  Trying to work with Cliff who is \nadamant\nPRESS:  Did Press Conference with Gov. Jared Polis (D-CO); WNBC NY TV;\nDecember 2, 2020 – Global – 63,400,000/1,500,000;   USA – 13,600,000/270,000\nSituation remains tenuous.   Note from Deb Birx associated with her daily slide set:  \nThe situation we find ourselves is deteriorating beyond words.  Please help me convey to senior leaders \nthat is the worse combination of factors that we have seen since the beginning of the pandemic. \nCombining the Spring and Summer surge into a winter surge is what is deeply concerning.  Despite my \nwarnings there are OVP staff that undermine this message everyday and have greater access to the VP. I \nknow its hard to see it coming, I know its hard to fathom, but it is coming even independent of the \nThanksgiving potential due to the movement into populous states and nearly 50% of the country still \nbelieves this is being over blown, that it’s a hoax, that masks don’t work and I think the most damaging \nthere is a set curve independent of mitigation – ie it doesn’t matter what you do it will look the same. \nYes there is an epidemic curve to both mitigated and unmitigated surges BUT the peak is higher and the \nduration of the surge is 2X longer without mitigation. Yes when hospitals get overwhelmed people do \ntake more precautions and flatten the curve but that results in nearly 2X the fatalities as a mitigated \nresponse.  Inadequately mitigated is nearly 2X the area under the curve as mitigated – 2X the \nhospitalizations and potentially 2X the deaths.  Finally unlike the spring the asymptomatic group under \n35 will not mitigate in the same way and will continue to drive infections and that is why more \nprecautions must be implemented now – both state level mitigation policies and personal mitigation \nefforts. Deb\n2600+ Deaths today.   Worse since the NYC surge in early Spring\nReleased by Chairman Rand Paul\n241•Call from Mark Meadows saying that it was OK to do press conference with Gov. \nCuomo.   Also, he really wanted a reality check on the fact that the MHRA of the UK has \ngiven their equivalent of an EUA to the Pfizer vaccine.  He wanted to know if our FDA \nwas dragging their feet.   I totally supported the FDA, Peter Marks, and Steve Hahn and \nsaid that the UK were “hot-dogging” it and that even the EMA were blasting the UK for \nhot dogging.   It seemed that Mark was on the brink of firing Hahn.   Hope I blocked that\nReleased by Chairman Rand Paul\n242•Got call from Jeff Zients in preparation of my briefing the Biden “landing team” \ntomorrow.   Jeff wanted to alert me that Biden will be calling me right after the briefing.\n•Received the Eleanor Roosevelt Prize for Global Human Rights Advancement from the \nAmerican Bar Association Center for Human Rights\n•PEOPLE Magazine names me 2020 Person of the Year together with George \nClooney, Selena Gomez and Regina King\nPRESS:   CNN: Elton John honors Anthony Fauci on World AIDS Day;  CNN Heroes with \nAnderson Cooper; KTVQ TV – Billings, MT; ABC News PRIME (Online); Fox TV News;  \nFrank Bruni writes in the NY Times: Anthony Fauci is the steely superhero of my deep state, and \nhe’s flanked and fortified by all the government health officials who also pushed back against the \nquackery of Scott Atlas, the Trump-flattering pandemic adviser who resigned on Monday\nDecember 3, 2020 -  Global – 64,000,000/1,500,000;   USA – 13,800,000/273,000\nRecords being broken:  3000 deaths yesterday; >100,000 hospitalizations; >200,000 new \ninfections.\nWith gauntlet of\nToday I met with President elect Biden’s landing team.  It was a good meeting that was led \nby Jeff Zientz,  Vivek Murthy, and included David Kessler, John Auerbach, Tom Inglesby, \nReleased by Chairman Rand Paul\n243among others.  We went on to discuss the challenges associated with the rollout of the \nvaccination campaign.  In addition, I gave them my advice on what the most effective \ncommunication strategy would be for the upcoming administration.  In addition, they wanted \nmight take on what the challenges with be in the coming months of January, February, march, \nand beyond.  It was an excellent conversation in which they all expressed their gratitude and \nrespect for me for the work that I have been doing over the past several months.  At exactly 3:00 \nPM, 1 hour as to the beginning of the meeting there was a prearranged call with President elect \nJoe Biden together with chief of staff Ron Klain.  President-Elect Biden was very glad to chat \nwith me and immediately stated that he wanted me to continue in my position as director, \nNIAID.  In addition, he wanted me to be his chief medical adviser.  Then, Ron and President \nelect Biden asked me a series of questions concerning some of the decisions that they would \nlikely have to make in the coming months.  \nMayor Bill De Blasio called me up  asking for advice about the surges that are occurring in \nNYC and how much of a lock down he should implement. He wanted to keep things mostly open \nuntil after the holidays and then shut down.  I told him that this was a big mistake since by that \ntime, the damage will have been done and he will have precipitated a major surge.   I urged him \nto close the bars and restaurants and subsidize the establishments so that they do not go under.   \nIf he does that and discourages private, large gatherings, he could get away with keeping the \nshopping areas open.\nI apologize to the UK on BBC radio for implying that their process of the approval of the \nvaccine was rushed and sloppy\nPRESS:  CBS News “The Takeout” with Major Garrett;  Sky News UK TV; MSNBC with \nAndrea Mitchell;  New York Times interview with Tara Pope Parker; KQED  NPR Radio, \nSan Francisco; BBC World News; New Zealand Herald (Dick Brass) print media;\nBloomberg:\nReleased by Chairman Rand Paul\n244December 4, 2020 – Global – 64,500,000/1,500,000  USA – 14,000,000/276,000\nDid photo shoot and interview with Alice Park of TIME Magazine.\n•I called up Rosa De Lauro to congratulate her on being chosen by Nancy Pelosi as Chair \nof the Appropriations Full Committee.   She had tears in he eyes thanking me nd saying \nhow excited she was that Biden has announced that I would be his Chief Medical \nAdvisor.\n•Spoke with Don Fehr of the NHL Players Association about the likelihood of the NFL \nhaving a season and what my projection for 2021 was.\nReleased by Chairman Rand Paul\n245\nReleased by Chairman Rand Paul\n246More records broken – 200,000 cases; 2885 deaths; >100,000 hospitalization.   Hospitals are \nstarting to get over-run.   California starting lock-downs to avoid hospital crisis (see above \nfigure)\nPRESS:   NBC Today Show with Savannah Guthrie;  Multiple press stories about Biden \nspeaking with me, asking me to stay on as NIAID Director and offering me the title of Chief \nMedical Advisor; Greta Van Susteren “Full Court Press” TV (VOA); “Today with Kaye” \nBaltimore Radio Show;  CNN Town Hall with Anderson Cooper and Sanjay Gupta;\nBiden said he asked Fauci to stay on and be a \nchief medical adviser in his administration\nBy Jim Acosta, Jim Sciutto and Kate Sullivan , CNN\nDecember 5, 2020 –  Global – 65,000,000/1,500,000; USA – 14,300,000/278,000\nSurge continues with more records broken.   California locking down because they are at 15% or \nless of beds available and thousands of cases of coming in for hospitalizations.\nReleased by Chairman Rand Paul\n247Trump still insisting that the election was “rigged” and that he won by a landslide.   More than \n30 court cases have been thrown out as frivolous.   \nAlyssa Farah resigns.   Good for her.   One of the few good people in the administration.  This \nmight mean that I am not allowed out in the media any more since she has always advocated for \nme. \nDecember 6, 2020 (Sunday) – Global – 65,900,000/1,500,000   USA – 14,500,000/280,000\nHad important Zoom call today (11:00 AM) with Jeff Zients and Jake Sullivan – Jeff and \nJake are going to make some policy announcements for the Biden tam next week (Tuesday0 and \nthey wanted to make sure that it was cleared by me.   They had 3 issues: 1) the 100 days of mask \nwearing.   I advised that they say “at least 100 days” or give some indication that it might be \nlonger since when they get to 100 days, we may need to extend; 2) they want to say that they will \ndistribute100milindoses of vaccine in teh1st 100 days of the Biden administration.   I warned that \nthis might actually be an underestimate.   They first need to check that we will actually have a \nsupply (check with Perna, but also make sure that we do not seem that this is undershooting.  \nSince we are now saying that we will have 40 million doses by the end of December and even \nmore by the end of January, then 100 million by the first 100 days of the Biden administration is \nfar too little; 3) Schools – I suggested that they always lead with saying that the default position \nis to open and keep open the schools.\nReleased by Chairman Rand Paul\n248They also want to announce on Tuesday the important role that I will have to be the Chief \nmedical Advisor for the Administration.   They will send me the wording to make sure that I am \nOK with it.\nGov. Cuomo called me today (1:30 PM) – He wanted to touch bases with me in anticipation for \nthe fact that I will be joining him tomorrow on a press conference for the state of MY.   He \nwanted to brief me on what he was going to say.   He and I have a growing and strong \nrelationship.\nReceived a call (3:00 PM) from Olivia Dalton from the Biden Transition team asking me to \nparticipate in an event (I asked to do it virtually) in Wilmington where Biden will announce his \n“health team” including me.   We discussed my virtual remarks and other issues.\n \nDeb Birx on MTP pleading (as I have been doing) with the public to abide by public health \nmitigation methods.\nExample of state by state increases in deaths and cases:\nReleased by Chairman Rand Paul\n249\nReleased by Chairman Rand Paul\n250December 7, 2020 – Global – 66,400,000/1,500,000;   USA – 14,600,000/281,3000\nBracing for post-Thanksgiving surge!\nDeb’s Daily Report:\nData and reporting has stabilized and we are back on the same accelerating curve as before the delayed \nreporting and substantial declines in testing over the past 10 days.  This week we expect to see the \nbeginning of the post Thanksgiving surge as this would be when the silent spread starts to impact the \nmore vulnerable Americans.  We now have only 2 states (HI, VT) and DC in the green zone, 12 in the \nyellow and orange zone and 36 in the red zone.  We are now seeing significant resurgence in all states \nexcept VT and HI and rapidly increasing cases across America that will lead to escalating hospitalizations \nthe end of this week into next week and then fatalities. This is the worse situation we have faced and \nalthough vaccinations will help towards the end of Jan the next 7 weeks will be overwhelming if we \ndon’t work with states to increase their mitigation and provide the highest level of Administration \nsupport to the behavioral changes needed by every American. Deb  \nReleased by Chairman Rand Paul\n251See below for dire situation in NYC and Los Angeles\nReleased by Chairman Rand Paul\n252At Task Force meeting on prior agreement between Deb and I, Deb says that the country is in \ndire straits and we need to give the message from above that this is serious and we must double \ndown on mitigating.   I jump in and say that we must be out there warning the people that if they \ndo not mitigate, the hospitals will be over-run.   The elephant in the room is that the POTUS is \nignoring this and the message must come from him since the people who are not paying attention \nand who will not wear masks or not travel or not congregate are his people.   The VP after the \ndiscussion got going for the first time ever got defensive and even hurt that we (mostly Deb) \nwere implying that the administration was not taking the pandemic seriously.   The issue is that \nmaybe we are taking it seriously, but the POTUS and his people certainly are not.   That is the \nlesion.   The POTUS is undermining everything that we are trying to do.   Deep down the VP has \nto realize this and still he fiercely defends the POTUS.  Tragic!\nPRESS: CNN New Day with John Berman; Press conference with Gov. Cuomo (Boradcast \nfrom Albany, NY; Fireside chat with Norah O’Donnell (CBS) at the Milken Institute \nFuture of Health Summit; Interview with Katy Kay for the Bloomberg American Health \nSummit; taping for ABC Special on Vaccines\nReleased by Chairman Rand Paul\n253December 8, 2020 -    Global 66,700,000/1,500,000;   USA – 14,800,000/283,000\nReleased by Chairman Rand Paul\n254Harvey Alter to receive Nobel Prize in Physiology or medicine to be presented to hi at NIH \n(Natcher) by the Swedish Ambassador to the USA.   I am invited and will use this as an excuse \nnot to attend the “Vaccine Summit” at the White House today.  Trump will use it as a PR stunt to \nclaim credit for the vaccines.   Pfizer (Bourla) and Moderna (Bancel) have pulled out of \nattending.\nBiden announced his medical team today in Wilmington, DE.   I was announced as his “Chief \nMedical Advisor”.   I have made a video of my message to the group since I cannot attend (see \nabove).  \n•Had call with Joan Baez who wanted information about the effectiveness of masks in \nprotecting you from acquisition of infection.   Also, she is worried about her son and \ndaughter-in-law who want to travel to South America.   She wants to be able to tell them \nthat I said that it was ill-advised.\n•Call with Ellen Sigal and then Larry Horowitz about FDA Commissioner.   Lots of \nrumors and the usual anxiety about candidates.   Josh Sharfstein is being considered but \nmany people are pushing back.   Kessler is being considered, but most everyone thinks \nthat this is a bad idea.  Janet Woodcock is emerging as a top choice.   I like that.\n•Much concern that we did not contract with Pfizer for enough vaccine; we just did not \naccept their offer to provide more.  Now it seems that this was a big mistake.   Press are \nall over this.\n•Nancy Messonnier called.    She is concerned that Gen. Perna is making decisions \nwithout proper knowledge and/or consultation with CDC.  She has had long-standing \nproblem with him.\nReleased by Chairman Rand Paul\n255•Katie and Stephen Miller called me to thank me for the baby gift I sent them for \ndaughter Mackenzie.  We had a nice discussion about life after Trump.\n•I was awarded “Sicilian of the Year” by the Magazine I Love Sicilia\nPRESS:  KTWV Los Angeles Radio; BBC “Hard Talk”, TV and Radio; Wall Street Journal \nCEO Council;   \nDecember 9, 2020 – Global – 67,800,000/1,600,000;   USA – 15,000,000/285,000\nDeaths reached record of 3000 today!\nJust waiting to realize the full brunt of the Thanksgiving holiday.   Trump still totally pre-\noccupied with trying to overthrow the election.   Biden carefully putting his team together\nReleased by Chairman Rand Paul\n256PRESS:  Interview with Ed Yong of The Atlantic; CNN discussion of 1918 Influenza wuth \nAnderson Cooper (to be shown in a week); Fireside Chat with Sanjay Gupta for the \nHarvard T.H. Chan School of Public Health “When Public Health Means Business”\nDecember 10, 2020 – Global -68,200,000/1,500,000;   USA – 15,300,000/289,000\n217,000 cases today!\nReleased by Chairman Rand Paul\n257I zoomed with the Novovax site investigators encouraging them in their trial and stressing the \nimportance of recruiting minorities into the trial.\nThe FDA’s advisory committee VRBPAC meets today for Pfizer product.   They recommend \napproving the EUA\nReceived the Ripple of Hope Award from the RFK Foundation.   Wonderful virtual ceremony \nwith co-awardees:  Colin Kaepernick, Dolores Huerta (Activist), Dan Schulman (CEO PayPal), \nDan Springer(CEO, Docusign).   Very warm and moving tributes.\nI am chosen as Time Magazine “Guardian of the Year”\nPRESS:  CBC Canadian Radio; CNN with Chris Cuomo;\nDecember 11, 2020 Global    USA\nNumbers continue to be stunning with >200,000 news cases each day; >3000 deaths per day; \n289,000 total deaths and 15,3000,000 cases \n•Received a call from Ethel and Kerry Kennedy explicitly inviting up to Hyannisport \nfor 4th of July weekend.   They were so nice over the phone.   They said that they loved \nand admired me and were so please that the Kennedy family could honor me.\nReleased by Chairman Rand Paul\n258PRESS:   NY 12 TV (NY, CT, NJ); JAMA Livestream with Howard Bauchner; MSNBC \nwith Ari Melber;\nDecember 12, 2020 – Global – 69,500,000/1,600,000; USA – 15,700,000/295,000.  \nFDA has approved an EUA for the Pfizer mRNA vaccine for people 16 years and older!!\nUSG authorized an additional 100 million doses of Moderna mRNA (in addition to the original \n100 million that we contracted for. \nAlthough some states that are mitigating are showing stabilization, several others are showing \nthe impact of the Thanksgiving holiday.\n•Had Zoom call with Jeff Zientz and Natalie Quillian  about what the Biden team \nshould be doing as they hit the ground on January 21.   I mentioned: 1) the importance of \na clear and consistent message from above; 2) the importance of testing (diagnostics) for \nasymptomatic people for the purposes of surveillance and screening such as in schools \n(mentioned my conversation with Raj Shah and the Rockefeller Foundation people) about \ntesting school teachers 2x per week and K-12 children 1x per week.   Also early testing is \nkey for early treatment; 3) Treatment – importance of early treatments with either direct \nanti-virals or perfect the mAb and hyper immune-Ig; 4)   Make sure that vaccines are \nsmoothly and equitably distributed.\nThere has been much play in the media over the past few weeks about what they are calling the \n“Fauci effect” whereby the medical school admission have gone up about 50% over the past \nyear due in large part to students realizing what I have been doing and able to accomplish as a \nphysician and this is inspiring them to go to medical school.   See story from NPR below:\n'Fauci Effect' Drives Record Number Of \nMedical School Applications\n•Facebook\n•Twitter\n•Flipboard\n•Email\nDecember 7, 20207:56 AM ET\nJON MARCUS\nReleased by Chairman Rand Paul\n259\nReleased by Chairman Rand Paul\n260PRESS:\nTWEET FROM BIDEN - \nI've seen him take on HIV/AIDS, H1N1, Ebola, Zika, COVID-\n19, and every infectious disease in between, over his nearly \nforty years of service to our country. Trusted. A truth teller. A \npatriot.\" — President-elect Biden on Dr. Anthony Fauci\nI was portrayed on Saturday Night Live by Kate McKinnon.  A spoof with me and Deb \nBirx.  They slammed Deb\nDecember 13, 2020 (Sunday)- Global – 70,200,000/1,600,000   USA – 16,000,000/298,000\nVaccine dose from Pfizer now being shipped to various locations.    Cases continue to explode \nthroughout the country.\nReleased by Chairman Rand Paul\n261Statement from Birx below:\nReleased by Chairman Rand Paul\n262PRESS:\nCNN HEROES – INTERVIEW WITH ANDERSON COOPER\nReleased by Chairman Rand Paul\n263December 14, 2020 -  Global   USA - 16\nVaccine doses are being shipped as I write this.   Vaccinations will start today.   Discussions \nongoing whether to vaccinate the White House staff.   Also Jeff Zientz wants to speak with me \nabout when the President-elect and VP-elect should be vaccinated.\n•Bitter-Sweet day – vaccinations start but we reach landmark of 300,000 Americans \nhave died of COVID-19\nReleased by Chairman Rand Paul\n264•Call from Sen. Joe Manchin (D-WVA) asking whether I recommend that he and others \nget vaccinated.  Also, wanted to know which was better Moderna or Pfizer.   I]assured \nhim that they were equal.\n•Received virtually the 2020 John Maddox Prize for Standing Up for Science from Nature \nmagazine\nPRESS:  BILD German Online TV interview; MSNBC with Hallie Jackson; Bloomberg \nLaw interview with Jeanne Bauman; BBC Newsnight TV interview;\nDecember 15, 2020 - Global – 71,400,000/1,600,000; USA – 16,300,000/300,000\nBrian Morgenstern is the new White House media person who seems to have taken over from \nAlyssa Farah.   He has been OK with getting me out there, but there was a recent issue where Jon \nKarl (ABC) has been asking for me a lot and not getting approved.   Jon is rather pissed.\nReleased by Chairman Rand Paul\n265Jared Kushner called to congratulate and thank me for our efforts to develop safe and effective \nvaccines for COVID-19.\nPRESS:  ABC - Good Morning America with George Stephanopoulos; NPR “Morning \nEdition” with Rachel Martin; VOX (Online TV) – “Today Explained” with Sean \nRameswaram;\nNature’s 10: ten people who helped shape \nscience in 2020\n•Anthony Fauci: Science’s defender\nA storied US doctor became his nation’s conscience on COVID-19 even as detractors threatened \nhis life.\nBy Heidi Ledford\nReleased by Chairman Rand Paul\n266Credit: Al Drago/Getty\nIn his more than 40-year career as an infectious-disease researcher, Anthony Fauci has been \nhailed as a hero and damned as a murderer. His most dedicated fans have created baseball \ncards and bobble-head dolls in his likeness, whereas others have issued death threats and \nharassed his children. \nAs head of the US National Institute of Allergy and Infectious Diseases (NIAID) in Bethesda, \nMaryland, Fauci has guided six presidents and an anxious nation through fears of bioweapon \nattacks and outbreaks of HIV, Ebola and Zika. Now, his role advising the government and \ncommunicating to the public during the coronavirus pandemic has made him the nation’s \ndoctor. He has offered guidance on the US response to the outbreak, often in conflict with the \nwishes of President Donald Trump , and he has made time to treat individuals with COVID-19 and \nHIV in the clinic. “Seeing the patient really gives you a different feel for what the disease is,” \nsays Fauci, who works 18 hours a day, 7 days a week. \nThe scale of the COVID-19 pandemic — and the politicization of the public-health response to it \n— has forced Fauci to go far beyond anything he’s done before, says epidemiologist Michael \nOsterholm, director of the Center for Infectious Disease Research and Policy at the University of \nMinnesota in Minneapolis. “He has been a very key part of trying to help the public understand \nwhat the science means and what we can do about it — and that includes, of course, our \nelected leaders,” says Osterholm. \nReleased by Chairman Rand Paul\n267Those efforts were met with resistance, but Fauci is no stranger to friction. \nAt the height of the AIDS epidemic, in 1988, playwright Larry Kramer called Fauci a “murderer” \nand an “incompetent idiot” on the cover of the San Francisco Examiner magazine. Kramer and \nother AIDS activists felt that the NIAID’s clinical trials for HIV drugs were moving at a glacial pace \nwhile thousands of people were dying. When a group gathered outside his office to protest, \nFauci invited some in for a chat. Over time, he built a relationship with them that would lead to \nchanges in the way people with AIDS got access to experimental drugs. It was a revolutionary \napproach at a time when people with a disease had little say in the science aimed at treating \nthem. “That was a tough period,” he says. “There were many scientists who thought that I was \ncaving in”. \nWarm but blunt, with a pronounced Brooklyn accent, he has often worked well with political \nleaders. Former US president George H. W. Bush called him a hero for his work on AIDS , and \nFauci worked with his son, former president George W. Bush, to design the President’s \nEmergency Plan for AIDS Relief (PEPFAR), a global programme to provide treatment for people \nwith HIV. But this year, his staid and steady advocacy for public-health measures to slow the \nspread of COVID-19 earned him stiff criticisms from President Donald Trump and others who \nwere eager to play down the severity of the pandemic and get the US economy restarted. \nTrump has suggested that he might fire the scientist, and a stream of vitriol has poured from \nsome of the president’s followers. Steve Bannon, a former Trump adviser, said that he would \nlike to see Fauci’s head on a pike outside the White House. Fauci now has federal guards \noverseeing his security. \nThe threats made him “more pissed off than afraid”, he says. “I’m out there trying to give a \npublic-health message to save people’s lives.” \nBut some researchers were also frustrated with Fauci’s public performance. He often stood next \nto Trump during press briefings as the president repeatedly misrepresented the severity of the \npandemic. Although Fauci sometimes contradicted Trump, he did not directly confront the \npresident. \nSuch briefings stopped in April. Fauci has since become more outspoken, says Mark Harrington, \nexecutive director of Treatment Action Group, a New York City think tank that focuses on the \ntreatment and prevention of AIDS, tuberculosis and hepatitis C virus. “He’s been speaking truth \nto power for the last few months in a way that none of the other people in the task force or \nfederal government have been doing,” Harrington says. Fauci, who turns 80 in December, has \nno plans to retire soon. He has agreed to stay on at the NIAID and to serve as president-elect Joe \nBiden’s chief medical adviser. Osterholm says he expects Fauci to continue to have an active role \nin front of the cameras. \nBut Harrington is looking forward to the day when Fauci can focus his attention again on other \npressing concerns, such as HIV and hepatitis C. “He needs to be able to do his day job,” he says. \n“It’s a big job.” \nReleased by Chairman Rand Paul\n268December 16, 2020 – Global – 72,000,000/1,600,000;  USA – 16,500,000/303,000\nSurge continue in some areas and leveling in others.   On phone last night with the David \nBarr group.   Chicago (Alison) doing better, but LA (Sharon) doing worse.   Bitter sweet \nsituation as vaccines rolling out (Moderna coming within the next couple days) while \nrecords being broken with deaths and hospitalizations:\nReleased by Chairman Rand Paul\n269PRESS:  CBS This Morning with Gayle King; Interview with Rodney Edwards of \nIrish Independent Sunday print paper;  CNBC “Healthy Events” with Meg Tirrell\nDecember 17, 2020 – Global – 72,900,000/1,600,000;   USA – 16,800,000/306,000\nThe surge continues.  Some states improving; others getting worse (see below for CA, \nTX, among others)\n3656 deaths yesterday – another record!!\nRed flag in CA, TX, PA, FL, TN as their absolute number of cases and rate of rise of cases is deeply \nconcerning.  If these populous states have the same depth and breadth of the surge experienced in the \nNorthern Plains hospitalizations and fatalities will dramatically increase over the next 2 weeks.  Deb\n \n \n•Had good conversation with Christopher Whitty (Chief Medical Officer of the \nUK) and Sir Patrick Vallance (Chief Scientific Advisor to the UK Government) \nregarding comparing notes between UK experience and USA experience.  Of \nnote, the UK is seeing more than just the two instances of anaphylactic reactions \nto the mRNA vaccine of Pfizer\n•VRBPAC approves the Moderna product.   Waiting for FDA to officialy issue the \nEUA.  Likely will start vaccinating with Moderna in a few days\nPRESS:  WUSA TV with Gabe Cohen; FOX TV with Bill Hemmer;  Alan Alda \nFireside Online Chat – “Soldiers of Science”\nReleased by Chairman Rand Paul\n270December 18, 2020 – Global – 73,300,000/1,700,000;   USA – 17,000,000/310,000\nModerna’s mRNA vaccine gets EUA from FDA.   Likely start vaccinating within a \nfew days (likely Monday, 21 December)\nJust found out that NIH will finally get doses of vaccine from Moderna (see above) \nwhich means I will likely get vaccinated on Tuesday, 22 December.   I am insisting \nthat I receive vaccine ONLY if Clinical Center ICU people ALSO receive it at the \nsame time as I do,\n•Cases continue to surge.\n                     Deb’s  comments: Continued deterioration in CA, AZ, NV,TX, FL, PA, OH, NJ, NY and will \nneed staffing support in most of these states except FL and TX – most concerning is CA and NV for ICUs \nand hospital staffing.  States are now using their vents that are in their state stockpiles which is the first \nwe have seen this occur since summer. There is significant diversity in approach to vaccination – many \nstates approach are self defined co-morbidities which could lead to long lines if its not a combination of \nage plus – ie first group essential worker over 50 and general population over 65 combination of risk of \nexposure and risk of severe disease.  Mortality from the states that have been improving is still very high \ndaily. Deb\n               \nReleased by Chairman Rand Paul\n271Did ceremonial vaccination with the Pfizer Product of VP Pence, Karen Pence and \nJerome Adams in EEOB-350 at 8:03 AM.   I gave remarks at the ceremony talking about \nthe challenges ahead, the bitter-sweet nature of the situation with Bitter (record number \nof cases) and Sweet (Vaccines here).   Also light at the end of the tunnel\nPRESS:  NBC Today with Savannah Guthrie;  on CNN for live coverage of the \nWhite House vaccination of the VP; Taped CNN Sesame Street with Sanjay Gupta \nand Erika Hill; WCBS Radio NYC; Stanford Fireside Chat with Alan Alda; \nFireside chat with Andy Slavitt; Fireside Chat with the California State University \nsystems; CNN Town Hall (done together with Jerome Adams) with Don lemon and \nSanjay Gupta\nDecember 19, 2020 – Global    USA\nDeb’s daily comment:\nCoasts and Sunbelt continue to deteriorate.  AZ, MS, FL, GA are not mitigating to the level of summer \nmitigation policies. There is deep confusion out there about vaccine volumes and clarity on the 1b and 2 \ncategories to most efficiently vaccinate and potential to use the current supply to save lives over the \nnext 30 days.  The word is the ACIP was supplied modeling in October that showed no impact of \nvaccination on lives saved but it was modelled without taking into account a surge of cases and \nhospitalizations.  IF this is true this needs to be addressed and remodeled and that new data supplied to \nthe ACIP. Deb  \nAnother record broken:\nCovid-19 Live Updates: U.S. Sets Daily Record \nWith Over 250,000 Cases \nReleased by Chairman Rand Paul\n272December 20, 2020 – (SUNDAY) – Global – 75,100,000/1,700,000;  USA – \n17,600,000/315,300\nReleased by Chairman Rand Paul\n273See Deb’s notes below:\n1.The Northern Plains, Upper Mid-West, Rocky Mountain States and \nHeartland continue to improve decreasing test positivity, cases, \nhospitalizations. Strong vigilance messaging should continue to \nensure decline through the upcoming Holiday season. \n2.The Coasts (80% of America's population) are now driving the \nincreasing cases, hospitalizations and soon deaths. The rate of rise \nis deeply concerning as it is similar to the Northern Plain States. \n            New strain of virus – B.1.1.1.7 arising in UK with concern that it is spreading much \nfaster that other strains. Some EU countries are banning flights from UK.   Probably an over-\nreaction since there is no evidence that the strain is more virulent or that it escapes vaccine-\ninduced immunity.   We (VRC/NIAID) will start examining for these issues.\nPRESS:   Despite the approval of Moderna vaccine a few days ago, I was not \nallowed on any Sunday TV shows.   FOX and MTP wanted me.   Need to emphasize \nthe dysfunction of the White House Comms group, particularly Roma Daravi.   It \nseems that she has a thing with me.\nWashington Post (Yasmeen Abutaleb et al):\nThe inside story of how Trump’s denial, \nmismanagement and magical thinking led to \nthe pandemic’s dark winter\nDecember 21, 2020  Global  USA\nMuch concern and discussion about the mutant virus (see above) that is in UK and South Africa.  \nI will be speaking with the Biden people about this today.\n1.The Northern Plains, Upper Mid-West, Rocky \nMountain States and Heartland continue to \nReleased by Chairman Rand Paul\n274improve decreasing test positivity, cases, \nhospitalizations. Strong vigilance messaging \nshould continue to ensure decline through the \nupcoming Holiday season. \n2.The Coasts (80% of the population) are now \ndriving the increasing cases, hospitalizations \nand soon deaths. The rate of rise is \nconcerning, however due to aggressive \nmitigation there is a more rapid stabilization \nof cases then we saw in the Fall with the \ncenter of the country which should lead to an \nearlier peak if the Holiday Season surge can \nbe blunted. \n                 Had Zoom call with Biden.   Also, present were Ron Klain, Jeff Zientz, Rochelle \nWalensky; Natalie Quillian; Vivek Murthy.   Discussion centered around: 1) state of the outbreak \n(me); 2) Mutants from UK (me); 3) vaccine rollout (Vivek).   I strongly recommended not \nbanning travel from UK.  Ron Klain and Biden were not so sure.   Ron suggested that we might \nhave a 10 day ban over the holidays.   I pushed back and said that this would not help since the \nvirus would come from other places.   I suggested that we very explicitly state that we are \nwatching this very carefully and are all over it.   The potential effects of the mutation is : 1) \nincreased transmissibility; 2) increased virulence; 3) evasion of protection from vaccine (and to \nsome extent from mAb).   All of these are testable.   Bottom line – do not do anything \nprecipitous, but watch it closely\nPRESS:   BBC Interview with Jeremy Farrar to be aired on December 28, 2020;SiriusXM \nSports – Mad Dog with Chris Russo; Telemundo TV with Randy Serrano; Fivethirtyeight \nABC Podcast with Anna Rothschild; PBS NewsHour with Judy Woodruff;\nDecember 22, 2020 – Global -76,300,000/1,700,000;  USA – 18,000,000/319,000\nReleased by Chairman Rand Paul\n275Hospitalization at 118,000 – record for the pandemic.   East and West coasts now surging.\nPRESS:  Good Morning America (ABC) with CeciliaVega;  BBC World News TV; Briefed \nNew York Daily News editorial board; CBC TV (Canada) News Show – “The National”; \nFox News with John Roberts; Politico Instagram Live with Sarah Owermohle; CNN The \nSituation Room with Wolf Blitzer\nReleased by Chairman Rand Paul\n276Slate ranked me the #1 most influential 80 year old and older person:\n \nThe Most Influential 80-Plus-Year-Olds in \nAmerica\nHere are the top 20.\nBy Molly Olmstead\nDecember 23, 2020 – Global – 76,900,000; 1,700,000;   USA – 18,200,000/321,700\nMayer Bowser of DC declared December 24, 2020 “Anthony S. Fauci, M.D. Day in Washington, \nDC:\n“Dr. Fauci has been a hero to our nation during this incredibly difficult year, working tirelessly to save \nlives and guide our nation’s response to and recovery from the pandemic,” said Mayor Bowser. “We \nare incredibly proud to count him among the many DC residents who are sacrificing so much to keep \nour communities healthy and safe. I issue this honor on behalf of all Washingtonians in gratitude and \nrecognition of Dr. Fauci’s service to our nation and our city.”\nReleased by Chairman Rand Paul\n277“Surprise” tribute to me from the 1st responders at NIH and Montgomery County:\n https://drive.google.com/file/d/10Vi4mozXkpCjolo9phs0XoWpwoxSJ_oj/view?usp=sharing\nA group of activists from “the old days” surprised me with a surprise birthday party on Zoom in \nmy office at 4:30 PM.   Organized by Peter Staley and Janet Tobias.   On the Zoom were: Gregg \nGonsalves, Peter Staley, David Barr, Mark Harrington, Jim Eigo, James Kellerstein, Peggy \nHamburg, Judy Auerbach, Wafaa El Sadr, Matthew Rose, Moises Agosto\nHad Zoom call last night with Vivek Murthy, Rochelle Walensky and David Kessler.   Vivek \nwanted to discuss in more detail what our advice would be to Biden regarding the mutant virus in \nthe UK.   We discussed options of 1) shutting down travel from UK; 2) requiring pre-boarding \ntesting from UK flights or even all flights from EU and South Africa or even all foreign flights; \n3) also discussed post-landing strategy such as giving people BINAX tests to take home and test \nthemselves after they arrive.   Seems we will recommend at least pre-boarding testing, probably \nfrom all of EU and RSA.\nSurge continues in some areas and decreases in others.   Deb’s notes:\nThere is a growing evidence showing aggressive public mitigation and clear messaging together does \nflattening the curve.  When one compares TN to OH, NC, WVA, KY – surrounding states.  TN \nfatalities/pop is 30-40% higher as states with more aggressive mitigation as it decreases the area under \nReleased by Chairman Rand Paul\n278the curve – decreasing hospitalization and deaths per populations.  When all is done excess mortality \nwill be greater in states with less mitigation when normalized for population age and other \nmultivariants.  Deb \n1.The Coasts (80% of the population) are now \ndriving the increasing cases, hospitalizations \nand soon deaths. \nThe East and West Coast, Sunbelt, IN, OH,  KY, TN, \nWVA surging cases will drive cases and \nhospitalizations over the next week stressing their \nhospital systems and and inpatient care\nThe Vaccine Before Christmas\nBy Kevin A. Wilson (with apologies to Clement Clarke \nReleased by Chairman Rand Paul\n279Moore)\n‘Twas some days before Christmas—how many I’m not \nsure\n(The days ran together; everything was a blur).\nAll the houses were locked down from COVID-19,\nWith everyone wishing for the promised vaccine.\nThe children were nestled and sleeping just fine.\nThey were all tuckered out from their classes online.\nAnd mamma in her kerchief and I in my cap\nHad just sanitized our hands and hung up our masks.\nReleased by Chairman Rand Paul\n280The year had been hard. We were due a vacation.\nBut the thing wanted most? Emergency use authorization.\nThen out on the lawn there arose such a clatter,\nI assumed it was another 2020 disaster.\nI ran to the window and put on my mask,\nBut what would I see? I was too scared to ask.\nThe neighbors were quiet and socially distant,\nAwaiting the time they’d be COVID resistant.\nBut despite travel bans, there then did appear\nA miniature sleigh and eight tiny reindeer.\nReleased by Chairman Rand Paul\n281But this wasn’t Santa. His gut wasn’t paunchy.\nIt was the trusted presence of Anthony Fauci.\nMore rapid than eagles, at warp speed they came,\nAnd he whistled, and shouted, and called them by name:\n“Now Pfizer! Now Sanofi! Now Johnson & Johnson!\n“On Moderna! On BioNTech! On Adaptive and Amgen!\nTo the top of the porch! To the top of the wall!\nNow vaccinate, vaccinate, vaccinate all!”\nAs a virus expelled by a cough or a sneeze\nWhen it meets plexiglass rises up on the breeze;\nReleased by Chairman Rand Paul\n282So up to the house-top the pharma all flew,\nWith the sleigh full of hope, and Dr. Fauci, too.\nAnd then, in a twinkling, I heard on the roof\nThe prancing and pawing of each little hoof.\nAs I drew in my head, and was turning around,\nDown the chimney Fauci came with a bound.\nHe was dressed in a suit, as was always his way,\nAnd his neatly cut hair was a smart silver-grey.\nA chart in one hand, a syringe in the other,\nAnd a medical bag—a gift from his mother.\nReleased by Chairman Rand Paul\n283The wisdom in his eyes and the knowledge in his head\nSoon gave me to know I had nothing to dread.\nWith his reassuring smile covered up with a mask,\nHis no-nonsense style led him straight to the task.\nHe sprung to my side as I rolled up my sleeve,\nAnd he stuck in the vaccine as quick as you please.\nHe flew to the bedroom, gave mamma a shot,\nThen vaxxed both our kids without waking them up.\nInoculations complete, he returned to the chimney,\nAnd gave me a pamphlet about what he put in me.\nReleased by Chairman Rand Paul\n284Then raising his finger but not touching his nose,\nAnd giving a nod, up the chimney he rose.\n“C’mon, team!” he said. “We’ve a great opportunity.\nIf we vaccinate more we can reach herd immunity!”\nThen he yelled back to me, as the sleigh quickly rose,\n\"I’ll be back in a fortnight for the follow-up dose.\"  \nPRESS:  WNYW Local NYC TV with Rosanna Scotto – great interview.  The entire TV \ncrew sang Happy Birthday to me on the air; Bloomberg TV – “Balance of Power” with \nDavid Westin; CBSN- Online TV; ITV (UK) news interview with Tom", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: POTUS  loves this and is tweeting that Fauci and Birx shut down the country for only 9000  deaths.   What an idiot!!  Released by Chairman Rand Paul 61See below:   Cases/day are not dramatically falling.   Looks like they may be  plateauing again Got called down to White House to do the Governors’s call. Released by Chairman Rand Paul 62PRESS: Washington Post Article indicating that Scott Atlas is pushing for a  “herd immunity” approach to the outbreak and said he was the “anti-Fauci”  in the White House. New York Times article will come put today with same  story. September 1, 2020 – Global 25,300,000/848,000; USA – 6,000,000/184,000 Did the usual weekly Miami Mayor’s call with Deb and Redfield.   Mayor Suarez  and Major Jimenez Released by Chairman Rand Paul 63Another inappropriate…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 4, "page_count": 1141}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 5 of 10)", "content": "Bradby;\nWashington Post article:\nCoronavirus Living\nHealth\nFauci’s Christmas Eve: Turning 80 \nand fighting the pandemic\nReleased by Chairman Rand Paul\n285Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and head \nof the U.S. pandemic response, on Dec. 12. (André Chung for The Washington Post)\nBy \nJoel Achenbach\nDec. 23, 2020 at 8:00 a.m. EST\nDecember 24, 2020 – Global – 77,500,000/1,700,000;    USA – 18,400,000/325,000\nI am 80 years old!   Amazing number of Birthday wishes coming in.  Truly moving….\nBirthday video from the OR Nursing/DPM staff in the NIH Clinical Center:\nDr. Fauci.pptx\nBeautiful and loving tribute to me from my children on a video:\nhttps://drive.google.com/file/d/1wgTkwmAlUhlnLKzIhWPlIR4E4WPpUMh6/view?usp=drivesdk\nJoan Baez texted me: “HAPPY FUCKING BIRTHDAY AND MANY MORE”\nReleased by Chairman Rand Paul\n286Nature magazine picked me as one of Nature’s 10 – People who shaped science in 2020.\nOver the past 3 weeks I have been on the cover of TIME magazine X2, once as one of the 100 \nmost influential people in the world again as the “Guardian of the Year”.   Also, on the cover of \nPeople magazine\nBy Kevin A. Wilson (with apologies to Clement Clarke Moore)\n \n‘Twas some days before Christmas—how many I’m not sure\n(The days ran together; everything was a blur).\nAll the houses were locked down from COVID-19,\nWith everyone wishing for the promised vaccine.\nThe children were nestled and sleeping just fine.\nThey were all tuckered out from their classes online.\nAnd mamma in her kerchief and I in my cap\nHad just sanitized our hands and hung up our masks.\nThe year had been hard. We were due a vacation.\nBut the thing wanted most? Emergency use authorization.\nThen out on the lawn there arose such a clatter,\nI assumed it was another 2020 disaster.\nI ran to the window and put on my mask,\nBut what would I see? I was too scared to ask.\nThe neighbors were quiet and socially distant,\nAwaiting the time they’d be COVID resistant.\nBut despite travel bans, there then did appear\nA miniature sleigh and eight tiny reindeer.\nBut this wasn’t Santa. His gut wasn’t paunchy.\nIt was the trusted presence of Anthony Fauci.\nMore rapid than eagles, at warp speed they came,\nAnd he whistled, and shouted, and called them by name:\nReleased by Chairman Rand Paul\n287“Now Pfizer! Now Sanofi! Now Johnson & Johnson!\n“On Moderna! On BioNTech! On Adaptive and Amgen!\nTo the top of the porch! To the top of the wall!\nNow vaccinate, vaccinate, vaccinate all!”\nAs a virus expelled by a cough or a sneeze\nWhen it meets plexiglass rises up on the breeze;\nSo up to the house-top the pharma all flew,\nWith the sleigh full of hope, and Dr. Fauci, too.\nAnd then, in a twinkling, I heard on the roof\nThe prancing and pawing of each little hoof.\nAs I drew in my head, and was turning around,\nDown the chimney Fauci came with a bound.\nHe was dressed in a suit, as was always his way,\nAnd his neatly cut hair was a smart silver-grey.\nA chart in one hand, a syringe in the other,\nAnd a medical bag—a gift from his mother.\nThe wisdom in his eyes and the knowledge in his head\nSoon gave me to know I had nothing to dread.\nWith his reassuring smile covered up with a mask,\nHis no-nonsense style led him straight to the task.\nHe sprung to my side as I rolled up my sleeve,\nAnd he stuck in the vaccine as quick as you please.\nHe flew to the bedroom, gave mamma a shot,\nThen vaxxed both our kids without waking them up.\nInoculations complete, he returned to the chimney,\nAnd gave me a pamphlet about what he put in me.\nThen raising his finger but not touching his nose,\nAnd giving a nod, up the chimney he rose.\nReleased by Chairman Rand Paul\n288“C’mon, team!” he said. “We’ve a great opportunity. \nIf we vaccinate more we can reach herd immunity!”\nThen he yelled back to me, as the sleigh quickly rose,\n\"I’ll be back in a fortnight for the follow-up dose.\"\n \nPRESS: ABC News Joan Hamburg; Instagram Live with Geoff Edgars of Washington Post\nWall Street Journal: Through AIDS, Ebola and Covid, Dr. \nFauci Is Still Treating Patients \nThe nation’s top infectious-disease official received the \nvaccine in part because he still does rounds in the hospital \nseveral days a week.\nReleased by Chairman Rand Paul\n289By Ben Cohen at ben.cohen@wsj.com  and Louise Radnofsky at louise.radnofsky@wsj.com\nDecember 25, 2020 – Global – 78,00,000/1,700,000;  USA – 18,600,000/328,000\nTrump at Mar-a Largo while country in crisis.  Cases still surging in certain areas (see \nbelow).   Relief bill in purgatory since he does not want to sign it because of disagreement about \namount of relief ($600 versus $2000).   Everyone had agreed to $600 even though the Dems \nwanted more.   White House staff agreed to the bill.   Sent to Trump for signature, except that \nnow that he has finally looked at it, he wants the $2000 per person, which is what the Dems \nwanted to begin with, and the GOP objected to.   And so now, he is bucking against his own \nGOP.   In the meantime, people are starving without aid.  Also, the USG might shut down since \nthe Omnibus budget bill has not been signed either.   Amidst all this, Trump is pardoning a large \nnumber of people (>40), almost all who were involved in the issues surrounding the probe of him \nand the impeachment matters.   He also pardoned Gen. Flynn, Roger Stone, and Charles \nKushner.\nDeb’s daily report:\nAggressive post Holiday testing of those who gathered and rapid utilization of Mab in those at highest \nrisk for severe outcomes will be critical over the next 2-3 weeks to blunt the impact of Holiday \ngatherings. Deb\n1.Summarizing the current state of the pandemic :  overall the USA is at \na high plateau for cases and hospitalizations and due to lagging \nfatalities reporting in improving states we won't see the fatality \nplateau until the next 2 weeks\n2.I summarized the top 10 states in this data summary for cases in \norder : CA, FL, NY, GA, PA, OH, TX, AZ, IL, IN – slides 11-20 – of these \nstates only PA, OH, IL are improving the others are escalating or at a \nhigh plateau.  \n3.Data will be unstable for the next 2 weeks with both Christmas and \nNew Years but will be tracking new admissions and rate of new \nadmissions\n4.The current pandemic state is a combination of continued \nimprovement in the center of America and continued deterioration in \nCA, NV, TX, across the sunbelt and up the East Coast and including TN \nand WVA\nReleased by Chairman Rand Paul\n290PRESS:   Print version of Joel Achenbach’s feature on my birthday appeared in the \nWashington Post.\nDecember 26, 2020 – Global – 78,400,000/1,700,000;   USA – 18,700,000/330,000\n1.Data will be unstable for the next 2 weeks with both \nChristmas and New Years but will be tracking new \nadmissions and rate of new admissions\n2.24 States did not report yesterday on critical pandemic \nparameters and will cause a surge in cases and fatalities \ndue to this reporting issue in the next few days\n3.Summarizing the current state of the pandemic :  overall \nthe USA is at a high plateau for cases and \nhospitalizations and due to lagging fatalities reporting in \nimproving states we won't see the fatality plateau until \nthe next 2 weeks\nAdrienne Arsht sent me an amazing video that she asked Robert Pullen (Kennedy Center) to put \ntogether to celebrate my 80th birthday.   They gathera whole bunch of celebrities to sing to me \nand offer words of praise and congratulations:  Orlando Bloom, Mila Kunis and Ashton Kutcher, \nReleased by Chairman Rand Paul\n291Amy Poehler, Lily Tomlin, Sophia Bush, Matthew McConaughey, Steve Buscemi, Magic \nJohnson, Joan Baez, and many others.   It was very moving.\nSituation unchanged.   Still outrage that Trump is messing up the relief bill.\nHarmony Foundation gave me:\nTop US doctor among 10 to get Mother \nTeresa Award\nMohammed Wajihuddin / TNN / Dec 25, 2020, 09:38 IST\nPRESS:  Good historical documentation of the CDC screw-up with the COVID-19 test by \nDavid Wilman in the Washington Post -  \nThe CDC’s failed race against covid-19: A \nthreat underestimated and a test \novercomplicated\nThe Atlanta headquarters of the Centers for Disease Control and Prevention. (Ron Harris/AP)\nBy \nDavid Willman\nDec. 26, 2020 at 8:00 a.m. EST\nAdd to list\nDecember 27, 2020 – Global – 79,200,000/1,800,000;   USA – 18,900,000/331,000\nDeb’s note for the day: Hospitalizations had stablized and specific metros were significantly declining \nso we will be able to see a post-Holiday surge in cases and hospitalizations and predict depth of surge \nimpact by 10 Jan. \nReleased by Chairman Rand Paul\n2921.Data will be unstable for the next 2 weeks  and decreases cannot be \ninterpreted with both Christmas and New Years but will be tracking new \nhospital admissions\n2.24 States did not report yesterday on critical pandemic parameters and will \ncause a surge in cases and fatalities due to this reporting issue in the next few \ndays\n3.Summarizing the current state of the pandemic :  overall the USA is at a high \nplateau for cases and hospitalizations and due to lagging fatalities reporting \nin improving states we won't see the fatality plateau until the next 2 week s\nSome areas going done and others are still surging.  Big question will be whether we will have a \npost-holiday (Christmas and New Year surge).  \nLetter from VP \nPence - December 18  \nPhoto with VP \nPence - December, 2\nRaising concern about what Trump might do as a last-ditch effort to prevent Biden from assuming the \nPresidency .   He is already calling for demonstrations in Washington at the time of the January 6 \nratification of the electoral votes by the Congress.   He could induce riots and then invoke martial law to \n“control” the riots.   Also, he could not sign the Omnibus budget bill and cause a government shutdown \nthat could interfere with the inauguration\nPRESS:  CNN State of the Union with Dana Bash;\nThe Guardian:\nInterview\n'New disease, no treatment, no cure': how \nAnthony Fauci's fight against Aids prepared \nhim for Covid-19 \nBenjamin Ryan \nDecember 28, 2020 – Global – 79,900,000/1,800,000;   USA – 19,100,000/332,200\nReleased by Chairman Rand Paul\n293POTUS changed his mind and signed the Omnibus budget bill avoiding a closure of USG.\nSpoke with Deb. This AM (this is one of many early morning 6:00 AM calls that I have with her \njust to check in and schmooze about what is going on.   She is concerned (probably correctly so) \nthat the Biden people think that there is some COVID-19 response structure here and there is not.  \nThere is her and backup from CDC and she railed on about how bad the CDC is (I agree with her \nin part).   She feels that they completely blew COVID-19 by acting like it was influenza  and \nthey plugged in the “syndromic” model where you follow and test only those who are \nsymptomatic since it took them forever to admit that COVID-19 was spread symptomatically \nand was very much different from influenza.\nReleased by Chairman Rand Paul\n294PRESS:   Taped podcast with ABC Jonathan Karl for later viewing;\nDecember 29, 2020 – Global – 79,900,0900/1,800,000;  USA – 19,200,000/334,000\nReleased by Chairman Rand Paul\n2951.Most concerning are where COVID \nadmissions are rising now showing \nsignificant community spread just prior to \nthe Holidays and could have the most \nsignificant post Holiday surge – this is \nTX, GA, SC, NC, WVA.\nPOTUS in Florida playing golf.   Massive explosion in Nashville, TN – he has no comment at \nall.   Case now at 19,000,000 with 332,000 deaths and he has not mentioned COVID-19 in \ndays/weeks.\nMet by Zoom with Dr.  Jeong, Eun-kyeong, Commissioner of Korea Disease Control and \nPrevention Agency to discuss ongoing and future collaborations in COVID-19.   They were part \nof the ACTT therapeutic trials.\nCall with Peggy Hamburg.   She is concerned about what she is hearing that Janet Woodcock \nwill be FDA Commissioner and that David Kessler will be the “FDA person in the White \nHouse”.   She has trouble with both of them. She is feeling left out in that the Biden people are \nnot conferring with her about anything.\nAm getting concerned that the administration of vaccines is lagging far behind the projected \nnumber of 40 million by end of December.   They have actually administered only ~2 million \nthis far with 2 day left in the year.\nLetter from Michael \nR. Bloomberg to Dr.  \nSpoke with Adam Silver (NBA Commissioner) about rest of NBA season.   They have come out of the \n“bubble” and wanted my take on what the immediate future looked like regarding infections.   They \nhave done very well and have had to cancel only 1 game.  David Ho is helping to advise them and was on \nthe Zoom call.\nContinue to get calls from Jeff Zientz  just checking facts and policy with me when Biden is about to go \nout and make a speech\nRounds with Clinical staff during COVID:\nReleased by Chairman Rand Paul\n296\nSKM_C754e2012291\n8270.pdf\nPRESS:  CNN New Day with Jim Sciutto; TV interview with Steve Clemons – “The Bottom \nLine” shown on Al Jazeera English; NPR Radio with Joe Palca\nTrump ends Obama's 12-year run as most \nadmired man: Gallup\nBy Zack Budryk  - 12/29/20 07:32 AM EST 3,058 \n \nPresident Trump has ended former President Obama's 12-year run as the most admired man in America, \nedging out his predecessor in the annual Gallup survey  released Tuesday.\nEighteen percent of the survey's respondents named Trump as their most admired man, compared to 15 \npercent who named Obama and 6 percent who named President-elect Joe Biden . Three percent named \nNational Institute of Allergy and Infectious Diseases Director Anthony Fauci, while 2 percent chose Pope \nFrancis.\nRounding out the top 10 were Tesla CEO Elon Musk, Sen. Bernie Sanders (I-Vt.), Microsoft founder Bill \nGates, Los Angeles Lakers star LeBron James and the Dalai Lama, all of whom received 1 percent.\nMost Admired Man, 2020\nWhat man that you have heard or read about, living today in any part of the world, do you admire most?\n% Mentioning Number of top 10 finish\nDonald Trump 18 10\nBarack Obama 15 15\nJoe Biden 6 2\nDr. Anthony Fauci 3 1\nPope Francis 2 8\nElon Musk 1 4\nBernie Sanders 1 6\nReleased by Chairman Rand Paul\n297% Mentioning Number of top 10 finish\nBill Gates 1 21\nLeBron James 1 1\nDalai Lama 1 11\nCombined first and second mentions; rankings based on total number of responses\nG A L L U P ,  D E C .  1 - 1 7 ,  2 0 2 0\nDecember 30, 2020 – Global    USA\nReleased by Chairman Rand Paul\n298General Gus Perna asked to speak with me this Am (7:30 AM) for advice and “comfort”.   \nThere has been criticism about the roll-out of vaccines.   @0 million doses were promised by the \nend of December and we only have 11 million.   Also, only 2-3 million have been administered \n(the latter is not his responsibility).  He realizes that there is disappointment and wants advice.   I \ntold him that above all he needs to be transparent and honest and not try to coverup any \ndeficiency.   This is a big operation and he should expect bumps in the road.   He bemoaned that \non the battlefield when he was on the radio he could tell from the background sounds and the \n“vibes’ on the radio how the battle was going.   With vaccines, even on conference calls, he \nreally cannot get a good feel for what all the players are doing and  how honest they are being.   \nHe does not trust Pfizer; he thinks that they keep moving the goal posts.   He likes Moderna.   He \nwas very grateful for the call.\nSenator Marco Rubio is acting like a real asshole.   He is publicly calling me a liar about my \nstatement in the NY Times about my assessments for the percent vaccinations needed for herd \nimmunity. I had said that I modified my assessment of 70 to 75%  to be 70 to 85% because we \nreally did not know the precise number and I wanted to encourage people to get vaccinated to \nachieve herd immunity.   Actually, I made that change by extrapolating the measles situation \nwhere measles vaccine is 98% effective whereas SARS-CoV-2 is 94-95% effective.   Measles \nbegins to lose herd immunity at around 89-90% of population vaccinated and so I brought up the \nSARS-CoV-2 to 85% with the range being 70 to 85%.   For that he called me a “liar” Big \nhypocrite as he continues to kiss Trump’s ass – the world’s biggest liar.\nReleased by Chairman Rand Paul\n299“Sen. Marco Rubio: Dr. Fauci lied about coronavirus — I am appalled by his \narrogance”\nPlacing blind faith in unelected celebrity scientists has its limits, and we must \nnot be afraid to call them out\n By Sen. Marco Rubio | Fox News\nHad 2nd conversation with Rochelle Walensky where I am advising her on her new position as \nCDC Director.  I briefed her on the fact that as good as some of the CDC people are, as an \ninstitution they have hubris and are often incorrect.   She needs to follow her good instincts and \nquestion what they are doing in a friendly, non-threatening manner.\nPRESS: WTOP Special Radio with J.J. Green; UK TimesRadio interview; C-SPAN TV \ninterview with Gov. Newsom of California; MSNBC “The Last Word” with Lawrence \nO’Donnell\nDecember 31, 2020 – Global – 81,500,000/1,800,000;  USA – 19,700,000/341,200\n1.Most concerning are rising case counts during a dramatic \ndecline in testing – CA, TX, FL and where COVID \nadmissions are rising consistent with significant \nundetected community spread prior to the Holidays and \npotentially the most significant post Holiday surge – this \nis FL, TX, GA, SC, NC, WVA.\nReleased by Chairman Rand Paul\n3002.New admissions rising in OK, TX, AL, MS, GA, FL, NY, MA, \nWVA, KY High Plateau in CA, AZ, NM, AR, TN, MD, CT, NJ\n3.States with the most hospital staff stress are those states \nin the dark red zone and still rising – CA, AZ, GA and \nthose states in the red zone and still rising – OK, TX, MS, \nAL, SC, TN, DE, NY\n4.The Coasts (80% of the population) are now driving the \nincreasing cases, hospitalizations and deaths. \nMackenzie Miller (Daughter of Katie and Stephen Miller)  admitted couple \ndays ago first to Georgetown Hospital and then transferred to Children’s National.   \nDeveloped acute onset of unresponsiveness.  Improved significantly on IV fluids \nand antibiotics and acyclovir.   Baby (6 months old) exposed to grandmother who \nhas cold sore and so HSV encephalitis suspected.   MRI (brain), EEG, physical \n(some hyporeflexia) all OK.   Have spoken with her ID physician Reinhard \nWiedermann and will speak with neurologist Elizabeth Wells.  Am on phone \nfrequently with Katie and Stephen.\nPRESS:  NBC Today Show with Craig Melvin; WBAL Baltimore Radio; MSNBC with \nAndrea Mitchell;\nReleased by Chairman Rand Paul\n301January 1, 2021 – Global – 81,900,000/1,800,000;   USA – 20,000,000/345,000\nRecords continue to be broken with 125,000 hospitalizations and >3000 deaths.  GOP and \nTrump planning to challenge the January congressional certification of the electoral votes.   \nDisgraceful assault on democracy.\n•Spoke with Mitt Romney this AM who ran by me an OpEd he wants to submit \npointing out the lack of success and weaknesses of the vaccine rollout plan and \nsuggestions of how to improve it.  Clearly there is a problem (see below)\nProblem with vaccine rollout.   Plan was to have 40 million doses delivered by December 31 with 20 \nmillion in the arms and 20 million in reserve.   This far 14 million delivered and 2.7 million in the arms.   \nClearly, they need to catch up.   There is no central “plan” similar to no plan for testing and no plan for \nPPE.\n1.Most concerning are rising case counts during a dramatic \ndecline in testing – CA, TX, FL and where COVID \nadmissions are rising consistent with significant \nundetected community spread prior to the Holidays and \npotentially the most significant post Holiday surge – this \nis FL, TX, GA, SC, NC, WVA.\n2.States with the most hospital staff stress are those states \nin the dark red zone and still rising – CA, AZ, GA and \nReleased by Chairman Rand Paul\n302those states in the red zone and still rising – OK, TX, MS, \nAL, SC, TN, DE, NY\n3.The Coasts (80% of the population) are now driving the \nincreasing cases, hospitalizations and death\n        January 2, 2021 – Global – 82,400,000/1,800,000; USA – 20,100,000/347,000\nDeaths now averaging around 3000 per day.   Hospitalizations continue to break records.\nTrump totally focused on disrupting the transfer of power and declaring the election invalid.   \nBig day coming up on January 5 when the Congress certifies the Electoral Votes.\nJanuary 3, 2021 – Global – 82,600,000/1,800,000;  USA – 20,300,000/350,000\nReleased by Chairman Rand Paul\n303Data remains unstable but early signals are increasing test positivity (49) states and in some states rising \ncases – tracking closely.   Concerned about upcoming post-holiday surge\n1.Reporting remains unstable and will create this current \nvalley and peak (slide ¾) due to reporting alone – \nwatching slope of rise.\n2.Testing is down 40% over the past 7 days creating a high \nadmission rate/case across all age groups and any \nincrease in cases concerning\n3.49 states have rising test positivity and 17 rising cases \ndespite reporting issue – this normal precedes a \nsignificant surge is hospitalizations\nTotal deaths have not reached 350,000!!\nTweet from Trump:\nReleased by Chairman Rand Paul\n304Got a call from Jeff Zients wanting to confirm the I still am in favor of Janet Woodcock for FDA \nCommissioner.  He was getting some negative signals from some people that she was involved in \nthe EUA for hydroxychloroquine.   I explained to Jeff that this was really Mark Meadows \npressuring Steve Hahn who caved in.\nPRESS:  ABC “This Week” with Martha Raddatz; NBC “Meet the Press” with Chuck \nTodd;\nJanuary 4, 2021 – Global – 83,700,000/1,800,000;   USA – 20,600,000/350,700\nExpecting the post-holiday surge\nReleased by Chairman Rand Paul\n3051.I have included the European data in slides 3 and 4 – most of the European \nincreases being driven by the UK\n2.You can also see from slide 3 the rate of rise of our Fall/winter surge was more \ndramatic consistent with the USA having its own more infectious variant\nThings starting to move with my involvement with the Biden team.   Biden is concerned \nabout making sure that he reaches 100 million doses of vaccine in the 1st 100 days.   We are \nmeeting by zoom with him tomorrow and today and tomorrow we had/will have pre-brief \nmeetings to discuss our plan – led by Jeff Zients.   Present were Natalie Quillian, Vivek Murthy, \nMarcella Nunez-Smith, Rochelle Walensky, David Kessler, Asma Mirza, and Sonya Bernstein.  \nPlan is to develop community vaccination centers, use mobile units to get to rural areas, etc.\nNursing staff in the OR at the Brigham and Women’s Hospital all wearing Fauci caps.   Email \nsent to me by Atul Gawande.\nReleased by Chairman Rand Paul\n306PRESS:   Did zoom interview with the Newsday Editorial Board; MSNBC “All In” with \nChris Hayes\nJanuary 5, 2021 – Global – 84,200,000/1,800,000  USA – 20,700,000/352,000\nDeb’s notes:  Made this shorter to make serious points.  First and foremost our Fall surge slope is \nnearly identical to the UK slope suggesting we have had our own more transmissible strain since then \nand it was responsible for the Fall surge in the Northern Plain states. My concern then was this type of \nsurge moving into the more populous states as it has now in CA and now Tx and the sunbelt is unstable \nas well as the midAtlantic and NorthEast. Viruses are always in search of escape mutants than are more \ntransmissible yet preserving replication capacity.  This is happening around the globe and the \nimmunologic pressure on viruses drive this potential and we continue to increase the immunologic \npressure through percent of population infected, use of plasma and monoclonal Ab and now \nimmunization.  Key to RNA viruses with this of high mutation potential is to rapidly immunize the \npopulation especially those most likely to have high replication potential – those over 65.  We have to \naccelerate the immunization of those over 65 ASAP.  We can’t hold back on the rest of Tier 1 awaiting \n1a.  We have been in 1a for a month without adequate progress. Deb\nReleased by Chairman Rand Paul\n307 \nTrump going completely crazy.  Was recorded on an hour-long telephone call with Secretary of \nState of Georgia Brad Raffensperger to change the votes and asked for 11, 780 votes to be \nchanged (he lost Georgia by 11,779).   Clearly a criminal act of trying to influence an election.  \nMore cowardly GOPs are backing Trump in the House Kevin McCarthy (R-CA) and Senate (Ted \nCruz (R-TX) and Josh Hawley (R-MO)\nReleased by Chairman Rand Paul\n308•Big discussion and debate in the press about whether to give more single doses of \nvaccine and wait few months before the second dose.   The UK is doing this with \nthe AZ vaccine.  There is no scientific data to justify this.  They are doing it \nbecause they want to give more people first doses.   Our problem is not more \npeople than doses, it is that we are not injecting as many people (4 million) with \nthe doses that we have (14 million).   Much discussion in the press about this.\n•Had Zoom meeting with Biden and Harris.   Meeting led by Jeff Zients.   \nPresent was Ron Klain, Natalie Quillian, Marcella Nunez-Smith, David Kessler, \nVivek Murthy, Rochelle Walensky, Bechara Choucair.   Topic was that Biden \nwants to announce in a speech 3 transforming steps that he will initiate regarding \nvaccines.   Natalie presented our plan and there was discussions about using \npharmacies first and then as we get more doses, opening up “Community Vaccine \nCenters”.  I described status of the outbreak.  Biden is much more in favor of \nfederal presence than is the Trump administration.   Slide deck is below:\nSlide Deck - COVID \nPolicy Briefing 1 5.pd\nPRESS:  Interview with Newsweek UK; AP Online interview with Lauren Neergaard;\nJanuary 6, 2021 -  Global – 84,800,000/1,900,000;   USA – 21,000,000/356,000\nSpoke on chat with Chiefs of Police and with Presidents of Jesuit Schools (led by Fr. Dan Lahart \nof Regis)\nMade rounds on COVID-19 patient at Clinical Center.   I have been doing this about 1X per \nweek.   Saw patient today with COVID disease - 73 y.o.  AA male, ex-marine, ex-State Trooper.   \nSays this is worse he has ever felt.\n•My group (Mascola, Graham, Lane, Marston briefed the ART team led by Lu Borio and \nMarcella Nunez-Smith and David Kessler.  We spoke about the mutant viruses in UK and \nRSA and their impact on mAbs and vaccines.\n1.There is a significant increase in test positivity rate and a high hospital \nadmission rate/case across all age groups\n2.I have included the top 10 states for cases and it is a mix of states that were \nsurging prior to the Holidays NY, TX, FL, GA, AZ and states that were improving \nor stabilzing prior to the Holidays CA, PA, OH, IL, NJ and tracking these states \nwill be key to estimating the impact of the Holidays on cases and eventually \nhospitalizations\nThe Fall surge in the Northern Plain states was more aggressive and we warned if this type \nof surge hit populous states this would threaten the health care system – this is what we \nare seeing in CA and to be clear this is spreading across the Sunbelt and into the North East.  \nReleased by Chairman Rand Paul\n309Trump incites riot as protestors storm the Capitol, break windows and occupy \nPelosi’s office.   Capitol Police utter failure to control them. Democrats take both \nSenate seats in Georgia Election - Jon Ossoff and Raphael Warnock.   \nBiden electoral votes certified by Joint Session of Congress.   Sens. Hawley and Cruz \nfight to the bitter end to their shame.   Several senators who originally had \nsupported the attempt to overthrow the election have changed their mind because of \nthe shock of the storming of the Capitol\nPRESS:  Podcast Fireside Chat with David Rubenstein for the Economic Club of \nWashington, DC; BNN Bloomberg Canadian TV; \nJanuary 7, 2021 – Global – 85,500,000/1,900,000;    USA – 21,300,000/360,000\nRecord number of deaths yesterday - >3963.  Today another record at 4000.   Surging continues.   \nSlow start in the implementation of administration of vaccines.   Was supposed to have 20 \nmillion doses distributed and administered by December 31.   Today there have been 15 million \ndistributed and 5 million administered.\nReleased by Chairman Rand Paul\n310PRESS:  NPR – “Morning Edition”, Noel King; France24 TV (Arabic language); WJLA \nTV; \nNew York Times: NYT: Fauci says he thinks that January will get worse, and that the \nvaccination effort needs more time.\nJanuary 8, 2021 – Global    USA\n4111 Deaths!!  Record hospitalizations.\nI have been on the phone with Jeff Zients a few times today.  I checked the number for \nprojected requirement of vaccines to fulfill the promise of 100 million doses in arms in 1st 100 \ndays of Biden administration.  The number in the Biden slides (Kessler derived) was 275 million \ndoses and 135 million people (getting 2 doses) by end of April.   I called Moncef Slaoui and got \nthe actual numbers and they totaled 189 million.   I called Jeff and let him know.   He checked \nwith Kessler who then checked with Moncef and they figures that the doses that had already \nbeen allocated prior but not given yet would make up for the difference.   I am concerned that we \n(Biden team) will not meet the promise.   Too many vicissitudes in vaccine production.   Perhaps \nJanssen will bale us out with the 25 million doses in March and 40 million in April (single dose \nrequired).    Then, Biden team announced that they would not hold back any doses to save for 2nd \nshot, but will immunize everyone then can with doses they have.   This places a lot of faith in the \nprecision of the production/delivery of doses.  They may have to pause with 1st doses to catch up \nwith 2nd dose requirement.\nAt 8:00 PM tonight as I was over Rob and Ellen’s “open Garage” dining room, Jeff Zients \ncalled  me again asking for a favor.  A Politico reporter is already getting ready to write a story \nspreading rumors that Biden is upset with his COVID team and Jeff is asking a favor for me to \ngo on “background” and tell the reporter that they are doing a very good job.   I told Jeff that I \nwould of course be happy to do this.\nReleased by Chairman Rand Paul\n311PRESS: NPR International – “The World”; C-SPAN doing “Facts and Faith” at VCU talk \nwith Virginia Governor Northam.   Speaking to Black Faith leaders\nJanuary  9, 2021 -  Global  -  87,600,000/1,900,000;  USA – 22,000,000/368,000\nThe pandemic is getting more scary.   Every day more and more cases and deaths.  Patients in \nthe hallways in California.   Nurses and MDs exhausted.  It seems that people are getting \ninfected who are being careful and have no idea why they are getting infected.   N501Y mutation \nis here in the USA, but it is not dominant.   We may actually have out own mutant that we have \nnot recognized since the CDC has not really been looking.\nReleased by Chairman Rand Paul\n312Had conversation this AM 12:10 PM to 12:50 PM with 2 reporters from Politico (Adam Cancryn \nand Tyler Pager).   Call set up by T.J. Ducklo (see note about regarding call from Jeff Zients).  \nSee above regarding content of call.  I convinced them that the Biden team is a good team and \nthat the discontent is typical Washington, DC rumors.  Interesting that someone associated with \nBiden campaign is already spreading damaging rumors about the team.   Probably someone who \nwanted a place in the transition and is not satisfied with what was given to them.\nDavid Ho is doing tests on convalescent sera and sera of people who were vaccinated and is \nfinding disturbing data in both the UK and worse in the RSA mutants.  It looks like the vaccine \nmight be compromised.   We need to prepare to modify the vaccine if this observation holds up.   \nAlso, Peter Staley and James Kellerstein are writing an article for an OpEd to ask for the DPA to \nbuild a plant so that we can make unlimited amount of vaccine.   Ewe can use this if we need to \nquickly do a strain change.\n   \nReleased by Chairman Rand Paul\n313\nReleased by Chairman Rand Paul\nhistorical record of A.S. Fauci – Part 3\nJanuary 10, 2021 – Global – 88,400,000/1,900,000  USA – 22,100,000/371,100\nAnd the surge goes on…..  There is a real concern that we have our own mutant that is resulting \nin an increased surge in cases.   People are saying they have no idea how they got infected since \nthey have been observing public health recommendations.   See below comments from Birx.\nAfter Thanksgiving the Northern Plains MN, IL, MI held and did not significantly deteriorate.  In contrast \nthis current post Holiday surge is causing deterioration in all metros including metros that were stable \nand metros that did not experience a significant post Thanksgiving surge.  NYC has returned to case \ncounts equal to the Spring recognizing we are testing at much higher rates but this surge is just \nbeginning in NYC and with this current rate of rise of cases could drive significant cases, hospitalizations \nand deaths especially if it deteriorates at the rate of LA.  Proactive setting up of infusion sites now is \ncritical in all large metros and active immunization of those over 65.  We have enough vaccine in the \nStates to immunize nearly 15M senior which would be nearly 25% of all seniors over 65.  We need to \ntreat this current situation as the emergency it is. Deb\nDeb’s report:\n1. Reporting has stabilized and we have returned to the pre-thanksgiving rate of cases as the current \nresurgence moves into the populous states from CA to TX to FL and resume a full log phase \nrate\n2. EVERY METRO over 500K residents is deteriorating except Honolulu. -  even those that had \nbeen stable now have rising cases  slides 6-52 : NYC area is now reached cases greater than the \nSpring surge\n3. All of the most populous states are deteriorating or continuing to deteriorate – CA, TX, FL, NY – only \nCA maybe showing signs of reaching a high plateau – TX, FL, NY will become the new epicenter of this \nsurge over the next 3 weeks – I believe we have had our own evolved and more transmissible strain \nReleased by Chairman Rand Paul\nor strains since September by reviewing all the epidemiologic data – this fall/winter has a more rapid \nrate of rise from the beginning which predated Thanksgiving and continues at the rate post the \nHolidays (slide 3) – this rate of rise is now independent of the weather as it is occurring across the \nSouth, LA, etc -  the surge is more difficult to mitigate - which will require more aggressive action to \ncontrol and all actions need to be taken now to flatten this curve and preserve the health system) \nNormally the weekly high for fatalities is Wednesday – deeply concerning that both Weds Thurs and \nnow Friday have deaths near 4000/day\nSee graphs on slide set below (frightening):\n10Jan2021DataSum\nmary.pptx\nMajor discussion among Congress in invoking the 25th Amendment to remove Trump.   \nPelosi is going to go ahead with impeachment proceedings  even though there would be no time \nto convict, they can impeach.   Several people in the White House and Cabinet are resigning – \nElaine Chao, Matt Pottinger.   POTUS is attacking Pence for not going along with his attempts to \noverthrow the election.   Poor Pence.   He had been so loyal, but I am pleased to see that the \ngoodness that I recognized in him is coming out, albeit a bit late in the game.   The crazies in the \nTrump following are calling for the execution of Pence, similar to Crazy Steve Bannon calling \nfor my beheading.\nPRESS: WGN Radio (Steve Dale) – Chicago;\nSatire from The Borowitz Report\nFauci Says Immunity from Trump Requires \nTwo Doses of Impeachment\nReleased by Chairman Rand Paul\nBy Andy Borowitz\nJanuary 11, 2021 – Global – 88,800,000/1,900,000;   USA – 22,300,000/373,200  \nSurge continues unabated.   Deb’s notes:\n1.Reporting has stabilized and we have returned to the rapid pre-\nthanksgiving rate of cases as the current resurgence moves into the \npopulous states from CA to TX to FL\n2.Nearly all METROs over 500K residents is deteriorating. -  even \nthose that had been stable now have rising cases  slides 22-26: NYC \narea is now reached cases greater than the Spring surge\n3.All of the most populous states are deteriorating – CA, TX, FL, NY – only \nCA maybe showing signs of reaching a high plateau – TX, FL, NY will \nbecome the new epicenter of this surge over the next 3 weeks – as \nviruses evolve and strains are imported– the fall/winter has a more \nrapid rate of rise predating Thanksgiving and continues at the rate post \nthe\nReleased by Chairman Rand Paul\nContinued discussion about invoking the 25th Amendment.   Trump have been permanently \nbanned from Twitter and at least temporarily from Facebook (maybe permanent).  Trump stating \nthat “it is only beginning”.   Intelligence chatter indicating that there will be massive \ndemonstrations and even violence associated with the inauguration.\nMick Mulvaney made some interesting comments on a CNN Special on “insurrection”.   When \nasked why so many people stuck with Trump when all the signs were there that he was acting \ncrazy.   Mick said that when you lie with him in the WH day after day, you see that he has \naccomplished a lot and you tend to downplay in your mind the signs of craziness.   I even saw \nsome of that during the time that I went to the WH every day for months in the Spring and \nSummer.\nMarc Short called me and asked for me to make connection with the Biden people and invite \nsomeone to today’s Task Force Meeting so that the Biden Team can get a feel for how the \ncurrent task Force works.   I called Jeff Zients and Jeff gave them Cyrus Shahpar who is on the \nBiden team and works for Tom Frieden.\nDid a chat with Bishop TD Jakes including Kizzy Corbett.  Trying to\nReleased by Chairman Rand Paul\nSpoke with Pat Foye of the Metropolitan Transportation Authority (MTA).   They want me to do \na 1 minute PSA to encourage their  employees to get vaccinated.\nPRESS: Rural TV Network – “Rural Health Matters”, Nashville, TN TV; \nPOLITICO: ‘There is a palpable concern’: Biden presses advisers over 100 million Covid \nshot goal  (This relates to my conversation with Zients/Ducklo)\nCDC: No sign of homegrown U.S. coronavirus \nvariant, but scientists need to look harder\nBy \nJoel Achenbach , \nKim Bellware  and \nHamza Shaban\nJanuary 12, 2021 – Global – 89,400,000/1,900,000;   USA – 22,500,000/375,100\n4400 deaths today\nJohn Mascola working with David Ho to determine the possibility that the UK (N501Y; \nB.1.1.7) and/or the RSA mutants evade the antibodies induced by vaccines.   According to Ho, \nthe RSA mutants are much more troublesome in that they do not eliminate the protection of \nvaccine induced antibodies, but they definitely decrease by 2 to 3-fold their potency.   David is \nnow working on studying the UK mutant. Stay tuned.\nThe next 4 weeks will be determined by whether the large Southern, upper Mid-West,  Mid-Atlantic and \nNorth-East metros will be able to contain the rapid accelerating viral spread or have the prolonged log \nphase followed by the high plateau of LA (now entering month 3).  Deb\n1. Reporting has stabilized and we have returned to the rapid pre-thanksgiving rate of cases as the \ncurrent resurgence moves into the populous states from CA to TX to FL : cases are up 7% from \nlast week's same time period. \n2. Nearly all METROs over 500K residents is deteriorating. -  even those that had been stable \nnow have rising cases slides 7-45: NYC area is now reached cases greater than the Spring \nsurge\nThroughout “the 2019 flu season from Sept. 29 to Dec. 28, the CDC reported more than 65,000 \ncases of influenza nationwide,” while “during the same period last year, the agency reported 1,016 \ncases.”\nReleased by Chairman Rand Paul\n•Had discussion with Chris Whitty and Patrick Vallance of the UK regarding their mutant \nand their vaccine program.  They confirmed that the mutant is spreading widely in UK \nand other EU countries and also that there is no increase in virulence of escape from \nvaccine-induced antibodies.   They also mentioned that they are more concerned about \nthe RSA variant (mutants).\n•Did Fireside Chat with Barbara Bush on “Future Forum for Preparedness” (her Global \nHealth Corps)\nHad discussion with Azar, Pence, and the OWS crew about vaccine rollout.    We will as of \ntomorrow (announce at the Governor’s call) that we are changing our rollout strategy.   We are \ngoing to be more flexible and not strictly wedded to the ACIP/CDC guidance of Phase 1a.   We \nshould continue that, but move on the people >65 years old and people 16 (or 18) to 64 with \nunderlying conditions\nAm communicating with Stanley Tucci.   He has heard through the media that I make Tympani:\nFrom:  Stanley Tucci <sta914@gmail.com> \nSent: Tuesday, January 12, 2021 2:28 PM\nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nCc: Lottie Birmingham <lottie.birmingham@icloud.com>\nSubject: Re: Stanley Tucci and Timpano\nDr. Fauci,\nThank you so much for your timely response and your kind words. The books will be whisking \ntheir way towards you imminently.  It is my hope that someday we might prepare and enjoy a Timpano \ntogether.  All the best to you and your family. \nWith great respect and \nadmiration, Stan  \nOn 12 Jan 2021, at 6:54 pm, Fauci, Anthony (NIH/NIAID) [E] < afauci@niaid.nih.gov> wrote:\nMr. Tucci:\n     Thank you for your very kind note.   I was thrilled to hear from as I am a great \nfan of your acting and am looking forward to watching your CNN Special.   I would \nbe honored if you could send me autographed copies of your cook books.  My \nReleased by Chairman Rand Paul\naddress is 3012 – 43rd Street, NW; Washington, DC 20016.   I hope that you are \ndoing well during these difficult times.   Please stay safe. \nWarm regards,\nTony\n Jeff Zients called me to get approval of a statement that Biden will put out criticizing the Trump \nadministration for opening up the floodgates of the Phases for vaccines (see above) given that \nthere is not enough vaccine to go around at this point.  Indicated that I did not like the statement \nsine it was a gotcha.  Jeff did not like that but nonetheless changed it somewhat according to my \nsuggestions.\nPRESS: Here Are 18 Celebrities (And Public \nFigures) Who Have Gotten The \nCoronavirus Vaccine\nFrom politicians to performers.\nby Matt Stopera\nBuzzFeed Staff\nJanuary 13, 2021 – Global – 90,100,000/1,900,000; USA – 22,700,000/379,000\nThe surge continues.   Could this be that we are dealing with our own highly contagious variant, \nbut we do not realize it since the CDC sequencing surveillance has not been very comprehensive \nas has the UK surveillance?   See below\n1.Reporting has stabilized and we have returned to the rapid pre-\nthanksgiving rate of cases as the current resurgence moves into the \npopulous states from CA to TX to FL : cases are up 7% from last \nweek's same time period, as CA improves, the high population \nstates of TX and FL will surge and the fatalities will increase, many \nstates are reaching 0.2% rates per population deaths\nReleased by Chairman Rand Paul\n2.Nearly all METROs over 500K residents is deteriorating. -  even \nthose that had been stable now have rising cases  slides 15-18: NYC \narea is now reached cases greater than the Spring surge\n \nTrump impeached for 2nd time!   Several Republicans vote in House for impeachment.   \nUnlikely to come to trial in Senate until after inauguration.   Biden does not want distraction \nfrom his 100 days agenda.\nHad zoom call with President of Ecuador – President Lenin Moreno Garces.   We discussed \nthe situation in Ecuador, vaccines and a whole bunch of questions that he had.  Seems like a very \nsmart person.   I promised to advocate for equitable availability of vaccines throughout the world \nincluding Ecuador.\nHad Zoom call with Biden team – (Marcella Nunez-Smith, David Kessler, Rochelle Walensky, \nVivek Murthy, Connolly Keigler and Maju Varghese).   David led discussion regarding the \ninauguration.   Originally there was supposed to be 250 people on the platform 6 feet apart  \n()POTUS and VP and Family, supreme court justices, leaders of Congress.   6 feet apart, all \nmasked, all tested.   Then then wanted 29,000 on the West Front.  Maju Varghese was \noperationally responsible for arrangements.   These 29,000 were cut down to 2000 by David \n(who is overall responsible for arrangements).   The meeting today was to determine if we were \nOK with this.   We all (Marcella, Rochelle, Vivek) voted that there should be no one on the West \nFront.   I made the argument that some of the GOP Congressmen could make trouble by not \nwearing masks the way they refused when the Capitol was attacked and they were crowded in a \nReleased by Chairman Rand Paul\nroom.   Also, if someone gets infected, the press will jump on us.   David will bring this back to \nBiden and Klain.\nHad regular every 2 weeks call with Bill Gates – Bill and Trevor Mundel know about the issue \nwith the mutations that David Ho is working on.   We discussed working together to track them \nas well as using Gates money to jump-start the development of mRNA vaccines to match the \nmutations (B.1.1.7 variant) with the N501Y mutation.   We need to be ready to respond\nFront Page Story of Italian Magazine “I Love Sicilia”\nSKM_C754e2101131\n7230.pdf\nSome Black Muslims accusing me of trying to experiment on Blacks.   He mistakenly \n(deliberately) is ignoring that I, Pence, Biden, Harris have all gotten vaccinated.   He is saying \nthat Blacks would be the herd immunity that would protect whites:\nBeyond Tuskegee: Targeting of Black people \nfor Covid-19 vaccine\nBy\nAnisah Muhammad, Contributing Writer\nOn January 10, Student Min. Muhammad, a researcher, scholar and author, delivered the Nation of \nIslam’s Sunday address at Mosque Maryam, titled, “Beyond Tuskegee: Why Black People Must Not Take \nthe Experimental Covid-19 Vaccine.” \n“Why beyond Tuskegee? The vaccine mafia who want Black people to be the first injected with this \nexperimental vaccine have centered the Tuskegee experiment in their narrative, most prominently Dr. \nFauci.\nLet’s say we get 75 percent, 80 percent of the population vaccinated,” Dr. Fauci said on Dec. 9. “If we do \nthat, if we do it efficiently enough over the second quarter of 2021, by the time we get to the end of the \nsummer, i.e., the third quarter, we may actually have enough herd immunity protecting our society that \nas we get to the end of 2021, we can approach very much some degree of normality that is close to \nwhere we were before.”\nAs of July 1, 2019, the U.S. Census Bureau reports that 76.3 percent of Americans are White.\nReleased by Chairman Rand Paul\nBob Woodward came to my house tonight to deliver the transcripts of the tapes of his \ninterviews of me for his book “Rage”.  He said that it would help me with the writing of my \nbook, He really wanted to come over and tape an interview with me about my current dealing \nwith Biden.   I explained the interactions with Biden (see above).   Nothing controversial; \nhowever, it was clear why he wanted to come over.  He is writing yet again another book.   We \nmet outside in the cold due to COVID-19\nI wrote a belated birthday note to Joan Baez (her birthday was Jan.9, 1941).   I had forgotten due \nto recent events at the Capitol, and so I wrote her a note apologizing.   She wrote back: “Of \ncourse I accept!.   There was a postcard circulating in Frace under a liberal administration in the \neighties, “nous sommes tous dans la merde”.   We are all in the shit.   I don’t speak French \nanymore, but the post card stands out.  Yes, we are the same age!  You are a rock star and I am a \nbadass, and age is very much beside the point.   Thinking of you.  Joan”\nPRESS:   WPIX TV New York City with Dan Mannarino;  Children’s Hour Public Radio; \nWMBD radio and WYZZ TV (Central Illinois);  The Children’s Hour Public Radio; \nJanuary 14, 2021 – Global –  90,800,000/2,000,000;  USA - 23,000,000/383,400   \nNote from David Ho.   Mutants are becoming very troublesome:\nReleased by Chairman Rand Paul\nHere is an overview first.  Will share detailed organized data in a couple of days.  I am available to chat \nat a mutually convenient time.  Patrick Vallance from the UK is reaching out to me to get preliminary \nresults as well.\nWe have constructed SARS-CoV-2 pseudoviruses that contain all 8 mutations in the \nUK variant and all 9 mutations in the SA variant.  In addition, we have also \nconstructed pseudoviruses that contain each of the 16 mutations (501Y mutation is \nshared) individually.  This entire panel has been tested on a collection of ~30 spike-\nspecific neutralizing monoclonal antibodies, 20 convalescent plasma, and 18 \nvaccinee sera (Moderna and Pfizer).  First, both UKdelta8 and SAdelta9 showed \nincreased replication capacity in vitro, which is consistent with their increased \ntransmissibility in vivo.  Overall, the impact on virus neutralization is profound, with \nthe SA variant being worse than the UK variant.  It is quite clear that these two \nvariants could now resist several classes of neutralizing monoclonal antibodies \nalready used in the clinic or still in development, and in most cases we understand \nwhich of the mutations are conferring the resistance.  This information is particularly \nrelevant to companies like Lilly and Regeneron, which have approved clinical \nproducts that are severely affected by these results.  In addition, a large majority of \nconvalescent plasma samples showed an appreciable loss in activity against the new \nvariants, suggesting re-infection may be more likely when confronted with either of \nthese two strains.  Finally, we also observed a significant impact on vaccinee sera in \nthat every serum sample tested showed a substantial loss in neutralizing activity \nagainst the SA variant, whereas the loss in activity against the UK virus is not as large \nor as universal.  Again, we believe the latter findings should be shared promptly with \nthe field, because these new strains threaten the effectiveness of the current \nvaccines.  Importantly, the strategy that the UK is now contemplating (giving one \ndose and delaying the second dose) is quite dangerous in that one or two additional \ncritical mutations on top of either strain (under suboptimal antibody concentrations \ninduced by one shot without a booster) could render current monoclonal antibodies \nand vaccines useless.  Our data are germane to that debate.  Our data are more or \nless complete, except for live virus neutralization results.  We are still waiting for the \nUK and SA to be distributed by the US government to our lab.  We expect to have the \nlive viruses soon, and could generate the confirmatory results in about 7-10 days \nafter receiving the viruses.  \nReleased by Chairman Rand Paul\n•Received the Ken Shine Prize in Health Leadership from the University of Texas at \nAustin Dell Medical School\n•Briefed the Congresssional Blue Dog (moderate Dems) and Moderate GOP members led \nby Rep. Stephanie Murphy (D-FL) and Rep John Katko (R-NY)\n•Met with Rep. Espaillat  (D-NY) who want me to meet with a contingent from the \nDominican Republic.   I will do so, but after the inauguration\n•Got call from Beth Cameron (NSC)  informing me that Biden want me to be the Head \nof WHO delegation and to announce on January 21 (4:10 AM ET) that the USA is back \nin the WHO.\n•Biden give big speech (7:15 PM) announcing $1.9 trillion budget package including \n$415 Billion for COVID response\n \nPRESS:  KSEE24 TV (NBC Affiliate in Fresno, CA)\nJanuary 15, 2021 – Global – 91,500,000/2,000,000; USA – 23,200,000/387,300\nHad Zoom briefing of Biden and Harris  to prep them for the speech that Biden will give at \n3:45 PM on the vaccine rollout plan.   We briefed him at 2:30 to 3:30 and he and Harris (only he \nspoke) gave briefing to the Nation.\nBiden announced today that he has asked Francis Collins to stay on. I had some influence on \nthis.   Eric Lander will be head of OSTP.\nConsiderable concern about the new mutants in UK, Brazil and especially South Africa –   \nDavid Ho is studying this carefully and finds that the UK variant results in a 2-fold decrease in \nability of vaccine-induced antibodies to neutralize.   For the South African variant it is 4 to 5-fold \ndecrease.  Had Zoom with David and John Mascola and others and David went over the Mutant \ndata.   Bottom line is that against the UK mutant the vaccine (Moderna)-induced sera is \nweakened by 2-fold; however, against the RSA (and by extrapolation although did not look the \nBrazilian) mutant the sera are diminished by 5-fold)   MAJOR IMPLICATIONs for vaccine \ndevelopment and for policy such as letting people into the country\nPRESS: Ebro in the Morning Radio Show in NYC; Today Show NBC TV with Craig \nMelvin; CTV - Canadian TV – Sunday Show (Ian Wood); WUSA TV Jan Jeffcoat; \nJanuary 16, 2021 – Global – 92,300,000/2,000,000; USA – 23,400,000/391,000\nReleased by Chairman Rand Paul\nJeff Zients gave me the entire Biden plan to look at and approve - I mentioned to him in \ndetail the recent data from David Ho.   We will set up a call for Sunday with the Biden team \n(doctors) since now several teams such as Michel Nussenzweig, Jess Bloom and others are \nfinding the same thing as Ho.   I want the call on Sunday since Michel is publishing his data in \nBioRx on Monday.   I will bring John Mascola on the call with me to describe with some slides.\nAlso, I have pushed with JZ to get Ned Sharpless re-appointed as NCI Director otherwise \nhis resignation letter will go into effect on January 20. I asked JZ to get in touch with Ron Klain \nand re-appoint hi.   JZ called me back this evening and said he spoke to Ron and Ned will stay as \nNCI Director.\nPost-holiday surge seems to be stabilizing.   See Deb’s comment below:\n1. For the first time in weeks all indicators except fatalities are flat or declining.  This \nsuggests with full data triangulation that we have reached in most of the country the post \nHoliday peak and declines should continue to follow with continued mitigation.  Testing \nrates have resumed to pre Holiday levels as for the first time week over week cases have \ndeclined (SLIDE 4) from last week's high – but testing for asymptomatic cases must \nincrease to sustain the gains.  Finding the containing the silent spread will be key to \nholding the current gains\n2. CA is stabilizing at a high plateau and if AZ, FL, TX, NY can hold at their current plateau or \nearly declines we could see National improvement beginning next week and \nimprovement in fatality rates in 30 days but not without reaching 450K in 4 weeks and \n500K fatalities over the next 8 weeks based on current case load and rate of rises\nReleased by Chairman Rand Paul\n3. Most of the rapidly rising metros appear to be reaching peak or at a high plateau and \nsome like Chicago and NYC are beginning to decline.  The key will be continued aggressive \nmitigation\n4. New COVID hospital admissions are stable at a high plateau nationally but if the larger \nstates and metros can hold or improve the rates should steadily decline if we can keep \neveryone focused on vigilance as we vaccinate PLEASE SEE SLIDE 3 SHOWING ICU BED \nOCCUPACY – SHOWING CLEARLY THE PRIMARY CURRENT STATES WITH THE WINTER \nSURGE\nPRESS:\nJanuary 17, 2021 – Global – 92,300,000/2,000,000;   USA – 23,700,000/395,000\nWe may have reached the peak of the surge upon a surge\n1.For the first time in weeks all indicators except fatalities are \nflat or declining.  This suggests with full data triangulation that \nwe have reached the post Holiday peak in most of the country \nand declines should continue with continued mitigation. These \ngains can be sustained and can accelerate if behavior change \nholds\n2.Test positivity is declining. Testing rates have resumed to \npre Holiday levels as for the first time week over week cases \nReleased by Chairman Rand Paul\nhave declined from last week's high – but testing for \nasymptomatic cases must increase to sustain the gains.  \nFinding the containing the silent spread will be key to holding \nthe current gains.\n3.Cases are declining or stable across the country (down 8.8%)\n•John Mascola and I presented to JZ and the Biden medical team the results from David \nHo’s work on the UK and RSA mutants.   (see above).   We explained that this requires \ncareful messaging since people would interpret incorrectly that this nullifies the vaccine \nwhich it does not.   JZ has tasked me to write a 2-paragraph description to send to \nBiden tonight.  I did so and now we have a meeting tomorrow AM to discuss possibility \nof travel restrictions from RSA and Brazil.\nPRESS:   Meet the Press (NBC) with Chuck Todd; Che Tempo Che Fa Italian Sunday TV \nShow; MSNBC Lawrence O’Donnell\nJanuary 18, 2021 – Global – 94,000,000/2,000,000; USA – 23,800,000/397,000\nZoom meeting at 7:30 AM with JZ and the team + Jake Sullivan – discussed the restrictions \non travel to RSA, Brazil and perhaps other countries.   Leaning towards requiring PCR 72 hrs \nbefore board to USA followed by Ag test upon boarding followed by Ag test within 3 days of \nlanding + quarantine.   Will present to Ron Klain and POTUS after inauguration.\nDeb Birx’s next to last TF note:\nThis is the last metro case analysis. We are seeing mostly significant improvements or major metros \nholding at a high plateau.  I am worried about the 12 metros that are still increasing and one of them is \nDC.  I walked some of the areas downtown on Sat while I was moving out of my State Dept office and \nthere are major feeding tents set up around downtown for the workers and National Guard – these can \nbe super spreading locations and the National Guard is from around the country including hotspots. \nNational Guard troops must be tested and must be tested when returning but I worry we are creating a \nmassive viral spreading event as troops deploy to DC and then return home and the co-mixing of local \nmetro police with National Guard.  That said by all indicators we are stabilizing as a country and \nimprovements should continue.  New hospital admissions are down across the country and is super \nspreading events can be managed we should continue to see improvements as more states will be able \nto utilize health personnel to support massive vaccination. On the personal level getting the elderly – \nthe highest risk group over 75 - immunized is incredibly difficult.  We have the entire family working to \nsecure sites for my parents but you need to be tech savvy and able to constantly refresh sites and search \nmultiple county and state websites. Then you have to be able to transport and move them to the \nvaccine sites.  We think we may have secured a PG county option for this week but if elderly do not have \ntech support or outreach and transportation support this will be incredibly difficult for them.  Deb\nReleased by Chairman Rand Paul\n1.For the first time in weeks all indicators except fatalities are improving and are \neither flat at a high plateau or declining over 7 days.  This suggests with full data \ntriangulation that we have reached the post-Holiday peak in most of the country and \ndeclines should continue with continued mitigation. These gains can be sustained \nand can accelerate if behavior change holds and testing increases to find the \nasymptomatic cases to prevent community spread\nHad farewell conversation with Vice President Pence.   I called up Marc Short to ask him to \nhave the VP call me today since I was not sure that I would be able to attend (virtually) the last \nTF meeting this Tuesday.   The VP called and we had a very touching and person discussion \nsaying how much he respected me and how the TF would not have been able to accomplish what \nit did without me.  He was very touched.   I told him how important it was for his legacy that he \nacted with such dignity and resolve over the last days when he refused to go along with Trump’s \nattempt to get him to overthrow the election results.  WE parted by saying we will always be \nthere for each other.\nReceived material from Beth Cameron for my announcement on early AM of Jan. 21 that we \nwill re-join the WHO.  I will edit it and get it re-approved.   Very nice that I have been chosen to \nbe head of delegation to the WHA in Geneva (virtually) to make this announcement.\nSummary of some events over past few days/weeks:   Jeff Zients calls me multiple times per \nday checking facts, etc.   I brought up to him that it would be a good idea for continuity that he \nkeep on Francis as NIH director since if he does not act to tear up the required letter of \nresignation, Francis automatically is gone and we have an acting (which would not be bad since \nLarry Tabak is great).   Ned Sharpless is in the same boat as presidential appointee at NCI.   And \nso I mentioned to Jeff that we should keep Ned on and he made it happen.   And so, in fact I am \nresponsible for keeping the NIH and NCI Directors in their jobs.   A surprise is that Harold \nVarmus called me up and expressed great concern that Francis was staying on.   He said many \nsubstantial members of scientific community (Bruce Alberts, Shirley Tilghman, etc) are quite \nconcerned and feel that it is time for a change.  I explained to Harold that this was probably \nReleased by Chairman Rand Paul\ntemporary and related to need for continuity related to COVID-19 efforts.   He is trying to get \nmomentum to have this reversed.   Harold has always felt that change is important \nPRESS: TNT “The Arena” with Cari Champion;\nJanuary 19, 2021 – \nReceived booster dose of Moderna vaccine today together with Francis Collins and Alex Azar.  \nSaid goodbyes to Alex and Brian Harrison (his COS).   Alex described how terrible it was \ndealing with the White House people.   He specifically mentioned Marc Short.   He feels that \nMarc, Joe Grogan, and Deb. Birx undermined HHS.\nDeb Last e-mail:\n1.The country is in a better place than we have been since before \nThanksgiving. All indicators except fatalities are improving and \nare either flat at a high plateau or declining over 8 days.  \nMonday represents weekend reporting but last night was the \nlowest case number since the beginning of Nov. Full data \ntriangulation that we have reached the post Holiday peak in \nmost of the country and declines should continue with \ncontinued mitigation. These gains can be sustained and can \naccelerate if behavior change holds and testing increases to \nfind the asymptomatic cases to prevent community spread – \nwe must find those asymptomatic cases to ensure new \naggressive variants rapidly spread undetected\nLast coronavirus Task Force meeting.  VP asked Ben Carson to start with a prayer.  VP \nPence saying goodbye and how proud he is of what the group has accomplished.  He read a letter \nthat he is sending to all of us thanking us.   He also has chronicled the “accomplishments” of the \nTF and the government’s efforts.  He will send such a letter and the list of accomplishments to \nBiden.   He thanked all of us sincerely and expressed multiple times how much of a privilege it \nwas to work for us.  He asked that we help the incoming Biden people in the transition (a little \nlate!!!)   Alex Azar warned that their work would be denigrated by the incoming group and their \npress people, but that is “natural”.  Alex delineated everything that he felt we did right.   He \nspoke of our accomplishments in testing, PPE, etc.   One would argue about that.  Deb Birx  \nspoke about how great it was in working with everyone.   She spoke of trust and belief in your \ncolleagues.  Wow, this is interesting given how often she threw CDC under the bus and how she \nReleased by Chairman Rand Paul\nand Marc Short were in disagreement on everything, and how she hated Brett Giroir and \nbadmouthed him all the time saying that he always promised more than he could deliver.  Brett \nGiroir praised the VP and said that the VP brought out the best in everyone.  VP Pence asked \nme to say words.   I praised him and also praised the VP’s staff.   I did not mention Marc Short \nand Katie Miller, but they knew I was referring to them.  Bob Redfield praised the VP as well as \nDeb Birx.  Pete Gaynor explained what a honor it was to work for the VP.  VP then thanked a \nnumber of people including Jerome Adams, VP staff, Marc Short, Katie Miller and others, \nBen Carson, Keith Kellog.   VP signed off to a resounding round of applause!\nPRESS:  The PBS Masters people have started filming in earnest for their documentary; \ninterviewed by Adi Ignatius and others for the Harvard Business Review;\nNYT: As Fauci receives his second dose, he urges Americans to get vaccinated; CNN with \nJake Tapper;\nJanuary 20, 2021 -   Global – 94,000,000/2,000,000; USA – 24,000,000/400,300  \n Inauguration Day!  Trump refusing to attend inauguration and left with a flare that was very \nsparsely attended.   Biden was at Mass as Trump flew off to Mar-a-Largo.   Trump’s speech was \nsurrealistic talking about all the great accomplishments of his Presidency.   He also strongly \nhinted that he will be back with a “movement”.   He is a very dangerous man!!\nI am preparing for my early AM speech to WHO Executive Board tomorrow.  Beth Cameron has \ngiven me much leeway on the Speech (which her staff put together).  \nMutants of SARS-CoV-2 getting much play in the scientific “preprint” arena.   Final papers will \nsoon come out.   We will put restrictions (requirement for pre - and post - flight testing + \nquarantine) from RSA.  Will brief POTUS Biden tomorrow.\nAm still quite achy from vaccine booster shot from yesterday.\nHere are my remarks for WHO tomorrow early (4:00 AM) morning:\nRemarks of Dr. \nAnthony S. Fauci at          \nGot a call from Jared Kushner from Air Force 1 on his way to Mar-a-Largo thanking me for \nwhat we did with COVID-19\nSpectacular Inauguration speech by Biden!  Poem by Amanda Gorman was amazing (she is \n22 years old).   Lady Gaga sang the national anthem; J-Lo sang, as did Garth Brooks.   Biden hit \nthe right tone.   The speech was in my mind comparable to those of Lincoln, Kennedy, FDR\nReleased by Chairman Rand Paul\nQuotes from speech:  “Let us not lead by example of power, but by the power of example”;  “We \nmust end this uncivil war”\nPRESS:\nCNBC - Dr. Fauci to lead U.S. delegation at WHO \nmeetings as Biden plans to reverse Trump \nwithdrawal \nPublished Wed, Jan 20 20218:41 AM EST\nNoah Higgins-Dunn@higginsdunn\nJanuary 21, 2021 – Global – 95,000,000/2,000,000;   USA – 24,300,000/405,000\nMade speech at Executive Board of WHO (4:00 AM ET) to announce that USA is rejoining \nWHO.   Also, we are rescinding Mexico City Policy.  I spoke as representing newly \ninaugurated President Biden\nRemarks of Dr. \nAnthony S. Fauci at          \nTedros response:\nWHO Director-General's remarks at the 148th \nsession of the Executive Board\n21 January 2021 \nThank you, my brother Tony, and welcome to the WHO Executive Board as head of delegation for the \nUnited States of America. \nThank you, my friend, for your personal support for WHO over many years, and especially in the past \nyear.\nReleased by Chairman Rand Paul\nWe have benefited immensely from your participation as a member of our regular global health leaders \ncalls, since the start of the pandemic.\nAnd thank you for your incredible leadership against the pandemic in the United States.\nThis is a good day for WHO, and a good day for global health.\nI send my deep thanks and warm congratulations to President Biden and Vice President Harris, and to \nthe American people.\nTerrific day!   Briefed Biden and Harris in the State Dining Room of the White House.  \nTogether with JZ, Natalie Quillian, Rochelle Walensky, Marcella Nunez-Smith.  Really relaxed \nand warm interchange with both Biden and Harris.  Then, I went with Jen Psaki and did a press \nbriefing in the White House press room (first time in a long time).   They really want me out \nthere and there is no pushback at all for my appearances.   CNN went into major panel \ndiscussions about the fact that Biden chose me as the first scientific press briefing.\nPRESS:   Did full press briefing in the White House press room.\nWashington Post article by Philip Bump:\nFauci, unchained\nThe government’s leading infectious-disease expert exults in \nbeing able to speak frankly\nFauci says it's 'liberating' to 'let the science speak'\nGood Morning America (ABC) with Michael Strahan; CBS Sunday with Ted Koppel; \nCNN with Chris Cuomo;\nJanuary 22, 2021 – Global – 96,000,000/2,000,000; USA – 24,500,000/409,000\nSome confusion about whether 100 million doses in 100 days or 100 millionb people in 100 \ndays.   Finally straightened it out and it is “doses” not “people”.   Press are starting in aready in \nfirst criticizing that the goal is too lofty and now they are saying that the bar is tyoo low since we \nare already getting 800K per day.   You just cannot win.\nReleased by Chairman Rand Paul\nPRESS:  CNN New Day with John Berman;  Black News Channel with former Mayor \nSharon Pratt; WTOP Radio with Mike Murillo; University of Montana Student newspaper \n(Jacob Owens); NPR – “All Things Considered” – Mary Louise Kelly; NBC LX TV with \nTabitha Lipkin and Ashley Holt;  Conference of Mayors Panel – with Vivek Murthy – \npicked up by networks, cable, and C-SPAN; MSNBC – Rachel Maddow;\nJanuary 23, 2020 – Global – 97,000,000/2,000,000; USA – 24,700,000/413,000\nPRESS:  Vaccine Town Hall with Ebro Darden & Kizzy Corbett; MSNBC with Alex Witt; \nInterview with Donald McNeil for the New York Times on my experience with the Trump \nadministration; MSNBC “Politics Nation” with Rev. Al Sharpton;\nStat:\nThe 10 Biden officials to watch \non the Covid-19 response\nBy R A C H E L  C O H R S  @rachelcohrs\nJ A N U A R Y  2 1 ,  2 0 2 1\nReleased by Chairman Rand Paul\nJanuary 24, 2021(Sunday) – Global – 97,500,000/2,100,000; USA – 25,000,000/416,000\nDeb Birx had a 45 minute taped interview with Margaret Brennan right after me.   It was moving \nin some respects, but a fair bit of revisionist history. \nPRESS: CBS “Face the Nation” with Margaret Brennan; CBS Sunday with ted Koppel; \nDonald McNeil interview in the NY Times: NYT: Fauci on What Working for Trump Was \nReally Like\nJanuary 25, 2021 – Global – 99,000,000/2,100,000; USA – 25,000,000/418,000\n•Did really good WORLD ECONOMIC FORUM Panel chaired by John Mickethwait \n(Bloomberg) with panelists: Prime Minister of Greece Kyriakos Mitsotakis; Nancy \nBrown (CEO of American Heart Association) and Frans van Houten (CEO of Royal \nPhilips)\n•The vaccine is now being referred to as the “Fauci Ouchie”\n•Many interviews today focusing in part on the fact that Deb (on Face the Nation) and I \n(in the interview with Donald McNeill) opened up about the difficulties in dealing with \nTrump Administration.\nA lot of discussion about the RSA and UK variants and the potential effect on mAbs and \nimportantly vaccines.  Thus far, even though the mutants diminish somewhat the efficacy \nof the vaccines, the antibody response of the vaccine is still within the cushion of \nefficacy.   Recent data indicate that the UK strain is also increased in virulence as well as \ntransmissibility.\nOn an interview with Erin Burnett (CNN) I went\nPRESS: Good Morning America (ABC) with George Stephanopoulos; Today Show with \nSavannah Guthrie; CBS This Morning with Tony Mason;  Latino USA Radio with Maria \nHinojosa (NYC); Fireside chat with Leroy Hood on receiving the 2021 Precision Medicine \nWorld Conference Luminary Award; WBUR Boston NPR Radio; WGN Radio Chicago – \nBob Sirott Show;  ABC TV News Live Lindsey Davis;  Spectrum News TV with Alex \nCohen; CNN with Erin Burnett;\nJanuary 26, 2020 - Global – 99,000,000/2,100,000; USA – 25,200,000/420,000\nVP Harris visited NIH for her booster shot with Husband Greg Emhoff.   She and I did a PSA \ntogether.\nHad moving conversation with Moncef Slaoui who felt that the Biden people were discrediting \nand bad-mouthing OWS that Moncef led.   In fact, Moncef did a fabulous job in getting 2 \nReleased by Chairman Rand Paul\nvaccines (Moderna and Pfizer) approved (EUA) that are highly efficacious with other candidates \n(Janssen, AZ, Novavax) not far behind.   He feels badly for the OWS team and for himself.   I \ntold him that he has done a fabulous and historic job in what he accomplished.   I told him that to \nme and many others, he is a hero.  He was very touched by the conversation.\n•Got on my usual Tuesday evening Zoom call with health officials throughout the country \n(Hosted by David Barr) and asked question of what the problem was with doses of \nvaccine.   Was it that we had doses but could not logistically get them into the arms of \npeople OR was it that the demand far outstripped the supply.   Overwhelmingly they said \nthat there was not enough supply.   Group was:  Sharon Balter (LA), Jeff Duchin \n(Seattle), Jennifer Avegno (NOLA), Allison Arwady (Chicago), La Quandra Nesbitt \n(DC), Marci Layton (NYC)\n•Spoke with basketball mega-star Karl-Anthony Town.   Terrific young man. He has \nCOVID-19.   His mother died of COVID-19.   He is Columbian and was brought to my \nattention by Congressman Espaillat from NYC who is Columbian.\nPRESS: FOX America’s Newsroom with Dana Perino and Bill Hemmer;  NBC TV Special \nwith Richard Engel; \nReleased by Chairman Rand Paul\nJanuary 27, 2020  - Global    USA\nReally good relations developing with the WH Comms team led by Jen Psaki and particularly \nCourtney Rowe.   Dramatic difference from Trump WH Comms\nDid “Fireside Chat” with NEJM – Eric Rubin and Lindsey Baden\n•315 cases of the B.1.1.7 lineage (UK) in 28 states; RSA lineage B.1.351 is worrisome as \nit is evading mAbs and diminishing neutralizing caoacity of Abs from vaccines.\nVery important historical review in USA Today about the development of the Moderna \nvaccine:\nUSA Today: Luck, foresight and science: How an unheralded team developed a COVID-19 \nvaccine in record time  https://bit.ly/36i7ffM  \nPRESS: White House Press Conference with Walensky, Fauci, Slavitt, and Zients; The Hill \nTV with Steve Clemons; Fox America Reports TV with John Roberts and Sandra Smith; \nPBS South Florida Town Hall; CNN  Town Hall with Sanjay Gupta and Anderson Cooper \n– on with Rochelle Walensky;\nDaily Beast:\nDr. Fauci Shoots Down Fox News Host Bill \nHemmer’s Trump Questions\n‘READY TO MOVE ON’\n“It just seems like there’s this aggressiveness toward the Trump administration,” Fox News anchor Bill \nHemmer pressed. Dr. Anthony Fauci wasn’t having it.\nReleased by Chairman Rand Paul\nArticle in The Atlantic by Peter Nicholas – will clearly cause a stir:\nHow Anthony Fauci Got Through the ‘Bullshit’\nThe new White House chief medical adviser reflects on the last year working for the Trump \nadministration.\nPeter Nicholas\nFOX News:  Fox News pundit Steve Hilton pushed a \nridiculous conspiracy theory that Dr. Fauci is \nbehind the coronavirus\nJanuary 28, 2020 – Global – 100,200,000/2,200,000;  USA – 25,500,000/428,000\nTedros called me up and aske me to help him connect with the Biden people, i.e. Sec Becerra, \nJeff Zients, the VP, etc.   Stewart Simonson willing to help me since I am ultra busy.\nHad confidential conversation with the Janssen people – Paul Stoffels et al about the Ad26 \nvaccine data.   Not that great.  77% VE in USA and ~50% in RSA.   Will get more details later.   \nData better against severe disease but this will be a messaging problem.\nNovavax and Janssen came out with their embargoed (until tomorrow) results of their trials: \nNovavax phase 3 in UK – 90% VE; Phase 2b in RSA – 50% VE.\nJanssen  phase 3 in USA/RSA/Brazil -  72% VE at 28 days (a 1 dose vaccine); 85% VE against \nsevere disease; 57% VE in mod/severe disease in RSA at 28 days and 88% VE with severe \ndisease in RSA\nMuch press activity and emphasis on the fact that antigenic variation has clinical consequences.   \nAlso, with both vaccines, good news for the global supply\nPRESS: Good Morning America (ABC) with George Stephanopoulos; NPR Morning \nEdition with Sarah McCammon;\nJanuary 29, 2020 – Global    USA\n•Fireside Chat with NYC Health Commissioner David Chokshi\nReleased by Chairman Rand Paul\nMet with Jeff Zients and Team to discuss what to do with 2nd dose of vaccine, i.e. hold it \nback completely, hold it back 90%??\nPRESS:  Did press conference at NIH for the release of the Janssen data; Did White House \npress conference for COVID-19 in general;  PBS NewsHour with Judy Woodruff; NBC \nNightly News with Lester Holt; WUSA TV with Gabe Cohen; New York Press Club \nFireside Chat with Steve Scott; Filming with Sanjay Gupta for CNN Documentary;\nJanuary 30, 2021 – Global – 101,400,000/2,200,000; USA – 25,900,000/435,2000\nDaily cases continue to come down, but growing concern about the arrival of mutants: B.1.1.7 \n(UK) in 30 states and 434 people infected; B1.351 (South Africa) with 2 cases in South Carolina; \nP.1 (Brazil with 1 case in Minnesota\nRSA strain identified today in person in Maryland\nWent on a filmed walk with Sanjay Gupta and Chris on the C & O Canal as part of the \nDocumentary that he is doing (See yesterday).\nHad zoom call with Rob Manfred (Commissioner of MLB) and Dan Halem (Deputy \nCommissioner).   They want to delay opening Spring training from February 17 to March17 and \nhave a comparable delay in opening day.   They want to do this since they feel (rightly so) that \nthe decreases in cases will be even more pronounced with an additional month and they will be \nable to get more of the umpires and players vaccinated with the delay.   Of note, Tom Frieden \nspoke with the MLB Players Association and the players want to start earlier since it affects their \nsalaries.   Now the Players want to speak with me.\nReleased by Chairman Rand Paul\nJanuary 31, 2021 (Sunday) – Global – 102,100,000/2,200,000;   USA – 25,900,000/438,000\nZoom calls today discussing: a) vaccinations for the Federal workforce b) Vivek just wanting to \ndiscuss masks, variants, schools, etc. – touching base.\nFebruary 1, 2021 – Global – 102,600,000/2,200,000;  USA -26,000,000/440,000\nHad usual MWF Press conference by Zoom\nHad discussion with the team (+John Mascola) about how best to utilize the J & J product \n(Ad26).   There will be a messaging issue about 72% versus 94-95%.   We cannot designate it for \nany specific group for that reason and so we decided to just out it in the mix with the other \nvaccines and have people make their choice based mostly on 1 dose vs 2 doses.\nGot call tonight from Mayor Bill Di Blasio very concerned that the supply of vaccine for NYC is \nno where near meeting demand.   He is begging me to check with WH and see  if anything can \nbe done – DPA or some other mechanism.  I will speak with David Kessler about this.\nPRESS:  White House Press conference with Nunez-Smith, Walensky and Slavitt; mGreta \nvan  Sustern – VOA; KMEX 34 TV – Los Angeles – Hispanic; CNN Situation Room with \nWolf Blitzer\nFebruary 2, 2021 – Global – 103,000/2,200,000; USA -26,200,000/442,000\nDaily cases going down but deaths still lagging at around 3000 per day\nReleased by Chairman Rand Paul\nMutants continue to evolve with the 484K mutation characteristics of the B.1.351 lineage in RSA \nnow being seen in the UK with the B.1.1.7 lineage.   Goes along with what I have been saying \nthat viruses will mutate if you give them free rein to replicate.   Viruses that do not replicate will \nnot mutate.\nBill DiBlasio called me back and I explained to him that I had spoken to David Kessler about the \nSupply-demand issue with the vaccines and that there really was no solution.  It is too late to \ninvoke the DPA to have other factories make mRNA vaccine.   By the time they gear up, there \nwill be enough vaccine from multiple companies to vaccinate the entire country.\nMet with POTUS and VP in the Oval office  with Jeff Zients, Natalie Quillian, Andy Slavitt \nand Walensky and Nunez-Smith on video screen.   Discussed the status of the outbreak \n(Walensky) and vaccines, particularly recent data on J & J and implications for variants (Fauci)\nPRESS:  Washington Post Live – Online interview with David Ignatius; Australia  “60 \nMinutes” TV; MSNBC “All In” with Chris Hayes; CNN with Don Lemon\nWashington Post – 02/02/2021: Poor handling of virus cost Trump his reelection, campaign \nautopsy finds  “Voters in the states overwhelmingly supported a mask mandate — 75 percent — and \nAnthony S. Fauci, the country’s top infectious-disease specialist, secured an approval rating almost as \nhigh. Trump did not support a mask mandate — sometimes mocking the wearing of masks — and \nregularly criticized Fauci, threatening to fire him at times.\nAdvisers repeatedly encouraged Trump to wear a mask, stop attacking Fauci and signal to the public that \nhe was taking the coronavirus more seriously”\nReleased by Chairman Rand Paul\nHow Anthony Fauci beat Donald Trump in \n2020\nFebruary 3, 2021 - Global   USA\nBiden Comms team putting me out there with the press continually.  They are giving me totally \nopen clearance for everything that I get asked to do.   Completely different from the ridiculous \nrestrictions of the Trump Comms team\n•Daily cases continuing to come own.   Much emphasis on the impact of the variants. \nReleased by Chairman Rand Paul\nPRESS: ABC Good Morning America with George Stephanopoulos; NBVC Today Show \nwith Savannah Guthrie;\nFebruary 4, 2021 – Global – 104,000,000/2,3200,000; USA – 26,400,000/449,000\nDiscussions last night and prior evenings regarding the use of the excess J & J vaccine of clinical \ntrial grade.   Move to donate this to RSA to vaccinate their HCWs.   RSA has been pleading with \nthe USA to help them get vaccines since they are being ravaged by the B.1.351 variant.  Phone \ncall last night with David Kessler, Beth Cameron/Hilary Marston (NSC), me and Cliff Lane to \nfigure out a mechanism to get this to them since it is only clinical trial grade. And we want to \navoid the optics that we are either a) giving away vaccine meant for USA to RSA or b) we are \n“experimenting” on black Africans.\n•Gave one of several plenary addresses at a Brookings -Tsinghua University Roundtable \nof US-China Collaboration on COVID-19. Chinese Speakers included Zhong Nanshan, \nWang Chen, Gao Fu\nHad nice conversation with the MLB Players Association with Tony Clark (Exec Director), \nBruce Meyer (Senior Director, Collective Bargaining and Legal), Ian Penny (General Counsel), \nKevin Slowey (Director Player Services), Matthew Nessbaum (Deputy General Counsel), Robert \nLenaghan (Assistant General Counsel) and Max Scherzer (member, Exec. Comm.).   They asked \ngreat questions about vaccines.   I emphasized that I did not want to get in the middle of a \ndispute between MLB and players regarding when to start the season.   They understood \nperfectly.   I had some nice back and forth with Max Scherzer.\nPRESS: BBC Radio with Tim Harford; NBC TV Boston – LaToya Edwards; MSNBC with \nAri Melber; NBC TV “off the record” discussion with the entire NBC TV team; CNN with \nChris Cuomo.\nFebruary 5, 2021 – Global   USA - \nHad terrific conversation today with Bob Cousy.   Sen. Joe Manchin (D-WV) had called me a \ncouple of weeks ago saying that Bob Cousy would love to connect with me by phone,   Joe is a \ngood friend of Cousy’s.   I called Bob’s cell phone and we spent 20 minutes chatting about all \nkinds of things.   He has a great sense of humor.   He is disturbed by the devisiveness in our \nsociety (similar to my concern).  He spoke about his being 92 years old and that he body in \n“falling apart” despite the fact that he has “all my smarts”.   He is a rally charming guy.   We \ndeveloped a great rapport on the phone.   Note that he came to my lecture at Holy Cross a few \nyears ago and we had dinner together.\nPRESS: Had usual White House Virtual Press Conference with Andy Slavitt, Rochelle, me \nand Tim ….; FOX TV with Neil Cavuto;\nReleased by Chairman Rand Paul\nFebruary 6, 2021- Global -105,000,000/2,300,000;  USA – 26,700,000/458,000\nHad Zoom call with David Kessler and the BARDA people trying to decide whether to invest \nconsiderable money in guaranteed purchase of the Lilly mAb combination that will soon go for \nan EUA.   Their data look fairly good for treatment of early disease to prevent hospitalization \nand PEP\n•Got call from Mike Osterholm trying to convince me to go with his \nconcern/recommendation that we go with1st doses to as many people as possible given \nthe fact that B.1.1.7 (UK) may become dominant in the USA and increase \ncases/hospitalization.   This is a difficult problem sine we only have data for prime/boost \nwith mRNA vaccines.\nFebruary 7, 2021 (Sunday) – Global – 105,400,000/2,300,000;  USA – 26,800,000/461,000\nSuperbowl Sunday!   Tom Brady beast Patrick Mahomes\nPRESS:  Meet the Press (NBC) with Chuck Todd; \nReleased by Chairman Rand Paul\nFebruary 8, 2021 – Global – 106,000,000/2,300,000;  USA – 27,000,000/462,000\nImportant point is that the vaccines are protecting against severe disease (hospitalization and \ndeath):\nFirst day since Nov. 2 that daily cases were less than 100,000:\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nKat McKinnon played me again on Saturday Night Live: https://bit.ly/36SyePm \nDid fireside chat with Prince Georges County -  County Executive Angela Alsobrooks and Drs. \nCarter and Wright to discuss vaccine in the African-American community\nPRESS: AP Interview with Mike Stobbe; FOX TV News “Special Report” with Bret Baier\nFebruary 9, 2021 – Global – 106,100,000/2,300,000; USA – 27,000,000/464,000\nReleased by Chairman Rand Paul\nEric Lander (OSTP) visited the VRC today and I we briefed him on our activities, particularly \nthe development of the mRNA vaccine and Barney’s development of the stabilized pre-fusion \nSpike protein.\nOf note, Martin Fletcher of the Daily Telegraph did a profile of me and told me that the London \nTimes had asked him to gather information for them for an obituary that the Times wanted to put \n“in the can” just in case I passed away suddenly.   They wanted to be the first to have an obituary\nPRESS:   Fireside Chat with the COVID Collaborative – Gov. Dirk Kempthorne, Gov. \nDeval Patrick, and Gary Edson; Interview with Martin Fletcher of the Daily Telegraph for \na profile of me; \nFebruary 10, 2021 – Global – 106,600,000/2,300,000; USA – 27,000,000/467,000\nCases continue to fall considerably.   We are now at less than 100,000 cases per day, when we \nwere up to 400,000 at one time.\n•Had zoom with Dr. Hans Kluge WHO Regional Director for Europe\n•Did Fireside Chat with David Rubenstein as part of the Duke Global Health Institute \nVictor Dzau Lecture\n•Pleasant thing – I had mentioned on a radio or TV show that what I missed most about \nNYC was the Nathan’s hot dogs.   Today sitting on my home from steps were two \npackages of Nathan’s hot dogs – a gift with a nice note from Tim Shriver saying that he \n“could not resist the hot dog invitation”. \nReleased by Chairman Rand Paul\nHad a wonderful experience this evening.   I received (virtually) the Award of Courage from \nAmFAR.   It was presented to me virtually by Julia Roberts  from her breakfast room in her \nhome in Northern California.   She was so charming.   When my image came up on the screen \nshe gasped and said that every time she sees me her throat gets dry and she gets nervous and \nexcused herself to go into the kitchen and get a glass of water.   When she came back and \nintroduced me it was the most wonderful introduction.  She introduced me to her son while we \nwaited to check the filming and we chatted a bit.   She is so charming, natural, fun and amazingly \nbeautiful.\nPRESS: Did routine MWF White House Press conference.  I spoke about making sure that \npeople with immune deficiencies or on immunosuppressive drugs get vaccinated since they \nare very vulnerable; Interview with Rima Krist of the Navajo Times\nFebruary 11, 2021 – Global – 107,000,000/2,300,000;   USA – 27,100,000/470,100\nNumber of daily cases continue to diminish.  CDC starting to do practical things that I have \nactually been pushing for some time.   For example:   Wearing 2 masks could be better than just \none.   They did a dummy study and showed that a cloth mask over a surgical mask actually gives \na more complete fit and keeps out aerosols.   Another example is that people who are vaccinated \ndo not need to go into quarantine after exposure to a documented COVID-19 case.\nReleased by Chairman Rand Paul\nPOTUS Biden visit to NIH.  Biden visited the NIAID VRC today at 3:30 PM on a sleety and \nsnowy day.   It was a great visit.  I presented to him the history of the VRC and the importance of \nthe work that Barney Graham has done with the stabilized spike protein.   We brought Biden into \nthe room where the experiments were done and Barney and Kizzy Corbet presented to him.   He \nwas accompanied by Jeff Zients.   We then went to Natcher Auditorium where he addressed \n(virtually) the NIH community with a great speech in which he called out Francis and I multiple \ntimes.\nPRESS:  Today Show (NBC) with Savannah Guthrie – discussed new mask \nrecommendations from CDC and the B.1.1.7 variant; BBC Radio; “What a Day” podcast; \nCNN Sports TV with Charles Barkley and Ernie Johnson; Univision TV interview; Axios \nTV for HBO – update with Margaret Talev\nNice article in Vogue:\nFor Dr. Anthony Fauci and Dr. Christine Grady, \nLove Conquers All\nBy Michelle Ruiz\nPower Players\nCNBC:\nBill Gates and Dr. Fauci talk regularly — here’s \nwhat they’re discussing now\nPublished Thu, Feb 11 202112:25 PM ESTUpdated Thu, Feb 11 202112:26 PM EST\nCory Stieg@corystieg\nFebruary 12, 2021 – Global – 107,000,000/2,400,000; USA – 27,200,000/474,000\nDavid Kessler and I had discussion with Sen. Burr and Murray about viral variants.   They \nwanted to be briefed on the threat and what we are doing about it.\nDid a briefing of the Foreign Press with Andy Slavitt\nReleased by Chairman Rand Paul\nBriefed the Deputies and Cabinet Secretaries  led by Jeff Z.  \nPRESS:  Good Morning America (ABC) with George Stephanopoulos; Univision TV with \nJorge Ramos; ABC/FOX Montana TV; Podcast with Al Franken;\nFebruary 13, 2021 – Global – 107,800,000/2,400,000; USA – 27,300,000/479,200\n•Trump acquitted by the spineless GOP Senators.   However, 7 GOP Senators did vote for \nconviction.   Sorry day for our country.   Trump still has them in his grip.\nFebruary 14, 2021 – Global – 108,200,000/2,400,000;  USA – 27,400,000/482,500\nCases continue to come down.   People like Mike Osterholm are saying that we will inevitably \nhave yet again another surge due to B.1.1.7 that will become dominant.   I do not necessarily \nbelieve that this will be the case.   I believe that if we double down on public health measures \nand continue to push vaccinations, we do not necessarily have to experience a surge.   Having \nsaid that, WE MUST BE PREPARED FOR A SURGE.\nReleased by Chairman Rand Paul\nPRESS:  ABC “The Week” with George Stephanopoulos\nFebruary 15, 2021 – Global – 108,600,000/2,400,000;  USA – 27,500,000/484.000\nDown to 68,000 cases yesterday!\nReleased by Chairman Rand Paul\nDid  Zoom call with Winnie Byanyima (Exec Dir. Of UNAIDS) together with Regan Hofmann.   \nWinnie was very grateful for my leadership in COBID-19 and HIV/AIDS.   We discussed the \nimportance of having a global effort (hopefully led by USA) to get the world vaccinated against \nCOVID-19.   Winnie was excited about the fact that I mentioned the loosening of patents in a \nrecent interview to allow wider availability of COVID-19 vaccines.    I promised that I will \ncontinue to push the “international and global” agenda.   I mentioned that we would need to get \nthings under better control in the USA before we would be able to generate interest in global \nissues.\nPRESS:  Telemundo HOY DIA TV;  NBC Local TV Doreen Genzler; \nNPR (Daniel Estrin):  \nThe Coronavirus Crisis \nFauci Awarded $1 Million Israeli Prize For \n'Speaking Truth To Power' Amid Pandemic\nFebruary 16, 2021 – Global – 108,800,000/2,400,000; USA – 27,500,000/485,100\nReleased by Chairman Rand Paul\nCases continue to come down globally:\nMedia trying to show discrepancies in the Biden team response.  CDC and \nWalensky under criticism for their recent guidelines for opening schools since they \nare really quite confusing.   They say open the schools but the guidelines show that \n85-90% of the country is in the “red” zone and therefore, should hold off on \nopening.  I believe that this is typical CDC confusion and lack of clear crisp \nguidelines no matter who is CDC Director.  Also, the are pitting (a little) what I am \nsaying against what VP Harris is saying.   VP saying that we have to “start from \nscratch” in the vaccine roll out and I have been saying that some things were done \nwell such as the mechanism for shipping vaccines.  I reconcile this by saying that \nthe mechanisms for getting doses into people’s arms were in bad shape when the \nBiden team came in.   The press are accepting this.\nBriefed (together with Francis Collins, Rochelle, and Janet Woodcock) the House \nand Senate Caucuses on COVID-19 variants\nPRESS: CNN with Jim Sciutto;  LA Times TV; NPR – “Science Friday” with \nIra Flatow;\nNew York Post:\nReleased by Chairman Rand Paul\nEverything you need to know about Fauci-ing, \nthe new COVID dating trend \nBy Emily Jacobs\nFebruary 17, 2021 – Global – 109,200,000/2,400,000; USA – 27,600,000/486,400\nCases continue to plummet:\nColumbus Citizens Foundation's Dr. Anthony S. \nFauci Scholarship - Created For Graduate \nStudents In Medical And Public Health Fields - \nNow Accepting Applicants \n•Did Fireside Chat with AME Reid Temple Church (Maryland) – Pastor Mark Whitlock\n•Did podcast “Pod Save America” with Jon Favreau\nReleased by Chairman Rand Paul\n•Did podcast with James Hildreth from Meharry Medical College\nPRESS: CBS This Morning with Gayle King and Tony Dokoupil; Online TV interview \nwith Clive Cookson (Editor, Financial Times) for the UK Science Museum event;  White \nHouse Press Conference on the usual MWF schedule; CNN “360” with Anderson Cooper.\nFebruary 18, 2021- Global – 109,600,000/2,400,000;  USA – 27,700,000/489,100\nBig Ice-storm in Washington DC and major ice storms and snow over southwest (Texas) with \nseveral deaths.   Currently heavy snow in NYC and Boston\nCases continue to drop\nBriefed President Biden today in Oval (Virtually).  I briefed him on pediatric vaccine trials \nand mentioned that we likely will have high school children (13-17 yo) vaccinated by mid-Fall, \nbut it would take until Q1 of 2022 to get the trials done and approval for elementary school \nchildren (6 to 12 yo).   He asked good questions but he rambled a bit, seemingly repeating things \nthat he had said a few minutes previously.\n•Did really fun “Fireside Chat” with Karl-Anthony Towns (All-Star NBA Player – Rookie \nof the Year in 2015-2016) and “Dominicans on the Hill”.    He had COVID-19 and` his \nmother died of COVID-19.   We gave good messages to the Dominican community\n•Spoke with the PEPVAR group about USA providing $4-5 billion to build plants to \nproduce Moderna mRNA for the world – Peter Staley, James Krellenstein, David Barr, \nChristian Urrutia, Wafaa El Sadr.   I will bring this up to Jeff Zients.\nPRESS: MSNBC with Andrea Mitchell; Council on Foreign Relations podcast – “Why it \nMatters”;  Interview with Char Koosta News (discussed tribal Vaccine hesitancy with Sam \nSandoval);  Interview with Times of Israel on my Dan David Prize; Interview with Alice \nPark of Time Magazine on 1st 100 days of Biden Administration; Did Buzzfeed interview \nwith Dan Vergano on the Fateful March 11, 2020 when we shut down Europe.\nFebruary 19, 2021 – Global    USA\nOnline preprint paper cam out from Israel saying that a single dose of Pfizer mRNA protected \nwell (85% at 15-28 days against symptomatic disease and 72% against symptomatic and \nasymptomatic disease).   9000 individual study of young and healthy people.  We do not know \nthe durability of this protection.   I made point at the press conference (see below) that we will \nReleased by Chairman Rand Paul\nstick with the 2 dose since we know from our studies that the 2nd dose increases the response 10-\nfold over the 1st dose.   This height of response gives a cushion against the existing variants and \nalso if you have a less-than-optimal response (albeit a good response) to the 1st dose, you may \nactually “select” for more variants.\n•Call from Jeff Sachs about the International Monetary Fund (Special Drawing Rights – \nSDR) and the possibility of a $40-$50 billion dollar program to vaccinate the entire \nworld.   He wants me to have a special role.   Moe later.\n•Gave Harvey lecture virtually at Georgetown\n•Met with Francis C, Carl D, John Martin, and Larry Tabak about the COVID targeted \ndrug development program that I am trying to set up with the $743 million that we put \ninto our total NIH budget request.   It will be based in NIAID with Carl as the lead.   As \nusual Francis wants governance to be somewhat under his control.   All good.   We will \nget it done.\nPRESS:  Interview with Erin Banco – The Daily Beast; White House Press Conference; \nESPN Baseball TV with Buster Olney; interview with Ben Samuels of Haaretz Israel \nNewspaper (he tried to get me involved with commenting on the policy of Israel and I \nrefused); MSNBC with Joy Reid;\nFebruary 20, 2021 – Global -110,400,000/2,400,000;  USA – 27,800,000/494,000\nPRESS:\nReleased by Chairman Rand Paul\nFebruary 21, 2021 – Global – 110,700,000/2,500,000;  USA – 27,900,000/499,000\nMatt Pottinger’s interview with Margaret Brennan on Face the Nation.  Good summary of \nhistory of the early months: https://cbsn.ws/3pGH9tR \nMike Osterholm still predicting an “inevitable” massive surge in the Spring.   He also is insisting \nthat we can study the 1 dose strategy in time for meaningful results.\nPRESS:  Sunday shows:  NBC - Meet the Press with Chuck Todd;  FOX Sunday with Chris \nWallace; CNN State of the Union with Dana Bash.\nFebruary 22, 2021 – Global – 111,100,000/2,500,000; USA – 27,900,000/500,000\nReached 500,000 deaths in the USA today!!\nHowever, numbers of new cases continue to come down.  Will be race between the new variants \nand our two tools of defense: 1) vaccine; 2) public health measures.   Luckily the mRNA \nvaccines and J & J are good against the B.117 (UK).  Even though they are less effective against \nthe B1.531 (RSA) isolate they still likely will protect against hospitalization and death – the J & \nJ definitely does (tested in RSA) and we can extrapolate that the mRNA (not yet tested in RSA) \nalso does.\nReleased by Chairman Rand Paul\nPRESS:  The Telegraph: \nhttps://www.telegraph.co.uk/politics/0/dr-\nanthony-fauci-had-publicly-disagree-\ntrump-allowed-terrible/ \nAnthony Fauci exclusive interview: 'When I \npublicly disagreed with Trump he let \nterrible things happen' \nGood Morning America (ABC) with George Stephanopoulos; CBS This Morning with \nGayle King and Anthony Mason; PBS “GZERO WORLD” with Ian Bremmer; White \nHouse Press Briefing – I outlines therapeutics and the new FDA updated guidelines to \ncompanies for handling variants; Fireside Chat with David Rubenstein upon my receiving \nthe 2021 Great Americans Medal from the Smithsonian’s National Museum of American \nHistory; Reuters online TV interview with Julie Steenhuysen; i24 TV News (Israel); \nFireside chat with  Leon Panetta at his Panetta Institute for Public Policy.\nReleased by Chairman Rand Paul\nFebruary 23, 2021 – Global -111,400,000/2,500,000; USA – 28,000,000/500,000\nHad great call with Barbra Streisand.   She called my cell at 6:05 PM.   She has recently had \nzoster with lesion on hip/buttock.  She has post-zoster neuralgia down her leg, but the primary \nlesion had healed.   She wanted to know if it was OK to get the mRNA vaccine.   I told her yes.  \nWe then stared discussing life in general.   I told her that I work listening to her songs on \nALEXA.  She really did not know what ALEXA was.   I accidentally butt called her later in the \nevening and she said that she was going to call me anyway since she wanted to know if there was \nany difference between the Moderna and the Pfizer product.   I told her none.   I then explained \nto her more about ALEXA.   I brought the phone over to ALEXA and asked to play “Songs by \nBarbra Streisand”.  When the song came on loud and clear, she started laughing and absolutely \nloved it!\nPRESS:  Yahoo News Interview\nFebruary 24, 2021 – Global – 111,800,000/2,500,000; USA – 28,100,000/501,200\nThe PBS team is here today filming their documentary.\nReceived the 2021 Larry Foster Award for Integrity in Public Communication from the Arthur \nW. Page Center (Donald P. Bellisario College of Communications of Pennsylvania State \nUniversity\nPRESS:\nReleased by Chairman Rand Paul\nFebruary 25, 2021 – Global – 112,200,000/2,500,000    USA – 28,000,000/503,600\nCases continue to come down, but yesterday was 1st day that cases actually started to back up a \nlittle.   Could be artifact.   Variants gaining much attention.  The B1.427/429 in California is \nspreading in CA and seems to be somewhat more transmissible. The new B.1. 526 in NYC is \nalso troublesome and spreading.\nIssue with J & J. VRBPAC will meet on Feb. 26 (tomorrow).   \nBig Day at the White House -   Met with POTUS and VPOTUS in the Oval office  for our \nweekly briefing on COVID.   In Oval with us was Jeff Z, Natalie Q; on screen weas Rochelle \nand Marcella.   I presented the options for the upcoming ruling on J & J for EUA.   Data on >60 \nWITH comorbidities doers not look good.  Overall USA efficacy 72%.  I also described the \nModerna efforts to do with NIAID Phase 1 trials with a boost to previously vaccinated and \nprime/boost for previously not vaccinated people using the B.1.531 (South African variant).\nThen went with the POTUS and VPOTUS to South Court auditorium to watch NIH OMS nurse \nElizabeth Galloway administer mRNA (Moderna) to 4 volunteers to celebrate before a packed \npress the 50 millionth vaccine within 37 days of Biden Presidency\nThen went to do PSAs with the White House digital Comms team.   They all wanted selfies with \nme.\nHad 5:00PM call with Janet Woodcock, Francis Collins, John Mascola, Cliff lane, Peter Marks,  \nand we decided that it would be best to recommend and EUA for people younger that 60 years \nold because the >60 years with co-morbidities had only a 42% efficacy.\nHad 6:30 PM talk led by Bechara Choucar and including me, Rochelle and Marcella at the \nrequest of Jeff Z to discuss what two vaccinated people can do together.   We were getting \ncriticism that we were not using common sense to tell people that they can now relax a bit and \nenjoy each other.   Example I give in being able to hug Jenny now that we are both vaccinated.   \nTh right wing crazies at FOX have been criticizing me for not recommending loosening up.   I \nhave true to not get ahead of the CDC sine I feel stringy that two vaccinated people can act \ntogether like there is no outbreak.   However, in society, this would be different.   My point is \nthat the risk is very small and each person should evaluate the level of risk they are willing to \ntake to start getting back to normal.  I will give my professional judgment while we are waiting \nfor the CDC to come out with some guidance.   I will be on all the Sunday Shows this weekend \nand this is what I will say.  Rochelle agrees and says that the CDC will be coming out with some \nprofessional judgment guidelines soon.\nE-mail from Leon Panetta:\nFrom:  Panetta Institute < info@panettainstitute.org> \nSent: Wednesday, February 24, 2021 8:15 PM\nTo: Conrad, Patricia (NIH/NIAID) [E] <conradpa@niaid.nih.gov>\nSubject: From Leon E. Panetta to Anthony Fauci\nReleased by Chairman Rand Paul\nDr. Anthony Fauci\nDirector\nNational Institute of Allergy and Infectious Diseases\nc/o Patricia Conrad\nconradpa@niaid.nih.gov\nDear Tony:\nSylvia and I want to express our deepest thanks for your generous participation in our Lecture \nSeries.  We broke a record with over 1,400 attendees and received a number of compliments on your \nperformance.  One of our friends – a former Trump supporter – said “I’ve changed my mind – Fauci is a \ngood guy!”  Of course, he too is Italian.\nWe look forward to one day taking you and your wife to a great Italian restaurant whether in \nWashington or here in Monterey. Either way, we are deeply grateful for your kindness and service to our \nnation.\nRegards,\nLeon\nLEP:sb\nPRESS:   Today Show (NBC) with Savannah Guthrie; Newsweek interview with Jack \nDutton (British); CBSN Interactive with Tanya Rivero;  CNN with Chris Cuomo\nFrom Axios:\n21 mins ago - Health\n\"This is a race\": Fauci urges Americans to take \nwhatever COVID vaccine is available\nSarah Mucha\nGood summary of the year:\nReleased by Chairman Rand Paul\nA year after Trump said coronavirus was \n‘under control,’ a look back at the first news \nstories\nPresident Donald Trump at the Centers for Disease Control and Prevention in Atlanta on March 6, 2020. \n(Alex Brandon/AP) \nBy \nPhilip Bump\nFeb. 24, 2021 at 9:36 p.m. UTC\nFebruary 26, 2021 – Global – 112,600,000/2,500,000;  USA – 28,200,000/506,800\nCases continue to fall however we're paying considerable attention to the possibility of surges \nassociated with the variants.  Of note, Pfizer is planning to do a boost at about six months in \norder to increase the level of neutralizing antibodies that could cover indirectly the variants. OK \n put together a zoom meeting for me to talk to members of the RED organization to discuss the \nglobal aspects of the COVID-19 pandemic. They were people from all over the world whom I \ndid not recognize but several of them were apparently famous artists and entertainers. One of \nthem was Larry Gagosian who is a very famous art dealer. The tone of the discussion and the \nquestions was the importance of a global response to a global pandemic. In this regard I stressed, \nand they totally resonated with me, the importance of making vaccine available to the entire \nworld since an outbreak in any part of the world is threatening to every part of the world. There \nwas some nice warm interchange between Bono and I at the beginning of the discussion and \nthroughout. He mentioned that his son has started a rock band and since his son has asthma they \ncalled the band the inhalers.  \nUnfortunate and sad situation – Received a call from Tony DiNovi, Chair of the Board of \nTrustees of Regis High School, that Father Dan LaHart has been removed indefinitely from the \nPresidency of Regis High School.   Apparently, he was involved in sexual impropriety with adult \nmale members of the Regis community.  There is also an issue of alcohol abuse.  He is currently \nsecluded in a treatment center.  Tony called me because the story will likely be in the New York \nReleased by Chairman Rand Paul\nTimes on Monday and the press might be calling me since it is widely known that I am strongly \nconnected with Regis\nPRESS: We had the usual White House press conference on the Monday , Wednesday, \nFriday schedule; CBS 60 Minutes PLUS (taped);  MSNBC Town Hall with Joy Reid.\nFebruary 27, 2021 – Global – 113,200,000/2,500,000;   USA – 28,300,000/509,000\nHad good conversation with Ashish Jha. He is a good guy and he wants to understand much \nbetter why I am insisting on a single dose of the vaccine rather than adhering to what others are \nsuggesting about giving all one doses and then worrying about the second dose three months \nlater in order to protect as many vulnerable people as one can. I explained to him our strategy \nthat the major concern is the evolution of mutations (variants) that would not be covered by a \nless than optimal level of neutralizing antibody. We know that when we look at the in vitro data \nthe variants diminish the efficacy of the vaccine-induced antibodies; however, the high levels of \nantibodies induced by the 2nd dose give some degree of protection  (cushion) even against the \nmutants. Therefore. we are concerned that if we only give first doses and we wait three months \nor more to give the second dose that variants may dominate and infect the suboptimally protected \npeople. In addition, a suboptimum level of response could actually select for mutants. In \naddition, there was no reason why we cannot dramatically increase the administration of doses \ntogether with the markedly increased availability of vaccine such that we can have our cake and \neat it, namely, we can give a lot more first doses at the same time as we keep up with the second \ndoses. We really need the CDC or another organization to model that. I will explain this all to \nRon Klain on Sunday. \nI had an important conversation today led by Janet Woodcock and Peter Marks of the \nFDA about the J & J EUA. Also on the call were Francis Collins, Cliff Lane, and Rochelle \nWalensky.The subject matter was that their advisory committee (VRBAP) for consideration for \nan EUA for the J & J product (Ad26). The committee unanimously and  strongly recommended \nan unqualified EUA even though the data for elderly individuals older than 60 years old with \ncomorbidities was 42%. However, there were not enough data points to be able to make a \ndefinitive statement that there is a significant diminution of efficacy in that subgroup. Janet and \nPeter are very concerned since they wanted the recommendation to be that the EUA would \ninvolve people younger than 60 years old. Apparently, the AC IP will go along with that \nrecommendation. Rochelle and I in our conversation with Jeff Zients had decided that when \nasked by the press we would say that this is an excellent vaccine equivalent to the other two. It \nmight become problematic if the press focuses on that group older than 60 years old with \ncomorbidities. The fact is that the numbers are so low that you cannot say anything about the \nsubgroup analysis.  Janet and Peter will face the press tonight. We help them to get a consistent \nmessage with ours. This is critical since I will be on four of the Sunday talk shows tomorrow. \nThroughout the late afternoon I was on several calls with Jeff Z who kept on checking with \nRon Klain regarding what the right approach would be when asked on TV about what \npeople who had both doses of vaccine could do with each other such as having a dinner with \nReleased by Chairman Rand Paul\nfamily and a few guests all of whom were vaccinated. Ron was quite concerned that I not go too \nfar out on a limb and say that vaccinated people can safely interact with unvaccinated people in a \nhousehold setting. Ron was also concerned about the issue a vaccinated people interacting with \nunvaccinated children.  Finally after many calls going back and forth between me and Jeff and \nthen between Jeff and Ron and back to me again we decided to have a 3 way call among Jeff, \nRon, and me. We worked it out such that I will say that I am comfortable with adults in a small \ngathering within the home not wearing masks as long as everyone was vaccinated. Importantly, I \nwould stay that the CDC would be coming out with recommendations in the next couple of \nweeks. \nPRESS:  On Saturday Night Live played by Kate McKinnon:\nPop Culture\nSNL dreams up a Fauci-hosted game show \nwhere contestants vie for the vaccine\nTravis M. Andrews\nFeb. 28, 2021 at 12:51 a.m. EST\nFebruary 28, 2021 (Sunday) – Global – 113,500,000/2,500,000;  USA - 28,400,000/510,800\nBig topic on the Sunday shows (see below) was the EUA Issued by the FDA for the Johnson and \nJohnson adeno virus vaccine. Also, there is concern that I expressed about easing up on \nprevention modalities since the decreasing slope up infections is starting to show signs of \nplateauing. On Face the Nation( see below) Margaret Brennan showed a clip of me being \nportrayed on Saturday Night Live by Kate McKinnon.  Also, the governor of South Dakota \nKristi Noem said that I was almost always wrong. She claims that the most important parameter \nof how well you are doing is how you maintain hospital capacity. When Margaret play that clip I \nwas kind to the governor by saying different states do different things and in different ways, \nwhereas I might have pointed out that her state has the most deaths per capita by COVID-19 than \nany other state in the country.\nGot a call from Jeff that Anita Dunn saw me on all the shows and said that I was fabulous.\nFlattening of decline concerning.  We shall see what happens in the coming days and weeks. \nReleased by Chairman Rand Paul\nHad zoom call today with Ron Klain arranged by Jeff an included me Bechara, Marcela, \nRochelle, Natalie, and others. The main topic was whether we should stick with our strategy of \ntwo doses in the usual time frame or switch to one dose and extend the interval by a couple of \nmonths before giving the second dose. Ron is concerned that in November we will be criticized \nfor having let a few million people who would have been vaccinated remain UN vaccinated \nReleased by Chairman Rand Paul\nbecause we wanted to give two doses to everyone. I was the main explainer emphasizing that the \nsecond dose gives a much higher titer of antibody that will address at least partially the inevitable \nevolution of variants including those from California and importantly the B.1.526. Ron did not \nwant to tell us what to do but he wanted to make sure that we seriously considered both \nalternatives and were comfortable without decision to stick with two doses on the regular \nregiment.\nThe ACIP recommended to CDC to implement the EUA for the J & J vaccine. Now the \nCDC needs to recommend the distribution and we can start distributing 4,000,000 doses almost \nimmediately and then we will have 20 million by the end of March and a total of 100,000,000 by \nthe end of June \nPRESS:  Was on 4 Sunday talk shows:  ABC This Week with George Stephanopoulos; CNN  \nState of the Union with Dana Bash; CBS Face the Nation  with Margaret Brennan; NBC \nMeet the Press with Chuck Todd.\nMarch 1, 2021 – Global – 113,800,000/2,500,000;   USA – 28,400,000/512,000\n•We did our weekly briefing of Principals – Cabinet members and deputies\n•Did a podcast with the New Jersey Council of Churches\nPRESS: NPR Radio 1A; Podcast with Kai Kuperschmidt (Science Magazine) on HIV \nversus COVID-19 vaccines; White House Press Conference (Routine 3x/week);Satellite \nRadio Tour for Native Americans; Podcast with the Interactive Advertising Bureau (David \nCohen);\nMarch 2, 2021 – Global – 114,100,000/2,500,000;   USA – 28,500,000/513,100\nStill coming down, but the slope is changing:\nReleased by Chairman Rand Paul\nParticipated in the University of Edinburgh “Futures Conversations” Chaired by Professor \nPeter Mathieson (Vice-Chancellor, University of Edinburgh) and involving a conversation \nbetween me and Professor Nanshan Zhong (China) and Sheila Tlou (former Minister of Health \nof Botswana) on the global impact of COVID-19.  We spoke about global solidarity for vaccine \nequity.   Also, spoke about the variants.   Also, spoke about the approach that China took with \nthe outbreak, i.e. complete lockdown\nCall from Larry Horowitz.   Nancy Pelosi is angry about the fact that J & J is being equated with \nthe mRNA vaccines since she has seen the data about the people >60 yo with co-morbidities.   \nAlso, she does not like the 72% versus 94-95%  for mRNA.   She is taking her annoyance out on \nthe medical team (she has not\nReleased by Chairman Rand Paul\nPRESS: Podcast with Kai Kuperschmdt (follow-up from yesterday0; Seattle Gay News \ninterview; Interview for Pritzer Forum/Chicago Council; Hispanicize PSA taping (Paola \nRamos); Telemundo 52 Los Angeles;   \n In Washington Post (see below)\nFauci: U.S. must stick with two-shot strategy \nfor Pfizer-BioNTech, Moderna vaccines\nDelaying a second dose to inoculate more Americans creates \nrisks, infectious-disease expert says\nBy \nDan Diamond\nMarch 1, 2021 at 8:38 p.m. EST\nMarch 3, 2021 – Global – 114,400,000/2,500,000;  USA – 28,500,000/515,300\nStill plateauing:\nReleased by Chairman Rand Paul\nNote that Europe cases are going up.   They are using the 1 dose of vaccine approach:\nGovernors of Texas and Mississippi withdraw all public health measures such as masking and \nnot doing indoor dining.   I and Rochelle and Biden on TV saying that this is risky and ill-\nadvised.\nReleased by Chairman Rand Paul\nPRESS: BBC Scotland Morning Radio Show;  Black News Channel with Kelly Wright; \nBrandeis Webinar with Atul Gawande and Elizabeth Rosenthal; Town Hall with United \nFood and Commercial Worker Union; CNN with Erin Burnett;\nMy prediction, one year ago on NBC reported here by brian Williams:\nOne year ago, Fauci predicted how bad a Covid \npandemic could be\nIn March 2020, Dr. Anthony Fauci spoke with NBC News Chief Foreign Correspondent Richard \nEngel before Covid-19 became a global pandemic. MSNBC's Brian Williams shares how \nshockingly accurate Fauci's predicted ended up being.\nReleased by Chairman Rand Paul\nMarch 4, 2021 – Global – 115,000,000/2,600,000;   USA – 28,600,000/517,200\nContinuing to plateau:\nGovernors of Texas and Mississippi are pulling back on all public health guidelines such as \nmasks (removing the mask mandate), physical distance, crowds.   Press slamming them for \nthisand Rochelle and I are being asked about this on every media hit.\nHad very good discussion with Dr. Soren Brostrom, Director General of the Danish Health \nAuthority Danish representative on the WHO Executive Board AND Lone Dencker Wisborg, \nDanish Ambassador to USA on Global Health matters and potential collaboration between USA \nand Denmark in global health security and pandemic preparedness.\nAlso met with  Congressman Espaillat regarding variant B.1.526 in his district in NYC.\nHad back and forth with Jeff and Rochelle regarding the guidelines that CDC is preparing on \nwhat people who are vaccinated can and cannot do.   Jeff Wants to make sure that I am \ncomfortable with the guidelines. I looked at them in the usual manner the CDC had too many \nqualifying statements in there that were necessary. Jeff had a problem with putting a vaccinated \nperson in the same room with a person who is not vaccinated and not using masks. I convinced \nhim that we should assume the very small risk and if the person who is not vaccinated is of low \nrisk, then one does not have to wear a mask. Jeff was very sensitive in not having the White \nHouse interfere and so he went along with my suggestion that actually agreed with the CDC, \nexcept for the fact that they were not precise in their wording can I edited their document some \nwhat. The bottom line is that we would say that two vaccinated people can be indoors together in \na home setting without masks or physical distancing. In the home setting, where one person is \nvaccinated and the other person is not, the vaccinated person has a minimal risk and attention \nReleased by Chairman Rand Paul\nshould be paid to the risk of the  unvaccinated person.  If the person who was not vaccinated is of \na low risk then they can do away with masks and can be together. If the person who was not \nvaccinated is of high risk of severe disease then the vaccinated person needs to wear a mask. I \nworked with Rochelle and returned the document to her.Let us see how it ultimately turns out    \nI received the AmFAR “Award of Courage” on a virtual Gala tonight.   The award \npresented to me (recorded) by Julia Roberts\nPRESS: MSNBC “Morning Joe”  with Joe Scarborough, Mike Brzezinski, and Willie \nGeist; Interviewed with Alexis Papachelas of Greek Kathimerini Newspaper; WTOP with \nMike Murillo (Online and Radio); NPR with Rob Stein; Town Hall with Blue Star \nFamilies; CNN “The Lead” with Jake Tapper; CBS Newspath with Jon LaPook; NBC with \nLester Holt – doing special of last photos that people took before the Pandemic struck.   I \nshowed photo and gave interview about that 2019  Christmas Eve dinner at my sister’s \nhome; Interview with The Atlantic with James Hamblin on COVID-19 epidemiology\nMarch 5, 2021 – Global -115,300,000/2,600,000; USA – 28,600,000/519,100\nPlateau maintaining:\nBriefed POTUS and VPOTUS virtually.   He was in Oval.   I was at NIH. I explained about \nvariants and how the “cushion” of antibodies provided by the 2nd dose of vaccine give \nconsiderable protection against severe disease\nReleased by Chairman Rand Paul\nPRESS: Black News Channel Morning Show (TV); Time video regarding Sesame Street; \nWashington Post interview regarding vaccine hesitancy (Online TV); 2 PSA with Gloria \nEstaban and Carolina Sandoval; White House press conference;\nMarch 6, 2021 – Global – 115,700,000/2,600,000; USA – 28,700,000/521,300\nHad pre-brief with the WH comms team (Courtney Rowe, Ben Wakana, Kate Berner, Mariel \nSaez, Ian Sams, etc for my appearance on Face the Nation tomorrow (Sunday).\n7day average is not exactly plateauing, it is just flattening a bit:\nReleased by Chairman Rand Paul\nGOP at the local level are trying to pass laws that suppress minority voters such as saying that \nyou cannot give food to people who are waiting in line for hours to vote.   This \ndisproportionately affects African American voters.\nPRESS:   MSNBC with Tiffany Cross;\nMarch 7, 2021 – Global – 116,100,000/2,600,000; USA – 28,800,000/523,000\nStatus of vaccines in USA from Monica Ghandi:\nThe intensity of both my popularity and of the hate that the far right have of me increases:\nFauci.pdf\nPRESS:   CBS “Face the Nation” with Margaret Brennan\nMarch 8, 2021 – Global 116,500,000/2,600,000; USA – 28,800,000/524,000\nPlateau starting to come down”\nReleased by Chairman Rand Paul\nHad a very nice and informative discussion with the minister of foreign affairs of Bosnia and \nHerzegovina, Bisera Turkovic.  She is in a very difficult situation in that she was promised \nvaccine from CoVAX; however, they have not come through on their promise. Therefore, she is \nasking me as a trusted person for suggestions on how she might address the outbreak in her own \ncountry. As of February 22, 2021 there have been 128,000 cases and 5000 deaths in Bosnia and \nHerzegovina.  I could not help her very much except to encourage her to have her people \ncontinue to wear masks and observe appropriate public health measures. I also suggested to her \nthat she tried to make a deal with the Russians to try to get some of their vaccine. I also \nsuggested that are possible long range solutions to try and get some of the surplus vaccine that \nwould be left over after the USA vaccinated its entire population. She was very grateful for the \ndiscussion.  \nWas on panel with President Clinto Chair) for a discussion of the shortage of oxygen in the \nLMIC.   Also there were: Joy Phumapi and John Nkgengasong\n•Received the Tufts University Presidential Medal and did a Zoom Q and A with the Dean \nof the Tisch College of Civic Life at Tufts\nPRESS: Interview with Sarah Owermohle for Politico; White House Press Conference; \nAxios interview about March 11 – with Naomi Shavin; Fireside Chat  with National league \nof Cities; Fireside Chat with Tufts University Dean of Tisch Colege on the occasion of \nreceiving the Presidential Medal; CBS New Radio, Los Angeles interviewed together with \nL.A. Mayor Eric Garcetti\nReleased by Chairman Rand Paul\nMarch 9, 2021 Global – 116,900,000/2,600,000;  USA – 28,900,000/525,000\nOops!   See below.   Likely a fluke:\n•Had a very nice virtual ceremony inducting me as a Honorary Fellow into the Royal \nCollege of Physicians of Ireland by its President Dr. Mary Horgan.  Bill Powderly \n(Washington University of St. Louis) connected us.   Mary had taken an infectious \nDiseases fellowship at Wash U.\n•Did Fireside Chat with Paul Kelly (Chief medical Officer of Australia) on the differences \nbetween COVID-19 in USA and Australia.   Sponsored by CSIS (Steve Morrison and \nKatherine Bliss)\nReleased by Chairman Rand Paul\nPRESS: NPR “All Things Considered” with Mary Louise Kelly (done together with \nFrancis Collins); VICE TV Documentary Taping; Gray TV Special with Greta Van \nSusteren; Did podcast with Tom Inglesby from Hopkins; \nMarch 10, 2021 – Global – 117,300-,000/2,600,000;  USA – 29,000,000/526,200\nHad a very moving tribute to me upon the receipt of the Yale University School of Management \n“Legend in Leadership” Award from the Chief Executive Leadership Institute.   Moving \ncomments by Albert Bourla (Pfizer), Alex Gorsky (J & J). \nPRESS:  CNN “New Day” with John Berman; Interview with Carolyn Johnson of the \nWashington Post; Instagram with Eugenio Derbez (Mexican-American entertainer)\nHistorical comparison of the vaccine efforts of Trump versus Biden in NY Times article by \nSharon La Franiere:\nReleased by Chairman Rand Paul\nBiden Got the Vaccine Rollout \nHumming, With Trump’s Help\nTrump administration officials grumble that they laid the groundwork for surging \nvaccinations, but some hard work in the trenches has helped pick up the pace of \nproduction.  See link below:\nhttps://www.nytimes.com/2021/03/10/us/politics/biden-coronavirus-vaccine.html  \nMarch 11, 2021 – Global -117,800/2,600,000; USA – 29,100,000/527,700\nHad Zoom with Jeff and the team to go over the POTUS speech for tonight to commemorate the \n1 year anniversary from the time (March 11, 2020) when the WHO declared this a pandemic of \nglobal health concern and we shut down travel from Europe.   This was a big day for me 1 year \nago – (go back to notes of March 11, 2020).   Also, I have been pushing with Jeff and Rochelle \nto have the CDC be a bit less “risk averse” in their recommendations of what a person can do \nReleased by Chairman Rand Paul\nonce they are fully vaccinated.   The CDC really needs to step up and give recommendations for \ntravel, workplace, houses of worship.   They are dragging their feet.   I am gently coaching \nRochelle to go by her own instincts and not always yielding to the rigidity of the career CDC \nstaff.\n•Had Zoom call with Gov. Dan McKee of Rhode Island asking advice about the next few \nweeks and his plans for the state\nPRESS:  NBC “This Morning” with Savannah Guthrie; ABC “Good Morning America” \nwith George Stephanopoulos;  ESPN “First Take” TV with Max Kellerman, Stephen A. \nSmith, and Molly Qerim Rose (discussed my 5 favorite athletes); Podcast (“We Can Do \nThis”) with Robin Roberts; CBS Evening News with Norah O’Donnell; Filmed Stephen \nColbert for tomorrow night; MSNBC – Rachel Maddow\nMarch 12, 2021 – Global -    USA\nStill plateauing:\nBriefed the Principals for our weekly briefing.   I showed the replication cycle of SARS-CoV-2 \nand the vulnerable targets for direct anti-viral therapy\nDavid Kessler together with Rick Levin (formerly of Yale) made a proposal to provide through \nthe congress 5 billion to me and NIAID to decide how we wanted to put together a “vaccine \nmanufacturing plan that would involve everything from the fundamental research going into \npandemic preparedness to the actual manufacturing of 300,000,000 doses of vaccine per year. \nReleased by Chairman Rand Paul\nThis is an extraordinary offer then I will have to sit down with my team particularly John \nMascola who was on the call with us to determine what aspect of this multifaceted plan that \nDavid proposed would be owned by us here at NIAID versus what we would give to \nHHS/ASPR/BARDA.  I asked John to think about a team that we could put together in the \nbeginning of the week to come back to David with a plan. Obviously, we will have to go 2 \nFrancis Collins and thoroughly briefed him and get his buy in.  \nPRESS: Zoom interview with Spike Lee for a documentary that he is filming; \nPolitico by Sarah Owermohle and Erin Banco\nFauci takes on a new role: Biden’s Covid whisperer\nFew others cast as long a shadow as Fauci — who over the last year has given America a crash course in \nepidemiology — especially with top health posts vacant.\nMarch 13, 2021 Global – 118,800,000/2,600,000; USA – 29,200,000/530,700\nPRESS:   Filmed with Mark Manucci for PBS\nMarch 14, 2021 – Global – 119,200,000/2,600,000; USA – 29,200,000/531,800\nReleased by Chairman Rand Paul\nPRESS:  NBC “Meet the Press” with Chuck Todd; CNN State of the Union” with Jake \nTapper; Fox News with Chris Wallace; Gray TV “Full Court Press” with Greta Van \nSusteren\nMarch 15, 2021 – Global – 119,600,000/2,600,000;  USA -29,300,000/532,400\nGot call tonight from Larry Horowitz saying that Drew Weissman and his collaborator are \nplanning to hold a press conference to discuss their studies in mice showing that an \nintramuscular injection of the mRNA vaccine leads to an immune response in the amniotic fluid \nof the pups in a pregnancy model. The FDA has already received the DART (Development and \nReproductive Toxicology) studies from Moderna and Pfizer. According to Emily these studies \nwere clean. The FDA has heard about the Weissman studies and feels that they are invalid. The \ntwo companies also feel that the studies are invalid. However, we cannot blow them off for \nobvious reasons. Even if the Weissman studies prove to be invalid, the fact that they are holding \na press conference is going to create a huge mess. Hopefully, we can get this sorted out and have \na repeat of studies to counter this finding. More later. \nJeff Zients has heard about this and called me tonight at 9:30 PM.   I told him we have to get the \nFDA out their showing that they have DART studies and explaining what their studies showed.\nCases coming down:\nYet Europe is seeing an upswing of cases resulting mostly from B.1.1.1.7:\nReleased by Chairman Rand Paul\nToday I received on a virtual zoom the Ivan Alan Award for Social Courage given by Georgia \nTech University and it's President doctor Angel Cabrera. There was a video about my \naccomplishments and Rochelle Walensky joined us to celebrate the award. Rochelle was very \ngenerous in calling me her hero, her mentor, and her friend. I should point out at this point that \nRochelle has become closer and closer to me in our very collegial relationship. In addition, I \nshould point out that I have been getting a number of awards and prizes that I had not even \ndocumented in these notes. It is a shame that things are moving so quickly that I don't even have \ntime to savor for a moment the many awards that I have been getting. \nPRESS: Did White House Press briefing today with Rochelle and Andy; \nMarch 16, 2021 – Global – 120,000,000/2,700,000; USA – 29,300,000/533,100\nI took the led in pushing Janet Woodcock (FDA) and Rochelle Walensky (CDC) to make sure \nthat all their ducks were in order.  In fact, Janet checked and both Pfizer and Moderna had clean \nDART studies on record and CDC was following closely 2000 vaccinated pregnant women from \na cohort of 31,000 and no red flags.   All good so far.\nParticipated in a very nice function at the National Cathedral where Francis Collins and I and \nEliseo Perez-Stable gave brief remarks to various ministers from surrounding counties such as \nMontgomery, Arlington, Fairfax, District of Columbia, and others. The purpose was to have \nthese African American pastors get publicly vaccinated in the cathedral so that their constituents \nwould follow. It was one of many outreach efforts that Francis and I and others have been doing \nover the past months to stimulate interest in getting vaccinated.  \nSummary of vaccines below:\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nPRESS: MSNBC “Morning Joe” with Joe Scarborough; ABC “GMA3” with Jen Ashton; \nWall Street Journal – CEO Council with John Bussey; Podcast with The Economist; \nNational Cathedral Function with Press\nMarch 17, 2021 – Global – 120,400,000/2,700,000; USA – 29,400,000/534,100\nTestified before the House Energy and Commerce Oversight & Investigations Subcommittee \nchaired by Diana De Gette (D-CO) with ranking member Morgan Griffith (R- VA).   Good \nhearing with the usual snarkiness from David McKinley (R-WV) and Gary Palmer (R-AL).   \nSeveral question centered around the GOP angry because the Dems are not giving Trump enough \ncredit for the vaccine.   It is reflecting what Trump has been saying to the media.\nPres. Joe Biden sent me a thank you letter:\nLetter from \npresident Joe Biden  \nPRESS: NBC Late Show with Seth Meyers; White House Press Conference\nMarch 18, 2021 – Global – 120,900,000/2,700,000; USA – 29,400,000/535,200\nTestified before the Senate HELP Committee chaired by Sen. Patty Murray (D_WA) and \nranking Minority Richard Burr (R-NC).   I had my typical fight with Sen. Rand Paul who \ninsisted that masks were pure theater.   I blew him away.\nAfter the Hearing, I briefed the POTUS and VPOTUS on Building Vaccine Confidence.   \nPresent virtually – me, Andy Slavitt, Marcella Nunez-Smith, and Courtney Rowe.   In the Oval – \nJeff, Natalie Quillian, Anita Dunn.\nHad call with Jeff, David K. Natalie, Anne Schuchat regarding alarming increase in NYC of \nB.1.526.  Anne will call Zucker to suggest strongly to shut down bars and restaurants. We \nare afraid of a surge that we had expected since NYC tends to follow Europe, which is surging \nnow following a plateau.\nSA giving vaccine to Canada and Mexico.   For Mexico it is a quid pro quo to control \nimmigration at the border.\nAlso, AstraZeneca continues to mess up on their examination of data with the DSMB.   They \nhave shown extreme incompetence throughout this entire affair with mixing up clinical trial data \nin the UK to not having equity demographically in their USA trial\nReleased by Chairman Rand Paul\nPRESS: NBC “Today” with Savannah Guthrie; Did short TV hots with local stations in \nAlabama, Louisiana; North Carolina; South Carolina; CNN with Chris Cuomo\nMarch 19, 2021 – Global    USA\nStill flattening.   General worry about surge while several states are pulling back on mask \nmandates and other public health measures:\nPRESS:  CBS “This Morning” with Gayle King; Snapchats with White House Comms; \nMSNBC “All In” with Chris Hayes\nMarch 20, 2021 – Global – 122,000,000/2,700,000; USA – 29,600,000/538,300\nHad our newly established Saturday AM meeting with the medical team led by Jeff Zients to go \nover important issues.   I brought up for the first time the issue of having Biden lead an effort to \nallow LMICs to produce their own vaccine.   This could be a legacy issue for him similar to what \nGeorge WQ. Buch did with PEPFAR.\nCases starting to come up after the plateau:\nReleased by Chairman Rand Paul\nPRESS:  NBC “Today Weekend” with Kristen Welker and Peter Alexander;\nMarch 21, 2021 – Global   USA\nStill flat or slightly increased:\nReleased by Chairman Rand Paul\nWhile Europe continues to surge:\nAnd Brazil follows:\nReleased by Chairman Rand Paul\nMarch 22, 2021 – Global -123,000,000/2,700,000; USA – 29,700,000/540,000\nTrump has been attacking me (and Deb Birx) in recent interviews on FOX News and “the Hill” \n(see below) saying that we were wrong most of the time.   However, he actually says that I am a \nnice guy and he likes me.\nBig semi-scandal!  AstraZeneca again messed up. Today was the day when they announced the \ndata of their phase three clinical trial of a covid vaccine. The data showed a 78.9% efficacy with \ngood efficacy against severe disease. They put out a press conference and press release and we \nfollowed with a press release that mirrored their release. As it turns out the data and safety \nmonitoring board, which was getting impatient with them and was having trouble with their \nsubmission from the beginning, send them a harsh letter also addressed to me indicating that the \ndata in their press release was not the most recent data an actually made the data looked more \nfavorable. When the White House found out about this, it triggered a series of zoom calls with \nthe comms team of the White House (Courtney Rowe et al) led by Jeff Zients. the final decision \nwas that we would put out a press statement from NIAID in the middle of the night urging AZ to \ncome clean with the DSMB and to straighten out their press release. See below the letter from \nthe DSMB to me and AZ as well as our press release. \nReleased by Chairman Rand Paul\nfinal Concern over \nAZ press release.pdf\n \nNIAID Statement on AstraZeneca Vaccine\nLate Monday, the Data and Safety Monitoring Board (DSMB) notified NIAID, BARDA, and AstraZeneca that it was concerned by \ninformation released by AstraZeneca on initial data from its COVID-19 vaccine clinical trial. The DSMB expressed concern that \nAstraZeneca may have included outdated information from that trial, which may have provided an incomplete view of the efficacy \ndata. We urge the company to work with the DSMB to review the efficacy data and ensure the most accurate, up-to-date efficacy \ndata be made public as quickly as possible. \nAuthorization and guidelines for use of the vaccine in the United States will be determined by the Food and Drug Administration \nand Centers for Disease Control and Prevention after thorough review of the data by independent advisory committees.\nReleased by Chairman Rand Paul\nPRESS:   White House Press briefing – I presented the AZ results – 78.9% effective and \n100% effective against sever disease – 0 in vaccine; 5 in placebo;  BBC Radio World News;\nThe Hill:\nTrump says Fauci 'a \npromoter more than \nanything'\nBY JUSTINE COLEMAN - 03/22/21 09:18 AM EDT 621\nReleased by Chairman Rand Paul\nMarch 23, 2021 –  Global -123,400,000/2,700,000;  USA – 29,700,000/540,500\nDid Governor’s Association call and gave them an update.   Was introduced by Governor Cuomo \nwho bragged about my New York City roots and that I am Italian-American.\nDid a Fireside Chat with the Forum of Small States – 100 of the smaller nations of the world.   It \nwas very enjoyable and they were totally appreciative of me and many said how popular I was in \ntheir country.   The Irish Ambassador said I was “beloved in Ireland”.\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nPRESS:  ABC - Good Morning America with Robin Roberts; much press calls associated \nwith the AZ issue described above; Entravision interview with Tsi-Tsi-Ki Felix from \nUnivision;   many print interviews related to the AZ issue (see above)\nPolitico:\nFauci: AstraZeneca needs to 'straighten out' vaccine data\nMarch 24, 2021 – Global -123,900,000/2,700,000; USA – 29,800,000/541,300\n•Moncef Slaoui fired from GSK Board of Directors for sexual harassment charges dating \nback a few years\n•AZ continues to mess up on everything they seem to do.   Hopefully, we will bring their \nmiscommunication to an end as they finalize their discussions with the DSMB.\n•Got a call from Tom Frieden today about 2 issues: 1) Tom wants to know how I feel \nabout working with Moderna in getting them to give up some intellectual property so that \nwe can get vaccine to the developing world . He wants to see if I have a relationship with \nModerna. If so, he would like to help with seeing if we can get Moderna to cooperate in \nbuilding plants in the developing world to provide vaccine. Tom is going to send me \nsome talking points that I might bring to Jeff Zients so that I do not go rogue on this \nwithout letting the administration know. 2) Tom is quite concerned that there is no \ndecision yet on the commissioner of the Food and Drug administration. He is very much \nin favor of Josh Scharfstein over Janet Woodcock. He is trying to figure out ways to get \nthe administration to seriously consider Josh. Apparently Ron Klain is concerned that \nJosh would have trouble getting confirmed by the Senate. Tom thinks that this is not an \nissue.  \nReleased by Chairman Rand Paul\nPRESS: White House Press Briefing – most questions still about the AZ situation; Town \nHall on Sirius XM “Rock the Bells” with LLCoolJ – guests – me, Marcella Nunez-Smith \nand DJ Jazzy Jeff;\nENTERTAINMENT \n03/24/2021 07:45 am ET\nDana Carvey Goes Full ‘Godfather’ \nWith Hilarious Dr. Anthony Fauci \nImpression\n“She was having sex with Dr. Anthony Fauci, now she’s banging a \nf**king star.”\nhttps://www.huffpost.com/entry/dana-carvey-anthony-fauci n 605b174dc5b66d30c74022cc \nThe Brooch Is Back, Baby\n“These days, better than a tweet,” as one stylist put it.\n•\n•\n•\n•\n•\n•\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nMarch 25, 2021 – Global  - 124,200,000/2,700,000; USA – 29,800,000/543,000\nAfter a Zoom meeting yesterday with the DSMB Chaired by Rich Whitley, it became clear \nthat they are furious with AZ since they feel that the AZ people are “pathological liars”.   It is a \nshame, because their vaccine is really a good vaccine; however, with their dishonest actions, they \nare casting discredit on the vaccine.\nContinues to plateau amid concerns for surge.   Spring break is at hand.\nVariants in the USA:\nReleased by Chairman Rand Paul\nThe plateau continues:\nPRESS:  Bloomberg podcast; Podcast “Just Getting Started” with Rich Eisen;\nReleased by Chairman Rand Paul\nMarch 26, 2021 – Global – 125,200,000/2,700,000;  USA – 29,900,000/544,000\nHave continued to make virtual rounds on patients at the clinical center. I have not been \nindicating it in these notes; however, I have been regularly going to rounds at least once per \nweek and occasionally two times per week. I want to make sure that I do not lose contact with \nwhat is going on in the trenches both with HIV and with COVID-19. \nCases creeping up…….\nPRESS:  White House Press Conference – I introduced the college campus transmission \nstudy (Larry Corey);\nMarch 27, 2021 – Global -125,800,000/2,800,000; USA – 29,900,000/545,300\nReleased by Chairman Rand Paul\nPRESS:  ABC – Good Morning America (Weekend);\nMarch 28, 2021 Global   USA\nGoing in the wrong direction:\nReleased by Chairman Rand Paul\nPRESS:  CBS – Face the Nation with Margaret Brennan; Viewing of the Sanjay Gupta \npiece on CNN of the “6 doctors”;\nMarch 29, 2021 – Global – 126,900,000/2,800,000; USA – 30,100,000/546,700\n•Considerable commenting rom the press about the Sanjay Gupta Special last night on the \n“6 Doctors” where me, Birx, redfield, Hahn, Giroir, and Kadlec were interviewed.   I cam \nout fine, but the press criticized the rest , particularly Birx, Redfield and Hahn for using \nthe interviews to try to rehabilitate their reputations that suffered by their performance \nduring the Trump administration where they did not speak up against the misinformation \nfrom Trump (see below under “Press”)\n•Briefed the POTUS and VPOTUS on our usual weekly briefing.  \n•President Trump lashed back in response to the CNN Special last night and wildly \ncriticized Deb and I even making up stories that I bad-mouthed Deb all the time.  He is \ntruly an obnoxious adolescent.   Below is his statement:\n– March 29, 2021 –\nStatement by Donald J. Trump, 45th President of the United States of America\nBased on their interviews, I felt it was time to speak up about Dr. Fauci and Dr. Birx, two self-promoters \ntrying to reinvent history to cover for their bad instincts and faulty recommendations, which I \nfortunately almost always overturned. They had bad policy decisions that would have left our country \nopen to China and others, closed to reopening our economy, and years away from an approved \nvaccine—putting millions of lives at risk.\nWe developed American vaccines by an American President in record time, nine months, which is saving \nthe entire world. We bought billions of dollars of these vaccines on a calculated bet that they would \nwork, perhaps the most important bet in the history of the world. Dr. Fauci and Dr. Birx moved far too \nslowly, and if it were up to them we’d currently be locked in our basements as our country suffered \nthrough a financial depression. Families, and children in particular, would be suffering the mental strains \nof this disaster like never before.\nIn a fake interview last night on CNN, Dr. Fauci, who said he was an athlete in college but couldn’t throw \na baseball even close to home plate, it was a “roller,” tried to take credit for the vaccine, when in fact he \nsaid it would take three to five years, and probably longer, to have it approved. Dr. Fauci was incapable \nof pressing the FDA to move it through faster. I was the one to get it done, and even the fake news \nmedia knows and reports this.\nReleased by Chairman Rand Paul\nDr. Fauci is also the king of “flip-flops” and moving the goalposts to make himself look as good as \npossible. He fought me so hard because he wanted to keep our country open to countries like China. I \nclosed it against his strong recommendation, which saved many lives. Dr. Fauci also said we didn’t need \nto wear masks, then a few months later he said we needed to wear masks, and now, two or three of \nthem. Fauci spent U.S. money on the Wuhan lab in China—and we now know how that worked out.\nDr. Birx is a proven liar with very little credibility left. Many of her recommendations were viewed as \n“pseudo-science,” and Dr. Fauci would always talk negatively about her and, in fact, would ask not to be \nin the same room with her. The States who followed her lead, like California, had worse outcomes on \nCovid, and ruined the lives of countless children because they couldn’t go to school, ruined many \nbusinesses, and an untold number of Americans who were killed by the lockdowns themselves. Dr. Birx \nwas a terrible medical advisor, which is why I seldom followed her advice. Her motto should be “Do as I \nsay, not as I do.” Who can forget when Dr. Birx gave a huge mandate to the people of our Nation to not \ntravel, and then traveled a great distance to see her family for Thanksgiving—only to have them call the \npolice and turn her in? She then, embarrassingly for her, resigned.\nFinally, Dr. Birx says she can’t hear very well, but I can. There was no “very difficult” phone call, other \nthan Dr. Birx’s policies that would have led us directly into a COVID caused depression. She was a very \nnegative voice who didn’t have the right answers. Time has proven me correct. I only kept Dr. Fauci and \nDr. Birx on because they worked for the U.S. government for so long—they are like a bad habit!\nHospitalizations in people <65 years old:\nReleased by Chairman Rand Paul\nPRESS:  Had a “Roll Up Your Sleeves” chat for a PSA with Matthew McConaughey; \nMSNBC – Meg Tirrell; \nWashington Post:\nFeuds, fibs and finger-pointing: Trump officials \nsay coronavirus response was worse than \nknown\n'That’s what bothers me every day’: Birx and others admit \nfailures that hampered the White House response\nWhite House coronavirus response coordinator Deborah Birx, left, and National Institute of Allergy and \nInfectious Diseases Director Anthony S. Fauci listen as President Donald Trump speaks last spring. (Jabin \nBotsford/The Washington Post)\nBy \nDan Diamond\nReleased by Chairman Rand Paul\nMarch 29, 2021 at 8:09 a.m. EDT\nMarch 30, 2021 – Global    USA\nI remain close to Deb Birx and she still communicates with me about he observations of how \nthings are going.  Below is an e-mail she sent me this morning:\nTesting rates continue to drop reaching under July levels \ndespite substantial increase in number of test and testing \nsupplies available.  \"Surveillance testing\" or testing for this \nsilent spread is so critical. The original rising test positivity in \n18-24 is now 25-44 and rising.  This is how all the prior surges \noccurred - due to vaccination level the fatalities maybe be less \nand the risk to the health system maybe less but the potential \nfor significant increases in morbidity and long term impact of \nCOVID 19 will be most evident in these age groups. Simply \nrepeating the same public health messages without tailoring to \nspecific age groups on specific media platforms where the \nmessage will be heard will not have the impact we need at this \nmoment.  Please take care of yourself.  Deb\nReleased by Chairman Rand Paul\nTrump furious and being inarticulate in responding to our appearance on CNN Special.    He is \nstill talking about my errant pitch on opening day last year.   He is rambling on.   Meadows and \nNavarro  are attacking me on FOX News.   Navarro calling me a pathologic liar and calling the \nvirus the “Fauci Virus’.   The Trump team is really acting like a bunch of idiots.\nPeter Navarro being delusional again:\nPeter Navarro Slams Dr. Fauci: Virus Came From ‘Building’ He Built\n•Had Zoom meeting with Brazilian Minister of Health Dr. Marcello Queiroga.   They \nneed help from the USA because they are having a terrible problem and President \nBolsonaro is very Trump-like and hurting the country with his approach.   I offered to \nhelp by collaborating in research and discussing strategies.   They really want vaccine \nfrom us, but the USA policy is that we will wait until we vaccinate our whole country \nbefore we give away excess vaccines.   Unfortunately, that is all that I could offer them.  \nThey will get plenty of vaccine from Pfizer, AZ and J & J in late May and early June.  \nAfter the zoom meeting, I received a note from one of their scientists – Dr. Jorge Kalil.   \nHe asked me to please help them and hang in their with them sine Bolonsaro in terrible \nand the Brazilian scientific community and Brazilian people hold me in high regard and \nthey need me to stick up for them\nReleased by Chairman Rand Paul\n•Had Zoom meeting with Marshawn Lynch former running back for the Seattle \nSeahawks.   Really interesting.  A lot of street talk.   It was actually a “PSA” for \nvaccinating African Americans\n•Had Zoom with D.L. Hughley – famous entertainer - another interesting chat on his \nshow about African Americans and CVID vaccinations\n•WHO Report is out saying that it is “very unlikely” that the virus originated from a lab \naccident.   There is concern that the Chinese had a lot of influence over what data the  \nWHO group had access to\nPRESS:  Did interview with Phil Rucker about his book on the Trump response to COVID-\n19                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 \nPolitico: Trump lashes out at Fauci and Birx after CNN \ndocumentary\nThe former president released a fact-challenged statement criticizing the former advisers after they \ncriticized his administration’s pandemic response.\nHealth\nFauci and others look ahead to the \nholidays: Put another leaf in the table\n(QuickHoney for The Washington Post)\nBy Marlene Cimons\nMarch 27, 2021 at 10:00 a.m. EDT\nReleased by Chairman Rand Paul\nMarch 31, 2021 – Global – 127,900,000/2,800,000; USA – 30,200,000/548,200\nStill flat or inching up:\nReleased by Chairman Rand Paul\n•Had my every other week call with Chris Whitty and Patrick Valance of the UK.   They \nare as concerned as we are about the potential for another surge.   They are waiting on \nordered doses of vaccine.\n•Did nice interview with Nick News for Children answering their questions about \nvaccines.\n•Did interview with Ricky Martin scheduled for Latin Grammy awards.   Asked \nquestions about vaccines.\n•I have been praising David Ho to the White House people regarding his studies of the \nvariants.   On that basis they are now probing whether he might be a good choice for \nFDA Commissioner.\nSource\nDr M Gandhi  UCSF:\nReleased by Chairman Rand Paul\n•\nPRESS:WJLA TV – discussed Nats baseball season; CNN with Chris Cuomo;\nMorning Joe’ Trashes Fox News Host for \nAllowing Navarro’s Unhinged Fauci Rant: \n‘That’s Fireable’\nApril 1, 2021 – Global – 128,500,000/2,800,000; USA – 30,300,000/549,100\nThe Trump people including Meadows, Navarro and several other minor figures are going \non a rampage on FOX news attacking me.   Navarro calling me a psychopath and pathologic \nliar and Meadows blaming me for not weighing in on Children at the border.   Amazing!!!  Other \nnews media are criticizing them strongly for doing this.\n•Had nice Fireside Chat with American Red Cross – Gail McGovern (CEO).  The \ncomments on the chat box were uniformly positive\nReleased by Chairman Rand Paul\n•Had a Zoom with Prize-winning artist Hugo Crosthwaite and Taina Caragol of the \nNational Portrait Gallery.   Taina will be commissioning Hugo to do a portrait of me \nfor the National Portrait Gallery Collection.   The whole process will take about 1 year.\n•Majorie Taylor Greene is trying to introduce legislation to fire me.  Really!!!!:\n•Marjorie Taylor Greene: Fire Fauci and \nban vaccine mandate and passport\n        by Paul Bedard, Washington Secrets Columnist | \nPRESS: CBS This Morning with Gayle King; WXYZ TV Detroit; FOX L.A. TV “The \nIssue Is” with Elex Michaelson;  NBC Nightly News with Lester Holt; NATs Podcast with \nAl Galdi and Mark Zuckerman.\nApril 2, 2021 – Global – 129,3000,000/2,800,000; USA – 30,400,000/550,200\n•Had nice Fireside Chat with Rep. Doris Matsui.\n•Am still being attacked by the far right wing including Senators (Lindsey Graham) and \nmedia (FOX).   Interesting that they are asking me to explain the “crisis” at the border \nwhen that has nothing to do with me.\n•Had great interview with Neal Cavuto of FOX (see below under “Press”) in which he \nallowed me to counter all of the criticisms of people like Mark Meadows, Lindsey \nGraham, Navarro, etc.   Navarro is calling me a pathological liar saying that I had nothing \nto do with the vaccine.   He said this in response to my saying that one of the best \nchoicesI made was to push ahead with Barney Graham’s collaborationwith Moderna.   \nObviously, Navarro has no idea about this and so has no idea what he is talking about\n•Another important issue – Robert F. Kennedy, Jr has written a book about me entitled \n“The Real Anthony Fauci”, which will almost certainly be a slanderous book.   Am \nundecided about whether I should get lawyers involved\nPRESS: NPR Morning Edition with Noel King; NBC TV Detroit with Dr. Frank \nMcGeorge; White House Press briefing; Politico Podcast with Jeremy Siegel; Interview \nwith Business Insider; Interview with The Guardian; FOX News with Neal Cavuto.\nApril 3, 2021 – Global – 129,900,000/2,800,000; USA – 30,400,000/552,800\nReleased by Chairman Rand Paul\nWent to a “Spring celebration” at Bob Seder’s house to observe the Cherry Blossoms at \nKenwood.  I am a little nervous sine people were hugging and not wearing masks, although \nvirtually everyone had been vaccinated.\nStill lingering at ~60,000 new infections/day:\nPRESS: CNN with Jim Acosta;\nApril 4, 2021 – Global – 130,400,000/2,800,000;  USA – 30,500,000/553,700\nThings getting a bit scary.   As B.1.1.7 becomes more dominant, we re seeing surges in some \nareas with younger people (even school kids) getting infected and hospitalizations increasing in \nrelatively younger people.   See below:\nReleased by Chairman Rand Paul\nRace between the vaccines (4 million shots administered yesterday!!!) and a new surge:\nApril 5, 2021 – Global -131,000,000/2,900,000;  USA – 30,500,000/554,100\nStill putting pressure on me to switch to a single dose.  \nReleased by Chairman Rand Paul\nMike Gerson wrote an amazing column in the Washington Post about me:\nOpinion: Why tearing down Fauci is essential \nto the MAGA myth\nOpinion by \nMichael Gerson\nColumnist\nApril 5, 2021 at 4:35 p.m. EDT\nMAGA political philosophy is not systematic, but it is comprehensive. Right-wing populism offers a \ndistorted lens to view nearly all of life.\nThrough this warped lens, progress toward equal rights is actually the oppression of White people. Free \nand fair elections, when lost, are actually conspiratorial plots by the ruthless left. But perhaps the most \nremarkable distortion concerns the MAGA view of covid-19.\nWe have all seen the basic outlines of pandemic reality. Experts in epidemiology warned that the \ndisease would spread through contact or droplets at short distances, which is how it spread. The experts \nrecommended early lockdowns to keep health systems from being overwhelmed, and the lockdowns \ngenerally worked. The experts said Americans could influence the spread of the disease by taking basic \nmeasures such as mask-wearing and social distancing. The disease was controlled when people did \nthese things. The disease ran rampant when they did not, killing a lot of old and vulnerable people in the \nprocess.\nThere were, of course, disagreements along the way about the length of lockdowns and the form of \nmandates. But on the whole, American citizens have witnessed one of the most dramatic vindications of \nscientific expertise in our history. We have been healthier when we listened to the experts and sicker \nwhen we did not.\nThis is the context in which the MAGA right has chosen to make Anthony S. Fauci — the director of the \nNational Institute of Allergy and Infectious Diseases since 1984 — the villain in their hallucinogenic \nversion of pandemic history.\nReleased by Chairman Rand Paul\nIt is worth disclosing when a columnist has a personal connection to a public figure. I have known Fauci \nsince I was in government during the early 2000s and watched him help create the President’s \nEmergency Plan for AIDS Relief. He is the best of public service: supremely knowledgeable, personally \ncompassionate, completely nonpolitical, tenacious in the pursuit of scientific advancement and resolute \nin applying such knowledge to human betterment. He has no other ambition or agenda than the health \nof the country and world.\nYet slamming Fauci was a surefire applause line at the Conservative Political Action Conference in \nFebruary. Former Trump administration officials continue to target him. Republican members of \nCongress vie with one another to put Fauci in his place.\nFor Trump officials, including Donald Trump himself, this makes perfect sense. If Fauci has been right \nabout covid, then playing down the disease, mocking masks, modeling superspreader events, denying \ndeath tolls, encouraging anti-mandate militias and recommending quack cures were not particularly \nhelpful. If Fauci has been right, they presided over a deadly debacle.\nWhen former Trump trade adviser Peter Navarro claims that Fauci is “ the father of the actual virus ” or \nformer chief of staff Mark Meadows complains about Fauci’s indifference to the (nearly nonexistent) \nflow of covid across the southern border, the goal is not really to press arguments. It is to create an \nalternative MAGA reality in which followers are free from the stress of truth — a safe space in which \nmore than half a million people did not die and their leader was not a vicious, incompetent, delusional \nthreat to the health of the nation.\nMetaphorically (but only barely metaphorically), there is a body on the floor with multiple stab wounds. \nThe Trump administration stands beside it with a bloody knife in its hand. It not only claims to be \ninnocent. It claims there is no blood. There is no body. There is no floor.\nCongressional Republicans who criticize Fauci to prove their populist manhood are even more pathetic. \nTheir self-abasement is voluntary. Watching Sen. Rand Paul (R-Ky.) debate science with Fauci during \ncommittee hearings is like watching Albert Einstein being disputed by his dry cleaner. Fauci is often \nreduced to making obvious points in a patient voice. Fauci deserves his Presidential Medal of Freedom \njust for his heroic forbearance.\nAll these critics of Fauci have chosen to attack the citadel of science at its strongest point. With squirt \nguns. While naked and blowing kazoos.\nThis useless exertion is somehow wrapped in the language of freedom. Freedom from the servitude of a \npiece of cloth on your face that might save your neighbor’s life. Freedom to light off fireworks below a \npotential avalanche. Freedom to store uranium in your backyard. Freedom to set fire to a crowded \ntheater.\nHere is the reality of covid. It is not an easy thing to persuade hundreds of millions of people who feel \nperfectly healthy to wear masks, socially distance and get a vaccine injected into their arms. Fauci is \ndedicated to these goals. Anyone who purposely undermines them is a danger to the health and safety \nof their fellow citizens.\nReleased by Chairman Rand Paul\nFauci is practicing epidemiology. His critics are practicing idiocy. Both are very good at their chosen \nwork.\nPRESS: PIX 11 TV – New York City;\nApril 6, 2021 – Global – 131,500,000/2,900,000; USA – 30,600,000/554,400\nHad Zoom call with Pascal Soriot, CEO of AstraZeneca.   He wanted to apologize for the \nmiscommunications concerning the interactions between AZ and the DSMB a couple of weeks \nago.   He wanted my advice as to the best way forward.  I explained to him that the most \nimportant thing for him to do would be to wait until the United States FDA comes out with their \nEUA. This would give the AZ product the validity that he is hoping for. I also mentioned that the \nconfusion associated with the mixed up dosing situation associated with the Oxford group added \na degree of skepticism about the entire AZ product. Best thing to do is to wait to see but the FDA \nsays about the product. \nWe seem to be stuck at around 60,000 per day:\nPRESS: ABC - Good Morning America with George Stephanopoulos; MSNBC – Morning \nJoe with Joe Scarborough; National Press Club Interviews; Fox Local TV Stations\nReleased by Chairman Rand Paul\nApril 7, 2021 – Global -132,000,000/2,900,000;  USA – 30,700,000/555,200\nTerrific experience tonight – On my walk tonight with Christine through American University  \ncampus, on the way back we were met by throngs of American University students who illegally \nsitting on the grass enjoying themselves. In groups of three to five people they kept coming up to \nme wanting to get photographs and selfies. It was truly amazing as it went on for group after \ngroup after group. I must have posed for photographs with over 50 young kids from American \nUniversity. Then, on the way down past  Al Dente restaurant where we stopped to pick up a \npizza, customers outdoors and inside the restaurant kept coming up to me asking to be \nphotographed with me. My pizza took a long time to be ready and so I must have spent 15 \nminutes at the door of the restaurant allowing people mostly young kids but some adults to have \nselfies with me. The entire situation was culminated when I walked out of the restaurant with \nAndre Jacobs, my security man, and the entire population of people who are eating outdoors at \nAl Dente and Chef Geoff’s burst into a prolonged round of applause. It was really quite \ncharming. Andre had gotten nervous throughout the entire situation since some people just ran \nup to me with their camera in their hand to get a selfie. Andre does not like people just running \nup to me an almost body slammed a man who meant well but who didn't realize that he had \ncharged up to me. A memorable experience! \nPRESS:  CBS “This Morning” with Gayle King; White House Press Conference (I \ndiscussed durability of vaccine-induced response; CNN with Anderson Cooper 360;\nApril 8, 2021 – Global -132,700,000/2,900,000;  USA – 30,700,000/556,100\nSpoke with Olive Shisana and Morena Makhoana (Biovac) about setting up capability to \nmanufacturing mRNA vaccines in South Africa.   Olive claims to be the special advisor to \nPresident Cyril Ramaphosa of RSA.   They want me to help to get Moderna to assist RSA in the \nform of Makhoana’s company Biovac to make mRNA vaccines for RSA.\nI taped my NAS remarks receiving their Public Welfare Medal.   I spoke of my relationship with \n7 Presidents including the difficult relationship with Trump.\nMet virtually for our regular weekly meeting with the POTUS and VPOTUS.  Interesting \nsituation.   Marcella has been quite ill with inflammation of her brain stem (acute). She was quite \nincapacitated but is now improving rapidly on corticosteroids. She actually took the zoom call \nfrom her rehabilitation institution. We were joking that the loudspeaker might soon say that \nvisiting hours are over and the president and vice president would hear it over the zoom. In \naddition Vivek was zooming from Miami and in the middle of the discussion a Peacock outside \nhis window started making noise. What a scene. \nDaily cases still going up – 74.5 million yesterday: \nReleased by Chairman Rand Paul\nPRESS: RAI Italian TV; France 24 TV Interview\nNew York Times (— Isabel Kershner) : Israel marks Holocaust Remembrance Day with \na virtual march and remarks by Dr. Fauci.\nHeld virtually for a second year because of coronavirus restrictions, the event featured recorded \nremarks by two prominent figures in the battle against the coronavirus: Dr. Albert Bourla, a son \nof Holocaust survivors who is the chief executive of Pfizer, the pharmaceutical company that, \ntogether with BioNTech, produced a leading coronavirus vaccine; and Dr. Anthony S. Fauci, the \nleading infectious disease expert in the United States.\nApril 9, 2021 – Global – 133,600,000/2,900,000;  USA – 30,800,000/557,100\n•Bad day – Chris brought her right arm  (distal radius0 playing basketball with me for \nfilming for Nat/Geo.   Happened on the last 10 seconds of playing\nPRESS:   Stephen Colbert had a skit about me and “the 4th Wave” - \nhttps://www.youtube.com/watch?v=xb0fB13xYYg \nReleased by Chairman Rand Paul\nApril 10, 2021 – Global – 143,300,000/2,900,000;  USA – 30,900,000/558,000\n•Spoke again with Ari Emanuel and his team of Don Walker (lawyer, represents Obama \nand Clinton) and Jay Mandell (Mostly involved with books).   They just wanted to check \nin to see if IU needed anything.   I mentioned the situation with Robert F. Kennedy, Jr \nwho is writing a book about me entitled “The Real Dr. Anthony Fauci”, which \nundoubtably will be a very scandalous book. Don Walker was adamant that we should do \nnothing about this since Bobby Kennedy has absolutely no credibility over the past \nseveral years. because of how crazy he has been acting Over the past several years. His \nstrong recommendation is to just let it go. Don emphasized again how much money that I \nwould be making with my lectures. I re emphasize to him that although I like the idea \nabout making money, my most important goal is to do good , and that I would prefer to \ndo several speeches pro bono depending upon who asks me. \n•Joan Baez will receive the Kennedy Center Award and there is a reception at the State \nDepartment on May 19th.   She has invited me as her guest.   What fun!   Just spoke with \nher over the phone to check if there will be mask wearing since the press will have a field \nday if they saw me with Joan and we did not have masks.\n•We vaccinated 4.6 million people today\nDaile cases continue to rise – 81,400:\nA\nA\nApril 11, 2021 – Global – 135,000,000/2,900,000; USA – 31,000,000/558,800\nReleased by Chairman Rand Paul\nSunday -quiet day.   Catching up on writing Commencement address.\nHeard during my interview with MSNBC (see below) that Trump , while on FOX with Laura \nIngraham said I was “full of crap” and that he never listened to me.   Hasan came back on \nMSNBC and said that is why hundreds of thousands of people died, because he did not listen to \nme.  Appasrently, Trump also made this comment during a fundraiser at Mar-a-Largo where he \nsharply attacked 2 people: me and Mitch McConnell.\nPRESS:  MSNBC with Mehdi Hasan;\nApril 12, 2021 – Global    USA\nThe Daily Mail in their reporting of the removal of Father Lahart from his position of President \nof Regis High School made sure to mention that I was an alumnus of the school (of course) (see \nbelow under Press. \n•Had a good Zoom meeting with Hon. Luigi Di Maio, Minister of Foreign Affairs and \nInternational Cooperation of Italy.   He is in the USA to celebrate the 160th anniversary of \nItalian relations with USA.   Good conversation.  He wanted advice of the COVID-19 \nsituation in Italy and Europe.   Interesting how these foreign leaders want my opinion on \nthese issues that have policy as well as public health implications.\n•Got call at 10:00 PM from Rochelle Walensky that the CDC and FDA had called a \npause of the J & J vaccine due to 6 cases (all women – ages 18 to 48) of Cerebral \nVenous Sinus Thrombosis (CVST).   I died, 3 hospitalized (2 in ICU), 2 discharged.   \nEvents occurred from 6 to 13 days after vaccination.   CDC/FDA will do press \nconference tomorrow at 10:00 AM. \nPRESS:  Daily Mail: Jesuit priest, 59, is removed as president of Manhattan's prestigious \nRegis High School - that Dr. Fauci attended - for 'non-consensual sexual misconduct with \nadult subordinates'; BBC radio interview (2 part series) on 40th Anniversary of recognition \nof AIDS pandemic; BBC - Radio “The Today Programme”; CNN “Situation Room” with \nWolf Blitzer. \nI have been speaking about this all the time:\nReleased by Chairman Rand Paul\nApril 13, 2021 – Global – 136,200,000/2,900,000;  USA – 31,100,000/559,700\nJeff Z. calls me at 5:46 AM telling me to clear my calendar since the WH wants me out \nthere with the press.   See below – I engaged in the Jen Psaki Conference in the White \nHouse press room with Jeff Z.\nObviously, this is a big deal even though it is a very rare event 6 cases in 6,850,000.\nI was on the Governors call with Rochelle and Jeff to explain the situation to the Governors.\nReleased by Chairman Rand Paul\nPRESS:  White House Press Conference with Jen Psaki and Jeff Z.; CBS Evening News \nwith Norah O’Donnell; NBC Evening News with Lester Holt; ABC Evening News with \nLinsey Davis; MSNBC with Chris Hayes\nApril 14, 2021 – Global -137,000,000/3,000,000;  USA – 31,200,000/560,600\nThere is a very important issue going on regarding a dispute between the vaccine Research \nCenter an Moderna regarding the inventorship of the patent associated with the confirmation of \nthe spike protein. For some strange reason Moderna wants to give us Co ownership of the patent \nbut not inventorship of the patent. The VRC insists with good reason that we are true inventors \nof the patent. We had a conversation this morning among Francis Collins , myself , John \nMascola, and Mark Rohrbaugh concerning any leverage that we might have over Moderna to \npressure them in sharing the expertise of their technology with developing countries particularly \nin southern Africa. They have made a public statement that they will not interfere with any \ncountries that want to use their technology. However, given the complexity of the technologies it \nis important that they pitch in and help the companies transfer the technology. Peter Staley and \nhis activist friends are understandably pushing us to exert pressure on Moderna to transfer their \ntechnology  to the developing world. The reason why the patent issue becomes relevant here is \nthat the more control we have over what Moderna does the better we will be able to pressure \nthem into the above. We decided that the best approach would be for Francis Collins and I to \nhave a telephone call with the CEO of Moderna , Stephane Bancel and the POresident of \nModerna, Stephen Hoge.\nHad call with Chairwoman Rosa DeLauro of the House Appropriations Committee.   She \nwants to know what I think she should do with the $6.5 billion that they want to give to ARPA-H \nthat would go to NIH.   There is a fear among NIH grantees that the regular increases  that NIH \nusually receives on a yearly basis will be diminished be 'cause the Congress is now giving the \nNIH $6.5 billion for “special projects”. They were thinking of giving the NIH $2.5 billion for the \nregular appropriation plus $6.5 billion for the special projects for a total of $9 billion, which is a \nlot. I suggested to Rosa that she called some of the money off the $6.5 billion and add it to the \nregular appropriation for the NIH. She seemed OK with this.   \nI had recently received a letter from senator Lindsey Graham essentially demanding that as the \nchief medical advisor to president Biden, I go down to the border and look at the difficult health \nconditions there regarding the SARS coronavirus. Subsequent to that I received a letter from \nabout 8 or 9 congressmen asking me to do the same thing. In fact, in his letter to me senator \nGraham said I was neglecting my responsibility as the adviser to the president if I did not go \ndown to the border and report back on the “terrible conditions” on the border. This is clearly a \nset up trying to embarrass the president. Tomorrow I testify before the house Energy and \nCommerce Select Committee on COVID-19. Two congressmen who signed the letter will be \nthere. I anticipate that they will ask me the same question about going to the border. Today I \nasked Jeff Zients to ask Ron Klain and the president if it is OK for me to say that since I \nam the chief medical advisor to the president I would be happy to go to the border if the \npresident ask me to. However, with all due respect I am not the adviser to the Congress but to \nReleased by Chairman Rand Paul\nthe president. I will do what he asked me to do, and again with all due respect not what the \nCongress asks me to do. Ron Klain and the president are OK with this approach.\n•Got call from Jeff that the Oxford group were coming out with a paper tomorrow saying \nthat in a large data base they found that mRNA vaccinbes had even more thrombosis \nthan AZ.   Obviously, bullshit.   They did not look for thrombocytopenia and so the \nobservation is invalid.   Also, not surprising fr the Oxford group sine their vaccine is in \ntrouble and I would not be surprised if they were trying to disparage the other vaccines.\nPRESS:  MSNBC – “Morning Joe” with Willie Geist; CNN “New Day” with John Berman; \nNBC “Today” with Savannah Guthrie;  White House Press Conference (regular 3x/week).  \nDid 4 separate Local TV hits with Cameron Webb in Mississippi Stations\nApril 15, 2021 – Global – 137,900,000/3,000,000; USA – 31,200,000/561,400\nStill hanging around 70,000/day:\nMajor clash with Rep. Jim Jordan during the House Energy and Commerce Select Committee \non COVID-19 chaired by Jim Clyburn and Steve Scalise as Ranking Member.   Jordan did his \nusual aggressive asking me multiple questions without giving me a chance to answer.   He was \nharping on my giving him a definite date when he can get his “liberty and freedom back” that I \nwas restricting him from.   I insisted that this was not a matter of liberty and freedom, but was a \npublic health issue.We had a heated discussion.   I finally told him that he was “ranting”.  In \naddition, I told him that he was making this a personal issue. He denied that, but I insisted that he \nReleased by Chairman Rand Paul\nwas indeed making it a personal issue. Finally, when his time was up he kept on talking and \nrepresentative Maxine Waters told him to shut up. \nPRESS:  All over TV in my clash with Rep. Jordan at the E and C Hearing – CNN covered \nit extensively and Jimmy Kimmel had it in his monologue;  Reuters TV interview with Julie \nSteenhuysen;   Had conversation with member of NY Times editorial board member \nJeneen Interlandi about 1 dose versus 2 doses.   She seemed to side with me.\nApril 16, 2021 – Global – 138,700,000; USA - \n•Andy Slavitt remarked how proud of me he was as he watched me respond to Jim \nJordan.\n•Fox News is attacking me abut my interchange with Jordan, BUT MSNBC is attacking \nFOX for attacking me.   Example:\n•Scarborough slams Jordan for spreading \n'lies' about Fauci: 'It's sheer idiocy'\n•By Cameron Jenkins - 04/16/21 11:38 AM EDT 410 \n•In the Instagram with Tyra Banks (see below) she was wonderful.   People who wrote \ncomments were 95% positive, but some were really mean and vicious statements about \nme and Tyra.   One person said that Tyra was sexy, but I was even more sexy than she \nwas.   She read it and put a big smile on her face and said that she agreed with that but \nthen beautifully and gently shot this down by saying:   “Dr. Fauci, that is true and my \nmother is in love with you” .   Zing 😊\nPRESS: Veja Magazine (Brazil) – reporter – Julia Teixeira Braun; Facebook – “Now This” \nwith Zinhie Essamuah; Instagram with Tyra Banks (she was absolutely fabulous); MSNBC \n“Reid Out” with Joy Reid;\nApril 17, 2021 – Global – 139,500,000/3,000,000; USA – 31,400,000/563,200\nCases continue to creep up in certain states (>35).\nHad nice dinner over Ellen Sigal’s home with Diana DeGette, Chair of the House Energy and \nCommerce Subcommittee on Oversight and Investigations.\nDana Bash sent me a text:   “I just watched the whole Jordan thing.   Again, you’re a better man \nthan I….    As our friend Wolf Blitzer said to me yesterday – no one would have blamed you if \nyou said simply “Mr. Jordan, go f--- yourself”\nReleased by Chairman Rand Paul\nPRESS:   Had another of several interviews at home with Mark Manucci for the PBS \nMasters Documentary\nApril 18, 2021 – Global – 140,300,000/3,000,000; USA – 31,400,000/564,000\n•David Axelrod sent me a text saying that his wife Susan says that I look 10 years younger \nsince the change of administrations. \n•I received a text from Dana Bash pointing out that Vanity Fair recently had a headline \nthat said: Jim Jordan trips over his own asshole trying to debate Anthony Fauci. \nPRESS: ABC This Week with Martha Raddatz; NBC  Meet the Press with Chuck Todd; \nCBS Face the Nation with Margaret Brennan; CNN State of the Union with Dana Bash; \nMSNBC The Sunday Show with Jonathan Capehart;\nApril 19, 2021 – Global – 141,100,000/3,000,000; USA – 31,500,000;564,300\nToday is the day (April 19) when the POTUS said that everyone 16 years of age and older is now \neligible to receive a vaccine.   No more restrictions to priority groups\n•Kate Berner sent me a note saying that I was “outstanding” at the White House pressor.\n•I get a lot of FOIA requests regarding my financial statements as well as regarding text \nmessages , written correspondence, and phone calls . These are clearly directed at trying \nto catch me at something usually from conspiracy theorists but also from Republican \noperatives. The most recent FOIA requests have been for any text messages between me \nand Susan Rice, Ron Klain, Anita Dunn, and Kate Bendingfield. The most recent one has \ncome from the Republican National Committee in the person of Nicholas Erickson. \nClearly, I have become a prime target of the Trump Republicans \n•Had great conversation with Amb. Katherine Tai who is the US Trade \nRepresentative. The ambassador was extremely excited about partnering with me in \ntrying to get a waver of the patent restrictions for the production of vaccines by the \ndeveloping nations. She is also very well aware that the important issue is to transfer the \ntechnology and the expertise even after the wave it has occurred. I had mentioned to her \nthat I would soon meet with the CEO of moderna to try to get him to cooperate and \ntransferring this technology. We left it that we shall get back together after she does some \nwork on this problem.  In the arena of small world things, the ambassador mentioned to \nme that her mother was a scientist here at NIH and that she is a child was put Into the \nNIH daycare center. I believe that I will get along very well with her.  \nReleased by Chairman Rand Paul\nPRESS: NPR -Morning Edition with Rachel Martin; CBS “This Morning” TV with Tony \nDokoupil; Rickey Smiley Radio; Enrique Santos Show (TV); The Morning Hustle Show” \n(Radio) with Headrack; White House Press Briefing; did loal TV hits in Indianapolis, \nJacksonville, FL, and Birmingham, AL; Australian ABC News Radio\nApril 20, 2021 – Global   USA\nMaybe coming down a bit:\n•I was on the governor’s call today.   One of the questions that came up today was why we \nstill have a mask mandate for outdoors.   I agree that this is a problem.   Rochelle \nanswered that CDC is re-examining this issue.   I feel that we should obviously say that if \na person is out alone outside, they do not need to wear a mask.\n•Important issue brought to my attention regarding potential far right wing coming \nafter me.  \nIt appears that a few of the far right grantees of NIAID are joining with the radical right \nwing people in the public as well as people in the Congress such as congressman Jim \nJordan and Senator Rand Paul to try and connect me with the virus from WUHAN. In \nfact, David Morens has heard that these people are trying to “bring me down” .. They are \nsaying that I deliberately worked with the Chinese together with Peter Daszak to create a \nvirus that would be released to the world. This sounds very much like a way-out \nconspiracy theory, which it is. However, there are enough crazy people around to make \nthis a problem. I am going to arrange for a phone call with David in order to determine \nReleased by Chairman Rand Paul\nmore details as to what is going on. It is my suspicion that some of these so-called NIAID \ngrantees are Imperiale and Rich Ebright.  They have been complaining about gain of \nfunction research for years. They have even publicly made the claim that when they \nspeak against anything that I want I will prevent them from getting their grants. \nEverybody knows that this is absolutely preposterous, but they in fact are preposterous. \nLet us see if in fact these are the villains. \nPRESS:   BBC Radio – 2nd installation of a story that BBC is doing on the history of \nHIV/AIDS;  Columbia TV -NTN 24;  Instagram with Aidan Galassetti\nApril 21, 2021 – Global   USA\nCases back up again a bit – 57,000:\nHad an important call without colleagues in South Africa another southern African \ncountries to discuss the possibility of conducting a clinical trial with the moderna m RNA \nvaccine.  The issue is that they are in desperate need of a vaccine since the AZ vaccine does not \nwork against the variant B.1.351. In addition, the J&J vaccine that appears to do well against the \nSouth African variant will not be ready for at least several months and there is a window of \nopportunity to do a clinical trial with a delayed placebo crossover on 14,000 people. The issue is \nReleased by Chairman Rand Paul\nthat the South Africans particularly Glenda Gray and Linda GAIL Becker need to show that the  \nmRNA vaccine is effective in South Africa particularly among persons living with HIV. David \nKessler who will be key in getting the product to South Africa was on the zoom. I feel that this is \ndefinitely worthwhile doing since if we can prove that the mRNA vaccine works in South Africa, \nthen Glenda feels that they can convince the African countries to make a major investment in \nbuying the mRNA vaccine. On the phone call were the following :  Glenda Gray, Linda-Gail \nBekker, Philip Kotze, Mike Chirenje, Tulio de Oliveira, Larry Corey, David Kessler, Emilio \nEmini, Cliff Lane, John Mascola, Carl Dieffenbach, Emily Erbelding, among others.\nBeautiful situation of my impact on an autistic child.   See attachment:\n399065 Kirkland #2 \ncorr.pdf\n•I presented nomination of Barney Graham to NAS Section 44.  Bob Gallo made a random and \ncompletely unnecessary potentially negative comment about Barney while presenting another \ncandidate (Ray Schinazi)\nHello, my name is Nicholas Wilson and I am a senior at Arizona State University studying \nhistory, Political science, and education. \nThis year has been tough, but I got the vaccine. I wanted to thank Dr Fauci for all his hard work \nand to commemorate this modern marvel I got a tattoo. I hope you enjoy. \nReleased by Chairman Rand Paul\nPRESS: Hispanic TV hits: Despierta America; Actualidad Radio – Juan Gomez and \nRoberto Rodriguez (South Florida); CNN Newsroom with Victor Blackwell; NBC TV – \nDallas with Julie Fine;\nApril 22, 2021-  Global    USA\nNote the difference in mask mandates between the red and blue states:\nReleased by Chairman Rand Paul\n•I participated in an iPC meeting today chaired by Beth Cameron of the National \nSecurity Council. The purpose of the meeting was to figure out how we could ask for \n$30 billion for pandemic preparedness and put it into the American Jobs Plan bill. The \nNIH had put in a proposal through HHS of close to $30 billion for our needs alone. There \nappears to have been some confusion as to the fact that HHS did not send down our \nrequest to the NSC in time for inclusion in the NSC document that was being discussed at \nthe meeting. This led to a lot of running around on my part and on the part of Francis \nCollins and Larry Tabak to figure out how we can get our request properly represented in \nthe discussion. It seemed to have worked out OK as I together with Eric Lander made a \npresentation to the IPC that indicated the broad scope of our needs without necessarily \nmentioning the budget. It was one of those times where you walk in the morning and find \nout that you have to do something that nobody told you about until one hour before you \nhad to do it. I refer to my need to make a presentation on behalf of the NIH to the IPC. \n•\n•Did a Fireside chat with the American College of Physicians. The chat was chaired by \nDorilyn Moyer.   In addition, I was presented with the 2021 Boyle award from the \nAmerican College of Physicians. To illustrate how flooded I am with things , I had no \nidea I was being awarded the Joseph F. Boyle award and I had to make comments \naccepting the award. I had to quickly scramble to get Kim to go on the Internet and find \nout just what the Joseph F. Boyle award is. As it turns out it is an award bestowed upon a \ncurrent or former government official who has provided outstanding public service to \nimproving the delivery of health care. Again, I am running", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: Bradby; Washington Post article: Coronavirus Living Health Fauci’s Christmas Eve: Turning 80  and fighting the pandemic Released by Chairman Rand Paul 285Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and head  of the U.S. pandemic response, on Dec. 12. (André Chung for The Washington Post) By  Joel Achenbach Dec. 23, 2020 at 8:00 a.m. EST December 24, 2020 – Global – 77,500,000/1,700,000;    USA – 18,400,000/325,000 I am 80 years old!   Amazing number of Birthday wishes coming in.  Truly moving…. Birthday video from the OR Nursing/DPM staff in the NIH Clinical Center: Dr. Fauci.pptx Beautiful and loving tribute to me from my children on a video: https://drive.google.com/file/d/1wgTkwmAlUhlnLKzIhWPlIR4E4WPpUMh6/view?usp=drivesdk Joan Baez texted…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 5, "page_count": 1141}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 6 of 10)", "content": "at such an amazingly fast pace \nthat I do not know what I am about to do until I sit in front of the zoom and do it. \n•Met by Zoom with POTUS and VPOTUS for our regular weekly update.\nPRESS: KSNV- TV – Las Vegas with Jeff Gillian;  KABC - TV – Los Angeles with Denise \nDador; KCBS Radio – San Francisco with Mike DeWald\nReleased by Chairman Rand Paul\nApril 23, 2021 – Global – 144,400,000/3,100,000; USA – 31,700,000/567,400\nStill plateauing, but the 7-day average is slightly down (~10%):\nPresented before the Lasker Board with Elia Zerhouni, Peggy Hamburg, Al Reese, Joe Goldstein \nand I mentioned when they said I was their hero, that I was also a “target” for some.   They \nimmediately said “We have you back”.   Important in light of the antipathy of many against me.\nPRESS:  White House Press Conference;  Online – TV - The Birmingham News; Huntsville \nTimes and Mobile Press-Register with Ivana Hrynkiw; MSNBC with Ayman Mohyeldin; \nPBS Newshour with Judy Woodruff; MSNBC Town Hall with Alicia Mendez and Rep. \nRaul Ruiz\nApril 24, 2021 – Global – 145,200,000/3,100,000; USA – 31,800,000/568,200\nReal crazy anti-Fauci stuff going on. Two authors named Steve Deace and Todd Erzen wrote a \nbook about me entitled “Faucian Bargain” - The most powerful and dangerous bureaucrat in \nAmerican history. It is a cheap paperback of 179 pages which I will not even read but it contains \nthe same sort of nonsense that the other conspiracy theorists have been saying about me. It is \nreally getting worse and worse in the number of crazy people who are buying into this \nconspiracy theory and so now we have the book by Robert F Kennedy junior and this book by \nthese two guys as well as a number of right wing columnists such as Josh Rogin , as well as \nReleased by Chairman Rand Paul\nmultiple commentators on Fox News who spend much of their time making me out to be the \nworst villain in the world and or trying to discredit me. \nHad important meeting with Jeff Zients, David Kessler, Francis Collins, Car Dieffenbach, \nNatalie Quillian, Dina Halme, Lauren ….  To discuss the $3.15 billion for the COVID-19 anti-\nviral program.  There was considerable concern on our part that we would not be getting the \nfull amount of money for this very important program to develop antiviral drugs for COVID-19. \nOmb has indicated that they may use some of that money for the purchase of booster doses for \nthe vaccine program. We called this meeting together in order to get Jeff to support the fact that \nthis is an incredibly important program for the current and future pandemics. Carl describe the \nprogram very well and I believe that we have convinced Jeff to strongly support us. See below \npower for a detailed description with slides:  \nWe still are doing pretty well against the current variants with regard to our vaccines;\nEric Topol’s take on Variants:\nReleased by Chairman Rand Paul\nIndia is exploding with cases with the new variant B.1.617 (see below):\nWe have a serious problem of optics regarding our not sending to needy countries any of \nthe AZ doses of vaccine at the same time as we have a greatest supply than demand right \nnow. There is growing sentiment throughout the developing world at the United states is being \nunethical and amoral in not giving away doses of vaccine from AZ that we know we will never \nuse. This is particularly the case with India that is really exploding with infections.   The are now \nhaving >300,000 infections per day.  One can say that you cannot do this since AZ has only been \napproved under an EUA. However, there are certainly ways that we can get around this. The \nbottom line is that we are looking very bad in the eyes of the low and middle income countries. I \nwill continue to bring this up to Jeff Zients and other leadership.  In fairness to our position, we \ndo not really have a lot of doses of AZ vaccine hang around unused. Novovax does not come \nReleased by Chairman Rand Paul\nonline until around June, and so the argument that we want to secure enough doses for ourselves \nincluding boosters can be defensible. Unquestionably, this is a very difficult situation.  \nAmazing, but Vivek called me right after I wrote this with the same feeling as expressed above.  \nWe tried to get a meeting with Vivek, me, Rochelle, and Jeff to discuss how we are going to \nhandle the situation with regard to India , particularly on the Sunday TV shows that Vivek and I \nwill be on tomorrow. Unfortunately, Jeff could not squeeze in a meeting. \nPRESS:   Huffington Post:\nAnthony Fauci Delivers Short, Sharp \nShutdown Of GOP Senator’s Vaccine \nDoubt Bluster\nApril 25, 2021 – Global  - 146,100,000/3,100,000; USA – 31,800,000/569,000\nWe had an important zoom talk at 11:00 AM today with Jeff , me, Rochelle, Natalie, \nand Vivek regarding our response to the crisis in India. See above. Jeff is sensitive to \nour concerns and indicated that Jake Sullivan in NSC is already involved in sending \nmaterials to India including filters for vaccine production, oxygen supplies, ventilators, \ntherapeutics such as remdesivir and favipiravir, sedation meds, test kits, and PPE. I \nbrought up the fact that the real issue is sending our doses of the AZ vaccine that we \nnow have on the shelf. The issue is that we keep saying that we will do this when we are \nconfident that we will be able to vaccinate all Americans. However, this is somewhat \ncontradictory since we have already publicly said that we have enough vaccine from \nModerna and Pfizer to vaccinate everyone in the country who needs to be vaccinated. \nAnd so, it is clear that we're not going two need the AZ vaccine. Thus, why not send it \noff to India and other countries as soon as possible? Jeff and Natalie agreed and we will \npush this agenda soon. \nRelease today! - National Security Advisor Jake Sullivan spoke by phone today with \nNational Security Advisor Ajit Doval, expressing deep sympathy for the people of India \nfollowing the recent spike in COVID-19 cases. Mr. Sullivan affirmed America’s solidarity with \nIndia, the two countries with the greatest number of COVID-19 cases in the world. Building on \nthe seven-decade health partnership between the United States and India —including battles \nagainst smallpox, polio, and HIV — they resolved that India and the United States will continue \nto fight the global COVID-19 pandemic together. Just as India sent assistance to the United \nStates as our hospitals were strained early in the pandemic, the United States is determined to \nhelp India in its time of need.\nReleased by Chairman Rand Paul\nTo this end, the United States is working around the clock to deploy available resources and \nsupplies. The United States has identified sources of specific raw material urgently required for \nIndian manufacture of the Covishield vaccine that will immediately be made available for India. \nTo help treat COVID-19 patients and protect front-line health workers in India, the United States \nhas identified supplies of therapeutics, rapid diagnostic test kits, ventilators, and Personal \nProtective Equipment (PPE) that will immediately be made available for India. The United States \nalso is pursuing options to provide oxygen generation and related supplies on an urgent basis. \nThe U.S. Development Finance Corporation (DFC) is funding a substantial expansion of \nmanufacturing capability for BioE, the vaccine manufacturer in India, enabling BioE to ramp up \nto produce at least 1 billion doses of COVID-19 vaccines by the end of 2022. Additionally, the \nUnited States is deploying an expert team of public health advisors from the Center for Disease \nControl (CDC) and USAID to work in close collaboration with the U.S. Embassy, India’s health \nministries, and India’s Epidemic Intelligence Service staff. USAID will also quickly work with \nCDC to support and fast-track the mobilization of emergency resources available to India \nthrough the Global Fund.\nI had an important zoom meeting today with Larry Corey an Emilio Emini about \nthe same subject as above  , namely, how the United states can play a major proactive \nrole in getting mRNA vaccines to the developing world. In our discussion, it became \nclear that there are immediate needs as mentioned above; however, there is also the \nimmediate need of getting vaccine doses to lower and middle income countries. The \nUnited states could exert leadership in pressuring Moderna and Pfizer to scale up their \nvaccine production and sell it two developing nations at cost for production which is \napproximately $6 per dose as compared to the $30 produced that we are currently \npaying here in the developed world. Apparently there are liability issues that the \npharmaceutical companies are concerned with. These revolve around the fact that \nalthough the United States government can indemnify the companies against lawsuits \nhere in the United states the companies feel that they are liable to being sued for \nadverse outcomes by people in the countries to whom they're providing vaccine. Some \nmechanism needs to be worked out to address this concern. I have asked Emilio and \nLarry to put a one pager together summarizing our discussion so that I can bring it to \nJeff who could bring it to Ron Klain who could bring it to the president. More later. \nBreakthrough infections are very rare:\nReleased by Chairman Rand Paul\nFront page of the Washington Post had a major article on the drastic situation in India \nand reported on the universal criticism there is of the United states in not doing \nsomething about it right now. I will be on ABC This Week with George Stephanopoulos \nthis morning and will likely get asked questions about India. \nMore studies showing that vaccines dramatically diminish asymptomatic infection and \nso great er argument for not needing to wear masks following vaccination:\nPRESS:  ABC “The Week” with George Stephanopoulos; CNN – Weekend Prime \nTime with Jim Acosta; NYT: Fauci and other top U.S. health officials stress the \nurgency of vaccinations and their safety. https://nyti.ms/3dPn1ms\nReleased by Chairman Rand Paul\n Phenomenal article in the Sunday New York Times  about me by Frank Bruni:\nOpinion\nSo Anthony Fauci Isn’t Perfect. He’s Closer \nThan Most of Us.\nWe owe him gratitude, not grief.\nBy Frank Bruni\nThe phrases “public servant” and “public service” are exhausted to the point of meaninglessness. \nThey’re tics. They roll off politicians’ tongues as readily as requests for money, suggesting that adulation \nand power aren’t the more potent draws to elected office. They’re invoked in regard to other \ngovernment workers, as if decent paychecks and generous pensions weren’t a significant lure.\nBut if anyone ever deserved to be described in those terms, it’s Anthony Fauci. That was true before the \ncoronavirus. It’s truer now — despite the times when he has revised his message on how to deal with it, \ndespite assessments of the pandemic that didn’t bear out and despite Republicans’ efforts to use all of \nthat to turn him into some bespectacled Beelzebub.\nShocker of shockers: Fauci isn’t perfect. But he has been perfectly sincere, perfectly patient, a \nprofessional standing resolutely outside so many of the worst currents of American life. More than that, \nhe has been essential. We owe him an immeasurable debt of gratitude, not the mind-boggling \nmagnitude of grief that he gets.\nIf anything, that grief has grown more intense of late. It was on garish display during a House hearing \njust over a week ago, when Representative Jim Jordan, doing a fan dance for Fox News, tore into Fauci \nas a doomsday addict less intent on saving people’s lives than on scrapping people’s liberties.\n“Dr. Fauci, when is the time?” Jordan, an Ohio Republican, asked, meaning the moment when we can all \nstart behaving as if nobody’s getting infected or dying anymore. (For the record, on a given day, more \nthan 60,000 Americans are still testing positive for the coronavirus and an average of 700 lose their lives \nReleased by Chairman Rand Paul\nto Covid-19.) “In your written statement, you say now is not the time to pull back on masking, physical \ndistancing and avoiding congregate settings. When is the time? When do Americans get their freedom \nback?”\nJordan noted angrily that “15 days of ‘slow the spread’ turned into one year of lost liberty.” He made \nthat sound like Fauci’s fault, when the truth is that if more people, including Jordan and many of his \nconstituents, had taken the “slow the spread” period more seriously, the year that followed it would \nprobably have been much less brutal and significantly less deadly. But they were often too busy railing \nagainst Fauci to reform their own conduct.\nJordan isn’t some grandstanding outlier. He’s an emblem and instrument of widespread fury within his \nparty, where the demonization of Fauci hasn’t just survived Donald Trump’s presidency but \nmetastasized since its end.\nFrank Bruni’s Newsletter: Get a more personal take on politics, newsmakers and more with Frank’s \nexclusive commentary every week.\n“Fauci” was a dirty word uttered from the stage of the Conservative Political Action Conference in \nFlorida in February. “Fauci” is a dirty word prevalent in conservative publications. In Breitbart News \nseveral days ago, Fauci was dismissively referred to as America’s top “public health celebrity.” “Fauci \nFallacies at All-Time High” was a recent headline in The Washington Free Beacon. In the span of one \nweek this month, National Review published articles titled “Anthony Fauci Has Worn Out His Welcome,” \n“Anthony Fauci’s Misadventures in Fortune-Telling” and “Another Dismal Sunday-Show Circuit for Dr. \nFauci.”\nJust a few days ago in The Washington Post, Dan Diamond mentioned Fauci antipathy in the opening \nparagraph of a report about people who refuse to get vaccinations against the coronavirus. The message \nfrom one focus group of such people, he noted, was that “if you’re trying to win over skeptics, show us \nanyone besides Dr. Fauci.”\nPhilip Bump, one of Diamond’s colleagues at The Post, correctly observed that “Fauci has become what \nTrump always wanted him to be: the scapegoat for unpopular government recommendations.”\nBut it’s even bigger and weirder than that. “He doesn’t work for us,” the writer Naomi Wolf said on Fox \nNews on Monday, referring to Fauci and reacting to a $1 million prize given to him by a philanthropy in \nIsrael as a recognition of his, yes, public service. She cast the money as evidence that he was “so \nconflicted” and not sufficiently guided by concern for the “public health of the American people.”\nThere’s a lot of this out there, and all of it is out there. We live in times that are viciously partisan and \noratorically sloppy — but Fauci is neither.\nHe’s consistently cool, answering the rants of Jordan and others with expert insights and logical \nanalyses.\nReleased by Chairman Rand Paul\nHe’s generally cautious, and the people constructing scorecards of his correct and incorrect predictions \ndisingenuously conflate him with Oscar-pool contestants placing bets on best supporting actress. Fauci \nwasn’t making wagers, wasn’t saying sooths. He was giving his best educated guesses, based on what \nwas knowable at that juncture. His guesses evolved as his — and our — education improved. Informed \nguidance like his is better than no guidance at all, and information isn’t static.\nOver three and a half decades as the director of the National Institute of Allergy and Infectious Diseases, \nFauci, now 80, has advised and earned the trust of Republican and Democratic presidents. He managed \nsomehow to correct Trump and yet not be replaced with a sycophant who would have fed the former \npresident’s delusions and further endangered Americans’ lives.\nThat’s more than public service. That’s magic. And he was thanked for it with death threats, issued not \njust to him but also to his family, and with a piece of mail that, when he opened it, sprayed an \nunidentified white powder all over him. He sat there covered in it while a hazardous materials team \nswept in.\n“My wife and my children were more disturbed than I was,” he told The Times’s Donald McNeil in an \ninterview in January. “I looked at it somewhat fatalistically. It had to be one of three things: A hoax. Or \nanthrax, which meant I’d have to go on Cipro for a month. Or if it was ricin, I was dead, so bye-bye.”\nWhy didn’t he say bye-bye to this awful role and the nonstop vitriol, given how much he’d contributed \nto the country from the AIDS epidemic onward and given that most 80-year-olds like him are taking it \njust a tad easier?\n“I always felt that if I did walk away, the skunk at the picnic would no longer be at the picnic,” he told \nMcNeil, referring to his ability to challenge the happy talk of Trump administration officials who wanted \nsimply to wish the coronavirus away. “Even if I wasn’t very effective in changing everybody’s minds, the \nidea that they knew that nonsense could not be spouted without my pushing back on it, I felt was \nimportant. I think in the big picture, I felt it would be better for the country.”\nHe felt correctly. That assessment would be self-aggrandizing only if it weren’t true, just as his many \nmedia interviews would smack of preening if there weren’t such clear educational purpose to them. The \nkey to his temperament — and to the greater measure of humility than of hubris in it — lies in how, \neven now, he talks about Trump. Although Fauci has ample cause for venom, there’s little trace of it in \nhis words. He faults Trump without mocking him. That shows a discipline that’s rare. I never achieved it.\nSure, Fauci won a $1 million prize, but he didn’t agitate for it, and there isn’t a doubt in my mind that \nduring many points over the years, he could have left government for the private sector, traded on his \nstature and connections, and become an exponentially wealthier man. He refrained from that as surely \nas he has from the pettiness that most of the rest of us can’t resist.\n“He has no other ambition or agenda than the health of the country and world,” wrote the  Washington \nPost columnist Michael Gerson, who, as a senior official in the George W. Bush administration, became \nacquainted with Fauci.\nReleased by Chairman Rand Paul\nI understand — and personally feel — any American’s frustrations with the continued caveats regarding \nmasks and gatherings and such. But it’s Fauci’s mandate to urge the safest possible behavior. I \nunderstand how maddening it can be to get different answers at different times. But uncertainty is the \nnature of this beast.\nI don’t understand the rage at a remarkable public servant, and I’ll let Gerson have the last words on \nthat. “Fauci is practicing epidemiology,” he wrote. “His critics are practicing idiocy. Both are very good at \ntheir chosen work.”\nApril 26, 2021 – Global – 146,800,000/3,100,000; USA – 31,900,000/569,300\nI had an interesting conversation with Vivek late last night. He called me up after we had a \nmeeting with Jeff and the medical team concerning the guidelines that the CDC was about to put \nout regarding the wearing of masks outdoors as well as indoors in vaccinated versus \nunvaccinated people. Vivek was concerned about something that I had been concerned about for \na long period of time. That is the CDC often puts things out that none of us can really adequately \ndefend because it is either unclear or just does not make any sense. This is exactly what \nhappened last night when Rochelle presented a color-coded guideline that no one could really \nunderstand . Yet, the CDC was about to put it out. To her credit, Rochelle ran it by the medical \nteam.  Rochelle is in a difficult position since she is new in the job and is reluctant the contradict \nher team which has been in place for decades. That is really the fundamental problem of the \nCDC. For as long as anyone can remember they are isolated in Atlanta, are extremely arrogant, \nand are offended if anyone on the outside asks to see their material before they actually put it \nout. They are very close-to-the-vest.  I have known this for some time as have my colleagues \nhere at NIH. However, it is interesting and in some respects gratifying that Vivek has now picked \nthat up on his own and fully realizes the problem. \n•Did Town Hall with the Harvard T.H. Chan School of Public Health led by Sam Baker of \nAxios and included Mary Bassett, Karen DeSalvo, Garth Graham, and Michael Mina\n•Did Principal’s meeting with Cabinet.\nHad a wonderful zoom session with President Obama - I was on a zoom one on one \ndiscussion with President Obama for the purpose of encouraging people to get vaccinated. He \nwas his typical engaging and highly intelligent self. Similar to what my experience was when he \nwas in the White House, he had a perfect grasp of all of the details surrounding vaccines. It just \nreminded me of what an incredible person he is and what an amazing president he was. We joked \naround a lot about what I had gone through over the last year. I even mentioned to him that \nduring an interview with some of the sports reporters I had mentioned that if I went one on one \nwith him in basketball even though he is very tall and has a great jump shot, I still would be able \nto dribble around him since I'm so fast. He started to laugh and said that I better stop talking \nReleased by Chairman Rand Paul\ntrash to him because now he's mad and if we ever get to play together he'll block every one of \nmy shots. The interview was really a terrific experience. \nPRESS:  Newsy TV Interview with Kellan Howell;  NBC TV interview with Lester Holt for \nthe Aspen Institute Online; \nApril 27, 2021 – Global – 147,500,000/3,100,000; USA – 31,900,000/569,800\nComing down.   2nd day in a row in the 30s:\nPRESS:  Sanjay Gupta podcast; IAS Podcast on 40 years of HIV; White House Press \nConference (spoke on variants); WTOP Radio with Megan Cloherty; NY Times Editorial \nBoard;  NPR – “All Things Considered” with Mary Louise Kelly; Windy City Times \ninterview – 40 years of HIV; Interview for Research!America with Opray Winfrey; \nMSNBC with Chris Hayes;\nApril 28, 2021 – Global -148,300,000/3,100.000;  USA – 32,000,000/570,400\nReleased by Chairman Rand Paul\nLetter to Dr. Collins from Republican Congressmen Cathy McMorris Rodgers, Brett Guthrie, \nand Morgan Griffith asking many questions about the origin of SRAS-Cov-2.   Clearly trying to \ndig up dirt and implicate the NIH in collaborating with the Chinese leading somehow (???) to the \nrelease or escape of SARS-CoV-2 from the Wuhan lab:\nSKM_C754e2104280\n6490.pdf\nI am starting to put much more pressure publicly on pushing for a global response to the \npandemic by urging us to help low and middle income countries with focus now on Indias.  See \ntoday’s Washington Post: \nCovid-19 live updatesGlobal pandemic \nneeds a more global response, Fauci says, \namid record-breaking deaths in India\nLatest: How to access the risks of returning to the gym\nThe Fauci “thing” is as thick as ever:\n•Francis and I were on a Zoom call with Stephane Bancell (CEO of Moderna) and Stephen \nHose (President of Moderna).   We discussed two things: the fact that we felt that \nModerna should be doing more to provide vaccine for low and middle income countries. \nWe wanted them to help out by transferring their technology two nations such as Senegal \n, Ethiopia, and countries in South America in order to allow those countries to make \nvaccines for themselves. They felt that this is something that they would likely do but that \nit would take at least two years for those countries to stand up their plants even if the \ntechnology was transferred. Their idea was a two-pronged approach. First, they are \nramping up their capability of producing vaccine and by the end of 2022 they feel that \nthey will be able to produce a total of 3 billion doses. They would be happy to make \nthose doses available at a lower tiered price to the developing world. In addition, they \nReleased by Chairman Rand Paul\nagreed that they would participate in a longer range plan to transfer technology 2 low and \nmiddle income countries to make their own vaccine. In addition, Frances and I spoke \nabout the patent dispute between the NIAID Vaccine Research Center and Moderna.  The \nstory is that the lawyers of Moderna feel that the VRC people such as Barney Graham an \nothers technically should not be inventors on the patent for the discovery of the vaccine. \nWe strongly disagree with that an as a matter of fact so do Stephane and Stephen.  they \nrealize that it is unfair to exclude us from the patent; also it would be a public relations \ndisaster for them if they excluded us. They promised that they would get this resolved \nsoon. \n              It is clear that Pfizer can do the same thing. In fact, Pfizer can likely produce 3 billion \ndoses by the end of this year and even more next year . If this is possible which I believe that it \nis, then we could probably vaccinate the entire world that wants to be vaccinated within the next \nyear and a half. \nPRESS:  NBC “Today” with Savannah Guthrie; CNN with Jim Sciutto;\nWall Street Journal – Robbie Whelan - Vaccines Appear to \nBe Slowing Spread of Covid-19 \nInfections\nWith more than 37% of U.S. adults fully vaccinated, Anthony Fauci \nexpects case numbers to drop significantly\nApril 29, 2021 – Global -149,200,000/3,100,000; USA – 32,000,000/571,300\nMMWR:\nLinked Clusters of SARS-CoV-2 Variant B.1.351 \n— Maryland, January–February 2021\nBack up again to 53,000/day:\nReleased by Chairman Rand Paul\n•Did a zoom podcast interview with Quinn Bradlee (son of Sally Quinn and the late Ben \nBradlee).   He is disabled and Sally asked me to do this.   I could not refuse since I \nadmired Ben so much and he was always so gracious and kind to Chris and me.  He was \nso excited to have the opportunity to interview me.\nImportant Issue: Francis Collins forwarded an email to me (see below )which triggered \na concern about whether the Indian variant – B.1.617 was resistant two antibodies induced by \nvaccines. I forwarded this email to the medical team including Jeff Zients and Rochelle \nWalensky.  Rochelle called me up and mentioned that her colleagues in Boston including those \nat the Broad Institute as well as Dan Barouch were finding that the Indian variant could be very \nproblematic with regard to its resistance to vaccine induced antibodies. In addition, I spoke with \nBob Seder and the work that he has been doing with monkeys also indicates that B.1.617  could \nbe very problematic. Then, Jeff Zients called me up together with Natalie Quillian and feels that \nwe should call a temporary halt on travel from India until we sought this out and based on the \ninformation that I sent him. This is a critical decision since if we don't block travel from India \nand things look bad later on we will be sharply criticized for not doing so. However , if we do \nblock travel, there will be those who criticize us for doing so. This is very similar to the \ndeliberations that we had during the Trump administration regarding China, the Eu and the UK.\nSEE E-MAILS BELOW starting with the e-mail that I sent to the medical team of \nWalensky, Vivek, Bechara, Slavitt, Zients, Nunez-Smith.  (Rochelle subsequently \nforwarded it to Dawn O’Connell at HHS)\nTeam:\nReleased by Chairman Rand Paul\n    Please see e-mail below from Dr. Venkatachalam to Francis Collins.   Although \nthis is still at the level of anecdote, I am hearing from people who are doing \nstudies in vitro that the B.1.617 variant is at least as concerning as the \nB.1.351.   We should discuss this at our next meeting.\nBest,\nTony\nAnthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nThe information in this e-mail and any of its attachments is confidential and may contain sensitive \ninformation.  It should not be used by anyone who is not the original intended recipient.  If you \nhave received this e-mail in error please inform the sender and delete it from your mailbox or any \nother storage devices.  The National Institute of Allergy and Infectious Diseases (NIAID) shall not \naccept liability for any statements made that are the sender's own and not expressly made on \nbehalf of the NIAID by one of its representatives.  \nFrom:  Collins, Francis (NIH/OD) [E] < collinsf@od.nih.gov> \nSent: Thursday, April 29, 2021 5:56 AM\nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>; Lane, Cliff (NIH/NIAID) [E] \n<clane@niaid.nih.gov>; Mascola, John (NIH/VRC) [E] <jmascola@mail.nih.gov>; Erbelding, Emily \n(NIH/NIAID) [E] <emily.erbelding@nih.gov>; Wholley, David (FNIH) [T] <dwholley@fnih.org>; Menetski, \nJoseph (FNIH) [T] < jmenetski@fnih.org >\nSubject: FW: Concerning news about the B.1.617 variant from India and your view\nMore concerns about B.1.617 and the effectiveness of vaccines.\nFrom:  Venkatachalam, Sundar (NIH/NCI) [E] < sundar.venkatachalam@nih.gov> \nSent: Thursday, April 29, 2021 4:53 AM\nTo: Collins, Francis (NIH/OD) [E] <collinsf@od.nih.gov>\nSubject: Concerning news about the B.1.617 variant from India and your view\nReleased by Chairman Rand Paul\nDear Dr. Collins,\nI hope this message finds you and your family well.  I wanted to bring to your attention about a public \nhealth like message circulating among the Indian diaspora in the New Jersey area. Apparently, parents \nvisiting from India who tested negative before their flight in India have come down with Covid (the \nmessage claims it is the B.1.617 variant from India) after 10 days.  They have also visited a variety of get \ntogethers, temples before the symptoms arose.  This variant was detected in the Bay Area earlier this \nmonth and the CNBC article quotes Dr. Pinsky from Stanford saying that the variant may be a challenge.\nMore concerning is the news from a friend of mine from Texas who says that two IT professionals who \nhad both their shots in the US were visiting India to take care of their parents (infected with Covid). \nUnfortunately, the vaccinated IT professionals have died of Covid. He has promised to provide details as \nI have been skeptic of social media posts without backing.  NPR also had a story yesterday that said 37 \nvaccinated doctors in Delhi have come down with Covid in New Delhi but did not say anything about \ntheir condition.\nAs you already know that the daily caseload reported in India during the past 4-5 days has been ~200 to \n300K  and is probably closer to half a million or a million given the infrastructure and access to \nhealth.  Even as early as last year I have suspected the numbers from India were being manipulated (see \nattached PDF) while looking at the Worldometer Covid update site.  Sadly, I am speaking of the country I \nwas born in and grew up- but cannot relate to or understand her values anymore.\nI was wondering if we are running the risk of another wave of infection in the US as hundreds (if not \nthousands) are flying between the US and India daily.  I see that ~30% of the US population is fully \nvaccinated as of today and 43% have received a single shot -an enormous success by any rate in this \nshort period.  However, is it a risk, as we relax the guidelines in the US while allowing new variants enter \nand circulate in the community with more than half the population yet to be vaccinated?  \nWe have come this far and I really hope this sad episode does not repeat again.  Sadly, there are folks \nwithin and outside our country who are waiting to use any opportunity to blame NIH/science and our \npresident.   I have lost sleep thinking of it since I saw the news circulating and thought that you or Dr. \nFauci could provide an answer. I apologize for this long email.  \nSincerely,\nSundar\nReleased by Chairman Rand Paul\nSundar Venkatachalam, Ph.D.\nChief, Preclinical Therapeutics Grants Branch\nDevelopmental Therapeutics Program\nDivision of Cancer Treatment & Diagnosis\nNational Cancer Institute\nsundarv@nih.gov\nBioNTech chief confident Covid jab will work on \nvariant found in India \nVISIT TO BALTIMORE WITH VP HARRIS - Today I went to Baltimore at the invitation of \nVice President Harris to accompany her to the M&T Bank stadium where the Baltimore Ravens \nfootball team plays. The stadium has served as a mega hub and mass vaccination site for the \nadministration of vaccines in the city of Baltimore. It was a delightful trip strengthening my \nrelationship with the vice president. She was her usual delightful self and as we walked through \nmultiple sections of the indoor component of the stadium, we passed hundreds of people: people \nwaiting to be vaccinated by the hundreds; people already vaccinated being observed; national \nguard who are helping with the vaccinations; and a wide array of sections of people vaccinating , \nentering information into a computer, and  a pharmacy dispensing the vaccine. As we walked \nthrough the different sections people equally screamed out “we love you Doctor Fauci” and “we \nlove you Vice President Harris. We stopped dozens of times to take selfies with a whole variety \nof people. The vice president was genuinely pleased to see the attention paid to me as well as to \nher. She is a real winner.    \nPRESS:  NBC interview with Heid Przybyla on the role of the VP in outreach to promote \nthe uptake of vaccines; Italian TV La7 News; much press related to the visit to the VP to \nBaltimore.\nReleased by Chairman Rand Paul\nAxios - Joe Rogan walks back anti-vaccination \ncomments\nApril 30, 2021 - Global – 150,100,000/3,200,000; USA - 32,100,000/572,200\nWe shut down travel from India – See above.   Travel from India will cease for all non-USA \ncitizens.   Will start on Tuesday May 4.   I am concerned that by delaying the actual shutting \ndown we will be faced with the same situation that we faced with China and the European \nUnion. In those circumstances there was a rush of people trying to get to the United states who \nare noncitizens, and so a large number of people who were likely infected in fluxed to this \ncountry.   \n•Senator Lindsey Graham has written 2 letters to me telling me that I must go to the \nborder and see the seriousness of the situation since I am the chief medical advisor to the \npresident. Obviously this is a political ploy to embarrass president Biden. I just wrote \nback to senator Graham and told him that my job is to develop vaccines and drugs and to \nbe involved in strictly medical issues, and that the border problems are the CDC, the \nDepartment of Homeland Security, or the Department of State. \nPRESS:   Interview with India Express (print); White House Press briefing (discussed 2nd \nshot); Canadian Broadcasting Company (CBC) – TV; Fireside Cat Online with Canadian \nGenomic Forum; WBUR (NPR) – “On Point” with Meghna Chakrabarti; Instgram with \nEva Longoria; Local TV for Memphis, TN and New Orleans, LA; \nReleased by Chairman Rand Paul\nInstitute), Torrian Baskerville of NASTAD, Edward Bitarakwate, Uganda Country \nDirector for EGPAF, and Joyce Ouma of National Empowerment Network of PLWH in \nKenya, and Maureen Goodenow of OAR \n●Had usual Zoom meet with Sec Becerra.   I informed him of Novovax results.\n●Had SCIF meeting with Deputies regarding global distribution of vaccines\nPRESS:   Andy Slavitt tweets a strong defense of me; Health Care Radio Interview\nJune 15, 2021 – Global – 176,000,000/3,800,000;  USA – 33,300,000/598,000\nCases continue to come:\nPRESS: NBC “The Tonight Show” with Jimmy Fallon\nJune 16, 2021- Global – 176,000,000/3,800,000; USA – 33,300,000/600,000\n●Bob Redfield is out there spouting incorrect information saying that he feels strongly that \nthis was a virus that leaked from a laboratory. The basis of his saying this is that he feels \nthat the virus was so well adapted to humans right from the beginning that it had to have \nReleased by Chairman Rand Paul\nleaked from a lab. Any respectable virologist would know that this is total nonsense since \nthe virus clearly could have jumped species as a less efficient spreader and causer of \nserious disease and had been circulating in the human population beneath the radar screen \ngathering efficiency in transmission and pathogenesis until it was finally recognized in \nthe middle of December of 2019 when many people were getting seriously ill. This is the \nway viruses evolve from nature. In fact, we are still seeing that to this day in what we are \ncurrently experiencing in that variants are developing greater capability of spreading and \ngaining even greater pathogenesis. Another example of Bob Redfield being dead wrong. I \nam surprised and disappointed that he is out there spouting such nonsense.  I guess that \nhe wants to feel relevant now that he is no longer CDC Director. \n●Email of support fro Michel Kazatchkine:\nFrom: Michel Kazatchkine <contact@michelkazatchkine.com >\nDate: Wednesday, June 16, 2021 at 9:54 AM\nTo: \"Lane, Cliff (NIH/NIAID) [E]\" <clane@niaid.nih.gov>\nSubject: Tony\n \nDear Cliff,\n \nHope you are well. As many these days,  I am looking forward very much to America being back \nin global / multilateral health!\nAs many many people around the world, I feel deeply sorry and frustrated about the attacks on \nTony.\nI know that his box is full.\n \nThat is why I allowed myself to use your mail to convey him a message of friendship and \nsupport.\n \nWarm greetings\n \nProfessor Michel Kazatchkine\nSpecial Advisor to the Joint United Nations Program on AIDS (UNAIDS) in Eastern Europe and Central Asia\nSenior Fellow, Global Health Center, the Graduate Institute of International and Development \nStudies, Geneva\nReleased by Chairman Rand Paul\nPRESS:   CBS “This Morning”; ITV (UK TV); Interview with Alison Young of USA Today \non lab-leak hypothesis; Interview with Yahoo Life; Did White House digital team PSA at \nNIH; New York Times Sway Podcast with Kara Swisher\nVery Important piece in Foreign Policy by Justin Ling:\nThe Lab Leak Theory Doesn’t Hold Up\nThe rush to find a conspiracy around the COVID-19 pandemic’s \norigins is driven by narrative, not evidence.\nBy Justin Ling\nQuote from the article below:\nAnd what about RaTG13, the virus that Wade and Baker argue is so similar to COVID-19 that it would \nonly need some tuneups? In a statement from April 2020, Edward Holmes—an evolutionary biologist \nand virologist at the University of Sydney—noted that “the level of genome sequence divergence \nbetween SARS-CoV-2 and RaTG13 is equivalent to an average of 50 years (and at least 20 years) of \nevolutionary change\nThe Washington Post:\nTwo weeks later, Tucker Carlson’s attack on \nFauci has quietly collapsed\nThe News Corp. building on 6th Avenue, home to Fox News, the \nNew York Post and the Wall Street Journal, on March 20, 2019, in New York. (Kevin Hagen/Getty Images)\nBy Philip Bump\nReleased by Chairman Rand Paul\nHistorical record of A.S. Fauci - Part 4 \nMay 1, 2021 – Global – 151,000,000/3,200,000; USA – 32,100,000/573,000\nI am going public that pharmaceutical companies should share their technologies with \ndeveloping nations to allow them to make their own vaccine developed by the companies.   Also, \nthey should receive vaccines while the plants are gearing up in their own countries to start \nmaking product (see below)\nPRESS:  MSNBC with Jasmeen Vossoughian; \nWashington Post – Dan Diamond:\nWhite House is split over how to vaccinate the \nworld - The proposal was discussed last week by Anthony S. Fauci, a top coronavirus adviser to \nPresident Biden, and Katherine Tai, the U.S. trade representative, who spoke about ways to help the \ndeveloping world as it reels from a worsening crisis.\nFauci briefed Tai on the benefits of sharing technologies from companies that hold vaccine patents — a \nposition that he supports, arguing that it would allow developing countries to rapidly  produce their own \nvaccines, said people with knowledge of White House deliberations who spoke on the condition of \nReleased by Chairman Rand Paul\nanonymity because of the conversations’ sensitivity. Tai separately told colleagues that she’s considered \nadvocating to lift some patent protections but is still gathering information, said two of those people.\nMay 2, 2021 - Global – 151,800,000/3,200,000; USA – 32,200,000/573,800\n•Had dinner over Jeff Zients’s house with wife Mary, Bob Seder and Deb Harman, Denis \nMcDonough and wife Kari.   Terrific time.   Jeff is as wonderful on a personal basis as he \nis professionally.  His home at 4500 Garfield Street, NW is absolutely magnificent.\n•Jeff Zients Called me this evening giving me a heads up that he might want me to write a \none page memo the president Biden explaining to him the situation in India particularly \nwith regard to the variants. I convinced him that it might be better to arrange for a phone \ncall between me and the president so that I could respond to his questions rather than \nhave him receive a memo that he would have questions about. Jeff said we could think \nabout it overnight and decide tomorrow. \nPRESS: Connecticut Public Television “The Jane Whitney Show”\nMay 3, 2021 – Global – 152,500,000/3,200,000; USA – 32,200,000/574,200\nReleased by Chairman Rand Paul\nIndia is exploding:\nGood number today for the USA:\nReleased by Chairman Rand Paul\nJeff called me this morning and said that it would be best for them to arrange for me to speak \none on one with the president over the next couple of days concerning the India issue . I believe \nthat this is the best way to go. \n•regarding the situation at the Texas-Mexico border. The congressman has an interesting \nproblem and an issue. Apparently, people coming from Mexico to the United states who \nare holding valid visas are not being allowed to come in through land crossings. Most of \nthese people are poor and cannot afford to fly in.  However, the wealthier people who can \nfly into the United states but who are required to have a test before they get on the plane \nare allowed to come in. This becomes an economic issue for the border towns in the \nUnited states such as Laredo. Visa-carrying Mexicans spend about $19 billion per year in \nthe border towns. It becomes a serious economic issue if they are not allowed in. The \ncongressman wants my help since Homeland Security says that this is a medical issue and \nthe congressman points out that it is not a medical issue; but it is an economic issue. I \nexplained to the congressman that I believe that Homeland Security thinks it is a medical \nissue because the people who come over on land crossings do not have testing readily \navailable to them and so given the possibility that some of them are infected, Homeland \nSecurity considers this a medical issue. My suggestion for a solution is to figure out a \nway to get the United States side of the border to provide rapid testing for the visa-\nholding Mexicans as they enter the country , and if they are negative, they are allowed to \nenter. I promised to check with the medical adviser to Homeland Security to see if we can \nstraighten this out.  I will have our staffs connect us.\n•Two countries that have done things differently from us – UK and Israel.   They both \nlocked down completely until their number started to come down sharoply and then they \nramped up vaccinations and now their test positivity is 0.1%.   See the results below:\nReleased by Chairman Rand Paul\nThe far right continues to accuse me of fostering dangerous gain-of-function research.   \nThe letter to the editor of the National Review refutes this:\nLetter to the Editor \nNR.pdf\nPRESS: Interview with Press Trust of India Washington Correspondent (print); Seattle \nNBC TV (on the “Fauci effect” in med schools); Science News interview with Aimee \nCunningham; WBAL radio and TV (Baltimore); King TV (Seattle) – interview together \nwith Larry Corey;\nSheryl Stolberg in The New York Times:\nPressure Mounts to Lift Patent \nProtections on Coronavirus Vaccines\nDr. Anthony S. Fauci, Mr. Biden’s chief medical adviser for the pandemic, said in an \ninterview Monday that the drugmakers themselves must act, either by greatly expanding \ntheir manufacturing capacity to supply other nations at “an extremely diminished price” \nor by transferring their technology to let the developing world make cheap copies. He \nsaid he was agnostic on a waiver.\n“I always respect the needs of the companies to protect their interests to keep them in \nbusiness, but we can’t do it completely at the expense of not allowing vaccine that’s \nlifesaving to get to the people that need it,” Dr. Fauci said, adding, “You can’t have \npeople throughout the world dying because they don’t have access to a product that rich \npeople have access to.”\nMay 4, 2021 – Global – 153,200,000/3,200,000; USA -32,300,000/574,700\nLower numbers – 32,500:\nReleased by Chairman Rand Paul\n•I did the Governors’ call and did the epi update since Rochelle was not able to be on the \ncall.  I clarified with Governor Cuomo why we should not get hung up on the “elusive” \nconcept of herd immunity threshold since no one knows what that is.   We should just \nfocus on getting as many people vaccinated as quickly as we possibly can and for sure the \nnumber f cases will come down.\n•I did the briefing for the “TV Docs” in preparation of the POTUS speech on the goal of \n70% of adults vaccinated by July 4\n•Spoke with Indian Ambassador to the USA (Taranjit Singh Sandhu) about the situation in \nIndia.\nPRESS:  BBC Worldwide Radio (interview on India); MSNBC – “Deadline White House” \nwith Nicole Wallace; CNN – Situation Room” with Wolf Blitzer;  NBC@Peacock with \nMehdi Hasan;  ABC - Jimmy Kimmel Live\nFinancial Times got the story right, but the headline wrong:\nFauci warns against discarding trade rules on Covid \nvaccines \nBiden senior adviser says move would spark legal disputes and delay \ninoculation campaigns\nReleased by Chairman Rand Paul\nMay 5, 2021 – Global – 154,000,000/3,200,000; USA – 32,300,000/575,500\n•Daily cases today at 41,000\nIn discussions with the medical team and with the White House comms group, I made it \nclear but I really do have a problem defending the ultra-conservative approach of the CDC \nregarding the wearing of masks outdoors. In particular, I was on an interview on the \nToday show with Savannah Guthrie and she pushed me on how inflexible the guidelines \nwere for children in camp, where we have kids wearing masks all the time in 90 degree \nweather playing outside. I admitted that the CDC guidelines were “conservative”. \nSavannah try to get me to say that they were excessive but I stuck with my original \ncharacterization. We really do need to get the CDC to loosen up on some of their guidelines \nbecause our credibility is going to be attacked if we do not do that.\nI had a very interesting conversation with Nancy Messonnier last night. I called her up to \nask her advice about how we can get some clear metrics from the CDC regarding when \ncities in states could start relaxing their restrictions. She surprised me by telling me that \nshe was no longer part of the COVID response group and that she has essentially been \nfired by Rochelle Walensky.   Something strange is going on here since it is very difficult to \nfire anybody in government even when they do something awful , and certainly Nancy has \nnot done anything awful. In fact, she even thought that maybe I was involved in her \nremoval but was very pleased to see that I did not know anything about it. \nPOTUS announced that the USA would waive the TRIPS and lift patent restrictions!!!\nPRESS: NBC “Today” with Savannah Guthrie; Israeli TV; MSNBC with Stephanie Ruhle; \nMet with the Politico Editorial Board (on the record); Interview with The Hill with Steve \nClemons; Israeli Public broadcasting Corporation; Sky News Australian TV;\nMay 6, 2021 – Global – 154,800,000/3,200,000; USA – 32,400,000/576,200\nI had an important conversation this morning with Rochelle Walensky who wanted my \ninput on putting together some specific metrics for when the country can open up and stop \nwearing masks. I have been encouraging her to do this over the past several weeks since many \nmembers of the press and the public have been pushing us to give some sort of a metric \nregarding the number of cases as well as the percent of the population that is vaccinated that can \nbe used to allow states, cities, towns, and counties to know when they can open up and stop \nwearing masks. She showed me a bunch of slides which proposed a color-coded system County \nby County that would provide some form of metrics. She proposed that if a County gets to less \nthan 50 cases per 100,000 population over seven days and has 70% of its population receiving at \nleast one dose of the vaccine that this could be the metric for opening. I am very pleased to see \nthat they are moving in this direction since this is what I have been encouraging them to do now \nfor several weeks. I believe it would counter the intense criticism that the CDC and I are \nreceiving because of a lack of definitive metrics. \nReleased by Chairman Rand Paul\nI had a terrific experience today, which is Nurse’s Week. A couple of nurses from the \ndifferent wards had written emails to me asking me to drop by and say hello to nurses on the \noccasion of Nurse’s Week; they felt that the nurses would really appreciate seeing me and being \nable to take pictures with me. And so, today with the help of the head of nursing at the NIH \nGwen Wallen and the various Ward supervisors, I visited every nursing unit in the NIH Clinical \nCenter to congratulate and thank each of the nurses on Nurse’s Week and to take literally \nhundreds of photos both as groups and as individual selfies. The nurses went absolutely wild to \nsee me they were squealing and laughing and clapping. It was something to behold. The hour and \na half that I invested in doing that was well worth the time in that it had to have been an \nextraordinary morale builder for the nurses.\n•I did a bunch of ceremonial social things virtually at Vanderbilt University where I \ntaped my commencement address today to be given as a taped version next week. The \nVanderbilt community was very excited to help me with them even though it was virtual  \nPRESS: Interview with Joel Achenbach of the Washington Post; CNN Interview from \nIndia;\nMay 6, 2021 – Global    USA\nDaily cases at 44,000\nIncidence and vaccine coverage\n•US (13/100K) 1st dose 45%| 2nd 33% \n•UK (2/100K) 1st dose 52%| 2nd 24% \n•Israel (0.7/100K) 1st dose 58%| 2nd 54%\nReleased by Chairman Rand Paul\nThe issue of the escape of the virus from the Wuhan Chinese lab is starting to heat up \nagain.  The usual cast of characters that had been bugging us about gain of function research or \nadd it again claiming incorrectly that we have funded gain of function research for the Wuhan \nlab. Somehow or other they're trying to connect funding gain of function with a Chinese \ninvestigator getting infected with the spread of COVID-19 throughout the world. They seem to \nbe hung up on the fact that they believe that we have funded gain of function research for the lab \nwhen in fact we have not. Nonetheless, they will certainly be up to mischievous behavior. In this \nregard Francis Collins has received an 11-page letter from right wing Republican Congress \nperson Cathy McMorris Rodgers, cosine by congressman Brett Guthrie Ann Morgan Griffith. \nThey have 29 questions concerning the conspiracy theory that the virus originated from the \nWuhan lab. See attachment below. In addition, on March 5th I received a letter from \ncongressman Mike Gallagher (see attachment below) with similar questions about gain of \nfunction research and the possibility of an escape of the virus from the Wuhan lab. It is inevitable \nthat they will be hassling me about this for some time. \nSKM_C754e2105071\n2531.pdf\nSKM_C754e2105071\n2540.pdf\n•Nancy Messonnier resigns (see above)\nPRESS:  White House press conference; Times Now Indian TV;\nMay 8, 2021 – \n•Weekly (weekend) touch bases with media team (11:00 AM – Saturday)  in anticipation \nof Sunday shows.\nMay 9, 2021 – Global – 157,300,000/3,300,000; USA – 32,500,000/578,500\nCOVID Cases  \n05.09.21 powerpoin  \nCases still hanging around 30-40,000/day\nReleased by Chairman Rand Paul\nThe anti-Fauci stuff continues with individual articles and FOX news continually implying \nthat gain of function research funded by NIAID (which never occurred) was related to escape of \nvirus from Wuhan Institute of Virology.  Typical conspiracy theory. (see below)\nFrom Jane Whitney:\nDear Dr. Fauci,\nRarely are we at a loss for words.\nBut we're hard pressed to adequately express how grateful we are for your extraordinary appearance \nduring our season premiere of “Common Ground” last Sunday. \nThe rave reviews for your “Human Google” pandemic database and your candor continue to roll in. But, \nit was your earthy sensibility that lifted the broadcast to a visceral level which resonated with so many. \nDuring this chaotic chapter when we’re trying to cope with the pandemic plus a bitterly divided country, \nyou give people hope that leadership, integrity — and humanity -- can lift us to better days. Your friend \nand WaPo columnist Michael Gerson captured your gestalt when he observed that you have “no other \nambition or agenda than the health of the country and the world.” \nReleased by Chairman Rand Paul\nNot since I interviewed former Secretary of State Madeleine Albright last summer had the phrase \n“national treasure” popped into my head. But, your constancy and commitment to leading our nation \nthrough the scourge of the coronavirus, warranted using that phrase again during the close of our \ninterview.\nOn behalf of our entire “Common Ground” team, we are especially thankful that you were willing to \ndonate your talent and considerable time to join us for our series launch on national television\n•Had call with Jeff Zients who (like me) is concerned that the CDC and Rochelle are \nbeing too conservative with regard to not loosening up restrictions for people who have \nbeen vaccinated.   The CDC is beginning to lose credibility.   Jeff realizes this and \nbecause of my close relationship with Rochelle, he wants me to get her to understand \nthat.   She is sticking closely with the advice of her career people who are often behind \nthe real world.\n•Followed up with Rochelle and told her in a fatherly advice that the CDC is loosing \ncredibility by being so rigid with the guidelines for vaccinated people.\nPeter Navarro slandering me on his twitter account:\nPRESS: NBC “Meet the Press” with Chick Todd; ABC “This Week” with George \nStephanopoulos; MSNBC with Joshua Johnson;  \nWall Street Journal: China, Fauci and the Origins of \nCovid \nDid the virus come from a Chinese lab funded by the \ncelebrated doctor’s U.S. government institute?\nMay 10, 2021 – Global  - 158,000,000/3,300,000; USA – 32,500,000/579,000\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n•Did 1 hour interview for the Obama Oral History\n•Joined President Obama to chat with professional athletes to encourage them to be \ntrusted messengers to get people vaccinated.\nIn vitro data suggest that B.1.617 will be at east partially sensitive to vaccine induced antibodies: \nbioRxiv: SARS-CoV-2 B.1.617 emergence and sensitivity to vaccine-elicited antibodies \nhttps://bit.ly/3y2IYq3 \nReleased by Chairman Rand Paul\n“…Therefore, at population scale, \nextensive  vaccination  will  likely  protect  against  moderate  \nto  severe  disease  and  will  reduce  transmission of B.1.617 \ngiven the in vitro neutralisation data we and others have \npresented”\nSARS-CoV-2 B.1.617 emergence and sensitivity \nto vaccine-elicited antibodies\nPRESS:  The Carlos Watson TV Show (YouTube); \nMay 11, 2021 – Global – 158,700,000/3,300,000;  USA – 32,600,000/579,400\nNumbers coming down:\n•Senate HELP Hearing today with Kessler, Walensky and Peter Marks. Senators Rand \nPaul and Roger Marshall came at me regarding gain of function research. They obviously \nReleased by Chairman Rand Paul\nwere trying to do the usual connecting me and NIAID with the emergence of COVID-19 \nfrom China. The questions were very accusatory and laden with agenda. This is likely a \ntrend that will continue and could be getting more serious.  \nPRESS: “Clubhouse” with Sanjay Gupta; Politifacts Interview;\nMay 12, 2021 – Global – 159,300,000/3,300,000; USA – 32,600,000/580,100\n•I had an interesting conversation today with Tom Frieden About the possibility of South \nKorea playing an important role in manufacturing doses of the M RNA vaccine for the \nrest of the world. Tom feels that we cannot depend upon the pharmaceutical companies \nModerna and Pfizer to really provide doses of vaccine for the rest of the world at a \nreasonable price. Tom is going to present this proposition to Jeff Zients tonight. I will \nfollow up with Jeff to make sure that he understands that I am very much in favor of this. \n•Things are really heating up with the GOP against me:\n•Republicans propose bill to fire Fauci amid \ngrowing discontent with top Biden medical \nofficials\n•Fauci has been National Institute of Allergy and Infectious \nDiseases director since 1984\nPRESS: Washington Post interview with Yasmeen Abutaleb and Damian Paletta about \narticle about my FOIA’d e-mails; New York Times interview with Jane brody about being \n80 years old; MSNBC Town Hall meeting with President Biden, Sec Becerra, and Vivek \nMurthy;\nMay 13, 2021 – Global    USA\n•My conversation with Rochelle the night before the hearing must have worked. She \njust called me to tell me that she has made a major change in the CDC recommendations. \nReleased by Chairman Rand Paul\nShe will take my advice and change the guidelines to read that a vaccinated person can go \nwithout a mask whether or not they are indoors or outdoors. This is a major change and \nI'm very pleased that she listened to me.  The radical right-wing maniacs who blamed me \nfor the rigidity of the CDC recommendations will probably not realize at all that it was \nme that triggered this change. \n•Had a productive meeting with David Marchick and his team from the United States \nInternational Development Finance Corporation (DFC) to determine how they may help \nto use their financing capability to provide vaccine doses to low and middle income \ncountries. We discussed the multiple ways that this can be done ranging from financing \ntransfer a technology two actually buying doses from companies to distribute to poorer \ncountries. Also want to call besides Francis Collins and I were the teams from DFC and \nUSAID. Also there was John Mascola and Cliff Lane.\n•Things continue to heat up regarding the innuendoes about our being responsible \nfor the COVID-19 pandemic because of our grant to EcoHealth.  Amazing!!!   All \nthe right wing conspiracy theorists are piling on with no data at all.\nPRESS: CBS “This Morning” with Gayle King; CNN with Jake Tapper; NBC Nightly \nNews with Lester Holt; \nMay 14, 2021 – Global – 160,800,000/3,300,000; USA – 32,700,000/581,600\nIn The Onion sarcastically spoofing the recent relaxation of mask mandates from CDC:\nDr. Fauci: ‘There’s No Longer A Need For \nStatues To Wear Masks Outside’\nYesterday 12:11PM\nPRESS: MSNBC – “Morning Joe” with Joe Scarborough; MSNBC with Andrea Mitchell; \nBlack News Channel (TV); \nMay 15, 2021 – Global – 161,500,000/3,400,000; USA – 32,7600,000/582,300\nCases coming down, but not precipitously:\nReleased by Chairman Rand Paul\nIt is a really tough world that we're living in. In a commentary about my commencement \naddress at Vanderbilt one of the newspapers (The Tennessean) reported that as I was giving the \nspeech → While he was speaking on YouTube, trolls were calling him a liar.\n•Cliff Lane and I together with Francis Collins have always been skeptical about \nthe efficacy of convalescent plasma for the treatment of COVID-19. \nAccumulating data over the past few months have made it clear that despite the \nclaims of people such as Arturo Casadevall and others that convalescent plasma \nworks and is beneficial , it is clear that Cliff and I and Francis were correct all \nalong. \n•In a situation very similar to what I had faced multiple times such as when I \npicked up food at Chef Geoff’s tonight I went with Chris to pick up carry out \nfrom Raku restaurant on Wisconsin Ave. As soon as people recognized me \nthere was a wave of applause and squealing and screaming and clapping \nand thanking me with multiple people coming and asking for selfies . It was a \nlittle bit embarrassing, but it was just a manifestation of how people need a \nsymbol of integrity and truth. \n•Joan Baez texted me tonight asking me about what she should wear for the \nState Department dinner since she heard that it was going to be 90 plus degrees \nin Washington on Friday and she anticipated that the air conditioning in the \nstate Department would be freezing. \nReleased by Chairman Rand Paul\nRand Paul continues to act disrespectful to me and like a complete idiot.   Here is what he \nsaid on FOX news:  Rand Paul: ‘Little Dictator’ \nFauci ‘acts like an ignoramus every day’ \nover masks\nBy Samuel Chamberlain\nMay 14, 2021 | 11:43pm | Updated\nMay 16, 2021 – Global -  USA\nNumbers still coming down:\nKate McKinnon played me again last night  on “Saturday Night Live” in the context of the \nnew CDC guidelines (see above).   The CDC (Rochelle) got slammed on all the Sunday \nShows  for the abruptness of the announcement without planning for it or alerting people.  People \nare confused as to what to do in certain settings such as businesses, shops, etc.   I tried to clarify \nthis on Sunday TV shows (see below).\n•Chris and I (with the detail) went for our Sunday walk on the Mall as opposed to the \nCanal.   Just as with Raku last night restaurant, we ran into groups of students who had \nReleased by Chairman Rand Paul\njust had their graduation ceremony from George Washington University on the Mall.   A \nfew recognized me and started squealing and laughing as asking for selfies, which I gave \nthem.   Then more and more people gathered around and soon we had the same sort of \ncrowd around me as has happened at AU, Chef Geoff’s, and Raku.   It looks like for at \nleast a while this is what is going to happen.\nPRESS:  CBS “Face the Nation” with John Dickerson; MSNBC “The Sunday Show” with \nJonathan Capehart; Che Tempo Che Fa (Italian TV);\nMay 17, 2021 – Global – 162,800,000/3,400,000; USA – 32,800,000/583,100\nMay be just the weekend decrease, but the numbers are very low today – 17,700:\n•Had a good and interesting day at the White House today. president Biden and I \nteamed up to do some PSAs on vaccines. We were questioned by a number of online \ncelebrities such as Manny MUA and “Brave Wilderness” and Jackie Aina   I had a good \ntime with the president as we joked around about a number of things. He teased me then I \nhave my own television show since I am on TV almost all the time. Then he sincerely \nthanked me for everything that I have been doing with regards to COVID-19. \nReleased by Chairman Rand Paul\n•Fringe press such as “Pulse Nation” starting to scale up on conspiracy theory rhetoric \nabout GOF.\n•Anne Schuchat announced her retirement from CDC today.   As expected, the press \nare trying to make something out of this that it may not be. They are suggesting that there \nwas a rift between Rochelle and Anne and Nancy, and that is why Ann and Nancy are \nleaving. This is almost certainly not the case since both and Nancy have good reasons to \nwant to leave. Both of them have been there for decades and clearly and clearly Anne \nwants to retire.   Nancy may just be burned out.   \n \nPRESS:  Black New Channel (TV) with Charles Blow; Did White House PSAs with \nPresident Biden; MSNBC with Chris Hayes; PodSave America Podcast\nMay 18, 2021 – Global   USA\n2nd day in a row that numbers are way down – 19,500:\nWe are having a serious problem here in that the Public Affairs people at HHS  are refusing \nto allow Francis to put on the NIH website an explanation about what we did with the grant \nassociated with the Wuhan laboratory. The HHS people are misguided thinking that by \nexplaining the grant as well as what gain of function really means we will be calling attention to \nReleased by Chairman Rand Paul\nthe issue. They completely fail to realize that there is already intense attention paid to this issue \nand the legitimate press including the Washington Post and the Atlantic are asking legitimate \nquestions and wanting to know why we are not responding. We are going to put more pressure \non HHS to allow us to be able to develop a statement for the NIH website as well as provide \ntalking points and Qs and As. It is clear that the far right has stirred this up enough that now the \nlegitimate press is beginning to ask questions. \n•Received this evening at the home (Villa Firenze) of the Italian Ambassador to the USA \n(Armando Varricchio) the Cavaliere di Gran Croce Ordino al Merito della \nRepubblica Italiana – Knight Grand Cross of Order of Merit of the Italian Republic \nconferred (in absentia) by Italian President Sergio Matarella\nWe have a long and difficult conversation with the HHS people over the phone last night. \nFrancis, Larry  and I along with others on the NIH team discussed with the HHS team led by the \nnew ASPA Sarah Lovenheim and Ian Sams among others. They were very reluctant to have us \nput a statement on the NIH director's website concerning the gain of function issue. This is \ncompletely ridiculous since if we do not respond to the many misleading statements that are \nbeing made then it will look like we're covering things up. The HHS people do not seem to \nunderstand that. They also are reluctant for us to directly answer letters of inquiry from the GOP \nmembers of Congress who are probing around the Wuhan issue. They are a new group and very \ninexperienced but they can really mess things up if we don't hold our ground. We finally got \nthem to agree to put Francis's statement on the NIH webpage; however, they're still not allowing \nus to proactively put out the talking points and will only allow us to do that in specific answer to \nquestions that come in. In another amazing aspect of the discussion they were actually claiming \nthat we should not answer the letters that we get from Congress.  More later on this struggle.\nPRESS:  Good Morning America with George Stephanopoulos; White House Press \nconference (I spoke on variants and vaccines); Axios Online interview; NBC News \nSnapchat; multiple interviews at the Villa Firenze by the Italian press in association with \nmy “Knighthood”.\nMay 19, 2021 – Global – 163,900,000/3,400,000; USA – 32,800,000/584,300\nCOVID-19 cases in USA <30,000 for 4th day in a row\nThe “buzz” about the origins of the virus continue with multiple inquiries from the press. One of \nthe real problems is that people are conflating whether or not we approved gain of function \nresearch for Wuhan and the possibility that the Chinese created SARS-C0V-2 in the \nlaboratory. Whether or not one agrees as to the conduct of gain of function research, when you \nlook at the bat viruses that was studied under the grant and compare the genetic sequences with \nSARS- CoV-2 it becomes clear that SARS-C0V-2 could not have come from the bat viruses \nReleased by Chairman Rand Paul\nassociated with the grant that was funded. This obvious fact appears to get lost in the zeal of \nsome to point fingers at us to be the cause of the problem. \nPRESS: Interview with The Advocate; NBC Today Show (40 years of HIV); WTOP Radio; \nLife Out Loud Podcast; CBS Evening News; Bowdoin University Fireside Chat; CNN \n“Prime Time” with Chris Cuomo\nMay 20, 2021 Global – 164,500,000/3,400,000; USA – 32,900,000/585,000\nThe White House and HHS want me to do them a favor. There is a Washington Post reporter \n(Annie Linskey) who is trying to write a story that the CDC is taking on a much broader role of \nmaking policy and giving guidelines when in the past they have been more of an advisory group. \nThe White House and HHS want me to disabuse the reporter of this story since as a matter of \nfact it was only in the last administration with Trump that the CDC was diminished to just being \nadvisory. In every other administration with which I have been involved, the CDC has always \nmade policy and guidelines . The outlier is what happened during the Trump administration. I \nwill try to set the record straight in discussing with a Reporter. \nThere is really an organizer effort to discredit me.   This truck was seen on the streets of DC:\nReleased by Chairman Rand Paul\nEric Lander confirmed as Head of OSTP\nCases starting to come down in India:\nReleased by Chairman Rand Paul\n•I had a very interesting day today in that I accompanied first lady Jill Biden to \nChildren's Hospital National Medical Center in Washington DC where we both \nvisited the clinics that were vaccinating children from 12 to 15 years old. Doctor Biden \nspecifically asked that I accompany her.  After we toured the clinic, Doctor Biden and I \ngave a joint press briefing. Interestingly, most of the questions were directed to me \n•The inappropriate trolling continues. The most recent of which is someone tweeting that \nChristine Grady is responsible for pushing through the vaccines towards an EUA. \nThey are saying that she bypassed all the appropriate procedures to rush the vaccines \nthrough approval. This is getting really ridiculous as they are now involving Christine in \nsomething that she has nothing to do with. Totally shameful behavior together with the \ntruck situation as described above. \nThis is the slanderous inuendo:\nDid Fauci Fund ‘Gain of Function’ Research, \nThereby Causing COVID-19 Pandemic?\nReleased by Chairman Rand Paul\n•Terrific profile of me in Time Magazine:  https://time.com/5960529/anthony-fauci-\nprofile/  \n•Jill Biden calls Dr. Fauci 'our American hero' during visit \nto D.C. children's hospital after he said Americans should \nNOT completely ditch masks\nPRESS:  Virtual Interview with Damian Denys for the John Adams Institute (Center for \nAmerican Culture in Amsterdam); Washington Post Live – with Yasmeen Abulateb; The \nBloomberg Business Week; White House organized interaction with Black Press – Blavity; \nBlack Girl Nerds; The Root; Huff Post Black Voices; The Grio with April Ryan; CNBC \nwith Shepherd Smith\nMay 21, 2021 – Global    USA\nCases continue to decline with 28,000 today\nMore crazy stuff – An article appears online in RealRawNews that I was planning to flee \nthe country since there was an arrest warrant out for me for crimes against the world: \nDr. Fauci Prepping to Flee \nCountry\nPRESS:  The Hill: Jill Biden recognizes Fauci as an 'American hero’; CBS “This Morning” \nwith Gayle King; The Hindu Newspaper interview; NBC – LX interview; WGBH Public \nRadio – The World.\nMay 22, 2021 –  Global – 165,800,000/3,400,000; USA – 32,900,000/586,300\nReleased by Chairman Rand Paul\nJoan Baez - I had a most extraordinary and memorable evening last night at the Kennedy \nCenter. Joan Baez invited me to be her escort on the occasion of her receiving the Kennedy \nCenter medallion for lifetime performance as a performing artist. Other awardees included Dick \nVan Dyke, Garth Brooks, Debbie Allen, and Midori Goto. Finally, I got to meet her in person \nafter the year-long building up of our friendship via texts and phone calls. She is an absolutely \namazing, warm an endearing person, and our friendship was cemented last night as it became \nclear that we really were, as I said, “meant for each other “. I got to meet her family including \nher son Gabe and her granddaughter Jasmine, who is an absolutely beautiful 17 year old girl, \naspiring songwriter who will be entering college in Miami in September. Also present was Irwin \nRedlener who is the one who introduced me to Joan about a year ago. I was somewhat taken \naback by the attention that was paid to me by all the celebrities who were there who are gushing \nto have their picture taken with me and to tell me how much they were appreciative of what I had \nbeen doing. A typical example was Garth Brooks’s wife Trisha Yearwood who was just gushing \nto meet me.  The same was true for many other people including co-award winner Debbie Allen \nand Broadway legend Chita Rivera, as well as Dick Van Dyke, another award winner. I got to \nescort Joan up to the stage to receive her award and I sat with her as she waited to go on the \nstage. after the awards ceremony we all went out to the outside deck of the Kennedy Center and \nhad champagne and snacks.  All in all, it was a spectacular evening \nPRESS: ABC - Good Morning America (Weekend Edition); New York Times: Jane \nBrody and Dr. Anthony Fauci on Staying Fit \nand Focused at 80.\nMay 23, 2021 - Global – 166,300,000/3,400,000; USA – 32,900,000/586,800\nCases continue to come down.   All 50 states have decreases:\nReleased by Chairman Rand Paul\nAppropriations Hearing (Senate and House) coming up next week.   Interesting to see if they \nfixate on the lab. Escape theory.  I had a very interesting and helpful conversation today with \nChristian Andersen of Scripps Research Institute. He was very emphatic that the work that \nwas done at the Wu Han Institute in Association with our grant was not gain of function . In \naddition he confirmed that if you match the chimeric viruses that were made in the context of the \nNIH grant in Wuhan, they are not even close sequence wise to the SARS-CoV-2. Christian will \nbe writing a letter together with some data on this topic; however, I feel much better now that he \nis in total support of what I have been saying. \nMay 24, 2021 - Global – 166,900,000/3,500,000; USA – 32,900,000/587,300\nNumbers continuing to come down:\nReleased by Chairman Rand Paul\nHad typical White House press conference; briefing of “Principals”; and briefing of Sec. Becerra \n– Busy day\nHad conversation with Jon Avnet, famous filmmaker who wants to make a film about the \ndevelopment of the COVID-19 vaccine featuring Corbett, Graham and others.  He wants my \nadvice and help in convincing these people to cooperate in the film.\nAlso did fireside chat with Northwest Indian federation\nCases coming down now in India:\nReleased by Chairman Rand Paul\nPRESS:   Interview with “The Monocle” – a Canadian publication; Sirius XM Radio with \nMarc Siegel; Interview with Ben Ryan for The Guardian.\nGreat Opinion piece by Mike Gerson blasting the far right for slanderous attacks on me:\nhttps://www.washingtonpost.com/opinions/2021/05/24/right-is-dwelling-\nslanderous-myths-about-origins-covid-19/\nMay 25, 2021 – Global – 167,000,000/3,500,000; USA – 33,000,000/587,800\n•We had the House Appropriations Subcommittee Hearing today (virtually).  it went \nwell except for some snarky comments by Congressman Andy Harris concerning the \norigin of the virus. He maintains we should never be doing any research involving China \nand is part of the conspiracy theory. Rosa DeLauro chaired and was wonderful.   Tom \nCole is Ranking Minority and was also a gentleman.\nCases continue coming down:\nReleased by Chairman Rand Paul\nI did a Town Hall with POTUS last night: Biden and Fauci field questions on \nvaccine hesitancy from YouTube influencers.\n•FOX News on a rampage against me on every show and pushing the lab leak origin \nPRESS:  Tucker Carlson continues with his slanderous attacks: Tucker \nCarlson: Fauci, the WHO, and \nmainstream media lied \nReleased by Chairman Rand Paul\nabout COVID origins for \nmore than a year.\nThe Australian: 'Virus warfare' in China military \ndocuments\nThe Australian Online\nMay 7, 2021 Friday 12:30 PM AEDT\nThis just does not make any sense since why would someone want to make an \nagent that could equally infect your own population. Something is wrong with this \nreport . I will have to follow up on it. In the meantime, senator Rand Paul has \nintroduced an amendment to ban gain of function research in China. In the \nstatement they say that I am a strong advocate of gain of function research, which \nin fact I am not. I have been very clear that it should only be done on the very \nspecial circumstances when the public health need requires it and that it needs to \nbe done on the very restricted conditions. The complete distortion of what I have \nbeen saying continues on the part of the radical right.\nMay 26, 2021 – Global – 167,500,000/3,500,000;  USA – 33,000,000/588,400\nThe situation continues to get “out of control” with regard to the press reports concerning my \n“flip flopping” concerning the theory of the origin of the virus. I had always said that the very \nhighly likelihood is that the virus originated naturally from an animal reservoir jumping to a \nhuman. However, over the past couple of days given the amount of speculation about the \npossibility of a lab leak I have been saying that no one is 100% certain of the origin including me \nand so I am calling for a thorough investigation. This is backed by Andy Slavitt as well as a \nnumber of other government officials. Calling for an investigation is merely to put to rest the \nextraordinary amount of speculation and conspiracy theories. However, this is being interpreted \nas Fauci flip flopping again. The far right is really amazing in their distortion of reality. \nReleased by Chairman Rand Paul\n•We had our Hearing today before the Senate Appropriations Subcommittee chaired by \nsenator Patty Murray with ranking minority Roy Blount. As expected, several Republican \nsenators got a bit snarky with me asking questions about the origins of COVID-19. In \nparticular senator Kennedy (R-LA).  In addition, Sens. Braun, Rubio and Lindsey Graham all \nasked questions with a hint of the conspiracy theory that somehow the Chinese let the virus \nescape from a lab and possibly the NIH inadvertently contributed to this by funding the lab to \ndo research on coronavirus. This type of conspiracy theory is getting very hot and heavy of \nlate with multiple publications promoting all sorts of theories. \n•One of the most recent theories is that President Biden suppressed the investigation of the \nChinese. President Biden came out with a statement today explaining his position on all this. \nHere it is:\n•Statement by President Joe Biden on the \nInvestigation into the Origins of COVID-19 \n•May 26, 2021 • Statements and Releases \n•Back in early 2020, when COVID-19 emerged, I called for the CDC to get access to China to learn \nabout the virus so we could fight it more effectively. The failure to get our inspectors on the \nground in those early months will always hamper any investigation into the origin of COVID-19.\n \nNevertheless, shortly after I became President, in March, I had my National Security Advisor task \nthe Intelligence Community to prepare a report on their most up-to-date analysis of the origins \nof COVID-19, including whether it emerged from human contact with an infected animal or from \na laboratory accident. I received that report earlier this month, and asked for additional follow-\nup. As of today, the U.S. Intelligence Community has “coalesced around two likely scenarios” but \nhas not reached a definitive conclusion on this question. Here is their current position: “while \ntwo elements in the IC leans toward the former scenario and one leans more toward the latter – \neach with low or moderate confidence – the majority of elements do not believe there is \nsufficient information to assess one to be more likely than the other.”\n \nI have now asked the Intelligence Community to redouble their efforts to collect and analyze \ninformation that could bring us closer to a definitive conclusion, and to report back to me in 90 \ndays. As part of that report, I have asked for areas of further inquiry that may be required, \nincluding specific questions for China. I have also asked that this effort include work by our \nNational Labs and other agencies of our government to augment the Intelligence Community’s \nefforts. And I have asked the Intelligence Community to keep Congress fully apprised of its work.\n \nThe United States will also keep working with like-minded partners around the world to press \nChina to participate in a full, transparent, evidence-based international investigation and to \nprovide access to all relevant data and evidence.\nReleased by Chairman Rand Paul\n•The Chinese are now upset with me about my saying that there should be an investigation:\n•Chinese state media is turning on Fauci \namid Wuhan lab controversy\n•By Nectar Gan  and James Griffiths, CNN\nMay 27, 2021 – Global – 168,000,000/3,500,000;  USA – 33,000,000/589,500\nThe onslaught of far-right Republican venom against me continues. We're being bombarded \nwith letters asking dozens of questions regarding our role in research at the Wuhan institute of \nvirology. In addition, Rand Paul continues with other senators to call for my dismissal because I \nhave “misled the American public”.   \nFunny satire about FOX News and me: https://www.theonion.com/new-evidence-shows-fauci-may-\nhave-been-created-in-chine-1846984205\nPRESS:  Sirius Radio – Joe Madison Show (Concerning my Emory University \nCommencement Address); Interview with The Guardian\nMay 28, 2021 – \n•The secretary of HHS we'll ask the Inspector General to do an audit of EcoHealth and its \noversight up the subaward to the Wuhan institute of virology. I am certain that there will \nbe some deficiencies that the IG will find as is always the case with IG audits. Certainly, \nwhatever they find it will be misconstrued by those who want to make a case for our \ninvolvement in the outbreak. I am starting to feel that it is important for me to write an \neditorial or an opinion piece giving our side of the story. \nPRESS: FOX got hold of An article that I wrote in 2012 in mBio where I spoke about the \nmoratorium on gain of function. They completely misconstrued it to say that I was in favor \nof gain of function research even if it meant the risk of a pandemic. The New York Post \npicked it up and their headline is :\nReleased by Chairman Rand Paul\nFauci once argued for risky viral experiments \n— even if they can lead to pandemic \nBy Gabrielle Fonrouge\nThis is truly outrageous. I contemplated writing a response to fox news, but they only gave me about an \nhour to do so comma and when I thought about the situation, it  became clear to me that they would \ncherry pick words from my response and turn it against me. And so I decided to do nothing. Hopefully \nthe intensity of this will diminish somewhat over the next few days.  \nMay 29, 2021 – Global    USA\n•Received honorary doctor of science from Bowdoin live, but virtual.   I was in my home \noffice dressed in the commencement regalia and waved to the graduates at the ceremony \nas I was conferred the honorary degree.\nPRESS:   Great article in Wired about the whole controversy: \nThe Covid-19 Lab Leak Theory Is a Tale of \nWeaponized Uncertainty\nMay 30, 2021 – Global – 169,600,000/3,500,000;  USA – 33,100,000/591,300\nCases continue to come down (see below), but Jeff Z, is concerned that the daily vaccinations are \nalso dropping such that the current rate may not get us to 70% of adult population vaccinated by \nJuly 4;\nMay 31, 2021 – Global – 169,600,000/3,500,000; USA – 33,100,000/591,400\nVery few cases, probably as a result of holiday weekend:\nReleased by Chairman Rand Paul\nJune 1, 2021 – Global – 170,400,000/3,500,000;  USA – 33,100,000/591,500\nA couple of interesting things today. Did the governor's call or I spoke about the possible need \nfor boosters. In addition I had an interesting podcast with Chelsea Clinton . She is really a very \nnice person, much sweeter than I anticipated. Also had our usual weekly meeting with secretary  \nBecerra. Also, we had an important meeting with the deputies in the SCIF to discuss the broad \nplans for the government’s response to COVID-19 including sharing vaccines with other nations. \n•I am absolutely furious today because the print version people of the National \nGeographic film group has published the list of my statements and words of wisdom in a \nbook which they are claiming was written by me. It is listed in Amazon and Borders \nBooks as a book “by” Anthony Fauci. This has triggered the usual frenzy from the far \nright crazies on social media saying that I am a hypocrite making a lot of money on the \npandemic. Many of ask how much royalties I am making from the book. I have gone \nballistic big demanding of the Nat Geo people that they correct this publicly and make it \nvery clear that I did not write this book nor am I getting any royalties from it. When I \nallowed them to use my words from former speeches and commencement addresses, I \nassumed that they were going to use this merely as promotional material for the \ndocumentary. The fact that they made this into a book that they are selling in my mind \nisn't egregious violation of trust and collegiality. I am not going to cooperate at all in the \npromoting of this film. \n•In a Buzzfeed analysis of emails of mine that were FOIA’d, there is an email from \nme to Morgan Fairchild which clearly demonstrates that in February I was warning \nReleased by Chairman Rand Paul\nabout the possibility of a global pandemic in contrast to what people are accusing \nme of, namely, saying that there was no risk to us. This is a very important email:\n \n \nReleased by Chairman Rand Paul\nPRESS: Jasmeen Abutaleb and Damien Paletta’s  Washington Post article about my e-\nmails: https://www.washingtonpost.com/politics/interactive/2021/tony-fauci-\nemails/?no_nav=true&tid=a_classic-iphone\nCNN with Elizabeth Cohen; Wisconsin NPR radio;\nJune 2, 2021 – Global – 170,800,000/3,600,000; USA – 33,100,000/592,200\n•I gave a taped speech today to the opening session of the G7 meeting taking place in \nEngland. I spoke about the similarities between the COVID-19 pandemic and the HIV \naids pandemic. I called upon all partners to collaborate and to continue to support \nscience. Secretary Becerra is representing the United states at the health component of the \nG7 meeting. \nAlso, in line with my participation virtually in the G7 meeting , I took part in a discussion on the \nG7 global vaccine confidence summit. It was a discussion together with John Nkengasong, the \ndirector of the African CDC moderated by Vivienne Parry. We discussed the issue of vaccine \nhesitancy in various countries throughout the world particularly in the United states and in \nsouthern Africa. \nNat Geo film people are also very upset about the shit storm caused by the book  people and \nhave come out with a statement that it is their book, not mine and I have not received any \nroyalties or other payments from the book or the documentary.   Unfortunately, the damage is \nalready done.\n•Met with POTUS and VPOTUS in Oval with Jeff Zients and Natalie Quillian. I \ndiscussed with him the mechanisms and implications for the mRNA vaccine platform \ntechnology. He was very grateful for the discussion and as usual vice president Harris \nasked excellent questions. He told the story that when he was at Rehobeth beach in \nDelaware with his family, three burly MAGA-type men approached him and started trash \ntalking him. The Secret Service were very discreet and did not want to make a scene; \nhowever his daughter Ashley jumped in front of them and started screaming at them to \nstay away from her father. The lesson of the story was that young women have more guts \nand fire then certain Secret Service agents. \nPRESS:The story on my emails is in the print version of the Washington Post this morning; \nMonth of Action (promo video); Podcast with the George Bush Foundation – All the Best \nwith Sam LeBlond; WGN Donilon Report (Leland Vittert) – was not the original person to \ninterview me and attacked me about e-mails and Wuhan; NPRE “Science Friday” with Ira \nFlatow; Time Health Summit Interview by Alice Park with Stephjane Bancel; Time \nChildren’s Interview; NBC Nightly News; MSNBC with Nicole Wallace;  CNN defends me \non the e-mails issue:  \nReleased by Chairman Rand Paul\nThousands of emails from and to \nFauci during the pandemic's early \ndays were published. Here's what \nthey show about him\nBy Christina Maxouris and Paul LeBlanc, CNN\nUpdated 6:01 PM ET, Wed June 2, 2021\nJune 3, 2021 – Global – 171,300,000/3,700,000; USA – 33,100,000/592,800\nNumbers continue to come down:\n•Writeups by CNN and Washington Post regarding my emails are making me look \nvery good.  They show that I never  criticize president trump and that I am always very \nReleased by Chairman Rand Paul\ncourteous and measured in my responses. Even with that the crazies such as senator Rand \nPaul are saying things like “I told you so “, implying that my emails are validating what \nthey have been saying about me. Total nut cakes!  The right-wing fringe social media \nare ablaze with anti-Fauci stuff\n•while all this is going on, incredibly the far right maniacs in certain states such as \nArizona are trying to yet again force an unvalidated recount in an attempt to still \noverthrow the election and reinstate Trump. What is happening to our country ????\nPRESS: CNN “New Day” with John Berman;  MSNBC – Morning Joe;  \nWashington Post:  The alleged Fauci ‘smoking gun’ \nemails\nBy \nAaron Blake\nSenior reporter \nJune 3, 2021 at 12:42 p.m. EDT\nIn any case, like most data dumps that have careful redactions, the Fauci email trove has no smoking-\ngun evidence of wrongdoing. You could make the case, as I and others have, that Fauci had certain \nprejudices and dispositions that were deeply unhelpful in his leadership of the pandemic response — \nand you’ll find evidence of those here. He had a very strong bias against existing drugs and for new and \nexperimental ones. He has been slippery on masks and clearly was willing to say things in public that he \nthought “helped” the response even if they weren’t strictly true.\nNew York Post: Trump tears into Fauci after release of \nearly COVID emails \nBy Mark Moore\nReleased by Chairman Rand Paul\nWashington Post:  The Health 202: Five takeaways from \nFauci's email exchanges\nBy \nPaige Winfield Cunningham\nReporter \nJune 2, 2021 at 8:30 a.m. EDT\nwith Alexandra Ellerbeck\nEarly in the coronavirus pandemic, Anthony S. Fauci expressed skepticism that deaths in the United \nStates would top 500,000.\nHe called the public’s fascination with him “surrealistic.” \nAnd he assured China’s top public health official that “We will get through this together.”\nHundreds of pages of emails obtained by The Post and BuzzFeed News through Freedom of Information \nAct requests confirm the way Fauci is already viewed by many — as diplomatic, tactful and responsive to \ninquiries from the public, a quality which often kept him up late at night answering emails.\n“The correspondence from March and April 2020 opens a window to Fauci’s world during some of the \nmost frantic days of the crisis, when the longtime director of the National Institute of Allergy and \nInfectious Diseases was struggling to bring coherence to the Trump administration’s chaotic response to \nthe virus and President Donald Trump was seeking to minimize its severity,” The Post's Damian Paletta \nand Yasmeen Abutaleb write .\n“Fauci’s actions during that period and beyond remain an intense focus for many Americans and political \nleaders,” they add. “During daily televised briefings at the White House, Fauci emerged as an at times \nreluctant — and polarizing — media star: To Trump supporters, he was a contrarian who seemed to \nundermine the president at every turn, while others viewed him as a reassuring voice of reason.”\n“The emails show that he was inundated with correspondence from colleagues, hospital administrators, \nforeign governments and random strangers — about 1,000 messages a day, he says at one point — \nwriting to seek his advice, solicit his help or simply offer encouragement.”\nReleased by Chairman Rand Paul\nHere are five takeaways from Fauci’s emails.\n1. Fauci stayed far away from any Trump-bashing.\nTrump blasted the public health expert throughout the pandemic, at one point threatening to fire him \nafter the November election. And from time to time, Fauci would criticize the administration's response \nin interviews, although almost always indirectly (in October, he told The Post the country needed an \n“abrupt change” in public health behaviors).\nIn Fauci's correspondence, he was even more circumspect.\nIn April 2020, Marc Short, Vice President Mike Pence’s chief of staff, emailed Fauci about some apparent \ncrossed wires before Easter Sunday. At the time, Trump was starting to butt heads with public health \nofficials as he tried to move on from the pandemic.\n“You correctly noticed the symptoms but misdiagnosed the root cause,” Short wrote in a heavily \nredacted email that closes: “Apologies for a poor poker face.”\nFauci responded: “Thanks for the note. Understood. I wish you a peaceful and enjoyable day with your \nfamily.”\nIn another exchange, a former acquaintance wrote to Fauci that “The leadership from the top is utterly \nlacking and incompetent and dangerous to the American people.”\n“Thank you for your note,” Fauci wrote back. “I hear you!”\n2. Fauci didn't like the public adoration.\n“Our society is really totally nuts,” Fauci wrote in an email he forwarded, which included the link to an \narticle titled “'Cuomo Crush and Fauci Fever' — Sexualization of These Men Is a Real Thing on the \nInternet.”\nOn March 31, a colleague at the National Institutes of Health sent Fauci an article from The Post with the \nheadline, “Fauci socks, Fauci doughnuts, Fauci fan art: The coronavirus expert attracts a cult following.”\n“Truly surrealistic. Hopefully, this all stops soon,” Fauci replied. In another note, he added: “It is not at \nall pleasant, that is for sure.”\n3. Fauci accepted a sort-of apology from the director of China's public health agency.\nGeorge Gao, director of the Chinese Center for Disease Control and Prevention, had been quoted in \nScience magazine as saying the United States was making a “big mistake” by not telling people to wear \nmasks in spring 2020.\nGao, who has long been friends with Fauci, reached out personally to clarify his remarks.\nReleased by Chairman Rand Paul\n“I saw the Science interview, how could I say such a word ‘big mistake’ about others? That was \njournalist’s wording. Hope you understand,” Gao wrote to Fauci in a March 28 email. “Lets work \ntogether to get the virus out of the earth.”\n“I understand completely. No problem,” Fauci wrote back. “We will get through this together.”\n4. Fauci defended himself to colleagues.\nIn April 2020, prominent oncologist Ezekiel Emanuel wrote to Fauci that he was “perplexed” by his \n“seeming strong endorsement” of remdesivir. Fauci had publicly praised the antiviral drug, which had \nappeared effective in treating coronavirus patients.\n“Was it just a bit forced?” Emanuel wrote. “My reading was the data was weak and in normal times for \nnormal disease it is not enough to approve. And very unlikely to really impact COVID-19 disease pattern-\n-regardless of supply issues.”\nFauci resisted the characterization, replying that he didn't “'strongly' endorse it.”\n“I specifically said it was not a knockout drug and was only a baby step in the direction of developing \nmore and better drugs,” Fauci wrote. “I said that it was important because it proved in a well-powered, \nrandomized, placebo-controlled clinical trial that one can suppress the virus enough to see a clinical \neffect, as modest as the effect was. I do not think I forced anything.”\nIn an email the following day, Emanuel sent another email apologizing to Fauci and inviting him over for \ndinner “on the porch.”\nIn another email, Fauci pushed back against Gregg Gonsalves, a prominent Yale School of Public \nHealth epidemiologist, after Gonsalves had appeared to insinuate that Trump was influencing him and \nother public health leaders.\n“Gregg: I am surprised you included me in your note, ” Fauci wrote. “I genuflect to no one but science \nand always, always speak my mind when it comes to public health. I have consistently corrected \nmisstatements by others and will continue to do so.”\n5. Fauci corresponded with a wide array of people.\nHe didn't just hear from administration and public health officials. The emails also show exchanges with \nmembers of Congress and regular citizens. Fauci certainly didn't answer every single email he received, \nbut the tranche shows he made an effort to respond amid the many demands on his time.\n“The medical director of the National Football League Players Association asked Fauci for a confidential \nbriefing on how to safely start the next NFL season,” Damian and Yasmeen write. \nReleased by Chairman Rand Paul\n“A documentary filmmaker working on a forthcoming Disney-backed biopic asked to ride along as Fauci \ndrove to work.  An adviser to Microsoft co-founder Bill Gates expressed concern about Fauci’s health. \nAnd a senior House Republican told Fauci to ‘keep being a science truth teller’ despite skepticism about \nthe virus from other GOP lawmakers and Trump himself.”\n“I was getting every single kind of question, mostly people who were a little bit confused about the \nmixed messages that were coming out of the White House and wanted to know what’s the real scoop,” \nFauci said in a recent interview. “I have a reputation that I respond to people when they ask for help, \neven if it takes a long time. And it’s very time consuming, but I do” respond.\nThousands of emails from and to Fauci during \nthe pandemic's early days were published. \nHere's what they show about him\nWhile many federal government staffers prefer the phone to email, this correspondence offers a rare \nglimpse into Fauci's frantic schedule and polite, to-the-point demeanor during the time he emerged as a \nrare source of frank honesty within the Trump administration's Covid-19 task force. \nBut they also reveal the weight that came with the role. \nBy Christina Maxouris and Paul LeBlanc, CNN\nJune 4, 2021 – Global 171,800,000/3,700,000; USA – 33,100,000/593,400\n•I had my usual every two-week meeting with my English colleagues doctor Chris Whitty \nand Patrick Valance. The discussion was somewhat disturbing since they seem to be \nhaving 2 issues simultaneously in the UK. They were controlling the B.117 variants very \nwell and were preparing to open up. however, the B.1. 617variant appears to be much \nmore effective in transmitting than the B.117. and so they are experiencing a surge of the \nB 617. They were planning to open up the country , but now they are having second \nthoughts since they are afraid that the new variant will create a second major surge for \nthem. I will bring this up to our own medical team since we do have a low level of \nB.1.617 in our own country and if a certain proportion of people (mostly in the red states \n)do not get vaccinated, we may be faced with the same problem that the Brits are facing. \nReleased by Chairman Rand Paul\n•The onslaught against me but the radical right continues. The right wing press is \nintensifying their attacks on me as well as the right wing congressman and senators.  \nsome of the valid press such as the Washington Post , the LA Times , and others are \ncalling out the lies of the far right.    \nPOTUS defends me:\n \n Kyle Griffin\n￿@kyleg\nriffin1￿\nPool report: Biden left the room to a shouted question \nregarding whether he has confidence in Dr. Fauci. \nSuddenly, POTUS's head peeked around the corner, and \nhe answered:\n\"Yes I'm very confident in Dr. Fauci.\"\n \n6/4/21, 11:30 AM \n•I did a kickoff event for the month of action – “We can do this”. I did it together with \ncongressman Cedric Richmond who is director of the office of public engagement. We \naddress the people who will be the trusted messengers going out into the community to \ntry and encourage people to get vaccinated. \nVery important and very strange briefing of me by the CIA in the NIH SCIF this afternoon \n(5:00 PM).   I received an extremely strange an unexpected briefing today by the CIA related to \nthe origin of the virus. Beth Cameron from NSC was listening in on one of the other screens. \nAnd as it turns out she was as baffled as I was by the briefing. It was very similar to some of the \nvery disappointing briefings that I had previously received in  prior years from the CIA. A young \nwoman whose name was Camille Hartman gave most of the briefing. She was accompanied by \nwhat was probably the senior male CIA person and another young woman. Camille in my mind \nwas almost pathetic in her naivety an obvious lack of appreciation of any of the science of what \nReleased by Chairman Rand Paul\nshe was talking about. She gave instances of things that she said were gotten by CIA intercepts \nof conversations in China, particularly in Wuhan.  her major point was that she feels but the \nChinese have not been transparent about what was going on in their labs since there were no \nreports publicly of what they found out from intercepts. This included the transfer of Pangolin \nviruses from a group in Beijing two Wu Han. They felt that this was being used in a study using \ntransgenic mice. I have no idea why this was any great concern to them since it would be \nperfectly natural for a lab that studies coronavirus to look at Pangolins. In addition,  she spoke \nabout the observation that WIV was sampling Pangolins and several members of WIV took a trip \nto obtain Pangolins. They also spoke about the fact that they have information from sources that \nunknown experiments well conducted by the military in Wu Han. The thing that blew me away \nabout how naive and uninformed they are was the fact that they mentioned that they had word \nthat in July of 2020 there was a super spreading event in China related to passage of virus in the \nlaboratory. This astounded Beth and I for the same reason. Why would they suspect that a super \nspreading event that occur in the middle of a major outbreak in China was related to the passage \nof virus in the laboratory?   The  naivete of the briefing stunned both Beth and me. Also, in the \nmatter in which she was asking me questions almost made me believe she was grilling me \nprompting me to say somewhat tongue in cheek whether I should have a lawyer with me. I got \non the phone with Beth immediately after the briefing and she was very upset saying that she \nwas going to check up the chain who and why this briefing was called and why there was no \nforwarding material to prepare us for what they were doing. There is something very fishy about \nall of this.   \nPRESS:  BBC Radio; White House regional press (3 stations);  Mediaite: Chris Wallace \nDefends Fauci From ‘Highly Political’ Attacks: His Lab Leak Emails Contain ‘No Smoking \nGun’  https://bit.ly/3ciVYik\nJune 5, 2021 Global – 172,200,000/3,700,000; USA – 33,200,000/594.,000\n40th anniversary of the first cases of AIDS reported in MMWR  - a lot of appropriate \nattention is being paid to the 40th anniversary. There were several articles in the press recounting \nthe early days and focusing on my role . I did a number of print and TV and radio interviews.  \nThe attacks on me continue to ramp up. Trump planning on blasting me during his speech \ntonight at a Republican party gathering. \nPRESS: Caught in crosshairs, Fauci calls GOP \ndescriptions of his emails 'profoundly \nmisleading'\nReleased by Chairman Rand Paul\nBy Michael Warren , Kaitlan Collins , Gabby Orr and Daniella Diaz, CNN\nJune 6, 2021  -  Global -   USA\nToday I fly up to New York City with first lady doctor Jill Biden to promote vaccinations \namong the African American community. We will be visiting the Abyssinian church in \nHarlem. \nThe vicious assault on me continues . Most recently House Minority Leader Kevin \nMcCarthy has called for me to be fired. What an amazing coward he is. The entire extreme \nright wing republican group in the House and Senate have completely sold their soul to the \ninfinitely lying ex president trump.\n•I spoke with Jeff Zients this morning and he told me that Ron Klain told him that \nPresident Biden is 100% behind me (see above). \nJune 7, 2021 – Global – 173,000,000/3,700,000; USA – 33,200,000/594,800\n•Eventful day - I went to New York today with first lady doctor Jill Biden for two \nreasons: 1st )to visit the Abyssinian Baptist Church in Harlem in order to thank them for \nsetting up a vaccine clinic and to encourage them to continue to advocate for young \npeople to get vaccinated. I flew up with the first lady on one of the Air Force planes \nassigned to the White House and had a great conversation with her on the plane up as \nwell as on the plane down. She is an amazingly natural and one person with whom I \nbelieve we have now started a good friendship. The people at the Abyssinian church or \nextremely kind to me in saying how much they appreciated that I was there and all of \nthem wanting to take selfies with me. We stayed at the Bowery hotel at the interface \nbetween Chinatown and the Bowery. i was surprised that we picked the hotel Since \nwhere we want to go for the TV hit the following morning was way Uptown. Brett \nRowland and I had a great Italian dinner at the Primi restaurant in the Bowery. The \nfollowing day the first lady and I appeared together on the Kelly Ripa and Ryan Seacrest \nShow (KABC). It was very lighthearted and enjoyable. \n   Another very important aspect of the day is that as I was getting ready to take off \nwith the motorcade from the White House on the way to Andrews Air Force Base, the \npresident came walking down the back alley , the Secret Service called me out of the car , \nand the president put both his hands on both my shoulders and said “I just want to tell \nyou that I am behind you 1000%”; and he repeated again “I am behind you 1000%.” He \nsaid “those people are crazy they have no idea what they're talking about and just don't \npay any attention to them.” \n•Back to the dark side. Scott Gottlieb had appeared on Face the Nation and mentioned in \nan attempt to help me then I had actually gone to Europe in Jan/Feb. 2020 to brief health \nReleased by Chairman Rand Paul\nministers about the possibility that the virus could have been constructed an escape from \nthe laboratory. He did this to indicate that I was not hiding anything because I already \nknew that this was a possibility and so I didn't change my mind currently by saying that a \nlab leak is a possibility since I was talking about it openly back then.  As it turns out, he \nwas a little bit mixed up because on January 31st, 2020 I received a call from Jeremy \nFarrar who conferenced in Christian Andersen to tell me that Ed Holmes and Christian \nhad seen a copy of the sequence of the virus and felt that there was a possibility that \nbecause of the unusual furin cleavage site that this could possibly have been a constructed \nvirus. as indicated in my notes of January 31st and February 1st , 2020, since I am not an \nevolutionary biologist I called together by phone a group knowledgeable scientist \ntogether with Francis Collins and a few other people to discuss this. After a considerable \namount of discussion about half of the people felt that this was possibly a constructed \nvirus and the other half were convinced that this was a natural occurrence. A few weeks \nlater Christian Andersen got together with Bob Garry and Andrew Rambaut to examine \nthis more carefully and they came to the conclusion that they were convinced that this.  \nwas a natural occurrence and a jump from the animal reservoir. They published their data \nin a preprint server in February followed by a nature paper in March of 2020 . That is the \nreason why it appears that a I briefed people which I did not . I was briefed by them . \nScott had said that I had briefed a group of international health people he seemed to have \ngotten some of the story wrong , but overall he was correct. \nCases continue to come down:\nJune 8, 2021 – Global – 173,3000,000/3,700,000;  USA – 33,200,000/595,300\nReleased by Chairman Rand Paul\nCases continue to come down:\nFar right still slamming away.   It is very clear that this is a well-organized effort.\nPRESS: Interview with Dutch newspaper NRC Handelsbad – Bas Blokker interviewer; \nSmithsonian Channel TV Documentary (Israel) – “Vaxxed Nation”; Harvard Nieman \nFoundation of Journalism – Fireside Chat – with Jeneen Interlandi (NY Times); White \nHouse Pressor (I discussed Delta variant in UK and danger to USA)\nBlinken casts doubt on \nmethodology of coronavirus \nlab-leak report\nReuters\nThis is report from Lawrence Livermore Lab that supposed lent credence to the lab leak \nhypothesis, which it did not. Blinken got it right here by saying the report was flawed.\nReleased by Chairman Rand Paul\nTerrific article in the LA Times strongly defending me: Column: The \nright’s attack on Fauci shows it has nothing in its \npolicy tank but slogans\nBy MICHAEL HILTZIK BUSINESS COLUMNIST \nJUNE 8, 2021 5 AM PT\nAnother great article in the Miami Herald defending me:\nDespite Trump’s new round of bullying, Fauci \nsays COVID likely didn’t leak from a Chinese \nlab | Opinion\nBY ANDRES OPPENHEIMER\nJUNE 08, 2021 09:13 AM, \nUPDATED 19 MINUTES AGO\nLA TIMES – MICHAEL HILTZIK:\nColumn: A Nobel laureate backs off from \nclaiming a ‘smoking gun’ for the COVID-19 lab-\nleak theory \nJune 9, 2021 – Global – 173,700,000/3,700,000; USA – 33,200,000/595,600\nToday the president went to England on the first leg of the trip involving the G7 summit. \nWith regard to COVID-19, he has a very important message to deliver which I am very pleased \nabout. He will announce that the United States will give away 500 million doses of the Pfizer \nvaccine to countries that do not have the capability of getting their own vaccine. I have been \npushing for this for some time with Jeff and I have even spoken to the President and VP about \nthe need to take a leadership role in getting vaccines to the lower and middle income countries. \nThis is a first step towards vaccinating the world and to having the United States resume our \nleadership role throughout the world.   I will continue to push to have technology transfer to the \nReleased by Chairman Rand Paul\ndeveloping world so that ultimately they may be able to make their own vaccine. But for now, \nthe role of the United states as a world leader has been clearly affirmed by the President's action  \nPRESS: CNN with Erika Hill; Podcast with former Congressman Pete Sessions; MSNBC \n“Meet the Press Daily” with Chuck Todd; Wall Street Journal Tech Summit; My picture \nwas on the 1st page of the Style Section of the Washington Post together with Jill Biden and \nDebra Frazier-Howse\nWashington Post:\nBiden administration to buy 500 million Pfizer \ncoronavirus vaccine doses to donate to the \nworld\nBy \nTyler Pager\nand \nEmily Rauhala\nJune 10, 2021 – Global – 174,000,000/3,800,000;  USA – 33,200,000/596,000\nCases still low:\nReleased by Chairman Rand Paul\n•I had a really nice conversation with Chuck Todd this morning. He had texted me to \nask what I thought of the interview yesterday. I told him that I thought it was absolutely \nterrific, but I wanted some advice from him . I asked him whether he thought that I \nshould pull back from publicly defending myself against the slanderous attacks since that \nmight call more attention to them. He completely agreed and said that Fox News and \npeople like Tucker Carlson would use anything I say as the theme for their next show. \nChuck is really an excellent journalist and although he must maintain his objectivity and \nreporting it is very clear that he is really being a friend in understanding the difficult \nposition that I am in. \n•Did Fireside chats with Irini Sereti; Bio Annual Meeting Fireside chat with Julie \nGerbelding; “Reaching adolescents” interview with Vivek Murthy\nPRESS: Univision Interview with Ilia Calderone; Washington Post  - Only in our \nanti-truth hellscape could Anthony Fauci \nbecome a supervillain\nReleased by Chairman Rand Paul\nAnthony S. Fauci, director of the National Institute of Allergy and \nInfectious Diseases, listens during a Senate hearing last month. (Stefani Reynolds/Pool/AP)\nBy Margaret Sullivan\nMedia columnist\nJune 10, 2021 at 7:00 a.m. EDT\nJune 11, 2021 – Global – 174,500,000/3,800,000; USA – 33,300,000/597,000\nPress are beginning to push back and point out how ridiculous the criticism of me is (see below \nin Vanity Fair)\n•Did multiple outreach chats today with mayor Muriel Bowser, with the college challenge \nevent and with two White House arranged interactions with young “influencers “ \n•Also have a zoom meeting with David Kessler , Peter Staley, and  James Krellenstein. \nPeter and James have been pushing to have the United States government make a major \ninvestment in Lanza, which is the company that produces the doses for Moderna. David \nexplained to them that there is enormous capacity with the mRNA companies themselves \nand so was not particularly amenable to going straight to Lanza. I have been trying to \nbroker an understanding between Peter and James and David , but I'm not so sure how \nsuccessful I would be \n•.  The data were extremely exciting with a 90.4% vaccine efficacy and 100% efficacy \nagainst severe disease. We are becoming almost complacent with these spectacular \nresults about vaccine efficacy . However, this result will add an important component to \nour armamentarium  \nPRESS: NDTV New Delhi, India;\nReleased by Chairman Rand Paul\nRepublicans Are One Week Away From \nDemanding Anthony Fauci Be Deported to \nWuhan\nConservatives are obsessed with the baseless idea that the veteran immunologist had something to do \nwith COVID-19’s origins.\nBy Bess Levin\nJune 12, 2021 – Global    USA\n•had our usual medical team meeting with Jeff this AM (Sat).  The important good news is \nthat the president's announcement a 500 million doses of vaccine going to low and \nmiddle income countries is going across very well throughout the world. As the president \nhas said, “America is back “ in our rightful leadership role. \n•Had a very good conversation today with Hugo Crosthwaite and Taina Caragol .  \nHugo is a famous artist who will be doing a commissioned “motion” portrait of me for \nthe National Portrait Gallery.   Taina works for the NPG.  The theme of the portrait is the \nshow that I have been the symbol of truth and science and have been attacked by the \nforces of untruth and evil. His prior work is in an unusual medium where he those pencil \ndrawings of a person Anne photographs them to look like a mini movie picture. I have \nseen some of his work and it is extraordinary and spectacular. I am looking forward to \nseeing what the result will be. The results should be sometime at the end of the year.  \nPRESS: New York Times (Davey Alba) - No, Fauci is not profiting from a \ncoming book on lessons he’s learned from his public service.\nThe above article points out the fact that despite Nat Geo making it very clear that I \nreceived no money from their book the far right including many GOP congressman I still \ninsisting that I was profiting while people were dying. The extraordinary crazyness \ncontinues. \nReleased by Chairman Rand Paul\n \nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nJune 17, 2021 – Global   USA\nParticipated in Faith Vaccine Roundtable – young Muslim messengers\nPRESS:  NPR “Morning Edition” with Leila Fadel; did the White House Press Conference \n– I announced the new $3.2 billion Antiviral Program for Pandemics, which a 2 pillar \nprogram for Development and Discovery of antivirals for COVID-19 and other viruses of \npandemic potential; \nGreat Article in Politico that describes the lies of the Trump people about the “lab leak” \ntheory:\nTop Trump officials pushed the Covid-19 lab-leak theory. \nInvestigators had doubts.\nNew documents and interviews show how the president and his senior aides cherry-picked evidence and \nsidelined the government’s own virus sleuths.\nReleased by Chairman Rand Paul\nA Northwell Health lab technician uses the Abbott ID NOW Covid-19 rapid tester on a participant before \na news conference on April 14, 2021, in Elmont , N.Y. | Mary Altaffer, Pool/AP Photo\nBy ERIN BANCO and DANIEL LIPPMAN\nReally good article in Politico:\nHamburgers, Fauci and election fraud: How Biden World combats disinformation\nThe White House has two dozen staffers working on it. And they’ve outsourced even more.\nReleased by Chairman Rand Paul\nPresident Joe Biden stops to talk to the media as \nhe drives a Ford F-150 Lightning truck at Ford Dearborn Development Center, May 18 in Dearborn, Mich. \n| Evan Vucci/AP Photo\nBy NATASHA KORECKI\n06/16/2021 11:48 AM EDT\n From “the Sun”\nFroma Harrop: The right’s \nreal problem with Dr. \nAnthony Fauci\nAs the virus threat recedes, not every pronouncement Fauci \nmakes will grab headlines, but he's not there for that. He's there \nto do the science. The right-wing attacks on him can't be \npleasant, but Fauci will end his long career with a legacy of \npublic service and, importantly, his dignity intact.\nDonald Trump is no longer president. COVID-19 is no longer the threat it \nwas. And Dr. Anthony Fauci, America’s top infectious disease expert, is back \nto more routine briefings on vaccination rates and such. So why does Fauci \nremain so much in the news?\nReleased by Chairman Rand Paul\nBecause the Trump camp can’t stop bashing him. And why is that? Why does \nthe right continue to portray this mild-mannered public official as the enemy?\nIt may be that Fauci publicly refuted some of Trump’s ignorant musings \nduring that presidency, but that’s not really it. Republicans such as Texas \nSen. Ted Cruz hit at Trump in the past. During the 2016 campaign, Cruz \ncalled Trump a “sniveling coward.”\nThe difference is that Cruz later came crawling on his belly to praise Trump, \na man who insinuated that his father helped kill JFK and that his wife was \nugly. Fauci never made that kind of round trip. Nor would he.\nAnd what surely riles the right even more than Fauci’s refusal to cave is that \nhe didn’t care. Fauci saw Trump as a politician to manage rather than to fear. \nThe lack of abject submission punched a few holes in the Trumpian myth \ncentered on an all-powerful authority.\nFauci met the attacks on him with sighs. He responded to nutty declarations \non science with patient correction. The right wants angry conflict, and Fauci \nnever delivered on his end.\nWe now have the sad sight of another Texan sacrificing his good family \nname to appease Trump. George P. Bush is campaigning to be the \nRepublican nominee for Texas attorney general on the wings of Trump’s \nremark that he was “the only Bush who got it right.” It’s printed right on \nGeorge P.’s campaign beverage sleeves.\nGeorge P. is the son of former Florida Gov. Jeb Bush, whom Trump demeaned as \n“Low-Energy Jeb.” Trump tweeted that Jeb “has to like the Mexican Illegals because \nof his wife,” who immigrated from Mexico. That Mexican immigrant would be \nGeorge P.’s mother.\nGeorge P. is the nephew of former President George W. Bush, whom Trump \nmaligned after George W. put out a video applauding health care workers but \nnot praising him. He is the grandson of former President George H.W. Bush, \nwho found Trump so appalling he voted for Democrat Hillary Clinton in \nReleased by Chairman Rand Paul\n2016. And Trump wasn’t invited to speak at the grandfather’s funeral as \npresidents traditionally do.\nIf George P. Bush’s name had been George P. Jones, his political rise \nundoubtedly would have been less smooth. But now he’s shocking a lot of \nBush family admirers in his quest to receive a pat on the head from Trump — \nor at least not a swat. Sure, a lot of Texas Republican primary voters worship \nTrump, but is winning a nomination for state office worth losing one’s \nhonor?\nIt’s a guarantee that Fauci would not kiss the rear end of anyone who insulted \nhis family. What we have here is a short guy from Brooklyn basically \nbrushing off Trump’s menacing antics while swaggering Texas Republicans \ncollapse at the sign of a New Yorker’s displeasure.\nAnd there’s one other reason for Trump’s continued obsession with Fauci: \nenvy. Trump is fading from national prominence. Even Fox News no longer \ncarries all his speeches live.\nBut Fauci goes on. He’s still respected by the sort of people whose respect serious \nleaders want. His polls numbers remain high.\nAs the virus threat recedes, not every pronouncement Fauci makes will grab \nheadlines, but he’s not there for that. He’s there to do the science. The right-\nwing attacks on him can’t be pleasant, but Fauci will end his long career with \na legacy of public service and, importantly, his dignity intact.\nJune 18, 2021 – Global – 177,000,000/3,800,000; USA – 33,300,000/600,000\nReceived important e-mail with attachment from Jesse Bloom:\nHi Francis, Stephen, and Toni,\nI’m just writing to give you a heads up that I identified a data set of early Wuhan SARS-CoV-2 sequences \nthat has been deleted from the NIH’s Sequence Read Archive (SRA). I was able to recover the deleted \nReleased by Chairman Rand Paul\nfiles from the Google Cloud and analyze the sequences, and have attached a pre-print on the analysis \nthat I just submitted for posting by bioRxiv.\nSince SARS-CoV-2 origins and early spread has become a hot-button topic, I wanted to give you a heads \nup. I made sure to emphasize in the discussion that the SRA has many sequences and so isn’t in a \nposition to vet all deletions. Nonetheless, I think it would be highly worthwhile to do a comprehensive \nanalysis of SRA (and other NIH) data that might be relevant to this topic that could have been deleted or \notherwise overlooked. If I can be of any assistance, let me know.\nI have been running a pipeline to identify additional deleted SRA data using various heuristics including \nthose in described in the attached pre-print, but have not yet completed the analysis enough to know \nthe extent that the data I have recovered is relevant to SARS-CoV-2’s origins or early spread. But as I \nmention in the pre-print, there are two known SRR deletions that are worth looking at. I definitely think \nit would be good to perform a SRA side search as well, since that will obviously be easier and more \nefficient, and could identify deleted data not on the cloud.\nAnyway, I hope overall this can be a good opportunity for the NIH to take the lead by using its \nremarkable data archives to make progress in resolving some of the important questions about the \nvirus’s origins.\nThanks,\nJesse\n----\nJesse Bloom\nAssociate Professor, Fred Hutch Cancer Research Center\nAffiliate Associate Professor, Genome Sciences & Microbiology, University of Washington\nInvestigator, Howard Hughes Medical Institute\npaper.pdf\nI believe that it was somewhat imprudent on the part of Jesse bloom to make statements such as \nhe has that indicate nefarious motives on the part of the Chinese when we have no idea why they \ndeleted the sequences. He used words such as “obscure” and “surreptitious” which will certainly \nReleased by Chairman Rand Paul\ncreate a firestorm when conspiracy theorists read it. The best thing to do is to have Frances and I \nagain convene a group of evolutionary virologists to discuss the potential meaning of this . We \nwill do this two days from now on Sunday June 20. See below.  \nCases at around 12,000 per day\nNIH helped fund research \ninvolving donated fetal \ntissue, but Fauci was not \ndirectly involved\nPRESS:  Excellent refutation of the lab leak hypothesis in The Guardian:\nThough it is newly respectable, the Wuhan lab \ntheory remains fanciful\nDavid Robert Grimes\nJune 19, 2021 -  Global   USA\n Horrible roller coaster day – Due to some acute transient right posterior chest pain 2 days \nago, Ted Li order a CT scan. - I got a call from the radiologist at Sibley hospital where \nI had gotten a chest CT in the morning telling me that I had a lesion in my right lower \nlobe that he felt was a cancer (non-small cell carcinoma). I felt like I got hit like by a \nMack truck. Doctor Li quickly followed up on this and show the film to Andrew Lerner \nat Sibley who is a pulmonologist specializing in pulmonary nodules. Doctor Lerner felt \nthat it was more likely an inflammatory lesion and there were multiple other lesions that \nwere very small throughout the right lower lobe. In addition, I had a pulmonary infarct in \nthe right lowest segment that was definite. Again, Dr. Li called David Hellmann Who \nwas with his son who is an oncologist who looked at it and said that it looks more benign \nthen neoplastic and felt that it did not look like a non-small cell carcinoma. Finally, they \nshowed the films via computer to Dr. Elliot Fishman who is the top radiologist at \nReleased by Chairman Rand Paul\nHopkins. He agreed that it was more likely inflammatory and that the only definite thing \non the film was the pulmonary infarct. He recommended a follow-up CT in three months \nand begin anticoagulation immediately with Eliquis.\n●Chris and I viewed the “FAUCI” documentary doe by Nat/Geo together with the \nleadership of Nat/Geo films at the national geographic headquarters on 17th Street, NW.  \nVery impressive film.\n●At the request of the White House I did a walking tour of the Anacostia neighborhood Of \nWashington DC together with Mayor Muriel Bowser. we started off at anacostia high \nschool where we thanked the volunteers in the basketball gym who were administering \nvaccines to people in the neighborhood . We then went on and addressed the volunteers \nin the schoolyard of Kramer Middle School.  After that, the mayor and I went door to \ndoor knocking on the doors and encouraging people in the neighborhood to get \nvaccinated. We did that for about an hour and 15 minutes. it got written up the next day \nin the Washington Post (see below).\nPRESS:     Washington Post:  “For Ward 8 residents, coronavirus vaccine appeal comes \nwith a touch of celebrity: ‘It’s Fauci!”  https://wapo.st/3vFzhLZ \nJune 20, 2021 – Global   USA\nUneventful and somewhat relaxing day . Still trying to process the news from yesterday. Will \nhave to live with uncertainty for the next three months. \nAs indicated above, Francis Collins organized a zoom call for today with a group of \nevolutionary biologists  as well as Steve Sherry from the NIH databank in order to discuss this \nissue. Jesse bloom was also on the call. See email below from Francis having organized the \nmeeting:\nFrom:  Collins, Francis (NIH/OD) [E] <collinsf@od.nih.gov> \nSent: Sunday, June 20, 2021 2:33 PM\nTo: Tabak, Lawrence (NIH/OD) [E] <lawrence.tabak@nih.gov>; Fauci, Anthony (NIH/NIAID) [E] \n<afauci@niaid.nih.gov>; Embry, Alan (NIH/NIAID) [E] <embrya@niaid.nih.gov>; Sherry, Steve \n(NIH/NLM/NCBI) [E] <sherry@ncbi.nlm.nih.gov>\nCc: Kristian G. Andersen <kga1978@gmail.com>; Bedford, Trevor <tbedford@fredhutch.org>; Bloom \nPhD, Jesse D <jbloom@fredhutch.org>; Garry, Robert F <rfgarry@TULANE.EDU>; \nrasmus_nielsen@berkeley.edu; spond@temple.edu\nSubject: RE: URGENT: Seeking your expert advice\nAllow me to suggest this agenda:\nReleased by Chairman Rand Paul\n1) Introductions\n2) Retrieval of SARS-CoV-2 reads deleted from SRA by submitter – Jesse Bloom\n3) NCBI SOPs for handling submitter requests to delete reads in SRA – Steve Sherry\n4) Likelihood of other sequence deletions from SRA? – Steve Sherry\n5) Significance of this new sequence information for origin of SARS-CoV-2 – Jesse, Kristian, \nTrevor, Bob, Rasmus, Sergei\n6) Discussion and next steps – All\nLooking forward to the discussion.\nFrancis\nPlease see the people copied on the above email for a list of those who were present at the \nzoom call. The only person on the list who was not there was Trevor Bedford who could not \nmake the zoom connection. After considerable discussion among the group,  it became clear \nthat Jesse Bloom had really jumped the gun and made assumptions that the Chinese were \nsurreptitiously hiding sequences by deleting them. Several of the scientists including Sergei \nPond and Rasmus Nielsen felt that the sequences that were deleted and ultimately recovered \npartially were not of any particular consequence in shedding any light on the origin of SARS Co \nV2.  The entire group felt that this was an inappropriate move on the part of Jesse to publish a \nsingle author paper making serious innuendos without running it by anyone else. As it turns out \nafter discussion with Steve Sherry  who is in charge of the NIH Sequence Read Archive (SRA) \nfrom which the sequences were deleted, it became clear that this is not an unusual occurrence \nfor scientists to delete sequences if they are found to be either inaccurate , not up to date, or \nlisted on another databank. He went back and looked at the required email to have the Wuhan \nsequences deleted, and the Chinese had indicated that they were removing it because they \nwere putting it on their own separate database. According to Steve this would be a perfectly \nvalid reason to remove a sequence. This obviously is going to cause us a lot of difficulty since \nthose who feel that the Chinese are trying to cover up a lab leak will certainly say that this \ndeletion of sequences proves that that is the case. It is really a shame that Jesse acted really in \nmy opinion somewhat immaturely in making inflammatory statements in a preprint without \nfurther investigating the reasons behind the deletions. \nThe NIH came out with the following statement in response to press inquiries regarding the \nBloom preprint:\nNIH is aware of Dr. Bloom’s preprint submission. Staff at the National Library of Medicine, which hosts \nthe Sequence Read Archive (SRA), have reviewed the submitting investigator’s request to withdraw the \ndata. These SARS-CoV-2 sequences were submitted for posting in SRA in March 2020 and subsequently \nrequested to be withdrawn by the submitting investigator in June 2020. The requestor indicated the \nsequence information had been updated, was being submitted to another database, and wanted the \ndata removed from SRA to avoid version control issues. The submitting investigator published relevant \nReleased by Chairman Rand Paul\ninformation about these sequences by preprint in March, 2020  and in a journal in June, 2020. \nSubmitting investigators hold the rights to their data and can request withdrawal of the data. \nCurrently, the National Library of Medicine (NLM) has no plans to change the policy that recognizes \nsubmitters rights to their own data and the right to petition that their data be withdrawn from the \nSequence Read Archive (SRA). The National Center for Biotechnology Information (NCBI), part of the \nNLM that manages the database, is the U.S. participating member of the International Nucleotide \nSequence Database Collaboration, which provides guidelines for withdrawing data: \nhttp://www.insdc.org/documents/insdc-status-document. NLM/NCBI can’t speculate on motive beyond \na submitter’s stated intentions.  \n \n \nJune 21, 2021 – Global -178,000,000/3,900,000; USA – 33,400,000/600,000\nDid an Instagam live with FGOTUS Doug Emhoff and Dikembe Mutombo to encourage \npeople to get vaccinated.    We are putting a full-court press in encouraging people to get \nvaccinated.\nDid TIKTOK interviews (rapid fire questions) from 8 young TIKTOK “influencers who \namazingly have millions of followers\nFOX News is blasting me for saying that an attack on md is an attack on science.   I am going to \ngo on the offensive against them.   To me, it is a badge of honor to be criticized by FOX.\nImportant article in the Post today by Joel Achenbach (see below)\nPRESS:   NY Times by Carl Zimmer and James Gorman:\nFight Over Covid’s Origins Renews \nDebate on Risks of Lab Work\nExcerpt from above NY Times article:\nReleased by Chairman Rand Paul\n“When questioning Dr. Fauci last month, Senator Paul brought up one of the most cited \nexamples of gain-of-function research, a study of coronaviruses done by Ralph Baric at \nthe University of North Carolina published in Nature Medicine in 2015. Working with \ndata sent from Shi Zhengli, the director of the Wuhan Institute of Virology, Dr. Baric \nand his colleagues built a new coronavirus from an existing one. All of the work was \ndone in the North Carolina lab, and neither Dr. Zhengli nor members of her lab \nparticipated.\nThe so-called chimeric virus that resulted was not more pathogenic than the parental \nvirus, Dr. Baric said. “This work was approved by the N.I.H.., was peer-reviewed, P3CO \nreviewed and approved,” Dr. Baric wrote in an email last month. The work also \n“involved a very different strain of beta coronavirus than the one that causes Covid-19,” \nhe said, and was considered low risk because of the particular strain in question.\nIn the paper, he and his colleagues cautioned others about similar research. “The \npotential to prepare for and mitigate future outbreaks must be weighed against the risk \nof creating more dangerous pathogens,” they wrote.”\nPeter Hotez writing in the Daily Beast :\nThe Unique Terror \nof Being a COVID \nScientist After Jan. \n6\nTHE NEXT WAR\nIt’s no coincidence that one of the first guilty pleas in connection with the Capitol \nriot was of an anti-vaxxer.\nReleased by Chairman Rand Paul\nPeter J. Hotez\nUpdated Jun. 21, 2021 4:43AM ET / Published Jun. 21, 2021 3:35AM ET \nAlex Wong/Getty\nBeing a scientist was not exactly fun during the height of the coronavirus \npandemic  in America. But somehow, even as cases and deaths are way \ndown in the United States , the attacks on us are worse than ever.\nTake Anthony Fauci, a punching bag for the far right since the earliest \ndays of the outbreak. The “Fire Fauci Act,” a twisted piece of legislation \nfirst introduced by Rep. Marjorie Taylor Greene in April, gained \nadditional Republican support this past week, now reaching at least a \ndozen House members.\nThat leaders of the GOP would go out of their way to reduce Dr. Fauci’s \nsalary to zero and ultimately force his retirement must be examined for \nwhat it really is. This is no simple beef with someone who was frequently \ntargeted by the administration and its allies under Donald Trump. It is, \ninstead, a piece of a much larger and systematic anti-science project on \nthe far right, one that is increasingly hard to separate from the Stop the \nSteal myth powering the right-wing fringe.\nCNN: 'Let me give you a flash': Hear Dr. Fauci fire back at \ncritics   https://cnn.it/35FZOy9 \nWashington Post\nReleased by Chairman Rand Paul\nHealth\nScientists battle over the ultimate origin story: \nWhere did the coronavirus come from?\nBy \nJoel Achenbach\nJune 20, 2021 at 5:58 p.m. EDT\nJune 22, 2021 – Global     USA\n●Had podcast with the Conference of Mayors\nVaccinations coming along very well:\nPRESS:  BBCTV with Katty Kay; CNN “The Lead” with Jake Tapper; MSNBC “All In” \nwith Chris Hayes\n Very good interview on New York Times “Sway” with Cara Swisher:\nNYT/Sway: Anthony Fauci on the Lab Leak Theory and Emailing Mark Zuckerberg \nhttps://nyti.ms/2UfIr4K \nThe Hill: Poll: 61 percent say Fauci has been truthful to the best of his knowledge on COVID-\n19 origins;\nReleased by Chairman Rand Paul\nNPR Radio – 1A; \nThe New Yorker:\nAnthony Fauci, Lifeguard\nThe doctor is in, no matter what time of year.\nBy Barry Blitt\nJune 24, 2021 – Global – 179,000,000/3,900,000; USA – 33,400,000/600,000\nI had another terrific day with First Lady Dr. Jill Biden. We flew to Florida from Andrews \nwith all the bells and whistles of motorcades to visit two cities: Osceola County near Orlando \nand Tampa Bay. We have become somewhat of a good team together in visiting with the sites \nthat were administering the vaccine, mingling with both the people who are being vaccinated as \nwell as the staff who were doing the vaccinating. At each stop both doctor Biden and I made \nremarks and spoke with the press. Of particular note was the visit to Tampa Bay where we met \nwith Mr. Jeff Vinik, the owner of the Tampa Bay Lightning , the hockey team that would be \nplaying the 7th game of the semifinals for the Stanley Cup finals the following day. They gave \nboth Jill and I our own jerseys with our names on them. We gave our speech on the ice of the \narena where the Tampa Bay Lightning plays. I am getting to be quite good friends with Jill and I \nthink that our relationship will strengthen as we continue working together.  \nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nJune 23, 2021 – Global – 179,000,000/3,900,000; USA – 33,400,000/600,000\nDid an Instagram with Jennifer Garner on vaccines.  She was wonderful as she was last time.  \nWe spoke of the vaccination of her 3 children.\nCong. Stephen Scalise wants to hold a panel on the originals that would be a “set-up” to \nattack Francis Collins and me:\n2021.06.22 Fauci \nInvite.pdf\nHere is the announcement of the “set-up” hearing.  We would be crazy to honor it.   The \nPanel 1 are a bunch of wackos:\nSelect Subcommittee Republicans \nAnnounce Expert Witness Forum on \nCOVID-19 Origins\nForum to be held with expert witnesses on Tuesday, June 29\nWASHINGTON—On Tuesday, June 29 at 12:00 p.m. ET, Republican Whip and Select \nSubcommittee on the Coronavirus Crisis Ranking Member Steve Scalise (R-La.), House \nCommittee on Oversight and Reform Ranking Member James Comer (R-Ky.), and \nSelect Subcommittee Republican lawmakers will hold a forum with expert witnesses to \nexamine the origins of the coronavirus. For more than a year now, Republicans have \nrepeatedly called on Democrats to investigate the mounting evidence showing the virus \noriginated from the Wuhan Institute of Virology (WIV) lab, but Democrats continue \nrefusing to launch an investigation.\n“The left-wing media called it a ‘fringe conspiracy theory,’ Big Tech censored it, activists \nin white lab coats dismissed it and Democrats ignored it, but there is growing evidence \nCommunist China started the pandemic, covered it up, and is responsible for the deaths \nof more than 600,000 Americans and millions more worldwide,” said Scalise and \nComer . “Despite Speaker Pelosi’s efforts to create diversions and cover this up, the \nAmerican people deserve the truth and are demanding accountability, and House \nRepublicans will insist on getting these answers.\n“The House Democrat majority’s refusal to follow the science, listen to the experts, and \ninvestigate the origins of COVID-19 is a dereliction of their duty. Next week, Select \nSubcommittee Republicans will hold a forum with expert witnesses to advance our \ninvestigation into the origins of COVID-19,” added Scalise and Comer . “The American \npeople deserve to know the truth, even if Washington Democrats refuse to seek it.”\nReleased by Chairman Rand Paul\nIt was recently reported that three researchers from the Wuhan lab became ill with \nsymptoms consistent with COVID-19 and sought hospital care in November 2019. \nAdditionally, Dr. Fauci’s recently released emails from February 2020 reveal that \nscientists raised the possibility of a lab leak and also expressed concern the virus \nappeared to be engineered. \nWHAT:  Select Subcommittee expert forum entitled “Led By Science: The COVID-19 \nOrigin Story”\nWHEN:  Tuesday, June 29 at 12:00 p.m. ET\nWHERE:  HVC-215, Capitol Visitors Center\nWHO:\nWitness Panel I\n●The Honorable Brett P. Giroir, former Assistant Secretary for Health, U.S. \nDepartment of Health and Human Services: Admiral Giroir brings firsthand \nknowledge about the public health response to the COVID-19 pandemic. As \nCOVID-19 testing czar, he oversaw creating a nationwide testing apparatus \nfrom scratch which was made particularly difficult by China’s lack of \ntransparency. Admiral Giroir will also discuss the investigatory failures of \nthe World Health Organization and why a U.S.-led origins investigation is \nvital.\n●Dr. David Asher, Senior Fellow, Hudson Institute: Dr. Asher has decades of \nnational security experience and most recently led the U.S. Department of \nState’s COVID-19 origins investigation. His testimony will provide inside \ninformation into the origins investigation and the role of the Chinese \ngovernment’s efforts to block a thorough and impartial investigation.\n●Dr. Richard Muller, Emeritus Professor of Physics, University of California \nBerkeley: Dr. Muller is an acclaimed scientist that used his own research to \nstudy available data in attempting to determine the origins of COVID-19. He \nrecently penned an op-ed in the  Wall Street Journal pointing out there is \nstrong evidence COVID-19 was developed in a laboratory using gain-of-\nfunction acceleration. \n●Dr. Steven Quay, Founder, Atossa Therapeutics: Dr. Quay is one of a \ngrowing number of scientists dedicated to finding the origins of COVID-19. \nHe has conducted his own research using the publicly available viral data \nand reached conclusions apart from outside influence. He brings \nsignificant scientific expertise to this endeavor including over 87 patents \nand hundreds of published scientific articles.\nMember Panel\nReleased by Chairman Rand Paul\n●The Honorable Cathy McMorris Rodgers, Member of Congress\n●The Honorable Michael McCaul, Member of Congress\n●The Honorable Devin Nunes, Member of Congress\n●The Honorable Mike Gallagher, Member of Congress\nWitness Panel II (invited but hasn’t yet accepted)\n●The Honorable Francis Collins, Director, National Institutes of Health\n●Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious \nDiseases\n●Dr. David Hassell, Chairman, P3CO\nWATCH:  A livestream will be available HERE.\nPRESS: WSJ: Dr. Fauci and the Mask Disaster; CBS “This Morning” with Anthony \nMason; NBC “Today” with Savannah Guthrie; Month of Action interviews with \ninfluencers on TikTok and Instagram (one with Jennifer Garner)\nJune 24, 2021 – \nHad a great day with FLOTUS Dr. Jill Biden - I flew on one of the presidential planes with \nDr. Jill Biden, assembling at the White House for the motorcade to Andrews Air Force Base. \nBrett  Rowland came with me.  We went to Florida for a two city stop to promote vaccines. The \nfirst stop was at Osceola County near Orlando. The next stop was at Tampa Bay where we did a \nvaccine promotion event right on the ice in the arena that is used by the Tampa Bay Lightning \nteam. Of note, tomorrow the team plays the 7th game of a seven game semifinal before the \nStanley Cup finals . They will be playing the New York Islanders. We had a nice conversation \nwith Jeff Vinik and his family. Jeff is the owner of the hockey team and he gave me a team \njersey with my name on it as well as a team jersey to Jill with her name on it. It was a very \nproductive day as both Jill and I gave speeches at each of the locations and encourage the \nworkers there and the people lined up to get vaccinated. No doubt Jill and I are now developing a \nvery strong relationship, as we really have developed a comfortable and warm rapport with each \nother. \nJune 25, 2021 - Global – 180,000,000/3,900,000; USA – 33,400,000/601,000\nI did something this morning that I feel very good about.  I went over to the clinical center and \nparticipated in the “graduation ceremony” of the people in project search who are a group of \nhandicapped individuals who underwent a training program here at NIH and were then given \njobs here. I did selfies with each and every one of them, took a group photo, and gave them a pep \ntalk about why their work is so important. I have such empathy for people who through no fault \nof their own were dealt a difficult hand in life. \nReleased by Chairman Rand Paul\nAs a bit of background, Mayor Bill Di Blasio of New York City had invited me to be the \nGrand Marshal of the parade of heroes for the 4th of July weekend in New York City . It \nwould be similar to the ticket tape parades that honored returning war generals. The purpose of \nthe parade was to honor health care workers and first responders to the outbreak in New York \nCity period, and since I am a well-known New Yorker, he wanted to make me the Grand \nMarshall of the parade. I did not think that this would be appropriate since we have not yet \ncontrolled the outbreak and since those people (far right radical GOP) who have been attacking \nme viciously over the last several weeks would probably have a field day if I did that , I decided \nthat I would express my gratitude for the invitation but would decline. On my way in the \nmotorcade between airports in Florida yesterday (Friday) Bill called me up on my cell phone to \nsee what my decision was about the invitation. I explained to him my reason for declining, and \nthankfully he was extremely gracious and understood . He promised me that he would get \nanother chance to honor me for what I have done for New York City and for the country. \nHad meeting in my office with Dr. Jeff Lehman, former president of Cornell University and \nnow current American President and Vice Chancellor of NYU in Shanghai. Jeff has been in \nShanghai for the last nine years and has considerable insight into the Chinese culture. He asked \nto visit me to explain to me what his take is on the tension between the United States and China \naround the Wuhan laboratory and COVID-19. I believe that he got everything about right in that \nit is extremely unlikely at the Chinese are truly hiding anything substantive. Because of their \nsuspicious and somewhat paranoid nature it is likely that they were in denial about the outbreak \nin the early months and we're not really trying to hide anything but we're trying with almost \nwishful thinking that it would go away without anybody knowing about it. However, they did \nquickly come around identify the virus and make the sequence publicly known. This argues \nagainst any attempt to truly hide anything. All of the other stuff is a reflection of their suspicious \nnature. He also feels that there was no way that they would allow an outside investigative group \ninto their labs anymore then we would allow a Chinese-led international group to come to the \nFredrick lab.  Jeff believes as I do that the only way to make any headway in all of this is to have \na good faith collaboration between Chinese and other international scientists including United \nStates scientists in order to cooperatively try to find the source of the origin of SARS Cov-2. \nAlso, as a result of his in depth understanding of Chinese culture , he feels strongly that the \nWuhan lab would not have been used for any deleterious research such as bio warfare. He \nconfirmed the doctor Shi is a highly respected scientist and her reputation would argue against \nher being involved in anything outside of the realm of science. I expressed to Jeff that I agree \nwith much of what he says , but the environment in the United states is so toxic with regard to \nChina and the delusions of the far right radicals, that it is unlikely that we could come to a \ncollaborative approach with the Chinese to come to a better understanding of the origin of \nCOVID-19. \nJust got an email now from Ian Lipkin asking if he could arrange a phone call between \nhim, me ,and Nancy Messonnier. I wonder what this is going to be all about ?\nReleased by Chairman Rand Paul\nPRESS:  WINS Radio NYC 1010; Podcast on Progressive Voices Network – “Before you \nknow it….” with David Bender; important defense of me by “The Times Leader” - \nhttps://www.timesleaderonline.com/uncategorized/2021/06/envy-is-the-rights-real-problem-\nwith-dr-fauci/ \nJune 26, 2021 – Global -     USA – 33,400,000/601,000\nI had a very interesting evening last night. Christine and I had dinner over the home of Sally \nQuinn. Other guests were Bob Woodward and Elsa Walsh as well as Rick and Jane Atkinson. \nWe had a lot of inside the Beltway discussions about Bob's books and Rick’s books and the \nexperience that I had with Trump during the last year of his presidency.  In addition, I had the \nopportunity to see Quinn Bradlee and who I believe is his wife or girlfriend. Sally was very \npleased that I had done a podcast with her son Quinn.  \nFox News continues to come after me by making false accusations that I have misled \ncongressional committees during questioning under oath. they just do not want to stop harassing \nme, but that is going to go nowhere.   \nJune 27, 2021 -\nCases continue to slowly come down:\nPRESS:  Latest thing on Fox News over the last couple of days is that they are accusing me \na lying under oath at a house and energy subcommittee hearing when I said That I did not \nknow the precise reason why the president told us to cancel the WuHan grant.  The fact is \nReleased by Chairman Rand Paul\nthat we were told via mark meadows that we need to cancel the grant and when we told \nthem that there has to be a specific reason the White House said we don't need a reason , \njust cancel the grant. When doctor Collins and doctor Tabak and indirectly when I said \nthat it was illegal if we didn't have a specific reason , the White House came back and said \nmake up a reason. Therefore, what I said under oath at the hearing is absolutely true. \nFrom a review of Jasmeen Abutaleb’s and Damian Paletta’s book by William Hanage of \nthe Washington Post:\nOver and over again, whenever public health and public relations came into conflict, public health lost \nout. Trump’s complaints directed at “the Doctors” kept coming back to the same charge — negativity — \nincluding a remarkable, petulant presidential Oval Office outburst roughly halfway through the book. “I \nam sick and tired of how negative you all are. . . .  I spend half of my day responding to what Tony Fauci \nhas to say, and I’m the president of the United States!” Later in the same exchange, Trump told \ncoronavirus response coordinator Deborah Birx: “Every time you talk, I get depressed. You have to stop \nthat.” As if the pandemic could be defeated by the power of positive thinking, and Birx should just cheer \nup and promote policies that she knew would lead to more illness and death than the alternatives.\nI received a call today from David Wilman , who I thought was a friend  and who has been having a \nconversation with me regularly every Sunday for the last several months in order for me to keep him up \nto date on what is going on with COVID. He was hinting early on that he was working on a story on gain \nof function research. He never interviewed me at all on the details of this but today he calls me up \ntelling me how much he respects me, but he has a heads up for me that he is doing a story on gain of \nfunction and that I am in the story. He then went on to describe how much he respects me and that my \nfavorite saying “precision of thought, economy of expression “ is one that he lives by and has it pasted \non his computer. This looks to me like a hatchet job on me is coming and he is telling me what a great \nperson I am before he drops the bomb. We shall see. \nJune 28, 2021 – Global – 181, 000,000/3,900,000; USA – 33,500,000/602,000\nPRESS:   BET Instagram with Mark Tallman and Ronreaco Lee; Month of Action Zoom \nwith Partner organizations;\nJune 29, 2021\nDelta variant swarming globally.   It definitely is a more efficient transmitter.   WHO is now \nrecommending that even vaccinated people wear masks.  Vaccinated people are getting infected, \nbut without serious disease.\nFLOTUS sent Chris and me and the family a beautiful basket of vegetables grown in the White \nHouse Garden:\nScanned from a \nXerox Multifunction \nReleased by Chairman Rand Paul\nDear Sir, \nMany in Australia, self included, have admired your steady hand in heavy and often dangerous seas. \nI saw this cartoon recently ... and I hope you like it … in the nicest possible way!\nRegards, \nBrian Dawes, \nPerth, Western Australia.\nPRESS:   Constituency Hispanic TV (x3); NBC Nightly News with Lester Holt; ABC World \nNews Tonight; PBS NewsHour with Judy Woodruff; PSAs; CNN with Don Lemon;\nSee below:   This is the Hearing that the GOP called with crazy witnesses and they wanted \nFrancis Collins and I to testify.   Pelosi and WH said no way\nFOX:  House Republicans hold own hearing on \nCOVID-19 origins\nGOP lawmakers claim Pelosi is holding up full committee \nhearings:\nRep. Jim Jordan, R-Ohio, said that Fauci \"didn’t have the courage\" to \"come defend himself\" at the \nhearing. \n\"I’m convinced these guys knew right from the get-go what the truth was and they misled the American \npeople,\" Jordan claimed, citing a slew of Fauci emails made public in early June. \n\"He showed up everywhere for a year and a half. You couldn't go a day and not see Dr. Fauci \nsomewhere, he was everywhere and now when we have emails… all this evidence suddenly you can't \nfind him.\" \nReleased by Chairman Rand Paul\nKate Messner’s Children’s Book – “Dr. Fauci” has come out.   It is beautifully done and \nobviously well-researched.\nJune 30, 2021 – Global  182,000,000/3,900,000; USA – 33,500,000;602,000\nI just received an assembly concurrent resolution number 195 of the 219th legislature of the State \nof New Jersey it is a concurrent resolution honoring the life and the work of Dr. Anthony \nFauci. (see below)\nScanned from a \nXerox Multifunction \nParting note to me from General Gus Perna upon his retirement:\nTony, thank you for your note and very kind words!\nReleased by Chairman Rand Paul\nIt truly been my honor and pleasure to work with you!  I brag to my circle of friends about you - ‘always \nhad time to say hello or explain anything to me, as well as, impeccable moral courage to do the right \nthing’.  Thank you for all that you have done for our Nation - you are one of my personal heros!!!\nBest of luck with all your future endeavors!!!  \nVr Gus\nPRESS: MSNBC “Morning Joe” with Joe Scarborough; WTOP Radio;\nJuly 1, 2021\nIt is becoming very clear that the extreme far right in the press with Fox News, in social \nmedia but the far right crazies, and especially in the Congress with the senators and \ncongressmen who are frightened of former president Trump and who are using attacks on \nme to show their loyalty to Trump. The issue that they are focusing on mostly in recent days is \nsaying that I perjured myself in front of the House and Energy Subcommittee Hearing by saying \nI did not know why we were asked to cancel the Wuhan subgrant. In fact, I had checked with \nFrancis Collins and Larry Tabak just to be sure , and there is no doubt that we were told by the \nWhite House to cancel the grant and not ask any questions about it. When we said that we had to \nhave a specific reason for canceling the grant since it would be illegal for us to cancel it without \na specific reason , the word came down from the White House predominantly via  Mark \nMeadows that we should just go ahead and make up a reason but we definitely had to cancel the \ngrant or else. The general counsel of HHS under Bob Charrow agreed that we had no specific \nreason to cancel the grant and so we had to reinstitute the grant but withhold funding until they \nmet certain conditions which would be very difficult for them to meet anyway. It really was a \nwork around to prevent us from funding the grant. Therefore, I was completely honest in saying \nthat I did not know why the grant was asked to be cancelled since they never gave us a specific \nreason to do so.\nThe pressure on me is extreme!!!   They “bad guys” are taking everything I say and \nquoting it out of context.   Really trying to destroy my credibility.\nCases starting to go up a bit in the unvaccinated areas.   Must watch closely  \nReleased by Chairman Rand Paul\nPRESS:   Axios - Fauci: Divergent vaccination rates \ncould create \"two Americas\"\nI taped the Sunday “Meet the Press”.   It will be a 4th of July Special.\nJuly 2, 2021 – Global    USA\nCOVID-19 cases in UK increase 67%, but hospitalizations are not going up indicating that \nvaccines are preventing severe disease.\nReleased by Chairman Rand Paul\nPRESS:   Regional media TV with: WRAL NBC Raleigh-Durham; WSB-TV – ABC \nAtlanta; WREG-TV – CBS Memphis;\nJuly 4, 2021\nReleased by Chairman Rand Paul\nToday is the celebration of the independence from the virus. There was the most beautiful \ndisplay of fireworks on the mall that I have ever seen. Let us hope that the congregation of \npeople at the celebration does not lead to a discernible surge in cases . As I have said on various \nTV shows including on Meet the Press this morning, there is a possibility of being two Americas, \none that is vaccinated without any surge of infections and one that is unvaccinated leading to \nregional surges such as in those southern states with 35% or less of their population vaccinated. \nThis includes places like Missouri , Alabama , Mississippi , Louisiana, Wyoming , among others.   \nPRESS:  appeared on NBC “Meet the Press” 4th of July Special with Chuck Todd\nJuly 5, 2021 -  Global    USA\nCases increasing in certain regions.   Will watch carefully to determine whether this has impact \non hospitalizations. We will brief the president tomorrow about the role of Delta variants  with \nregard to vaccine protection. \n \nVirus lab leak theory dogs Democrats eager to \nkeep focus on Trump's Covid failings\nReleased by Chairman Rand Paul\nDemocrats worry that murky conclusions that don’t identify the origin of \nthe virus could play into the Republicans’ hands.\n \nJuly 6, 2021 - Global   USA\nA considerable amount of concern about the fact that reports from Israel indicate that the \nPfizer vaccine is less protective  against infection since the protection a few weeks ago prior to \nthe emergence of the Delta variant was about 94%, whereas now that the Delta variant has \nemerged, protection against any infection is down to 64%. However, the good news is that the \nPfizer vaccine is still more than 90% effective against serious diseases including hospitalization. \nIt is conceivable that this discrepancy about the efficacy against the initial infection is due to the \nfact that the Israelis are doing a lot more testing of asymptomatic people than other countries \nincluding the United States. This needs to be followed closely.\n•I participated as I do most of the time in the weekly Governors’ briefing. I explained to \nthem the situation of the threat of the Delta variant. \nI had my weekly briefing of the President today. This time I did it in person in the Roosevelt \nRoom of the White House. We discussed the situation of the degree of protection afforded by our \nvaccines against the Delta variant. I also explained to him the situation regarding the Israeli data \n( see above).  The president remarked how much Jill  enjoyed traveling with me and he thanked \nme for that saying that it means a lot to them.\nPRESS: I did YouTube interview with two African American physicians from California: \nDoctor Jamie Rutland and doctor Italo brown. We discussed how we handle vaccine \nhesitancy among African Americans and how we can use the barbershop environment to \nconvince them to get vaccinated. \nJuly 7, 2021 – Global – 184,000,000/4,000,000;  USA – 33,600,000/604,000\nWe are stuck at ~12,000 to 14,000 cases per day:\nReleased by Chairman Rand Paul\nSee below.   It is very clear that the Israelis are increasing greatly their testing that could explain \ntheir results on asymptomatic  infections in vaccinated people (see above and figure below):\nI had a very important meeting today with the NSC led by Beth Cameron and Maher Bitar \nwho is the senior director for intelligence programs at NSC. We met in the EEOB SCIF and \ndiscussed the briefing document that the NSC had presented to the President a week or so ago. \nBeth wanted me to have an official briefing because of the catastrophic briefing that the amateurs \nfrom the CIA gave me several weeks ago. There were no new surprises for me in the briefing \nReleased by Chairman Rand Paul\nexcept that it became clear that the FBI has no idea what they're talking about since they are \nconvinced that the origin of COVID-19 is from a laboratory leak. The reasons that they give do \nnot make any sense. In contrast the NSA gave some reasonable hypotheses leaning heavily \ntowards a natural jump of species in the environment. I spent some time explaining to Maher and \nBeth my own theories that the Chinese act like they're covering up something even when they \nhave nothing to cover up. They manifested this in their response to the original SARS-CoV-1 \nwhen they insisted this was just an atypical influenza when in fact it was the beginning of a \ncoronavirus pandemic. In addition, they likely shot themselves in the foot when they denied the \npresence of wild animals in the market when we know they were present and the Chinese \ncleaned out the market before adequate testing of animals could occur.   In essence, they clouded \nthe possibility of proving a natural emergence.   I urged the NSC folks to work closely with \nqualified card-carrying evolutionary virologists such as Kristian Andersen, Eddie Holmes, Bob \nGarry, Andy Rambaut, among others. I also explained to them the multiple reasons \nepidemiologically and molecularly why it is almost certain that the virus evolved naturally from \na species jump, even though I emphasized that I keep an open mind about the possibility of a lab \nleak . However, in this regard , I emphasized that just because two alternatives are possible that \ndoes not mean that they are equally probable. I believe that they understood where I was coming \nfrom and that it turned out to be a very good meeting.  \nPRESS:  Interview with Frank Bruni for his book on aging; interview with Betsy McKay of \nWSJ on GoF; Sirius XM Radio with Marc Siegel; MSNBC with Chris Hayes;\nJuly 8, 2021 - \nKristian Andersen, Bob Garry and many others came out yesterday with on a preprint server a \npaper strongly arguing with good evidence for a natural emergence of SARS-CoV-2 rather thsan \na lab leak:  The Origins of SARS-CoV-2: A Critical Review  https://bit.ly/3jSK1Ep \nCNN: “Coronavirus almost certainly came from an animal, not a lab leak, top scientists \nargue”\nI had a very useful and enjoyable conversation with the President of Chile – President \nSebastian Pinera. He was very gracious and wanted advice from me about how to handle the \noutbreak in Chile looking forward. He was very complimentary to me in many waves and asked \na number of very intelligent and important questions relevant to his country. He seems like an \nextremely engaging person and it was an enjoyable half an hour that I spent speaking with him \nvia zoom. \nPRESS:  NPR – “All Things Considered” with May Louise Kelly;\nJuly 9, 2021 – Global – 185,000,000/4,000,000; USA – 33,600,000/604,000\n is waning after a period of several months. This created a lot of confusion and we all gathered \non multiple phone calls yesterday evening in order to come out with a statement jointly from the \nReleased by Chairman Rand Paul\nCDC and FDA indicating that at this time if you are fully vaccinated you do not need a booster \nshot. In the middle of all of this I called up Mikael Dolstein and try to find out what was going \non. He said that their statement was based on the Israeli data as well as data from their original \nphase three study which showed a modest degree of waning immunity after several months. \nLater in the evening I received a phone call from Pfizer CEO Albert Bourla who was very \nsorry and apologetic that he did not Alert me about the Pfizer announcement ahead of time. We \nwill be arranging a meeting next week likely on Monday July 12 to discuss all of this with the \nvisor people. \nPRESS: Instagram with Ana Navarro; NBC Evening News; CNN “Situation Room” with \nWolf Blitzer\nJuly 10, 2021\nWasting a lot of time responding to letters from Congress and Senate about Wuhan.  \nEgregious waste of time!!\nMuch concern about the Delta variant.\nCases coming up in USA:\nReleased by Chairman Rand Paul\nJuly 11, 2021 – \n33,000 cases yesterday.  Clearly the unvaccinated are getting infected\nReleased by Chairman Rand Paul\nPRESS: ABC “This Week with George Stephanopoulos”; CBS “Face the Nation” with \nJohn Dickerson; CNN State of the Union” with Jake Tapper;\nJuly 12, 2021 -  Global    USA\nIt is important to point out how many hours we are all wasting in responding to the multiple \nletters from senators and congressmen fundamentally driven by conspiracy theories that the NIH \nhas funded work at Wuhan institute of virology that lead to SARS-CoV-2. For example, over the \nweekend I was on multiple zoom calls with my staff fine tuning the letters in response to the \nmultiple questions from people like senators Rand Paul, Marshall, Burr.  I am somewhat \nsurprised that's senator Burr was part of this since he generally is a friendly person to me. \nWe had a very important meeting today by zoom with Mikael Dolsten and others from \nPfizer with members of HHS including myself, Rochelle Walensky, David Kessler, Francis \nCollins, Janet Woodcock, all of the people from ASPR such as Dawn O'Connor.  The Pfizer \npeople present the data from the Israeli study which we already knew showed a decrease of \nefficacy against all infection down to 64%. In addition they showed some of the follow-up data \nfrom their phase 3 trial  which showed a decrease in efficacy down to 83%. Clearly, Pfizer is \nintending to suggest boosts particularly for those who are elderly and with underlying conditions \n. In Israel they are already boosting some of the elderly and those with underlying conditions. \nThere was a big debate in our own country and worldwide about giving a third shot to fully \nvaccinated people when most of the world is completely unvaccinated. This is a debate that will \nintensify. I believe we need to go ahead and explore the possibility of needing a boost at the \nsame time as we provide vaccines for people in low and middle income countries. I have been \nemphasizing in my public appearances that the requirement for a boost does not mean that the \nvaccines are not highly effective. A boost relates to the durability of the protection not to the \neffectiveness of the protection. This is a concept that is often missed by the public. \nReleased by Chairman Rand Paul\nPRESS: CBS “This Morning” with Gayle King; NPR Baltimore – WYPR with Tom Hall; \nCNN with Chris Cuomo\nJuly 13, 2021 -  Global – 187,000,000/4,000,000; USA – 33,700,000/605,000\nNew cases are increasing in at least 41 states. This is particularly true among seven states in \nthe South  where the percentage of people who are vaccinated is very low. It is clear that we are \nentering into a period where the steady decline in cases has now stopped and we are seeing an \nincrease in cases with daily cases hovering around 33,000. There is a war of words going on \nbetween the Fox News TV hosts and democratic senators such as Richard Durbin. The attacks \non me by the far right and Fox News (Tucker  Calrson and Laura Ingraham) are relentless \nand occur on a daily basis. Marsha Blackburn, Marjorie Taylor Green, and all of the other nut \ncakes attack me on a daily basis .  \nPRESS: CNBC “Squawk Box”; NPR “Here and Now”; MSNBC “Andrea Mitchell Report”\nJuly 14, 2021\nI had a very pleasant experience today down at the White House where I engaged in a number of \nInstagrams, PSAs, and YouTube videos with the new sensational young entertainer Olivia \nRodrigo. The purpose of the interaction was to encourage young people who are followers of \nOlivia to go out and get vaccinated. I was amazed to learn that with all her social media Olivia \nhas 25 million followers. She is a very down to earth sweet 18 year old woman. The White \nHouse comms team for digital we're delighted with the interaction.  \n•I'm spending a lot of time with the team in preparing for the July 20 HELP Senate \nhearing. This is all a colossal waste of time in which the far right is trying to link the \nCOVID pandemic with work supported by NIAID In a sub award to the Wuhan institute \nof virology.  I would likely get attacked by Senators Rand Paul , Marshall, Kennedy \ncome on and Rubio among others. We shall see.   \nJuly 15, 2021 – Global    USA\nThe republican Party has gone completely crazy.   See letter below where Congressmen are \naccusing me of collaborating with the Chinese Communist Party:\nFollow Up NIH Re. \nEmails 71521 (2).pdf\nThere are a few things to point out. For example, tonight we had a meeting that we generally \nhave prior to briefing the president . Tomorrow we will be briefing the president and tonight at \n9:00 PM we had a zoom meeting with me, Rochelle, Jeff , and Natalie to go over the plans for \nReleased by Chairman Rand Paul\nhow we were going to breathe the president tomorrow (Friday). We divided the responsibility \nbetween Rochelle and me. \nAlso, we had another one of the unusual experiences with the United states Congress. A \ngroup of 20 Right Wing Republican Congressman wrote a letter to Francis Collins and me \nasking a number of ridiculous questions in an accusatory manner as they have been for the last \nseveral weeks. In fact, the letter was first sent to the right wing publication the Daily Caller who \nthen called us up and asked us what our response to the letter was when we had not yet even \nreceived the letter. And so, it was quite obvious that they were doing it mostly as a publicity \nstunt. In any event, one of the most amazing parts of the letter was the part where they made the \nstatement: “Doctor Fauci was working closely with the CCP (Chinese Communist Party)”.  \nThey gave a reference for that statement that was an email sent to me from George Gao on \nMarch 28th 2020. In fact, that email was George apologizing to me for seemingly contradicting \nme in an article in Science  in which he said that the United States was making a mistake by not \nrecommending that people universally wear a mask. He did not want that to be interpreted that \nhe was criticizing me and he apologized. In addition, George was saying how concerned he was \nabout the outbreak and that he was worried about me and hoped that I was doing well. I wrote \nback to him and said “Thank you for your kind note I hope that all is well with you.”  If anyone \ncan construe that exchange as my working closely with the Chinese Communist Party, they have  \nto be out of their mind. For that reason, it is clear that these types of letters are nothing but a \nbunch of unmitigated bullshit. \nPRESS:  Local print media – Las Vegas Review Journal, Arkansas Democrat-Gazette, \nGannett Missouri;\nJuly 16, 2021\nI briefed the President in the Oval Office today about the Delta variant and its impact on our \ncountry. Present at the briefing were: Ron Klain, Susan Rice, Natalie Quillian, Jeff Zients, Anita \nDunn, Brian Reese, Mike Donilon and Rochelle Walensky virtually. Given the increasing \nnumber of cases in the United States, even though the hospitalizations have not increased, the \nPresident was concerned that his message that by July 4th we would be seeing an independence \nfrom the virus here in the United states might actually be now subject to question. We spoke to \nhim about the importance of emphasizing that vaccinated people do not get severe disease even \nfrom the Delta variant . In addition, we pointed out the possibility that we may need to give \nbooster shots , namely a third dose following the two doses of the mRNA vaccine. The President \nwas concerned that people would say that he was giving a mixed message when he asked \neveryone to get the standard regimen of vaccination and now we are telling them that they may \nneed to get an additional dose. I pointed out to him that most people who are vaccinated would \nbe quite amenable to getting a third dose so long as they thought it would increase the duration of \ntheir protection and or make them more highly protected.   It is the people who do not want to \nget vaccinated to begin with who are going to be in trouble because they will get infected and \nthey will need hospitalization.   The POTUS and Jeff kept asking whether I thought that it would \nReleased by Chairman Rand Paul\nget as bad as the winter of 2020/2021.   I said no since we did not have vaccinated people back \nthen.\nFox News hosts  Tucker Carlson and Laura Ingraham and mocking our attempts to get people \nvaccinated likely leading to loss of lives.\nRand Paul and Jim Jordan tweeting about me all the time and actually raising money by trying \nto discredit me\nCases continue to climb:\nPRESS: MSNBC – “The Reid Out”; Peacock MSNBC – Joshua Johnson; CBS Evening \nnews; NBC Nightly News with Lester Holt;\nJuly 17, 2021\n \nNo change.   Cases continue to rise.   Gov. DeSantis has made anti-Fauci T-shirts.  Amazing!!\nPRESS:  CNN with Jim Acosta;\nJuly 18, 2021\nReleased by Chairman Rand Paul\nCases continue to increase.   The question that is being asked is whether fully vaccinated \npeople who have breakthrough infections can transmit the infection to others.   Still no direct \ndata either way:\nJuly 19, 2021\nJeff Z. called me early this AM (6:45 AM) concerned about the breakthrough infections of \nvaccinated people and waned my opinion about moving towards masking of vaccinated people \nwho are in hot zones.   I think that we should.\nJeff called again at 10:00 AM  concerned about the time FDA is taking to grant a full BLA for \nthe vaccines.   He is acutely aware of the sensitivity of not interfering with or pressuring the \nFDA, but we need the BLA since many people are not getting vaccinated until the vaccines are \n“fully approved”.    Also, Jeff want me to get firm information on how long it will take for the \npeds (11 years old and younger) approval to come.\nStock Market plunging >700 down due to concerns about the spread of the Delta variant.\nMayor Bill Di Blasio called  and ask my opinion about a strategy that he would like to do to try \nand get more people vaccinated and safe from the delta variant. He is proposing to give the \npeople of New York City two alternatives if they are not vaccinated: 1) get vaccinated or 2) be \nrequired to get tested with a nasal swab at least once a week. The mayor feels that people will \nlikely get tired of getting tested every week and my opt to get vaccinated purely for the \nconvenience of it. Even though the requirement for a nasal swab is indeed a mandate, the mayor \nfeels that this is much less intrusive they mandate for a vaccine. \nReleased by Chairman Rand Paul\nPRESS:   CNN with Kate Boldun; Bloomberg TV “Balance of Power” with David Westin; \nPBS NewsHour with Judy Woodruff\nJuly 20, 2021 – Global – 191,000,000/4,100,000; USA – 34,000,000/607,000\nTestified today before the Senate HELP Subcommittee - There was the expected big splash \nat the hearing today As Senator Rand Paul accused me of lying under oath at a prior hearing and \nasked me if I wanted to retract my statement when I said that the NIAID has never funded nor \ndoes it funds now gain of function research at the Wuhan Institute of Virology. He referred to the \nPlos Pathogens  paper of 2017 and insisted that there was gain of function in those experiments \nand said I therefore lied. He quoted Dr. Richard Ebright as saying that those experiments were \ndefinitely gain a function. I exploded right back at Senator Paul and told him that he had no idea \nwhat he was talking about. I told him that I did not lie and have never lied certainly not before \nthe Congress and then I would not at all retract anything I previously said before a congressional \ncommittee. He then implied that the work that we were doing may have been the cause of \nthousands of deaths. At this point I blasted back at him that if that is what he is implying he has \nno idea what he is talking about because the viruses that we were dealing with and that were in \nthe progress reports and that are in the literature in no way could become SARS-CoV-2. I went \non to say that it was molecularly impossible for the viruses that we were dealing with to become \nSARS-CoV-2.  I finished by looking him in the eye and telling him that if anybody is lying \nhere it is he. Several of the other senators on the democratic side after the discussion between \nPaul and me was finished made statements saying how confident they are in my integrity and in \nmy service.  Senator Marshall later asked questions about the furin cleavage site and the CGG \ncodon.   Then he started talking about the S1 segment of the spike protein and had absolutely no \nidea what he was talking about.   He rambled on until I told him that I had no idea what he was \nsaying; it make no sense.   He made a fool of himself.\nCases continue to climb:\nReleased by Chairman Rand Paul\nPRESS: CBS “This Morning”;  Multiple stories on TV about my encounter with Senator \nPaul\nJuly 21, 2021 – Global – 191,000,000/4,100,000; USA – 34,000,000/607,000\nCases continue to climb:\nReleased by Chairman Rand Paul\nTypical e-mail from a supporter of me after the Rand Paul clash.   One of dozens and \ndozens:\nDear Dr. Fauci,\nI've wanted to write you at various points over the last year, but seeing the hideous treatment you \nreceived from Rand Paul played on the PBS \"Newshour\" last night has prompted me to wait no longer. \nMy husband, Breck Montague, and I want to thank you from the bottoms of our hearts for the \ninimitable leadership, courage and wisdom you have shown since you've had to become a frequently \ncalled-upon national spokesperson for good health sense and public health during this pandemic.\nI am certain you remember my father, Frank Williams, during his time as director of NIA.  I actually recall \nwhen you came on board at NIAID -- I believe my father marvelled about how you were perhaps the \n\"youngest person ever\" to assume an NIH directorship. If so, thank goodness you were, because here \nyou still are, with the benefit of decades under your belt, at such a critical time.  Thank you for telling \nSen. Paul it was he who was lying -- and for not accepting his dangerous rhetoric. We were so proud of \nyou!\nIn our rural community, we do everything we can to support fact-based conversation and exchange of \ninformation. In such a disheartening period in this country's history, we're immensely grateful to have \nleaders such as you who speak out and act according to your beliefs. Keep it up, and please accept our \nsupport and thanks.\nMary Williams Montague\nGloucester, Virginia\n(8576 Toddsbury Lane\nGloucester, VA 23061)\nFrancis Collins defends me against Rand Paul nonsense on CNN and MSNBC tonight\nI visited Eric Lander (Director of OSTP) at the White House today. He asked for the \nmeeting and wanted to do two things. First, he wanted to express his strong support for me in \nlight of what just went down with senator Paul. Second, he wanted my help in trying to nail \ndown the possibility of our getting much of the $30 billion  that are still available from the JOBS \nAct to put together a major program for pandemic preparedness for the future. He wanted to \nwork with Francis Collins and I to make this happen and suggested that we might write an op Ed \ntogether. \nThis evening I got a text from Beth Cameron of NSC. Beth indicated that I was her hero for \nwhat I did with Rand Paul and that she had heard from Eric Lander that I was discussing with \nhim the issue of the $30 billion. I texted her back saying that I would push hard for this with Ron \nKlain and Jeff Zients.  I will be seeing the President in the Oval Office today and hopefully Ron \nwill be there so that I can discuss this with him.  \nReleased by Chairman Rand Paul\nIt should be pointed out that I have been meeting with the president personally in the Oval Office \nonce a week for the past several weeks. It seems that Jeff prefers that I am there personally \nduring the Presidential briefings. Also, it is rather strange that it seems that Jeff does not \ntrust the CDC or even Rochelle and always wants me involved when it comes to the \nPresident. This may be a bit unfair to Rochelle, but his skepticism about the CDC historically is \njustified. \nIn the meantime, the GOP led by despicable Kevin McCarthy continue to push back on doing an \nadequate investigation on what led up to the January 6 insurrection against democracy. Thank \ngoodness that Nancy Pelosi has rejected the GOP suggestion of putting Jim Jordan on the panel \nthat would be investigating the January 6 insurrection. Also, the GOP continues to blast me in \ntheir social media. It seems like it is an all out war between me and the radical right wing of the \nGOP\nPRESS:  Interview with Sentinel Record (Zoom) – Arkansas newspaper with Tyler Wann; \nNPR “All Things Considered” with Mary Louise Kelly; CNBC “Closing Bell”; MSNBC \nwith Ari Melber\nJuly 22, 2021 – Global – 192,000,000/4,100,000;  USA – 34,000,000/608,000\nDaily cases continue to climb:\nHad my usual weekly meeting with the POTUS today at 1:00 PM in the Oval Office.   Also \npresent: Jeff Z., Natalie Quillian, Mike Donilon, Jake Sullivan (NSC).   When I walked into the \nOval the POTUS put his hands on my shoulder, brought me close and said: “You did a great \nReleased by Chairman Rand Paul\njob in stuffing that horse’s ass” referring to Rand Paul.  He also said that 1st Lady Jill was \n“cheering for me” as she watched it on TV.\nAs I walked through the White House, several people thanked me for “my service and for what I \ndo” and a few remarked about Paul and said how proud they were of me.\nBriefed the Senate and House by Zoom together with Jeff, Natalie, and Marcella Ninez-Smith\nEngland surging with USA following:\nSteve Scalese  is now promoting vaccines.   It seems that several of the GOP who were originally \nagainst vaccines are now realizing that they are on the wrong side of history.\nPRESS: CBS Evening News with Norah O’Donnell; Twitch Livestream;\nJuly 23, 2021\nI had a very productive conversation in my regular every two week call with our UK \ncolleagues – Chris Whitty and Patrick Vallance, this time accompanied by Thomas Waite. I \nexplained to them the situation that we have here in the United states with the delta variant. The \nUK seems to be a couple of weeks ahead of us in every way. They have vaccinated a slightly \nlarger proportion of their population than we have and the surge in delta that they are \nexperiencing is much steeper then what we have at this time. The efficacy of the vaccine against \nhospitalization and death continues to hold. They are a skeptical about the Israeli vaccine \nefficacy data for asymptomatic and mildly symptomatic disease as we are here in the United \nReleased by Chairman Rand Paul\nStates.  The UK has made the decision similar to us that they will try to get all the children back \nto school in person by the fall. However unlike us, the unvaccinated children will not be required \nto wear masks when they go back to school. They have essentially decided that since you cannot \nvaccinate the younger children yet and since they generally have very mild disease, that you \nshould accept the fact that sooner or later these young children are going to get infected and so \nbe it. They do not want to close the schools or go to virtual learning. I will continue to follow the \nsituation with them since it is very helpful to us here to learn what the UK is doing.  \nOf note, both Chris and Patrick wanted me to know that I am held in extremely high \nregard in the UK by virtually everyone on the basis of my standing up to Rand Paul and \nhis nonsense in the Senate \nRight-wing attacks on me intensify – North Carolina GOP Congressman Madison \nCawthorn -  \"I thank Rand Paul for bringing it up and I will tell you right \nnow Anthony Fauci does not have the best interests of the American \npeople at his heart,\" he said. \"I believe he is a pawn for the Chinese \ngovernment by giving them funding to do militaristic funding to try and \nfigure out how they can make an animal virus more transmissible to \nhumans. It's disgusting, it's wrong, and 4 million people are dead all \naround the world because of it.\"\nDid my usual weekly briefing of the Cabinet (“Principals”) together with \nRochelle, Natalie, Jeff, and Vivek.   Brought them up to date on Delta \nvariant becoming dominant.\nPRESS:  CBC (Canadian) “Power and Politics; FOX with Neil Caputo; \nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nPRESS: Very good article in the LA Times by Melissa Healy:\nLA Times: Fauci: ‘There’s no way’ the coronavirus was made with U.S. research funds. \nHere’s why  https://lat.ms/3ruPOC6\nJuly 25, 2021 – Global    USA\nThe USA is not doing so great in vaccinations compared to other developed countries:\nReleased by Chairman Rand Paul\nFully vaccinated people:\nPRESS: CNN “State of the Union” with Jake Tapper; MSNBC “Sunday Show” with \nJonathan Capehart;\nJuly 26, 2021\nHumor:\nReleased by Chairman Rand Paul\nImportant stuff going on!!We had at least two zoom meetings today with Jeff, Rochelle, Vivek, \nand Bechara to discuss the upcoming change in masking guidelines that the CDC will be \nproposing. It relates to the fact that data or showing that the level of virus in the nasopharynx of \nvaccinated people with asymptomatic breakthrough infections is similar according to CT values \nto that in individuals who are infected asymptomatically and who have not been vaccinated. \nThese data are strongly suggestive that individuals who are vaccinated and who get infected can't \ntransmit the virus two others as easily ask an unvaccinated people. This is triggering the need to \ntell vaccinated people that when they go to situations that are indoors that now they have to wear \na mask or should at least seriously consider wearing a mask", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: at such an amazingly fast pace  that I do not know what I am about to do until I sit in front of the zoom and do it.  •Met by Zoom with POTUS and VPOTUS for our regular weekly update. PRESS: KSNV- TV – Las Vegas with Jeff Gillian;  KABC - TV – Los Angeles with Denise  Dador; KCBS Radio – San Francisco with Mike DeWald Released by Chairman Rand Paul April 23, 2021 – Global – 144,400,000/3,100,000; USA – 31,700,000/567,400 Still plateauing, but the 7-day average is slightly down (~10%): Presented before the Lasker Board with Elia Zerhouni, Peggy Hamburg, Al Reese, Joe Goldstein  and I mentioned when they said I was their hero, that I was also a “target” for some.   They  immediately said “We have you back”.   Important in light of the antipathy of many against me. PRESS:  White House Press…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 6, "page_count": 1141}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 7 of 10)", "content": "depending on the level of infection \nin the community where they are living. Rochelle is really having a very tough time in \nnegotiating this with Jeff in the context of “her team” at CDC that seems to be operating in their \nusual manner independently of running things by the White House. For example at the end of a \nlong and tortuous discussion about getting the wording correct in the new guideline, Rochelle let \nus know that two days from now (Wednesday) the CDC will be coming out with an MMWR that \nwill overlap with what we have been wordsmithing for the guideline. Jeff and everyone else was \nblown away that these two parallel things were going on and we did not even know about it. I \nfeel badly for Rochelle since she is dealing with an ingrained CDC system that has been that way \nReleased by Chairman Rand Paul\nfor the decades that I have been dealing with them. Jeff and the White House Comms people \n(Courtney Rowe) are very concerned about mixed messaging.  We decided that we would sleep \non this and address it again in the morning. \nJuly 27, 2021 – Global – 194,600,000/4,200,000; USA – 34,500,000/609,000\nJust got a call from Jeff that he wants me to brief the President today about the issues \ndiscussed above. It is very clear and unfortunate that confidence   in Rochelle is very low within \nthe White House team of Jeff, Courtney Rowe, and others.    STAY TUNED\nHad a good conversation with the President in the Oval Office this afternoon at 12:30.   I \nexplained to him the new CDC guidelines for wearing masks indoors even if you are vaccinated \ngiven the fact that the delta variant is causing breakthrough infections in vaccinated individuals \nand vaccinated individuals with breakthrough infections can transmit the virus two uninfected \nindividuals. In addition, I explained to him the data that the level of virus in the nasopharynx of \nvaccinated people with breakthrough infections is similar to the level of virus in the nasopharynx \nof unvaccinated infected people. We had a good conversation; he asked a lot of good questions. \nRight before the discussion he was on the phone with former senator Barbara Boxer who had just \nbeen mugged outside of her house. She asked to talk to me when she heard that the president \nwould be meeting with me and we had a good conversation. She relayed that she felt very badly \nthat idiots are attacking me and that she always has had the highest degree of regard for me. She \nrecalled back in the days when we were fighting HIV together. I asked the president if Jill had \ncome back from the Olympics in Tokyo. The President informed me that she had and so I sent \nher my regards through him. \nAs Jeff , Natalie Quillian, and I were sitting in front of the Resolute Desk, I had a very \nstrange, almost out of body experience. I just recalled at that time so clearly the bizarre \nsituations that I had been through in the past when I sat in front of the desk trying to brief \nPresident trump. I recalled his incredible lack of concentration ability where his attention span \nwas measured in seconds rather than minutes. This is in stark contrast to the seriousness, dignity, \nand integrity that now permeates the entire White House, particularly the Oval Office. Only now \nin retrospect do I fully appreciate what a disaster Trump was as President. This applies not only \nto his policies, but to the fact that he diminished the dignity of the presidency enormously. The \nfeeling in the Oval Office now is very similar to what I experienced when I was in the Oval \nOffice with presidents George HW Bush, George W Bush, Bill Clinton, and Barack Obama. This \nis such an entirely different feeling and vibration that I have when I enter the room and sit down \neither on the couch or in front of the desk. There was always that feeling of anxiety with Trump \nwhere I was anticipating that he would say or do something outlandish. \nPRESS:  Big announcement from CDC about masking for vaccinated people indoors \nattracting much media – Print interviews with NY Times and Washington Post.\nThe Intercept:  Rand Paul’s Attack on Anthony Fauci Chills Scientific Debate Over Gain-\nof-Function Research    https://bit.ly/3iR7zHP\nReleased by Chairman Rand Paul\nThe Black News Channel “The World Tonight”;  NBC “Nightly News” with Lester Holt; \nNPR “All Things Considered” with Ari Shapiro; PBS “NewsHour” with Judy Woodruff; \nUnivision National TV;  Telemundo TV; CNN with Chris Cuomo; MSNBC with Chris \nHayes;\nA Man Was Arrested For Allegedly \nThreatening To Kill Anthony Fauci And His \nFamily\nThe 56-year-old sent emails with a long list of threats, including to beat Fauci and his family to \ndeath, prosecutors said.\nNicole FallertBuzzFeed News Reporter\nPosted on July 27, 2021, at 6:35 p.m. ET\nReleased by Chairman Rand Paul\nJ. Scott Applewhite / AP\nAnthony Fauci addresses Sen. Rand Paul on July 20.\nA 56-year-old man was arrested for allegedly sending messages threatening Anthony \nFauci, the nation's top infectious disease scientist, and his family, saying they would be \n“dragged into the street, beaten to death, and set on fire.”\nThomas Patrick Connally Jr. of Greenbelt, Maryland, was charged with threats against a \nfederal official and interstate communication containing a threat to harm, according to a \nfederal criminal complaint filed Monday.\nADVERTISEMENT\n“We will never tolerate violent threats against public officials,” acting US Attorney \nJonathan Lenzner said in the complaint. “Our public health officials deserve our thanks \nand appreciation for their tireless work, and we will not hesitate to bring charges against \nthose individuals who seek to use fear to silence these public servants.”\nConnally allegedly sent threatening emails from December 2020 to July 2021 telling \nFauci to \"blow your own fucking brains out\" and referred to the doctor as a \"liar\" and a \nReleased by Chairman Rand Paul\n\"fraud.\" The threats to Fauci and his family were sent from an email account via a \nprovider of encrypted services based in Switzerland, according to investigators.\n\"Hope you get a bullet in your compromised satanic elf skull today,\" the subject line of \ntwo emails Fauci received in December 2020 states. On April 24 alone, he received seven \nemails from the encrypted email account, according to the affidavit filed in support of the \ncriminal complaint. The emails also encourage Fauci to kill himself and contain death \nthreats against him and his family.\nIf convicted, Connally faces up to 10 years in federal prison for threats against a federal \nofficial and a maximum of five years in federal prison for interstate communication \ncontaining a threat to harm.\nADVERTISEMENT\nTwitter: @MacFarlaneNews\nThis isn't the first time Fauci and his family received death threats amid the coronavirus \npandemic, and it's only gotten worse as conservatives manifest their frustration over \nCOVID-19 restrictions into more vitriol.\nJust last week, Republican Gov. Ron DeSantis of Florida announced drink koozies and T-\nshirts reading \"Don't Fauci My Florida\" as part of a campaign, the Washington \nPost reported. Fox News host Tucker Carlson has called Fauci — now a White House \nmedical adviser — a \"fraud\" and has pushed for an investigation of the doctor's role \nconcerning the origins of COVID-19. Republican members of the House filed a \"Fire \nFauci Act\" in April.\nFauci's strained relationship with former president Donald Trump has also made him a \ntarget for conservatives. The doctor told the New York Times earlier this year of his \ndifficulty to get Trump to listen to his scientific recommendations.\n\"I would try to express the gravity of the situation, and the response of the president was \nalways leaning toward, 'Well, it’s not that bad, right?' And I would say, 'Yes, it is that \nbad,'\" Fauci told the Times.\nADVERTISEMENT\nFauci has been vocal about the death threats directed at him and his family, which he \ntold the Times started as early as March 2020. In one instance, he received a letter \ncontaining powder that exploded all over his face and chest.\nReleased by Chairman Rand Paul\n\"Getting death threats for me and my family and harassing my daughters to the point \nwhere I have to get security is just, I mean, it's amazing,\" Fauci said during an online \nforum last year. At that time, he called the threats \"unseemly things that crises bring out \nin people.\"\nFauci told CNN this week that the US is \"going in the wrong direction\" in terms of \nCOVID-19 cases. He blamed unvaccinated Americans for the surge in infections, \nparticularly with the more contagious Delta variant.\nConnally is due to appear in a federal court on Wednesday.\nStory also covered in other media – New York Post, Axios, Forbes, Newsweek, CNN, The \nHill\nJuly 28, 2021 – Global        USA\nCases continue to surge:\nPRESS: MSNBC – “Morning Joe” with Joe Scarborough; Joe Madison Radio Show; \nMorning Hustle Radio Show;\nJuly 29, 2021\nReleased by Chairman Rand Paul\nThere are a lot of important things going on that I do not have a chance to comment on in \nmy daily diary.   Some of these are the continual conversations that I have been having with Jeff \nabout who should be the FDA Commissioner. Jeff and Ron Klain continue to run by me names \nof potential candidates. Today for example, David Kessler came to me with a surprising request \nthat I float his name to Ron as a possible candidate. David is currently the head of the \ncountermeasure acceleration group (CAG) of HHS. He is a former FDA commissioner and \nwould likely do a very good job. I will float his name and see what happens. \nIn another vein, I continue to get harassed by letters from far-right congressmen and \nsenators who are cherry picking my FOIA’d emails and trying to establish that I have lied under \noath when I said that the NIH has never done gain of function research at the Wuhan institute of \nvirology. In addition, Tucker Carlson and others at Fox News continue to attack me virtually \nevery night. Carlson saying multiple times that I created the virus.  This is an extremely stressful \nsituation but I will have to push on with the job that I have as director of NIAID and as chief \nmedical advisor to President Biden. \nAnother issue that is percolating it's a growing discontent with the CDC and with Rochelle’s \ndifficulty in clearly articulating their somewhat shifting positions such as that of masking \nindoors. I do not believe that it is Rochelle’s fault but it is a fundamental lesion in the CDC.  One \nof the problems is the typical CDC mentality that antedated Rochelle. Rochelle and the CDC are \nhesitant to show anyone data that backs up their policy because it is supposedly “embargoed. The \nproblem is that the embargo relates to the MMWR, which is the CDC's own publication. \nTherefore it seems that if they wanted to break the embargo they could easily do it. Again, this is \na recurrent problem with the CDC keeping data close to their vest and making policy without \nallowing outside experts to weigh in.  \nIt was an evolving situation here. Got a call from Jeff just now reading a sentence from the \nPresident's speech that he will give today in which he said that children do get infected, but a \nserious outcome is “extremely, extremely rare”.  In my meeting with my office team this \nmorning someone pointed out that in Arkansas on Wednesday there were 24 infections in \nchildren; seven of them wound up in the ICU and two of them are on respirators. I had originally \ntold Jeff to get rid of one of the “extremelies” and just say “extremely rare”.  After hearing about \nthe infections in Arkansas I called back Jeff and told him to get rid of both “extremelies” and just \nsay “rare “.  We actually do not know the full impact of this virus on children at this point and so \nwe really need to be careful about what we say and what we allow the POTUS to say.   \nWe are on a similar track as UK but a few weeks behind (as is usually the case):\nReleased by Chairman Rand Paul\nVery important essay by Peter Hotez:\nPLoS Biol/Hotez: Mounting antiscience aggression in the United States     \nhttps://bit.ly/3lbsKXF \nWe had a briefing today from the house Select Committee on COVID-19 chared by \nrepresentative Clyburn. It was supposed to be limited to a discussion on the delta variant. \nHowever, it was clear that when the Republicans were allowed to ask questions they went off \nthe subject and started to ask questions about infections coming over the border from Mexico. In \ntypical fashion Jim Jordan asked me if I was a member of the P3CO oversight committee when \nin fact there is no such a thing as a P3 CO oversight committee. We have an executive committee \nof which I am not a member. Fortunately, even though I did not know what he was talking about, \nI said that I was not a member. He then asked for a list of the members. Since I really didn't \nknow what he was talking about I said that I would get him that list. As it turns out, this is a list \nthat HHS does not want to make public. HHS will get back to him and explain that to him. \nObviously, he will make a big deal about this publicly. \n  The Republicans in the Congress as well as Fox News continue to attack me viciously. I \nwas particularly disappointed today to read Newt Gingrich whom I have always liked and \nrespected came out and said that it was time for me to retire. He said that although I have had an \nillustrious career, I am trying to defend the indefensible. I am really not sure what he meant by \nthat. Did he mean that I was defending gain of function research or did he mean that I was \ndefending the CDC's masking guideline?  As Peter Hotez said in the article above, no one is \nstepping up in the scientific community to defend me since they are afraid of being threatened by \nthis extreme group that seems to be very well organized. \nWent to a book signing party add the home of Adrienne Arsh. The book is “I alone can fix it “ \nbye Phil Rucker and Carol Leonnig. The Super a list from Washington DC was there. It was a \nlittle bit uncomfortable since I was wearing a mask with the new guidance from the CDC and \nalmost everyone else was without a mask. When they saw me with a mask , several of them put a \nmask on. \nReleased by Chairman Rand Paul\nOne of the things for discussion in the book for this time frame is the extraordinary confidence \nthat the president, Ron Klain, and especially Jeff is placing in me. When I briefed the \npresident before his speech a couple of days ago , Jeff did not want Rochelle to brief the \npresident even though the discussion was strictly about CDC guidelines. \nPRESS: South African TV – Bhekisisa Center for Health Journalism with Mia Malan;  \nKen Jeong Instagram; WTOP Radio; NBC LX TV;\nJuly 30, 2021 – Global    USA\nThere is growing frustration fall apart of Jeff with the CDC and particularly with Rochelle. \nI love her but she does not seem to have control over organization. We were being briefed the \nother night about what we were going to be saying about boosters and about the effect of the \ndelta variant. In the middle of the conversation we found out that an MMWR was already written \nthat could possibly be in conflict with what we were discussing. (see above). Now we have a \nsituation where a slide set that was for internal discussion within the CDC was leaked by the \nCDC to the Washington Post including a discussion of things that we had not vetted out with the \nMedical Group. Jeff was extremely concerned that we are now on the defense trying to explain \nor defend things in an internal document that is now public. He called a special zoom meeting \nwith himself , me , and Rochelle to try and sort this out. It became clear during the discussion \nthat Rochelle herself was somewhat unaware of what her own CDC people were doing. I felt \nvery bad for her because she is clearly very competent.  we will have another zoom meeting later \ntoday since Jeff tasked me to review the papers upon which the CDC conclusion that the delta \nvariant causes more severe disease was based. I will have myself, Andrea Lerner, Cliff lane, and \nDean Follmann review the papers.   After review by my “team” we found that the Singapore data \nwas very weak but that the Scotland and Canada data suggest that there is an increase in severity \nwith the delta variant. I communicated this both to Jeff and to Rochelle.\nI had a very interesting conversation with the Prime Minister of Israel, Naftali Bennett, \nwho requested a zoom call with me. Based on the diminishing efficacy of the Pfizer vaccine in \nIsrael, the Prime Minister together with his health ministers have decided that they will give a \nthird booster shot to individuals older than 60 years old. They are already giving a booster to \npeople who are immunosuppressed. the Prime Minister wanted to get my opinion and ultimate \nsupport of what he is doing. with my permission he taped our discussion so that he could put it \non his Instagram to show to the people of Israel. I pointed out to him that there will be some \nconcern that he is boosting people in his own population while much of the world has not yet \nreceived their first dose. He understands that but pointed out to me that is real is a country of \nalmost 9 million people and they have just enough doses to take care of their own people , and \nunlike the United states, they do not have the resources to supply the rest of the world. He asked \nfor my cell phone number so that he might intermittently call me for advice. With the approval of \nthe State Department I gave it to him. It seems that we have developed a very good rapport on \nthe basis of this first meeting.   It turns out that the Prime Minister is an extremely interesting \nman who was a combat commander (Major) in the Israeli Defense Forces in a Special Forces \nReleased by Chairman Rand Paul\nunit. He led many Special Forces operations.  In addition, he has spent many years in the United \nStates and has made millions of dollars as a software entrepreneur. \nPRESS: Global National TV – Canada; Spectrum News TV – California; NPR – “All \nThings Considered” with Ailsa Chang\nJuly 31, 2021 – Global – 196,6000,000/4,200,000; USA – 34,800,000/610,000\nInstagram from Israeli PM Bennett:\nAugust 1. 2021 – Global     USA – 34,900,000/611,000\nI got involved in an interesting situation regarding the expiration of the moratorium on \nevictions with the CDC in the middle of it. Apparently, the CDC has the authority to block \nevictions during a public health emergency. The moratorium expired and the Supreme Court \nruled that they could not reinstitute it. Now Nancy Pelosi is furious because the public is blaming \nthe Congress for not solving the problem. Pelosi is asking the White House to do it and the \nWhite House is turfing it to the CDC. The CDC does not have the authority to overrule the courts \nand so there's a lot of tension going on. Larry Horowitz who works with Pelosi called me to ask \nme to try and convince Rochelle to reinstitute the moratorium, get sued (which she will lose ), \nand thus give enough time to get money to the people who are being evicted to prevent their \neviction. I got on the phone with Rochelle and offered to help her by giving her encouragement \nand support. It all worked out when Jeff Zientz worked with Ron Klain to have Rochelle write a \nletter to the president saying that she would love to keep the moratorium but it is legally out of \nReleased by Chairman Rand Paul\nher hands. In this way the good intention of the administration would be displayed , but they \nwould not get into legal difficulty.  \nPRESS: ABC “This Week” with Jonathan Karl; CBS “Face the Nation” with John \nDickerson\nAugust 2, 2021 – Global    USA\nI briefed the President today in the Oval Office. It was part of the weekly briefing that we do \nwhere Rochelle and Vivek and Marcella were on the zoom screen and I was in the office with the \nPresident and the Vice President. I briefed him on the efficacy of the vaccine against the delta \nvariant as well as on the issue of breakthrough infections and the possibility of our need for \nboosters. The President was his usual pleasant and calm self; however, he seemed a bit troubled \nabout two issues: first, he is aware that everyone is waiting for the FDA to give final approval to \nthe vaccines and that this would go a long way to getting more people vaccinated. He clearly \ndoes not want to interfere with the FDA; however, he is growing impatient with the length of \ntime that is taking for them to come across with a full approval. Second, he is concerned about \nthe fact that the moratorium on evictions of people from their homes has expired and the \nSupreme Court has voted five to four that the moratorium cannot be extended. He has the power \nto call together constitutional scholars and claim that they have given him enough reason to \noverrule the opinion of the Supreme Court and order the CDC to continue with the moratorium \non evictions. He is hesitant to do that since although he believes it is the right thing to do from a \nhumanitarian standpoint, he does not want to set a precedent for a President to use his or her \nPresidential authority to overrule a Supreme Court ruling. He is afraid that if we get another \nPresident similar to Trump, that a lot of mischief and bad acting could occur if such a precedent \nwere set. And so, he has to live with the uncomfortable situation of Nancy Pelosi essentially \nyelling at him on the phone to do something about the eviction situation when in some respects \nhe is powerless to do so. I feel for him and I am more appreciative close and personal of the \nweight of the Presidency. \nAs it turns out, the President did get an opinion from some constitutional scholars and \nmade the decision to ask the CDC to extend the moratorium for 30 days.  As Ron Klain said \nin the White House , it is likely that the courts will overturn this extended moratorium pretty \nquickly . We shall see. The general spin is that the president did this because of extensive \npressure from Nancy Pelosi and the Democratic Congress. \nGovernor Ned Lamont of Connecticut called me today in frustration that the FDA has not yet \ngiven full BLA approval to the COVID-19 vaccines. He asked if I could do anything about it . I \nexplained to him that that would be difficult since it would suggest that we are putting pressure \non the FDA which could backfire on us. I told him that I was very much in favor of accelerating \nthe process and that I felt that the approval would likely come within the next couple of weeks . \nHe also asked about booster shots and I explained to him that boosters for the \nimmunocompromised would likely come very soon and that it would probably take a couple of \nmonths before there was enough data to recommend booster shots for the elderly. \nReleased by Chairman Rand Paul\nGot a call today from John Bel Edwards, Governor of Louisiana. He is having the biggest \nsurge of cases of any state in the country right now and he is asking for my support in what he \nwill soon do and that is to put in a mask mandate for all indoor public settings as well As for \neveryone in the school system which will start today.  He asked if I had any further suggestions. I \nasked if he had ordered a restricted capacity or closing of bars and restaurants and he said that \nalthough he would like to do that, he feels that the legislature would rebel against him and take \naway his emergency powers for public health. And so he wants to get his mask mandate through \nas his first priority. I agree with him. In addition before we hung up he said that he really \nadmired me and felt badly of what I was going through with the far right attacking me. He said a \nvery nice thing when he said: “you have bigger clowns to deal with than I do; maybe not more \nclowns, but certainly bigger clowns, but at least you can sleep at night with a clear conscience “.  \nThe conspiracy of the far right and the trump loyalists continues. Recently representative \nMike McCall the minority On the House Foreign Affairs Committee released a report by \nthe panel's republican staff essentially saying that the lab leak was the cause of COVID-19 \nand hinting the NIH's role in creating the virus. This is based on no new information or no \nnew data. It is very clear what is going on and it needs to be called out. It is all part of “The Big \nLie”. First, trump actually won the election; next, January 6th was a friendly visit to the capital \nbook shop; next trump was right and China caused the virus; next Fauci and the NIH helped the \nChinese create the virus; next, discredit Fauci and it looks like trump is telling the truth. It is \nplain and simple a concerted effort aimed at getting trump re-elected and exonerating him from \nany blame in the complete mess up of his response to COVID-19. \nLindsey Graham has contracted COVID-19 period since he is vaccinated he has a mild case. I \nasked his staff to have him give me a call , which he did and I expressed concern for him and \noffered to help if I could. He was very grateful for my concern instead we would keep in touch. \nPRESS:  White House pressor;\nAugust 3, 2021 – Global – 198,000,000/4,200,000; USA – 35,200,000/612,000\nWe continue to average about 70,000 cases per day\nAn ironic situation is going on in Florida where Governor DeSantis has a state that has the \nmost infections per day in the country and is still insisting that mask mandates are not allowed at \nthe local level by the schools or by anyone else. In addition, he continues to raise money by \nslamming me with T shirts as well as by his slogan “don't Fauci my Florida”.  Besides being a \ntotal jerk, he is causing people to die in his home state.  \nDid Governor’s call today – Chaired by Gov. Asa Hutchinson (R-AK)\nWhite House has asked me to interview candidates for the position of FDA commissioner. \nAnd so today I am interviewing Sudip Parikh whom I knew when he was the staff director for \nthe Senate Appropriations Committee. I was impressed with his interview since he is a very \nsmart and energetic person. I also interviewed James Hildreth who is currently president and \nCEO of Meharry medical school. I have known Jim for a long time and he is highly qualified. \nReleased by Chairman Rand Paul\nGov. Cuomo is in serious trouble politically. A report came out today detailing 11 instances of \nsexual harassment. President Biden as well as Nancy Pelosi has called for his resignation . If he \ndoes not resign, he will likely be impeached. \nRichard Ebright (Rutgers) has proven again that he is truly an asshole. Francis Collins was \non CNN this morning and misspoke saying that adults who have children at home should wear a \nmask at home , which is clearly not correct. However , Frances very quickly corrected his \nstatement by putting out a tweet , apologizing , and saying that he was incorrect. Yet \nimmediately after that doctor Richard Ebright followed this up with a very nasty tweet . See \nbelow:\nThis evening I was asked by Erin Burnett on CNN to clarify the situation once and for all. I \nstated that Francis misspoke but to his great credit he immediately apologized and corrected the \nmistake. \nI e-mailed Susan Rice tonight asking her to call me, and she returned call at around 9:00 \nPM.  I wanted to explain more fully to her the misperception about the “likelihood” that a \nvaccinated person would get infected. In a discussion we had yesterday where I briefed some of \nthe economic leaders including Janet Yellin and Susan Rice, the question came up as to what it \nmeans when there is a 79% efficacy of a vaccine against the delta variant. Many people interpret \nthis to mean that there is then a 21% chance that a vaccinated person will get infected . This is \nobviously incorrect since you must compare it to the unvaccinated people. Since not all the \nunvaccinated people get infected by any means, then the 79% protection compared to the \nunvaccinated people means that a very, very small proportion of vaccinated people will get \ninfected. Susan was very grateful for the phone call and said as he has often dos when she sees \nReleased by Chairman Rand Paul\nme that she “loves” me. We have become good friends over the years dating back to the Obama \nadministration, and I really like her. \nPRESS:  Axios interview with Eileen O’Reilly; Podcast with Creative Artists Agency – \nagent for many entertainment and sports figures; Podcast with CSIS – Steve Morrison; \nCBS Evening News with Nikki Battiste; CNN with Erin Burnett; Did a Webinar with \nVirginia Governor Northam;\nAugust 4, 2021 – Global   USA\nHad 100,000 cases yesterday!!  104,000  cases today\nI received the call today from former Vice President Dick Cheney - This is medically \nconfidential and not for publication in my memoir. The VP was asked to give the eulogy for \nformer Secretary of Defense and dear friend Donald Rumsfeld.  Cheney had a heart transplant \nseveral years ago and is on immunosuppressive regimen. It is likely that his immune response \ntwo the vaccine is suboptimal. He called his cardiologist , Jonathan Reiner, at GW and asked his \nadvice about coming to Washington to give a eulogy for Rumsfeld given the current situation \nwith the delta variant. Reiner recommended that he called me. I made it very clear to Cheney that \nI strongly recommended he get the third boost of the mRNA since he is highly susceptible to \ngetting infected if he comes into contact with an infected person.  We spend some time \ndiscussing the courage of his daughter Liz Cheney and sticking up against the far right \nRepublicans who want to whitewash the January 6th insurrection. I told him that she was a chip \noff the old block and I really appreciated the fact that she has been sticking up for me. Cheney \nsaid he admired very much my courage and fortitude and standing up for what was right and he \nReleased by Chairman Rand Paul\nis proud to tell friends that he knows me and used to work closely with me. I told him that the \nfeeling was mutual when I talk about him to my friends. \nCall with Eric Goosby - Eric is concerned that we are not utilizing the infrastructure of \nPEPFAR to solve the distribution problem of vaccines in sub saharan Africa. Eric points out that \nthe obstruction here interestingly is Gayle Smith who is now the special director in the \nDepartment of State for global affairs. Eric points out that it is the same competition intention \nbetween USAID and other global entities of the federal government. Gayle and USAID want to \nbe the focal point of the failing distribution of vaccines in Africa, while PEPFAR already has an \nextraordinarily effective infrastructure that was built for HIV. Eric is frustrated that we are not \nusing that infrastructure. \nDid Zoom with Senator Dick Durbin  who wanted a briefing on breakthroughs and boosters\nPRESS: Katie Couric podcast; Wall Street Journal podcast with Ryan Knudson; Australian \nbroadcasting TV “7/30”\nAugust 5, 2021 – Global   USA\nI had a very busy day today. Jeff arranged for me to brief both the house and the Senate via \nzoom on the latest in the COVID situation. In addition , I joined the first gentleman Greg Emhoff \nin discussing with a bunch of young communicators the importance of their work in getting their \nyoung peers vaccinated. This is the second time that I have done an event with the first \ngentleman. In addition, I met by zoom with Kathy Russell the head uh White House personnel to \ndebrief her on the interviews I did with FDA candidates James Hildreth and Sudip Parikh. \nDuring the debriefing when they asked me if there were any other candidates that I would \nrecommend, I strongly recommended Zeke Emanuel.  However, as usual there was a concern \nabout the fact that he can be a bit of a loose cannon. This is unfortunate since he is a very \ntalented guy , intellectually brilliant, and very visionary. He is also a good friend. \nThe nonsense of the far right in trying to discredit me continues . A day does not go by \nwithout either the far right GOP congressman or senator criticizing me and even calling for my \nremoval together with the far right media , particularly FOX, being sharply critical of me in \nevery respect. \nPRESS:  ABC “Good Morning America” with George Stephanopoulos; Rickey Smiley \nRadio Show; Taped CNN Fareed Zakaria for this Sunday;\nAugust 6, 2021 – Global – 200,800,000/4,300,000; USA  - 35,500,000/614,000\n67,000 7-day average\nCases continue to climb. There has been a lot of discussion about whether or not we should move \nquickly in instituting a program. I have been a very strong and vocal advocate to give booster \nshots immediately to people who are immune compromised such as those who are transplant \nrecipients, those war on cancer chemotherapy, and those who are immunosuppressed because the \nReleased by Chairman Rand Paul\nborder immune diseases. I have been explicit about that and have also been pushing the CDC to \ngive us at least some preliminary data on the cohort studies that they say will inform us about the \ndurability of protection among various groups of people. Other countries including France, \nIsrael, and Germany, have decided to give boosts to the elderly right now. The UK has decided \nthat they will start doing this in September. In this context, Jeff is getting very disillusioned with \nRochelle and the CDC in their traditional way of not giving anyone even a slight hint of what the \ndata shows until they are ready to announce it officially. A typical example of this has occurred \ntoday. I will be on a lot of press calls today and over the weekend and the CDC just announced \nthat they have an MMWR that will be coming out together with a couple of papers in JAMA. I \nhave no idea what is in these publications. This is unacceptable . Similar to what Sylvia burwell \ndiscuss with me years ago about firing Tom Frieden, Jeff is seriously thinking about either \nbringing in someone else to assist Rochelle or outright getting rid of her. I have argued that \nwe should absolutely not fire her, and I have offered to speak with her about this issue. \nI had a long call with Rochelle tonight and explained the entire situation to her. I confirmed \nthat I totally support her, but she really has to address the ingrained and somewhat ossified \nculture of the CDC. I particularly pointed out to her that she just cannot hold back information \nfrom Jeff and the White House team because she is waiting for her team to finalize data. If she \nhas preliminary data she needs to tell us about it since we may need to talk about policy that \nwould depend on such data. She just cannot give us an MMWR on the same day that is coming \nout. The last time this happened she said she could not give it to us because it was “under \nembargo “. I pointed out to her that this enraged Jeff since the CDC owns MMWR and as \ndirector of CDC she needs to realize that no one is trying to influence what goes into MMWR \nbut it is important that she does not surprise Jeff or the president with something that she knows \nand that we do not know. I love Rochelle and she knows that. I explained to her what she needs \nto do to make things right with Jeff . A human explained to her the story from years ago when I \nsaved Tom Frieden from getting fired by Sylvia Burwell because of how he messed up the ebola \nsituation as a result of his listening to “his guys “.  I believe that Rochelle gets it and will survive \nthis very difficult time. I support her totally. \nPRESS: WJXX -Jacksonville TV;  Bloomberg TV interview – Madison Mills; 1 hour with \nUSA Today Editorial Board; Zoom Call with Michael Spector for his adio-book; MSNBC \npeacock TV with Joshua Johnson\nAugust 7, 2021\nThe surge continues:\nReleased by Chairman Rand Paul\nGovernor DeSantis is a complete disgrace. He is blocking the local authorities from mandating \nmasks in various locations including schools. He is doing this while at the same time Florida is \nvirtually on fire with surging cases. Approximately 20% of all the cases in the country right now \nare in Florida. When you add Florida with Texas you get about 40% of all the cases in the \ncountry. At the same time he together with his Greek chorus of Rand Paul and other GOP \nmembers of Congress together with all of the stooges at Fox News (Carlson, Hannity, Ingraham), \ncontinues to actively criticize me and talk virtually every day about my being wrong on \neverything I say and then I should be fired. This is an obviously calculated plan of disparaging \nme and any other scientists (but focusing heavily on me) that speak up against their crazy \nstrategy. I am convinced even more that this is part of the total dystopia going on in certain \nelements of the country and it is all linked to “The Big Lie” involving the election and the denial \nof January 6. I really am worried more about the country then about myself since if this goes on I \nfear that our democracy is in dire danger. \nWe had an important conversation today with Glenda Gray and Linda-Gail Bekker of the \nRepublic of South Africa. The discussion centered around the fact that Glenda and Linda GAIL \nwant to do a randomized placebo-controlled trial using the Moderna M RNA. The purpose of the \nstudy is to determine if and how well mRNA vaccine works in persons with HIV. We have a real \nproblem with doing a randomized placebo-controlled trial and so we got on the phone with \nDavid Kessler, the people from NIAID including Cliff, John Mascola, Mary Maravich, Carl D., \nand others. I came up with a solution that everyone liked. That was to do a trial where each arm \ngets a prime in boost dose of Moderna and then one group gets randomized to placebo and the \nother group gets randomized to a third dose boost. This will kill two birds with one stone. It will \navoid the controversial use of a placebo and at the same time tell you whether the mRNA \nvaccine works in persons with HIV and whether and whether or not they need a boost for \noptimal response. \nReleased by Chairman Rand Paul\nAugust 8, 2021 – Global   USA\nPRESS: CNN “GPS” with Fareed Zakaria; NBC “Meet the Press” with Chuck Todd\nReleased by Chairman Rand Paul\nAugust 9, 2021 – Global   USA\nCases 140,000 yesterday.   It seems that my prediction of 200,000/day will come true \nunfortunately.\nWe're having continual and difficult discussions concerning boosters. With my strong persuasion \nwe have now finally arrived to the reality that we must give an additional dose to \nimmunocompromised people as quickly as possible. The real issue that we are struggling with is \nwhen how and to whom we should give boosters among the population in general. Clearly, we \nwant to stagger it so that we don't have rush to the gate. We're trying to get as much data as \npossible to validate a decision to start giving it to the elderly at approximately 8 months \nfollowing their initial vaccination. \nReleased by Chairman Rand Paul\nI continue to struggle with having to defend the CDC against reasonable concern about the fact \nthat they are generally behind the curve when it comes to accumulating data that would inform \nproper public health action. He gets back to previous conversations that we had concerning the \nentrenched culture at CDC who feel that they know best and they are not accountable to anyone. \nUnder non pandemic conditions this goes un-noticed. However, in the middle of an outbreak of \nthis proportion it is a glaring deficit.  \nPRESS: Black News Channel (TV); Hugh Hewitt Radio; Navajo Times Interview; BBC \nWorld News TV\nAugust 10, 2021 -  Global   USA\nThe soaring of cases continue. It is really looking rather ominous in that there have been \nnumerous reports of gatherings of completely vaccinated people in a moderate to small sized \nparty 20 thirty 40 people where you have outbreak of infections among these individuals. It is \nvery clear that this virus is very different in its ability to transmit compared to the alpha variant. \nThere have been a number of discussions regarding the use of additional booster shots. I \nhave been a strong proponent and have led the discussion in getting additional booster doses to \nthe people who are immunosuppressed, and to get these doses to them imminently. We have had \nReleased by Chairman Rand Paul\nseveral meetings with Jeff and the team and in some cases with the FDA to try and expedite this. \nIt becomes an issue of the clinical data in a somewhat preliminary form balanced against the \nneed of the FDA to have firm data before they modify the EUA. The tension between Jeff and \nthe CDC continues in that the culture does not allow the CDC to share data in real time in a \nsituation in which you actually need data in real time to make a decision. The lack of confidence \nin Rochelle and the rest of the CDC is manifested by the fact that Jeff is having me as opposed to \nRochelle brief the President about things that appear to be strictly epidemiological. The same \nholds true for briefings of the principles and the governors. I don't know what to do to help \nRochelle change the culture of the CDC because this is a decades-long problem. Vivek is in total \nagreement with me on this issue.\nI met with the President today in the state dining room of the White House to discuss \ntogether with the administrator of FEMA Deanne Criswell and Assistant to the POTUS for \nHomeland Security Liz Sherwood-Randall among others and together with Natalie and Jeff. The \ntopic of the discussion was how we were going to handle the obvious heavy hurricane season \nthat is approaching in the context of major outbreaks of COVID in the gulf states that have the \nlowest levels of vaccination and the highest levels of infection. I presented the epidemiology data \nand Liz and Deanne presented  the hurricane data. My impression was that the president was not \nparticularly happy with Deanne’s presentations since she was not able to give him the answer to \na lot of his questions. Nonetheless being the gentleman that he is he did not really act annoyed \nwith her although as I get to know his body language better I could sense that he was \ndisappointed. \nAs indicated above David Kessler and I and most recently with the support of Jeff have been \ntrying to push the concept of getting the US government to make a major investment in Lonza \ncompany that makes the mRNA four Moderna. We're making some progress in the \nimplementation of the concept of the US government bankrolling Lonza to expand this capability \nto supply billions of doses of vaccine to the developing world. We had been working on this in \ncollaboration with Peter Staley, James Krellenstein, and David Barr.  Unfortunately, Peter in his \nenthusiasm to get things done quickly, orchestrated a letter signed by 175 public health \nadvocates essentially criticizing the Biden administration for acting too slowly in getting vaccine \nto the developing world. They sent the letter to the president simultaneously with sending it \nto the Washington Post and my media friends Yasmeen Abutaleb and Dan Diamond wrote \nan article in the Post indicating that David Kessler and I were working with them to get the \nhigher ups in the administration to agree with the plan but that we had not been successful. \nUnfortunately, this may have blown our entire plan of getting this done under the radar screen. It \nis likely that this could now interfere with what David and I were trying to do. Yasmeen called \nseveral times for an interview; however, I did not see any purpose in getting involved in this \ncontroversial issue and also she had already written the story.  See below:\nWpost: ‘Act now’ on global vaccines to stop more-dangerous variants, experts warn Biden\nVivek called me tonight after resume call with Dawn O'Connell and told me that a number of \nscientists and public health people that were originally on the advisory committee to Biden's \nelection group we're writing to Ron Klain urging the administration to fire Rochelle \nWalensky as the CDC director. I believe this is very unfair since after I have spoken to her she \nReleased by Chairman Rand Paul\nis really trying very hard to gain control of the agency and to change there are somewhat ossified \nculture. \nPRESS:  MSNBC “Morning Joe” with Mika Brzezinski;  Did Instagram and TikTok \ninterviews with  “influencers” including Actor Edgar Ramirez, Kathleen Barnes, Jax \nJames, Merrick Hanna Chris Olsen/Ian  Paget, Wisdom Kaye\nAugust 11, 2021\nDavid Kessler is pissed at Peter Staley.  David feels betrayed that Peter mentioned his name \nand my name in his interview with Yasmeen. Last night I called up Courtney Rowe and had a \nlong about the pros and cons of responding to Yasmeen who has been trying to get a comment \nfrom me regarding the article. We came to the conclusion that it would not do any good since the \nquote could be misinterpreted. I agree with Courtney. However we may have a problem that the \narticle may set us back in getting jeff's support to push for billions of dollars to expand capacity \nto be directed 2 low and middle income countries. I will try to repair any damage that has been \ndone to this effort. I had a good conversation with Peter this morning and I believe Peter realizes \nthat he may had done some damage by mentioning my name and David's name in his interview \nwith Yasmeen. It is again a delicate balance of trying to get an activist-driven push to get the \nright thing done and still operate within the system that alone has the capability of getting the \nright thing done with all of the political sensitivities involved. \nEmail from David Barr to David Kessler:\nFrom:  David Barr <davidbarr376@gmail.com> \nSent: Wednesday, August 11, 2021 8:47 AM\nTo: Kessler, David (HHS/IOS) <David.Kessler@hhs.gov >; Fauci, Anthony (NIH/NIAID) [E] \n<afauci@niaid.nih.gov>\nSubject: Follow up from the Washington Post story\nDavid -\nI saw your message to Peter. I think you have every reason to be annoyed at Peter's quote in the \nstory.  The story is about the sign-on letter that was developed as an outcome of a meeting sponsored \nby Yale School of Public Health, PrEP4All, ICAP at Columbia and AVAC, in which Peter was not \ninvolved.  The letter is focused on the proposed plan to scale up mRNA vaccine manufacturing, a plan \nthat has been public for many months now. The letter has nothing to do with the discussions we've \nbeen having with you and Tony and there was no reason whatsoever for Peter to have mentioned those \ndiscussions to the reporter. I don't see the quote as revealing any detailed information, but I do see how \njust saying publicly that we've been talking could undermine your negotiations.\nI've let Peter know that I'm not happy about this. I feel that you've worked with us in good faith and are \nmaking progress as evidenced by our last call. I hope we can keep these discussions going forward. \nReleased by Chairman Rand Paul\nOur goal is to ensure that vaccines are available to the world as quickly as possible. I know you share our \nconcerns and understand the urgent need for this. I do not envy your current role in all this, as it must \nbe both exhausting and frustrating. I remain confused as to why the President and the global public \nhealth establishment do not seem to truly share our concerns.  Rather than lengthy negotiations with \nModerna, why hasn't Biden hauled them into the Oval Office and said 'this is what is going to happen'? \nInstead of a piecemeal structure based on donations, why hasn't the WHO called for wartime footing to \nsolve this problem? Meanwhile, the caseload grows and the potential for a new variant grows with it. \nAgain, thanks for your efforts to date and I very much hope we can continue our discussions.\nDavid\nPOTUS called me up today.   Jeff is giving the president a briefing about a number of things \nand he wanted me to specifically brief him about the importance of giving a third dose of vaccine \nto immune compromised people. Jeff felt that it was not worth my going all the way down to the \nWhite House again since I was there yesterday and so he arranged in the middle of the meeting \nthat he was having with the president to have the president call me on my cell phone and have \nme explained to him the rationale of the third dose , namely a booster, to immune compromised \npeople since they never had an adequate immune response to begin with. The confusion that the \npresident might have is to distinguish the boost for the immune compromised versus a boost for \nthose who overtime have an attenuation of their response even though they are immunologically \nnormal. It was for this reason that Jeff wanted me to do the explaining. I believe that the \npresident understood what I was saying. \nJust to note that almost without exception every week I brief the Principals together with Jeff, \nNatalie, and Rochelle. the principles consist of cabinet secretaries as well as other high ranking \nWhite House officials. I don't report on it every week but it essentially occurs every week. Today \nI briefed them on various aspects of the delta variant. \nI did a favor for the State Department today by answering a series of Qs and As about the \nmRNA vaccines\nPRESS: CNN International with Christiane Amanpour; ABC World News Tonight and \nABC Evening News; podcast – “America Dissected” with Dr. Abdul El-Sayed\nBorowitz satire report in the New Yorker: New Yorker: Fauci Says It Is Safe to Watch \nYouTube Now That Rand Paul Has Been Suspended\nAugust 12, 2021 – Global   USA\nNow averaging (7 day) >100,000 cases per day\nHospitaliations in children increasing per 100,000 population\nReleased by Chairman Rand Paul\nHad a good call with Hans Kluge, WHO Regional Director of Europe.   Good discussion \nabout mutual interests concerning COVID-19 and issues such as vaccine hesitancy.\nHad a very important Zoom with Chris Whitty and Patrick Valance see above) from the \nUK. Jeff has suggested that I call up Chris and Patrick and ask them what the strategy is in the \nUK regarding booster shots. To my surprise, I found out that they have not yet implemented \nbooster shots for the immune compromised. They plan to do that in September. However, the \nbigger surprise was that although they are planning to give booster shots to the elderly starting \nwith those who are 70 years old and older and then moving to the 60 years old and older, they \nwill not boost anyone less than 50 years old . This means that they have no intention of boosting \nthe general population who are not immune suppressed. Of note, this is consistent with their \nstrategy that they care less about transmission of virus among individuals than they do about \nkeeping people out of the hospital . That's why they feel that although the general population \nmight have a decrease in effectiveness of the vaccines leading to infection and transmission, they \nare not concerned since the protection against severe disease is holding strong. This is consistent \nwith their strategy of not wearing a mask and sending the children back to school without masks. \nIn other words, they feel that we will have to live with transmission of the virus so long as we \nprotect people from getting severe enough disease to be hospitalized. Jeff and president Biden \nwere concerned that we would be behind other countries in protecting our citizens when in fact \nwe are ahead of them, certainly ahead of the UK. \nPRESS:  White House Press Conference; ABC “Good Morning America” with Amy \nRobach; NBC “Today” with Craig Melvin;  CBS “This Morning” with Vladmir Duthiers; \nReleased by Chairman Rand Paul\nABC “World News Tonight” with David Muir; NBC “Nightly News” with Lester Holt; \nPBS “NewsHour” with William Brangham; KMBC (ABC) TV – Kansas City, MO with \nMike Mahoney; KDFW TV (FOX) Dallas-Fort Worth with Steven Dial; WPLG TV (ABC) \nMiami with Ben Kennedy; Univision TV with Lourdes del Rio; Telemundo National TV \nwith Jose Diaz-Balart; Univision Atlanta TV with Rafael Olavarria; MSNBC “The Reid \nOut” with Joy Reid; CNN AC/360 with Anderson Cooper;  \nAugust 13, 2021\nCases continue to surge \nWe had multiple zoom calls and conversations today concerning the proper approach to his \nbooster vaccinations.  In addition, based on this submission to the FDA on data in diminished \nresponse in the immune compromised, the ACIP recommended that people who are immune \ncompromised including transplant patients, cancer patients on chemotherapy, any patients on \nsevere immunosuppressive therapy, people with advanced HIV disease, and people with primary \nimmune deficiencies receive a booster dose. We also had considerable conversations about the \nbest way to roll out the recommendations to boost the entire population in an orderly fashion \nstarting likely sometime in mid to late September. The COVID team agrees that this is the way to \ngo; however, it must be done within the context of the FDA regulatory framework. I am pushing \nmy people who are doing clinical trials on booster doses to get data as quickly as possible to the \nFDA and the CDC so that they can analyze it for the purpose of making policy. Jeff is very \nsensitive to the fact that he does not want us to look like we have come in too late to the boosting \ngame. This is actually not the case since as mentioned above , if anything, the UK is actually \nbehind us. There will certainly be international concern by the fact that we in the USA are giving \nReleased by Chairman Rand Paul\nboosts to otherwise healthy people while the rest of the world is lacking even their first boost . \nHowever, the argument that I am giving is that the USA is donating more doses and money two \ninternational vaccines for low and middle income countries then the entire rest of the world \ncombined . At this point we have contracted for 500 million doses to be distributed in the \nfollowing cadence: 200 million doses by the end of 2021 and 300 million doses before the first \nhalf of 2022 ends . In addition, we have already given away 110 million doses to 60 countries. \nThis includes 80 million of our own doses. In addition, the USA has either given or pledged $4 \nbillion to COVax. \nThere is an interesting concept that is heavily debated among us. Although we all agree that \nwe need to do as described above, we are not fully appreciative of what the decrease in incidents \nof infection actually means if the current rate of hospitalization and death appears to remain \nstable. Are we vaccinating people with a boost because we feel that ultimately those increases in \ninfection will lead to increases in hospitalization and deaths, or are we concerned that even if \nvaccinated people get infected and spread the infection that we are trying to suppress \ntransmission in addition to serious disease. Stay tuned for how this all rolls out.  \nPRESS: WTOP with JJ Green; Twitter responses with WH Digital team; CBS Radio Los \nAngeles; CBS Radio NYC; White House twitter with digital team;\nAugust 14, 2021 – Global -     USA – 36,300,000/618,600\n140,000 cases in the USA today.\nWe had continued discussions today with Jeff and David Kessler as to how we are going to \ndeal with the activists (Peter Staley et al) in our attempts to cooperate with them in getting doses \nto the developing world. We need to get them to understand that we are with them and trying to \nexpand the number of doses we give ; However, they need to understand that we have already \ngiven more than the entire world combined. So they really need to recognize that we've done a \nlot at the same time that they work with us to do even more rather than attacking us for not doing \nenough. \nModerna has not acted in good faith. They have actually put in their patent application and \nhave explicitly said that Barney Graham, John Mascola, and Kizzy Corbett are not inventors of \nthe M RNA 1273 patent.  This is absolutely outrageous and I have had conversations with \nFrancis Collins, Larry Tabak, and earlier this evening with Jeff indicating that we have to get a \nheavy hitting law firm to argue our case. I suggested as did Jeff that we employ the firm of \nWilliams/Connelly to represent us. \nWe are planning to roll out next week the program of giving a booster shot to everyone starting \nwith those in long term care facilities and the elderly, but ultimately including everyone related \nto their anniversary date of their last shot. Clearly, we will get both praise and criticism for this. \nAugust 15, 2021 (Sunday)   Heat wave throughout the country.\nReleased by Chairman Rand Paul\nI had a very intensive day with the medical team trying to fashion to coherent message to \njustify the announcement that we plan to make this week that we will be giving a booster \nshot to everyone who wants one regardless of age or underlying condition.  This has been a \nvery difficult situation since the data for diminution of efficacy regarding hospitalization and \ndeath are unclear because of the confounding variables of some studies dominated by delta , \nsome studies dominated by alpha , and some studies with a combination of both. In addition, \nwhen we talk about hospitalizations , it is unclear from several of the studies whether those who \nwere hospitalized were almost exclusively the elderly and /or people with underlying conditions. \nJeff is bent on having a coherent sharp message about this when in fact that is very difficult to do \ngiven the paucity of data. If we are too precise we will be called out because we cannot back it \nwith data. If we are general, Jeff feels that the public will be confused. I am trying to convince \nhim that it is OK to say that we do not know nor do we have all of the data to make a decision \nand sometimes you have to make a clinical or public health decision just based on clinical \njudgment. In this case the judgment is that delta is a very bad virus and even though we don't \nhave firm data yet that younger people are getting seriously ill, we don't want to be late to the \ngame. I used the metaphor of Wayne Gretzky who always said it is important to skate where the \npuck will be rather than where the puck is. We do not wait until younger people start requiring \nhospitalizations before we decide that we want to give them a boost. My job in all of this is to \ngive the immunological basis for providing a boost. Bottom line is that the controversy will be \nnot that we need to give a boost, but do we really need to give it to everyone instead of just to the \nelderly and those who have underlying conditions. One of the most important aspects about all of \nthis is that when you boost someone with a third dose at about six months or so after the original \nprime boost the level of antibody goes dramatically high and I believe that this would provide \ndurable protection against delta and any other variants that come along. My concern is that the \nMedical Group will not articulate this concept well enough and I will have to be out there trying \nto pick up the pieces as is usually the case. \nSummary of what has been going on hat I might not have had he time to document.  I am \nmore and more astounded by the fact that our society is so dystopic in that untruth and out and \nout lies seemed to win the day . In addition, I am concerned that even good scientists playing a \ngame of using their longstanding concern with gain of function to call attention to this by what is \ngoing on regarding the argument about the origin of the virus. There is no question in my mind \nbased on so many factors including history, molecular makeup with the virus, among others that \nthis virus naturally emerged from an animal reservoir. Yet , people like David Relman and others \nare not realizing that by their focusing on the gain of function which they believe is what we \nfunded at Wuhan could possibly be the cause of SARS Co V2 when in fact they know that this is \nmolecularly impossible. I have evolved into something that would have been unimaginable \nto me just a few years ago. There are some positive aspects to it ; However, for the most part I \nfeel like it is no longer me. I am now probably one of the most recognizable faces in the world. \nMillions of people idolize me and the far right radical group absolutely hate me. I cannot go out \nin public to a restaurant or even walk through a crowd since someone immediately recognizes \nme and wants to take a picture or congratulate me or just say that they said hi to me. This is \ndriving my security group crazy as they are afraid fair among these legions of admirers will be \nReleased by Chairman Rand Paul\nsomeone who wants to kill me. All of this together with the stress associated with the fact that \nthe president and others in the administration rely heavily on me four major decisions and I have \nvery little staff relatively speaking who could help me.  \nPRESS:  CBS “Face the Nation” with Nancy Cordes\nAUGUST 16, 2021\nPediatric hospitalizations surging:\nSomeone leaked  our plan for boosters.  The press are texting me all evening.   I am not \nanswering.\nPRESS:\nAugust 17, 2021\nThere is a lot going on and a lot of moving parts. We have been working very hard on trying \nto get a plan and a program out to deliver third boost shots to people who have received the \noriginal two dose vaccine regimen for M RNA. This is a complicated issue because it appears \nthat the vaccines in the United states as well as globally particularly in places like Israel and \nEngland among others are still holding strong and preventing hospitalization and deaths but there \nis a dramatic diminution with the delta variant in protection against infection and symptomatic \ndisease. There is an inkling that we are starting to see increase in hospitalizations particularly in \nIsrael in vaccinated people. Jeff together with the White House team has been working on a plan \nto be implemented starting September the 20th to get a third shot to everyone in a cadence \nbeginning with those who originally had received the vaccine first. These people are \nfundamentally health care workers, the elderly, and people in long term care facilities and \nnursing homes. The problem is the data that definitively show that we are seeing an increase in \nhospitalizations with delta are not there yet. However , as I and others know from experience , \nwhen you are dealing with COVID-19 , particularly the delta variant, you may be behind the \nReleased by Chairman Rand Paul\ncurve by a few weeks at the time you realize you were behind the curve. I use the analogy of \nskating to where the puck will be not where it is now . In this regard, there will be criticisms that \nwe acted too soon particularly since so many people around the world have not yet received any \nvaccine. This is countered by the fact that the United states is doing more than the rest of the \nworld combined to get vaccine to lower middle income countries. There is an additional \ncomplicating issue here in that Jeff is insisting that when we announced this, it looks like it is a \ndone deal and we are definitely going to do this . However, it really does depend on or \nauthorization from the FDA together with recommendation from the CDC via advice from the \nACIP. If we come out and definitively say we're going to do it prior to the FDA approval , it \nlooks like we have politically influencing the FDA. I am warning Jeff about this because even \nthough he is trying to do the right thing , we have to be careful that we don't look like we are \ntipping the scales and overriding the FDA. Janet Woodcock is very concerned about this and I do \nnot blame her. \nAnother complicating issue is that last night someone leaked our plan to the press and although \nwe are going to make the announcement tomorrow the press is running wild with speculations \nand partial data right now. I have not answered any press calls because I do not want to get \ninvolved invalidating the breaking of a very strict code of silence. Shame on the person or \npersons who leaked this period now we have to explain things without necessarily giving \neverybody all the necessary information. In addition , we have faced with the usual problem of \nthe CDC not giving us all the information that we need and even continuing to refer two \nembargoed MMWR papers to come out. We absolutely need to see those data if we are going to \ndefend our policy. \nEmail that I sent to Ian Sams:\nFrom:  Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> \nSent: Tuesday, August 17, 2021 2:02 PM\nTo: Sams, Ian (HHS/ASPA) <Ian.Sams@hhs.gov >; Kessler, David (HHS/IOS) < David.Kessler@hhs.gov >; \nMurthy, Vivek (HHS/OASH) <Vivek.Murthy@hhs.gov >; Collins, Francis (NIH/OD) [E] \n<collinsf@od.nih.gov>; Walensky, Rochelle (CDC/OD) <aux7@cdc.gov>; Levine, Rachel (HHS/OASH) \n<Rachel.Levine@hhs.gov>; Nunez-Smith, Marcella (OS/ASPR/IO) (CTR) <Marcella.Nunez-\nSmith@hhs.gov >\nCc: Phillips, Alexandria (HHS/OASH) <Alexandria.Phillips@hhs.gov>; Perry, Sherice (OS/IEA) \n<Sherice.Perry@hhs.gov>\nSubject: RE: Latest statement + Tough QA\nThanks, Ian.   The following that is in the statement is a very important \npart of the statement. Please make sure that it does not \ndisappear.  “…once FDA conducts an independent evaluation and \nReleased by Chairman Rand Paul\ndetermination of the safety and effectiveness of a third dose of the Pfizer \nand Moderna mRNA vaccines and CDC’s Advisory Committee on \nImmunization Practices (ACIP) issues formal recommendations.”\nBest,\nTony\nAnthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nI called Janet Woodcock to encourage her to stick by her guns and do the FDA work quickly but \nby the books.   She is even concerned that some FDA whistleblower will tell the press that FDA \nis being “pressured”.\nDespite the fact that the leak has made things very complicated , we are putting the finishing \ntouches on our plan for the rollout of the booster statement tomorrow. After that I will brief the \npresident. This should be interesting since he cannot be in a good mood given the total disaster \nthat has gone on with the withdrawal from Afghanistan and the complete takeover by the \nTaliban. \nI had an incredible and stressful evening tonight on the phone multiple times with Jeff and \nRochelle and then later with John Mascola.    Poor Rochelle!  She had been telling all along to \nJeff that the acip would go along with what we are doing. Jeff wrote a speech for the president \nthat definitively said what we are doing. Now that the leak has occurred the acip is furious that \nwe have already decided what we want to do without even consulting them. Jeff is being very \nrigid in getting a very clear crisp message of what the plan is and when Rochelle heard that \nNatalie had asked her to put together a schedule of how to roll out the plan, she panicked since \nthis would actually pushed the acip over the line that they are being treated as a rubber stamp. I \ncalled up Jeff and explained to him that we really need to pull back on the schedule issue . After \nmuch discussion in which he got very agitated , but maintained his friendship and respect for me \nwe decided to call up Rochelle and Vivek and have a zoom conversation. He was furious with \nher because he said that she kept on telling him that she had the acip in total alignment with what \nwe're doing and now all of a sudden the acip is a problem. I believe that her job is in danger. I \nspent a lot of time on the phone trying to get Jeff to appreciate that we have got to stay within the \nprocess of how recommendations are made and that we can do that at the same time ultimately \nReleased by Chairman Rand Paul\ndoing what we feel is right. I finally got him to listen to me and I had him change some wording \nin the president's speech for tomorrow that would add a degree of flexibility to the fact that we \nwill ultimately get done what we want to do but that we would tip our hat to the \nrecommendations of the acip. After it was all over and at 10:15 PM Jeff called me up again to \nsee what my thoughts were. He had changed the POTUS comments to include the caveat that the \ndetails are dependent on FDA approval and recommendations from the CDC’s advisors.  He was \nconsiderably calmed down and I went step by step with him and told him that we likely will be \nable to pull this off and get it right without having the rest of the world think we were railroading \nthe acip which really was not what we wanted to do. He seemed OK with that.   At the end of the \nday, after the BLA, people and physicians will boost whoever they want to boos whenever they \nwant to. \nPRESS: PBS South Florida TV; National Association of Black Journalists – Interview of \nme and Cameron Webb by Dr. Ian Smith (Physician/journalist/author)\nAugust 18, 2021 – Global -  208,500,000/4,400,000;  USA – 37,100,000/621,300\nYesterday 180,000 cases.   7 day daily average >100,000\nHad a very eventful and stressful day today; however things worked out well with the rollout \nof the booster plan at the White House press conference. Following that I briefed the president \nand VP in the Oval Office  together with Vivek, Jeff, Rochelle, Berchara, and Marcella, and \nNatalie.   Only Vivek and I in person.  The president and vice president asked good questions , \nparticularly with regard to the president's concern that this is contingent upon FDA and acip \nrecommendations . He picked up right away on the concern that Jeff had that we needed to do \nthis and make sure that we don't have a stumbling block with the FDA and acip. The one issue \nthat could arise is that the FDA may feel that the risk benefit ratio of boosting young kids 18 \nyears old and there abouts may not be favorable in the context of the risk of myocarditis \nbalanced against the risk of their winding up in the hospital as a result of COVID. The president \nis having a bad few days given what is going on in Afghanistan with the Taliban having taken \nover the country in just a couple of days following withdrawal of USA troops.   \nAs expected the response to the rollout of the booster plan was very mixed, and quite \nunderstandably. The CDC messaging all along has been dysfunctional . I do not think that \nthis is the fault of Rochelle, but just the function of the culture  at CDC where they hang on to \ndata without letting anybody know about it until it's ready to be published. We had another \ninstance where Rochelle was very reticent to show any of the medical team what was in the \nupcoming MMWRs that actually impact greatly the booster roll out because in typical fashion it \nwas “embargoed “.  One cannot imagine how ridiculous this is that a public health agency is \nacting like an academic department in a Medical Center where the most important thing is \npublishing data as opposed to guiding public health decisions. I take this opportunity now to talk \nabout it , but this has been a chronic problem literally for the decades that I have been the \nReleased by Chairman Rand Paul\ndirector of NIAID. Of note, Yasmeen Abutaleb wrote an article this morning in the \nWashington Post in which she described this exact problem. (see below).\nGetting back do the concept of boosters, it is very clear that it is the right thing to do . However, \ngiven the fluid nature of the situation , we had to make some “majestic leaps” by anticipating that \nsomething was going to happen such as diminution of vaccine protection and acting on this now \neven though the data we're not absolutely firm. A lot of people got bent out of shape about this, \nbut they are not responsible for the public health and they could guess and say whatever they \nwant as have many “talking heads” with impunity because if they are right they look great but if \nthey are wrong , which they usually are, then no one really cares because they have no authority \nor responsibility. \nPRESS: NBC “Nightly News” with Lester Holt; CBS “Evening News” with David \nBegnaud; MSNBC “The Reid Out” with Joy Reid; CNN with Chris Cuomo;\nThe Post's View\nOpinion: The covid-19 boosters have the same \ngoals as the first shots: Survival and resilience\nReleased by Chairman Rand Paul\nWashington Post: Fears over rising illness and death \nfrom the delta variant fuel Biden \nadministration push for boosters\nHealth officials expected to announce recommendation \nWednesday that Americans get extra shots\nBy \nTyler Pager , Laurie McGinley, Dan Diamond and Lena H. Sun\nAugust 19, 2021 – Global     USA\nCases recently >200,000/day   weekly average >100,000\nReleased by Chairman Rand Paul\nI just had a good conversation, my first conversation with New York State Lieutenant \ngovernor Kathy Hochul.  Starting on Monday August 23rd she will be the governor of New \nYork State replacing Andrew Cuomo who resigned affective August 23rd related to the sexual \nharassment scandal in which he was involved. The conversation with Kathy was very positive \nand she is very interested in working very closely with me and getting advice from me regarding \nhow New York State should handle the explosive outbreak of the delta variant. \nMuch press (see below) regarding the announcement yesterday on booster shots. \nI received an email late in the evening from Elizabeth Alexander the communications \ndirector for the first lady Jill Biden. She wanted me to edit an opinion piece that the first lady \nwas writing for Time magazine . I spent about an hour late at night doing it for her.sorry one \nsecond \nPRESS: Another hour long TikTok/Instagram session with young “influencers” who \namazingly have millions of followers; did 6 Regional TV hits at request of the White House: \nWSVN Miami with Lynn Martinez; WTVT Tampa with Craig Patrick; WTMJ Milwaukee \nwith Charles benson; DBI Radio with Rene Miller; Univision (National) with Janet \nRodriguez; Telemundo (National) Lourdes….;  MSNBC  with Andrea Mitchell;  CNBC \n“Closing Bell” with Sara Eisen and Wilfred Frost; CNN with Jake Tapper;\n \nAugust 20, 2021\nCases still increasing:\nReleased by Chairman Rand Paul\nI had a conversation today with the Minister of Health of Gabon – Dr. Guy Patrick Obiang \nNdong.  The purpose of the meeting was for me to give him an idea of how we handle COVID \nin the United states and to answer some of his questions particularly around the area of \nmisinformation and disinformation that has led to vaccine hesitancy which as it turns out is a \nmajor problem in southern Africa including his own country. We had a good conversation \nmoderated by Ms. Anne Soy, a journalist from BBC.  The MOH did not mention it but I'm sure \nthere is this feeling of concern that we are planning to give out third shot boosts at the same time \nthat Africa has very very little vaccine. I have explained on several of the TV shows and imprint \nthat the USA has already given more doses to LMICs then the entire rest of the world combined \n(see above). In addition, we plan to give hundreds of millions more and they are also working \nwith Peter Staley and the activists to provide major increases of doses to the rest of the world \n(see below ).\nThere is still ongoing controversy among some people regarding whether the idea about \ngiving a boost was justified by the data. I had a good conversation with Paul Offit who fields \nthat we may have jumped the gun. Vincent Racaniello has written in his blog that he does not \nthink that the boosters are justified. They are all waiting to see data regarding an increase in \nhospitalization as a result of delta and waning immunity. I still believe given the Israel data that \nboosters in their country are already showing a significant decreases in the number of \nbreakthrough infections that we did the right thing in making our decision. In addition, those \nwho object seemed to forget about the fact that short of hospitalizations a lot of people get \nseriously ill with symptoms and signs of long COVID that can be very troublesome. The \nboosters are safe and to put it in plain terms it can help, and it certainly cannot hurt.\nAugust 21, 2021\n184,000 cases today!\nAugust 22, 2021 (Sunday) – (no shows for me today – predominantly Vivek Murthy)\nHad a zoom call today with Jeff and the medical team planning how we can roll out the \nbooster situation putting all the pieces together with the FDA, the CDC, and the acip . We \nalso heard that FISA will get it's BLA on Monday August 23rd. One of the important parts of the \ndiscussion was my relating data that we have received from the Minister of Health of Israel. The \ndata clearly show that hospitalizations for people with two doses of vaccine are going up \nsignificantly particularly among the elderly and those with underlying conditions . In addition, \nthey are showing that the efficacy of two doses against infection and symptomatic disease has \ndramatically diminished, and when you give the third dose boost, this turns it around \ndramatically and diminishes the breakthrough infections. These data are well ahead of the \nsomewhat disjointed data from the CDC. However what it does do is_that we are correct in \nasking for boosters essentially for everyone. \nReleased by Chairman Rand Paul\nIn addition, I am going to pursue with calls to Peter Staley and others (Krellenstein and \nBarr) as well as a follow up call with Jeff , David Kessler, and me to plan a more coherent \nstrategy about getting doses led by the United states to the rest of the world. The plan to do \nthis would be to increase dramatically the production capacity of the companies particularly \nmoderna even if we have to deal with Lonza directly since Lonza is a major multilocation \ncompany that is producing the vaccine for Moderna. Stay tuned.\nIn a follow up conversation with Jeff and David Kessler, Jeff was amenable to pursuing the \nplan of Peter and the activist group ; however, he wanted to make sure that we got the \nsituation with the Moderna booster straight before we started to go to war with Moderna to get \nthem to cooperate with us on the Lonza deal. I believe that Jeff is serious about this and we may \nin fact go that route once we get the approvals to use moderna as part of the booster plan. In this \nregard, Tom Frieden call me up tonight urging me to push ahead with the “nuclear option “a \nforcing moderna to cooperate in expanding capacity for the developing world. Tom feels that \nmoderna or a bunch of used car salesman and he does not trust them at all. He has stated , which \nis partially true, that they would be nothing without the NIH and the federal government. \nIn this regard, Beth Cameron from NSC wanted me to look over a summit plan for addressing \nthe global issue of COVID. I wrote back to her and emphasized that I feel strongly that the \nUnited states should take a PEPFAR-type approach in assuming any leadership role in getting \ndoses to low and middle income countries.\nThe Israeli data are emerging as extremely important since it is clear , as they are about a \nmonth and a half ahead of us and everything, that the vaccine efficacy is diminishing \nsignificantly overtime against infection and symptomatic disease. However, unlike the situation \nhere in the USA, the Israelis are starting to see a diminution in protection against hospitalization \nand death. This is exactly what we have predicted in our decision to move ahead with the booster \nprogram. Furthermore, the Israelis are starting to see a very positive effect following giving \nboosters to over 1,000,000 people in the sense that the number of infections have dramatically \ndiminished in association with the administration of the boosters.  \nAugust 23, 2021 – Global   USA\nBLA granted for Pfizer by the FDA!!\nI just did a site visit to the Department of State facility that does the screening for \ndiplomatic pouches and mail. This is the facility that has been screening my mail ever since I \nhad the anthrax scare with the power in one of my letters literally one year ago four days from \nnow. Brett Rowland arrange for me to go there to thank the people in the facility and to \nencourage them in their work. They were very grateful but I took the time to visit them and there \nwas the usual selfies galore. \nAnother important issue today was that we were told by Larry Tabak at the state department \nwanted us to remove any names of people in Afghanistan that we are interacting with through \nReleased by Chairman Rand Paul\ngrants or contracts from our public facing databases and websites. The reason for this is that we \nare concerned that the Taliban will use the websites to identify people in Afghanistan with \nconnections to the United states and would then assassinate them. It is very clear that things are \nnot going well following the withdrawal of U.S. troops from Afghanistan. The Taliban has easily \ntaken over the country and now we are having trouble getting Americans as well as Afghanistan \nallies such as interpreters out of Kabul safely. It's a very bad time for the Biden administration \nsince they are being severely criticized for not having the right intelligence capability to indicate \nto them that the Taliban would take over so quickly without allowing time for us to withdraw our \nown personnel in an orderly fashion. What we did was withdraw the military first thinking that \nwe would have ample time to withdraw diplomats and other personnel safely . Obviously this is \nnot the case and it is still a very tenuous situation in Afghanistan. \nPRESS: Podcast 70 Over 70; NPR “All Things Considered” with Mary Louise Kelly; \nPodcast “A Starting Point” with Mark Kassen and Chris Evans; PBS ”NewsHour” with \nJudy Woodruff; MSNBC “Peacock” with Mehdi Hasan;\nAugust 24, 2021 – Global     USA\nCases, hospitalizations and deaths (to a lesser extent) continue to soar.\nMore conspiracy theory like letters keep coming in from congressmen and senators trying \nto link us to the origin of COVID-19. This is an amazing and unbelievable waste of our time \nand has no bearing whatsoever on what we have actually done with that minor, minor  $125,000 \ngrant to the Wuhan institute of virology. It is totally mind boggling how they are distorting the \ntruth to try and distract from the reality of what actually had happened during the Trump \nadministration where he lied and underplayed the outbreak. \nStrange but not surprising thing happened as a result of several of the shows that I was on \nover the last 24 hours. On several of the TV shows I was talking mostly about the favorable \naspect of the final approval of the BLA for Pfizer. However, in one of the conversations someone \nasked when I thought we were to get back to normal. I gave the usual caveats but then went on to \nsay if we get as many people vaccinated as we possibly can as quickly as we possibly can we \ncould diminish the number of cases and if we get through the winter which will be complicated \nby influenza and other respiratory infections, then I believe we could get back to some form of \nreal normality by the spring of 2022. Much to my surprise I got a call this morning from Jeff \nclearly upset because the news media had jumped on that and said that Biden has been saying \nwe're going to get out of this soon and Fauci who knows what's going on is saying it's going to \nbe into next year. I am getting a little bit concerned, even though I understand Jeff's concern \nabout the distortion of a message for a political purpose, that we may be tailoring a message that \nis not totally aligned with the truth. In fact, I believe we would be very lucky if we're back to \nnormal by the spring of 2022. I told Jeff that from now on when asked to predict I will just say \nwe don't know. This might actually not go over very well with the press anyway, but that is what \nI will say. Of note shortly after my call with Jeff, Courtney Rowe called me up in a much more \nReleased by Chairman Rand Paul\nconciliatory manner saying she understands how these things get taken out of context and said \nthat she heard it a lot more the way I meant it; however, we really need to be careful that people \nwould be distorting our message. I agree with her. \nPRESS: CBS “This Morning” with Gayle King; NBC “Today”; MSNBC “Morning Joe”; \nTelemundo TV Hoy Dia with Adamari Lopez;\nAugust 25, 2021 – Global    USA\nCases continue > 120,000/day\nHad an extremely interesting Zoom meeting yesterday with the Israeli Minister of Health \nand several Israeli scientists.   The Israelis have always been about a month or so ahead of the \nUSA temporarily with regard to the dynamics of the outbreak, the percentage of population \nvaccinated, and their recent decision to provide booster shots as third doses first to their elderly \nand then to progressively younger people. On the zoom call that Danny Douek and Bob Seder \nhelped organize since Danny spent a year sabbatical in Israel, it became clear that's what we \nsuspected was actually true. On the call for the Israelis were: Nachman Ash, Minister of Health \nof Israel; Sharon Alroy-Preis – Director of Public Health Services for Israel; Ran Achitov – \nSenior Advisor to the Israel Prime Minister Naftali Bennett; Ron Milo – Weizmann Institute; \nBoaz Lev.  The Israelis were seeing a gradual waning of protection of the Pfizer vaccine over a \nfew months to the point of protection against infection and mild disease was dramatically \ndiminished after several months. Importantly, they found that the protection against severe \ndisease leading to hospitalization also significantly decreased. This latter point is extremely \nimportant because the data from the USA cohorts was suggesting that But did not definitively \nshow it. In addition, they gave booster shots to about 1.6 million people and have shown that the \nbooster shots dramatically reconstitute the protection against infection. clinical disease and \nhospitalization.  Furthermore, they found a decrease in the Ro strongly suggesting that the \nbooster also diminished transmission. These findings completely validate I would decision to \nbegin giving boosters here in the United States.  I briefed Jeff on this last night and we will \narrange an additional call with the Israelis including John Mascola, David Kessler, and others \ninvolved in our program. \nPRESS:  \nThe Times of Israel:\nHealth Ministry officials said to update Fauci \non COVID booster shot campaign\nToday, 9:02 pm \nReleased by Chairman Rand Paul\n•\nUS top infectious disease expert Dr. Anthony Fauci testifies before the Senate Health, Education, Labor, \nand Pensions Committee, on Capitol Hill in Washington, on July 20, 2021. (J. Scott Applewhite, Pool/AP)\nThe Kan public broadcaster reports that top Health Ministry officials, including director-general \nNachman Ash, held a virtual meeting with Dr. Anthony Fauci to discuss Israel’s COVID-19 vaccine booster \nshot campaign.\nThe report says that the Israeli officials updated Fauci, who is director of the National Institute of Allergy \nand Infectious Diseases and US President Joe Biden’s chief medical advisor, on figures showing that the \nthird vaccine dose provides increased protection against infection and serious morbidity.\nThe US is planning to begin administering booster shots next month.\nAugust 26, 2021 -   Global – 213,400,000/4,460,000; USA – 38,300,000/631,400\nCases still soaring\nThe people in the White House medical team are all excited now about the Israeli data, and they want \nme to arrange for resume between members of our White House team and our Israeli colleagues. I would \nbe happy to do this since I want them to appreciate the extraordinary data that the Israelis have. \nReleased by Chairman Rand Paul\nPRESS: Washington Post:  A science in the shadows\nControls on ‘gain of function’ experiments with supercharged \npathogens have been undercut despite concerns about lab \nleaks\nBy \nDavid Willman\nand \nMadison Muller\nAugust 27, 2021 – Global – 214,500,000/4,470,000; USA – 38,500,000/632,800\nJust as a follow up over the last days to weeks  - I continue to get attacked viciously by the \nfar right social media including FOX News. they are still dancing around the inappropriate \nconflating of gain of function research (See Willmann article above) and the origin of the virus. I \nam starting to get so annoyed by this that for the first time ever I'm seriously discussing with \nChristine the timeline not my stepping down from this ridiculously thankless situation that I'm in \n. I say that still knowing that it is very unlikely that I will do that. \nReleased by Chairman Rand Paul\nPOTUS slight mis-speak – Interesting situation arose today. We were in our pre brief for the \nWhite House presser that would take place in 1/2 an hour. In the middle of the pre brief , \npresident Biden called me up on my cell phone. He said he was in with the Prime Minister of \nIsrael and the Prime Minister was telling him that Israel will be giving their booster shot at five \nmonths. The president wanted to know what we were doing about that and were we following \nthe lead of Israel. I told him that we were sticking with eight months but since the ultimate \ndecision will be with the acip that they would likely give us the possibility of a range from six to \nnine months and so depending on the data, we would have the option of giving it earlier . \nHowever, for now we were sticking with eight months beginning on September the 20th. Very \nshortly after I said that the president got up and said that we might start boosting earlier perhaps \nat five months because the Israelis are doing that and he spoke to me about it. As one might \nimagine this created a flurry among the press and White House comms . The good news is that \neverybody in White House comms knew exactly what I said to the President and so it was just \none of those things that the President will say what the president will say (see below).    \nAnd has been wanting to get more closely involved in the data flow and information flow . In \nthis regard, he has asked me to see if I could get him more involved in the various meetings that \nwe have among the White House medical team . I have arranged that and we will have him join \nthe weekly meeting that Vivek organizers among the White House docs. In addition I have \narranged for him to visit NIH and sit down for a roundtable chat mostly but the people from the \nVRC. We did that today and it was interesting as usual since Eric is a very smart guy. \nPRESS:   TV and Radio for local stations: Black Information Network (Radio); Rolling \nOut (TV); The Root (Radio); Instagram Live with Geoff Edgers (Washington Post);\nWhite House plans to clarify Biden boosters \nstatement\nCaitlin Owens  (Axios)\nAugust 28, 2021 (Saturday) – \nZoom meetings with Jeff -  There is concern about sticking with the eight month projection for \nthe beginning of boosting. Jeff is adamant not to waver on the 8 month projection even though it \nis clear from the data in Israel as well as from the general knowledge that in Israel there is \nwaning of protection as early as five months. I will be on all the Sunday shows tomorrow and I \nwill have to walk a tightrope to stick with eight months on the one hand and leave the flexibility \nfor earlier than eight months on the other.\nReleased by Chairman Rand Paul\nThe intelligence community report on the origins came out and in some respects it was good \nnews in that they felt fairly confident that it was not a bioweapon nor that it was bioengineered. \nThey still left open the possibility that it could be a lab leak ; However, more elements of the \nintelligence community felt that it was a natural occurrence compared to the single component \n(FBI) who seemed to feel strongly that it was a lab leak , although this is based on no data at all. \nThe reaction to the report was rather typical with Bob Garry saying that he was pleased that it \nruled out bio engineering and David Relman making the incredible statement in a Nature news \narticle that he would like to see all of the records of the NIH in their dealing with Chinese \nscientists. Truly amazing! There is no doubt that he has an agenda here and that is unfortunate. \nAugust 29, 2021 (Sunday) – \nCases continue to surge   with increases in hospitalizations as well as deaths. The cases have \nbeen between 100,000 and 150,000 for several days in a row now. \n Thus far the piece by David Willman has not received much attention. It has only appeared \nonline and I expected it to be on the front page of the Sunday Washington Post and in fact it was \nnot there it is possible that the situation in Afghanistan as well as the horror of the upcoming \nhurricane Ida has pushed this out of the news. \nI will have to navigate all of the difficult questions today since the White House is putting me out \non all the Sunday shows. \nThe boosts that the Israelis are giving or having a profoundly positive effect on deminishing the \nnumber of cases that are severe . See below: \nIsrael: Two weeks after the third dose campaign, and for the past two weeks, there is a \ndecrease in the fraction of cases who become seriously ill https://bit.ly/3gKS7fY \nReleased by Chairman Rand Paul\nPRESS: CNN “State of the Union” with Jake Tapper; ABC “This Week” with Martha \nRaddatz; NBC “Meet the Press” with Chuck Todd;\nAugust 30, 2021\n>150,000 cases today\nDid podcast with American Muslim Health Professionals\nJeff continues to be frustrated with Rochelle.  she does not seem to have the control over her \nagency that Jeff would like to have her execute. He is frustrated that she doesn't tell anybody \nwhat's coming out in MMWR as if it were a private journal as opposed to what it really is - the \njournal of the CDC. In addition, Jeff is very concerned that she is out of touch with what goes on \nin the acip and in other various components that interact with the CDC. The other night I had to \ntalk him down from feeling like he had to let her go. I continue to have faith in her and that she is \na very good person but she is dealing with a rigid and secretive organization that has been that \nway decades before she arrived. \nPRESS:  Sinclair TV; TikTok with influencers including Grammy Award-winner (4X) \nJason Isbell;\nAugust 31, 2021 -   Global -216,900,000/4,500,000; USA – 39,100,000/637,400\nTrouble at the FDA.  Today it was announced that Marion Gruber and Phil Krause will leave \nCBER at the FDA. The reason being given is that they are upset that decisions have been made \nby acip and by the White House that should have been made first at the level of the FDA. This \nhas been superimposed upon the fact that the administration is having a hard time making a \ndecision about who the next FDA commissioner will be. There is pushback from some senators \nparticularly Joe Manchin (D-WV) against Janet Woodcock even though she should be the top \ncandidate. The loss of Marion and Phil is a big blow to the FDA. \nMore drama with the FDA CDC relationship.   Another late night call from Larry Horowitz \ntelling me that the CDC with Rochelle want the ACIP to discuss publicly data that might confuse \nthe issue since the FDA has confidential data that might change the direction of the discussion. \nSomehow or other the CDC does not fully appreciate that traditionally their ACIP working group \nwas allowed to discuss in private data related to a particular study, but they would not publicly \ndiscuss it until the FDA weighed in on it. As it currently is rolling out, Rochelle seems somehow \ninfluenced perhaps by Amanda Fine who is a CDC employee but who is the executive secretary \nof the ACIP. They want to publicly discuss data before the FDA weighs in with data that they \nhave that is confidential. Bottom line is that if the ACIP publicly discusses incomplete data, \nwhen the FDA weighs in with the confidential data it would cause a lot of confusion. This is \nReleased by Chairman Rand Paul\ndriving Jeff crazy and again he is on the verge of firing Rochelle.  Again, Jeff is asking me to \nhelp solve the problem by speaking to Rochelle and explaining to her why it is so important to do \nthings in the traditional format of giving the FDA the chance to make decisions about data before \nthe ACIP ways in with recommendations concerning those data to the CDC. I called up Peter \nMarks last night and Peter feels that the CDC and the ACIP are breaking tradition here and Peter \nfeels strongly that it is OK for the working groups acip to discuss data so  long as they do not do \nso publicly before the FDA opines from a regulatory standpoint.   \n PRESS:\nSeptember 1, 2021   Global – 217,600,000/4,500,000; USA – 39,300,000/638,700\nI spoke to Rochelle this AM.  I tried to explain to her the dilemma that we are in with this \ndisagreement between CDC /ACIP and the FDA where Jeff agrees that the acip should not opine \nbefore the FDA rules. Clearly, Jeff is expecting me to be the arbitrator here and fix this. Jeff is \nvery concerned that the acip will come out with recommendations contrary to what we had \nalready planned and what the FDA will allow and that this will make it look like we are “the \ngang that could not shoot straight “.   Rochelle feels that we are all going to be in the same place \nanyway but Jeff is concerned to the contrary.  Jeff asked me to broker a meeting between senior \nCDC and senior FDA officials to see if we can settle this dispute regarding the role of acip.  \nPRESS:  CNN “The Situation Room” with Wolf Blitzer\nSeptember 2, 2021 – Global -     USA - \nWeekly average 149,000 cases/day\nReleased by Chairman Rand Paul\nImportant reflection about “controlling the message” - I thought I would make this comment \nnow since it is something that has been ongoing for some time. It relates to the fact that this \nadministration particularly in the form of Jeff does not at all want to interfere with the science or \ndictate what the science should be saying. This is completely different from the interference with \nscience and the actual contradiction of science that was so rampant during the Trump \nadministration. However, in the situation where we came out with the statements that we should \nbegin boosters on the week of the 20th of September and at 8 months from the time individuals \nfinish their original immunization regimen, it is clear that the timing was not totally science \ndriven . It was logistically driven. In other words, we found out in late July that it was clear \nbased on the hint of what we were seeing here in the United States and what the Israelis were \nseeing that we would need to boost. From a logistics standpoint we could not begin to do that \nuntil September which would put it eight months following the time that the first people got their \nvaccination in January. And so the eight month timeframe was not based on any biological or \nclinical science. It was based purely on logistics. And yet whenever we have a discussion Jeff \ninsists that we stay with eight months because the science dictates that it is 8 months. That is just \nnot true. It very well may be and in fact it looks like it should be earlier, such as six months. The \nreason Jeff did not want to change or veer away from 8 months is that he did not want it to seem \nthat we were saying one thing on one day, and a week or so later we would change it, for \nexample changing from eight months to six months. I consider this a fixation on messaging \nwhich is really unnecessary. I would have said we chose eight months because it was already \neight months from the time that people got their first vaccination. Jeff was afraid that we would \nget criticized that we should have been doing it earlier if we switch from eight to six months. I \nwould have said what the truth was that we picked eight months at first because that was the \nlogistic reason and as soon as we found out that it was better to do it at six months we would \nthen change to six months. It is the truth and there's nothing wrong with that. \nImportant principals meeting today in the SCIF.  the meeting was led by Jake Sullivan of \nNSC . The subject matter was how the United states could take a leadership role in the global \nresponse to the COVID-19 pandemic. Specifically, the question arose about how we can get \nforeign countries including China and India to participate in the process of getting doses to low \nand middle-income countries. A number of the principals weighed in including Samantha \nPowers, Tony Blinken, and others. Although I have a keen interest in this concept and I have \nbeen discussing it in detail with Jeff and with Peter Staley and David Kessler, I did not \npreemptively make any comments since they did not ask me to. However, in the future I will \ngive my opinion as how we can best accomplish this goal. \nSept. 3, 2021 – Global    USA\nContinued tension between CDC /Rochelle and Jeff concerning the rollout of the booster \nprogram. The consistent problem is the concern that Jeff has that the ACIP might come out with \nsignificant variance from what we had planned. Jeff does not want to control the science , but he \nclearly wants to make sure that we do not have a garbled message. Going back over this in time, \nJeff wanted to get out a crisp message of what we will do with boosters because he felt that if we \nReleased by Chairman Rand Paul\ndid not, the country would say that we were behind the curve and that we allowed people to die \nwithout getting boosted. For that reason we put out the statement that we have a plan to boost. \nNow among some it appears that the White House and the medical team haver gotten ahead of \nthe science and the usual process , which actually is not the case. \nThe National Geographic documentary “FAUCI” came out yesterday at Telluride Film \nFestival.  I am understandably concerned that the radical right and others who hate me will \nconsider the film self-aggrandizing. However, it is very clear that I did not solicit this film. it \nstarted off as a film about HIV driven by Janet Tobias.  At the onset Glenda Gray and I were \nfeatured people in the film centered around HIV vaccines. When the producers that Janet met \nwith saw some of the filmed material they felt that it would be better to do a film about me \nfocusing on the concept of “The Public Servant”.  When National Geographic took over, they \nmade it a very polished documentary which was not at all a hero worship of me but was a \nrealistic portrayal of the stress and strain and ups and downs of what I have been through with \nmultiple outbreaks, particularly HIV and COVID. Having said that the film will likely be praised \nby many but also used by some to continue to attack me. Such as life.  \nParticipated in “The European House” Ambrosetti Conference in Lake Como (virtually) \nwith panelists Kai-fu Lee, Stephane Bancel and moderated by Mariya Gabriel\nDifficulties setting in with the booster rollout.  As I suspected it is not going to be a smooth \nrollout of all three companies being able to provide boosters by September the 20th. One of the \nkey obstacles has been Moderna who is insisting on making their booster dose 50 micrograms. \nGiven the fact that everything else has been done with 100 micrograms this will cause a delay by \nat least a few weeks for the rollout of the Moderna product. Therefore, this will lead to a \ndisjointed program.  Jeff is not happy, but it is what it is.\nPRESS: Podcast with Andy Slavitt; Canadian Broadcast TV; MSNBC with Chris Hayes\nSeptember 4, 2021 – Global -    USA – 39,800,000/644,800\nStill a fair amount of confusion and concern about the rollout of the booster program. \nDavid Kessler comes down hard on the fact that the ACIP cannot be out of sync with the FDA. If \nthe FDA says that boosters are OK for people 18 and older, David feels it is not appropriate for \nthe ACIP to restrict it to 65 years of age and older. Obviously, Jeff is upset by what has gone on \nsince this is what he has tried to avoid. \nSeptember 5, 2021- Global   USA\nVery nice thing happened tonight. Jeff called me by phone just to thank me for everything that \nI am doing. He read the transcripts of my appearances on the Sunday shows and wanted to tell \nme how grateful he was for the fact that I've been doing this for such a long time, much longer \nthan any of the others , and he thought that it would be important for me to know that everybody \nappreciates what I'm doing. \nPRESS:  CBS “Face the Nation”; CNN with Jim Acosta\nReleased by Chairman Rand Paul\nSeptember 6, 2021 - Global    USA\nJeff brought over my house this evening the POTUS speech for Wednesday to have me \ncheck for any issues or inaccuracies.   I made a few edits, but nothing substantial.\nSeptember 7, 2021 – Global    USA\nCases  averaging >150,000/day.  \nGoing back and forth with FDA (Peter Marks) about whether  there will be enough safety \ndata on young people to justify boosters for everyone.   Peter is aligned with me. I feel that if \nthe safety data holds we should definitely give boosts to everyone at every age. I do not believe \nthat you have to show a diminution in protection against hospitalization in order to trigger a \nbooster. No way in a clinical trial would you require hospitalization to be a primary endpoint. \nWe need to prevent symptomatic disease in everyone as well as preventing the spread of \ninfection. That is why we need a booster for everyone . I have said it before , and I will say it \nnow that I feel the proper regimen for COVID-19 vaccinations should be a prime followed in \nfour weeks by a boost followed and five to seven months buy a third shot boost. \nPRESS: CNN “New Day” with Jim Sciutto; NPR “Morning Edition” with Rachel Martin; \nLa Stampa (Italian TV); New York Times Podcast with Apoorva Mandavilli\nSeptember 8, 2021\nI had an interesting visit today in the Oval Office with President Biden. I was there to brief \nhim about the mu variant as well as to go over his six-point speech that he is going to be \ndelivering tomorrow. Clearly, President Biden is troubled by getting the right message to the \nAmerican people. He is concerned that people would be under the impression that we will never \nget out of the oppression of this pandemic. And so, he struggled with the words in his upcoming \nspeech which I had the opportunity over the last few days to help edit. He was struggling with \nthe issue of how we can say that the unvaccinated people or an impediment to where we want to \ngo without discouraging the vaccinated people from feeling that even though they are vaccinated \nthey are powerless to be able to lead a normal existence so long as the unvaccinated people are \ncontinuing to propagate the spread of the virus. I suggested to him that instead of saying that the \n25% of the population that are unvaccinated are hindering the 75% of the population that are \nvaccinated , he should focus on the fact that the unvaccinated people are not harming the \nvaccinated people physically but they are preventing us from returning to a normal life which at \nthe end of the day is a negative issue for the 75% of the population who are vaccinated. It is a \ncomplicated message, and he is struggling with it . I am convinced that he is an extremely \nsincere and good person who wants to do the right thing. \nSeptember 9, 2021 – Global – 222,400,000/4,600,000; USA – 40,500,000/652,500\nReleased by Chairman Rand Paul\n>160,000 infections today\nPresident gave his national speech today on the 6th part plan to combat the delta variant. As \nmentioned above I played a role and editing his speech and in discussing yet with the president \nhimself yesterday as well as with Jeff and the White House team. \nPRESS:  Podcast with David Rubenstein; Fireside chat with The Boston Globe; NBC \nNightly News with Lester Holt; PBS NewsHour with Judy Woodruff; CNN “AC360” with \nAnderson Cooper; \nSept. 10, 2021\nPRESS: NBC News Now (Online TV) with Savannah Sellers; Regional TV -Raleigh-\nDurham (Jonah Kaplan); St. Louis (Cory Stark); Little Rock, AR (Mitch McCoy); “The \nSkimm (Alex Carr); Politica Ya Unvision (TSi-Tsi-Ki Felix); Telemondo (Julio Vaquiero)\nGreat review of the documentary “FAUCI”:\nThe Heavy Burden of Being Dr. Anthony Fauci\nMISGUIDED HATE\nThe new documentary “Fauci” follows the infectious-disease expert—the COVID-19 adviser to Trump \nand Biden—throughout the pandemic, probing his deepest thoughts and fears. \nNick Schager\nUpdated Sep. 10, 2021 5:28AM ET / Published Sep. 10, 2021 4:51AM ET \nReleased by Chairman Rand Paul\nNational Geographic for Disney+\n“It reduces my trust in humanity” is how National Institute of Health (NIH) nurse and bioethicist Dr. \nChristine Grady describes her feelings about the abuse heaped upon her husband, Dr. Anthony Fauci, in \nFauci. \nFor those who’ve grown frustrated with their unvaccinated fellow citizens’ egotism, stupidity, and \nrecklessness, it’s a familiar and relatable sentiment, and one that colors John Hoffman and Janet Tobias’ \ndocumentary (in select theaters Sept. 10) about the director of the National Institute of Allergy and \nInfectious Diseases (NIAID) and chief medical adviser to President Joe Biden. Driven by interviews with \nFauci himself, it’s an insightful portrait of a man who’s dedicated his career to helping solve some of the \nworld’s most serious disease-related crises, as well as a celebration of the selfless courage, compassion, \nand open-mindedness of a physician who’s stood tall in the face of unjust vilification and threats.\nTucker Carlson, Laura Ingraham, and Lou Dobbs (remember him?) all appear in Fauci, slamming the \ndoctor in various disgusting ways and, in the process, stirring up opposition to the very figure most \nresponsible for guiding the nation through the ongoing COVID-19 pandemic. When Fauci describes \nrecently opening an envelope that covered him in white powder, and the immediate thoughts that ran \nthrough his head—is this a hoax, anthrax or ricin?—Hoffman and Tobias’ film underlines the constant \nand immediate danger that Fauci is now in, thanks to a percentage of the population that views him as \nthe embodiment of both the pandemic and the social restrictions required to mitigate it. He’s at the \ncenter of a Republican-led maelstrom born from ignorance and insanity, and as he remarks about the \nglobal catastrophe that’s still unfolding, “I think we’re going to get through it, but we’re going to get \nthrough it in spite of this divisiveness, and this politicization. We’re not going to get through it because \nof it.” \nFauci’s opinion is offered up in the context of Fauci ’s look at the 1980s-1990s AIDS crisis that consumed \nthe doctor, and which was finally wrestled under control via a combination of good medicine, staunch \nReleased by Chairman Rand Paul\nactivism, and two opposing sides learning that collaboration was more productive than combativeness. \nPeter Staley and other AIDS activists from that era speak candidly about their fight for AIDS attention \nand action, primarily through the Larry Kramer-led AIDS Coalition to Unleash Power (ACT UP), which \naggressively made noise in public and scientific spaces in order to oppose prejudice and demand help. \nConvinced that the government wasn’t doing enough to research and treat the fatal disease—which was \nlargely decried as an affliction that plagued only gay men and women—they saw Fauci as a bureaucrat \nwho didn’t care about the sick and the suffering, and castigated him accordingly.\nAs Fauci himself explains in a lengthy interview that forms the core of Fauci , he heard that \ncondemnation but soldiered on anyway. Breakthroughs regarding the identification of AIDS as a virus, \nand how to effectively stymie its growth through a cocktail of drugs, were earned through countless \nhours of work, and in an environment that became increasingly hostile thanks to the fury of those who \nwere losing loved ones to the disease, and vehement that more could be done to save them. In what \nwould be a turning point in the AIDS fight, in Fauci’s life, and in the history of medical science, Fauci \nchose to listen to those voices, attending an ACT UP meeting where he went toe-to-toe with his critics, \nand then speaking on their behalf at a 1990s AIDS conference in San Francisco. In doing so, he charted a \nnew course in which the experiences and input of subjects were taken into greater consideration during \nclinical trials.\nFauci makes plain the parallels between Fauci’s “bookending” battles against AIDS and COVID-19, along \nthe way depicting a man who’s given his life to the investigation and treatment of the world’s worst \nailments. Sandwiched in between those two all-caps epidemics were his clashes with SARS, Swine flu, \nMERS and Ebola, against which he led the charge. In a telling moment in Hoffman and Tobias’ non-\nfiction biopic, Fauci says that he sought to destigmatize Ebola by hugging recovered patient Nina Pham \nat a press conference, and such leadership-through-example is again seen in a late clip of him receiving \nthe COVID-19 vaccine on a stage in front of cameras. Time and again, the individual presented by the \nfilm is one who puts others first and takes risks in order to guide and reassure the American public.\n“Time and again, the individual presented by the film is one who puts others first and takes risks in order \nto guide and assuage the American public.”\nHe’s also a scientific titan who, having served as adviser to seven presidents (beginning with Ronald \nReagan), isn’t afraid to deliver unpleasant truths that many—including his bosses—don’t necessarily \nwant to hear (or, at least, don’t want to hear said into a microphone). Clips of Fauci ruffling Trump’s \nfeathers by pushing back on his hydroxychloroquine nonsense, and setting out a realistic timetable for a \nvaccine, reconfirm this point, painting him as an honest, candid grown-up in a milieu that’s full of self-\ninterested officials who’d prefer to tell people what they want to hear. It’s clear that he’s made mistakes \nover the course of his tenure; The New York Times global health reporter Apoorva Mandavilli highlights, \nfor example, Fauci’s confusing mask messaging. Yet the fact that Fauci has now been labeled all manner \nof undeserved things by right-wing anti-science loons—at great emotional cost to him, his wife \nChristine, and their three daughters—only accentuates his bravery, resilience, and staunch adherence to \nreason and evidence.\nReleased by Chairman Rand Paul\nSince no amount of logical arguments, cajoling or bribery will change the minds of zealous conspiracy \ntheorists, Fauci probably won’t convince skeptics that the NIH bigwig is a paragon of public service. \nNonetheless, through a mix of archival footage and interviews that smoothly segue between the past \nand present, Hoffman and Tobias’ documentary proves a tribute to a legitimate national hero, one \nwhose ambition and resolve are as great as his empathy and thoughtfulness. Even when it skews a bit \ntoo heavily toward lionization, the lasting impression left by Fauci  is that we’re lucky to have this 80-\nyear-old man on our side.\nSept. 11, 2021\nIncreases in cases starting to taper.   Still 150,000-ish, but hospitalizations and deaths \ndecreasing slightly from prior week\n20th anniversary  of 9/11 - Multiple memorials occurring in New York , Pennsylvania , and at \nthe Pentagon. Starting with the president’s announcement of the six point plan yesterday, there \nhas been the expected pushback and objection from Republican congressmen and senators.\n In addition, There appeared yesterday in the publication “Intercept” a story about the typical \ngain of function issue regarding NIAID granting and the Wuhan lab. It resulted from the \npublication through FOIA of a progress report from the laboratory. It alluded to the possibility of \ngain of function . This created and expected firestorm of tweets that I had lied to the Congress \nand that gain of function actually took place and I covered it up. This has gained some \nmomentum in the fringe press but nothing at all from the standard press. \nSept. 13, 2021 – Global   USA\nAn article appeared today in The Lancet written by Phil Krause, Marion Gruber (FDA) \nand people from WHO.  It was a bit of a revolt on the part of the FDA and WHO who wrote in \nthe article that they do not believe there is enough scientific evidence to do boosters . This is \nclearly sour grapes on the part of the FDA who feel that they are being pressured to approve \nboosters. However, if they look at the data from the CDC as well as from Israel it will be very \nclear that boosters are needed and greatly enhanced the waning response from the original \nvaccine. Janet Woodcock is very upset that the FDA people did this without clearing the article \nthrough the usual channels. There seems to be a couple of camps forming now with one feeling \nthey should not be boosters , mostly because the developing world does not have easy access to \nvaccines. I have been stressing that it is possible to do both , namely, you can provide boosts for \nyour own citizens at the same time as providing doses of vaccine to low and middle income \ncountries. In this regard the USA is making major contributions to getting doses to the \ndeveloping world. This includes already distributing 130 million doses to 90 countries and \nproviding 500 million doses between now and the first half of 2022. In addition we have given \n$4 billion to CoVAX. Furthermore, I am working with Jeff and the White House to plan a \nPEPFAR-like program to get doses to the developing world \nReleased by Chairman Rand Paul\nPRESS: Taped “The Daily Show” with Trevor Noah – to air tomorrow; Newsy TV \nInterview; \nSept. 14, 2021\nModerna presented to us (Medical Team + other interested parties) their data on the open \nlabel study involving the crossover from their phase three trial.   Consistent with the data \nfrom Pfizer they see a waning of immunity particularly in association with the delta variant. This \nis another bit of data to argue for the booster program that we will soon roll out during the week \nof September the 20th.\nHad a very heated and intense Zoom discussion this evening with the medical team as well \nas people from CDC, FDA, and HHS -   Key players among many were: Peter Marks, Janet \nWoodcock, Rochelle Walensky, Amanda Fine (CDC), Stephen Cha, David Kessler, Vivek \nMurthy, Leslie Dach, et al.  The subject matter of the intense discussion was trying to align the \nFDA with the CDC in the interpretation of data from Israel regarding the safety and efficacy of a \nthird shot booster dose. It is clear from the Israel data that there is waning immunity across all of \nthe age groups not only for infection protection but also for protection against severe disease. \nThe sticking point is that if the FDA pushes for approval of the third booster shot for all ages \nthere is the question of a lack of a lot of data for safety among young individuals particularly in \nthe context of myocarditis. The CDC , particularly in the person of Amanda Fine, was very \nconcerned that the ACIP would balk at recommending for younger individuals the third dose \nbecause there was not enough safety data. As we all know Jeff is very much intense on getting \nthis approval through. I would imagine that he would be OK with the approval now of doses \ndown to around 30 or 40 years old with the stipulation that as soon as safety data comes in for \nyounger people, we could approve that for all ages. We will continue the discussions over the \nnext 24 to 36 hours. What was supposed to be 1/2 an hour meeting tonight turned out to be a 2 \n1/2 hour meeting. This subject is being intensely discussed throughout the community and into \nthe media. The people who were involved in the Lancet article discussed above we're actually \nshooting from the hip without knowing anything about the Israeli data. It will become clear that \nthey were completely off base as soon as the Israeli data becomes known to everyone. After the \nphone call I spoke to Jeff and explain what happened at the meeting. He seemed OK so long as \nwe don't stall on the approval. \nPRESS: MSNBC – “Morning Joe”; ABC GMA Instagram with Tony Morrison; CNN “The \nLead” with Jake Tapper; MSNBC – “All In” with Chris Hayes\nSept. 15, 2021 – Global – 225,700,000/4,600,000; USA – 41,400,000/662,600\nConfusion and controversy continues.   There is a lot of discussion in the media about whether \nor not there's enough data to make a determination about giving boosters and at what age level to \ngive them. The medical team feels pretty much in agreement that the FDA should approve \nReleased by Chairman Rand Paul\nboosters down to about 30 to 40 year olds and go the rest of the way down to 18 years old after \nwe get more safety data regarding myocarditis in the younger group. The media are having a ball \nin talking about imagined conflicts and disagreements between the FDA and the CDC. I keep \ninsisting that I feel that a third shot boost should be part of the standard vaccine regimen and that \na boost is not just the luxury but an integral part of the regiment. That is why I reject the concept \nthat if protection against hospitalizations remains stable but infection rate is not protected by the \nvaccine that everything is OK. I believe that infection with mild to moderate disease is \nsomething that we should do whatever we can to prevent not only because it disrupts individuals \nand society but because of the problem of long COVID.  The talking head docs on the outside all \nhave their own opinion, many of whom have not seen the data that we have seen.   The FDA’s \nVRPAC will meet on Friday Sept. 17 and then all will be settled\nPRESS: Radio One Atlanta 107.9 FM – Beyonce Alowishus; Univision Radio “Santo \nRemedio” – Monse Medina; El Show de Erazno y Chokolata\nSept. 16, 2021 – \nToday – 155,000 cases\nHad my every couple of weeks Zoom call with Chris Whitty (UK).   Oatrick Vallance is \nusually on the calls, but was not on today.  We discussed a number of items including the \ntension around booster shots that I have described above. The UK has decided that they will give \nboosters to everyone 50 years of age and older as well as to their health care providers and \nimmunocompromised. They are going to wait and observe before they go any younger than 50 \nyears of age also they will very unlikely be vaccinating children younger than 12 years old. This \nis in contrast to our plans to complete the clinical trials and vaccinate two as young as six months \nold . It is likely that we will have enough data to vaccinate children from 11 years old to five \nyears old by the middle to end of October into early November.  \nPRESS: Daily Telegraph – Nick Allen -print; Instagram with Jessica Waller; YouTube with \nRoland Martin “Unfiltered”; WTOP Radio with Mike Murillo\nKLN (Kaiser Health News):  \nHow Fauci and the NIH Got Ahead of the FDA \nand CDC in Backing Boosters\nBy Sarah Jane Tribble and Arthur Allen September 16, 2021 \nReleased by Chairman Rand Paul\nDr. Anthony Fauci, the nation's top infectious disease expert, and Centers for Disease Control and \nPrevention Director Dr. Rochelle Walensky are sworn in before testifying at a House Select \nSubcommittee hearing on April 15. (Susan Walsh-Pool / Getty Images) \nIn January — long before the first jabs of covid-19 vaccine were even available to most Americans — \nscientists working under Dr. Anthony Fauci at the National Institute of Allergy and Infectious Diseases \nwere already thinking about potential booster shots.\nThis story also ran on Los Angeles Times. \nA month later, they organized an international group of epidemiologists, virologists and biostatisticians \nto track and sequence covid variants. They called the elite group SAVE, or SARS-Cov-2 Variant Testing \nPipeline. And by the end of March, the scientists at NIAID were experimenting with monkeys and \nreviewing early data from humans showing that booster shots provided a rapid increase in protective \nantibodies — even against dangerous variants.\nSept. 17, 2021\nVery important decisions made today at VRPAC meeting. They voted unanimously to \napprove booster shots for people 65 years of age and older as well as those with underlying \nmedical conditions that put them at risk for severe disease as well as those with occupations that \nput them at risk for infection. This is going to be a very difficult communications challenge. We \njust got off a phone call with the medical team following the announcement of this decision by \nVRPAC. And it is clear that if you keep all these people in the loop even though it looks like it's \nvery restrictive you're gonna have about 80% of the population that are eligible to be vaccinated \nwill be getting that third boost. More later. \nReleased by Chairman Rand Paul\nPRESS:  Univision TV “Despierta America”; MSNBC with Craig Melvin; White House \nPress conference; \nSept. 19, 2021 \nWas on three Sunday shows today talking about the FDA decision (see below).  As expected \nall of the questions related to what was perceived as confusion between what the Medical Group \nand the president said versus what the actual outcome of the meeting of the VRPAC was. I \nexplained in all of the shows that we had always said that what we were talking about and what \nthe president was talking about was a plan to be able to roll out boosters starting the week of \nSeptember the 20th. We would be prepared to do it for everyone who is eligible. The fact that the \nrecommendation from VRPAC only included people over 65 years old and those from 18 to 64 \nwho either had an underlying condition that would give them a higher likelihood of severe \noutcome or individuals who because of their institutional or occupational status puts them at an \nincreased risk of infection . As mentioned above this constitutes about 80% of the population . I \nemphasized in my interviews that this was not the end of the story and that over the next several \nweeks two months we might see an expansion of the recommendation. Jake Tapper did ask me \nweather I had received a booster always planning to receive a booster. Since I did not want to \ngive away my medical history I was very vague in my answer saying only that I definitely will \nreceive a booster but he equivocated about whether or not I had received a booster. \nAlthough I was discreet and politic in the interviews, I still believe that the VRPAC got it wrong \nsince they do not understand that the end game is not just to prevent hospitalizations. However, I \nwill not push this , but I will let it play out. \nIsrael data keep coming in:\nReleased by Chairman Rand Paul\nPRESS:  NBC “Meet the Press” with Chuck Todd; ABC “This Week” with Martha \nRaddatz; CNN “SOTU” with Jake Tapper.\nSept. 20, 2021 – \nOver 2000 COVID deaths in USA yesterday\nI have to mention I had an extremely enjoyable interview with Bryant Gumbel (see below). \nI had not previously met him and I did not realize what an incredibly nice person he is. Just \nsaying. \nImportant day in the relaxation of prohibition on traveling to the United State.  It was just \nannounced that travelers from any foreign country can come to the United states provided they \nshow proof of vaccination and are tested within 3 days before getting on the plane coming to the \nUnited states and submit themselves to contact tracing if necessary. This news was widely \nwelcomed by countries such as the UK and others in the European Union. \nHad another important and somewhat contentious meeting with the medical team tonight. \nWe were discussing the importance of having the ACIP be aligned with what the decision of the \nFDA was from last week. Rochelle indicated that she believed that the ACIP would be aligned \nwith the FDA. However , in a friendly but firm manner, I challenged her and asked her what she \nherself would want to do and not to rely on being driven by the acip. The discussion went on \nuntil 10:45 PM. Jeff was again frustrated by the fact that he wanted Rochelle to lead the acip and \nnot to be blindly led by the acip. He felt this way because he wanted to have an organized non \nconfusing response to all of this. We all felt that we were in line until the meeting was over and \nLeslie Dach sent an email to Vivek and David indicating that Peter Marks from FDA just heard \nReleased by Chairman Rand Paul\nthat the CDC and acip we're not going to accept the recommendation of FDA about providing \nboosters for those who's occupational or institutional status put them at an increased risk of \ninfection. Peter got so frustrated that he said he will pull back that recommendation so that we \ndon't get into a fight with the CDC. e-mails below: \nFrom:  Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> \nSent: Monday, September 20, 2021 10:40 PM\nTo: Murthy, Vivek (HHS/OASH) <Vivek.Murthy@hhs.gov >; Kessler, David (HHS/IOS) \n<David.Kessler@hhs.gov >\nSubject: RE: READ THIS\nDefinitely!   This was exactly the point that I was worried about when I started off the \nconversation tonight saying that I was disappointed with what VRPAC arrived at and that I \nwould be even more disappointed if the ACIP restricted that even more. My fears are realized. \nIt looks like Peter is pulling back on the occupational and institutional exposure part in order to \nnot be in conflict with what he projects the ACIP will do. We should definitely discuss this.\nFrom:  Murthy, Vivek (HHS/OASH) < Vivek.Murthy@hhs.gov > \nSent: Monday, September 20, 2021 10:20 PM \nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>; Kessler, David (HHS/IOS) \n<David.Kessler@hhs.gov >\nSubject: Fwd: READ THIS\nWe should discuss \nSent from my iPhone\nBegin forwarded message:\nFrom:  \"Dach, Leslie (HHS/IOS)\" <Leslie.Dach@hhs.gov>\nDate: September 20, 2021 at 10:13:20 PM EDT\nTo: \"Zients, Jeffrey D. EOP/WHO\" <Jeffrey.D.Zients@who.eop.gov>, \"Murthy, Vivek (HHS/OASH)\" \n<Vivek.Murthy@hhs.gov >\nSubject: READ THIS\n \nGet Outlook for iOS\nReleased by Chairman Rand Paul\nFrom:  Marks, Peter <Peter.Marks@fda.hhs.gov >\nSent: Monday, September 20, 2021 10:10:30 PM\nTo: Cohn, Amanda (CDC/DDNID/NCBDDD/DBDID) <anc0@cdc.gov >; Berger, Sherri (CDC/OCOO/OD) \n<sob8@cdc.gov>; Walensky, Rochelle (CDC/OD) <aux7@cdc.gov>\nCc: Walinsky, Sarah (FDA/CBER) <Sarah.Walinsky@fda.hhs.gov >; Dach, Leslie (HHS/IOS) \n<Leslie.Dach@hhs.gov>; Tierney, Julia (FDA/OC) <Julia.Tierney@fda.hhs.gov >\nSubject: Follow up \n \nDear Rochelle, Amanda, and Sherry,\n \nBy report, it would appear that ACIP WG and others at FDA and CDC are not happy with giving boosters \nto healthcare workers and others less than age 65 at risk of occupational or institutional exposure.  I am \nnot going to fight over this, because I know that within two months they will be proven absolutely \nwrong.\n \nThough we have not yet finalized the language, here is where we are heading at the moment:\n \nA Pfizer-BioNTech COVID-19 vaccine booster dose administered at least 6 months after completion of \nthe primary series is authorized for use in:\n•individuals 65 years of age and older, and\n•individuals 18 through 64 years of age at high risk of severe COVID-19\n \nWill continue to keep you posted here.  Also happy to discuss. \n \nBest Regards,\nPeter\nSee e I believe this is a major mistake. See tomorrow's events below.  \nPRESS:   NPR radio “Morning Edition” with Rachel Martin; BBC World News TV with \nLucy Hockings; HBO with Bryant Gumbel; BBC Radio 4; NBC Universal Online “Top \nStory” with Tom Llamas; CNN “The Situation Room” with Wolf Blitzer\nSept. 21, 2021 – Global – 228,800,000/4,700,000; USA – 42,200,000/675,100\nDiscussions continue to go on trying to align the FDA and CDC.  Concern is mostly centered \naround the risk of myocarditis in younger individuals . We finally got the FDA agreed to agree \nthat their recommendation or authorization would be four people greater than 65 and then 18 to \n64 for people at risk for severe disease due to underlying conditions and 18 to 64 for people at \nReleased by Chairman Rand Paul\noccupational or institutional risk with the statement that 18 to 30 would be a permissive \nrecommendation meaning that they should consult their physician. This is something that the \nCDC Advisory Board (ACIP) could probably live with . However, we shall see what happens \ntomorrow and in subsequent days. \nJeff has been on the phone with me multiple times per day asking me to continue to mentor \nRochelle such that the CDC /ACIP does not veer too far off the FDA recommendations and our \nultimate intent. She is really very good and I love her but she just does not have enough \nexperience to steer CDC and the direction that we all feel let you go. \nI must make a point that over the last few weeks more intensively over the last few days I have \nbeen stressed beyond the limit particularly compounded by the dark web far right maniacs \ncontinuing to attack me in the area of gain of function research, accusations of lying to the \nCongress under oath, and a variety of other conspiratorial accusations.\nTonight I went to a reception at the temporary home of the British ambassador to the United \nstates on 2934 Edgevale terracet, northwest. it was an honor of Prime Minister Boris Johnson of \nthe UK and foreign minister Elizabeth Truss. It was a great reception and I got the opportunity to \nchat with the Prime Minister who clearly knew who I was and was very complimentary to the \nway I would have been leading the COVID-19 response effort in the United states we chatted for \na bit and I told him how pleased I was with the relationship that we had developed with his \nmedical people Chris Whitty and Patrick Vallance with whom I have a zoom call about every \ntwo to three weeks. \nThe next couple of days I'm going to be interesting to see how the situation rolls out with the \nbooster plan  \nSept. 22, 2021\nWe continue to have 2000 deaths per day !!!\nNice op Ed in the Post today. Written by Jeff and Tony Blinken announcing that the USA will \ndonate an additional 500 million doses a vaccine (Pfizer) to the developing world superimposed \nup on the 160 million those says they have already given 290 countries and the 500 million doses \nthat they will be distributing. The ultimate total will be about 1.5 billion doses with more to \ncome. \nWonderful e-mail from King Holmes.  See below:\nFrom:  King K Holmes <kkh@uw.edu> \nSent: Tuesday, September 21, 2021 5:04 PM\nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nCc: Wendy Wertheimer <wjwertheimer@gmail.com>; Virginia Gonzales <gonza@uw.edu>; Folkers, Greg \nReleased by Chairman Rand Paul\n(NIH/NIAID) [E] <gfolkers@niaid.nih.gov>; Elisabeth Gunningham <eg01@uw.edu>\nSubject: Thank you message from King Holmes, for Dr Anthony Fauci\nDear Tony,\nThank you so very much for taking time out of your busy schedule to record and forward that very kind \nand complimentary birthday video in time for my September 1st Birthday. I have been one of your many \nfans since the earliest days of the AIDS crisis. Your support via the NIH, especially in building our \nDepartment of Global Health, has enabled the University of Washington to have national and \ninternational impact in many ways. It is especially meaningful to have a trusted, respected, and talented \ncolleague like yourself offer such a wonderful tribute. I certainly return your regard, with much \nappreciation! \nAfter we received your video, I was telling my assistant about the days when you were taking on \nleadership at NIH, and how you appointed me to chair one of the new committees you formed. What a \nfantastic opportunity that was, and how many of my greatest friendships were begun and deepened in \nthose early days of the NIHAIDS initiatives for research, prevention, and treatment of HIV/AIDS and \nHIV/AIDS coinfections. It’s hard to believe that we have come so far in de-stigmatizing STDs and \nHIV/AIDS, and have successfully advocated for higher funding priorities at the national and international \nlevels for all such infectious diseases over the course of our careers. \nOn that note, I have also been following your work on the current pandemic with much interest and \ngreat respect. Your own career has spanned such a prodigious era of infectious disease research, from \nEbola to the current pandemic, and your reputation as a reliable, straight shooting, “scientist’s scientist” \nis fully deserved. You have navigated difficult political waters and public anti-scient biases with aplomb \nand at the NIH have kept a steady hand on the tiller as we navigated the most recent rise of an entirely \nnew pandemic virus, demonstrating principled and fact-based scientific rigor at every stage. Your \nexample serves to educate everyday citizens to the merits and reasonable expectations of science and \nthe scientific process, thus becoming an ambassador for science to new generations, as well as to a few \nolder ones – who seem to have embraced your wisdom with more than the usual enthusiasm Scientists \nengender.  New fans of yours now “Fauci” (i.e. lose the phone number of) a date who doesn’t wear a \nmask or refuses to get vaccinated.  Now that is a practical public health trend! \nI must admit that I have succumbed to the Fauci fandom that has (justifiably) arisen in your wake. A few \nmonths ago, I was proudly wearing my Fauci socks when my son, King Jr. came over to join me for a walk \n– and showed me his own Tony Fauci socks. Clearly, I have taught my kids (and grandkids) well. \nReleased by Chairman Rand Paul\nIn closing, I know that you have multiple demands on your time and attention, so I am exponentially \ngratified by the time you took to make my birthday greeting so memorable. You are a truly great human \nbeing, in addition to being a world-class scientist and public health leader.\nWarm regards,\nKing\nKING K HOLMES, MD, PHD\nDistinguished Professor Emeritus / Department of Global Health\nProfessor Emeritus / School of Public Health\nProfessor Emeritus / School of Medicine\nDirector Emeritus / UW/Fred Hutch Center for AIDS Research (CFAR)\nCo-Director Emeritus / UW Center for AIDS and STD \nUniversity of Washington\noffice: 908 Jefferson Street / 13th Floor, Room 1311 \nmail: HMC # 359931 / 325 Ninth Ave / Seattle, WA 98104\nphone 206.744.3620  /  fax 206.744-3694\nexec assistant: Elisabeth Gunningham / eg01@uw.edu \nkkh@uw.edu  /  globalhealth.washington.edu\nEveryone is tense about how things are going to turn out between the FDA authorization \nand the CDC recommendation. Jeff is very concerned and wants me to keep “mentoring \nRochelle about the fact that she needs to show leadership and letting the ACIP know how \nshe feels about what the recommendation should be. She seems reluctant to give any \nindication to them what you think should be done , thus leaving it totally up to them, where \nby she blindly follows their recommendation . This is driving Jeff, Larry Horowitz, and \nLeslie Dach completely crazy with frustration. They feel that she is showing no leadership \nqualities at all. I feel for her because I think she wants to do the right thing but he's very \ninexperienced in this role.   \nThe FDA came out with a decision that is inexplicable.   Checkout 3rd bullet that is no \ndifferent from the 2nd bullet:\n•individuals 65 years of age and older;\nReleased by Chairman Rand Paul\n•individuals 18 through 64 years of age at high risk of severe COVID-19; and \n•individuals 18 through 64 years of age whose frequent institutional or occupational \nexposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19 \nincluding severe COVID-19.\nNow we have a serious problem of how the CDC is going to interpret this regulatory approval . \nClearly there is strife within the FDA which lead to this completely confusing authorization. \nRochelle has her own problems with the acip who are not going to want to recommend anything \nfor people less than 30 or 40 years old.  What a mess. Let us see if in the long run we can make \nsome lemonade out of these lemons. \nPRESS: CBS Major Garrett “The Takeout”; Washington Post 202 Blog with Jackie \nAlemay\nSeptember 23, 2021\nHighly eventful day!!!   Today was the day that the acip would make their recommendation to \nthe CDC regarding the use of boosters. Inexplicably, they voted to allow boosters for people 65 \nyears of age or older, which is fine, as well as those from 18 to 64 with underlying conditions \nleading to severe disease, which is fine . However, they rejected the proposal to give boosters to \npeople who by occupational or institutional exposure would find themselves at high risk for \ninfection. There was absolutely no reason at all to do this since that would mean that a 25 year \nold person who was obese would get a booster, but a 55 year old school teacher or a 55 year old \nintensive care nurse could not get a boost. The rationale for the acip was completely \ndiscombobulated. It had nothing to do with safety since they were talking about policy that was \nunrelated to the scientific issues at hand . They got distracted and began talking about what they \nwere going to do with people who had Moderna as their primary regimen or J&J as their primary \nregimen, avoiding the fundamental scientific and public health question at hand. When I heard \nthis we began a series of phone calls, multiple phone calls, among me, Leslie Dach, Jeff, and \nVivek – all outrages by the recommendation. I texted Rochelle and I begged her to call me in \norder that I could explain to her how this would be a fatal mistake if she took the \nrecommendation of the acip since none of us would be able to defend this. It was a very dramatic \nsituation where she was in with the secretary and I was texting her late in the evening to please \ncall me so that I can tell her what I feel she must do. Jeff and Courtney Rowe and Ian Sams were \nsuggesting that I call up the secretary and give him my opinion. Things were getting very dicey \nsince the hours were going by and no decision was made. I finally got a chance to speak with \nRochelle and literally begged her to override that decision which was only a 9 to 6 decision and \nnot an overwhelming unanimous recommendation. The tweets that were coming in when they \nheard of the recommendation of the acip were absolutely overwhelmingly against that decision. \nYet Rochelle still felt she could not go against her committee. I pleaded with her over the phone \ntelling her that I would absolutely strongly defend her publicly if she made allowance for \nteachers and healthcare workers to get vaccinated even though they were healthy. Again, she \nseemed hesitant to overrule them. Jeff called me multiple times asking me to call the secretary \nReleased by Chairman Rand Paul\nmyself. I felt that I could not do this since it would be totally destroying Rochelle if I did that.  I \nexplained to Rochelle that if she does not do that she would be forever branded as someone with \nno leadership capabilities at all and if she did overrule them she could turn lemons into lemonade \nbecause she could reclaim her role as a leader since her reputation is one of unfortunately being a \nvery weak leader. I am dictating this at 10:00 PM on September the 23rd and she still has not \nmade her decision. I told her that I would be available all evening and the rest of the night if she \nwanted to talk. The whole team in the department and the White House is counting on my \ninfluence on her to get her to do the right thing here. I cannot understand why she is so reluctant \nto go against a 9 to 6 recommendation when the recommendation is so blatantly incorrect.  \nGood thing happened tonight - I received the 2021 Bill Foege Award for Global health \ntogether with Carlos Del Rio and Kati Kariko.  This was followed by a very enjoyable fireside \nchat with Bill. He is one of the true icons in public health and it was an honor to be talking to \nhim  \n PRESS:  ABC ONLINE Town Hall with Jennifer Ashston; Irish Radio RTE “This Week”; \nSept. 24, 2021\nAlas!   Rochelle listened to me.  She overruled the recommendation of the ACIP.  She actually \ncalled me last night at 11:25 PM and then a couple of minutes later to tell me that she had taken \nmy advice and overruled their rejection of the third bullet. Unfortunately David Awwad had put \na “do not disturb” between 11:00 PM and 5:00 AM on my cell phone and I missed her call. I \nthen texted her add 5 30 AM telling her that I was sorry that I missed her call. She texted me \nright back and we spoke by phone at around 5:40. I congratulated her on what she had done and \ntold her that she has now shown clear leadership as the director of CDC. Her recommendations \nare indicated below “\nCDC recommends:  \n•people 65 years and older and residents in long-term care settings should  receive a booster shot \nof Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary \nseries,   \n•people aged 50–64 years with underlying medical conditions should  receive a booster shot of \nPfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary \nseries,\n•people aged 18–49 years with underlying medical conditions may receive a booster shot of \nPfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary \nseries, based on their individual benefits and risks, and \n•people aged 18-64 years who are at increased risk for COVID-19 exposure and transmission \nbecause of occupational or institutional setting may receive a booster shot of Pfizer-BioNTech’s \nReleased by Chairman Rand Paul\nCOVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their \nindividual benefits and risks.\n \nPRESS: Breitbart: Fauci Defends NIH Funding Wuhan Lab: ‘Only Regret’ Is That It’s \nCaused ‘Such a Degree of Distraction’ – This was an interview that I gave to Major Garrett \non his podcast.\nSept. 25, 2021 -  Global -    USA – 42,800,000/684,900\nI had a wonderful evening this evening. Joan Baez and her son Gabe who were supposed to \ngo to New York City with Gabe's daughter Jasmine who wanted to go to a concert in Queens, \nNY. In addition, Joan was supposed to meet with officer Mike Fanone. For some strange reason \nofficer Fanone just dropped out of sight and did not meet with her. He's the officer who was \nbrutalized during the attack on the capitol on January the 6th, 2021. Really rather stange.  And \nso, Joan and Gabe were stuck in Washington and planning to fly back to California tomorrow. \nSince they had nothing to do she took a chance and called me up to see if I was free. I was, and \nwe had Joan and Gabe over the house for a pasta dinner. Gabe was constantly on the phone with \nhis daughter in Queens who was totally excited at the concert and kept calling him.  It was totally \ndelightful as Joan is such an extraordinary person. We had a wonderful time.  \nSept. 27, 2021 – Global     USA\nThings turning around with all parameters starting to come down even though things are \nstill bad:\nReleased by Chairman Rand Paul\nThere is now considerable confusion about exactly who should get the boost. We know what \nthe general categories are; however, when people ask exactly who within these categories should \nget vaccinated there is lack of clarity. For example, when you say people with underlying \nconditions, exactly what are those underlying conditions. It is found somewhere on the CDC \nwebsite, but it is very difficult to find and it does not very succinctly tell you what these \nconditions are. For example, of the underlying conditions we always talk about the fact that \nobesity is very importan in that regard . Yet, when you search for it, obesity is not in those areas \nthat are easily accessible. \nPRESS: CNN “The Situation Room” with Wolf Blitzer\nReleased by Chairman Rand Paul\nSept. 28, 2021\nYesterday was an important day during one of the zoom calls with the “TV doctors “, i.e. \npeople who are practicing physicians and public health people who regularly appear on TV \nshows.  I made it very clear that I was very much in favor of providing booster shots for virtually \neveryone who is eligible for a vaccination. I said to the group of perhaps 50 people , mostly \ndoctors, that the idea that only thing that you have to worry about with vaccines is keeping \npeople out of the hospital is a false narrative since there are many people who do not require \nhospitalization who suffer greatly from getting infected with the virus. I know that this is \ncontrary to the current recommendations of the CDC and the current authorization by the FDA . \nHowever, I believe that the judgment of who should get it was overly determined by an \nunderstandable consideration of the lack of doses for people in the developing world. In addition, \nthere is a concern about safety regarding myocarditis for younger people, mostly men; however, \nonce this is taken care of in my mind there is no reason not to vaccinate essentially everyone. \nThis becomes even more important since there is great confusion right now with the so called \ngradation and prioritization of who should get vaccinated regarding when and how. We are \ngetting a lot of blowback about this confusion which I totally predicted when I said we should \nmake things very simple. Anyway, I made my thoughts very clear to the group on this call. \nAnother important thing that is rolling out is that Rochelle is getting a lot of widespread \ncredit , which she deserves, about making a broader recommendation than the ACIP indicated. \nAs indicated above , she made this decision based on very intensive persuasion that I made to her \nlate at night before she actually made the announcement. \nJust a statement about things that have been evolving overtime.  There is a lot of discussion \nright now and scrambling about getting doses of monoclonal antibodies for people who get \ninfected. This is a major change from previously when monoclonal antibodies were underused. \nIn addition, I have not mentioned it but on a very regular basis, literally weekly, we brief the \ngovernors is on a governors's call; we brief the principles (cabinet members and others); we have \na zoom call with the physicians and public health people who are out there on the TV circuit (see \nabove) in order to keep them up-to-date as to what we are thinking ; and we briefed the President \nhimself. I do not take notes after each of these ; however it is important to mention that they \noccur on a very regular basis. \nNoteworthy is the fact that I had an extraordinary podcast interview for one hour with famous \nactor Alec Baldwin. He is an amazingly intelligent , funny, an extremely likable person who was \nvery much in tune with my history and my life and asked very penetrating and important \nquestions. Without a doubt, from a intellectual and substantive standpoint it was one of the best \nif not the best interview that I have ever given. \nIt was a good day for interviews in that my interview with Ed Yong for the Atlantic festival was \nalso extremely good. This is not surprising as Ed is one of the most impressive writers and \ninterviewers that I have ever met   \nReleased by Chairman Rand Paul\nPRESS:  MSNBC “Morning Joe” with Joe, Meka and Willie; NBC Nightly News with \nLester Holt; NBC with Lester Holt for “kids”; Interview with Ed Young as part of “The \nAtlantic Festival”; Podcast with Alec Baldwin.\nSept. 29, 2021 – Global – 232,600,000/4,800,000; USA - 43,200,000/691,500   \nHad a very tough and ridiculous interview with Hugh Hewitt. Hugh, who usually is a \nreasonable, albeit very conservative person, was extremely aggressive with me in an interview in \nwhich he kept insisting that people are not getting vaccinated because I am telling them to get \nvaccinated and strongly suggested that I step down and retire since I am the obstacle to people \ngetting vaccinated. He quoted a survey saying that middle to right people want me to retire and \nare not getting vaccinated because I'm the messenger telling them to get vaccinated. Truly an \nincredible train of thought on his part. He said we need fresh faces telling people to get \nvaccinated and if we had fresh faces then people would get vaccinated. I countered by saying we \ndo have fresh faces in the form of Rochelle Walensky and Vivek Murthy. And so does he \nconsider that although all three of us are saying to get vaccinated including two new fresh faces \nthat people are not getting vaccinated merely because I'm one of the three people telling them to \nget vaccinated?? I have never heard of a more distorted train of thought. \nThis conversation triggered in me some serious thinking about several things including when I \nactually would want to retire from the untenable situation that I am in of having 10s of millions \nof people hate me because I stand for the truth. Also, this nonsense about conflating the \ndiscussion about gain of function with the lab lead theory is preposterous and totally distracting \nand draining of everyone’s energy. Richard Ebright with his gain of function obsession is a total \nasshole who is pushing this theory because he “wants to be somebody”.  I am terribly \ndisappointed with Jesse Bloom and David Relman  for doing somewhat of the same thing.  they \nhave been pushing to stop any gain of function research for a long time and I believe that in \nsome respects they are pushing for an even hoping that this was a lab leak , which the molecular \nanalysis of the viruses that we used in the lab compared to the virus SARS-CoV-2 clearly \nindicate that it is molecularly impossible for the viruses under the auspices of the NIH grant to \nhave been manipulated into or evolved into SARS-Cov-2.  The opposition to me is part of the \n“big lie” – “Lock her  up”; Trump won the election; January 6th was really a friendly visit to the \nCapitol; “the China virus” and Trump was correct, “Fire Fauci” since he was wrong all along and \nso let's discredit him, and so on.  Quite frankly , I am finally coming to the realization that our \ndemocracy is truly threatened and that it is possible, even likely, that our democracy will \ncrumble with the 2024 election. If trump wins , we are finished . If trump loses, his far right \nlunatics will likely try again to overthrow the election. And with the attempts to have state \nlegislators (Republican) validate the electoral votes, I am really afraid that they might be \nsuccessful. Having said all of this, there is no way that I am going to retire before this \noutbreak is under control.    \nReleased by Chairman Rand Paul\nI continue to give regular interviews about every couple of months with Sheri Fink who is \ndoing a book on COVID-19. I am trying to stay out of any Trump versus Fauci discussion and \nfocus more on the evolution of the outbreak.  \nMatthew Memoli is turning into a real problem. He has written an email dated July 30th to \nme to Hugh Auchincloss and to Cliff Lane. The long and short of it is that he feels that \nvaccinating people is a bad idea even though he is the major proponent of challenge studies for \nvaccines. He believes that by vaccinating people we will be selecting for variants which in the \nlong run will be detrimental to the population. This is a little bit more sophisticated effort than \nthat of Scott Atlas. He has gone further than that, however. He has released the email to \ncongressional committees and to the press and now without a doubt he is going to be talking \nabout the fact that even though he is a clinical center employee he will refuse to follow the \nvaccine mandate that soon will be implemented at the NIH. In addition, he likely will go on the \nmedia spouting this extraordinary philosophy of his. I have made it clear to everyone that we \nshould not interfere in any way with what he is doing because without a doubt he will say that \nwe are trying to muzzle him and that will create more of a problem than the incredible nonsense \nthat he is spewing. It looks like we will just have to buckle down and let him proceed with his \ncraziness and hopefully he will not do a lot of damage to our attempts to get people vaccinated. It \nis inconceivable to me that he actually feels that it is OK to let everybody get infected just so that \nwe can get immunity where the virus is not selected for by vaccine induced immunity. Letting \npeople get infected has led to 680,000 deaths in the USA thus far.  How can he miss the fact that \nthe virus circulating within people who don't get an adequate immune response will lead to \nvariants just as easily as vaccine immunity-induced mutations. He just makes no sense at all. \nMatt Memoli has now gone completely rogue.   He is turning into a complete Scott Atlas (see \nabove). Not only does he think that we should not be vaccinating people, he believes that \nmandating is unethical because it's going to make matters worse vis-à-vis the immune response. I \nthought nothing could be worse than that, but now he's done something unbelievable. He has \ntaken a speech or an interview that I gave saying that although children statistically do much, \nmuch better than adults which regard to developing severe disease there are still (given the delta \nvariant) a significant number of children who get sick and hospitalized and in fact there are more \ndeaths among children from COVID-19 and there are after flu. He comes out now with an email \nto me saying that this is untrue and that there are more deaths by far with flu rather than COVID-\n19. In fact, he wants me to publicly retract my statement!!!!   However, what he is doing is that \nhe is looking at “estimated burden of flu” which is calculated with a model at the end of the year \nwhich is usually three times the amount of the “reported cases”. I was referring to the reported \ncases which are much less. And so, he seems to be out to make me look bad for reasons that I \ndon't understand except that he is a complete contrarian. He's an infectious disease person who \ndoesn't want to vaccinate people, who thinks mandates are unethical, and who is now telling me \nthat I need to retract statements that I've made. He's a junior member of the institute and he is \ntelling the institute director that I need to retract the statement based on information that he \nthinks is incorrect, but is correct. Unbelievable what I have to deal with!  We have decided that \nwe are not going to do anything with him; w are not going to approach him; we are not going to \nReleased by Chairman Rand Paul\neven talk to him about this since I know from my experience that if we do anything, he will say \nthat we were trying to muzzle him. As far as I am concerned he could say whatever he wants to \nsay, as crazy as it is, whatever he wants to say. Also he said that he is refusing to get vaccinated  \nThe problem with this is that the new rule from the federal government is that if he does not get \nvaccinated he is going to get fired unless he has a religious exemption. If it turns out that he \nwinds up getting fired, he will almost certainly say that it is retaliation.   \nPRESS:  Hugh Hewitt radio interview; NPR Radio “Here and Now” with Tonya Mosley; \nMSNBC – “Reports” with Andrea Mitchell; KLZ Israeli Radio;\nSept. 30, 2021 – Global  - 233,100,000/4,800,000; USA - 43,300,000/694,700  \nCases continue to gradually come down as do hospitalizations. Deaths, however, are still \nincreasing as a late indicator and lagging.\nJust had a great conversation with Shane Crotty of the La Jolla Institute of Immunology. I \nspoke to Shane because I wanted to find out his perspective on the immunological justification \nfor booster shots to the mRNA vaccines. Shane is a brilliant immunologist and gave me some \nterrific insights. He feels , similar to Bob Seder, that the antibody levels are very important in \npreventing initial entry of the virus and seeding of the virus in the upper respiratory tract. The \nhigher levels of antibody the more protection you have. They also taper off reasonably quickly \nleading to rather quick (months) waning of immunity to infection. However, he points out that B \ncell memory and particularly CD8 and CD4 positive T cells are absolutely critical in preventing \nsignificant disease in the lungs. These are longer duration than serum antibody.  This explains \nwhy protection against severe disease (lung involvement) seems to last long and wane less than \nprotection against infection (antibody that wanes quickly).  The thing he pointed out that is \ninteresting and important is that there is a reasonably longer period of time for people to develop \npulmonary involvement and severe disease since the T cells have enough time to protect the \nlung. When they fail then you get lung involvement and this usually takes some time which \nexplains the unusual finding of why it takes so long from the time a person gets infected to the \ntime they actually wind up in the hospital on a ventilator which is usually about 21 days. This is \nquite different from other acute viral infections in which the lung is quickly attacked and people \nwind up in the hospital within a couple of days. In addition, he spoke of the long durability of the \nT cell memory and B cell memory response indicating that protection against severe disease will \nactually last for a longer period of time whereas protection against infection tends to veer off \npretty quickly. It is right in line with what his pathogenic explanation is as described above. He \ndoes feel that giving a third shot boost is a good idea and that it likely will give a much longer \nprotection against both infection and likely would enhance the durability of the protection \nagainst severe disease in the lungs. We also discussed the situation of why in late disease you \nhave an aberrant inflammatory and immunological response. He believes it's a combination of \ninnate immunity mediated predominantly by monocytes and polys together with robust T cell \nReleased by Chairman Rand Paul\nactivity attempting to control virus which has made its way from the upper airway to the lung. \nSometimes this attempt to control the virus leads to so many inflammatory mediators combining \ninnate with adaptive immune responses that the effects is a profound pathogenic response that \nmay or may not be suppressed by anti-inflammatories and immune suppressors. \nA group of non USA scientists and others Whom I have never heard of Are trying to get rid \nof Peter Daszak at ecohealth . See PDF of letter immediately below :\nLetter to Nancye \nGreen.pdf\nI do not know who these people are but something strange is going on here.\nI met with Leslie Dach at my home this evening to discuss the situation of attacks upon me by \nfar-right elements. I gave to Leslie some reprints of papers that strongly favor the natural origin \nof COVID. We discussed strategies of how to stay ahead of this insidious campaign to discredit \nme. We feel that the best approach would be to lay low and not give it any more legs than it has. \nIn addition, Leslie spoke to me about how pleased he was about how I have mentored Rochelle \nWalensky. He also expressed concern about her lack of leadership capabilities and her total \ndependence upon professionals at CDC who Leslie feels are antiquated in their thinking and in \nmany respects are often incorrect. He referred to the experience he had with them when he was \nspecial advisor to Sylvia Burwell when Sylvia was Secretary of HHS. Leslie understandably has \nvery little respect for the CDC and in fact wants me to help to get Rochelle to start thinking for \nherself instead of depending so heavily upon her CDC team. Leslie also expressed some concern \nabout the lack of involvement of Secretary Becerra in the entire COVID effort. \nPRESS: Interview with Fast Company magazine\nOct. 1, 2021 – GLOBAL    USA\nWe have reached 700,000 deaths in the USA!!\nBig anti-viral drug advance.   Merck (Ridgeback) drug – Molnuvirapir (an RNA-dependent \nRNA polymerase inhibitor by inducing mistakes in the virus replication.  The CEO of Merck \nRon Davis  briefed us last about the results. They were striking. In a study looking at people with \ndocumented mild to moderate infection not requiring hospitalization at the time within five days \nof diagnosis were given either placebo or drug. In the placebo group there were 53 \nhospitalizations in the drug group there were 28 hospitalizations with a 7.3% hospitalization in \nthe drug group and 14.1% hospitalization in the placebo group. This led to a 50% efficacy with a \nP value of 0.001. There were eight deaths in the placebo group and zero deaths in the treatment \ngroup. This is really a major breakthrough in that it is another antiviral drug together with \nReleased by Chairman Rand Paul\nremdesivir that is keeping people out of the hospital. I am sure there will be more on this later. \nThe United states has already committed to buy 1.7 million doses for a price of $700 per dose  \nGave the 2021 Beatty Lecture of McGill University, “COVID-19:  Lessons Leaned and \nRemaining Challenges”, October 1, 2021, Montreal, Quebec, Canada (Virtual).  It was widely \nviewed throughout Canada and according to the organizers throughout the rest of the world. This \nwas followed by a Q&A which was very stimulating and a fireside chat with some of the \nstudents at McGill. A thoroughly enjoyable experience. It was associated with my receiving an \nhonorary doctorate from McGill \nWin over Jeff Zients's house last night with his White House team for a pizza and beer party . I \ncould only stay there for about 1/2 an hour because I had to leave for another dinner over the \nhome of Jeffrey Blount and Jeanne Meserve. I was impressed by the camaraderie among jeff's \nteam many people of whom I had never met since I only meet daily by zoom with the core \nMedical Group. Jeff was extremely kind in calling attention to my presence at the reception since \nI had to leave after 30 minutes. Eceryone gave me a round of applause.  Chris was with me and I \nintroduced her to all the people that I deal with among that larger group. After the reception, \nAndre our security person for the evening drove us the block and a half to Jeffrey and Jeanne’s \nhome where we had an interesting dinner and a conversation about race in America. Jeffrey is an \nAfrican American man and Jeanne is white \nPRESS:  Usual WH press briefing; CNBC “Closing Bell”\nOct. 2, 2021 – \nI had written an email to Robert Davis the CEO of Merck indicating to him that I was \nconcerned that in the press release for their drug Molnupiravir they did not mention that the \noriginal basic research was funded by NIH at Emory. Rob called me today (Saturday) and \napologized for that slight and promised that in future press releases they would include the \ncollaboration and contribution of NIAID /NIH. \nOctober 3, 2021 – \nGot a really nice note (see below) yesterday from Barney Graham thanking him for my support \nof him over the 21 years that he has been at the NIAID vaccine Research Center. of note he has \nwon a number of prizes already for his work on developing the optimum immunogen for the \nCOVID-19 vaccine . He has one the Albany prize as well as a number of other prizes. In addition \n, drew Weissman , my former fellow, has already won a number of prizes including the Lasker \naward. It will be interesting to see who wins the Nobel Prize this coming Monday.  \nThank you \nnote_Fauci .pdf\nReleased by Chairman Rand Paul\nWhile all of this is happening , I must comment that the country is headed to or might already be \nin a constitutional crisis with the far right clearly indicating that they're going to try and disrupt \nelections and essentially destroy the democracy. The attacks on me I believe are all a tangential \npart of that process . I speak of the big lie of which I unfortunately have been drawn into being a \ntarget of the far right because I represent something that is antithetical to them , namely, the \ntruth. It is stunning how much time is consumed on warding off the egregious lies about the \nNIID grant that funded hey small project in the Wuhan institute of virology. They claim that we \ncreated the COVID virus. Among the scientist who fall into this trap are the usual suspects of \nRichard Ebright  and David Relmann . However , Jesse bloom has really surprised me claiming \nthat a lab leak is highly probable when there is absolutely no evidence whatsoever that a lab leak \nhas occurred the only issue is that it occurred in a city that happened to have a laboratory that \nstudies bats. Amazing that he has come to this conclusion. \nPRESS:  ABC “This Week” with Jonathan Karl; CNN “State of the Union” with Dana \nBash; CBS “Face the Nation” with Margaret Brennan\nOct. 4, 2021\nVery interesting link showing the evolution of cases throughout the United states from the \nvery first months of the pandemic using a heat map approach:\nhttps://bit.ly/3uE40dF \nI participated in a zoom Q&A regarding the Columbus Citizens Foundation scholarship \nthat is given to an Italian-American medical student and that was given in my name as the \nFauci scholarship. The recipient was Danielle Rinaldi who graduated from Boston College and \nwho just entered the University of Virginia medical school. We had an interview with Danielle \nand I wished her luck in her career \nE-mail from Chris Whitty (UK) together with attachment bringing up important point about \npeople in vaccine clinical trials counting as “vaccinated” for “vaccine passport” purposes.\nFrom:  Whitty, Chris <Chris.Whitty@dhsc.gov.uk> \nSent: Monday, October 4, 2021 3:59 AM\nTo: Adomako, Melissa (NIH/NIAID) [E] < melissa.adomako@nih.gov>\nCc: chelsea.dickson@fcdo.gov.uk; Collet-Fenson, Luke <Luke.Collet-Fenson@dhsc.gov.uk >\nSubject: Participants in vaccine trials and international travel\nDear Melissa\nWould this be possible to pass on to Dr. Fauci?\nReleased by Chairman Rand Paul\nMany thanks\nDear Tony\nI hope all is good. \nWe have discussed very considerable concern we have about people who have taken part in properly \nregulated vaccine trials then not being able to travel because they are not counted as ‘vaccinated’ for \nsome countries. This is a major public health own gaol, because it is now proving a substantial \ndisincentive to people taking part in trials, or to withdrawing from them. \nWe think this is an easily fixable problem, but getting the international system to fix it is proving slow \nand difficult. A group of senior scientific and medical advisers to government in Europe has drafted a \nletter on this. I attach it for your interest, and in case you were also interested in being a cosignatory. \nBest wishes\nChris\n20210929 - DRAFT \nopen letter on immu        \nOn our usual weekly call with Secretary Becerra, we discussed the issue of getting many \nmany more testing kits for home testing out into the community. We are talking about hundreds \nof millions of tests which the Brits and others are doing to follow people particularly those with \nasymptomatic infection who may be spreading infection. This has been a weak point in the US \ngovernment approach for some time now. Although Carol Johnson has been the key person for \ntesting for the US government, it appears now that Tom Ingelsby is going to be playing a major \nrole.  this is also somewhat connected with the fact that the CDC is not really doing a very good \njob of screening for asymptomatic breakthrough infections among vaccinated people.  \nFrancis Collins told me a few days ago that he is going to announce his retirement on \nOctober 6th. I was one of the only people he told and we were hoping that it would not leak. He \ngave an exclusive interview to the Washington Post  to Lenny Bernstein and Carolyn Johnson. \nWhile I was on my walk tonight with Christine I got a call from Erin Banco from The Daily \nBeast. Ellen asked me if I knew that Francis was going to announce his retirement. I told her “no \ncomment”; she asked again and I said “no comment”. I immediately called up Francis and \nalerted him that someone had leaked it. He now has to make up his mind whether he's going to \nReleased by Chairman Rand Paul\nabort his plan of announcing it to the IC directors tomorrow and then making the announcement \non Thursday. The best laid plans ……. \nInteresting situation where Lindsey Graham mentioned to a group of Republicans that they \nshould get vaccinated and they boot him out of the room. Goes to show you how crazy the world \nis gone we have one of the most conservative Republicans gets booed when he tells far right \nRepublicans to get vaccinated \nPRESS:  CNN “At This Hour” with Kate Bolduan; Washington Times: Dr. Fauci: \nAmericans, especially those vaccinated against COVID-19, should enjoy Christmas\nOct. 5, 2021 – Case and hospitalization continue to come down; however less sharply down \nthan other surges\nHospitalizations and cases continue to come down. Deaths still up somewhat as a lagging \nindicator. The big question that is being debated by everyone as we go into the fall is whether or \nnot we're going to have another surge as we get into the winter . I keep saying that that will \ndepend on whether or not we get vaccinated a large proportion of the 70 million people who are \nunvaccinated who are eligible to be vaccinated.  \nFrancis Collins retirement.   Francis and I tried to keep the announcement confidential until the \ntime when he wanted to announce it which was yesterday . However, as expected in Washington \nDC it leaked and all the press were bombarding me and others about comments. Justifiably and \nappropriately I gave glowing comments to the press. The leak was probably through \ncongressional staff after Francis notified the chairs and minority of the various committees. \nalthough I will miss Frances greatly , it is good that he is leaving now while the Senate is under \ndemocratic control and we have a democratic president . Otherwise it could be a disaster is the \nRepublicans take over the Senate whereby they would unlikely approve a good candidate. In \naddition it would really be a disaster if he stepped down on the Republican president particularly \nDonald Trump. I recalled in all of the interviews about his retirement that I had pleaded with him \nwhen he was trying to step down during the trump administration. I knew that if he did that \ntrump would hire an unacceptable person. Francis listened to me and waited until Biden became \nPresident and we had a Democratic Congress.  \n PRESS: ABC “The Breakdown” ONLINE with Terry Moran and Kyra Phillips; MSNBC \nPeacock with Zelinda Maxwell; \nOct. 6, 2021\nReleased by Chairman Rand Paul\nHugh Hewitt (see  below with PRESS) - As a follow up of the interview with me in which \nHugh Hewitt suggested that I stepped down, he has written an op Ed in the Washington Post \nsaying the same thing. It is extraordinary how he can blame me for everything that has gone \nwrong with the CDC the FDA and HHS. It is becoming very clear that this is part of a truly \nconcerted effort to discredit me. \nCall from Barbra Streisand. Barbra Called me on my cell phone today and they asked me \nquestions about her booster shot she and her husband James Brolin are going on a trip and they \nboth had two shots of Pfizer and was asking about whether she should get a boost. apparently \ntheir antibody levels are not particularly high and she was concerned about boosting since she \nwas a little bit confused about it. Since she and James are both older than 65 years old , I \nrecommended that they both get boosted. We had some fun on the phone joking about our \nmutual Brooklyn accents. It is always good to hear from her.  \nPRESS:Bloomberg TV with David Westin;\nOpinion: Is it time for Anthony Fauci to step \naside?\nOpinion by Hugh Hewitt\nContributing columnist \nToday at 8:00 a.m. EDT\nOct. 7, 2021 – Global – 236,000,000/4,800,000;  USA – 43,900,000/707,100\n102,000 case today.   All parameters continue to come down slowly\nMandates are working – 25% businesses, 40% hospitals and colleges serving 37% of students \nare using mandates\nThe nonsense still goes on regarding EcoHealth Alliance and the Congress probing as to \nthe gain of function issue. We now find out that Eco Health was late in the submission of a \nprogress report which showed some increased pathogenicity in a mouse model. There will \nReleased by Chairman Rand Paul\ncertainly be a conflation of their administrative failings with the proposal that many of the far \nright are pushing that the grant created the virus which as we've said multiple times is \nmolecularly impossible. However, anything that is even a minor infraction of that grant will be \nconflated with the issue of the origin of the virus. In fact, Eco Health should have let the NIH \nknow that in some of the mouse experiments there was an increase in pathogenicity associated \nwith the chimeric virus. However what people will not appreciate is that even with that increase \nin pathogenicity, the experiment and the result still does not fall under the category that would \ntrigger P3CO.  In other words, According to the operable definition of gain of function of \nconcern at the time, this was not gained a function of concern. Namely, it was not an experiment \nthat would increase the transmissibility and pathogenicity a virus that would likely cause \nwidespread transmission and morbidity/mortality IN HUMANS. Some people may not like that \ndefinition under which we were operating, but that is the definition that was established by \noutside groups after a 3 year deliberative process. As I have said in the past if they don't like the \ndefinition then they should change the definition. However, what was done was done according \nto the existing definition at the time.   \nPRESS: Gray Media  TV “Full Court Press” with Greta van Sustern;\nOct. 8, 2021 -  Global – 236,600,000/4,800,000;   USA – 44,100,000/708,800\nHatred on twitter!!  I have not been commenting on this in my daily notes . However, the vitriol \nand outright hatred towards me by the far right on Twitter is accelerating and is really \nextraordinary. Greg Folkers describes it as a cesspool of hate against me. This is amplified by the \nFox News network who uses every opportunity particularly with Tucker Carlson, Sean Hannity, \nand Laura Ingraham who almost every night say something about me that is a total lie and would \nunder other circumstances be extremely libelous. This is part of the total movement of the “big \nlie”.  CNN with Don Lemon last night showed clips of former Vice President Pence, Minority \nLeader Kevin McCarthy, Minority Leader Mitch McConnell, and Lindsey Graham condemning \nformer president trump for being the instigating force behind the January 6th insurrection and \ninsisting that he be held responsible for this. Then Don Lemon fast-forwarded to their statements \nrecently in which they acted like January 6th never occurred. For example, former vice president \nPence said that January 6th was a creation and fabrication of the media . This is astounding that \nthese lies can be said without blinking an eye. I am concerned in some respects about myself \nand my safety even though I have security. However, I am even more concerned about \nwhether our democracy will survive. \nThere had been some talk that countries such as the UK, EU, and Israel we're allowing people \nwho have recovered from COVID infection to be considered as equivalent to being vaccinated \nand hence would be allowed to have a “green pass “. As it turns out that certainly is not the case \nfor the UK (see above – Chris Whitty) and recently Israel has also denied that that is the case for \nthem.  However, post-infection people will need 1 dose of vaccine for a green pass. The new \nReleased by Chairman Rand Paul\nmeasure will be introduced on the same date that anyone who has not received a booster shot six \nmonths after getting a second vaccine dose will have their Green Pass revoked.\nThere has been considerable disagreement and discussion about whether the delta variant \nis more severe in children compared to other variants . Certain studies showed that delta \nvariant appears to be more serious in adults compared to other variants; however, there is \ndisagreement about children. A recent study came out from the UK showing that severity of \nillness was similar in children who were infected with the alpha variant compared to the delta \nvariant . See link below: \nhttps://www.medrxiv.org/content/10.1101/2021.10.06.21264467v1.full.pdf \nAs booster discussions and disagreements continue, the Israeli data more and moire show that \nmy stance on boosters is correct. For example, it is becoming clear that boosters protect against \nthe waning immunity for infection and severe disease for individuals as young as 40 years old \nand not just for individuals who are 65 years of age and older . See recent paper in preprint \nserver: \nProtection Across Age Groups of BNT162b2 Vaccine Booster against Covid-19 Yinon M. Bar-On*, M.Sc., \nYair Goldberg*, Ph.D., Micha Mandel, Ph.D., Omri Bodenheimer, M.Sc., Laurence Freedman, Ph.D., \nSharon Alroy-Preis, M.D., Nachman Ash, M.D., Amit Huppert*, Ph.D. and Ron Milo*, Ph.D. *Contributed \nequally\nHad very successful leadership forum today. Somewhat sentimental since it is Francis Collins’s last \nleadership forum \nOct. 10, 2021 – Global    USA\nHad a rather slow relaxed day (Columbus Day holiday). Also Chris went to New Orleans to help \nMegan and Melissa move into their new home. I spend time reading in depth certain articles \nincluding the frightening article in the New York Times by Robert Kagan on the danger to our \ndemocracy. In addition I read a bunch of scientific stuff that felt good since I usually AM 1/2 an \ninch deep and five miles wide. \nI'm trying to put out of my mind the continual attacks by the far right dark web, Fox News, and \nthe lying senators and congressmen who keep harping on the gain of function nonsense. I'm \ntrying hard to not let it distract me, but it clearly is an organized assault on me \nPRESS:  CNN “State of the Union” with Dana Bash\nOct. 11, 2021\nOver the past few months and more intensively over the past several weeks there has been \nconsiderable discussion between Peter Staley, James Krellenstein, and David Barr and Jeff \nReleased by Chairman Rand Paul\nZients, David Kessler and me concerning the activists’ desire to get the federal government \nto pre-emptively increase the capacity of companies, particularly moderna, to make more \nvaccines for low and lower middle income countries. the activists want us to invoke the \ndefense production act (DPA) to force moderna to allow Lonza to increase their capacity for \nvaccine production for LMICS.  below is just one of a series of emails reflecting the frustration \non the part of Peter and colleagues with our inability to do that right now . What they do not \ncompletely understand is the complexity of the issues involved , although their ultimate goal as is \nmine is laudatory namely equity for vaccines for the rest of the world . See below emails :\nFrom:  Kessler, David (HHS/IOS) <David.Kessler@hhs.gov> \nSent: Monday, October 11, 2021 1:04 PM\nTo: Konyndyk, Jeremy (USAID.GOV) <jkonyndyk@usaid.gov>; Fauci, Anthony (NIH/NIAID) [E] \n<afauci@niaid.nih.gov>; natalie.h.quillian (eop.gov) <natalie.h.quillian@who.eop.gov>; \nJeffrey.D.Zients@who.eop.gov\nSubject: Fwd: Moderna, Racing for Profits, Keeps Covid Vaccine Out of Reach of Poor\nJeremey\nHow should I respond to Peter.   Seems like the discrepancy between what Covax and the activists are \nsaying is a key issue.   \nThAnks \nD\nSent from my iPhone\nBegin forwarded message:\nFrom:  peterstaley@verizon.net\nDate: October 11, 2021 at 12:46:40 PM EDT\nTo: \"Kessler, David (HHS/IOS)\" <David.Kessler@hhs.gov >, \"Fauci, Anthony (NIH/NIAID) [E]\" \n<afauci@niaid.nih.gov>, James Krellenstein <james@prep4all.org>, jeffrey.d.zients@who.eop.gov\nSubject: RE: Moderna, Racing for Profits, Keeps Covid Vaccine Out of Reach of Poor\n \nJames should know what COVAX is saying. From our view, if you don’t count the badly \nunderperforming vaccines, then we’ll need about 4 billion doses more than currently promised.\nAnd buying doses still matters, especially since we waited this long to look at manufacturing. I \nknow you got burned with Emergent, but J&J should be back in the mix at this point.\n \nCheers,\nPeter\nReleased by Chairman Rand Paul\nFrom:  Kessler, David (HHS/IOS) <David.Kessler@hhs.gov > \nSent: Monday, October 11, 2021 12:33 PM\nTo: Peter Staley <peterstaley@verizon.net>; Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>; \nJames Krellenstein <james@prep4all.org>; Jeffrey.D.Zients@who.eop.gov\nSubject: RE: Moderna, Racing for Profits, Keeps Covid Vaccine Out of Reach of Poor\n Peter\nHow many mrna doses to you want delivered to l/lmic countries by end of 2022 beyond what we and \ncovax/au have already contracted for?   What do you understand Covax to be saying the gap is?\nd\n From:  Peter Staley <peterstaley@verizon.net> \nSent: Monday, October 11, 2021 7:55 AM\nTo: Kessler, David (HHS/IOS) <David.Kessler@hhs.gov >; Fauci, Anthony (NIH/NIAID) [E] \n<afauci@niaid.nih.gov>; James Krellenstein <james@prep4all.org>; Jeffrey.D.Zients@who.eop.gov\nSubject: Re: Moderna, Racing for Profits, Keeps Covid Vaccine Out of Reach of Poor\n Adding Jeff. If you all had used the DPA to setup a GoCo factory with Lonza back in February, we’d be \ndelivering millions of doses of NIAID’s vaccine to low income countries right now. \n Instead, you still won’t talk directly to Lonza (even though", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: depending on the level of infection  in the community where they are living. Rochelle is really having a very tough time in  negotiating this with Jeff in the context of “her team” at CDC that seems to be operating in their  usual manner independently of running things by the White House. For example at the end of a  long and tortuous discussion about getting the wording correct in the new guideline, Rochelle let  us know that two days from now (Wednesday) the CDC will be coming out with an MMWR that  will overlap with what we have been wordsmithing for the guideline. Jeff and everyone else was  blown away that these two parallel things were going on and we did not even know about it. I  feel badly for Rochelle since she is dealing with an ingrained CDC system that has been that way …", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 7, "page_count": 1141}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 8 of 10)", "content": "their CEO has told us he’s ready to talk to \nyou) because you fear offending Moderna. \n Jeff, David, Tony—let me be frank. You all need to grow a pair. \n James will be sending an email soon suggesting we hash all of this out over good food and wine in DC \nsoon. I hope you’re all up for it. \n Peter\n Sent from my iPhone\n \nFrom:  Peter Staley <peterstaley@verizon.net>\nSent: Monday, October 11, 2021 7:28 AM\nTo: Kessler, David (HHS/IOS); Tony Fauci (af10r@nih.gov); James Krellenstein\nSubject: NYT: Moderna, Racing for Profits, Keeps Covid Vaccine Out of Reach of Poor\n Moderna, Racing for Profits, Keeps Covid Vaccine Out of Reach of \nPoor\nhttps://www.nytimes.com/2021/10/09/business/moderna-covid-\nvaccine.html\nReleased by Chairman Rand Paul\n Sent from my iPhone\nPRESS: CNN “The Situation Room” with Wolf Blitzer\nOct. 12, 2021 – Global  - 237,400,000/4,800,000; USA – 44,400,000/714,000\nSenator Rand Paul continues his assault on me. His latest rant is that I owe and apology to the \n100 million people in this country who he believes had been infected. He claims that I am in \nfavor of mandating that they get vaccinated even though they are now protected and so given the \nfact that recent data indicate that there is reasonably good protection following infection, now all \nthese people deserve an apology. I never said that they are not protected. I only said that they can \nbe more protected if they get vaccinated. Another example of his gross distortion of the truth.\nHad a Nice fireside chat but the Council on Government Relations talking about COVID-19 in \ngeneral. The people with whom I spoke were David Norton and Wendy Streitz \nPRESS: WJLA Locel TV “Corona Special” with Lindsey Mastis;\nOct. 13, 2021  - Global   USA\nDid a very enjoyable fireside chat with Rebecca Katz of Georgetown under the auspices of \nthe Smithsonian. \nBroad observation. The medical team and I have been struggling with this issue that is out there \npercolating. It relates to the fact that people who might not want to obey the mandate to get \nvaccinated are saying that if they had previously been infected that this should count the same as \nalready being vaccinated and so they should not be mandated to get vaccinated and they should \nnot lose their jobs if they are in a situation where it is required that should be vaccinated to work \nin a certain organization. Although there are much more data about vaccinated people people \nwho have post infection immunity comma it is in fact a legitimate question that they Are asking. \nThe idiots like Rand Paul as indicated above do nothing but aim their criticism at me as if I am \nthe person that's doing the mandates. However, despite that we still have to addressed this issue. \nThe medical team last night had a zoom meeting at 9:00 PM with some of the outside physician \ncommunity including Paul Offit, Peter Notez, Akiko Iwasaki, Mike Osterholm. We all agreed \nthat although those who were infected with post infection immunity have a point , we still must \nget people vaccinated since vaccination following infection give the highest degree of protection \nand we do not have a good handle on the durability and the breath of protection following natural \ninfection whereas we have much more information about those parameters following \nvaccination. \nOct. 14, 2021 – Global    USA\nReleased by Chairman Rand Paul\nI briefed the POTUS in the Oval Office today. As usual he was a little bit late. We were \nsupposed to have a briefing at 11:30 and it was not until after 12 that we started the briefing. The \nbriefing was with the usual group including me, Jeff, Natalie, Vivek, Rochelle, and marcella. The \nPresident was alone and not with the vice president . We briefed him on the status of the \noutbreak , on the booster situation, and I briefed him on the recent data of the successful trial of \nMolnupiravir as an antiviral agent . Recent data showed a 50% decrease in the likelihood of \nhospitalization and death compared to placebo. However, during the discussion the president \nbegan to philosophize a little bit about the stress that is on the country . He refers \nspecifically to a conversation that he had with Xi Jinping, President of China. Xi told him in a 45 \nminute conversation that he felt that democracies throughout the world are failing and given the \nneed to have rapid decisions about important items, a form of dictatorship works much more \nefficiently the democracy. He referred to the dysfunction in the United states Congress as a \nperfect example of this. President Biden and his discussion with us emphasized the importance \nof preserving democratic principles but did bemoan the fact that we do really have a \ndysfunctional situation in this country and trying to get things done in an expeditious manner. \nBiden showed during the discussion his empathy, his kindness, that is deep feeling about the \nimportance of democracy. It was a very interesting discussion. \nOct. 15, 2021\nHad a very nice zoom conversation with Raj Panjebi. He is the new director of the president's \nmalaria initiative (PMI). He set up a zoom call with me, Lee Hall, and several of his staff. He \nwanted to strengthen the relationship between NIAID and PMI based on the historically great \ninteractions that we've had over the years. He went out of his way to recognize that I played an \nimportant role in the creation of the PMI. I promised Raj that I would work closely with him and \nthe PMI to maximize the interaction and collaboration among us. \nMy staff wants me to lay low a little bit as we approach the Senate HELP hearing on November \n4 since there certainly will be a lot of fireworks with Rand Paul and others. I am going to be on a \nfew of the Sunday shows again this weekend and then after that I think I will be very selective in \nthe TV shows that I go on . The reason for this is that no matter what I say the far right will \nabsolutely distort it and make it into something political. It is striking that literally every single \nday I am criticized and attacked on social media, Fox News, and the tweeting of the far \nright including by people like senator Paul. The latest that trump is doing is putting signs up \nthat fouchy stole Christmas. This is based on a question that Margaret Brennan asked me on Face \nthe Nation a couple of weeks ago about whether I could predict what the outbreak would be as \nwe get into the winter I merely said that we really can't predict it will depend on how many \npeople get vaccinated. That got translated by the far right in that I was stealing Christmas from \nthem. Truly unbelievable nonsense  \nPRESS: Interview with NBC Health (print); \nOct.17, 2021\nReleased by Chairman Rand Paul\nImportant couple of days over the last few days. the booster data from moderna and J & J \nwere presented to the FDA . In addition, the mix and match data from NIAID were evaluated. It \nis going to be an interesting dilemma since the Moderna and Pfizer boosted J & J better than J&J \nboosted itself. It should be interesting to see how the recommendations come out. \nThe same old crap is going on with the far right continuing to attack me . The latest is a book \nwritten by an Australian person who says I'm the father of gain of function research with quotes \nfrom the infamous Richard Ebright saying that I'm a liar and I have misled everybody about gain \nof function. What a bunch of nonsense! The far right continues to try and discredit me. On a very \nnice interview that I had with Chris Wallace (see below), Chris asked me what I thought was \ngoing on concerning my being a very polarizing figure . I answered that it is not surprising that \nI'm a polarizing figure since I speak the truth and people who are lying , who are propagating \nconspiracy theories , and who don't admit the facts even when they're staring them right in the \nface uh certainly people who will be polarized against me since I stand for something that makes \nthem very uncomfortable and that something is the truth. \nChris and I went to a wonderful brunch over Adrienne Arsh’s home.  The brunch was in \nhonor of Christine LaGarde.  the typical Washington a list was there. It was a fun brunch since \nAdrienne is such a wonderful and generous person. I tend to shy away from these functions since \neveryone gathers around me wanting to take photos and telling me what a wonderful job I'm \ndoing. Even though this is something that is not unpleasant, I still am uncomfortable when \npeople call attention to me when I'm in a crowd. However they are all well meaning and I should \nfeel gratified that they do pay attention to me. \nPRESS:  Fox “News Sunday” with Chris Wallace; ABC “This Week” with Martha \nRaddetz; MSNBC with Alex Witt;\nOct. 18, 2021\nSad news today!! Colin Powell passed away due to complications of COVID-19.   He had been \nunder treatment for multiple myeloma.   He was vaccinated against SARS-CoV-2.   He died at \nWalter Reed Hospital.  I got to know him through social events.   He was always very kind, \ngenerous and gave me advice about writing my memoir.  Very likeable person.\nI received a call this morning from Dr. Jason Blaylock of Walter Reed hospital. I got to \nknow Jason from when he came over to the office and gave me an Army medallion for giving a \nlecture to Walter Reed. In addition, he was involved in the care of President Trump when he got \nCOVID. He wanted to speak to me to run by me exactly what he did in the treatment of Colin \nPowell to determine if I would have done anything different and if he had made any mistakes in \nthe treatment. It was a very humble reaching out to me by a very sincere physician who cared \ndeeply about whether he gave optimal care to General Powell. I went over with him each and \nevery step in detail from the time Powell entered the hospital to the time he died this morning. At \nevery single point in his care I had no problems or issues with the way he was treated or handled. \nI would not have done anything differently and I believe that General Powell received as good \nReleased by Chairman Rand Paul\ncare as he could have gotten anywhere in the country or the world. It was merely an example of \nan 83 year old man with an underlying malignancy , in this case multiple myeloma, together with \nParkinson's disease, chemotherapy for his multiple myeloma , as well as underlying \ncardiovascular disease and hypertension. He was given superb care and yet he still succumbed. \nHe had been vaccinated with the Pfizer product back in February but because of scheduling and \nother problems, he never received a 3rd booster dose which he should have gotten given his \nimmune compromised state. Bottom line is that I do not think anything could have been done \ndifferently. Doctor Blaylock indicated to me that they are already receiving a lot of negative \nsocial media by anti-vaxxers who are now saying that General Powell was vaccinated but he still \ndied; therefore, people should not get vaccinated. Typical anti-vaccine nonsense. \nHad a very productive conversation with my UK colleague Chris Whitty. There has been \nsome recent reports a mini-surge in cases in the UK. The UK is considerably under vaccinating \nchildren compared to the United States. In addition, they do not require that children wear masks \nin school. Chris mentioned that the surge is among children and that for the first time we are \nseeing transmission from the children who are infected in school to their parents and relatives \nwithin the household. This is very different from prior assumptions that children do not transmit \ninfection to adults. Chris thinks that this was true with the alpha variant which was not \nparticularly transmissible. However, he feels that with the delta variant and its high degree of \ntransmissibility that this is what we are now seeing. He gave us a heads up because the UK is \nusually about a month ahead of us in the dynamics of the outbreak. We may not be seeing this \ntype of a surge since we are pushing very hard to vaccinate children. In fact, next week the FDA \nwill look at the data from Pfizer on vaccinating children from 5 to 11 years old. One other point \nwith the UK is that they are not enthusiastic about mandating vaccination even though they are \ndoing well with having vaccinated about 85% of their population with at least one dose. \nOct. 19, 2021 – Global – 241.000,000/4,900,000;  USA – 45,000,000/726,000\nInteresting zoom with White House protocol staff today arranged by Jeff. The purpose of \nthe meeting was to get my input about how to restrict or not events and visitors to the White \nHouse moving forward . This is particularly relevant as we approach the holiday season and the \nprotocol people have to make decisions regarding holiday receptions, state dinners and tours of \nthe White House. It was an interesting discussion in which they relied on my judgment as to how \nrestrictive they should be regarding the size of the crowd, the requirement of testing, and the \nrequirement of vaccination. \nI have received a lot of honors over the last year and a half from a number of prestigious \norganizations . Unfortunately there are so many of these that it is very difficult to fully appreciate \nthem as they all seemed to pile up in a very intense time frame. However, last night I received \none that was particularly nice . It was the History Maker Medal from the New York \nHistorical Society which was associated with the fireside chat between me and my good \nfriend David Rubenstein.  As a special treat they had the Regis High School jazz ensemble \nplay music in the background in my honor  \nOct. 20, 2021 – Global  - 241,000,000/4,900,000;  USA – 45,000,000/728,000\nReleased by Chairman Rand Paul\nPRESS: NBC “Nightly News” with Lester Holt; CNN with Chris Cuomo\nAn example of the insanity out there making me the boogeyman for the extreme right.   \nThis is just one example of many:\n'You're crazy': CNN reporter tells off doctor to \nhis face after he says vaccines will result in \n'genocide' \nBrad Reed  \nOctober 19, 2021 \nScreen cap / CNN \nCNN's Drew Griffin on Tuesday conducted an interview with anti-vaccine Dr. Rashid Buttar in which the \ndoctor claimed that COVID-19 vaccines would result in a \"genocide\" worse than anything Nazi dictator \nAdolf Hitler did during World War II.\nDuring the interview, Griffin confronted Buttar for his past comparisons between Hitler and Dr. Anthony \nFauci, the nation's leading expert in infectious diseases.\n\"You think Dr. Fauci is involved in some kind of plot to kill millions of people?\" Griffin asked. \"I just want \nto make sure I understand this.\"\n\"Again, Drew, I'm a reasonable person,\" Buttar replied. \"I said it could be this, but I can tell you that Dr. \nFauci is not an innocent bystander. He is very well aware of what he is doing.\"\nReleased by Chairman Rand Paul\nLater in the interview, Buttar claimed that the majority of deaths from the delta variant of the novel \ncoronavirus were caused by \"vaccine injury,\" despite the fact that the vast majority of deaths came from \nthe unvaccinated.\n\"I don't want to be part of this mass genocide that I see happening,\" Buttar told him. \"And I think that \nwhat's going on right now will be remembered as a worst time in history compared to... World War II.\"\n\"I just want to be straight with you,\" said Griffin. \"I think you're crazy.\"\nOct. 21, 2021\nLarry Tabak, representing the NIH, released some progress reports from the EcoHealth \ngrant which were late in their submission. It indicated thatn mice became sicker than the \ncontrols and could be interpreted by some as “gain of function” even though it does not \nqualify for P3CO.  As expected, this led to an avalanche of extremists calling Larry, \nFrances, and I liars. This was all lead by the infamous Richard Ebright who made a tweet \nas shown below. I must write something about this complete idiot In my book since he \nreally is a horrible person:\nThe NIH received the relevant documents in 2018 and \nreviewed the documents in 2020 and again in 2021. The \nNIH--specifically, Collins, Fauci, and Tabak--lied to Congress, \nlied to the press, and lied to the public. Knowingly. Willfully. \nBrazenly.\nIn addition, a number of people: Mark Meadows, Sen. Tom Cotton and others are tweeting that I \nlied under oath\nPRESS: CBS :Mornings” with Gayle King;\nOct. 22, 2021 -  Global  -  242,000,000/4,900,000; USA - 45,100,000/730,000;\nLarry Tabak was treated very poorly by several Republican congressmen and senators that \nhe briefed yesterday. They continue to distort the truth insisting that I and to some extent doctor \nCollins have lied about whether or not the NIH funded “gain of function” research. They do not \nunderstand nor do they seem to want to understand that we were operating under the framework \nof P3CO which clearly indicates that the experiments that were funded by the NIH in Wuhan fell \nunder that auspices and were properly conducted according to the existing guidelines at the time. \nThey want to hear none of that and continue to insist that we are denying that gain of function \nresearch was done and they put forth the preposterous suggestion if not the strong indication that \nReleased by Chairman Rand Paul\nthe research that we funded created SARS-CoV-2. It looks like I'm going to have a tough time at \nthe hearing on November the 4th since they are clearly politically motivated and are doing \nanything to discredit me and the NIH. \nI had an enjoyable and productive discussion with the Minister of Health and Social \nServices of Quebec (Christian Dube and his chief medical advisor Horacio Arruda). The \nminister was very interested in my advice about where I think we are going with the outbreak \nlooking forward. He asked the question that many ask as to when I believe we may return to \nsome form of normality including when we can get along without wearing masks. I gave him the \nadvice I usually give to people emphasizing how importance the implementation a vaccine \nprogram will be in determining when a given country can get back tomorrow. \nPRESS:  MSNBC “Morning Joe”; CNN “New Day” with John Berman;\nOct. 23, 2021 Global – 242,300,000/4,900,000;  USA – 45,300,000/733,834\nThere was the typical but not unexpected backlash on the part of the far-right media \nconcerning the letter that Larry Tabak sent out concerning the progress report from \nEcoHealth that was late. In order to be totally transparent, Larry sent out a note to \nCongressman Comer saying that Ecohealth was late in submitting a progress report of their grant \nand mentioned in the letter that some of the mice in the study had an increase in viral growth and \ngot sicker. This was immediately taken up by the far right as proving that Fauci and Collins were \nlying when they said we did not fund gain of function research at Wuhan. They failed to mention \nthat in that same letter Larry made it very clear that the research did not rise to the scrutiny of \nP3CO. In other words by our definition, it was not gain of function. This set off a firestorm of far \nright media craze saying that Francis and I lied. Therefore, I spent the greater part of today, \ntonight and tomorrow morning putting together a statement for the NIH website to correct the \nmisrepresentation on the part of the far right media. \nOct. 24, 2021\nWe are finally getting the statement in shape to put on the NIH website (see above).  \nFortunately, I was on the Sunday TV Show this morning (see below) with George \nStephanopoulos where George gave me the opportunity to refute Rand Paul who will be saying \ntonight on HBO that I lied and that the President should fire me. I pushed back firmly on this \nduring the TV hit with George and in today's press including Rolling Stone and the Washington \nExaminer they accurately picked up my push back. This is turning into a continual conflict \nbetween me and the far-right Congressman and the far-right media. I will not back down to these \nridiculous accusations. \nReleased by Chairman Rand Paul\nPRESS:  ABC “This Week” with George Stephanopoulos\nOct. 25, 2021\nThere seems to be no end to the nonsense. No doubt there was a concerted effort led by a \ngroup that I'm not sure what it is but it likely is the Republican National Committee which \nliterally has squads of people looking out for anything and everything that I'm involved with and \nfinding some way to attack me. The latest that came out last night and today is the fact that there \nis apparently an NIAID grant that is testing a vaccine for leishmaniasis in dogs. It vaccinates the \ndogs and allows sand flies infected with leishmania to bite the dogs. It is now being billed as \nhorrific cruelty to animals directed personally by me. I have no idea what the grant is nor what \nthey are doing in the grants and I'm asking the staff to investigate that now but it has triggered a \nnew hashtag called #Arrest Fauci.\nWe know now that apparently the grant was not an NIAID grant that supported the controversial \nresearch on the dogs. They listed us as the grantee when in fact that was a mistake. We are trying \nto correct this now with a statement to the press. And the crap goes on and on ……..  \nNow they have begun harassing campaign where I am getting does is in dozens of calls on my \ncell phone using FaceTime from numbers that I do not recognize which are clearly people who \nnow have my cell phone number for harassing me about the Beagle study \nWonderful article by Dana Milbank in the Washington Post blasting the right wing for \nharassing me:  https://www.washingtonpost.com/opinions/2021/10/25/fauci-puppy-experiments-\nconspiracy-republicans/\nAnother great article by Pavlovitz (blog) again attacking those right wing elements for \nharrassung me: https://johnpavlovitz.com/2021/10/25/the-mortal-sin-of-anthony-\nfauci/?fbclid=IwAR3WZ4c5uvgNMye_1LH6JKD86rUReE37IJxJN1dbU5W3uE_crpYt-9RYyg8\nJeff called me up tonight in a very nice phone call. He said that he felt very badly that I was being \nattacked viciously by the far right and he said that he would do anything that he could if I needed any \nhelp from him . But he totally empathized with the fact that I'm being egregiously attacked by the far \nright. \nIn addition I had a very nice phone call with Chris Wallace of FOX News who called me asking some \nmedical advice about a trip that he wants to take to Oxford to lecture at the Oxford Union . I went over \nthe pros and cons and risk benefit of making such a trip . In the course of the conversation he \nempathized greatly with me about the attacks that I'm under by the far right and  he fully understands \nwhat is going on. \nPRESS:  See above link;\nReleased by Chairman Rand Paul\nCNN’s Reiner: NIH Funded Research That \nCaused Virus to ‘Gain Function’ But Fauci’s \nTestimony Is True Because That Wasn’t the \n‘Intent’\nOct. 26, 2021   -   GLOBAL – 243,600,000/4,900,000; USA – 45,468,434/736,048\n. It is so very clear now that this is a concerted effort to discredit me and assassinate my \ncharacter. We have counted the attacks regarding the Beagle dog experiments , but still the \nattacks continue falsely claiming that NIAID funded the studies. \nFDA VRBPAC met to discuss the data from the Pfizer trial in 5 to 11 yo children.   \nVRBPAC recommended approval and on Oct. 29, FDA issued an EUA for age group.   They \nreceived 10 micrograms instead of the full dose of 30 micrograms\nPRESS:   Fauci had no involvement in study on \nmonkey threat responses\nBy ALI SWENSON  2 hours ago\nAP\nOct. 27, 2021 – Global    USA\nAndy Slavitt is out there tweeting in my defense.  Yasmeen Abutaleb (Washington Post) Has \nagreed to write a story trying to uncover the source of this organized effort to discredit me period \nup to this point I have told her to hold back on doing any big story. However, I think the time is \ncoming very soon uh to do something about this unprecedented attack that I am experiencing. \nWe are getting bombarded by letters from Republican congressmen and senators (Ranking \nMinorities) on the various committees asking pages and pages of ridiculous questions that really \nhave no answers concerning our oversight of the Wuhan Ecohealth grant and demanding \nexplanation for things that really in many respects are trivial.  All of it is underscored by a strong \naccusatory tone in all the questions. One letter in question was 14 pages long from Cathy \nMcMorris Rogers addressed to Francis Collins. it contained the most miniscule details about \ntechnicalities of grants that was getting to the point that we did not have good oversight of the \nReleased by Chairman Rand Paul\necohealth grants and hence the strong implication that we may have supported research that led \nto SARS-Cov-2.  Absolutely preposterous !!! \nPRESS: NPR “Morning Edition” with Noel King; Spectrum News1 TV “Inside the Issues” \nwith Alex Cohen; CNN with Don Lemon\nHow Trump’s allies are still trying to insulate \nhim from blame for the coronavirus pandemic\nPresident Donald Trump waves to members of the media as he leaves \nthe White House to go to Walter Reed National Military Medical Center after he tested positive for the \ncoronavirus on Oct. 2, 2020, in Washington. (Alex Brandon/AP)\nBy Philip Bump\nNational correspondent\nToday at 10:30 a.m. EDT\nOn Tuesday, freshman Rep. Madison Cawthorn (R-N.C.) gave a speech from the floor of the \nHouse that was as furious as it was terse, as inscrutable as it was accusatory. Over the span of 64 \nwords, he called for the creation of a commission aimed at exploring the origins of \nthe coronavirus at the heart of the pandemic, called the country’s top infectious-disease expert \nAnthony S. Fauci a “demon doctor,” accused Fauci of lying to Congress, accused Fauci of having \na hand in creating the virus and suggested that Fauci was linked to “funding the torture of \npuppies in Africa.” It took 65 words just to summarize the claims, which should tell you \nsomething about Cawthorn’s succinctness.\nOct. 28, 2021 – GLOBAL – 244,385,444/4,961,489; USA – 45,655,635/740,348\nI had a long conversation with Yasmeen Abutaleb of the Washington Post yesterday . She is \ngetting very worked up about the fact that she realizes now that there is an organized effort to \ndiscredit me and she wants to use the investigative reporter capabilities of the Washington Post \nReleased by Chairman Rand Paul\nto try and find out if they can track funding for this effort to the Republican Party or to any other \norganization that is trying to discredit me. Let us see how this turns out. \nAnd Paul continues to look for trouble and this recently asked that the witnesses at the \nupcoming HELP hearing testify on the oath . He is obviously referring to me because he \nwants to be able to say that I lied under oath. Please see the letter that he wrote to me \nbelow :\n21.10.28 Letter to \nNIAID Director Fauci   \nPolitifact is trying to debunk the lies about me that are swirling around fast and furious about killing \ndogs, starting the AIDS epidemic and killing orphaned children.   This is a massive campaign to attack \nme and discredit me.\nUnpacking the noise around Dr. Anthony Fauci \nand beagle experiments \nBy Bill McCarthy  October 28, 2021 \nHad a terrific evening last night at the Kennedy Center. Barney Graham and Kizzmekia \nCorbet received the Sammie Awards and I and Jeff Zients presented them with the awards.  A;sp, \nEliseo Perez Stable and Gary Gibbons received special awards.   Good night.   \nPRESS: Telemundo “Produccion Hoy Dia” with Arantxa Loizaga; regional TV – Houston, \nDetroit, DesMoines; \nOct. 29, 2021 – Global – 244,879,472/4,970,435;  USA – 45,759,230/741,566\nFDA issues EUA for Pfizer 5 to 11 yo. vaccine\nYasmeen Abutaleb Is continuing to gather data on the conspiracy of the far right against \nme. She is working with Courtney Billet on gathering information connecting this activity with \nthe far-right Republicans. Most recently they discovered that Donald Trump Jr. in his campaign \nrunning for office is selling shirts that say “Fauci  kills dog”.  Hopefully, Yasmeen we'll have a \nstory out of this. \nPRESS:   Washington Post “fact checker” Glenn Kessler gives Rand Paul 2 Pinocchios in \nsaying that I lied about funding GOF research:\nReleased by Chairman Rand Paul\nFact Checker\nAnalysis\nThe repeated claim that Fauci lied to \nCongress about ‘gain-of-function’ research\nOct. 30, 2021\nHad a meeting in my home today with Hugo Crosthwaite who will be doing one of his \nextraordinary artistic renditions of me which is a sketched portrait in motion. He was \naccompanied by Dr. Taina Caragol who is the curator of painting and sculpture and LatinX art \nand history at the National Portrait Gallery. He wanted to explain to me what he will be doing \nover the next couple of months in putting together his portrait of me. \nLast night we had a delightful time visiting the on Massachusetts Ave where we were given a \ntour of the beautiful library end of the world clock.  \nOct. 31, 2021 – Uneventful Sunday\nPRESS: Italian TV – Che Tempo Che Fa – with Fabio Fazio\nNov. 1, 2021   \nContinued attacks from far right..   “National Pulse” talking about a book soon to come out by \nPeter Navarro that attacks me. \nJust found out that Nicholas Erickson of the Republican National Committee has been \nFOIA-ing my emails as well as “copies of Anthony Fauci’s scheduled meetings, appointments, \nscheduled events, outlook calender events, and aily briefing books between the dates 6/1/21 to \npresent” (Sept 2, 2021)\nPreparing for the Nov. 4 Senate HELP Hearing.  Rand Paul has sent letter to me, Rochelle, \nDawn O’Connell and Janet Woodcock asking if we would be willing to testify under oath. This \nis completely unusual for a minority who is not even the ranking minority to make such a request \n. It is very clear where he is going with this. He wants to be able to tweet after the hearing that \nwhatever I said was lying underoath similar to what he had said before. I doubt very seriously \nwhether the chair of the committee, Patty Murray, will allow this. However, we shall see.  \nDid the Stubing Lecture of the Greenwall Foundation this evening. It was a fireside chat \nmoderated by Sanjay Gupta who interviewed Christine and I in front of a virtual audience of a \nnoteworthy because of the extraordinarily polished performance that Christine gave in the \nfireside chat interview. It is very clear that she is highly respected by her colleagues in the field \nof ethics. Her performance was flawless. \nPRESS: CBS “The Late Late Show” with James Corden;\nReleased by Chairman Rand Paul\nNov. 2, 2021 – Global – 246,594,191/4,998,784;   USA – 46,024,349/745,274\nThe decline in cases in the United states is unfortunately beginning to plateau. We have \nstarted to see the inklings of this as the steepness of the deflection has diminished and we are \ngetting stuck for several days now at around 70,000 cases per day. We will have to watch this \nclosely. In addition, cases in the European Union particularly in Eastern Europe are starting to \nsurge. This is all bad news as we enter into the cold season of the fall and winter. \nFrancis Collins and I had a conference call with chairperson Patty Murray of the HELP \ncommittee. She was very sympathetic about the fact that the Republicans would have come at me \npretty hard and she wanted me to explain to her about gain of function research so that she could \nget a better understanding of things and she promised that she would give me the opportunity to \nrespond if people like Rand Paul do not give me the possibility of the chance of responding \nACIP meets today to discuss Pfizer vaccine for 5 to 11 yo.   Voted unanimously to \nrecommend vaccines for 5 to 11 year olds\nGovernor Phil Murphy of New Jersey was involved in a very close race for re election. The \nnext day (tomorrow) I texted him and congratulated him on his close win. He texted me back \nthanking me for my friendship and sending his best regards to Christine. He is really a good guy. \nNov. 3, 2021 –\nFinal pre for the HELP Hearing.   I fully expect that they will come at me hard\nPRESS:  CNN “New Day” with Briana Keilar; Usual WH Press briefing; CNN with Chris \nCuomo; MSNBC with Chris Hayes\nNov. 4, 2021 – Global – 247,472,724/5,012,337; USA – 46,180,190/747,970\nVery important Day!!\nSenate HELP Hearing - I together with Dawn O'Connell, Janet Woodcock, Rochelle Walensky \ntestified before the Senate HELP hearing chaired by Patty Murray . We had expected to have the \nsame conflict with Senator Rand Paul who continues to lie egregiously about the gain of function \nresearch which he claims was done at the Wuhan Institute of Virology funded by NIAID. During \nthe last Hearing I had a direct conflict with him in which he accused me of being responsible for \nthe death of four million people by funding research at Wuhan. At that time, I angrily said that he \nwas the liar.  He continued along this line totally misrepresenting facts and accusing me of lying \nbefore the Congress. However, in contrast to what I did last time I did not aggressively call him a \nliar, which he is. What I did was very calmly counter all of his arguments that this was a proven \nleak from the Wuhan lab, that we were continuing to fund the Wuhan lab, and that I was \nReleased by Chairman Rand Paul\nresponsible for the COVID-19 pandemic. Chairperson Patty Murray was extremely helpful in \nallowing me to counter his ranting lies . I closed the session by saying then I have a great deal of \nrespect for the institution of the United States Senate, but in fact everything he said was \n“egregiously incorrect “.   see link to the actual testimony below: https://bit.ly/2ZZzqAa \nCall from Barack Obama – Leslie Dach had contacted Barack Obama to ask him to give me a \ncall to see what he could do to counter the slanderous lies there have been coming from the far \nright press, extreme right elements in society, and even several members of the Senate and the \nHouse. President Obama called me tonight at 5:00 PM on my cell phone and offered to help in \nany way that he can. He started off the conversation by saying that he was concerned about me \nand how I was holding up under this onslaught of slanderous lies. HE SAID THAT I WAS A \n“CIVILIAN” and that I should not have to put with this nonsense.   He as a politician is used to \nthis, but I have done nothing but serve that American public and the world for decades. He \nexpressed concern that this would interfere with my important work on behalf of the American \npeople.   I explained to him what was going on and he was extremely sympathetic and in fact \nsaid that he would call up Ron Klain and or Jeff Zients to ask them to have the administration be \nproactive in countering these lies. I explained to him that President Biden as well as Ron Klain \nand Jeff Zients had been extremely helpful and supportive in making it very clear that they had \ncomplete confidence in me. In addition, I told him then Jen Psaki had continuously said at White \nHouse press conferences when asked whether the President would fire me that indeed the \nPresident would never fire me and that this was a bunch of nonsense. President Obama felt that \nwe should do more than just claiming that they have my support and actually go on the offensive \nand call out people who are allowing this to be said and are not stepping up. President Obama \nsaid that he would call up Jeff Zients and tell him to mobilize some of the people in the \nadministration to proactively go out and defend me. I told President Obama about the crazy \nthings that the far-right Republicans were doing including the fact that Donald Trump, Jr. had on \nhis website the sale of sweatshirts and T shirts to collect money for his campaign and on the T \nshirts and sweatshirts it said “Fauci kills puppies “.  Obama said That Donald Trump junior is “A \nfucking moron”.  He apologized for using crude language but then went on to say that Donald \nTrump was a hopeless idiot who was a pathologic liar. He was very upset that none of the \nmoderate Republicans were actually speaking out on my behalf and were distancing themselves \nfrom all of this terrible slanderous behavior against me. It was a great conversation that lasted for \n25 minutes and he said that if he hears anything about movement in this direction he will get \nback to me. It indeed was an incredibly memorable phone call.  \nReceived the call late at night tonight from Albert Bourla, the chairman and CEO of \nPfizer. He wanted to alert me that tomorrow morning they will announce extremely \nfavorable results from their protease inhibitor + ritonavir (PAXLOVID).  The results are \ntruly striking. In a randomized , placebo controlled trial, the efficacy of this oral formulation was \n89% if given within the first three days following symptoms and 85% efficacy if given within the \nfirst five days of symptoms. The group were people 18 years old and older with 1 or 2 risk \nfactors such as smoking, diabetes, and hypertensions.   There were no deaths in the treatment \nReleased by Chairman Rand Paul\ngroup and 10 deaths in the placebo group. Albert recognized that NI AID played a significant \nrole in the early development of this drug. They will apply for anyway soon. \nNovember 5, 2021 – Global – 247,968,227/5,020,204; USA – 46,268,465/749,876\nPhone call with Mikael Dolsten of Pfizer and his team.  They explained to a group of us \n(USG) the details of the Pfizer drug trial results (See above)\nI continue to get hassled by people FOIA-ing my emails . For example today we got a request \nfrom a Robin Bravender of Insider (a trash publication) for my e-mails from Nov. 3, 2021\nAnother extraordinary Day !!!  I attended the Funeral services of General Colin L Powell \nat the Washington National Cathedral  at the invitation of the Powell family. Beautiful sunny \ncrispy cool Fall day!  It was truly a moving and extraordinary event characterized by moving \nspeeches from Madeleine Albright, Richard Armitage, and General Powell's son Michael K. \nPowell. A notable  part of the event was the extraordinary rendition of the song “How great thou \nare” by Wintley Phipps. The entire “A” list of present and former administrations including the \nPresident (Biden) and first lady, former Presidents Barack Obama and George W Bush, and \nformer Secretary of State Hillary Clinton. I went over and chatted with all of them right before \nthe ceremony. I thanked President Obama for our discussion the other night (see above), and I \nhad a very interesting and amusing situation with Hillary Clinton. As soon as she saw me she \nopened up her arms and we gave each other a big warm hug. She whispered in my ear “now you \nknow what it feels like “clearly referring to the issue with the emails and all the other flak that I \nam taking. I told her some details of what I was going through and she commiserated with me \nthoroughly. She also said that she wanted to give me a call very soon so we could get together. \nPresident Biden recognized me from across the room and gave me a nod and a finger point. On \nthe wayout General Mark Milley came up to me put his arms around my shoulder and said “the \nonly person who was getting his balls kicked more than me in Washington is you “.  I responded \nby saying “no shit”.  he then responded by saying “Fuck ‘em”.  I also ran into a number of other \npeople from former administrations who chatted with me including James Baker, and Donna \nShalala. I also met Ken Duberstein who is looking very frail and in a wheelchair. I didn't \nrecognize him until the person who is taking care of him re-introduced us he said that he was the \none who convinced Ronald Reagan to appoint me as director of NIAID and that I make him \nproud every single day particularly when he sees me out on TV doing my good work. BTW - It \nreally is nice having a security detail to whisk you in and out of these events . It would have \ntaken me forever to get in and I would have been locked in there forever. However, with Brett \ntaking care of me it was as smooth as could be. \nPRESS: NPR “All Things Considered” with Mary Louise Kelly;\nNov. 6, 2021\nReleased by Chairman Rand Paul\n'God' asked people who should be sainted \nnext. Here are the top 20 most popular \nresponses. \nNov. 9, 2021 – Global – 249,743,428/5,047,652;  USA – 46,541,113/753,564\nPfizer announced yesterday  that they were going to ask the FDA to approve on an EUA \nboosters for everyone 18 years old and older. There is still concern on the part of Rochelle that \nthe ACIP will not recommend boosters for everyone but would hold back on younger individuals \nparticularly young men because of the risk of myocarditis. I have been pushing hard within the \nMedical Group as well as publicly saying that given the fact that we have plateaued on cases at \naround 70,000 per day and that we have already lost 750,000 Americans we should clearly boost \neveryone. Germany has already decided to boost every adult as has Israel. This is a situation \nwhere I am clearly at odds with the conservative approach of the ACIP\nReleased by Chairman Rand Paul\nJust a reminder of ongoing events - I have not been indicating this in my daily notes since they \nare ongoing activities but we are still are having anywhere from two to three White House press \nconferences per week as well as a weekly governors call inwhich I participate as well as a \nweekly briefing of the principles (cabinet members). For example, we had a very good \nconversation today with the governors about the recent approval of the Pfizer vaccine for \nchildren 5 to 11 years old and what this might ultimately mean both for the children as well As \nfor the dynamics of the outbreak in this country. \nLarry Horowitz (Former staffer to Ted Kennedy) and confidante of Nancy Pelosi - Just to \ncatch up on the note keeping , Larry has been very bullish about getting the Pfizer product to be \nused as a booster for all age groups. I agree with him strongly, but it is very clear that he has very \nclose ties with Pfizer , in addition to his obvious strong relationship with Nancy Pelosi. Larry \nkeeps texting me with all information about how other countries including Germany, Israel, uh \nand now Canada have decided to boost with Pfizer at all age groups. Of course the CDC and \ntheir ACIP may not be as enthusiastic given what I believe is an overly concerned attitude about \nmyocarditis in the younger male age group. Today Pfizer has submitted their application to the \nFDA for an EUA for boosters for people 18 and over. Let us see how this turns out. \nDid another zoom call with Pastor Connie Miller  of Maryland where I spoke to her with her \nparishioner children listening.  I explained why it was important to get vaccinated and I told him \nthat I would be going to the North Pole to vaccinate Santa Claus’s young elves.  \nCall from Larry Jameson, Executive Dean and Senior Vice-President of Penn Medicine - \nLarry called me today with a very interesting proposal of what I can do when I step down as \ndirector of NIAID. He would like me to consider assuming a named professorship at the \nUniversity of Pennsylvania School of Medicine. He said I could have offices in Washington DC \nin the Joe Biden center which is located in downtown DC and is part of the University of \nPennsylvania. I could spend most of my time in Washington and intermittently visit Penn. This is \nlikely the first of several offers at this type that I will get; however, this seems like exactly the \nkind of thing I would want to allow me to write my books , give lectures, and have a home base \nin a highly reputable institution. \nTown Hall with Congresswoman Anna Eshoo (D-CA) - I have been doing a number of town \nhall appearances with various Congress men and women over the last several months , almost all \nDemocrats. I have not mentioned them in my notes for the most part however the one I did \ntonight with Anna who is special since she is such an avid fan of mine and effusively praised me \nthroughout the town hall meeting. Her district is the San Mateo and Palo Alto area. Interestingly, \nthat is where Joan Baez lives. We spoke about boosters, vaccinations in general, vaccine \nhesitancy, and what the end game is of getting back to normal in this pandemic. \nPRESS:  Bloomberg TV with David Westin; NPR Radio interview with Joe Palca; \nNov. 10, 2021   Global  - 250,154,972/5,054,267;  USA – 46,626,034/755,201\nReleased by Chairman Rand Paul\nMany Eastern European countries by having record surges of COVID with increases in \nhospitalizations and deaths. These countries include the Ukraine, Romania, Russia, Bulgaria, \namong others. In the United states although the cases are plateauing as a group, there are other \nareas of the country particularly some of the western and northern states it is starting to see \nincreases including the important state of California. In fact, the daily average over the past week \nfor the country has shown a 5% increase in cases. \nMet by Zoom today with Eric Schultz at the request of Barack Obama - Eric was really very \nhelpful. He has enormous experience at being a comms expert working with Barack Obama. He \nwas involved in deflecting a lot of the criticism against Obama during his Presidency. Eric was \nvery realistic about what can be done in my case although he admitted that the level of attacks \nagainst me was clerly organized and unprecendented. He wanted to find out what was being \nnegatively impacted by all of this. I explained to him that it was a very strong strain on me but \nthat I'm strong enough to withstand it and he seemed to resonate with that. I told him that my \nscientific staff seems to be able to do their job even though the onslaught of this is so clear to \nthem and they feel badly about what I'm going through. I told him that the group that is getting \nmost overwhelmed with this is my legislative and my communications staff. Eric felt that it \nwould be very difficult to shame the right wing media and even the right wing members of \nCongress and the Senate, and so he is unsure whether going after them would make a difference. \nHe wanted to know whether I needed more help at the staff level in communications and \nlegislation. I don't think that we do need that but I referred him to Courtney Billet with whom he \nhas already scheduled a meeting. He did say that he was interested in the Washington Post piece \nthat will be written by Yasmeen Abutaleb. He feels that if we can galvanize other media people \nto call out these groups that are attacking me that this could be very helpful. Once you expose the \npeople who are instigating this, they often are reluctant to continue. And so, I am waiting to see \nhow is conversation with Courtney goes.  I am very thankful to Barack Obama for helping to set \nup this meeting with Eric. \nNice fireside chat with Bill First Bipartisan Center - The audience were a number of policy \nmakers who listened in on the bipartisan senators discussions. Bill asked the usual questions ut \nthe status of the outbreak but where we're going what does the end game look like and all the \nother questions that are generally asked. \nPRESS:Interview with “The Daily” – New York Times – Michael Barbaro; \nNov. 11, 2021\nJust to catch up on what is going on with the Moderna/NIH patent dispute. It has been very \nclear from the very beginning that there was a very strong collaboration between investigators at \nthe Vaccine Research Center (VRC) and the Moderna company . In particular John Mascola , \nBarney Graham, and Kizzmekia Corbett were heavily involved in the development of the mRNA \n-1273 vaccine. It was assumed by everyone that there would be a joint patent inventorship. And \nso, when a few months ago we heard that there was some disagreement among the tech transfer \nReleased by Chairman Rand Paul\npeople of the NIH and the lawyers at Moderna, Frances and I engaged in a couple of telephone \nconversations with Steve Hoge and Stephane Bancef of Moderna. Steve and Stephane said that \nthe actual inventorship was solely Moderna and that although the NIH had rights to the patent \nand licensing of the S2P immunogen, Moderna claimed that the actual “inventorship” was theirs. \nThis is critical since even though we would get a considerable amount of royalty from this \ntechnicality and even though we could be “co-owners” of the patent but not inventors of the \npatent this would still give Moderna complete control over who can or cannot use the  mRNA \nvaccine . This is particularly relevant if we try to get the vaccine produced for low and middle \nincome countries at a very, very low price. And so, after many attempts at resolving the issue we \nwere very surprised that Moderna unilaterally went out and filed the patent and specifically and \nexplicitly excluded John, Barney, and Kizzy.  The entire academic community, when they found \nout about this, was totally taken aback. And so, just this week Francis made it clear in an \ninterview with Reuters that we are going to bring Moderna to court and let the courts determined \nthe outcome . See below. \nUPDATE 1-Moderna COVID-19 vaccine patent \ndispute headed to court, U.S. NIH head says\nBy Julie Steenhuysen\nScience magazine has written a critical appraisal of NIH and it has really pissed off Francis \nCollins:\nEditorial\nSelf-inflicted wounds\nH. Holden Thorp \nScience • 11 Nov 2021 • Vol 374, Issue 6569 • p. 793 • DOI: 10.1126/science.abn1244\n•0eLetters\nNov. 12,2021 – GLOBAL – 251,266,207/5,070,244;   USA – 46,783,309/757,663\nI gave an interview with Peter Baker today for the book that he is writing on president \ntrump. \nReleased by Chairman Rand Paul\nPRESS: NYTimes/The Daily: An Interview with Anthony Fauci https://nyti.ms/3ohAA22 ; \nSTAT Summit Interview with Helen Branswell; Sirius XM “Doctor Radio” with Marc \nSiegel; NBC Nightly News with Tom Costello;\nNov. 13, 2021- Global – 251,788,329/5,077,907;  USA – 46,910,412/759,552\nI had an important TV interview with Ted Koppel to be aired on CBS tomorrow (see \nbelow).  The main gist of the interview was the attacks on me from the radical far-right. \nHowever, Ted did bring up an issue that Hugh Hewitt brought up in a different context (see \nabove). Ted asked me (and he is a good friend) whether or not I realized that I was speaking to \nthe converted and the 50% of people who love me are already doing what I want them to do and \nthe 30% who hate me will never do what I say no matter what and so have I ever considered \npulling out of being a public spokesperson and just focus on my job as the director of NIAID. He \noriginally asked whether I should “step down” because I had to remind him that I do have a very \nimportant job that has nothing to do with speaking to the press. When he understood that, he \ncorrected himself and said why not just pull back from interviews since I'm wasting my time. I \npointed out to him that there are still people who are on the fence whom I can convince and since \nI am such a valued spokesperson and a good communicator that the President and the \nAdministration want very much for me to be out there. He got that and agreed, but it is \ninteresting that he even brought it up.  \nI have been including Larry Corey in one of the three weekly division director meetings \nbecause in my opinion he is one of the most brilliant clinical trialists in the country if not the \nworld. However there is some growing tension that the division directors, particularly Emily \nErbelding and Carl Dieffenbach resent Larry being there since they feel he is giving himself an \nunfair advantage inventing his ideas in front of me and putting them in a position that they have \nto agree since everybody knows that he is a very close personal friend of mine. And so, at the \nlast meeting they spoke to me about asking Larry not to take part in the division director \nmeetings anymore since this in their mind is a conflict of interest. They do have a point but I \nbelieve that they do not fully appreciate how much value added he is. And so tonight I had to call \nLarry and tell him that he can continue to very frequently consult with me with his ideas but that \nhe cannot attend the division director meetings by zoom anymore unless invited for a specific ad \nhoc issue. He was disappointed, and vented a bit about their lack of creativity , but he understood \nand will stand down on this. I will continue to use him frequently as an advisor. \nPRESS:  Interview with Ted Koppel for CBS “Sunday Morning” to air tomorrow (Sunday)\nNov. 14, 2021\nThe interview with Ted Koppel went extremely well and I got more emails and texts than ever \nsaying how impressed people were with it. The tone of the interview was interesting in that he \nallowed me to talk about the divisiveness in the country and he even brought it up in a good \nReleased by Chairman Rand Paul\ncontext the fact that many people don't believe me anymore and even want me to resign. He \nasked my opinion about that and I was very firm in saying that I focus on my job and that I did \nnot create the divisiveness in the country and certainly if people keep lying about me and \ndistorting the truth in egregious ways, of course some people are going to believe that and some \npeople are not going to like me but that's not what I'm all about. I'm all about doing my job and \nI'm not going anywhere until COVID-19 is in the rearview mirror.\nIt is also interesting that with other things in the news including the contempt of Congress \ncharges against Steve Bannon with other charges soon coming against mark meadows, the \nattention on me has lessened. Perhaps this is a temporary low but it certainly is noticeable.   \nNov. 15, 2021 – Global    USA\nWent down to the White House today to participate with secretary Becerra - In a Health \nSummit for Indian Nation.I gave a brief overview of the outbreak and the importance of getting \nbooster vaccinations and secretary Becerra and I answered a bunch of questions from different \ntribal leaders. Well down there I ran into Susan Rice who gave me a big hug as usual as well as \nMerrick Garland with whom I had a nice chat. He joked and said you've got to save us from this \noutbreak and I joked back and said you've got to save us from the crazies who are out there. He \nshook his head in affirmation and said he's trying. \nOver the weekend I had been back and forth on the phone with Larry Horowitz as well as \nJeff Zientz. The issue at hand is that many of the states including Colorado, California, New \nMexico, and soon Minnesota as well as a number of countries such as Canada Israel Germany \nFrance and others are all recommending that everyone 18 years of age and older get their third \nbooster shot of an M RNA vaccine. The FDA is collecting the data from Pfizer to make the \nauthorization through an EU A for that age group. We are hoping that the CDC does not hesitate \nno matter what the ACIP says and goes ahead and shows leadership to get everyone a booster \nshot. The reason why this is important , despite the fact that there was concern about myocarditis \nin younger men, is because the message of who should get boosted is ambiguous and even \npeople who should be getting boosted are hesitant to do so because they are not sure whether \nthey qualify for a boost. If you just say across the board that everybody who's received a primary \nvaccination should get boosted within six months, then there is clarity about the fact that \neveryone should get vaccinated. I have been respectful of the CDC and the process that they go \nthrough , but over the last couple of days I have been very explicit saying that in my professional \nopinion I feel that everyone should get vaccinated.  \nGot a call from Ari Emanuel today - He told me that he will be coming to Washington DC in \nthe next month and wants to come over the house for dinner to explain to me how naive I am and \nnot fully appreciating just how much money I can get from book deals films and speeches. Ari \nhas been calling me about once every several weeks to just check in on me and see how I am \ndoing and to maintain the connection. He is very obviously hot to be my agent when I step down \nfrom the United States government. \nReleased by Chairman Rand Paul\nPRESS: WTOP Radio with Gigi; Business Insider  with Hillary Brueck (Print); CNBC with \nShepherd Smith\nNov. 16, 2021 – Global  - 253,163,330/5,098,174; USA – 47,145,861/761,426\nMichael Hiltzik of the LA Times - Has written another insightful review of the profound \nweaknesses of the lab leak theory. He exposes Alina Chan of the Broad Institute as someone \nleaning towards the conspiracy theory who has written a book providing no evidence whatsoever \nother than conjecture about the lab leak theory (see below). \nDiscussion with Jeff and the medical team today. - Although the cases are starting to surge up \nin more than 30 states, we have to start preparing for what level of acceptance of infection in the \ncommunity we are willing to live with. I have been explaining on TV/Radio shows the multiple \nphases of outbreaks from pandemic phase, to deceleration phase, to control, to elimination , to \neradication. We have only eradicated one infection and that is smallpox. We have eliminated \ninfections from the United states such as polio, malaria, and measles. What we have looking \nforward is “control “. However, there are multiple levels within the bracket of control and we \nshould not accept control at a level of 70 to 80,000 cases per day. We must get it down much, \nmuch lower . In my mind that is considerably lower than 10,000 cases per day. Importantly, the \nnumber of hospitalizations should also figure into that calculation since as I have been discussing \nwith David Morens and Jeff Taubenberger, systemic vaccination (subcut). Subcutaneous \nvaccination does not give mucosal immunity very well except when you have very high levels of \nantibody. When anybody levels fall below certain level one is acceptable to infection . However , \nB cell memory and T cell memory very often protect against pulmonary infection. And so we \ncan expect that there will be a time as we boost people that we continue to get mild infections \nsuch as with the common cold but very few people wind up getting very sick requiring \nhospitalization. Jeff and David also pointed out that for those vaccines that are required from the \nrespiratory move and do not result in viraemia we do not have good vaccinations to prevent \ninfection although we do have vaccinations that prevent the progression two serious disease. I \nrefer to influenza, parainfluenza , respiratory syncytial virus, and metapneumovirus. However, \nviruses such as measles, smallpox, and other viruses that result in viraemia and systemic \ninvolvement with virus give lifelong immunity after infection as well as after vaccination. These \nare important considerations that very few people fully appreciate. \nPRESS: Reuters TV with Julie Steenhuysen; NBC News Medical Unit - TV with Ashkay \nSyal; \nThese authors wanted to push the COVID-19 \nlab-leak theory. Instead they exposed its \nweaknesses \nReleased by Chairman Rand Paul\nBy Michael Hiltzik Business Columnist  \nNov. 15, 2021 6 AM PT \nOn the Shelf\nBy Alina Chan and Matt Ridley\nNov. 17, 2021 – Global  -253,640,693/5,104,899;    USA – 47,244,379/762,994\nI went to a book party last night for Jonathan Karl’s new book about Trump.  It took place \nat the Cafe Milano. The place was incredibly crowded and I was almost forced to take my mask \noff for 2/3 of the time I was there since they were serving drinks and people were talking and \ntaking selfies. I was totally swamped all night by people wanting to say hello, shake my hands, \nand take pictures with me. I could not get away from it . Although some people may think that \nthis is great to have people treat you like Elvis Presley , but it was really very unnerving. Jon was \nvery gracious to me being very excited about my meeting his family . We took hundreds of \npictures with each member of his family, as well as one big family photo. It turns out that his \nfather-in-law grew up in Bensonhurst and knew about my father's pharmacy on 13th Ave. The \nbook party event was punctuated by doctor Bill Hughes whom I know for years and who is \nmarried to Ann Compton getting a vaso-vagal attack and I tended to him at the bar. We called an \nambulance, but Ann took him home after we documented that he was stable. When I went home \nthat night I was nervous all night looking at the ceiling concerned about having gotten infected in \nthat very crowded restaurant despite the fact that vaccination proof was required to get in. I'm \nwell aware that many people who are vaccinated are still getting infected and that worried me a \nlot. I'm supposed to go to an even bigger black tie affair at the home of the French ambassador \ntomorrow. I think I am going to cancel out since I don't want to go through the nerve-wracking \nexperience that I did last night worrying about having gotten infected.   \nOf note, there are more than one congressional bills that have been proposed with my name \non it . One is the “Fires Fauci Act” which was written by Marjorie Taylor Greene. Another bill \nfloating in the Senate (proposed by Senator Joni Ernst) is forbidding gain of function research \nand that bill is called the “Fauci Act”\nPRESS: NBC Now TV with Hallie Jackson;\nDid an interview with Margaret Brennan today to be shown two weeks from now on Face the Nation. \nCuriously she spent most of the time asking me to justify the many “mistakes “that have been made by \nthe CDC during this outbreak both during the trump administration and the Biden administration. I was \nReleased by Chairman Rand Paul\ntrying to defend the CDC to the best of my ability, but this was not easy since in many respects she was \nright. I try to steer the conversation so with discussion of what I am responsible for namely the \ndevelopment of vaccines and therapeutics. She responded by saying I am “America's doctor “and so I \nshould have to answer these things . She was not being mean since Margaret is tough but she's a very \nfair and good person. \nNov. 18, 2021    Global   USA\nCall from Jeff Zients today with a message from Ron Klain – It is noteworthy that in prior \ndemonstrations it was always a concern when you give a message about a public health issue that \nthe administration is always afraid get the public to concern we're not concerned enough to be \nincompatible with the message that they're trying to get. This was brought to the far extreme \ntrump administration in fact the message was completely garbled and riddled with allies from the \npresident , which I had to rectify. However, I was a bit surprised when I got a phone call from \nJeff saying that Ron thought I was doing a terrific job with the messaging but he was a little \nconcerned that I might be saying that we might have a tough time this winter pressing message. \nHowever I was being perfectly truthful since in fact we are seeing the beginning of a surge and \nwhen you look at what I said I was actually quite certain spectrum said that we can do something \nabout preventing surge and you just pull up to us if we want to blunt but could be an inevitable \nsurge of people continue to not getting vaccinate just the thought that there is some contact \ncommonality among all the ministrations but messages even the terrific ones like we're dealing \nwith now. \nPhone call with Sen. Roger Wicker (R-MS) – Roger wanted information regarding global \nCOVID since he is going to a conference in Halifax about global response to COVID.   He asked \ngood questions and then he asked about GOF and I explained the entire situation to him.   He \nseemed not hostile and understanding.   Clearly, not all GOPs are jerks.\nInteresting article in Axios that goes along with my saying that we did not know that masks \nwork until later on.   This article came out today!!! – \nMask-wearing reduces COVID incidence by \n53%, study shows\nPRESS:  Interview with Carl Zimmer of New York Times an the antiviral program for \nCOVID and other viral families; NPR “Morning Edition”/All Things Considered” with \nReleased by Chairman Rand Paul\nAlison Aubrey; Russ Parr Morning Show (Radio); The Laura Coates Show (Radio); The \nRyan Cameron Show (Radio Atlanta); MSNBC Peacock – Mehdi Hassan;\nNov. 19, 2021 – Global – 255,324,963/5,127,696;   USA – 47,587,441/770,461\nPRESS: Fantastic article in the Washington Post online today by Yasmeen Abutaleb the \nbunking in an incredibly efficient manner the false claims against me by the right wing \nmotivated White Coat Waste project regarding the Beagle experiments :\nhttps://www.washingtonpost.com/investigations/2021/11/19/fauci-beagle-white-coat-waste/\nInvestigations\nFauci’s office flooded with attacks over \nbeagle experiments\nCovid chief’s phone line rings 3,600 times in 36 hours after \ncampaign by little-known animal rights group\nNew York Times article about my advocating boosters:\nF.D.A. Authorizes Coronavirus Booster Shots \nfor All Adults\nIf the C.D.C. agrees, adults who received a second shot of the Pfizer or Moderna vaccine at least six \nmonths ago could be eligible by this weekend.\nBy Sharon LaFraniere and Noah Weiland\nNov. 19, 2021, 8:31 a.m. ET\nWASHINGTON — The Food and Drug Administration on Friday authorized booster shots of both the \nPfizer-BioNTech and Moderna vaccines for everyone 18 and older, opening up eligibility to tens of \nmillions more fully vaccinated adults.\nModerna and Pfizer both announced  that regulators had broadened the authorization for their booster \nshots. \nThe move simplifies eligibility, fulfills a pledge by President Biden to offer the shots to every American \nadult and formally allows a practice already in place in at least 10 states. Fearful that waning protection \nReleased by Chairman Rand Paul\nand the onset of winter will set off a wave of breakthrough infections, a growing number of governors \nhad already offered boosters to everyone 18 and older ahead of the holidays.\nDr. Anthony S. Fauci, the federal government’s top infectious disease expert, has argued relentlessly \nover the past month for booster shots for all adults, a position shared by most of Mr. Biden’s other \nhealth advisers. Dr. Fauci has said that a dip in antibody levels in fully vaccinated people was a clear sign \nthat booster shots were needed. Public health experts who argue that healthy younger adults do not \nneed them, he has said, are ignoring the risks of symptomatic Covid-19.\n“Enough is enough. Let’s get moving on here,” he said at an event Wednesday night. “We know what \nthe data are.”\nPolitico “Playbook:\n•Mask on, mask off. That as the name of the game for ANTHONY FAUCI  at JONATHAN KARL’s \nbook party Tuesday night at Café Milano. As gawkers tried to snap pictures of him indoors not \nwearing a mask, America’s doc would put it on and take it off depending on whom he was \naround.  SALLY QUINN  — who’s known Fauci since his days as a young NIH doctor, when he \ninspired a love interest in one of her erotic novels — asked him why he was at a party with a \nmask in hand, not on face. “I said, ‘You seem pretty ambivalent about your mask’ because no \none else was wearing one,” Quinn told Playbook. “He said, ‘I just decided that if anyone came up \nthat I didn’t know, I would put my mask on.’” \nQuinn added that “paparazzi” were surrounding Fauci trying to get that “gotcha moment” of \nthe Covid czar without a mask on. Guests had to show proof of vaccination to enter the party. \n“He was being safe,” Quinn said in his defense. “He knew everyone was vaccinated. If it was \nsomeone we knew, he would trust them, and if it was somebody else, he didn’t.” Another guest \nobserved Fauci’s mask on/mask off dance, but said that the mask was firmly on when he came \nto the rescue of a guest who had collapsed. We reached out to Fauci via NIH but didn’t hear \nback Thursday night.\nNY Times :\nDr. Anthony Fauci has become “a very, very relentless advocate” for boosters, The \nTimes’s Sharon LaFraniere, who covers the federal government’s response to the \npandemic, told us. “He keeps pointing out that the data is getting stronger.”\nNov. 20, 2021 – Global  - 254,847,065/5,120,712;  USA – 47,471,270/768,619\nOn both of these TV shows we discussed the authorization of boosters for everyone over 18 \nyears of age and the EUA for Pfizer for 5 to 11 yrs old and what we have to look forward to for \nthe Holidays (see below).  The major conversation topic over the last several days has been the \nrecent approval (finally) by the FDA and recommendation by the CDC to give booster shots to \npeople 18 years of age or older. However the CDC continues to abide by there ACIP \nrecommendations which confused the issue some what by talking about different categories that \nReleased by Chairman Rand Paul\neither “should” or “may” be vaccinated with the booster shot. I clarified unambiguously on TV \nthat we should not let that confuse us and that everybody should go ahead and get a booster shot \nif they have had get full vaccination. I also made it very clear that although the cases very well \nmay surge in the upcoming cold months that the people who are vaccinated and preferably \nboosted can enjoy a comfortable safe holiday with their family indoors without wearing masks. I \nwas very explicit about that because every time I even hint that people need to be careful over \nthe holidays the far right radical idiots take things out of context and have a field day.  \nThere is some buzz around regarding the Justice Department moving against not only \nSteve Bannon , but also Mark Meadows, and Peter Navarro. The reason for the subpoenas or \nthat they refuse to abide by the house subpoena to appear before the committee. Peter Navarro \ncontinues to claim that I am responsible for causing the death of over 4 million people worldwide \nbecause I created COVID-19 \nMore and more papers are appearing in the medical literature making it very clear that the \noutbreak was almost certainly a natural occurrence and not a lab leak. The most recent \npaper was one by Michael Worobey that appeared in Science 3 days ago:\nhttps://www.science.org/doi/10.1126/science.abm4454 \nAlso, commentaries by Eddie Holmes (Australia) and others are nailing down the natural \norigins story.   Yet, the 3 stooges (Richard Ebright, David Relman, and Jesse Bloom) are still \npushing the lab-leak hypothesis literally based on absolutely no solid evidence, but only \nconjecture \nNov. 21, 2021 – Global   USA\nMike Osterholm and Eric Topol wrote an editorial in the New York Times sharply \ncriticizing the CDC and the ACIP for not giving a clear message that everyone over 18 \nyears old should get a boost. This is something that I have also felt strongly about in that the \nACIP is being very rigid and overly careful and give a confusing message of who “should” get \nvaccinated versus “who” may get vaccinated. Mike called me up after that and told me that \nRochelle called him and was very pissed off at him for writing the editorial; however, as much as \nI love her, Mike and Eric were correct.  The editorial got Jeff concerned since it did point out the \nreality of the problem with the CDC, but it also reflects poorly on the federal government \nresponds . Jeff was extremely pleased as was Ben Wakana about the strong response that I gave \non the TV shows today ; however, Jeff wanted me to call Mike and ask him to tone down the \ncriticism since it reflects badly on the USG response. I gave Mike a call and we discussed the \nsituation and ne promised to make sure going forward that he separates the CDC response from \nthe total government and Tony Fauci response. I don't know what I can do to get the CDC and \nparticularly Rochelle to move away from that overly careful, slow, rigid approach that the CDC \nand the ACIP had been taking for so long; it leads to nothing but confusion. On the Sunday \nshows today I was very clear that we should not worry about “should” or “may” and that \nReleased by Chairman Rand Paul\neverybody who is 18 years of age or older whose been vaccinated absolutely should get a \nbooster. Another example of the real problem we have with the CDC and its current mindset. I \nshould make sure that I spend considerable time on this in the book. \nPRESS: CNN “State of the Union” with Dana Bash; ABC “This Week” with Martha \nRaddatz; Yasmeen Abutaleb and Beth Reinhard’s Article in the Washington Post calling \nout the lies about me regarding the Beagle experiments came out in the print form today , \nfront page Sunday. This was online a couple of days ago. \nNov. 22, 2021 – Global   USA\nI had another very helpful conversation with my UK counterpart Chris Whitty discussing \nthe upcoming challenges of the winter in the UK versus the USA. They are seeing a surge of \ncases similar to what we're seeing and they're seeing it even among vaccinated people \nunderscores even more strongly need to boost everybody since boosters clearly protect better just \nthe two doses. \nGot a call from Kathy Hochul – Governor of New York - She was asking for some help and \nsupport in her upcoming decision of reinstituting the indoor mask mandate for the state of New \nYork. She wants to exclude New York City from this mandate since they are doing a good job of \nkeeping their infections down. However, since the rest of the state is surging, she wants to make \nsure that she doesn't let the surge get even greater. I supported her and told her that that was the \nright thing to do and that she should distinguish New York City from the rest of the state even \nthough it is likely that this is going to get a lot of Flack. \nPRESS:  NPR “Morning Edition” with Steve Inskeep; MSNBC “Morning Joe”; CBS \nMornings with Gayle King; Print interview with Alice Park of Time Magazine; ABC \nAustralia TV – News Breakfast;\nNov. 23, 2021 -  Global – 256,966,237/5,151,643;  USA – 47,813,785/772,180\nI continue to do the Governor's calls as well as the Principal’s calls once a week. I do not \ncomment on them regularly but each time Jeff asks me and Rochelle to give an update on the \nepidemiology and the latest science . For example, today I briefed the governors and the \nprincipals on the science behind the necessity for an the efficacy of boosters. \nDr. Markey is trying to help us get money for the development of a universal coronavirus \nvaccine.   See his letter:\nReleased by Chairman Rand Paul\n(11.23.21) NIAID \nUpdate on Universa     \nImportant interview with Ari Melber on MSNBC tonight where I hit back at criticisms by \nthe far right particularly Ticker Carlson and Peter Navarro.   It is a must to listen to:\nhttps://bit.ly/32j3EPg \nhttps://www.msnbc.com/the-beat-with-ari/watch/dr-fauci-tucker-carlson-s-personal-attacks-\nare-a-badge-of-honor-127012421649\n \nPRESS: BBC World News TV; WBAL Baltimore Local TV; MSNBC “The Beat” with Ari \nMelber;\nNov. 24, 2021 – GLOBAL – 257,469,528/5,158,211;  USA – 47,916,623/773,779\nVery gratifying public response to the Yasmeen article in the Washington Post:\nhttps://www.washingtonpost.com/comments?storyUrl=https%3A%2F%2Fwww.washingtonpost.com%2\nFinvestigations%2F2021%2F11%2F19%2Ffauci-beagle-white-coat-waste%2F\nJeff just called me and told me that he wants me to brief the President in the Oval Office on \nMonday from 4:00 to 5:00 PM on what we need to do looking forward but the pandemic. \nHe wants it to be only me representing the Medical Group because he feels I had a degree of \nprecise clarity. Tomorrow is Thanksgiving and I have been doing a lot of press in the usual \nsituation of having to predict and advise people of how to handle their safety during the traveling \nperiod of the coming holidays.\nMike Osterholm and Eric Topol wrote a scathing article in the WashPost criticizing the CDC for \nnot giving a clear message on boosters: \nhttps://www.washingtonpost.com/opinions/2021/11/24/cdc-got-it-wrong-it-should-have-urged-\nall-adults-get-covid-19-booster-shots/\nReleased by Chairman Rand Paul\nOver 250,000 Black and Latino Churches \nExpress Full Confidence in Dr. Fauci's \nLeadership and Medical Advice\nNews Provided By\nNational Black Church Initiative  \nNovember 22, 2021, 20:24 GMT \nBased on COVID-19 data, Dr. Fauci has provided the world with sound advice on preventing the virus \nfrom spreading, identified the importance of vaccinations, and advised on executing a plan for \ndistributing COVID-19 vaccines. NBCI, along with Conversation's Newsletter (December 2020), agrees \nthat Dr. Fauci was well-positioned to be the face of the COVID-19 pandemic. His preparedness stems \nfrom following from his possession of the following qualities:\n* Intelligence – He is brilliant and knowledgeable, with a background in science and humanities.\n* Integrity – He has said that he has a personal responsibility to make a positive impact on society.\n* Empathy – He has concern for others' well-being.\n* Flexibility – He can redirect his work as needed.\n* Energy – He has several meetings throughout the day that he attends and responds to emails daily.\n* Trustworthiness – He is credible through his research and publication.\n* Connections – He has been the adviser to seven U.S. presidents where his work has been covered by \nscience reporters since the 1980s.\n* Communication – He is a clear communicator and listens before speaking.\n* Recognizability- He has a distinct name, voice, and look.\n* Team Building – He shares the importance of doing things as a team and being a part of a team.\nPRESS: PRI Radio – “The World”; Philadelphia Radio “Reality Check” with Charles \nEllison; Univision TV with Andrea Linares; “The Grio” Online TV with April Ryan; CNN \n“AC360” with John Berman\nNov. 25, 2021 (Thanksgiving Day) Global   USA\nThe New York Times had a Thanksgiving day write-up on A summary of where we are with \nCOVID-19 in the context of an interview with me. The last question they asked was what I was \nthankful for at Thanksgiving. My response is given below: \nAdam: Last year we asked you what you’re thankful for, you very sweetly talked about your wife. \nWhat in the last 12 months are you thankful for — personally, professionally, or both?\nReleased by Chairman Rand Paul\nFauci: Well, I’ll give you one of each. I’m professionally thankful that we successfully did something that \nwas unprecedented in the history of vaccinology. And that is, we went from the sequence of a virus to a \nvaccine that was highly effective and safe. And we’ve been able to vaccinate a substantial proportion, \nalthough not as much as I would want, but a substantial proportion of the of the population. That’s \nprofessional.\nPersonally, it’s the same thing. It’s no secret that I have been clearly targeted by rather radical elements \nwho just keep attacking me every day, all day — Fox News, Breitbart — all those other crazies. And what \nI’m thankful for is what I said last year, that I have an incredible partner who is really amazing in her \nunderstanding of me and just keeps me grounded in reality when you have hand grenades being thrown \nat you every day. To have somebody that reminds you that what you’re doing is absolutely important for \nthe health and the safety of the country, so don’t pay any attention to all that nonsense. That’s what I’m \nthankful for\nMajor Serious Issue with new South African Variant!!  - It is Thanksgiving Day and \nsomething has come up today that is very serious. I got an email from Jeff Zients who forwrsded \nan email from Stephane Bancel.  Stephane was alerting Jeff to the fact that he had heard that \nthere was a new variant in South Africa called B.1.1.529. See below:\n25Nov2021 SGTF \nsequence report - N\nOne of the problems is that the mutations that have accumulated which are now greater than 30 \non the Spike protein including 10 mutations at the RBD would predict an escape from immune \nprotection . In addition, the variant in RSA has rapidly gone from a couple of percent to double \ndigits. Clearly, it is highly transmissible and has been demonstrated in people who have \nrecovered from the Delta variant. This is very disconcerting since besides its transmissibility, this \nsuggests that is eluding immune protection. I engaged in a bunch of phone calls with Larry \nCorey and John Mascola and multiple calls with Jeff Zients. I tried repeatedly to contact \nRochelle Walenski, but she is not answering texts, emails or telephone calls. However, it turns \nout that there is a glitch in my connection to her text and my texts keep getting sent to an e-mail \naddress.   We will fix this.   I finally go to her later in the evening.  Larry Corey has arranged a \nzoom for 10:30 AM tomorrow with our South African colleagues including Glenda Gray, Penny \nMoore and Tulio de Oliveira who is the evolutionary biologist from South Africa. Of particular \nnote, as I was scrambling around to contact people, the UK announced that they are banning \nflights not only from South Africa but also from Namibia , Lesotho , Botswana , Eswatini, and \nZimbabwe. In addition, they are going to require PCR tests for all arrivals into the UK. Israel has \nalso now announced it will ban its citizens from traveling to southern Africa covering the same \ncountries as well as Mozambique. Again, with multiple phone calls with Jeff , we decided to wait \nuntil tomorrow morning when we will have contact with the South Africans to get a clear review \nof what is going on. When I finally connected with Rochelle later in the evening, it was clear that \nshe really didn't have any idea what was going on. I am really surprised by this since the CDC \nReleased by Chairman Rand Paul\nshould be all over these types of leads. In addition, when I began to probe it is clear that this \nissue had been circulating for a couple of days, and amazingly on the calls with the White House \nmedical team Rochelle and the CDC never brought it up. This is really strange since I would \nimagine that with their global connections they would have been all over this. I have arranged to \nhave both Rochelle and Francis Collins join the zoom call that Larry Corey set up for us to \nengage with the South Africans.  Just heard tonight that the WHO has called a special meeting to \naddress the issue:\nFirst meeting of Scientific Advisory Group for the Origins of Novel Pathogens \n(SAGO)\nhttps://www.who.int/news/item/24-11-2021-first-meeting-of-scientific-\nadvisory-group-for-the-origins-of-novel-pathogens-(sago)\nWHO Director-General's opening remarks at the First meeting of the WHO \nScientific Advisory Group for the Origins of Novel Pathogens (SAGO)\nhttps://www.who.int/director-general/speeches/detail/who-director-general-\ns-opening-remarks-at-the-first-meeting-of-the-who-scientific-advisory-group-\nfor-the-origins-of-novel-pathogens-(sago)\nWHO calls special meeting to discuss new Covid variant found in South Africa \nwith ‘a large number of mutations’\nhttps://www.cnbc.com/2021/11/25/who-calls-special-meeting-to-discuss-\nnew-covid-variant-from-south-africa-with-large-number-of-\nmutations.html?fbclid=IwAR1VKOrWxAWjeHqVzJH0KLpPgPBRhEH lWZU\nKrN4bol3qFcrLgLYOjrO5aI\nCovid: New heavily mutated variant B.1.1.529 in South Africa raises concern\nhttps://www.bbc.com/news/health-59418127\nNew variant displaying a ‘big jump in evolution’ detected in South Africa.\nhttps://www.nytimes.com/2021/11/25/world/variant-south-africa-covid.html\nReleased by Chairman Rand Paul\nMore later.    I sent an email to Rochelle telling her that she better be prepared to move \nquickly with her team no later than tomorrow if in fact we decide that we are going to shut \ndown travel from southern Africa. I tried to give her the benefit from my prior experience with \nshutting down from China as well as from the European states. She did not seem to be on top of \nthings, and so I gave her a real strong briefing about the fact that she is going to have to move \nand move boldly. \nNov. 26, 2021 – GLOBAL   USA\nAll set for Zoom with RSA folks this AM.  Story starting to break as the South African \npublic health people had a meeting and discussed all the details of the increase in cases that \napparently are spreading rapidly throughout South Africa. \n25Nov2021 SGTF \nsequence report - N\nNot sure about the evasion of vaccines , but the situation is certainly heating up . Will \ndiscuss whether or not we're going to restrict travel from South Africa later today at a 12 \nnoon call with Jeff. \nEmail from Cyrus Shahpar on 11/26/2021:\nReleased by Chairman Rand Paul\nDeputy Health Minister in UK gave statement to Parliament about why they are \nprohibiting travel fro RSA and other African countries:\nOral Statement on B.1.1.529 variant \nThe Secretary of State for Health and Social Care has given a statement to Parliament on a new variant \nunder investigation and action government is taking. \nFrom:\nDepartment of Health and Social Care and The Rt Hon Sajid Javid MP \nPublished\n26 November 2021\nDelivered on: \n26 November 2021\nEmail from Elodie Ghedin   on her briefing by the South Africans:\nGhedin, Elodie (NIH/NIAID) [E] <elodie.ghedin@nih.gov> \nSent: Friday, November 26, 2021 8:57 AM\nTo: Collins, Francis (NIH/OD) [E] <collinsf@od.nih.gov>\nCc: Tabak, Lawrence (NIH/OD) [E] <lawrence.tabak@nih.gov >; Menetski, Joseph (FNIH) [T] \n<jmenetski@fnih.org >; Wholley, David (FNIH) [T] <dwholley@fnih.org>; Holland, Steven (NIH/NIAID) [E] \n<sholland@niaid.nih.gov >\nSubject: Re: New variant\nGood morning-\nWe had an ad hoc/emergency meeting of the WHO Technical Advisory Group on Variant Emergence \n(TAG-VE) this morning with a presentation from South African scientists.\nWe were asked to not report our discussion until the WHO puts out a statement later today so the \nreport below is confidential.\nHere is the low-down:\n•S.A. had gotten to a stage of very low infection rate so that they noticed this new variant—\nB.1.1.529—because of its very rapid increase in cases; the rate of infection is higher than \nexpected. (as background, seroprevalence in S.A. was at 80-85% so that the low infection rate \nthey were seeing with Delta was likely due to the fact the virus ran out of susceptibles; \nvaccination rate is at 30%).\n•The first evidence was an increase in positive cases associated with S gene target failure (drop \nout) in the qPCR assay; Sequencing of those early samples in Gauteng showed new mutation \nReleased by Chairman Rand Paul\npatterns. While whole genome sequencing is still just ramping up (they have 77 genomes from \nGauteng and will have 100 new ones by the end of the day), they do see the same S-gene drop-\nout pattern in many other provinces; so far this pattern is 100% associated with the new lineage \nso they suspect it will be the case for these samples in other provinces. In summary: this is not a \nunique outbreak cluster in Gauteng. \n•Cases are starting to pop up in other countries, but numbers are still low. We suspect they will \nincrease quickly. \n•Mutations: 10 in the receptor binding motif, many are similar to mutations observed in other \nlineages but also new ones. High number of mutations – \n•multiple in the RBD and NTD that are usually associated with resistance to neutralizing \nantibodies\n•Cluster of mutations (H655Y + N679K + P681H) adjacent to the furin cleavage site – \nusually associated with more efficient cell entry\n•NSP6 deletion (105-107) - convergent evolution as has been observed in Alpha, Beta, \nGamma and Lambda - could be associated with evasion of innate immunity, possibly \nincreased transmissibility\n•Mutations in the N gene - R203K and G204R (also seen in other lineages) that are \nassociated with increased transmissibility\nSo mutation profile is predicted to be associated with significant immune evasion and enhanced \ntransmissibility, but no experimental evidence yet and epi data is still sparse.\nIt clearly has a different mutation profile than other circulating VOC/VOI but full significance is \nnot yet clear.\n•One big question is how this highly mutated virus emerged. There are signs of possible \nrecombination at around nt 20,000. One of the spike mutations (N679K) is rare and also \nobserved in C.1.2; a lot of convergent mutations observed. One hypothesis is that because of \nS.A.’s high rate of HIV/low CD4, this virus could have developed in immune suppression with a \nrecombination event.\n•No evidence yet for different clinical presentation; age distribution tracks young so far but that's \nbecause the first outbreak was at a university, but it is also the age group that is most mobile \nand not vaccinated.\n•Most are symptomatic but severity is still being established.\nWe are planning another meeting Monday. Will let you know if I have anything new to report.\nBest,\nElodie \nBriefing with RSA colleagues: Glenda Gray, Tulio de Oliveira and others -Clearly we have a \nserious situation in South Africa. The virus is spreading rapidly in virtually all the provinces with \na concentration in Gauteng province which is where Johannesburg and Pretoria are located.  \nReports now in multiple countries almost all related to travel from RSA.  infections in RSA seen \nin people who have recovered from delta as well as breakthrough infections in those who have \nbeen vaccinated with the Pfizer product. What is unclear is what the severity of the infections are \nReleased by Chairman Rand Paul\n, and this is a moving target that Glenda Gray and Tulio said they would keep us informed on as \nsoon as they get real data. Multiple countries in Europe and elsewhere are blocking travel from \nRSA and neighboring countries.  I briefed Jeff about this immediately after the 10:30 AM zoom \nwith the South Africans. Jeff wants me to brief the POTUS immanently. The president is \nspending the Thanksgiving holiday with his family in Nantucket.  \nConference call with President Biden: Jeff arranged for me to brief the president on a \nconference call that included Jake Sullivan (NSC), Natalie Quillian, Ron Klain and Jeff. I \ndescribed the medical and public health situation to the President and Natalie and Ron discussed \nthe issue of blocking travel from RSA and neighboring countries. I explained to the President \nthat this is all the more reason to get people vaccinated and boosted. The president will make a \npublic announcement soon, likely this afternoon, that he has spoken with me and that the \ndecision has been made about the travel restriction.   Announcement about travel restrictions went \nout at 2:00 PM today. 212F is the authorization for restrictions  \nSlides on mutations:\nIncredibly busy Thanksgiving Day. We had zoom calls with the Pfizer group led by Mikael \nDolsten to scope out what their plan is regarding scaling up boosters against prototype as \nwell as the advisability or not of developing Omicron-specific boosters.  Also met with the \nModerna people for similar discussions.  \nClearly, the virus is spreading widely with five cases in Israel all of which were picked up \nby screening at the airport. E-mail from Danny Douek:\nDear Tony,\nI have been on the phone with the Israelis this morning.\nThey have identified 3-5 cases of B.1.1.529\nOne case was AZ x2. Symptomatic.\nAnother was Pfizer x3. Asymptomatic.\nAll identified on screening on entry at the airport.\n1 case from Malawi, 1 from Jordan, 1 from Egypt via Belgium.\nPRESS:   CNN “New Day” with Brianna Keilar (she was rude and asked questions about \nBrett Giroir out of context); Interviews with Sheryl Stolberg – NY Times; Kaitlan Collins – \nReleased by Chairman Rand Paul\nCNN; NBC “Evening News” with Lester Holt\nBloomberg:\nU.S. Needs Data on \nVariant Before Limiting \nAny Flights, Fauci Says\nBy Kathleen Hunter\nNovember 26, 2021, 8:17 AM EST\nNov. 27, 2021 – GLOBAL   USA\nConversation with Jerome (Jay) Powell, Chair of the US Federal Reserve.  Bob Grady texted \nme this morning to connect me with Jay Powell who wanted to talk to me about the implications \nof the new variant on the economy since he was in the process with the Federal Reserve of \nmaking trillions of dollars in loans to other countries. He wanted to hear from me first-hand \nabout what my projections for the outbreak would be. He will be testifying before Congress this \ncoming week and we agreed that I would keep him posted as to any additional information that \ncomes out. I briefed him thoroughly and what we know up to this point. \nPRESS: NBC “Today” with Kristen Welker and Peter Alexander;\nNov. 28, 2021 (Sunday)    Global     USA\nReleased by Chairman Rand Paul\nVery Important Day!! - An extraordinary amount has been going on over the last 24 to 48 \nhours. It is very clear that with the Omicorn variant is rapidly spreading from the epicenter in \nSouth Africa with mostly travel-related cases to a number of countries at this point including \nBotswana, the Netherlands, England, Hong Kong, Australia, Italy, Israel, Belgium, Czech \nRepublic, and several other countries. This is unquestionably a highly transmissible virus. We \nhad a very productive zoom call at 12 noon Washington DC time with our South African \ncolleagues once again. The main players among the South Africans were Tulio de Oliveira, \nGlenda Gray, and Carolyn Williamson. The have been extraordinarily transparent and helpfu \ngiving us data in real time.   It is a shame that we had to block travel from RSA.   However, we \nwould have gotten killed by the press if we did not as we are now getting killed for having done \nit.  I expressed my deep gratitude to them for their help.  The South Africans gave us a really \ngood feel about the fact that there are things that we know and things that we don't know at this \npoint. The combination of the many mutations in the spike protein together with the fact that \nthey are seeing spikes in infection among people who have recovered from delta as well as those \nwho have been vaccinated. The critical question is how severe is this disease that likely will \nresult from this new infection. \nImmediately after the briefing with the South Africans, Jeff wanted me to come to the White \nHouse to help prepare the speech that the President will be making tomorrow about Omicorn. I \nspent a considerable amount of time in Jeff's office together with Natalie working on the \npresentation that I would be giving to the President this evening as well as the content of his \nupcoming speech tomorrow. After we worked on the presentation and his speech, we went to the \nOval Office at around 3:30 PM and sat around the Resolute Desk. Briefing the President were \nRon Klain, Jon Fine, Natalie, and Jeff. I gave a full briefing to the President about what the \nsituation was with the new variant. In addition, we all sat around and edited with him the speech \nthat he will deliver tomorrow at a White House press conference. At the end of the briefing, Ron \nand Jeff strongly suggested and the President agreed that I should be at the press conference with \nhim tomorrow morning at 11:00 AM to answer any of the scientifically related questions. The \nPresident was very much in favor of this. I was a little bit concerned because I did not want it to \nappear that we were pushing out the surgeon general (Vivek) and the CDC director (Rochelle). \nBTW, both of them were not in DC (Miami and Atlanta).  However, Jeff and Ron were very \nadamant that it be me alone since they did not want there to be any confusion about who would \nanswer which question. One of the things that I noticed that was very clear is that the President \nappeared extremely tired and very muted and low key. I'm beginning to see that this is his \nstyle . However, when we got to the question and answer. He asked all the right questions. And \nso I can understand why his critics can often refer to him as “Sleepy Joe” when in fact he really \nis paying attention and is very measured in his responses. In addition, he speaks in a very low \nmonotone which makes it appear almost that he is frail when he is not. \nAfter the briefing I rushed home and joined the Sunday night call with the COVID medical team \nled by Jeff. Tomorrow will be a big day. We are hearing a lot of pushback from people who are \nsaying we should not have blocked travel from southern African countries. They fail to \nunderstand that we are not trying to completely prevent the influx of infection. Rather, we want \nReleased by Chairman Rand Paul\nto buy ourselves a little bit time usually measured in a couple of weeks to better prepared, \nunderstand better what is going on, and to get people vaccinated and boosted. However, as usual \nno matter what you do people are going to try and punch holes in it and give a reason why they \nthink it is a mistake. I have gotten extremely used to this and understand that very well.  \nSee Below:\nReadout of President Biden’s Meeting with \nCOVID- ￿19 Response Team on the \nOmicron Variant \nNovember 28, 2021 • Statements and Releases \nFollowing up on the regular briefings he had on COVID while traveling, the President met in person \ntoday with his Chief Medical Advisor, Dr. Anthony Fauci, and members of his White House COVID \nResponse Team. Dr. Fauci and members of the COVID Response Team updated the President on the \nlatest developments related to the Omicron variant. Dr. Fauci informed the President that while it will \ntake approximately two more weeks to have more definitive information on the transmissibility, \nseverity, and other characteristics of the variant, he continues to believe that existing vaccines are likely \nto provide a degree of protection against severe cases of COVID. Dr. Fauci also reiterated that boosters \nfor fully vaccinated individuals provide the strongest available protection from COVID. The COVID \nResponse Team’s immediate recommendation to all vaccinated adults is to get a booster shot as soon as \npossible; all adults are eligible for a booster if they were vaccinated six months ago or more with Pfizer \nor Moderna, or two months ago or more with Johnson & Johnson. Importantly, those adults and \nchildren who are not yet fully vaccinated should get vaccinated immediately. The President will provide \nan update about the new variant and the U.S. response on Monday.\nPRESS:  ABC “This Week” with George Stephanopoulos; NBC “Meet the Press” with \nChuck Todd; CBS “Face the Nation” with Margaret Brennan – she played an extensive \ntaped interview with me that is worth viewing since I pushed back on some of the nonsense \nthat is going on.   I called out Rand Paul, Ted Cruz and the far right Republicans that have \nbeen slamming me.\nNov. 29, 2021 GLOBAL     USA\nPOTUS Press Briefing - I was called to the White House to help to prepare the President for the \npress briefing that he would give this morning at 11:45 AM. I got to the White House at 10:00 \nAM and went over his speech with Jeff and Natalie and went over the Qs and As that the \nReleased by Chairman Rand Paul\nPresident would need to prepare him. We then went to the Oval Office and directly briefed the \nPresident . In the Oval Office were Natalie, Jeff, Jake Sullivan, the vice president, Ron Klain, Jen \nPsaki, and a few others. We tweaked the Qa and As and helped him answer them in his own \nmind and then the President, the vice president, and I went out to the press briefing which took \nplace in the Roosevelt Room. They only needed me to answer one of the questions that was \nasked of the President and that related to the travel restrictions on southern Africa and what we \nwere doing right now to prevent people from other countries who might be infected with \nOmicron from coming into our own country. I explained that now anyone coming into the \ncountry who is not an American citizen needs to be vaccinated as well as having a test before \nthey get on the plane whereas American citizens and LPRs need to be tested before they get on \nthe plane and when they get off the plane they are quarantined voluntarily for seven days and \nmust get a PCR test within three days. \nPRESS: ABC “Good Morning America” with George Stephanopoulos; CBS “Mornings” \nwith Gayle King and Tony Dokoupil; PBS NewsHour with Judy Woodruff; CNN “The \nLead” with Jake Tapper; MSNBC “The Reid Out” with Joy Reid; Peacock TV with Mehdi \nHassan\nNov. 30, 2021 -  Global   USA\nThere's been a lot of concern and discussion about the decision to block travel from \nsouthern Africa. The Africans are feeling like they're being punished as a result of their \ntransparency in getting this information out quickly. I totally understand their concern and I do \nhope that this travel ban will be quite temporary. On the other hand in typical fashion the far \nright is now criticizing me together with President Biden for using the Omicron variant as \na political tool against the Republicans. I have no idea how they make this connection, but \nthey are totally crazy. In addition, I got criticized by the New York Post for being too slow in \nconsidering a travel restriction and therefore likely caused loss of life. Obviously, this is a lose \nlose situation. \nHad a very important conversation with Trevor Bedford last night. Trevor is a \ncomputational biologist in Seattle. He discussed some models for John Mascola, Larry Corey, \nand others by zoom at 8:00 PM last night. He is concerned about the immune evasion \ncapabilities of this virus  but admits that it is too early to tell what the ultimate impact will be. \nHe believes that in a delta-immune population such as in the United States that it is very likely \nthat this new variant will spread widely and be dominant by the time we get to the end of \nFebruary. However, he underscores that this is purely an estimate on his part based on his \nmodel and may not turn out to be the case. We still do not know with the level of severity of his \nviruses and only time will tell. By assaying on whole virus and pseudovirus, we will have a \ndetermination in the next two to three weeks regarding the degree of immune evasion. \nReleased by Chairman Rand Paul\nPRESS; MSNBC with Craig Melvin; NPR with Rob Stein;\n \n \nReleased by Chairman Rand Paul\n \nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nPart 6 – Continued from Part 5\nMay 31, 2022   Global   USA\nConspiracy theories about me continue and abound:\nThe Spectator: The Harvard connection\nWas a Fauci-endorsed Chinese donation part of the lab-leak cover up?\nPRESS:   Korean Broadcasting System documentary “Corona Chronicles interviewed by \nYoonki Kang\nJune 1, 2022    Global 527,603,107/6,290,452;  USA – 83,949,036/1.002.067\nIt is becoming very clear that there is a different dynamic now that Ashish Jha has taken \nover from Jeff as the COVID coordinator.  He clearly likes very much and wants to be the \nprimary person dealing with the press. And for the first time we're seeing him wanting to do the \nWhite House press briefing alone without anyone else when it was always with Rochelle and I \nand sometimes Vivek. Also, it is clear that when calls are coming in for Sunday shows that the \nWhite House is putting him on instead. Since he is the boss of the coms people related to \nCOVID, it is clear that he is telling them to do that. I do not begrudge him that because I know \nthat he does want to be on TV a lot (and he is good at it) as he was before he took the job. But \nthis is certainly a change in the dynamics. I'm still doing a lot of TV during the week but when it \ncomes to things like the White House press conference and Sunday shows it is very clear that he \nis promoting himself above me and the rest of the team.\nEmily Bass wrote a terrific “Guest Essay” in the NY Times today both praising and \ncriticizing the Biden administration or not taking a strategic approach globally towards COVID \nthe way George W. Bush and I took towards aids with PEPFAR. It is a really good article to read \nfor historic purposes:\nGuest Essay\nAmerica Led on Global Health Before. It Must \nDo So for Covid.\nJune 1, 2022, 5:00 a.m. ET\nReleased by Chairman Rand Paul\nA day or two ago Ashish, David Kessler, Rochelle, Vivek and I had an important meeting with Andrea \nPalm and Dawn O'Connell regarding the fact that we are running out of money and have no money \nleft to purchase anymore monoclonal antibodies.   If we do not purchase any the company will stop \nmaking it and an important tool in our toolkit will now be missing this could be disastrous for people \nwho are immunocompromised and who do not have the capability of making anybody in response to \nvaccines. We pushed really hard but Andrea and Dawn had no solution for us since the Congress is still \nnot granting us the supplement that we've been asking for for some time. We pushed hard and there \nwas a bit of tension in the room, but we found out today have we made an impression on them since \nthey have found some extra money to keep the antibody production going for at least a few weeks. The \ncompany, Lilly, does not want to commercialize the antibody (Bebtolivumab) and will only make it if the \ngovernment pays for it. It looks like we had an impact on them when we stood together and insisted \nthat we needed the money.\nToday, we had another important conversation among the team.I have been pushing and I was very \nexplicit about it that we should make vaccine available to anyone younger than 50 years old who wants \nit. The emergency use authorization does not allow this right now but we are trying to find a way around \nthis by setting up a meeting with Rob Califf to see if there is any mechanism that would allow us to make \nvaccine available. The reason we want to do that is that we have plenty of vaccine that we're not using \nand even though a fourth dose does not substantially increase the protection against severe disease (it \ndoes it a little bit), it could prevent symptomatic infection which could in the long run diminish the \namount of long COVID that we experience. I came on very strong with my opinion that we should make \nvaccine available to anyone who wants a fourth dose at any age. Rachel was uncomfortable with this \nbecause she did not think we could get it through the FDA or the ACIP. I still insisted that we should go \nahead and try.\nHad a very important meeting on Monkeypox today organized By Raj Panjabi (NSC \npandemic preparedness leader).  The meeting was attended by Rochelle Walensky, Harold \nPhillips of the White House AIDS office and a whole bunch of activists including Peter Staley, \nDavid Barr, and a wide range of others. Emily from my group was present as was several CDC \nfolks.   We all agreed that we need to put all our resources together and engage the LGBTQ \ncommunity in our planning about testing, treating and vaccinating people with monkeypox. It \nwas a wonderful meeting because it showed right from the beginning of what could be an \nimportant outbreak that the White House was working with the health authorities like myself and \nReleased by Chairman Rand Paul\nRochelle as well as with the activist community. We vowed to continue to work together to try \nand make sure that this disease gets properly addressed and we do not underplay it or overplay it. \nThere obviously is a danger of stigma generating from this disease because of its propensity to be \ninfecting gay men. More to come on this new partnership.\nThe New York Post is truly fabricating   This has to do with the proposed “Pandemic \ntreaty”:\nBeware Fauci’s scheme to empower the \nWorld Health Organization\nBy \nBetsy McCaughey\nMay 31, 202\nPRESS:  FOX with Neil Cavuto; “Life Itself” with Sanjay Gupta and interviewed by Seth \nMacFarlane (Virtually – I received a standing ovation from the audience at the Coronado \nHotel in San Diego).   \nJune 2, 2022  Global   USA\nMonkeypox continues to spread now involving over 23 countries with 800 cases. There are \n19 documented cases in the USA but this is likely a very significant undercount at this \npoint.\nPRESS:  South Florida PBS interview for Town Hall with Michael Zinner; USA Today \ninterview on HEROS study (food allergy and COVID)\nJune 3-6, 2022 –Global – 528,816,317/6,294,949;  USA – 84,424,159//1,003,308\nI had an idyllic weekend at Jeff Zients’s palatial estate in Annapolis. Chris and I (together \nwith Brett and Tony….) had a spectacular weekend. The weather was absolutely perfect at 85 \ndegrees with a cool breeze and not a single cloud in the sky for the entire 2 1/2 days that we were \nthere. We did everything: swim, boat, fish, basketball, tennis and most importantly – bird-\nwatching.  There were osprey all over the place with a nest in a tree in his back yard. There were \nReleased by Chairman Rand Paul\ncopious varieties of birds that we saw and heard. Gave me the opportunity to return, however \nbriefly, to some form of “normality”. it was entirely refreshing.\nI received an important call during my stay in Annapolis. Secretary Becerra wanted to \nspeak to me to get my advice about whether we were doing all we can as a department to \naddress the emerging monkeypox challenge. He was calling upon my experience in \nprevious outbreaks to make sure that HHS (particularly CDC) was doing everything that \nthey could. This was triggered by the fact that Ron Klain is very concerned about whether \nthe CDC is up to the job and would not drop the ball again with regard to things like \nmaking a number of tests available. The secretary asked me what I thought the potential \nvulnerabilities were and I emphasized the fact that we cannot accept the CDC saying that \nthey are the only ones that can do a test for monkeypox. We've got to convert this to a \ncommercialization as quickly as we possibly can so that we don't have the same problem \nwith not enough tests to understand whether or not we are dealing only with the tip of an \niceberg. I offered up the cohorts of stored server that we (NIAID) have from the days of \nHIV/AIDS to see if there was smoldering below the radar screen infection with monkey pox \namong the gay population for some time before we even recognized it. Right now, as the \nresults are coming in, it is clear that overwhelmingly the cases in the non-endemic areas of \nthe United States, Europe, and other continents are predominantly among gay men. It is \nstriking that the secretary “hinted” that Ron Klain is on the verge doing something \ndramatic with the CDC, such as removing Rochelle, which I believe would be a mistake \nsince it is not her fault; it is the institutional rigidity of the CDC that has been the problem \nfor decades. I explained this to the secretary and told him that it was not Rochelle that was \nthe issue it was the structure beneath it. I got the impression that he completely understood \nthis and was asking for my help and making sure things get done correctly.\nJune 6, 2022 –\nAngela Rasmussen did an excellent job of blasting Jeffrey Sachs (and also co-author \nRichard Ebright) for their article claiming that COVID was due to a lab leak.  See link and \nsome selected excerpts from Angie’s tweets:\nLink - https://bit.ly/390lafa \nNot overlooked, but ignored because I don’t wish to further amplify it. But here’s a quick \nsummary:\nLike many of his fellow economists with Ivy League credentials but no specific expertise \nin biology, he suffers from the delusion that he knows what the fuck he’s talking about.\nJeff Sachs is the chair of @TheLancet  COVID-19 Commission. This isn’t an official \ngovernment board with any real mandate. It’s just a prestigious medical journal deciding \nto make up a task force of prestigious people to write more prestigious content for said \nprestigious journal. \nReleased by Chairman Rand Paul\nThe Lancet COVID-19 Commission will issue a bunch of reports that are glorified opinion \npieces stating the obvious: we weren’t prepared for the pandemic, there are massive \ninequities, it had huge global impact, need more vaccines/infrastructure, etc.\nThis includes Richard Ebright, the human manifestation of Pepe the Frog, who spends \nhis days squatting on his Twitter lily pad croaking at everyone who disagrees w/ his \nuninformed views on biosafety, virology, & evolution that they are shills, stooges, & \nthralls of the CCP. \nFeel free to lecture me about professionalism here & get blocked w/ a quickness. I gave a \ntalk on Twitter disinfo & had an entire slide cataloguing every time he called someone \n(inc me) a stooge in the prior 2 weeks. He’s an abusive bigot & I don’t owe him \nprofessional courtesy.\nCases starting to come down in Northeast, but still cases going up in undervaccimated \nareas, mostly in the South\nMonkeypox problem growing:\nGlobal.health tracker -- 921 confirmed MPX cases,  70 suspected (non endemic countries)  \nhttps://bit.ly/392v2F1 \nJune 7, 2022   Global  - 5630,266,292/6,299,364; USA – 84,762,952/1,004,260\nNote for the memoir regarding my PTSD around memories of my HIV/AIDS experience: I \ndid an interview today (see below) with The Independent”, a UK News outlet on the issue of \nwhat I described in the NAT GEO book “Expect the Unexpected” talking about my PTSD \naround HIV/AIDS. The reporter asked me to describe how the PTSD expressed itself in me and \nwhat triggered it. In my description of it to the reporter, it became clear to me that it is something \nthat I should include and expand a bit in my memoir.\nLast night, Stephen Hoge of Moderna explained their booster data using hybrid boosts to a \ngroup of us from HHS.  The bottom line is that boosting with an omicron together with \nwildtype bivalent, The response protected against omicron – B.1, but not against BA.4 and BA.5. \nThis has important implications in what decision the FDA and CDC make about what the 4th \ndose boost should consist of. Should it be an omicron boost or should we steer it towards BA4 \nand BA5 which does not seem to be protected against by maybe one boost.\nMet withVidar Helgesen CEO of the Nobel Foundation; Anna Sjostrom Douagi of the \nFoundation and Dr. Franklin Carrero-Martinez of NAS.   They want me to be a lead speaker at \nthe Nobel/NAS Symposium in May, 2023 on “trust and information”, a theme right in tune with \nmy commencement addresses on “the normalization of untruths”\nReleased by Chairman Rand Paul\nPRESS: Interview with “The Independent” (UK) by Io Dodds; Interview with Theodora \nTsoli for “The Bima” – Greek Newspaper;\nJune 8, 2022    Global    USA\nIo Dodds piece came out.   Excellent historical piece: \nExclusive: Anthony Fauci on the AIDS crisis, \nmonkeypox, trans rights and his retirement\nIn an exclusive interview with Io Dodds, Dr Anthony Fauci \nlooks back on his decades-long career in public health \nMet with a delegation from the UAE on the 6th Floor of Building 31.  Leading the \ndelegation was Sheikh Abdulla Al Hamed, Chairman of the Abu Dhabi Department of \nHealth. They are here to try and generate collaborative efforts between their group and our VRC \nand other elements of our program, particularly Danny Douek and Adrian McDermott In the \ncontext of the PREMISE program that was started at the VRC. This would be the first time that \nwe are having any substantial interaction with the UAE.\nCases not going down very much over past week although certain regions are plateauing:\nPRESS: Bloomberg TV Quick Take – “Emma Barnett Meets”; Interview with Robert \nGaynes for his book second edition of “Germ Theory”\nReleased by Chairman Rand Paul\nJune 9, 2022  Global    USA\nThe big discussion items over the past 24 hours have been the growing number of cases of \nmonkeypox which at last count is over 1400 globally and over 70 in the United States. In \naddition, there was concern about what kind of decision will be made regarding the 4th \nshot boost with the mRNA vaccines. Although the Moderna data indicate that the bivalent \nvaccine of wildtype plus omicron gives quite good response to omicron, their data show only a \nmodest protective effect with a three to fourfold decrease in efficacy against BA4 and BA.5. The \ndata from Pfizer are even more dramatic in showing the lack of a good response against BA4 and \nBA5 when you vaccinate with a bivalent consisting of wildtype and omicron. The real issue is \ngoing to be that by the time the Fall comes it is very likely that neither omicron (BA.1) nor \nBA.4/BA.5 will be dominant since even though BA4 and BA5 are starting to take over \ndominance, they will likely peak and come down by the time the Fall comes and so we will be \nmaking a booster for a virus that very likely does not exist in society at the time that you are \nusing the vaccine. Clearly, this is a major dilemma that we are all facing with the virus that \nmoves so quickly.\nGood history of the evolving of variants:\nPRESS: NBC Medical Unit Interview with Akshay Syal;\nReleased by Chairman Rand Paul\nJune 10, 2022\nLast night I received another humbling honor associated with the honorary doctorate in \nscience that I received from Rockefeller University in New York City. I could not attend in \nperson because of scheduling conflict and so I taped my acceptance speech. However, last night \nthere was a black tie affair in which individuals presented the life work of the degree recipients. \nJeffrey Ravetz did an amazing job in presenting my story going back to my early days in \nBrooklyn. At the end of his presentation Rockefeller President Rick Lifton was very generous in \nhis praise for me and pointed out that the audience at the celebratory dinner was giving me a \nstanding ovation, which I could not see since I was connected to the affair by Zoom. It has been \nan extraordinary spring with all of these wonderful honors that I have received. This will have \nbeen my 58th honorary doctorate.\nMajor issue that I am involved with regarding the choice of the 4th dose boost in the Fall.  \nEveryone is trying to decide what 4th dose boosts will be given to the entire population in the \nFall. A recent study by Moderna showed that there was a modest advantage of the bivalent \nomicron plus ancestral strain vaccine boost over ancestral strain alone when one measures \nantibodies against omicron. They are pushing this now to be the candidate for the 4th dose boost \nin the Fall. However, there is no Omicron (BA.1) around right now and even though BA.4 and \nBA.5 are emerging, by the time we get to the Fall we will have already peaked and declined with \nBA.4/5 and so we will have a vaccine that is directed against a variant that very likely will not be \npresent in the fall and winter. We have hundreds of millions of doses of ancestral strain vaccine \nand in order to get a new bivalent boost available we would have to make a decision in July or \nAugust to get it ready for October or November or later, which actually might be too late. If we \ndo not use those hundreds of millions of doses of ancestral strain they will go to waste and have \nto be thrown away. And so as far as I'm concerned the ancestral strain boost may not raise the \ntiters against different variants to a very high level, but it does keep them within a protective \nrange so I would make an argument then rather than waste millions of doses and invest in a \ncandidate that might not do anymore of protection against a given variant in the fall and winter, \nwe should go ahead and utilize the ancestral strain vaccines that we have which might do just as \ngood a job against any future variants. I will try to make that case as we talk about future plans \nfor boosters.\nPRESS: Zoom wih Clara Lussich of El Pais (Uruguay); Radio interview with Marc Siegel \nSirius Doctor Radio; \nJune 11, 2022 – Global   USA\nHad a glorious and historic day at Holy Cross today. The college named their integrated \nscience complex – “Anthony S. Fauci Integrated Science Complex” in my honor. The \noutpouring of love, affection, and admiration on the part of the students and the faculty at Holy \nCross was very moving. I gave a Q and A session with about 30 students, which was really \nReleased by Chairman Rand Paul\nterrific.it is a beautiful renovated building of laboratories and classrooms. My visit to the college \nwas on the occasion of my 60th reunion. I ran into some old friends that I have not seen in \ndecades including Jim Mulvihill, Jack Fellin and Mike Leding.  President Rougeau gave a \nwonderful introduction of me, and one of the thrills of the day was to see that Bob Cousy drove \nhimself to the campus just to be there and honor me. I had a great conversation with “Cous” who \nis 93 years old. All in all, it was a wonderful day.\nI did a terrific fireside chat with David Rubenstein at the meeting of the Trilateral \nCommission at the Mandarin Oriental hotel in Washington DC. David was his usual \nhumorous self and we had a typical interview that we have had several times in the past. He \nasked the usual questions about his own health am I kidded him about the fact that he is a \nhypochondriac.  Prominent people at the meeting were David Petraeus, Meghan O’Sullivan, Jake \nSullivan, Fareed Zakaria, among many others.\nPRESS: I gave an extended and exhausting all day interview with a half day photo shoot to \nAnna Peele, who is a freelance reporter doing a front page extensive Washington Post \nmagazine article on me to be published in the next few weeks.\nJune 13 – Global   USA\nNet cases and hospitalizations coming down, but very slowly. Some counties/states coming \nway down while others rising or plateauing. BA4/5 becoming more dominant.   Sec. Becerra got \ninfected for the 2nd time in 4 weeks.\nMonkeypox getting considerably more attention.   >1400 cases in non-endemic areas with \n~50 cases in USA\nWonderful memorial for Rob Stein at the Evermay Estate in Georgetown.   I gave one of the \nEulogies.   Remarkable man in life and as he was dying.  He was beloved by many and a very \ndear friend to me and my entire family\nJune 14 – Global – 533,816,957/6,309,633;  USA – 85,520,045/1,006,8890\nBA4/5 creeping up in dominance:\nReleased by Chairman Rand Paul\nI had another very productive discussion, which I have had on a regular basis, with the UK \nchief medical officer Chris Whitty. We discussed the evolving situation in the UK and \ncompared it to that in the United States. He mentioned to me that they were starting to see a \nsurge of cases of  BA5 which he feels will ultimately become dominant. In addition, \nunfortunately hospitalizations are starting to tick up and he believes that they are likely going to \nsee a bit more of a wave in the coming weeks. This is very disconcerting since we were hoping \nthat there would be a sharp downturn in omicron sublineage viruses in the UK which usually \nforeshadows what is going to happen in the United states.\nEgregious example of “PORK” on the part of the Senate Appropriations Subcommittee \nconcerning the earmarking of funding for the BSLs\nReleased by Chairman Rand Paul\nnot support the best science.   Despite these concerns, the Subcommittee staff indicated that this \ndirected funding would be likely to continue in FY2023and for the foreseeable future\nJune 15, 2022\nReleased by Chairman Rand Paul\nBig tragedy is that I will be missing my daughter Megan's wedding in New Orleans. This is \nmuch more painful and disturbing then the fact that I have a disease that could possibly \nkill me.\nGetting literally hundreds of texts and e-mails from all over the world wishing me a speedy \nrecovery.   Very much appreciated.  Write-ups in all major news media (Times, Post, NPR, \netc.). My symptoms fortunately are relatively mild with one bad night tonight with flushing \nfeeling and a lot of primary and some cough. I started Paxlovd\nJimmy Fallon: “I read that Dr. Fauci has tested positive for COVID, but luckily, he’s only \nexperiencing mild symptoms. COVID must feel like it just reached the final boss in a video game, \nlike, ‘We did it. We beat Fauci.’ Right now, even Fauci is reading the CDC guidelines like, ‘Damn, \nthese are confusing.’”\nJune 16, 2022  Global – 535,248,141/6,313,229;  USA - 85,825,048/1,007,964   \nFeeling considerably better today. I bit the bullet and testified before the Senate HELP \ncommittee. Rand Paul was his usual stupid self asking questions about royalty payments. It \nwas a three hour hearing and I was exhausted but I made it through.\nCases, deaths, and hospitalizations seem to have stabilized and are not coming down any \nfurther:\nPRESS:\nPolitico:\nCovid doesn't stop Anthony Fauci from taking on Rand Paul – \nagain \nThe two engaged in their usual heated debate at a Senate HELP Committee hearing on Thursday. \nReleased by Chairman Rand Paul\nJune 17, 2022  Global   USA\nSymptoms still relatively mild. I'm on day three of Paxlovid.  many texts and emails \nwishing me well from friends and people that I do not know in the USA and around the \nworld.\nPRESS:\nThe Independent:\nDr Fauci accuses Rand Paul of ‘absurd \nexaggeration’ over claims about booster shots\nJosh Marcus\nTrevor Noah: “Dr. Fauci has COVID, which feels a little like finding out Smokey the Bear got \ntrapped in a forest fire.”\nSeth Meyers: “Dr. Anthony Fauci tested positive yesterday for a breakthrough case of the \ncoronavirus. Fauci is like COVID’s final boss. This is like hearing that the Coyote caught the \nRoadrunner. Also, you caught it now? You made it through all that time in the maskless Trump White \nHouse and you caught it now? That’s like running a triathlon with no problems and then throwing \nyour back out while petting a dog.”\nJune 18, 2022\nFDA gives EUA to Moderna and Pfizer for vaccines for children 6 months to 5 years old.  \nCDC recommends!\nI'm really starting to feel the depression and sadness that I will be missing Megan's \nwedding today in NOLA where I would have been with my entire family had I not \ncontracted COVID.  I viewed the ceremony buy live stream as well as interacting with \npeople during the reception and the picture taking via FaceTime .Will Fekeci and Sam \nprovided the face timing for me.\nThe usual stuff is going on regarding my infection with Tucker Carlson doing A5 or 10 \nminute discussion tearing me down but the usual accusations and belittling the people who \nare supporting me. What a total asshole!!\nI just finished Yasmeen Abutaleb’s and Damian Paletta’s book “Nightmare Scenario”.  \nThey did a very good job and I should use that book heavily as a reference in my own \nupcoming book.\nPRESS:\nReleased by Chairman Rand Paul\nGov. DeSantis not recommending vaccines for children 6 months to 5 years:\nwashingtonpost.com \nGov. Ron DeSantis abandons Florida children\nEditorial Board\nBut Mr. DeSantis appears to relish playing politics with public health. He is running for reelection and \nhas his eye on a Republican presidential campaign. His decisions and comments are a craven bid for \nsupport from the anti-vaccine movement. We’ve seen this before. Mr. DeSantis also fought vaccine and \nmask mandates. His campaign sells “Freedom over Fauci” flip-flops that leave a message when worn on \nthe beach: “Fauci can pound sand.”\nJune 19, 2022\nPRESS:  Book about the disgraceful behavior of authorities at NY Hospital-Presbyterian \n(particularly Laura Forese) during the outbreak peak in NYC:\nFacing Death During the Pandemic\nMarie Brenner’s “The Desperate Hours” looks at how health care workers dealt with the perils of Covid.\nBy Sandeep Jauhar\nJune 20 2022\nTested negative today and have had an essentially asymptomatic course.\nBegan reading Deb Birx’s book “Silent Invasion” and it is clear already from the first couple \nof chapters that she is revising history regarding her initial involvement. I am sure that part of it \nis true but it wants me to be careful that I have to be strict to the truth of exactly what happened \nand not pad it in my favor\nImportant discussions today by phone with me and separately David Kessler, Larry \nHorowitz, Richard Koup and Peter Marks regarding what the ultimate choice for the \nbooster vaccine for the upcoming fall surge.  I have been very concerned of late that we are \nnot carefully analyzing the immunological basis for the choice of a booster shot to be \nadministered before the potentially upcoming Fall surge. The companies Pfizer and Moderna \napparently want to give a bivalent of wildtype plus omicron since that is what they already seem \ncommitted to and are making. It is my opinion that by the time we get to the fall season omicron \nwill be completely gone and off the map since it is already gone. The closest thing that we likely \nwould see would be a surge of BA4/5. Yet everything seems to be pointing to the decision of \nReleased by Chairman Rand Paul\ndoing an omicron/wildtype bivalent. Peter Marks who will make the ultimate decision at the \nFDA agrees with me that we will be fighting yesterday's war if we go with omicron. There will \nbe many discussions this week that I will catalyze to make sure that we get all the appropriate \ninformation for the FDA to make a good decision about the booster.\nJune 21, 2022\nGOP threatening me if they assume control over Congress:\nTop Republican On House Oversight Eyes Hunter Biden, Fauci As Investigative \nTargets – ‘The Takeout’.\nCBS News (6/17, 5.39M) reported that “if Republicans take control of the House in the next \nCongress, the House Oversight Committee” would investigate NIAID Director Dr. Anthony Fauci, \naccording to Rep. James Comer (R-KY), the top Republican on the committee. Fauci has \n“maintained that COVID-19 likely resulted from a ‘natural occurrence,’ as opposed to a lab leak in \nWuhan, China, telling a Senate committee this week that the virus likely jumped from ‘an animal \nhost, perhaps through an intermediary host, into a human species, which then spread throughout the \nhuman population.’” Comer told CBS News chief Washington correspondent Major Garrett on this \nweek’s “The Takeout” podcast, “We are not going to let up on that. I think the American people \ndeserve to know the truth about COVID 19. They deserve to have a government try to actually find \nthe truth about where the COVID 19 originated from.” \nClyburn’s Committee has finally shone a bright light on the destructive nature of the Scott \nAtlas dogma of “herd immunity” and the Great Barrington Declaration:\nHouse Select Subcommittee on the Coronavirus Crisis\nNew Select Subcommittee Report Reveals Full \nScope of Trump Administration’s Embrace of a \nDangerous and Discredited Herd Immunity via \nMass Infection Strategy\nJun 21, 2022 \nPress Release \nReport is the first in a series on the Select Subcommittee’s investigation into the Trump Administration’s \npolitical interference with the federal coronavirus response\nReleased by Chairman Rand Paul\nPRESS:   Read this.   More preposterous nonsense about me by the radical right media.   \nThis is one of hundreds of such items coming out on a daily basis:\nThe Fauci Protocol: Treating Fauci’s Covid Diagnosis According To His Own \n‘Standard Of Care’.\nFor “The Corner” of the National Review  (6/17, 798K), George Leef linked to a piece in the \nBrownstone Institute  by Jordan Schachtel, who argued that NIAID Director Dr. Anthony Fauci, is \nunlikely to follow his own advice after being infected with COVID-19. \nRegional Press – Nextstar with Raquel Martin; Hearst with Christopher Sales; Gray with \nMolly Martinez;  “Fatherly” with Tyler Santora; Telemundo National with Francesco \nFajardo; Parents Magazine with Nicole Harris;\nJune 22, 2022\nThere has been some considerable tension between the new H-CORE group who is headed \nby Jason Roos and the rest of the HHS tream. They are involved in making major decision \nabout distribution of money. Yet the leadership component of H-CORE consisting of  the \nfollowing has not been consulted on any major decisions: \nSeveral people including Cliff Lane and I are concerned that decision are being made in a \nvacuum and Jason seems uninterested in calling the leadership group for advice and consultation\nPRESS: regional press: The Klay Kane Show (Sirius XM) with Klay Kane; Revolt TV with \nRyan Dennis; The Midday Party on Hot 103 Jamz (Kansas City) with Julee Jonez; Cox \nwith Kirstin Garris; WSB (ABC Atlanta, GA) with Linda Stouffer; WDIV (NBC Detroit, \nMI) with Dr. Frank McGeorge\nJune 23, 2022\nReal problem evolving with people having got infected at Megan’s wedding on June 18. \nMegan is devastated since at least a dozen family members and friends seemed to have gotten \ninfected while in NOLA, likely, but not definitely at the wedding.\nReleased by Chairman Rand Paul\nRep Steve Scalise is agitating with Rep Jim Jordon about getting me to testify or be \nquestioned in closed doors by the House Select Committee on the Coronavirus Crisis chaired \nby Rep. Jim Clyburn. They are saying that the USG is “hiding” me.  Clyburn does not want to \nallow it since he knows they will make it into a circus.   However, they are playing it out publicly \nthat I am hiding something and that is why I do not want to testify.   If it were up to me, I would \nabsolutely testify.\nPRESS:  BBC News TV;  White House Press Briefing (of note, this is the 1st one that I have \nbriefed at in several weeks (see my comment above about Dr. Jha)\nJune 24, 2022\nWe are stuck at around 100,000 cases/day and this is very likely a significant \nunderestimate.  Deaths remain low:\nHad and important Zoom conversation with Peter Marks and a whole bunch of people (see \nbelow) regarding the upcoming choice of a booster for the fall season.   I am in favor of a \nbivalent wild-type/BA4/5 or a monovalent BA4/5.\nReleased by Chairman Rand Paul\nJune 25, 2022\nBad day with rebounds sxs.  Started on 2nd course of Paxlovid\nJune 26, 2022\nFeel much better this morning, on my second day of Paxlovid. Will take it very easy today \nand see what happens over the next couple of days. \nI'm reading Deb Birx’s book and it can serve as a really good reference for me to refresh \nmy memory about dates and events.\nJune 27, 2022\nJust for the record – Ashish Jha is promoting himself on all major TV and clearly \nexcluding Rochelle, Vivek and me.   Rather obvious and a big deviation from Jeff Zients \napproach\nReleased by Chairman Rand Paul\nWe seem to be “stuck” at around 100,000 cases per day (surely an underestimated since \nmost cases are not reported due to home Ag tests) and 300 deaths per day:\nJune 28, 2022\nMonkeypox cases continue to increase.   USA activists (James Krellenstein et al) now \nincreasing pressure on HHS (ASPR) to be explicit on how many tests, antivirals, vaccines \nare available for distribution.\nPRESS: National Press Foundation Roundtable; Foreign Policy Global Health Forum \nKeynote;\nJune 29, 2022\nPatterns starting to show insidious increases in all parameters:\nPRESS:   Monkeypox press briefing (with Raj Panjabi) for LGBTQ community press; \nMulti-cultural media briefing for children vaccines\nReleased by Chairman Rand Paul\nDaily Mail: Anthony Fauci says that he's experienced rebound Covid symptoms after \ntaking a Pfizer's antiviral Paxlovid - which studies now show is NOT effective for people \nwho are vaccinated.\nWashington Post (Online)\nThe Pandemic Is Waning. Anthony Fauci Has a \nFew More Lessons to Share .\nAmerica’s most famous doctor on mitigating covid, giving your \nadversaries the benefit of the doubt and working way too \nmuch\nBy Anna Peele\nJune 29, 2022 at 10:17 a.m. EDT\nJune 30, 2022\nReleased by Chairman Rand Paul\nStill recovering from COVID. I had a rebound as indicated above after stopping my first course \nof Paxlovid.  Have now finished my second course and my antigen positivity is very very slight. \nHopefully it will disappear by tomorrow.\nLittle by little going in the right direction.\nImportant zoom meeting with Karl Lauterbach (Minister of health of Germany), Ugur \nSahin (CEO, BioNTech) and Ashish Jha. We discussed the pros and cons of what the optimal \nbooster would be in the fall. Carl and Ashish called upon Ugur and me to give the scientific \nrationale of why our FDA has come down on the side of recommending a BA.4/5 bivalent (with \nWild type) boosts for the fall. Although it may take a little bit longer to get enough doses to start \noff early in the fall, the advantage of having a powerful BA.4/5 stimulus and response may be \nworth the slight delay. We also agreed that if we get a surge very early in the fall before we have \nenough BA/4/5, then we can actually boost with the ancestral monovalent since this does induce \na reasonable response although not optimal against BA. 4/5.  Karl mentioned that Germany had \nbeen leaning towards and omicron bivalence, particularly in the context that this is what \nModerna has been pushing since that is what they have decided to make at risk and they don't \nwant to lose the use of those dosages. At the end of the discussion it was clear that Ugur and I \nconvinced Karl that the better direction to take would be as discussed above with BA. 4/5.   It \nwas a very good discussion and I came away impressed that Ugur is a brilliant scientist and \nseems to be a really nice person.\nHad my usual every two week zoom call with Chris Whitty of the UK.  Chris and I have \ndeveloped a very good relationship and we exchanged information about what is going on in the \nUK compared to what is going on here. They are unclear as to what boosts that they would use \ngiven the fact that they do not believe that they will have enough time to get enough BA. 4/5 \nboost made to meet a potential false surge we both agreed that if the surge comes early they can \nutilize the unused ancestral Wuhan vaccine that they have plenty of.\nPRESS:\nThe New York Times (Shery Stolberg):\nFauci says he believes Paxlovid kept him out of \nthe hospital, even though he tested positive \nagain.\nDr. Anthony Fauci, President Biden’s top pandemic adviser, sought to discourage doubts about the \nantiviral drug Paxlovid following what appeared to be a “rebound” of Covid-19 after taking the pills.\nJuly 1, 2022  Global – 543,352,927/6,331,059;   USA – 87,298,343/1.012,767\nTested Ag negative today!!\nReleased by Chairman Rand Paul\nImportance of vaccination + boosters:\nCases clearly going up everywhere in the USA and in UK:\nI am struggling with the issue of what the precise and most appropriate time to step down \nfrom my current position to move on to writing books and entering the next phase of the \nwinter of my career. It is very difficult for me to pull away from being the director of NIAID \ngiven the extraordinary history that I have created and lived through over the last 38 years as \ndirector. As we approach the decision making time of this summer although I lean very strongly \ntwo announcing my departure in August and leaving at the end of 2022, the thought of this still \ncauses considerable anxiety in me as to whether or not I am doing this too soon. However, I will \nReleased by Chairman Rand Paul\nbe 82 years old at the end of the year and I have always said that I want to go out while I am still \nvery much on top. That is the driving force that has me feel that I will go through with the plan\nPRESS:\nhttps://paw.princeton.edu/article/commencement-speakers-offer-parting-words-2022-grads\nJuly 2, 2022 \n 2nd day  in a row Ag negative\nNoteworthy is that Senator John Kennedy (R-LA) despite his seeming antagonism of me \nsent me a very nice, handwritten “get well soon” note.\nMonkeypox problem growing…..\nGlobal.health: 6178 confirmed MPX cases in 67 non-endemic countries; 51 suspected.  459 \nin USA\nJuly 3, 2022\nUK reporting anther “concerning variant – BA. 2.175\nJuly 4, 2022\nReleased by Chairman Rand Paul\nI had a very relaxed day today. Went on a nice walk. After that we hung around the house \nand towards the evening we went fishing on the canal but, as usual, we didn't catch \nanything. Yesterday was a fun day in that not only did we go for a good walk, but I also \nthrew the baseball around in preparation for my trip to Seattle, and then Brett and I shut \naround some baskets at Horace Mann school. Next week is going to be a tough week in that \nthere's a lot of stuff going on in addition I have my CT scan on Sunday.\nJuly 5, 2022   Global   USA\nRecent article in The Atlantic by Cary Gross and Zeke Emanuel criticized the NIH for not \nmoving quickly or effectively enough on research on COVID.   Larry Tabak wrote a letter in \nstrong response:\nTHE CONVERSATION\nLetter: The NIH Has \nResponded Forcefully to \nCOVID-19\nThe nation’s leading health-research agency, its acting director \nwrites, has moved with unprecedented speed against a global \nthreat.\nJuly 6, 2022   Global   USA\nActivists including James Krellenstein, Gregg Gonsalves and Peter Staley among others are \ngetting agitated at HHS and NSC (Raj Panjabi) for the lack of Jynneos (MVA – Bavarian \nNordic) for PrEP for Monkeypox for the Gay community (MSM)\nMPX cases increasing greatly in USA especially in DC, NYC and Chicago\nJuly 7, 2022\nBA.2.75 increasing in Australia, India and several other countries.   Some cases in USA.   \nWatching it closely\nReleased by Chairman Rand Paul\nMet with Adam Russell, Acting Deputy Director of newly formed ARPA-H\nPEPFAR Oral history:  https://www.bushcenter.org/publications/essays/pepfar.html \nPRESS:  Newsy TV Interview; Radio New Zealand RNZ;\nJuly 8, 2022   Global USA\nPRESS: Mother Jones Interview on HIV Vaccines with Jackie Lynn Mogensen\nJuly 9, 2022\nPeople are acting like and hoping that COVID is over, but it is not.   There are still \n>100,000 cases/day which is likely a gross undercount since many cases (perhaps x5) are \nnot reported and deaths are stuck at ~300 with hospitalizations increasing:\nI had a conversation with Rochelle and Vivek about this today (Saturday) indicating that I \nbelieve we are not doing enough in a proactive way of getting out there with the press and \nin other venues talking up how we need to increase mitigations such as reminding people \nabout the importance of wearing masks as well as pushing to get people vaccinated and \nboosted. Also, as I have said in the recent discussion with Dan Diamond of the post in which he \ntweeted I would discussion that we need to be more liberal in getting people a fourth shot who \nare less than 50 years old but might have some underlying conditions without necessarily being \nReleased by Chairman Rand Paul\nimmune compromised. Bottom line is that I am pushing that we be more aggressive. I am \ndisappointed that I have not been out in the classic media of TV and radio either because the \nmedia are not interested or because the White House is not sending them my way. The same \nholds true for Rochelle and Vivek. They are not being out there as much as I believe we all \nshould be.\nDan Diamond tweet: Officials have been debating, for months, \nwhether to recommend a 2nd booster, especially because so \nmany Americans haven’t gotten their 1st. But TONY FAUCI \ntold The Post he’s “leaning toward flexibility” for more \nyounger Americans to get another booster shot.\nMPX still increasing in USA and around the world.   In USA 790 reported cases.  Likely \nand undercount.\nReleased by Chairman Rand Paul\nGlobal.health  9060 confirmed MPX cases in 71 non-endemic  countries, 40 suspected \nPolitico – Story about BARDA contract to company Phlow to make continuous generics.   \nThey did not fulfill their contractual responsibility.\nTrump-era federal Covid contract recipient has yet to meet \nmajor deadlines \nTwo years in, Phlow Corp. has not delivered on high-tech methods to domestically manufacture cheap \ngeneric drugs.\nPeter Navarro was likely influential in picking the company that was not even a company \nyet when BARDA gave them hundreds of millions of dollars:\n“Evidence uncovered by the Select Subcommittee raises questions about whether White House officials, \nincluding Mr. Navarro, exercised inappropriate influence over contract awards for [personal protective \nequipment] and medical supplies that should have been handled by career procurement staff,” the \nletter continued.\nJuly 10, 2022\nPreprint (MedRXiV): Asymptomatic monkeypox virus \ninfections among male sexual health clinic \nattendees in Belgium\nWe need to be careful that we do not fall into the same issue that we did early on with COVID, \ni.e. not appreciating the importance of asymptomatic spread.\nFollow-up Chest CT – Unchanged!!!\nJuly 11, 2022\nOn our weekly call with the secretary, I brought up the issue that we need to be much more \nproactive in warning people about the spread of infection and that we have to be pushing \nthe wearing of masks and getting people vaccinated and boosted. The secretary agreed and \nwe're going to discuss this even more with Ashish tomorrow.\nReleased by Chairman Rand Paul\nWashington Post article describes my pushing to be more aggressive during this surge of \nBA.5 variant:\nBiden officials push to offer second booster shots to all adults\nPlan would make coronavirus shots available to millions more amid rising \ncases, hospitalizations.\nBy Dan Diamond, Laurie McGinley and Lena H. Sun\nWhile the booster plan still needs formal sign-off from regulators and public health officials, it \nhas the backing of White House coronavirus coordinator Ashish Jha and Anthony S. Fauci, the \ngovernment’s top infectious-disease expert, according to five officials who spoke on the \ncondition of anonymity because they were not authorized to discuss the plan.\nIn an interview, Fauci said that he’s “leaning” toward allowing second booster shots for younger \nadults, pending authorization from the Food and Drug Administration and agreement by the \nCenters for Disease Control and Prevention.\nWhile persuading those who haven’t gotten vaccinated or fully vaccinated to get the full regimen \nand their first booster shot is critical, Fauci said, “we also need to allow people who are under 50 \nto get their second booster shot, since it may have been months since many of them got their \nfirst booster.”\n“If I got my third shot [in 2021], it is very likely the immunity is waning,” Fauci added.\nJuly 12, 2022\nWas called to the White House for a meeting with Ron Klain, Ashish Jha, Sec. Becerra, \nRichelle Walensky and Dawn O’Connell.   Ron was really ****** that he is getting a lot of \nFlack from New York City who feels that they are not getting enough doses of monkey pox \nvaccine. Ron is upset with the formula of distribution among the states. He  feels that doses \nare being sent to places with few cases and not being used and there are lines of people \nwaiting to get vaccinated in New York City and they are making a big stink about this \ncausing what may turn out to be a political problem for POTUS. I kept quiet through most \nof the discussion which was pretty tense between secretary Becarra and Ron. However, it \nbecame clear to me that the lesion was that the contractor who is shipping the doses from \nDenmark to the United States do not appear to realize that this is an emergency and they're \ntalking about sending one plane per week with about 140,000 doses per plane. I brought up \nthe point when Ron mentioned that I was being very quiet and he wanted to know my \nopinion. I said that  it is inconceivable to me that we cannot do better than 140,000 doses \nshipped per week when we have about a million doses in Denmark sitting ready to be \nshipped. I believe that this is an example of people not pressuring to get things done during \nan emergency and accepting business as usual. The astounding fact is that they said that \nthe reason they have to rely on the plane flying back from the United States to Denmark to \nreload with another bunch of vaccines is that they only have limited carriers to put the vials \nin when they are shipped on the plane. What are they talking about?? One can make \ncarriers with 3D printers. In addition, I don't understand why they can only do 140,000 at \nReleased by Chairman Rand Paul\na time. After the meeting I emailed Dawn and expressed to her my astonishment that we \ncan't do better than this. She checked and found out that all of a sudden they could now \nship 400,000 doses of vaccine per plane instead of 140,000. In addition I encouraged her to \nwork with the Department of Defence to get more planes in the air. This is another example \nof a serious logistic snafu that could have easily been solved if somebody was just thinking \nwith a clear head. \n------------------------------------------------------------\nGood coverage of the White House press conference where I emphasize the need to take the \ncurrent situation seriously without letting it disrupt our lives:\nThe Hill - Fauci: Take new subvariant seriously, but \ndon’t ‘let it disrupt our lives’ \nby Peter Sullivan  - 07/12/22 11:10 AM ET\nNY Times – Sheryl Stolberg As BA.5 spreads, the White House warns \nthat Covid is not over.\n:\n“Variants will continue to emerge if the virus circulates globally and in this country ,” Dr. Anthony S. \nFauci, Mr. Biden’s chief medical adviser for the pandemic, said at a White House news briefing. “We \nshould not let it disrupt our lives. But we cannot deny that it is a reality that we need to deal with.”\nPRESS:   White House Press Briefing;  MSNBC with Chris Lansing; Nexstar with Don \nKauffman; Interview with Eileen O’Reilly for Axios; Fox TV with Neil Cavuto;\nJuly 13, 2022\nHospitalizations going up.  Deaths stable at ~300/day.   BA4/5 >80% of isolates with BA5 \n>50%   Europe having a big surge of BA5.\nMet with Bob Barnett again last night planning the announcement of my stepping down \nand the subsequent linking up with publishers and speaking bureaus after I actually leave.\nReleased by Chairman Rand Paul\nGOP in Congress inappropriately trying to shut down all research collaborations with \nChina:\nDraft bill would ban CDC, NIH from funding lab \nresearch in China\nHouse of Representatives measure catalyzed in part by \nsuspicion that pandemic virus escaped from Wuhan \nlaboratory\n•12 Jul 2022\n•6:00 PM\n•ByJocelyn Kaiser\nPRESS:  CNN “New Day” with John Berman\nJuly 14, 2022   Global – 5546,897,312/6,356,812;   USA – 88,932,987/1,018,035\nCases, hospitalizations, and deaths now going up:\nRochelle called me up tonight and arranged to have a zoom with me to get my advice about \npressure she is getting from the White House who is responding to New York pressuring \nthem to get more monkey pox vaccines (see above on July 12). This relates to the meeting we \nhad a couple of days ago with Ron Klain where he was very concerned that we are being \nReleased by Chairman Rand Paul\nperceived as being unresponsive with regard to vaccines and the POTUS is getting a lot of \npressure from NYC for more vaccines. The White House wants her to distribute the vaccine \naccording to the number of cases and she feels correctly that that is not a totally fair way since \nthere is a consideration for the at-risk population in certain locations that don't yet have a lot of \ncases.  Also, southern states with black MSM are not really tresting since they are stigmatized \nand cases are not being recognized.  I counseled her that it is a battle she will lose if she insists \non distribution other than just by case numbers. She will lose the fight with the WH.  In 1 to 1 \nand 1/2 weeks there will be hundreds of thousands of vaccines shipped from Denmark. At that \npoint we can do what I would strongly suggest is to blanket the at risk community with vaccines \nfor everyone who is at risk particularly those who are on prep for HIV or who are infected with \nHIV and are suppressed with their viral load due to antiviral drugs. Those are the ones that are \nout there having sex and not feeling vulnerable because they are on antiviral therapy. I told her to \nhang tight for week or so and the problem will solve itself.\nPRESS: Rickey Smiley Radio Show; KAMR TV Amarillo, TX; NBC Livestream News with \nPhil Lepof; CNN with Erin Burnett;\nJuly 15, 2022  Global    USA\nAfter talking with Ashish this morning, Rochelle decided to allocate vaccines for \nmonkeypox at 75% according to the number of cases and 25% for the level of risk and a \ngiven community. That seems like a reasonable compromise which I agree with and will \nback Rochelle on. As mentioned above, in two weeks this will be a moot point since there \nwill be hundreds of thousands of doses of vaccines arriving from the outside. \nWe are not keeping up very well on booster shots:\nPRESS:  Univision Digital with Borja Voces; Skimm TV ONLINE with Maria Corpus; \nBloomberg TV “Balance of Power” with Joe Mathieu\nReleased by Chairman Rand Paul\nJuly 16, 2022\nPRESS:   CNN with Laura Coates\nJuly 17, 2022 (Sunday)\nImportant conversation with Ashish Jha. But she's called me up and wanted my opinion and \nbacking on what he wants to bring up to Ron Klain. He wants to propose putting billions of \ndollars into a program that would mimic operation warp speed in which he has been calling \n“hyperdrive”. The purpose is to put a full court press on getting you closely administered \nvaccines to prevent infection and transmission as well as next generation platform and imagine \ndesigns for greater breadth and durability of response. These latter concepts word described by \nme to him. The reason Ashish wanted my help was that he heard from Ron that unless we're \nproposing something that is more than just incremental and that would actually be transformative \nand play a major role in turning around how Americans think about COVID, then he doubts that \nRon will take the step to go to the president to have the president use a chit with the Congress to \nget the money. The trick about all of this is that Ron will want a product to go into the arms of \nAmericans within 18 months to coincide with approaching the end of the administration and the \nelection for the presidency. I told Ron that I would back him on the transformative nature of the \ntwo pillars that I mentioned above, but I have considerable skepticism as to whether or not we \ncan do this in 18 months. I suggested to Ashish that week altogether a group comprised of him, \nme, Peter Marks and Rob Califf from the FDA as well as some knowledgeable people from \nbiotech and pharma.  Unless we have corporate sponsors we are not going to go anywhere with \nthis and we will never be able to do it in 18 months. Ashish will set-up the meeting and hopefully \nwe can make a determination and get back to the president. Ashish feels that if we cannot \nconvince Ron about this then there is no way that we can get the money.\nJuly 18, 2022\nSarah Ohermohle wrote an article in Politico where I mentioned that I would be leaving the \nNIH sometime before the end of President Biden's first term to which is January 2025. This \nis being interpreted by many in the press that I'm announcing my retirement. This is \nobviously not the case because I have given no date for stepping down and I am not retiring \nwhen I leave government service. However given the interest in me it is not surprising that \nthis is now gone viral:\nAnthony Fauci wants to put Covid’s politicization behind him\nThe disease fighter says he’s plotting his departure and reflecting on how he wants to be \nremembered.\nFinancial Times:  Kiran Stacey\nReleased by Chairman Rand Paul\nUS chief medical adviser Anthony Fauci to step \ndown in Joe Biden’s first term\nKiran Stacey\n4-5 minutes\nWashington Post:\nFauci says he will retire from government post \nby the end of Biden’s term\nBy Yasmeen Abutaleb\nJuly 18, 2022 at 11:45 a.m. EDT\nNew York Times (Sheryl  Stolberg):\nFauci Says He Will ‘Almost Certainly’ Retire by \nJanuary 2025\nDr. Anthony S. Fauci, 81, said he expected to see out President Biden’s current term.\nWall Street Journal – Stephanie Armour and Betsy McKay\nAnthony Fauci Plans to Retire by End of \nBiden’s Term\nOne of the leading public faces of the U.S. public-health \nresponse to Covid-19 says he hasn’t decided on exact date\nReleased by Chairman Rand Paul\n----------------------------------\nI had a very good talk today with  Sam Bankman-Fried and his brother Gabriel Bankman \nwho runs a foundation called “Guarding Against Pandemics”.   Also on the call were their \nassociates Jacob Swett and Annabel Snidow. (see above) .  We spoke about how Sam with his \nbillions of dollars could partner with the NIH and pushing the scientific agenda for the \nprototype pathogen approach of pandemic preparedness. Sam is a good friend of senator Joe \nManchin and Joe is the one who originally pointed Sam in my direction to see if somehow we \ncan all work together to having some sort of a partnership where the Congress puts in a certain \namount for pandemic preparedness using the prototype pathogen model and Sam puts in an equal \namount to support the effort through NI AID. We left it that they put together a proposal and that \nI serve as the scientific advisor for the amount of money that Sam wants to put into this even \nthough I must be careful and will be careful about not getting involved in writing any legislation \nsince Manchin has been talking about writing this into a reconciliation bill.\nPRESS:   CNN with Kate Bolduan; Reuters interview with Julie Steenhuysen; NBC Online \nWeb;  NPR with Rob Stein (talking about the Politico article (see above)\nJuly 19, 2022\nI had an important conversation this morning with Peter Staley in which I asked his advice \nabout messaging to the gay community regarding monkey pox. There seems to be a debate in \nNew York City among public health officials versus some gay leaders. The tension is whether or \nnot to tell gay men to hold off on multiple sexual partners until they get a PrEP version of the \nvaccine. Some people are saying that that would increase the stigma against gay men. However, \nPeter agrees with me that there is nothing wrong with and probably a good idea to tell gay men \nto just hold off and cool it for the next couple of weeks until we get enough vaccine to vaccinate \nall people who are at risk namely those who've had multiple sexual partners within the last 14 \ndays. I will be out in the press talking about this and I just wanted to check with Peter as to \nwhether he agreed with me and in fact he does.\nBA.5 dominating isolates:\nReleased by Chairman Rand Paul\nPRESS:  The Hill Health Summit Interview and streaming with Steve Clemons;  Good \nHousekeeping with Zee Krstic; WHUR 96.3 FM DMV/ HBCU Network with Harold \nFisher;WJLB 97.9 Detroit with Bushman; WNYM (FOX-NYC) TV with Lori Stokes;\nJuly 20, 2022\nI just had an important conversation with Rochelle in which I related to her the \nconversation that I had last night with Carlos Del Rio in which Carlos articulated that there's \na great deal of concern and agitation in the gay community, which I already am aware of, \nregarding the difficulty in getting TPOXX for the treatment of monkey pox. I decided to call \nRachel and give her a heads up that the community is really starting to get very agitated to the \npoint that they may be attacking the administration and her and the FDA and all of us in the press \nif we don't do something soon to cut down the difficulty in getting TPOXX to those in need. I \nsuggested to her that she and the FDA think in terms of doing something akin to the parallel \ntrack approach that I initiated decades ago during the HIV pandemic. She will look into this \nwith her people.\nI had a great meeting today in building 31 with Dr. Karl Lauterbach, the Minister of \nHealth of Germany. He relied heavily very heavily on my advice about how to handle the \ndecision about and distribution of booster shots for COVID in Germany. He is having some of \nReleased by Chairman Rand Paul\nthe same problems as we are having here in trying to decide what the correct booster should be in \nthe fall. He has already ordered millions of doses of Moderna bivalent which is an omicron plus \nancestral as well as Pfizer which is a BA.4/5 bivalent plus ancestral. Moderna is obviously \npushing their product, but Karl was very interested in what my opinion was. I told him that on \nthe advice of me and others, the FDA has already authorized the bivalent of BA.4/5 and ancestral \nfor the full dose. It is now up to the CDC and teir ACIp to make a recommendation f who \n“should” versus “may” receive the dose.\nWe also spoke about the tension regarding vaccinating people now who are at risk of severe \ncomplications given that there is a wave of infections in Germany as well as in the United States \nversus waiting until a more variant-specific boost is available in the fall. Germany is facing the \nsame dilemma as we are in that some people in Germany are arguing in a very similar way to \nPaul Offit who is saying that we should not be vaccinating people now. Paul is smart and a good \nfriend but he is a victim of what I consider making the perfect the enemy of the good. From a \npurely immunological standpoint it is obviously not optimal to have a boost now (ancestral) and \nrequire an even better boost (bivalend BA.4/5 + ancestral) just a couple of months down the pike. \nHowever, you have to balance the public health benefit  of getting some form of vaccine to \npeople who are at risk for infection and severe disease now compared to the relatively minor \nnegative effects of giving a vaccine shot now followed in 2 to 3 months by a vaccine shot with a \nbetter boost. I was surprised that bloggers such as Paul Offit  have a major impact globally. Karl \nmentioned to me that he and his colleagues listen very carefully to what I say and it would be \nvery helpful to them to hear what I am telling him today and that I agree completely with him \nsince he is absolutely in the same lane as I  as well as many of my NIH colleagues including \nRick Koup and others. It was a very stimulating conversation and I was on my A game. \nWe then went on to discuss the issue of monkeypox. According to Karl monkey pox is out of \ncontrol in Germany and similar to what we are seeing in the United States the gay community is \nvery frustrated with the lack of as many vaccines as they need as well as the lack  of easy access \nto antivirals. They seem to be having no trouble with diagnostics which are plentiful. I explain to \nhim that our situation is very similar here in the United States. The conversation ended with him \nwanting to take a picture with me since his daughter who is 15 years old apparently is a great fan \nof mine. We exchanged cell phone numbers and he promised me that he would be calling me \nfrequently.\nJohn Laureman (Bloomberg) wrote a very nice laudation of me today:\nAn Early Farewell to America’s Top Pandemic \nExpert\nJuly 21, 222\nHarassment from the far right continues:\nReleased by Chairman Rand Paul\nRand Paul Sends Message To Fauci: You’ll Have To Testify Under Oath If GOP \nWins.\nFox News (7/20, 23.99M) reports, “Sen. Rand Paul, R-Ky., issued a warning to Dr. Anthony Fauci: If \nthe GOP takes back Congress in the midterms, be prepared to testify under oath regarding the \ncoronavirus pandemic.” On Wednesday, he argued on “America Reports” that “the American people \ndeserve the truth and answers on whether there was a cover-up for a lab leak in China.” \nPresident Biden tested positive today (Thursday)!   Tested negative on Tuesday, went to \nBoston on Wednesday; had mild sxs this AM and tested positive.  \nhttps://www.whitehouse.gov/wp-content/uploads/2022/07/Letter-7.21.pdf\nObvious media storm.   He has mild sxs.   My only concern in the way that his MD (Kevin \nO’Connor) is treating him is that he D/C’d his Eliquis and Lipitor.   I do not care about the \nLipitor, but I am very concerned about the discontinuing completely of the Eliquis. The president \nhas a atrial fibrillation and I would have merely lowered his dose to 1/2 the dose rather than \ncompletely discontinuing it because of my concern about him throwing analysis in getting a \nstroke. I mentioned this to a sheesh during a briefing called this evening since we are all going \non television tomorrow.\nCouple of interesting things related to the infection of the president. 1) I called up Kevin \nO'Connor who is the physician to the president and got a briefing from him for the simple \nreason then when I go out on TV and I'm asked whether or not I have been consulted with it \nwould be rather embarrassing to say that they did not call the so-called most famous infectious \ndiseases expert in the world, who happens to also be the chief medical advisor to the president. I \nexplained to Kevin my concern about the anticoagulation. He understood my concern and said \nthat he has started the president on low dose aspirin which is a good thing. Kevin explained that \nthe president was negative for an antigen test on Tuesday, did not sleep well on Wednesday \nevening,  and woke up on Thursday predominantly with fatigue. Tested himself on a routine \nbasis which for him is 2 to three times per week. The test came back positive, confirmed by a \nPCR. Throughout the day he then began to get sniffles, at first a dry cough and then a loose \ncough. His temperature rose to 99.4 F, which came back to normal with tylenol. His oxygen \nsaturation was 97 to 98%. He was resting reasonably comfortably when Kevin left him tonight. \n2)  We had a meeting with the comms people and Ashish Jha this late afternoon in preparation \nfor media requests tomorrow. I was under the impression that they were going to spread out the \nrequest for morning shows between Ashish and me. I found out later in the evening that all the \nmorning shows will go to Ashish and they will give me regional meeting in the afternoon. As \nmentioned several times above it is very clear that Ashish is trying to dominate the media scene \nwith regard to COVID-19 and is telling his staff to lead me out of the major media hits. Again, \nhe does a good job but it is a bit of Bush league to do that. I have asked Courtney to \nReleased by Chairman Rand Paul\ncommunicate with the White House calms people and two in a very nice way ask them just what \nis going on here.\nMonkeypox continues to spread throughout the world.  15,000 cases worldwide  in 70 \ncountries; >2000 in USA:\nMonkeypox Virus Infection in Humans\nacross 16 Countries — April–June 2022\nJ.P. Thornhill, S. Barkati, S. Walmsley, J. Rockstroh, A. Antinori, L.B. Harrison,\nR. Palich, A. Nori, I. Reeves, M.S. Habibi, V. Apea, C. Boesecke,\nL. Vandekerckhove, M. Yakubovsky, E. Sendagorta, J.L. Blanco, E. Florence,\nD. Moschese, F.M. Maltez, A. Goorhuis, V. Pourcher, P. Migaud, S. Noe,\nC. Pintado, F. Maggi, A.-B.E. Hansen, C. Hoffmann, J.I. Lezama, C. Mussini,\nA.M. Cattelan, K. Makofane, D. Tan, S. Nozza, J. Nemeth, M.B. Klein,\nand C.M. Orkin, for the SHARE-net Clinical Group*\nThe activist community is very angry .   See Washington Post article:\nOpinion \nThe Biden administration’s monkeypox \nresponse has been a mess\nBy Gregg Gonsalves\nJuly 21, 2022 at 3:56 p.m. EDT\nPRESS: FOX “Good Day” NYC TV with Rosanna Scotto; WGN Chicago Radio with Peter \nMcMurray and Rob Martier; \nJuly 22, 2022\nKevin O'Connor called me this morning at 10 48 AM to give me an update on the \npresident's condition. He is quite stable has a slight fever up to 99F that is easily brought \ndown by tylenol. He has a cough which started off as dry but now is a bit “loose” as \ndescribed by Kevin which means it seems deeper in the chest. However, the president feels \nwell enough to continue to work from the White House although he is a bit fatigued as you \nmight expect. More later. \nReleased by Chairman Rand Paul\nLetter from Kevin O’Connor to the USA – POTUS doing well:\nReleased by Chairman Rand Paul\nThe Guardian – Gay community in revolt about monkeypox.   Article about Peter Staley:\n‘Nobody’s acting like this is an emergency’: Act \nUp veteran Peter Staley condemns US \nmonkeypox response\nWilfred Chan\nRochelle has pleaded with me to back the CDC plan of distributing vaccine more on the \nbasis of at risk population then on the actual number of cases since it is anticipated that \nwith a variety of gay pride galas coming up including “Southern Decadence” among others \nthat although there are not a lot of cases in the southern states including Louisiana, there \nwill be soon and although New York City and other large cities but particularly in New \nYork City is hammering the White House about the lines that there are to get vaccine in \npeople who perceive themselves and in fact are practicing risk behavior even though they \nhave not been in direct documented contact with an infected person. The White House is \nresponding to the complaints of the gay community that the response to the monkeypox outbreak \nhas been a terrible disaster (see above with Peter Staley) and they are pushing Rochelle and the \nsecretary to distribute it favoring New York since they have the most cases. Rachel wants me \nand I agree to back her in making it a 75% on risk and 25% on cases whereas the White House \nwants the distribution to be 25% on risk and 75% on cases. I believe that this is short sighted \nbecause we are quickly going to see areas that do not have a lot of cases now but will very soon \nnot having enough vaccine to prevent the outbreak. I was very forceful in the zoom call with the \nsecretary and the HHS team in saying that I would back Rochelle; however, we must have the \nflexibility of apportioning doses to the at risk locations in small allocations so that if they don't \nuse them we will not have given them all of their doses at one time and thus cannot recall them \nto give them to cities and locations that actually have a large number of cases. Once you send \ndoses to a location, by FDA regulations, you can't pull them back and send them somewhere \nelse. And so smaller allocations are the answer. Whether or not Ron Klain will accept this is a \nbig question. He is very interested in the political blowback from New York. This is \nunderstandable since he is a politician but he is not looking at it from a purely public health \nstandpoint. I was very forceful with the HHS team when the comms people were suggesting that \nwe explain this gap that we have in availability of vaccines on the lack of funding. I told the \nsecretary on the zoom that I have to be frank with them, but I thought that this would be a total \ndisaster since that is an excuse and not an explanation and the  gay community would kill them \nfor making excuses. I mentioned that we had to own the problem and tell them that it would have \nbeen nice to have all the doses that everybody needed, but the fact is we don't have all the doses \nand therefore we will do everything we can to get as many doses to people as we can in an \nequitable manner. Bottom line is that I told them what I told the Trump administration, and that \nis the only way to solve a problem is to first own the problem.\nReleased by Chairman Rand Paul\nWas on multiple TV shows (see below). One of the things that came up was why the \npresident's physician, doctor Kevin O'Connor, was not out there describing the president's \ncondition. I answered that I was not in the loop and I did not know why. However it is very clear \nas mentioned above and as confirmed by Dori Solcido that Ashish really wants the spotlight and \nwants to be the one talking about the president's condition. I consider that an unforced error \nbecause that's what the press is going to focus on that we are hiding something. I do not want to \nget into that seen Ashish wanting to essentially be on every single possible major TV show, but \nthat's the way it is. Also, the White House was concerned that Kevin mentioned that the \npresident had a temperature of 99.4F. the temp responded very well to Tylenol and I brought up \ntoo Dory as to how foolish it is to get upset because Kevin mentioned his temperature. It is the \nperfectly normal thing to have a low grade temperature with a upper respiratory infection. Even \nthough this White House is a good White House they're concerned about message control is ill \nadvised and they are only making unforced errors. \nI spoke again tonight (10:00 PM) with Kevin O'Connor and he brought me up to date on \nthe President's condition . He still requires Tylenol to keep his temperature down. He is very \ncomfortable and even played some golf on the putting range in the White House outside because \nhe was getting a little bit cabin fever. According to Kevin he continues to improve, but Kevin is \nconcerned about Paxlovid rebound and is considering giving him eight days of the drug. He \nwanted my opinion as to whether or not that was a good idea. I am ambivalent about this since \nthere will be a lot of blowback about why he was treated differently than the recommendations. \nCliff lane would not treat him for an extra few days but would take the chance that he was going \nto rebound. I will recheck with Kevin tomorrow.\nI had a long talk with Raj Panjabi (NSC) who sought my advice about how to deal with the \nactivist group who feel that he is lying to them and that they have lost confidence in his ability to \ngive them straight information. I mentioned to Raj that he needs to be straight with the activists \nand put himself in their shoes where they are looking at hundreds of millions of dollars invested \nin a product to be put in this row tegic national stockpile, and now that we need that product it is \nnot available to the gay community. They are outraged and all he and his colleagues are doing is \nmaking excuses for it (see above about owning the problem).  I made it clear to Raj and cannot \nhave his comms person speak to Peter Staley, David Barr, and James Krellenstein et al.  he must \ndo it himself otherwise it would be showing disrespect to the activists. Raj was extremely \ngrateful for my tutoring of him in this regard.\nPRESS:  CBS Livestream Online; NY1 Spectrum News TV with Kevin Frey; Alice Park \nwith Time magazine; ABC World New Tonight; NBC Nightly News with Lester Holt; CNN \n“The Situation Room” with Wolf Blitzer; FOX News with Brett Baier; MSNBC “The Beat” \nwith Ari Melber; KMOJ FM (Minneapolis) with Freddie Bell; Univision National \nwith Andrea Linares; Telemundo National with unknown\nReleased by Chairman Rand Paul\nJuly 23, 2022\nYesterday I spoke with dawn O'Connell and told her that I would be very much in favor of \nthe secretary declaring a public health emergency for monkeypox. She is now running it up \nthe chain to see what others think about that..\nI had my usual call this morning with Kevin O'Connor, the president's physician. It was a \ndisturbing call because Kevin told me that Ashish is really trying to manipulate what Kevin \nsays regarding the health of the president and Kevin is starting to get very aggravated by \nthis. For example, Ashish did not want Kevin to mention that the president's temperature \nwas 99.4F  because then that would be a topic for the news discussion. That is completely \nridiculous because it is totally expected that someone with a URI would have a mild \ntemperature responsive to Tylenol. In addition, Ashish did not like the use of the word \n“malaise” which was the exact word the president used to describe how he felt. Ashish was \nafraid that that word would bring up recall of president Jimmy Carter and the negative \nresponse that the country had to his describing “malaise” in the country. And then finally \nin today's report Kevin wanted to put in a new symptom that the president complained of \nwhich was muscle aches, an entirely understandable symptom that has nothing to do with \nprogression of disease. They insisted that he not add that. Kevin pushed back and said that \nhe would not sign off on anything if they force him to hold back on what the true symptoms \nare.\nReleased by Chairman Rand Paul\nCall from Larry Horowitz regarding Ron Klain saying to him (Larry) that the President \nwants to make some changes since Health area (COVID/MPX) is not going well.   \n“Someone needs to get fired.”   Primary target is Becerra, but they feel that they cannot \nfire him since they never would get a replacement confirmed in he Senate.   Next in line in \nRochelle.  They really are disappointed with Rochelle and want to fire her.   They asked \nLarry for suggestions for replacements.   Larry called me about this.   He suggests Mark \nMcLellan or Anne Schuchat.   Wants names from me.  Larry also called Jeff Z.   They do \nnot know that Jeff is working with me regarding my stepping down.   Could get \ncomplicated.  I called Jeff and we discussed the situation.   See below my discussion the \nnext day (Sunday) with Jeff.\nHad a long conversation with Jeff about the above issue concerning firing someone at \nHHS/CDC. Similar to the situation that I faced years ago with Secretary Burwell wanting \nto fire Tom Frieden because of poor performance with Ebola where I defended Tom, I \nfound myself defending Rochelle. Rochelle is a wonderful person, but she does not have \ncontrol over her agency and she has to learn to balance the politically expedient thing while \nReleased by Chairman Rand Paul\nstill maintaining solid scientific principles. The problem is she relies too heavily on the \nentrenched people at CDC who are smart and will meaning but who have no oversight or \nquality control from the outside. This allows them to proceed with somewhat antiquated  if \nnot ossified ideas. As the discussion went the options were to fire Secretary Becerra; \nhowever, this would be very difficult since it would be tough to get a Senate confirmation \nfor a secretary within a relatively acceptable period of time. The other option is to fire \nRochelle, but now is not the time to do that and it would be against my recommendation. \nOne of the points that Jeff made is that they are considering in a humane way to ask \nRochelle to step down at the end of the year before the beginning of the second-half of the \nfirst term. Despite my trying to protect Rochelle there is a very good chance that that will \nhappen. \nKevin O’Connor continues to call me 2x/day. The president continues to improve and is \ncompleted his 4th day on Paxlovid.  .He was out for four hours today by the pool doing \nreading work. The next big question is whether to give him eight days or 10 days instead of \nfive days of pax livid. That would be a problem since it would be against FDA \nauthorization and the public would cry out that we had treating him differently than other \npeople. the concern on the part of the White House is that if he rebounds after he is \nnegative for several days, he will likely be out talking and mingling with people. If he \ninfects someone following an inadvertent rebound, he will be blamed for infecting other \npeople. My suggestion would be to treat him for five days have him stay in the White House \nvirtually for an additional five days testing him everyday if he turns negative as soon as he \nturns negative send him out even if it's before the 10 day. And have him wear a mask in \norder to avoid him inadvertently infecting people if he rebounds, I would just test him \nevery morning before he gets up and goes out to meet with people. If he is negative he will \nbe OK, if he is positive continued isolating.\nEmergency phone call among HHS people (Becerra, Dawn et al) regarding convincing \nPOTUS (and Ron) to declare a Public Health Emergency (PHE) for MPX.   Becerra says \nthat POTUS will rely heavily on my opinion.  Problem is that they are concerned that if you \ndeclare a PHE for monkey pox then why not declare it for gun violence or for reproductive \nrights. That sounds very much like the negativistic attitude of RON.\nReleased by Chairman Rand Paul\nPRESS: ABC “Good Morning America” Weekend; CBS Mornings (Weekend); CNN “New \nDay” Weekend; Fox News with Neil Cavuto\nJuly 24, 2022\nKevin O’Connor continues to call me 2x/day. The President continues to improve and is \ncompleted his 4th day (Sunday) on Paxlovid.  He was out for four hours today by the pool \ndoing reading work. The next big question is whether to give him eight days or 10 days \ninstead of five days of Paxlovid. That would be a problem since it would be against FDA \nauthorization and the public would cry out that we had treating him differently than other \npeople. The concern on the part of the White House is that if he rebounds after he is \nnegative for several days, he will likely be out talking and mingling with people. If he \ninfects someone following an unrecognized rebound, he will be blamed for infecting other \nReleased by Chairman Rand Paul\npeople. My suggestion would be to treat him for five days, have him stay in the White \nHouse virtually up to an additional five days testing him everyday. If he turns negative, as \nsoon as he turns negative send him out even if it's before the 10 day period. And have him \nwear a mask in order to avoid him inadvertently infecting people if he rebounds, I would \nbe OK, if he is positive continued isolating.\nHad long conversation with Ashish who was asking my advice. He started off the \nconversation by saying that the White House continues to have a lot of problems with \nRochelle, the latest of which was the apportionment of vaccine doses.   (See discussion \nabove about strong consideration of asking her to step down).   Ashish said that Ron wants \nmy take on the situation with Rochelle/CDC and the distribution of vaccine doses.  She \nwants to divide the vaccines for monkey pox according to the formula of 25% according to \ncases and 75% according to risk. This is something that we had discussed yesterday in a \ncall with the secretary. During that call I promised that I would back Rochelle's proposal \nbecause of the fact that if they do not distribute more, namely 75%, according to risk, when \nwe have outbreaks related to “Southern Decadence” and other gay pride functions we will \nnot have vaccine in place to counter it. However Ron Klain is adamant that he does not \nwant vaccines shipped to locations in which there are few cases and when they do not get \ncases or they do not administer vaccine to their case countthat the vaccine goes to waste \n(you cannot reship vaccine). I made the following point to the secretary yesterday and I \nrepeated it word for word to Ron today. I would be supportive of a 25% for cases and 75% \nfor risk distribution only if the jurisdictions that received the 75% for risk are given the \nvaccines in small apportionments. For example if they were scheduled to get 400 vaccines, \nyou would give them 100 and tell them that if they don't use that 100 expeditiously the next \nshipment of 100 would not be given to them but would be given to a jurisdiction that has a \nhigh number of cases. I explained this to Ron when he called me today and told him that \nthat would be my position. He said that Ron is very interested in what I would do and that \nthis would hold a great deal of weight in the discussions that we will have tomorrow, which \nis Monday. \nHad a long conversation with Jeff about the above issue concerning firing someone at \nHHS/CDC. Similar to the situation that I faced years ago with Secretary Burwell wanting \nto fire Tom Frieden because of poor performance with Ebola where I defended Tom, I \nfound myself defending Rochelle. Rochelle is a wonderful person, but she does not have \ncontrol over her agency and she has to learn to balance the politically expedient thing while \nstill maintaining solid scientific principles. The problem is she relies too heavily on the \nentrenched people at CDC who are smart and will meaning but who have no oversight or \nquality control from the outside. This allows them to proceed with somewhat antiquated  if \nnot ossified ideas. As the discussion went the options were to fire Secretary Becerra; \nhowever, this would be very difficult since it would be tough to get a Senate confirmation \nfor a secretary within a relatively acceptable period of time. The other option is to fire \nRochelle, but now is not the time to do that and it would be against my recommendation. \nOne of the points that Jeff made is that they are considering in a humane way to ask \nRochelle to step down at the end of the year before the beginning of the second-half of the \nReleased by Chairman Rand Paul\nfirst term. Despite my trying to protect Rochelle there is a very good chance that that will \nhappen. \nKevin O’Connor continues to call me 2x/day. The president continues to improve and is \ncompleted his 4th day on Paxlovid.  He was out for four hours today by the pool doing \nreading work. The next big question is whether to give him eight days or 10 days instead of \nfive days of pax livid. That would be a problem since it would be against FDA \nauthorization and the public would cry out that we had treating him differently than other \npeople. the concern on the part of the White House is that if he rebounds after he is \nnegative for several days, he will likely be out talking and mingling with people. If he \ninfects someone following an inadvertent rebound, he will be blamed for infecting other \npeople. My suggestion would be to treat him for five days have him stay in the White House \nvirtually for an additional five days testing him every day if he turns negative as soon as he \nturns negative send him out even if it's before the 10 day. And have him wear a mask in \norder to avoid him inadvertently infecting people if he rebounds, I would just test him \nevery morning before he gets up and goes out to meet with people. If he is negative he will \nbe OK, if he is positive continued isolating. \nOf note, Ashish states that he wants Kevin to go up in front of the cameras to describe the \nPresident's condition, but it is Ron who does not want him to go up as well as Karine Jean-\nPierre.  That is interesting because I am hearing that it is Ron who does not want Kevin to \nget up in front of a camera. \nPRESS: MSNBC with Jonathan Capehart\nJuly 25, 2022\nSpoke with Kevin O'Connor again this morning and evening. the president is doing \nextremely well and continues to improve. He we'll complete his fifth day of Paxlovid today. \nThe next question will be when he can go out into", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: their CEO has told us he’s ready to talk to  you) because you fear offending Moderna.   Jeff, David, Tony—let me be frank. You all need to grow a pair.   James will be sending an email soon suggesting we hash all of this out over good food and wine in DC  soon. I hope you’re all up for it.   Peter  Sent from my iPhone   From:  Peter Staley <peterstaley@verizon.net> Sent: Monday, October 11, 2021 7:28 AM To: Kessler, David (HHS/IOS); Tony Fauci (af10r@nih.gov); James Krellenstein Subject: NYT: Moderna, Racing for Profits, Keeps Covid Vaccine Out of Reach of Poor  Moderna, Racing for Profits, Keeps Covid Vaccine Out of Reach of  Poor https://www.nytimes.com/2021/10/09/business/moderna-covid- vaccine.html Released by Chairman Rand Paul  Sent from my iPhone PRESS: CNN “The Situation Room”…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 8, "page_count": 1141}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 9 of 10)", "content": "society. I have a phone call with Ashish \nthis afternoon and I will recommend that we not give him additional days of drug but that \nwe have him stay masked inside for 5 days or until he tests negative by antigen test. They \nare concerned about rebound; however, I have told them that if he tests every morning for \nfive to 10  days after his Paxlovid course ends and he does not show any positivity, he can \ngo out that day and proceed with business. That would be much more acceptable to the \ngeneral public then to give him an extra few days of drug which would not actually \nguarantee that he does not rebound.\nReleased by Chairman Rand Paul\nPRESS:   The Hill “Rising”; CBC Radio with Robin Bresnahan;\nJuly 26, 2022\nContinuing my twice per day discussion with Kevin O'Connor regarding the president's \ncondition.  The POTUS Is doing very well and improving substantially each day. Today is \nReleased by Chairman Rand Paul\none day following the termination of his  Paxlovid therapy and his CT level is 35 which \nmeans that he has very little replication competent virus in his nasopharynx. He feels very \nwell and we had a long discussion this evening with Kevin, Ashish Jha, and Ron Klain as to \nwhat the presidents activities could be looking forward. He tested negative today by antigen \ntest and has a very nice CT level as mentioned above. The White House staff is concerned \nabout possible rebound and I made a suggestion that he stay masked and in isolation until \nhe gets two negative antigen tests in a row. After that he can go out and do duties on the \noutside provided that he does not travel and that he wears a mask. I would test him \nintimately a few times a week to see if he rebounds. It became clear to me that Ron Klain \nand the president rely heavily upon my advice but what to do with the president's \ncondition. I have developed a very good relationship with Kevin O'Connor and he calls me \ntwice a day.\nWe had some serious discussions with secretary Becerra about having a consistent message \nabout the distribution of the monkey pox vaccine . See above about the concern of having \nvaccine in places that are not being utilized well there are lines in other jurisdictions. I \nsupported the CDC recommendation of distributing the vaccine with 75% to risk areas and \n25% to actual cases so long as individual jurisdictions utilize the vaccine. The CDC will \nsend out the vaccine in tranches that will not be followed up with more vaccine until the \njurisdiction actually utilizes the vaccine so that we don't have unused doses in one area and \ndemands more than supply in another area.\nWe also discussed whether or not we should declare monkeypox a public health emergency. \nI argued strongly that we do that in order to send a signal to the MSM community that we are \nvery serious about the situation that they find themselves under.\nWe had the vaccine summit today in the Indian treaty room of the executive office building. \nI gave a talk on the NIH research agenda. Also I did an enormous amount of press today which \noverlapped with a number of meetings with the White House as well as with secretary becerra. \nBig time stressed today and I feel it.\nPRESS: CNN “New Day” with John Berman; MSNBC “Morning Joe”; NPR “All things \nConsidered”; News Nation Now TV; MSNBC “The Reid Out” with Jason Johnson\nJuly 27, 2022\nPaper in Nature today validates my disagreement with the CDC last year when Vivek and I \npushed back against their saying that you do not need to test after 5 days of isolation after \ninfection since most of the transmissions occur in the first few days of infection and after \nday 10 you are OK (see prior notes):\nHow long is COVID infectious? What scientists \nknow so far\nReleased by Chairman Rand Paul\nThose with SARS-CoV-2 are often advised to isolate for only a few days. But evidence is mounting that \nsome people can continue to pass on the virus for much longer. \n•David Adam \nPOTUS back to work.  The letter below is based on conversations I had last night with \nRon, Kevin, Anita Dunn, Mike Donilon, etc.:\nReleased by Chairman Rand Paul\nI was part of the opening panel of the introduction of the UN aids report very beginning of \nthe  IAS meeting in Montreal. The name of the report presented by Winnie Byanyima (Exec \nDirector of UNAIDS) is “In Danger”.   Also on the panel was John Nkengasong (PEPFAR), \nAdeeba Kamarulzaman (President of IAS), Andriy Klepikov (Dir. Alliance for Public Health in \nUkraine, Keren Dunaway, International Community of Women Living with HIV, Anita \nVandenbald Canadian MP.\nAP reporting on the above:\nPeople are exhausted with epidemics and pandemics,” said Dr. Anthony Fauci, the U.S. government’s \nleading AIDS expert. “We have to fight twice as hard to get HIV back on the radar screen where it \nbelongs.”\nYesterday it was a little bit of a distributing and embarrassing situation where Raj Panjabi \npiggy-backed his own little mini session on monkey pox right after Vaccine summit at the White \nHouse at the very last minute without letting dawn or Connell know until literally I have to now \nwill before he was asking her to speak. bottom line is it all is that although everyone agrees that \nRaj is a really good guy and his heart is in the right place he is really over his head in his job at \nthe NSC in charge of pandemic preparedness. Dawn believes that the White House is well aware \nof that and that is the reason why they are appointing any “Monkeypox Tsar”\nWashington Post:\nThe Fauci ‘ouchie’ was a near miracle. We \nneed another. \nBy the Editorial Board\nJuly 27, 2022 at 2:51 p.m. EDT\nVariety:\nReleased by Chairman Rand Paul\nDr. Fauci, Roberta Flack and Zora Neale \nHurston Documentaries on the Way, PBS Boss \nAnnounces \nWent to a terrific social function at the incredible home of Adrienne Arsht at 6 Chevy \nChase Circle.   It was a cabaret night where American Pops Orchestra founder/leader had a \ncontest played old songs and had the audience guess the singer.   I thought that I might win since \nI got only 2 wrong, but Renee Fleming won with an even better score.   Had interesting \nconversation with Brett Baier where he finally admitted that the 2 recent Science papers by \nWorobey, Andersen, Rasmussen et al convince him that the lab leak theory is really not true.\nPRESS:  New York Daily News interview with Tim Balk; NPR WBUR Boston with John \nRinger; \nDr. Anthony Fauci says government response \nto monkeypox must address anti-gay stigmas\nMuri Assunção, New York Daily News\nJuly 28, 2022\nCases and hospitalizations continue to rise slowly with very little increase in deaths.\nI recommend to Becerra to declare PHE.\nMonkeypox:\nGlobal.health: 20,671 confirmed MPX cases, 42 suspected in 84 non-endemic countries. \n4600 in USA.   2 children infected in USA from mother who had sex with bisexual man\nThe Montreal Gazette concerning my comments (virtually at the UNAIDS report \nunveiling):\nDr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the United \nStates and chief medical adviser to U.S. President Joe Biden, said the UNAIDS report is “a reminder that \nthe global plague” of HIV/AIDS “continues to rage,” even though much of our attention diverted to the \nglobal pandemic of COVID and now, monkeypox.\n“All of us in the global HIV community must work to reach vulnerable communities,” he said, and the \nreport is a reminder that “we can do better in this, the fifth decade of AIDS. The priority must be to \nReleased by Chairman Rand Paul\nimplement better treatment modalities, while improving and optimizing the next generation of \ninterventions.”\nThe COVID pandemic and, now, monkeypox, mean “people are exhausted with epidemics and \npandemics. We have to fight twice as hard to get HIV back on the radar screen, where it belongs,” Fauci \nsaid.\nI was involved in a very difficult zoom cool this evening with Peter Marks. Rob Califf, \nVivek, David Kessler, Julia Tierney (FDA), Hillary Marston, among others about the \npotential conflict that might occur tomorrow when Ashish has convinced the president to \ncome out and say that anyone who's not been boosted recently should get boosted. \nHowever, we now know that both moderna and Pfizer will have the BA.5 bivalent boost \navailable the first week of September. This will create a major messaging problem since we are \ntelling people to get boosted with the vaccine that doesn't cover the current BA.5 variant when \nthe actual variant-specific boost will be available 5 weeks from now. Somehow or other Ashish \ntook the initiative to convince the president to say this without consulting with the FDA or the \nCDC. If these mixed messages go out it will be a major cluster. I tried to bring this up to them \nand suggested strongly that they have a zoom in the morning before any of these announcements \nare made in order to get a common message otherwise it will look like one of the worst mixed \nmessages to come out in a long time. I'm starting to see right now the advantage of having Jeff as \nthe coordinator since he understands the interactions among the different agencies of government \nwhereas Ashish is smart, a very good communicator and is well meaning, but he is more about \nlooking like he's taking the lead on things than coordinating. \nLater in the evening, I had dinner over jeff's and Mary’s house which was a great evening. \nGuests at the dinner besides Chris and I were: Susan Rice, Secretary of Defense Lloyd Austin \nand his wife Charlene, Deb Harmon, Wally Adeyemo.  The discussion was very stimulating \nparticularly Susan Rice telling us stories of her escapades during the Obama administration and \nsecretary Austin telling us about the tension in his multiple responsibilities. One of those \ndiscussions of the night was the desire of Nancy Pelosi to go to Taiwan which everybody feels is \na very bad idea given the geopolitical situation. However for some reason she feels she needs to \ngo there and everyone seems to be against it.\nJuly 29, 2022\nSee e-mail chain below regarding the confusion about mixed messages related to my note \nyesterday:\nFrom:  Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> \nSent: Friday, July 29, 2022 7:35 AM\nTo: Marks, Peter (FDA/CBER) < Peter.Marks@fda.hhs.gov >; Califf, Robert <RMC001@fda.hhs.gov>; \nTierney, Julia (FDA/OC) <Julia.Tierney@fda.hhs.gov >; Tabak, Lawrence (NIH/OD) [E] \n<Lawrence.Tabak@nih.gov >; O'Connell, Dawn (OS/ASPR/IO) <Dawn.Oconnell@hhs.gov>; Levine, Rachel \n(HHS/OASH) <Rachel.Levine@hhs.gov>; Murthy, Vivek (HHS/OASH) <Vivek.Murthy@hhs.gov >; Kessler, \nDavid (HHS/IOS) <David.Kessler@hhs.gov >; Varrone, Michael (HHS/OGC) <Michael.Varrone@hhs.gov >; \nReleased by Chairman Rand Paul\nRoos, Jason (OS/ASPR/H-CORE) <Jason.Roos@hhs.gov>; Mahon, Barbara (CDC/DDID/NCIRD/OD) \n<bdm3@cdc.gov>; Goldstein, Robert (CDC/OD) <qyd2@cdc.gov>; Berger, Sherri (CDC/OD/OCS) \n<sob8@cdc.gov>; Marston, Hilary (FDA/OC) < Hilary.Marston@fda.hhs.gov >\nSubject: RE: Confidential – Next Steps on Expanding Eligibility for Additional Booster\nTeam:\n    I know that we are all struggling with this and trying to get it right, but I really \nhave a problem with the 4/8/12 message. It is not that it is incorrect from a \nmedical and/or immunological standpoint. It is that it will it be very confusing. I \nknow that we are trying to save lives by getting people vaccinated and boosted; \nhowever,  for the overwhelming most part, the people who are going to get \nvaccinated (particularly the elderly) are already vaccinated and I am not sure how \nmuch we are going to move the needle in getting the “unboosted” to get boosted \nwhen we are simultaneously saying that in 5 weeks we will have a much better \nand more specific vaccine.   That is an inherently confusing message that would \nbe counterproductive. Right now if we were three months away or even two \nmonths away from a variant specific boost I could see making a big push to get \npeople boosted now. However, starting with Monday we will be five weeks away \nfrom a variant specific boost. If we want to have one cogent prevailing message it \nis that we have a very important boost that will be available in five weeks. The \nmessage should be focused on that. Anything that confuses that will work against \nus. Just my take….\nThanks,\nTony\nAnthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nReleased by Chairman Rand Paul\nThe information in this e-mail and any of its attachments is confidential and may contain sensitive \ninformation.  It should not be used by anyone who is not the original intended recipient.  If you \nhave received this e-mail in error please inform the sender and delete it from your mailbox or any \nother storage devices.  The National Institute of Allergy and Infectious Diseases (NIAID) shall not \naccept liability for any statements made that are the sender's own and not expressly made on \nbehalf of the NIAID by one of its representatives.  \nFrom:  Marks, Peter <Peter.Marks@fda.hhs.gov > \nSent: Friday, July 29, 2022 6:58 AM\nTo: Califf, Robert <RMC001@fda.hhs.gov>; Tierney, Julia (FDA/OC) <Julia.Tierney@fda.hhs.gov >; Tabak, \nLawrence (NIH/OD) [E] <lawrence.tabak@nih.gov >; O'Connell, Dawn (OS/ASPR/IO) \n<Dawn.Oconnell@hhs.gov>; Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>; Levine, Rachel \n(HHS/OASH) <Rachel.Levine@hhs.gov>; Murthy, Vivek (HHS/OASH) <Vivek.Murthy@hhs.gov >; Kessler, \nDavid (HHS/IOS) <David.Kessler@hhs.gov >; Varrone, Michael (HHS/OGC) <Michael.Varrone@hhs.gov >; \nRoos, Jason (OS/ASPR/H-CORE) <Jason.Roos@hhs.gov>; Mahon, Barbara (CDC/DDID/NCIRD/OD) \n<bdm3@cdc.gov>; Goldstein, Robert (CDC/OD) <qyd2@cdc.gov>; Berger, Sherri (CDC/OD/OCS) \n<sob8@cdc.gov>; Marston, Hilary (FDA/OC) < Hilary.Marston@fda.hhs.gov >\nSubject: RE: Confidential – Next Steps on Expanding Eligibility for Additional Booster\nDear Rob,\nThanks. \nPerhaps the 4/8/12 messaging is going to be the best way to go then\nAt least 4 weeks if you are over fifty until next booster (I know the immunologist don’t love this, but \nthere are different antigens in the booster and mRNA vaccines are not the same as protein based \nvaccines. This seems to balance the potential benefits and risks)\nAt least 8 weeks if your are under fifty \nAt least 12 weeks if you recently had COVID\nIf you are immunocompromised, you will need to wait at least 4 weeks, but follow your healthcare \nproviders recommendation\nReleased by Chairman Rand Paul\nBest Regards,\nPeter\nFrom:  Califf, Robert <RMC001@fda.hhs.gov> \nSent: Friday, July 29, 2022 6:26 AM\nTo: Tierney, Julia <Julia.Tierney@fda.hhs.gov >; Tabak, Lawrence A (NIH) <lawrence.tabak@nih.gov >; \nO'Connell, Dawn (OS) < Dawn.Oconnell@hhs.gov>; Fauci, Anthony S (NIH) <afauci@niaid.nih.gov>; \nLevine, Rachel (OS) <Rachel.Levine@hhs.gov>; Murthy, Vivek (OS) <Vivek.Murthy@hhs.gov >; Kessler, \nDavid A (OS) <David.Kessler@hhs.gov >; Varrone, Michael (OS) < Michael.Varrone@hhs.gov >; Roos, Jason \n(OS) <Jason.Roos@hhs.gov>; Mahon, Barbara (CDC) <bdm3@cdc.gov>; Goldstein, Robert H (CDC) \n<qyd2@cdc.gov>; Berger, Sherri (CDC) <sob8@cdc.gov>; Marks, Peter <Peter.Marks@fda.hhs.gov>; \nMarston, Hilary <Hilary.Marston@fda.hhs.gov >\nSubject: Re: Confidential – Next Steps on Expanding Eligibility for Additional Booster\nHad a good “Ashish session” late last night.  He is moving forward, but understands that the \nfaster than expected timetable for bivalent vaccine is a really good thing.  He agreed that its \ncritical that we reach agreement on the best set of words that capture the common ground \nthat we want people to get boosted (now 5 RWE studies showing the big effect of even the 4th \nshot on reducing death and hospitalization), but with the bivalent imminent lower risk people \nhave the good option of waiting.  For those who get boosted now—they can still get the \nbivalent in xx weeks.\nFrom my view the only thing that will be bad for public health out of our options would be for \nus to have different messages.  All other options are a net positive in terms of reducing death \nand severe illness.\nrmc\nFrom: Julie Tierney <Julia.Tierney@fda.hhs.gov >\nDate: Thursday, July 28, 2022 at 10:41 PM\nTo: Robert Califf <RMC001@fda.hhs.gov>, Lawrence Tabak <lawrence.tabak@nih.gov>, \n\"O'Connell, Dawn (OS)\" <Dawn.Oconnell@hhs.gov>, Tony Fauci <afauci@niaid.nih.gov>, Rachel \nLevine <Rachel.Levine@hhs.gov>, Vivek Murthy <Vivek.Murthy@hhs.gov>, David Kessler \n<David.Kessler@hhs.gov >, \"Varrone, Michael (OS)\" <Michael.Varrone@hhs.gov >, \"Roos, Jason \n(OS)\" <Jason.Roos@hhs.gov>, \"Mahon, Barbara (CDC)\" <bdm3@cdc.gov>, \"Goldstein, Robert H \nReleased by Chairman Rand Paul\n(CDC)\" <qyd2@cdc.gov>, \"Berger, Sherri (CDC)\" <sob8@cdc.gov>, Peter Marks \n<Peter.Marks@fda.hhs.gov >, \"Marston, Hilary\" <Hilary.Marston@fda.hhs.gov >\nSubject: Confidential – Next Steps on Expanding Eligibility for Additional Booster\nAs a follow up, we’re still working through the FDA statement and will circle back tomorrow morning \nwith next steps. Thanks for your patience. \nHad a very interesting conversation with the HHS team regarding a memo at the secretary \nwill be sending to the president regarding the declaration of a public health emergency \n(PHE). the secretary expressed some concern about whether we should do that or not but his \nstaff actually wrote a memo making it seem like he definitely wanted it I brought this out to them \nwhen I read quickly the memo while we were on the Zoom and the secretary requested that I \ncan't fully look at the memo and make comments. I actually think we should definitely declare a \nPHE and I modify it the conclusion of the memo to be unambiguous about this. It was really \nstrange that the secretary said he had reservations and his staff wrote a memo that strongly \nrecommended that we do it. In my memo back to them I told them that they have to make up \ntheir mind one way or the other and have the memo strongly recommend what he actually wants. \nI rewrote the conclusion assuming that he will take my recommendation to declare it \nJuly 30, 2022 (Saturday)\nJust got a call at 12 noon from Kevin O'Connor that the president has had a rebound with \na positive antigen test today. He is asymptomatic. This is the real problem since there are no \nguidelines from the CDC which dictate what to do when you have someone who you are testing \nvirtually every day. The CDC health advisory on what to do following a rebound after Paxlovid \ntreatment does not mention testing at all. the duration of isolation is based purely on symptoms \nand time from resolution of symptoms. Here again it goes back to my objection many months \nago of the guidelines the CDC put out about reentry into society following infection. I had \ninsisted back then that even though it might not be practical for everyone to get testing and often \npeople need to get back to work after five days, they still should have put some guidance in for \npeople who can get tested period now we are flying in the dark. Ron Klain is going to want him \nout as soon as possible; however, given that he is known to now be antigen positive he has to \nisolate for five days and then the question will arise of how often to test him and if he is positive \nshould he be let out even with a mask. Cliff Lane feels  strongly that he should be in isolation so \nlong as he is antigen positive and can go out once he has two negative tests in a row.\nGot a call from Ashish making sure that we are on the same page.   Also, he asked me if we \nshould start a 2nd course of Paxlovid.   I told me not to unless the POTUS gets significant sxs\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nRep. Lauren Boebert (R-CO) spoke about a proposed rule that would lower Dr. Fauci's salary to $1.Stay \nConnectedForbes on Facebook: ...\nFlag as irrelevant \n*****Wall Street Journal piece by Peter Loftus on July 29, 2022 is critical in its historical \nportrayal of the interaction of NIAID and Moderna/Pfizer.   Important for the book!!\nWSJ: The Partnership That Made the First U.S. Covid Vaccine\nGay community getting very agitated about that they perceive as the government’s slow \nresponse and resting the rapidly evolving multi pox outbreak:\nFrustration builds in LGBTQ community over \ngovernment response to monkeypox\nJen Christensen, CNN\n12-15 minutes\nJuly 31, 2022\nI gave the special session plenary lecture at the International AIDS Society (IAS) meeting \nin Montreal via a virtual presentation. I have given a plenary lecture and virtually every one \nof the IAS meetings since 1984.  I reflected on what has transpired since the last meeting in \nMontreal which was in 1989. My presentation triggered a prolonged standing ovation from the \naudience. The session was chaired and moderated by Laura Waters of the UK.\nThe president remains antigen positive for the second day in a row following his rebound. \nHis CT values are 16 to 18.  He has had no additional symptoms although he still has somewhat \nof a lingering cough. The plan is to keep him isolated until he asked two negative antigen tests in \na row.\nReleased by Chairman Rand Paul\nI got a call from Rochelle who is stuck in Amsterdam following the cancellation of her \nflight from Amsterdam to Washington. She is coming back from a trip to Uganda and Kenya. \nShe thanked me profusely for sticking up for the CDC's decision about allocation of vaccines for \nmonkey pox.\nGot a call from Jen Ashton of ABC expressing concern about something that I have been \nalmost obsessing about today and most recently. That is the fact that the public may be taking \nmonkeypox too lightly assuming that it will stay confined to the population of men who have sex \nwith men. In addition, we are doing nothing proactively to encourage people to cancel such \nevents as  ”Southern Decadence” and Black gay pride galas. We are starting to see cases of \nspillover into non men who have sex with men populations. Also, there is so much that we do not \nReleased by Chairman Rand Paul\nknow about the Natural History of this disease and with the potential is to spread beyond MSM. I \nwill have to talk to people at HHS and the White House that we cannot under play this outbreak.  \nCall from Francis Collins, Acting Science Advisor to POTUS regarding NIH Director \nChoice – Charles Sawyer at MSKCC. Francis wants me to talk to him about the possibility of his \nbeing considered for the job of NIH director. It is essentially a recruiting call that Francis wants \nme to have with Charles. Apparently the president is not satisfied with either of the two names \nthat was submitted to him: Mary Klotman (Duke) and Kimryn Rathmell (Vanderbilt).\nAugust 1, 2022\nI have been somewhat concerned about Monkeypox the very beginning, but I am getting \nmore and more concerned about it as time goes by. It clearly is spreading rapidly throughout \nthe world the community of MSM with an estimated doubling time of about seven days; my \nconcern is that we are all seeing some spray into the non-MSM communities such as the recent is \nvery much bothering me is the continued plans to have MSM and gay pride galas at the same \ntime that we are having acceleration of COVID as well as outbreaks of monkeypox (see above \nmy conversation with Jen Ashton)\nI got my usual follow up call from Kevin O'Connor regarding the President's condition. He \nis concerned that his viral load is going in the wrong direction, namely, his CT value went \nfrom 18/16 to 16/14.   He called me together with Walter Reed ID physician Wes Campbell to \nsee if I agreed with them that they should not restart Paxlovid since the president does not have \nany new symptoms and his oxygen saturation is 98%.  His chest is clear despite the fact that he \nhas his typical nagging cough that antedated his illness. I agreed with them that they should not \nstart a second course of Paxlovid.\nThe administration will announce tomorrow that they are appointing a monkey pox \nCoordinator (Bob Fenton) and a Deputy Coordinator (Demetre Daskalakis). Clearly the \nresponse or at least the perception of the response of the government to monkeypox has not been \ngood. They are hoping to reinvigorate the response by this appointment. Tonight, Kevin Munoz \n(WH Comms) called me and he asked me if it was OK to put a quote in the press release \nsupporting this decision. The White House feels that because of my street credibility with the gay \ncommunity that this would make the choice more acceptable. I agreed and provided a brief \nquote.\nOverwhelming evidence of benefit of vaccines and boosts:\nReleased by Chairman Rand Paul\nJuly 2, 2022 \n*****Important debate going on that relates back to the conflict that I had with the CDC I \nwas concerned that they did not call for antigen testing following infection before someone \nis able to go back out into society.    The president got infected, went on Paxlovid, and then \nrebounded. And so the question is when can he go back into society. Since he is the president \nand we test them every day he is staying isolated until his antigen test reverts to negative. At the \nsame time, a number of papers including in the NEJM have shown that the median time of \nreversion to negative antigen test is actually five days and many people stay positive until day \n8,9,10 and beyond.  The CDC recommendations say that after five days since no requirement is \nmade for testing (which I was very much against this decision and caused a ruckus by \ndisagreeing with the CDC many months ago), A person can go out into society after five days \nwith the mask so long as they have no symptoms. And after 10 days, if they still have no \nsymptoms they can take their mask off. This obviously Will lead to people going out into society \nwho are still antigen positive and are likely spreading the virus. That was my original concern \nwhen I disagreed with the CDC.\nBA.5 now 86% of isolates in USA:\nReleased by Chairman Rand Paul\nA lot of activity working with Rob at the FDA and Ashish and CDC to get the right \nmessaging about recommendations for the booster in the fall.  The FDA would like to say \nthat the bivalent BA.5 boost is significantly better then the mono valent ancestral strain \nboost.   There is a lot of pushback from the immunology community led by John Moore saying \nthat the bivalent BA.5 boost is only marginally better then the monovalent ancestral strain. The \ndata is somewhat confusing as explained below in an e-mail from Rick Koup to me. The debate \nis whether to ask people who are otherwise that low to moderate risk to get vaccinated now with \nthe ancestral strain will wait until September when a supposedly much better boost is available. \nMost of us have no problem with low risk people waiting, however, I and others are concerned \nabout overselling that the bivalent boost is much better then the ancestral boost, which is not the \ncase I will list a couple of emails below that outline the dilemma:\nFrom:  Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nSent: Monday, August 1, 2022 6:53 PM\nTo: Califf, Robert <RMC001@fda.hhs.gov>\nCc: Murthy, Vivek (HHS/OASH) <Vivek.Murthy@hhs.gov >; Kessler, David (HHS/IOS) \n<David.Kessler@hhs.gov >; O'Connell, Dawn (OS/ASPR/IO) <Dawn.Oconnell@hhs.gov>; \nAshish.K.Jha@who.eop.gov  <ashish.k.jha@who.eop.gov>; Salcido, Dori A. EOP/WHO \n<Dori.Salcido@who.eop.gov>; Barclay, Lisa L. EOP/WHO <Lisa.L.Barclay@who.eop.gov >\nSubject: Follow-up of our call \n \nReleased by Chairman Rand Paul\nRob:\n    The point that I was making during the zoom call was that we should get the \ndata which I believe is available that looks specifically at the titer of neutralizing \nantibody against BA.5 induced by the bivalent BA.5 boost versus the title of the \nneutralizing antibody against BA.5 induced by the monovalent ancestral boost. \nThe reason I say we need that data at hand is because if we are going to say that \nthe BA.5 bivalent boost is far superior to the ancestral boost and that is the \nreason should wait for it until the Fall, we better make sure that we have data \nthat substantiates that.   This is important, since there are people out there saying \nthat the BA.5 variant boost is really not that much different from the monovalent \nancestral boost when you compare neutralizing antibody titers against BA.5.  If \nthe data show that the BA.5 bivalent boost is only marginally better than the \nancestral monovalent boost,  we should say that the bivalent is “somewhat” \nbetter and not make it look like the bivalent is a major advance. Having said all of \nthat, I still believe that the scenario that we agreed upon as delineated in your not \nto me is sound.   I just do not want us to oversell how good and different the \nbivalent boost will be because this will trigger pushback from the immunology \ncommunity.\nBest regards,\nTony\n------\nFrom:  Koup, Richard (NIH/VRC) [E] <rkoup@mail.nih.gov> \nSent: Tuesday, August 2, 2022 9:08 AM\nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nCc: Lane, Cliff (NIH/NIAID) [E] <clane@niaid.nih.gov>\nSubject: RE: Follow-up of our call\nHi Tony,\nSorry about not getting back to you earlier.  I don’t know why I didn’t see this on my cell phone this \nmorning.\nThere is no question that the bivalent BA4/5 will probably do better against BA4/5 than the current \nancestral boost.  This is based upon circumstantial evidence, some of which is presented below.  (Mouse \nimmunogenicity, infection with omicron).  The actual human data do not exist yet.  The best we have is \nfrom John Beigel in the mix and match study, which shows only a marginal increase in BA4/5 neut titers, \nReleased by Chairman Rand Paul\nand which Peter Marks decided not to present at the VRBPAC, probably because the data did not \nsupport his desired outcome.\nI think the problem is that the FDA wants to say that they have a better vaccine coming.  Instead, they \nshould be saying that if people need vaccination now they should get the vaccine now.  As with all \nvaccines, they will be rolling out updated vaccines as they become available and when there are data to \nsupport the change.  People in need of vaccines now should not delay in hopes of getting a “better” \nvaccine.\nJohn  Beigel can share his data with you.\nBest,\nRick\nRichard A. Koup, MD\nActing Director\nChief, Immunology Laboratory\nVaccine Research Center, NIAID, NIH\nTel: 301-594-8585\nFax: 301-480-2779\nrkoup@mail.nih.gov\n \nHad my twice daily follow up conversation with Kevin O'Connor regarding the condition \nof the president.  The POTUS continues to remain with minimal an unchanged symptomatology \ncharacterized by fatigue and his usual post nasal drip related cough. It is still rather concerning \nthat his CT levels are still very low and have not come back reflecting a very high viral load. We \nmaintain the decision discussed above about not treating a lab test and only reinstituting therapy \nif he has an exacerbation of symptoms.  I emphasized that he must be followed closely for \nreturn of significant sxs, which might trigger retreatment.\nReleased by Chairman Rand Paul\nAugust 3, 2022\nSpoke with Kevin O’Connor.   POTUS stable, but still Ag positive.\nReleased by Chairman Rand Paul\n------------------------\nMonkeypox spreading globally:\nReleased by Chairman Rand Paul\nMy comment in NY Times article by Sheryl Stolberg:\n“Centering the response operation at the White House gives the \nadministration more flexibility to coordinate efforts across a range of \nagencies that might be involved, including FEMA, the Health and \nHuman Services Department and the Department of Homeland \nSecurity. It also creates a designated team that has no responsibilities \nother than to combat monkeypox — a move that makes sense”, said \nDr. Anthony S. Fauci, Mr. Biden’s chief medical adviser.\nNY Times keeps hammering HHS for slow response in getting vaccines out to the community \nfor monkeypox.   Article by By Sharon LaFraniere, Noah Weiland and Joseph Goldstein:\nNYT: “U.S. Could Have Had Many More Doses of Monkeypox Vaccine This Year”\nI met with Rino Rappuoli in my office today. They are planning to make him the chief \nscientific officer of a pandemic preparedness program by the Italian government in Sienna.  Rino \nwants me, either before or after I leave the NIH to help them in an official way to set-up their \nprogram.\nReleased by Chairman Rand Paul\nI gave an interview with Nate Silver about a book that he's writing about risks in society.\nRand Paul together with Roger Marshal, Rick Scott, Josh Hawley, Ron Johnson is holding \na “hearing” on origins with the witnesses:  Richard Ebright (Lab Director Waksman Lab. Of \nMicrobiology, Rutgers), Kevin Esvelt, (Assistant Professor of Media Arts and Sciences MIT \nMedia Lab) and Steven Quay (CEO, Atossa Theapeutics) all totally non-credible.   Angel \nRasmussen is blasting them on twitter as hacks.   Once per year the minority are allowed to call a \nhearing and so Paul et al are using this as a publicity stunt.   The majority has not even showed \nup.   It is a total farse.   I got a follow-up from Chase Crawford from my legislative staff who \nlistened to the hearing and the result was expected in which Ebright came out strong saying that \nwe did do gain of function and that I lied Quay also said that. However Esvelt said that some \nmay call this gain of function whereas other scientists would say it's not since gain of function is \nsuch an ill defined term. He came the closest to reality. The rest of them would just pounding \naway that NIH funded gain of function and it likely caused the outbreak and that I lied saying \nthat we did not.\nCOVID:\nAugust 4, 2022\nThe Wrap:\nFox News host Tucker Carlson continued to imply that infectious disease expert and \nWhite House advisor Dr. Anthony Fauci somehow is responsible for creating the \nReleased by Chairman Rand Paul\ncoronavirus pandemic during Wednesday night’s episode of “Tucker Carlson \nTonight.”\n*****Critically important issue with CDC.  Usual problem The CDC surprised us all by \nannouncing that they are going to come out tomorrow with an updating of their guidelines \nacross several areas including how one addresses getting back in to the public after a bout \nof COVID. The updated recommendations that they give are really inherently inconsistent. \nA number of things about them are troublesome, but the one that really stands out is the \nfact that they say that if you are infected you must isolate for five days and if you decide to \ntest and have tests available you cannot go out into society with positive tests until after day \n10. If you test negative for two days in a row within the 10 day period, you can go out into \nsociety but you still have to wear a mask until day 10.  Importantly and disturbingly, if you \ntest positive on day 10 since you have already reached the 10 day mark you can then still go \nout into society without a mask!!!!  On the other hand,  if you decide not to test at all, on \nday five you can go out into society with a mask and then on day 10 after day 10 you could \ntake the mask off without knowing whether you're positive or not.  This seems just so \ninherently inconsistent that it's going to be very difficult to explain that to the public.\nWhen Ashish heard that this was going to be announced tomorrow he demanded that \nRochelle brief us on it tonight. When she did it became clear that the above contradictions \nexisted (see above). Prior to that meeting,  Rochelle called me up during the day and tried \nto explain what they were doing and it immediately didn't make any sense to me. I called \nup Cliff and he agreed with me. They seem to think that a positive test on day 10 doesn't \nnecessarily mean that you're dangerous to go out into society because you should really be \nnot infective after day 10 when in fact if you have a documented positive antigen test on \nday 10 all the data indicate that you definitely are transmissible since a positive antigen test \nmeans that you have replication competent virus. And so, the recommendations for those \nwho cannot test because they don't have access to test are inherently contradictory to the \nrecommendations for those who can test. This is going to drive Ron Klain completely crazy. \nIn fact, Ashish called me up and said that Ron Klain is already so furious with Rochelle \n(even before he has heard this) that he fears that her job is in serious danger.\nCovid perhaps plateauing:\nReleased by Chairman Rand Paul\nPOTUS continues to improve:\nReleased by Chairman Rand Paul\nWilliam Patrick Connelly, Jr who threatened me and my family goes to jail.   This is the \nguy yhat Brett Rowland tracked down.   See Washington Post article:\nWest Virginia man sentenced for threats \nagainst Fauci, officials Thomas Patrick Connally, Jr., \nwas sentenced to more than three years in federal prison\nReleased by Chairman Rand Paul\nCOVID cases:\nUnited States \n•Total Cases: 91,676,264, 7-Day average: 117,351 (-7.3%)\n•Total Deaths: 1,027,370, 7-Day average: 378 (-4.9%)\n•Total new hospital admissions: 5,078,893, 7-Day average 6,112 (-4.4)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 578,142,444 ( 972,954 new)\n•Total Deaths: 6,405,080 (2,491 new)\nPRESS:  MSNBC Black/Hispanic Journalists Fireside chat with Alicia Menendez;\nAugust 5, 2022\nMet with Hans Kluge – WHO Regional Director for Europe.   He is seeking my advice on \nmultiple issues such as COVID, MPX, and vaccine related polio.   He said the Europeans \nrely very heavily on my opinion:\nReleased by Chairman Rand Paul\nHeard from Rochelle last night.   Latest decision is that they wil hold off on the above \nannouncement.  Had meeting with Bruce Tromberg, Rochelle, Robbie Goldstein and CDC \nfolks together with FDA folks (Rob Califf and team) and Steve Sha to try to get an \nagreement about guidelines for testing for isolation/quarantine when to stop \nisolation/masking, etc.   We are coming to an agreement that is not perfect, but that is \nworkable.   Had another Zoom with the same team + Dawn O’Connell to explain to her our \nPOTUS still positive on day 7 following rebound.\n****Had a really major victory today resulting from a great collaboration between FDA, \nCDC, BARDA, me and John Beigel who was responsible for the design of a trial that would \nconfirm that the study published in the journal Vaccine in 2015 by Frey et al and Bob \nBelshe showed that 1/5 the dose of the MVA  monkey pox vaccine administered \nintradermally was as effective as a full dose of the subcutaneous administration.  When we \nReleased by Chairman Rand Paul\nmade this known to Bavarian Nordic (BN), lower level marketing people in the company \nobjected strenuously, very likely because they saw this as a diminution in the need for full \ndoses. Amazingly, they distorted the data and tried to marshal congressional support for \nblocking the use of the doses in the 1/5 dilution intradermally. This was an egregious \nattempt to interfere with the sound public health maneuver. To make a long story short \nwhen John Beigel showed all the data from the 2015 paper come it became clear that this \nwas a very important way to expand the number of doses that were available. We finally \ngot the leadership of BN to agree to continue to ship us the doses since their lower level \npeople as indicated above were trying to block shipment in order to prevent us from \ndistributing the vaccine in the 1/5 dilution. After much discussion with the FDA, we finally \nconvinced them to issue an emergency use authorization (EUA) for the administration of \nthe MVA vaccine in the1/5 intraderma; dilution. This is a major victory for the prevention \nof monkey pox because it turns 300,000 doses into 1.5 million doses and 1,000,000 doses \ninto 5,000,000 doses. I consider this one of the major victories that I was a part of in trying \nto expedite the response to monkey pox.\nPRESS:  WTOP Podcast with Luke Garrett & Megan Cloherty; CNN with Erica Hill; \nMSNBC with Andrea Mitchell;\nAugust 6, 2022\nContinued drama now involving Larry Horowitz calling me up talking about how angry \nRon Klain is at Rochelle for wanting to come out with a statement that the vaccines do not \nprotect against infection at all. I have to look at the data but I think that although \nprotection against true infection is low to modest at best, it is not zero and so I cannot \nfigure out, and I am sure that this is what is bugging Ron, why the CDC needs to put that \nstatement out now exactly at the time when we are pushing people to get the new BA.5 \nvariant in early to mid-September. \nAugust 7, 2022 (Sunday)\nLong conversations with the CDC team (Sherri Berger; Rochelle), Steve Sha, Vivek, \nKessler to get the wording correct on the condition to end isolation regarding testing and \nmasking.\nAugust 8, 2022\nFor some time now the issue of  ”Long COVID”  has been gaining momentum with much \nfrustration in the community since recent studies showed that up to 20% of people develop \nmore COVID following infection. Senator Tom Kaine (D-VA) has been a strong advocate \nfor support since he is suffering for well over a year from long COVID characterized by \ndysesthesias.  The NIH has been given $1.15 Billion to study long COVID. However, I have \nReleased by Chairman Rand Paul\nbeen very disappointed in the initiatives that have been brought forth under the leadership \nof NHLBI with Gary Gibbons and Amy Patterson as well as Walter Koroshetz.   Rachel \nLevine is now been given the leadership for this at HHS.  Recent description:\n  Politico:\nTim Kaine has long Covid. That’s not moving Congress to act.\nWhile Kaine and other Democrats in the House and Senate are pushing for action, they have \nfailed to gain meaningful momentum due to lack of GOP support.\nWe had important conversations with activists James Krellenstein, Gregg \nGonsalves, Peter Staley and Emily Bass regarding MPX vaccination.   Peter alerted \nme today that James and other activists are concerned about misrepresenting the effective of the \n1/5 approach to Jynneos (see above).   I put together a hastily arranged Zoom at 12:45 PM to get \nus together and figure out what the problem is.  The problem is that the activists are concerned \nthat the data are not strong that 1/5 the dose of Jynneos intrasdermally (ID) will be protective.  \ntheir argument is a bit inconsistent since the antibody titers induced by Jynneos  ID are exactly \nequivalent to a full dose delivered subcutaneously (SC). The activists do not seem to be \nconcerned about the efficacy of the SC dose, but they are concerned that we might be overselling \nthe efficacy of the 1/5 dose. This may be an example of their making the perfect being the enemy \nof the good. It is much better to have some vaccine rather than no vaccine and so we needed to \nsettle what their concern was since the FDA will be issuing tomorrow an EUA for the 1/5 ID \ndose.  I got the activists on the zoom with Cliff, John Beigel, and me and we hashed it out. Peter \nStaley was agreeing with us and we finally got James and Gregg to come to the agreement that it \nis best to go ahead with the 1/5 ID program at the same time as trying to get data with a clinical \ntrial that John will do as to the efficacy. That is better than having not enough doses and having \na 5 minute notice getting the activist community together with my team to try and straighten out \na potential disagreement. \nWe had another zoom discussion with the HHS team led by Sherri Berger (CDC) to \ntry to get the precise language for the CDC updating of their website discussion of \nthe efficacy of the vaccine in preventing infection and transmission (see above). I \nbelieve that we got it right after a very good discussion among the group. The critical issue was \nto indicate that the vaccine protection against infection and transmission is only modest and \ndiminishes with time. The concern was on the part of the White House that the CDC would say \nthat it was zero.   Now this is not really a consideration since the wording indicates in a positive \nway (by my suggestion) that although the protection against infection and transmission wanes \novertime, that is a good reason why we encourage people to get the updated BA.5 bivalent boost.  \nI believe we avoided a confrontation between the CDC and the White House which would have \nendangered Rochelle\nPRESS:  Interview with Giuseppe Sarcina of Italian newspaper – Corrierre Della Sera;\nAugust 9-11, 2022  Global – 585,086,861/6,422,914; USA – 92,426,945/1,030,777\nCases and hospitalization plateauing but deaths still at ~300-400/day\nReleased by Chairman Rand Paul\nHad a wonderful trip to Seattle where I received the honorary “Hutch” award from the \nFred Hutchinson Cancer Research center and the Seattle Mariners baseball organization. I \ndid a fireside chat at the Medical Center with Larry Corey and then threw out the first pitch that \nevening for the Mariners and New York Yankees baseball game. In contrast to the disastrous \npitch at the Washington Nationals game two years ago, this was a perfect pitch to the manager of \nthe Mariners, Scott Servais, who served as the catcher. Sat in the “owner’s box” at the stadium \nand watched the game.   Had a great conversation with Eddie Vedder (lead vocalist and guitarist \nfor the rock band Pearl Jam.) and his wife Jill.   Eddie reminds me a lot  of Bono.     \nOne of the things that was striking about the evening at the ball game was that when they \nannounced me as receiving the award with giant pictures of me on the photocam, I received a \nprolonged standing ovation from 45,000 people in the stands. Yet, the far right as exemplified \nby the newspaper The Washington Examiner put on YouTube the headline “Fauci booed at \nMariners game.  They put the microphone next to about five or six people out of 45,000 who \nwere booing and saying I should go to jail and they completely ignored the 45,000 people that \ngave me a prolonged standing ovation. This is so exemplary of the distortion of reality by the \nfar right.\nMonkeypox continues to surge:\nAugust 12, 2022\nDeaths seem to be up a bit at around 400/day!\nReleased by Chairman Rand Paul\nAugust 13, 2022\nMore drama with regard to the CDC and Rochelle Walenski. After much going back and \nforth between the CDC and the other docs including me, Vivek, Steve Cha, and to some extent \nDavid Kessler, we thought we had gotten them pulled back from making the statement that the \nvaccines were not effective at all in preventing infection and transmission. The reason this is an \nissue is that if they came out with that statement, which in fact is not entirely true since there is \nsome degree of modest but declining protection as you would expect, then this would conflict \nwith the statement and effort of recommending that people get the updated bivalent BA.5 \nvaccine in September.   In addition, it would undermine the DoJ’s efforts at mandates for \nvaccines under certain circumstances.   In any event, the CDC agreed to pull back on the \nstatement of absolute lack of efficacy of vaccines against infections and transmission  and take a \nmore measured approach of saying that the vaccines provides only modest and waning efficacy \nagainst infection and transmission and that is why we should heed the advice of getting the \nupdated booster in Sept.  However, although they did this on their website, the MMWR that cam \nout yesterday had the same original damning language.   When Larry Horowitz and Ashish \nnoticed this, Larry went off the wall and in a somewhat agitated manner called me up this \nAM and said that this is the last straw and he was sure that when Ron Klain gets back from \nSpain this weekend he would fire Rochelle.   Ashish was more measured and seems to have \ncome to the conclusion that sooner or later (maybe not right now) Rochelle would have to go.  \nLet us see what happens…..probably nothing\nAugust 14, 2022\nHad a wonderful dinner last night at the extraordinary home of Adrienne Arsht at 9 Chevy \nChase Circle, Chevy Chase, MD.  Guests included Alexandra Villard de Borchgrave \n(Chairman. Light of Healing Hope Foundation and former war correspondent), Jonathan \nCapehart (MSNBC and Washington Post), Pamela Melroy (former astronaut and Deputy \nAdministrator, NASA), Sen Bill Nelson and Wife Grace (Administrator, NASA), Vivian Salama \n(WSJ – war correspondent), Jonathan Goodrich (Attorney, Interior Department).\nReleased by Chairman Rand Paul\n35,000 cases of MPX globally:\nAugust 15, 2022\nGreat disparity of COVID deaths comparing USA and other countries:\nReleased by Chairman Rand Paul\nPRESS:  The Shade Room (Online streaming); The Grio TV;\nAugust 16, 2022\nI had a very important and moving conversation with Ron Klain in his West Wing Office \ntoday at 11:45 AM (bright, sunny, mild day).   I announced to Ron that I would be stepping \ndown from all of my positions including chief medical advisor to the President. I will make \nthe announcement next week and my date for stepping down will be sometime in December \nof this year. One of the concerns that Jeff Zients and I had would be that Ron would want \nto push back on my leaving giving all the trouble that he's having with the CDC. However, \nhe somewhat surprised me by saying that his instinct would be to push strongly to convince \nme not to leave, given that he considers me “one of the most important public servants in \nthe history of the country” given that I have saved millions of lives over the last several \nyears. He would be almost embarrassed trying to convince me to change my mind about \nsomething that I obviously have thought about for some time and that I thoroughly \ndeserve. He went on to say so many nice things that I was embarrassed. He said that he \nconsidered it a major privilege in his life to have had the opportunity to work with me both \nduring the Obama administration with Ebola and now with COVID and monkey pox. He \nsaid that he would arrange tomorrow for me to either see the president if the president \ncomes to the White House tomorrow; if he does not come to the White House then arrange \nReleased by Chairman Rand Paul\na phone call between me and the president tomorrow. It was a most moving meeting the \nextraordinary praise shown towards me and the sincere appreciation for all that I have \ndone for the country and the world during my long career. He sounded extremely sincere.\n---------------------------------------------------------------------------------\nNIH will write a Science Forum on NIH accomplishments in COVID.   Below is a \npreliminary outline of what will be said.   I added a mention of the role of the COVID -\n19Prevention Network (CoVPN) in the clinical trials of all the vaccines:\nKey COVID-19 Milestones – NIH\nHigh-level COVID-19 Accomplishments\n2020\nJanuary 10:\nThe genetic sequence of the SARS-CoV-2 virus was released, which was used as the blueprint for \nthe rapid development of the mRNA COVID-19 vaccines.\nBlurb: SARS-CoV-2 genetic sequence released \nImage: Ask Palladian for timeline image\nJanuary 13:\nNIH and Moderna finalized the design of a vaccine candidate and began working to produce it.\nBlurb: NIH/Moderna finalized COVID vaccine candidate design\nImage: https://www.flickr.com/photos/nihgov/50047466123/in/album-72157713108522106/ \nJanuary 31:\nThe United States declared COVID-19 a public health emergency.\nBlurb: U.S. declared COVID-19 a public health emergency\nFebruary 25: \nNIH launched the Adaptive COVID-19 Treatment Trial (ACTT) series of studies with a \nrandomized, placebo-controlled clinical trial to evaluate the safety and efficacy of the antiviral \nremdesivir in adults hospitalized with COVID-19 (ACTT-1).\nPress release\nBlurb: NIH launched trial of the antiviral remdesivir\nImage: https://www.shutterstock.com/image-photo/remdesivir-covid19-liquid-medication-\nbackground-1706609728 \nMarch 11:\nThe World Health Organization declared COVID-19 a pandemic.\nBlurb: WHO declared COVID-19 a pandemic\nReleased by Chairman Rand Paul\nMarch 16:\nThe Phase 1 clinical trial started for the investigational vaccine, known as mRNA-1273, co-\ndeveloped by NIH and Moderna.\nPress release\nBlurb: NIH/Moderna COVID vaccine Phase 1 clinical trial started \nImage: 3.16.20 Phase 1 Moderna\nApril 17:\nNIH launched the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) \ninitiative, a public–private partnership focused on developing treatments and vaccines for \nCOVID-19. ACTIV streamlined the process for adding new agents into trials and rapidly deployed \nexisting NIH networks of more than 620 trial sites across the U.S. and internationally. The \ninitiative evaluated over 800 therapeutic agents and prioritized 33 for inclusion in ACTIV master \nprotocols. Six of these agents have shown compelling evidence of benefit in randomized clinical \ntrials. \nPress release\nBlurb: NIH launched ACTIV, a public-private partnership to develop treatments and vaccines\nImage: 4.17.20 ACTIV\nApril 21:\nAfter convening a panel of academic and government experts to critically review and synthesize \navailable data from clinical trials and other study reports, the first NIH COVID-19 Treatment \nGuidelines were published to provide clinicians with guidance on how to care for patients with \nCOVID-19. T he panel has issued more than 50 updated editions since April 2020 and the \nguidelines have been visited more than 30 million times.\nPress release\nBlurb: NIH published the COVID-19 Treatment Guidelines\nApril 29:\nNIH launched the Rapid Acceleration of Diagnostics (RADx) initiative to speed innovation leading \nto reliable diagnostic testing. \nPress release\nBlurb: NIH launched RADx initiative to speed innovation in diagnostic testing \nImage: 4.29.20 RADx\nMay 22:\nPreliminary peer-reviewed data from the ACTT-1 trial indicated that the antiviral drug \nremdesivir is safe and improved clinical outcomes for hospitalized adults with COVID-19.\nPress release\nBlurb: Antiviral drug remdesivir found safe and effective. \nImage: https://www.shutterstock.com/image-photo/medication-prepared-people-affected-by-\ncovid19-1731814354 \nReleased by Chairman Rand Paul\nMay 24:\nNIH created a public COVID-19 OpenData Portal  to openly and quickly share COVID-19-related \ndrug repurposing data and COVID-19 variant-specific effects against all approved drugs. It was a \nkey resource for the ACTIV Tracking Resistance And Coronavirus Evolution (TRACE) efforts.\nBlurb: COVID-19 OpenData Portal shares data on drug repurposing and variant effects with \ndrugs. \nImage: 5.20 COVID Data Portal variants\nJuly 8:\nNIH launched the COVID-19 Prevention Network (COVPN), a clinical trials network to test \nCOVID-19 vaccines and other prevention tools.\nPress release\nBlurb: NIH launched COVID-19 Prevention Network to test COVID vaccines and treatments. \nJuly 27:\nThe Phase 3 clinical trial started for the investigational vaccine mRNA-1273, co-developed by \nNIH and Moderna. The trial enrolled approximately 30,000 adult volunteers who did not have \nCOVID-19.\nPress release\nBlurb: NIH/Moderna COVID vaccine Phase 3 clinical trial began, enrolling ≈30,000 adult \nvolunteers. \nImage: https://www.shutterstock.com/image-photo/covid19-vaccination-asian-male-patient-\ngetting-1831245058\nAugust 4: \nNIH launches the first ACTIV clinical trials to test the safety and efficacy of treatments both for \nmild and moderate COVID-19 patients and for patients hospitalized with COVID-19. \nACTIV-2 press release, ACTIV-3 Press Release\nBlurb: First ACTIV trials to evaluate the safety and efficacy of COVID therapeutics begin. \nImage: 8.4.20 ACTIV trials\nSeptember 16:\nRecognizing the need to ensure inclusive participation in vaccine trials, NIH launched \nCommunity Engagement Alliance (CEAL) Against COVID-19 Disparities.  CEAL provided outreach \nand engagement opportunities in racial and ethnic minority communities disproportionately \naffected by the COVID-19 pandemic. (In 2021, NIH supplemented the effort with $29 million in \nfunding from the American Rescue Plan).\nSeptember press release  \nBlurb: NIH launched CEAL to ensure diversity in vaccine trials and reach out to \ndisproportionately affected communities. \nImage: 9.16.20 CEAL\nReleased by Chairman Rand Paul\nSeptember 30:\nNIH expanded research to improve COVID-19 testing among underserved and vulnerable \npopulations as part of the RADx initiative, the RADx Underserved Populations (RADx-\nUP) program.\nPress release\nBlurb: NIH expanded RADx initiative to improve COVID-19 testing in underserved populations. \nImage: 9.30.20 RADx UP\nOctober 2:\nQuidel Sofia 2, the first point-of-care test to detect COVID-19 supported by NIH’s RADx initiative, \nreceives emergency use authorization (EUA) from the FDA. \nBlurb: First RADX-supported COVID test received EUA.  \nImage: 2.2.20 Test Kit\nDecember 11:\nThe ACTT-2 trial found that baricitinib, an anti-inflammatory drug, reduced time to recovery for \npeople hospitalized with COVID-19 who were treated with remdesivir.\nPress release\nBlurb: Trial results showed remdesivir in combination with anti-inflammatory drug baricitinib \nreduced hospital recovery time\nImage: https://www.shutterstock.com/image-photo/medication-prepared-people-affected-by-\ncovid19-1970653763\nDecember 15:\nThe first over-the-counter COVID-19 test, developed with support from NIH’s RADx initiative, \nreceived an FDA emergency use authorization.\nBlurb: First RADx-supported over-the-counter COVID-19 test received EUA.\nImage: 12.15.20 RADx OTC\nDecember 18:\nFDA authorized the NIH-Moderna vaccine for emergency use for people 18 years of age and \nolder. The NIH-Moderna vaccine went on to receive authorization for various age groups and is \nnow available for everyone over the age of 6 months. \nBlurb: FDA grants EUA to NIH/Modera vaccine\nImage: https://www.shutterstock.com/image-illustration/cracow-malopolskie-poland-october-\n10-2021-1891094320\n2021\nJanuary 5:\nNIH’s RADx launched an interagency variant task force to evaluate the impact of new variants on \nthe performance of all authorized point of care and over the counter diagnostics, as well as tests \nReleased by Chairman Rand Paul\nin pre-authorization review. This ongoing partnership with FDA informs regulatory decisions, \nRADx investments, manufacturer designs, and government procurements.\nBlurb: Interagency variant task force launched to evaluate impact of variants on COVID tests\nImage: 1.5.21 variant tests\nJanuary 20:\nThe ACTIV Tracking Resistance and Coronavirus Evolution (TRACE) initiative launched. It is \nfocused on identifying emerging variants of SARS-CoV-2. TRACE aims to prioritize which viral \nvariants should be studied to determine the effectiveness of vaccines and therapeutics, \ncoordinate data sharing, and report results regularly to allow confident decision making by the \nU.S. Government, health professionals, and pharmaceutical organizations.\nBlurb: The ACTIV Tracking Resistance and Coronavirus Evolution (TRACE) initiative began to \nidentify, evaluate, and report on emerging variants.\nImage: https://www.flickr.com/photos/nihgov/52129878815/in/album-72157713108522106/\nFebruary 27:\nFDA authorized the Janssen COVID-19 vaccine for emergency use. NIH supported the \ndevelopment of the single-shot vaccine, which does not require special refrigeration.  \nBlurb: FDA grants EUA to Janssen COVID vaccine \nImage: https://www.shutterstock.com/image-photo/izmir-turkey-january-17-2021-coronavirus-\n1925271767\nMarch 31:\nIn collaboration with the CDC, NIH launched an innovative community health initiative called \n“Say Yes! COVID Test” for counties in North Carolina and Tennessee to determine if frequent \nself-administered COVID-19 testing can help residents reduce community transmission. Say Yes! \nCOVID Test went on to distribute 6.8 million rapid tests that were developed with RADx support \nin numerous targeted areas throughout the country. \nPress release\nBlurb: NIH launched community health initiative Say Yes! COVID Test to assess frequent self-\ntesting. \nImage: 3.31.20 Say Yes COVID Test\nApril 15:\nNIH announced the Safe Return to School Diagnostic Testing Initiative, which awarded up to $48 \nmillion over several months to fund projects to build evidence on safely returning students, \nteachers, and support staff to in-person school in areas with vulnerable and underserved \npopulations. (Additional funds issued July press release).\nApril press release\nBlurb: NIH launched Safe Return to School Diagnostic Testing Initiative \nImage: https://www.shutterstock.com/image-photo/side-view-portrait-young-africanamerican-\nman-1967011807 \nReleased by Chairman Rand Paul\nAugust 4:\nPart of the ACTIV initiative, an NIH-supported clinical trial showed that treating moderately ill \nhospitalized COVID-19 patients with a full-dose blood thinner reduced their need for organ \nsupport, such as mechanical ventilation, and improved their chances of leaving the hospital.\nPress release\nBlurb: ACTIV-4 clinical trial found that a full-dose blood thinner improved outcomes for \nmoderately ill hospitalized patients.\nSeptember 15:\nNIH announced $470 million in funding for a nationwide study of tens of thousands of people to \nsupport research on the long-term effects of COVID-19 called the NIH REsearching COVID to \nEnhance Recovery (RECOVER) Initiative.\nPress release\nBlurb: NIH funded REsearching COVID to Enhance Recovery (RECOVER) Initiative to study \nCOVID’s long-term effects. \nImage: Can we use this image from the timeline? NIH Strategic Response to COVID-19 | NIH \nCOVID-19 Research\nOctober 9:\nBrii Biosciences filed for an FDA emergency use authorization for the ACTIV-3 monoclonal \ntherapeutic antibody combination amubarvimab/romlusevimab that demonstrated clinical \neffectiveness in preventing progression of disease for mild to moderate COVID-19 patients.  \nBlurb:  ACTIV-3 trial found monoclonal therapeutic antibody combination effective in preventing \ndisease progression in mild to moderate patients.\nOctober 27:\nNIH announced the Independent Test Assessment Program (ITAP), which established an \naccelerated pathway to support FDA evaluation of tests with potential for large-scale \nmanufacturing. The program is an extension of the NIH RADx initiative. In less than two months, \nthe first two over-the-counter tests that went through the ITAP accelerated pathway received \nEUAs, contributing millions of tests per month to the domestic supply.  \nPress Release\nBlurb: NIH announced ITAP, an accelerated pathway to support FDA evaluation of COVID tests.\nImage: https://www.shutterstock.com/image-photo/portland-usa-feb-5-2022-closeup-\n2118748202\n2022\nJanuary 26:\nThe NIH clinical trial on booster doses of different COVID-19 vaccines to determine the safety \nand efficacy of mixed vaccine regimens found that all combinations of primary and booster \nReleased by Chairman Rand Paul\nvaccine resulted in increased neutralizing antibody levels. The data strongly suggest that mixed \nCOVID-19 vaccines could increase protective efficacy against symptomatic SARS-CoV-2 infection.\nPress release\nBlurb: NIH clinical trial data strongly suggest that mixed COVID-19 vaccines could increase \nprotective efficacy against symptomatic SARS-CoV-2 infection.\nImage: FC getting his vaccine? https://www.flickr.com/photos/nihgov/50747919667/in/album-\n72157717478402642/ OR https://www.shutterstock.com/image-photo/black-teen-girl-shows-\nvaccine-mark-1899903244\nJune 2: \nTopline results from the ACTIV-1 Immune Modulators clinical trial showed that immune \nmodulator drugs improved survival for people hospitalized with COVID-19.\nPress release\nBlurb: ACTIV-1 immune modulators trials meet secondary endpoint/improved survival\nJuly 20:\nThe CDC recommended that Novavax’s COVID-19 vaccine be used as another primary series \noption for adults in the United States ages 18 years and older. NIH supported development of \nthe Novavax vaccine, NVX-CoV2373, and is studying it in the “mix & match” trial, where adult \nvolunteers who have been fully vaccinated against COVID-19 receive booster doses of different \nCOVID-19 vaccines to determine the safety and immunogenicity of mixed boosted regimens.\nBlurb: CDC recommended Novavax vaccine for adults\nImage: https://www.shutterstock.com/image-photo/novavax-coronavirus-vaccine-doctors-\nnurses-hands-1904970715\nApril 29:\nTwo years after its launch, RADx-supported companies increased cumulative U.S. capacity by \n>2.5 billion tests, helping drive a national paradigm shift where over the counter (home) and \npoint of care tests become the dominant form of testing.\nBlurb: After two years, RADx-supported companies increased U.S. capacity by >2.5 billion tests\nImage: 4.29.22 RADx test capacity\nMonkey pox cases in the UK starting to trend downward:\nReleased by Chairman Rand Paul\nAugust 17, 2022\nE-mail from Ron Klain after I met with him and asked to speak with the POTUS:\nFrom:  Klain, Ronald A. EOP/WHO <RK.COS@WHO.EOP.GOV> \nSent: Wednesday, August 17, 2022 10:19 AM\nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nCc: Goepfert, Stephen M. EOP/WHO <Stephen.M.Goepfert@who.eop.gov>\nSubject: [EXTERNAL] RE: Thank you\nTony,\nSad for me, sad for America, but no one has earned it more.\nThe President is anxious to speak with you today – he travelled to Delaware last night.  I am copying \nStephen Goepfert here, who is with the President in Wilmington, to arrange the timing for your call.\nRon\nI just had a wonderful conversation with President Biden. He called me up (started the conversation \nwith “Hi, Joe here….”) and told me how much he admired me and how much of a pleasure it was to \nwork very closely with me over the past year and three quarters. He told me that he wanted to \nguarantee that I would have as much protection as I need for as long as I need it. I told him how much \nI enjoyed working with him and that I was actually thinking of leaving government at the end of the \nReleased by Chairman Rand Paul\nlast administration. However, when he became president and offered me the job as his chief medical \nadvisor it was a job that I absolutely could not refuse. I also told him that working with him over the \nlast two years was the capstone of my career. He was quite moved by that and seemed to be very \npleased with hearing that.\nPRESS:  Interview with Rolling Stone (Matt Sullivan) regarding story on Steph Curry\nAugust 18, 2022  Global – 590,659,276/6,440163;   USA – 93,124,238/1,034,118\n----------\nCDC (Rochelle Walensky) comes out with a strong statement of “mea culpa” admitting \nthat the CDC is broken and has failed terribly in the response to the COVID pandemic.   \nLONG OVERDUE!\nCDC Moving \nForward Fact Sheet.\nNY Times (La Franiere and Weilland):\nWalensky, Citing Botched Pandemic Response, \nCalls for C.D.C. Reorganization\nAmong other flaws, public guidance during the coronavirus pandemic was “confusing and \noverwhelming,” the agency said.\nReleased by Chairman Rand Paul\n------------------------\nRFK, jr continues his destructive ways:\nArs Technica: Anti-vaccine activists giddily celebrate as poliovirus spreads in NY\n--------\nI defend CDC and Rochelle regarding their admission of their botched response by \ncommending them for honesty and trying to reform.   I did this on MSNBC with Andrea \nMitchell.\nPRESS: MSNBC with Andrea Mitchell; Podcast “In the Bubble” with Any Slavitt; CNN – \n“The Situation Room” with Wolf Blitzer\nAugust 19, 2022\nCases seem to be plateauing throughout the country with some exceptions. Perhaps we are \ncoming into a downswing as we enter the Fall\nPRESS:  Interview with Marissa Evans of LA Times on racial disparities in MPX; WTOP \nRadio;\nAugust 20, 2022\nHad my usual every three-week zoom meeting with Drs. Li and Hellmann. I explained to \nthem that as of Monday at 11:00 AM when I made the announcement of my stepping down \nfrom the NIH, I will enter a new chapter in my career and in my life. There's obviously \nstress and anxiety associated with this decision.  However, there's also excitement for the \nnew adventure and unknown.\nHad a wonderful Zoom meeting with Nathan Chen at 12:30 PM.  He had been wanting to \nmeet me for some time now and we finally connected by zoom. He was so modest and nice \nand kept expressing what an honor it was to meet me and speak with me. He is going into his \nthird year at Yale having taken off most of two years to practice for the Olympics where he gave \nprobably the most historically perfect performance to win the gold medal. He plans to go to \nmedical school after he graduates. I was struck by his maturity and modesty when I asked him \nwhy he was interested in medicine. He said all his life he had been practicing to make himself \nbetter and better and better, but it was all about himself. Now he wants to do something that has \na positive impact on society and on other individuals. The sign of a very mature young man.\nReleased by Chairman Rand Paul\nI had a very long (1 hour and 10 minue) exclusive interview with Yasmeen Abutaleb \n(Washington Post) concerning my upcoming stepping down from Government service.   \nEmbargoed until Monday at 11:00 AM\nAugust 21, 2022\nInteresting trivia (Sports Business Journal):\nDr. Anthony Fauci’s First \nPitch Sets Baseball Card \nRecord\nBy Tom TaylorJuly 28, 2020\n•\n•\n•\nTopps has issued a trading card of Dr. Anthony Fauci, the director of the \nNational Institute of Allergy and Infectious Diseases, throwing out the first \npitch of the MLB season last week. The card was only available for 24 hours, \nunder the company’s Topps Now brand, but it set a new record with 51,512 \nsold.\nAugust 22, 2022\nTODAY IS THE DAY!  I announce that I will be stepping down from the NIH as well as \nfrom my position as chief medical adviser to the president effective December, 2022.\nThere has been a literal avalanche of positive feedback about my announcement with \nhundreds and hundreds of texts and emails of congratulation and praise for me. President \nReleased by Chairman Rand Paul\nhas come out with a statement as have a number of other prominent individuals. See the \npresident statement below:\nStatement from President Joe Biden \non the announcement of Dr. \nAnthony Fauci’s Departure \nfrom NIAID\nAUGUST 22, 2022•STATEMENTS AND RELEASES\nDuring my time as Vice President, I worked closely with Dr. Anthony Fauci on the United \nStates’ response to Zika and Ebola. I came to know him as a dedicated public servant, and a \nsteady hand with wisdom and insight honed over decades at the forefront of some of our most \ndangerous and challenging public health crises. When it came time to build a team to lead our \nCOVID-19 response – in fact, in one of my first calls as President-elect – I immediately asked \nDr. Fauci to extend his service as my Chief Medical Advisor to deal with the COVID-19 crisis \nour nation faced.  In that role, I’ve been able to call him at any hour of the day for his advice as \nwe’ve tackled this once-in-a-generation pandemic.  His commitment to the work is unwavering, \nand he does it with an unparalleled spirit, energy, and scientific integrity. \nDr. Fauci has served under seven Republican and Democratic Presidents during his career, \nbeginning with Ronald Reagan.  He was awarded the Presidential Medal of Freedom in 2008 \nunder President George W. Bush.  For almost four decades, he has served as Director of the \nNational Institute of Allergy and Infectious Diseases, helping our country navigate health crises \nranging from HIV/AIDS to COVID-19.  Because of Dr. Fauci’s many contributions to public \nhealth, lives here in the United States and around the world have been saved.  As he leaves his \nposition in the U.S. Government, I know the American people and the entire world will continue \nto benefit from Dr. Fauci’s expertise in whatever he does next. Whether you’ve met him \npersonally or not, he has touched all Americans’ lives with his work. I extend my deepest thanks \nReleased by Chairman Rand Paul\nfor his public service. The United States of America is stronger, more resilient, and healthier \nbecause of him. \nStatement of Sec. Becerra:\nStatement by HHS Secretary Xavier Becerra on \nUpcoming Departure of Dr. Anthony S. Fauci\nToday, Anthony S. Fauci, M.D. announced he is stepping down in December 2022 from the \npositions of Director of the National Institute of Allergy and Infectious Diseases (NIAID) and Chief of \nthe NIAID Laboratory of Immunoregulation, as well as Chief Medical Advisor to the President.  U.S. \nDepartment of Health and Human Services (HHS) Secretary Xavier Becerra issued the following \nstatement:\n“This is a decision we all knew would eventually come but hoped never would. As HHS Secretary, I \nam privileged to know Dr. Fauci professionally and personally and deeply admire his decades of \npublic service that have undoubtedly improved the health of millions of people globally. When I \narrived at HHS, the world was one year into the COVID-19 pandemic. I quickly came to rely on Dr. \nFauci’s wisdom and counsel in our response, and along with his scientific acumen, I treasure his \nability to break down complex science in simple terms to the American people to save lives.\n“His selfless passion to bring hope and healing to people fighting for their health knows no bounds. \nIn fact, Dr. Fauci’s pioneering approach to tackle public health decades ago included a critical role in \nour nation’s domestic and international response to HIV/AIDS, ultimately helping create the \nPresident’s Emergency Plan for AIDS Relief.\n“I will be sorry to see Dr. Fauci depart in December, but I wish him all the best in his future \nendeavors and look forward to witnessing his next chapter.”\nLarry Tabak statement:\nReleased by Chairman Rand Paul\nStatement from Lawrence A. Tabak, \nD.D.S., Ph.D., on the departure of \nAnthony S. Fauci, M.D.\nAnthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases\nToday marks the end of an era with the announcement by Anthony S. Fauci, M.D., that he will \nbe stepping down as the Director of the National Institute of Allergy and Infectious Diseases \n(NIAID), Chief of the NIAID Laboratory of Immunoregulation, and Chief Medical Advisor to \nReleased by Chairman Rand Paul\nPresident Biden. Tony’s departure will cause a tectonic shift in the modern history of the \nNational Institutes of Health.\nHe is the model public servant — dedicated and selfless, and a brilliant scientist and physician \nwho is passionate about developing treatments and cures for those who are sick and suffering. \nHe has dedicated his life’s work to advancing knowledge about the causes of complex diseases \nranging from HIV to asthma, rarely satisfied with anything less than a cure. For Tony, it’s \npersonal. He works tirelessly on behalf of all patients, often at great personal expense, and \nalways bringing his Brooklyn tenacity to the fight. I know of no one more dedicated than Tony \nto the mission of the NIH and the health of the American people.\nTony’s NIH career spans 54 years, 38 of those leading NIAID, advising seven U.S. Presidents, \nand reassuring the public as America’s doctor during outbreaks of infectious diseases, from \nHIV to Ebola to COVID-19. Without exception, he is always guided by the science. It’s been an \nextraordinary privilege and honor to have worked by his side and to have learned so much \nfrom him — I will miss him greatly. But I also look forward to seeing what Tony will do next. I \nhave no doubt that he will continue to have an enormous impact on the world.\nLawrence A. Tabak, D.D.S., Ph.D.\nPerforming the Duties of the NIH Director\nAshish K. Jha, MD, MPH\n@AshishKJha46\nTony Fauci is the most consequential physician scientist of \nthe past half century Having served 7 Presidents through \nHIV/AIDS, Anthrax, H1N1, Ebola, Zika, and of course COVID \nThousands consider him their mentor, including me Grateful \nfor your service to our country Dr. Fauci   \nRonald Klain\nReleased by Chairman Rand Paul\n@WHCOS\nI cannot think of a public servant who has done as much to \nsave as many lives for as long a period as Dr. Tony Fauci. \nAnd he is a gem of a person.\nTweet\nSee new Tweets\nConversation\nBarack Obama\n@BarackObama\nI will always be grateful that we had a once-in-a-century \npublic health leader to guide us through a once-in-a-\ncentury pandemic. Few people have touched more lives \nthan Dr. Fauci – and I’m glad he’s not done yet.\nPRESS:   Beautiful article in the Washington Post by Yasmeen Abutaleb: \nFauci plans to step down in December after \nhalf a century in government\nBy Yasmeen Abutaleb\nReleased by Chairman Rand Paul\nUpdated August 22, 2022 at 2:20 p.m. EDT| Published August 22, 2022 at 11:00 a.m. \nEDT\nNY Times  by Cheryl Gay Stolberg:\nFauci Says He Will Step Down in \nDecember to Pursue His ‘Next \nChapter’\nMSNBC with Rachel Maddow (Rachel was extremely laudatory)\nAugust 23, 2022\nNY Times  Opinion piece by Gregg Gonsalves is really nice:\nOPINION\nGUEST ESSAY\nAnthony Fauci’s Retirement Marks \nthe End of an Era\nAug. 23, 2022, 5:00 a.m. ET\nPRESS:  WTOP with Nick Iannelli; CNN “New Day” with Kaitlan Collins; WGN Bob \nSirrott Show (Chicago Radio); Canadian Broadcasting Corporation (CBC Radio);  FOX \nNews “Live” with Neil Cavuto; BBC Newsnight TV; NPR “All Things Considered” with \nMary Louise Kelly\nAugust 24, 2022\nThe number of texts and e-mail of thanks and praiseupon the announcement of my \nstepping down are stunning, ranging in the several hundreds. I am getting truly exhausted \ntrying to answer all of them.\n-----\nReleased by Chairman Rand Paul\nJill Biden rebounded after a course of Paxlovid just the way I did!!\n--------\nCases slowly (very slowly) coming down:\nVery nice article about me and retirement in Nature:\n‘He has saved countless lives’: US scientists \non Fauci leaving NIH role\nFrom the AIDS epidemic to the COVID-19 pandemic, the iconic medical chief \nhas advised seven presidents on numerous outbreaks.\n•Max Kozlov & \n•Lauren Wolf\n---------------\nProbably the best article ever written about me in the Washington Post today:\nTHE CRITIQUE\nFauci carried all our angst and anger with \npatience and decency\nReleased by Chairman Rand Paul\nPerspective by Robin Givhan\nSenior critic-at-large|Follow\nAugust 23, 2022 at 7:10 p.m. EDT\nWith all of the praise and adulation that I'm getting from so many sources, the far right \nGOP keep saying that they're going to investigate me after I stepped down even though \nthere's absolutely nothing to investigate me about; they are looking very mean spirited.\nAugust 25, 2025\nInteresting cartoon in Washington Post concerning my stepping down:\nReleased by Chairman Rand Paul\nWe are really not coming down in cases/hospitalizations/ or deaths very sharply.   We \nseemed to have hit a plateau with a very slight trend downward.\nUnited States \n•Total Cases: 93,777,133, 7-Day average: 90,676 (-6.7%)\n•Total Deaths: 1,037,281  7-Day average:  390 (-11.6%)\n•Total new hospital admissions: 5,198,924  7-Day average 5,614 (-6.6%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 596,119,505 (829,163 new)\n•Total Deaths: 6,457,101 (2,564 new)\nReleased by Chairman Rand Paul\n-------\nIn Science indicating how Tucker Carlson was ranting about me after hearing of my \nstepping down:\nAlmost everything Tucker Carlson said about \nAnthony Fauci this week was misleading or \nfalse\nScience fact-checks the Fox host’s rant against “Saint Tony,” \nwho announced his retirement on Monday\n•25 Aug 2022\n•6:10 PM\nBy Jon Cohen\nTweet from Bill Gates:\nTony, you were an amazing public servant long before \nCOVID-19 struck – and now you are a hero to millions of \npeople, including me.\nReleased by Chairman Rand Paul\nnpr.org\nFauci to step down in December after decades of public service\nDr. Anthony Fauci helped guide the U.S. through the COVID crisis, and earlier in his career \nplayed a key role in the response to AIDS. He has served under seven presidents.\nThe Soapbox Quoting the New Republic:\nWe May Never See Another Lifelong Public \nServant Like Anthony Fauci\nIn a distinguished government career spanning more than half a \ncentury, he expertly steered America through two devastating \npandemics. But given how Republicans have maliciously attacked \nhim, why would anyone want to follow in his footsteps?\nReleased by Chairman Rand Paul\nPRESS:   Bloomberg News with David Westin;  Spectrum News Los Angeles with Giselle \nFernandez; \nAugust 26, 2022\nDan Diamond story in the Washington Post:\nHealth\nHouse panel: Trump sought to pressure FDA on covid vaccines, treatment\nThe report offers fresh details about that campaign and how it rattled agency officials.\nThis panel report documents the attempts of Peter Navarro and Hatfill to undermine me \nand get me fired since I pushed back on Hydroxychloroquine:\nhttps://coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/2022.08.24%20The%20Tru\nmp%20White%20House%E2%80%99s%20Relentless%20Attacks%20on%20FDA%E2%80%99s%20Corona\nvirus%20Response.pdf\nPRESS: London Times Radio with Carole Walker; Gray TV interview; \nAugust 29, 2022\nPrevious 2 days my daughters and partners were here for the weekend.  Very slow with \nregard to COVID.\nClearly people like John Moore (who is the most reasonable) and Paul Offit (not so much) \nare pushing back on the drive to boost people in September with the “updated” BA.5 \nbivalent since they say that boosters are not needed (Offit) or that the original vaccine is as \ngood as the bivalent (Moore)\nAshish Jha called me today asking advice on when to give the POTUS the bivalent BA.5 \nboost.   I told him 3 months after his recent infection.   Same for the First Lady.\n-------\nMonkeypox cases starting to plateau – probably a combination of behavioral modification \n+ vaccine availability:\nReleased by Chairman Rand Paul\nStatement from Tedros: Then, on my friend, Tony, Tony Fauci. We have been friends for many years. \nI respect him dearly and greatly. He’s an incredible scientist, amazing human being and congratulations \nto him for all the job that he has done. I know retirement doesn’t mean he will stop working. Retiring for \nhim is like changing a tyre, meaning another mission, and I look forward to continue working with him \nclosely through other things he will, I know, continue to do. So, I wish him all the very best. Tony is so \nspecial and everybody knows, I think. \nWith COVID, we are still doing worse with deaths than any other country:\nReleased by Chairman Rand Paul\nPRESS:   Interview with Swiss newspaper -Finanz und Wirtschaft;\nAugust 30, 2022\nUSG (FDA) getting ready to issue EUA for BA.5 bivalent boost\nPRESS:  JAMA Interview with Editor-in-Chief Kirsten Bibbens-Domingo; \nAugust 31, 2022\nNY Times  Opinion piece by Ari Schulman (rather critical of me):\nWhy Many Americans Turned on \nAnthony Fauci\nAug. 31, 2022\nReleased by Chairman Rand Paul\nGrowing evidence that people who get COVID have higher incidence of heart disease, \ndiabetes and other chronic disease compared to those who have not been infected (see \nFinancial Times):\nft.com \nThe growing evidence that Covid-19 is leaving \npeople sicker\nSarah Neville, Federica Cocco\n15-19 minutes\n------------------\nCall today from Rajeev Vankayya inquiring about whether I might want to be on Board of \nCEPI and also his new company after I step down.   I told him I cannot talk about this until \nI actually step down.\n------\nI received a phone call today, former vice president Richard Cheney congratulating me on \nmy career and thanking me for all that I have done over the decades that I had been in \npublic service.  We went on to reminisce about the things we did together to take away the \ncreation of project bioshield. I told him how impressed I was with what his daughter lives \nwas doing and pushing back against the extreme right and the trump people. He is \nobviously very proud of her and expressed that.\nPRESS:  Sirius XM Radio – “The Briefing” with Steve Scully; Bloomberg News Interview \nwith Jeanie Bauman, John Lauerman, Riley Griffin;\nSept. 1, 2022\nUnited States \n•Total Cases: 94,385,669  7-Day average: 85,762 (-6.6%)\n•Total Deaths: 1,041,280  7-Day average:  404 (-5.4%)\n•Total new hospital admissions: 5,235,025  7-Day average 5,106 (-5%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 600,555,262 (670,371 new)\n•Total Deaths: 6,472,914 (2,676 new)\nVery telling graph about the role of vaccination in preventing death:\nReleased by Chairman Rand Paul\nFDA gave EUA to BA.5 bivalent boosts and USG has ordered 170 million doses to be \nadministered starting next week.   As usual some concern among some “talking heads” \nabout doing this from Paul Offit who generally feels that most people really do not need \nboosters to a milder John Moore who is concerned about the immunology of a poor \nresponse.   Eric Topol gives the pros and cons today in his usual blog:\nReleased by Chairman Rand Paul\nRecent article in Salon (worthwhile reading  whole article):\nCOMMENTARY\nFarewell Dr. Fauci: How the \nright turned a national hero \ninto a villain in service of \nDonald Trump\nThe right's attack on science is the most dangerous of its cynical power plays. \nFauci is just collateral damage\nBy HEATHER DIGBY PARTON\nColumnist\nNice cartoon from 2020 by Mark Tatulli  :\nReleased by Chairman Rand Paul\nOther Tatulli cartoons with Lio:\nMay 11, 2020\nhttps://www.gocomics.com/lio/2020/05/11\nMay 12, 2020\nhttps://www.gocomics.com/lio/2020/05/12\nMay 13, 2020\nhttps://www.gocomics.com/lio/2020/05/13\nJune 5, 2020\nhttps://www.gocomics.com/lio/2020/06/05\nNice article in Science by Jon Cohen:\nAnthony Fauci, loved and hated, plots his next \nmove: ‘I'm not going to sit in my house’\nReleased by Chairman Rand Paul\nIn a candid exit interview, the NIAID head reflects on the \nseven presidents he served, controversial decisions, and \nfeuding with Rand Paul\n•1 Sep 2022\n•6:50 PM\n•By Jon Cohen\nPRESS:  KNSD NBC (TV) + KUAN Telemundo, San Diego with Mark Mullen;\nSept. 2, 2022\nThere is a very interesting situation that has emerged from the White House particularly \ninvolving Ron Klain and Ashish Jha in the context of the BA.5 bivalent booster shot. The \nFDA has authorized and the CDC has approved the use of the bivalent BA.5 booster for \nindividuals 12 years of age and older. The concern of Ron and Ashish is that we need to sell it to \nthe American people in a manner in which they feel this is something “new and different”  that \nthey really should partake of. However, even though we all feel that people should be getting a \nbooster shot, to sell it as something that is going to be much better than the prototype boost \nwould be somewhat of a stretch since although one can project that there would be an advantage \nof a variant specific boost, early indications from an immunological standpoint indicate that \nalthough it is likely going to be somewhat better it is not going to be a lot better.  In addition, \nthere is the push back from some in the scientific community that we are doing this with very \nlittle human clinical data. One can extrapolate from clinical immunological data using a BA.1 \nbivalent variant boost where the data are plentiful. In addition, we have extraordinary amount of \ndata on the safety of using this type of vaccine in billions of doses and billions of people \nworldwide. Also, the preclinical mouse data with the specific BA.5 bivalent vaccine indicates \nthat it gives an anti-BA.5 response much higher then the prototype vaccine does. Ron and Ashish \nare struggling with ways to sell this and the latest thing they're trying to do is to say that it could \nbe part of a yearly booster similar to what we do with flu. All of this is fine except that they're \nstraining to get a message so that a lot of people will get boosted when in fact this is unlikely \ngoing to be the case. No matter what we say, the message will not change the facts and we're \ngetting close to the line of overselling something. In one instance today, Ron was upset that \nVivek had said that this was an updated “boost” instead of an updated “vaccine” because he felt \npeople don't want this to be yet again another boost whereas if we sell it as an updated vaccine in \nthe context of making it a yearly occurrence then that would be perceived as something that is \ntruly new.\nPRESS:  NPR with Rob Stein; MSNBC with Yasmeen Vossoughian; CNN with Ericka Hill; \nPBS NewsHour with Judy Woodruff;\nReleased by Chairman Rand Paul\nSept 3, 2022\nEmail exchange between Ron Klain and me regarding the above:\nFrom:  Klain, Ronald A. EOP/WHO <RK.COS@WHO.EOP.GOV> \nSent: Saturday, September 3, 2022 7:31 PM\nTo: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>\nSubject: [EXTERNAL] Re: yearly vaccine\n No worries Tony.  My concern is that we have so much Covid fatigue in the country, so little take up of \nfourth shots, we just need to try something new.  I cannot stomach a winter of back to 2000 deaths a \nday.  We have to find a way to get people to take the new shot — I think annual vaccine is a good \nmessage but you know best.  Whatever whatever we can do to get big take up on this new bivalent — \nit’s our only real hope to not have a third winter of death.   Bless you for all you are doing to help this \neffort.  \nSent from my iPhone\nOn Sep 3, 2022, at 5:04 PM, Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> wrote:\n \nRon:\n    I just spoke with Dori about your concern that I did not mention the planned strategy of a \nyearly updated COVID vaccine for most of the population in the PBS (Judy Woodruff) \ninterview.   As you probably know, I clearly mentioned this strategy  in the CNN Interview and \nthe MSNBC interview earlier in the day.   I was planning on mentioning it in the PBS interview, \nbut then she steered he conversation towards resources available for the distribution of the \nupdated vaccines. I was hoping to get back to the subject to bring up the yearly issue, but then \ntowards the end of my last comment they said in my earpiece that we were done.  I probably \nshould have squeezed in the concept earlier when she asked “who should get it and \nwhen”.   Sorry.\nThanks,\nTony\n \nReleased by Chairman Rand Paul\nAnthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nSept. 4, 2022\nMPX stabilizing globally and in USA:\nSept. 5, 2022\nReleased by Chairman Rand Paul\nVery nice counter and fact check about the misinformation spread about me by ther \nAnnenberg Public Policy Center:\nFactCheck.org: Correcting Misinformation About Dr. Fauci  https://bit.ly/3eo3g86 \nNature Medicine:\n•Published: 05 September 2022\nLong-term cardiac pathology in individuals \nwith mild initial COVID-19 illness\nSept. 6, 2022\nWashington Post/Bloomberg:\nSo Long to Anthony Fauci, Unlikely Avatar of \nPolarization\nAnalysis by David A. Hopkins | Bloomberg\nSeptember 5, 2022 at 5:11 p.m. EDT\n----------------\nCrazy Peter Navarro in the Washington Times:\nThe FDA's mass murder of more than \nhalf a million Americans \nHCQ and Ivermectin: The Voldemorts' of America's medicine cabinet \nBy Peter Navarro and Dr. Steven Hatfill - \nMonday, September 5, 2022 \nCOVID cases trended down more now:\nReleased by Chairman Rand Paul\nPRESS:  We  had our regular White House Press briefing – this time with Jha, Walensky, \nBecerra and me.   Since Jeff left, we are only have these every few weeks.;  Canadian \nBroadcast TV; Government Executive interview\nSeptember 7, 2022\nFrom Government Executive interview:\nDr. Fauci to Young Scientists: Follow the \nScience and ‘Stay out of Politics’\nAfter nearly six decades of civil service, Dr. Anthony Fauci \nhopes his post-government life will focus on inspiring the next \ngeneration of public servants.\nI had an interesting evening last night. I went over Zeke Emanuel’s together with Chris to \ncelebrate a surprise 65th birthday party. At the party was Rahm and Ari Emanuel Together \nwith some of Rahm’s children. The dinner was catered by Pineapples and Pearls restaurant. The \ndinner took place is Zeke's almost renovated amazing new home at 3303 Highland Place, NW\nMPX – 55,000 globally and 21,000 in USA\nPRESS:  Sinclair News “The National Desk” with Jan Jeffcoat; Florida PBS Town Hall; \n“Positive Living” Fireside Chat with Kurt Goodman and Butch McKay\nSept. 8, 2022\nReleased by Chairman Rand Paul\nI was supposed to be with the President today in the Roosevelt room of The West Wing for \nhis announcement about how we are going to approach the upcoming full season with \nregard to our response to COVID. This relates to the new message of trying to get updated \nCOVID vaccines (in this case BA.5 bivalent) to be given on an annual basis similar to the \nflu. However, sadly, Queen Elizabeth passed away within minutes of the scheduled press \nbriefing and so we called it off and we will reschedule.\nThe PBS documentary film coming out in April, 2023:\nDr. Fauci Pandemic Documentary on the Way \nFrom PBS American Masters\nThe program charts 14 months in the life of the storied physician\nPRESS:  Interview with Il Messaggero (Italy); Sways Univese with Kelly Kincaid; Rolling \nOut TV with Munson Steed;\nSept. 9, 2022\nUnited States \n•Total Cases: 94,888,931  7-Day average: 70,488 (-18.8%)\n•Total Deaths: 1,043,921  7-Day average:  314 (-28.1%)\n•Total new hospital admissions: 5,267,624  7-Day average 4,620 (-10.5%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 603,711,760 (472,582 new)\n•Total Deaths: 6,484,136 (1,277 new)\nMPX cases continue to come down globally and in USA (see graph below).   We are having \ntrouble getting supplemental funding from Congress to vaccinate a wider group of \nmoderate risk people suchas commercial sex workers, prisoners, trans people, etc.  I have \nbeen pushing for elimination of MPX with wider vaccination and ring approach as opposed \nto elimination.\nReleased by Chairman Rand Paul\nHad a wonderful evening last night going with Chris to a concert by Dionne Warwick at \nthe Warner Theater in DC.   Met her after in her dressing room.   Lovely woman.\nMarc Siegel wrote a very nice piece in USA Today about me:\nDr. Anthony Fauci knows he's \nmade 'a lot of enemies.' Here's \nwhat I know about him.\nHe is a great resource within the medical world. Why has he become \nsuch a polarizing figure during the COVID-19 pandemic?\nDr. Marc Siegel\nReleased by Chairman Rand Paul\nOpinion columnist\nHad a wonderful evening at the Library of Congress at a function sponsored by Catherine \nand Wayne Reynolds. The featured people at the dinner who were Jimmy Page (Creator \nand lead guitarist of Led Zeppelin) and his wife poet Scarlett Sabet who sat at my table.   \nJimmy and Scarlett were absolutely wonderful and people and creative artists.   Jimmy now \ncollaborates with Scarlet on making albums of her recited poems.\nSept. 10, 2022\nHad a great dinner over my house with Jeff and Mary Zients and Bob Seder.  It was really \ngreat to spend time with them particularly since Jeff has been so amazingly helpful to me in \nplanning when I transition out of government. We had some interesting conversations about the \nfuture of the Biden ministration throughout the current term as well as the possibility of the \nsecond term.\nSt. Louis Post Dispatch:\nstltoday.com  \nEditorial: Kids suffered dearly during pandemic \nschool closures, but don't blame Fauci\nthe Editorial Board\n4 minutes\nSept. 11, 2022\nThe New York Post continues to lie and distort.  This is abut the conspiracy theory that \nMark Zuckerberg and I were colluding to suppress free speech:\nFauci’s direct line to Zuck proves Facebook \nCOVID censorship was all about power, not \npublic health \nBy \nReleased by Chairman Rand Paul\nPost Editorial Board \nSeptember 9, 2022 4:59pm \nSept.12, 2022\nCovid cases continue to decline:\nSept. 13, 2022\nFlorida physicians defending me in the Gainesville Sun :\nDr. Anthony Fauci deserves better \nfrom Gov. Ron DeSantis than \ninsulting comments\nBruce Stechmiller and more than 30 others\nGuest columnists\nStatement made during the last NIAID Council meeting of mine as NIAID Director:\nOn behalf of the AIDS Research Advisory Committee, ARAC, I want to take a moment to \nreflect, as we open the September 2022 meeting, which will be the last ARAC meeting under the \nNIAID leadership of Dr. Anthony Fauci. As you all know, Dr. Fauci has led NIAID since 1984, \nand it is impossible to capture the enormity of his contributions. His extraordinary leadership of \nNIAID, and through it the Division of AIDS, has been unparalleled. His ability to see the world, \nand make it better, has been astonishing: from the most fundamental scientific questions, to the \nmost difficult clinical problems of our lifetimes, to the many public health challenges the world \nReleased by Chairman Rand Paul\nhas faced over the past 40 years, in HIV and so many infectious and other diseases. These efforts \nhave had profound and life-saving effects, on individuals, communities, and the entire world. We \nthank him, on behalf of people everywhere, and we look forward to what will no doubt be \ncontinued extraordinary accomplishments as he opens a new chapter. Thank you Dr. Anthony \n(‘Tony’) Fauci.\nSept. 14, 2022\nImportant day! Today at 10:00 AM I testified before the Senate HELP committee chaired \nby Sen. Patti Murray with Richard Burr as Ranking minority. It will be likely the last time \nthat I will be testifying before the United States Congress in my position as the director of \nNIAID.  Rand Paul was his usual self asking hostile questions of me saying that I am denying \nthe existence of natural immunity. He showed a C-SPAN film clip of me taken out of context \nwhere I say that a person who was infected with flu did not need a vaccination – I then held up a \nclip from Reuters “Fack-Checker”  saying that Rand Paul was taking me out of context:\nFact Check- Fauci’s 2004 comments \ndo not contradict his pandemic \nstance\nBy Reuters Fact Check\n He then accused me of not providing the amount of royalties that people on advisory committees \nget. I pointed out to him that I have nothing to do with the VRPAC or ACIP. All in all, he made \na fool of himself and threatened to haul me before committee’s under oath if GOP takes over the \nSenate.\nSept. 15, 2022\nMonkeypox cases continue to decline in daily cases.   Total for USA = ~22,000; for world \n~60,000:\nReleased by Chairman Rand Paul\nJoel Szabat who was the acting Secretary of DoT during the trump administration asked \nme to say a few words to his group at the Department of Transportation at his last COVID \nmeeting with them. Joel is really a good guy and he was so pleased that I took the time to pipe \nin by zoom to his last meeting and congratulate him and all the Department of Transportation \nworkers for the good work that they did during the COVID outbreak. I was extraordinarily well \nreceived by the group for taking the time out to join them and to congratulate them on their good \nwork.\nI also have been doing on a regular basis the principals meeting as well as our resuming on \na more regular basis the White House press briefings. I have not mentioned these in previous \nnotes but they are occurring on a regular basis. Today I briefed the principles on the rationale for \nthe BA .5 bivalence booster shots.\nLetters of congratulations on my career and retirement from Pres. George W. Bush and Sen. \nPatrick Leahy:\nLetter from Pres. \nGeorge W. Bush  on               \nLetter from Sen. \nPatrick Leahy (D-VT)    \nPRESS:  LBC TV in UK with Andrew Marr; Texas  Tribune Festival Interview with Evan \nSmith; Financial Times interview; National Journal Interview\nReleased by Chairman Rand Paul\nSept. 16, 2022\nI have always thought that Bob redfield was somewhat of a bizarre personality and his \nhistory dating back to his time at Walter Reed has proven that. But I didn't think that he \nwas as crazy as he is now manifested by an interview he gave with a totally weird person \nPaul Thacker in which he condemned Francis Collins and me I think we're the first ones \nbeginning this award for misleading the American public and for lying to the American \npublic and even accusing me of lying under oath at a congressional hearing.It is truly \nunfortunate that as a former CDC director he has stooped so low as to get into the \nconspiracy theory space:\nFormer CDC Director Robert Red field On Inside Battles \nWithAnthony Fauci, And Why Classified Information Will Point \nto aLab Accident in Wuhan\nROBERT REDFIELD: DICHRON INTERVIEW\nPaul D. Thacker\nSep 15\n--------\nThe Lancet report on COVID by a panel chaired by Jeffrey Sachs has recently come out \nand inappropriately equated the possibility of a lab leak with that of a natural occurrence \nof the virus. There has been an uproar among the biology community against Jeff who \napparently removed from the panel anyone who felt strongly about the natural occurrence \nand actually went on a podcast with Robert F Kennedy, Jr talking about how the lab leak \nwas likely the cause even though there is absolutely no evidence to indicate this. Prominent \nvirologists including Angela Rasmussen and Peter Hotez have come out very strongly \ncondemning Jeff saying that he should have been removed as chair on the basis of his \nstrong prejudice and certainly on the basis of his allying himself with Robert F Kennedy \njunior. This is another example I believe of Richard Horton the editor of Lancet trying to \nget involved in controversial issues which bring attention to his journal. This is not the first \ntime he has done this: \nThe Telegraph :  Major Covid report suggests virus \ncould have leaked from a US lab \nThe Lancet’s paper said it is ‘feasible’ that Sars-Cov-2 emerged from a natural spillover or a lab incident, \nbut elements provoke backlash \nReleased by Chairman Rand Paul\n*****Truly an insane piece by Bob Redfield:\nFormer CDC \nDirector Robert Red                   \nPRESS:   “Breaking Med”   online interview with Michael Smith;\nSept. 17, 2022\nChris and I had dinner over Ellen Sigal’s home together with Diana DeGette and her \nhusband Judge Lino Lipinsky. It was an interesting conversation and part of the discussion was \nthe fact that the GOP will probably haul me before their oversight committees and make a \nspectacle of the Wuhan, gain of function situation. Diana is the current Chair of the Energy and \nCommerce oversight committee and if the GOP wins the House, she will be the ranking minority \nmember. This is very good for me but it doesn't completely shield me from there attacks which I \nneed to be prepared for that will come either in the House with Jim Jordan et al or in the Senate \nwith Rand Paul et al.   They will likely treat me like they treated Hillary Clinton during the \nBengazi Hearings.\nSept. 18, 2022 – \nMet John Podesta and Leslie Dach at an award ceremony for me at Georgetown Prep  \nwhere Chris and I received the Pedro Arrupe, SJ award for Exemplary Public Service.   \nThey were both aware that I will be attacked by the GOP after the election and I will likely \nneed legal assistance. John offered to put together a program to develop a fund to pay my \nlegal bills.\nSept. 19, 2022\nI had to help clean up a bit of a mess today when the President casually said on a “60 \nMinutes” interview that the pandemic was over. I had a number of press today and certainly I \ngot asked the question particularly on NPR about how this relates to the fact that all of us have \nbeen saying that we are still in the middle of a pandemic and 400 people are dying each day. I \ngave the explanation that it really is a matter of semantics and that the president was referring to \nthe fact that the fulminant stage of the outbreak is no longer present since we were experiencing \n800,000 cases a day and over 3000 deaths per day several months ago and the situation is very \ndifferent now. However, I did emphasize that we are still in the middle of a pandemic.\nIt is likely that there will be another wave of infections in November:\nVariant report 2022-09-14\nReleased by Chairman Rand Paul\nA variant wave is likely to start in at most 3 months\nThe BA.2.75 sublineage BA.2.75.2 (S:346T, S:486S, S:1119N) currently doubles in share every week (+80-\n120%). It made up between 0.1 and 0.5% in samples from two weeks ago in Europe (in Asia, North \nAmerica and Oceania, the share is higher at between 0.5-5%).\n•Global Cov-Spectrum query\n•Europe Cov-Spectrum query\nIf this growth trend continues, this variant will dominate in about two months. At this point, the growth \nadvantage would manifest in increased overall growth in incidence and a variant wave would start \naround November - on top of the expected seasonal acceleration of transmission.\nThe growth advantage over resident BA.2 or BA.5 lineages is of the same order of magnitude as was the \ncase when BA.5 displaced BA.2, which was sufficient to cause a summer wave.\nCurrently, BA.2.75.2 is the fastest growing lineage with more than 350 sequences available. The rest of \nthis report will focus on other lineages that may end up growing faster than BA.2.75.\nPRESS:  Canada TV “The Agenda” with Steve Paikin;  NPR “The World”  with Marco \nWerman;Podcast with Steve Morrison at CSIS; MiddleEast Broadcast Interview (TV); \nRural Health Matters TV with Dr. Jeffrey Gold;\nSept. 20, 2020\n•Typical media distortions.   Vivek Murthy was on MSNBC with Morning Joe and \nthey showed a clip of POTUS saying that the pandemic was “over” and then they \nshowed immediately after a short clip of “part” of my interview with Steve \nMorrison in a CSIS podcast of my saying:  FAUCI [clip]: “we are not where we need to be \nif we're going to be able to quote live with the virus because we know we're not going to \neradicate it. we only did that with one virus, which is smallpox, and that was very different. \nbecause smallpox doesn't change from year to year or decade to decade or even from century \nto century.”   As expected this created somewhat of a disturbance with the meme being \npitting me against the president of the United states. Rather typical press nonsense.\nThe POTUS is getting pushback and criticism in that he has inadvertently undermined out \nattempts to get more money from the Congress for COVID since the GOP will now quote \nhim as saying the pandemic is “Over”.   I have been out there explaining that the POTUS \nmeant that the “fulminant” nature of COVID when we were getting 3 to 4000 deaths per day is \nnow behind us, whereas now even though we are at an acceptably high level of three to 400 \ndeaths per day, it is still much better than it was many months ago. It is as good an explanation as \nReleased by Chairman Rand Paul\nany to get us back on track with the world realizing that we still have to take COVID very \nseriously with the current toll per day as well as the possibility that we might wind up getting \nanother variant such as BA.2.75.2 in November.\nWent to the Kennedy Center last night to participate in the presentation to Cliff Lane of the \nPaul Volcker Career Achievement Medal (the “Sammies”)\nPRESS:  Lancet Podcast interview; Podcast “Inside the Issues” with Alex Cohen \n(California); TED interview (Fireside Chat with David Biello);\nSept. 21, 2022\nNice Q & A with Erin Durkin in the National Journal about my relationship with Congress \nand different administrations:\nWednesday Q+A with Dr. Anthony Fauci\nThe infectious-disease expert-turned-political lightning rod \ndiscusses his next chapter, the high points of his work for \nseven presidents, and the lessons learned from the COVID \noutbreak. \nI had a very enjoyable interview for 45 minutes at the Atlantic Festival held at the new \nWharf section of DC right off Main St. It was a very successful interview with an \nextraordinarily enthusiastic crowd then gave me the opportunity to explain in detail some \nof the nuanced issues associated with COVID and the interviewer Ross Anderson (Deputy \nEditor of The Atlantic  also asked a lot about my history dating back to my very early years \nat NIH.\nWill receive Fulbright Prize on April 19, 2023:\n2022 Fulbright Prize to Drs. Kizzmekia Corbett \nand Anthony Fauci\nBenefits of vaccination and boosts:\nReleased by Chairman Rand Paul\nPRESS:  Fireside chat at The Atlantic Festival (see above)\nSept. 22, 2022\nUnited States \n•Total Cases: 95,700,347  7-Day average: 54,186 (-10.6%)\n•Total Deaths: 1,049,864  7-Day average:  314 (-12.2%)\n•Total new hospital admissions: 5,327,014  7-Day average 3,971 (-9.9%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 610,866,075 (428,321 new)\n•Total Deaths: 6,510,139 (1,395 new)\nReleased by Chairman Rand Paul\nRussia threatening nuclear attack on Ukraine as their forces are now losing to the \nUkrainians\nI testified before the Bipartisan Commission on Biodefense held at the Hudson Institute \n(Scooter Libby is Senior VP).   The group that I testified before was Joe Lieberman, Donna       \nShalala, Rep. Susan Brooks, Jin Greenwood, Tom Daschle, Tom Ridge (by zoom – unfortunately \nstill severely compromised due to a stroke a couple of years ago).  The Commissioners all \ncongratulated me on my career and praised me for my decades of public service. I gave a very \nenergetic and passionate plea for support in the long term and consistently of our research \ncomponent of the pandemic preparedness plan. I also spoke about the importance of major \nfunding to modernize the CDC and their surveillance efforts. All in all, it was a very good \nappearance before an important Commission.   My old friend Joe Lieberman wished me “Cent \nAnni” and made a great joke:  “In every 75 year old person is a 35 year old that wondered what \nthe heck happened.”\nThe White House MPX coordinators (Bob Fenton/Demetre Daskalakis) are trying to \nmicromanage (Project by project) our and the CDC’s portfolio.   Bad news!!  They mean \nwell, but this is unprecedented for any WH element to micromanage a research portfolio.\nI received a delightful call today (pre-arranged) from former Congressman Joseph P. \nKennedy III   informing me that I have been chosen to be honored at a gala in Boston with by \nthe Edward M Kennedy Institute for the United States Senate. The award is given for service to \nthe country and the co-awardee with me would be basketball legend Bill Russell formerly of the \nBoston Celtics. I had a wonderful conversation with Joe over the phone in which he expressed \nextraordinary admiration for me for what I have been through and the attacks against me by the \nfar right.\nOn my way tomorrow to Aspen for “The Weekend” where I will do a “fireside chat” on COVID.\nMonkeypox cases declining:\nReleased by Chairman Rand Paul\nSept. 23-25\nI had a wonderful weekend in Aspen Co where I attended “The Weekebnd” hosted by \nMukesh  Ambani (Reliance; Edythe Broad (The Broad Foundation); John Doerr (Kleiner \nPerkins); Ari Emanuel (Endeavor); Robert Kraft (New England Patriots); Yuri Milner \n(DST Global); Eric Schmidt (CEO Google); Patrick Whitesell (Endeavor).  The meeting \ncoincided with the wedding in Aspen of my niece Carolyn Huskey.  The participants in the \nmeeting were the typical AAA crowd of politicians, economists, journalists, sports figures, \namong others. On the side I had a very nice conversation with Alex Rodriguez (A-Rod) who \nproved to be a very intelligent thoughtful person. There were also very interesting discussions \nabout Ukraine and Russia and cyber security. I did a fireside chat with David Agus on COVID. \nMany people including Ash Carter of Harvard Kennedy School and Marc Tessier-Lavigne \n(President of Stanford) were approaching me about my post-NIH life.  As usual, I said no \ndiscussion until 2023.\nSept. 26, 2022\nI had another of my very regular zooms with Sir Chris Whitty and Sir Patrick Valance from \nthe UK and compared notes on COVID and Monkeypox\nIn the GE Hatchett newspaper:\nReleased by Chairman Rand Paul\n’Work from the shadows’: How Trump’s COVID response ties to a former professor’s GW \nemail\nEmails and documents obtained from the subcommittee found that Hatfill devised a plan for \nNavarro to call on the Department of Justice to investigate Anthony Fauci, the director of the \nNational Institute of Allergy and Infectious Diseases, his staff and other officials like former FDA \nCommissioner Steven Hahn to “shut them up for a bit.”\nSept. 27, 2022\nI did not think that Rick Bright would last at the Rockefeller Foundation. They may have \ncaught on to him.   He is probably the “former BARDA official” who said nasty things \nabout me to the WSJ.\nFormer Health Official Bright to \nLeave Pandemic Prevention Post\nRick Bright in 2020. Photographer: Greg Nash/The Hill/Bloomberg\nBy Madison Muller\nSeptember 26, 2022 at 9:35 PM EDT\n \nRick Bright, a former US health official who condemned the Trump \nadministration’s Covid-19 response, is leaving a Rockefeller \nFoundation pandemic prevention effort just over a year and a half after \nbeing tapped to lead it. \n \nReleased by Chairman Rand Paul\nSpectrum News:   Rand Paul pushing back against additional COVID funds that I and our \nHHS/WH colleagues are asking for:\nSen. Rand Paul introduces bill to divert COVID-\n19 funds toward disaster recovery efforts\nVaccine effectiveness from Israel:\nSept. 28, 2022\nHad a great dinner last night at my home with Tom Frieden and Chris. Tom is the president \nand CEO of Resolve to Save Lives, In the organization he formed with the financial help of \nMichael Bloomberg and Mark Zuckerberg. It was a very interesting evening and I got a lot of \ninformation of what it is like to leave the federal government as he did when he left the CDC and \nto go out on your own in a new adventure. Tom has always been a good friend and emphasized \nhow much I helped and supported him in the CDC when he was the director.\nAmazing that Mbeki is still spoutin AIDS-denialism.   He is currently Chancellor of a university \nin RSA (Unisa):\nReleased by Chairman Rand Paul\nTAC slams Mbeki for repeating his 'HIV \ndenialist' views, demands apology \nTerrific podcast of TWIV with Vince Racaniello who interviews Eddie Holmes who \nvigorously defends me regarding the famous Feb. 1, 2020 teleconference.   He says that I have \nbeen terribly unjustifiably vilified  when I should be commended for my behavior during that \nphone call:\nTWiV 940: Eddie Holmes in on viral origins\nSept. 29, 2022 \nI had a terrific meeting with Jeff Zients this morning on the back deck of my house in our \nusual breakfast meeting, of which we have had many over the last almost two years.  Jeff \nwas following up with me to see how I was doing following the announcement of my retirement. \nHe has been extremely helpful in guiding me about the proper steps to take in the transition to \nnon-government life. It is also noteworthy that he and his former deputy Natalie Quillian have \nbeen asked by President Biden to line up names four people to occupy leadership positions in the \nadministration at the end of the second year and as the new Congress comes in. In addition to \ndetails about what I am going to be doing over the coming months, Jeff asked my advice about \nnames of people who could fill senior positions particularly in the arena of health and science.\nEbola is starting to heat up in Uganda.    Deputies meeting tomorrow via SCIF to scope out \nthe situation.  I will attend.    About 50 cases in rural Uganda\nSept. 30, 2022\nUnited States \n•Total Cases: 96,052,716  7-Day average: 47,112 (-13.1%)\n•Total Deaths: 1,053,173  7-Day average:  344 (-6.7%)\n•Total new hospital admissions: 5,353,767  7-Day average 3,733 (-7.4%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 613,942,561 (460,497 new)\n•Total Deaths: 6,520,263 (1,248 new)\nWe had the deputies meeting in the SCIF today on Ebola in Uganda led by the White \nHouse National Security Council. This was preceded by a preparatory meeting among the \nHHS team led by Andrea Palm. During that meeting Andrea got very upset with Henry Walke \nand Rochelle of CDC Because they were falling into the same trap as they did with COVID \nReleased by Chairman Rand Paul\nwhen they were indicating that they will likely go into slow walk the availability of diagnostics. \nIt seems that the CDC just has not learned a lesson at all about the catastrophe regarding the \navailability of diagnostics during COVID.  During the meeting with the deputies, my role was to \ntell them about the 100 doses of the Sudan ebola vaccine that we have at the VRC.  it was a lot of \ndiscussion about everything from isolation to travel to availability of interventions to dealing \nwith the Ugandans. There are currently no cases outside of Uganda in cases have been confined \nto four provinces in Uganda. There was a concern that the neighboring countries of Rwanda and \nDRC are vulnerable.  Also, there was considerable discussion about how we would handle the \nentry of potentially or actually infected patients from Uganda into the country. Approximately \n140 people a day fly in to the United states indirectly from Uganda since there are no direct \nflights from Uganda to the United States.\nJAMA news article by Len Strazewski:\nDr. Fauci stood up for science when it counted. \nWhat’s next?\nOther variants are starting to evolve such as BA.4.6, BF.7 and BA.2.75.2:\nOct. 1, 2022 –\nReleased by Chairman Rand Paul\nWe had a 1 hour meeting today with all the relevant members of HHS (CDC, NIH, \nBARDA, ASPR, etc. ) led by deputy secretary Andrea Palm to work out the departmental \napproach towards the Ebola outbreak in Uganda. The NIH’s (NIAID) major role will be to \nprovide 100 doses of the Sudan specific ebola vaccine from our VRCfor Uganda. In order \nto go through the proper diplomatic channels, Dr. Tedros (DG of WHO) wrote me an \nofficial letter requesting that I send our hundred doses to Uganda (see below):\nDirector_National \nInstitute of Allergy a   \nOct. 2, 2022\nWe had multiple zooms today (with HHS folks) that will culminate with a briefing of \nsecretary Becerra on the evolving situation of Ebola in Uganda.  I brought up in the \npremating the consistent difficulties that we have with WHO who always want to actually \ndesign the protocols and then have organizations like NIH or CDC be the implementers of their \nprotocols. This arrogance lies fundamentally with Anna Maria Restropo who has clashed \nfrequently with Cliff Lane in prior Ebola situations dating back to 2014. We shall see how all of \nthis plays out. Currently, there are 30 confirmed cases of Ebola in Uganda and more than 20 \nprobable cases. In the zoom meetings we discussed all of the things that we discussed in the past \nwhen ebola struck West Africa and DRC. This has to do with the availability of testing, with the \nissue of travel into the country of people who might be infected with ebola, as well as our role in \nsupplying vaccines testing and therapies in the form of monoclonal antibodies and other drugs to \nthe Ugandans. More to come. Becerra backs my concern about the WHO trying to dictate the \ndesign of clinical trials.   I referred to Anna Maria Restropo without mentioning her name.   \nBecerra gets it.\nOct. 4, 2022\nStarting to get significant uptick in cases in the UK. This is troublesome since we usually \nfollow them by about four to five weeks.\nOct. 5, 2022\nAn example of the White House over ruling CDC. Rochelle and the CDC do not want to \nrequire entry screening of people coming in from Uganda in the context of ebola; however, \nthe White House is very hyper about covering all the bases and on demanding a modified \nform of entry screening even though Uganda is requiring exit screening.\nPRESS:   CBS “The Late Show with Stephen Colbert\nOct. 6, 2022\nReleased by Chairman Rand Paul\nYesterday I went up to New York City to appear on The Late Show with Stephen Colbert. \nIt was hilarious and the theme was to give people their booster shot. As part of the scripted show \nhe asked me if I was going to get my booster and I said I'm due for it and he said well let's go get \nit. We got up walked out of the studio went to the Duane Reade pharmacy and got the shot.  The \nresponse to the show has been phenomenal!!\nMany new variants hovering around.   From Trevor Bedford:\nPRESS:  NJ PBS “Chat Box” with David Cruz; News Nation with Chris Cuomo;\nOct. 7, 2022\nNote the growth advantage that BQ.1.1. has over BA.5.   We definitely need to watch out \nfor these new Omicron sublineage variants as we approach late Fall/early Winter :\nReleased by Chairman Rand Paul\nWe are doing very poorly compared to other countries in boosting out population:\nReleased by Chairman Rand Paul\nOct. 8, 2022\nUnited States \n•Total Cases: 96,363,451  7-Day average: 43,693 (-8.4%)\n•Total Deaths: 1,056,029  7-Day average:  324 (-13.1%)\n•Total new hospital admissions: 5,376,728  7-Day average 3,376 (-7.8%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 616,951,418 (466,669 new)\n•Total Deaths: 6,530,281 (1,543 new)\nOct. 9, 2022\nPRESS:  CNN with Pamela Brown;\nOct. 10, 2022\nMike Gerson wrote an amazing piece on me in the Washington Post:\nOpinion \nReleased by Chairman Rand Paul\nWhy Anthony Fauci is the greatest public \nservant I have known\nBy Michael Gerson\nColumnist |\nOctober 10, 2022 at 1:08 p.m. EDT\nAmerican political disagreements have often come down to us in the form of vivid dyads. Alexander \nHamilton vs. Thomas Jefferson. Stephen A. Douglas vs. Abraham Lincoln. Franklin D. Roosevelt vs. Arthur \nH. Vandenberg.\nOne such conflict over the past few years has been Sen. Rand Paul (R-Ky.) vs. Anthony S. Fauci , the \nlongtime head of the department of infectious diseases at the National Institutes of Health.\nI am not referring here to any moral or intellectual equivalence between the figures. Their inequality, in \nfact, is a central part of the story. Paul’s contempt for expertise, his spread of conspiracy theories, his \nuse of oversight as ambush — all this indicates a performative approach to governing. Reality does not \nReleased by Chairman Rand Paul\nultimately count; the play is the thing. And Paul has found an audience among ideologues who \ndemonstrate their fidelity by taking some extra poison  in their pudding.\nThe single most shocking fact to come out of the recent pandemic has been the unfair self-\napportionment of pain and death. People in majority-Republican counties experienced 73 more deaths \nfrom covid-19 per 100,000 people than those in majority-Democratic counties. There are a variety of \nexplanations. One is certainly the use of high office to discourage the most basic means of self-\npreservation during a deadly disease outbreak. Imagine if it had been Democratic public authorities \nencouraging Republican self-victimization. But it was Republican officials who did it — and found it an \neffective method of self-publicization.\nOn the other side has stood Fauci. In more than 50 years at the NIH, Fauci has been accustomed to \nscientific debates in which disagreements emerge as the result of seeking different methods in the \npursuit of the same goals. But Paul and his co-ideologues have left the assumption of shared objectives \nin tatters. And this has constituted an attack on the very idea of public service — the notion that true \nexperts can make a career in seeking the common good.\nFor Fauci, it has been a professional and moral commitment that politics should stop at the human \nbiome’s edge. This does not imply that scientific experts are perfect. To the contrary, the purpose of the \nscientific method is to organize failure into deeper insight. But it does mean that scientific truth is not \nrelative — or determined in the political realm.\nIn attempting to demonize  Fauci, his critics gained a fundraising target. And that, by their own lights, is \nthe definition of political success. But seldom has the choice of an attack been more of a self-indictment. \nFauci is not only a symbol of public health orthodoxy; he has done as much as any scientist to turn \nmedical innovation into humanitarian progress.\nFor generations, Fauci has applied a low-key excellence to fighting domestic AIDS, tropical infectious \ndiseases, global AIDS and Ebola. His role in the creation of the President’s Emergency Plan for AIDS \nRelief has helped save tens of millions of lives and built medical infrastructure across the developing \nworld. His focus and public investment have brought us to the verge of vaccines against malaria, one of \nthe world’s deadliest parasites.\nFauci is a symbol of sorts. He demonstrates what can happen when a nation at the height of its power \nemploys the finest scientific minds of their generation to the pursuit of public health goals few believed \nwere possible. The result has been a golden age of public health, motivated by an American belief in \nhuman dignity.\nThis is not the kind of reputation to be dented by political attacks or internet rumors. It is a legacy \npraised each day by the chorus of millions of breaths that would otherwise be silent. A vast chorus of \nthe nearly lost.\nAs someone who worked for a few years with Fauci during George W. Bush’s administration, I saw how \nhe pushed for new ideas and new funding: by expressing his passion for the scientific project itself. He is \nReleased by Chairman Rand Paul\nthe ultimate explainer. In briefings, he did not conspire to make himself seem smart. He made those he \nbriefed feel they had spent a few minutes looking out on a vast landscape of innovation.\nRobin Givhan: Fauci carried all our angst and anger with patience and decency\nFauci assumes that everyone is rational and thus persuadable. That is not quite true. But when he \ndescribed to me the shifting shell of sugars that surround and protect the AIDS virus, or how mRNA \nvaccines work, it left a few impressions. First, how something that can kill you can be so fascinating. But \nalso how much Fauci’s friendship felt like mentorship. The greatness of his calling rubbed off a bit. And \none was left with the infection of his mission.\nFauci’s forthcoming retirement as director of the National Institute of Allergy and Infectious Diseases \nwill cost Americans, and people around the world, far more than they realize. But he will ever remain \nthe greatest public servant I have known.\nOct. 11, 2022\nMet with the Indian contingent for the VAP program (Vaccine Action Plan), a program I \nstarted with India 34 years ago.  We signed an updated MOU to continue the program.   Dinner \ntonight at the Indian Ambassador to USA (Taranjit Singh Sandhu) at his home together with the \nIndian Finance Minister tonight\nPRESS:  NBC News Medical Unit with Ashkay Syal;\nOct. 12, 2022\nMet in Building 31 with Stella Kryiakides, Commissioner of EU for Health and Food Safety \nand Peter Piot to discuss COVID and other issues including Monkeypox.   Enjoyable \nmeeting.   She told me how much all of Europe relied on my advice on COVID, particularly \nduring the 1st year.\nReleased by Chairman Rand Paul\nOct. 13, 2022\nHad a very disappointing conversation today with Dep Sec Andrea Palm, Kevin Barstow \nand the HHS General Counsel Samuel Bagenstos.   They essentially told me that they will \nnot be able to help me at all after I leave government service on December the 31st.  In \nReleased by Chairman Rand Paul\nparticular, they will not be able to provide me with legal backup if I get called before \noversight committees if the GOP takes over the Congress. In addition, they are going to \ndiscontinue my protective service that has been given to me for the past 2 1/2 years. They even \nwent on to suggest that I could hire a private security firm to protect me. I would say that this is a \nrelinquishment of their responsibility to me since everything that I've done that has put me into \nthis position I've done in my service to HHS and the US government.\nPRESS: Interview with Rodney Russel for the journal Viral Immunology; Interview with \nWHO Bulletin; Interview with Ed Randell “Fans for the Cure” Radio Show;\nOct. 14, 2022\nUnited States \n•Total Cases: 96,640,059  7-Day average: 38,949 (-11.9%)\n•Total Deaths: 1,058,692  7-Day average:  328 (-8.5%)\n•Total new hospital admissions: 5,400,083  7-Day average 3,268 (-4.4%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 620,301,709 (417,329 new)\n•Total Deaths: 6,540,487 (1,094 new)\nI had a delightful zoom conversation with a 3rd year student at Bronx High School of \nScience – Ayshi Sen, an immigrant from Bangladesh. She is writing for her school newspaper \nand she asked for an interview.   She was over the moon that I agreed to do the interview\nConsiderable concern that is growing about the impact of new variants that have a \ntransmission advantage and that evade the critical monoclonal antibodies such as Evusheld:\nReleased by Chairman Rand Paul\nPRESS: Interview with Erin Banco of Politico;   Interview with The Guardian with David \nSmith\nOct. 16, 2022\nDid a panel at the Annual meeting of the NAM.   Panel chaired by Salim Abdul Karim.  I \nspoke on “Lesson Learned from COVID-19”.   Has a brunch at “Founding Farmers” restaurant \nwith Salim and Quarraisha.  Still very tough going out in public since I get swamped by people \nwanting selfies.   The agents do not like that since if I say yes to one then a whole crowd forms.\nWashington Post Opinion piece by John Erickson:\nOpinion \nAnthony Fauci’s work saved countless lives\nOctober 16, 2022 at 12:15 p.m. EDT\nNice 50th Anniversary Gala of NAM at the Building Museum. I was individually recognized \nand got a prolonged standing ovation.   Heartwarming as I as totally mobbed by my colleagues \nwanting selfies.   I must have done at least 100 (no exaggerating!)\nPRESS:   ABC “This Week” interview with Jon Karl;\nReleased by Chairman Rand Paul\nOct. 17, 2022\nCrazy thing has now emerged. Boston University investigators have done an experiment \nthat clearly would have fallen under the category of oversight by the P3CO process. Yet \nthey never told our NIAID program people about it, nor was there any mention of these \nexperiments in the grant that they cited in the pre print paper, nor was there any mention of this \nin the progress reports from the grant. What they did was swap an omicron spike on to a Wuhan \nmatrix to determine the effect of the chimera on the function of the virus. As you might expect \nthe people who have been attacking us for gain-of-function research  are jumping all over this. \nWe are putting out a statement indicating that we knew nothing of these experiments and they \nshould have told us about them and put it through the P3CO process. Let us see how this plays \nout.\nOct. 18, 2022\nHad one of my intermittent calls from Joan Baez just checking on seeing how I am doing.  I \nwould love to visit her after I step down just o see where she is living in California\nOct. 19, 2022\nBU admits that they did the experiments on their own and did not use NIAID funds.  Stll \nongoing discussion whether this was actually GOF since fewer mice died.   In any event, we \nare clear of this.\nPresented for the last time as NIAID Director to the Executive Committee of IDSA at the \nMarquis Marriott Hotel in DC\nPRESS:  CBS TV News; \nOct. 20, 2022\nHonored with Chris and Francis Collins and Diane Baker at a Rooftop Reception by the \nFriends of Patients at NIH\nPRESS:  WNYC Radio – “The Brian Lehrer Show”; Taped Local NBC TV with Doreen \nGentzler;\nOct. 21, 2022\nUnited States \nReleased by Chairman Rand Paul\n•Total Cases: 97,063,357  21 -Day average: 39,803 (-30.9%)\n•Total Deaths: 1,065,152  21-Day average:  388 (-13%)\n•Total new hospital admissions: 5,422,246  7-Day average 3,156 (-4.4%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 623,470,447 (371,876 new)\n•Total Deaths: 6,551,678 (1,143 new)\nPresented Alexander Fleming Award of the IDDSA to Larry Corey at the DC Convention \nCenter\nHumbling experience for me as I received a prolonged standing ovation from the crowd of 6000 \npeople as I walked on to the stage to introduce Larry. Also, the IDSA established a perpetual \nprize in my name the IDSA Anthony S. Fauci Prize for “courage in leadership in speaking \nscientific truth, perseverance in the face of opposition and serving as a change agent for \nhealth care and patients around the world”.\nBQ.1.1 is gaining ground!\nOct. 22, 2022\nPRESS: ABC “Good Morning America” (weekend); Gave interview with Roxanne Roberts \nof the Washington Post in connection with the unveiling of my portrait by Hugo \nCrosthwaite at the National Portrait Gallery\nReleased by Chairman Rand Paul\nOct. 24, 2022\nThe Uganda Ebola outbreak is spreading in Kampala and causing concern.\nInteresting meeting this AM at the Pentagon.   At the invitation of general Charles Brown, I \nwas given a tour of the Pentagon. Apparently, a lot of people at the Pentagon admire me very \nmuch and wanted to have the opportunity to show me around the facility. I spent close to two \nhours getting a tour that was truly fascinating and enjoyable given my love of the history of wars, \nand the response to me was very moving. Several women civilian employees as well as military \nofficers came over to me wanting selfies and in their telling me how much they admired what I \nhave done throughout my career, more than one of them actually broke into tears as they were \ntelling me how much they appreciated me. It was very moving. I also had the opportunity to have \na chat with Secretary Lloyd Austin as well as my friend Chairman of the Joint Chiefs of Staff \nMark Milley.  Mark was amazing.  He gave me his new Joint Chiefs Chairman challenge coin \nas well as a signed copy of three books: the Constitution, the Declaration of Independence, And \nWashington's rules of civility. He was also hilarious and telling me that President Biden, \nAttorney General Merrick Garland, himself, and I are going to be attacked by the GOP if they \nReleased by Chairman Rand Paul\ntake over the house and the Senate. Mark’s comments to their attempts on attacking us amounted  \nto two words that he told me: “Fuck ‘em”.  He told me he was not going to take any shit from \nthem. As a military officer he will act with civility, but if they try to push him around and \nembarrass him and humiliate him publicly he will blow them away. It was refreshing to hear him \nand his response to what I will almost certainly be facing, and I totally agree with him.\nPRESS:  Extensive profile interview with Der Spiegel with Raphaela von Bredow\nOct. 25, 2022\nCOVID in Poland versus USA\nI did an event at the White House with President Biden where he got vaccinated in front of \na TV camera after interacting with me, Ashish, and Vivek, as well as several CEO's of \npharmaceutical corporations such as CVS, Rite Aid, Walgreens, and Albertsons.  The POTUS \nwas extremely nice to me giving me a big hug in front of everyone and telling everybody that he \nand I have been through hell together and that I saved the country and was the one that kept it all \ntogether when things really got bad. He was really quite sincere and very nice.\nThe anti-Fauci rhetoric is heating up leading to election on November 8:\nSTAT : On the campaign trail, Republicans ramp \nup anti-science, anti-Covid, often anti-Fauci \nmessaging\nPRESS:   Interview with “HCare”; Hearst TV; MSNBC TV with Lindsey Reiser; “The \nSkimm” podcast; WHUR DC radio; KMOJ Minneapolis radio; WAMJ Atlanta radio; \nMichigan Chronical newspaper; NewsStitched newspaper; “Make it Plain” podcast with \nRev. Mark Thompson; MSNBC with Alex Wagner\nOct. 26, 2022\nImportant history of women accusing me of sexual misconduct.   This is well-documented \nin the attached document:\nFAKE NEWS\nReleased by Chairman Rand Paul\nShe Said Anthony Fauci Sexually \nAssaulted Her. Now She Says Jacob \nWohl and Jack Burkman Paid Her to Lie.\nAfter failing to frame Robert Mueller, Elizabeth Warren, and \nothers for sexual misconduct, the infamous Trumpster hoaxers \ntried to go after Fauci. But the woman they hired to play the \nvictim had second thoughts.\nNANCY ROMMELMANN  | 5.7.2020 11:00 AM\nShare on Facebook Share on TwitterShare on RedditShare by \nemail Print friendly \nversion\nhttps://reason.com/2020/05/07/she-said-anthony-fauci-sexually-assaulted-her-now-she-says-\njacob-wohl-and-jack-burkman-paid-her-to-lie/  \nI'd just finished Saturday morning's second cup of coffee when an email \npopped through, subject line: \"Exposing Jacob Wohl and Jack Burkman.\"\n\"Hi Nancy, I hope you are having a nice weekend. I feel very bad about lying \nto you and others about Dr. Fauci. I took it upon myself to call Jacob Wohl \nand Jack Burkman and record them (see attached)… Many thanks and again, \nI feel very bad about all this. I apologize to you, the other reporters and Dr. \nFauci.\"\nThe writer of the email identified herself as Diana Andrade. I had never \nbefore emailed with Andrade, but had spoken with her 10 days earlier, when I \nknew her as \"Diana Rodriguez.\" At that time, Rodriguez alleged that when \nshe was 20 years old, in 2014, she'd been sexually assaulted by Dr. Anthony \nFauci, the director of the National Institute of Allergy and Infectious Diseases \nand one of the most visible faces in the government's response to the \nCOVID-19 pandemic.\nFor those lucky enough to be unfamiliar with the exploits  of Wohl and \nBurkman, they are pro-Trump provocateurs who've found a niche drumming \nup fake sexual harassment allegations that end comically badly, including \nagainst former FBI Director Robert Mueller (who turned out to have been \nReleased by Chairman Rand Paul\nserving jury duty the day he was supposed to have committed the assault) and \nDemocratic Sen. Elizabeth Warren (the press conference for which took place \non Burkman's stoop, and whose supposed victim was a 24-year-old Marine).*\nBeing on the receiving end of an allegation of sexual misconduct is now a rite \nof political passage—a perverse sign you've made it. Fauci's star rose in \nMarch as he appeared at COVID-19 briefings day after day, outshining \nPresident Donald Trump and occasionally knocking the president's \npronouncements out of the headlines. Here, then, was an opportunity for \nWohl and Burkman to take down the newest of Trump's perceived enemies, \nto maybe become favorites in Trump's actual orbit. On the chance it would \ncause their own star to rise, they would move Fauci toward irrelevancy, if not \ninfamy.\nThe rollout of their latest smear job was a fiasco, a series of \"media alerts\" \nannouncing press conferences with no start times, never mind that neither the \npublic relations contact nor the company she worked for appeared to exist, \nand a \"statement\" from Rodriguez so breathless it seemed intended to steam \nup the windows. (Not for nothing, Sally Quinn recently confessed she based a \nthinly veiled D.C. heartthrob in her 1991 bestseller Happy Endings on Fauci, \nso Wohl and Burkman aren't the first to write this particular fan fiction.)\n\"He looked rich and powerful, and I love smart men with grey hair. He told \nme all about his fantastic career in medicine, so I went upstairs,\" Rodriguez \nwrote of her fictional meeting with Fauci at the bar of the Four Seasons Hotel \nin Washington, D.C. After detailing some ineffective hotel bed wrestling and \nmanaging to flee with her honor intact, Rodriguez closed with the statement, \n\"Now, when I see him on TV touted as some kind of hero, I want the nation \nto know the truth. This is my truth. This is my story.\"\nIt was all in a league of its own weirdness, a collision of Harlequin romance \nand #MeToo. Nevertheless, several journalists called into a conference call to \nhear Rodriguez's story. We were treated, instead, to Wohl and Burkman on \nthe line, stating they'd on the fly been invited to represent Rodriguez, who \nhaltingly told a story that varied significantly from the media alert and, when \nquestioned for clarification, was talked over by Wohl.\nReleased by Chairman Rand Paul\n\"People come forward against figures that are considered media darlings with \nvery credible allegations and are attacked by the media,\" he told us. \"And you \nsee the same sort of victim-blaming here.\"\nHe and Burkman then tried to dissemble past there not being one verifiable \nfact or person in their latest confection, implausibly invoked the name of \nKevin Spacey as someone who would speak for their client, and confirmed \nfor reporters that the original location of the press conference had been at the \nChinese Embassy.\n\"They were kind enough to offer the venue and there's not a lot of open \nvenues these days,\" said Burkman during the call. (He had \"a contact there.\") \nIt was all beyond absurd, and when the reporters finally stopped laughing, \none asked, \"Can you just tell us you're pulling a prank here?\"\nWith the exception of The Daily Dot, which covered the claim only to \ndebunk it, no outlet touched the story. There was no there  there, and while it \nmight've been instructive to show readers how the rancid sausage is made, \ndid we want to give these charlatans more sunshine, especially in light of \nFauci leading the battle against a deadly pandemic?\nAnd that would have been that—until Saturday's email, which included \nAndrade telling me, \"The reality is that I've known Jacob since 2018 and that \nhe charmed me into taking money to do this (see attached picture of us \ntogether),\" taken when they were romantically involved. Also, that Wohl and \nBurkman \"had me do something like this…back in January.\"\n\"And I understand they're trying to get another girl to do it, too,\" she writes. \n\"They asked me if I knew anyone to do it.\"\nAndrade was correct. The day before, I'd received another press release, this \ntime from Burkman, citing a new accusation by \"Karen Draper,\" a \"former \nassistant\" of Fauci—a person and claim almost certainly as vaporous as the \nlast. Why did they keep trying the same scam when they were clearly so bad \nat it?\n\"They are interested in one thing: power,\" Andrade writes. Sure, but how \ncould such buffoonery be perceived as power? Were they so desperate to \nReleased by Chairman Rand Paul\ncatch Trump's eye they would pounce on anyone garnering public adulation, \nsomething the president was temperamentally unable to abide? And was there \nany upside to the rest of us knowing what animates a couple of amateur dirty \ntricksters, wannabe Roger Stones minus the charisma and connections?\nAndrade, having been in the muck with these two, thought people should \nknow. She had not acted nobly—and had taken money for not acting nobly—\nto try to bring down a man she had never met. Disgust with the enterprise \nmade her want Wohl and Burkman to admit what they'd put her up to. The \ndeciding factor to get them on tape, however, was Wohl asking her to provide \nanother girl.\n\"I ignored his inquiry about this,\" she writes. \"But it led me to feel like I \nneeded to blow the whistle.\"\n***\nDuring the nine-minute, 35-second call, Wohl and Burkman do not cover \nthemselves in glory. They hector Andrade when she says she's feeling \nparanoid and wants reassurance that everything's fine.\n\"What could be wrong, Diana?\" Wohl asks. \"You did a good job, you got \npaid. What's the problem? What seems to be the issue? You're freaking out. \nYou're texting me late at night. What's the issue?\"\n\"What's the problem? What's your problem?\" echoes Burkman. \"Tell me \nwhat the problem is? What's your problem?\"\nShe says she's uncomfortable with the money they gave her, some guy \nshowing up, claiming to be a lawyer, with his face hidden by a cap.\n\"Is he even a real lawyer?\" she asks. \"I looked him up.\"\n\"Yeah, he's a real lawyer,\" Wohl says. \"He's a good lawyer,\" and then goes \non to brag about that lawyer's White House connections.\nIt's possible that a White House–connected lawyer might have hand-delivered \nfive figures in cash to Andrade in Los Angeles. It's also possible Wohl made \nReleased by Chairman Rand Paul\nup the whole thing. But she says she did get the money, and Wohl and \nBurkman are clearly eager to imply that they are intimate with Team Trump.\nThe cloaks and daggers might have been discomfiting, but ultimately were a \ndistraction from what Andrade wanted on tape. She proposes she give back \nthe cash and instead receive a wire transfer (thus creating a trace), a \nproposition Burkman shoots down. (\"Cash is best,\" he tells her. \"We don't \nwant any records of this nonsense.\") She wants the men to admit they are \ntrying to bring down a person who in no part deserves it.\n\"Let me tell you something, Diana,\" says Burkman. \"This guy shut the \ncountry down. He put 40 million people out of work. In a situation like that, \nyou have to make up whatever you have to make up to stop that train and \nthat's the way life works, OK? That's the way it goes.\"\nAndrade counters that he and Wohl are not taking COVID-19 seriously. \"It's \nnot just any virus. I mean, it's a huge deal….I think you guys think it's \nsomething made up, and it's not.\"\n\"Mother Nature has to clean the barn every so often,\" Burkman counters. \n\"How real is it? Who knows? So what if 1 percent of the population goes? So \nwhat if you lose 400,000 people? Two hundred thousand were elderly, the \nother 200,000 are the bottom of society. You got to clean out the barn. If it's \nreal, it's a positive thing, for God's sake.\"\n\"So, what? Survival of the fittest?\" Andrade asks, a bit more pique in her \nvoice. (The sense you are dealing with people who have an enthusiasm for \neugenics can do that.) But Wohl's not having it.\n\"Diana, look, can you just do this for me?\" he says. \"Can you just keep your \nmouth shut and just…just do it for me.\"\n\"Oh Jacob, come on,\" she says. \"You have a way of charming people…and \nthere are a lot of things I don't want to say in front of Jack but I am so done \nwith you. I do not want to deal with this anymore. I think you're actually an \nevil person…you're just, you're just so charming until you get me cornered. I \ndon't know how you do it, but you find a way to make me go along with your \nlittle plans.\"\nReleased by Chairman Rand Paul\nAt this, the men talk over each other, telling Andrade she \"readily \nvolunteered\" and asking who cares if she \"made up a story. Grow up, for \nChrist's sake.\" And those harassing phone calls she's started getting since the \nconference call?\n\"Probably telemarketers,\" Wohl tells her.\nShortly afterward, Andrade ends the call. Then she emails me.\n***\n\"I'm sure you noticed I wasn't following the script,\" she says, after our first \nemail, with regard to the story told on the conference call not lining up with \nthe press statement. Yes, I say, it was pretty bad.\nThere was \"no preparation!\" she says. Jacob \"just told me, because he knows \nmy other story, he just said, 'Use the same stuff.'\"\nThe \"same stuff\" is a reference to a sexual assault Andrade says she \nexperienced when she was just out of high school, when she was attacked in a \ncar by a much older man. The incident caused her shame, both having been \nassaulted by someone she barely knew but thought she could trust and also \n\"because I lied to my mom about where I was when this happened.\"\n\"For many reasons, I couldn't talk about it,\" she says, but she had told Wohl, \nback when they were involved. It had made him angry on her behalf, and this \npast January, he had made her an offer.\n\"He said, 'Well, you know you don't want to talk about this, but maybe this \ncould be another way of talking about it.'\" He then asked her to recraft her \nexperience into an accusation against an Academy Award–winning actor. He, \nWohl, would pay her to do it.\n\"He said, 'We actually need someone like this, and maybe it'd be good \npractice for you to be able to talk about this,'\" she recalls. \"'Just talk about \nhow you feel about the real thing, but take it out against this other person.'\" \nAndrade made the accusation. She never knew why Wohl wanted her to do \nthis, and the story never gained traction. Wohl then had her try again with \nFauci. Another strikeout.\nReleased by Chairman Rand Paul\nAs feeble as they are at pulling off these cons, Wohl and Burkman appear to \nappreciate what a powerful motivator shame can be and how it has been used \ntraditionally to keep women quiet. They have refashioned \n#BelieveAllWomen into a tool for their own purposes, including in their most \nrecent media alert about the press conference, called for this Friday, for \nalleged Fauci victim \"Karen Draper.\"\n\"This is becoming a disturbing pattern, and the left-wing media has no \ninterest in letting women speak their truth,\" Burkman wrote in the press \nrelease. \"I'm hopeful that Karen will be able to tell her story and help bring \nthis troubling series of events to light.\"\n\"I don't know how they do all these things and why they do all these things,\" \nAndrade says. \"Also, he tried to frame Mueller…I'm like, how is he not in \njail?\"\nReached by email for this story, Wohl responded \"no comment\" and \nBurkman replied only: \"We stand by Diana and her allegations.\" Even \nAndrade herself has been vague on some details of her own biography, \nadding another layer of obfuscation and mystery to an already fantastical \nnarrative.\nI ask Andrade if she'd ever considered that Wohl might blackmail her by \nexposing the assault she experienced. She says she does not think he will, and \nthat despite what he'd roped her into she \"still wishes good things for Jacob.\" \nBut there was one thing she did wonder, in light of his attempts to bring \ndown Mueller and Fauci.\n\"I don't understand,\" she says, \"how he doesn't get in trouble.\"\n***\nMaybe it was the noncommittal murmurs Andrade had started to make, but a \nlittle more than seven minutes into the taped call, something seemed to occur \nto Wohl.\n\"You haven't talked to anybody, have you?\" he asked.\n\"Mm,\" said Andrade.\nReleased by Chairman Rand Paul\n\"No one, no one, Diana,\" he said. \"I think it's the weekend; you're bored, \nyou're worked up. Can you sit on this for the weekend? Don't talk to anyone \nabout this. Not your parents, not anyone, and it'll be fine.\"\n\"And is Dr. Fauci fine?\" she asked. \"I mean, is everything going to be fine \nwith him?\"\nWith adversaries as chaotic and inept as Wohl and Burkman, the answer \nseems to be yes.\n*CORRECTION: The original version of this story said Sen. Elizabeth \nWarren's accuse\nPRESS: CNN with Kate Bolduan;\nOct. 27, 2022\nI went to Boston yesterday to do a fireside chat with Peter Staley at the Harvard Kennedy \nSchool Institute of Politics. It was a record crowd of students from Harvard who are literally \noverwhelming in their enthusiasm and response to me. Among the students and present in the \naudience were Larry Summers (former President of Harvard and former Secretary of the \nTreasury) and Bill DiBlasio (former Mayor of NYC).  Had dinner with Jenny in Cambridge and \nshe was radiantly beautiful!\nCOVID down in children:\nReleased by Chairman Rand Paul\nI was part of a tribute to Larry Kramer  where a Medallion describingwas placed at the front \nof 2 Fifth Avenue the apartment in Greenwich Village near Washington Square Park where \nLarry lived since 1973\nEvery day there is more conspiracy theory disinformation about me:\nThey had a Fauci “look-alike” contest in Florida with a prize being a weekend at an \nexclusive Inn:\nReleased by Chairman Rand Paul\nTHE AVENUE  |  LIFESTYLE\nDr. Anthony Fauci look-alikes take over \ndowntown Gainesville\n7 contestants pretended to be the president’s chief \nmedical advisor\nBy Jiselle Lee \n•\nOctober 27, 2022 | 2:19pm EDT\nPRESS:  Joe Madison Sirius XM Radio; Frank Ski Show – Frank Ski and Nina Brown \n(Georgia/DC radio); Midday Flavor Radio (Alabama) with Jimmie Doctrie; WVON \nMorning Show (Chicago) with Rufus Williams; Epicenter NYC Jeanne Pinder Podcast;\nOct. 28, 2022\nUnited States \n•Total Cases: 97,329,787  21 -Day average: 37 (-25.1%)\n•Total Deaths: 1,066,351  21-Day average:  373 (-13.7%)\n•Total new hospital admissions: 5,445,602  7-Day average 3,217 (+1%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 626,090,018 (267,575 new)\n•Total Deaths: 6,564,556 (618 new)\nBQ.1 and BQ.1.1 becoming more prevalent:\nReleased by Chairman Rand Paul\nPRESS:   MSNBC with Yasmin Vossoughian; Newsy with Marista Georgiou; Amsterdam \nNews (New York) Heather Butts;V-103 (Atlanta)\nInterviewer:  Maria Boynton; CNN with Jake Tapper;\nOct. 30, 2022\nOn “Meet the Press” this AM (Sunday) Chuck Todd discussed the attack on Paul Pelosi \nand mentioned several prominent people in Congress and Supreme Court who were also \nthreatened and mentioned the arrest of the person who threatened me and my family\nOct. 31, 2022\nPRESS:  ITV News – UK with Alex Sandler; Wired with Steven Levy;\nNov. 1, 2022\nMet with Josh Levy today (via Zoom) and with his staff in person (Connie and Pang) to \nstart making arrangement to give my papers and other material such as honorary \ndoctorates to the Library of Congress.\nReleased by Chairman Rand Paul\nPaxlovid saves lives:\nPRESS:  CBS News interview with Michelle Miller (in anticipation of the Mohammed Ali \nAward; Diane Rehm podcast;\nNov. 2, 2022\nReleased by Chairman Rand Paul\nFor 1st time in months, the 7 day average numbers are creeping up:\nPRESS:   Article in Washington Post today by Roxanne Roberts on my portrait in the \nNational Portrait Gallery; Tape American Cities Rebuilding with Jeff Greenfield; NPR \nwith Rob Stein; Washington Post Podcast with Maggie Pennman;\nNov. 3, 2022\nWashington Post story this AM indicating that Rand Paul will come after me if GOP tkes \nover Senate and he becomes chair of wither HELP or Homeland Security:\nPOLITICS\nRand Paul says U.S. botched covid. He could \nsoon lead probes of it.\nThe Kentucky Republican, a fierce critic of the pandemic \nresponse, is in line to chair Senate health panel if GOP \nwins control\nBy Dan Diamond\n and \nRachel Roubein\n \nUpdated November 2, 2022 at 6:00 a.m. EDT|Published November 1, 2022 at 11:30 p.m. \nEDT\nReleased by Chairman Rand Paul\nNov. 3, 2022\nHad Tabletop exercise at the EEOB-350 for emergence of new variant.  Led by Ashish Jha \nand Kevin O’Prey.   Present was HHS crew (with Becerra virtual) and Denis McDonough \n(VA).   Only 90 minutes.   We really did not accomplish much.   Some good comments by Denis \nMcDonough.\nAm starting to feel the reality of the fact that I am leaving for good in about 7 weeks.   A lot \nof clearing out to do in my office.\nPRESS:  ABC (Local) WJLA TV – “Government Matters” with Mimi Geerges;\nCanadian Broadcasting Company (CBC) The National News Program (Exit interview) \nwith Adrienne Arsenault; Al Jazeera TV; News Radio 849 WHAS (Kentucky News Station)\nNov. 4, 2022\nI received the call today from David Ho who had recently published a preprint article \nshowing that the neutralizing antibody response against the BA4/5 variant induced by the \nbivalent BA 4/5 boost versus the ancestral strain boost were essentially equivalent, namely, \nthe BA4/5 bivalent boost was no better than the standard boost. Last night, I heard from \nPfizer in a zoom call with Jha and all of HHS (Walensky, Murthy, Kessler and my team at NIH) \nthat in their experiments there was a fourfold higher titer associated with the boost by the \nbivalent BA4/5 compared to the boost with the ancestral strain. Pfizer claims that their study was \ncontrolled whereas the studies by Ho and Barouch were not and the numbers were small. David \nHo called me today and emphasized that the combination of numbers of his study and Barouch's \nstudy made them equivalent in size to the Pfizer numbers. In addition, he made the important \npoint that there were some discrepancies in the data that were in the press release from Pfizer \nwhich did not contain all of the data that made them concerned about the Pfizer data. In addition, \nDavid suggested that it is in Peter Mark's interest to agree with Pfizer since Pfizer confirms what \nhis decision was about the BA4/5 bivalent boost. I do not know whether this is David Ho \nconcerned that his data are not holding up or whether he has a very good point that Pfizer is not \nbeing totally above board with the presentation of their data. I will have to try to figure this out \nby discussing it with a few other people. I have already discussed it with Cliff  Lane and he \nthinks that both of those studies don't definitively show the answer since they both have \nweaknesses. Cliff recommends that the data undergo significant statistical analysis.\nHOWEVER, Eric Topol reviews the different studies:\nReleased by Chairman Rand Paul\nGreat put down of the HELP Report in LA Times:\nColumn: ProPublica and Vanity Fair are pushing \nthe COVID lab-leak theory, but their exposé is a \ntrain wreck\nBY MICHAEL HILTZIKBUSINESS COLUMNIST \nNOV. 1, 2022 1:15 PM P\nBQ.1 and BQ.1.1 continues to overcome BA4/5:\nReleased by Chairman Rand Paul\nPRESS: CBC TV “Rosemary Barton Live”; \nNov. 5, 2022\nI had an amazing evening at the Mohammed Ali Gala in Louisville Kentucky where I \nreceived the Mohammed Ali Humanitarian Award for Lifetime Achievement. Others who \nreceived similar rewards included Jose Andres and former NBA Rookie of the year.  I had a \nwonderful tour of the Muhammad Ali Museum at the Muhammad Ali Center and I was \nintroduced by Ali's wife Lonnie Ali.  I also received a personal tour of the Louisville Slugger \nbaseball bat factory and I was given a bat specifically named for me. And enjoyable time all \naround. \nOf note was the extraordinarily enthusiastic reception I received from the people at the \nLouisville airport and at the Gala event.   I was totally mobbed for selfies.   Interesting that \nthis is Rand Paul’s state (Kentucky) and I thought that I might not be well-received and I \nactually was totally met with love and admiration.\nSix other honorees were recognized at Saturday's ceremony for embodying Muhammad Ali's Six core \nprinciples: confidence, conviction, dedication, giving, respect and spirituality. Those honorees include:\n•Confidence Award winner Gitanjali Rao, a 17-year-old from Louisville was named Time \nMagazine's Kid of the Year for \"inventions help to detect lead content in water, provide early \ndiagnosis of prescription opioid addiction, and counter cyberbullying.\"\n•Conviction Award winner Lefteris Arapakis from Greece for his work fighting pollution in the \nMediterranean Sea. Arapakis also heads up an organization, Enaleia, that teaches people how to \nclean plastic out of the sea.\n•Dedication Award winner Mohamad Al Jounde from Syria, has helped give 200 children access \nto education via the Gharsah School in Lebanon.\n•Giving Award winner Liam Elkind, a Yale student who co-founded Invisible Hands during the \nCOVID-19 pandemic to help ensure at-risk community members have access to food and \nmedical supplies.\n•Respect Award winner Malcolm Brogdon, the former NBA Rookie of the year, for his work in \nTanzania with the Brogdon Family Foundation, which helps people access clean water and \nquality education.\n•Spirituality Award winner Lual Mayen from South Sudan for working for refugee and migrant \nrights. He also founded Junub Games, an organization that teaches the \"importance of peace \nthrough video games.\"\nNov. 7, 2022\nI had a very important meeting today in Jeff Zients’ office where he arranged me to meet \nwith Robert Bauer, former lawyer for President Obama and Dana Remus, lawyer for \nPresident Biden until July 2022 (4 months ago). Jeff wanted them to advise me about how I \nshould handle my legal counsel for the upcoming oversight hearings that certainly will occur if \nthe GOP take over the house and/or the Senate. It is clear that even with Pro bono considerations \nReleased by Chairman Rand Paul\nthat this is going to cost me a lot of money since the GOP has promised that they would make \nmy life miserable and blame me for virtually everything that happened bad to the country during \nthe pandemic. Jeff has been an amazing friend to me and the next challenge would be to make \nsure that I have Secret Service protection after December 31st at which point HHS has stated that \nthey have no responsibility or authority to protect me despite the multiple threats on my life. In \naddition, HHS will not provide me legal protection after I leave.\nLater in the day I took off for New York City to receive the Yitzhak Rabin lifetime medical Leadership \nAward given by  American Friends of Rabin Medical Center at the Plaza Hotel. Before I got there it was \nsomewhat of a harrowing experience since I was recognized walking from the Hilton Hotel on 6th Ave \nand 52nd St to the Plaza Hotel on 59th St and 5th Ave. I was beset by a horde of at least 20 paparazzi  \nwho followed me from 6th Ave to 5th Ave walking backwards surrounding me and flashing lights that \nblinded me. That has never happened to me before and is a full warning of what I'm going to have to \nexpect. I absolutely must have security protection or I am going to be in deep trouble.\nNov. 8, 2022\nElection day!\nDeaths worldwide down 95% according to WHO\nRSV surging in USA and also early and touch flu season emerging.\nPRESS:  Cox Media TV; \nNov. 9, 2022\nRed (GOP) wave did not occur with many (not all) election deniers supported by Trump \nlosing throughout the country.  Rand Paul wins in KY and during his acceptance speech \nsays many times that the first thing he is going to do is to Investigate me.   However, the \nSenate may not flip to GOP.\nVery tough races.   Will not know results until December since there is a runoff in Georgia \nbetween Warnock (D) and Walker (R).\nPrepped Erik Stemy for briefing the E & C Oversight Staffers on Wuhan grant\nPRESS:   NPR “Science Friday” with Ira Flatow\nNov. 10, 2022\nJust for the record here is the full story on Connally whom Brett arrested:\nS. Attorneys » District of Maryland » News\nSHARE\nDepartment of Justice\nU.S. Attorney’s Office\nReleased by Chairman Rand Paul\nDistrict of Maryland\nFOR IMMEDIATE RELEASE\nThursday, August 4, 2022\nMan Who Made Threats Against Dr. Anthony Fauci and \nOther Federal Officials Sentenced to Over Three Years in \nFederal Prison\nGreenbelt, Maryland – U.S. District Judge Paula Xinis sentenced Thomas Patrick Connally, Jr., \nage 57, most recently of Snowshoe, West Virginia to 37 months in federal prison, followed by \nthree years of supervised release, for making threats against a federal official, specifically for \nsending emails threatening harm to Dr. Anthony Fauci, the current Director of the National \nInstitute of Allergy and Infectious Diseases at the National Institutes of Health (NIH).  Connally \nfurther admitted threatening Dr. Francis Collins, the former Director of the NIH, Dr. Rachel \nLevine, currently the Assistant Secretary for Health at the U.S. Department of Health and Human \nServices, as well as a Massachusetts public health official and a religious leader. \nThe sentence was announced by United States Attorney for the District of Maryland Erek L. \nBarron and Deputy Inspector General for Investigations Christian J. Schrank, Office of Inspector \nGeneral of the U.S. Department of Health and Human Services.\n“Everyone has the right to disagree, but you do not have the right to threaten a federal official’s \nlife,” said U.S. Attorney for the District of Maryland, Erek L. Barron.  “Threats like these will be \nprosecuted to the fullest extent of the law.” \n“Today’s sentencing shows that individuals threatening violence against federal officials and \nothers will be held accountable for their crimes,” said Deputy Inspector General for \nInvestigations Christian J. Schrank of the U.S. Department of Health and Human Services Office \nof Inspector General.  “The public, including public servants, deserve the utmost safety and the \nassurance that they can perform their duties without interference.  Our agency, working closely \nwith our law enforcement partners, will continue to bring those who threaten violence to justice.”\nAccording to Connally’s plea agreement, from December 28, 2020, to July 25, 2021, Connally \nused an anonymous email account from a provider of secure, encrypted email services based in \nSwitzerland, to send a series of emails to Dr. Anthony Fauci, the current Director of the National \nInstitute of Allergy and Infectious Diseases (“NIAID”) and the Chief Medical Advisor to \nPresident of the United States, threatening to harm and/or kill Dr. Fauci and members of his \nfamily.  One of the emails threatened that Dr. Fauci and his family would be “dragged into the \nstreet, beaten to death, and set on fire.”  On April 24, 2021, alone, Connally sent seven \nthreatening emails starting at 10:05 p.m.\nAs detailed in Connally’s plea agreement, also on April 24, 2021, beginning at 9:34 p.m., \nConnally sent Dr. Francis Collins, the then-Director of the NIH, a series of four emails \nthreatening Dr. Collins and his family with physical assault and death if Dr. Collins did not stop \nspeaking about the need for “mandatory” COVID-19 vaccinations.\nReleased by Chairman Rand Paul\nAs stated in his plea agreement, Connally admitted that he sent the threats to Drs. Fauci and \nCollins with the intent to intimidate or interfere with the performance of their official duties and \nwith the intent to retaliate against Dr. Fauci and Dr. Collins for performing their official duties, \nincluding discussing COVID-19 and its testing and prevention.\nConnally also admitted sending emails threatening harm to three other individuals.  Specifically, \non November 24, 2020, Connally sent a series of six threatening emails to Dr. Rachel Levine, \nthen Secretary of Health for the State of Pennsylvania, at Dr. Levine’s email account at the \nPennsylvania Department of Health.  The subject lines and body of the emails threatened Dr. \nLevine with physical violence and death.  Similarly, on August 31, 2020, Connally sent an email \nthreatening physical violence and death for a public health official in Massachusetts.  Finally, on \nApril 21, 2021, Connally sent a series of four threatening emails to four individuals who work \nfor a religious institution in Newark, New Jersey.  The four emails threatened physical violence \nand death to a religious leader at the institution.\nInvestigation revealed that the anonymous encrypted email account was associated with \nConnally.  On July 27, 2021, law enforcement arrested Connally in Snowshoe, West Virginia, \nand executed a search warrant at his residence as well as on his vehicle, seizing five laptops and \ntwo cellular telephones which belonged to Connally. \nUnited States Attorney Erek L. Barron commended the HHS OIG for its work in the \ninvestigation.  Mr. Barron thanked Assistant U.S. Attorneys Rajeev R. Raghavan and Jessica C. \nCollins, who prosecuted the federal case.\nFor more information on the Maryland U.S. Attorney’s Office, its priorities, and resources \navailable to help the community, please visit https://www.justice.gov/usao-md/community-\noutreach.\n# # #\nTopic(s): \nNational Security\nComponent(s): \nUSAO - Maryland\nContact: \nAlexis Abbott 301-344-4342\nCrazy RFK, jr. has now made a film trashing me.  In addition, other far-right crazies have \nalso made a film.   See below:\nReleased by Chairman Rand Paul\nAnthony,\n \nIf you missed the first part of End Game, don’t fret. \n \nThere is good news.\n \nRevealed Films has flipped the switch and made the part \ntwo live!\n \nIt’s the most timely and critical opportunity for you to \nwatch.\n \nBut it won’t be up for long before it expires, so don’t wait \non this one.\n \nTonight starts out with:\nReleased by Chairman Rand Paul\nDr. Zach Bush! He’s one of the rare triple board-certified \nphysicians in the U.S., and he’s known for his deep \nmedical knowledge, research, and practices... \n \nBecause he’s right, and they work.\n \nHe answers some deep questions… What are the \nchances of healing the self-inflicted wounds to the human \nrace from decades of poor choices? \n \nPay attention to when he answers these two questions: \n \n•Can we learn from our mistakes? \n•Are we capable of changing our future?\n \nThe history of human behavior paints a clear picture of our \npotentially devastating future.  \n \nDon’t fret, he’s got answers, and they’re brilliant!\n \nThe next guest is an elite among the elites:\nReleased by Chairman Rand Paul\nLarry Yatch, a former Navy Seal Commander turned \nsuccessful business mentor and coach, lays out the exact \nplan that you should have to keep your family safe.\n \nBefore you start to think that his interview consists ONLY \nof him teaching you how to fight and the skillset to survive \nin harsh conditions... guess again .\n \nCatch it all here...\n \nWe’d hate for you to miss out, so CLICK HERE to start \nwatching right away.\n \nRemember, you have the next 24 hours to watch for \nfree…  so don’t wait too long or it’ll be gone.\n \nWith appreciation, \nThe Real Anthony Team\n \n \n \n \n \n \n \n \n \nIf you happen to purchase anything Jeff Hays Films recommends, in this or any of our communications, \nit’s likely we will receive some kind of affiliate compensation. Still, we only recommend stuff that we truly \nbelieve in and share with our friends and family. If you ever have an issue with anything we recommend \nplease let us know. We want to make sure we are always serving you at the highest level. FTC \nDISCLOSURE: Any health claims shared by viewers, students, friends, subscribers, or clients are \nunderstood to be true and accurate, but are not verified in any way. Any products, programs, or \npersonal recommendations made in this or any email communication from Jeff Hays Films for 3rd \nparties will likely result in some form of compensation from said 3rd party. Always do your own due \ndiligence and use your own judgment when making buying decisions and investments. Always consult a \nphysician before making any health-related decisions. 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When you access another website or purchase \nReleased by Chairman Rand Paul\nthird-party products or services through the Site, use of any information you provide is governed by the \nprivacy policy of the operator of the site you are visiting or the provider of such products or services.\n \nHad my usual Zoom meeting with Sir Chris Whitty from UK.   WE have become long-\ndistance friends over these couple of years.   He mentioned that I have the support of the \nUK and global medical and scientific community.  I should definitely include a discussion \nabout my relationship with Chris and with Patrick Vallance in the book. \nPRESS:  Global News Canada (TV); \nNov. 11, 2022\nExciting day.  In preparation for the installing of my “living portrait’ by Hugo Crosthwaite \ninto the National Portrait Gallery tomorrow, there was a gala celebration at the home of \nJeff Bezos 2330 S Street, NW.  His home is an enormous mansion that goes on and on. It was \nformally a textile museum that he converted to his Washington DC home. The guest list was \nAAA.  Notable conversations well with Jose Andres who wants to cook a special one-on-one \ndinner with me at his home in DC. Also I had a very serious conversation with Hillary Clinton  \nwho said that she thinks about me every day knowing that I will have an experience if the GOP \ngames either chamber of the Congress similar to her experience with Benghazi. She offered to \nappear with me at the hearings as a physical show of support. I am not so sure that that is a great \nidea since that might politicize me even more than I've been politicized. I also have a warm \nconversation with Marian Wright Edelman …and several others.   The other awardees (and \ntheir presenters) were: Jose Andres (Laurene Powell Jobs), Clive Davis (Alicia Keyes)Ava \nDuVernay (Isabel Wilkerson), Marian Wright Edelman (Hillary Clinton), Serena Williams \n(Mellody Hobson) Venus Williams (Sonya Haffey and Isha Price)   David Rubenstein will \npresent me.\nAfter the gala we were invited to another gala at the Cafe Milano, celebrating their 30th \nanniversary. I went there out of respect to Franco Nuschese.   However, it was somewhat of a \nstressful experience since I got completely surrounded by “well-wishers” who anted selfies \nand/or to shake my hands.   It was really overwhelming and reminds me why I will need security \nfor some time.\nNov. 12, 2022\nJeff Zients 56th birthday.   I dropped off a signed copy of Harrison’s at his house.\nAn historically memorable day at the National Portrait Gallery. A Gala event was held \ntonight honoring the inductees to the National Portrait Gallery. It was the highest level of \nAAA list you could imagine in Washington DC. There was a red carpet entry to the gallery \nwhich resembled the red carpet entry into the Academy Awards with multiple TV and \nReleased by Chairman Rand Paul\nradio and print interviews as you walk along the red carpet before you get to the main \nplace where photographs were taken. It started off as a very wamt night for November 12 \nat 75 F and clear sky, but by the end of the night and into tomorrow morning it got much \ncolder.  It was very clear that the extraordinary talent and unique approach that Hugo \ntook captivated the audience of more than 750 people at this gala opening and dinner \naffair. I was the first awardee who was recognized, being introduced by David Rubenstein. \nI received a prolonged standing ovation from the crowd (as did others).   David gave his \nusual tongue-in-cheek introduction of me telling the story of how he offered me a “higher \ncalling’ in private equity 12 years ago.   I had wonderful conversation with other awaredees \nand others who expressed sincere appreciation of what I have done over more than 50 \nyears.  Of particular note were conversations with Marian Wright Edelman who called me \n“her hero and a true national treasure”.  Also, Jose Andres (he wants to invite me to a \nprivate dinner at his home) Clive Davis, Ava DuVernay and Isabel Wilkerson, and Venus \nWilliams (not so much Serena) were very warm towards me.  It was an extraordinary \naffair.   In the middle of it, Dan Diamond from the Washington Post  texted me that the \nGOP did not take the Senate and so Rand Paul will not have the opportunity to harass me \nwith senate oversight hearings.      We were invited to go across the street by Jose to his \nrestaurant Zaytinya for after hours champagne.  He quickly stopped there but Jose had not \narrived and so we left a message of greeting to him and took off since it was already 11:50 \nPM.  A truly AMAZING evening!!\nPRESS:  CBS Saturday Morning with Michelle Miller; Der Spiegel article came out (see \nabove);\nNov. 13, 2022 (Sunday)\nMark Dybul texted me to alert me that Mike Gerson was fading quickly and was in \nGeorgetown Hospital waiting for Hospice.  Bles Building, 4th Floor, Room 24.  It was very \nsad to see. Mike was in dire straits literally on his last few hours to few days. He recognized me \nand was obviously very glad to see me. We had a brief conversation I told them how important \nhe was to me and to the rest of the world and he said that he truly appreciated that.  A truly great \nman will soon leave us. \nWas briefed today by the Moderna team led by Steve Hoge on the latest data of their \nbivalent BA4/5 boost.  The data look really very good and it is clear that the updated booster \nperforms very well and better than the ancestral booster across the board in inducing antibodies \nagainst BA 4/5 and all of the sub variants of omicron including BQ.1.1.  This is very good news \nfor the upcoming winter. However, there is still very little uptake of this updated booster by the \ngeneral public. There is this complacency that the pandemic is over and the confusion about why \nwe need to continually get updated boosts because of the combination of appearance of new \nvariants together with the lack of durability of response to either vaccine or infection.\nCatch up on prior important information.   From May, 2020:\nReleased by Chairman Rand Paul\nAll of Jacob Wohl’s Spectacularly \nFailed Smear Attempts\nBy Bridget Read\nJacob Wohl. Photo: John Middlebrook/CSM/Shutterstock\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nIn my phone call with Ashish today, I emphasized that they need to dial this back since \nthe naysayers (John Moore, Paul Offit, et al)  will blast us for making statements without \nclinical data.\nI did the Oxford Union Fireside Chat via zoom– very enjoyable.\nPRESS: McClatchy TV “Exit Interview”; NEJM Podcast associated with my upcoming \n“exit commentary” in NEJM; My comment in Washington Post article by Dan Diamond \ntoday: “The supplemental requests that we keep putting in … just because they don’t go anywhere, \ndoesn’t mean the need for them disappears,” Anthony S. Fauci, the government’s top infectious-disease \nexpert, said in an interview last week.; Regional Media – “Make It Make Sense” with Monique \nPressley; Rolling Out with Rashad Milligan; Philadelphia Tribune (print) with Alec Larson\nNov. 15, 2022\nBQ1.1 is continuing to take over.   XBB is very low but is a quick transmitter as shown in \nSingapore\nPRESS:   STAT Summit interview with Helen Branswell; \nNov. 16, 2022\nReleased by Chairman Rand Paul\nTerrific event last evening. I was honored at the home of the French Ambassador  to the \nUnited States (2221 Kalorama Road, NW) where I received the Pasteur Medal commemorating \nthe bicentenary of Louis Pasteur's birth in 1822. Only a dozen medals are given this year being \nawarded to leading scientists, benefactors, philanthropists, and representatives of several \ncountries. The stock of metals will be exhausted by the end of 2022 and no other metals will be \nminted. It was very much of a love fest with a very nice presentation of the metal to me by \ndoctor Stewart Cole  who is the Director of the Pasteur. Ambassador Philippe Etienne was \nvery gracious and a very nice person.   They sang my praises and we had a very elegant dinner.   \nVery rainy and cold night.  Janet Tobias was there. \nPhoto shoot at my home and at work by prize-winning (MOMA) photojournalist Wolfgang \nTillmans\nDemocrats (Leslie Dach) are pushing back on the GOP who are trying to investigate me:\nRevealed: Democrats' new 'war room' will \ninvestigate Republicans for abuse of power \nMatthew Chapman \nPolitico:\nPolitico: Investigating the investigators: Dem strategists to launch counterpunch to House \nGOP\nPolitifact: Dr. Anthony Fauci, Ron DeSantis and others “are ALL in a diamond mining \nbusiness in Oklahoma together!”  We rate the claim that DeSantis, Fauci, Moody and Redfield are \nin a diamond mining business Pants on Fire!\nHad very nice dinner of Lasagna, wine, bread over my house with Chris and Rochelle \nWalensky.   We discussed the sensitive issues associated with the attempts on the part of some \nto have her removed as CDC Director.   Also, we marveled at the fact that with Rochelle and I \ntogether, there were 4 armed OIG Special Agents outside my house guarding Rochelle and me\nPRESS:  Regional Media - Nexstar  with Raquel Martin;  Hearst with Kalyn Norwood; \nSpectrum with Julia Benbrook\nNov. 17, 2022\nReleased by Chairman Rand Paul\nMichael Gerson, Post columnist and Bush \nspeechwriter on 9/11, dies at 58\nMr. Gerson helped shape President George W. Bush’s \nmessaging after the 9/11 attacks and then moved to The \nWashington Post, where he wrote about politics and faith\nPRESS:  Der Spiegel –\nThe Evil in the World\"Anthony Fauci's Life as a Right \nWing Target\nHe has been an adviser to seven presidents, and he played a major role in protecting \nmillions of people from AIDS. Now, pandemic expert Anthony Fauci is stepping down – \nas one of the most loved, and most hated, medical professionals of all time.\nBy Rafaela von Bredow\n17.11.2022, 19.28 Uhr\nNov. 18, 2022\nUnited States \n•Total Cases: 98,174,364  7-Day average: 40,102 (-3.2%)\n•Total Deaths: 1,073,115  7-Day average:  317 (-5.3%)\n•Total new hospital admissions: 5,516,552  7-Day average 3,308 (-4.4%)\nWorldwide [Source: WHO]  - most recent day\n•Total Cases: 633,263,617 (188,389 new)\n•Total Deaths: 6,594,491 (544 new)\nRecent immune evasion studies from David Ho show that BXX and BQ.1.1 evade \nmonoclonal antibodies and have increased evasion from immune responses.   Hybrid \nimmunity is OK, but vaccine induced  immunity with Abs is down while protection against sever \ndisease is OK (in Singapore).\nReleased by Chairman Rand Paul\nNov. 19, 2022\nRochelle called me up this morning and arranged for a zoom at 10:30 AM to discuss her \nside of the story of why she wants to simplify the boosting regimen for children less than \nfive and six years old for the", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: society. I have a phone call with Ashish  this afternoon and I will recommend that we not give him additional days of drug but that  we have him stay masked inside for 5 days or until he tests negative by antigen test. They  are concerned about rebound; however, I have told them that if he tests every morning for  five to 10  days after his Paxlovid course ends and he does not show any positivity, he can  go out that day and proceed with business. That would be much more acceptable to the  general public then to give him an extra few days of drug which would not actually  guarantee that he does not rebound. Released by Chairman Rand Paul PRESS:   The Hill “Rising”; CBC Radio with Robin Bresnahan; July 26, 2022 Continuing my twice per day discussion with Kevin O'Connor regarding the…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 9, "page_count": 1141}
{"title": "Tony's Diary — Fauci's Private Diary vs. Public Statements (Sen. Rand Paul / HSGAC release) (Part 10 of 10)", "content": "Moderna and Pfizer boost. There is a tension between her/CDC \nand Peter Marks and Larry Horowitz (FDA) regarding whether or not the younger children \nshould all get the bivalent boost or have them finish their primary regimens with the ancestral \nstrain vaccine. Peter and Larry had both called me up previously (couple of nights ago) making it \nlook like the CDC was holding back on wanting to give the most updated boost to the children. \nYet, when Rochelle explained this to me this morning it became clear that it is a much more \ncomplicated situation than Peter and Larry described to me by phone a couple of nights ago. \nUltimately, in January all children of all ages will get a unified vaccine either for the primary \nseries or the boost and that will be the bivalent BA.4/5. Rochelle explained that to insert that \nbivalent boost into the already complicated regimen for the small fraction of children who have \nstarted on their primary series would create an enormous amount of confusion for pediatricians. I \ntend to side now with Rochelle even though when Peter and Larry explained that in the \nsimplified form it seemed that they were making sense. However, according to Rochelle's \nexplanation I believe she is correct. We will all sort this out on a zoom call with HHS tomorrow \n(Sunday) evening.\nEbola still smoldering in Uganda:\nReleased by Chairman Rand Paul\nRichard Ben-Veniste called me today offering pro bono help with my defense during the \nGOP Hearings.\nNov. 20, 2022\nOf note, all of the Omicron sublineages that we are currently dealing with are offshoots or \nsublineages of BA.2 (see below):\nReleased by Chairman Rand Paul\nHad a Sunday evening Zoom call regard the situation of boosts for children 5-6 years and \nyounger (see above).  It involved: me, Rochelle, Robbie Goldstein, Peter Marks, Rob Califf, \nDawn O’Connell, Vivek Murthy, Larry Tabak, among others.   We all agreed that this was a \nclose call and both sides have a good point.   The important issues is that this involved only \nabout 5% of the eligible children since the other 95% have not yet received their primary \nvaccination and those are truly the vulnerable ones if we get a winter surge.   At the end of \nJanuary, 2023, the VRPAC will meet to recommend that going forward all vaccinations (primary \nseries and boosters) will be the BA.4/5 bivalent and so this will be a moot point.   The question \nstill remains unsettled as to give the children the best boost now even though it logistically will \nbe difficult for the pediatricians since they will have multiple (11) different products in their \noffices from Moderna + Pfizer) or wait until we have a uniform boost for everyone at the end of \nJanuary.   No firm decision was made.   FDA will try to push the date for VRPAC closer to close \nthe gap.  More to come\nPRESS;   Taped a segment with Margaret Brennan – CBS “Face the Nation” for next \nSunday – somewhat of an exit interview\nNov. 21, 2022\nPresentation by the Shionogi (Takeki Uehara) Phase 3 data.  The drug is an anti-viral \nsimilar to Paxlovid.   The data were not particularly impressive since the study was done on \npeople with very few symptoms and all the drug did was diminished by 24 to at the most 48 \nhours the duration of the symptoms. The study was not designed to determine whether or not the \ndrug prevents the need for hospitalization than people with a high risk of severe outcome. All in \nReleased by Chairman Rand Paul\nall I was not impressed with the data because they were looking at the wrong population of \npatients.\nPRESS:Pocast for LGBTQ+ community with Avi Ravinath; NFID Podcast with Bill \nShaffner and Marla Dalton; Interview with “Popular Science”;  Sheryl Gay Stolberg (NY \nTimes) came to my house tonight to do an exit interview with photgrapher\nNov. 22, 2022\nI addressed the UK Parliament today on lessons learned from the COVID pandemic. It was \nfollowed by a very productive and insightful question period from the members of \nparliament\nLawsuit by officials from Louisiana and Missouri have ruled that several government \nofficials including me, Jen Psaki, Vivek Murthy among others must undergo a deposition \nsince we are charged with trying to influence his social media to suppress the free speech of \na number of people including those involved with the Great Barrington Declaration. It is a \ncolossal waste of time since there is absolutely nothing there and the prep for the deposition \nwould be about 8 hours over three days and the deposition itself which I will do tomorrow will \nbe 7 full hours on the clock. This is total harassment. We tried to get the deposition stopped, but \na Louisiana judge ordered that we have to do it. Just yesterday another judge overturned the first \njudge and the beck murthy does not have to be deposed, but I still have to be.\n***Extraordinary press briefing in the White House Press Room today.  Today was an \nhistoric day for me  in that the White House comms team led by Karine Jean-Pierre and \nKevin Munoz arranged for me to be part of the press briefing from the White House \nbriefing room podium. it turned out to be a celebration of my nearly 40 years getting \nbriefings at the White House. The moving part about it was that both Karine and Kevin \nwere brought to tears when they said goodbye to me after the briefing.   In addition, all of \nthe press room personnel wanted selfies with me before I left.   In addition, the briefing \nroom was packed with media people who are there to hear the latest update on COVID but \nthey directed most of their questions to me related to my retirement, my legacy, and other \nthings that had direct relation to me. It was a very moving and historic time for me.\nFauci to brief reporters for last time before \nleaving government after 50 years\nReleased by Chairman Rand Paul\nRepublicans promise to investigate the nation's top infectious disease expert.\nFauci bids farewell with a final plea: \nGet vaccinated \nB Y  K R I S T A  M A H R ,  A D A M  C A N C R Y N  | 1 1 / 2 2 / 2 0 2 2  0 2 : 1 0  P M  E S T  \nWash Post:\nFauci urges updated coronavirus shots in ‘final \nmessage’ from White House\nBy Eugene Scott\nProfound effect of Vaccines:\nReleased by Chairman Rand Paul\nPRESS: White House Press briefing from White House Briefing room.   Major coverage of \nmy “final” appearance in the WH press room today and over the next 2 days\nNov. 23, 2022\nI had my 7 hour (on the clock) deposition by lawyers for the Missouri Vs Biden plaintiffs. It \nshowed up as spectators as the plaintiff’s lawyer John Sauer questioned me for seven \nhours. I had been well prepared for the previous few days by the DoJ lawyers including Adam \nKirschner and Josh Gardner as well as Amanda Chuzi Anant Humar, Brian Netter and HHS \ncouncil Chris Hammond.  Although this was supposed to be on the topic of the Biden \nadministration including me interfering with free speech by influencing the social media \nplatforms to not allow opinions differing from our own to be put on social media, very many of \nthe questions were directed at things unrelated to that including the origins of COVID, the \nWuhan grant, Peter Daszak, my position on masking, and a variety of other issues that the \nCongress has been concerned about. I must say I did extraordinarily well and the DOJ lawyers \nsaid that that was one of the best performances and the deposition that they have ever seen.\nNov. 24, 2022 (Thanksgiving)\nOn “The View”:  Alyssa Farah Griffin: GOP Made Fauci \nBoogeyman Because They Misunderstood His Role\nReleased by Chairman Rand Paul\nNov. 25, 2022\nI am receiving so many wonderful warm and affectionate notes from people on the occasion \nof my stepping down. One among many typical notes came from Beth Cameron of the \nNSC. Beth texted the following note to me late last night associated with the prior note \nwishing me a happy Thanksgiving:  “Be well.  And thank you so very much. I very much hope \nto continue to learn from you in your future roles, and I also hope you are able to get a little bit \nof time to rest (though that may not be in your DNA!) All the very best.  I stand in awe of not \njust what you have done but how you have done it and with the humanity with which you have \ndone it.”\nBQ.1 and BQ.1.1 still creeping up.   Noe appearance of XBB:\nNov. 27, 2022  (Sunday)\nI received a call yesterday from Dori Solcido and a similar call last night from Ashish Jha \ntelling me that Ron Klain was upset mostly at Ashish for indicating in interviews that we \ncould expect a mild winter. Ron was concerned that we should not be in the business of \npredicting lack of severity of COVID for this winter because if we have a bad winter with \nCOVID then confidence in the government would diminish. Ron has a point there, but I'm not \nsure exactly what Ashish said. According to Dori, the New York Times  made it look like Ashish \nwas saying that we don't need to worry very much over the coming winter. I know as a fact that \nthat is not what he said but he is a bit in the doghouse now with Ron because of that. This just \nReleased by Chairman Rand Paul\ngoes to show you that no matter what administration you're in there is a great deal of sensitivity \nabout messaging.\nSunday shows went very well.  Chuck, Margaret and Jonathan were very kind to me.   \nFlurry of activity in the press following my apearances.\nThe Hill (Commenting on my “Face the Nation” appearance): Fauci says ‘we \nneed to keep the politics out of’ investigating \nCOVID origins \nThe Hill (Commenting on my “Meet the Press” appearance): Fauci pushes \nback on Pence remarks: ‘I don’t align myself \nwith anybody’ \nPolitico (Commenting on my “Face the Nation” appearance): Fauci on Covid lab \nleak theory: ‘I have a completely open mind’ \nPRESS:  NBC “Meet the Press” with Chuck Todd (Exit interview); CBS “Face the Nation” \nwith Margaret Brennan (Extensive Exit Interview); MSNBC “The Sunday Show” with \nJonathan Capehart\nNov. 28, 2022\nMet with in 31/7A-18 Ambassador Pamela Hamamoto who is US Negotiator for the \nPandemic Accord.   We (Cliff, Gray Handley and I) brought up some of the landmines that \nmight arise in such an accord regarding conditions placed on receiving reagents.   Also, we \nbrought up the recurring issue of the problem with WHO feeling that they should be directing the \nresearch associated with outbreaks – long history here (see Cliff’s experience with Anna Maria \nRestropo.\nEbola cases in Uganda stabilizing:\nReleased by Chairman Rand Paul\nHad a Fireside Chat podcast with Mitchell Warren of AVAC.   A lot of sentimental good-\nbyes these days as I prepare to step down.\nDid a Fireside Chat  with Holy Cross students at the Les Aspen Center in DC.   They are here \nas part of a semester long program bringing students to DC  to be exposed to government.\nPRESS:  CNN with Jake Tapper\nNov. 29, 2022\nMarty Hirsch and David Hooper from Mass General did a very nice thing and Thanked me \nvia Journal of Infectious Diseases and put my photo on the cover:\nReleased by Chairman Rand Paul\nI had an enjoyable “fireside chat” at the White House Jackson St facility in which I had \nlunch with the White House Fellows. I enjoy this very much and have done this several times \nover the past few years. They are an outstanding group of about a dozen individuals from various \nwalks of life many of which have served in the military including in the special forces; practicing \nphysicians; lawyers, among others. I enjoy speaking with them because they are the cream of the \ncrop and give me hope for our nation particularly in the context of the incredible divisiveness \nand disregard for the truth and integrity that we are seeing now in our nation.\nIt is surprising that Breitbart wrote a very sympathetic article about my retirement:\nBreitbart: Fauci ends 50 years in government marked by response to AIDS, COVID-19\nPRESS:   PBS podcast with Walter IsaacsonDr. Anthony Fauci has been at the helm of the \nNational Institute of Allergy and Infectious Diseases since the 1980s, guiding the United States \nthrough AIDS, SARS, H1N1, and of course COVID-19. Prior to his retirement, Dr. Fauci joins \nWalter Isaacson to reflect on a storied career.\nhttps://www.pbs.org/video/dr-fauci-his-retirement-universal-covid-19-\nvaccine-3cvqjq/\n ; Extensive exit interview at my home with Jen Ashton of ABC and Eric Strauss; \nNov. 30, 2022\nDisaster!!!  Chris felt ill last night and decided to sleep in Jenny’s room.   She felt worse \nthis AM and tested positive for COVID.  I have started her on Paxlovid. I'm sure she will do \nfine, but this has completely destroyed one of the most intensive social commitments that we \nhave over the next few days. I have decided that even though I have now tested negative multiple \nReleased by Chairman Rand Paul\ntimes that I really cannot go to the state dinner tomorrow (Dec. 1) at the White House since it \nwould be unconscionable for me to be secreting virus while being asymptomatic and antigen \nnegative and endanger the president of the United states. In addition, I will have to modify my \nvisit tonight to the home of the Italian ambassador (Mariangela Zappia) who invited people from \nall over the country including California to come to the ambassador’s home for a celebratory \ndinner in my honor. I went there tonight and did a fireside chat with a mask on with a well \nknown Italian author Antonio Monda, and then left before the dinner since I did not want to take \nmy mask off. I will also have to Mr planned dinner with Bob Seder and Jeff Zients and families \non Saturday.\nPRESS: Wall Street Journal podcast with Kate Lindbaugh; Univision TV with Jorge \nRamos; Bloomberg interview (Exit)\nDec. 1, 2022\nHad a really nice Town Hall meeting with FDA led by Rob Califf asking me questions.\nPRESS:  MedPage interview about my NEJM piece; L’Espresso Italian Magazine Exit \nInterview; Washington Post Live with Yasmeen Abutaleb; WUSA TV (Local)\nDec. 2, 2022\nI am really being somewhat embarrassed by the amount of honors that are be given to me \nand kudos my way. For example, today we went to the Hay-Adams hotel for a ceremony \ncommemorating PEPFAR and world aids day. The ceremony involved multiple speeches \nincluding a speech by secretary of state Tony Blinken in which he effusely praised me for \nmy role as an architect of pepfar as well as for decades of my contribution to HIV aids \nresearch and research in general. In addition, we had a fireside chat led by Sandy \nThurman between John Kkengasong and myself. The entire ceremony at the hay Adams \nincluded multiple crazy by several people on me. As I said it was somewhat embarrassing \nsince I do not like that kind of attention.\nStory in Today’s SF Chronicle celebrating World AIDS Day:\n“When the history of AIDS in 1989 is written, the transformation of Anthony Fauci may well emerge as \none of the most dramatic — and consequential — of human interest stories,” Shilts wrote for The \nChronicle that year.\nReleased by Chairman Rand Paul\nFauci, who had been the subject of protests in the 1980s, became friends and allies with activists from \nACT UP and other organizations —breaking ranks with the FDA and encouraging federal officials to \nspeed up testing and approval for drugs that treat life-threatening diseases.\n---------------------------------------------------------------------------------------------------------\nInfections creeping up in certain parts of the country and throughout the world. BQ.1.1 and BQ.1 \ncontinue to take over in the USA:\nDec. 3, 2022\nThank goodness, I am still COVID negative.   Chris doing well on Paxlovid.\nData remain overwhelming showing the advantage of vaccinated/up to date versus \nunvaccinated:\nReleased by Chairman Rand Paul\nRight around World AIDS Day, the data on the results of PEPFAR are striking (see the \nevent at the Hay-Adams with Sec. Blinken and John Nkengasong above):\nChris wrote an editorial about me in the American Journal of Nursing:\nReleased by Chairman Rand Paul\nGuest Editorial\nA Tribute to Dr. Fauci\nGrady, Christine PhD, MSN\nDec. 4, 2022\nWonderful afternoon at the White House and evening at the Kennedy Center. Actor \nGeorge Clooney, singer-songwriter Amy Grant, singer Gladys Knight, composer Tania \nLeón and rock group U2  were celebrated as the Kenney Center Awards. I was the guest of \nsecretary Becerra at a White House reception with the President that occurred at 3:30 PM before \nwe all motorcaded to the Kennedy Center for the ceremonies of the awards. It was a star-studded \nevening and I had pleasant conversations with people some of whom I had met before such as \nJulia Roberts, Sean Penn, Matt Damon, Mike Ferrone, among many others. It was a spectacular \nevent mixing entertainment with honoring the honorees. The situation was somewhat unusual as \nI was completely swamped with people yelling my name and applauding it as I left the vehicle in \nfront of the Kennedy Center and walked that long red carpet walk to the theater. There must have \nbeen hundreds of people lined up behind a rope down area and I was amazed how this \nrecognition of me has reached such a height. I am certainly not getting a big head about it but it \nis rather weird and a little bit unnerving. Joked with Hunter Biden as we shook and hands and \nhugged.   He said if someone snapped a photo and put it on line, the internet “would explode” \ngiven we are both being attacked by the far right GOP\nReleased by Chairman Rand Paul\nDec. 5, 2022\nForbes wrote a very complimentary article about my leadership:\nWhat Dr. Anthony Fauci Teaches Us \nAbout Leadership In A Crisis\nEdward Segal\nSenior Contributor\nI cover crisis-related news, issues and topics.\nPRESS:   CNN “Who’s Talking” with Chris Wallace; Health Alliance Network podcast \nwith Ambrose Lane, Jr.;  Interview with George Stephanopoulos regarding a book he is \nwriting on “The Situation Room”\nDec. 6, 2022\nA very touching tribute and “good-bye” to me by the AAI Council.   I regularly for 38 years \non an annual basis address the council here in Bethesda, they gave me a very warm last meeting \nwith a prolonged standing ovation as I walked into the room.\nTerrific evening at Jeff Zients’s home.   He had a reception on the occasion of making \navailable online the tapes of conversations between Richard Stengel (Editor of Time Magazine) \nand Nelson Mandela.   Mandela attended Jeff and Mary’s wedding as did Richard.   Had nice \nconversation with Merrick Garland and I encouraged him that we have faith in his judgment \nand integrity to do the right thing regarding the issues with Trump.   Also, finally saw in person \nKaty Kay who has interviewed me multiple times virtually over the years for the BBC \nPRESS:  BBC New “American Politics” TV; IDSA Podcast with Carlos Del Rio; NBC \n“Nightly News” exit interview with Lester Holt;  Interview with Medline Plus magazine; \nWTOP Exit interview Podcast; ABC Australian TV “7:30”; KNXV TV (ABC, Scripps, \nPhoenix)\nDec. 7, 2022\nI stood for many dozens of photographs of 1-on-1 with members of NIAID who wanted to \nsay good-bye.   Very moving.\nDec. 8, 2022\nReleased by Chairman Rand Paul\nWe had our 9th annual meeting today with Bill Gates in the context of the NIH-Gates \nFoundation collaboration on multiple projects. In the course of the meeting they showed to \nmy surprise film clips of Bill Clinton, Tedros, and Slim and Quarraisha Karim thanking me \nfor my many years of service. I should comment here on the really close relationship that I've \ndeveloped over the years with Bill Gates and the mutual respect we have for each other. We \nalso joined by the common issue of the conspiratorial theorists out there who think that Bill and I \nare doing strange things like putting chips in the vaccines that we're trying to get them to receive. \nIt's the source of fun jokes between Bill and me.\nSenator Richard Burr (R-NC) called me today to wish me well and to tell me how much he \nhas enjoyed over the years working with me.   He congratulated me for my “extraordinary \nservice to our nation over decades”.\nFour astronauts visited the Clinical Center today and the Children’s Inn.   The said that the one \n“must thing” that they wanted was to meet me and so I went over to the Medical Board meeting \non the 4th Floor and met with and took photos with them:  Thomas H. Marshburn, Kayla Barron, \nMatthias Maurer, Mark T. Vande Hei\nJust met with the German Minister of Health Karl Lauterbach who has become somewhat \nof a friend in that every time he is in DC he wants to come and see me.   He values my advice \nand says that I am a “rock star” in Germany.   Also, at the meeting was German Ambassador to \nUSA Emily Haber.\nPRESS: CBC News Canada (TV); Washington Post Exit Interview with Blair Guild; \nDec. 9, 2022\nCases and hospitalization are increasing as expected following Thanksgiving and into the \ncolder weeks:\nWashington Post: HEALTH\nReleased by Chairman Rand Paul\nFauci slams ‘lowlife’ trolls harassing his wife, \nchildren over covid\nBy Adela Suliman\nVery nice and warm reception in my honor given by the IDSA and ASM at the ASM \nheadquarters on 17th and N St., NW.  Rosa DeLauro came and gave a very nice tribute to \nme.   People are really showing a lot of love to me that is very humbling.\nPRESS:  NYC Fox TV “Good Day” with Rosanna Scotto; Press Interview with Japanese \nnewspaper Asahi Shimbun; \nWashington Post: HEALTH\nFauci slams ‘lowlife’ trolls harassing his wife, \nchildren over covid\nBy Adela Suliman\nI participated with First Lady Jill Biden and with Ashish Jha at the White House to do a \nPSA for AARP encouraging elderly people to get vaccinated. Jill was very kind in the \nintroduction she announced that this was the last time that I would be on this stage with her and \nshe will miss me greatly. When she left the event she gave me a big hug and said she loved me \nand would miss me. I said back at you\nCute cartoon:\nReleased by Chairman Rand Paul\nPRESS:  NYC Fox TV “Good Day” with Rosanna Scotto; Press Interview with Japanese \nnewspaper Asahi Shimbun; PBS NewsHour with Judy Woodruff (Exit Interview);\nDec. 10, 2022\nPublication of my essay in the NY Times:\nReleased by Chairman Rand Paul\nThe photographer for the NY Times essay Wolfgang Tillmans wrote a short piece in \nassociation with my essay:\nDec. 11, 2022\nReleased by Chairman Rand Paul\nAll of a sudden, Elon Musk has started to viciously attack me with tweets on Twitter:\nMany people are coming to my defense on tweets and some like Marjorie Taylor Green are \napproving of his tweets although Mark Kelly (astronaut) tweeted that I funded GOF \nresearch that killed millions of people:\nElon Musk targets Dr. Anthony Fauci in viral \ntweet, drawing backlash - CBS News \nCBS News \n\"My pronouns are Prosecute/Fauci,\" the Twitter CEO wrote on \nSunday.\nFlag as \nirrelevant \nDec. 12, 2022\nReleased by Chairman Rand Paul\nMany people in the press and outside are asking about and concerned about the attacks on \nme by Elon Musk.\nLook at this tweet.   What bullshit!\nWhite House Says Elon Musk's Tweets Attacking Fauci 'Disgusting' - Bloomberg \nBloomberg.com \nFauci, the director of the National Institute of Allergy and Infectious Diseases, will retire this month after 54 years \nin government. Fauci became ...\nFlag as irrelevant \nPRESS:  Interview with Nature (Max Kazlov) for future publication; Sirius XM Radio “Dr. \nRadio” with Marc Siegel;  “Axe Files” podcast with David Axelrod; MSNBC with Andrea \nMitchell\nDec. 13, 2022\nReleased by Chairman Rand Paul\nPress still active about the Musk attack on me.   Sargent at the Post say libeal ourage does \nnot help counter Musk since it merely shows that he is having an effect.   Sargent suggests \nwe ignore him:\nMusk’s ugly attack on Fauci shows how right-\nwing info warfare works\nBy Greg Sargent\nI went to Boston to receive the Edward M Kennedy award for Inspired Leadership at the \nEdward M Kennedy institute for the United states Senate. It was a really nice affair and I was \nshowered with affection and admiration. A person who is a Broadway actor/singer (Alan H. \nGreen) Sing a beautiful song from Les Miserables and dedicated to me and as he was mentioning \nthe dedication he emotionally choked us.   Very moving.   I was introduced and had a Fireside \nChat with Kristen Welker of NBC.   Joe Kennedy and Patrick Kennedy were wonderful with me.\nPRESS:  MSNBC “Morning Joe”;\nDec. 14, 2022\nTrying to work out my protection post Jan. 1.   Still up in the air.\nPRESS:  CNN with Kate Bolduan; CBS Exit Interview with Jon laPook; LA Tims \ninterview with Melissa Healy;\nDec. 15, 2022\nPBS team in for final filming for the Documentary.   They are filming me taking down my \nphotographs from the walls\nPRESS:  Urban Faith TV with MAINA Mwaura;  NPR – Scott Simon (Exit Interview); \nJapan Nippon TV with Sho Watanabe; LA Times Podcast; Podcast with Alice Park (Time \nMagazine); \nReleased by Chairman Rand Paul\nDec. 16, 2022\nMomentous Day!!!  Today we had the ceremony for my “stepping down” at NIH.   I chose \na simple ceremony with 3 minute speeches by Larry Tabak, Francis Collins, John Gallin, \nCliff Lane and Christine.   This was followed by a 15 minute Q and A with John Burklow \nand a concluding speech by me.   I thought that I would get through the entire speech \nwithout choking up but when I got to the point about Christine, I choked up  for about 15 \nseconds.   The ceremony was exactly like I wanted it – no bells and whistles.  \nPRESS:   Exit interview with the Guardian with David Smith; Exit Interview with AP with \nLauran Neergaard; Firesude Chat with Massey Center; infectious Diseases ews interview;\nDec. 17, 2022\nIt is clear (I have not been reporting it every day) that the far, extreme right and Qanon \nliterally hate me and De Santis is starting to play into this with his growin campaign for \npresidency.   From the New York Times:  Although “vaccine paranoia and Fauci hatred are still \nniche positions in the electorate at large,” if anyone “imagines that replacing Trump with DeSantis as \nthe G.O.P.’s leader would signal a party on its way to becoming sane again is in for a rude shock.” \nReleased by Chairman Rand Paul", "summary": "Sen. Rand Paul's 24 July 2026 release of Anthony Fauci's personal diary entries (December 2019 - December 2022), obtained through the HSGAC oversight process and presented alongside his contemporaneous public statements. Released ahead of Fauci's subpoenaed testimony before HSGAC on 29 July 2026.\n\nExcerpt: Moderna and Pfizer boost. There is a tension between her/CDC  and Peter Marks and Larry Horowitz (FDA) regarding whether or not the younger children  should all get the bivalent boost or have them finish their primary regimens with the ancestral  strain vaccine. Peter and Larry had both called me up previously (couple of nights ago) making it  look like the CDC was holding back on wanting to give the most updated boost to the children.  Yet, when Rochelle explained this to me this morning it became clear that it is a much more  complicated situation than Peter and Larry described to me by phone a couple of nights ago.  Ultimately, in January all children of all ages will get a unified vaccine either for the primary  series or the boost and that will be the bivalent BA.4/5. Rochelle…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.24_Tonys-Diary-Package.pdf", "pdf_url": "/archive-docs/fauci-files/014d53b120e651a0493179f1cc21fd47/pdf", "doc_date": "2026-07-24", "case": "covid-19-origins", "sub_case": "hsgac-2026-diary", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "tonys diary", "tony's diary", "fauci diary", "fauci diaries", "personal diary", "rand paul", "rand paul release", "paul senate", "hsgac", "diary release", "private vs public", "fauci testimony 2026", "tonys-diary"], "part_number": 10, "page_count": 1141}
{"title": "HSGAC Release — Fauci Email, 2 Feb 2020 (\"science and narrative\" / deletion request)", "content": "From: \"Fauci, Anthony (NIH/NIAID) [E]\" \nTo:\"Collins, Francis (NIH/OD) [E]\" \nSubject: FW: 2019nC-V\nDate: Sun, 02 Feb 2020 14:15:16 -0500\nImportance: Normal\nI agree with you.   Mik\ne and Bernhard ar e good people but they really slow things down, particularly Mike Ryan\nwhose main concern is not offending anyone.  \n  Please delet e this e-mail after you read it.\nFr o m: Collins, Francis (NIH/OD) [E] \nSen t: Sunday, February 2, 2020 1:45 PM\nT o : Jeremy Farrar \nCc: Fauci, Anthony (NIH/NIAID) [E] ; Tabak, Lawrence (NIH/OD) [E] \nSu b ject:  Re: 2019nC-V\nSounds mostly encouraging though I don’t understand the choice of working through Mike and Bernhard and\nnot just going straight to Tedros.  But tha\nt’ s fine as long as these next steps are initiated very quickly!\nFC\nSent from my iPhone\nOn Feb 2, 2020, at 12:48 PM, Jeremy Farrar  wrote:\nMike\n and Bernhard\nThank you for phoning – very helpful, copying in Francis and Tony as well as Tedros.\nFully agree with your summary.\nBest is if this is addressed under the umbrella of WHO\nHas to be framed as ‘To understand the source and evolution of the 2019n-CoV”\nWithin that  a number of issues to be addressed including – Environmental and animal sampling, human\nviral g\nenome sequencing and analysis, and more\nQuickest is via a Working Group within an established structure rather than set something new up\nMultiple options for this within WHO\nMike and Bernhard will work out best approach\nAppreciate the urgency and importance of this issue in midst of a very troubling epidemic\nGathering interest evident in the science literature and in mainstream and social media to the question of the\norigin of this virus\nCritical that responsible, respected scientists and agencies get ahead of the science and the narrative of this and\nare not reacting to reports which could be very damaging.\nI am sure I speak for Francis and Tony when I say we are here and ready to play any constructive role in this\nDo think this is an urgent matter to address (among many we appreciate)\nFully agree to your comments on the GCM.\nHope that is a reasonable summary\nHSGAC_NIH_18135\n\nWellcome exists to improve health by helping great ideas to thrive. We support researchers, we take on big health\nchallenges, we campaign for better science, and we help everyone get involved with science and health research. W e are a\npolitically and financially independent foundation.\nThe Wellcome Trust is a charity registered in England and Wales, no. 210183. Its sole trustee is The Wellcome Trust Limited, a\ncompany registered in England and Wales, no. 2711000 (whose registered office is at )\nHSGAC_NIH_18136", "summary": "Email among Anthony Fauci, Jeremy Farrar and Francis Collins (2 February 2020) discussing management of 'the science and narrative' around COVID-19 origins, with a request that the message be deleted. Released by HSGAC Chairman Rand Paul, September 2025.\n\nExcerpt: From: \"Fauci, Anthony (NIH/NIAID) [E]\"  To:\"Collins, Francis (NIH/OD) [E]\"  Subject: FW: 2019nC-V Date: Sun, 02 Feb 2020 14:15:16 -0500 Importance: Normal I agree with you.   Mik e and Bernhard ar e good people but they really slow things down, particularly Mike Ryan whose main concern is not offending anyone.     Please delet e this e-mail after you read it. Fr o m: Collins, Francis (NIH/OD) [E]  Sen t: Sunday, February 2, 2020 1:45 PM T o : Jeremy Farrar  Cc: Fauci, Anthony (NIH/NIAID) [E] ; Tabak, Lawrence (NIH/OD) [E]  Su b ject:  Re: 2019nC-V Sounds mostly encouraging though I don’t understand the choice of working through Mike and Bernhard and not just going straight to Tedros.  But tha t’ s fine as long as these next steps are initiated very quickly! FC Sent from my iPhone On Feb…", "source_url": "https://www.hsgac.senate.gov/wp-content/uploads/HSGAC_NIH_181351.pdf", "pdf_url": "/archive-docs/fauci-files/d1830696cbcf112a9fa79b16b0047bb6/pdf", "doc_date": "2020-02-02", "case": "covid-19-origins", "sub_case": "hsgac-records-deletion", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "deleted records", "fauci deleting records", "deletion request", "farrar", "francis collins", "hsgac", "rand paul", "science and narrative", "federal records act", "hsgac-deleting-records-1"], "part_number": 1, "page_count": 2}
{"title": "HSGAC Release — Fauci Email, 20 Jul 2020 (Sen. Paul remarks / deletion request)", "content": "From: \"Fauci, Anthony (NIH/NIAID) [E]\" \nTo:\"Greg Folkers \" \nSubject: FW: rand paul tweet // Not really fair to compare states with countries, but NY death rate is\nhugh\nDate: Mon, 20 Jul 2020 20:27:00 -0400\nImportance: Normal\nInline-Images: image001.jpg; image003.jpg; image004.jpg\nGreg:\n    As usual he s full of s..t.   Mark Meadows curiously had t o same response and was upset when I said that NY\ngot things right by finally getting the numbers down and successfully began opening up.    I will past e in a note I\nsent to Mark:\nI am sorry, Mark.   I do not think you are missing anything and I understand what you are saying, but I guess we\nare just looking at this from different perspectives.   NY certainly made mistakes, but we learned a lot from the\ndifficult experience that they went through that hopefully benefitted cities and states that subsequently got hit.\nI am just talking about the fact that they got the numbers down and now they seem to be opening safely and\nsuccessfully.   Also, please forgive me because I am not trying to be contrary, but let us look at the numbers.   The\nNY Metropolitan area has a population of 20.3 million.   With 32,000 deaths,   the death rate at the population\nlevel is 0.0016.    Miami Dade county has a population of 2,717,000.   With 5000 deaths, the death rate at the\npopulation level is 0.0018, and they are not out of it yet.   And so on a population level Florida may ultimately\nturn out not to be too different from NY .\nI do not want t\no engage any more with this nonsense.   An so, please delet e this e-mail after you read it/\nThanks,\nASF\nFr o m:\n Folkers, Greg (NIH/NIAID) [E] \nSen t: Monday, July 20, 2020 2:33 PM\nT o : NIAID OD AM ; Haskins, Melinda (NIH/NIAID) [E] ; Selgrade,\nSara (NIH/NIAID) [E] ; Crawford, Chase (NIH/NIAID) [E] \nSu b ject:  rand paul tweet // Not really fair to compare states with countries, but NY death rate is hugh\nHSGAC_NIH_18140\n\n \n \n  \n  \n      \n      \n   \n     \n           \n                \n              \n              \n            \n             \n              \n          \n             \n             \n             \n             \n            \n           \n            \n            \n          \n            \n            \n            \n             \n             \n \n \n \n \nHSGAC_NIH_18141", "summary": "Email (20 July 2020) containing dismissive remarks about Senator Rand Paul and another deletion request. Released by HSGAC Chairman Rand Paul, September 2025.\n\nExcerpt: From: \"Fauci, Anthony (NIH/NIAID) [E]\"  To:\"Greg Folkers \"  Subject: FW: rand paul tweet // Not really fair to compare states with countries, but NY death rate is hugh Date: Mon, 20 Jul 2020 20:27:00 -0400 Importance: Normal Inline-Images: image001.jpg; image003.jpg; image004.jpg Greg:     As usual he s full of s..t.   Mark Meadows curiously had t o same response and was upset when I said that NY got things right by finally getting the numbers down and successfully began opening up.    I will past e in a note I sent to Mark: I am sorry, Mark.   I do not think you are missing anything and I understand what you are saying, but I guess we are just looking at this from different perspectives.   NY certainly made mistakes, but we learned a lot from the difficult experience that they went…", "source_url": "https://www.hsgac.senate.gov/wp-content/uploads/HSGAC_NIH_181401.pdf", "pdf_url": "/archive-docs/fauci-files/c63442d5b647d455e63a84581b6b932d/pdf", "doc_date": "2020-07-20", "case": "covid-19-origins", "sub_case": "hsgac-records-deletion", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "deleted records", "fauci deleting records", "deletion request", "hsgac", "rand paul", "federal records act", "hsgac-deleting-records-2"], "part_number": 1, "page_count": 2}
{"title": "HSGAC Committee Letter to Dr. Fauci (9 Sep 2025)", "content": "September 9, 2025  Anthony Fauci, M.D. 37th and O Street, N. W. Washington D.C. 20057  Dear Dr. Fauci:   The Committee on Homeland Security and Governmental Affairs is continuing to conduct its investigation into the origins of COVID-19 and risky life sciences research. During the course of its investigation, the Committee has obtained records revealing that you directed employees of the National Institutes for Health (NIH) to destroy federal records. These documents suggest your direct involvement in efforts to conceal information related to the Committee’s investigation and appear to contradict your previous testimony before Congress. Accordingly, I request that you provide additional information and formally invite you to appear before the Committee to clarify your previous testimony.    On June 3, 2024, when questioned by members of the House Select Subcommittee on the Coronavirus Pandemic, you unequivocally denied under oath ever deleting official records. Congressman Comer asked, “Dr. Fauci, did you ever delete an official record?” and you responded, “No.”1 Similarly, when Congresswoman Lesko asked, “Were you ever engaged in attempts to obstruct the Freedom of Information Act and the release of public documents?” you again responded, “No.”2 Additionally, when Congresswoman Malliotakis asked, “Did you delete any emails or records related to the Wuhan lab or the origins of the virus?” you answered, “No, I did not.”3 However, emails obtained by the Committee appear to contradict your testimony. For example, in an email dated February 2, 2020, you directed then-NIH Director Dr. Francis Collins to “Please delete this e-mail after you read it.”4 In another email dated July 20, 2020, to an NIH employee you stated, “I do not want to engage any more with this nonsense. And so, please delete this e-mail after you read it.”5   1 A Hearing with Dr. Anthony Fauci Before the H. Comm. On Oversight & Gov’t Reform, 118th Cong. 18 (2024) (statement of Anthony Fauci and answering questions from Rep. James Comer) (“Dr. Fauci, did you ever delete an official record?”). 2 A Hearing with Dr. Anthony Fauci Before the H. Comm. On Oversight & Gov’t Reform, 118th Cong. 30 (2024) (statement of Anthony Fauci and answering questions from Rep. Debbie Lesko) (“Dr. Fauci, were you ever engaged in attempts to obstruct the Freedom of Information Act and the release of public documents?”). 3 A Hearing with Dr. Anthony Fauci Before the H. Comm. On Oversight & Gov’t Reform, 118th Cong. 25 (2024) (statement of Anthony Fauci and answering questions from Rep. Nicole Malliotakis) (“Did you delete any emails or records related to the Wuhan lab or the origins of the virus?”). 4 E-mail from Anthony Fauci, Dir., Nat’l Inst. of Allergy & Infectious Diseases, to Francis S. Collins, Dir., Nat’l Insts. of Health (Feb. 2, 2020, at 02:15 PM). 5 E-mail from Anthony Fauci, Dir., Nat’l Inst. of Allergy & Infectious Diseases, to Greg Folkers, Chief of Staff, Nat’l Inst. of Allergy & Infectious Diseases (July 20, 2020, at 08:27 PM). \n\nI have reason to believe that you may be in possession of additional records related to the Committee’s ongoing investigation. These records are necessary for the Committee to fully understand the federal government’s actions to identify the origins of COVID-19, and the extent to which taxpayer dollars were used to conduct risky virological research, as well as to weigh potential legislative reforms.  For this reason, I request that you provide the following, in complete, original, and unredacted form, no later than 5:00 PM on September 23, 2025: 1. A list of all email addresses, phone numbers, and messaging application usernames you used at any point between January 1, 2018, and January 1, 2023. 2. All email communications, including attachments, sent or received by you between January 1, 2018, and January 1, 2023, whether on government-issued or personal accounts/devices, that refer or relate in any way to NIH, HHS, CIA, FBI, DOD, COVID-19, the “Proximal Origins” paper, the Wellcome Trust, Jeremy Farrar, the P3CO Review Group, gain-of-function research, dual use research of concern, EcoHealth Alliance, Peter Daszak, the Wuhan Institute of Virology, Ian Lipkin, Ralph Baric, Zhengli Shi, the DEFUSE proposal, DARPA, DTRA, USAID PREDICT, the Rocky Mountain Laboratory, Vincent Munster, Fort Detrick, the Integrated Research Facility, the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), or the National Biodefense Analysis and Countermeasures Center (NBACC). 3. All email communications, including attachments, created, sent, received, copied, or otherwise transmitted between January 1, 2018, and January 1, 2023, whether on government-issued or personal accounts/devices, between or among you and Jeremy Farrar, Francis Collins, Hugh Auchincloss, Ian Lipkin, Ralph Baric, Vincent Munster, Kristian Andersen, Andrew Rambaut, Edward Holmes, or Robert Garry, including communications in which you appear in any field (to, from, cc, bcc) or in forwarded chains. 4. All records of calls and voicemails, whether on government-issued or personal devices/accounts, between January 1, 2018, and January 1, 2023, between you and Jeremy Farrar, Francis Collins, Hugh Auchincloss, Ian Lipkin, Ralph Baric, Vincent Munster, Kristian Andersen, Andrew Rambaut, Edward Holmes, Robert Garry, or Samantha Power, including call logs, voicemail transcripts, and audio recordings. 5. All text messages, iMessages, and communications conducted through encrypted or third-party messaging applications, including but not limited to Signal, WhatsApp, Telegram, and WeChat, sent or received by you between January 1, 2018, and January 1, 2023, whether on government-issued or personal accounts/devices, that refer or relate in any way to NIH, HHS, CIA, FBI, DOD, COVID-19, the “Proximal Origins” paper, the Wellcome Trust, Jeremy Farrar, the P3CO Review Group, gain-of-function research, dual use research of concern, EcoHealth Alliance, Peter Daszak, the Wuhan Institute of Virology, Ian Lipkin, Ralph Baric, Zhengli Shi, the DEFUSE proposal, DARPA, DTRA, USAID PREDICT, the Rocky Mountain Laboratory, Vincent Munster, Fort Detrick, the Integrated Research Facility, the U.S. Army Medical Research \nInstitute of Infectious Diseases (USAMRIID), or the National Biodefense Analysis and Countermeasures Center (NBACC). 6. All text messages, iMessages, and communications conducted through encrypted or third-party messaging applications, including but not limited to Signal, WhatsApp, Telegram, and WeChat, sent or received by you between January 1, 2018, and January 1, 2023, whether on government-issued or personal accounts/devices, between you and Jeremy Farrar, Francis Collins, Ian Lipkin, Ralph Baric, Vincent Munster, Kristian Andersen, Andrew Rambaut, Edward Holmes, Robert Garry, or Samantha Power. Additionally, please provide in writing no later than 5:00 PM on September 23, 2025, your availability to testify before the Committee on the following dates:  • October 28-30, 2025 • November 4-6, 2025 • November 18-20, 2025 • December 2-4, 2025 • December 9-11, 2025 Thank you for your prompt attention to this important matter.  Sincerely,    Rand Paul, M.D.       Chairman        U.S. Senate Committee on Homeland      Security and Governmental Affairs", "summary": "Chairman Rand Paul's committee letter to Anthony Fauci regarding evidence of deleted official records, calling him to testify before HSGAC.\n\nExcerpt: September 9, 2025  Anthony Fauci, M.D. 37th and O Street, N. W. Washington D.C. 20057  Dear Dr. Fauci:   The Committee on Homeland Security and Governmental Affairs is continuing to conduct its investigation into the origins of COVID-19 and risky life sciences research. During the course of its investigation, the Committee has obtained records revealing that you directed employees of the National Institutes for Health (NIH) to destroy federal records. These documents suggest your direct involvement in efforts to conceal information related to the Committee’s investigation and appear to contradict your previous testimony before Congress. Accordingly, I request that you provide additional information and formally invite you to appear before the Committee to clarify your previous…", "source_url": "https://www.hsgac.senate.gov/wp-content/uploads/2025.09.09_SRP-Letter-to-ASF_Final1.pdf", "pdf_url": "/archive-docs/fauci-files/cb1924850406a44a8ab1d532849bebac/pdf", "doc_date": "2025-09-09", "case": "covid-19-origins", "sub_case": "hsgac-records-deletion", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "hsgac letter", "subpoena", "testify", "rand paul", "hsgac-letter-to-fauci"], "part_number": 1, "page_count": 3}
{"title": "Read Tony's Diary: The Prequel (Part 1 of 8)", "content": "From: \"Fauci, Anthony (NIH/NIAID) [E]\"\n</O=NIH/OU=NIHEXCHANGE/CN=NIAID/CN=AFAUCI>\nTo:\"Fauci, Anthony (NIH/NIAID) [E]\" <AFAUCI@niaid.nih.gov>\nSubject: history\nDate: Sat, 11 Jul 2015 17:50:16 -0400\nImportance: Normal\nAttachments: historical_record_of_A.S._Fauci.docx\nReleased by Chairman Rand Paul\n1 HISTORICAL RECORD OF HIV/AIDS\nAnthony S. Fauci, M.D.\nDirector\nNational Institute of Allergy and Infectious Diseases\nNational Institutes of Health\nThis written record will start today (April 11, 2001) and will state some events \nretrospectively.  I have other records including 2 dictated tapes that should be noted. The event \nthat precipitated this written record, which I hope that I can regularly contribute to is the tidal \nwave of activity concerning the possibility of treating HIV-infected individuals in developing \nnations and in sub-Saharan Africa specifically.\nTowards to end of the Clinton Administration, Leon Fuerth who was the National \nSecurity Advisor to VP Al Gore had set into motion a Task Force on which I was included (see \nother records) to develop a plan to “treat infected Africans and provide some infrastructure, \nprevention, etc. The group involved USAID, CDC, NIH, White House, State Department and \nothers.  After the election, obviously, this dissolved.  However, with the new George W. Bush \nadministration, Secr. of State Colin Powell and Secr of DHHS, Tommy G. Thompson became \nvery interested.  Starting from the end of March I began intensive briefings of Secretary. \nThompson and members of his staff, particularly Terrell Halaska (Deputy Chief of Staff, DHHS) \nand William Steiger (Special Assistant for International Affairs at DHHS) trying to convince \nthem of the need for USA involvement in the rapidly growing international interest in developing \na forum for treating Africans with HIV.  Also, I had several interactions with Anne Phelps of the \nDomestic Policy Council at the White House.  During all of this, I had turned down the offer to \nbe Director of NIH.  I was asked by Ed. Moy (Director of Presidential Personnel at the White \nHouse) and by Secr. Thompson.  My reason was that I wanted to concentrate of Global Health \nproblems, particularly HIV/AIDS in developing nations such as sub-Saharan Africa.  They \nregretted my not taking the job, but were enthusiastic and quite flattering about my work on \nAIDS and encouraged to take a leadership role in pushing the AIDS (as well as TB and malaria) \nglobal agenda.  This was especially true of Secr. Thompson with whom I was rapidly developing \nan excellent relationship.\nMarch 2, 2001 – meet with Anne Phelps at White House to discuss global AIDS and other \nissues.\nApril 3, 2001 – Extensive briefing of Secr. Thompson’s staff (Halaska, Steiger, Ann Agnew) \nregarding International AIDS.  Secretary Thompson dropped by and spent most of the hour.  \nAfter the meeting he called me into his office to speak in private (Bob Woods (Chief of Staff) \nand Brett Davis (Special Assistant to the Secretary) were there.  Thompson said he wanted me to \nbe his point man on AIDS and to spearhead our international endeavors.  Stated that he and Colin \nPowell would lead a Task Force on International AIDS and he wanted me to be the “go-to \nperson”.\nApril 4, 2001 -  I was asked to prepare talking points on AIDS for Secretary. Thompson for his \nupcoming plane trip with Pres, Bush to (?).  I did so.  Thompson’s staff was so impressed with \nReleased by Chairman Rand Paul\n2the talking points that they mentioned that Thompson wanted me to accompany his staff to the \nWhite House the next day to develop a white paper for Powel and Thompson to use in upcoming \nmeeting with the POTUS.  \nApril 5, 2001 -  Several hour meeting in the Situation Room of the White House chaired by Gary \nEdson (Condoleeza Rice’s Deputy) of NSC.  Meeting attended by…..  Bill Steiger charged with \ndeveloping paper.\nApril 8 – 10, 2001 – I exchanged several drafts of white paper with Steiger and make significant \nchanges and input.  It was clear that much of the paper included material from my talking points \nfor Thompson (see above).\nApril 11, 2001 – Attached below is the document and some comments.  \n---------------------- Forwarded by Millicent H. Schwenk/NSC/EOP on\n04/11/2001 11:16 AM ---------------------------\nGary R. Edson\n04/10/2001 09:00:45 PM\nRecord Type:   Record\nTo:   Millicent H. Schwenk/NSC/EOP@EOP\ncc:\nSubject:\nMillie: I haven't reviewed this to see what;'s changed, but you should look\nat it.\n---------------------- Forwarded by Gary R. Edson/NSC/EOP on 04/10/2001\n09:01 PM ---------------------------\n                                                                  \n (Embedded                                                        \n image moved   steigerw@usa.net                                   \n to file:      04/10/2001 07:05:59 PM                             \n PIC07622.PCX)                                                    \n                                                                  \nReleased by Chairman Rand Paul\n3Record Type:   Record\nTo:   Gary R. Edson/NSC/EOP\ncc:   terrell.halaska@hhs.gov\nSubject:\nmy hhs dial-up e-mail is down tonight.  i wanted to send you a slightly\nmodified version after receiving additional comments from dr. fauci. i am\nsending in the body of the e-mail because i am not certain the attachment\nwill\ngo through.  let me know if you have any questions or need me to do\nanything\nelse.  thanks, steiger\nDraft\nPrivileged and Confidential\nFor Official Use Only\nInfectious diseases, including HIV/AIDS, malaria, and tuberculosis, are\nravaging developing nations, causing 25 percent of all deaths worldwide and\neroding recent gains in economic growth, education, and life expectancy.\nTuberculosis accounted for 1.7 million deaths last year, while malaria\nkilled\nmore than one million, mostly children in Africa. At the same time, the\nspread\nof HIV/AIDS is triggering a crisis in international public health, the full\nscope of which we are only beginning to recognize. The Joint United Nations\nProgramme on HIV/AIDS (UNAIDS) estimates that 36 million people are now\nliving\nwith HIV or AIDS, 70 percent of them in sub-Saharan Africa, where the\ndisease\nis now the leading cause of death.  Nearly 60 million people have become\ninfected with HIV since the beginning of the epidemic in the 1970's and\nover\n22 million of them have already died from AIDS.\nThe U.S. has been the leader in research and assistance to battle these\ndiseases, and the President?s recent proposed budget increase for the\nNational\nInstitutes of Health (NIH) reaffirms that commitment.  NIH spent an\nestimated\n$90 million on international HIV/AIDS research in FY 2000, a number that is\nexpected to rise to $130 million by the end of FY 2001.  The U.S. is the\nReleased by Chairman Rand Paul\n4largest single donor to UNAIDS and the largest contributor to international\nHIV/AIDS treatment and prevention programs, a total of more than $460\nmillion\nin FY2001. The Centers for Disease Control and Prevention (CDC) spent over\n$100 million on HIV/AIDS prevention in FY 2001.  The U.S. Government has\nalso\ndramatically increased its investment in international malaria and\ntuberculosis efforts to $110 million in FY 2001.\nOur programs for taking care of our own population affected by HIV/AIDS and\ntuberculosis are also world leaders.  HHS is providing over $10 billion in\nFY\n2001 for HIV/AIDS-related assistance. This includes $795 million for\nprevention services through the CDC and other agencies, $1.8 billion for\nRyan\nWhite medical and related support services for individuals and families\nwith\nHIV/AIDS, including the AIDS Drug Assistance Program; $2.2 billion for\nNIH-funded HIV/AIDS research, including $280 million in vaccine research;\n$4.3\nbillion for HIV/AIDS-related coverage for Medicare and Medicaid\nbeneficiaries.\nOver the last several years the scope of the infectious disease crisis in\nthe\ndeveloping world has led the U.S and other industrialized nations to make\ninternational public health an important item on their foreign policy\nagendas.\n In Okinawa in July of 2000, the U.S. and our G-8 partners committed to\npromoting investments and partnership to prevent and control HIV/AIDS,\ntuberculosis and malaria and to accelerate the development of new vaccines.\nMore recently, wider public attention has turned to the challenges posed by\nthese diseases as pharmaceutical manufacturers have announced price\nreductions\nin developing countries for their main anti-retroviral drugs.  These price\ncuts are a significant step forward and have sharpened debate on the\nquestion\nof how best to provide treatment to the populations most affected by the\nHIV/AIDS epidemic, malaria, and tuberculosis.\nAs Senator Bill Frist (R-TN) has recently suggested, the U.S. has a moral\nobligation to provide leadership in mobilizing additional resources for\ninternational health.  Stopping the spread of infectious diseases is also\nin\nour own enlightened self-interest, given the threats HIV/AIDS and other\nmaladies now pose to the political and economic stability of Africa and\nother\nimportant regions of the world.  It is in our public health interest to\naddress tuberculosis as well, since 43 percent of U.S. TB cases are among\nReleased by Chairman Rand Paul\n5foreign-born persons.  We also believe the U.S. has a duty to ensure that\nthose resources go to efforts that are medically and scientifically sound\nand\nwill contribute to the development of a sustainable health infrastructure\nin\nthe most affected countries so that they can meet their challenges\nthemselves\nover time.\nProviding drugs at or below cost is only part of the solution.  It is\nestimated that approximately 50 percent of HIV-infected people in the U.S.\nmeet the HHS treatment guidelines for beginning antiretroviral therapy.\nWhat\nthis percentage might be in developing nations is unclear.  However,\nperhaps\nas important as providing antiretroviral drugs in some circumstances is\ntreating opportunistic infections and providing nutrition and clean water.\nYet even if enough drugs to treat every single infected person were sent,\nfree\nof charge, to the African continent, an adequate surveillance\ninfrastructure\nfor testing for HIV infection and an adequate health care delivery system\nfor\nadministering the drugs do not exist in many countries.  Furthermore, the\ncapability of monitoring patients to insure they are taking these complex\nregimens of drugs properly and  to determine the spectrum of toxicity and\nthe\neffect of treatment on the spread of the disease There is no existing\nsurveillance capability to ensure that patients follow extremely\ncomplicated\ndrug regimens accurately, or to monitor what effect the treatment has on\nthe\nspread of the disease is sorely lacking in many places.  We should begin to\nhelp create the basic system to provide needed medications for\nopportunistic\ninfections and symptomatic care, while also building the more complex\nsystems\nneeded to provide antiretrovirals and other medicines safely and\neffectively\nto avoid creating resistant strains, a lesson we have learned from efforts\nto\ncontrol tuberculosis.\nAt the same time, we must continue to focus our efforts on prevention ? a\nproven strategy that is cost-effective.  Government accountability,\nindividual\nbehavior change and abstinence-based approaches (where they are culturally\nappropriate) must be part of prevention efforts.  We have found that\nReleased by Chairman Rand Paul\n6working\nwith local organizations, such as missionary hospitals and clinics, is an\neffective way to lessen the impact of the epidemic on individuals, families\nand communities.  We should also encourage countries to adopt\ncomprehensive,\nevidence-based national strategies to ensure the resources we devote to\nthis\nchallenge are well-managed to produce the results we seek.\nThis is not, however, an issue that the U.S. Government can -- or should --\nsolve single handedly.  We must reach out to a number of partners: our\nallies,\nthe international community, pharmaceutical manufacturers, non-profits like\nthe Gates Foundation, and the faith-based community that has infrastructure\non\nthe ground in the developing world.  A successful strategy to reduce the\nimpact of infectious disease requires close donor cooperation to achieve\nmaximum efficiency and avoid competition and duplication of efforts.  The\nBush\nAdministration stands ready to contribute to a comprehensive plan to\nimprove\nthe public health delivery system in Africa and other parts of the world\nwhere\nHIV is rapidly expanding, an effort that should include prevention of new\ninfections, care for the sick, provision of drugs, and training of medical\nprofessionals.\nTo this end, we appeal to the world to join us in establishing a new,\nmulti-lateral Global Fund to Fight Infectious Diseases, an international\npublic-private partnership to provide grants for prevention and health\ninfrastructure development focused on fighting HIV/AIDS, malaria, and\ntuberculosis.\nWe believe the fund should operate under the following series of core\nprinciples:\n?    Our goals are to prevent new HIV infections and treat those already\nafflicted, to build the infrastructure for health care and disease control,\nand to develop and train human resources.\n?    We seek to support a community-driven process that identifies the\nneeds of\naffected areas and allows communities themselves to develop an appropriate,\ncomprehensive set of medical, social and support services.\n?    We must build on already established institutions and networks in\nlocal\nareas, including research relationships, to ensure we are creating human\nand\nphysical capacity that is sustainable over the long run.\n?    We support an integrated approach focusing on prevention, delivery,\ncare and\nReleased by Chairman Rand Paul\n7treatment.  We also wish to include components for health infrastructure\nimprovement, surveillance of epidemics and care for orphans.\n?    We will outline and agree to fund a core menu of ?best practice?\nprograms,\naccording to certain quality standards and experience with evidence-based\nmodels proven to work in developing countries.\n?    We will solicit letters of intent from governments and\nnon-governmental\norganizations (NGOs), especially faith-based groups, that describe plans to\nimplement one of more of our core models in local areas.\n?    We will require demonstration of local leadership and adherence to\ninternational standards of financial accountability and transparency.  We\nwill\ngive preference to comprehensive plans that involve governments and civil\nsociety working together.\n?    We will link our efforts in health to expanded programs in the areas\nof\neducation and nutrition in an international parallel to the\nAdministration?s\ncampaign to ?Leave No Child Behind.?\n?    We are committed to a policy of promoting intellectual property\nprotection,\nincluding for pharmaceutical patents, because of its critical role in the\nrapid innovation, development, and commercialization of effective and safe\ndrug therapies and vaccines.  Financial incentives are needed to develop\nnew\nmedications.  No one benefits if research on such products is discouraged.\nWith more than 50 years of experience with health projects and a proven\ninstitutional capacity to manage large financial transactions, the World\nBank\nshould serve as the fiscal agent for the Fund.  As trustee, the Bank would\nnot\nbe involved in matters of policy, but would serve as the repository for\ncontributions from both governments and private donors and ensure the\nprompt\ndisbursement of grants.  A small Executive Secretariat housed at the Bank\nand\njointly staffed by the Bank, UNAIDS and the World Health Organization would\nundertake the day-to-day management of the trust fund, including soliciting\ngrant proposals.\nA high-level Governing Council would provide the overall strategic\ndirection\nfor the fund.  Donors that contribute at least $xx million and\nrepresentatives\nof the developing world (serving in their own personal capacity and not as\nthe\nReleased by Chairman Rand Paul\n8emissaries of any particular state) would form the membership of this\nboard.\nThe Council would fully control all fund decisions, including determining\nprogrammatic allocations, operational rules and procedures, policies and\nstrategies, approving financial plans and work programs, and attracting\nadditional donations.  In addition, the Council would make the final\ndetermination of the list of ?best practice? models the fund would\nunderwrite\nand the criteria necessary to win approval of letters of intent.  The\npresident of the World Bank, the Director General of UNAIDS and the\nDirector\nGeneral of WHO would be ex officio, non-voting members of the Council.\nMuch like a university endowment, the fund would have a two-tiered\nfinancial\nstructure.  The \"core fund\" would comprise a pool of resources that could\nbe\nsupport any activity falling within the work program and eligibility\ncriteria\napproved by the Governing Council (except for limited restrictions by\ndonors).\n At the same time, however, the fund would permit donors to earmark\ncontributions for use on their particular priorities, as long as they fell\nwithin the overall purposes and priorities of the trust fund.  Both ?core?\nand\ndedicated resources would be combined in each grant in a way transparent to\nthe recipient.\nComposed of international scientific, medical, public health and\ndevelopment\nexperts, a Scientific and Public Health Review Committee would perform a\nrigorous technical peer review process to assess the grant applications.\nDrawn from developing and developed countries and international\norganizations,\nwith experience in the affected countries, such as UNAIDS and WHO, the\nCommittee will make final decisions about the feasibility and\nsustainability\nof proposed programs according to criteria for each ?best practice? model\nprescribed by the Governing Council.  The Committee will also operate under\nbroad guidelines that spell out the recommended ratio of expenditures on\nprevention, treatment, and research the Council would prefer projects\nfollow.\nThe models we might support could cover primary prevention and education\nprograms up to more sophisticated, comprehensive efforts that could involve\nbasic care and treatment, controlled delivery of antiretroviral therapy,\nmedical training, and clinical trials.  Applicants will determine which one\nof\nthe approved packages would be most appropriate and useful for the local\nReleased by Chairman Rand Paul\n9context.  Some might ask for resources to upgrade or build health centers\nto\ndeliver basic HIV/AIDS or tuberculosis care and prevention programs.\nOthers\nmight want help with such programs plus training for physicians, lab\nworkers,\nnurses, community health volunteers, and pharmacists.  Still others might\nintegrate both models with the provision of complex drug treatment.  Every\nfunded model will also include localized monitoring to assure the efficacy\nof\nthe grant and to help inform the selection of proposals in the future.  We\nwill also emphasize technical assistance to those countries and\norganizations\nthat are unable to satisfy our criteria in their letters of intent, so that\nover time they might also be able to participate.\nThe Administration is committed to making the fight against the global\nHIV/AIDS epidemic and other killers a priority, and we ask our friends and\npartners to join with us in a single, worldwide effort.\n____________________________________________________________________\nGet free email and a permanent address at http://www.amexmail.com/?A=1\nApril 11, 2001 – Attached below is what is to be the final document:\nDraft\nPrivileged and Confidential\nFor Official Use Only\nInfectious diseases, including HIV/AIDS, malaria, and tuberculosis, are ravaging developing \nnations, causing 25 percent of all deaths worldwide and eroding recent gains in economic \ngrowth, education, and life expectancy.  Tuberculosis accounted for 1.7 million deaths last year, \nwhile malaria killed more than one million, mostly children in Africa. At the same time, the \nspread of HIV/AIDS is triggering a crisis in international public health, the full scope of which \nwe are only beginning to recognize. The Joint United Nations Programme on HIV/AIDS \n(UNAIDS) estimates that 36 million people are now living with HIV or AIDS, 70 percent of \nthem in sub-Saharan Africa, where the disease is now the leading cause of death.  Nearly 60 \nmillion people have become infected with HIV since the beginning of the epidemic in the 1970's \nand over 22 million of them have already died from AIDS. \nThe U.S. has been the leader in research and assistance to battle these diseases, and the \nPresident’s recent proposed budget increase for the National Institutes of Health (NIH) reaffirms \nReleased by Chairman Rand Paul\n10that commitment.  NIH spent an estimated $90 million on international HIV/AIDS research in \nFY 2000, a number that is expected to rise to $130 million by the end of FY 2001.  The U.S. is \nthe largest single donor to UNAIDS and the largest contributor to international HIV/AIDS \ntreatment and prevention programs, a total of more than $460 million in FY2001. The Centers \nfor Disease Control and Prevention (CDC) spent over $100 million on HIV/AIDS prevention in \nFY 2001.  The U.S. Government has also dramatically increased its investment in international \nmalaria and tuberculosis efforts to $110 million in FY 2001. \nOur programs for taking care of our own population affected by HIV/AIDS and tuberculosis are \nalso world leaders.  HHS is providing over $10 billion in FY 2001 for HIV/AIDS-related \nassistance. This includes $795 million for prevention services through the CDC and other \nagencies, $1.8 billion for Ryan White medical and related support services for individuals and \nfamilies with HIV/AIDS, including the AIDS Drug Assistance Program; $2.2 billion for NIH-\nfunded HIV/AIDS research, including $280 million in vaccine research; $4.3 billion for \nHIV/AIDS-related coverage for Medicare and Medicaid beneficiaries.\nOver the last several years the scope of the infectious disease crisis in the developing world has \nled the U.S and other industrialized nations to make international public health an important item \non their foreign policy agendas.  In Okinawa in July of 2000, the U.S. and our G-8 partners \ncommitted to promoting investments and partnership to prevent and control HIV/AIDS, \ntuberculosis and malaria and to accelerate the development of new vaccines.  \nMore recently, wider public attention has turned to the challenges posed by these diseases as \npharmaceutical manufacturers have recently announced price reductions in developing countries \nfor their main anti-retroviral drugs.  These price cuts are a significant step forward and have \nsharpened debate on the question of how best to provide treatment to the populations most \naffected by the HIV/AIDS epidemic, malaria, and tuberculosis.\nAs Senator Bill Frist (R-TN) has recently suggested, the U.S. has a moral obligation to provide \nleadership in mobilizing additional resources for international health.  Stopping the spread of \ninfectious diseases is also in our own enlightened self-interest, given the threats HIV/AIDS and \nother maladies now pose to the political and economic stability of Africa and other important \nregions of the world.  It is in our public health interest to address tuberculosis as well, since 43 \npercent of U.S. TB cases are among foreign-born persons.  We also believe the U.S. has a duty to \nensure that those resources go to efforts that are medically and scientifically sound and will \ncontribute to the development of a sustainable health infrastructure in the most affected countries \nso that they can meet their challenges themselves over time.  \nReleased by Chairman Rand Paul\nProviding drugs at or below cost is only part of the solution.  Only a portion of the total HIV-\ninfected population will meet criteria for beginning antiretroviral therapy.  Far more need \ncommunity support and basic care for opportunistic infections, such as tuberculosis, and for \nprevention, care and treatment of sexually transmitted diseases.  Yet even if enough drugs to \ntreat every single infected person were sent, free of charge, to the African continent, an adequate \ninfrastructure to deliver them does not exist. There is no existing surveillance capability to \nensure that patients follow extremely complicated drug regimens accurately, or to monitor what \neffect the treatment has on the spread of the disease.  We should begin to help create the basic \nsystem to provide needed medications for opportunistic infections and symptomatic care, while \nalso building the more complex systems needed to provide antiretrovirals and other medicines \nsafely and effectively to avoid creating resistant strains, a lesson we have learned from efforts to \ncontrol tuberculosis.  \nAt the same time, we must continue to focus our efforts on prevention – a proven strategy that is \ncost-effective.  Individual and government accountability, behavior change and abstinence-based \napproaches that are culturally appropriate must be part of prevention efforts.  We have found that \nworking with local organizations, such as missionary hospitals and clinics, is an effective way to \nlessen the impact of the epidemic on individuals, families and communities.  We should also \nencourage countries to adopt comprehensive, evidence-based national strategies to ensure the \nresources we devote to this challenge are well-managed to produce the results we seek. \nThis is not, however, an issue that the U.S. Government can -- or should -- solve single handedly.  \nWe must reach out to a number of partners: our allies, the international community, \npharmaceutical manufacturers, non-profits like the Gates Foundation, and the faith-based \ncommunity that has infrastructure on the ground in the developing world.  A successful strategy \nto reduce the impact of infectious disease requires close donor cooperation to achieve maximum \nefficiency and avoid competition and duplication of efforts.  The Bush Administration stands \nready to contribute to a comprehensive plan to begin building a public health delivery system in \nAfrica and other parts of the world where HIV is rapidly expanding, an effort that should include \nprevention of new infections, care for the sick, provision of drugs, and training of medical \nprofessionals.\nTo this end, we appeal to the world to join us in establishing a new, multi-lateral Global Fund to \nFight Infectious Diseases, an international public-private partnership to provide grants for \nprevention and health infrastructure development focused on fighting HIV/AIDS, malaria, and \ntuberculosis.  \nWe believe the fund should operate under the following series of core principles:\n•Our goals are to prevent new infections and treat those already afflicted, to build the \ninfrastructure for health care and disease control, and to develop and train human resources.\n•We seek to support a community-driven process that identifies the needs of affected areas \nand allows communities themselves to develop an appropriate, comprehensive set of \nmedical, social and support services.\nReleased by Chairman Rand Paul\n12•We must build on already established institutions and networks in local areas, including \nresearch relationships, to ensure we are creating human and physical capacity that is \nsustainable over the long run.\n•We support an integrated approach focusing on prevention, delivery, care and treatment.  We \nalso wish to include components for health infrastructure improvement, surveillance of \nepidemics and care for orphans.\n•Our intent is to start with a relatively limited number of projects, to research which \napproaches work best and are adaptable to local conditions, before scaling up over the next \nfew years.\n•We will outline and agree to fund a core menu of “best practice” programs, according to \ncertain quality standards and experience with evidence-based models proven to work in \ndeveloping countries.\n•We will solicit letters of intent from governments and non-governmental organizations \n(NGOs), especially faith-based groups, that describe plans to implement one of more of our \ncore models in local areas.\n•We will require demonstration of local leadership and adherence to international standards of \nfinancial accountability and transparency.  We will give preference to comprehensive plans \nthat involve governments and civil society working together.\n•We will link our efforts in health to expanded programs in the areas of education and \nnutrition in an international parallel to the Administration’s campaign to “Leave No Child \nBehind.”\n•We are committed to a policy of promoting intellectual property protection, including for \npharmaceutical patents, because of its critical role in the rapid innovation, development, and \ncommercialization of effective and safe drug therapies and vaccines.  Financial incentives are \nneeded to develop new medications.  No one benefits if research on such products is \ndiscouraged.\nWith more than 50 years of experience with health projects and a proven institutional capacity to \nmanage large financial transactions, the World Bank should serve as the fiscal agent for the \nFund.  As trustee, the Bank would not be involved in matters of policy, but would serve as the \nrepository for contributions from both governments and private donors and ensure the prompt \ndisbursement of grants.  A small Executive Secretariat housed at the Bank and jointly staffed by \nthe Bank, UNAIDS and the World Health Organization would undertake the day-to-day \nmanagement of the trust fund, including soliciting grant proposals. \nA high-level Governing Council would provide the overall strategic direction for the fund.  \nDonors that contribute at least $xx million and representatives of the developing world (serving \nin their own personal capacity and not as the emissaries of any particular state) would form the \nmembership of this board.   The Council would fully control all fund decisions, including \nReleased by Chairman Rand Paul\n13determining programmatic allocations, operational rules and procedures, policies and strategies, \napproving financial plans and work programs, and attracting additional donations.  In addition, \nthe Council would make the final determination of the list of “best practice” models the fund \nwould underwrite and the criteria necessary to win approval of letters of intent.  The president of \nthe World Bank, the Director General of UNAIDS and the Director General of WHO would be \nex officio, non-voting members of the Council.\nMuch like a university endowment, the fund would have a two-tiered financial structure.  The \n\"core fund\" would comprise a pool of resources that could be support any activity falling within \nthe work program and eligibility criteria approved by the Governing Council (except for limited \nrestrictions by donors).  At the same time, however, the fund would permit donors to earmark \ncontributions for use on their particular priorities, as long as they fell within the overall purposes \nand priorities of the trust fund.  Both “core” and dedicated resources would be combined in each \ngrant in a way transparent to the recipient.\nComposed of international scientific, medical, public health and development experts, a \nScientific and Public Health Review Committee would perform a rigorous technical peer review \nprocess to assess the grant applications.  Drawn from developing and developed countries and \ninternational organizations, with experience in the affected countries, such as UNAIDS and \nWHO, the Committee will make final decisions about the feasibility and sustainability of \nproposed programs according to criteria for each “best practice” model prescribed by the \nGoverning Council.  The Committee will also operate under broad guidelines that spell out the \nrecommended ratio of expenditures on prevention, treatment, and research the Council would \nprefer projects follow.\nThe models we might support could cover primary prevention and education programs up to \nmore sophisticated, comprehensive efforts that could involve basic care and treatment, controlled \ndelivery of antiretroviral therapy, medical training, and clinical trials.  Applicants will determine \nwhich one of the approved packages would be most appropriate and useful for the local context.  \nSome might ask for resources to upgrade or build health centers to deliver basic HIV/AIDS or \ntuberculosis care and prevention programs.  Others might want help with such programs plus \ntraining for physicians, lab workers, nurses, community health volunteers, and pharmacists.  Still \nothers might integrate both models with the provision of complex drug treatment.  Every funded \nmodel will also include localized monitoring to assure the efficacy of the grant and to help \ninform the selection of proposals in the future.  We will also emphasize technical assistance to \nthose countries and organizations that are unable to satisfy our criteria in their letters of intent, so \nthat over time they might also be able to participate.\nWe believe the nearly complete drive to eliminate polio offers us a model to develop a strategy \nto control HIV/AIDS and the other major killer infectious diseases.  The Administration is \ncommitted to making the fight against the global HIV/AIDS epidemic and other killers a priority, \nand we ask our friends and partners to join with us in a single, worldwide effort.\nBullets for above document are listed below:\nDraft—For Official Use Only\nReleased by Chairman Rand Paul\n14Global Fund to Fight Infectious Diseases\nBush Administration response to the crisis HIV/AIDS and other diseases have triggered in \ninternational public health.\nMulti-lateral, international public-private partnership to provide grants for prevention and \nhealth infrastructure development focused on fighting HIV/AIDS, malaria, and tuberculosis. \nComprehensive plan to begin building a public health delivery system in Africa and \nelsewhere, an effort that should include prevention of new infections, care for the sick, \nprovision of drugs, and training of medical professionals.\nCooperation by many partners: our G-8 allies, the international community, pharmaceutical \nmanufacturers, non-profits like the Gates Foundation, and the faith-based community that has \na presence on the ground in the developing world.\nGoals\n•Prevent new infections, treat those already afflicted, build infrastructure for health care and \ndisease control, and develop and train medical personnel.\n•Identify the needs of affected areas and allow communities themselves to develop an \nappropriate, comprehensive set of medical, social and support services.\n•Build on already established institutions and networks in local areas, including research \nrelationships to ensure countries can sustain the fight on their own over time.\nApproach\n•Integrated approach focusing on prevention, delivery, care and treatment, along with \ncomponents for health infrastructure improvement, surveillance of epidemics and care for \norphans.\n•Start with a relatively limited number of projects, to research which approaches work best \nand are adaptable to local conditions, before scaling up over the next few years.\n•Link our efforts in health to expanded programs in the areas of education and nutrition in an \ninternational parallel to the Administration’s campaign to “Leave No Child Behind.”\n•Work cooperatively with major pharmaceutical companies to ensure greater availability of \naccess to key drug treatments.\n•Continue to promote intellectual property protection, including for pharmaceutical patents, \nbecause of its critical role in the rapid innovation, development, and commercialization of \neffective and safe drug therapies.\nStructure\n•World Bank as trustee-- not involved in matters of policy, but repository for contributions \nfrom both governments and private donors\n•Small Executive Secretariat jointly staffed by the Bank, UNAIDS and the World Health \nOrganization to undertake day-to-day management of the trust fund, including soliciting \ngrant proposals. \n•Two-tiered financial structure like a university endowment:  \n•\"core fund\" of resources to support any activity falling within the work program and \neligibility criteria \nReleased by Chairman Rand Paul\n15•donors could also earmark contributions for use on their particular priorities, as long as they \nfell within the overall purposes and priorities of the trust fund.  \n•Both “core” and dedicated resources combined in each grant in a way transparent to the \nrecipient.\nGovernance\n•High-level Governing Council to provide overall strategic direction.  \n•Donors and representatives of the developing world (serving in their own personal capacity);\n•President of the World Bank, Director General of UNAIDS and Director General of WHO as \nex officio, non-voting members.\n•Council to fully control all fund decisions, including determining programmatic allocations, \noperational rules and procedures, policies and strategies, approving financial plans and work \nprograms, and attracting additional donations. \nGrant-Making\n•Governing Council to outline and agree to fund core menu of “best practice” programs, \naccording to certain quality standards and experience with evidence-based models proven to \nwork in developing countries.\n•Fund to solicit letters of intent from governments and non-governmental \norganizations (NGOs), especially faith-based groups, that describe plans to \nimplement one of more of core models in local areas.\n•Applicants to determine which approved packages most appropriate and useful for \nlocal context. \n•Models could range from simple prevention and education programs to more \nsophisticated, comprehensive efforts that could involve basic care and treatment, \ncontrolled delivery of anti-HIV therapy, medical training, and clinical trials.\n•Emphasis on individual and government accountability, behavior change and \nabstinence-based approaches.\n•Technical assistance to countries and organizations unable to satisfy our criteria in their \nletters of intent, so that over time they might also be able to participate.\n•Scientific and Public Health Review Committee to perform rigorous technical peer review \nprocess to assess letters of intent.\n•International scientific, medical, and development experts drawn from developing and \ndeveloped countries and international organizations\n•Empowered to make final decisions about feasibility and sustainability of proposed programs \naccording to criteria for each “best practice” model prescribed by the Governing Council.  \n•Broad guidelines that spell out the recommended ratio of expenditures on prevention, \ntreatment, and research the Governing Council would prefer projects follow.\n•Demonstration of local leadership and adherence to international standards of financial \naccountability and transparency required.  \n•Preference given to comprehensive plans that involve governments and NGOs working \ntogether.\nReleased by Chairman Rand Paul\n17well. If you have a few moments, please take a look below. Do you have answers\nfor my questions? Feelings about these issues?\n I welcome responses......Hey, I'm a reporter: I ask questions and hope to get\nthoughtful answers.\nThanks very very much for your time and thoughtful attention.\nLaurie Garrett\nlgarrett@newsday.com\n***************************************************************\nGregg,\nDid you see Newsday's editorial two days ago? Total support for your position\nregarding treatment access.\nLast night I was in a screaming match with a  doc who does work in South Africa. An\nAmerican. He actually said, \"I don't give a fuck about microbicides! I don't\ngive a fuck about prevention! Fuck all you public health assholes! This is about\nwhat is morally right --- treating. Fuck everything else! Bitch!\"\nUnbelievable.\nIt is absolutely amazing to me that the classic Public Health v Organized\nMedicine dichotomy has so deeply divided the AIDS community all of a sudden.\nCorrection: the do-gooder community of Westerners. I haven't heard many African\nvoices chiming in on this one.\nWhy the hell is there any dichotomy? Haven't we learned anything from all the\nmistakes made with TB, drug resistant bacteria, vaccine campaigns......? Jesus!\nI have never seen a moment so desperately in need of leadership. Somebody needs\n----   IMMEDIATELY  ---  to call an emergency scientific meeting, with a very\nvery focused agenda, super-fast.  We need:\n-  Assessment of the validity of the Harvard model. And of other HAART treatment\nmodels. With emphasis on AFRICAN reactions and desires to said model (and not\njust five African academics who have been collaborating with Americans or\nEuropeans for years. REAL people, who toil in thankless jobs in horrible clinics\nall over the continent.)\n- Assessment of the questionable validity of a few assumptions in that report,\nincluding:\n     - HAART is a public health measure because is lowers transmissability (oh\nreally? ALL studies of the    matter at the Human Retrovirus meeting showed that\nthere was no clear correlation between blood       viral load and semen or\nReleased by Chairman Rand Paul\n18vaginal viral loads. Do we really know this is true? We have ONE study ---  The\nRakai survey. That's it.)\n     - HAART will, to quote Sachs, \"save millions of lives\". Really? But we now\nhave 3 studies on large       patient pops. showing the life expectancy benefit\nof HAART in USA and Europe is perhaps as little, on     average, as 1.5 years,\nno more than 5 years. That's not even a \"saved life\" in cancer terms, as in \"5\nyear survival rates\".  When grim data came out a year ago critics charged that\nthe high failure rates   were due to large populations of Americans who were\ngetting diagnosed and treated in late stage HIV    infection. Well, now we have\nchanged the treatment reccommendations to specifically say that later\nstage treatment is preferable --- so much for that explanation, no?  What\nreally, truely, is the statistically valid efficacy of HAART?\n- In terms of the pentultimate concern that I believe (I hope) is the bottom\nline for all sides --- SAVING LIVES --- what would be the impact of a massive\nspending commitment aimed at:\n     - cleaning up the blood supply (less than 10% of which globally, according\nto WHO, is currently          screened for Hep B, C and HIV)\n     - global large scale distribution of autodestruct nonreuseable syringes and\nMANDATORY coupling of    all injectable drug and vaccine products with such\nsyringes. In other words, if a vial of measles          vaccine contains 10\nchild doses, if should be vaccum sealed to a slab of cardboard on which are 10\nautodestruct syringes. Talk about immorality! How in the world can ANY\nhumanitarian, medical or UN   agency POSSIBLY justify distributing vaccines in\ncountries with greater than 5% HIV rates without        attaching enough\nautodestruct syringes to ensure that EVERY SINGLE CHILD receives a sterile\ninjection? I have seen this with my own eyes ---nobody can BS this one. I have\nbeen in African villages      where 20 kids were vaccinated with the same\n\"single use\" plastic syringe. And I have been in        Ukarianian hospitals\nwhere syrgines were passed from child to child like candy. Consider these\npoints:\n          - Russia estimates that by 2006 12% of her population will be HIV+,\nand nearly all the infected        will be under 29 years of age, IVDUs. It's\nnot a sexual epidemic --- YET --- in Eastern Europe          and ex-USSR. The\nopportunity to stop that part of the pandemic COLD is there. It's easy. It's\n     mass access to autodestruct syringes. And it's this question: which\nsocietal concern should       guide HIV policy --- hatred of narcontics users,\nor fear of the virus? Am I wrong about this?\n          - CDC just released a report indicating there were 19 BILLION (yup)\nmedical injections last       year globally, some 90% of which were\nunnescessary. And 80% in Asia were nonsterile, 75%           in SS Africa and\n70% in ex-USSR. PHYSICIAN DO NO HARM: why the hell hasn't anybody\nasked what %age of this pandemic is nosocomial, iatragenic?????\nReleased by Chairman Rand Paul\n19     - creating a prize --- say, $10 million --- as incentive to the first\nscientific team that develops a truely safe   and effective vaginal microbicide\nthat can be affordably mass produced. (Total global current\nmicrobicide R&D is now less than $50 million, as far as I can tell.) Would that\nwork? Just how large an  intellectual problem is anti-HIV microbicides? Isn't it\na helluva lot easier than coming up with a 90+%    effective preventive vaccine?\nSo, we're working on that vaccine --- FINALLY. Why not a serious\ncommitment to the microbicides, too? (Is it the word \"vaginal\"?)\n     - linking treatment tightly with prevention education, in a quid pro quo\nmanner (tax payers are        subsidizing your HAART, and you are free to live\nwithout prejudice or discrimination, stay healthy and   continue to have a rich,\nfull life. BUT, you must in return understand you have a social responsibility,\nand cannot knowingly do anything that might spread your virus to others. This\nincludes females, who,   you African males disdain and consider subhuman. This\nincludes male & female prostitutes who you    pay to accept risk.) I know of no\nrigorous case controlled study done anywhere in the world that asks    whether\nor not this will work. Have I missed them?  But clearly, in the USA and Europe,\na very         significant %age of HAART recipients feel NO social obligation\n---- why else would we have resurgent    syphilis, gonorrhea, HIV and a national\n14% DRUG RESISTANT HIV rate?\n     What I'm really asking here is whether the fine difference between\n\"treatment\" and \"cure\" can be fully      understood, and integrated into\nbehavior, without intense counseling, etc. Obviously we have           problems\nwith comprehension here in the richest country in the world, especially among\ncollege        educated white middle class males.\n     - reassessing the results of the Levine Report and the seeming tendency for\neverything at NIH to          revert. Would a serious recommittment to\naddressing long unanswered basic science questions be in     order right now?\n     - before we start mass distributing HAART, do we know:\n          - which of the drugs are heat sensitive? What is the half life of a\nprotease inihibitor that is stored            under a tin roof in 90% humidity\nat consistent ambient temperatures above 90 degrees F? Are        there Cold\nChain issues with any aspects of HAART or OIs treatment?\n          - which of the drugs have interactions with antimalarials? With\nantiparasitics? With rotgut              booze? with other drugs that have\nundergone chemical change due to storage in above                 conditions?\n          - what percentage of the target populations have TB, and what %age of\ndeaths in the local           HIV pop are due to TB? Do we know everything we\nneed to know to guide co-treatment of TB           and HIV with TB-DOTS and\nHIV_DOTS?\n          - why TB DOTs has largely failed globally, resulting in MDR-TB strains\nsurfacing in 112              nations over the last 6 years (when it was limited\nReleased by Chairman Rand Paul\n20to less than 10 countries before then)? Do we           really know how much of\nthat failure is due to insufficient monetary support, how much to\ninfrastructural failure and how much to the DOTs model, itself, in varying\ncultural and political        settings?\n          - which HAART combos are least likely to lead to multiple drug\nresistance, or cross resist-       ance and how that compares with the cheap\ncombos proposed by CIPLA and MSF, etc?\n          - what key factors have, for the last decade, prevented distribution\nof the Essential Drugs lists       in most African countries? (Hint: it aint got\ncrap to do with the cost of the drugs, prices set by              manufacturers\nor WHO policies. It has everything to do with corruption, black markets,\n     Russian mob,  bad roads, lack of ship off-loading capacity at ports,\nwarehousing in                high heat, etc etc.)\n     - WHY AFRICA? OK, I'm asking a rhetorical question here. But if global\ndistribution of HAART makes sense for ssAfrica, why not also for Vietnam?\nUkraine? Cambodia? Russia? Estonia? Is it a question of a certain cut-off, such\nas \"societies with greater than 10% HIV+ rates?\"  Or 5%? Who has the right to\nmake that decision? What are the moral issues here? Do white doctors from\nAmerica  and Europe get to choose which HIV poor populations on earth get to\nhave freebie drugs? Does WHO decide? MSF? YOU??????  (If I were an AIDS doc in\nBombay or Kiev right now I would be mighty pissed off....).\n     - If, indeed, Senegal, Uganda, Thailand and Brazil have not only lowered\ntheir mass HIV rates, but sustained lowered levels, what worked? (From my\nobservations in Uganda I would say the lowering was transient, and it is now\nresurging in much of the country. It was not sustained. Senegal never did have a\nhigh rate: why? All of west Africa has lower rates....why? Many believe it has\nlittle to do with prevention programs or drug access, and everything to do with\nmale/female power balance issues and female access to the cash economy.)  Jon\nMann for ages had a mantra: if a prevention effort works, why? and why isn't it\nimmediately replicated elsewhere?\n     - Why were all the questions raised in opposition to phase 3 vaccine trials\nnot raised for largescale HAART? Remember when NIAID decided to can Phase 3\nvaccine studies? The reasons were not so much about the likelihood the vaccines\nwould work (nobody thought they would), but concerns that people who received\nthe vaccines would then put themselves and their partners at higher risk, based\non the assumption that they were at least somewhat protected. That was shouted\nfrom the rafters, and continues to be a huge issue. NIH and CDC have spent loads\nof money trying to figure out how to counsel vaccine volunteers, what to say\nabout safe sex, etc. It has been an ENORMOUS concern in the vaccine arena ---\nwell in advance of actually having a product worth testing. But with HAART?\nBupkiss. Nada. Zilcho. This seems a glaring contradiction bordering on mass\nhypocrisy.\nReleased by Chairman Rand Paul\n21OK, that's my venting for the day.\nI try to report the truth. I strive for balance. It's getting harder because\neverybody is fudging the truth now. Everybody is letting their agendas guide\npolicy ---NOT the science. For the most part, as far as I can tell, the science\nhas never really been done. Please, prove to me that I've merely missed it.\nLaurie\nApril 15 – 20 – Trip to Uganda\nTRIP TO UGANDA\nApril 15 – 20, 2001\nApril 15 – Leave Washington, DC\nApril 16 – Arrive Entebbe/Kampala at 7:00 PM \nApril 17 – Spent the day  touring medical facilities and making patient rounds at various \nhospitals and facilities in Kampala.  Jack Killen (Director, Division of AIDS, NIAID) \nwas my traveling partner.\nStarted the day off by meeting with Nelson K. Sewankambo (Dean, University of \nMakerere School of Medicine.  Went off to the Mulago Hospital Antenatal Clinic \nescorted by Professor F. Mmiro, a charming and enthusiastic 50-ish OB-GYN doc and \nLaura Guay, a pediatrician.  This was a most extraordinary experience. I witnessed and \ninteracted with  large numbers of Ugandan women who come to the clinic for antenatal \ncare.  If they request, they are screened for HIV infection and counseled.  Most of them, \nalthough they come to the antenatal clinic, deliver at home unless there are complications \nsuch as twinning or toxemia.  The percentage of HIV-positivity among them used to be \n>40 percent.  Now it is approximately 20 percent.  The physical nature of the clinic was \nthat of open rooms connected to outside virandas.  The clinic was packed. Many women \nlooked healthy, but several clearly had HIV disease.  Since no treatment is available, no \none from among the clinic patients gets treated for HIV.  If they can pay something, they \nget treatment for OIs and many get prophylactic Bactrim.  Patients who can pay fully will \nget reasonable care. I had to hold back my tears.\nNext we went  on to the Makerere University (MU)-Johns Hopkins University \n(JHU) Project that is heavily funded by NIAID.  We were shown around by Laura Guay \nand Phillip Musoke  Mudido, a Ugandan physician.  Laura is extraordinary.  She is an \nAmerican woman who has been in Uganda for 13 years.  She is single and has adopted \n(or at least supports) a few Ugandan children who are AIDS orphans.  They showed me \naround their clinical research projects.\nNext went to the U.S. Embassy to meet with Ambassador Martin Brennan, a 40-\nish man who appeared extremely interested and knowledgeable about HIV in Uganda.  I \nReleased by Chairman Rand Paul\n22discussed with him the NIAID initiatives as well as my recent interactions with Secretary \nThompson, the State Department, NSC, Domestic Policy Council, and the White House \nconcerning the development and implementation of a White House and US Government \npolicy and plan of action for treatment of HIV in Africa and AIDS care in Africa. At the \nmeeting was Ms. Dawn Liberi, USAID Chief for Uganda and Jonathan Mermin, a CDC \nperson assigned to the US Embassy.  Excellent meeting.  Extraordinary security related to \nthe terrorist attack on the Nairobi Embassy last year. We could not even take cell phones \ninto the ambassador’s office.\nNext went on to the Joint Clinical Research Center (JCRC) escorted by Peter \nMugenyi and Cissy Kityo.  Like Nelson Sewankambo, Peter is clearly an important \nphysician in Uganda and the JCRC does much clinical research on HIV/AIDS.  It was \nunclear how patients get put on a protocol and are followed at JCRC versus getting \nadmitted as a regular patient to Mulago Hospital.  The JCRC is the source of many of the \nimportant clinical studies that have come out of Kampala.  I was impressed by the \nsophisication of their operation.  Many Africans and some expatriots (mostly Americans) \nwork here and also at other facilities that I visited including the Rakai Project (see \nbelow).  Most Staff (PH.Ds, MDs, MPHs and even technicians have spent some time \nlearning techniques and theory in the USA.\nNext went on to make Ward Rounds in the Department of Medicine at Mulago \nHospital with Roy Mugerwa and Harriet Mayanja.  This was clearly one of the defining \nmoments of the trip for me and changed the way I think about the reality and potential of \nAIDS care and health care in general in Uganda and Africa since Uganda is considered \none of the best.  The wards were packed; people were lying in hallways, in open air \nvirandas, and some were waiting with their families to gain admission.  Most looked \nextremely ill and cachectic.  Others were reasonable fit, but obviously acutely ill. I have \nrounded on thousands of patients over the years, but I have never seen anything like this \nexcept maybe when I made rounds at the King Edward Hospital at the University of \nNatal in Durban, South Africa in July, 2000.  The difference here is that virtually no one \ngets treated specifically for their disease because of lack of anti-retrovirals and inability \nto pay even for drugs for OIs, TB and malaria.  The rule (with few exceptions is that if \nthe patients cannot pay something (even a dollar or 2), then they get no specific \ntreatment. If they can pay, but are poor, they do “cost sharing” whereby they pay for part \nof what is to be done (i.e. chest x-ray, medications, etc.); however, it is severely limited \nby the amount which they cost share. If you are relatively wealthy and can pay, you go to \na different ward and anything is possible diagnostically (chest x-ray, CT, blood work) \nand therapeutically (ARV, OI treatment, etc.).  I saw patient after patient with HIV \ndisease (mostly diagnosed not by serology since ELISA was too expensive - $4.00) and \nOIs.  Overwhelmingly, patients had active TB.  Here again, diagnosis was made \nclinically without chest x-ray and frequently without sputum smear and culture.  \nCertainly, no CTs, bronchoscopies etc.  I remember specifically a 17 year girl who had \nHIV disease (diagnosed by wasting and oral thrush) and likely cryptococcal meningitis \n(dx made clinically); they were considering doing an India ink stain on CSF, but decided \nnot to since they could not do anything for her anyway since she could not afford \namphotericin or fluconazole.  The plan for the patient was hydration, analgesia and \nReleased by Chairman Rand Paul\n23discharge home to her mother.  It was tragic!  Again, I could barely hold back tears. A \nsimilar case was that of a man in his 30s with obvious HIV disease and likely \ndisseminated TB.  Again, no specific therapy.  It hit me like a truck!  We were here in \nUganda talking about the possibility of AIDS care now that drugs would likely be \navailable at markedly reduced prices for Africa (see other discussion regarding tidal wave \nof movement to provide drugs).  The problem that was clear to me was that even in the \nMulago Hospital, which is one of the best in Africa there was not even basic health care!  \nImagine (see below) in the rural areas where there are hardly any doctors.  In addition, \nwhat kind of training were the house staff getting when they could not definitively \ndiagnose and certainly only rarely treat anyone?  It became clear to me that we must use \nthe enthusiasm about providing AIDS drugs to Africans to catalyze an effort to address \nfundamental health care in Africa.  Even in the best of places (Uganda), there is hardly \nany health care infrastructure.\nApril 18 -  Visit to Rakai. Went with Jack Killen (who was with me throughout the entire \ntrip).  Leading the trip was Nelson Sewankambo, David Serwadda, T Lutalo, and F. \nWabwire.  This was one of the highlights of the trip.  NIAID funds, in collaboration with \nMakerere University, Columbia University, and Johns Hopkins, a project in the Rakai \ndistrict of Uganda (southwest of Kampala towards the border with Tanzania and \nRwanda).  The project has been going on for about 13 years and has been the source of \nmany major papers including most of Tom Quinn’s work on the role of STDs in HIV \ntransmission, the relationship between viral load and transmission in discordant couples, \nand the protective effect of circumcision on transmission of HIV, among other studies.  \nThe site was inspiring, particularly the dedication of the staff who were mostly young \nUgandan MDs, PH.Ds, technicians, nurses, etc.  Also included among them were a few \ndedicated American expatriots who were either permanent or doing a fellowship (usually \nout of Hopkins).  Of note, were Noah Kiwanuka, a Ugandan, born in Rakai, who went to \nmedical school in Kampala and received his MPH from Hopkins.  He was as good as \nthey get and clearly was in command of the project.  Also of note was Mary Meehan, an \nAmerican wife, mother of 3, and a scientist who had been living with her journalist \nhusband in Uganda and working at both the Uganda Virus Institute in Entebbe and the \nRakai project. \nOf particular note on the trip was the level of available care in this district, which \nmade Mulago look modern.  I visited the Kalisizo hospital as well as a “subdistrict” anti-\nnatal and general medical clinic.  There was almost no physical access.  The best of the \nroads were almost impassable.  There were large ruts and gigantic potholes in the \nunpaved road.  Even with a four-wheel drive van, we barely made it since it was the rainy \nseason and segments of the road were partially washed away.  I will never forget the \npatients that I saw at Kalisizo and the rural clinic.  There were benches full of patients \nwaiting to be registered and hallways full of people waiting to be seen.  Some patients \nwere tended to by their families and were lying on the walkways and hallways or on the \nlawn without a bed.  The pediatric ward had 2 children per bed.  I was told that among \ntheir other diseases such as HIV and TB, the majority of the people in the wards, \nespecially the children, had malaria.  I say several children being transfused for malaria-\ninduced anemia.  Now in 2001, the blood supply is well-screened.  I can only imagine \nReleased by Chairman Rand Paul\n24how many children got HIV-infected years ago before blood screening by these \ntransfusions given for malaria.  The faces of the patients were haunting.  They were very \nquiet; no one made a sound, even the most ill.  The Kalisizo hospital was staffed by 3 \nMDs whose training was medical school and 1 to 2 years of house staff training.  These \npeople did everything that did not absolutely require secondary and tertiary care.  They \nperformed deliveries, Caesarean sections, abdominal surgery (including bowel resection \nand anastomosis), fractures and other trauma as well as some types of chest surgery.  \nWith all due respect to their dedication, I thought at the time and still do now that despite \nthe fact that on-the spot training is critical, these people could not be highly skilled \nsurgeons since the only formal training that they had before they came to this place was a \ncourse in “surgical techniques” in medical school.  This involved resecting bowels of \nsheep and other animals.  There was no senior attending here supervising them.\nAn important point about the visit was the extraordinary sophistication and \ndedication of the staff of the Rakai Project.  They were amazingly organized in their \nsystem of following patients on study. They had a large number of counselors and field \nworkers who went out into the field and tracked and counseled their patients.  They went \nout by truck, motorcycle or on foot.  They were mostly young Ugandans who were \nclearly dedicated.  The success of the projects clearly depended on them.\nApril 19 – The meeting entitled “AIDS Care in Africa” started today and I gave a brief \nopening address that I had carefully prepared with a written statement and slides that I \nhad asked Greg Folkers to immediately post on the NIAID Website after the talk (please \nsee copy of speech).  Given the tidal wave of enthusiasm of getting antiretroviral drugs to \nAfricans, there was in the global community immediately prior to this meeting a major \ndichotomy between those who were concerned that providing treatment would suck off \nresources from prevention and other activities and those who felt that we should proceed \nvigorously towards treating African with anti-retrovirals now that the prices of drugs \nwere markedly decreased.  It was clear to me from my reflections before the meeting (see \nmy speech) and from my 2 days of observing first-hand the situation in Kampala that \nthere needed to be a balance between treating Africans and accelerating the prevention \nmeasures.  Also, and extremely important was the fact that as mentioned above, there was \nhardly any health care infrastructure in Uganda (which was better than most African \ncountries).  I stressed that we must act in a comprehensive manner by building \nsustainable health care and research infrastructure and by also considering other basic \nhealth care issues such as clean water; treatment and prophylaxis for malaria, TB; \nvaccinations against childhood diseases; treatment of diarrheal and acute respiratory \ndiseases.  My remarks were extremely well received and clearly the meeting organizers \nand participants were pleased that I was there and were looking to me for sober \nleadership in this difficult problem.\nAn interesting event transpired at the morning session.  Ugandan President \nMuseveni was scheduled to speak immediately before my talk.  He was late and so I gave \nmy talk and chaired the session for about 1 ½ hours.  Just at the end of the question \nperiod, the President walked into the Ballroom of the Sheraton Hotel where the meeting \nwas held.  He was accompanied by his Chief Deputy Dr. Ruhakana Rugunda.  Everyone \nincluding myself left the stage to make way for the President.  I took a seat in the first \nrow of the audience.  Just then, Dr. Rugunda stepped down from the stage, grabbed my \nReleased by Chairman Rand Paul\n25arm and led me to the stage saying that the President very much wanted me to sit down \nnext to him during his speech.  I was told that the President has long been an admirer of \nme and respected all that I had done for AIDS.  The President greeted me with a \nhandshake and began his speech by recognizing me to the audience.  After his speech, Dr. \nRugunda asked me to say some words.  I extemporaneously spoke into the microphone \ndirectly to the President and told him that he was a model of African leadership and that \nhe was highly respected in the USA and throughout the world for his sensitivity, insight \nand leadership in the fight against AIDS, and that we often refer to the “Uganda Model”.  \nI told him that when I returned to the USA part of my responsibility was to report back to \nmy Minister of Health, Secretary of DHHS, Gov. Tommy Thompson and the staff of the \nWhite House.  I said that I would tell them that what we have heard about President \nMuseveni was true and that you were indeed an inspired leader and that we look forward \nto continuing to work with him. He was obviously very pleased with my remarks and \ngave me a hearty handshake and a very warm smile.\nAt dinner that night, The Rockefeller Foundation hosted a working dinner for \nseveral of the participants to discuss the meeting.  I was asked to serve as rappateur for \nmy table and we had lively discussions about where we go next in this process.\nApril 20, 2001 -  Last day of meeting and my day of departure.  Discussions continued \nand we all realized how difficult it would be to accomplish this lofty goal of providing \nantiretroviral therapy for Africans.  There was good news during the meeting that the \nconsortium of drug companies had withdrawn their ill-advised lawsuit against South \nAfrica for trying to distribute drugs outside of patent restrictions.  Now the South African \ngovernment (which has been extremely problematic at best with President Mabeki \nshowing bizarre behavior regarding whether HIV causes AIDS) would have to move to \nstart treating their people since the drug companies could no longer be considered the \nobstacles.\nLincoln Chen of the Rockefeller Foundation gave a very nice summary of the \nmeeting as the last speaker and used many of my direct quotes from my talk and my \ndiscussions to make important points.  One in particular was my warning to beware of the \n“ethical police” who would only want us to do studies in Africa that would be acceptable \nand relevant in the USA.  This centers around the issue of the Declaration of Helsinki \nwhich states that the control arm of any trial in a developed country (or anywhere) would \nhave to be the best possible therapy for the disorder.  By “best possible therapy”, they \nmean best anywhere.  This would make research to answer questions that are relevant to \nAfrica virtually impossible.  We all agree that high ethical standards are necessary; but to \ndemand the best therapy anywhere as the control arm in a nation where there is virtually \nno health care and which would not be relevant to Africa is unrealistic.  Everyone in the \naudience agreed and gave me a long applause.\nAfter the meeting, we drove to the Uganda Virus Institute in Entebbe on the way \nto the airport to visit Dr. Sylester Sempala, a well known Ugandan virologist whom I had \nmet previously at a meeting in Naples, and Mary Meehan.  It was a nice facility (by \nAfrican standards) and the view was magnificent.  It was perched overlooking the shores \nof Lake Victoria.\nReleased by Chairman Rand Paul\n26This was an extremely important trip for me in that it gave me a first-hand \nappreciation of the dire situation in Africa, not only with regard to HIV/AIDS, but also \nwith regard to heath care in Africa in general.  I believe that this trip will change me \ndramatically towards a direction that I have already been heading for the past couple of \nyears.  This direction is towards a greater effort and interest on my part in global health.\n  \nApril 24, 2001 – Spent 30 minutes on the phone with Secretary Tommy Thompson \nbriefing him on my trip to Uganda.  Thompson is getting ready to brief the Cabinet and \nconvince them that the USA should take a leadership role in the AIDS in Africa initiative.  \nHe mentioned that he will rely very heavily on me to help him accomplish this important \ngoal.\nMay 5, 2001 – Important conference call with DHHS.  On call was Art Lawrence \n(Acting ASH), Eric Goosby, Helene Gayle, ASH-Designate Claude Allen, Jeff Copeland, \nTerrell Halaska, Bill Steiger.\nWe (Me, Jeff Copeland, Terrell Halaska, Bill Steiger)  had been working for \nweeks on putting together a position paper for Secretary Thompson on the response to the \nchallenge of AIDS in Africa.  UN Secretary General Kofi Annan will come out with a \nproposal for a Global Trust Fund for AIDS in Africa in June at a Special Session of the \nUN General Assembly.  The White House used our White paper as background to get out \nfront on the issue and announce that the USA would contribute to the Global Trust Fund.  \nWe were told on the call that the Cabinet Council met with Pres. Bush.  The Cabinet \nCouncil consisted of Secr. Thompson, Secretary Colin Powell, Carl Rove, OMB Director \nMitch Daniels, Domestic Policy Council Margaret La Montagne, Pres. Counsel \nRodriguez and members of VP Cheney’s office.  The decision was made for Pres. Bush \nto announce on May 9, 2001 that the USA would contribute in FY 2002 $200 million to \nthe Trust Fund.  However, of great relevance to me and NIH, there would be no new \nmoney.  It would all be budgetary offsets.  Of the $200 million, HHS would give $100 \nmillion, Dept. of State would give $60 million and $40 million would come from the \nexisting AIDS trust fund.  Of the $100 million from HHS $95 million would come from \nNIH as a transfer.  $65 million would come from B & F, $25 million from NIAID, $5 \nmillion from NIH OD and $5 million from cyber security.  Of considerable note is that \nBill Steiger mentioned on the call that he was very “grateful for the generosity of Tony \nFauci who has offered to provide the $25 million from his FY 2002 appropriation.  Since \nNIAID will get a 14.2% increase, when you subtract the $25 million, this means we \nwould still get a $260 million increase in our >$2 billion budget.  It would not be taken \nout of the base, but would be a one time transfer.”.  The fact is that I had offered to help a \nfew weeks earlier in my conversation with Terrell Halsaka.  By “help” I was not referring \nto the Trust fund; I was referring to putting more research money into the AIDS effort in \nAfrica.  There was no way that I offered $25 million for the trust fund.  However, I did \nnot object over the phone since it was obviously a done deal and the President was going \nto announce it.  It would look very bad if I objected.   There was nothing that I could do \nbut turn this “challenge” into an “opportunity”.  In the end, it really is the right thing to \ndo since it shows leadership in an important cause and our base was not impacted.  I will \nprobably take some heat from our constituencies.  However, who can cogently argue \nReleased by Chairman Rand Paul\n29August 2, 2001 – Had meeting at NIH (Building 31, 7A-24 Conference room called by \nRichard Falkenrath of the National Security Council who is Ambassador to the Biological \nWeapons Convention.  Present at the meeting were:  John La Montagne, Thomas Monath \n(Acambis Co.- Vice Pres. For Research and Med. Affairs), Stuart Nightingale (DHHS), \nRobert Mikulak (Director, Office of Chemical & Biological Weapons Convention, Dept. \nof State), Carole Heilman (DMID/NIAID), George Poste, Matthew Meselson (Harvard), \nMargaret Hamburg, Joshua Lederberg.\nPurpose of meeting was to review a White Paper that had been put together as an \ninternal document for President Bush.  The President had just rejected signing the \nrenewal of the Biological Weapons Convention (BWC) on the basis that it was \nunenforceable.  Falkenrath was tasked with putting together a briefing document that was \nan expression of our interest in the problem, but was an alternative approach to the BWC.  \nWe crafted something that was a “high road” approach indicating that since we cannot \nenforce restrictions among committed users and abusers, then at least we can support \nbiomedical research to provide better diagnostics, therapeutics and vaccines.  At worst, \neven if it does not help with bioterrorism, it would be useful for mankind.\nAugust 9, 2001 -  After much deliberation and soul searching, President Bush decided \nand announced that Federal funding would be allowed for research on embryo-derived \nstem cells.  However, funding would be restricted to work on embryonic stem cell lines \nthat had either already been established or were in the process of being established (i.e. \nthe stem cells had already been removed from the embryo as of August 9, 2001).  NIH \n(mostly in the form of Lana Skirboll) had canvassed the world and found that 60 such \nlines were in existence, many in the private sector.  The lines were growing robustly and \nwere established according to the 4 points that President Bush mentioned in his speech, \ni.e. they had to be in vitro fertilized embryos that fulfilled the following criteria: 1) \ninformed consent; 2) in excess of clinical need; 3) not done as a result of financial \ninducement; 4) embryos not established for the purpose of research.\nThe public response was that the far right felt that the President had betrayed his \npledge not to fund research on embryonic stem cells.  Several scientists felt that he had \nnot gone far enough since he restricted granting of Federal funds for further (after August \n9) use of embryos to derive stem cells.  I felt that Bush went as far as he could go \npolitically since on the one hand, if he disallowed any work on embryonic stem cells, the \nfar right would have been happy, but it would not be a sustainable position for the general \npublic.  On the other hand, if he allowed the unrestricted use of embryos that had been \nestablished for in vitro fertilization (even though this was what I hoped he would do), the \nconservatives would have damaged him politically.  In other words, I believe that he went \nas far as he could go.\nAugust 10, 2001 – Secretary Tommy Thompson came to NIH to hold a press conference \nto discuss the embryonic stem cell decision.  He requested that I be with him on stage \nalong with Claude Lenfant, Lana Skirboll, Ruth Kirschstein, and Audrey Penn (acting \nDirector of NINDS).  When he asked me to speak, I made a statement thanking him for \nhis leadership (since he favored allowing funding all along) and also thanked the \nPresident for his courage in making a difficult choice, but one that will allow us to go \nReleased by Chairman Rand Paul\n30forward and do some good for mankind.  I also pointed out the important fact that now \nwe can do head-to-head comparisons of stem cells derived from embryos versus adults \nversus fetal tissue.  My comments appeared on the front page of the New York Times on \nAugust 11 and a clip of my comments was shown on the Lehr Newshour on the evening \nof August 10.  I am sure that some scientists will criticize me for saying that the decision \nwas a positive thing.  However, it is clear to me that these types of people are clueless \nwhen it comes to the world of Washington, D.C.  Furthermore, the far right will also be \nupset since I favored the use of embryonic stem cells at all.  I care even less about what \nthey think of my position.  All in all, I believe that this was a good day for biomedical \nresearch.  Lana Skirboll deserves much create for turning the President around.\nAugust 12, 2001 – CNN in association with Time Magazine ran a special program on \n“America’s Best in Science and Medicine”.  I was featured in an 11 minute segment \nalong with 4 other scientists.  This was in association with Time Magazine naming me \none of 18 scientists as “America’s Best in Science and Medicine”.  This feature appeared \nin the August 26 edition of Time that reached the newsstands on August 13.\nAugust 13, 2001 – Bob Wood (Chief of Staff for HHS Secretary Thompson) phoned and \nsaid that Secr. Thompson and President Bush have been discussing my turning down of \nthe NIH Director’s job and they want me to reconsider and to name my own conditions \nincluding maintaining my Directorship of NIAID and virtually anything else I wanted.\nAugust 14, 2001 – Terrell Halaska (Deputy Chief of Staff to Secr. Thompson) called \nwith almost identical pleas as that of Bob Wood (see above).  She mentioned that I am \nfrequently mentioned at the White House and that the President wanted very much for me \nto be NIH Director.  I told Terrell that I did not want to do this and explained to her that \nmy reasons were similar to those 12 years ago when I said no to President Bush (the \nelder), i.e. I wanted to work fulltime on the AIDS epidemic and on Global Health and \nInfectious Diseases.  She was very understanding and was quite complimentary to me, \nsaying what an honor it was to work with me.  Clearly, the phone call went well.\nAugust 15, 2001 – As I had promised, I called back Bob Wood and told him exactly \nwhat I had told Terrell Halaska.  Bob also was very understanding.\nAugust 20, 2001 – Secr. Thompson spends entire day at NIH as part of his week at NIH.  \nI presented to him on Global Health and Vaccine Development at NIH.  Also, Gary \nNabel and I gave him a tour of the NIAID Vaccine Research Center.\nAugust 21, 2001 – Attended a meeting at the White House of the Policy Coordinating \nCommittee of the Biological Weapons Conference group.  Chaired by Robert Joseph \n(Special asst. to the President) and Richard Falkenrath (Deputy to Condolezza Rice).  \nPresent at meeting was Ambassador Donald Mahley, Special Negotiator at State \nDepartment for Chemical/Biological Weapons, as well as representatives from Justice \nDept., State, DOD, DHHS (me, John La Montagne, William Steiger), etc.  Purpose was \nto review document that the group put together (White Paper) as a policy that the \nPresident will articulate in association with the USA refusing to re-certify the Biological \nReleased by Chairman Rand Paul\n31Weapons Conference.  The paper takes a high road approach about how to handle this \nproblem, while recognizing that much of what was contained in previous agreements was \nunenforcible.  John La Montagne and I had contributed to the scientific components of \nthe white paper.\nAugust 23, 2001 – Secr.Thompson on a visit to NIH again offered me the position as \nNIH Director and said that the President wanted me and that I could indeed be NIH \nDirector, NIAID Director, and keep my Lab.  I told him that I wanted to remain doing \nwhat I was doing at full speed and so refused his offer.  He was extremely gracious and \nquite complimentary to me.  He said that I was the most outstanding person that he had \never met ….really.  He said that he would not ask me again unless I brought it up.\nSept. 11, 2001 – Day of infamy. I was in New York City at the time of the attack on the \nWorld Trade Center.  Below is a note that I sent to Andy Saxon (in response to his \nconcern for the safety of me and my family) after returning to Washington, D.C. that \nexplains what happened:\nDear Andy:\nThanks for the note.   I was actually in New York City about 30 \nblocks from the World Trade Center in a taxi cab getting ready to go to \na meeting of the Doris Duke Charitable Foundation at the precise time \nthat the first plane hit.  By the time I got to the meeting in mid-town \nManhattan and went into the building, I saw on TV the second plane hit.  \nIt was the most horrible day of my life.  I was not hurt nor was I ever \nin any danger; however, it is an experience that I will never forget. \nAs you know, my father lives alone in New York, but his apartment is \nabout 70 blocks uptown from the WTC and he is fine.  Also, as you know, \nmy girls go to school in Washington, D.C; however, they are reasonably \nfar from the Pentagon.  They saw the smoke from their classrooms on the \ngrounds of the National Cathedral and as expected were emotionally \ntraumatized.  All DC schools were immediately dismissed and the \nchildren went home.  However, Jenny, Megan, and Alison (not to mention \nChris) were very frightened since they knew that I had just left for \nNew York City that morning.  I could not phone to tell them that I was \nOK since all of the cell phones and fixed phones were jammed.  Finally, \nI got through to them and they were obviously very relieved. I feel \nvery fortunate. I was stranded in NYC for a while, but finally caught a \nlate night train out to DC.\nWashington is an eerie town right now.  Military police are all \nover downtown, National Airport is closed INDEFINITELY, and F-16 jets \nare flying in combat formation all day and night over the city.  The \nNIH has concrete barricades at every entrance and if your car does not \nhave an NIH sticker and you do not have an NIH ID, you could be the \nPope and you will not get on campus.  This is true of all Federal \nBuildings.  As you probably know from the News, the FBI now knows that \nthere are several cells of terrorists still in the USA with plans to \nexecute terrorist attacks, and Washington, D.C. is the prime target.  I \ndo not think that things will be the same around here. What a terrible \nsituation for us and the world.\nAgain, thank you for your concern.\nBest regards,\nTony\nReleased by Chairman Rand Paul\n32September 17 – 20 , 2001  - I have been called to several top secret meetings over a 4 \ndays period at the White House with the National Security Council (NSC) in a group \nchaired by Richard Falkenrath (see other notes) to discuss short and long range plans for \nhow to handle a bioterrorism attack, particularly one of smallpox.  Also, several meeting \nin top secret format were held at DHHS in the Humphrey Building.  People at the DHHS \nmeetings include Stewart Simonson (Chief of Staff to Claude Allan), Scott Lillibridge, \nClaude Allan (deputy Secretary), Tom Month of  Acambis company that is making \nsmallpox vaccine, D.A. Henderson (Hopkins), Kathy Zoon (FDA), Ann Agnew (Exec \nSec. OD/DHHS, John La Montagne (NIAID), James Meegan (NIAID), Bill Raub \n(DHHS), and others.  Check files.  At the White House (Chaired by Richard Falkenrath, \nDeputy to Condi Rice) there was Avis Bohlen (State), J.D. Crouch (Defense), Kenneth \nJustice )Commerce, Kathy Zoon (FDA), John La Montagne (NIAID), Bill Steiger \n(DHHS), Don Mahley (State), Michael Chertoff (Justice), General John Parker (Defense), \nPeter Jahrlin (Defense) and others.  Check with John La Montagne and other notes.  We \ndiscussed and provided ‘White Papers”  a) to justify our not agreeing to the renewal of \nthe 1992 Bioweapons Convention because it is un enforcible and would also hinder our \nlegitimate scientists workiing on biomedical research on these organisms. b) justification \nfor not destroying the smallpox stores since we need them to do research to counter \neffects of a smallpox terrorism attack with diagnostics, vaccines, and therapy.c)  Short \nand long range plans for countering an immediate or distant bioterrorism attack.\nSeptember 17, 2001 – While I was at DHHS for the smallpox meetings, Secretary \nThompson called me in his office and said that although he had said that he would not \nask me again to be NIH Director unless I brought it up, he said that he had to do so now \nsince “…the country needs me, particularly during these stressful times.  I want you very \nmuch and President Bush wants me very much”.  Although I had been resisting this for \nmonths (and years) (see above), I felt that I could not refuse this call to duty.  Thompson \nsaid to name my conditions.  I wrote them down and deliver them to him the next day on \nSept. 18.  The conditions were: 1) Dual roles as NIH Director and NIAID Director; 2) \nAdditional staff; 3)  Direct access to him; 4) Good faith discussions regarding plans that \nhe has to do administrative restructuring (centralizing) at NIH OD and away from the \nindividual institutes such as budget, human resources, etc.  I felt that particularly budget \nand to a lesser extent HR centralization would not work; 5)  $300,000.00 salary ; 6) \nContinue to do editing with royalties (especially HPIM) and remain on Board of Trustees \nof the Doris Duke Charitable Foundation.  The Secretary agreed on all of these except he \ndecreased the salary number to $295,000.00.  I told him that I accept the offer.  He will \nsend all of this to the White House to clear that they also accept these conditions.  I do \nnot expect anything to happen soon given that we are headed to war and likely additional \nterrorist attacks.\nSeptember 24, 2001 – Yet another visit to the White House, this time to review the final \ndocument  on Biological Weapons Convention (BWC) Alternative Concepts.  We agreed \non the document to be sent forward to Condoleezza White and Colin Powell.(see hard \ncopy files).  Attending the meeting were:  Robert Joseph (WH), Avis Bohlen (State), J,D, \nCrouch (DOD), Kenneth Juster (Commerce), Claude Allen (DHHS), Tony Fauci (NIH), \nReleased by Chairman Rand Paul\n33Bill Steiger (DHHS), John La Montagne (NIH), Kevin Chilton (Joint Staff), Ken Baker \n(DOE), Alan Foley (CIA), Don Mohley (State), Michael Chertoff (Justice)\nSeptember 24 – Oct.10 – Multiple meetings at White House and DHHS regarding \nresponse to Bioterrorism.  Anthrax cases (3 thus far) identified in Florida.  USA on \n“heightened alert”.  \nOct. 10, 2001 – Met at St Regis Hotel in Washington, D.C. with Secretary Thompson; \nSecretary of State for Health, UK Mr. Alan Milburn; Minister of Health of Canada, Mr. \nAllan Rock; Secretary of Health of Mexico, Julio Frenk to discuss international \ncollaborations in Public Health related particularly to the response to bioterrorism.  \nClaude Allen and Tommy Thompson appoint me chair of a committee to advice on \ntechnical matters related to smallpox vaccine manufacture, testing and application.\nOctober 8-21, 2001 – Historic, breaking news every day.  New York City, Washington, \nD.C., Florida are targets of mail-related anthrax cases.  As of Oct. 21 there have been 9 \ncases of anthrax – 1 death from inhalation, 2 serious inhalation anthrx and 6 cutaneous \nanthrax with about 40 documented “exposures:.  Check news clips for accuracy.  \nSecretary Thompson appointed me Chair of the Vaccine Technology Team to determine \nthe scientific and technical feasibility of upscaling the production of smallpox vaccine – \nsee Memo of October 17 (Wednesday) from ASF to Claude Alan (Deputy Secretary, \nDHHS).  \nWithin this period of time there has been major inconsistencies regarding the \n“grade” of the anthrax involved in the above exposures.  I have spoken with USAMRIID \ncurrent and former scientists, particularly Co. Peter Jahrling.  He has examined the \nmaterial from Sen. Daschle’s office and finds that it clearly is finely milled and what he \nwould consider “weapon grade”.  He told me that it was better than any bioweapon of \nanthrax that the USA has ever made.  He believes that it was from Iraq.  To my \namazement, Gov. Ridge (Penn) was recently appointed to the Cabinet-level post of \nDirector of the Office of Homeland Security and he went on television stating that he was \ntold by scientists (likely CD and/or Army people that this was “garden-variety” anthrax; \nthat is was sensitive to all antibiotics and that it was definitely not weapon grade.  I was \nfloored.  I called back Peter Jahrling and he said that he looked at under low power and it \nlooked like a clump, which would suggest that is was crude and not weapon grade.  \nHowever, when he looked under electron microscope he saw pure spores that were finely \nmilled.  He hydrated the system and the spores became totally suspended and remained \nso which is the definition of weaponized.  Clearly, someone is intentionally not telling \nGov. Ridge the truth or he is masking the truth.  The obvious potential reason is that the \nUSA does not want to deal right now with the obvious conclusion that the material came \nfrom Iraq.  I have been trying to cry the warning.  I mentioned this to Terrell Halaska \n(Deputy Chief of Staff to Tommy Thompson) as well as to Stuart Simonson of \nOGC/OS/DHHS.  I also hinted to Tim Russert, Sen Lieberman and Sen John McCain \nwho were my co-guests on “Meet the Press” on Sunday, Oct. 21, 2001.\nI believe that there will be hell to pay when the American public realizes that they \nhave not been dealt with in a totally open manner.\nReleased by Chairman Rand Paul\n34Oct. 8 - 17, 2001 – Thompson asks me to chair a “Vaccine Technology Team” to provide \nscientific and technical feasibility with pros, cons, and recommendations on how to \nexpand the existing smallpox vaccine stores and develop new, additional stores.  See my \nOct. 17 memo to Thompson.\nOct. 21 – 22, 2001 – More cases of inhalation anthrax, most recently in a DC Postal \nworker who did not touch the Daschle letter, but who was only in the central Post Office \nBuilding where the letter was initially sorted.  I am convinced that this is very high grade \nmaterial.  I in good conscience cannot refrain from bringing this to the attention of DHHS \nforcefully.  I spoke to Stu Simonson (Oct. 21) and told him that he must tell Secretary \nThompson of my concerns.  I also mentioned this to Frank Sesno (CNN) who has called \nme at home because of the concern that there may have been an exposure at CNN since \nthey have contracted a private environmental firm to monitor their offices.  They received \na tentative positive ID for anthrax in the environment and called me.  I told Frank that he \nmust report this to the CDC and gave him the appropriate number.  He did so and is now \nworking with the CDC.  On Oct. 22 at a CNN morning appearance, I saw Frank Sesno \nagain and he wanted to pursue our conversation.  I strongly urged him to explicitly ask \nGov. Ridge just from whom he is getting information that this is not weaponized \nmaterial.  I believe that it is of weapons grade given my conversations with Peter Jahrling \nat USAMRIID.\nAlso, I received a phone call from Sen. Bill Frist who was in NYC.  We had both \nbeen on the Diane Rehm Show this AM and he called to ask advice on how to get the \ncorrect message out.  I also implored Sen. Frist to look into the weaponizing situation in \nthe same manner that I did with Frank Sesno.  Hopefully this will get straightened out \nbefore all credibility is lost.\nSee New York Times article of October 22, 2001 by Judith Miiler and Sheryl \nStolberg.\nOct. 23, 2001 – Major problem in that DC Postal workers are enraged that they were not \ngiven CIPRO.  They feel that there was not enough care in surveying their Brentwood \nmail facility.  See news accounts around this time.  I directly and forcefully told Sec. \nThompson that Gov. Ridge had either been mislead or was misleading the American \npeople (which I doubt) regarding the quality of the anthrax spores that had been obtained \nfrom the Daschle letter (see above).  I strongly suggested to him that he meet with the \nPresident and with Gov Ridge to emphasize that we cannot serve the public well with \nregard to the Public Health if we are not given correct information.  Someone at that \nmeeting leaked this to the NY Times and Sheryl Stolberg called me and heard that I had \n“angrily confronted the FBI for withholding information”.  I refused to comment; \nhowever, off the record I mentioned that the FBI was not in the room at that meeting and \nthat I was trying to get Sec. Thompson to demand the truth.\nOct. 24, 2001 – Called to emergency meeting at DHHS.  Thompson in a very concerned \nstate of mind; asked for my help and counsel.  We now have reliable intelligence that the \nUSA will be hit with a major bioterrorism attack within the next several days (from \npresent to Oct. 31).  He appointed me in charge of all vaccines.  It was clear that the CDC \nwas not responding adequately.  I was amazed at the disconnect between that CDC and \nReleased by Chairman Rand Paul\n36Stewart Simonson, Michael Osterholm, Margaret Hamburg, C.J. Peters, William Patrick, \nJames LeDuc, Phil Russell, Les Caudell, Co. Edward Eitzen.\nOct. 31, 2001 – NYC “outlier” women dies of inhalation anthrax.  Still no connection \nwith postal cases.  Could this be an outlier of the existing paradigm or the sentinel case of \nan entirely new paradigm?  Did major media today with The Today Show with Katie \nCouric, Grand Rounds at NIH covered by all networks, CBS Evening News, Jim Lehr \nNewshour, etc.\nNov. 1, 2001 – Had extraordinary briefing of Democratic Senate Caucus on bioterrorism.  \nPresent among others were Sens. Lieberman, Daschle, Boxer, Mikulski, Cleland, \nHollings, Wellstone, Jeffords, Biden, Wydan, Levin, etc.  In all there were about 30 \nsenators.  They were extraordinarily complimentary to me for my public leadership on \nbioterrorism, calling me an “American hero”, a national treasure, etc.  I thoroughly \nbriefed them.  They felt strongly that I should lead the nation’s efforts. I politely \nsuggested that I prefer my present job.\nNov. 2, 2001 – Important Senate Hearing of the Labor, HHS Subcommittee chaired by \nTom Harkin.  Also present were Sens. Spector, Byrd, and Stevens.  Hearing on smallpox.  \nI was able to communicate to Specter that NIAID was not allowed to put in a request in \nthe $1.6 billion supplement of DHHS for bioterrorism.  In other words we needed $153.7 \nmillion additional to the PB, but we were not allowed to submit for the supplement by \nOMB.  I “busted” the budget by telling Specter after the Hearing what we needed.  He \npromised to put it into our appropriation.\nNov. 3, 2001 – There was a spoof on me and Attorney General Aschroft on “Saturday \nNight Live”.  No new cases of anthrax.  Kathy Nguyen case in NYC still a mystery.\nNov. 4, 2001 – I appear on “Face the Nation” with Sen. Ted Kennedy and others; also on \nCSPAN’s Washington Journal and CNN Special.  No new issues.\nNov. 5-12, 2001 – relatively quiet re: bioterrorism.  No new cases.\nNov. 13, 2001 – Went to an extraordinary dinner at the home of the Saudi Ambassador to \nthe USA (Prince Bandar bin Sultan bin Abdul Aziz) Sat at table with his wife Princess \nHaifa Al Faisal (Late King Faisal’s daughter).  Also at the table was CIA Director George \nTenet and Sen. Ted Stevens.  Dinner in honor of Nelson Mandela.   The Princess \nspecifically mentioned me as a very honored guest when she introduced the program.  \nNov. 13- Dec.1, 2001 –   At \nfirst no connection with spores in mail  However, careful detective work has indicated \nthat this might be a tertiary mail contamination that gave inhalational anthrax, which is \nnot supposed to happen.  Letter that passed through Trenton with the Leahy letter got \ncontaminated and went to a post office in CT.   may have gotten a letter that \nwas next to the secondary contaminated letter.  Check news stories for details.  I appeared \nReleased by Chairman Rand Paul\n\n37in virtually every newspaper and TV with statements.  Washingtonian Magazine choses \nme as one of Washington’s “Best and Brightest” – Dec, 2001 issue.\nSecretary Thompson told me that over the past week and ½ he has spoken to Pres. Bush  \nabout appointing me Director, NIH.  Apparently, there is some resistance by Sen. \nBrownback who is a born-again Christian and right winger.  He is pushing Bob Redfield \nand other strict conservatives.  Apparently, he believes that I am too liberal because of \nmy association with gays in the AIDS work and because of my statements about the \nscientific need for embryonic stem cell research.  Thompson re-iterates my conditions for \ntaking the job.  Science advisor Jack Marburger is against my doing dual job.\nOn Nov. 27 and 29 I appeared before 2 Senate committees.  On Nov. 29, I testified that \nwe needed $200 Million (professional judgment) more than the PB. Jeff Koplan (CDC \nDirector) testified with me that CDC needed an additional $2 Billion for bioterrorism \nresearch.  We both made big NY Times and Washington Post coverage.  My picture in \nNY Times on Nov. 30.\nWeekend of Dec. 1 & 2 – Thompson asked me to prepare talking points for him in his \nvisit to the Pres. To argue against reneging on the promise to give NIH $4 Billion in \nFY2003 to complete the doubling trajectory.\nDec. 4, 2001 -   Probably one of the most significant days for NIH and me regarding the \nbudget of the institution.  Word was that the “pass back” for NIH would be $0.5 billion, \nwhich would be devastating for NIH (no new initiatives and $275 shortfall on Type 5s). I \nentered into intensive negiations with Tommy Thompson over a 2-3 hour period in his \noffice during which time he frequently called the White House discussing our \nnegotiations.  The bottom line is that Tommy and the President wanted to give the NIH a \npass back that I would be able to publicly defend to the constituents, the Press, and the \nCongress.  I laid down some strict conditions of this support.  It was $2.0 billion for NIH \nexcluding bioterrorism.  I calculated that it would take $1.3 billion to reach current \nservices, $200 million for maintenance of campus (including security).  This would leave \nabout $500 for new initiatives. On top of that I needed 1.0 billion for bioterrorism.  They \nwanted to know my opinion of whether the constituents would accept this “almost” \nmeeting the doubling trajectory.  I told Tommy to tell the President that I would \ndefinitely defend this pass back since it actually was a great deal given the constraints on \nbudget due to the demands of the war and the bioterrorism (BT) defense.  I gave him my \nword that I would support him and the President.\nTommy also informed me that a few people in OMB were very pissed off at me \nbecause I testified at the 2 Senate Hearings (especially the Specter Appropriations \nHearing) that we needed $200 million more in FY2002 for BT.  He also re-affirmed that \nSen. Brownback was not in favor of my nomination for NIH Director because he felt that \nI was too liberal and he wanted his candidate who is Bob Redfield, a born-again \nChristian.  Tommy said that the President wanted me , but was getting pressure from the \nfar right.  I am perfectly comfortable with this situation.  I am what I am.  Take me or \nleave me.  I am happy with what I am doing now.\nReleased by Chairman Rand Paul\n38 Dec. 7, 2001 -  Negotiated with Ed Sontag (Asst Secr. For Management at DHHS) \nregarding restructuring and consolidation of the NIH from an administrative standpoint, \ni.e. Budget, HR, Legislation, Procurement, Public Affairs, Grants Management, IT, etc.  I \nhad an agreement with Tommy Thompson that Budget should be sacrosanct and should \nstay in the ICDs as opposed to consolidating at the level of NIH.  Ruth Kirschstein \n(Acting Director, NIH) almost gave away the farm in the negotiations.  I stepped in and \ntook over the meeting for NIH.  Ruth was about to agree to give up 850 FTEs.  I insisted \nthat we could not cut down by any more than 200.  Sontag came down to 275; we agreed \nupon 250.  Also, Sontag was concerned that the new Clinical Research Center was \nprojected to be $142 million over.  Ed asked how we were going to handle it and Ruth \nsaid that this did not happen on her watch and that it was someone else’s fault at NIH and \nshe would see that this person (Steve Ficca) would be held responsible (?fired).  She gave \nno indication how she would handle the real problem except to say that she would take it \nout of the IRP.  I insisted that we would need major flexibility from the Department \nregarding how we could make up this money and that we could not hurt the IRP so \nabruptly and severely.  Sontag agreed to help.  Poor Ruth is in way over her head.  I will \nhave to make some difficult decisions if I become NIH Director about keeping her on as \nDeputy.  I may need to appoint another Deputy and have her keep her title, but not her \nresponsibilities.\nDec. 8, 2001 – Thompson tried to call me at home last night (Friday), but I was out.  He \ncalled me on Saturday in my office and told me that President Bush has agreed to appoint \nme NIH Director.  Thompson wants me to speak with Sen. Brownback to try and \nalleviate his concerns about my position on stem cells, embryos, etc.  I will set up to meet \nhim next week.  Thompson wants to make announcement before Christmas.\nDec. 12, 2001 – Met with Sen. Brownback and his aide Rob Wassinger.  Brownback was \nconcerned about statements that I made 13 years ago! Concerning the then new SCID \nmouse that could be reconstituted with fetal tissue to regenerate a human immune system \nin a mouse.  I stated at an ACT-UP meeting in NYC that this was a promising area of \nresearch and that it would require the use of fetal tissue.  At the time there was the \nbeginning of a moratorium by President Reagan and later Bush on the use of fetal tissue \nfor transplantation into humans.  I apparently (reported in the press) urged the ACT-UP \npeople to make their concerns known so that this could be taken into consideration by the \nadministration and lawmakers.  Brownback and Wassinger said that several “right-to-\nlifers” had called them very concerned that I was being considered for NIH Director \nwhen I had been a vocal advocate for the use of fetal tissue.  \nI had a lengthy (1 ½ hour) discussion with Sen. Brownback about embryonic stem \ncells, fetal tissue, etc.  I believe that the conversation went as well as could be expected.  \nHe was very cordial, but concerned about “how I would advise the President if I were \nNIH Director”.  I told him that I do not advise the President on Ethical or Moral issues \nsince I trust that the President has his own strong moral compass.  I mentioned that I am a \nscientists and that I merely give him accurate scientific facts and he can make up his own \nmind within the framework of his own values.  I think that Brownback respected that \nanswer.  We left with his still being concerned about me, but I do not think that he will \ntry to block me.\nReleased by Chairman Rand Paul\n39Dec. 14, 2001 – Spoke with Rick Klausner about his perception about NIH Director.  \nRick feels that the WH is not leveling with Thompson since he has heard that they think \nthat doing both jobs (NIH and NIAID) is a “non-starter” and they are against it.  There is \na disconnect here since Thompson feels that they (WH) will accept this, and he merely \nneeds to get the Brownback issue out of the way.  Something is strange here since \nThompson is talking about getting the President to announce me before Christmas and \nRick says the “rest of the WH” is against this.  Stay tuned.\nDec.15, 2001 – Sat. meeting at NAS regarding recommendations of giving anthrax \nvaccine to people who were exposed to anthrax and who are just finishing their 60 course \nof antibiotics.  I, Jeff Koplan, D.A. Henderson, and Kathy Zoon (FDA) playing major \nrole of setting policy and advising the Secretary.\nDec. 16-19, 2001 – Much controversy and last minute scrambling in getting the consent \nform and the protocol out for the discretionary use of anthrax vaccine in exposed people \nwho had been receiving antibiotics, but who are coming off their 60 day course.  The \nCDC is really relinquishing their responsibility of doing a good job with the informed \nconsent. They handed us a piece of junk as a draft.  Stewart Simonson (Counsel to Secr. \nThompson) has asked me to help get it right.  I had been working all day and into the \nnight on Dec.16-19 revising the consent forms and helping people get straight why \nDHHS is offering the vaccine to people.  The Press are very suspicious and as usual \ncritical of the Administration.  I have exhaustively reviewed the data (with Cliff Lane as a \ngreat help) and come to the conclusion that vaccine + antibiotics is no better than \nantibiotics alone for post-exposure.  Yet, Dr. John Eisold (the Navy physician who takes \ncare of Capitol Hill people) is insisting that the Senate staffers also get the vaccine.  We \nare in a dilemma.  It is true that there is a “theoretical” reason to make the vaccine \navailable in that animal studies show persistence of spores weeks after antibiotics and \nthere is a fear that after antibiotics are discontinued the disease will occur.  I would not \ntake antibiotics.  However, Eisold and the Senate Staffers are demanding that they get the \nanthrax vaccine.  In fact, I received a phone call from Ms. Laura Petrou from Senator \nDaschle’s staff on Dec. 19, 2001 enraged that we were taking so long in getting the \nvaccine to the staffers.  Apparently, D.A. Henderson and Tommy Thompson had told \nDaschle that the vaccine would be available 2 days ago.  They were insistent. The blacks \nin the postal service are quite skeptical.  I have insisted that if I am going to help we must \nnot “recommend” the vaccine since the data in animals show that it is not better than \nantibiotics alone. The difficult situation is that politically we essentially have to give it to \nthe Senate staffers since they are demanding it.  If we give it to them and do not offer it to \nthe postal workers, we will be accused of racism and not treating the postal workers \nequally. Remember that they were outraged that the Senate staffers got antibiotics right \naway and the postal workers only got antibiotics after 2 people at Brentwood died.  \nTherefore, we are offering, but not recommending the vaccine for any of the 9000 people \nwho were put on 60 antibiotic course.  We are not explicitly telling the public that this is \nreally the rationale for what is going on. There is some confusion as to why we are not \nrecommending it and if we are not recommending it, why are we even offering it.  I have \nReleased by Chairman Rand Paul\n40tried to articulate this to the public as I did on a Dec. 19 appearance on Jim Lehr’s News \nHour.\nDec. 19-24, 2001 – As expected, publicity went bad for HHS on the anthrax vaccine \nstory.  Washington Post writer Ceci Connelly keeps blasting HHS and particularly \nTommy Thompson and the CDC for lack of clear guidelines.  The mostly black postal \nworkers for the most part refuse the vaccine, saying that they do not trust the government \nand do not want to be “guinea pigs”.  They completely miss the point that no one really is \ntelling them that they should take the vaccine.  In contrast, the staffers from Daschle’s \noffice have a high % of people who are taking the vaccine.\nDec. 27, 2001 – Receive a letter from Sen Brownback dated Dec. 19, 2001 in which he \nstates that he is “deeply concerned by your inability to define the entity created after the \nsuccessful procedure referred to by some as human somatic cell nuclear transfer \n(SCNT)…”  He wants me to respond.  I do not want to put anything in writing and so I \ncall his office and ask to speak with the Senator.  His unbelievably right wing staffer, Rob \nWassinger, answers and says that they will not put the call through to the Senator and that \nI should answer the questions in writing.  Clearly, they are trying to trap me and clearly \nWassinger is an asshole.\nJan. 6 – 22, 2001 – Clearly, it is unclear what is going on with the White House and my \nnomination. Secretary Thompson keeps pushing the President to appoint me and the \nPresident defers to Clay Johnson, Director of White House Personnel, who has actually \nnever interviewed me.  I get word indirectly from Scott Whitaker, Bob Charrow and \nothers that there really is a political battle going on in the WH with a strong anti-\nThompson faction led by Clay Johnson who does not want to appoint me because he \nwants to put down Thompson who is pushing me.  On the other hand, there are those who \nclearly want me, but are less aggressive in pushing any agenda since they are assuming \nthat I will get appointed.  It is unclear what role Sen Brownback is playing in influencing \nClay Johnson.  I hear from Rick Klausner that the issue is just that they are reluctant for \nme to do two jobs simultaneously.  I doubt this and believe that there is something else \ngoing on.\nJan.22, 2001 – Finally, I get called to the West Wing of the WH to meet with Clay \nJohnson and Ed Moy (Johnson’s deputy) to discuss the job.  Johnson was cold and \nabrupt.  He said that the President was getting confused messages about my “conditions” \nfor the job and the POTUS had asked Johnson to clarify things.  Johnson coldly and \nabruptly asked how I can do 2 jobs simultaneously.  I explained about the extraordinary \noverlap in what the NIH Director must know and do with what the Institute Directors \nmust know and do and tell him that I feel that I will have no problem doing this.  He \nclearly was not convinced.  Then he wanted to know why I wanted 2 full salaries, i.e. the \nNIH Director’s salary and the NIAID Director’s salary.  I explained that this was not the \ncase, and that I merely did not want to lose money by relinquishing my retention bonus \nthat I could not take as NIH Director as well as several outside activities that I could not \ndo as NIH Director.  He acted (coldly) like he understood that.  As soon as I answered \nthese 2 questions, he abruptly said: “Well, you answered my questions and told me what I \nReleased by Chairman Rand Paul\n41need to know.  Thanks a lot and have a nice day”, whereupon he ended the meeting.  \nNever did he even approach asking what my vision for the NIH was or other related \nsubstantive questions.  Clearly he had made up his mind before the meeting and was only \nmeeting because the President had asked him to.  \nJan 24, 2001 – Tommy Thompson calls me at home at 9:30 PM (he was sequestered in \n“the bunker” for security reasons) and tells me that he spoke with Clay Johnson today \nand Johnson told him that he was going to recommend someone else and not me to the \nPresident.  Thompson was clearly very angry and sad.  I am more convinced now that this \nis a Clay Johnson agenda working here.\nJan. 26, 2001 – I go to the Annual Alphalfa Dinner at the Capitol Hilton as a Guest of \nRobert Wood (“Woody”) Johnson IV.. Amazing scene!  Virtually every important \ngovernment official (the entire Cabinet, military leaders, etc) was there.  At the reception, \nI met Barbara Bush who was very warm with a hug and kiss and told me that she is \n“pulling for me”.  I did not pursue this since this is not my style.  I then met former \nPresident Bush who was his usual wonderful self with me, hugging me and telling guests \nwho were standing around that I had won the 1988 election for him when he told the \nworld that I was his hero.  I mentioned that we had just received the President’s Budget \nfor FY2003 this week and that the President has fulfilled the promise to double the NIH \nbudget and had given NIAID and additional $1.5 billion for bioterrorism research.  I told \nBush that this was similar to what he, himself, had done with me in the 1980s when he \nincreased my AIDS budget, but that this was on a much larger scale.  I told him how \nmuch I appreciated this. He told me to make sure that I tell the POTUS this.\nI also saw Tommy Thompson at the dinner and walked into the ballroom with \nhim.  He seemed very sad and troubled.  He again said that he was going to see the \nPOTUS next week and will tell him that I am not only the best person, but the “only” \nperson for the NIH Director’s job, regardless of what Clay Johnson will tell him.\nAt the dinner Woody Johnson brought me over to the head table to say hello to \nthe POTUS.  Bush greeted me warmly (he clearly knew who I was).  I thanked him for \nthe BT money and he asked about our efforts; I briefly told him.  He then surprised me by \nasking whether I had seen Clay Johnson yet, and so he knows that the meeting was set \nup.  I told him that I did see him a couple of days ago.  The POTUS said “Good, I will \ntouch bases with Clay next week”.  Later on I met Laura Bush and she too complimented \nme on my work and we had a very nice conversation.  In none of these encounters did I \nmentioned the NIH Director’s job.  My feeling at this time is confirmed that the President \nreally does not know the situation except that he has heard a lot about me, but this is \nconfounded by the fact that it is clear that Clay Johnson does not want me.  Is it really \nbecause he is against 2 jobs, or is there some hidden agenda.  I feel strongly that it is the \nlatter.  We shall see….maybe.\nFeb. 4, 2002 – An editorial in the Washington Post calls for President Bush to \nappointment me as the NIH Director.\nFeb. 5, 2002 – Spectacular day!  I traveled on Air Force One with President Bush to \nPittsburgh to spin his FY2003 budget on Bioterrorism and to visit scientists at Univ. of \nReleased by Chairman Rand Paul\n42Pittsburgh who are working on a novel early warning system for BT.  I met the group at \nAndrews Air Force Base and flew up at 11:00 AM.  Did not see the President on the \nflight up; however, spent considerable time with him in Pittsburgh.  The motorcade trip to \nand from the Pittsburgh airport was exciting.  I was in a van about 4 cars behind the \nPresident and the motorcade was heavy with Secret Service and Police.  The President \nwas extremely complimentary to me during the visit as he spoke to other people about me \nin front of me.  He specifically thanked me for my great work in his speech that was \ncovered by CNN.  During the flight back to DC he called me to his state room and spent \nthe entire flight back speaking with me!!!  In the room were Gov. Ridge, Secretary \nThompson, and D.A. Henderson.  Thompson mentioned to me in Pittsburgh that they \nspent much of the trip going up to Pittsburgh talking about me and the work that I have \nbeen doing.  Tommy is pushing hard with the President to appoint me.\nFeb. 8, 2002 – Sheryl Stolberg suggests in the New York Times that Bush should appoint \nme.  She mentions that the sticking point is my requirement to do both jobs.\nFeb. 15, 2002 – Laura Meckler wrote a piece for AP on the right wing Family Research \nCouncil opposing my nomination for NIH Director based on my philosophy on fetal \ntissue and stem cells.  They refer to my comments in 1988 about the utility of the SCIDhu \nmouse model.\nFeb. 23, 2002 – Article in New York Times by Sheryl Gay Stolberg telling the story as it \nhappened saying that I am no longer a candidate for NIH Director’s job. She states that \nthe White House says that the reason is the objection to the 2 jobs, while the social \nconservatives say that my views on abortion and stem cells make me unacceptable to \nthem.  Also, mentions the Sen. Brownback story.  Key article since it is factually correct.\nMar. 5, 2002 – Secretary Thompson called me today and said that he was very upset, but \nI will not be asked to be NIH Director.  He said that he was being forced by the White \nHouse to submit Dr. Elias Zerhouni’s name and that he was not happy at all about this.  \nHe stated that as far as he was concerned, I was his number one person at the NIH and he \nwas looking forward to working with me in the future.\nMar. 9, 2002 – Attended Gridiron Club dinner in Washington, D.C.  Spent time speaking \nwith President Bush, Karl Rove, Clay Johnson, Donna Shalala, Tim Russert, Sam \nDonaldson, John Neroponte, Cokie Roberts, etc.  The topic was often concern and \ndismay on the part of people (non-White House) that Bush was not going to offer me the \nNIH job.  Most felt that it really was the litmus test issue and not the 2 jobs issue.  Clay \nJohnson, who I believe is behind all of this, actually volunteered to me that ”Dr. Zerhouni \nis no Tony Fauci, but then again, there really is only 1 Tony Fauci”.  It is tough for me to \nfigure out just how much the Social Conservative/Sen. Sam Borwnback issue played in \nClay Johnson’s insistence to the president that I not be NIH Director.\nMar. 26, 2002 – I went to White House ceremony where Pres. Bush announced Elias \nZerhouni as nominee for NIH Director.\nReleased by Chairman Rand Paul\n43Mar. 27, 2002 – Went to NYC for Press Conference for the announcement of my \nreceiving the Albany Medical Center Prize in Medicine, which is the largest prize in \nMedicine in America and the second largest in the world to the Nobel Prize.  Amount = \n$500,000.00. \nMar. 28, 2002 – Big press conference at DHHS for the announcement of the publication \nin NEJM of the dilution studies for smallpox vaccine.  Also, in same issue of NEJM was \nmy editorial calling for an open dialogue as to whether there should be pre-emptive \nvaccination of ”first responders” or even of the enitre population on a voluntary basis.  \nD.A. Henderson is not particularly happy about my editorial since he continually has \ntrouble admitting that a smallpox attack is a danger.  Clearly this is related to the fact that \nhe has devoted much of his professional life to trying to eliminate smallpox.\nMar. 31 – April 6, 2002 – Went on a terrific trip to Africa with Sec. Thompson and a \ndelegation listed below.  We visited Mozambique, South Africa, Botswana, and Cote \nD’Ivoire.  The trip was designated a Presidential Mission and so we received the royal \ntreatment.  Flew over on an Air Force jet and were received at each country with Secret \nService protection and local military and police escourts via motorcades etc.  Visited \nCDC and NIH funded facilities.  Met with President Joaquim Chissano of Mozambique.  \nLong conversation with South African Health Minister Manto Tshabalala-Msimang \nregarding reluctance of South African government to provide nevirapine to prevent \nmother to child transmission (MTCT). I disagree with her stance, but respect the difficult \nsituation that she is in.  She is driven by a need to decide things for herself since she was \none of the original ANC members who were in exile during apartheid and she does not \ntrust anyone but her own people. She, however, told me that President Tabo Mbeki \nrespected me greatly and frequently speaks highly of me,  During the Stay in South \nAfrica the Supreme Court of SA ruled that the government must supply nevirapine to \npregnant infected mothers and their newborns according to ACTG protocol 012.  Met \nwith President Festus Mogae of Botswana.  He too had heard about me. Met with Prime \nMinister of Cote D’Ivoire.  Representative people on the trip that I developed good \nfriendships with in addition to Sec. Thompson and his staff of Bill Steiger, Terrell \nHalaska, Dave Boyer, Corina Gardner, Matt Bluhm and others were: Former \nCongressmen Ronald Dellums and Ray McGrath, Scott Evertz of the White House, \nCongresswomen Barbara Lee (D-CA) and EB Johnson (D-TX), Michael Miller of NSC, \nAnne Peterson of USAID, Bill Roper and others.\nApril 25-30, 2002 – During the trip to South Africa, I spent about 1 ½ hours at dinner \ntrying to convince her to help President Mbeki change his stance on treatment of HIV-\ninfected people including pregnant women (see above).  Of note, just this week the South \nAfrican government has made a major change in their stance.  They now allow treatment \nfor rape victims and soon will start treating infected pregnant women.  It is entirely \nconceivable that my discussions played some role in this turnaround.\nMay 23, 2002 – For the past 2 weeks, Mark Dybul, Terrell Halaska and I have been \nworking on a proposal for prevention of mother-to-child-transmission (MCTC) in \ndeveloping nations to present to president Bush who wants to use this as an \nReleased by Chairman Rand Paul\n44announcement of a major initiative at the G-8 Conference this summer in Ottawa.  Terrell \nasked me to put it together for her and I enlisted Mark Dybul who did a great job with \nme.  I and Terrell had several pre-meetings at the White House Conference Center on \nJackson Place during early May and then today Mark, Terrell and I met with Gary Edson \nand Jay Lefkowitz of the WH. To present our plan to save 146,000 babies from being \ninfected per year for a cost of about $100,000,000 per year. Gary and Jay loved the plan \nand will present it to the President within a couple of days. It was a great meeting and \nthey were very impressed at how we organized the data and the presentation.\nMay 29, 2002 – I briefed President Bush in the Hamilton Room of the West Wing on the \nMCTC plan.  Present were Josh Bolton (Deputy Chief of Staff), Andrew Card (Chief of \nStaff),  Karl Rove, Mr Calio, Gary Edson, Secretary Thompson, Andrew Natsios \n(USAID), Terrell Halaska, Christen Silverberg, Jay Lefkowitz and others.  The President \nliked very much our plan, which I presented to him succinctly, but completely.  The \nbackground of the initiative is that Sens. Frist/Kerry are trying to get through a \nsupplemental Bill on adding more money to the Global AIDS Fund.  The President is \nagainst this since he feels that the Fund has no plan and the money will be wasted.  This \nis the reason that he wants to seize the opportunity of the Congress throwing more money \nat us to put forth his own initiative on a concrete proposal as opposed to the vagaries of \nthe Fund.  He accepted my proposal.  Interesting dynamics at the meeting in that Andrew \nNatsios was upset that this was an HHS proposal and started (quite inappropriately in \nfront of the President) getting into a turf war where he pointed out that he has an MOU \nwith the CDC that with regard to AIDS in Africa, USAID has the lead.  The President \npicked up on this discord and said that the only thing that he knows is that he likes \n”Tony’s plan” and that HHS and USAID should work out (with Gary Edson as referree) \nhow it is going to be implemented.  He stated, however, that he wants ”a person” to be \nheld accountable for the success or failure of the project.  To say the least, Sec. \nThompson was angry with Natsios.  From my standpoint, the meeting was a great success \nsince our plan was accepted by the President and he was extremely friendly to me.\nJune 6, 2002 – I found out at National Airport that President Bush was establishing a \nDepartment of Homeland Security (DHS) that would encompass 160,000 employees with \na budget of >$30 billion by consolidating all activities related to terrorism, including \nbioterrorism in one Department.  This would mean that $1.748 billion of NIAID money \nfor FY 2003 would go to DHS.\nJune 6 – 12, 2002 – Spending a lot of time working with the DHHS and th White House \nin trying to hash out the details of legislation that would create the DHS.  Everyone \nseems to agree that the research would still be done at NIAID under my direction; \nhowever, the money likely will first go to DHS and thenn be passed through or contracted \nto me to perform the research.\nAlso, the President is planning to announce the MTCT program that I helped to \nput together in a few days.\nReleased by Chairman Rand Paul\n45June 10, 2002 – Had breakfast with Treasury Sec. Paul O’Neill this AM to discuss the \nentire concept of AIDS in Africa. We related very well and he received my advice, \nconsultation very enthusiastically.\nJune 13, 2002 – Received a call from Richard Falkenrath at the White House who said \nthat he had heard that I was concerned about the $1.748 Billion going to Department of \nHomeland Security (DHS).  We wanted to assure me that the money would come directly \nto me from DHS and the research would be directed by me.  He agreed that the research \nshould be incorporated completely into the emerging diseases research agenda of NIAID \nand not fragmented out.  He said that Sen. Kennedy mentioned to the WH that I was \nconcerned and they wanted to alleviate my concerns.\nInteresting intrigue going on.  I just got a call from Sue Hardesty of Sen. Richard \nDurbin’s office who said that the Senator had heard from Bono (of U2 fame) that I was \nagainst the global AIDS fund and had convinced President Bush not to support it.  The \nSen. wanted to know if this were true.  In addition, Sue told me that Sen. Frist had said \nthat he changed his mind and decided not to support the Global AIDS Fund because he \nhad heard that I was against it.  I believe that if this is true about Frist, then he is covering \nhis ass since he backed down on his promise to support the extra money for the fund.  I \nknow that he backed down because Bush told him to.  Now he is trying to make it look \nlike I am the one against it.  It is interesting that rumors are forming that I am involved in \nconvincing the Pres. that we should not invest in the Fund.  I believe that this results from \nmy being involved in putting together the MTCT plan, which some feel that the Pres. \nactually wants to substitute for the increase in the Fund.  Of note, Jeff Sachs called me \nfrom Rome last night asking about the same issue.  Welcome to Washington!!!\nJune 13 – 18, 2002 – Extremely busy with putting the finishing touches on the MTCT \nproposal that the Pres. is planning to annouce soon.  I am trying and succeeding (I \nbelieve) in having them do it correctly, i.e. this is not a substitute for the Global Trust \nFund, but as a comlement to it.  Have been working very hard with Terrell Halaska and \nMark Dybul in getting the Pres. speech written and his talking points arranged for the \nannouncement.\nSimultaneously with this going on, I have been working with Stewart Simonson \nin trying to get the correct authorization language written for the proposed bill for the \nnew Department of Homeland Security (DHS).  The WH wants me to be comfortable \nwith it; however, they seem inflexible in that they clearly want the $1.748 billion of NIH \nmoney to go to the new DHS and they want the perogative to set the research agenda.  \nRichard Falkenrath of DHS assures me that despite this, they want me to run the program \nfrom NIH.\nJune 19, 2002 – Most extraordinary day!!  The POTUS requested that I join him and \nSecs, Thompson, O’Neill, and Powell and Sen. Frist and Andrew Natsios at the Rose \nGarden Ceremony to announce the MCTC plan that Mark and I essentialy created.  I met \nwith the Pres for about 10-15 minutes in the Oval Office before the announcement.  He \nwas extremely gracious and complimentary.  During the announcement, he specifically \nthanked me for all that I have done with the project.  \nReleased by Chairman Rand Paul\n46After the annoucnement, I went with Ari Fleischer and gave a press briefing in the \nWH press room on the program.\nImportantly, the Pres. asked Josh Bolten to meet with me and get my feel for the \nbig picture of what the Adminsitration should be doing with AIDS (domestic and global). \nPresent at the meeting were me, Josh, Margaret La Montagne Spellings, Robin \nCleveland, Jay Lefkowitz, Gary Edson, Kristen Silverberg, Allen Gilbert.  Josh asked \nwhether we should do a Manhattan Project for a vaccine and not invest in international \nprevention and treatment.  He said that I should assume that money was not an issues and \nI should tell them what is ”the right thing to do”.  I gave details about the importance of \nbuilding a sustainable (low tech) infrastructure of clinics and trained Africans.  This \ninfrastructure could then be used for HIV prevention and ulitmately treatment, but could \nalso be used for approaching malaria, TBC, and other important diseases.  I said that the \nUSA needs to be the world leader in making international health a driving force in our \nforeign policy.  If we lead, other countries will follow.  Josh seemed genuinely moved \nand agreed with me.  He even stated that it is his feeling that years from now, this \nAdministration will be judged by how it handled the International HIV/AIDS Pandemic.  \nHe stated that the Pres. was very sympathetic to me and what he has heard me say on \nvarious occasions, but there is a skepticism that money will be wasted if there is no \naccountability.  This is also fed by Paul O’Neill and Mitch Daniels.  I said that I agree \nthat we should not do it unless there was strict accountability. We need to have someone \nto run the program who could ”kick ass”.  Josh and I resonated very well.  I believe that \nthe WH will be calling upon me soon to help with such a strategic plan.  In fact, I am \ngoing to proceed to put one together and present to them pre-emptively.\nIt was a great day!!!  I may have accomplished more for global health on this day \nthan on many, many others put together.\nJuly 7-12, 2002 – XIVth International AIDS conference in Barcelona. – Very important \nconference.  The science was completely overshadowed by the policy, which in turn was \ndominated by the discussion of the incredible numbers and projections for the developing \nworld.  Latest figures are that approximately 40 million additional infections will occur \nworldwide by 2010 and up to 70 million dealths will occur by 2020 if serious \nintervention (prevention and therapy) are not implemented.\nI gave a highly scientific talk and used it to come to the conclusion that we must \nimplement treatment and prevention for the North and the South.  Please see records on \nmy speeches for the full text of the talk.  It was a Plenary Lecture on July 10.  I spent \nmuch time with Secretary Thompson and his team (Terrell Halaska, Tony Jewell, Bill \nSteiger et al).  There was an aggressive demonstration against Secretary Thompson \nduring his address on Tuesday, July 9.  I was with him and predicted to him exactly what \nwould happen.  I had heard from Gregg Gonsalves that ACTUP would demonstrate for \nawhile and then allow him to speak provided that he would meet with them afterwards.  \nHe agreed to meet, but they shouted him down and although (as per my suggestion) he \ncalmly finished his speech, the audience could not hear what he said.  This was unlike \nSecretary Sullivan in San Francisco when the TV and microphones allowed audiences \n(TV and present ) to at least here what he said. I helped Secretary Thompson with the \nPress (backstage)immediately after the shout-down.  There was an issue that I handled.  \nDuring the conference 2 days before the demonstration, at a Press Briefing during which \nReleased by Chairman Rand Paul\n47I sat next to the President, the Press asked about needle exchange.  Tommy G. Thompson \n(TGT) was not briefed on this issue and I told him briefly that we (Fauci, Jeff Koplan of \nCDC, David Satcher – Surgeon General, Alan Leschner – Director NIDA and others) had \nrecommended to Donna Shalala upon review of the scientific data that the Clinton Adm. \nallow Federal funding of needle exchange.  However, based on objections of Gen. \nMcAffrie (Drug Czar) and certain Black leaders, Clinton would not allow it. (Of note \nClinton was at the AIDS Conference in Barcelona and publicly stated that he regretted \nthat decision and wished that he had allowed needle exchange).  In essence, I told TGT \nthat Clinton did not allow it and we (current administration) are not allowing it.  This \ncreated a bit of a stir in the press since when asked at the press event (backstage) after the \ndemonstration, he seemed confused about the dichotomy between scientific data and \npolicy.  I had to come in and explain the issue.  I made it very clear that based on the \nscientific data, I had recommended that Clinton allow exchange.  TGT said that he would \nask Dr. Fauci to go over the data again, which the Press did not buy since they know the \ndata are absolutely conclusive.  It was a little awkward for TGT, but he is going to have \nto face the issue that the Bush Adminstration will likely do (and is doing) exactly what \nthe Clinton Administration did and follow a policy that contradicts the scientific data.\nAn important event at the meeting was a meeting that I arranged in my hotel (Fira \nde Palace) among myself, Mark Dybul, Cissy (?last name) and Peter Mugyenyi from \nUganda.  Peter is the Director of the Joint Clinical Research Center (JCRC) in Kampala.  \nHe is successfully treating many Ugandans with antiretroviral therapy (ART).  We (Mark \nand I) want to use his model to try to implement the plan that Josh Bolten asked me about \n(see above and below).  Peter showed us his plan of a main center with regional satelites \nand subgroups out of the satelites.  These are low-tech clinics and each cost about \n$30,000.00 which is much less that the proposals that we have heard.  I was very \nimpressed with this and plan to use this as a model to put together a program to present to \nthe WH (see below)\nIt was a great meeting for me in that I became even closer (if that is possible) to \nTGT.  He implicitly and explicitly trusts me and my opinion.  I appeared on the Aaron \nBrown Show on CNN during the conference and this went extremely well.\nJuly 14, 2002 – C-SPAN’s Washington Journal – I appeared for 45 minutes on the show \nthe morning after returning from the AIDS conference.  I had spent July 7-10 at the \nconference and July 11-12 in Genoa as Chair of the International Scientific Committee \nthat is reviewing the Gaslini Institute for Lorenzo Moretta (its Scientific Director)\nJuly 16, 2002 – Diane Rehm Show – Spent a terrific 1 hour alone on the show with \nDiane.  I went over the AIDS Conference highlights.  I explained about and defended \nSecretary Thomspon vis-a-vis the demonstration against him.  Also, I defended the \nAdministration in that I related that they actually are willing to greatly support \ninternational AIDS efforts, but that they require developing nations and others involved \nto put forth a strategic plan with accountability, endpoints, projected deliverables, etc.  I \nreceived excellent reviews for the show.  I have it on tape as a reference.\nJuly 17, 2002 – Meeting at the White House with Gary Edson and Jay Lefkowitz.  We \ndiscussed the details and implementation of the MTCT project.  Obviously, there will be \nReleased by Chairman Rand Paul\n48difficulties with USAID.  They are resentful that DHHS is getting involved in \ninternational AIDS issues.  Anne Peterson was at today’s meeting.  I have no confidence \nthat she or her staff are capable of successfully pulling off this program.  Mark Dybul \nalone can do better than their whole group.  Sorry for being so direct, but it is true. Of \nnote is that I brought up to Gary Edson and Jay Lefkowitz the issue that I had discussed \nwith Josh Bolten regarding the more Global plan of therapy, prevention for HIV and \nother diseases in a ”low-tech” manner.  I discussed my meeting with Peter Mugyenyi and \nCissy (?last name) from Uganda (see above).  I told Jay and Gary that I believe that we \ncould pull off a program based on the ”Mugyenyi model”.  He told me to put together a \nproposal in a very short time frame (before the WH leaves for August break ( i.e. <2 \nweeks).  They want to determine if the POTUS could bring this initiative with him on his \nupcoming trip to Africa in January, 2003.  I will work with Mark Dybul to do this.\nJuly 21, 2002 – Over the past few weeks important issues have evolved regarding \nBiodefense.  There is a major struggle going on in the Congress about the formation of \nthe new Department of Homeland Security (DHS).  At issue (among other important \nissues) is whether the $1.748 billion that is in the President’s budget for FY2003 will be \ntransferred over to the new DHS and who will actually be responsible for the strategic \nplan and prioritization for biodefense.  DHS people (Gov. Ridge and Richard Falkenrath) \nclearly state that they want the money and the responsibility, but that they will work very \nclosely with me.  The Congress and all of the scientific Societies (FASEB. ASM. Etc.) \nsay that they want the money and prioritization with me.  As usual, I must publicly \ndefend the President’s position, but I work behind the scenes with people like Sens. \nLieberman, Kennedy, and Frist to get language in the new authorizing Bill that will not \ntransfer the money or responsibility (let us see what actually happens).\nMeanwhile, VP Dick Cheney is pushing for a Manhattan Project approach to \nBiodefense. He mentioned this at his visit to CDC and told Julie Gerberding that he \nwould mention this to me also.  Of note, I was quite influential in supporting Julie for the \nCDC job.  We have CIA intelligence that Iraq has smallpox and everyone in DHHS and \nthe WH are scrambling to get together an immunization plan that will go well beyond \nwhat the ACIP is recommending (i.e. pre-emptively vaccinate only about 10,000 – \n20,000 health workers and rely on ring vaccination in the event of an attack).  Cheney is \npushing for a much wider vaccine plan.  TGT will present our plan to Cheney within a \nfew days, which recommends a staged (1,2,3) process that vaccinates about 500,000 \nhealth workers from Oct. 02, to December 02 and then from Jan. 03 through the end of 03 \nvaccinate up to 10 million responders (phsyicians, nurses, police, firefighters, EM people, \nprimary care personnel).  After that and depending on the adverse event rate and the \nperception of threat, we will make vaccine available for the entire USA population on a \nvoluntary basis.  One of the reasons for the push by Cheney is that he knows that Iraq has \nsmallpox and he is planning to push out Sadam Hussein either by direct invasion of Iraq \nor by funding the opposition.  He is afraid that Sadam will strike Israel or even us if his \nback is against the wall.  There will be very intense discussions over the next couple of \nweeks with the WH and DHHS that involve me regarding smallpox vaccine policy.\nThings are obviously very busy with my being involved simultaneously with \nBiodefense and International response to HIV/AIDS.  Both of these involve my direct \ninteraction with the White House.\nReleased by Chairman Rand Paul\n49July 22-24, 2002  - Went to the beach (Beach Haven) to link up with family.  In the car \non the way up and while I was there, I spent considerable time on the phone trying to \nwork out with Sen. Spector’s staff (Bettylou Taylor et al) language in the Lieberman Bill \non authorization of DHS that Spector could support.  They want to make sure that I am \ncomfortable with the language.  I am trying to get language that give DHS ultimate lead \nin the overall prioritization of the research on biodefense, but the money stays in DHHS \nand the research is executed by NIH, but the development of the research agenda in done \nby DHHS in consultation with DHS.  Finally we had a conference call (I took it in the \nkitchen of the beach house) among me, the White House (Richard Falkenrath) and the \nSenate staff that are marking up the bill.  Richard and I agreed upon what I listed above.  \nHopefully, the bill will get through with that language.  It was important to have the WH \non the phone since I was getting concerned that they might think that I was undermining \ntheir efforts to get the DHS going.  By hashing it out with them, we are doing it up front \nand honestly.\nJuly 25, 2002 – Had top secret conference call with Jerry Hauer (HHS), Phil Russell \n(HHS), Stewart Simonson (HHS), and Lester Crawford (FDA).  Subject – VP Cheney has \nindicated that we will hit Iraq soon and we expect retaliation with a smallpox attack on us \nor on Israel.  Cheney wants us to greatly accelerate the process of getting vaccine \navailable to vaccinate everyone if necessary.  I offered to accelerate studies to determine \nif we can dilute the Dryvax even more than 1:5 and whether we can also dilute the 77 \nmillion doses of Aventis Pasteur  WetVax.  Stay tuned.\nThe House and the Senate Committees have adapted the language that I had \nsuggested to Richard Falkenrath.  Therefore, at this time it appears that the money will go \nto DHHS, the overall prioritization will rest with DHS, the strategic plan and specific \npriorities will be the responsibility of DHHS in consultation with DHS and the research \nwill be executed by and through the NIH.  If this holds, I will have won a big victory.\nJuly 26, 2002 -  Got an e-mail from Gary Edson at the WH asking if I had completed the \nGlobal AIDS Treatment plan to present to him in order to determine if it is worth \npresenting to the President for him to announce in his upcoming (January) visit to Africa.  \nMark and I are finished and we set up a meeting at the WH for Wednesday, July 31.  Let \nus see what happens.\nHad an unusual meeting at the Rayburn Building with Chairman Kolbe (R-AZ) of \nthe House Foreign Relations Committee and his chief staffer Charlie Flichner. I \naccompanied Claude Allen (Deputy Secretary, DHHS). They are very upset at the White \nHouse, particularly Gary Edson, for having the President announce the MTCT initiative \nwithout first consulting with them.  They made disparaging remarks about Gary \n(”Emperor Edson”, ”President Edson”).  They were cautious about being disrespectful \nabout the President; however, they were pissed.  They also disparaged Tommy Thompson \nabout getting involved in International issues when this is not the purvue of DHHS.  \nActually, it is becoming the purvue of DHHS with the CDC’s GAP (Global AIDS \nProgram).  This clearly was a turf issue.  They are a powerful Committee and they are \npissed that the President made an announcement without consulting them.  Wait until \nthey hear about the Global AIDS Treatment package that we are presenting to Gary \nReleased by Chairman Rand Paul\n50Edson and Jay Lefkowitz on Wednesday, July 31.  I am going to have to relate to Gary \nthe essence of my meeting with Kolbe and Flichner.\nAugust 1, 2002 – Met at the White House with Gary Edson, Jay Lefkowitz, and Margaret \nLa Montagne Spellings to present the Dybul/Fauci plan for comprehensive treatment and \nprevention of HIV in African countries.  This was in response to the original request by \nJosh Bolten and then the specific request by Gary Edson to put together a plan based on \nthe ”Mugyenyi Model ” of Uganda (see July 17 above).  Also present at the meeting was \nTerrell Halaska, Joe O’Neill, Mark Dybul, and Allen Gilbert.  Gary, Jay and Margaret \nwas extremely pleased and excited about the plan.  They mentioned that we had done a \n”fabulous” job.  They asked us to respond to about 5-6 questions in writing. Clearly they \nare going to run it by the President when he returns from his August vacation in \nCrawford, Texas.  He may well want to make this a Presidential initiative similar to the \nMTCT proposal that we had put together for him.\nAugust 16, 2002 – Went back to White House to present the revised Global AIDS Plan \nto Gary Edson.  Also present were Terrell Halaska, Mark Dybul and Joe O’Neill, \nDirector of Office of National AIDS Policy (ONAP).  Gary again liked the revised plan \nand liked how we answered the questions that he and Margaret Spellings posed to us at \nthe last meeting concerning: a) impact on Domestic AIDS issues; b) development of a \nsharp sound bite for the State of the Union Address in case it comes to that; c) \nrelationship to Global AIDS Trust Fund; d) Inclusion of Russia, India, and China; e) \nreason why the Gates/Merck/Harvard/Univ of Penn initiative in Botswana has failed; f) \nadministrative structure of the program.  He asked me to revise the document by \ntightening it up to an Exec Summary, 5 pages of text and a group of tables. He wants us \npresent it to Josh Bolten when Josh gets back from vacation next week.  Mark and I can \nquickly make this revision.\nAugust 26, 2002 – Meeting at the White House with Gary Edson, Jay Lefkowitz, \nMargaret Spellings, Ken Thomas (ONAP), Jim Capretta, Robin Cleveland (OMB) and \nMark Dybul.  We presented the condensed version (see above) to Gary , Margaret, and \nJay.  Several minutes into the meeting Robin and Jim showed up and in a somewhat \noffhand manner without evening knowing the details of what we were presenting, Robin \nbecame very critical of the idea and the project.  She actually parroted words that we had \nheard weeks ago from the Kolbe Committee (Charlie Flichner) about how they were very \nskeptical that we could actually get ”twin pairs” of hospitals.  Also, she questioned \nwhether the Uganda model would work even though she knew virtually nothing about it.  \nI kept my cool, was subliminally sharp in response to her, but was very pissed inside.  \nGary intervened and defended what we had done and indicated that we would come back \nto Robin with more details about the Uganda model etc. (which we had already done \namong us previously).  Afterwards, Gary, Ken, Mark and I met for about 45 minutes in \nThe Situation Room and discussed further revising of the documents.  I would not be \nsurprised if Robin leaked all of this to USAID and the House Foreign Ops Committee.  I \ndid not like the way she acted at the meeting and I do not trust her.  She acted a bit \ndisrespectful to us in my mind; however, I believe that this was not her intent and she was \nreflecting the questions that the House Foreign Ops Committee was asking her.\nReleased by Chairman Rand Paul\n51August 26 – Sept. 5 – Much discussion about pre-emptively attacking Iraq to neutralize \nthem before they use or get capacity for ”weapons” of mass desctruction.  This is pushing \nour HHS team to be ready to vaccinate the USA population.  Our plan for ”staged” \nsmallpox vaccination of immediate first responders to broad first responders to voluntary \nvaccination of general public is ready to go.  We are waiting for word from the White \nHouse to roll out the plan.\nSept. 6, 2002 – Two meetings at the White House today:\n1) Meeting in Executive Office Building (EOB_ in OMB’s Robin Cleveland’s office \nwith Robin, Gary Edson, Joe O’Neill, and Mark Dybul.  We presented our re-\nenforced implementation with a beautiful computer model of accessibility to \ncentral medical centers (CMCs), primary, secondary and tertiary clinics in \nUganda as a prototype.  Robin was still not entirely satisfied with the presentation \nsince she was hung up on quarantees that this plan would work given failures in \nprevious endeavors in these countries.  She and Gary also wanted to flesh out the \ncomputer model on India, Mozambique and Guyana.  We will go back and try \nagain.  Next meeting likely will be with Josh Bolten.\n2) Meeting in EOB with General Bruce Lawlor (deputy to Gov. Ridge of OHS), Col \nKadlac (OHS), and Col Gerald Parker of Ft. Detrick for me to present to Lawlor \nthe NIAID plan for research including collaborations with DoD and facilities at \nFt. Detrick.  I presented the NIAID Strategic Plan and Research Agenda.  It was a \ngreat meeting.  Lawlor was extremely impressed and highly supportive.  We \npromised to work together and he offered to help in any way possible.  He is a \ntough, nice , straight shooter.  His background is that he commanded a tank \nbattalion in the Gulf War.\nSept. 17, 2002 – Another meeting at the White House on the President’s AIDS initiative.  \nThis time I presented the program to Josh Bolten in his office in the West Wing.  Also \npresent were Gary Edson, Jay Lefkowitz, Terrell Halaska, Mark Dybul, Joe O’Neill, \nRobin Cleveland, Kristen Silverberg, Carol Thompson.  We are definitely moving along.  \nClearly Josh wants to do it.  He thoroughly liked my presentation.  The problem will be \nOMB and the question of where we are going to get the money.  Issue also is if the \nPresident accepts it, when can we announce since the budget for 2002 has not even been \nsettled and 2003 has virtually decided.  We want to announce soon since WHO and other \norganizations are dancing around the question of an implementation strategy and we do \nnot want to President to lose the leadership edge.  Josh asked OMB (Robin) to work out a \nbudget scenario and get back to him.  They also will elevate it up one more notch to \nAndy Card, Condolezza Rice and Mitch Daniels. We will meet again soon.\nSept. 18, 2002 – Briefed Secretary Thompson about the upcoming smallpox vaccination \npolicy and role-out.  Also present were Julie Gerberding, Stewart Simonson, Michael \nOsterholm, Jerry Hauer, Les Crawford, Ann Agnew, Terrell Halaska, etc.  We are \nadvancing towards the 3 stage policy that ultimately would allow voluntary vaccination \nfor anyone who wants it.\nReleased by Chairman Rand Paul\n52Had briefing at the White House on the fact that West Nile Virus can now be spread via \nblood transfusions (and transplants).  We are in the midst of a major epidemic with about \n1641 cases and 80 deaths.  It has been clearly documentd now that blood transfusions can \ntransmit WNV.  We discussed how we would handle the press, etc.  I strongly suggested \nthat we avoid the mistakes of the early 1980s regarding HIV and the blood supply.  I \nsuggested that we obviously try to avoid panic, but that we make it clear that transfusions \nare NOT entirely risk free with regard to WNV as well as several other pathogens.  It is a \nquestion of relative risk of the transfusion versus not getting the transfusion.\nINCREDIBLE evening – Bono the lead singer of U-2 and the best selling musician in \nhistory had called my office yesterday (his chief-of-staff) to say that he wanted to talk to \nme by phone or preferably in person to discuss how we could partner and how he could \nhelp me in my work on trying to get AIDS treament and care and prevention to sub-\nSaharan Africa.  He had, this past year, gone to Africa in a much-publicized trip with \nTreasury Secretary Paul O’Neill.  At mid-day we got a call that Bono wanted to fly from \nChicago to speak with me in person that evening.  He did and we met at my house.  We \nhad wine, Chris cooked pasta and we had an amazing evening, talking for hours.  He is \nalsolutely fantastic, passionate and very intelligent.  He will try to help by supporting me \nand President Bush in the evolution of our implementation plan for Africa. Also visiting \nwas his staff Jamie Drummond, Lucy Matthew, and Katrina......  We promised to stay in \nclose touch and work together.  I did not tell Jenny, Megan and Alison that Bono was \ncoming to the house for dinner.  When he walked in the door, they were speechless; \nhowever, he was wonderful with them.  They (and I) will never forget this extraordinary \nnight.\nSept. 24, 2002 – Had CIA briefing and overall review of smallpox plan in Secr. \nThompson’s office with Gov. Ridge, Col. Bob Kadlac, Julie Gerberding, Jerry Hauer, and \na Ridge person .  Clearly Russia had modified smallpox and very likely Iraq has \nsmallpox.  We reviewed the pre-emptive plan for vaccination that will be presented to \nPres. Bush tomorrow by TGT in anticipation that he will make the policy decision soon.  \nWe will recommend the 3 stage proceedure of 500,000 to 10 million to the general \npopulation.  Word in the meeting is that we will definitely attack Iraq by January.\nSept. 26, 2002 – White House briefing with Carol Kuntz (Assistant to VP Cheney), \nKristen Silverberg, Stewart Simonson, Jerry Hauer, Bob Kadlac and others regarding \nsmallpox vaccination policy.  Carol was concerned that she was getting different signals \nfrom different people about varying toxicities among children versus adults, primary \nvaccinees versus re-vaccinees.  Apparently, D.A. Henderson has been very dogmatic with \nher (what else is new?).  I told her that one can go to the literature and analyze the \ninformation in many ways.  Since she questioned my numbers, I just kept quite and \npromised myself to get back to her.\nSept. 27, 2002  - Spoke with Carol Kuntz over the phone and explained some \ncalculations that I had done (see attachment).  She apologized for questioning me the day \nbefore and even made the comment that ”Who is she to go mano-a mano with Tony \nReleased by Chairman Rand Paul\n53Fauci” since I am ”a legend” in the White House.  I had a great conversation with her and \nsent the document shown below to her.\nSeptember 27, 2002\nNOTE TO CAROL KUNTZ\n                   \nFrom:  Anthony S. Fauci, M.D.\nDirector\nNational Institute of Allergy and Infectious Diseases\nNational Institutes of Health\nCarol:\nAs per your request, I will summarize below the information that I discussed with \nyou over the phone and will provide as attachments (1 through 5) some data sheets:\n1)  The question arises whether the rate of serious complications due to primary vaccinia \nvaccination is greater in children versus adults and whether, because children will be \nobviously excluded from the cohort of health worker and first responder vaccinees, this \nwill result in a lower than anticipated rate of complications for the first 2 stages of the \nvaccine program, i.e. up to 10,000,000 people.  My reference is Lane JM et al: \nComplications of smallpox vaccination, 1968.  National surveillance in the United States. \nN Engl J Med 281:1201, 1969.  I worked from Table 1 of the paper (attachment #1) and \nanalyzed the “Primary vaccinations”.  I divided the cohort into 2 groups of <1 yr to 9 yrs \nold and 10 through 20+ yrs old in order to compare the actual rate per million \ncomplications in each group. I found the following:\nThere were 4,900,000 individuals in the <1 to 9 yr olds and 694,000 individuals in the 10 \nto 20+ yr olds.  The rate of complications in the 2 groups were as follows:\n                                                            <1 – 9 y.o.                       10 – 20+ y.o.\n                                                                                 per million\nPostvaccinial encephalitis                          3                                     1\nVaccinia necrosum                                   0.4                                  4.0\nEczema vaccinatum                                   10                                   14\nGeneralized vaccinia                                  22                                   26\nAccidental inoculation                                26                                  10\nDeaths                                                           1                                1.44\nTherefore, one can conclude from this analysis that the younger group has a higher \nincidence of encephalitis, but the older group is similar, if not slightly worse off, when \nReleased by Chairman Rand Paul\n54compared to the younger group with regard to the other complications of primary \nvaccination.  HOWEVER, the critical issue as I see it is the major difference between \npreviously unvaccinated and previously vaccinated individuals with regard to the \nfrequency of vaccine-related complications.  Whether you look at the figures from the \n1969 paper referred to above (attachment #2) or the 2001 MMWR (attachment #3), the \nrate of complications in the previously unvaccinated group is considerably higher than \nthat in the previously vaccinated group. For example, in the Table 6 of the 1969 New \nEngland Journal of Medicine paper (attachment #2), the complications per million are as \nfollows comparing previously unvaccinated versus previously vaccinated: Encephalitis – \n2.9 versus 0; vaccinia necrosum – 0.9 versus 0.7; eczema vaccinatum 10.4 versus 0.9; \ngeneralized vaccinia – 23.4 versus 1.2.  The differences are even more impressive in the \nTable from the 2001 MMWR (attachment #3)\n2) Since the differences are so striking between previously unvaccinated and previously \nvaccinated individuals with regard to the incidence of serious adverse events associated \nwith smallpox vaccination, I calculated the percent of people in the work force that we \ncould predict would be previously vaccinated or not.  I used the most recent US Census \n(2000) (attachment #4).  I consider the work force to be individuals from 20 through 64 \nyears old (this corresponded to natural breaks in the census data).  In 2000, there were \n281,421,906 people in the USA.  I found that there were 59 million people or 21% of the \ntotal population and 36% of the work force between the ages of 20 and 34 years.  These \npeople will have not been previously vaccinated.  Routine vaccinations stopped in 1972 \nand most children would not have been vaccinated before age 5 and so 34 years old is the \ncut off point.  I further found that 107 million people between the ages of 35 and 64, i.e. \n38% of the population and 64% of the work force were likely vaccinated.  Thus, 64% of \nthe people that we would be vaccinating in the first responder/health care worker \ncategory would fall into a group that historically has a much lower rate of serious adverse \nevents than the previously unvaccinated group. I believe that this must at least be taken \ninto consideration in our policy decisions.\n3)  You asked a question about residual immunity in people vaccinated decades ago.  If \nyou look at laboratory immunity (i.e. antibody levels and cell-mediated immune \nfunction), there is no question that the vast majority of studies indicate that there are \nvariable levels of residual laboratory immunity in people who were immunized even \ndecades ago.  The question remains whether the laboratory immunity is totally reflective \nand correlated with clinical immunity to an actual exposure.  There are several studies \nthat indicate that previous immunization, even decades ago, provides real, but variable, \ndegrees of protection against death (i.e. lower case fatality rates) compared to \nunimmunized individuals. It is impossible to determine the effect on actual infection \nwithout death.  Some of these studies such as the 1902-1903 Liverpool outbreak study is \npartially flawed in that there was some smallpox circulating in the community that might \nhave boosted immunity.  However, several studies that are summarized in a paper by \nMack TM et al: Smallpox in Europe 1950-1971. J. Infect. Dis. Vol.125, number 2, Feb. \n1972 (attachment #5) indicate that case fatality rates are significantly less in individuals \nvaccinated even more than 2 decades before.  I personally do not believe that all of these \npeople were protected because that were intermittently boosted by naturally occurring \nReleased by Chairman Rand Paul\n55smallpox.  There just were not that many widespread smallpox outbreaks to boost the \npopulation of Europe consistently during that time frame.  In fact, from 1950 through \n1971, there were only 680 cases of smallpox in the countries in question.  Therefore, I \nwould have to conclude (not definitively, but likely) that previously immunized people \ndo have a variable, but significant, degree of residual protective immunity against death \nfrom smallpox.\nI hope that you find this information useful.  Please give me a call if you have any \nquestions at (301) 496-2263.  Thank you and best regards.\nSincerely,\nAnthony S. Fauci, M.D.\nSept. 29, 2002 – Received ICAAC Award and gave the ICAAC Award lecture in San \nDiego on “Bioterrorism in the spectrum of emerging and re-emerging diseases”.  \nAudience was 10,000 people and received rave reviews for the lecture.\nSept. 30, 2002 – Got another top secret briefing from the CIA.  Apparently Russia is still \nmaking genetically modified microbes for offensive use.  Also, was briefed on Iraq’s \ncapabilities.  It is my impression that the CIA information is really very soft.  They have \nsources, but they are difficult to validate.  \nOct. 4, 2002 – Engaged with Julie Gerberding, Jerry Hauer, Kevin Keane in a briefing of \nState and local Public Health officials on the likely roll out plan of  smallpox vaccination \nin3 stages (500,000 smallpox response teams and emergency personnel, then 10,000,000 \nhealth care workers, primary care people, police and fireman, etc. followed by making \nvaccine available to general public after the Acambis product is licensed in early 2004.  \nThis was followed by a press conference, which did not go well since Jerry Hauer said \nthat we were not going to make any “announcements”. Note that there have been many \nleaks about the 3 stage plan and the press was clearly annoyed that the press conference \nstarted with a statement that we were not going to tell them anything important.  \nHowever, Julie proceeded to get up and say that we recommended the above plan.  She \nleft the stage for a few minutes and I corrected her (politely) by saying that we are not \n“recommending” anything, we are merely giving a likely option.  The Secretary \nrecommends something to the President and that is confidential.  The reason for this is \nthat we do not want to put the President in the position of possibly going against his top \nhealth advisors, i.e. boxing in the President.  Julie returned and confirmed my correction.  \nThe press rightfully thought that we were sloppy (not me, but DHHS).  We called the \nmain players – Larry Altman, Laura Mackler of AP, Ceci Connolly of Washington Post \nand Sheryl Stolberg of NY Times to clarify the situation.  All of this is happening \nbecause the WH is taking so long to come out with a policy and we are compromised \nbecause if we do not say that we favor a certain plan, then it looks like we do not know \nReleased by Chairman Rand Paul\n56what we are doing.  How can we not favor a certain plan if we have been working on this \nproblem for months???\nOct. 10, 2002 – Had 2 important meetings at the White House today:\nFirst - meeting with Gary Edson, Jay Lefkowitz and Robin Cleveland about the \ncomprehensive AIDS implementation plan for prevention, treatment, and care for \ndeveloping nations  for possible consideration by the President.  This was in response to a \ncall from Jay about 1 week ago asking to spread out the plan from 5 years to 7 years and \nto calculate how much money would be spent for each prevention intervention, i.e. \ncondom distribution versus sex worker education versus needle exchange versus family \ncounseling.  The point is that they feel that the request might be too much for the 5 years \n(Total = $9.987 billion over 5 years, including up to $1.0 billion for the Global Fund).  \nThey want us to spread it out so that the early years will be less.  Also, they want us to \nassume that countries other than Russia, China, and India (which will contribute 50%) \nwould be contributing some proportion.  We figured Botswana and South Africa could \ncontribute 30% each Namibia and Guyana 20% and Uganda 10%.  Furthermore, they \nanticipate that the President is going to ask just what the money is going for and if it is \nfor Condoms, sex workers and IV drug users, he should at least know that.  Obviously, \nthe right wing in the WH would be against this.  We crunched the number and I presented \nthis.  Right off  Robin mentioned that Jim Capretta (OMB PAD) had mentioned to Mitch \nDaniels that something was cooking vis-à-vis international AIDS and that this would \nrequire new money.  Mitch immediately said no chance and that no matter what we give, \nwe will be criticized.  Robin then left for another meeting.  I suggested to Jay and Gary \nthat another alternative would be to do this through the Global fund with the stipulation \nthat they work from our plan with suggestions from them. My reason was as follows. The \nWHO group just met in Geneva with Bernard Schwartlander to try to galvanize a plan \nand support for a global program. Mark Dybul went to that meeting.  It appears that they \nwill ask for a 3 year plan to treat 3 million people at a cost of $10-15 billion with $4.6 \nbillion from USA. They want to announce this on World AIDS Day (Dec. 1).  This could \npre-empt the President.  In other words, we will be pressured to give $4.6 billion to do \nsomeone else’s plan. This would be less that our 5 year and 7 year plan. Why not \nannounce that we will give $4.6 million to the global fund if they coordinate their \nactivities through our plan?  The President could announce this and get credit for \nleadership as well as for contributing to the Global AIDS Fund.  Also, it would avoid the \nimpression that we Americans are going off on our own.  Gary and Jay liked the plan \nvery much and asked me to put together a 3-pager for Josh Bolten.  They made me swear \nto tell no one about this, not even Mark, Terrell or TGT.  I finally convinced them that I \nreally needed to tell Mark since he is necessary to put these things together.  I am very \nuncomfortable about not telling Terrell.\nSecond meeting was a briefing of Vice President Cheney’s Staff on the NIAID efforts on \nbiodefense, i.e. what is our “vision” for spending the $1.75 billion as well as our long-\nterm vision.  At the meeting were Carol Kuntz, Seth Carus and Noreen Hynes (all from \nCheney’s senior staff) and Jerry Hauer (from the DHHS).  The meeting went extremely \nwell.  I wowed them with a passionately delivered presentation. I told them that we at \nNIAID could transform the way the country deals with bioterrorism threat from a \nReleased by Chairman Rand Paul\n57research  and public health standpoint. They loved it and asked what powers I needed that \nI do not have to execute this.  I mentioned that we should have a fund to purchase \nvaccines and drugs so that the pharmaceutical industry would have an incentive to get \ninvolved.  Also, I said the FDA needed to be more flexible.\nOct. 17, 2002 – Sent down the 3-pager that Jay and Gary wanted (see above).  It calls for \nthe USG taking the lead and committing a considerable amount of money THROUGH \nthe Global Trust Fund, but under the stipulation that other countries join us and \nimplement our plan. The plan would cost approximately $18.8 billion of new money over \n5 years.  In the covering memo to Jay and Gary, I mentioned that I was uncomfortable \nabout not telling Terrell what we are doing since I am supposed to me representing her \nand TGT at these meetings.  Of note, Gary and Jay usually respond almost immediately \nto me when I send material such as this.  However, over the subsequent 2 days (Oct \n18,19), I have heard nothing from them.  I suspect that they are put aback by my \nmentioned my discomfort about not telling Terrell about this.  We shall see what \nhappens.\nAlso, received a call from Stewart Simonson who said that Vice-President Cheney \nwants a meeting with me about my Biodefence Research Vision on Wednesday, Oct . 23.  \nThe White House has set up the meeting.\nOct. 20, 2002 – Gary Edson contacted me and likes very much the revised document (see \nabove).  We are closing in on it and he will soon show it to Josh Bolten.\nOct. 8 – 22, 2002 – Washington, D.C. area being terrorized by a sniper who has already \nshot 12 people and killed 9.\nOct. 22, 2002 – Had a terrific visit and briefing of  Vice President Cheney in the West \nWing of the WH.  Present were the VP, “Scooter” Libby, Carol Kuntz, Noreen Hynes, \nSeth Carus, (Gen.) Phil Russell, and Stewart Simonson. I went over our NIAID Research \nAgenda and Strategic plan for biodefense.  As I did in my briefing of Carol Kuntz (see \nabove), I stressed that we can and will do the job.  I stressed that we needed help in \ngetting greater regulatory flexibility, having the power to sole source contracts, and we \nneed to provide major incentives for industry.  We must work more closely with industry \nthe same way that the automobile industry made our planes and tanks during World War \nII.  It was a very easy and enjoyable interaction with the VP.  Of note, when we discussed \nbriefly the policy for smallpox vaccination, it was clear that Libby is the driving force for \nmass vaccination sooner rather than later.  The VP seemed rather measured on the \nsubject.\nOn the way out of the WH, I ran into Gary Edson in Josh Bolten’s office (Josh’s \nassistant had seen me walking by and asked me to come in to say hello to Josh).  Josh and \nGary were actually working on the plan that Mark and I had just sent to them.  They like \nit very much and I think that something is going to happen with it.\nOct. 23, 2002 – Met with Bono again at the Jefferson Hotel for breakfast.  Also present \nwere Jamie Drummond, Lucy Matthew, Katrina and Erin Chapman. We spent almost 2 \nhours going over options for how we can drive the agenda for universal care, prevention \nReleased by Chairman Rand Paul\n58and treatment for HIV infected people worldwide.  I emphasized the importance of \nengaging Russia, India, and China because of the large populations in these countries in \nwhich a mere increase in prevalence from 1% to 2% in countries like India and China (I \nbillion people in each country) could quickly create a pool of infected people that would \nequal all of Africa.  He will be meeting with Condolezza Rice this afternoon to push for \nthe USA getting involved in a major way with money (billions) and leadership.  I am \nimpressed with Bono’s good intentions and his intelligence and energy.  I am \ndisappointed that I cannot tell him about the program that Mark Dybul and I have been \nworking on for the “comprehensive implementation” plan.  Hopefully, we can make this \npublic soon so that we can engage Bono’s assistance with his bully pulpit.\nOct. 29, 2002 -  Received today the written version of the oral history that Victoria \nHarden collected from me a few months ago.  See attached document.\nFauci on biodefense \n8-9-02.doc\nOct. 30 – Nov. 1 – Multiple conversations and e-mail exchanges with Gary Edson \nregarding the AIDS Project (see above).  I believe that finally we are getting this straight.  \nHistorically (see above), every time that we try to calculate the needed resources for a \ncomprehensive program, Robin Cleveland (OMB) or someone else says that it will not \nfly (see note of Oct. 10, 2002).  Now Gary calls me and says that our most recent package \nmight be low-balling it since he recently read an article by Jeff Sachs in The Economist \nthat we need $25 billion per year.  I finally told Gary that I had had enough.  The world is \ncalling for $10 billion per year for 5 years with an increase to $15 billion per year by \n2007.  They all say that the USA commitment should be 35% of this or $3.5 billion per \nyears for 5 years.  I told Gary that this is what we should propose as the President’s \ninitiative provided that the other countries put in the remaining 65% and that they use our \nimplementation plan.  I told Gary that he and Robin need to figure out how much of $3.5 \nbillion per year we (USA) will have already been spending in order to determine the \namount (% of $3.5 billion) that really would have to be new money.  Finally, he agreed \nand now we can stop all of this ridiculous back and forth with Robin and him.  We may \nbe getting close to presenting this to the President.  We just need to convince Josh Bolten\nNov. 1, 2002 – Had a great meeting with Carol Kuntz, Noreen Hynes, and Seth Carus \nregarding the request of the Vice President for me to list what added powers that I would \nneed to make the BioD program work at NIAID. Stewart Simonson and Phil Russell also \npresent I listed a group of these and Carol et al liked and agreed with them.  They were \nmostly sole source contracting authority, rapid grants, DARPA-like powers, etc.  Next \nstep is arranging a meeting with me, TGT, and Cheney.\nNov. 12, 2002 – See note of Oct. 30 – Nov. 1 above.  Gary Edson called me last week \nand said that they were on the verge of making the decision regarding whether we will go \nfor the major implementation plan.  However, there is skepticism on the part of OMB \nReleased by Chairman Rand Paul\n59(and likely others that he did not mention) concerning whether this can be done.  They \nneed to do due diligence and get some outside opinions and so they Gary has asked me to \ngather for a meeting at the WH a group of people who have actually done developing \ncountry implementation.  They want to speak with these people without my being there, \ni.e. to check up on me.  I suggested and they agreed to bring in the following:  Peter \nMugyenyi (Uganda), Jean (Bill) Pape (Haiti), Paul Farmer (Harvard-Haiti), Eric Goosby \n(Pangea Foundation and Rwanda).  Gary asked me on a Friday and I needed to contact \nthese people who were scattered all over the world to come to DC to see me and then \nhave a visit to the WH.  Gary insisted that I not reveal the plan to them and so I had to \nconvince them to travel within a 72 hours period merely on faith as a favor to me.  They \nall agreed and came: Mugyenyi from Uganda, Goosby from Rwanda, Farmer from \nGermany, and Pape from Haiti.  Still Gary insists (despite my asking him again and \nagain) that I cannot tell Terrell Halaska about any of this.  I pushed Gary and he checked \nwith Josh Bolten who said that this week we indeed will be able to tell Secretary \nThompson.\nOn another issue, things are heating up regarding possible war with Iraq.  This \nmakes compelling the imminent decision of policy regarding smallpox vaccination of \ncivilians.  The Pentagon will imminently announce that 250,000 to 500,000 troops will be \nvaccination with vaccinia (Dryvax).  The question of the availability and \nrecommendations for  civilians remains.  I am pushing for “recommending” that the \n500,000 and then the up to 10,000,000 health workers and first responders get \nvaccinating.  However, I feel that although we should make available the vaccine for the \ngeneral public, given that the threat assessment is very soft, we should recommend that \nthey not take the vaccine unless they feel very strongly that they do not want to take any \nchances.  This is different from the situation with the anthrax vaccine where the DHHS \nsaid that had no recommendation either way; they just made the vaccine available if \npeople wanted it.\nWent down to the White House to pre-brief Gary Edson and Jay Lefkowitz on \nMugyenyi, Goosby, Pape, and Farmer.  They both inquired as to what pretense I used to \nget these people to come to the USA.  I said that I asked them to come and advise me \nabout clinical trials in developing nations.\nHad dinner at the Trattoria Sorrento in Bethesda (Cordell Street) with the 4 \nvisitors and told them exactly why I called them in and explained what type of questions \nwould be asked of them at the WH.  They look upon me as a hero for what I am doing.\nNov. 13, 2002 – Multiple meetings in the DHHS to plan roll out of smallpox vaccination \nplan.  It is imminent. The President is planning on having to start bombing Iraq in the 2nd \nweek of January and wants to start vaccinating the 500,000 people smallpox response \nteams by December 1 and the 10,000,000 first responders by January in order to prepare \nfor a release of smallpox by Iraq.  Much discussion about timing the announcement of \nvaccinating the military with the announcement about the general population. Concern is \nthat if we do not link the 2, the people will react to vaccinating the military by saying \n“what about us?”  It looked like we were going to make the announcement on Friday, \nReleased by Chairman Rand Paul\n60Nov. 16.  However, at the WH, the President told the cabinet (including TGT) that he \nnow wants to wait until he comes back from a foreign trip (Nov. 27) since Osama bin \nLaden just released a tape yesterday indicating that he is still alive and threatened the \nUSA, UK, and Russia.  Bush does not want it to appear that we are panicking in response \nto the tape.  I am relieved that we decided to wait since I would have had to cancel my \ngoing to Los Angeles to receive the RAND Prize ($10,000.00) in order to remain in DC \nfor the Press.\nHeard that the WH meeting with the 4 visitors on the global AIDS plan went \nextremely well.  I believe that we are convincing the skeptics that we can effectively treat \nHIV in developing nations.  Of note, Robin Cleveland asked to have Nils Daulaire there \nfor his opinion.  It is my impressions that she is resentful of the NIH and me.  This is \nlikely due to the fact that her OMB account for which she is responsible includes USAID \nand there is obviously some competition in her mind given that NIH always does so well \nwith the budget.\nNovember 19, 2002 – Another meeting at the White House with Jay Lefkowitz, Gary \nEdson, Joe O’Neill, Mark Dybul and me to further discuss the potential for getting the \nPresident to accept our proposal for a comprehensive $50 billion over 5 year plan.  Gary \nand Jay want me to further refine the presentation and actually start finalizing it for \npresentation first to Mitch Daniels and then ultimately to President. Jay had shown me a \nmemo that Nils Daulaire had sent to Robin after the meeting with Mugyemnyi et al and it \nwas clear that Robin and Nils are working together.  Nils is a fine former public servant \nand is now in the private sector.  However, judging from his memo, he is dead wrong on \ncertain issues, i.e. he does not believe that Russia, China and India will surpass Africa \nwithin the next 5 years in AIDS impact.  Also, I am not happy that Robin previously told \nNils about the plan at the same time that Gary and Jay will not allow me to tell Terrell \nHalaska or Secretary Thompson about it.  Strange situation in this WH regarding secrecy \n– they are almost pathologic about it.  At the meeting, Jay and Gary asked me and Mark \nto prepare again even more material for an upcoming meeting with Mitch Daniels (see \nabove).  We got it to them within 1 day.\nNovember 21, 2002 – Another pre-roll out meeting at the Department to prepare for the \nupcoming announcement by the President on the Smallpox vaccination policy.  Meeting \nwas with Kevin Keane, Bill Hall, Jerry Hauer, and on teleconference  - Michael \nOsterholm, Julie Gerberding and an assortment of CDC public affairs people.  I have \nconvinced them that we should not recommend  to the general public that they take the \nvaccine give the non-quantifiable risk.  I am also convincing them that for the Stage 2 \n(10,000,000 first repsonders), we also should not make a blanket recommendation that \nthey get vaccinated.  Rather, we should say that as a group the vaccine should be offered \nto them, but since this is a heterogenous group, the actual recommendation to take it or \nnot should rely on discussions between the CDC and the State and local public health \nofficials in light of the particular needs and situation within a given jurisdiction.  Clearly, \nthe Stage 1 group (500,000 smallpox response teams) should have a recommendation to \ntake the vaccine voluntarily.\nReleased by Chairman Rand Paul\n61Nov. 22, 2002 – Gave keynote address at the Holy Cross function at The Supreme Court  \nfor “Lift the Cross High”. Justice Clarence Thomas was our host and was the other \nspeaker.  My remarks were very well received by all.  It was a very elegant evening \naimed ultimately at fund-raising for Holy Cross.  Thomas is also an alumnus.\nNov. 26, 2002 – Briefing of Vice President Cheney at the White House regarding Project \nBioshield (I made up the name) which is requesting his help in getting me special \nauthorities for Countermeasure Advanced Development.  Meeting included VP Cheney, \n“Scooter” Libby (both on teleconference from secret location), Secretary Thompson, \nStewart Simonson, Bill Raub, Carol Kuntz, Noreen Hynes, Seth Carus.  Bill Raub \npresented the need for a $1-2$ billion Vaccine Trust Fund. Meeting went extremely well.  \nVP was very supportive of my proposals and told Carol to set up a meeting between me, \nTGT, Stewart and Josh Bolten.\nAlso met later in the day with Richard Danzig (former Secretary of the Navy \nunder Clinton).  He is a private consultant under contract to the DoD for Biodefense and \nwanted to get to know me since he has “heard so much about me”.  He wants to start an \ninformal group of people linked by common interest in biodefense.\nDec. 3, 2002 – Still waiting for the President to decide on the announcement of the \nsmallpox vaccine policy.  Should be tomorrow or next day.  Also, a lot of back and forth \nbetween me, Jay Lefkowitz and Gary Edson.  I believe that we are moving towards a \nGlobal AIDS Initiative.  Jay will present our plan and budget to Mitch Daniels today.\nPhone call with Jay Lefkowitz and Keith Hennessey and Doug Badger called \nwanting to know why we needed a vaccine trust fund as opposed to other mechanisms to \nguarantee purchase of vaccines.  This is what Bill Raub presented to the VP (see above); \nhowever, they are asking me about it because of “my credibility” (according to Carol \nKuntz.  Carol was on the phone with Kristen Silverberg.  There is some concern as this \npasses through the WH that there is not enough justification for a “Trust Fund”.  Carol \nKuntz wants to set up a meeting at the WH for me to help explain this sometime later this \nweek or next week.\nDec. 4, 2002 – Amazing day.  I was at one time on 3 different lines with 3 different \npeople at the White House – Gary Edson, Jay Lefkowitz, Carol Kuntz.  There was an \nintense and critical issue with Gary and Jay.  Gary was getting ready to meet with Mitch \nDaniels regarding our AIDS plan and he heard through his WH grapevine that Mitch was \ngoing to try to “Steamroller” him by bringing up the Washington Post article from a \ncouple of days ago about the program in Botswana being a failure.  In other words, if \nBotswana failed, why did we believe that our program would succeed.  I explained to \nGary that the Botswana Program was “Top Down” government as opposed to local \nnetwork.  They were using high tech., approach instead of grass roots.  Gary asked me to \ncontact our African friends and get their opinion (in one half hour!!!!).  I contacted Peter \nMugyenyi, Sam Kibende, and Eric Goosby and they all agreed with me.  Peter mentioned \nthat the big mistake that the Gates Foundation and Merck went directly to the Botswana \nGovernment and asked them to put together a plan.  Botswana then employed the \nHarvard AIDS Institute who developed a high-tech USA Harvard like plan with CD-\nReleased by Chairman Rand Paul\n62ROMs for developing voluntary Counseling and Testing.  Peter said that it was doomed \nto failure.  I relayed this to Gary and he was satisfied.\nAlso, more delays in the announcement of the smallpox vaccine policy.  It will \nnot be this week and so I will be able to go to Albany to give a talk associated with my \nAlbany Prize from last Spring.\nDec. 4 – 10, 2002 – Incredible amount of action going on.  Many calls and interactions \nwith VP Cheney’s staff (Carol Kuntz, Noreen Hynes, Seth Carus) regarding Project \nBioShield.  The VP wants to come to NIH and have me show him around the Vaccine \nResearch Center (VRC) in the context of the “Advanced Project Development” of Project \nBioshield.  Project Bioshield has caught on with the VP and his staff.  Scooter Libby is \nbecoming a strong ally and fan of mine. \nAt the same time there is a lot of buzz as to when the President is going to \nannounce his vaccine policy.  Many leaks, interestingly most from the WH itself.  We are \nbusily preparing our Qs and As for the announcement.\nElias Zerhouni feeling a bit out of the loop.  I am trying to keep him informed, but \nthe WH and DHHS wants to deal directly with me.\nDec. 11, 2002 – A truly terrific day!  Cheney came to VRC and I presented an updated \nversion of Project Bioshield in the context of going from concept to product in the VRC.  \nPresent at meeting were: Cheney, Scooter Libby, Carol Kuntz, Noreen Hynes, Seth \nCarus, Elias Zerhouni, Tommy Thompson, Stewart Simonson, Phil Russell, Gary Nabel \nand his staff.  Cheney and Libby were “wowed” by my presentation and by the VRC  \nCheney instructed his staff to do whatever is necessary to facilitate what I am doing \nincluding giving me special authorities.\nImmediately after the VP visit, I rushed down to the WH to present “Project \nBioShield” to Josh Bolten in the context of the VP wants me to sell the concept to Josh.  \nPresent at the meeting were Josh, Kristen Silverberg, Richard Falkenrath, Tommy \nThompson, Scooter Libby, Stewart Simonson, et al.  Josh questioned the need for the \nvaccine purchase fund component of Project BioShield (good questions).  I defended it \neven though this really is not my bag (Bill Raub was the original designer of it).  At the \nend of the meeting, Josh seemed supportive of the entire project.  Clearly the VP is \ndriving this process.\nAnother amazing event.  The vaccine policy roll-out is under very close hold at \nthe WH.  Today I received one of my many calls from George Stephanopoulos of ABC. \nGeorge pointed out that the President gave an interview with Barbara Walters to view on \nDec. 13 in which he said that he would allow vaccination of the entire population on a \nvoluntary basis.  George thought that this constitutes the long-awaited announcement of \nthe policy.  I told George that the Pres. was probably just speaking in broad generalities \nsince I know that there will be a formal announcement with me involved at the WH.  \nGeorge seemed convinced; however, the ABC people pursued this and confronted the \nWH who inexplicably confirmed the story and said that the roll-out would be Friday \n(Dec. 13).  I heard about this when I was in Josh Bolten’s office presenting Project \nBioShield.  My phone rang and CBS said that ABC had broken the story on the policy on \nthe basis of the Barbara Walter interview.  They wanted me on their show to discuss.  I \nsaid that I knew nothing about this and therefore could not appear.  I", "summary": "Watcher-discovered document from paul-readingroom (2026.07.27_Diary-Prequel-.pdf), auto-indexed 2026-08-05.\n\nExcerpt: From: \"Fauci, Anthony (NIH/NIAID) [E]\" </O=NIH/OU=NIHEXCHANGE/CN=NIAID/CN=AFAUCI> To:\"Fauci, Anthony (NIH/NIAID) [E]\" <AFAUCI@niaid.nih.gov> Subject: history Date: Sat, 11 Jul 2015 17:50:16 -0400 Importance: Normal Attachments: historical_record_of_A.S._Fauci.docx Released by Chairman Rand Paul 1 HISTORICAL RECORD OF HIV/AIDS Anthony S. Fauci, M.D. Director National Institute of Allergy and Infectious Diseases National Institutes of Health This written record will start today (April 11, 2001) and will state some events  retrospectively.  I have other records including 2 dictated tapes that should be noted. The event  that precipitated this written record, which I hope that I can regularly contribute to is the tidal  wave of activity concerning the possibility of treating HIV-infected…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.27_Diary-Prequel-.pdf", "pdf_url": "/archive-docs/fauci-files/c1dee44b66471ea95f8e8154b109f914/pdf", "doc_date": "2026-08-05", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-07-27-diary-prequel"], "part_number": 1, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 2 of 8)", "content": "hung up and \nReleased by Chairman Rand Paul\n63mentioned this to Kristen Silverberg.  She knew nothing and immediately called Dan \nBartlett (WH Press Office).  I did not hear what they said; however, apparently what \nhappened is that the press confronted the WH with the Walters interview and the WH \ncaved in and admitted to the policy.  The crazy thing is that it has now hit the press, but \nthe WH will not let us talk about it since the President has not officially announced it.  \nWe still do not really know what the policy will be nor when it will be announced.  More \nlater!\nDec.12, 2002 – Much activity back and forth with the White House and the DHHS \nregarding putting the finishing touches on the President’s Statement and the policy in \ngeneral.  In particular, Kristen Silverberg and checked frequently with me.  In mid-\nafternoon she called me down to the White House with Stewart Simonson to go over \nword-for-word the President’s statement.  We were the only DHHS people asked to do \nthis.  Big surprise in the statement was the fact that we will make vaccine available to the \npublic before 2004 by allowing people who insist on vaccination to enter into an ongoing \nclinical trial (Cangene, Acambis, etc.) or by creating a special IND protocol  (using \nAventis-Pasteur).  Exciting few hours at the White House with Karl Rove, Andy Card, \nJosh Bolten, Mike Gerson (President’s speechwriter), Kristen, Susan Neeley (Public \nAffairs for Homeland Security), Dan Bartlett (Deputy to Ari Fleischer)Stewart and I \nhaving lively back and forth conversation.  I insisted that they emphatically emphasize \nthat we do not recommend vaccine to the general public; however, we will make it \navailable to those who feel they still want it even though it is not recommended.  I \nconsider this a great victory since I am concerned about tens of millions of people getting \nvaccinating, which will surely lead to some serious adverse events.\nAfter the WH, Stewart and I went to the Department and worked on Qs and As \nfor hours until around midnight.  Also, we briefed the Governors of the States and the \nState Health Officials by teleconference.\nDec.13, 2002 – Day of the announcement by the President.  The DHHS team including \nme went to the WH at 1:00 PM in preparation for the 2:15 PM announcement.  We met in \nthe Roosevelt room and discussed the policy with Ari Fleischer, Dan Bartlett, and others.  \nBill Winkenwerder represented the DoD.  Big surprise was that we learned the President \nwould get the vaccine himself since he felt that as Commander-in-Chief of the Armed \nForces, he could not order the troops to do something that he himself would not do.  He \nwill say that Laura and his children will not be vaccinated since they are part of the \ngeneral public.\nPresident makes announcement.  On stage with him was me, Tommy Thompson, \nGov. Ridge, Julie Gerberding, Bill Winkenwerder, someone from State Dept.  \nAfterwards, the President left and we all gave brief remarks and answered questions.  The \nrollout went extremely well.  I was on CNN and Julie and I were on the Jim Lehrer \nNewsHours together.  I had been scheduled by Ari Fleischer to go on all of the Sunday \ntalk shows with Tommy Thompson on Dec. 15; however, we were bumped by the \nbreaking news of Trent Lott facing forced resignation because of his “segregationist” \ncomments at the birthday party of Strom Thurmond.  Nonetheless, I got my picture in \nboth the NY Times and The Washington post standing next to the President and TGT.  \nReleased by Chairman Rand Paul\n64Also, over next few days I appeared on CNBC, WTOP radio and NPR – “Talk of the \nNation”\nDec. 18, 2002 – Another exciting day at the White House.  Clearly, Scooter Libby and \nthe VP are in favor of pushing for the Vaccine Trust Fund.  OMB and the WH economic \nadvisors have a problem with the concept of a trust fund.  As usual, Carol Kuntz has been \nvery supportive.  Was called down to a meeting at the WH with OMB people (Jim \nCapretta), the VP staff (Carol K., Seth Carus, Noreen Hynes), DHS people (Richard \nFalkenrath, et al), Kristen Silverberg, Ken Bernard, Stew Simonson, Phil Russell, Bill \nRaub.  We had to discuss the vaccine research plan.  Again, must concern as to why we \nneed a trust fund instead of an appropriation.  I explained that one (the fund) is \nmandatory and the other (appropriation) is discretionary.  Jim Capretta came up with the \nidea of a “Permanent and Definite Appropriation” that would be mandatory and multi-\nyear.  In the middle of the meeting, Scooter Libby called me on my cell phone and said \nthat he was going into a meeting with the VP and the President at 1:00 PM (it was now \n11:30 AM) and he needed for me to write a ½ pager on the concept of a mandatory fund \nfor vaccine (he said trust fund, but we subsequently hashed out a Perm. And Def. Appr.  \nHe also wanted a microbe by microbe breakdown with time-lines and costs – all by 12:55 \nPM. In addition, he wanted me to meet with the CEOs of “Big Pharma” to determine if \nthey would support this.  I rushed to the DHHS with Stew, Kerry Weems, Phil Russell \nand Bill Raub and put together a great package to e-mail and FAX to the VP’s office \n(Carol K.) arriving a few minutes before 1:00 PM.  They loved it.  We will wait to see \nwhat happens.\nDec. 19-22, 2002 – Still much activity with the VP continuing to push to help us get a \nPermanent and Definite Appropriation for purchase of countermeasures, particularly, but \nnot exclusively for vaccines.  There is much concern about botulism and acquiring \nbotulism anti-toxin.  Many phone calls and meeting with Stewart Simonson with whom I \nnow speak with and/or meet at least several times per day.  Carol Kuntz and Noreen \nHynes are trying to help us.  They asked us to put together a programatic assessment of \nour procurement needs for countermeasures without consideration of budget constraints.  \nWe had previously put together a $4.2 billion package concentrated mostly on MVA and \nrPA (anthrax) with only about $450 million over 10 years for other countermeasures.  We \npresented this several days ago to OMB people in the presence of Kristen Silverberg (see \nabove).  OMB was miffed that they had not seen these numbers before, when in fact the \nnumbers were contained in our budget submission for ’04, but were not specifically \ndesignated as purchase.  Clearly OMB is resisting the VP’s attempts to get this fund \nthrough.  The new “no budget constraint” package that we put together was \napproximately $15.0 billion over 3 years (FY04 – 06) with considerable amount now to \nother countermeasures such as botulism, plague, Ebola, tularemia, Rift Valley Fever, \nEEE/VEE/WEE, Staph. Enterotoxin, antibiotic resistance, pandemic flu, WNV, etc.  \nEven though this was put together by Phil Russell with help from DMID, the VP wants \nme to defend it to OMB since they are cashing in on my reputation and scientific \ncredibility.  The VP has set up a meeting for Dec. 23 at the WH with himself and Scooter \nLibby teleconferenced from Jackson Hole and me, Mitch Daniels, Nancy Dorm (OMB \nDeputy Director), Tommy Thompson, the VP’s staff, etc. (see below).\nReleased by Chairman Rand Paul\n65Dec. 23, 2002 – Critical meeting at the White House (see above).  Attending were VP \nCheney and Scooter Libby by teleconference from Jackson Hole; Stewart Simonson, Phil \nRussell, Kerry Weems (Budget, DHHS), Carol Kuntz, Noreen Hynes, Seth Carus, Nancy \nDorm (Deputy Director OMB), Tom Reilly and Jim Capretta (OMB).  Issue was that \nScooter and the VP had asked Carol Kuntz a couple of days ago to put together a threat \nrelated proposal for a wide range of microbes with no concern for budget to be used for \nprocurement of products.  It should be program and need driven.  Carol tasked me to do \nthis with Phil Russell.  I worked until late through the night of Dec. 22 fine-tuning this \nand learning it cold.  The proposal went beyond MVA, rPA, and included botulism, \nplague, tularemia, Ebola and other hemorrhagic fevers, pandemic flu, West Nile. Etc.  \nThe proposal came to $15 billion from FY’04 – ’06.  The OMB had agreed several days \nago to creating a “Permanent and Indefinite (first it was definite) appropriations authority \nto purchase vaccines for BioT for a total of $4.2 billion.  In typical OMB fashion, they \nwere against any new spending.  The intense interest of the VP was the reason why we \nwere being listened to.  Importantly, Carol Kuntz called OMB people to the meeting \n(Mitch Daniels was supposed to be there, but he was out of town) but did not warn them \nthat they would be faced with a $15 billion exercise in front of the VP.  I convinced Carol \nto let them know at least a few minutes before the meeting started.  They were mortified \nand enraged that they were not warned in advance.  As Nancy Dorm said, every time she \nsees me, it costs her billions of dollars.  The VP called upon me to present the proposal.  \nNancy did not get it.  She was tied down in process.  She insisted that the original \nagreement was for vaccines only and not what she called “countermeasures” such as \nbotulism antitoxin and Cidofovir, which were on the list.  She did not understand that \n“Countermeasures” is the big umbrella under which are vaccines, antitoxins, etc. Also, \nshe argued that we she not include in the purchasing authority anything that was not \nlicensed.  I proposed that we should include anything that was “licensable”, i.e. on the \nway to license by the FDA, but perhaps months away because of the FDA process.  The \nVP very clearly was on my side and did not hide it.  He even said to Nancy “ Do you \nexpect me to go to the President and the American people and say that we cannot provide \ncountermeasures against threats that we either know or strongly suspect that Iraq has \nbecause we do not want to broaden authorities and because the “process” will not allow \nit?”  She then said that she would work with us to get something out.  The VP was \nspectacular!  It was a  classic example of OMB not being able to get beyond process and \nmissing the entire point of the concept.  Amazingly, Nancy said that “look what happened \nwith the smallpox vaccine.  We bought it and now we are not even going to use it \nwidely”.  She considers the smallpox vaccine situation, which was one of the great \nsuccesses of the year to be a failure since many Americans would opt not to take it.  She \ndoes not understand that the fact that we have it is critical.  Amazing!\nThe meeting ended with the VP clearly in my corner.  My relationship with him, \nScooter and the whole staff, particularly Carol is getting very strong.\nDec. 24, 2002 – Nice surprise today.  At 1:00 PM, I received a call in my office.  I \nanswered the phone since everyone else had left for the ½ day Christmas eve.  On the \nother end someone sang the full verse of “Happy Birthday”.  It was Secretary Thompson \ncalling from Wisconsin on a cell phone from a shopping center.\nReleased by Chairman Rand Paul\n67discussed the need to establish a BAT team or biological anti-terrorist team to be \navailable to the President for advice and service in the event of a catastrophic attack. \nPresent was among many others: Julie Gerberding, David Franz, Lisa Gordon-Hagerty, \nJosh Lederberg, Richard Danzig, Bill Patrick.  Entire attendee list is in my files.\nJan. 13 or 14, 2003 – Meeting in the West Wing (Ward Room) of the White House with \nKristen Silverberg, Ken Bernard, Carol Kuntz, Amy Jensen, Sally Canfield (DHS), Jim \nCapretta, Tom Reilly, Richard Falkenrath, Stewart Simonson and others from WH \ncommunications to continue to fashion the precise language of the Project Bioshield \n(authorities, Procurement, FDA regs) in preparation for getting this into the President’s \nState of the Union (SOTU) address .  We wrangled a bit about the precise language.  We \nwill meet again in 2 days to finalize it.\nJan. 17, 2003 – Another meeting at the White House in Andy Card’s office (he was not \nthere).  Met with all of the above (Jan. 13/14) plus Patrick Aylward and minus Amy \nJensen, Jim Capretta, and Richard Falkenrath to continue discussion.  We went over \ncomments regarding draft legislation and discussed the role-out for the SOTU address. \nAlso, the WH has decided that soon after the address (around Feb. 3) the President will \nrole out Project Bioshield more formally at an event likely at DHHS or at NIH.  I will be \nthere and then will be called upon to do a lot of briefings of the Press and Congress.\nJan. 22, 2003 – Just heard from Ken Bernard at the WH that the President has decided to \ninclude Project Bioshield in the SOTU address.  Also, he plans to visit the NIH on Feb. 3 \nto roll out the plan.\nJan. 23, 2003 – Another important meeting in the White House with the same people as \non Jan. 17 plus Amy Jensen, Ginger Loper.  Putting the final touches on the 3 Bills (a) \nPermanent and indefinite authority, b) Special FDA authorization of products in \nemergency, and c) my special authorities.  Also, discussed plans for President’s visit to \nNIH.  After the meeting, went to see Josh Bolten to get a feel for what the President \nwould like to do during his visit.  Josh invited Kristen Silverberg and I into his office to \nmeet and talk with Mr. Sandy…… (Ambassador to China) and Bo Derek.  We discussed \nAIDS in China and then Josh and I went out of the room and talked about what the Pres. \nMight want to do.  Apparently he likes to observe technical things, but does not like to \n“sit down and be a prop”.  Went back to EEOB to a going away party for Seth Carus and \nNoreen Hynes.\nIt appears that Elias Zerhouni is getting uneasy and insecure about my dealings in \nBiot, particularly with the WH connection.  When I dutifully told him today that the Pres \nwas coming to NIH, he said that he really needed to become more visible in the arena of \nBiodefense.\nJan. 24, 2003 – More activity back and forth with Gary Edson, Jay Lefkowitz and me on \nthe AIDS issue.  It is still alive.  They now want me to bring back Peter Mugyenyi from \nUganda to meet with Mitch Daniels (and me). \nReleased by Chairman Rand Paul\n68Jan. 26, 2003 – Peter M. arrives from Uganda and Mark Dybul and I prep him for the \nWhite House visit.  We have late lunch-early dinner at Mark;s house to brief Peter. \nSuperBowl Sunday.\nJan 27, 2003 – We (Peter and I) meet with Mitch Daniels.  Mitch seems genuinely \nmoved by Peter’s description of AIDS in Africa and is very deferential to Peter and me.  \nGary and Jay ask that I plan to spend the entire day at the White House on Tuesday, the \nday of the State of the Union Address.  Something is up, not sure.  They even suggest that \nPeter might join a group of VIPs in a satellite site (i.e. White House or EEOB) to watch \nthe SOTU address.\nJan. 28, 2003 – One of the most amazing and important days of my life!  Spent the entire \nday (11 hours) at the White House. I arrive at the White House and Gary Edson and Jay \nLefkowitz inform me that the President has decided to adopt our AIDS Implementation \nplan – the full version!!!  $15 billion over 5 years starting with $2 billion in FY2004.  $10 \nbillion will be entirely new money including $1 billion to the Global Fund for HIV/AIDS \nTuberculosis and Malaria.  Peter Mugyenyi will sit next to Laura Bush in her box at the \nCapitol for the speech.  I spend the whole day at the WH proofing the SOTU, fact \nchecking, preparing and proofing Qs and As with Jay and Gary.  The WH personnel are \nall congratulating me for pulling this off.  Josh Bolten told me that I am his hero; Karl \nRove and Andy Card are generously congratulatory towards me.  Gary, Jay, Kristen, \nJosh, et al ask me to stay at the WH to have pizza with them and watch the SOTU \naddress. I had to leave at 7:00 PM to prepare for my Senate Hearing on Smallpox the next \nday.  The SOTU was fabulous.  He rolled out BOTH Project BioShield and the AIDS \ninitiative – 2 things conceived of and planned by me (with obvious help from many, \nparticularly with BioShield).  This has truly been an historic day!\nJan. 29, 2003 – Testified to the Senate Appropriations Subcommittee Hearing chaired by \nArlen Specter. Also present were Sens. Harkin and Murray Hearing on Smallpox \nvaccination plan.  Julie Gerberding and I testified.  Concern on the part of local health \nofficials and hospital people that the USG plan does not provide for compensation to \npeople injured by receiving the vaccine. Hearing went quite well. Spent the rest of the \nday at the WH doing post SOTU briefings and handling press calls.  I used Jay \nLefkowitz’s office.  We sent off Peter back to Uganda.  At the end of the day, I briefed \nAri Fleischer for 1 hour on Project Bioshield.\nJan. 30, 2003 – Testified at the Senate HELP (Health Education Labor and Pensions) \nSubcommittee Hearing with Julie Gerberding again on the subject of smallpox vaccine \nplan.  Issue of compensation came up again.  At the Hearing was Sens. Judd Gregg, Bill \nFrist, Alan Reed, Barbara Mikulski, Hiliary Clinton.  Hearing went well.  Spent rest of \nday at the Department are downtown doing Congressional Briefing to HELP committee \non Project BioShield and to Secr. Thompson on Smallpox.  Did the CNN Wolf Blitzer \nshow with Secr. Thompson, Julie G., Mark McClellan (FDA) and Jerry Hauer on the \nsubject of the HHS Biodefense Command Center.\nReleased by Chairman Rand Paul\n69Jan. 31, 2003 – Spent most of day at DHHS and the WH.  President gave absolutely \nwonderful speech at the WH to the PACHA (Presidential Advisory Committee of \nHIV/AIDS) and the African Ambassadors.  He truly reflected his commitment and \npassion concerning our moral obligation to do something about HIV/AIDS \ninternationally.  He mentioned me specifically.  Interesting that the activists who were \ncompletely trumped by the POTUS announcement, now can only complain that only $1 \nbillion of the $10 million new money is going to the Global Fund.\nFeb. 1-2, 2003 – Much preparation for the President’s visit to NIH and for the briefing of \nthe President on Feb. 3 on BioShield.  Many calls from WH I am asked by WH people to \nfact check things that he will say.  Also, they want me to be responsible for arranging the \ndetails of his visit to the Vaccine Research Center.  His advance people keep calling me \nand Kristen and others keep asking if everything is going OK.\nFeb. 3, 2003 – Another magical day!  In the AM, I brief the POTUS on Project \nBioShield.  Place = Roosevelt Room of the WW.  Present are POTUS, VP Cheney, Tom \nRidge, Tommy Thompson, Scooter Libby, Condi Rice, Karl Rove, Josh Bolten, Kristen \nSilverberg, Adm Abbott, Ari Fleischer, Dan Bartlett, Ken Bernard, Elias Zerhouni, Carol \nKuntz, etc.  I played major role in walking him through the Project.\nWe rush back to NIH to greet him (Flying in on Marine One) at the VRC.  We \ngive him a tour and he is smash hit with the staff.  We go over in motorcade to Natcher \nBuilding where he gives major address.  He specifically mentions me as an old friend and \nsomeone who he thanks on the part of the country because I have been for many years \nTHE general in war on AIDS.   His speech drew applause every time he would mention \nme, Zerhouni,  or AIDS in Africa Plan, but no applause when he spoke of the likely need \nto go to war with Iraq. He leaves and I spend rest of day and also Feb. 4 doing press calls \nto describe in detail Project BioShield.\nFeb. 4, 2003 – The world knows that the President’s Plan came from me and I am \nbriefing many people.  The WH refers all questions about Project BioShield and The \nPresident’s AIDS Plan to me  Got a call from Richard Feachem, President of the Global \nFund for AIDS, Tuberculosis, and Malaria, congratulating me on the Plan, but expressing \nconcern that since the USA only put $1 billion new money in the Fund over 5 years that \nnow the other countries would be reluctant to contribute more to the fund than the USA.  \nI told him emphatically, but in a nice way,  that I disagreed.  The original purpose of the \nGlobal Fund was not to replace bilateral agreements, but to complement them.  Feachem \nis essentially saying that the other $9 billion in new money does not really count in a \nmatching game since we did not put this in the Global Fund.  Unbelievable.  I have now \ntold people.  This is not about the Fund or about your particular choice of  how you give \nmoney.  It is about saying the lives of people in Africa and the Caribbean.\nAnother looming problem is the Mexico City Agreement which states that \nForeign NGO who counsels on abortions or who supports the performance (with funds) \nof abortions is not eligible for USG funding.  This might make the implementation of the \nPlan through NGOs difficult.  Also, I need to check with the US Trade Representative \nabout the generics and breaking patents.\nReleased by Chairman Rand Paul\n70Feb. 6, 2003 – Snow storm in DC.  Went out to dinner with Stew Simonson and driving \nback home from Etrusco’s restaurant on DuPont Circle I hit a patch of ice on Cathedral \nAve., spun around twice and broad sided a telephone pole. No other cars or people \ninvolved.  I was unhurt and drove my wrecked car home.  Luckily it still ran since only \nthe side doors (passenger side) were destroyed.\nFeb. 6 – 12, 2003 – Much briefing of White House and Congressional staff on Project \nBioShield and the President’s AIDS plan.  Much, much activity.  The WH wants me in \non all briefings.\nFeb. 13, 2003 – Delivered Plenary lecture at the 10th Conference on Retroviruses and OIs \nin Boston.  Spoke on Role of viremia in host abnormalities.  Very well received; it was \nhard core basic science, which was in sharp contrast to the publicity that I have been \ngetting for the policy issues.\nReturned in early afternoon to go to WH to brief Congressional leaders on Project \nBioShield.  Received secret briefing from CIA Torrey Froscher (Deputy Director, \nWINPAC, CIA).  Present were Admr Stephen Abbott, Tom Ridge, Tommy Thompson, \nJim Capretta, Kristen Silverberg, Chris Cox  and Ginger Poers (Special Assistants to the \npresident for Leg Affairs), Sens Gregg, Congressmen Burr, Turner Cox, Tauzin, Sen \nCollins; Sally Stansfield, Stewart Simonson, Carol Kuntz.  The President walked in \nduring the meeting and greeted the Congressmen and gave me a special warm greeting \nsaying that the “A” team was there.  He now has his special name for me.  It is not Tony \nor Dr. Fauci it is “Fauci”.\nFeb. 13, 2003 – Received wonderful FAX from Bono congratulating me on the AIDS \ninitiative.  Referred to us as “partners in crime”.  Did more briefings on the hill as well as \nbriefing of activists Paul Davis, Asia Russell, Rachel Cohen (MSF) on the Pres. initiative.  \nStill much concern out there that we did not put all of the money in the Global Fund.  \nYet, the Global Fund has not really done anything yet.\nAlso, issues such as generic drug purchase and the Mexico City Agreement \n(MCA) have come up.  Importantly, Jay Lefkowitz is supporting my view that even if \norganizations would not qualify to receive USG funds because they are not in accordance \nwith the MCA, i.e. they do counseling that encourages abortion or they actually do \nabortions, they can in fact receive funds as long as they use them for treatment and not \nabortion performance or counseling.  Major victory for me if Jay supports me since \notherwise many groups would be disqualified to participate in the  AIDS implementation \nplan.  Also, according to the TRIPS (Trade-Related Aspects of Intellectual Property \nRights) agreement, the WTO countries would not permit breaking of patents or use of \ngeneric.  However, in paragraph 6 of the Doha Ministerial Declaration on the TRIPS, \nmembers could use “compulsory licensing themselves or have a third party compulsory \nlicense for them to make drugs in the case of an epidemic emergency such as AIDS, \nmalaria, TB, cholera, Ebola, etc. so long as certain conditions are met such as this must \nbe in poor countries and drugs cannot be sold back to rich countries.  Thus, the TRIPS \nagreement will not interfere with our giving money to poor countries to buy generic or \ncompulsory licensed drugs.  Please refer to TRIPS and Doha documents.\nReleased by Chairman Rand Paul\n71Feb. 14 – Mar. 2 – I have been leading (with Stew Simonson and occasionally Mark \nMcClellan (FDA) many, many briefings of senators, Congressmen and staffers on Project \nBioShield.  The WH has proposed our legislation.  Zerhouni is acting extremely insecure \nand (I believe) inappropriate regarding the mentioning of NIAID in the authorizing \nlegislation for BioShield. He and Stew and having a terrible fight since Stew insists that \nNIAID remain in the language. I am trying not to get caught in the middle.  \nA few days ago, I presented the Jimmy and Rossalyn Carter Award of the NFID \nto former Congressman John Porter.\nMar. 3, 2003 – Had dinner with Senator Bill Frist in his Majority Leader’s Office in the \nCapitol.  He regularly (on Mondays) brings together people with whom he likes to \ndiscuss various topics.  This time it was bioterrorism.  Besides me was Herb Pardes, \nMark Halperin (NBC News), Stuart Taylor (Editor, National Journal), Georges Benjamin \n(Director, American Public Health Assoc), Bill Madia (Oak Ridge), Rev. Anthony Davis \n(Director, DC Black Church Initiative), Michael Byrne (Dept. of Homeland Security, \nCoordinator for DC, MD, and VA) and Ginny Wolfe (Counselor to Sen. Frist).\nMar. 3 – 10, 2003 – Many briefings on Project BioShield.  Most recent on Mar. 10 at the \nWhite House with the usual cast of people, i.e. Kristen Silverberg, Ken Bernard, Carol \nKuntz, Stew Simonson, Tom Reilly (OMB), some people from DHS and OMB.\nMar. 12, 2003 – Conference call with me connected to about 50 industry people \norganized by John Kelly of PhRMA to explain BioShield to them.  Always a concern \nabout anti-trust laws and so the General Counsel for PhRMA (Ken Ewing) made sure that \nno questions were asked by industry that would violate this.\n2003 March 12 \nTeleconference on Pr   \nStewart Simonson told me yesterday that he resigned because of serious clash \nwith Jerry Hauer.  I offered him a job at NIAID that he was very moved by.  Got a call \ntoday that Secretary Thompson insisted that he does not resign.  Stew gave in to TGT.\nMar. 13 – 16, 2003 – We are getting closer to war with Iraq.  The French, Germans, and \nRussians are threatening to block any attempt on the part of the USA to have the UN pass \na resolution that if Iraq does not immediately comply with Resolution 1441 and disarm, \nthe UN will use force to disarm them.  USA, Britain and Spain may go it alone.\nI am extremely concerned about the appearance in Asia (Hong Kong, Quangdong \nProvince in China, Vietnam, Thailand, Singapore of a mysterious acute respiratory \nsyndrome.  Thus far 400 people, 150 in last week, 9 deaths.  We have no idea what it is, \nbut the attack rate nosocomially is very high.  More than 30 health workers in Hanoi got \ninfected from a single patient.  Many people on respirators.  The new disease is called \nSevere Acute Respiratory Syndrome (SARS).\nOn evening of March 16, had a great dinner at Galileo’s in DC.  Host was Bono \nwho is in town to receive an award on St. Patrick’s day (March 17).  Small dinner at \nwhich Bono paid very kind tribute to me for putting together the President’s Emergency \nReleased by Chairman Rand Paul\n72Plan for AIDS Relief.  At dinner were Chris Grady, Bono, Sens. Leahy, Dodd, Santorum, \nSteve Case and wife Jean, Comedian Chris Tucker, Josh Bolten and girlfriend (?name), \nJamie Drummond, Bobbie Schriver, Cardinal ? from DC, Father Perry and others.\nMar. 17, 2003 – Gala St. Patrick’s Day dinner and Award Ceremony from The Ireland \nAmerican League at the National Building Museum.  Humanitarian Award to Bono.  \nChris and I sit at Bono’s Table as his guest. Bono recognizes me in his acceptance \nspeech.  \nPres. Bush gives Saddam Hussein 48 hours to leave Iraq or we will attack.\nMar. 18, 2003 – Senate passes Project BioShield Bill.  I hold meeting on \nMedical/Chemical Biodefense Research at the Bethesda Hyatt as a sequel to February 26 \nmeeting on Radiological Biodefense.  I am trying to frame the landscape of this to pursue \nan appropriate research agenda.\nMar. 19, 2003 – Bombing of Iraq begins.\nMar. 19-28, 2003 – Major focus on war. Push towards Bagdad; massive precision \nbombing; Iraqi irregulars have executed GIs on El Azeera TV to the horror and anger of \nUSA; \nSARS is getting out of control.  1500 cases and 53 deaths worldwide.  At first, \ninvestigators isolated a paramyxovirus (metapneumovirus) at first seen on EM.  \nHowever, this may have been a mistake since several groups led by CDC are now finding \nan unusual form of coronavirus (common cold).\nBriefed the VP on SARS and recent cardiac complication of smallpox vaccine via \nteleconference.\nMarch 27 – Testified with Secretary Thompson on Project BioShield at the House \nEnergy and Commerce Committee.  Several members (mostly Democrat) are balking at \nthe mandated appropriations authority.  They are reluctant to give up the power of the \npurse.\nMarch 28, 2003 - I gave a talk on Bioterrorism at the American Dental Association \nmeeting in DC on March 28.  The last person to come to the microphone to ask a \nquestion after my talk said that he had waited many years to publicly address me.  He \nrelated that in 1979, his 7 year old daughter was gravely ill on a respirator with a diffuse \nautoimmune-like disease that her doctors could not figure out.  She was moribund and \nthey were about to give up on her.  A doctor said that there was only one doctor in the \ncountry that he thought could come up with something and so they called me.  \nApparently, I spent over an hour on the phone walking through with them a plan for the \npatient that included plasmapheresis together with cytoxan and prednisone.  Within days, \nhis daughter began improving, got off the respirator, spent over a year in rehab, graduated \nhigh school, went to Barnard College, graduated first in her class, became a Ph.D. \npathologist, got married and had a child.  She is entirely well now.  He said that he just \nwanted to thank me publicly for “saving his daughter’s life”.  The audience gave me and \nhim a standing ovation.  It was one of the most moving things that I had experienced.\nReleased by Chairman Rand Paul\n73March 29 – April 1, 2003 – It is hitting the fan.  SARS is getting out of control.  More \nthan 1800 cases and 62 deaths worldwide.  3.6% mortality.  Clusters of cases appearing \nmostly in Hong Kong and China.  Now there are 17 countries.  USA has 72 cases in 27 \nstates – no deaths yet.  It appears that it is spread by respiratory droplets, but also recent \nevidence that by fine aerosal and objects – not unlike other coronaviruses.\nI will brief the POTUS this week on SARS.  The war in Iraq is raging with troops \nengaging the Republican guard close to Bagdad.  More myocarditis complications with \nsmallpox vaccine.  What a week so far!!!\nApril 4, 2003 – Big day!  US army captures Iraq International Airport.  I testify before \nthe House Government Reform Committee on the subject of Project BioShield.  Mark \nMcClellan testifies with me.  The House (Shays, Waxman, Chairman Case generally \nsupport the concept of BioShield, but have some concerns such as with the “permanent” \nand indefinite Appropriations Authority.  After the Hearing I, together with Julie \nGerberding and Tom Ridge, brief President Bush, Laura Bush, VP Cheney, and the \nsenior White House Staff on SARS and Smallpox vaccine program.  We bring executive \norder to the POTUS on quarantine for SARS and he signs it.  At meeting are Josh Bolten, \nKarl Rove, Ari Fleischer, Richard Falkenrath, Adm Steve Abbott,, etc.  POTUS and VP \nas usual very warm and complimentary to me and to Julie.  After the meeting, I spoke \nwith Josh Bolten and volunteered to go to Iraq for the President if the Iraqis use \nbiological, chemical or radiological weapons on our troops.  I offered this to allow a \npublic appreciation of the link (my being a civilian health authority) between Iraq and the \ndanger of bioterrorism against the USA civilian population.\nApril 5-9, 2003 – Incredibly busy.  I have testified at >6 Congressional Hearings over the \npast few days on SARS, Appropriations, AIDS, Biodefense, etc.  SARS is spreading.  \nHave been on many network TV shows discussing SARS – CNN (several different \nshows), Good Morning America, News Hour, CNBC, etc.  Iraq is falling; Bagdad \noccupied by US troops.\nApril 10, 2003 – Wonderful day.  Went with Chris ( my father, Denise and Jack Scorce \nwere also there) to Ellis Island to receive the Ellis Island Family Heritage Award.  Other \nawardees included Yogi Berra, Bob Hope, Cicely Tyson, Abie Abraham (hero of the \nBataan Death March).  It was a wonderful ceremony with a fantastic video of my history \nincluding the ship’s manifest with my grandfather Antonio Fauci’s name.\nApril 11 – 18, 2003 – Iraq war over as troops occupy essentially all of Iraq.  Saddam \nmissing as is most of Iraqi leadership.  Much attention now focusing on SARS.  Cases \nnow at 3400 with 175 deaths.  Much media interest.  For example, on April 17 alone I \nappeared on Channel 5 News, Diane Rehm Show, Charley Rose, CNN’s Aaron Brown, \nand CNN International in addition to several print media.\nApril 19, 2003 – Just an unrelated historical note to put all of this in perspective.  My \ndaughters are doing marvelously well in school and sports.  All 3 are virtual straight As \n(an occasional A-). Megan and Ali excel in gym and Jenny is doing extremely well in \nmultiple varsity sports.  She clearly is the best varsity diver at NCS.  She is on the first \nReleased by Chairman Rand Paul\n74team varsity for cross-country and just this year (junior year) has taken up crew.  She \nloves it and is a starter on the varsity 4 person lightweight boat.  Thus far, they are 3 for 3 \nin meets; I saw a meet at the Georgetown Harbor today.\nApril 20-28, 2003 – War is essentially over. Still no weapons of mass desctruction. Still \ndoing an incredible amount of press.  Did This Week with George Stephanopoulos on \nSunday, 27th April.\nApril 29, 2003 – Amazing day!!!  Spoke at a Republican leadership lunch at the Senate \ntogether with VP Cheney.  We were there to promote S-15 (the legislation for BioShield).  \nI was extremely warmly received by the Senators with many complements from Sens. \nFrist, Hatch, Stevens.  I presented my thing and then the VP got up and praised me for \nmy leadership on Project BioShield and made a few comments on the threats.  We \n(Ginger Loper and I) next took the WH limo to the WH for the President’s ceremony on \nthe Emergency Plan for AIDS Relief, aimed at drumming up support for the legislation \nfor the plan’s funding. The ceremony was supposed to be in the Rose Garden, but was \nmoved to the East Room because of weather. The President was wonderful to me, \nspecifically winking and saying “Hello Tony” as he was scanning the crowd.  He then \nmade the comment in his speech to the group that he wanted to specifically thank me for \nall of my work on behalf of mankind.  After the ceremony, he specifically came down to \ngreet people and put his arm around my shoulder and thanked me again for all that I have \ndone.  It was a terrific day.\nApril 30-May 1, 2003 – Much effort on my part in working the Congress (briefing \nSenators and Congressmen and staff) in support of Project BioShield.  Clearly the \nreluctance on the part of the Congress has to do with not wanting to give up the control of \nthe “purse” to a mandatory and indefinite appropriations authority.\nMay 2, 2003 – Did “Field Hearing” in Harrisburg, PA for Sen. Specter on SARS.  He is \nrunning for re-election and clearly wanted to impress his constituents.  It worked.\nMay 3, 2003 – Great evening.  I received the “Golden Plate Award” of the Academy of \nAchievement.  It was a Gala affair at the Mellon Auditorium in Washington, D.C. I was \non a panel chaired by Mike Wallace of “60 Minutes” during the day and had a black tie \ndinner in the evening.  Other awardees were Jose Carreras (did not show), Hillary \nClinton, Sen. Tom Daschle, Bob Dylan, author and Washington Post columnist Thomas \nFriedman, Rudy Giuliani, Donald Graham (CEO of Washington Post), Baroness Susan \nGreenfield, Dr. Robert Sanger, Leonard Lauder (CEO of Estee Lauder), Trent Lott, John \nMcCain, Simon Peres, Franklin Raines, Justice Antonin Scalia, Robert Strauss, \nArchbishop Desmond Tutu, Alvaro Uribe Velez, President of Columbia.\nThe banquet was attended by all of the Glitterati including President Clinton who \nwas the hit of the night, dancing away like crazy .  It was a wonderful time with \nincredible entertainment including Patti Austen, Ray Charles, Aretha Franklin, and \nChuck Berry who drove the house down.\nReleased by Chairman Rand Paul\n75May 3 to 13, 2003 – Spending almost full time working with White House on trying to \nshape the BioShield Legislation with the Senate and House.  I have daily been briefing \nsenators (such as Sen. Byrd) and staff of the House as well as members such as Henry \nWaxman, Chris Cox, Fred Upton, etc. on why they should support the President’s (Sen. \nJudd Gregg’s) Bill.  Congress is reluctant to make the purchase authority “Mandatory, \npermanent, and indefinite”  It seems now that we are winning the battle for mandatory, \nbut it is going to be tough to get permanent and indefinite.  We will have to settle for a \ncap according to the budget resolution and a sunset at 10 years.  People at the White \nHouse that I am working closely with are Ginger Loper, Candi Wolff, Carol Kuntz, Ken \nBernard, Chris Cox, Mike Allen et al.\nAlso, during this time I gave the Commencement Address at Emory in front of \n14,000 people and received an honorary degree.\nMay 14 – 20, 2003 – Continued doing Congressional briefings and Hearings on \nBioShield and SARS.  The epidemic is appearing to come under control.  Spent sometime \ntoday (May 20) helping the White House write the POTUS speech on the AIDS initiative. \nWonderful thing happened yesterday.  The WH is planning a signing ceremony for the \nAIDS Bill ($15 billion authorization).  It was originally schedule for May 28.  I wrote an \ne-mail to Gary Edson and Jay Lefkowitz saying that I had to give the Commencement \nAddress at SUNY Downstate on May 28 and if it occurred then, would they send my \nregrets to the POTUS.  Jay responded by e-mail that since I was the honored guest, they \nwill change the ceremony to May 27.  Amazing!\nMay 20 – 27, 2003 – Busy time for Bioshield and giving Commencement Addresses \n(Emory, Albany Medical, Univ. of MD and SUNY Downstate) and receiving honorary \ndegrees (Emory, Albany, Univ. MD, Yale).  Major article (feature piece) on me in the \nweekend edition of The Financial Times; mostly very flattering with the usual few \njealous comments from “unamed sources”.\nMay 28, 2003 – Historic day.  President Bush signs the Authorizing legislation for the \nPresident’s Emergency Plan for AIDS Relief in the Dean Acheson Auditorium of the \nState Department.  Again, he specifically thanked me in his speech for my work on AIDS \nand for being there.  I was given a “seat of honor” in the first row.  In his speech the \nPresident used word-for-word the sentence that I composed for him describing the \ninitiative as the “largest single up-front commitment in history to an international public \nhealth initiative involving a single disease”\nMay 31, 2003 – Extraordinary feature article on me in The Financial Times with full \npage picture and complimentary story.\nJune 8, 2003 – Feature story on me in the nationally syndicated Parade Magazine of The \nWashington Post. \nJune 8-18, 2003 – Continued activity and briefings, conference calls concerning the \nBioshield Legislation.  White House still relying me on pushing the prospect of \nReleased by Chairman Rand Paul\n76mandatory versus discretionary funding for Bioshield.  Also a number of network and \nCNN TV appearances on emerging disease including SARS and monkey pox.\nJune 18, 2003 – Went to West Wing of WH to brief General John Gordon the new \nDirector of the WH Office of Homeland Security and Special Assistant to the President \nfor Terrorism.  I briefed him on what the NIH Biodefense Research Agenda was.  Good \nguy.  We had a nice discussion.\nAlso, delivered a standing room only Grand Rounds at the Lipsett Auditorium on \nSARS.\nJune 19, 2003 – Appeared on a panel at the Council of Foreign Relations with Ted \nKoppel (Chair), Patti Stonesifer (Gates) and Senator Durbin to discuss “Are we prepared \nto deal with global pandemics?”.\nJune 20, 2003 – Appeared on CNN’s Lou Dobbs show to discuss emerging and re-\nemerging diseases.\nJuly 2, 2003 – Attended White House ceremony for the announcement of Randall Tobias \nas the Coordinator of the President’s Emergency Program for AIDS Relief.  Randy is \nformer CEO of Lilly.  Pres. (as usual) mentioned me and said that it was an honor to have \nme there.  I strongly recommended to TGT that Mark Dybul be appointed in the State \nDepartment to the new program to help Joe O’Neill who was clearly emerging as the \nsecond in command.\nJuly 2 – 7, 2003 – Much attention paid to post-war guerilla action in Iraq with several \nUSA service people getting killed in terrorist/guerilla action.\nJuly 8, 2003 – Attended meeting in Situation Room of the White House chaired by \nRichard Falkenrath. Attending were Deputies of all of the relevant agencies, Carol Kuntz, \nKen Bernard, Jorge Tavel, Bob Kadlac etc.  Purpose was to agree upon a long range Plan \nfor SARS called CONPLAN.  Also, discussed revamping the organizational structure \namong the various Agencies for a coherent Biodefense Agenda.\nAppeared on CNBC’s Capitol Report with Alan Murray and Gloria Borger to \ndiscuss the President Bushes Emergency Plan for AIDS Relief.  I had the opportunity to \npraise the POTUS for his leadership in this Plan.  \nJuly 9, 2003 – Visited new AIDS Coordinator for the Plan (Randall Tobias) at the State \nDept. and briefed him on how the President’s Plan came about and how I suggest he \nimplement it.  I strongly suggested that he get Mark Dybul to work for him since Mark \nwas so important in putting the details of the plan together.\nJuly 12-18, 2003 – Trip to Paris for the 2nd Annual International AIDS Society (IAS) \nmeeting.  I gave the “Extraordinary Plenary” lecture on Monday, July 14 on the topic of \n“HIV and AIDS: 20 Years of Science”.  I was immediately followed by Nelson Mandela \nwho gave a lecture on the societal aspects of 20 years of AIDS.  My talk was extremely \nwell received; many said that it was the best talk that they had ever heard me give.  There \nReleased by Chairman Rand Paul\n77were >5000 people in the main auditorium at the Palais de Congres in Paris.  Of \nparticular note was the fact that prior to leaving for Paris, Dr. Brian Brink who is the \nSenior Vice President for Health of  Anglo American Corporation, a gold mining firm in \nSouth Africa had contacted me.  Brian is an advisor to Mr. Mandela on HIV/AIDS and \nwas asked to write Mandela’s speech for the meeting.  Brian called me and asked for \nsuggestions about what Mandela should say.  I mentioned to Brian that Mandela had been \nseriously criticizing Pres. Bush for the Iraq war and that it would be very important for \nMandela to publicly congratulate and praise Bush for the $15 billion Emergency Plan for \nAIDS Relief.  I said that Mandela would lose credibility if he did not do this. I even made \nup a paragraph for him to put into the speech.  Brian agreed, but said there was no \nguarantee that Mandela would actually include it in the speech.  To my great pleasure, \nMandela included the paragraph practically word-for-word.  I let Jay  Lefkowitz  know \nabout this by e-mailing him from Paris.  Jay was very pleased and said that he would \nmention this to the President.\nJuly 19-30, 2003 – Have had a number of briefings with TGT as well as the VP’s staff \n(Carol Kuntz et al) on various subjects such as smallpox, anthrax, SARS, etc.  \nConstituencies still upset that NIAID will have to do advanced development and some \nprocurement of rPA anthrax vaccine to the tune of about $250 million even though the \nCongress removed the $250 million from our budget that OMB put in to do this.  Josh \nBolten (now OMB Director, replacing Mitch Daniels) has allowed us to spend this over 2 \nyears instead of 1 year.  Nonetheless it will be a burden.  There are philosophical \nquestions here regarding how much advanced development should be done by NIAID \nversus the drug companies.  We are trying to allow BioShield to pay for some of the \nadvanced development instead of limiting it just to the actual procurement of \ncountermeasures.\nAugust 1, 2003 – Briefing at the White House.  Two parts to the briefing.  Jorge Tavel \nand Heather Wingard of CIA briefed on threat assessments and I briefed on \nCountermeasure Development.  Present at briefing were:  Carol Kuntz, Stewart \nSimonson, Andrew Hallman (CIA), Heather Wingard (CIA), Dr. McCreary (DHS), Bill \nParrish (DHS), Parney Albright (DHS), Sally Stanfield (DHS), Ken Bernard (OHS), \nJorge Tavel (OVP), Richard Falkenrath (for while, OHS), Julie Gerberding (CDC)\nCarol was very pleased with my presentation as I touched on all of the points that \nwe had previously discussed with the Vice President such as genetically modified \norganisms, botulism, etc.\nAugust 1 – 21, 2003 – Summertime lull.  Usual issues.  Zerhouni pushing his “Roadmap” \nagenda .  Few people can figure out what it really is and how it will be implemented.  \nIOM report on the “Structure of NIH” came out.  As usual, they commented on things \nthat they were not asked to comment on.  They pushed having greater resources in the \nOffice of the NIH Director and having more “high risk” research to be managed out of \nthe OD as well as trans-NIH research planned out of the OD.  Seems like Zerhouni wrote \nthe report.  Also, and amazingly, they recommend 5 year term limits for IC Directors \nwith the possibility of only 1 five year renewal.\nReleased by Chairman Rand Paul\n79of having the NIH Recombinant DNA Advisory Committee (RAC) serve as a mechanism \nto provide a “culture of responsibility” among scientists similar to what was done in the \nmid-1970s. At the briefing was the usual people – Gen Gordon, Ken Bernard, Richard \nFalkenrath, Carol Kuntz, several DoE people, WH communications people, etc.  Decision \nwas to put together a briefing for the Secretaries.\nSept. 18 –19, 2003 – Went to NYC to give Plenary Lecture at the AIDS Vaccine 2003 \nmeeting.  While I was there, Hurricane Isabel hit Washington, D.C. and there was \nwidespread devastation with major power outages (3 million people in DC, VA, and MD \nwithout power).  Power not expected to be restored for at least 1 week. \nSept. 24, 2003 – Power back finally.\nSept. 25, 2003 – White House meeting with Jay Lefkowitz, Gary Edson, Mark Dybul, \nJoe O’Neill, Carol Thompson to discuss the controversy regarding $2 Billion versus $3 \nbillion in FY ’04 for the President’s $15 billion, 5 year plan.  Bono and other activists \nwant a full $3 billion in ’04.  However, if we did that, then we would put less in ’05, ’06, \netc.  I recommended to Jay et al to stick with the Plan and leave flexibility to match other \nfunds by 1/3.  See below my e-mail to Jay from 9/25/03:\nJay/Gary:\nJust a recap of my suggestion from this afternoon for your consideration.  Mark was on \nthe same page on this also. I believe that we must remind people and strongly underscore that \nthe President's Plan is a $15 billion program over 5 years involving 14 countries. Within the \ncontext of such a plan (we must emphasize this point), the best way to spend the money and \nthus to save the most lives is by phasing in with $2 billion in the first year and more than $3 billion \nper year in subsequent years.  We all realize that more money can be spent globally on AIDS and \nthus more lives can be saved. This is a no-brainer.  We never said that the President's Plan of \nitself would cover all of global AIDS.  We should not get into an \"absorptive capacity\" argument \nsince no matter how clear we are, people will confuse absorptive capacity in the President's Plan \nof 14 countries and absorptive capacity for the rest of the developing world.\nI suggest that we take a 2 pronged approach. 1) We stick with the President's Plan as it \nhas been outlined, and; 2) We publicly recognize that more money can indeed be spent on AIDS \nglobally.  We are hoping that other countries will follow the President's lead and put more money \ninto programs either bilaterally or through the Global Fund. In fact, we are willing to go the extra \nmile and to contribute 1/3 of the global effort if other countries rise to the occasion. In '03, the \nworld total was $3.6 billion with $1.4 billion by us (39%).  Since we are giving $2 billion in '04, the \nrest of the world should give $4 billion.  If the rest of the world gives more than $4 billion, we will \nmatch them by 1/3.  Thus, if they want us to give $3 billion in '04, the rest of the world must total \n$6 billion.  If this happens (which it will not), then we will put the additional money into a mix of \nGlobal Fund and other countries (beyond the original 14) bilaterally. In this way we show \nleadership and flexibility.  If no one else gives an additional penny, we still are committed to the \nPresident's Plan as we have outlined.  If other countries meet the above mentioned benchmarks, \nthen we are flexible enough to match them by 1/3.  Finally, if the Congress appropriates a couple \nof hundred million over the $2 billion and the President signs such a Bill, we would give that \nadditional money to the Global Fund and/or additional countries and back up our contention that \nour funding plan for the 14 countries is indeed sound.\nI would be happy to discuss this further with you.\nThanks,\nTony \nReleased by Chairman Rand Paul\n80Sept. 26, 2003 – White House meeting on Bioshield with the usual suspects – Stewart Simonson, \nJorge Tavel, Ken Bernard, Bill Winkenwerder, Larry Kerr, etc.  We are getting ready for finalizing \nthe legislation.  After the meeting in the EEOB, I went over to the West Wing to see Richard \nFalkenrath.  NIAID will be awarding 2 NBLs (BSL-4 labs) and  9 RBLs (BSL-3 labs) on Sept. 30.  I \nhave been getting incredible lobbying pressure from people like Sen. Hillary Clinton and others \nfor their state or district sites.  Chicago is in the running for an NBL and the President is going to \nChicago on Sept. 30.  The WH wants me to delay the announcement until 2:00 PM after the \nPresident leaves Chicago since Chicago got an RBL, but not an NBL and the WH wanted to \navoid any embarrassment for the President to be there when bad news arrived.\nOct. 7, 2003 – Briefing in the Situation Room of the White House for Andy Card on the \nCraig Venter issue of synthesizing microbes.  Also at the meeting were:  Tommy \nThompson, Spencer Abraham (Secr. Of DoE), Dan Bartlett; General Gordon; Ken \nBernard, Harriet Miers (Card’s Deputy), Bob Card from DoE, Ray Auerbach (DoE), \nBruce Alberts (NAS), Gerry Fink giving summary of Fink Report on “Biotechnology \nResearch in an Age of Terrorism”, which is an NAS/NRC report; Stewart Simonson; \nCarol Kuntz; Larry Kerr;   I have essentially been adopted by the WH to be the one who \nexplains the science of Venter’s work.  This, I was the major briefer. Also, I have been \nspearheading the NIH effort to create a subcommittee of the RAC to provide the “culture \nof responsibility” for the scientific community on these issue similar to the 1970s with \nthe RAC following the Asilomar Meeting in 1974.\nOct. 13, 2003 – Went to White House ceremony (President’s speech) and reception to \ncommemorate Columbus Day.  The President specifically greeted me in his remarks \nsaying how proud he was of how I was the General in the Global War on AIDS.  After \nthe ceremony, I ran into Josh Bolten in the hallway of the EEOB.  He asked about my \nopinion of the controversy of $2 billion versus $3 billion in FY ’04 for the President’s \nEmergency Plan for AIDS Relief.  Bono has been giving the WH a hard time saying that \nthe President was reneging on his promise when in fact he promised $15 billion over 5 \nyears staring with $2 billion in ’04 (see above).  He specifically asked my opinion of how \nRandy Tobias was doing as the new AIDS head of the program.  He indicated that he did \nnot think that there was anything wrong, but that he was getting the vague feeling that \nthings were not moving along as aggressively as he thought that they would be.  He asked \nme to quietly check it out.\nOct. 16, 2003 – Had breakfast (at his invitation) with Jay Lefkowitz at the White House \nMess to say goodbye.  He is leaving as Director of  Domestic Policy Council to return to \nhis law firm in its NYC branch.  He will likely return after 2 years for the President’s 2nd \nterm (if this occurs).  We had a great conversation in which he mentioned how honored \nhe was to work with me on the President’s Emergency Plan for AIDS Relief, the MTCT \nplan and to a lesser extent on the stem cell issue.  I sincerely told him that he was second \nto none in people that I have worked with at the WH over the past 19 years.  He asked my \nhelp in making sure that the AIDS Plan does not get derailed by the mischief of USAID \nin trying to lobby the legislation such that power is taken away from Randy Tobias and \nhe would not be given an independent account.\nOct. 17, 2003 – Went to going away reception in Indian Treaty Room of EEOB at White \nHouse in honor of Jay Lefkowitz.  Great time just talking to the White House crew and \nReleased by Chairman Rand Paul\n81others that I have gotten to know over the past 2+ years: Jay, Margaret Spelling, Kristen \nSilverberg (just back from Iraq and will replace Jay), Karl Rove, Scooter Libby, Josh \nBolten, Ginger Loper (WH Leg. Affairs), Terrell Halaska, Allen Gilbert, Mark McClellan \n(FDA), Scott Whitaker, Ladd Wiley, Alex Lazar, etc. \nOct. 24, 2003 – Met with Sen. Barbara Mikulski to try to convince her not to support \nRep. Chris Van Hollen’s attempt to block the construction of the biodefense building \n(Bldg. 33) on the NIH campus and move it to Ft. Detrick.  He keeps calling it a bioterror \nbuilding. She was sympathetic, but indicated that we must engage the community more.  \nFact is….we have been doing this, but a very recalcitrant few do not want to building on \ncampus no matter what.  This is the same group that did not want to fence put up around \nNIH.  This is a political issue since Van Hollen made 2 campaign promises: 1) no fence; \nand 2) no biodefense building. He already lost the first and does not want to lose the \nsecond.  We will try to work with him.  Also present at the meeting were several of \nMikulski’s staff, Elias Zerhouni, John La Montagne, and Marc Smolonsky.  Also, I \nhosted Julie Gerberding to deliver the NIAID Joseph Kinyoun Lecture and then took her \nto dinner with John La Montagne, Ed Tramont, Pamela McInnes.\nOct. 25, 2003 – Had biodefense strategizing meeting at Wye River Conference Center \nrun by Richard Danzig.  Discussed issues related to dealing with mass casualties.  The \nusual suspects were there – DA Henderson, Julie Gerberding, David Franz, Michael \nOsterholm, Bill Patrick, C.J. Peters, George Tavel, people from DoD, FBI, CIA, etc.\nOct. 27, 2003  - Had a Policy Coordinating Committee for an “end-to-end” analysis of \nbiodefense responsiveness at the White House EEOB.  Meeting run by Ken Bernard and \nBob Kadlec.  Attended by all the usual suspects from each agency – CIA, FBI, DHS, \nHHS, OMB, OVP, etc.\n     After the meeting I met with Bob Kadlec about the possibility of going to Iraq to \ninteract with the medical and research community.  Apparently, the copies of HPIM-15 \nthat I had sent to Iraq through Kristen Silverberg were a smash hit and the Iraqis want \nvery much for me to go to Iraq.  However, over the past few weeks there has been a great \nescalation of insurgency and terrorism with many suicide bombings and rocket and rocket \npropelled grenade attacks on both military and civilian targets.  It appears that the \nterrorists are targeting the Iraqis who are cooperating with the USA in trying to rebuild \nthe country.  Kadlec does not trust the security associated with the ministries of health to \nprovide for my safety.  He actually feels that if word gets out that I am coming that I \nwould be targeted by snipers.  He feels that if I go, he will arrange for CIA operatives to \nget me into the country and move around “under the radar” and that CIA operatives \nwould provide my security.  We decided to wait a few weeks before resuming plans \nabout going to Iraq and consider going in January/February.  Bob will have to go there at \nthis time anyway to continue search for weapons of mass destruction.\nOct. 29, 2003 – Met with Ray Gilmartin (CEO of Merck) and Adel Mahmoud (Merck) to \ndiscuss ways that Merck can collaborate with NIAID in AIDS and in biodefense.  Great \nmeeting.  Also, discussed how Merck can interact with BioShield process.\nReleased by Chairman Rand Paul\n82Nov. 3, 2003 – Carol Kuntz informed me that the Vice President wants me to brief him \non what we are doing with Rad/Nucl research and countermeasures.  This is tough since \nthis is not really my issue; however, the VP wants it and so we will put something \ntogether for him\nNov. 5, 2003 – Meet in my conference room with Israeli Ambassador to the USA – \nDaniel Ayalon to discuss potential for collaborations with Israel.  We got along very \nwell; he is quite engaging.  We discussed scientific collaboration as well as our difficult \nsituation in Iraq with the insurgency and terrorism.\nNov. 6, 2003 – Meeting at the EEOB (White House) to discuss how I will brief the VP on \nNov. 20, 2003.  VP wants me to take care of the Nucl/Rad countermeasure situation since \nhe does not have confidence in the scattered others.  Issue is that this is not my primary \narea of expertise.  He wants me to do it anyway.  Nice compliment, but this will be a lot \nof work.\nAlso, Anthrax situation evolving at Anacostia Naval Post Office.  Possibly \ncontaminant.\nNov. 7, 2003 – Still sorting out the likely anthrax contaminant at the Anacostia Post \noffice. \n Met in my office today with  the South African activist who last \nyear refused to be treated with ART for his HIV because the S. African government was \nnot providing treatment for the rest of the country.  He is a very gentle person and a true \nhero.  He just wanted to come and meet with me. \nNov. 13, 2003 – Met with the PCC (Policy Coordinating Committee) regarding the \nresponse to the Fink report.  The PCC adopted for the most part the responses of the \nDHHS to the Fink report.  We (Stewart Simonson, Stuart Nightingale, Amy Patterson, \nLana Skirboll, John La Montagne) have been working on DHHS’s response for several \nweeks now.\nAlso, I was on conference call this afternoon with Secret Service, DHS, DHHS, \nFBI regarding a letter that contained ricin that was sent to Greenville, SC; however, now \na letter addressed to the White House also containing ricin has been discovered.  The \ndiscussions among the Secret Service, FBI, Department of Transportation, etc. is chaos.  \nIt is somewhat embarrassing.  The discussion centered around the investigation and not \nthe public health issues until DHHS (Bob Blitzer) brought up the fact that we really need \nto find out who might have been exposed.  This phone call was like the Keystone Cops!\nNov. 14, 2003 – Continual conference calls regarding the ricin incident.  It turns out that \nsomeone crushed some castor beans and stuck crude material into an envelope to \nblackmail the Dept. of Transportation.  Letter was also sent to WH.  Bottom line – no \nhealth threat.\nNov. 20, 2003 – Went to West Wing of WH to brief VP Cheney on Nuclear and \nRadiological Threat Countermeasures.  As I was crossing Pennsylvania Avenue to enter \nWest Wing at 9:30 AM, there was an alarm that a small aircraft had encroached upon \nReleased by Chairman Rand Paul\n\n83WH airspace.  WH was evaculated and many machine gun armed Federal police \nappeared.  After  a while they let us in, but the VP had already been scooped off to safety \nand so the meeting was cancelled and rescheduled for a few days from now.  President \nBush was in UK at the time.\nNov. 25, 2003 – Briefed the Vice President  today with Scooter Libby, Stewart \nSimonson, Carol Kuntz and Jorge Tavel in attendence.  I spoke about \nNuclear/Radiological countermeasures and our need for a strategic plan and the need for \nsomeone (us – DHHS/NIH) to take the lead in this since the effort is fragmented and \nDoD has been neglecting this area since the end of the Cold War.  I also gave him a \nprogress report on our microbial biodefense program.  He loved both presentations and \nrelated to Carol, (who told me) that the briefing was “very impressive, very impressive, \nin fact great!”  I am still having trouble with Zerhouni who is infuriated that the VP’s \npeople are “excluding him” from these briefings.  In fact, they merely maintain that the \nVP does not like crowds and he does not like the chain of command to be present on \nbriefings to him.  Zerhouni cannot accept that.  I am trying to explain this to Zerhouni, \nbut he is just plain angry.\nNov. 28, 2003 – Significant Influenza A activity already with a variant strain (Fujian) that \nis not contained in current vaccine. This is quite early for heavy burden of influenza \ncases. 4 deaths of children in Colorado.  Concern mounting that we will have a very bad \nyear.  I have been on CNN (X2) CNBC and Good Morning America over the past 2 days \nto talk about this.\nDec. 1 – 7, 2003  - Trip to Africa as part of Secr. TGT’s delegation.  Cameroon (fuel stop \n+ ambassador handshake), Zambia, Rwanda, Kenya and Uganda.  Most incredible visit. \nIncluded Julie Gerberding (CDC), Elias Zerhouni, Randy Tobias (Ambassador for \nPresident’s Emergency Program for AIDS Relief (PEPAR), Richard Feachim (Director \nof Global Fund for AIDS, Malaria, and TBC),  Peter Piot (UNAIDS), Amb. Richard \nHolbrooke (UN Ambassador for Clinton, now representing business coalitions), Bill \nWinkenwerder (DoD), Senator Don Nichols (R-OK), Congressman Dave Weldon (R-\nFL), Linda Conlin (Assist. Secr. For Trade Development, Dept. of Commerce, Ann \nPeterson (USAID), plus many other VIPs plus a large number of CEO-types in industry \nsuch as Hank McKinnel (CEO-Pfizer), CEO Peter Dolan of BMS, Chris Viehbacher \n(Pres., GSK), John Martin (CEO, Gilead), Per Wold-Olsen (Pres. Merck Europe/Middle \nEast/Africa), etc.  In addition, many people from faith-based organizations such as Father \nO’Brien (Pres. Les Aspin Center at Marquette) and Shepherd Smith (Institute for Youth \nDevelopment).  Christy Feig from CNN was on board as was Sabin Russell from San \nFrancsico Examiner and Marilyn Marchione from Milwaukee Sentinel. Purpose of the \nvisit was fact finding and to get industry involved in economic impact of AIDS in Africa.\n      So many incredible aspects to trip with the underlying theme that the Africans \n(particularly in Uganda) are showing that they are ready for implementing the PEPAR \nand the Global Fund (see below the experience in Tororo, Uganda). Also, many new \nfriends from the delegation.\nZambia (Dec. 1-2) –  Greeted by US Ambassador Martin Brennan and Zambian \nMinister of Finance and Economic Development Emmanuel Kasonde and Zambian \nReleased by Chairman Rand Paul\n84Minister of Health Brian Chituwo. Stayed at the Zambezi Sun Hotel at the evening had a \nlocal dinner (open pit outdoor barbecue) at a Boma. Also, walked down to Victoria Falls \nwhich was absolutely breathtaking. Looked across the Zambezi River to Zimbabwe. \nParticipated in a World AIDS Day parade through the city  center of Livingston. Many \nlocals came out to greet us. Visited a faith-based organization St. Francis Community \nHome-Based Care Center as well as LISCA Linda Center giving care to children – called \nLISCA. \n Rwanda (Dec 2-3)  On afternoon of Dec. 2, flew to Kigali, Rwanda and \nimmediately went to the Genocide Memorial.  Clearly this was one of the 2 most \nimportant parts of the trip.  I spoke with many Rwandans who suffered from the genocide \nand the enormity of it really is not appreciated by the world in general.  In 1994, over a 4 \nweek period in April, the majority Hutus slaughtered 800,000 to 1 million Tutsis while \nthe world watched and did nothing.  In fact, the French actually came in to protect the \nHutus against Paul Kigame’s  (Tutsi) rebel army that came in from Uganda to stop the \nmassacre.  I ultimately had an audience with now-President Paul Kagame in the \nPresidential Palace.  We also spoke with many Rwandans whose families escaped.  \n(Please refer to history books about the massacre).  Of not, as in my visit to South Africa \nin 2002 vis-à-vis Apartheid, the Rwandan Society in dramatically impacted by the \ngenocide.  Most ministers are people who fought together with Kagame to stop the \ngenocide.  Those who were there said that atrocities were unimaginable.  Machete-killing \nof tens of thousands of people, women, children per day until bodies cluttered the streets \nand the rivers.  Of note, 13% of the population of 8.2 million are infected with HIV and \nso AIDS potentially will kill more people than the genocide massacre. During visit, met \nwith US Ambassador Margaret McMillion. Visited Kabgayi Hospital 1 hour outside of \nKigali. TGT gave a gift of a cow named “Elroy” (after his hometown in Wisconsin). On \nthe previous night (Dec. 2) we had an extraordinary discussion among the delegation.  \nWe had just received a high red alert that there would be a terrorist attack against US \ninterests, particularly hotels and possibly ground to  air missiles at aircraft in Kenya the \nnext day. There was a frank discussion at dinner at the Milles-Collines Hotel among \ndelegates led by Jay Hodes (chief of DHHS Security) and TGT.  Decision was that \nanyone among government people could opt out and go straight to Uganda skipping \nKenya; however, all non-government people were bumped off and sent directly to \nUganda except for a very few like Sabin Russell and some others. I definitely wanted and \ndid stay with the group as did Julie Gerberding and Elias Zerhouni.  The Milles Collines \nHotel was where the Hutu Command post was during the genocide.\nThe next day we went to Kabgayi (see above), then flew to Entebbe Airport \nUganda, left off about 70 people and the remaining 25 – 30 went back to Kenya. We \nwere flying on a German Charter (same one as last year with German pilot Chris who \nformerly was a Luftwaffe Major).  On the approach to Nairobi airport, Chris slowed \ndown for about 15 minutes to “cool” the engine ( to decrease chance of hear-seeking \nmissiles) and then dove sharply to the landing field.  All went well.\nKenya (Dec 3-4).  In Kenya, we went to a rather boring Global Coalition Event \nand then had a reception at the residence of US Ambassador William Bellamy.  Security \nwas depressing. From the airport, we were escorted downtown by a truck-load of Kenyan \nArmy soldiers all with AK47s.  The entire perimeter of the hotel was blocked off to \nReleased by Chairman Rand Paul\n86husband and other brother-in-law.  She is not abused by her in-laws and states proudly \nthat they love her very much.  It was clear from their reaction that she was correct.\nAfter Tororo, we went to the Grandmother’s (JAJA/Mildmay) house in Jinja, \nUganda.  This was a beautiful facility that was more a referral facility that a primary care \nplace. \nNext day (Dec 6) went to Mulago Hospital grounds and visited the TASO Mulago \nCenter for a ribbon cutting of a new building largely built by Pfizer through  a donation \nfrom Hank McKinnel. It is a beautiful facility. After this we went to Entebbe and visited \nthe Uganda Viral Research Institute on Lake Victoria.  I gave a small speech.  The Rakai \ngroup supported by NIAID gave a booth presentation led by Noah Siwanuka (Spelling?).  \nAfter this we had dinner at the Lake Victoria Hotel in Entebbe and took off for Frankfurt \nright after midnight on Dec. 7 with a fuel stop in Larnaca, Cyprus.\nGeneral Comments: See above in Introduction.  Also, in Uganda, CDC program \ndirector Jonathan (Jono) Mierman was wonderful…very enthusiastic and good-\naggressive person. Also, interacted with Minister of Health Jim Muhwezi. He has an \ninteresting history.  He is trained as a lawyer, was a political activist against Idi Amin and \nMobutu.  Was jailed, shot himself (3 escaped and 1 was killed) out of jail, escaped to a \nhotel that was surrounded by hundreds of troops that were looking for him.  He dressed \nlike a woman and slipped away right in front of the soldiers.  He escaped to the North \nwhere he joined Museveni.  He became a Brigadier General in the Ugandan resistance \narmy and after Museveni won, he was made chief of intelligence.  After 10 years there, \nhe was made Minister Of Health.  Similar to the Kagane story in Rwanda, practically all \nof the ministers started off as fighters in the resistance army with the person who \nultimately became President, in this case Museveni.  None of these places are really a \ndemocracy since opposition parties are generally restricted.  It just happens that \nMuseveni is an enlightened President.\nBecame friends with Tommie Thompson, TGT’s daughter who is very nice.  \nAlso, developed beginnings of bonding relationships with many people including Sen. \nNichols, Cong. Weldon, Randy Tobias, Richard Holbrooke and many of the staff at HHS \nthat I already knew well, as well as Elias Zerhouni.\nAs experienced as I am, I was greatly moved by the trip.  I learned much and was \ndeeply moved by the experience in Tororo.  I felt so good and yet humbled about my role \nin developing the $15 billion PEPAR program.  It may turn out to be my greatest \naccomplishment.\nDec 7, 2003 – Major scandal at NIH with article in L.A. Times that shows that high NIH \nofficials including Steve Katz, John Gallin and others have made hundreds of thousands \nof dollars consulting for pharmaceutical and biotech companies.\nDec. 8-10, 2003 – Much media attention regarding the Fujian strain of influenza and the \nearly indications of a bad season with deaths of children in Colorado and elsewhere.  \nVaccine has run out and people are panicking.  83 million doses distributed.  I have \nalready been and will be on CNN multiple times, MSNBC, CNBC, CBS, etc.\nDec. 13, 2003 – Saddam Hussein captured by US Army outside of Tikrit, Iraq!!\nReleased by Chairman Rand Paul\n87Dec. 16, 2003 – Went to dinner reception at the home of Assistant Secretary of Defense \nfor Health Affairs William Winkenwerder in honor of Dr. Khudair Abbas, Health \nMinister of Iraq.  Present among others were Kristen Silverberg (who spent time in Iraq – \nsee above regarding the books of HPIM-15 that I sent to Iraq), Ken Bernard, Surgeon \nGeneral Richard Carmona, Congressman Fred Upton,  etc.  Iraqs really want me to go to \nIraq for moral support of the Iraqi medical establishment and health system.  They were \nall very appreciative of the books that I sent.  It is still very dangerous in Iraq, but I am \npursuing going with Secretary Thompson in Jan/Feb if possible.\nJan. 21, 2004 – Over the past month a number of issues have arisen.  There have been 3-\n4 cases of SARS in China.  The Fujian strain of Influenza A escalated and now is \ndeclining.  It may be that it was just a moderate year that peaked early and had people \nworrying about it being a catastrophic year.  It may turn out that it was not that bad.  Big \nworry is the appearance of H5N1 with 4-5 cases of jumping from chicken to man in Viet \nNam and massive chicken illnesses and deaths in Viet Nam, S. Korea and Japan.  We are \nall busy in planning for a potential pandemic flu.  No transmissions from person to \nperson.\nAlso, we had been working on the document in response to the IOM report on \n“dual use” microbes.  We (HSC, DHS, etc) established a Memorandum of agreement and \na Charter for the National Science Advisory Board for Biosecurity to advise the \nSecretary, HHS, the Director, NIH, and the Secretaries of all of the Agencies involved in \nthe conduct and support of potential dual use research in the life sciences.  I presented the \nMOA and the charter to the Deputies in the situation room in the White House.  It was \nwell received and will ultimately be signed by the Secretaries.\nOn the way out of the WH, I saw Margaret Spellings who said that the President \nwas talking about me today in that he wanted to be briefed by a group including me and \nJulie Gerberding on prevention of HIV/AIDS by abstinence, be faithful and condoms \n(ABC).\nJan. 21 – Feb. 25, 2004 – Very busy with many issues.  Two Congressional Hearings: 1) \nHouse Gov. Ops – Pandemic Flu; 2) Full Approp (Senate) on BSE.  Also, much stress \nwith situation of outside activities.  I was “interviewed” by Alan Slobodin as was Andy \nvon Eschenbach, Francis Collins, Don Lindberg and ethics offices about “lecture \nawards”.  Does not appear to be a problem for me, but they will likely force much greater \nrestrictions on outside activities.\nWhite House (Gary Edson) has asked me to put together a proposal for \neradication of a few “neglected diseases” in developing countries similar to what I did for \nthe PEPFAR.\nI was very persistent and finally got into TGT’s party to go to Iraq.  I feel almost \nan obligation to do this for my country even though I must admit it is a bit scary. It \nsounds corny, but it is the “Band of Brothers” feeling that I seem not to be able to get \naway from.  I am a visible public servant and this is what I do. This is probably the most \ndangerous situation I will have ever been in.  Will report details when I return.\nFeb. 26, 2004 – Leave for Iraq!\nReleased by Chairman Rand Paul\n88Feb. 26 – Mar. 1, 2004\nFeb. 26 – Left for Amman, Jordan – Iraq on a Gulf Stream air force aircraft from \nAndrews Air Force Base.  Trip purpose – “show the USA flag” in the context of health \nissues and determine whether the USG/DHHS/NIH can do more in the Middle East.  On \nthe trip was Secretary Thompson (TGT), Andy von Eschenbach, Bill Steiger, Press- \nSanjay Gupta, Christy Feig  and Joe Farre (CNN) and Mark Sherman (AP); Security – \nJay Hodes.  In Amman/Iraq we met Charles Curie (Head, SAMSA), Howard Zucker, Dr. \nDavid Smith (Humanitarian and Refugee Services), Andy Knapp and Mike Lonetto \n(Security advance), Adm Van der Wagner (USPHS).\nWe landed in Marka Airfield in Amman and almost immediately changed planes \nto an Air Force C-130 to Baghdad.  This would turn out to be one of the most memorable \ndays of my  life.  In the approach to Saddam Airport we did a sharp “corkscrew” landing \nin which it felt like the plane flipped over.  The airforce guys explained that this is the \nway that they avoid shoulder to air missiles as well as sporadic fire from AK 47s.  In \naddition, the airport gets randomly mortared every day.  These are just  pockets of \ninsurgents that rarely hit targets, the real targets are the convoys of troops accompanying \ncars (like ours) and isolated troops on patrol, as well as more recently, Iraqi police and \nofficials who are trying to rebuild the country.  We went from the airport to the “Green \nZone” (relatively safe with high security, despite the fact that rocket and mortar attacks \noccur on almost a daily basis; these usually do not hit specific targets, but do cause \ncasualties) in Baghdad with several car-loads of Special Forces and DoD Criminal \nInvestigation Division (CID) security people and 4 Humvees full of Military police \nmanning M-4s and fixed machine guns.  The ride to Baghdad was thrilling and \nfrightening.  The alignment of the motorcade was that every time we passed a person(s) \nwalking along the highway or a parked car or truck, the special forces car would insert \nthemselves between the suspects and TGT's car (I was riding with TGT).  When we \npassed an overpass or a car on our right, the Military police would aim their machine \nguns up at the overpass and swing around the turret of the machine gun as we passed the \noverhead.  The reason is that frequently insurgents drop grenades from overpasses and \nrun.  We passed cars driving with people or when cars pulled up alongside, the military \npolice and special forces would wave them over and point their guns directly at the \ndriver.  Reason – frequently, isolated cars drive by and shoot at the convoy.\nFirst stop – meeting with Ambassador Paul (Jerry Bremer) in his office in the \nimperial Palace formerly main palace of Saddam and now  headquarters of the Coalition \nProvisional Authority (CPA). Tom Foley (Bremer’s Deputy) was not present, but we met \nhim later on in the trip).  Had great discussion of the difficulties in transition to the \ngoverning council.  He made an interesting statement that democracy is a concept that is \nforeign to the Iraqis.  They are taking a lot of time with their constitution  and agreeing \non their form of government since they seek “consensus”.  Democracy means that the \nmajority rules, and as we see in the USA, the minority has much power and the balance \ncan and does changes. The Iraqis are not used to the majority winning a vote since \nhistorically, minorities get persecuted.  They need to understand that minorities are \nminorities for a particular idea/law/regulation and that Sunnis, Shia’s and Kurds can be \nminority, majority or both.  Sunnis and Shia’s can live together since there are many, \nmany mixed marriages.  Highly intellectual discussion.  Bremer is an impressive man.  \nReleased by Chairman Rand Paul\n89Also, met Jim Haveman who is the USA Health person (also impressive). Jim was with \nus for most of the remainder of the trip in Iraq and Jordan.   He thanked me for the books \nthat I sent to Iraq from McGraw-Hill.\nHad lunch at the home of MOH Khudair Abbas.  Present at the lunch  was Dr. \nEbrahim Al-Jafari, head of the Shiite Party and member of the Iraqi Governing  Council \n(IGC)and Dr. Rajaa Khuzai a women OB/GYN physician and also member of the IGC.  \nHad a very stimulating conversation regarding Iraqi politics, the history of Iraq medicine \nand how Iraq was the “jewel” of medical care and training in the 50s, 60s and early 70s.  \nWhen Saddam came into power, he diverted money to weapons and neglected health.  \nThe system deteriorated and now it is terrible.  They want to restore it.  I also heard first \nhand of the cruelty and true insanity of Saddam and his sons Uday and Qusai and how \nthey tortured and killed at will.  Many of the people at lunch lived in exile or remained in \nIraq, but had relatives who had been jailed, tortured or killed.\nThe defining experience of the day was the visit to IBN Sina Hospital which is the \ncombat (trauma) support hospital.  I had to constantly hold back tears.  Everyone carried \na weapon in the hospital, even the doctors and nurses performing procedures in the OR or \ntrauma rooms.  I say young kids (18-25 yo soldiers) with bullet wounds in the face.  \nCommon wound is a cheek-through-cheek bullet that either kills the victim or goes right \nthrough without hitting vital structures.  I am told that it is a common wound by snipers \nsince the troops wear body armor up to their neck and a helmet down to their eyes.  It is \none of the few exposed parts.  One such soldier was wheeled in as we were touring the \nhospital. He had just been shot.  I say shattered legs, abdominal wounds and Iraqi citizens \nshot in cross-fire and Iraqi insurgents getting x-rayed with a special forces person \npointing an M-4 at him in case he tried to escape.  I saw an Iraqi collaborator who was \nhelping the Special Forces in the North and another Iraqi came up to him when no one \nwas around and shot him in the back of the head.  The bullet miraculously went through \none posterior jaw and exited the face.  When taken to the hospital, he told the SF who the \nattacker was that left him for dead and the SF had just left the hospital to “take care of \nhim”.  Many army physicians and nurses recognized me either from TV or more often \nfrom Harrison’s. I ran into a young neurosurgeon – Major Koop who knew me from \nHPIM.\nUpon return to the airport via “ambush alley”, the 2 main Humvees of the 4 that \nescorted us back had young women at the machine guns.  I inquired about this to our SF \ndriver and he said that as of this week, women soldiers have more confirmed kills than \nmen soldiers.  Upon take off, we had the same corkscrew maneuver, but this time 2 \nairmen were at each window with radio contact with the cockpit in case they saw puffs of \nsmoke or flashes indicating a shoulder to air missile or Ak-47 , at which point they would \nalert the pilot to divert.\nLanded in Amman; we did not sleep at the Rasheed Hotel in Baghdad since it was \nrecently attacked with rockets while Paul Wolfowitz was staying there. Had a marvelous \ndinner at the home of the Jordanian MOH – Dr, Said. S. Darwazah.  Also present was our \nteam (minus the press), plus the US Ambassador to Jordan (Edward W. “Skip” Gnehm), \nDr. Samir Khleif, (NCI), Director of the King Hussein Cancer Center in Amman  and \nSaid’s brother Mazen and his father Samih.  We talked for hours about the complex \nissues of Israel and Palestinians and Iraq and USA.  It is clear that they want to live in \npeace with Israel, but they all feel that the USA in unfairly siding with Israel on not \nReleased by Chairman Rand Paul\n90disallowing settlements.  Clearly, one of the most stimulating evenings I have spent.  The \nJordanians are truly wonderful people and very friendly and affectionate to Americans. \nThe food was incredibly good.\nFeb. 28, 2004 – Visited the King Hussein Cancer Center in Amman. Dr. Samir Khleif \nshowed us around the modern facilities that have NIH-style telemedicine in real time.  \nToured the pediatric cancer wards with patients who had ALL, squamous cell carcinoma \nof ear and other tumors.  There is a Jordanian Program called Project Iraq in which \nselected patients are chosen from sick Iraqis and are transferred to the Cancer Center for \ntreatment.  We say several Iraqi mothers with their sick children.  Had a nice warm \nconversation with Princess Ghaida Salaam who is married to Prince Talal ibn Muhamed \n(Nephew of the late King Hussein) and Princess Dina who is also married to the nephew \nof the late king.  Both women were beautiful, articulate and spoke perfect English.  \nPrincess Ghaida  is the Chair of the Board of the Center and she recognized me from TV \nand said that she always wanted to meet me. I showed her my Harrison’s textbook in the \nKHCC library.  She spent years in DC and graduated from Georgetown in the 1980s.  \n  After the tour we had lunch and discussed  the various programs. Afternoon was free \nand we visited archeological ruins in Amman. \nThat evening, we had dinner at the home of Princess Ghaida.  This was a most \nunusual evening; I was incredibly impressed by the Princess’s husband Royal Prince \nTalal bin Muhamed.  He and Princess Ghaida both graduted from Georgetown in the \n1980s. He gave me a wonderful history of the Muhamed family that descended from \nKing Faisal I, hundreds of years ago.  The family split and one line took over Jordan and \nthe other first went to Syria and then Iraq.  He knew Sadam and his sons since he was a \nlittle boy and he feels that they were horrible sociopaths. He used to play with them as a \nchild during visits to Iraq and vice versa for Jordan.  Sadam gave him several guns as \ngifts.  In Arab countries, a gift of a gun is a show of respect and affection. Talal was the \nfavorite of his uncle King Hussein and told many stories of his loving relationship with \nthe King.  He proudly showed me his incredible gun collection (rifles, shotguns, and \npistols).  He was in the Jordanian paratroopers, is a polo player and rides motorcycles.  I \nfeel that this person could really be my friend if circumstances allowed.  Very intellectal \nand stimulating discussion at dinner regarding the war in Iraq and the Israel-Palastine \nsituation. He fees that the USA should have military rule in Iraq for 5 years before even \nconsidering handing over the government to the Iraqis. He said that the Iraqis would \nunderstand and respect this since what they want most is security.  He feels that a \nsituation similar to MacArthur and Japan would be desirable.  We discussed how this \nwould not be feasible politically in the USA, i.e. having a long-term occupation of Iraq.  \nHe is afraid of the instability that would follow in Iraq and the region if we handed the \ncontrol of the government over to a governing council (which he feels is made up of \nsome good people, but some people with no credibility such as Chalaby).  In addition, he \nfeels that the US military is so respected for their force and discipline, that this is the \nreason why the Iraqis fled.  He stated that the Iraqis are a “fierce” and proud people and if \nthe UN or the Poles and Spanish took over the security, the Iraqis would chew them up \nand anarchy would prevail.  He states that no Arab country wants the USA to leave any \ntime soon.\nReleased by Chairman Rand Paul\n91Feb. 29, 2004 – Last day in Iraq…mostly in the red zone.  Some very exciting and \nsomewhat scary moments with the convoy getting caught in traffic in  another “ambush \nalley” (narrow streets and high buildings where insurgents frequently shoot down on US \ntroops from roof-tops or windows). During several of these “stalls” in traffic, the special \nforces, military police escorts and the CID (criminal investigation division) of the army \njumped out of the cars and ran alongside with their M-4s pointed a the roofs and \nwindows.  They also ran up to cars that were blocking traffic and pointed drawn pistols \nand cocked M4s right into the cars to get people to move. Visited the MOH in the AM, \nthe Women’s clinic, had lunch with Iraqi health people.  This was all in the “red zone” \nand the SF had sniper observers on the roofs of the buildings surrounding the facility that \nwe were visiting. We then left for the airport had a wonderful dinner at Baghdad airport \n(Bob Hope Dining Hall)  with the troops of the 1st Armored Division, Military Police \nBrigade, the First Cavalry, and the 101st Airborne.  Our troops are incredible, including \nthe women.  They are extremely well disciplined, polite, good looking and nice.  General \nScaparroti (Chief of Combat maneuvers) brought TGT and me into the “classified” \ncommand room of the base and showed us how they track hostilities on a real time giant \ncomputerized map screen.  Met an incredible woman  Major Rogers who was a beautiful, \narticulate and smart, 35-ish deputy chief of intelligence for the command. Also met Col. \nFlake who was the combat coordinator – one tough looking soldier.  Also met Major \n(Doctor) John McGrath from the Medical Corps.  He knew me right away since his wife \nis a physician (Allergist/Immunologist) and always talks about me.  He asked for and got \na picture of us together. Finally, we flew on Blackhawk helicoptors to Balad AFB to \ncatch a C-17 to Rhein-Main AFB in Germany. The trip on the Blackhawk was tense and \nexciting.  I sat 2 feet from the machine gunner who was focusing on the ground looking \nfor flashes from small arms fire that happens all the time and usually misses the \nhelicoper.  As soon as they see a flash they immediately strafe the area with the M-50 \nmachine gun.  We flew all in the dark to avoid detection.  We landed at Balad, stayed for \nawhile and mixed it up with the troops and then flew to Rhein-Main AFB near Frankfurt.  \nFrom there we picked up the Gulfstream and flew back to Andrews AFB. We landed at \n6:00 AM, March 1, 2004.\nMarch 2-19, 2004 – Following the Iraq trip a number of relatively important issues have \narisen.  There is sweeping interest in the conflict of interest  arena with EZ forming a \nBlue Ribbon Panel on Conflict of Interest chaired by Norman Augustine and Bruce \nAlberts.  Also, the NIH Ethics Advisory Committee (NEAC) is now reviewing all out \nside activity requests (as well as any already approved ongoing outside activities) for \nhigh ranking NIH officials such as IC Directors, Deputies, Scientific Directors, Clinical \nDirectors, etc.  The NEAC is co-chaired by Raynard Kington and Michael Gottesman.  \nHappily they have approved my ongoing activities, including Harrison’s.  \nI met with the Blue Ribbon Panel and urged them to distinguish between outside \nactivities that could be conflictual such as consulting for drug companies and those that \nare purely academic such as writing, editing, lecturing (not on your immediate work) and \nawards.  They seem to “get it”.  I hope that their recommendations reflect this.  Several \ninvestigations will come including GAO, IG, and a least 2 Congressional Committees. \nAlso, the Congress is developing a subliminal hostility towards NIH because of the prior \nReleased by Chairman Rand Paul\n92doubling of the budget and because our advocates are still screaming for a 10% increase \nin FY2005 instead of the 2.5% increase of the PB.  Sen. Dominici called the NIHers \n“pigs” who are never satisfied.  Moral in quite low.\nGood stuff going on with Gary Edson and the “neglected diseases” project.  He \nreally likes the proposal that I put together for Lymphatic Filariasis (LF) and leprosy and \nmalaria.  We are going through the exercise now of several meetings back and forth in \ndeciding what to have the POTUS propose to the G-8 meeting in June in Sea Island.  \nThey want to have the POTUS show global leadership and urge the other G-8 countries \nto put up money and get involved; however, since we are already doing so much, he \nwants us to put up very little new money.  We will probably have to re-direct money – no \ngood deed goes unpunished.  Gary also wants me to explore the possibility of making the \nHIV Vaccine Enterprise a possible proposal.  He had spoken to Patty Stonesifer and she \nmentioned that Rick Klausner and I were working on this together.\nJohn Kerry won Democratic nomination prior to convention and he and Bush are \ngoing at it already.  The big issue is the terrorism that is going on in Iraq with foreign \nMuslim extremists with ties to Al Quaeda almost daily blowing up mostly Iraqis and \nsome US soldiers.  Massive terrorist attack in Madrid a few days ago with bombs in \ntrains; hundreds killed.  Muslim extremists claim responsibility and say that they did it \nbecause Spain has helped the USA in Iraq.  Incident occurred right before the Spanish \nelections and resulted in overthrow of the Party that supported Bush.\nMarch 24, 2004 – Had interesting and full day. Went to the National Defense University \nat Fort McNair, Washington, D.C. to participate in the DHS exercise of a hypothetical \naerosolized anthrax attack on Chicago.  It was for the benefit of press leaders.  Secretary \nRidge, Susan Neely (Assist. Sec. for Public Affairs, DHS), Ed Thompson (CDC) were \nthe main players.  It was exciting and the press totally enjoyed it and got engaged in \nactive Qs and As.  Virtually all of the senior producers and correspondents of networks, \nCNN, Fox, etc were present as were top print media.  Frank Sesno (CNN) moderated it \nand Aaron Brown (CNN) was present.  Tom Ridge relied virtually totally on me to \nanswer medical questions.\nAlso, had meeting at PEPFAR Headquarters (2100 Pennsylvania Avenue, N.W.) \nwith Gary Edson, Randy Tobias, Robin Cleveland (OMB), Mark Dybul, Joe O’Neill and \nAmbassador Lange to discuss how we can work an AIDS issue into the upcoming G-8 \nmeeting in June at Sea Island, GA.  Gary and I proposed the possibility of highlighting \nthe HIV Vaccine Enterprise that Rick Klausner and I have been working on for the past \nyear.  It would cost the USG virtually no new money since the “Enterprise” is a virtual \norganization that is proposing a strategic plan as described in our Science article.  The \nPOTUS can urge the G-8 countries to make a political commitment to make the \nEnterprise work.\nApril 2, 2004 – White House (Situation Room) -  Had meeting today as a culmination of \na series of PCC meetings related to preparedness against pandemic influenza.  We have \nbeen working with DHS, the VP’s office and DHHS to develop a white paper of needs \nReleased by Chairman Rand Paul\n93and plans.  Today we brought it to the PCC + deputies (Claude Allen of DHHS).  \nMeeting was chaired by Richard Falkenrath.  Present were several WH and departmental \npeople including Kristen Silverberg, Ken Bernard, Carol Kuntz, Bill Winkenwerder, \nStewart Simonson, Allen Gilbert.  We came to a good understanding of what we are \nultimately going to put before the full deputies and ultimately the Principals.\nApril 5, 2004 – White House (West Wing) – Met with Gary Edson. Attending were \nCarol Thompson, David Nelson and Gary’s assistant Martina Strong.  Discussed the G-8 \nissue regarding Gary’s concern that the other countries will bring up the issue of generics \nand PEPFAR, i.e. the false impression that we (USG) are against generics , particularly \nthe generic fixed dose combination of D4T, 3TC and nevirapine.  Gary does not want the \nPOTUS to be embarrassed if others blind side him with this.  The PEPFAR people \n(Tobias et al) should have straightened this out at a recent (March 29-30) meeting in \nBotswana.  There was a debate about WHO “pre-qualification” of these drugs and our \nconcern about the criteria and data upon which these drugs were pre-qualified.  Also, we \ndiscussed the issue of the POTUS proposing an endorsement of the HIV Vaccine \nEnterprise as our AIDS proposal for the G-8 meeting in June at Sea Island, GA.  We will \nwork with Gates (Patty Stonesifer) to endorse this, but the Gates Foundation is going to \nwant us to promise even more money for an AIDS vaccine.  Note that we are already \nspending>$500 million, vastly more than all other groups put together.  Gary will re-\nwrite the POTUS’s G-8 proposal regarding the Enterprise and run it by me, Kristen \nSilverberg, Secretary Thompson, Amb. Tobias before we launch it to the G-8.\nApril 6, 2004 – White House (EEOB) – Met with Kristen Silverberg, Robin Cleveland, \nRandy Tobias, Mark Dybul, Alan Gilbert, Press person from WH (?name, a woman), Joe \nO’Neill, and others to discuss issue of the bad press we are getting regarding the \nmisperception that the USG and PEPFAR will not buy generics, particularly the fixed \ndose combination (FDC) of D4T, 3TC and nevirapine that CIPLA and Ranbaxy are \nselling.  Decision was made to have Randy Tobias write and Op-Ed for The NY Times or \nthe Washington Post (I will review it for him) and then have me and Randy as necessary \ndo the TV circuit to get the truth out , i.e. that we will buy any drugs , even generics, so \nlong as they are of high quality (safe and effective) and the lowest possible price.\nApril 6-12, 2004 – Not much opportunity to implement issue above on April 6 because \nthe entire Press is consumed with the deteriorating conditions in Iraq.  Major insurgencies \nby both Sunnis (Fallujah) and Shiites (Baghdad) against American troops.  Several US \ntroops are getting killed each day and insurgents have resorted to kidnapping civilians \nfrom other countries who are working in Iraq, i.e. Japanese, Australians, UK, Chinese, \netc.  Bad situation that is getting worse.\nApril 13, 2004 – White House (West Wing) – 2 meetings.  First regarding the issue of \nthe HIV Vaccine Enterprise and whether we should make this an initiative for the \nPOTUS to present at the upcoming G-8 Summit in Sea Island, GA.  Present was Kristen \nSilverberg, Martina Strong (Gary Edson’s assistant), Joe O’Neill, Carol Thompson.  I \npresented the idea to Kristen and explained what Gary and I had been working on for the \npast several weeks. I explained how we wanted the POTUS to challenge the G-8 to \nReleased by Chairman Rand Paul\n94endorse and support the enterprise.  The USG is already investing for FY-04 about $488 \nmillion while the entire world’s contribution (including the USG) is about $600 to $640 \nmillion (these non-USG numbers are estimates.  Hence, most of the action is us. She \nliked the idea and wanted to pursue it.  She said that it would be a home run if we could \nspice it up with some new money.  She mentioned about $100 million.  I brought up that \nthe usual scenario would be that NIH would have to absorb this “new” money since there \nreally is no new money.  Kristen feels that if anyone can squeeze new money out of Josh \nBolten, it is me.  She is going to bring the issue up to Josh.\nThe second meeting was with Kristen, Joe O’Neill, Carole Thompson, Mark \nDybul, Randy Tobias, Jenday Fraser (new US Ambassador to South Africa).  Meeting \ntook place in Margaret Spellings office since it is one of the larger offices.  Margaret was \nnot there.  Discussion was regarding the options of how to address the FDC/generics \nsituation in the context of the PEPFAR.  We discussed a number of options.  Our goal is \nto get the lowest possible price for drugs that are clearly safe and effective.  Big issue \nwith FDA since they clearly will not approve a drug based only on “pre-qualification” by \nWHO.  There is much misunderstanding (see above) about the USG supposedly blocking \ngenerics since we are in the pocket of PHARMA.  This is nonsense since we are \nconcerned that we will be buying drugs that are not even generics; they are “knock-offs” \nfrom branded drugs.  I like the option of pressuring our drug companies to put 3 drugs in \na blister-pack (would take 1 month for the FDA to approve) to avoid the issue of \npotentially low quality Faces.  Other good option is to work with the FDA to speed \napproval (probably take 1 year since you would have to do some pharmacokinetics and \nbioavailability studies first) of FDCs contained the branded drugs.  Simultaneous option \nwould be to ask the South African Medicine Control Council (their FDA) to regulate the \nknock-off FDCs and to only buy it if they approve them.  This would be Africans making \ndecisions for Africans.  The only problem is that if they reject the drugs, it might look \nlike a typical erratic South African move, i.e. Mbeki and Shabalala Misemang are \nnotoriously weird.  Alternatively, if they accept the drugs with scrutinizing them and they \nare no good, we would be buying bad drugs.\nApril 14, 2004 – White House meeting (EEOB 476) with Gary Edson, Rick Klausner, \nRachel Ingram (Gates) and David Lane (Gates), Martina Strong, Carol Thompson to \ndiscuss the role of the Gates Foundation in the HIV Vaccine Enterprise.  Rick presented \nthe same case as I did and said that Gates would be willing to invest $100 million this \nyear and that the whole project would probably need $400 million per year for 10 years.  \nHe wanted the USG to try to put in more money.  Gary was concerned about the fact that \nwe have no new money, although he really likes the Enterprise concept.  After Rick left, \nGary and I discussed how much if any money would be feasible to invest as new money. \nAs opposed to just challenging the G-8 to join and endorse the process.  He wanted to \nthink about it more.  One of the issues that he brought up even when Rick was there was \nthe problem of doing something and then getting criticized the way that we have been \ncriticized about PEPFAR.\nApril 15-16, 2004 – Series of phone calls and e-mails involving Gary, Kristen and me.  \nApparently, Kristen really likes the idea about putting some substance (new resources) \ninto the POTUS proposal to the G-8 and Garry asked me to cost out a real center a virtual \nReleased by Chairman Rand Paul\n95center and also a vaccine production plant.  He sent it to Kristen who asked me for some \nclarifications and now will run it up to Josh Bolten.  This may be a go if we can convince \nJosh to get some new money.  I coasted a real center (with walls) at $55 million for \nconstruction and start-up and $47 million for annual operations.  I costed a virtual center \nas $15 million start up and $51 million annual operations.  Kristen asked me to brief Alex \nAzar (General Counsel for HHS) to see if we need any special authority/legislation \n(similar to BioShield) to make this work more quickly and smoother.  She will be out for \na week and then we will resume.  I handled these calls and e-mails while on a quick trip \nto Chicago to give a talk at the Clinical Research 2004 meetings.  I spoke on Emerging \nInfections.\nApril 19, 2004 – Extensive phone conversation with Josh Bolten (OMB Director), Jim \nCapretta and Tom Reilly (OMB) regarding the details of my proposal for the “virtual” \ncenter for HIV Vaccine as described above.  I described in detail the entire proposal to \nJosh. Josh was very supportive.  Issue was where to get the $15 million start-up costs for \n’05 and the $51 million yearly costs.  Josh indicated that he would figure out where to get \nthe money.  More than likely that we (NIAID) would have to absorb a portion of it. \nApril 20, 2004 – Had nice lunch with Jay Lefkowitz today at The Oval Room on \nConnecticut Avenue.  Beautiful warm Spring day.  Jay just wanted to catch up on things \nwith me.  We discussed the PEPFAR and the issues associated with it; and the new G-8 \nproposal that I was working on with Gary Edson. Kristen Silverberg, and now Josh \nBolten.  Also talked about war in Iraq and the POTUS.  Jay also inquired about what I \nwant to do differently if anything.  I told him that I wanted to remain in public service \nand the Secretary of HHS is a job that I would not strive for or promote myself for, but \nwould not refuse if asked. He is thoroughly enjoying his private sector life.   After lunch, \nhe invited a friend (Christine Carlisle Jones) to the table for coffee.  She is the CEO of a \ncompany that is working on freeze preserving eggs from women who might be getting \nchemo, and he wanted her to meet me.  Very attractive and intelligent woman in her 30s.  \nIt was great to spend time with Jay.  He has become a good friend.\nApril 21, 2004 – Busy day!  Beautiful sunny day.Testified at my House Appropriations \nSubcommittee (Chaired by Ralph Regula) in the AM , then rushed to brief Senate and \nHouse Staff (at Dirksen 116) from the Homeland Security and Appropriations \nSubcommittees on progress of Project Bioshield and its possible use to procure drugs for \npandemic influenza. Many people present such as Bettylou Taylor of Senate Majority \nAppropriations, Craig Stevens of House Majority Appropriations and a variety of staffers \nfrom Homeland Security Committees, the latter were as usual disdainful of DHS.  Bad \nnews relationships between DHS and their respective committees.  Also present were \nSally Stanfield of DHS (terrific person), Stewart Simonson, Michael        (WH Legisl), \nTom Reilly of OMB, Ken Bernard of WH Homeland Security Council\nAfter meeting, Ken and I rushed to OSTP on 1801 Pennsylvania Ave to meet with \nthe Weapons of Mass Destruction Medical Countermeasures Subcommittee.  I am on the \nSteering Committee of the National Science and Technology Committee (NSTC) \nSubcommittee on WMD Medical Countermeasures (Chaired by Bill Winkenwerder \n(DoD) and Phil Russell (HHS).  I rarely go to these meetings, but Ken Bernard wanted \nReleased by Chairman Rand Paul\n96me to be there for discussion of 1)Anthrax countermeasure development plan and 2) DoD \ndevelopment of butylcholinesterase (BC).  BC is unbelievable.  It is a naturally occurring \nplasma product that neutralizes the effects of VX and Sarin gas. It binds to the \nphosphogen cholinesterase inhibitors of the gas and protects animals from sarin and VX.  \nIt has no toxic side effects.  Taly Bar-Shalom from OSTP presented the data.  The DoD \npeople wanted NIH to do Phase 1 clinical trials on the plasma derived product and to pay \nfor the development of the recombinant product since they “had no money”.  The Phase 1 \ntrial would cost from $1 to 10 million depending on the design.  The development would \ncost a few million $.  I got up and chastized the army Colonels (Joe Perla et al) and told \nBill Winkenwerder that I was astounded that they had a countermeasure for a known \nthreat (Tokyo subway) that is completely effective in animals (rats, hamsters) and totally \nsafe, and yet they say that they do not have any money to develop it.  Unbelievable!  In \nsome fairness to them, the DoD money for Medical issues is so compartmentalized, that it \nis difficult for them to move $ from one silo to another.  They have no way near the \nflexibility that NIH has.  In addition, Bill Winkenwerder, who is Asst Secretary of DoD \nfor Health, really has no power or jurisdiction and cannot commit resources at a meeting \nlike this.  He is a very good guy and promised me that he would find the money.  I \noffered to share with them the effort and cost of a phase 1 trial.  In reality, if they drop the \nball on the clinical trial and development of recombinant product, I will pick it up.\nOn the way from the Rayburn to Dirksen building, I ran into Hillary Clinton on \nthe street and she gave me a big hug and kiss and we chatted for a few minutes (with her \nSecret Service people looking puzzled) about AIDS, etc.\nApril 23, 2004 – Went to dinner over Dan and Marina Ein’s home on Kenmore Drive in \nNW Washington.  Dinner was to bring together people in DC interested in bioterrorism \nand press folks who cover this.  Present among others was Bob Malsam (Head of DC \nHospitals) Dan Lucey (Medical Officer of DC DOH), Ceci Connelly (Washington Post), \nMike Iskowitz (Newsweek), Jerry Hauer (Biodefense Center at GW) and several others.  \nAmong topics that came up was the buzz around town of the recent intelligence that \nanother “big” terror attack will happen soon.  The weather was clearing or rain after a \nmajor thunderstorm.  I had wanted to go to the St. Albans vs Jefferson County (WV) \nHigh School baseball game, but it was cancelled because of rain.\nApril 28, 2004 – White House (West Wing) – Met in Kristen Silverberg’s office to \ndiscuss the FDC issue (see above).  Much discussion regarding our approach to FDCs in \nthe PEPFAR program. At meeting were the usual group: Kristen, Mark Dybul, Joe \nO’Neill, Mark McClellan, some FDA economists, Emit (FDA), Carol Thompson.\nI spoke with Kristen by phone after the meeting about my chose vis-à-vis options. \nApril 28-29, 2004 – Gary Edson called me and said that he had a “disturbing” \nconversation with Patty Stonsifer (Gates) in which she mentioned that the USG should \npromise NEW resources for the Enterprise proposal to the G-8.  Gary asked (and I did) \ncall Rick Klausner to get his take.  He is comfortable with our proposal.  Gary is \nconcerned that Gates will be lukewarm about our proposal and we will have another \nexample of the POTUS trying to do something good and then getting criticized for not \ndoing enough.\nReleased by Chairman Rand Paul\n97May 4, 2004 – White House (West Wing) – Me with Gary Edson and Patti Stonecifer \nregarding the HIV Vaccine Enterprise and the upcoming G-8 meeting in Sea Island, GA.  \nWe have come to an agreement that if the POTUS presenting the Enterprise proposal to \nthe G-8, Gates will soundly applaud the effort and work with us to get it going.  The USG \nwill not promise an new money over and above the $500+ million that we already spend \non HIV vaccine research (this is about 5/6 of the world’s total of $640 million).  \nHowever, we will challenge the other G-8 countries to endorse the Enterprise strategic \nplan and align current and future resources with the plan.\nMay 12, 2004 – Big White House day!  The President visited the NIH for a “No Child \nLeft Behind – Read First” ceremony.  It was held at NIH since the NICHD had some \nactivities in this area.  Ceremony held in Natcher Auditorium.  I sat in second row and the \nPOTUS recognized me from the stage and greeted me individually noting that I was in \nthe audience.  After his talk, he came down to “work the rails” and chatted with me for \nabout a minute on International AIDS.  He mentioned that he had just met with the \nHealth Minister of Angola.  He was as usual very complementary to me.\nIn the afternoon had a meeting in the WH with Kristen Silverberg, Allan Gilbert, \nRandy Tobias, Joe O’Neill, Mark McClellan, Lester Crawford and many others about \nfixed dose combination ARVs (FDCs) and the PEPFAR.  We have developed a plan and \na roll-out strategy.\nAfter the meeting, went to Indian Treaty Room and had a going away reception \nfor Richard Falkenrath of the Homeland Security Council (HSC).  Had nice chats with \nJohn Gordon (chief of HSC), Tom Ridge, Josh Bolten, Carol Kuntz, Clay Johnson and \nmany others.\nMay 19, 2004 – Good day!  Project BioShield legislation passed the Semate by a 99-0 \nvote.  The White House asked me to attend a press conference with Sens. Frist, Gregg, \nand Kennedy as well as Secretary Thompson at the Capitol.  We briefed the press and I \nanswered several questions. TGT called me the “father” of the BioShield Bill.\nMay 27, 2004 – Went to a nice retirement celebration at the White House (Indian Treaty \nRoom of EEOB) for Gen. John Gordon (Director of the Homeland Security Council).  I \nhave developed a very nice relationship with John over the past year or so and he was \nvery glad to see me there.  Attending were Andy Card, Condoleezza Rice, Karl Rove, \nHarriet Meiers, among others.\nGetting ready to go on June 8-10 to Savannah, GA for the G-8 conference at Sea \nIsland.  The White House (Gary Edson et al) wants me there to answer press questions \nregarding the HIV Vaccine Enterprise Proposal that the President will make to the G-8.  \nGary asked me to get Peter Piot (Director of UNAIDS) to write an editorial praising the \nproposal at about the time that it is announced.  I am working on this.\nJune 2, 2004 – Testified before the House Commerce Committee on Science chaired by \nMr. Bilirakis for the NIH Priority Setting in anticipation of reauthorization of NIH.  \nTestified with Elias Z., Andy VonEschenbach and Nora Volkow.  Tough questions, but \nReleased by Chairman Rand Paul\n98the Hearing went well.  Immediately went to brief an IOM Panel on Biodefense.  They \nwere very flattering of me and the work that we have done.\nJune 3, 2004 – Busy day.  Went to Ali’s Lower School Graduation and rushed to testify \nat House Select Committee on Homeland Security chaired by Chris Cox with Jim Turner \nas ranking minority.  Chris Hayes and Joe Barton were there.  Many tough questions \nsince the Presidential race is heating up and the Dems want to give the impression that \nthe Administration is not doing enough on Biodefense even though we have \naccomplished a lot.  I did very well.  \nImmediately after the Hearing I rushed to DHHS and briefed Sec. Thompson on \nthe G-8 meeting and the HIV Vaccine Enterprise.  Then I rushed to the White House for a \nmeeting called in the West Wing by Kristen Silverberg on the POTUS proposal (maybe) \nto facilitate vaccine development by addressing liability, intellectual property, tax \nbenefits, and monopoly issues.\nAfter WH rushed to go to Jenny’s Sports Banquet.  She received MVP for the \nDiving Team.\nJune 8-10, 2004 – Went to Savannah, GA (Sea Island) for the G8 Summit hosted by the \nUSA.  I was part of a White House Team that served as Presidential Surrogates to brief \nthe Press before, during and after the President’s proposals of initiatives to the G8 leaders \ngathered in Sea Island (UK – Tony Blair, France – Jacques Chirac, Germany – Gerhard \nSchroder, Italy - Berlusconi, Japan, Canada - , Russia - Putin, and USA). The other \nsurrogates on the Team were: Elliott Abrams (Special Assist. To the president and Senior \nDirector for Near-East and North African Affairs at NSC); Andrew Card (WH Chief of \nStaff); John R. Bolton (Under Secretary of State, Arms Control and International \nSecurity); James L. Connaughton (Chairman, Council on Environmental Quality); Glyn \nT. Davies (G8 Political Director); Kristen Forbes (Member, Council of Economic \nAdvisors); Jendayi E. Fraser (Special Assistant to the president and Senior Director for \nAfrican Affairs at NSC); Robert Joseph (Special Assistant to the president and Senior \nDirector for Proliferation Strategy, Counterproliferation and Homeland Defense); Alan P. \nLarson (Under Secretary of State, Economic, Business, and Agricultural Affairs); \nConstance Berry Newman (Assistant Administrator for Africa of USAID); Randall \nQuarles (Assistant Secretary of Treasury for International Affairs); Condoleezza Rice \n(National Security Advisor to the President); Frances Fragos Townsend (Assistant to the \nPresident and Homeland Security Advisor); Dan Bartlett (White House Communications \nDirector); Scott McClellan (Assistant to the president and White House Press Secretary); \nGordon Johndroe (Laura Bush’s Press Secretary); and Jim Wilkinson (Deputy National \nSecurity Advisor for Communications at NSC).  My job was to brief the press at formal \nand informal briefings on the Health Issues which were mainly the Global HIV Vaccine \nEnterprise (see above), the Polio Eradication Initiative, and to a much lesser extent, the \nFamine Initiative.  I also briefed on the progress of PEPFAR the Global Fund for AIDS, \nMalaria and TB and the issues on Fixed Dose Combination (FDC) and co-packaged anti-\nHIV drugs.  \nThe weather was beautiful and we stayed at the Westin Resort Hotel on \nHutchinson Island in Savannah.  All I did was work and did not get off the compound.  \nThe security to get on and off the compound was as tight as I have seen anywhere except \nReleased by Chairman Rand Paul\n99for Iraq. The Press center was adjacent to the Hotel. I spent most of the time in the White \nHouse press unit with White House staff led by Pamela Stevens, Paul Morrell, Jim \nWilkinson, Barry Bennett (Deputy of Communications, G8 Summit Planning \nOrganization, Colby Cooper, Dana Perino, M.C. Koch, Jana..?, Corey..? and others.  \nIt was exciting to be there and I ran into virtually all of my reporter friends on the \nWhite House Press Corps including among others, David Gregory, Terry Moran, Norah \nO’Donnell, Ann Compton, Bill Plant, John Roberts.  I had a great interview with an AP \nreporter Scott Lindlaw, whom I had not met before.  The initiatives were very well \nreceived.  However, as I have seen before, unpredictable events shape everything.  \nFormer President Ronald Reagan and died a few days before and the press was totally \nsaturated with Reagan history and funeral news to the point that the G8 issues were \nliterally pushed from the front page.  I appeared on TV only one time on CNN and that \nwas for an interview with Anderson Cooper on my impressions of Reagan’s legacy on \nAIDS, particularly during the early years when he did not even mention AIDS publicly.  I \nstated on camera that the criticism of this silence on the part of the activists was certainly \njustified; however, the activists are being too harsh (Larry Kramer wrote a piece calling \nhim worse than Hitler) since many things occurred behind the scenes that were good.  For \nExample he allowed me to go out and be proactive and speak on behalf of the gay \nconstituents.  Also, Surgeon General Koop was allowed to mail his report to every \nhousehold in the USA. I also got some press with interview in foreign TV such as VOA, \nAl Jazeera, Canada National TV, BBC, etc.  Also, a few mentions of my briefings in \nWSJ, and many papers that picked up the major AP story by Scott Lindlaw.  Otherwise, \nthere was much less press for the G8 in general and for me than would have occurred had \nnot Reagan died.\nJune 18, 2004 – Attended a farewell party at the White House for Gary Edson.  He is \nleaving NSC to work in the campaign.  His main job will be to prepare the POTUS for \nthe debates with Kerry.  I was the only non-WH person at the reception that was hosted \nby Condi Rice and Steve Hadley of NSC.  In her praising of Gary for his work, she \nmentioned 2 accomplishments among many: 1) the millennium account, and 2) the \nPEPFAR.  When she spoke of the PEPFAR, she caught my eye and said, “Oh Tony Fauci \nis here; they were the team that did this.  Tony was the brains and Gary was the brawn”.  \nJuly 9, 2004  -  2 meetings in West Wing.  First was a top secret briefing of Fran \nTownsend, the new Director of the Homeland Sceurity Council.  She replaced Gen. John \nGordon who retired in June (see above).  Present at the briefing were Ken Bernard, Bob \nKadlec, Larry Kerr, Kate Spitler (CIA) and some others.  Purpose was to brief Fran on \nthe experiments that were being proposed regarding genetically engineered monkeypox \nvirus to duplicate what was shown in the mousepox model where inserting the IL-4 gene \ninto mousepox made it lethal and elusive for both vaccine and therapy.  Debate was \nwhether to do experiments and whether to classify them.  Purpose of doing experiments \nwas to determine whether the mousepox work also applied to the monkeypox.  In \naddition, if it did, then we needed to develop countermeasurs such as anti-IL-4 drugs.\nFran was extremely complimentary to me saying that above all people, she \nwanted to know what my opinion was and she wanted me to explain the details and \nimplications of the experiments.\nReleased by Chairman Rand Paul\n100Next meeting was in the office of Faryar Shirzad (replaced Gary Edson on NSC; \nsee above). Present was Martina Strong.  Purpose was to plan the Fall meeting of the G-8 \nVaccine Enterprise as promised by the POTUS.  We discussed what the format of the \nmeeting should be and what level of representation from G-8 countries should be there.  I \nsuggested at least a top scientist from each country and then for formality, we should \nhave the Ministers of Health there after the strategic plan had been finalized.\nJuly 11 – 16, 2004 – Went to the XV th International AIDS Conference in Bangkok. The \ndepth of misunderstanding about the PEPFAR and the reason why the PEPFAR wants \nexpedited approval by FDA of the “copy” generics that are being used before USA \nmoney is used to buy them is huge.  The activists were out in full force disrupting Randy \nTobias’s speech with signs of “He’s Lying”.  Ultimately they let him speak, unlike the \nsituation in Barcelona in 2002.  There was an extraordinary amount of USA bashing by \nactivists, the liberal press and even by international figures such as Kofi Annan who \nstated that the USA was not showing leadership because we were not giving more to the \nGlobal Fund.  He seems to have selective amnesia regarding the PEPFAR’s $15 billion \nprogram.  Chirac made a similar statement.  Issues that were particularly misunderstood \nwere: 1) why the USA was not giving billions to the Global Fund; 2) why we wanted to \nhave an expedited approval of copy generics before the PEPFAR paid for these drugs; 3) \nWhy the DHHS only allowed 50 people from HHS to attend the meeting.  Most people \nclaimed that it was because the activists booed TGT at Barcelona and because we were \nupset that we were not controlling the agenda.  Before the meeting a group of far-right \nCongressmen wrote to the organizers of the meeting saying that they condemned the \nmeeting since more faith-based organizations were not given prominent roles in the \nmeeting and because not enough emphasis was placed on abstinence. This made the USA \nlook real bad.  Stupidly, the DHHS restricted the numbers of meeting participants \ngenerally without doing it by category and as it turned out, some scientists who were \nalready on the program had to cancel out.  Thus, the topic was this stupidity rather than \nall of the good things that were happening.  The activists were more misinformed than I \nhave ever seen. They had no idea what they were talking about.  All they wanted to do \nwas condemn the Bush Administration.  Bush asked the FDA (through Tobias, me, \nKristen Silverberg and others) to provide expedited review of these FDC products so that \nwe could have some guarantee of the safety and quality of the product before USA \ntaxpayer money paid for it.(see above).  This was the correct thing to do.  Can one \nimagine if we tried to give drug to Africans by a process that was “not good enough for \nAmericans””  We would all get killed by Congressional Committees and activists, some \nof which are the very ones who are crying for generic drugs right now. By the way, the \napproved drugs are now available for hundreds, not thousands of dollars in Africa.  The \nclaim of the generics companies that the drugs are available for $140 does not take into \naccount that it cost much more for shipping, storage, etc. and so the real price is not that \nfar away from the brand price.  Furthermore, no one is going without drug since it is not \nthe generics versus nothing.  The PEPFAR is buying the brand name drugs and \ndistributing them.  The response was that the administration is in bed with PHARMA \nsince we do not want to allow generics for fear of PHARMA losing money.  The generics \nare “pre-qualified” by the WHO.  However, the WHO is not a regulatory agency.  The \nFDA and Tobias and I pleaded that the generics companies submit the applications and \nReleased by Chairman Rand Paul\n101give the FDA a chance to show that they could give an expedited review.  We were \nasking for clinical data that Medicines Sans Frontiers already has and has published, plus \nbiochemical equivalency and pharmacokinetic data and plant inspection, all of which are \nreal easy to get.  However, no generic company has thus submitted applications.  They \nsay that they do not have to since WHO has prequalified them. The real reason is that \nthey are afraid that the FDA will actually find that the product may not be good.  I think \nthe product likely is fine, but the mistrust on the part of the rest of the world for FDA and \nthe USA is palpable.  This likely relates to the situation in Iraq. The other source of \ncontention is the situation of Global Fund versus PEPFAR.  I took great issue with the \nincredibly inappropriate public statement by Kofi Annan about the lack of USA \nLeadership in Global AIDS (Kofi, did you forget your leadership on the Rwanda \ngenocide??). I tactfully blasted him and this concept on BBC radio and TV and CNN. I \nwas quite discouraged by this Conference.  The science was irrelevant although my \nSpecial Lecture on HIV Pathogenesis went very well and was extremely well-received.  \nA major issue is that the USA is doing some stupid things like allowing the restriction of \nnumbers of scientists at the meeting and by having the far-right people act like they are \nrepresenting the USA.  However, this time, the activists and the international community \nare even worse.  They are totally misinformed about what is really going on, but they are \nlouder than ever.  This in turn feeds the far-right and it becomes a vicious cycle.\n \nThe following is a Washington Post article that summarizes the situation very well:\nSubject: [HEALTHGAP] WashPost: AIDS Activists Misfiring\nAIDS Activists Misfiring\nBy Sebastian Mallaby\nMonday, July 19, 2004; Page A17\nIn the past few years, global AIDS activists have worked miracles. They have shaken rich \ngovernments awake, causing international AIDS funding to rise 15-fold. They have \nbeaten back big pharma's jihad against cheap, non-brand medicines, creating an \nopportunity to treat millions of people in poor countries. But the activists, or at least some \nof them, are in danger of tipping from heroism into shrill anti-Americanism. The sound \nbites from last week's AIDS conference in Bangkok were straight out of a Michael Moore \nmovie.\nInconveniently for those who enjoy stereotypes, the Bush administration is far and away \nthe leader in the global AIDS fight. This year the United States will spend $2.4 billion on \nthe pandemic, nearly twice as much as all other donor governments combined; attacking \nthe Bush team for indifference to AIDS is like attacking it for inadequate defense \nspending. But when Randall Tobias, the U.S. global AIDS coordinator, addressed the \nBangkok gathering last week, he had to endure 10 minutes of furious heckling before he \ncould get a word in edgewise.\nReleased by Chairman Rand Paul\n102What triggers this hostility? The activists' first complaint is that U.S. AIDS spending will \nfinance programs to promote sexual abstinence and fidelity. Never mind that only 7 \npercent of the money will be spent this way; the abstinence agenda is derided as some \nkind of kooky anti-scientific plot cooked up by President Bush's evangelical supporters. \nYet the plotters actually include very un-evangelical people such as Edward Green, a \nHarvard medical anthropologist (and liberal Democrat) who's written a book on AIDS \nprevention. Green has shown how Uganda's success in cutting HIV infection rates from \n21 percent to 6 percent depended crucially on teaching abstinence. In the first half of the \n1990s, the number of young Ugandans engaging in premarital sex plummeted; by 1995, \nfully 95 percent of Ugandans reported that they were either abstaining or monogamous.\nElsewhere in Africa, experience also supports the Bush administration's desire to make \nabstinence and fidelity part of its prevention strategy. The evidence from Botswana, \nSouth Africa, Kenya and Zimbabwe suggests that there's no clear link between the \navailability of condoms and reduced HIV\nrates: All four countries have plenty of condoms yet plenty of infection. Meanwhile in \nSouth Africa, the single most promising development is that reported rates of teenage \nsexual activity have fallen for three years straight, disproving the notion that there's no \npoint in telling youths to change their behavior. In sum, it is not the Bush administration \nthat is ignoring the evidence. It is Bush's critics.\nThe activists' second complaint about the U.S. AIDS program is that it is hostile to \ngeneric medicines. Until recently, this was true: Perhaps because of its ties to the big \npharmaceutical companies that sell patented drugs, the administration has been \nscandalously slow to allow cheaper generic copies to be used in its programs. But in May \nthe Bush team finally announced that generics were okay, subject only to a six-week \nreview by the Food and Drug Administration to determine safety and efficacy.\nThe activists do not believe the FDA's change is for real, and their suspicions are \nreinforced by Cipla, a leading Indian producer of generic AIDS drugs. Cipla's charming \njoint managing director, Amar Lulla, explains to anyone who calls that he would love to \nget his drugs approved for distribution in U.S.-financed programs in the poor world but \nthat the Bush administration's fine print is cluttered with obstacles.\nOn close inspection, however, these obstacles aren't serious. For example, Cipla's best \nknown AIDS medicine is called Triomune; it combines three separate antiviral drugs in \none pill, simplifying treatment. Lulla says the FDA has not explained whether he needs to \ndemonstrate the safety of combining the drugs this way, in which case Cipla would have \nto conduct prohibitively expensive clinical trials. But if you go to \nwww.fda.gov/oc/initiatives/hiv/hivguidance.html, you'll find the explanation that Lulla \nsays he's waiting for. Attachment B lists three-drug cocktails that the FDA already \naccepts as safe, among them one combining stavudine, lamivudine and nevirapine, the \nthree constituents of Cipla's Triomune.\nCipla also says it worries that if it files an FDA application, it may be sued by U.S. patent \nholders. But the FDA's rules allow Cipla to file a statement certifying that its pills are \nReleased by Chairman Rand Paul\n103intended for sale outside the United States, a maneuver that would almost certainly \neliminate the risk of being sued for U.S. patent infringement.\nNone of this is to deny that the Bush administration panders to the religious right on some \nissues, or that it's cozy with pharmaceutical lobbyists. After misrepresentations on issues \nfrom tax policy to Iraq intelligence, the suspicion with which Team Bush is greeted is \npartly of its own making. And of course some criticisms of the administration's AIDS \nprogram remain fair, notably that it shortchanges multilateral efforts against the killer.\nAnd yet the bottom line on the Bush administration's AIDS initiative is that it is huge and \nserious. The AIDS activists at last week's conference, whose motives are doubtless \nhonorable as well, would do better to redirect their heckling to countries such as Japan \nand South Korea, which give shockingly little to their cause. When you're fighting an \nenemy that takes 8,000 lives a day, it pays to pick your targets wisely.\nmallabys@washpost.com\nJuly 19, 2004 – Appeared on the Jim Lehr Newshour defending the USA position on \nPEPFAR.  Steve Lewis from the UN was my “opponent” and we duked it out over the \nbilateral approach of PEPFAR versus the multilateral approach of the Global Fund.  I \nsaid both are good and working.  He feels that the USA should put all of its money into \nthe Global Fund.  He also did not understand the need to have some sort of approval for \ngeneric copy drugs (see above).  Everyone told me that I appeared cool and collected \nwhile Steve was shrill.\nJuly 21, 2004  -  Two visits to WH today.  The POTUS invited me to be at the signing \nceremony for the BioShield Legislation in the Rose garden.  I was asked to go up on the \nstage for the photo with the POTUS and the VP as well as Tom Ridge, Congressmen \nChris Cox and Waxman, House Speaker Dennis Hastert, Senators Ted Kennedy, Bill \nFrist among others.  Michael Allen of WH Legislative Affairs was my advocate to get me \non the platform.  The White House protocol women (?name) wanted Julie Gerberding on \nthe platform (even though she had nothing at all to do with BioShield) since there were \nno women there and she bumped me.  Michael insisted and they compromised by putting \nus both up there.  The POTUS, VP and Senators were very nice with me.  I now know all \nof these people very well.\nIn the afternoon, I briefed Carol Kuntz.  Ernie Takafuji accompanied me.  Carol is \ngreat, but she is going through one of her periodic periods of sadness and anxiety about \nher CML even though she is in a crisp remission on Gleevec.  I intermittently give her \nprivate psychotherapy and I did so that night.\nJuly 22, 2004 – Testified with Secretary Thompson and Julie Gerberding to the Senate \nCommittee on Health, Education, Labor and Pensions (HELP) on Public Health \npreparedness, surge capacity and medical countermeasures.  Present were Chairman Judd \nGregg, Ted Kennedy and Lamar Alexander.  It was a very friendly hearing and very \ncomplimentary to me and the others.\nReleased by Chairman Rand Paul\n104July 23, 2004 – West Wing – Had individual photo op with VP Cheney together with the \nentire “team” that worked on BioShield.  Many people there: Stewart Simonson, carol \nKuntz, Scooter Libby, Sally Canfield (DHS) (she just announced that she is leaving Tom \nRidge and going to work for Speaker Hastert), Mark McClellan, Ken Bernard, Michael \nAllen, Brenda Becker, Sharon…(Sen. Gregg’s staff), Noreen Hynes, Seth… (Noreen’s \nhusband), Vince Ventimiglia (Sen Gregg’s Committee Staff). I will provide full list later.  \nVery happy occasion.  Again, VP was very gracious towards me.\nAugust 11, 2004 – Met at EEOB Room 283 with Carol Kuntz and Bruce Miller and \nDorothy….  to discuss tentative plans to determine whether IL-4 gene inserted into \nmonkeypox would have the same effect as IL-4 inserted into mousepox virus, i.e. it \nwould suppress the immune response enough to allow lethal disease in the animal.  This \nrelates to concerns that terrorists will genetically engineer variola with IL-4 and so over-\nride vaccination and cidofovir.  Carol wanted to know which of several options for \nexperiments I would favor.  A White Paper was drawn up by the Office of Homeland \nSecrurity (Ken Bernard) with the various options.  Of note, I had previously briefed \nFrances Townsend in the White House Situation Room a couple of weeks ago (not \nrecorded above) on the same topic.  I favor Option #3 which is to conduct the research on \nIL-4-altered monkeypox in monkeys and do it as classified research.  However, we \nshould announce that we will be conducting such experiments so that people do not get \nsuspicious that we are totally hiding things.  We would keep the design, details and \nresults classified since if we found out that it did work in monkeys , but did not yet have a \ncountermeasure for it, then we would expose our vulnerabilities.\nSept. 1, 2004 – Had a interesting day.  Flew by helicopter from the Pentagon to Fort \nDetrick to visit USAMRIID with Deputy Secretary of DoD Paul Wolfowitz, Bill \nWinkenwerder, and a number of other DoD and DHS senior staff to hear presentations by \nGen Lester Martinez-Lopez and others regarding why the DoD should support the \nplanned new Biodefense Research Campus at Ft. Detrick.  The Army wanted me there \nsince they know that I am an articulate advocate of their cause.  The meeting went very \nwell and I finally got a chance to meet and intensively discuss with Wolfowitz.\nSeptember 13, 2004 – For the past few weeks, I have been involved in a number of \nbriefings of Carol Kuntz and Stewart Simonson regarding Biodefense and the concern \nabout the emergence of an H5N1 bird flu that has been smoldering in Asia (Thailand, \nViet Nam, China, Taiwan, etc) with jumping of cases from chickens to humans.  \nPresident Clinton had quadruple bypass surgery at Columbia-Presbyterian \nHospital related to unstable angina this past week.  I contacted Senator Clinton’s office to \nget his private e-mail address to send him my personal best wishes.\nToday, I had an official briefing at the White House for Carol Kuntz and Bruce \nMiller (her deputy) on research plans and strategy for countermeasures for “Genetically \nEngineered Microbes”.  The presentation was very well received.  Carol gave me a “red-\nlined” copy of the Bioshield Legislation that was signed by President Bush and VP \nCheney as a special gift from them to me due to my work on the development and \npassage of BioShield.\nReleased by Chairman Rand Paul\n105Oct. 4, 2004 – Meeting in the Situation Room of the White House to brief Ken Rapuano \n(Deputy to Fran Townsend) on the IL-4 – monkeypox experiment that is being proposed \nas a classified experiment to be performed by DHS.  I presented the rationale behind the \nexperiment.  Also present were Carol Kuntz, Ken Bernard, Stewart Simonson, Maureen \nMcCarthy, Gerry Parker, et al.  Although NIAID will not perform these experiments, \nFran Townsend wanted to make sure that I did the briefing since she trusts me.  The plan \nis for me to make the same presentation to Colin Powell and Donald Rumsfeld soon after \nthe election.\nOct. 5, 2004 – Historic day today with the UK regulatory agency suspending the license \nof  Chiron to ship out their influenza vaccine to the USA because of issues related to the \ninspection of the plant in Liverpool.  This is a huge issue for the USA since Chiron was \nscheduled to supply about 46-48 million doses or about 50% of our yearly requirement of \n100 million doses.  Only Aventis Pasteur  (50 millioin doses) and Medimmune (2 million \ndoses of Flumist) are available.  We heard about this abruptly this AM as we (Julie \ngerberding and I) were getting ready to testify at  House Hearing on Thimerasol in \nInfluenza vaccines.\nOct. 6, 2004  - Trip to Duke to honor retirment of Ralph Snyderman as Chancellor.  \nWhite House conference call at the airport in Raleigh-Durham on way back regarding the \ninfluenza vaccine issue.\nOct. 7, 2004 – Trip to Duke to honor the retirement of Ralph Snyderman.  Gave talk on \nEmerging Infectious Diseases.  White House conference call on Influenza issue (see \nabove).  Incredible amount of media appearances: radio, TV, print.  As much as I have \never done.\nOct. 8, 2004 – Big time Congressional Hearing on influenza vaccine problem before the \nHouse Government Reform Committee.  I testified with Julie Gerberding and Lester \nCrawford of FDA.  More media, White House Conference calls, and Jim Lehr NewsHour \nto finish the day.\nOct. 9, 2004 – Front page story in the Washington Post saying that the UK regulatory \nauthorities told our FDA about the problem at the end of August with the implication that \nthe FDA failed to act in preparing for the shortage.  Acting FDA Commissioner Lester \nCrawford explained on our regularly scheduled White House Conference Call that this is \nmisinformation.  As we (me, Julie and Les) have stated all along, Chiron kept reassuring \nus that there was a problem with about 4 million does due to contamination with Serratia \nmarcescens.  Never did anyone say to FDA or CDC (nor did Rino Rapualli say to me) \nthat there was a serious enough problem to suspend licensure.  John Kerry came out with \nugly statement saying that the Administration is covering up.\nOct. 10, 2004 – Things still hot and heavy with the Chiron/influenza situation. Had \nanother White House conference call with Margaret Spellings, Alan Gilbert, Phil Hall, \nHarriet Miers (Deputy Chief-of-Staff), Jon Burks, Ken Bernard, Trent Duffy, Scott \nReleased by Chairman Rand Paul\n106Whitaker, Julie gerberding, Les Crawford and Bruce Gellin.  Also more media \nappearances for me.\nOct. 12, 2004 – Important White House meeting at 1:00 PM in Roosevelt Room on the \nFlu situation.  Chaired by Margaret Spellings and Harriet Miers.  Also present were Fran \nTownsend (HSC), Joel Kaplan (OMB), Jack Marburger (OSTP), Alan Gilbert, Hobbs, \nLeitch, Montgomery, Jackson, Amit Sachdev (FDA), Stewart Simonson, Julie \nGerberding, Suzy DeFrancis (WH Communications), McGrath.  We  discussed strategies \nto handle problems.  I gave a background of flu vaccines in general together with the \nnature of the current problem.  Julie gave the plan for trying to get equitable distribution \nof the remaining doses from Aventis Pasteur that have not already been distributed.  The \nissue of the conflict in statements from our FDA and the British regulatory authorities \n(MHRA).  They said they told the FDA about the seriousness of the problem weeks ago \nand our FDA says no.  Our FDA is correct since I was hearing the same thing.  We \nbelieve the UK people have over-reacted and now it has caused a mess here in the USA \nand they are embarrassed to retract.  Important point that I brought up and again called \nMargaret Spellings about the evening of today was that John Kerry would likely try to \nembarrass the President in the debate on Oct. 13 by saying that the FDA knew and \ncovered up and that he believes the Brits.  I suggested to Margaret that the FDA come out \nwith a forceful statement BEFORE the debate declaring that the UK did not tell them \nabout the problem so that the President is not left hanging out there.  Margaret agrees and \nthey will do this on the morning of Oct. 13.\nOct. 13-14, 2004 – Multiple HHS and White House conference calls regarding the \ninfluenza vaccine crisis.  Report from FDA’s Jesse Goodman who just returned from UK \nis that the Liverpool plant  really did have some serious GMP problems and potential bio-\nburden problems.  Our FDA agrees with the findings of UK regulators, but not \nnecessarily with their action.  However, it is too close a call for us to say that we would \nhave released the lots.  Therefore, we will publicly say that the lots from Chiron are \nunusable.  We further discussed other issues about how we can get more vaccine from \nAVP or from Canada or from anyone else.  If we go with Canadian vaccine, this would \nhave to be done by an IND since it is not licensed by FDA.  Most we can get is 2-3 \nmillion doses.  Even this is a logistic nightmare to do under an IND.\nPresent on Conference call with WH are Spellings, Silverberg, Miers, Dan \nBartlett, Trent Duffy (Deputy Press Assistant), Alan Gilbert, and HHS team of Julie, \nStewart, Les Crawford, Scott Whitaker, and me.\nOct. 15 – 18, 2004 – Situation getting very hot and heavy.  Kerry campaign trying to \nmake this a political issue saying that the shortage is President Bush’s fault.  I have been \non every major TV show multiple times talking about the issues and what people need to \ndo.  Multiple (daily) White House Conference Calls. Almost constant briefings and press \ninteractions.  Will need to go on a New England bus tour this weekend from DC up the \ncorridor to Boston and fly back.  Very intense, at least as much as with the anthrax \nsituation, mostly because the election is 2 weeks away.\nReleased by Chairman Rand Paul\n107Oct 22-23, 2004 – Continued intensity of activity around the influenza vaccine shortage.  \nDaily White House Conference calls.  The DHHS team has broken up into several groups \nto “tour” the country in a bus for outreach and education to health authorities, the general \npublic and the Press.  I was part of a tour that went from D.C. to Philadelphia to Trenton, \nNewark, NYC, Hartford, Providence, Boston and back (Flew back from Boston).  Our \nteam was Claude Allen, myself, Howard Zucker (Deputy Asst Secretary of Health), Bill \nHall (DHHS Public Affairs), Sarah Greirich (Claude’s assistant), Kate (?).  It went well.  \nThis is becoming a serious political issue in that the Kerry Campaign is trying to paint the \nBush Administration as responsible for the Chiron mess.  President Bush in turn is \nclaiming that liability issues are the cause of Pharma not getting into the vaccine business \nand that Kerry supports trial lawyers who are the problem (VP candidate Edwards is a \nliability lawyer).\nOct. 25, 2004 – Went to LA to be Keynote Speaker at a USC conferenec on Multi-Sector \ninvolvement in research (Government, Industry, Academia).  Afterwards I gave a press \nconference with the Editorial Board of the LA Times.  The topic of influenza vaccine \ndominated the conversation.\nOct. 26- Nov. 8, 2004 – Daily White House conference calls on influenza situation.  \nTrying to get additional doses from Aventis, Medimmune and foreign sources.  \nBush re-elected.  Very good for me since the team stays in place.\nHorrible tragedy – John La Montagne, my beloved friend, colleague and Deputy \nDirector of NIAID dies suddenly on Nov. 2 after disembarking from flight from DC to \nMexico City (his birthplace) on passport line in Mexico City.  He had a pulmonary \nembolus, very likely from the flight with venous thrombosis.\nNov. 12, 2004 – Meeting in Roosevelt Room of WH to discuss the plans for influenza \npreparedness and for pandemic flu plans.  Major points are what we have been discussing \nfor the past few weeks about providing incentives for PHARMA to get involved and stay \nin flu vaccine field.  We (DHHS team) are proposing back end guaranteed purchases for \noverflow doses; liability protection, tax breaks, research to develop cell culture based and \nrecombinant DNA approaches to replace egg-based approaches; advanced purchase and \nstockpiling of vaccine for children.  TGT presented and I filled in.  Present were:  Karl \nRove, Josh Bolton, Margaret Spellings, Kristen Silverberg, Alex Azar, Scott Whitaker, \nGrant Dixton, David  Leitch, Harriet Miers, Alan Gilbert, Carol Kuntz and others.\nNov. 17, 2004 – House Hearing of Government Reform Committee on the flu crisis \ntoday.  I testified together with Julie Gerberding and Lester Crawford (Acting FDA \nCommisioner).  Mostly they slammed FDA for not acting more aggressively to monitor \nthe Chiron plant and pick up contamination.  \nBush shuffling around his Cabinet following election victory.  People that I know \nare moving out of positions where it was good to have a contact for me and into positions \nwhere it is also good to have a contact.  Condi Rice to State, Margaret Spellings to \nEducation.  Much rumor about TGT and whether he will go to DHS or whether it will be \nFran Townsend if Tom Ridge leaves.\nReleased by Chairman Rand Paul\n108Nov. 18, 2004 – Hearing today before House Commerce and Energy Investigations.  \nTogether with Julie and Les Crawford.\nNov. 19, 2004 – I arranged a meeting among Medimmune (Flumist), the FDA, and \nStewart Simonson to try to pursue ways to get broader approval and utilization of Flumist \nfor next year to make up for the anticipated shortages since Chiron will almost certainly \nnot be able to re-fill the gap by next year.  Present at the meeting were Medimmune CEO \nDavid Mott,  President Jim Young, VP of Reg Affairs Peter Patriarca, CMO Edward \nConnor, Sr. Director Scientific Affairs Kathleen Coelingh.  From FDA were Les \nCrawford (Acting Comm) and Jesse Goodman (head of CBER).  Also, Stewart \nSimonson, Bruce Gellin, Pamela McInnes, Ralph Tate.  I am trying to be the facilitator to \nhave FDA look at Medimmune data on 50 to 64 year old people sooner rather than later \nso that Medimmune can produce an extra 10 million doses for next year.  They need \napproval for this age group or else then cannot take the risk of making 10 million more \ndoses and not be able to sell them.\nNov. 30, 2004 – Memorial service hosted by me at Natcher Building at NIH for John La \nMontagne.  I delivered Eulogy (see speeches file).  I am only starting to come to grips \nwith the intense feeling of grief and sorrow at having lost John.  I really liked him very \nmuch.  He was such a fine human being.  Present at the Memorial Service were Secretary \nThompson, Margaret Spellings, Carol Kuntz, Stewart Simonson, Julie Gerberding, D.A. \nHenderson and hundreds of other friends of John.  I have appointed Cliff Lane as the \nActing Deputy Director of NIAID.\n Dec. 3, 2004 – Secretary Thompson resigns and asks me to come down to the \nDepartment as he makes his announcement.  He brought me into his office alone and with \nboth of us in tears he expressed his gratitude and admiration for my service to him, the \nDHHS and the country.  I expressed my mutual feelings for him.\nBelow is his resignation statement:\nDear Friends,\nThis morning, I submitted to President Bush my resignation\nas Secretary of Health and Human Services.\nIt was a difficult decision and one I did not make easily.\nBut after nearly 40 years of public service, it is time for\nme and my family to move onto the next chapter in our life.\nIt has been my honor and privilege to serve President Bush\nand the nation with each of you in this dynamic Department.\nAs I have often said, our 67,000-member family is home to\nthe finest employees in the federal government. When you\nwork at HHS, the greatest doctors, scientists and public servants in the world are your \ncoworkers. I am truly grateful for the opportunity to work with all of you in this noble \ncalling.\nReleased by Chairman Rand Paul\n109I am extremely proud of the work we did together at\nAmerica's Department of Compassion. President Bush set\nforth an ambitious agenda for our Department. And I love\na big challenge. Since the day I walked through the doors\nof this building, we have worked tirelessly to better the health and well-being of the \nAmerican people and our neighbors throughout the world.\nThanks to your work,\n        *       We delivered on our promise to modernize\n        Medicare with prescription drug coverage - the most\n        historic improvement to Medicare since it was created\n        in 1965. Now seniors and the disabled will get\n        substantial help paying for the modern medicines and\n        preventive services that extend and enhance their lives.\n        *       We're spending more in medical research than any\n        time in our history. And the President opened the door\n        to federal funding of groundbreaking stem cell research.\n        *       We're investing in our long-neglected public\n        health system, making our nation better prepared to\n        fight disease or biological attacks. We're improving\n        the safety of the food we eat and import.\n        *       We're developing the new medicines and vaccines\n        to protect our citizens from disease or bioterrorism.\n        *       Our children are healthier than ever, with health\n        coverage and immunization rates at record highs and\n        childhood drug usage going down.\n        *       We turned America's attention to disease\n        prevention, motivating Americans to eat better and\n        exercise more in order to improve their health and\n        quality of life.\n        *       And we're waging a bold new global fight against\n        HIV/AIDS, committing an unprecedented $15 billion toward\n        eradicating this scourge. This will be a jewel in the\n        President's legacy - and our years at HHS.\nTogether, we also faced challenges that were unpredictable and unimaginable.\n        *       HHS was among the first on the ground to care for\n        New York City residents and assist in the aftermath of\n        9/11.\n        *       From the day I arrived, we spoke of the need to\n        better prepare for bioterrorism, and together we helped\n        this nation weather the first biological attack on its\n        people with the anthrax letters.\n        *       We expanded our cache of smallpox vaccine, so we\nReleased by Chairman Rand Paul\n110        can now protect every man, woman in child if this vicious\n        disease were to return.\n        *       We protected America from SARS and we helped the\n        world understand this mysterious disease so we could\n        contain its spread.\n        *       We're leading the world to prepare for a world flu\n        pandemic and Avian flu.\n        *       And, together with our public health partners, we\n        have helped this nation manage an unexpected influenza\n        vaccine shortage.\nThat is quite a record in four short years. You all should be proud.\nAnd, best of all, we are working together more closely than ever before to better serve \nAmerican families. We truly are One Department - with the best and brightest working \ntogether across agencies to solve our nation's toughest problems. And we truly are the \nDepartment of Compassion.\nI will miss you all more than you can ever know. I will\nforever cherish the friendships I made here the last four years. And I will always be in \nawe of the talent, dedication and drive of the people of the Department of Health and \nHuman Services.\nKeep leading this nation forward. Keep putting the well-being of our people first. And \nkeep changing the status quo in search of a better way.\nYou will always be in my prayers and in my heart.\nWith gratitude and friendship,\nTommy G. Thompson\nDec. 20, 2004 – Terrible time over the past couple of weeks with a 4 part story by an AP \nreporter on the Jonathan Fishbein issue and the HIVNET 012 story.  Fishbein is a Title 42  \non a 2 year probation period in DAIDS.  His performance was terrible and Ed Tramont \nand Jon Kagan decided to remove him.  He got a high-priced whistleblower lawyer and \nclaimed whistleblower status despite the fact that he “blew the whistle” AFTER he was \ninformed that he would be removed.  He leaked internal documents regarding the \ntechnical difficulties with HIVNET 012 (use of nevirapine for prevention of mother-to-\nchild transmission (MTCT) of HIV.  In that landmark trial it was shown that the drug in a \nsingle dose was safe and effective for prevention of MTCT.  The use in these \ncircumstances has likely saved tens of thousands of children’s lives in developing \ncountries, particularly sub-Saharan Africa.  The paper appeared in Lancet in 1999 and \nseveral papers have corroborated the safety and efficacy of Nev. For MTCT prevention. \nSince the results of the trial (HIVNET 012) were so striking, the maker of Nev (BI) \ndecided to use the data from the trial to expand the licensed indication of Nev to MTCT \nReleased by Chairman Rand Paul\n111in the USA.  Upon inspection of the site and the data collection procedure, the FDA and \nan auditor ruled that there were “technical” problems that would not allow licensure.  Ed \nTramont decided to have a more comprehensive look at the “technical” difficulties and \nultimately found that the procedure was sloppy (not surprising for an inexperienced \nAfrican site); however, the data were sound, i.e. Nev is still safe and effective.  A low \nlevel person in DAIDS wrote a safety report that exaggerated (in Ed Tramont’s mind) the \nnegatives and indicted the entire trial. Ed used the report from the more comprehensive \naudit and changed the lower level report to indicate that there were technical difficulties, \nbut this does not change the results of the trial.\nFishbein in his attempt to not get fired for incompetence (totally unrelated and \nanteceding the issue of HIVNET 012) went to the Congress (Sen. Grassley – who never \nmet a whistleblower that he did not love) and finally the AP.  The AP story was \nincredibly misleading in that it published Fishbein’s “whistleblower” claims of \nwidespread misconduct in DAIDS, our (mine and others) failure to notify the president \nabout the problems with HIVNET 012 before he launched the $500 million MTCT \nprogram, and a variety of other charges.  This raised a lot a stink with and ABC Nightly \nNews show.  Surprisingly, the regular media did not take it up much, but it was all over \nthe internet circuit.  I worked hard to keep it off CNN, NBC, Washington Post, NY Times \nby pre-emptively discussing the truth with the reporters.  We are “hand-cuffed” in what \nwe can say since the Fishbein issue is a personnel matter and the Privacy Act is involved,  \nAlso, the Whistleblower statute (even though Fishbein is technically not a whistleblower \nsince he blew after he was fired).  Interesting how the laws protect the scoundrels.  Our \nmajor concern is that this publicity will cause the uninformed to stop using Nev for \nMTCT.  Of note, Rev. Jesse Jackson published his typical demagogue-like letter \ncondemning President Bush, accusing Ed Tramont of “crimes against humanity”, etc. \nWill give more follow-up soon.   \nDec. 20, 2004 to Jan. 14, 2005 – We have been occupied almost full time with doing \ndamage control against the Dec. 13, 14, 15, 2004 AP articles by John Solomon.  We have \nput on the NIAID Website a Q and A series that cogently addresses all of the allegations.  \nThis has apparently angered the reporter who is going after Cliff Lane and I now.  \nSomeone from the inside (Solomon said OGE, but I do not know whether I can believe \nhim) “blew the whistle” on Cliff and I with the preposterous allegations that we are \nreceiving hundreds of thousands of dollars from the IL-2 patent and that we are investing \nmillions of dollars of NIAID money to support IL-2 research.  Also, the whistle-blower \ntold Solomon that I made Cliff Clinical Director as a quid pro quo for his putting me on \nthe patent.  Also, he queried whether my wife Christine gave the ethics approval of the \nESPRIT IL-2 trial. This is nasty business.  Cliff was made Deputy Clinical Director in \n1986 and full Clinical Director in 1991.  The patent was done in 1997.  Chris has always \nrecused herself from any actions on NIAID business. The Bayh-Dole Act requires that \ngovernment employees file patents through the US Government on all inventions made \nduring official government business. I originally did not want to be on the patent because \nI am NIAID Director.  I was told by OGC and OTT that it was required since I was a \nclear inventor and to leave me off of the patent would make the entire patent subject to \ninvalidity.  I then queried of OGC as to whether royalties constituted a “financial \ninterest” and thus subject to conflict of interest laws under 18 USC, Section 208a.  I \nReleased by Chairman Rand Paul\n112found out that years ago the OGE ruled and the DoJ confirmed that royalties collected by \ngovernment employees on patents owned by the government on which the employee is an \ninventor cannot be considered as a financial interest and so cannot be a conflict.  The \nroyalties are considered government compensation similar to performance awards and \nsalaries.  I was still uncomfortable about taking royalties because of my high visibility \nand so I told Mark Rohrbough (OTT for NIAID at the time) to have the government NOT \nsend me the checks.  He related that they were legally required to give me the check in \norder to fulfill the requirements of the Federal technology Transfer Act (FTTA).  Thus, I \nhave given every penny of my royalties to charity – The Foundation for NIH, Inc.  Total \nroyalties since 1997 = $45,072.82.  Finally, I put the royalties on my financial disclosure \nstatement (SF278), but OGE told me to take it off since it was equivalent to government \nsalary that does not go on SF278. Nonetheless, Solomon wrote an article on the IL-2 \nstory on Jan. 9 with the theme that Cliff and I should have let patients know about the \n“conflict” (even though there was no conflict).  I believed that I saved the day by \nspeaking with the reporter and explaining all of the above.  It would have been better if \nmy name was not associated with any COI story, but at least he mentioned about giving \nthe money to charity as well as the fact that I tried to put the amount on my financial \nstatement.  The reporter has FOIA’ed our SF278s and so who knows what other smearing \nhe might try to do with misinformation.\nJan 15 – Feb. 3, 2005 – Story came out in AP about the IL-2 patent.  The reporter (John \nSolomon) did indeed mention that I was required to file a patent and that I tried not to \naccept the checks and ultimately gave the money to charity.  Also, he mentioned that I \nwas told to take off the entry of the money on my SF278.  In the end, it was not nice to \nhave a story about me with a implication that I did something wrong, when in fact, I went \nout of my way to avoid conflict.\nThe AP story led to CBS Evening News doing a story on the same thing on Feb.1.  \nHowever, their angle was that I was the hero/Saint in trying to avoid conflict, and the \nNIH would not let me do the right thing.  I came out looking good and the NIH looking \nfoolish.  In the end, it would have been better if the piece did not air.\nFishbein issue:  This abscess continues to fester.  Fishbein continually puts out \nmissives on his brother’s Website (honestdoc.org) about “widespread misconduct and \nscientific fraud at NIH” and plays the role of defender of the public health.  The Privacy \nAct (he is involved in a personnel matter) forbids us to respond.  We are faced with the \nimpossible situation of not being able to respond to this psychopathologic accusations.  \nHe can go public, but we cannot respond publicly.  This is untenable.\nInfluenza:  Avian flu (H5N1) is still percolating in Asia (mostly Viet Nam and \nThailand).  Most recent cluster of cases in Viet Nam.  We are continually having \nconference calls with the usual suspects on preparedness – Carol Kuntz, Julie Gerberding, \nme, Stewart Simonson, Lester Crawford, etc.  Had a meeting in the West Wing of the \nWH on Feb. 2 with Claude Allan who has replaced Margaret Spellings as Assistant to the \nPresident for Domestic Policy.  Present were Julie Gerberding, Stewart S., Allan Gilbert, \nBruce Gelling, Amit (FDA), etc.  We updated Claude who will brief President Bush.\nFeb. 3 – Mar. 8, 2005 – Another stress and crisis issue.  A microbiologist named Ebright \nfrom Rutgers circulated an open letter(to Elias Zerhoun) among all the microbiologists \nReleased by Chairman Rand Paul\n113stating that his analysis of study section data of non-biodefense grants over the past few \nyears shows a decrease at the same time as the biodefense funding shows an increase.  \nThe letter was published in Science, first as an e-publication and then almost 2 weeks \nlater (March 11) as a printed letter in Science.  Problem is that the data that he pulled was \nvia CRISP that is not designed to do comparative analysis of funding trends.  The letter \nwas signed by >700 microbiologists.  The hidden agenda of Ebright and a very small \ngroup of signees (like Stanley Falkow) was that they feel that we should not be spending \nany money on biodefense research.  They came to the conclusion in the letter that \nbiodefense research was “hurting” non-biodfense infectious diseases research by \ndiverting money away.  They released the letter to the press without ever calling us or \neven sending the letter to us.  This created a media storm and put us on the defensive to \nrespond to what turns out to be entirely misrepresentative data. They took information \nfrom 4 out of 30 study sections that really misrepresent the big picture.  The study \nsections involved mostly reflect activity in NIGMS that may be funding fewer “model \norganism” grants for reasons that have nothing to do with biodefense funding.  I was \nfurious!  Clearly some few individuals were pushing their anti-biodefense agenda and the \nrest of the microbiology community was following like sheep.  When several were asked \nabout this after the media storm, they were embarrassed (such as Barry Bloom) and said \nthat they really did not think that this was what they were signing on to.   Many \nnewspaper articles appeared and I led the rebuttal in the newspapers, NPR, and several \nspeeches.  EZ and I will write a letter in response to Science.  Clearly when you examine \nthe data correctly, non-biodefense has done as well or better at NIAID as the rest of NIH, \ni.e. when you compare the percent increases from year to year from 2001 to 2006.  Also, \nmuch of biodefense money is also spilling over to non-biodefense or “dual-use” projects \nsuch as innate immunity, influenza, SARS, diarhheal diseases, etc.  Clearly, the Ebright \nletter is misleading.  Problem is that since all money is now tight, people are acting as \nexpected, i.e. they want to blame someone or something for their personal and specific \nissues.  Now they are blaming biodefense resources with a sub-text of anti-Bush \nAdminstration and anti-Iraq war.  It is really ridiculous how they distort and I am in the \nmiddle of the fray.  However, this is one that I will not back down on.\nOn March 7, I met in my office with Michael Gerson, former top speech-writer \nfor President Bush and now senior advisor and Assistant to the POTUS.  Mike wanted to \ndiscuss ideas for addressing neglected or other diseases as an initiative for the POTUS to \nput before the G-8 summit.  This is very similar to last year’s activities (see above).  I \nwill work with him on a malaria intiative (see last year) and a TB in HIV disease \ninitiative.  Apparently Gary Edson and Josh Bolton sent him my way.  I will be \nsubmitting the malaria and TB proposals for the POTUS consideration.\nMarch 8 – March 27, 2005 – Continued concern about the H5N1 bird flu in Viet Nam, \nThailand, and Cambodia.  Most severe now in Viet Nam. Working closely with Stewart \nSimonson, Julie Gerberding and the DHHS on Pandemic Influenza Preparedness.\nMar. 27 – April 1 – Phenomenal vacation with Chris and the girls for Spring Break in \nCosta Rica.  First vacation that I have had unassociated with a lecture or other business in \n20 years since our honeymoon.  Went for 2 ½ days at Papaguyo Beach and 2 days in rain \nReleased by Chairman Rand Paul\n114forest and Arenal Volcano.  Did zip wire rides over the canopies.  One of the most \nexciting things that I have done.\nApril 4, 2005 – Amazing day at White House today.  Briefed the President on AIDS \n(domestic and International).  Reason for briefing was preparation by the WH for the \nreauthorization of the Ryan White AIDS Care Act originally passed in 1990.  The \nPOTUS wanted to make sure that we were not short-changing domestic AIDS in light of \nall of the money (PEPFAR) that we have recently been putting into international.  \nBriefing from 9:20 AM to 10:05 AM.  The POTUS walked into room and immediately \ngreeted me and although the briefing was supposed to be predominantly on Ryan White, \nhe asked me many questions for about 20  minutes.  It was a 2-way conversation between \nhim and me.  At the meeting also were VP Cheney, Scooter Libby, Andy Card, Karl \nRove, Dan Bartlett, Scott McClellan, Josh Bolten, Kristen Silverberg, Secretary Leavitt, \nClaude Allen, Joe O’Neill, Philo Hall, Tevi Troy.  Wonderful interaction between me and \nPOTUS…great day\nAlso, today I went to and presented a major lecture at the IOM Pandemic \nInfluenza meeting in honor of John La Montagne.  After that I got briefed by the IOM \ncommittee reviewing the HIVNET012 trial (see Fishbein above).  They totally agreed \nwith us and said the trial was effective, ethical, and safe.\nWent back to WH to brief Claude Allen on Influenza together with Stewart \nSimonson, Julie Gerberding, Philo Hall, Dean Casey, Tevi troy, Kristen Silverberg.  This \nwas in preparation of Secretary Leavitt and I briefing the POTUS on Wednesday , April \n6.  However, the POTUS meeting will be postponed until next week since the POTUS \nwill go to Rome for the Funeral of Pope John Paul II.\nApril 4 – 27, 2005 – More of the same with Fishbein situation.  IOM panel report came \nout very clearly supporting all that NIAID and we had been saying about HIVNET-012.  \nIn typical fashion, John Solomon of AP and Sen Grassley (who parrots everything that \nAP says) are claiming that the IOM panel report is invalid since some members of the \npanel receive NIH grants and so are conflicted.  The Fishbein/Grassley/AP axis is clearly \none of the most unethical and disgraceful situations that I have ever experienced.  They \nall have no integrity and absolutely no regard for the truth.  We are now working on a \npossible settlement with Fishbein to make this craziness go away.  He may well ask for \ntotally undeliverable conditions.  The DHHS is still reluctant to allow us to fire Fishbein \nbecause they are afraid of Grassley.\nApril 27, 2005 – Briefed the President about the potential for an H5N1 pandemic \ninfluenza.  At briefing were the POTUS, the VP, Karl Rove, Josh Bolten, Kristen \nSilverberg, Dan Bartlett, Scott McClellan, Fran Townsend, Michel Gerson, Claude Allen, \nJulie Gerberding, Sec. Leavitt, Scooter Libby, Philo Hall, Rajeev, etc.\nThe POTUS was very pleased with the briefing and asked the right questions.  He \nwas favorably disposed to our suggestion of considering having the USA public have kits \nof antimicrobials (Tamiflu, CIPRO, etc) in their homes in case of an emergency in order \nto get around the problem of distribution of drug to tens of millions of people in an \nemergency.  We are going to pursue this approach with Symposia to get the flavor of \nwhat the community thinks of it and then we will pursue it.\nReleased by Chairman Rand Paul\n115May 12, 2005 – Met today in Building 31, 7A-24 with the Ugandan Vice president \nProfessor Gilbert Bukenya, who is former Dean at Makerere University in Kampala.  We \nhad met previously when he was still in academics and now he is VP.  We discussed \ncollaborations between Uganda and NIAID.\nOver the past couple of weeks we are still engaged in trying to settle the Fishbein \nissue.  He continues to attack.  Cliff Lane is leading the arbitration effort for a settlement.  \nIt is clear that he, his brother Rand, his mother and their lawyer Steve Kohn are bad \npeople, well beyond the lawyer issue; they really suck without care for lives of people \nwhom their lying endangers.\nAlso, morale at NIH is the lowest that I have ever seen it.  House Chairman Joe \nBarton is trying to “reauthorize the NIH” by consolidating ICs and putting much more \nmoney into the NIH Director’s office.  We cannot tell if Barton is doing this on his own \nor if Zerhouni is behind it.  I tend to think that it is a bit of both, but that Barton is the \nmain driver.  Also, the conflict-of-interest issues have not been settled.\nMay 23 – 27, 2005 – Things again heating up with avian flu in Vietnam with press \nreports that the virus in evolving with possible resistance to Tamiflu and greater number \nof clusters in Vietnam.  Lesser virulence could mean that virus is adapting to humans \nbetter.  It is likely that all of this just reflects better surveillance and reporting as opposed \nto a significant degree of evolution of the virus. Nonetheless, the press has jumped on this \nand I have been on CNN a few times, Jim Lehrer Newshour, Lou Dobbs (CNN) and C-\nSPAN for a Congressional Hearing on Flu (Energy and Commerce with Chairman Deal).  \nAlso, several briefings at DHHS and the White House with the usual suspects.\nMay 30 – June 3, 2005 – Bird flu activities continue with briefing at DHHS a couple of \ntimes.  White House briefing on June 2 on purchases of Tamiflu versus vaccine in VP’s \nceremonial office in White House.  Present were: Carol Kuntz, Binita Ashar (Carol’s \nassistant, Tom Reilly (OMB), Norris Cochran, Jeremy Katz, Rajeev Venkkaya, Lance \nLeggitt, Stew Simonson, Bill Raub, Kerry Weems, Bruce Gellin, Laura Lawlor (by \nphone), Jesse Goodman, CDC by phone – Julie Gerberding, Charles Schable, Steve Bice, \nDavid Baden.  We are trying to reconcile the budget projects for FY 05 and 06  and 07 \nwith the purchase needs for stockpiles of H5N1 vaccine and tamiflu.  My role was \nimportant since we are doing the clinical trials with the H5N1 to determine the correct \ndose.  This will then determine whether we will buy and how much depending on the \nrequired dose.  We already have 2 million doses of vaccine in bulk and we plan to buy 20 \nmillion more vaccine doses. Also we are thinking of 20 million more treatment doses of \ntamiflu.  Also, White House briefing with Carol Kuntz on June 3 on biologics biodefense.\nJune 3 – 14, 2005 – I have not been recording events since I have been very busy, but \nover the past 10 days or so there has been considerable activity around the area of \npandemic flu, biodefense, etc.  I have briefed DHHS people as well as WH people.  In \naddition, on June 13 we had a Hearing of the House Government Reform Committee for \nBiodefense chaired by Rep. Christopher Shays.  I testified along with Stewart Simonson, \nDale Klein (DoD), Joe Vitko (DHS), and Ron Saldareni (formerly of American \nReleased by Chairman Rand Paul\n116Cyanamide and nowon an IOM Committee of Biodefense).  The Hearing was mostly \nblasting DoD for disorganization and “wasting money”.\nAlso, I went on my yearly trip to review the Gaslini Institute for Lorenzo Moretta \nfrom June 8 – 10.  \nWe are in the final stages of finally officially firing Jonathan Fishbein.  The issue \nis that Sen Grassley and his Committee will likely come after us for this since they \nalways take the side of whistleblowers, even though Fishbein is not really a \nwhistleblower as he blew the whistle after he was told that he would be fired for \nperformance.\nJune 14 – July 2, 2005 -  Many activities around briefings of White House, DHHS and \nCongressional Hearing continue.  Had 2 more Hearings within said period: 1) Senate \nForeign Relations on HIV Vaccines with actress Ashley Judd; 2) Hearing of House \nGovernment Reform Committee on Influenza Pandemic Threat.  I testified with Jim \nLeDuc (CDC) and Bruce Gellin (HHS).  Have been on CNN and all over C-SPAN.\nWe finally fired Jonathan Fishbein (on July 1) amid angry threats from Sen. \nGrassley’s staff.  I must include in my book how totally vicious and completely unethical \nthat crew is.  They are a disgrace to government.  They totally distort the Fishbein story \nand attack the NIH and everyone else, all in the name of protecting “whistleblowers” \neven though he is not a whisteblower.\nJuly 14, 2005 – Lots of stuff going on. Had more Congressional Hearings.  Today had \nHearing on success or failure of Project BioShield.  Testified before House Government \nReform Committee chaired by Tom Davis (R-VA) and Henry Waxman as Minority.  \nAlso, Chris Shays there and Congressman Issa, Davis, Issa, Cummings.  I testified with \nStewart Simonson, and Joe Vitko (DHS).  Interesting issues around current BioShield \n(BS) legislation.  The original Bill for BS was strong and contained indefinite authority to \npurchase for stockpile as well as other strong incentives for industry.  Remember when I \nwent around to the House and Senate at the behest of the VP to push BS, several Senators \nand Members, particularly Sen. Byrd tried to neuter the Bill since they did not want to \ngive big Pharma too much.  Now we have a Hearing where the Congress is chiding us \nsince we have not gotten enough products through BioShield.  The reason is that the big \ncompanies do not see any major advantage since they have no liability protection, no tax \nincentives and no patent advantages, and not a big pot of money.  This is an amazing \nirony.\nWent to White House for a regularly scheduled (have not been reporting on these) \nPCC on Pandemic Flu Preparedness.  Co-Chaired by Rajeev Venkayya (HSC) and Lance \nLeggitt (DPC).  Reps were there from every cabinet department, CIA, etc.  I presented \nthat we actually had a vaccine sine the results of the dosing shows a clear dose-response \ncurve for the prime-boost.  We tested 7.5, 15, 45, and 90 ugm and clearly 90 gave a good \nprotective response after 1 dose and an amazing response after 2 doses.  Now we have to \nfigure out the right dose sparing (adjuvant) strategy and/or the right combination of \nprime/boost.\nOn the way out of the WH, ran into Bob Woodward.  Of note, I had just read his \nnew book “Secret Man” about Deep Throat Mark Felt.  I congratulated Bob on the book \nand discussed it a bit.\nReleased by Chairman Rand Paul\n117Reauthorization language for the NIH has been circulating for comment.  It is \nincredible.  It give all of the power to the NIH Director by eliminating individual \nappropriations and by creating an IC within the NIH to “carry out” research.  Importantly \nand I must put this in the book.  Chairman Barton has threatened to a group of \nconstituency groups who had come to him objecting about the bill that if any NIH IC \nDirector publicly opposes the Bill, he will open an investigation of that IC until the \nperson begs for the legislation.  This is after they had “asked for comments”.  This is a \nclear case of blackmail and in my mind is unethical, and possibly illegal.  I was told this \nover the phone by his Committee Staffer Cheryl Jaeger.\nJuly 14-22, 2005 – Looks like the Reauthorization Bill is getting some opposition from \nconstituents; however, Barton is trying to ramrod it through.  Zerhouni testified at House \nHearing.  It is still unclear how specifically he orchestrated this.  My sense is that \nZerhouni inadvertently created this monster in that he declared the NIH “broken” when \nhe came in as Director.  All he wanted was a little more power and some money to “be \nsomebody”.  However, Barton seized on this to “be somebody” by radically changing the \nNIH.  Zerhouni may now be left with unintended consequences of his early attempts at \ngetting a bit more power.\nJuly 25 – 29, 2005 – One of the most extraordinary weeks that I have experiences \n(see below)\nJuly 25, 2005 – Briefed Secretary Leavitt on briefing that I will give tomorrow to VP \nCheney on Biodefense countermeasure development.  Leavitt will accompany me to the \nWhite House.  Real good team at the DHHS with Leavitt and Chief-of-Staff Rich \nMcKeown.  They are very good people.  NPR played the piece on “This I Believe” that I \nhad pre-taped for them.  I have received many verbal and e-mail comments from far and \nwide about how moved people were by the piece.\nJuly 26, 2005 – Briefed VP Cheney on Biodefense Countermeasure update for 1 hour.  I \nwas the primary and only briefer.  Present were Sec. Leavitt, Scooter Libby, Carol Kuntz, \nBruce Miller (Carol’s Deputy), Stewart Simonson.  We discussed progress since my last \nbriefing of the VP as well as some of the problems that we are facing with BioShield 1. \nThe Bill does not go as far as we had originally planned and the big companies are still \nnot incentivized enough.  We are left dealing with smaller companies like VaxGen, \nAcambis, and others when we really want to engage the Merck’s and Glaxo-Smith \nKline’s.  The VP loved the briefing and resonated very well with me and the group.\nWhile waiting in the upper West Wing Lobby to go into see the VP, I ran into \nSens. Ted Kennedy and John McCain. Kennedy and I have evolved into a very warm and \ncomfortable relationship over the years.  This is only the 3rd time that I had met McCain, \nbut I never really had a chance to talk to him before.  Had nice conversation about the \nbooks that they are writing.  Ted is writing a book about his dog.  \nJuly 27, 2005 – Busy, Busy day.  Briefed VP Cheney again for 1 hour, this time with Sec \nLeavitt on Pandemic Influenza.  Also, present were Carol Kuntz, Julie Gerberding, \nScooter Libby, Bruce Miller, Rajeev Venkayya,  and some others.  This is a prep for Sec. \nReleased by Chairman Rand Paul\n118Leavitt’s upcoming briefing of the POTUS on July 29.  I will accompany him there also.  \nCarol was not too pleased with the briefing.  She confided in me that HHS does not seem \nto be as prepared and definitive as she wants (excluding me, she said).  We (HHS team) \nworked on the briefing afterwards to make it better.\n   Also, appeared on Diane Rehm Show (Susan Page substituting for Diane) to discuss \nPandemic Flu.\nJuly 28, 2005 – Even busier day today.  Spent 3 hours in White House Situation Room \nwith Julie Gerberding, Carol Kuntz, Kristen Silverberg, Bruce Gellin, Michael Jackson \n(Deputy at DHS), Alex Azar, Tom Reilly (OMB), Joel Kaplan (OMB), Tevi Troy (NSC), \nKen….., and others to sharpen and focus the presentation of Sec. Leavitt for the POTUS \nfor the following day.  Then Julie and I testified before the House Committee on \nHomeland Security, Subcommittee on Prevention of Nuclear and Biological Attack.  \nChaired by John Linder, minority – Jim Langevin.  Also present were Chris Shays, Jane \nHarmon, Ed Markey, Normal Dicks, Eleanor Holmes Norton, Donna Christensen, Bennie \nThompson, Ron Simmons, Bobby Jindal, Michael McCall, Jim Gibbons.  Good Hearing \nfor me, but only fair for John Vitko (DHS).  Also testifying were Julie Gerberding and \nGen. Eric Schoomaker.  One of  several Hearings on BioD.  Norton gave Julie some flack \n(she always gets on Julie).\nAfter the Hearing we (Julie and I)  went back to HHS and spent the next 2 hours \nagain briefing Sec. Leavitt for the POTUS briefing.  At the briefing were Leavitt, Rick \nMcKeown, Alex Azar, Natalie Kochnour, Bill Raub, Bruce Gellin, Stewart Simonson.  \nWe are getting close to having it right.\nJuly 29, 2005 – Another amazing day.  Spent a couple of hours together with Julie \nGerberding and Bruce Gellin at DHHS again pre-briefing Sec. Leavitt for the visit with \nthe POTUS.  Then went to White House and briefed the POTUS for 1 hour on Pandemic \nFlu in the Roosevelt Room.  The POTUS was very engaged and went back and forth in \nan animated and interested way with Julie and me and the Secretary.  He vowed to do \nwhatever is necessary to stop the onset of a Pandemic Influenza.  He turned to Josh \nBolten (OMB Director) and indicated that no expense should be spared.  He essentially \ngave us a mandate to take care of this problem in no uncertain terms.\nPresent at the briefing were: VP Cheney, Karl Rove, John Bolten, Andy Card, \nHarriet Meiers, Fran Townsend, Kristen Silverberg, Dan Bartlett, Scott McClellan, Mike \nChertoff, Tevi Troy, Julie Gerberding, Sec Leavitt, and others.\nIn the late afternoon, I showed around the NIH Michael Gerson who was with \nMiss America Nicole Johnson Baker and her husband Scott Baker.  He was visiting the \nNIH to look around and get a feel for the place.  We presented an HIV-infected IL-2 \npatient (Terry Brown) and discussed our IL-2 work.  Then we went across the street and \ndiscussed malaria with Tom Wellums.  Mike Gerson is very interested in domestic AIDS.  \nHe will get back to me to work on this since he wants to put an initiative of this sort into \nthe 2006 State of the Union Address.   Very successful meeting.\nAugust 7, 2005 – Major Sunday news day with front page article in NY Times \npredominantly quoting me) regarding the successful preliminary data from the NIAID-\nfunded H5N1 vaccine trial that showed safety and an immune response that would be \nReleased by Chairman Rand Paul\n119predictive of protection.  This is obviously very good news in our comprehensive plan for \npandemic influenza preparedness.  This article in the Times kicked off a very positive \nmedia frenzy with front page articles in virtually every newspaper (it was on the Times \nweb page the night before and so other papers picked it up) including Washington Post, \nBaltimore Sun, Wall Street Journal (Web), AP, Reuters, etc, etc.  I appeared on ABC \nNightly News on Sunday night, NPR’s All Things Considered” on Sunday, CNN \nAmerican Morning on Monday AM.  Very positive “ink” weekend”.\nAugust 17, 2005 – Briefed Secretary of State Condoleezza Rice at the State Dept. on the \nthreat of Pandemic influenza.  Also present were Sec/ Mike Leavitt, Rich McKeown, Bill \nSteiger, Julie Gerberding, Bruce Gellin, Bill Raub, Dan Singer, and a few Assist. Secs in \nDoS.  We gave Dr. Rice a primer on Pandemic flu and also discussed the international \nimplications, particularly related to the recent findings that migratory birds have brought \nH5N1 to chicken flocks in Siberia, Russia, Mongolia, and Kazakhstan and flyways will \nlikely bring it to India and Europe.  She was very gracious and was glad to see me again \nsince I had briefed her a few times on HIV/AIDS and biodefense when she was at NSC\nAugust 19-28, 2005 – Very productive meeting of editorial board of Harrison’s \nPrinciples of internal Medicine (HPIM) – 17 and McGraw-Hill publishers at Spring \nCreek Ranch in Jackson Hole, WY to plan the 17th Edition that will be published in 2008. \nWe returned there after our 1991 planning meeting for a prior edition.  I am the editor-in-\nchief for the 17th and I picked Jackson Hole.  Great choice.  Beautiful weather and above \nall, Bob and Colleen Grady have  a beautiful home there and our girls stayed with them \nwhile Chris and I stayed at the Spring Creek Ranch.  Did fishing (caught several cutthroat \ntrout), hiking and just relaxing, although I worked every day (1 ½ day off) on the book.  \nVery frightening experience when Bob, Colleen, Chris and the girls took a (supposedly 6 \nhour) 12 mile hike on the Teton Crest trail.  A bit reckless on Colleen’s part in that we \nstarted late (1:45 PM) and would have cut it close to get to destination by nightfall.  Trail \nwe difficult, but incredibly beautiful.  Unfortunately, we got lost (wrong turn) and lost >2 \nhours.  We hiked the last hour+ in the dark.  Alison was totally frightened.  We saw up \nclose several bull moose, mountain lion tracks and wolf tracks.  Danger was being \nstranded in the woods overnight with temperatures going down to <40 F every night.  We \nfinally made it to the fire road and out by 9:25 PM.\n August 29, 2005 – Hurricane Katrina totally wrecked New Orleans, parts of Mississippi, \nAlabama and Florida.  Levies caved in  New Orleans and Lake Pontchartrain poured into \nNew Orleans together with the river.  May be biggest natural disaster in USA history.  \nThousands dead and stranded.  Hundreds of thousands of refugees living under terrible \nconditions unable to be rescued.  Cliff Lane and I are planning a consulting arrangement \nwith IDSA and RCEs for infectious diseases.  More to come.\nBird flu activities continue with migratory birds now infected in Russia, Siberia, \nKazakhstan.  Europe worried.\nSept. 2, 2005 – Interesting situation.  Congressman Henry Waxman might use an old \ndocument to help block the Bush nomination of John Roberts to the Supreme Court.  See \nletter in attachment:\nReleased by Chairman Rand Paul\n120\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n126 \nSept .7, 2005 -  Still major disaster in New Orleans, Mississsippi, Alabama.  Likely \nmajor repercussions about lack of ppreparedness on the part of State, local, and Federal \ngovernment in not heading warnings for years that the levees could not withstand a \ncategory 4 or greater hurricane.  In fact, the levees caved in and N.O. was flooded 80%.\nSept. 9, 2005 – Briefed Pres. Bush today in the Roosevelt Room on update in Pandemic \nInfluenza Preparedness.  This was in follow-up of our previous meeting on July 29.  I was \nwith Sec. Leavitt, Julie Gerberding, Bruce Gellin.  On the White House side was the \nPOTUS, VP Cheney, Scooter Libby, Josh Bolten, Scott McClellan, Andy Card, Attorney \nGeneral Alfred Gonzales, Harriet Meiers, Robert Zoellig from DoS, and others.  The \nPOTUS was very engaging.  Half- jokingly he said that “Tony will have to fix this \nproblem for us with his research…”   Another good and productive briefing of the \nPOTUS.  Mention was made about not repeating the errors of Hurricane Katrina \nresponse. \nSept. 14, 2005 – Briefed Carol Kuntz today on the", "summary": "Watcher-discovered document from paul-readingroom (2026.07.27_Diary-Prequel-.pdf), auto-indexed 2026-08-05.\n\nExcerpt: hung up and  Released by Chairman Rand Paul 63mentioned this to Kristen Silverberg.  She knew nothing and immediately called Dan  Bartlett (WH Press Office).  I did not hear what they said; however, apparently what  happened is that the press confronted the WH with the Walters interview and the WH  caved in and admitted to the policy.  The crazy thing is that it has now hit the press, but  the WH will not let us talk about it since the President has not officially announced it.   We still do not really know what the policy will be nor when it will be announced.  More  later! Dec.12, 2002 – Much activity back and forth with the White House and the DHHS  regarding putting the finishing touches on the President’s Statement and the policy in  general.  In particular, Kristen Silverberg and…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.27_Diary-Prequel-.pdf", "pdf_url": "/archive-docs/fauci-files/c1dee44b66471ea95f8e8154b109f914/pdf", "doc_date": "2026-08-05", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-07-27-diary-prequel"], "part_number": 2, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 3 of 8)", "content": "DHHS $7 to 9 billion supplemental \nbudget request for FY2006 for Pandemic Influenza Preparedness.  She wanted my \nopionion so that she could transmit this to the Vice President who wants to know what I \nthink of the feasibility of the request\nSept. 15, 2005 – Accompanied Sec. Leavitt and Bruce Gellin and Julie Gerberding to \nbrief 3 cabinet secretaries today on Pandemic Flu.  Briefed Sec. of VA Jim Nicholson, \nEPA Administrator Steve Johnson and Treasury Secretary Snow.  Got an e-mail from \nFran Townsend of HSC who mentioned that the President has mentioned that he always \nfeels more comfortable when he knows that I am working on important health problems \n(see visit to the POTUS on Sept. 9).\nSept. 19, 2005 – Again, accompanied Sec. Leavitt, bruce Gellin, Julie Gerberding and \nBill Raub to brief Sec of  Agriculture Johanns and Admininstrator of USAID Andrew \nNatsios on plans for Pandemic Influenza Preparedness.\nSept. 23, 2005 – Had very interesting and enjoyable evening at a reception at the home of \nMark and Nicole Wallace in honor of Kristin Silverberg in celebration of her \nconfirmation (a couple of months  ago) as Assistant Secretary for International \norganizations in DoS as well as her birthday.  Present among many others were a number \nof White House personnel such as Michael Gerson, Josh Bolten, Michael Allen, Randy \nTobias (DoS), etc.  Interesting part of the evening were the in depth and intense \ndiscussions that I had with Josh Bolten and Mike Gerson about the difficulties in funding \nthe POTUS’s planned programs over the next few years given the fact that Hurricane \nKatrina will cost over $100 Billion and Hurricane Rita is still percolating in the Gulf of \nMexico.  Important dilemmas – Do you let the deficit explode? Do you cut domestic \nprograms (difficult to do since the amount would be trivial compared to what is needed)?  \nDo you defund the war in Iraq (impossible)?  Do you abandon all or (as I suggested) part \nof the Tax Cut program?  Very enjoyable and interesting evening. The Wallace’s live on \nReleased by Chairman Rand Paul\n1274434 – Hawthorne Street, which is 2 blocks from my house.  Christine Grady \naccompanied me.\nSept. 28, 2005 – Sec. Leavitt, Julie Gerberding, Bruce Gellin, General Gordon (CIA) and \nI briefed a groups of Senators on H5N1 influenza pandemic potential in a “top secret” \nbriefing at the Capitol.  Among the Senators were:  Ted Kennedy, Barrack Obama, Tom \nHarkin, Durbin, Reid, Patrick Leahy, Max Baucus as well as others.  Typical Washington \nphenomenon ensued – two days later they proposed an amendment to a Defense Bill for \n$4 billion dollars for H5N1 preparedness emphasizing buying Tamiflu instead of the \nbalanced Vaccine/Therapy approach that we had suggested.  In addition, they knew (we \ntold them) that we were preparing a big ($7-9 Billion) supplemental request for the HHS \nFY2006 budget for vaccines/drugs.  It was clear that they wanted to trump the \nAdministration since the bill was proposed by Democrats as well as Frist, who is clearly \npositioning himself to run for President in 2008.  I love it!!\nSept. 30, 2005 – Appeared again (many times now) on the Lou Dobbs CNN Show to \ndiscuss bird flu.  He obviously respects me very much.  Of note, lately the DHHS people \nin OC (Bill Hall, Suzy DeFrancis Christina Pearson, and mostly Patti Conrad– I am not \nsure who is the culprit) have been hijacking the media requests for me when we ask for \npermission (routine) to accept.  Usually these are “rubber stamp”; however they are \ntrying to insert the secretary on shows that specifically ask for me.  I feel that this is fine \nsince the Secretary should trump everyone.  However, they are lying about it since they \nare telling us that when they offer up the Secretary, the shows are glad to have the \nSecretary instead of me.  However, I heard directly from Wolf Blitzer of CNN that he had \nspecifically asked for me.  The DHHS people called him up and said that I could not do it \nsince I had a prior commitment and they suggest that the Secretary take my place.  We \nhad made it perfectly clear to the DHHS people that I was totally free and able to do it.  \nThey are really acting poorly.  Why do not they just say that they want to insert the \nSecretary and not lie about it and give the networks the choice of me versus the \nSecretary.  I guess I have no recourse.  At the end of the day it will backfire on them.\nOct. 6, 2005 – A fever pitch is on about the Pandemic Influenza preparedness related to \nthe heightened awareness of the potential, the fact that new cases were seen over the past \nfew weeks in Indonesia, the POTUS giving a speech before the UN General Assembly \nabout the need for international preparedness, the meeting of Sec. Leavitt and I and others \nwith CEO’s off pharmaceutical companies, and a series of briefings that Leavitt, Bruce \nGellin and I have been giving to members of Congress and Senators.\nMany media appearances by me despite the above steering to Leavitt.  Leavitt \nhimself has been terrific.  We are quite a team with the media and the briefings.  \nToday, Leavitt and I briefed the POTUS in the Oval Office at 1:00 PM.  Hot \nsticky day for October.  The POTUS had the usual extremely attentive and warm \nreceptions for me.  He joked that he had mentioned my name at a press conference that he \nheld yesterday and he does that whenever he wants to appear smart.  He just mentions my \nname and people assume that he knows what he is talking about.  We had a few laughs \nabout other things also.  At the briefing were the usual cast of characters including: the \nVP, Andy Card, Josh Bolten Scooter Libby, Dan Bartlett, Scott McClellan, Fran \nReleased by Chairman Rand Paul\n128Townsend, Tevi Troy, Rajeev Venkayya, Candi Wolff, etc.  We briefed him in \npreparation for the meeting that is will have tomorrow in the Roosevelt room with the \nCEOs of Pharma to encourage them to help us prepare for pandemic flu.\nOct. 7, 2005 – More media appearances, NBC, CNN, German TV, BBC, etc.  Leavitt and \nI helped POTUS in the Roosevelt room talk with the CEOs regarding how we can engage \nthem in building a vaccine production capacity.  The POTUS heard from them what I had \ntold him the previous day, i.e. that we much revitalize the production capacity not just for \nH5N1, but we must create a sustainable market and capacity for seasonal flu that will \nthen provide a major head start in the event of a pandemic flu.  CEOs present were: \nDavid Mott of MedImmune, David Williams of Sanofi-Pasteur, JP Garnier of GSK, Dick \nClarke of Merck and Howard Pien of Chiron.  Again, the POTUS was very interactive \nwith me when he came in and left.  He concentrated heavily on the CEOs during the \nmeeting.  Afterwards, Scott McClellan had Leavitt and I give a press conference in front \nof the White House.  Multiple cameras, etc.  I will leave for SE Asia tomorrow with \nLeavitt to visit Thailand, Cambodia, Laos, Viet Nam, and Indonesia.\nOctober 8 – 18, 2005 – Trip to SE Asia as part of delegation of Secretary of HHS \nMichael Leavitt.\nCountries visited – Thailand, Cambodia, Laos, Viet Nam, and Indonesia.  Purpose of the \ntrip was fact-finding in association with the threat of an H5N1 pandemic influenza. \nDelegation included Michael Leavitt, Paula Dobriansky (Under Secertary of State for \nGlobal Affairs), Jong-Wook Lee (Director-General, WHO), Kent R. Hill (Acting \nAssistant Adm. For Global Affairs, USAID), James Butler (Deputy Under Secretary of \nAgriculture for Farm and Foreign Agriculture Service), Suzy DeFrancis (Assistant Sec. \nfor Public Affairs, DHHS), Julie Gerberding, Margaret Chan (Assistant Director general \nand Rep of WHO for Pandemic Influenza), H.E. Changchui (Assistant Dir.-Gen., Food \nand Agriculture Organization – FAO-), Alejandro Thiermann Pres. World Organization \nfor Animal Health – OIE ), Kenneth Bernard (Advisor to WHO Dir. Gen.), William \nSteiger, Kerry Weems (Deputy Chief-of-Staff, DHHS), Vaughan Turekan (Special \nAssistant to Paula Dobriansky), Allyson Bell (Director, Scheduling and Advance, \nDHHS), Jay Hodes and Michael Lonetto (Security).\nPlease see files for details of whom I met and when.  I will list some of my impressions \nbelow.\nMajor impression of the trip was the consistencies as well as the variabilities of \nthe 5 countries visited.  Thailand was certainly the most advanced.  They were taking \nvery seriously cleaning up and keeping clean the commercial poultry industry.  They \nexport chicken (mostly parts pre-cooked) all over the world.  The problem is with the \nsmall farmers who have variable number of chickens in their back yards.  \nThe most disturbing yet very interesting was Cambodia due to a society that was \nstill trying to recover from the Khmer Rouge genocide.  It is a beautiful people; very \nReleased by Chairman Rand Paul\n129sensual looking. Men almost effeminate.  The sexuality of both men and woman stood \nout. (This was also seen to some extent in Thailand.) The Institut Pasteur in Phnom Penh \nis the best science they have there.  \nI was very impressed with Laos.  I expected a stark, Communist-style society.  It \nwas very warm and friendly.  People seemed to look upon us as if we were normally \nthere.  They did not stare, nor did they smille too much.  They were “very normal” \nlooking.  Bill Steiger and I had a terrific time running around the track in the National \nStadium.  The Laotian National Track team was practicing there at dusk and we ran until \nit got dark.\nViet Nam was amazing.  Hanoi was a vibrant, bustling exciting-appearing city.  \nThe most amazing experience was trying to walk across the street with the motor scooters \nand cars going very fast and literally messing into each other from multiple different \ndirections. It was incredible that they did not hit each other continually.  The word from \nthe CDC folks who were with us was that you needed to just cross the street and not look \nor speed up or slow down.  Just cross at the same pace and the scooters and cars will \navoid you.  It was scary.  Haiphong was a different story.  It was more stark and gray.  \nThe Vietnamese women are incredibly beautiful.  We stayed at the Hanoi Hilton – \nbeautiful hotel, run by Vietnamese, but very western. It seems incredible now given the \nenergy, beauty and talent of these people that we could ever had been at war with them \nfor so many years.  Interestingly, they seemed to love Americans.  It appeared to be very \ngenuine.\nIndonesia was similar to what I imagine Hong Kong to be.  Many skyscapers in \nan Asian country.  The polluted stench in the air was similar to (but not quite as bad as) \nDelhi.  \nOct. 8, 2005  (Saturday)– Left IAD \nOct. 9, 2005 – Arrive Bangkok via Tokyo on commercial flight.  Met by Ambassador \nRalph (Skip) Boyce and Health Attaché Jordan Tappero.  Skip was terrific and we hit it \noff very well during the trip.  He knows Jim Huskey from prior DoS activities. He was in \nBeijing with Jim during the Tianman Square incident.  Stayed at Conrad Hotel.   Settled \nin at hotel.  Extremely hot and muggy.  This was just at end of rainy season and we \nexpected rain, but got very little throughout the trip.  However, I can remember the heat. \nVisited with deputy Prime Minister in the ornate, but beautiful Government House.  Of \nnote, the Deputy PM mentioned how happy he was that Thailand offered assistance to \nUSA during the Katrina Hurricane disaster.  Also met with Health Minister Suchai \nCharoenratanakul and Prat Boonyawongvirat Acting permanent Secretary.  Our CDC is \nnot entirely satisfied with the performance of the health ministry.  The Thais seemed to \nbe fixated on whether and how much Tamiflu the USA will give them for their stockpile.  \nWe celebrated the 25th Anniversary of the Thai MOPH – US HHS/CDC (TUC) \nCollaboration.  Had multiple meetings and luncheons with United Nations reps and \nNGOs.  Here and elsewhere, we had numerous Press Conferences.  Suzy DeFrancis \n(Assistant Secretary for Public Affairs) clearly did not want Julie or I in the spotlight (see \nabove comments).  She literally kept the press away from us so that they would \nconcentrate on the Secretary.  The Secretary was cool about everything; Suzy was the \nproblem.\nReleased by Chairman Rand Paul\n130    Had a great reception at Skip Boyce’s house.  Typical Ambassador’s house and party.\nOct. 11, 2005 - Next day we toured a typical commercial poultry farm – Charoen \nPokphand Foods PCL..  Much press.  We all suited up with protective gear (booties, caps, \ngowns, etc.).  The commercial farms are very careful about bird flu and are meticulous in \npreventing infections.  There was no history of infection in these flocks – all infections in \nbackyard and small farm flocks.  We visited a small poultry farm and saw the differences \nbetween commercial and small farms. Had lunch at airport restaurant and took off for \nPhnom Penh, Cambodia\nArrived at Cambodia and checked into Raffles Hotel in Phnom Penh.  Got a \n“Country Briefing” from U.S. Ambassador Joseph Adamo Mussomeli.  He is a very good \nguy – relaxed and friendly, but very competent.  That afternoon and evening we met with \nthe Cambodian Minister of Health – Nuth Sokhom and signed a memorandum of \nunderstanding.  Had a reception at the Raffles Hotel and then to bed.\nOct. 12, 2005 – Series of meetings with officials.  Met first with Minister of Agriculture, \nForestry and Fisheries.  It was clear that Cambodia was far less well-prepared than \nThailand for a bird and/or human pandemic.\n      Met with Deputy Prime Minister and Amb Mussomeli had a firm exchange with the \nDeputy Prime minister in which Joe objected to the fact that the Cambodians had arrested \na Cambodian Journalist for writing a story negative to the regime.\n     Next visited the Institut Pasteur in Phnom Penh.  The Institut Pasteur has 29 foreign \nsatellite institutes throughout the world.  Cambodian institute began in 1935, but was \nwiped out by the civil war and then by Khmer Rouge.  It was re-established in 1995.  \nSirenda Vong is a young scientists at the Institut Pasteur who made a very nice \npresentation about their work.  He is a rising star in my mind..  \n  Lasted only part of a day.\n     Met with King Norodom Sihamoni and toured the Imperial Palace.  The King is an ex-\nballet dancer.  He is single.  \n     Visited the Genocide Museum.  The story is horrible. 1.2 million people (10% of the \npopulation) were murdered, usually following torture over a 5 year period.  After the \nKhmer Rouge took over, they evacuated Phnom Penh and literally murdered anyone who \nwas middle class and/or educated.  They murdered people merely if they wore \neyeglasses.  They had this genocide maniac mentality (similar to the Nazis) of \ndocumenting everything that they did.  The walls of the museum showed thousands of \nphotos of people who were put into the prison (now museum) which was originally a \nhigh school.  They would photograph them, document their arrest, torture them and then \nkill them.  Either they died of the torture, starvation, etc. or they sent them to the killing \nfields to be hacked or bludgeoned to death.  They kept meticulous medical records of the \ndying and deaths of the prisoners.\nWe then visited with a group of NGOs who explained to us the problem of \ntrafficking in Cambodia.  It is a complex problem since the people who are trafficked are \nusually sold by their family because of poverty.\nThat afternoon, we flew to Vientiane, Laos and check into Lao Plaza Hotel.  Bill \nSteiger and I had a terrific evening run (right as the sun set) in the National Stadium \nwhere the Lao National Track Team was practicing.\nReleased by Chairman Rand Paul\n\n131Had a reception-dinner that night at the home of Amb. Patricia Haslach.\nOct. 13, 2005 – Spent day in Vientiane meeting with a variety of Ministers.  Met with \nMinister of Public Health Dr. Ponemek Daraloy.  He is a good person, well-regarded in \nhealth circles in SE Asia.  He is an old Pathet Lao.  Visited Mahoset Hospital and then \nvisited the Prime Minister and the Minister of Foreign Affairs..  Signed MOU.  Met with \nDr. Siene Saphangthong and then in mid-afternoon flew from Wattaya International \nairport to Hanoi, Viet Nam..\nArrived at Hanoi Noi Bai Airport.  Motorcade from airport to downtown Hanoi \nwas fascinating as we passed a bustling suburb with extremely interesting “vertical” \narchitecture of homes and offices.  Checked into the Hanoi Hilton Opera Hotel.\n         \nOct. 14, 2005 – Met with Minister of Health Tran Thi Tring Chien.  Then went to \nNational Institute of Hygiene and Epidemiology and met with its Director Dr. Nguyen \nTran Hien.  He is a terrific person and I sent him a signed copy of Harrison’s after I \nreturned home.\nAlso met with the Minister of Agriculture and Rural Development Cao Duc Phat.       \nAlso, met with Prime Minister Phan Van Khai in a very elaborate Government Palace at \n1 Bach Thao Street, Ba Dinh District with an enormous bust of Ho Chi Minh.  The Prime \nMinister was extremely impressive.  He spoke on all of the issues without notes.  He was \nwell-versed and clearly knowledgeable about specific issues.  Had dinner hosted by the \nMOH.\nOct. 15, 2005 – Great experience.  Visited the “wet markets” in Hanoi and got an great \nfeel for the bustling nature of this vibrant city.  \n     Drove 2 hours 15 minutes to Haiphong and visited Provincial Health Department.  We \nhad lunch at Van Tue Restaurant for Government Officials and then went to Viet Tiep \nHospital to visit their Clinics.  It was in this region that the cluster of cases occurred.  \nMOL visited with the family who got sick and who were featured on CNN a few weeks \nago.  Big difference between Haiphong and Hanoi in that Haiphong is clearly more \ndreary and less vibrant.\nOct. 16, 2005 – Flew to Tan Son Nhat International Airport in Jakarta, Indonesia. Stay at \nFour Seasons Hotel Jakarta.\nOct. 17, 2005 -   Visited NAMRU-2.  Was apparently a problem in that the Indonesian \ngovernment was threatening to cut off dealings with NAMRU-2 because they thought \nthat NAMRU-2 was being critical of them.  We finally sorted it out and at the end of the \nday got the president of Indonesia to endorse NAMRU-2.\n    We met with Coordinating Minister of people’s Welfare and Coordinating Minister of \nthe Economy.  There are issues in Indonesia of difficulty in transparency related to the \ndiffuseness of the country.  17,000 islands with a population of 220 million (4th largest \ncountry by population).\n     Met with President Yudhoyono. He was very impressive and knowledgeable.    \n     Flew from Jakarta to Tokyo on PM of Oct. 17 and arrived in Tokyo on Oct. 18\nReleased by Chairman Rand Paul\n132Oct. 18, 2005 – Flew Tokyo to Dulles Airport.\nOct. 19, 2005 – “Intrigue” at the White House\nUpon return from SE Asia, we have just heard that the overall responsibility for \nPandemic Influenza will be handed over to the Homeland Security Council (HSC) run by \nFran Townsend.  Also, DHS will be playing a more significant role.  We believe that this \nrelates to several factors: 1) the preparedness planning involves multiple agencies and so \nthere is a need for a coordinating entity. 2) The WH is concerned about the fact that it has \ntaken so long to get a plan out and now we realize that we need an Federal Plan (all \nagencies) as well as a National Plan (State, Local, Federal).  3) Anxiety about the failures \nof FEMA around Hurricane Katrina and the need to have centralized control over a \npotential disaster (in this case pandemic flu). 4) WH staff wanting to assert themselves\nAlso, it is becoming more and more obvious how the Public Affairs people at \nHHS are trying to block Julie Gerberding and me from being out front with the Press.  \nThey keep intercepting requests by the Press for me and Julie to put the Secretary out \nthere.  This was seen in SE Asia and again is seen here.  However, there is so much press \ngoing on that I am getting plenty.  They are, however, sucking off the good offers that I \nget (network TV).  In this regard, I am still doing a lot of CNN\nOct. 19, 2005 – Incredible evening.  U2 gave a concert at the MCI Center in D.C.  Bono \narranged for premier tickets for Chris and me.  We met with Bono in the hospitality suite \nbefore the concert and exchanged warm hugs and discussions.  Amazingly, in the middle \nof the concert in front of >25,000 people, Bono dedicated a song (“Miracle Drug”) to me.  \nHe praised me and said that I was doing wonderful things for HIV/AIDS globally and \nthen dedicated the song to me.  After the concert, he invited Chris and me to a private \nreception at his hotel  - The Ritz-Carlton in Georgetown – for drinks and discussion.  \nEveryone was bussing that he dedicated a song to me.  I thanked him and we discussed \nthe need to keep up the PEPFAR program and make sure that we do not stop drugs in \npeople because the program phases out.  There is no sign that the Administration will \nphase the program out after the 5 years are up.\nOct. 20, 2005 – Am wearing thn with exhaustion.  No sooner did I return from SE Asia \nthat I had to go to Chicago to receive the 2005 Scientist of the Year Award from R & D \nMagazine.  Took place at a black tie affair at the Navy Pier in Chicago.\nOct. 21, 2005 – Much press regarding trip and updating on pandemic flu.  The whole \nworld is getting exorcised.  Chickens now infected in Russia, KazakstanChina, Romania, \nTurkey.  Clearly, migratory birds are bringing the disease West.  Was on CNN, C-SPAN, \nNPR, Bloomberg News, etc.\nOct. 24 – 28, 2005 – Hectic week with bird flu and grand jury indictment of I. Lewis \n“Scooter Libby” for perjury, obstruction of justice and making false statements in the \nReleased by Chairman Rand Paul\n133investigation of the leak that Valerie Plame was a CIA agent.  She is the husband of Jim \nWilson who has been criticizing the war in Iraq.\nOct. 24 – briefing by me , Julie, Bruce Gellin and Secretary Leavitt (MOL from here-on) \nof several cabinet members in the Cabinet Liaison Office in EEOB.  Subject – pandemic \nflu.\nOct. 25, 26 – Boston to deliver Baruj Benacerraf Lecture at Harvard and Dana Farber \nCancer Center.  Nice dinner at Harvey Cantor’s house to celebrate Baruj’s 85th birthday.  \nSay Jenny in Cambridge after the dinner on Oct. 25.  Wonderful time with my amazing \ndaughter!\nOct. 27 – continue briefing of Hill members.  Briefed Tom DeLay, Steny Hoyer, and \nothers.  Incredible attention to pandemic flu in this country.\nOct. 28 – Briefed Speaker of the House Dennis Hastert.  The POTUS will unveil the \nPandemic Plan at NIH on Nov. 1.  I have been doing considerable press.\nNov. 1, 2005 – POTUS came to NIH to unveil the National Flu Pandemic Plan. Beustiful \nFall day with crystal clear skies and temperature around 65-70.  I along with Sec Leavitt, \nElias Zerhouni, Julie Gerberding, and others greeted him as he arrived.  During his \nspeech he specifally thanked me for my work.  Attending the speech in Natcher \nAuditorium were several Cabinet Secretaries including Coni Rice, Minetta, Mike \nChertoff, Johanns among others.  With the POTUS was Karl Rove, Fran Townsend \namong others.  POTUS gave a good speech.  Afterwards, I did a media blitch and \nappeared on CNN Wolf Blitzer, CNN Lou Dobbs, CBS Evening News, Charlie Rose and \ndid many print and radio interviews.  Ted Kennedy is concerned about the liability issue.  \nHe agrees that we should give liability protection to the pharmaceutical companies to \nkeep them in the business of influenza vaccine manufacturing.  However, he feels that we \nmust also provide compensation for those that might be injured by the vaccine.  He \nappealed to me to discuss this with the administration.  He followed this up 2 days later \nby having his staffer (David Bowen) call me and get more advice from me about how \nthey could tackle this problem.\nNov. 2 - 3, 2005 – Testified with MOL, Julie G., Bruce Gellin, and Bill Raub at both the \nSenate and House Appropriations Subcommittees for HELP.  We discussed the \nPresident’s Plan as well as the more detailed HHS Pandemic Plan.  We were generally \nwell received, but there was the usual partisan skepticism on the part of the Democratic \nregarding the fact that the Plan asks the States to put up about 75% of the cost for a \nportion of the Tamiflu that would go to them.  The point was made that the States do not \nhave enough resources to do this.  MOL makes the point that this is a co-pay situation \nsimilar to what is done for prescription drugs in Medicare and Medicaid.    Much press.\nBig stuff going on with the indictment of Scooter Libby.  The Democrats are \ntrying to drag in the VP and the entire WH, claiming that there was a wide conspiracy to \ncover-up the fact that the WH distorted intelligence to get us into a war with Iraq and that \nReleased by Chairman Rand Paul\n134Joe Wilson was smeared by outing his CIA wife in order to get back at him for \ndisagreeing with the evidence used for going to war with Iraq.\nNov. 3, 2005 – Top secret meeting at EEOB regarding conduct of certain experiments in \nthe area of developing countermeasures.  Cannot elaborate because of top secret nature of \ndiscussions.  More press regarding Pandemic flu  plan.\nNov. 4, 2005 – Tesitified before the House Government reform Committee with Tom \nDavis Chairing. Same cast = MOL, me, Julie, Raub, Gellin.  This was a tougher Hearing \nin that this Committee is generally tough.  Both the Republicans and Democrats gave \nsome heat to us.  As usual, the tough ones (Chris Shays, Dan Barton, Henry Waxman) \nwere quite deferential to me and so I did fine. Dennis Kucinich made a spectacle of \nhimself by pushing MOL on the issue of taking over Roche’s patent for Tamiflu.  \nKucinich wanted a government takeover and MOL argued that this would be a \ndisincentive for companies to ever make scarce products (MOL is absolutely correct).\nNov. 5, 2005 – Met Senator Bill Frist at the St. Alban’s – St.Stephen’s/St Agnes football \ngame (2:30 PM) at St. Albans field.  Beautiful Fall afternoon.  Temperature = 70 and \ntotally sunny. St. Albans won 42-20.  Frist’s son Brian plays for St. Albans (junior year – \nspecial teams and safety).  Frist discussed a whole range of issues, particularly pandemic \nflu.  He wanted my opinion on the budget bill for flu ($7.1 Billion).  Also, ran into Tim \nRussert at the game.  He told me that he wanted me for “Meet the Press” to talk about \nbird flu within the next couple of weeks.\nNov. 8, 2007 -  Testified before the House Commerce and Energy Committee (Joe \nBarton, Chair).  MOL, Julie, me, Bill Raub.  Topic = pandemic flu.  Somewhat different \ntwist.  Much discussion about funding.  Some Republicans such as Barton feel that we \nshould not have an emergency supplement, but that we should have offsets.  This is \ncontrary to what House Appropriations Chairman Jerry Lewis said at the Appropriations \nHearing (see above).  He feels that it should be new money.\nNov. 9, 2005 – Spirited Hearing before the Senate Foreign Relations Committee on \nPandemic Flu.  I testified along with Julie G., Andrew Natsios (USAID), and Paula \nDobriansky (DoS).  Committee chaired by Paul Lugar.  Present at Hearing were Sens. \nDodd, Biden, Obama, Sarbannes (all Dems.)  They kept pushing Julie and me about “who \nis in charge?”  We explained that it is primarily a health issue and in this regard, Sec. \nLeavitt is in charge.  In the sense that the issue may involve multiple Agencies, this is \ncoordinated through the Homeland Security Council and Fran Townsend is in charge.  \nThey did not like the latter and were pushing for a “Flu Czar”.  We said that this was a \nbad idea.  There was a lot of animated back and forth.\nAfter the Hearing, I met with Olafur Ragnar Grimsson, President of Iceland.  He \nwas referred to me by Congressman Ed Markey (D-MA).  He is sponsoring an Icelandic \nDrug Co (“Actavis”) that makes generics for HIV drugs and he wants to get Iceland \ninvolved in helping out with global AIDS by making 3-in-1 drugs available free to some \ncountries and sold at minimal prices to others.  He wanted my advice.  I strongly \nsuggested that he contact PEPFAR in the form of Mark  Dybul.  I also suggested that he \nReleased by Chairman Rand Paul\n135contact “Doctors without Borders” and Bono’s people (Jamie Drummond).  I will help \nthem out to connect.  They had already approached Bill Clinton and the Clinton \nFoundation, but felt that they did not really have a substantive network.\nNov. 10, 2005 – Frenetic activity continues.  Briefed together with Bill Raub and Julie G. \n(by phone) and Jerry Parker (Stewart Simonson’s Deputy at OEPHP) Secretary of \nCommerce Gutierrez (he is last of the Cabinet Secretaries to be briefed).  Bruce Gellin is \nin Geneva with Stewart for Global Planning meeting for Pandemic Flu.  They stopped in \nParis to visit Institut Pasteur.  This was in the middle of the riots around Paris by Muslim \nFrench Nationals who are enraged at poor living conditions and alleged prejudice in \nFrench Society against them.  \nWe also briefed the House Armed Services Committee and I gave a personal 1-\non-1 briefing to my old friend Sen. Barbara Mikulski.  She was gracious and very glad to \nsee me.  This evening Sec. Leavitt and I and Michael Osterholm (connected from \nMinnesota) did the Nightline Show with Ted Koppel from D.C.\nNov. 20, 2005 – Press still hot and heavy.  I appeared on “Meet the Press” with MOL, \nJulie Gerberding, and Mike Ryan (WHO) about bird flu.  Many e-mails saying that I gave \na great interview.\nNov. 23, 2005 – Press activity still very heavy.  I appeared today on the Diane Rehm \nShow and CNN’s “The Situation Room”.  \n     Michael Osterholm sent me an e-mail saying that he was concerned that I was saying \non the air that the probability of an H5N1 pandemic this winter is low.  He says that \n“health reporters” are e-mailing saying that I am giving confusing messages.  I am \nabsolutely certain that the “health reporter” in question is Laurie Garrett who is \ninherently hysterical.  I am disappointed in Michael since it is very clear that I am saying \nthat the probability of a pandemic (in the broad sense – any new virus) occurring is very \nhigh based on historical precedence.  However, the probability of there being an H5N1 \npandemic of the scale of the 1918 Influenza over the next month or two is low.  \nNONETHELESS, we must assume the worse case scenario and prepare as if it will \nhappen in its worse form and it will happen soon.  I have been very consistent about this.  \nI am actually asking the actuarial and probability people like Don Burke to figure out if \nwe can add some science to this concept.\nNov. 25, 2005 – HHS Flu Summit for States will take place on Dec. 5.  Julie Gerberding \nand I are at collegial “odds” with the DHHS people (Laura Lawlor and John Ogwanobi) \nin that we feel that the Department and the CDC specifically should be the first ones \ndiscussing the Plan.  The Agenda as of today has MOL (as appropriate) speaking and \nthen we bring on Rajeev from HSC, Jeff Runge from DHS, a person from DoA.  Julie \ndoes not come on until after lunch.  Even I (speaking on the science of flu as I usually do) \ncome on before Julie.  There is already concern in Congress and in the Press as to “who is \nin charge”.  I feel that the CDC should be right up front on this.  HHS and MOL are is \ncharge, but the major health instrument for preparedness and response is the CDC.\nReleased by Chairman Rand Paul\n136Nov. 26-30, 2005 – Media continues for me with Lou Dobbs, CNN Wolf Blitzer (The \nSituation Room), WTOP radio, CBS News, etc. regarding bird flu.  \n     The preparation of DHHS for the States Flu Summit on Dec. 5 is a major mess.  Laura \nLawlor somehow has taken over the preparation and it seems that no one knows what we \nare supposed to do.  MOL has taken  a major interest in a 75 city tour of himself, Julie, \nme and perhaps others to tell the States of their “responsibility” to be prepared locally for \na pandemic flu.  Every time this subject comes up, the States push back by saying that \nthey have no money and the Federal Government is giving them an unfunded mandate.  \nWhat I see is a clear example of a Secretary who is a good person who has gotten too \npersonally involved in an issue and who is doing some of the planning off the top of his \nhead and as a result there really is no one truly in charge of making sure something is \ndone correctly.  Everyone on his staff (John Ogwanobi, Suzy DeFrancis, Kerry Weems, \netc.) is afraid to say that the 50 states tour is likely to be a disaster.  They are like a Greek \nChorus telling him in this case that it is a good idea.  They do not know what the goal is \nor even why they are doing it.  I strongly suspect that Suzy DeFrancis deep-down thinks \nthat this is a campaign swing and , frankly, MOL does also to some degree.  I have told \nStewart Simonson and Bruce Gellin that I feel it would be a disaster.  I do not want to be \na part of it and have asked Stewart to tell Rich McKeown this.  Rich is the most sensible \none there and so hopefully I can get out of most or all of the tour.  They want me for my \ncredibility, but this is local and state public health stuff, which is not my area.  Also, I am \nhearing that the White House knows how disorganized they are and are getting anxious\n   The attacks in the press on Stewart Simonson seem to be winding down, but Sarah \nLuecke of the WSJ will be coming out with a big article.  I have spoken to her and \nhopefully she will give a balanced story.\nDec. 1, 2005 – World AIDS day.  I was invited by the White House to be a Principal at \nthe POTUS Speech (EEOB 450).  As with last year, the POTUS specifically recognized \nme as being in the audience for all of the work that I have done in AIDS.  Peter \nMugyenyi from Uganda was there as was an AIDS mother from South Africa and her 2 \nchildren who had benefited from the PEPFAR program.. \n    Had coffee with Julie Gerberding after the ceremony at Starbuck’s on Pennsylvania \nAvenue and she feels exactly the way I do about the States Summit and the “tour” (see \nabove).\nDec. 2, 2005 – Had pre-Table Top preparation at HHS with MOL, Julie Gerberding, \nStewart Simonson, Bill Raub, Bruce Gellin, Jesse Goodman, Rich McKeon and the entire \nDHHS staff.  I  have concern over these exercise since they are unrealistic and always \nmake everyone look bad.  I tried to interject some common sense into the discussions, but \nthere were too many people who were acting like they knew what they were talking \nabout.  I generally do not like those “group” briefings of the Secretary since everyone \ntrials to look smart and few people have a clue of what is going on.\n    That evening, went to an incredible affair at the Kennedy Center with Christine. It was \nthe Grand Opening of the Family Theater sponsored by the Catherine B. Reynolds \nFoundation Series for Artistic Excellence.  After the show which included extraordinary \nsuperstars, we had dinner on the stage of the Eisenhower Theater!!.  It was incredibly \nelegant and all the Washington Glitterati were there.  At my table with Chris was David \nReleased by Chairman Rand Paul\n137Rubenstein of the Carlyle Group, Super-Attorney Bob Barnett, UNICEF President Ann \nVeneman, Former Sen. John Breaux (D-La), Rita Braver (producer for CBS).  At the \ndinner were every media and politico you could imagine.  The dinner was amazing and \nwe all had a great time.\nDec. 5, 2005 – Big meeting (“Summit”) at the Grand Hyatt in DC to roll out the plan to \nvisit all 50 states to talk up pandemic flu preparedness.  Present were health officers of \nthe big cities and all the states.  Presentations by MOL, Julie Gerberding, me and the \nusual cast of characters.  I am very anxious since MOL wants to take me with him on the \ntour to visit 75 locations in all 50 states to talk up preparedness.  I just do not have time \nfor this.  Stewart Simonson and even Rich McKeown are aware of this and are trying to \nget me out of it.  However, MOL is so enamored of me that he wants me with him.\nDec. 6, 2005 – Strange article (Profile of me) on the front page of the Wall Street Journal \nby Bernie Wysocki.  It made it look like I have 100s of millions of dollars of biodefense \nmoney that I dole out at my whim to contractors.  The article was very likely (almost \ncertainly) instigated by the lobbyists from BioPort (AVA anthrax vaccine) and from \nHollis Eden (countermeasures for rad/nuc) who want contract money and did not get it.  \nThe article was extremely confusing since it mixed up what we do (research) and what \nHHS does (procure via BioShield).  Also, it made it look like there was no peer review \nand that I just hand out money to the “Fauci Club”.\nDec. 16, 2005  Paradoxically, mostly favorable responses to the WSJ article.  Most \npeople interpreted it as indicating that I was a powerful player.  Publicity dying down \nabout bird flu around holidays.  MOL went on the first of the State trips to Minnesota.  \nWith the help of Rich McKeown, I got out of the trip.  Julie Gerberding went and feels as \nI do that these series of trips will be a waste of time for us.\nArticle came out in WSJ by Sarah Lueck on Stewart Simonson with major quote \nby me defending him.  It was a fair article and will likely reverse the trend of bad press \nthat he has been getting as being the “Michael Brown of Public Health preparedness”.  \nWent to the VP’s mansion for a Christmas Party on Dec. 15 and then went to \nLessons and Carols at the National Cathedral right afterwards.  Took Stewart Simonson \nand his parents (who are in town for the holidays).\nDec. 16-31, 2005 – Reasonably calm.  Still doing press regularly related to pandemic flu. \nOn Dec. 27, 28, 29 did Today Show, Good Morning America, and CNN “The Situation \nRoom”, respectively.  Bush popularity polls going up slightly after a terrible year related \nto Iraq, prison abuses, Valerie Plume leak (Scooter Libby, Karl Rove), Katrina, etc.  \nPOTUS speaking more to the press and admitting more that certain things have not gone \nwell.  Am still trying to be low profile in requirement to travel with MOL on his 50 State \ntour.\nDec. 27-28, 2005 – Drove up to NYC with Chris and the girls to do Christmas \nsightseeing and to visit my father who does not travel down to DC/VA for the holidays \nthe way he used to do years ago.  Had a great time.  Went to Bryant Park around 42nd \nStreet and 5 Avenue (near NY Public Library and saw the Kenneth Cole tented exhibit in \nReleased by Chairman Rand Paul\n138the Park.  It was a series of photos and plastic molds of foot imprints of people who had \ndevoted themselves to fighting the AIDS epidemic.  My footprint was up there along with \nAngelina Joli, Brad Pitt, Whoopie Goldberg, Larry Kramer, Bono and a large number of \nother notables.\nDec. 31, 2005 – Carol Kuntz took Chris, me and the girls on a private tour of the West \nWing.  It was terrific.  I got an interesting new perspective of the place since I have been \nthere so many times over the past several years that I take it for granted and never really \n“look around”.  It was great to have a personal tour and take my time looking at rooms \nand furniture, some of which I have sat in when briefing the POTUS and others.\nJan. 4, 2006 – Met with David Rubenstein, Founder and CEO of The Carlyle Group.  He \nmade me an amazing offer to join the firm as head of a Medical Venture Capital \ncomponent of the Group. Compensation projected to be in the millions per year with a \nbase salary of $1 million!  Obvious question is whether I want to get out of the classical \nscientific/public servant arena.\nJan. 26-29, 2006 – Attended the World Economic Forum in Davos, Switzerland to \nparticipate in 2 events: 1) a dinner panel discussion on Pandemic Influenza and 2) a \nplenary panel moderated by Ira Flatow (NPR – “Science Friday”) on Pandemic Influenza.  \nOther panel members included David Nabarro of WHO, David Stout of Glaxo-Smith \nKlein, the Minister of Health of Spain.  The meeting was unexpectedly enjoyable in that I \nwent to “close-up” panel discussions, breakfasts etc with people like President \nMuschaaraf of Pakistan, President Karzai of Afghanistan, Bill Gates, Bono, Queen Rana \nof Jordan, Bill Clinton, a number of journalists, etc.  I was particularly impressed by \nleaders such as Karzai and Muschaaraf.\nThe activity and press interest in Pandemic Flu has calmed down somewhat with \nother issues in the news (Supreme Court Justice Sam Alito confirmation, Iraq, the Hamas \nelection victory in Palestine, etc.)  Yet I still did a few CNN broadcasts from Davos.\nFeb 3, 2006 – Attended Distinguished Lecture Series at Hilton Hotel with Chris.  Lecture \nby Bono to a crowd of several thousand in the Hilton Ballroom.  Bono spoke about his \nvision, etc.  He stopped during the talk to recognize me in the audience as a “hero” of his \nwho has done an enormous amount for global HIV/AIDS, particularly in being the main \nplayer working with President Bush in developing PEPFAR.  Then several times \nthroughout the speech when he mentioned global health or AID he would look in my \ndirection and mention my name saying something like “I am sure that Tony would agree \nthat….”  Bono has been incredibly generous to me in his public recognition of me.  He \nalso mentioned that the USA and the world should support his “One Campaign”.  Of \nnote, Jenny (Fauci) is a leader among the Harvard students in the One Campaign efforts.\nFeb. 3 – March 6, 2006 – Continued intensive interest in the potential for an H5N1 \npandemic influenza with several media appearances. Also, I testified on March 2, 2006 \nbefore the House Appropriations Subcommittee for Foreign Operations together with \nJulie Gerberding, Kent Hill (USAID) and Ambassador Nancy Powell (DoS).  Did Diane \nRehm show in addition to other media.  Spent an 90 minute lunch briefing the \nReleased by Chairman Rand Paul\n139Washington, D.C. Bureau of ABC News (particularly George Stephanopoulos’s people) \non bird flu.\nMar. 7, 2006 – Gave laudatio remarks at a reception in the Dirksen (430) Building at \n6:00 PM (beautiful crisp Winter day) in honor of Peter Piot who was celebrating 12 years \nat UNAIDS.  I reflected about his early days at Projet SIDA in Kinshasa, Zaire with Tom \nQuinn and Jonathan Mann.  Also, honored at the reception was Michael Iskowitz, \nformerly Sen. Kennedy’s Staffer, former White House AIDS Deputy Coordinator and \nrecently at AIDS Action.  He is entering a private consulting arena.  Met and spoke with \nSen. Hillary Clinton who recognized me specifically in her remarks.\nMar. 8, 2006 – Took quick trip to NYC to brief the NY Bureau of ABC News with \nDavid Westin (President) hosting me.  Afterwards, rushed back to DC to do a \nteleconference with the officials from all of the DC area (MD and VA) school officials \nfrom private high schools.\nMar. 12, 2006 – Had tea at the Four Seasons with members of the Mothers to Mothers to \nbe (M2M2B) an African Program founded by Dr. Mitchell Besser (Rich Besser’s brother) \nand involving HIV-infected South African women who have delivered babies (some \ninfected, others not) and who now work with other mothers to be who are HIV-infected \nto educate them, empower them and help them live a positive life.  They are visiting the \nUSA at the request of First Lady Laura Bush stemming from her trip last year to Africa \nwhere she met these women.  The Mothers Program is partially funded by PEPFAR.  I \nwill Chair a panel discussion at Georgetown tomorrow where the women will discuss \ntheir work.\nMarch 13, 2006 – Presentations at the White House (East Room) with Laura Bush and \nRandy Tobias followed by brunch in the State Dining Room. Mrs. Bush thanked me for \nserving as the Panel Chair.  Had good conversations with Kristen Silverberg, Randy \nTobias, Michael Gerson, Carol Thompson and other White House folks.\n   After the presentations at the White House we went to Georgetown (Healy Building – \nGaston Hall) for the panel discussion.  It was a beautiful sunny an unseasonably hot (84F) \nday for March 13.  Other members of the Program were Gene Falk and Robin Smalley.\nMar. 21, 2006 – First day of Spring 2006.  Had phone conversation with Carol Kuntz \ntoday and she was concerned that there have been “policy time” briefings with the \nPOTUS regarding pandemic flu involving Sec. Leavitt where she thought that I should \ndefinitely have been included.  The POTUS asked some questions that Rajeev Vankaaya \nand Leavitt could not answer that Carol knew for sure that I would have been able to \nanswer.  Carol asked whether I was having a problem with HHS.  I told her not at all, but \nI did mention to her my suspicion that HHS is trying to shed all of the light on Leavitt \n(probably because of his political aspirations) and having him share the spotlight with me \nor Julie Gerberding is something that makes HHS nervous.  We continually see this when \npress ask for me and HHS diverts them to Leavitt when we ask them for clearance for \nme.  Welcome to Washington!!\nReleased by Chairman Rand Paul\n140April 3, 2006 – Over the past 2 weeks, there has been continued medium-high interest in \nthe ever expanding bird flu situation with a constant low-level stream of new human \ncases and more countries getting either migratory birds or chicken flocks infected.   \nCurrent number are 188 infected and 103 dead.  Recently, there has been migratory birds \n(mostly swans) infected with H5N1 detected in Western Europe.  France as only country \nwith some domesticated chickens and turkeys infected.  They quickly handled it by \nculling.  Other countries such as Italy had migratory bird(s) infected, but no chickens and \nstill chicken sales in supermarkets and restaurants has plummeted by as much as 50 to \n60%.  My prediction is that infected migratory birds may (not definitely) make it to USA \nand that there will be very little contamination of chickens because of the agriculture \ncontrols.  Yet, it will affect (by misperception) the chicken industry.  \n    There has been some backlash among people in press about the over-hyping of the \nthreat.  I am in good shape here since I have always maintained that the threat, although \nnon-quantifiable, is likely low.  This is in contrast to others such as Rob Webster, who \nsays that there is a 50% chance that we will have a bird flu pandemic among humans with \nH5N1!!!   I have no idea how he came up with that number.  Also, my friend Michael \nOsterholm is also singing doom and gloom.\nApril 6, 2006 – Had dinner with Tara O’Toole of the Univ of Pittsburg Biodefense \nProgram.  She had just testified at the BioShield Hearing on the Hill and wanted to get \nmy perspective on how things were going with the Biodefense effort and if there was \nanything that she could do for me.  I explained to her that the reason the  current \nBioShield effort was not successful was that the Congress did not approve the Bill that I \nand VP Cheney and Scooter Libby had originally proposed.  The Congress limited the \nmoney to $5.6 Billion instead of an unlimited authorization to draw from the Treasury \nand the Appropriations Committees still controlled how much could be spent each year.  \nAlso, we could not do advanced development for products.  This put off the big \ncompanies (not enough money) and the little companies (advanced development) and so \nthe process has not been entirely successful.  We are attracting marginal companies like \nVaxGen that cannot get to the goal post. \nApril 8, 2006 – Attended the Annual Gala of the National Hospice Foundation at the \nHilton Hotel on Connecticut Avenue, N.W. where I presented the Global Vision Award \nto Ambassador Richard Holbrooke. At my table were Holbrooke, Margaret Warner from \nthe NewsHour, her husband John Reilly, Ann Morgan Vickery  and Bob Kyle of Hogan \nand Harston.  Usual gala-like atmosphere.  Has a chance to catch up with Richard \nHolbrooke, who is currently the President and CEO of the Global Business Coalition on \nHIV/AIDS.  We reminisced about our trip to Africa with Tommy Thompson in 2003.\nMay 2, 2006 – Dedicated Building 33 as the C.W. Bill Young Center for Biodefense and \nEmerging Infectious Diseases.  Terrific ceremonies with speakers being: me, EZ, \nSecretary Leavitt, Ralph Regula, Bill Young.  Tour of building, many festivities, \nbeautiful sunny day.  \nMay 24, 2005 – Have had continual trickling in of cases of human infections with H5N1 \nwith most recent count of 218 cases and 124 deaths.  Fifty countries now have birds \nReleased by Chairman Rand Paul\n141infected and 10 have birds and humans infected.  Of note that about 1-2 weeks ago it \nbecame apparent that there was a family cluster of 7 cases in Sumatra, Indonesia.  Recent \nevidence strongly indicates that this was human-to-human spread similar to the small \ncluster in Thailand in 2004 where 11 year old girl infected her mother and aunt who \nnursed her in the hospital before she died.  Similar situation in Sumatra where father \nnursed 10 year son and others in family slept in small room while one or 2 people were \ncoughing all night.  Bottom line was a media blitz.  I was asked by HHS and White \nHouse to go to “Pebble Beach” on the  White House grounds and do wall-to-wall \ninterviews to allay fears.  Fact is that the cluster looks like it is dead-ending.  I did \ninterviews with NBC Evening News, CBS Evening News ABC World News tonight, \nNightline, CNN Wolf Blitzer Situation Room, WTOP radio, MSNBC TV, etc.  Big time \nexposure.  HHS was very pleased with how I handled this volatile situation.\nMay 25, 2006 – I have not been recording this type of thing of late even though I have \ngone to several of these, but I went tonight to the 18th Annual National Education & \nLeadership (NELA) Awards Gala at the Omni-Shoreham given by the Sons of Italy.  I \nwas the guest of Chuck Conconi (Washingtonian Magazine, formerly columnist for \nWashington Post) and his wife Janelle.  At the Table were Ed Henry (CNN White House \nCorrespondent), Lloyd Hand, Mike Petruzzelo (Managing Director of Qorvis \nCommunications) and Mr. Thompson (?first name) African American billionare and his \ndate Cheryl Lee (CEO of BET).  Pres. Clinton and Hillery Clinton were guest speakers.  \nRan into the usual DC crowd – Sen Chris Dodd, Congresswoman Rosa DeLauro, Franco \nNuschese (Owner of Café Milano – who was also an awardee), etc.\nJune 11 – 17, 2006 –  Went to Tuscana with Chris and the girls for a few days and then \nwent on to Genoa for the annual review of the Gaslini Institute.  Wonderful time had by \nall.  Stayed in an amazing converted farm house (to a villa) owned by a friend of Jim \nHuskey’s from the Embassy in Florence.  The weather was amazing – warm and totally \nsunny during the day and cold at night requiring a fire in the fire-place and blankets in \nbed. Sunsets over the Tuscan hills with a glass of chianti was incredible.\nJune 20, 2006 -  Did a one hour face to face briefing of VP Cheny in his West Wing \noffice on pandemic flu.  Also present was Carl Kuntz, David Addington (new chief of \nstaff replacing Scooter Libby and Scott Diechman (new health person for the VP).  As \nusual, it was a lively briefing.  It is clear and Carol told me that the VP has said this that \nthe VP very much looks forward to being briefed by me.  The day was a typical hot \nsunny 90 degree day in DC.\nJuly 26, 2006 – Has been a busy few weeks with relatively mundane institute issues. \nWeather has been very hot - ~95+ degrees. Two days ago David Stout and Jean-Paul \nGarnier from Glaxo-Smith Kline called and briefed me on the great success of their \nH5N1 clinical trial using their proprietory adjuvant ASO3.  They got terrific results with \n3.8 micrograms X2 with adjuvant giving predictably protective responses in >80% of \npeople compared to the Sanofi study (see above) that gave predictably protective \nresponses at 90 micrograms X2 without adjuvant in only about 50% of people.\nReleased by Chairman Rand Paul\n142    I spent the greater part of July 26 with the press (mostly print – NY Times, \nWashington Post, USA Today, AP, Phil Inquirer, Bloomberg, Baltimore Sun, etc) as well \nas CNN (Christy Feig).  This is an important advance in trying to prepare for a pandemic \nflu since it seemingly overcomes the obstacle of a prohibitive requirement of high dose.\nJuly 27, 2006 – Went to NYC to participate in the Pandemic Flu Summit at City Hall.  \nPart of Secretary Leavitt’s program of visiting every state and some additional cities \nwithin states to talk about pandemic influenza preparedness.  Mayor Michael Bloomberg \nhosted us.  Secretary Leavitt spoke about the history of the 1918 pandemic in Utah and \nsaid that he came from a small town.  When it came to my turn to talk about the science \nof pandemic flu, I told the Mayor and the audience that I came from a small town called \n“Bensonhurst” and I brought the house down.  I mentioned that my father was born a few \nblocks away on Elizabeth Street and Grand Street in Little Italy.\nThe day was sweltering hot and sunny.  I got an exciting ride back to LaGuardia by an \nattractive young security woman named April who works in the regional office of the \nInspector General of HHS.  She got me through traffic with sirens and blinking lights to \ncatch my 3:30 PM Delta Shuttle in order to get to DC in time to pay respects at the \nretirement party of Carol Kuntz at the White House.  In her office in private, I gave her a \ngift of a statuette of Dr. Joseph Kinyoun with the inscription: “To Carol R. Kuntz With \nappreciation from your friends at NIAID”  She burst into tears.\nAugust 15-16, 2006 – Things have been fairly uneventful since last entry (July 27).  I \nwas one of the featured panelists at the 16th International AIDS Conference in Toronto on \nAugust 16.  The session was “25 Years of AIDS – Reflecting Back and Looking \nForward”.  Each of us gave a 7 minute presentation followed by a panel discussion.  I \nspoke on the “Scientific Response”.  Also presenting was Peter Piot of UNAIDS, H. \nBroadbent (AIDS patient), Gregg Gonsalves, and E. Madraa (African Community \nperson).  Session Moderated by Richard Horton, Editor of Lancet, and chaired by Mark \nWainberg and Helene Gayle (organizers of the conference).\n      There were 30,000 people at the conference and about 6000-7000 people in the \naudience for our session.  Of note, a group of USA activist wanted to protest the fact that \nthe USG was spending $90 million dollars on prevention this year and they thought that \nall that the USG was doing was purchasing the Orasure quicktest for HIV.  In fact, they \nwere incorrect and a good part of the $ was going for actual prevention education.  The \ngroup was very nice and almost apologized for disrupting my session.  They stormed on \nstage with the usual chanting and signs that said “George, listen to Tony” and “This is \nonly a test!” (referring to the Orasure test).  They disrupted me for the agreed-upon 2 \nminutes and then let me give my talk.  I started the talk by saying “Thank you for the \nkind introduction” and the audience laughed.  The talk was very well received.  The \nmajor theme of the meeting was “Time to Deliver”, but the real theme was prevention.  \nThe meeting was opened by Bill Clinton and Bill and Melinda Gates.  I did a lot of press \nduring the meeting and after I returned (Diane Rehm Show).\nAugust 28-29, 2006 – Went to Amsterdam for the AIDS Vaccine 2006 Annual Meeting.  \nInvited by Joep Lange.  On the evening of Aug. 28 I was part of a “Town Hall” – type \nmeeting in Amsterdam where we discussed “Viral Threats”  The panel consisted of Ab \nReleased by Chairman Rand Paul\n143Osterhaus of the University of Rotterdam, Marie-Paul Kieny from WHO, Jaap Goudsmit \nfrom Crucell.  It was moderated by a Dutch TV anchor.\n   I gave the Opening Ceremony Keynote lecture on the evening of Aug. 28 and provided \na “provocative” talk on “An AIDS Vaccine:  Will It Ever Fit the Classical Paradigm?”  It \nwas extremely well-received by an audience of about 1000.  Others that took part in the \nOpening Ceremony were Job Cohen (Mayor of Amsterdam), Hans Hoogervorst (Dutch \nMinister of Health), Princess Mabel van Oranje-Nassau (Director, EU Affairs, Open \nSociety Institute), Jean-Francois Rischard, Former VP of the World Bank, and David \nSalisbury (Director of Immunization, UK Department of Health).  We had a beautiful \nboat ride down the Amstel River to the Maritime Museum followed by dinner with all of \nthe speakers and Joep Lange at the Amstel Hotel.  Charming evening, but the weather \nwas raining and cool.\nSept. 3, 2006 – Had a most interesting dinner over Ellen and Gerry Sigal’s house in DC. \nGuest were Sherry Lansing (Hollywood producer – “Fatal Attraction”, Black Rain” and \nformer actress) and her husband, Billy Friedken (Multiple Academy Award winning \nProducer, Director and Writer – “Exorcist”, “The French Connection”, etc. )  He is now \nproducing (successfully) operas all over the world.  Also there were Joe Wilson, the \nambassador involved in the big Washington issue of the Administration “misleading” the \nAmerican public about WMDs in Iraq and his wife Valerie Plame , the CIA secret agent \nthat was “outted” by Robert Novack’s column and for which Scooter Libby has been \nindicted for perjury.  It was a most interesting discussion.  Valerie and Joe seemed like \nvery nice people despite being trashed by the Administration.  Valerie insisted that she \nwas still under cover despite the fact that it is reported that she had a desk job when she \nwas outted.  Joe, as he has said on TV multiple times, feels that the WH officials are all a \n“bunch of liars”.  Also present were Washington power-lawyer (Watergate, Whitewater, \n9/11 Commission) Richard Ben-Veniste and his wife Donna.\nSept. 12, 2006 – Went to farewell reception at the Atrium of the Equinox Restaurant in \nDC for Michael Gerson (former speechwriter and current Assistant to the President).  \nReception given by DATA (Bono’s group)  Saw old friends their such as Erin Chapman \nThornton and Jamie Drummond from DATA.  Mike is going to do a regular column for \nthe Washington Post and Newsweek.\n     Later in the evening went to an “Alliance for Aging Research” dinner and awards \nnight at the Four Seasons Hotel in Georgetown at the invitation of Allan Fox of FoxKiser \nLaw Firm (old friend – formerly of Jacob Javits and Ted Kennedy staff).  Dinner honored \nSens. Orin Hatch and Evan Bayh.  During Hatch’s remarks, he specifically mentioned \nthat he and I were dear friends and that I am one of the great heroes in medicine and \npublic health.\nSept. 13, 2006 – I played a major role in the 90th Birthday Party for Dr. C. Everett \n(Chick) Koop at the Cosmos Club.  I delivered remarks.  The 2 MCs were Hilary Clinton \nand Orin Hatch.  My friendship with Sen. Clinton grows as she continues to be very kind \nand warm towards me.  I roasted Chick a bit, and the audience loved it (see my written \nremarks).\nReleased by Chairman Rand Paul\n144Sept 25-27, 2006 – Trip to San Francisco for International Assoc. of Physicians for AIDS \nCare  (IAPAC) and ICAAC meetings and to speak at The Commonwealth Club.  I gave \ntalks on HIV/AIDS – the next 10 years (ICAAC); the decade of HAART (IAPAC) and \nemerging diseases (Commonwealth Club).  The talks and the trip was a roaring success.  \nGreat weather, spent Sunday with Bob and Colleen Grady and Matthew and my family \n(minus Jenny in Brazil).  Great hotel in SF – the “W” across the corner from the Mosconi \nCenter\nOct. 10, 2006 -  Attended the swearing in ceremony for Mark Dybul as the U.S. AIDS \nCoordinator with the Rank of Ambassador at the State Department (Benjamin Franklin \nRoom).  Presiding was Secretary Condi Rice with Laura Bush present.  I was given a \n“seat of honor” in the first row – sat next to Michael Gerson (former speech-writer for \nPres. Bush).  During her remarks, Condi specifically mentioned me – telling the story of \nhow this all started (PEPFAR) years ago when the POTUS had his staff including Condi \nin the Oval Office and the POTUS was told by Tony Fauci, who is here with us today, \nthat a lot of progress has been made in the treatment of HIV disease so that we could \nhave a global impact.\n    The day was a beautiful Fall day – bright sun and 75 F.\nOct. 19, 2006 – A lot of political maneuvering regarding the election of the next \nDirector-General of WHO  \n Kristen Silverberg (now at State as Assistant Secretary) asked me \nabout it at a dinner at Mark Dybul’s house the day before his swearing in (see above).  \nThe 2 candidates that I prefer are either Margaret Chan (Hong Kong) or Julio  Frenk \n(Minister of Health of Mexico).  Shigeru Omi from Japan, Bernard Kouchner from \nFrance (MSF), and Pascoal Mocumbi (Mozambique) are also among the contenders.  \nChristopher Murray from Harvard called me today to push for Julio Frenk since he feels \nthat he is the one who understands best the connection between science and public health.  \nHe knows that the White House has been and will contact me for my opinion and so that \nis why he called.\nOct. 20, 2006 – Served on a Panel at the Annual meeting of the White House Fellows \nFoundation and Association held at the Chamber of Commerce.  Subject was \n“Community Engagement and Preparedness” relating to terrorist and natural disaster \nthreats.  On panel with me was Lee Hamliton, former co-chair of the 9/11 Commission \nand Patricia McGinnis, President and CEO of the Council  for Excellence in Government.  \nHad nice conversation with Lee Hamilton who is the Director of the Woodrow Wilson \nCenter in DC (he has been a friend for a few years).  Lee has been asked by President \nBush to join with James Baker to come up with some alternative approaches to settling \nthe quagmire in Iraq, i.e. a mid-course correction.\nOct. 21, 2006 – Went to NIAF annual dinner at the Hilton Hotel with Chris.  Usual \ncelebrity show. Many friendly interactions with media (David Gregory of NBC; Sam \nDonaldson of ABC;  etc).  Hilarious impersonation of George W. Bush by comedian.  I \nreceived this award in 1994.  Major awardee tonight was Supreme Court Justice Samuel \nAlito.\nReleased by Chairman Rand Paul\n\n145Oct. 22, 2006 – Went to the Grand Opening of the House of Sweden (Swedish Embassy \nplus offices and art shows) on Georgetown Waterfront (right next to Sequoia restaurant).  \nKing Carl Gustav and Queen Sofia were greeting everyone.  Amazingly beautiful \nstructure with views of the canal and the Potomac. Crisp Fall night with bright stars.  Of \nnote, Queen Sofia asked specifically to speak with me after the greeting line finished \nsince she had been told of my work with HIV/AIDS.  She is committed to helping Russia \nwith its problem of HIV since she feels that the Russians would be more amenable to \ngetting help from the Swedes than from the USA.  She wanted to talk about how we (she \nand I ) could work together on this.  Had good discussion with Kristen Silverberg about \nthe problems the Administration is having.\nNov. 28, 2006 – Attended and spoke at the Aspen Symposium in DuPont Circle (DC).  It \nwas an unusual gathering of Iranian scientists meeting with various US officials, \nparticularly in the Dept. of State and HHS.  I was a main speaker and exchanged \ninformation with Iranians on HIV/AIDS, TB, and other diseases in Iran.  It was \nsurprisingly frank and open given the tense relations between USA and Iran surrounding \nthe Iranian nuclear program.  If fact, the Iranians who came to the USA were a bit \nnervous about the political fall-out for them.  I dealt with Kamiar Alaei and his brother \nArash Alaei on ID issues in Iran. Also present was Dr. Abolhassan Nadim, the Chair of \nthe Iranian Epidemiological Association.\nDec. 2, 2006 – Annual Christmas Party at Sam and Jan-Smith Donaldson’s House in \nMcLean.  Have been going to these parties for at least the past 10 – 15 years.  The usual \ninteresting and warm crowd was there.  This party is probably the most friendly of all of \nthe D.C. “glitterati” parties, mostly because of the warmth and friendliness of Sam and \nJan as well as the fact that the same people come every year +/- whoever is hot at that \ntime in the news. Over the years, we have run into virtually everyone who is “known” in \nDC.  Some highlights from this year.  Nice conversation with Colin Powell about AIDS \nin African-Americans.  The recent UNAIDS numbers are out showing that of the new \ninfections in the USA, among men, 50% are in Blacks and among women 65% are in \nBlacks.  On Nov. 30, I was supposed to be on the CNN Paula Zahn Show speaking about \nthis, but at the last minute, their producer (Marie….) cancelled because she said that they \nhave a guest who is really the “face of AIDS, since she got infected from her boyfriend \nby heterosexual sex”.  Turns out the guest is Regan Hoffman, the editor of POZ \nMagazine.  Regan is a beautiful, blond, blue-eyed WASP from Connecticut who clearly \naccidentally got infected from her white boyfriend who was almost certainly bisexual. \nFor every one of these, there are 10,000 poor black girls in an inner city area who got \ninfected from their drug-user boyfriends.  So there they were: beautiful, blond, blue-eyed \nand wealthy Paula Zahn speaking on TV with beautiful, blond, blue-eyed (likely also \nwealthy) Regan Hoffman smiling and saying how grateful she is that she has all the \nopportunities for treatment.  Her only “concern” is that the mother of her new boyfriend \nwas concerned that she was infected; but now all is well because the boy’s mother is an \n“educated person”.  I had watched this on TV and almost vomited.  This was as far from \nthe reality of what the “face of AIDS” is than I could ever imagine.  On Nov. 29 at a big \nHIV Prevention Meeting at the Mandarin Hotel in DC chaired by John Bartlett of \nReleased by Chairman Rand Paul\n146Hopkins and Ken Mayer of brown, one of the themes and the points that I made in the \npress conference is that AIDS in the USA was assuming the face of a young black \nwoman.  My good friend Phill Wilson (CEO of the Black AIDS Institute in LA) gave an \neloquent talk on this subject and he should have been with me on CNN instead of my \ngetting bumped by Regan.  I was pissed because that one 5-10 minute segment on Paula \nZahn likely undid by 100-fold the points that I and Phill were trying to make at the \nconference.  I had mentioned this to my CNN Producer friend Christy Feig and she was \nalso appalled and has since brought it up to the CNN Board.  In any event, at Sam’s \nParty, I was still pissed and discussed this with Powell who has been spending time on \nthe lecture circuit talking about prostate cancer, particularly in black men.  His comment \nwas “What do you expect?…. It is CNN.”   He promised that he would bring  up the issue \nof AIDS in Black America in his lectures.  I have known Colin for years from the time \nthat he was Secretary of State and I had briefed him on AIDS and went to the UN with \nhim during an UNGASS years ago.  Also, had discussions with my old friend Lee \nHamilton who is co-chairing the Iraq Study Group that will be giving their report to the \nCongress and the President in a few days.  It will be extremely critical of the execution of \nthe Iraq War and rebuilding. Also discussions with – Antonin Scalia, George Will (ABC), \nNina Tottenberg (NPR), Bob Shieffer (CBS), Bill Plante (White House correspondent) \nand many others.\nDec. 4, 2006 – Things mostly quiet on the NIH front.  Big problems in Iraq that are \ndominating the news with insurgency and civil war.  Bush is having a very hard time.  \nDemocrats have taken control of House and Senate, mostly by voter protest of the war in \nIraq.  Had World AIDS Day with usual press interest.  Secretary Leavitt wanted me to go \nto China with him from Dec. 6 to 13; I first said yes, but then backed out since I really do \nnot want to travel during this busy period and the purpose of the trip was secondary to my \ninterest and involvement, i.e. economic and trade considerations with only a side order of \nhealth. Jenny Fauci doing great in Brazil. She loves it and will return on Dec. 23.  I am \ngetting more and more involved in Global Health issues such as malaria, health care work \nforce support in developing nations through the DDCF, XDR tuberculosis, etc.  Have \ngiven many talks over the past few weeks on these issues.\nDec. 13, 2006 -  I hosted a press conference to announce the breakthrough study that was \nprematurely stopped by the DSMB.  Study was the use of medically supervised adult \nmale circumcision in Kenya (Kisumu) and Uganda (Rekai) to determine effect on HIV \ntransmission.  Results were striking.  Study was safe and led to a 48% (Uganda) to 53% \n(Kenya) decrease in transmission.  Big printed press coverage including front page of NY \nTimes.\nDec. 14, 2006 – Big White House Malaria Summit sponsored by Malaria No More and \nIntroduced by Laura Bush with the POTUS giving Keynote Lecture.  Held as ½ day \nmeeting at the National Geographic Society Headquarters on 17th Street in DC.  I had \nhelped Gary Edson who was consulting for Malaria No More in the scientific background \nfor the meeting which was mostly  talks by African Health Ministers, Melinda Gates, \nFaith-Based people (Rick Warren, etc.), Paul Wolfowitz, Margaret Chan (WHO DG).  I \nhad nice chats with each of these.   Purpose was to increase awareness of malaria and \nReleased by Chairman Rand Paul\n147how with little money we can dramatically reduce malaria, particularly in Africa.  Spoke \nof results in Africa of the President’s Malaria Initiative (PMI) that over the past 2 years \nwith $1.2 Billion for bed nets, indoor spraying with insecticides, and ACT (Artemisinin-\ncombination therapy)  malaria has been markedly decreased in certain countries.  MC \nwas Isaiah Washington of “Grey’s Anatomy” TV show.  I met and interacted with the \nusual cast.  Also included Sens. Pat Leahy, Bill Frist, etc.\n      VP Cheney’s Annual Christmas Party.  Chris did not come since she was setting up \nfor the reception following the Annual Lessons and Carols at the Cathedral (I went later).  \nUsual festivities with many people there.  Spent much time talking to Carol Kuntz.  Also, \nScooter Libby was there awaiting start of his trial for providing false information to the \nSpecial Investigator (Fitzgerald) about the Joe Wilson/Valerie Plame issue.  Spoke more \nwith Isaiah Washington.\nJan. 29, 2007 – Iraq war going very badly with civil war among Shia and Sunnis and \ninsurgency running wild.  Bush popularity in USA way down.  The war is dominating the \npolitical scene in USA and particularly DC including discussions by Presidential \ncandidates.  \nWent to an interesting dinner tonight at the Metropolitan Club hosted by Dr. Ward (Trip) \nCasscells in honor of the Surgeon General of the Armed Forces of Iraq  - Samir Abdullah \nHassan, M.D.  I sat next to him at dinner.  Good guy and smart and tough.  He explained \nthe disaster that USA inadvertently promulgated by dissolving the Iraqi military.  The \nProvisional government (Paul Bremer) dissolved the Iraqi medical corps and so now they \ndo not have any army hospitals or army doctors to take care of the wounded and sick \nIraqi soldiers.  Also told me that the entire bureaucracy in Iraq (sewer, transportation, \nutilities) was run by the military and so when Bremer dissolved the military he \ncompletely destroyed the infrastructure of the country.  Samir feels that this was an \namazing blunder.  Also, by dissolving the police, we now have anarchy in Iraq with \ncriminal elements running wild.\nFeb. 13, 2006 – Had dinner with Rahm Emanuel (Democratic Caucus Head and brother \nof Zeke Emanuel), Christine Grady, Zeke Emmanuel, Mary Richardson and a \nWashington Post reporter (?name) at Central Restaurant at 1001 Pennsylvania Ave, NW.  \nWe were in the middle of an ice storm that did not deter us.  Had very interesting and \nenjoyable conversations with Rahm about the Democratic Congress and the potential \nDemocratic candidates for President in 2008.  Rahm used to work for Bill Clinton when \nhe was POTUS and was part of Clinton’s original campaign team.  Rahm feels that \nHillary has the inside track because of the Clinton machine, her experience, and lots of \nmoney.  However, he feels that Barack Obama will give her a tough race.\nFeb. 14, 2007 – Briefed Bruce Miller (VP Cheney’s Chief of staff for biodefense) at the \nWhite House on AIDS, Pandemic Flu, Malaria, and biodefense in preparation for my \nfuture briefing of the VP that Bruce will set up.\nMarch 5, 2007 – Went to great memorial for Art Buchwald at the Eisenhower Theater of \nthe Kennedy Center at the invitation of Art’s son Joel and his wife Tamara.  Many VIPs \nReleased by Chairman Rand Paul\n148there including Ethel Kennedy, Ben Bradlee, Tom Brokow, Dave Barry, and most \nimportant people in the media in DC and nationally.  It was a warm and hilarious event \nfilled with stories about Art and film clips of him\nMarch 6, 2007 – Busy day.  Unfortunately, Scooter Libby was convicted today on 4 of 5 \ncounts of lying to FBI and grand jury in association with the Joe Wilson/Valerie Plame \nCIA leak.  Had House Appropriations Subcommittee Hearing today and it went well.  \nAlso, had a farewell dinner at Oceanaire in honor of Alex Azar who is stepping down as \ndeputy Secretary at HHS.  The old HHS crowd was there including former Secretary \nTommy Thompson.  Had a great conversation with him.  He has put his name in as a \ncandidate for Republican nominee for President.  He is optimistic about winning the Iowa \nCaucus.  He discussed with me the best plan that I have heard yet about how to handle \nthe dreadful Iraq situation.  Also, at the dinner were Janet Rehnquist, Stew Simonson, \nScott Whitaker, Bruce Gellin, Lester Crawford (recently convicted for lying on his \nfinancial disclosure when he was FDA Acting Commissioner), Paula Staudard, and \nothers.  Very cold day in DC with temps in the teens.\nMarch 13, 2007 – Briefed Vice President Cheney today in his WH office on second \nfloor.  Beautiful “pre-Spring” day with temps around 50 and sunny skies.  He wanted \nbriefing on Pandemic flu and biodefense.  I included a discussion about HIV/AIDS \nparticularly the great success of PEPFAR since I wanted him to know that this \nAdministration has done more than anyone in the world for Global AIDS.  The briefing \nwas as usual for the VP and me, i.e. very friendly and expressing multiple times how \npleased he was to get briefed by me since he enjoys it so much.  Also in the room were \nDavid Addington (Chief-of-Staff), Bruce Miller (Chief for Biodefense), Steve…? And \nScott Deitchman.\nMarch 16, 2007 – Have been preparing for a briefing of the POTUS on pandemic flu \npreparedness.  Interesting evolution of process.  The HSC staff (Joel Bagnell and Rajeev \nVenkaaya) want us (HHS) to present a major discussion of “gaps” in stockpiling and \nothers want us to just update the POTUS.  Friendly tension going on.  Today, we (me, \nBill Raub, Bruce Gellin and Eric Hargan – Deputy Secretary) briefed the Deputies in \nEEOB 208 in preparation to brief the Principals and then the POTUS.  Among them were \njunior staffers from WH as well as Rajeev, Joel Bagnell, Bruce Miller, Scott Deitchman, \nJeff  Runge.  Continued disagreement about what the Secretary (MOL) will ultimately \npresent to the POTUS.\nMarch 19, 2007 – MOL, Bill Raub and I briefed the principals today in final preparation \nfor the POTUS briefing.  Present were Fran Townsend, Michael Chertoff, Joel Kaplan \n(now Deputy Chief-of-Staff to Josh Bolten), Joel Bagnell, Bruce Miller, other cabinet \npeople.  Briefing went better than on March 16.  We are about ready to brief the POTUS.\nMarch 20, 2007 – Dinner at the Mellon Auditorium on Constitution Avenue, N.W. (13th \nStreet) for Research! America.  Usual DC Glitterati.  At my table was Susan Dentzer \n(Newshour), Sam and Jan Donaldson, Tenley Albright, Paul Rogers.  Awardees were \nDon Seldin, Joe Goldstein, Mike Brown, Mike Wallace, Sen. Orin Hatch among others.  \nReleased by Chairman Rand Paul\n149George Stephanopoulos was MC and I spent time catching up with him (knew him from \nClinton White House days).  Was a coldish night outside.  Chris and Meg and Ali went \noff to California (Big Sur/Monterey) for Spring break.  Wish I could have gone, but \nPOTUS briefing tomorrow.\nMarch 21, 2007 – Briefing of POTUS today at 2:30 – 3:30 PM in Roosevelt Room on \nPandemic Flu preparedness.  Secretary Leavitt, Bill Raub and I briefed him.  I did most \nof the formal briefing on state of the threat, vaccines, antivirals and diagnostics. Bill \nspoke on community mitigation strategy and the stockpile.  MOL spoke on overall \nresponsibility of the USG versus states.  Present were the POTUS, VP, Karl Rove, Josh \nBolten, Joel Kaplan, Dan Bartlett, Fran Townsend, Candi Wolff, Mike Chertoff, Paula \nDobriansky (Undersecretary of State), several people from Joint Chiefs of Staff, Rajeev \nVenkayya, Joel Bagnell.  \n    Briefing went very well.  POTUS was as usual very friendly and deferential to me.  \nWas at times serious and at times jocular with his characteristic joking around.  When he \ncame into the room, he looked at me and said “Fauci, glad to see you Tony.  I see we \nhave the first team here today”.  It was the first day of Spring and it was unseasonably \ncold out and cloudy.\nMarch 29, 2007 – Very interesting day. First, Megan received notification that she is \naccepted at Columbia, Barnard, and Yale with waiting list at Harvard and Dartmouth.  \nHer top choices are Columbia and Dartmouth and so she will wait to hear more from \nDartmouth before making choice.\nWent to a reception given by National Italian American Foundation (NIAF) given \nat a private home in Georgetown (3032 – N Street, N.W.) in honor of Mayor Adrian \nFenty.  Got to meet him again and chat.  Did not previously know this, but his mother is \nan Italian American.  Ran into my old idol from Brooklyn – Ken Aspromonte (brother of \nBobby Aspromonte also my idol from the old days), baseball great from Lafayette High \nSchool and Brooklyn sandlot baseball who then played in Major Leagues.  He was born \nand raised in Bensonhurst like me and we shared some warm discussions.  Beautiful \nSpring evening.\n          After the reception went to Café Milano and had dinner with the NIAF Board of \nTrustees.  Towards the end of the dinner, got up to go to men’s room and ran into Franco \nNuschese, owner of Café Milano (who has always been very warm towards me).  He \ninsisted on taking me into a private party in the restaurant that he was throwing for \nprominent blacks in DC and the nation.  I immediately ran into Secretary of State Condi \nRice and Colin Powell who were very warm and engaging with me.  This was \nparticularly true of Colin Powell who threw his arms around me and gave me a bear hug \nwith a kiss on the cheek.  Over the past couple of years, I have gotten to be friendlier and \nfriendlier with Colin, having seen him at various functions such as Sam Donaldson’s \nChristmas Party, etc.  All in all, a good evening.\nApril 17, 2007 – Scooter Libby contacted me and asked that I write a letter to Judge \nReggie Walton via Scooter’s lawyer William Jeffress to serve as a character reference for \nScooter.  Scooter has been found guilty of perjury and obstruction of justice in \nconnection with the Valerie Plame/Joe Wilson CIA leak (see above).  He is appealing the \nReleased by Chairman Rand Paul\n150case but may be sentenced to jail before his appeal is heard.  The purpose of the letter is \nto try and keep Scooter out of jail during the appeal.  I wrote him a very supportive letter.\nApril 18, 2007 – Testified before the House Committee on Homeland Security together \nwith Gerry Parker, Jesse Goodman (FDA) and Jeff Runge (DHS) on the successes and \nfailures of Bioshield.  Committee chaired by Jim Langevin.  Hearing called because \nseveral of the companies that were trying for Bioshield procurement contracts had failed, \ni.e. Vaxgen for rPA and Hollois Eden for Neumune (to protect and regenerate BM after \nradiation).  Richard Hollis testified against the USG and Dr. Davis from HGS (that makes \nAbThrax – monoclonal antibody against anthrax toxin) testified favorably towards the \nUSG.  Hollis looked like a whiner and the Hearing went fine.  It is clear that Bennie \nThompson, the overall Chair is in the pocket of the lobbyists as his questions reflected a \n“presumption” of failure on the part of DHHS and BioShield.\nApril 20, 2007 – Briefed Joel Bagnell and Rajeev Venkayya at the WH on the rolling out \nof justification for classified research.  Some friendly tension between Joel and me in that \nthey wanted us (CDC, FDA, HHS, NIH to sign off on the roll-out document and there \nwas a phrase in there that did not clarify that we do not do classified research.  It asked us \nto justify with all of our research why it should be unclassified making the default \nposition that everything should be classified.  I had them change it to read that we should \nexplain why it is not classified as opposed to justifying it as being unclassified.  We came \nto an agreement.\nApril 24, 2007 – Had lunch with Scooter Libby today at the Daily Grill in the Bethesda \nHyatt.  Hot muggy and sunny day.  Has been cold up until now.  Scooter looked very \nworn and down.  I gave him a big hug and he looked like he was going to have tears. I \nasked about the trial and he said that they really expected a not guilty verdict and that is \nwhy they did not pull out all of the stops and ask the VP to testify.  Also, it was clear that \nReggie Walton was “preening” for this since he had the courtroom wired for the press \nand bloggers which they never do.  He proclaimed complete innocence and is hoping that \nBush will pardon him.  He is sad that he has not been pardoned already and feels that \nperhaps if it looks like he will go to jail the POTUS will then pardon him.  He feels that \nthere are politicos in the WH who do not want the POTUS to pardon him since it will \nmake the Administration look even worse that the 30% approval ratings.  I told Scooter \nthat I could not imagine that the POTUS will allow him to go to jail, particularly with the \nVP pulling so hard for Scooter.  I spent the rest of the time briefing Scooter about \nbiodefense updates.\n   Also, had meeting at the White House called by Rajeev Venkayya and Mike Magan on \nXDR-TB including reps from CDC (Julie G. and Ken Castro), HHS (Craig \nVanderwagen, Gerry Parker) DoD, DHS, State, USAID, Mark Dybul.  Bottom line was \nto coordinate the multi-Agency efforts.  Good meeting. We (NIAID) has already put \ntogether a strategic plan as has CDC and so HHS looked good.  Mark Dybul mentioned \nthat the Policy Time with the POTUS on PEPFAR funding did not go well today.\nApril 25, 2007 – Had a lunch/reception at the White House followed by a presentation by \nLaura Bush and President Bush in the Rose Garden to celebrate the first ever Malaria \nReleased by Chairman Rand Paul\n151Awareness Day in the USA.  Day was sunny, hot and muggy.  I was given a reserved seat \nin the second row.  Had major and important conversations during the reception with \nRandy Tobias, Mike Gerson and Josh Bolten.  Apparently, at a meeting with the POTUS \nyesterday on PEPFAR funding, there was some opposition to maintaining the funding \nlevel.  Likely the major mover of  this restricted funding was Karl Rove.  Condi Rice is \nout of the country, but will be supportive of expanded funding.  Josh Bolten is supportive \nalso.  Josh asked me what I thought and I came on strong.  Josh pointed out that this was \nsupposed to be a $15 billion program with $3 billion per year for 5 years.  Josh said that \nat the time that I developed the program, I said that we could not absorb the entire $3 \nbillion in the first years and so we would do more in the later years.  Now the program is \nat $5 billion per year, which means that just to sustain it without increases would cost $5 \nbillion per year for 5 years or $25 billion.  Many conservatives would oppose this as a \nbottomless pit.  I also argued that we should get rid of the mandated 33% for abstinence \nof the 20% prevention money.  I am attaching an e-mail that I sent to Josh after getting \nback to my office in which I clarify my position:\nJosh:\n   It was good to see you at the Malaria event today and I appreciate your listening to Randy, Mike \nand me. I know that you are very much supportive of the full funding and even increase of the \ninitiative and I know that this view is not shared by all.  However, just to reiterate what I said to \nyou and what you already know, this is one of the most important things that this administration \nhas done and is doing.  The people of Africa look upon us with great admiration and gratitude \nbecause of PEPFAR.  We just cannot let it slip.  True, we cannot commit to treating every \ninfected person in the target countries, particularly since there are 4.3 million new infections \nworldwide each year, mostly in developing countries.  However, we are making significant \nprogress in prevention. I know that you are aware of how impressive the circumcision data are.  \nIn addition, although we are still years away from a vaccine, the most recent candidate has \nentered a phase 2 trial internationally (including Africa).  Even if it does not totally prevent HIV-\ninfection, there is a reasonable chance that it will slow the progression of disease if people do get \ninfected, and this will result in lower levels of virus in their bodies, which in turn makes \ntransmission to others less likely.  I tell you this because I believe that we are on the cusp of a \nslowing down of transmission, which would dampen the possibility of a \"bottomless pit\" of \ninfection in target countries for which we would feel obligated to treat.  Finally, with regard to \nprevention, I am sorry that I was at first not clear about my position on abstinence being \nmandated as one third of the 20% prevention piece of the pie.  We get enormous bad press (that \noften overshadows the enormous good that we are doing) because we mandate a specific \nnumber for abstinence.  The faith-based organizations are going to push abstinence with the \nprevention money that we give them anyway.  Therefore, abstinence will indeed be pursued \nthrough PEPFAR.  By mandating it, those who do not think that this is the way to go will only drop \nout of the funding stream and declare the program dysfunctional when it really is a breath-taking \nsuccess.  On balance, it is my opinion that if we remove mandated categories of prevention, \nabstinence programs will still go on in Africa and PEPFAR will be praised by everyone, \ndeservedly so.\n  I am sorry if I came on somewhat strong at the White House with you, but I feel deeply that \nPEPFAR is such an historically great program (that would not exist if it were not for you) and I \nwant it to function optimally.  As always, if you need me to pitch in on this and articulate my views \nto anyone, please call upon me.  I would jump at the chance.\nThank you and best personal regards,\nTony\nDuring the Rose garden ceremony, the POTUS actually got up and played the drums with \na troop of Senegalese/American dancers who provided entertainment on the stage in the \nReleased by Chairman Rand Paul\n152Rose Garden.  As he left the stage and went back to the Oval Office, we caught each \nother’s eyes and he said “Hi Denny”, walked a few steps, turned around, came back and \nsaid “What am I talking about,  Hi Tony”; he laughed and went on.\nApril 27, 2007 – Went to the National Cathedral this AM to see Megan receive the honor \nas one of 12 NCS girls to be inducted into the “Cum Laude Society” .  It was a beautiful \nceremony at the Cathedral.\n    Found out during the evening as I was on the way to a Nats Baseball game (call from \nGreg Folkers) with Bob Seder, Stewart Simonson, and Gary Nabel that Randy Tobias just \nabruptly resigned effective immediately.  There is a woman who runs an “escort service \nand sexual fantasy service” who is being charged with running a prostitution ring.  She is \na bit bizarre and is using as a defense that if her girls did prostitution, then they did it on \ntheir own.  For some unexplainable reason, she released the cell phone numbers of the \nclients of her girls and Randy’s number was on the list.  ABC News confronted Randy \nand he stated that he merely used the girls to get massages and had no sex, but he \nresigned anyway.  My impression is that unlike Attorney General Alberto Gonzales who \nwill not resign and keeps embarrassing the POTUS with his incompetence in handling the \nfiring of the Federal Attorneys, Randy does not want to cause more bad press for the \nPOTUS.  Irony is that Randy runs the AID Programs which require recipients of Federal \nFunds to condemn prostitution.  This is probably the reason that he resigned, i.e. the \nappearance of hypocracy.\nApril 28-May 6, 2007 – Just a very busy time for me preparing for the Board of \nScientific Counsellors Review of my Lab (LIR) to take place on June 4.  Weather turned \nabsolutely beautiful – typical DC Spring with sunny skies and balmy temperatures.  Have \nbeen following over the past several weeks the St. Alban’s baseball team.  They are \nhaving their best year in decades.  Danny Hultzen (pitcher/first base) is clearly the best \npitcher in the league and one of the best hitters.\nMay 7, 2007 – Went to the British Embassy for a Garden Party in honor of the visit to the \nUSA of Queen Elizabeth and Prince Philip.  Everyone who is anyone in DC was there.  \nSpent time speaking with Sen. Joe Lieberman, House Speaker Nancy Pelosi, Majority \nLeader of House Steny Hoyer, Columnist David Brooks, CNN’s Judy Woodruff, Fox \nNews Chief Editor Britt Hume, Former Mayor of Baltimore Schmoke, Harvey Fineberg \nof IOM, etc.  Spoke with Prince Philip who showed an astounding lack of understanding \nof what is biomedical research.  He asked me what I did and I explained.  He said “Of \nmedical stuff; that is statistics, i.e. numbers”.  I explained that we actually do research to \nanswer questions.  He insisted that it was all about statistics of diseases.  I said that the \nstatistics inform us of the extent of the problems, but then we do basic and clinical \nresearch to diagnosed, prevent and treat diseases.  He then said, “Oh yes, like I said, it is \nall about numbers”.  I hope that he was just jet-lagged.\nMay 10-14, 2007 – Had one of the most intensely busy weeks  in recent memory with \npreparations (rehearsals) for my upcoming Board of Scientific Counselors review of LIR, \nNIH Budget Retreat, NIH Roadmap Retreat, Commencement Address at Penn State, \nMajor talk in Miami to AAI,  NIAID National Advisory Council Meeting, and Senate \nReleased by Chairman Rand Paul\n153Appropriations Hearing Testimony – all in 5 working days.  It was exhilarating in a \nstrange sort of way.  Almost like being on call as an intern and having 5 admissions in a \nrow.  After a while, it does not make any difference how many they send you.  Weather \nhas been spectacularly beautiful – typical Washington Spring weather.  Sunny, dry, warm \nin day, cool at night.\nMay 19, 2007 – Gave Commencement Address at Penn State University College of \nScience\nMay 24, 2007 – Went to Sons of Italy Annual NELA (National Education Leadership \nAwards) dinner at the Washington Grand Hyatt Hotel on 10th and H Streets.  I took \nMegan with me and she really enjoyed it.  Sitting at our table was Nancy Pelosi and Rosa \nDeLauro.  Megan got to meet and speak with them as well as Hilary Clinton, Geraldine \nFerraro, Italian Ambassador Castellenata among others.  Megan was amazed as Sen. \nClinton was on her way out after having presented Geraldine Ferraro with an Award and \nwe thought that we would not have the opportunity to introduce her to Megan.  Hilary \nwalked past me, caught my eye and gave a big smile, and threw her arms around me in \ngreeting.  Megan could not believe it.  I introduced Megan and Clinton asked about her \nschool and her plans for next year.\nMay 24 – June 17, 2007 – Extremely busy:  \nSometime since last entry (May 24) I was informed by Jack Marberger (Science Advisor \nto the POTUS) that I would be receiving the National Medal of Science in a White House \nceremony in July.  I am humbled.\nAlso, Scooter Libby convicted by seemingly vengeful and self-absorbed Judge Reggie \nWalton and sentenced to 30 months – amazingly excessive!  Also, Walton published all \nof the letters written on Scooter’s behalf including mine.  Other letter writers were Paul \nWolfowitz, Donald Rumsfeld, General Pace, Henry Kissinger, etc.  Science magazine \n(Jon Cohen) wrote a small piece about my writing a letter.  He originally thought that I \nwould be in trouble since I did it on Government Stationary.  Sorry John – I got clearance \nby OGC – Ethics Division since the CFR says that I can do this.  Typical Jon, good  \nperson that he is, he is still trying to get me on something – the instincts of a reporter!\nJune 3, 2007 – Gave Commencement address to Megan’s NCS graduating class.  It was a \nthrill giving it from the main pulpit at the National Cathedral.  It was extremely well \nreceived; got many, many personal comments and e-mails. Please see text of speech in \nmy files.  Megan won many awards – Science Award, Community Service Award, Major \nAward voted by students as best all-around student, Major Award voted by faculty as \nbest all-around student (first time at NCS that same student got both)\nJune 4, 2007 – Underwent Board of Scientific Counselors 4 year review of my \nlaboratory – Laboratory of Immunoregulation.  I received the highest possible score \n(Outstanding).  I had been preparing for this review for almost 1 year since I wanted to \nnail it given that I am Director of NIAID and my review would be carefully scrutinized.\nReleased by Chairman Rand Paul\n154June 6, 2007 – Major, major world publicity regarding patient  who \nhad Extensively Drug resistant tuberculosis (XDR-TB) and traveled by plane to a number \nof countries in Europe despite somewhat bungled instructions by Georgia (he is from \nAtlanta) Health Officials and the CDC to not travel.  The CDC looking real clumsy on \nthis and the media continue to go after Julie Gerberding (Director, CDC) about this and \nother issues.  I believe that she is being treated unfairly by the press and the Congress.  In \nany event, I appeared with Julie and a customs official (Speaker crossed the border from \nCanada  to New York after secretly flying from Prague to Montreal) at a Senate \nAppropriations Committee Hearing (Tom Harkin, Chair) on the subject.  I was there to \ndiscuss the science of TB.  Julie got slammed by the Committee and Speaker was on the \nnext panel and said that the CDC was lying. What a mess.  I was on major media \nappearances for the next week – Nightline, NBC News, 20/20 (about Heimlich and \nmalaria treatment for HIV), NPR Morning Edition, WTOP Radio, CNN American \nMorning, etc)\nJune 18, 2007 – Informed by Don Koshland of the Lasker Foundation that I will be \nawarded the Lasker Award for Public Service in September ($150,000.00) – amazing.  \nThus, in 2007 I have won the Kober Medal for Physician Scientist, the National Medal of \nScience for Basic and Clinical Research and now the Lasker Award for Public Service.  I \nhave a lot to be thankful for!\n    Ironically, had dinner over Ellen and Gerry Sigal’s house last night with Joe Wilson, \nBill Wilson and Melody (Confidante of the Kennedy’s), Richard and Donna Ben-Veniste, \nJudge Judy who is trying the crazy $54 million “lost pants in the Dry Cleaners case and \nher husband Greg.  I mentioned to Ellen that if Joe was pissed at me because I wrote a \nletter for Scooter, then I would not come to the dinner.  Joe was very gracious and \ninsisted that I be there.  We had a good discussion and he said that he understood why I \nwrote the letter.  He, however, is filing a civil suit against VP Cheney, Karl Rove, and \nScooter and so it is not over yet.   Amazing how different are the perspectives of what \nhappened between Scooter and Joe/Valerie.  I am in the unusual situation of being friends \nwith both parties.\nJune 18, 2007 – Accompanied First Lady Laura Bush at Howard University Hospital for \na roundtable discussion of the implementation by Howard of the new CDC \nrecommendations for the “Routinization” of HIV testing.  Celia Maxwell (former NIAID \nfellow) led the discussion for Howard. Very cordial interactions with the First Lady and \nher staff, particularly Katy Montgomery.  She was engaged and interactive.  Very hot day \nin DC – sunny, slightly hazy and 94 degrees F.  I explained to her the benefits that are \ncoming out of this testing program as well as the PEPFAR program internationally.\nJune 21, 2007 – Met with Nancy Pelosi in her “Speakers Office” at the Capitol to discuss \nthe funding of the University of California at SF Center for AIDS Research (CFAR).  \nThey did not get the funding amount that they had hoped for and we finally worked it out \nto everyone’s satisfaction by getting some extra money from OAR and the NHLBI to \ngive them the additional $771,000.00 that they requested.  Nancy was satisfied.  I went \nwith Elias Zerhouni and Marc Smolonsky from OLA at NIH.  Her main staffer was Scott \nReleased by Chairman Rand Paul\n\n155Brule.  Nancy was as usual very warm and cordial to me.  We discussed a plan that she \nhad to get extra money to the NIH through a budget supplemental.  She felt that if we \nwrap in the cancer package, all of the Congress would be in favor even though it was \nunderstood that it would go way beyond cancer.  Elias and I and Marc will world on a \nstrategic plan for the initiative and get back to her.\n             Visited by USA Ambassador to Indonesia (just appointed) Cameron Hume.  I \nknow Cameron from time he was Ambassador to South Africa and we (Cliff Lane) \nestablished the Phidisa Project with the South African Military to treat HIV infection in \nthe military.  Cameron left South Africa and became (briefly) Ambassador to Sudan \n(during the Darfur crisis).  He is on his way to take over in Jakarta and wanted me to brief \nhim on Pandemic Influenza threat and what the USA is doing in this area.  Indonesia is a \nhot spot for recent cases of chicken to human H5N1\nChris and I had dinner tonight at the home of Australian Ambassador to the USA \nDennis Richardson and his wife Betty to celebrate the visit of immunologist Ian Frazer \n(wife Caroline) who is the 2006 Australian of the Year.  His research led to the \ndevelopment of the HPV vaccine with Merck (Gardasil).  Good food and conversation at \nthe beautiful Ambassador’s residence at 3120 Cleveland Avenue, N.W.  Balmy Spring \nnight in DC.\nJune 21 – July 4, 2007 – POTUS commuted 30 month jail sentence for Scooter Libby, \nbut did not pardon him.  The conservatives are enraged that the POTUS did not go far \nenough to pardon Scooter and the liberals are saying that the commutation was a \n“disgrace”.  \n     Went to the Gala Dinner of “The Golden Plate” with Chris.  Usual celebrity gala.  Met \nHillary Swank for the first time.  Others at the dinner were Alberto Gonzales, Margaret \nSpellings, David Rubenstein (Carlyle Group), and many many others.  Sitting at Table \nwith Chris and me were: Gen. Ralston (former Chairman of Joint Chiefs) Mac Macarty \n(former Chief-of-Staff to Pres. Clinton, Ann Venneman (UNICEF Director and former \nSec. Dept. of Agriculture.  Entertainment by Brooks and Dunn – country singers who \nwere fantastic (winner of many country music awards)\n     Went to a Cocktail Buffet at Jamie Gorelick’s house on June 30 and met with the \nusual cast of DC notables: Richard Ben-Veniste, Bill Jeffress (Scooter’s lawyer), David \nIgnatius of the Washington Post, Seth Waxman (lawyer), Judy Woodruff (PBS), Al Hunt \n(Bloomberg News), Mark Shields (Newshour), etc.  Living discussions about \nWashington Politics, including the fact that I wrote a letter for Scooter.\nJuly 5 – 7, 2007 – Went to the Aspen Ideas Festival in Aspen, CO.  Presented a session \non “Emerging and Re-Emerging Infectious Diseases:  The Perpetual Challenge to Global \nHealth”.  Beautiful mountain weather – warm, no humidity, clear skies.  Met and \ninteracted with many, many notable people: Colin Powell, Bob Hormats (Vice-Chairman \nof Goldman Sachs), Rahm Emanuel, Tim Wirth, Margaret Spellings, Dan Glickman \n(former Sec. Agriculture and current CEO of Motion Picture Association of America), \nWalter Isaacson (CEO of Aspen Institute), Jim Woolsey (Former Director CIA), Jim \nLehrer and his wife Kate (Lehrer NewsHour), and many, many more.  Very enjoyable \nexperience.  Perhaps started a friendship with Corby Kummer, whom I had not met or \nheard of before.  He is senior editor at The Atlantic magazine. He is one of the most \nReleased by Chairman Rand Paul\n156respected food journalists and he “narrated” the meal that was served to us at a very \nelegant dinner on July 6 at Plato’s restaurant hosted by Booz, Allan, Hamilton.  They \nbrought in a chef from Denver and provided a meal made only from local ingredients \n(lamb, vegetables, corn soup, etc.).  We had long discussions and  we flew back together \nfrom Aspen to Denver.  He offered Chris and me use of his Boston Apartment when we \ncome to Boston to visit Jenny.\nJuly 10-14, 2007 – Went to Genoa for my yearly review of the Gaslini Institute.  It was \nthe usual pleasant interactions with Lorenzo Moretta, Alain Fischer, and Sergio \nRomagnani (Committee members) as well as the people of Gaslini such as Gianni \nMelioli, Giovanni Rossi, Alessandro Moretta.  Since I was not allowed to take the \nhonorarium this year of any more, this might be my last time doing this.\nJuly 21 – 25, 2007 – Went to Sydney Australia with Chris, Megan and Alison to present \nthe opening session plenary lecture on the topic of “HIV/AIDS in 2007:  Much \nAccomplished, Much To Do”.  We had to turn around quickly and come home and thus \ncancel our plans for a mini-vacation in Australia together.  Reason was that I had to \nreturn to DC to receive the National Medal of Science (see below).  The trip was \nnonetheless very enjoyable notwithstanding the length of travel time.  My talk went over \nvery well, got much press and turned out to be the defining theme of the meeting that \ncaught on with the press and the other speakers.\nJuly 27, 2007 – Received the National Medal of Science from the POTUS at a 1:50 PM \nWhite House ceremony in the East Room.  Hot, sunny Washington day.  I was one of 8 \npeople who received the award for 2005 (yes 2005 – they are 2 years behind in awarding \nthem).  The POTUS was very nice with me.  The Army Major who announced the names \ncompletely blew the pronunciation of my name despite having a phonetic crib in front of \nhim.  The POTUS laughed and when I went up to the podium to get the medal and shake \nhis hand, he put his arm around me and whispered in my ear “Maybe this guy does not \nknow what you name is, but I certainly do”.  There was a nice reception after.  Condi \nRice gave me a hug and kiss and joked about the mispronunciation of my name. We saw \nthe POTUS leave from the WH lawn on Marine One Helicopter to spend the weekend at \nCamp David.  In the evening we had an elegant dinner with many guests from \ngovernment at the Ritz Carlton on 22nd  and M Streets, N.W.  Guests at my table were \nElias Zerhouni and John Gallin together with Denise and Jack Scorce.  Nice time.  I felt \nrather humbled by the amazing accomplishments of the other awardees (mostly physicists \nand engineers).\nJuly 27 – August 30, 2007 – A number of relatively minor issues over the past 4 weeks.  \nHad laparoscopic surgery for right indirect inguinal hernia on August 2 at Sibley Hospital \nby Dr. Martin Paul.  Minor complications of 2 ½ weeks of severe pain over the mesh that \nhad developed a “seroma”.  It is fine now.\n    Went to Seattle, WA to deliver opening session plenary lecture at the HIV/AIDS \nVaccine 2007 meeting run by Larry Corey.   Talk well received.  Have been having very \n“scratchy” voice that has significantly interfered with my lecture since my Plenary in \nSydney (when I first noticed it) in July.  I had laryngoscopy by Dr. Michael Siegel. It \nReleased by Chairman Rand Paul\n157should some very minor “singer’s nodules” similar to what Pres. Clinton had but much \nless severe (Dr. Siegel took care of Clinton), as well as some inflammation indicating \nesophageal-laryngeal reflux.  Will start on antacids.\n    Word is now out that I will receive the Mary Woodard Lasker Award for Public \nService on Sept. 28, 2007 in NYC (see below).\nAugust 30 – Sept. 13, 2007 – Went to NYC on Sept. 8 to visit my father for his 97th \nbirthday.  Recently had baloon valvuloplasty of aortic valve for progressively refractory \nCHF.  Remarkable improvement following procedure. NYC was beautiful and warm.  \nChris, Jenny and Ali were with me and we had fun as always in NYC.  Megan is in \nChicago with City Year (Americorps) and is lonely and sad since this is first time away \nfrom home.\nSept. 14, 2007 – Big day.  Went to White House for Karl Rove’s farewell party. Moving \nspeeches by Josh Bolten (who showed PowerPoint slides on Karl’s years with the \nPOTUS here and in Texas), the POTUS who choked up a few times when talking about \nKarl, and Karl himself who gave a very moving thank you to his friends at the WH.  He \nrecounted how after Bush won the election Karl did not want to come to DC with the \nPOTUS because he felt that although he was a good political strategist and tactician, he \ndid not like internecine warfare and he saw that during the administration of the \nPOTUS’s father George H.W.  Bush shook his head in agreement with this.  Karl went on \nto say that it would not be this way during his administration since it will be like a family \nand he would not allow backbiting.  My thought was that although this is an admirable \nthing, it might have had the unintended consequence of having a closed system that did \nnot accept outside ideas very well.  In any event it was a warm affair.  I had the \nopportunity to chat with Josh Bolten, Karl Rove, Fran Townsend, Mike Chertoff, Charles \nKrauthammer, and many other notables.\n    After the ceremony we waved the POTUS off from the balcony in Marine One on the \nway to Camp David for the weekend. I had a scheduled briefing of First Lady Laura \nBush’s staff with Anita McBride (Chief-of-Staff), Carrie Underwood (Deputy Director of \nPolicy and Projects), and several others.  The briefing went very well.  I talked about \nglobal health issues and what the FLOTUS could do for the last year domestically and \ninternationally to promote the health agenda.  I will be suggesting places that she could \nvisit. To do an event similar to what we did together at Howard University (see above – \nJune 18, 2007).\nSept. 15-16, 2007 – Press announcement for the Lasker Award.  Almost immediately, \nscores of congratulatory e-mails started arising.  My picture was in the Washington Post \nwith an article; article in NY Times and picture and article on Monday (Sept.17) in USA \nToday.\nSept. 19, 2007 -  Over the past few days, literally hundreds of e-mails and letters coming \nin regarding Lasker Award from friends, colleagues, people I knew years ago such as \nnurses from H-4 ward at NY Hospital, White house people, congressmen, etc.\n      Today had meeting at White House (EEOB-428) run by NSC (Mike Falan) and HSC \n(Rajeev Venkayya) to discuss updating and broadening the vision of the NSC/HSC TB \nReleased by Chairman Rand Paul\n158White Paper that we (NIAID) had contributed to a couple of months ago when we \nintroduced our Research Agenda for MDR/XDR-TB.  Beautiful Fall day (crisp and \nsunny).  Meeting from 9:00 to 11:00 AM followed by briefing from Tachi Yamada \n(Gates Foundation) who came from Seattle to present to us (USG) out of courtesy the \nnew $282 million Gates TB initiative.  In preparation for this I alerted Rajeev that we \nreally needed to coordinate the many USG activities on TB and present it in a vision \nformat so that the POTUS could claim the legacy of having addressed AIDS (PEPFAR), \nmalaria (President’s Malaria Initiative – PMI) and now TB.  It would be the 3rd leg in the \nstool of his Global Diplomacy program.  Rajeev agreed – unfortunately, he will be \nleaving government on Sept. 26.  It was great working with him over the past few years.  \nHis background is that he trained as an MD at Michigan and was actually Chief Medical \nResident when Tachi was Chairman of Medicine at Michigan.  In any event, we will \nupdate and sharpen our USG White Paper.\nSept. 20, 2007 – Another great crisp Fall day.  \nHeard real bad news regarding the Merck AIDS vaccine trial 502 in which adenovector \nHIV was immunogen.  Study done mostly on gay men and phase 2b was looked at by \nDSMB on usual periodic look.  Trial closed for “futility” in that the data showed that \nmore people got infected in vaccinate group versus unvaccinated group (19 vs 11 – not \nsignificant, but highly suggestive).  Also, viral set point exactly same in infected people \nwho were vaccinated versus those that were not.  Trail stopped – press releases imminent.  \nIt is going to be a hot time.  People will focus on whether we should proceed with the \nPhase IIb of PAVE 100 (Gary Nabel’s VRC trial).  The latter also was a adeno vector, \nbut is different in 3 ways: 1) it has a DNA prime; 2) it has envelope; 3) it is done also in \nheterosexuals.  More to come.\nWent to Gate-sponsored dinner at Le Paradou Restaurant at 678 Indiana Avenue, NW in \nhonor of retiring President of Botswana Festus Mogae.  I had met the President in 2002 \nwhen I went to Africa with Tommy Thompson in 2002 to develop PEPFAR.  At the \ndinner were: Todd Summer and Cheryl Scott (Gates), Jeff Struchio (Merck), Bobby \nPittman (NSC Director of African Affairs), Congresswoman Nita Lowey, Tommy \nThompson, Max Essex  (Harvard School of Public Health), Ambassador John Lange \n(former Amb to Botswana), Jendayi Frazer, Assistant Secretary of State for African \nAffairs.  Nice evening.  I commiserated with TGT about his failed attempt at Republican \nnomination for President.  Nice conversations with Nita Lowey about Iraq (Democrat \nviewpoint), and warm conversation with Mogae regarding my work on AIDS.\nSept. 25, 2007 – Was panelist at Science Magazine’s annual retreat of their staff at their \nheadquarters in Washington, DC.  Chaired by Editor Don Kennedy.  Lively discussion \nabout the future of science and biomedical research.\n    DSMB discontinues trial of Merck HIV vaccine based on Adenovirus vector.  Possible \nthat vaccine actually made things worse.  Big setback for HIV vaccinology.\nSept. 26, 2007 – Farewell reception at White House for Rajeev Venkayya (Deputy \nDirector – Homeland security Council).  I have worked closely with Rajeev for 5 years \non Biodefense.  He rose from WH intern to deputy Director in 5 years.  He is someone to \nReleased by Chairman Rand Paul\n159watch; good guy; physician trained at U of Michigan and UCSF.  Usual cast of WH \npeople, i.e. Fran Townsend, etc.\nSept. 27 – 28, 2007 – Glorious 2 days in NYC for the Lasker Awards.  Dinner on night of \nSept. 27 at La Grenouille (Mary Lasker’s favorite restaurant).  Lasker Lunch at Pierre \nHotel on Sept. 28.  Ralph Steinman received Basic Science Lasker; Alan Carpentier and \nAlbert  Starr (Starr-Edwards heart valve) received the Clinical Lasker; and I received the \nPublic Service Lasker.  On Friday, Sept. 28, the Washington Post did a very large piece \non me called “The Honored Doctor” talking about the Lasker, the National Medal of \nScience, the Kober Medal and other honors.  I have received literally several hundred \nletters and e-mails and greeting in person related to the Lasker and the Post article.  With \nme in NYC were Chris, Ali and Jenny.  Megan had to stay on Chicago with “City Year”.\nOct. 4 – 5, 2007 – Went to Aspen for the World Biomedical Forum.  Gave 4 to 5 talks on \nAIDS, Pandemic Flu, Emerging infections, etc.  Again, usual cast of notables there. Very \nnice time.  Weather in Aspen and DC has been spectacular for past couple of weeks.  \nSunny, Warm and no rain.\nOct. 11, 2007 – Featured speaker at a Global Health Symposium at the Italian Embassy \non Whitehaven Street in DC.  Spoke on “HIV/AIDS in 2007:  Much Accomplished, \nMuch To Do”.  Much congratulatory activity by the Italians related to the Lasker and the \nPost article.\nOct. 12, 2007 – Dinner at the Café Milano in association with the national Italian \nAmerican Foundation (NIAF) dinner the following night (Oct. 13).  Franco Luschese \nfound me a prime seat.  The whole restaurant was for the NIAF dinner.  I sat next to Jerry \nVale.  So many people who I knew from other such meetings were there:  Yogi Berra, \nTony LoBianco, Dion (and the Belmonts), Nancy Pelosi, etc. etc.  Great meal; nice time.\nOct. 13, 2007 – Took Ali to the Annual NIAF Gala at the Hilton.  She loved it since she \nwanted to meet Nancy Pelosi and Ellen Pompeio (star of TV’s Grey’s Anatomy).   She \ngot to meet and take picture of both.  Usual glitterati were there:  Antonin Scalia and Sam \nAlito; Nancy Pelosi; Yogi Berra; Dion; Jerry Vale;  George Tenet (I wanted to connect \nwith him, but we did not cross each other); Connie Stevens; Pater Pace; etc. etc.\nOct. 16-17, 2007 – Went to Seattle to participate (Panel) in the Bill and Melinda Gates \nMalaria Forum at the Sheraton Hotel at Union and 6th Streets in Downtown Seattle.  Mild \nand on and off rain.  Good meeting.  Just starting to see the galvanizing of interest and \nenthusiasm and finally even considering the possibility of eliminating and eradicating \nmalaria.  Melinda  and Bill gave an inspiring speech at 9:00 AM on Oct. 17.  All the \nmalaria people were very pleased that I was there to show the “flag”.  I have become \nincreasingly interested and supportive of malaria including my long-term support of \nStephen Hoffman (Sanaria) and his irradiated sporozoite vaccine.\n   Had a unique evening at dinner at the home of Bill and Melinda Gates on Oct. 16, \n2007. It was obviously a spectacular home, but I did not get the tour since while Melinda \nwas giving the other guests a tour, Bill wanted a private conversation with me.  He was \nReleased by Chairman Rand Paul\n160fascinated by how I have been running NIAID; said that he had heard so much about me \nand happy finally to meet me in person.  He wanted to know how I navigated the politics \nof DC, how I prioritized, how much flexibility I had in the budget, etc. etc.  It was a very \nnice conversation aimed at his wanted to get to know me and my responsibilities better.  \nPresent at the dinner were: me, Bill and Melinda Gates, Tachi Yamada, Regina \nRabinowitz, Margaret Chan (WHO), Michel Kazatchkine (Global Fund), Brian Chituwo \n(MOH of Zambia), Tedros Adhanom Ghebreyesus (MOH of Ethiopia), Michael Leavitt \n(Sec. HHS), David Mwakyusa (MOH of Tanzania), Ann Veneman (UNICEF),  also \nMOH of Mozambique Paolo Ivo Garrido and former MOH of Nigeria (Forgot her name).\nOct. 18, 2007 – Lectured in Building 31, Room C10 to the Mortimer Zuckerman Fellows \n.  This is a group funded through Harvard that takes medical, Law, and Business students \nfrom throughout the country and funds them for 1 – 2 year fellowship to study at either \nthe Kennedy School of Government, the Harvard School of Public Health or the Harvard \nBusiness School to learn other disciplines, i.e. medical students will go to the School of \nGovernment, and Law students will go to School of Public Health.  They wanted to hear \nabout me and how I got to where I am and my view of public service.  I lectured for 45 \nminutes and took over 1 hour of questions.  They were extremely enthusiastic about me \nand what I said.\nOct. 19, 2007 – Went to Boston to give Sheldon M. Wolff memorial lecture on \n“HIV/AIDS in 2007:  Much Accomplished, Much To Do”.  Largest crowd in the history \nof Tufts Grand Rounds (so I am told).  Saw Lila Wolff.  Got to Boston early (cloudy day, \nbut warm for October) and had breakfast with Jenny at Peet’s Coffee House in Harvard \nSquare.  Had first talk with Jenny about her personal “situation”.  Went very well.\n  That evening went to home of  Ron and  Beth Dozoretz for a reception for the Fellows.  \nThe fellows were so happy that I was there.  The Dozoretz’s live at 3005 – 45th Street, \nN.W. (2 blocks from my house).  At the party were many DC elites such as David Gergen \n(co-sponsor of event), Sandy Berger, Ron Carey (Newsweek), etc.\nOct. 26, 2007 – Gave talk at the opening of Sanaria’s new facility.  Sanaria is Biotech \ncompany making an irradiated sporozoite malaria vaccine.  Stephen Hoffman is the CEO \nand I have been very supportive of him over the past 20 years.  He recognizes this every \ntime he speaks in public.  Also at the Grand Opening were Congressman Chris Van \nHollen, Sen. Cardin (D- MD), Montgomery County Executive Ike Legget and others.\nOct. 27, 2007 – Great day.  Went to ISL/IAC cross country championship meet held at \nEpiscopal High in VA.  NCS and St. Albans won everything – JV and Varsity and under \n15.  In the NCS JV race the first 11 runners over the finish line were from NCS.  Ali \ncame out 6th in the race!\nOct. 29, 2007 – Went to dinner at Positano restaurant in Bethesda with Bob Gallo (part of \nour years long tradition of dinner in Bethesda to “catch up” on what is going on.  \nDiscussed the interesting topic of matching Bob, Luc Montagnier and me for nomination \nfor the Nobel prize for AIDS now that I have won the Lasker Award.  It could be helpful \nto Bob if I am on the “ticket” since there is no controversy connected with me and this \nReleased by Chairman Rand Paul\n161could make it a more desirable slate since the 2 of them alone always evokes memories of \ncontroversy.\nOct. 29 – Nov. 1, 2007 -  Full week of meetings with Ministers of Health from G-8 and \ntheir senior staff on topic of Global Health with an emphasis on Biodefense.  Ministers \nthat were present include: The Honorable Mike Leavitt, U.S. Secretary of Health and \nHuman Services The Honorable Michael Chertoff, U.S. Secretary of Homeland Security \nThe Right Honorable Tony Clement, MP, Minister of Health, Canada The Honorable \nMarkos Kyprianou, Esq. Commissioner for Health, European Commission The \nHonorable Ulla Schmidt, Federal Minister of Health, Federal Republic of Germany The \nHonorable José Angel Córdova-Villalobos, M.D., Secretary of Health, Mexico The Right \nHonorable Dawn Primarolo, MP, Minister of State for Public Health, United Kingdom \nDr. Donato Greco, Head, Department of Prevention and Communication, Ministry of \nHealth, Italy The Honorable Kenta Matsunami, Parliamentary Secretary for Health Labor \nand Welfare, Japan Dr. Anarfi Asamoah-Baah, Deputy Director-General, World Health \nOrganization.  I gave talk at VRC to the senior staff.  Had elegant receptions and dinners \nat the Corcoran Gallery (Oct. 31) and Library of Congress (Nov. 1).\nNov. 2, 2007 – Went to Boston to give Keynote at meeting of Harvard Business School \nAlumni Association – held at Harvard Medical School.  Spoke on Emerging Infections.  \nHad dinner with Jenny at Taranta’s restaurant in the North End on Friday night, Nov. 2. \nHad nice discussions about career options as she is now approaching graduation from \nHarvard.  She wants to take at least a year working at something that she loves (not sure \nyet what that is – could be a year in Cuba or a domestic political campaign) and then go \non to graduate school.\nNov. 7. 2007 – Ellen Sigal invited me and I attended the “Friends of Cancer” Awards \nnight at the Hotel George on Capital Hill (E Street).  “Leadership” Awardees were Ted \nKennedy, Sen,. Mike Enzi, and Bob Young (former NCA/Fox Chase).  Ted Kennedy \nexplicitly said that he would like me there and wanted to greet me.  He mentioned me \nwarmly in his acceptance speech.  Afterwards had dinner with a select few from the \nreception – Ellen Sigal, Marlene Malek, Sherry Lansing, John Porter, Amy McGuire \nPorter, Elias Zerhouni, Melody Miller (former staffer for Ted Kennedy).  Lively \ndiscussions (particular with Sherry Lansing who is a terrific person – she had been at my \nLasker Award ceremony).\nNov. 7 – 8 , 2007 – Very discouraging news from the Merck HIV vaccine trial (502/503 \n– STEP and Phambili Trials) using adenovirus 5 (Ad5) vector and gag, pol, nef inserts.  \nTook place in North and South America, Caribbean, Australia (STEP) and just beginning \nin Southern Africa (PHAMBILI).  First DSMB look stopped the trial on futility for 2 \nmajor endpoints (Acquisition and Viral Set Point).  Real problem is that it looks like \npeople with the higher underlying Ad5 titers had greater risk of acquisition in the \nvaccinated versus the placebo group.  Unclear why this is so but may be that giving Ad5 \nto people with underlying Ad5 immunity triggers robust activation providing vulnerable \ntargets for infection upon exposure to the virus.  This has important implications for \nReleased by Chairman Rand Paul\n162future trials with Ad vectors such as upcoming PAVE 100 trial – ethical issues.  Stay \ntuned.\n    On evening of Nov. 8 gave Keynote After Dinner talk to the Association of \nIndependent Schools of Great Washington (AISGW). Kathy and Dan Jamieson were \nthere as were heads of schools and senior officials for the DC/VA/MD independent \nschools.  Talk went very well – “Our Responsibilities as World Citizens:  Looking \nThrough the Lens of Global Health”.  I spoke at The Potomac School in Virgina.  Hugh \ncrowd.\nNov. 14, 2007 – Attended 60th Anniversary Gala for Meet the Press (invited by Tim \nRussert.  Held at 555 Pennsylvania Avenue, N.W. in the new Newseum Building.  \nAnother affair of all the glitterati of the Washington, D.C. press and politicians – John \nMcLaughlin, David Gregory, Norah O’Donnell, Fred Fielding, Ben Bradlee, Mike \nGerson, Sen. Kennedy, Kerry, Former Sen. McGovern,  Tom Ricks (Washington Post), \nAl Hunt, Dana Perino, Dana Priest, etc. etc.  Elegant affair, good food, plenty of cheer.\nNov. 30, 2007 – Chris an I attended a Holiday Dinner Party at the White House hosted by \nthe President and First Lady.  I had been at several Holiday receptions at the White \nHouse around Christmas Time, but this was the first time that I attended a Holiday \nDinner.  There were about 75 – 100 people in attendance.  Wonderful affair!  The \nPOTUS and First Lady circulated freely with guests as we had cocktails in the foyer \nadjourning the East Room.  Spent several minutes talking with the POTUS and First \nLady separately.  He and she had just finished an AIDS event in Mount Airy to \ncommemorate World AIDS Day (Dec. 1 – tomorrow).  The POTUS had a large 50 foot \nred AIDS Ribbon hung from the front portico of the White House and he was excited \nabout pointing it out to me.  The POTUS in his usual generous way with me kept \nintroducing me to people at the reception as one of the world’s greatest scientist who will \nget us an AIDS vaccine.  Again, as usual, he was very warm and friendly with me.  \nDinner was elegant – pumpkin soup, lamb, fine wines and champagne.  The evening was \ncrystal clear and cold (around 40 F). After dinner we had Christmas carols by the Army \nChoir and a trumpet and piano medley of Holiday Songs by 2 young black men from \nNew Orleans (?names).\nNov. 30 – Dec. 9, 2007 -  Pre-Iowa caucus heating up with Obama closing the gap with \nHillary Clinton who is front-runner. Romney and Giuliani neck in neck on the \nRepublican side.  Despite the fact that election is 1 year away, election politics is \ndominating the news.  The “surge” in troops in Iraq appears to be working in cutting \ndown the violence, but this is still a tenuous situation.  Latest NIE states that Iran \n(contrary to what was previously thought) has halted their nuclear weapons programs. \nLife  in DC as active and political as ever.\nDec. 9, 2007 – Invited by Catherine and Wayne Reynolds to attend a small private dinner \nwith Chris at Café Milano’s restaurant for Holiday Cheer.  Amazing night.  About 15 \npeople in the private Placido Domingo Room of Café Milano.  Attending among others \nwas VP and Mrs. Cheney, Bill Marriott, Sen. Thad Cochrane and his girlfriend, Elias and \nNadia Zerhouni, Chris Wallace (Fox News), Alma Wildenhorn, John and Debbie Dingell, \nReleased by Chairman Rand Paul\n163Mike and Meryl Chertoff, among others.  Spent nice time speaking with the VP about \nStephen Hayes’s book “Cheney” that I just finished 2 days ago.  We had fun since we \ndiscussed the parts of his earlier years from the book such as his sports in high school.  \nAlso discussed with Lynne Cheney the part about her giving him an ultimatum of shaping \nup in school or she would leave him as his girlfriend.  He had flunked out of Yale twice.\nDec. 11, 2007 – Another exciting Washington social night.  First visited home of Ellen \nand Gerry Sigal at 2909 – 44th Street, N.W. just 2 blocks from our house.  Occasion was \nbook signing party for Valeria Plame Wilson to celebrate publishing of her new book \n“Fair Game” about her outting as a covert CIA agent.  Chris and I have gotten to know \nher and her husband Joe Wilson over the past year, mostly through the Sigal’s.  \nInteresting irony (see previous notes) that I am friends with Joe and Valerie at the same \ntime as I am friends with Scooter Libby.  Had to leave party early to go to Italian \nAmbassador Giovanni Castellenata’s residence.  On way out as I apologized to Joe for \nleaving early, he joked “As long as you are not going to a party at the VP’s house”.  In \nfact, that is exactly what I am doing on Thursday (see below).\n   Function at Italian Ambassador’s house was fun.  Party to honor the visit of Italian \nPresident Enrico Napolitano.  Usual DC glitterati were there – Mike and Meryl Chertoff, \nColin Powell, Lee Hamilton, Frank Balducci (author),  D.C. Mayor Adrian Fenty and \nwife Michelle, former head of Italian CIA Carrado Cantatore (had nice conversation with \nhim about Italian covert ops in Iraq  - i.e. Italian Special Forces are still operating there \neven as Italian troops pull out), Sen. Pat Leahy, etc.  I sat next to my good friend Cecilia \nPiccione (Chief-of-Staff to the Ambassador).\nDec. 13, 2007 -  Two issues today:  Went down to White House with Mark Dybul to visit \nDan Price (new SHERPA for the upcoming G-8 meeting in July, 2008). Dan, at the \nsuggestion of Gary Edson, was looking for some bold initiatives for finish off the legacy \nof the POTUS over the next 11-12 months.  Gary mentioned to Dan how I had developed \nthe PEPFAR program.  We discussed various options.  I brought up several such as \nelimination of TB and malaria, and aggressively addressing neglected tropical diseases \n(NTDs).  Mark had the great idea of using the PEPFAR infrastructure that has been built \nup over the past 4 years to deliver the meds for NTDs.  The bulk of the costs for attacking \nNTDs is the delivery systems since the drugs are free (ivermectim) or very cheap.  In \naddition, Mark suggested major tax breaks for private sector corporations that donate \ntheir expertise such as computer programming, etc.  Mark and I were charged with \nputting together a proposal.  This matches nicely with what HHS, NSC, and HSC are \nasking me to do with putting a bold program together for TB together with CDC, FDA, \nUSAID, and DHS.  After talking to Dan, we walked over to Josh Bolten’s office and \ndescribed briefly the plan to him.  He likes it a lot and urged us to go forward.  Seems \nstrikingly similar situation to what we did with PEPFAR 5 years ago.\n   This evening I went to the Christmas Party at the Vice President’s mansion.  Chris is in \nBoston having given a lecture and ran into a big snow storm.  She is stranded in Boston \nand will have to take a train home that will get her in during the middle of the night.  I \ntook Ali to the VP party and she had an exciting time meeting the VP and such notables \nas David Addington (Chief-of-Staff to the VP),   Joel Bagnol (HSC), Bruce Miller (VP’s \nStaff, Carol Kuntz,  etc.\nReleased by Chairman Rand Paul\n164Dec. 14 – 19, 2007 – Series of the usual (now becoming enjoyable since I remember \nnames after seeing them so often) holiday parties, mostly centered around NCS/STA.  \nWeather unusually mild.  Looking forward to Jenny and Megan coming home\nDec. 20, 2007 – Meeting (pre-PCC) at EEOB run by Mike Magan of NSC and Bob \nKadlec of HSC to flesh out possibility of  putting together a major POTUS initiative on \n“Control or Elimination of Tuberculosis” to announce at the State of the Union Address \nin Jan. 2008.  After having various agencies present a totality of a program that would \ncost billions, it was decided that since there really will not be any new money, or if there \nwas, it would be very little, we should focus on the well-circumscribed topic of TB \nVaccine research.  I was tasked to do this and to write language for the State of the Union \nAddress.  In my proposal, I presented the case that this would cost relatively little.  NIH \nspends $150 million in 2007 on TB research ($120 M is NIAID).  Of this $20 million is \non TB Vaccine Research – this is  about 25% of world’s TB vaccine research spending \nwith Gates spending about 45% (they spend most of their TB money on vaccine).  The \nGlobal Plan to Stop TB – 2006-2015 calls for $184 million in 2009 (the FY that we are \ntalking about).  If we tripled our spending by adding $40 million to the $20 million, this \nwould give $60 million.  Right before the meeting Rajeev Venkayya (who left HSC and \nwill be joining Gates) called and e-mailed me saying that he has arranged a call between \nSecr. Leavitt and Tachi Yamada from Gates to agree that Bill Gates, Jr. will commit to a \nsignificant increase in Gates funding for TB if the USG puts up more money.  I have \nsubmitted a proposal for a $40 million increase for FY 2009 and I have included \nlanguage for the Address.  Let us hope that this flies.  Then I will have had impact on \nPEPFAR, the President’s Malaria Initiative (PMI) and now the TB initiative.\nDec. 22, 2007 – Has breakfast at Panera in Chevy Chase with Terry Lierman who is now \nChief-of –Staff to House leader Steny Hoyer (an old friend).  We discussed the usual \npolitics and I mentioned that the only job that I would take in a new administration is \nSecretary of HHS.  Terry said that everyone knows in the democratic party that I am most \nqualified, but that I have “a Bush problem” in that I am too closely associated over the \nyears with the Bush’s.  Such is Life; I am not at all upset about this since who knows \nwhat will happen and besides, I do not covet the job.\nDec. 23-27, 2007 – Discovered that Megan has an 8 mm left ovarian cyst – likely a \ndermoid that needs to come out for fear of torsion/twisting since it is so big.  She is seen \nby Mark Reiter’s group and Mark is arranging to have it removed on Dec. 31 \nlaparoscopically by a woman in his practice. He will assist.  He is giving her the VIP \ntreatment, but I know too little about the laparoscopic skill of the people in his practice.  I \ndo not want to upset the apple-cart, but ordinarily I would get David Jacobs involved; yet \nI do not want to interfere with the natural flow.  David would probably insist that \nsomeone else outside that practice do the procedure.  Mark wants to be in charge since he \ndelivered Megan and feels a strong responsibility to her.   I am conflicted and will hope \nfor the best.\nReleased by Chairman Rand Paul\n165Dec. 28, 2007 – Lucky for us that Dr. Sedghi (Megan’s primary GYN doctor asked for a \nrepeat sonogram.  Turns out the “cyst” was a loop of bowel.  She has a normal pelvis on \nrepeat sono.  Welcome to medical practice in the USA!  The radiologist actually called it \na dermoid cyst based on “calcification”, which now turns out not to be present.\nDec. 28, 2007 – Jan. 4, 2008 – The White House is getting excited about the possibility \nof pushing my TB vaccine research intitative for the G-8 and for the SOTU Address.  \nMet on Jan. 3 with Mike Magan and Patrick Marcham of NSC about pushing forward my \nTB intiative.  Also, Mike wants me to put together a similar initiative for a malaria \nvaccine.  I will present this to Dan Price (with Gary Edson present) on Monday at the \nWhite House.  Possibility exists for a two-fer, i.e. TB + Malaria vaccine initiatives.  A lot \nof activity (e-mails, phone calls, meetings) going on similar to the time right before we \nwent ahead with PEPFAR in Jan. 2003.  There is the usual concern on the part of NIH, \nHHS, and OMB as to where the new money will come from.  I have been very open in \nkeeping Elias Zerhouni and HHS informed of my White House meetings.\nJan. 5 – Jan. 18, 2008 – Democrat and Republican primaries getting very hot.  No clear \nleader with the GOP.  Fred Thompson dropped out; Rudy Giuliani counting on Florida as \nhe has done poorly so far in Iowa, NH, Nevada, Michigan and SC.  Romney dropping \nand McLain bouncing back with wins in NH and SC.  Dems race ugly with Bill and \nHillary attacking Obama.  This is causing racial tensions and blacks are getting pissed at \nBill and Hillary.  Bill is acting inappropriately in attacking Barack in an angry fashion.  \nHe is also clearly lying about what Barack has said and done.\n    My initiatives are still percolating at the WH.  Now they have asked me to put together \na malaria vaccine and malaria drug discovery proposal.  Will discuss these on Jan. 28 at \nthe WH.  Weather has been bitter cold in DC – very sunny, but freezing.\nJan. 19, 2008 – Dinner at Capitol Hilton Hotel to celebrate Sam Alito getting the Lido \nAward.  Dinner sponsored by NIAF.  John Salamone (Executive Director of NIAF) asked \nChris and me to sit at Alito’s table along with Gen. Peter Pace and his wife Lynne.  Had \nnice evening speaking with Martha-Ann Alito (Sam’s wife).  She is starting an “Italian \nDinner Club” and invited me to join.  I am considering it.\nJan 25, 2008 – Gave lecture Global health at USA Families Conference at the Mayflower \nHotel.  The speaker before me was my friend former Senator Tom Daschle.  Tom gave a \ngreat talk on health care in the USA based on a book that he has just written.  Of note, he \nis the health advisor for Barack Obama.  This is good since Tom likes me a lot and this \ncould be my entry into getting to know Obama a bit better since I know Hillary much \nbetter than I do Obama.\n   This evening went with Chris to an elegant “private” dinner (black tie) at the Academy \nof Achievement Town House at 1222 16th Street, N.W. given by Catherine and Wayne \nReynolds.  They have been very generous to me in inviting me to these great affairs.  In \ntypical Catherine Reynolds style, the details of the evening were amazing.  Great food \nand elegant wines (Montrachet and Margaux) and champagne (Dom Perignon).  Guests \nwere terrific.  Sens. Daschle, Cochrane, Byron Dornan; Bob Barnett,; Congressman \nDingle; Mack McCarty; John Negroponte; Mike Chertoff Steve and Alice Rosenberg, \nReleased by Chairman Rand Paul\n166etc.   Highlight of the evening was the command private performance by Bernadette \nPeters, who was amazing – talented and beautiful at 60 years old (next month)!  I was \nstruck by how short she is in real life.  Google lists her as 5’3”, but she was about 1.5 \ninches shorter then I and she had spiked (3 inch) heels on – great looking woman and \nincredibly nice as we spoke with her after the performance.\nJan. 26, 2008 – Activity mostly centered around the Democrat and Republic primaries.  \nMcCain surging from way behind, Giuliani is out.  Obama closing in on Hillary.\nJan. 28, 2008 – Went to White House to nail down with Dan Price, Gary Edson, Patrick \nMarcham, Mark Dybul, Paul Brown, Bobby Pittman and others the various aspects of the \ninitiatives that the POTUS might want to announce at G-8, or the Upcoming (Feb) Africa \ntrip, or the DC Global Health Summit.  My TB vaccine initiative ($40 million) is in.  \nMalaria vaccine and drug discovery is likely out.  Neglected Tropical Diseases is in.\n   That night, in the SOTU Address, the POTUS asked for $30 billion for PEPFAR and \npraised the POTUS Malaria Initiative (PMI).\nFeb. 1, 2008 – Did dry run of my upcoming presentation to VP Cheney on Bruce Miller.  \nHe really liked it.  Will soon set up for the VP.\nFeb. 3, 2008 – NY Giants beat NE Patriots in an upset in the Super bowl played in \nPhoenix.  NY’s defensive line kept Tom Brady off balance all night and Eli Manning \nplayed incredibly well.\nFeb. 4, 2008 – CROI meeting in Boston.  Went to show the flag, meet with African \ninvestigators from Uganda (Rakai) and see vaccine presentations.  Ron Desrosiers gave \nhis talk about the imbalance between discovery and development in vaccine agenda and \nsaid there is no evidence that any existing vaccine candidate will work.  I do not \nnecessarily disagree; however, he was terribly gratuitous in saying that “The NIH has lost \nits way on vaccine research”.   It is easy to criticize and place blame…much easier than \nhaving creative ideas to solve the problem.  He is not a bad guy, but he was an asshole \ntoday.\nFeb. 6, 2008 – Had lunch at café Milano with Franco Nuschese (Owner of Café Milano) \nto discuss an issue with the United Arab Emirates (UAE).  He would like to bring the \nhealth minister to the USA and have me show him around the NIH.  Also, he wants me to \ngo to UAE and help them with advice about research programs, i.e. establish an NIH-like \nsystem in UAE.  Franco knows the Middle east well since he has many contacts there and \nwant to help the country develop their biomedical research enterprise.  He will arrange \nappropriate meetings.\nFeb 8-9, 2008 – Flew to San Francisco and took “red-eye” back to give the Merle Sande \nmemorial Lecture at the Gladstone Institute at SF General Hospital (Mission Bay \nCampus).  Warner Greene (Director, Gladstone) and Tom Quinn arranged the visit.  I \ngave a lecture of “HIV/AIDS in 2008” and paid tribute to merle.  Told some stories about \nour friendship and experiences on the NY Hospital House Staff together where he was \nReleased by Chairman Rand Paul\n168situation in Washington, D.C. re: HIV/AIDS.  He was shocked at the numbers – DC is \n9X the national average for prevalence; 5% of the entire DC population is infected.\nFeb. 20-21, 2008 – Went to University of Chicago to deliver interdisciplinary lecture on \nHIV/AIDS.  Had dinner with Megan at Volare restaurant.  Went over very well and then \nflew early on AM of 21 Feb to DC to go directly to the White House for meeting with \nDan Price, Gary Edson, Mark Dybul, Patrick Marcham, Paul Brown, Tim Ziemer to \ndiscuss malaria, TB, health care workers and other initiative.  I am pushing for the \ntripling of resources ($20 M to $60 M) for TB vaccine research.\n    We had a big week with the POTUS visit to Africa and receiving great praise and \naffection for the PEPFAR and PMI programs.  POTUS announced a $350 M, 5 year \nprogram on Neglected Tropical Diseases (NTDs) to include attempt to eradicate in 300 \nmillion people in certain African , Asian and Latin American countries – Lymphatic \nfilariasis, Onchocerciasis, Schistosomiasis, trachoma and ground worms (whipworm, \nhookworm, and roundworm).  This is the same program that Gary Edson and I proposed \n3 years ago and so our prior work has belatedly come to fruition.  Great news!\nFeb. 26, 2008 – My picture and a story concerning me (in part) appeared in the Science \nSection of the New York Times today.  It was related to the interview that I gave in \nToronto last summer to 2 small children with the theme of explaining HIV/AIDS to little \nchildren.  The filmakers were the children’s parents.\nMar. 3, 2008 – Participated in a State Department function for Jenna Bush on the \noccasion of celebrating her new book  “Ana’s Story:  A Journey of Hope”.  Took place in \nthe main auditorium of the State department.  I was the main speaker and spoke on “The \nGlobal Effects of HIV/AIDS and the origins of PEPFAR”.  Other speakers were Kristen \nSilverberg, Assistant Secretary of State for International Organization Affairs, and Karl \nZinmeister, Director of the White House Domestic Policy Council.  Got a chance to chat \na fair amount with Jenna Bush as we waited together for the affair to begin.  She is a very \nnice person who said that she was “in awe” of me because of all of the amazing things \nthat I have accomplished over the years.  She worked for UNICEF for a year in Jamaica \nand also spent time in Panama doing AIDS work.  Very nice person; has a smile exactly \nlike her father.  I gave a history of the origins of PEPFAR and a short summary of \nHIV/AIDS.  I showed the MMWRs from June 4 and July 5, 1981.  When Jenna got up to \nspeak, she remarked to the audience how impressed she was with me and my work over \nso many years and when I showed the 1981 slide, she was floored by the fact that I was \ninvolved in AIDS then and that was the year that she was born.\nMar. 5, 2008 – Meeting in White House (EEOB 445) led by Bob Kadlec of HSC..  Was \n“Top Secret” meeting on anthrax threat with emphasis on drug resistant and even vaccine \nresistant anthrax.  Based on supposed intelligence that Al Qaeda has been “talking about” \nanthrax and based on supposed documents captured from Al Qaeda.  We were briefed by \n2 CIA young women who provided the same vague, soft and even embarrassingly bad \nintelligence that I have been briefed on several times before by CIA.  One gets a very bad \nimpression of the quality of our intelligence based on meetings such as this.  Also present \nwere Julie Gerberding, Art Friedlander, Ben Petro, Gerry Parker and a whole bunch of \nReleased by Chairman Rand Paul\n169CIA, Counter-terrorist people, Defense intelligence people, etc.  Subject was how do we \nprotect against drug resistant anthrax and vaccine resistant anthrax.\nMar. 8, 2008 -  Busy and nice social evening.  Dropped in briefly to the NCS Annual \nSpring Festival “Casino Night” at the Athletic Center.  Said hello to the usual suspects \nand then went to the Newseum at 555 Pennsylvania Avenue to celebrate the 65th Birthday \nof Gerry Sigal.  Beautiful setting with bay window view of the Capitol Dome.  Great \nfood, drink and dancing.  Joe Wilson and Valerie Plame at our table.  Elias and Nadia \nZerhouni were dancing away with us on the dance floor.  DC was beautiful with crisp \ncold weather (upper 20s) and clear sky.\nMar. 10, 2008 – Another in a long string of Global Health initiative meetings at the \nWhite House (EEOB 374) led by Dan Price (see above) with Gary Edson, Mark Dybul, \nPatrick Marcham, Mike Magan, Paul Brown, Dana  DeRuiter.  Mainly discussed Dan \nplans for the upcoming G-8 meeting in Japan (he is USG Sherpa).  Issues are NTDs, \nheath workforce, HIV, Malaria, and TB.  I was there representing the malaria and TB \ninitiatives (see above).  Apparently Josh Bolten is enthusiastic about both, but HHS is not \nsupporting it since their priority in a bad budget year is pandemic flu and biodefense.  \nNonetheless, I am still going to these meetings and pushing the TB and Malaria agenda .  \nI can do this since Dan Price (with Josh Bolten’s approval) is including me in the process \neven though the HHS is against it.\nMar. 19, 2008 – A most amazing and unique evening.  Michael Gerson (former Bush \nspeech-writer and advisor) and current Washington Post columnist (see other discussions \nabove) invited Chris and me to his house for a private dinner with President and Laura \nBush.  Other guests were Fred and Barbara Barnes (Fred is Executive Editor of The \nWeekly Standard , Bill and Hara Haley (Bill is pastor of a DC Church and is interested in \nAIDS in Africa), and Mike and his wife Dawn.  Dinner was at Mike’s home at 2412 \nCrest Street, Alexandria.  It was somewhat surreal, but incredibly enjoyable.  The \noccasion was just that Mike is good friends with the POTUS and when he had breakfast \nwith the POTUS a few weeks ago he asked the POTUS if he would like to have dinner \nover his house some time with a few friends.  The POTUS gladly accepted and said that \nhe almost never goes out to private dinners at people’s homes because no one ever asks \nhim, likely because they would reasonably assume that he would not accept.  Evening \nstarted at 7:00 PM.  We had to get their earlier (^:45 PM) since the secret service closed \nthe roads (395) to make way for the motorcade.  We had about 45 minutes of cocktail \nhour (POTUS had non-alcoholic beer).  Very friendly chatting about a variety of subjects.  \nMy long-time impressions of the POTUS held true that he is a very warm, funny and \nconsiderate, self-effacing person. Laura was great also.  Laura and the POTUS \nspecifically thanked me for saying such nice things about him and Laura at Jenna Bush’s \nevent at the State Department (see Mar. 3 above).  POTUS said that Jenna saw him and \nLaura that night and told them how kind I was to them in explaining the POTUS role in \nPEPFAR.  He sounded very sincere in thanking me for “making my daughter proud of \nme”.\n   Dinner was terrific with nice wines, tomato soup, steak/potatoes, salad with bacon, and \nfruit dessert.  At dinner we discussed frankly a wide variety of topics including: War in \nReleased by Chairman Rand Paul\n170Iraq; his recent trip to Africa; his dealing with various Heads of State; the upcoming \nSummer Olympics in Beijing and why he really must attend despite the current \nmisbehavior of China in brutally suppressing the Tibetan call for freedom. He told a great \nstory of when former Prince and now King of Saudi Arabia visited him at his ranch in \nCrawford and negotiations about the Israel/Palestine problem came up.  They reached an \nimpasse since the POTUS thought that the Prince was being frankly anti-Semitic and the \ndiscussions stalled.  The POTUS would not yield on one point and the Prince announced \nthat he was leaving.  POTUS sent in Colin Powell to convince him not to but Colin cane \nback and told POTUS “Boss, I am getting nowhere with him; you have to step in”.  The \nPOTUS visited the Prince, perceived the “chilly” atmosphere in the room and said before \nwe discuss anything, let me tell you what my religion has done for me.  The prince \nagreed and then the POTUS asked the Prince to talk about what the Prince’s religion \nmeans to him.  This warmed up the chill and POTUS took him out on his pickup truck to \ntour the ranch alone.  As they were talking about the problem, a turkey hen jumped up in \nfront of the truck and just stayed in the road.  The POTUS said that he had never seen a \nturkey on the road before.  POTUS explained what a turkey was and how Ben Franklin \nalmost got the turkey to be the National bird, but the bald eagle won out.  The Prince said \nthat in his country god often speaks to people through birds and this is clearly a sign from \ngod.  After that, the negotiations flourished and POTUS and the king have been the best \nof friends.\n   The conversation also included discussions about us and our families.  The POTUS and \nLaura were very interested in Jenny’s thesis on women in the criminal justice system. I \nexplained what she was doing and how she decided on this topic.  He seemed very \nconnected and empathetic to the problems of young girls getting caught up in the system.  \nHe also expressed concern that black leaders are not speaking up more about black men \nabandoning their children after they have them leading to the incredible statistics of out-\nof-wedlock pregnancies among blacks.\n   POTUS also thinks that the Dems will go into the convention with Obama ahead and \nthat it will be a behind closed doors brokered convention.  He said, “if it is a behind \nclosed doors convention, there is no chance that Obama will out-maneuver the Clinton \nmachine.  She will be the nominee, split the party and McCain will win.\n After dinner we all went over an Photo album of the POTUS and First Lady’s recent \nvisit to Africa.  The President left at about 9:25 PM in a 6 to 8 car motorcade.\n  All in all it was an incredibly memorable evening.  \n     \n   Earlier in the day I briefed Ms. Sandra Roelofs, the First Lady of Georgia.  She is \nDutch and a nursing student.  She was interested is speaking to me because she had heard \nabout my AIDS work.  We spoke of TB, AIDS and other IDs.  She had earlier in the day \nhad lunch with Laura and Jenna Bush.  Actually, Laura mentioned this to me at Gerson’s \nhouse.\nMar. 25, 2008 – I organized and ran what might be an historic meeting today on the \nfuture of HIV Vaccine Research.  Ever since the disappointing results from the STEP \ntrial (Merck ad5 prime-boost – see above), there has been increasing pressure within \nourselves and in the scientific and certain activist communities to re-evaluate whether we \nshould turn the knob of support more towards basic discovery as opposed to clinical trials \nReleased by Chairman Rand Paul\n171of vaccine candidates for an HIV vaccine.  On Nov. 16, 2007 I received a letter from a \ngroup of basic scientist/animal model HIV researchers asking to meet with me following \nthe failed STEP trial in which vaccinated people with pre-existing Ad5 titers actually \nseemed to have an increased risk of HIV acquisition compared to placebo.  They felt that \nwe were wasting money on vaccine trials which they claimed had no basis to predict \nsuccess based on animal model data.  They were particularly concerned about going \nahead with Gary Nobel’s VRC trial –PAVE 100 that tested  3 DNA primes followed by \nan Ad5 boost.  However, others point out that the animal model has not been validated in \nthe human and so unfortunately, we are really flying blind.  In any event, in a manner \nsimilar to how I handled the AIDS activists >20 years ago in that same room (31/7A-24), \nI listened and suggested that we have HIV Vaccine Summit to discuss the direction of \nAIDS research.  Hence the meeting today.\n    Just a few days ago, a group called AIDS healthcare Foundation stated that we should \nstop ALL HIV vaccine research and put the money towards proven prevention activities.  \n   We had the Summit today and it was enormously successful.  I played an active \nleadership role in the process as opposed to just listening.  The meeting was chaired by \nWarner Greene and Adel Mahmoud and there were 3 panels: 1) basic discovery chaired \nby Jim Hoxie and Dennis Burton; 2) animal models chaired by David Watkins and \nMalcolm Martin; and 3) Clinical Research chaired by Scott Hammer and Julie \nOverbaugh.  \n   Great press coverage.  I concluded at end of meeting that we would indeed turn the \nknob more towards basic discovery research and promised an immediate $10 Million for \na broad RFA to come from moneys saved from truncating some of the clinical trial \nactivity such as a tighter PAVE 100.  Recall that our budget has been flat for the past 5 \nyears and so there is no extra money coming in.\n   Below is an article from the NY Times by Larry Altman from Mar. 26 that summarized \nthe Mar. 25 meeting:\nRethinking Is Urged on a Vaccine for AIDS \nBy LAWRENCE K. ALTMAN\nWASHINGTON — Researchers must go back to the drawing board before they can \ndevelop an effective vaccine against H.I.V., AIDS experts said at a scientific meeting on \nTuesday.\nAnd Dr. Anthony S. Fauci, the top federal official responsible for AIDS research, agreed \nthat more fundamental knowledge is needed about H.I.V. and the way the body and \nexperimental vaccines respond to it before the goal of a licensed H.I.V. vaccine can be \nreached. Dr. Fauci, the director of the National Institute of Allergy and Infectious \nDiseases, pledged to re-evaluate the use of all $1.5 billion his agency spends on AIDS \nresearch to come up with the necessary money.\n“Everything is on the table,” Dr. Fauci said at the one-day meeting, a Town Hall-type \ndiscussion for vaccine researchers on how best to spend federal H.I.V. vaccine money in \nlight of a budget that has been flat for several years.\nReleased by Chairman Rand Paul\n172“There is not an immediate solution to the problem,” Dr. Fauci said in an interview. But, \nhe also said, the budgetary constraints mean that “we are going to have to justify what we \nare doing” and determine what steps to take after further discussions in smaller meetings \nwith researchers.\nThe reassessment comes after last September’s widely publicized failure of what had \nbeen the most promising candidate for an H.I.V. vaccine. Many health officials believe \nthat an effective vaccine would be the most crucial weapon in stopping the H.I.V. \npandemic.\nScientists do not have a full understanding of why the vaccine failed, or why it was \npossibly harmful, in two large trials in the United States and South Africa. Dr. Fauci’s \ninstitute helped pay for the trials of the vaccine, which was made by Merck. Such failures \nhave led a number of scientists to challenge the direction of federal H.I.V. research.\nOn Tuesday, the AIDS Health Care Foundation called for the suspension of money for \nH.I.V. vaccine research and reallocating resources into effective H.I.V./AIDS prevention, \ntesting and treatment strategies.\nBut Dr. Fauci strongly rejected the proposal. “Under no circumstances will we stop AIDS \nvaccine research,” Dr. Fauci said at the conclusion of the meeting.\nDr. James Hoxie of the University of Pennsylvania echoed the belief of many other \nparticipants by saying, “we are not close to having a vaccine” and “there is a tremendous \nneed for innovation” in developing one.\nExperts at the meeting also said that Dr. Fauci’s agency needed to support efforts to \nfurther develop animal models of human H.I.V. The experts also urged greater \ncooperation between AIDS scientists who work on such animal models and those who \nare trying to develop an H.I.V. vaccine for humans.\nA crucial issue is supporting younger researchers to replace the cadre of veteran AIDS \nscientists, many of whom are working beyond traditional retirement age. Dr. Fauci said a \nfirst step would be to pare existing projects to immediately provide $10 million to $15 \nmillion for about 30 grants to be awarded to scientists who propose novel ideas. Some of \nthe grants would be used to support young researchers, he said.\nSome scientists support conducting large vaccine trials in humans before all the fine \npoints of the vaccine research are complete in animals because of the urgency of the \npandemic.\nOthers urge caution out of fear that failures could destroy confidence among uninfected \npeople most at risk who would be needed as volunteers in future trials.\nEqually vocal groups call for testing everything as soon as the research shows promise \nbecause of the urgent need for a vaccine.\nReleased by Chairman Rand Paul\n173Dr. Warner C. Greene, a co-chairman of the meeting and director of the Gladstone \nInstitute of Virology and Immunology in San Francisco, said he hoped that a century \nfrom now, historians looking back on the AIDS pandemic would view Tuesday’s meeting \nas a turning point. \nMar. 26, 2008 – Rave reviews coming in regarding “my leadership” during the Summit.  \nWent down to White House (NEOB 5235) to brief OSTP WH Science Advisor Jack \nMarburger and his staff together with staff from FLOTUS on the HIV vaccine situation, \nparticularly given all of the publicity.  I had appeared on NBC News, VOA, Bloomberg \nTV as well as articles in Washington Post, NY Times (see above) and WSJ.  Now we \nneed to follow-up with RFA’s etc.\nApril 1 and 2, 2008 – Visited Princeton University  to Deliver the Inaugural Adel \nMahmoud Lectureship and to participate in a Panel discussion with Bill Frist, Andrew \nMcGuire, and Beatrice Hahn at a Symposium on “No Country Left Behind:  \nTransforming Global Health given by the Woodrow Wilson School of Public and \nInternational Affairs.  Bill Frist spent some time telling the audience that if it were not for \nme PEPFAR would not have happened.  Had dinner at a Princeton mansion, went to Adel \nMahmoud’s and Sally Hodder’s home (where I stayed overnight – beautiful modern \nSalvatore Dali-like home) for after dinner cocktails with some of the Princeton Faculty.  \nWas very impressed with the commitment to teaching students that I saw among the \nfaculty as well as the competency and popularity of Shirley Tilghman (President).  Next \nday taught a class in the Dept. of Molecular Biology run by Leon Rosenberg and Adel \nMahmoud. Spoke about the evolution of my career.  Students were great.\n   On evening of April 2, had long interview with Meredith Wadman of Nature who is \ndoing a story on PEPFAR and wanted a bit of the history.\nApril 3 – June 10, 2008 – Very busy and eventful times.  Had virtually no time to enter \nevents into diary.  We try to summarize.  The Democratic primary loomed hot and heavy \nwith Hillary refusing to concede despite the fact that numerically it was impossible for \nher to pull ahead of Barack Obama.  Finally after the Oregon (Obama) and South Dakota \n(Clinton) primary, she begrudgingly conceded on June 6.\nApril 21 – Participated with Sec. Leavitt in a “Georgetown Conversations” function at \nthe home of April and John Delaney in Potomac, MD.  This series is sponsored by Meryl \nChertoff (Mike Chertoff’s wife) and Larry Gostin.  Bring together a bunch of prominent \npeople in an elegant home and make brief statement, followed by Qs and As and then \ndinner.  Very enjoyable.\nApril 26 – Went to Chicago for the AAP Annual Meeting to induct Bob Seder into the \nAAP (I sponsored him).  Saw Megan and had a nice brunch and then went to L.A. for the \nMilken Institute’s Annual Global Conference where I participated in 2 stimulating Panel \nDiscussions on Global Health.  Greg Simon (Al Gore’s former Chief-of-Staff) got me \ninvolved.  Met a lot of political financial backers at the meeting.  Had dinner at the L.A. \nmansion (Sunset Boulevard) of Lynda and Stewart Resnick and gave dinner remarks.\nReleased by Chairman Rand Paul\n175June 17, 2008 –   I will be attending \nhis memorial service at the Kennedy Center tomorrow.\n    Bono called me today to congratulate me on receiving the Presidential Medal of \nFreedom.  I caught him up on my family and mentioned that Megan was starting at \nColumbia in September.  His daughter Jordan (JoJo) is also starting Columbia.  He asked \nme to send him Megan’s contact information since he is worried that his daughter will be \nlonely since she is coming directly from Ireland.  Perhaps they will become friends.\nJune 18, 2008 – Attended the memorial service for Tim Russert at the Kennedy Center.   \nExtraordinary Washington affair with the total “A list” present.   Hosted by Tom Brokaw.   \nSee book published in 2013 called “This Town” by Marc Liebovich for full details of the \nceremony.\nJune 19, 2008 – Extraordinary day at the White House for the Presidential Medal of \nFreedom Ceremonies.  Crisp, clear blue sky, sunny and comfortable day.  A lot of joy in \nthe presentations (see my written file records of what was said about me by the POTUS).  \nVery good media coverage.   The presentations for everyone were very warm.  Lots of \nwonderful pictures.  Many guests (some of whom came for me) such as Justice Scalia, \nSam Donaldson, Cuba Gooding, Judge Merrick Arlen, Gen. Richard Meyers,, etc.  I had \nvery warm interaction with the POTUS.  When we approached him with my group of 10 \n(Chris, Jenny, Ali, Denise and Jack, Cliff Lane, Hugh Auchincloss, J.J. McGowan, Greg \nFolkers and Patty Conrad) to take a group Picture, the POTUS hugged me and put his lips \nto my ears and said, “I love you Tony, Thanks for all you do for our country and the \nworld”.  The ceremony took place in the east Room and the reception took place in the \nBanquet room of the East Wing.  After the ceremony we watched from the balcony as the \nPOTUS took off in Marine One for a tour of the flood damage in Iowa.\n   After the reception, Chris took off with Ali to fly to Chicago to bring home Megan \nfrom her year there.  Jenny is home after graduation trying to decide what she will do \nnext year.\nJune 21 – 29, 2008 – Extraordinary trip to Greece with Chris, Jenny, Megan and Alison.  \nI went first to Thessaloniki to deliver Keynote Address at the Immunocompromised Host \nSociety Chaired by Steve Holland.  Spoke on HIV/AIDS (of course).  Then met family in \nAthens where I received an honorary doctorate at the University of Athens sponsored by \nHaralampous (Harry) Moutsopoulos, my old friend from NIH days 30 years ago.  \nAbsolutely fabulous time, elegant hotel (Grand Bretagne), wonderful food, elegant \nceremony (very formal with old robes), sight-seeing at Acropolis, Agora, Old Olympic \nStadium.  Then spent 3 days on the island of Santorini (Ali picked the place) in a \nbeautiful, but understated beachfront Hotel with Harry and his wife Foteini.  Santorini is \na volcanic island of indescribable beauty.  Perfect weather – no clouds at all for 1 week in \nGreece.  Great hospitality, especially from Harris Roussos, an old and dear friend of \nHarry’s who runs the biggest hospital in Athens and who owns an elegant home in \nSantorini.  They threw a “Greek-Style” party for us one night.  Spent evenings eating \nReleased by Chairman Rand Paul\n\n176elegant meals at mountain cliff restaurant or on the beach.  Visited Oia, Fira – stayed at \nKamara Beach.  One of the best vacations (albeit brief) that I have ever experienced.\nJuly 3, 2008 – Gave lecture at the Ideas Festival at Aspen, CO on HIV/AIDS in 2025:  \nWill we have a vaccine and a cure by then?”.  Usual ambiance of Aspen with nice dinner \non the night of July 2 catered by the famous Alice Waters of Chez Panisse in Berkley, \nCA and narrated by Corby Kummer, renowned food critic of The Atlantic (also the \nperson who lent us his apartment in Boston for Jenny’s graduation (see above).  Met \nusual celebrities at dinner.  Spoke with Chris Jennings (Clinton’s Health person who is \nnow with the Obama Campaign since Obama won the primary.  He wants to get me \ninvolved as a person to advice the campaign informally about what they are on track with \ncertain issues.\nJuly 6, 2008 – Wonderful day.  Chris Hultzen arranged to have Danny and Joe Hultzen \nand their friend Austin do “batting practice” with me at STA field.  Danny pitched to me \nand it was terrific. I hit several line drives to outfield, but the distance was poor, nothing \nlike the fence shots that Danny and the others were hitting.  It is clear that my power is no \nwhere near Danny’s and the others.  I pitched to Danny and he hit some over the right \nfield fence.\nJuly 17, 2008 – Made what some are saying is a “landmark decision not to proceed with \nthe PAVE 100 HIV vaccine trial of the NIAID VRC product.  This followed weeks and \nmonths of committee meetings and recommendation such as the AIDS Vaccine Research \nSubcommittee (AVRS) who voted to proceed and the Strategic Working Group (SWG) \nwho voted not to proceed.  The issue was that the Merck STEP trial failed and actually \nhad some safety issues.  The PAVE trial is somewhat different (3 DNA primes and an \nAd5 boost containing env) from the STEP trial (3 Ad5s without env), yet the preliminary \nimmunological data from PAVE 100 was in my mind (some such as Gary Nabel \ndisagreed) not much better than those of STEP.  I received many e-mails from people \narguing for and against.  The decision was mine alone and I decided to reject the \nproposed PAVE trial of 2400 people since it was powered to do immunological correlates \non a subgroup who might seem to benefit even if the endpoint of the entire group was not \n“effective”, i.e. decrease in viral set point after infection.  I argue that if the trial failed, I \nam not interested in the immunological correlates in a subgroup since this has no \nstatistical value.  There was much activity in the Press about my decision and the \nfeedback was overwhelming that I had made the right choice.  I encouraged Larry Corey \nof HVTN and Scott Hammer the PI of PAVE to come back to me with a “leaner, meaner” \nprotocol that is less expensive, fewer people, less samples to ask if the product works.  If \nit does, then we will go back and do immune correlates.\nJuly 30, 2008 – Christine, Meg and Ali left for Rwanda to spend 2 weeks working with \nPaul Farmer in his Clinic.  More later.\nJuly 30, 2008 – Invited to the White House (East Room) to witness and celebrate the \nsigning by the POTUS of the reauthorization of PEPFAR at $48 Billion.  The law is \nofficially H.R. 5501 – The Tom Lantos and Henry J. Hyde United States Global \nReleased by Chairman Rand Paul\n177leadership Against HIV/AIDS, Tuberculosis and Malaria reauthorization Act of 2008.  \nThe usual cast of HIV-related characters was there.  It felt good to see the attention, \nsuccess and promise of a project that I developed. Now we need to make sure that this \nreauthorization ultimately turns into an appropriation.\nJuly 31 – Sept. 15, 2008 – Busy summer with little time with family.  Chris and girls \nwent to beach while I stayed for duties at work.  Chris, Megan and Ali went to Rwanda to \nwork with Paul Farmer for 2 ½ weeks.  I did not go since I had to give Keynote Lecture \nat the IAS Meeting in Mexico City (August 3-8).  I focused on a discussion of whether \nwe will ever have a “cure” or a vaccine for HIV.  It stirred much discussion and was well \nreceived.\n    We moved Megan into her dorm at Columbia last week in August.  It was great fun.  I \nhave a very good feeling about Columbia and hope Megan has a good experience.  \n   Jenny has taken a job teaching in a Charter School in the Brownsville Section of \nBrooklyn (adjacent to Bedford-Stuyvesant).  She is living in Prospect Heights-Crown \nHeights.  After my childhood growing up in Brooklyn, I never would have imagined that \nmy 22 year old daughter would be living in the toughest section of Brooklyn.  She loves \nteaching the children.\n   Amazing political season in Washington, D.C.  Sarah Palin has been chosen as John \nMcCain’s running mate and this has shifted the momentum (amazingly so) to the \nRepublicans since she has energized the far-right conservative base. I may be pre-\njudging, but she seems to be totally unqualified to be Vice-President (or President) of the \nUSA.\n   On Sept. 14, went to a great BBQ party at Sam Donaldson’s home in McLean, VA.  All \nthe usual suspects were there with whom I have become friends with over the years and \nwe talked election year politics:  Colin and Alma Powell, Lee Hamilton, Bob Barnett, \nFred and Marlene Maleck, John and Debbie Dingel, Bill and Janet Cohen, Wayne and \nCatherine Reynolds, Steve and Alice Rosenberg, Ben and Candy Carson, Birch and Kitty \nBayh, and many others.\n  On the evening of Sept. 15 Chris and I attended one of the spectacularly elegant \nreception/dinner parties hosted by Wayne and Catherine Reynolds at the Eisenhower \nTheater of the Kennedy center to celebrate the re-opening (after upgrading) of the \nTheater.  Again, all the usual suspects of Washington glitterati were there – most people \nfrom Sam Donaldson’s party the night before as well as many other media, government \nand military people: Gens. Jim Walston, Wesley Clark, James Jones, Colin Powell; the \nEisenhower grandchildren (Anne and Susan); journalists (Chris Wallace, Wolf Blitzer) \nand on and on.  Really a very relaxed evening with spectacular entertainment.  The \nreception was in the foyer outside the Theater and the dinner was right on the Theater \nStage with performances by dance troupes, Jane Alexander, the entire original cast of \n“Mame” right within a foot or two of the dinner tables.  Wayne and Catherine do it again!\nReleased by Chairman Rand Paul\n178Sept. 16, 2008 – Testified before Rep. Henry Waxman’s House Committee on Oversight \nand Government Reform in Rayburn House Building Room 2154. Topic = HIV \nprevention in light of the new numbers from CDC showing that the incidence in USA of \nHIV is worse than was previously calculated – 56, 300 versus 40,000.  Other main \nwitness was Julie Gerberding with Kevin Fenton of CDC and Tom Insel of NIH as back-\nups.  Hearing went very well – generally friendly.  Maxine Waters gave Julie Gerberding \na hard time about not acting with leadership in a “crisis”.  I stated that needle-exchange \nworks and that abstinence only does not work.  This may upset some ideologues in HHS \nor the WH.  Mild Fall day – slightly cloudy.\nSept. 23-30, 2008 – Major crisis on Wall Street and in the banking industry with big \nbanks and financial institutions failing – Lehman Brothers (Bankrupt), Fannie Mae and \nFreddie Mack taken over by the government, AIG bailed out by the government; many \nbuyouts and mergers, stock market plunged by 777 points in 1 day – largest drop ever.  \nCongress trying to agree on a $700 Billion bailout package for financial institutions to \nrestore the credit flow in the USA.  Big problems!!\nOct. 1, 2008 – On Sept. 23, 2008 Elias Zerhouni announced that he would step down as \nNIH Director at the end of October, right before the election to avoid any confusion about \npolitical issues and to call attention to the vacancy for the incoming transition.  I was \nasked to be Acting Director and refused; Steve Katz was considered but was rejected by \nthe WH because of the LA Times story on him and conflict of interest a few years ago.  \nBetsy Nabel either withdrew her name or was not asked because of an issue of a COI of \none of her recently hired Senior Advisors.  Raynard Kington (current deputy NIH \nDirector) should have been asked directly but was not.  Not clear why the DHHS and/or \nthe WH are uncomfortable with him.  One version is that he is not well known in the \nCongress and among constituencies; anther more cynical version is that the WH has a \nproblem with a gay man (he is married and has an adopted child).  The WH and/or DHHS \ntried to then get me to agree to be publicly appointed as a “Senior Advisor” to the Acting \nDirector to quell the concerns of the outside people and indicate that a strong, visible, \nexperienced person such as me was “watching the store” even though Kington would be \nappointed as the official Acting Director.  I told Elias and Jamie Burke (White House \nLiason Office) that this was impossible and no way would I do this.  I told them explicitly \nthat I did not want to do it in the first place; second – it was an insult to Kington and \nwould undermine his authority; third – people would come directly to me and circumvent \nKington’s authority; fourth – it looks stupid.  She actually agreed and so the decision was \nto appoint Kington cleanly and have me be available “behind the scenes with no \nannouncements” to advise him if he needed advice.\nOct. 2, 2008 – Gave Inaugural Ben Kean Lecture on Global Health at New York \nPresbyterian Hospital - Weill Cornell Medical Center.  Great déjà vu  feeling about my \nyears there.  Much adulation among house staff at lecture and morning report.\nOct. 3 – 4, 2008 – Went to Parent’s Weekend at Columbia for Megan.  Jenny (living in \nBrooklyn) joined Chris and me for a couple of dinners with Meg. Went to Columbia-\nReleased by Chairman Rand Paul\n179Princeton football game.  Great weekend.  Jenny, Meg and I watched the Sarah Palin – \nJoe Biden debate.  What an idiot Palin is!!\n      Stock Market is tumbling badly.  It is scary as it looks like it is crashing as a result of \nthe bank credit crunch that is causing anxiety of Wall Street.  When this settles, I will re-\nthink the advisability of my even being invested in Wall Street as opposed to safe Money \nMarket investment or T bills.\nOct. 6, 2008 – Big news today.  Nobel Prize in Medicine or Physiology given to \nFrancoise Barre-Sinoussi and Luc Montagnier for HIV and to Harald Zur Hausen for \nHPV discovery..  This is a big slight to Gallo, likely because of the controversy from the \n1980s.  The Committee could have given the 3 (limit) to HIV and save HPV for another \nyear; yet they combined them and thus Gallo was out since it is clear from the 1983 \nScience paper that Montagnier and Barre-Sinoussi discovered the virus first, although \nGallo proved cause effect one year later and discovered TCGF (IL-2) that allowed \neveryone to grow T cells in culture and hence grow the virus.\n     Gave the after dinner address at the Woodrow Wilson Internal Center for Scholars \nDinner for their Board of Trustees, Councilors, and Scholars at the Ronald Reagan \nBuilding in DC.  Cool, crisp night.  I was invited by Lee Hamilton. Many notable people \nthere including Sam and Jan Donaldson, Marvin Kalb, Robin Cook, etc.  I spoke on \nHIV/AIDS:  An Historical Perspective.  Talk extremely well received.\nOct. 11 – 16, 2008 – Traveled to Cape Town, South Africa to deliver a keynote address \nat the 2008 AIDS Vaccine Meeting on “An HIV Vaccine: Science and Policy”.  The talk \nwas very well received.  I spoke of the particular challenges of  HIV vaccinology \ncompared with “classical” vaccinology.  Weather was beautiful and the city was in my \nmind a cross between San Francisco and Rio de Janeiro.  We took a drive on Monday \nAM, Oct. 13 around the countryside to vineyards and around the historical parts of the \ncity.  Most disturbing to me was the conditions that I saw at the “townships” a few miles \noutside of the city.  Particularly disturbing was Khayelitsha township that seemed to go \non for miles with huts that were made of corrugated tin roofs and plywood and other soft \nmaterial.  The huts were smack next to each other with very little room between them to \neven walk outside.  Apparently they have electricity in some huts and common water \nsources and latrines, but I cannot imagine anyone living there.  The black South Africans \nsay that it is not as bad as it looks and they are gradually trying to phase them out and \nreplace them with regular housing.  I cannot judge since this is the first time that I have \nseen them, but I would flatten the whole thing now and build high-rises.  Problem is that \nhundreds of thousands of people live there and you cannot just displace them now \nwithout a facility to put them in.\n   I have some concern at this point that the Vaccine Enterprise in the person of Allan \nBernstein is looking for ways to change the direction of HIV vaccine research even \nthough he has been in the field only for months.  He is a very good guy, but I repeat my \nusual statement of “everybody wants to be somebody” and “beware of people who do not \nReleased by Chairman Rand Paul\n182Anthony Fauci\n \nOn the art of persuasion. There's more than one way to get to the goal that you want to \nget to, but once you compromise your own principles, then you're lost. You're really lost. \nYou just can't do that, even if it means that people are going to be disappointed in you \nand you might not find yourself in the inner circle. Every time I go to a meeting in the \n[White House's] Roosevelt Room or the Oval Office or in the chambers of Congress, I \nkeep in my mind that I may have to say something that will disappoint people, and if that \ndisappointment leads to my not getting asked back, so be it.\nOn being principled without destroying relationships. You maintain a respect for the \nother person, and you reflect that in how you deal with that person—although you may \ndisagree with them, you respect them and their right to have their view. I've had \ndiscussions with people who somehow just didn't get it. You never walk away in \nfrustration. Some people feel, you make your case, if they listen to you, fine, if they don't, \nthat's it. That's not what leadership is. Leadership is trying to continue to make a case.\n•Click here for more of America's Best Leaders \n•Click here for more on Anthony Fauci\nAmerica's Best Leaders 2008\nDavid Gergen: Obama Is a Leader of Great Potential, but He Can’t Do \nIt Alone \nThis year’s Best Leaders are the kind of people who can help him lead us out of our \ndoldrums.\nLance Armstrong \nCyclist and Advocate Making tireless efforts on behalf of cancer survivors like himself.\nDavid Baltimore  \nCalifornia Institute of Technology This Nobel-winning scientist leads with \"a little bit of \nchutzpah.\"\nReleased by Chairman Rand Paul\n183Regina Benjamin \nLe Batre Rural Health Clinic  She believes that living in a tiny rural town shouldn't mean \ngiving up big-city healthcare.\nJeff Bezos \nAmazon.com The founder of the massive online retailer is a true Internet pioneer.\nTerence Blanchard and Herbie Hancock \nThelonious Monk Institute Their Thelonius Monk Institute of Jazz brings music education \nto public schools.\nBenjamin Carson \nJohns Hopkins Hospital A talented pediatric neurosurgeon and activist for inner-city kids.\nManny Diaz \nMayor of Miami A son of Cuban immigrants, Diaz leads one of the nation's major \nmulticultural cities.\nMarian Wright Edelman  \nChildren's Defense Fund A civil rights pioneer and crusader on behalf of children.\nAnthony Fauci \nNational Institute of Allergies & Infectious Diseases A leader on HIV/AIDS and a \nstraight talker on key health issues.\nMike Feinberg and Dave Levin \nKnowledge Is Power Program Raising educational expectations in underserved \ncommunities.\nOpinion\nThe Financial Crisis Kills Trust in Leaders \nBill George: We must do more than fix the crisis; we need to fix the mindset that got us \ninto it.\nReleased by Chairman Rand Paul\n184Obama and American Followership \nBarbara Kellerman: At this moment in history, diffusion of power overwhelms \nleadership.\nRobert Gates \nSecretary of Defense Pentagon chief looks for uses of \"soft power\" in a hard power \nworld.\nFiona Harrison and Maria Zuber \nNASA scientists The first two women to head their own NASA robotic space missions.\nFreeman Hrabowski \nUniversity of Maryland-Baltimore County He helped turn a no-name commuter college \ninto a center for math and science.\nAmory Lovins \nRocky Mountain Institute  For this bright light in the field of alternative energy, it's all \nabout efficiency.\nAnne Mulcahy \nXerox In reforming a troubled company, she had the courage to say \"No\" to Wall Street.\nIndra Nooyi \nPepsiCo Karaoke-singing chief executive is taking Pepsi in an unlikely direction--toward \nhealthful foods.\nLinda Rottenberg \nEndeavor Her nonprofit seeks to build profitable small businesses on a global scale.\nJeffrey Sachs \nUnited Nations Millennium Project An academic who looks for real-world ways to beat \nglobal poverty.\nSteven Spielberg \nFilmmaker He addresses important issues on the big screen and through his philanthropy.\nReleased by Chairman Rand Paul\n185Michael Tilson Thomas \nSan Francisco Symphony  A maverick maestro is winning big crowds of new classical \nmusic fans.\nU.S. Junior Officers \nMilitary They are rising in the military ranks with a hard-earned wisdom forged by war.\n \nA New Leadership Style For America  \nJoseph S. Nye Jr.: It's time to retire the \"big man,\" heroic warrior model of leadership.\nLance Armstrong: Beatrice De Gea/ The New York Times/Redux; David Baltimore: \nManjunath Kiran/EPA/Corbis; Regina Benjamin: Charlie Archambault for USN&WR; \nJeff Bezos: Brian Smale/Redux; Terence Blanchard: David Butow/Redux for USN&WR; \nBenjamin Carson: Gurinder Osan/AP; Manny Diaz: Paul Sancya/AP; Marian Wright \nEdelman: Jeffrey MacMillan for USN&WR; Anthony Fauci: Charlie Archambault for \nUSN&WR; Mike Feinberg: Kevin Horan/Aurora for USN&WR; Robert Gates: Jeffrey \nMacMillan for USN&WR; Herbie Hancock: David Butow/Redux for USN&WR; Fiona \nHarrison: David Butow--Redux for USN&WR; Freeman Hrabowski: Jeffrey MacMillan \nfor USN&WR; Indra Nooyi: Neville Elder/Corbis; Dave Levin: Jim Lo Scalzo for \nUSN&WR; Amory Lovins: Ben Stechschulte/Redux; Anne Mulcahy: Ben Baker/Redux; \nLinda Rottenberg: Peter Dejong/AP; Jeffrey Sachs: Chip East/Reuters; Steven Spielberg: \nSteven Henry/Getty Images; Michael Tilson Thomas: Chris Gordon/Getty Images; U.S. \njunior officers serving in war zones: Joe Raedle/Getty Images; Maria Zuber: Bill \nIngalls/NASA\nNov. 21, 2008 – Went to dinner party at Ellen and Gerry Sigal’s home.  Present were \nChris Grady, Ellen, Gerry, Richard and Donna Benveniste, Bill and Melody Wilson, \nLarry and Carla Silverstein, Neera Tanden and husband Dan.  Neera is on the Obama \ntransition team and I am sure that Ellen in her quest to get me to become NIH Director set \nthis up for us to meet.  I am very reluctant to take the job and soon I will likely have to \ntell the Obama people “no” if they ask. \nPrior to the Sigal dinner party I gave remarks at the opening reception for the TAG \nWorkshop on Eliminating Viral Persistence and Eradicating HIV infection.  This is \nbecoming a very hot issue that I have been pushing in the sense of a “functional” cure.\nReleased by Chairman Rand Paul\n186Nov. 22, 2008 – Was invited by former President George H.W. Bush to attend the \nchristening of the new aircraft carrier USS George H.W. Bush at Norfolk , VA on Jan. \n10, 2009.  \nNov.24, 2008 – Breakfast and panel discussion at the National Press Club in association \nwith my (and others) receiving the recognition of America’s Best Leaders 2008 (24 \nLeaders Who are Making a Difference) by U.S. News & World Report and the Center for \nPublic Leadership of the John F. Kennedy School of Government at Harvard University.  \nDavid Gergon MC’d the affair and C-SPAN-2 covered it.  We also all appeared in the \nDec. 1-8, 2008 issue of U.S. News & World Report.  Other winners who were present \nwere: David Baltimore, Regina Benjamin, Benjamin Carson, Manuel Diaz (Mayor of \nMiami), Marian Wright Edelman, Fiona Anne Harrison, Freeman A. Hrabowski (Pres. U \nof MD, Baltimore County, Dave Levin (Founder of KIPP Foundation, Linda Rottenberg \n(CEO, Endeavor), Mike Feinberg (C0-founder of KIPP), Maria Zuber (MIT).  Awardees \nwho were not there: Lance Armstrong, Jeffrey Bezos (CEO, Amazon.com), Terence \nBlanchard and Herbie Hancock (Thelonius Monk Institute of Jazz), Robert Gates \n(Secretary of DoD), Amory Lovins, Anne Mulcahy (CEO Xerox), Indra Nooyi (CEO, \nPepsiCo.) Junior Officers DoD, Jeffrey Sachs, Steven Spielberg, Michael Tilson Thomas \nMusic Director, SF Symphony.\n     David Gergon asked each of us what we would recommend to President-Elect Obama \nas an area that he should pay attention to.  I stressed the need for support of biomedical \nresearch and also the importance and moral obligation that we have towards promoting \nGlobal Health and its potential for “Health Diplomacy”.\nNov. 25, 2008 – Received a call from Aaron Pickrell who is running the Obama \ntransition team for HHS and sub-agencies.  He said that my name is actively being \ndiscussed for NIH director and he wanted to know if I was interested.  I was frank and \nhonest with him saying that I wanted to remain as NIAID Director, but I want to be part \nof the Obama team and perhaps we could work out something informal (without title) or \nmore formal (?Special Assistant or Special Advisor to the POTUS) for issues on Global \nAIDS, Emerging infections, and Biodefense.  He said that he would run this up the ladder \nand see how people react.  My real desire is to stay where I am but to be called upon as I \nhave been for 20+ years on issues mentioned above.  I do not want to give up my solid \nbase of scientific credibility.  I hear that Francis Collins is aggressively campaigning for \nthe job of NIH Director – not surprising.\nNov. 29, 2008 – Had brunch with small group of people at Richard and Donna Ben-\nVeniste’s house.  He is a great guy with whom Chris and I have developed a nice \nfriendship.  He asked about the NIH Director job and suggested without my implying that \nI should tell the Obama people that I want to do both NIAID Director and NIH Director.  \nThis is what I agreed upon with Tommy Thompson 6 years ago, but the WH (Clay \nJohnson) blocked it and said that I could take one or the other.  I picked NIAID Director.  \nI actually do not think that doing both jobs would work, mainly because people would \njump on the “appearance” of conflict every time that I made a decision that they did not \nlike or if their grant did not get funded, and on and on.  Also at the brunch was Carl \nReleased by Chairman Rand Paul\n187Feldbaum, the IG of the DoD during the Carter Administration and his son Harley who is \nat Hopkins School of Public Health and is very interested in “Health Diplomacy”.  He has \nbeen an admirer of mine for years as a student.  I hope to help him and perhaps advise \nhim on career choices.\nNov. 30, 2008 – Sunday AM (pouring rain).  I had backed out of the Redskins- NY \nGiants game with Gene Elrod because my daughters were home for Thanksgiving \nweekend. Got a call from Jay Lefkowitz who is writing a brief history of PEPFAR for a \ntrade journal (forgot which one).  He wanted to do a historical fact check with me about \nthe timing of meetings that we had with Josh Bolton, Gary Edson, Kristen Silverberg in \nthe WH.  His version of events was strikingly close to my historical memory.  During the \nconversation he asked about the NIH Director job and we reminisced about the Bush \nyears.  Interesting fact that he dropped.  He related that he was having a conversation \nwith Bush during the time of the", "summary": "Watcher-discovered document from paul-readingroom (2026.07.27_Diary-Prequel-.pdf), auto-indexed 2026-08-05.\n\nExcerpt: DHHS $7 to 9 billion supplemental  budget request for FY2006 for Pandemic Influenza Preparedness.  She wanted my  opionion so that she could transmit this to the Vice President who wants to know what I  think of the feasibility of the request Sept. 15, 2005 – Accompanied Sec. Leavitt and Bruce Gellin and Julie Gerberding to  brief 3 cabinet secretaries today on Pandemic Flu.  Briefed Sec. of VA Jim Nicholson,  EPA Administrator Steve Johnson and Treasury Secretary Snow.  Got an e-mail from  Fran Townsend of HSC who mentioned that the President has mentioned that he always  feels more comfortable when he knows that I am working on important health problems  (see visit to the POTUS on Sept. 9). Sept. 19, 2005 – Again, accompanied Sec. Leavitt, bruce Gellin, Julie Gerberding and  Bill Raub…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.27_Diary-Prequel-.pdf", "pdf_url": "/archive-docs/fauci-files/c1dee44b66471ea95f8e8154b109f914/pdf", "doc_date": "2026-08-05", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-07-27-diary-prequel"], "part_number": 3, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 4 of 8)", "content": "NIH Director decision and Bush said, “why not just \nappoint Tony Fauci”.  Jay agreed.  Jay now casually mentioned that Karl Rove was \nagainst my candidacy.  He did not say why.  I could be that he was against the “dual” \nappointment or perhaps he was influenced by Sen. Brownback’s concern about my stance \non fetal tissue and stem cell research.  I guess that I will never know.\nDec. 6, 2008 – Annual Christmas Party at Sam and Jan Donaldson’s home.  As usual, \ngreat time with the standard cast of characters some of whom are: Colin Powell, Wolf \nBlitzer (CNN), Bob Barnett, George Will, Ellen and Gerry Sigal (told me that Francis \nCollins is “aggressively” campaigning for the job of NIH Director.  I told her that I \npreferred to stay at NIAID.), Bob  Mueller (FBI), Gen. James Jones (new National \nSecurity Advisor for Obama; we spoke about the importance of biodefense and gave him \nmy card).  Great time was had!\n   After the Donaldson party went to the National Zoo (Amazonia) for the 50th Birthday \nparty for Greg Folkers thrown by his significant other Sheila Stinson.\nDec. 7, 2008 – (Sunday) – got e-mail asking me to call Mike Froman from the Obama \nTransition Team, wanting to know if I was interested in the NIH Director’s job.  He said \nthat Obama had mentioned my name to him and asked that he contact me.  I told him \nwhat I told Aaron Pickrell on Nov. 25 (above) that I felt that I could serve Obama, his \nadministration, and the American people better in my  current job and expressed a \nwillingness to work closely with them the way I have with the Bush and Clinton \nAdministrations.  He understood and asked if I would be willing to help vet names for \nthem as they narrow the search.  I told him that I would be happy to do that.\nDec. 9, 2008 – Chris and I went to the VP Mansion for the Annual Christmas Party.  \nBitter-sweet since this is the last one that I will have gone to the mansion for the Bush \nAdministration and maybe (who knows?) the last visit that I might make to the VP \nmansion.  Chris and I reminisced that the first time we came here was when George H.W. \nBush was VP in the early 1980s and how we returned several times for receptions and \nbrunches as the VP and I became friends.  Tonight there was the usual cast of people who \nI had the opportunity to talk to and thank for the years of working together and helping \nReleased by Chairman Rand Paul\n188each other out.  First and foremost was VP Cheney who expressed his appreciation for \n“all that I have done for our country” over the years that we had worked together and \nbeyond.  Also, reminisced with Bruce Miller (VP’s Chief for biodefense), David \nAddington (VP Counsel), Mike Chertoff, Mike Leavitt, Bob Kadlec.\nDec. 10, 2008 – On an unseasonably warm night for December, went to the Mandarin \nHotel in Washington, D.C. (12th and Maryland Avenue, SW) to receive the “25 Greatest \nPublic Servants” Award  from the Council for Excellence in Government.  It was \nsomewhat of a big deal.  Other awardees who were present were Everett Alvarez (Viet \nNam pilot POW), Lee Hamilton, Sen. Richard Lugar, Tom Ridge, Donna Shalala, Shirley \nJackson (President Rensselaer Polytechnic Institute).  Other awardees who were not there \nwere:  James Baker, Mayor Mike Bloomberg of NYC, Mayor Richard Daley of Chicago, \nFormer VP Al Gore, Tom Kean, Ted Kennedy, Congressman John Lewis, Wilma \nMankiller, Norman Pinetta, George Mitchell, Sandra Day O’Connor, Peter Peterson \n(Chairman, Council on Foreign Relations, Colin Powell, Alice Rivlin, Robert Rubin, \nGeorge Schultz, Paul Volker, John C. Whitehead Former deputy Secr. Of State.\nInteresting evening with a lot of friendly discussions about the Obama transition.  Clay \nJohnson of OMB was there and said a few words about the Bush Administration and told \nthe large dinner crowd that we are leaving the government and the country better than we \nfound it – the entire audience was struck silent.  You could feel the discomfort in the \nroom.  I sort-of like Clay (even though he screwed me years ago re: the NIH \nDirectorship), but he clearly proved how out-of-touch he and the Administration people \nare.\nDec. 10 – 26, 2008  – Jenny got home on Dec. 23 and Megan has been home since Dec. \n19.  Wonderful to have all 3 girls together in the house.  Jenny is as passionate as ever \nover the work that she is doing teaching science at a charter school in Brooklyn \n(Brownsville).  She lives in Park Slope.  I am a bit worried about her living in a tough \nsection of Brooklyn, but she is a careful young woman.  Interesting that she wound up in \nthe place on my birth.  Megan is somewhat sad and lonely in NYC even though she is \ndoing extremely well at Columbia (all As except for 1 A- and 1 A+).  She does not like \ncollege life, but I am sure that she will adjust since her main issue is she does not make \nfriends easily.\nDec. 26 – Jan. 1, 2009 – Had our every 3 ½ year big Editorial Board meeting of HPIM in \npreparation for HPIM-18 .  Meeting in Rio Grande (40 minutes West of San Juan). \nEnjoyed the stay, but Chris and the girls were there only from Dec. 28 (PM) until Dec. 31 \n(AM).  We had my 1 day off on Dec. 30 and spent day at beach with great weather (80 \nand sunny).  Chris and I and the girls together with the Hauser boys (Bennett, William \nand Stewart) went kayaking in an sea kayak out to a sand bar.  Spent the evening in Old \nSan Juan at a great outdoor restaurant in the old square near El Moro Fort.\nJan. 4, 2009 – Had our traditional New Years Eve dinner with the Gallin’s at their house \nthis time together with Ali and Megan since we missed the real New Years Eve as I was \nin PR.  \nReleased by Chairman Rand Paul\n189Jan 6, 2009 – Hectically busy since returning from PR.  Went to Philadelphia to receive \nthe Silver Award Lectureship at Children’s Hospital of Penn (CHOP).  Hosted by Steve \nDouglas.  Kept me very busy with lecture, dinner at a great restaurant (LaCroix) at the \nRittenhouse Hotel., multiple meeting with staff and fellows.\nJan. 7, 2009 – Dinner at the home (Villa Firenze on Albermarle Street, N.W.) Italian \nAmbassador to the USA Giovanni Castellenata and his wife Leila in honor of Dr. Enrico \nGaraci, the president of the Istituto Superiore della Sanita in Rome.  Also present were \nRuggero DeMaria Marchiano (Director of Research at the Institute), Frank Carlucci and \nwife, Daniel Daniello (Founding Partner of the Carlyle Group) Simone Bemporad (Senior \nVP, Media Relations and Intern. Affairs of Finmeccanica SPA), Michael Ansari (Pres \nand CEO MIC Industries), Francesco Celi of NIDDK, NIH.  Discussed what the Obama \nAdministration might mean for the future.\nJan. 9 – 10, 2009 – Most extraordinary 2 days.  Drive with Chris  to Norfolk, VA to \nwitness the commissioning ceremony of the USS George H.W. Bush  - CVN77.  This \nwas at the invitation of Bush 41.  Amazingly, I was given a “Red” pass which was for \n“super VIPs”.  Arrived on a Friday night (Jan. 9) and stayed at the Renaissance Hotel in \nPortsmouth, VA.  This was an overflow, yet superb hotel, since I send in my RSVP rather \nlate as I was somewhat ambivalent about driving 3 hours and 45 minutes to the \nceremony.  What a mistake that would have been not to go.  Patty Conrad used her \ninfluence and experience with White House social people to allow a late RSVP.  In fact, \nPatty was invited also related to her years in the Bush 41 White House as Advance Team \nmember.  Attended elegant reception and buffet on Friday night at the Marriott in \nNorfolk.  Met many of the Bush 41 and 43 people that I have known over the many years.  \nIncluded were Andy Card, Marlin Fitzwater, John Sununu (we reminisced about the day I \nsaid no the Bush 41 in the Oval Office when he offered me the NIH job). Also saw Phil \nBrady who worked for Bush 41 when he was VP, Tim McBride, David Demerest, Roger \nPorter, Kevin Moley, among others.  Bush 41 and Barbara Bush came to the reception \nand Bush made some comments.  Floods of people wanted to say hello.  I got to speak \nwith Mrs. Bush and she told me how proud she was of what I have been doing over these \nmany years and said that she and George H.W talk about me often when they see me in \nthe news.  Did not get a chance to say hello to Bush 41 since there were too many people \ncrowding him and I did not want to appear aggressive.  I will write him a note. Patty \nConrad was at the reception with Betsy Wilder and they saw many old friends from WH \ndays.\n     Saturday (Jan. 10) was glorious with clear blue skies and 45 to 50 degrees.  Chris an I \nwent on a nice run around the harbor in the AM and then took off for the ceremony.  The \nentire naval and naval air base of Norfolk/Portsmouth is immense and beautiful.  We \nwere fortunate to have red passes since there were 17,000 people at the commissioning \nand we zoomed right in.  We actually had seats on the side deck right across from the \nfront deck where Bush was.  We sat 1 row from W’s daughters Barbara and Jenna, both \nof whom I know (see notes above).  None of the ceremony took place on the top deck, all \nthe second level decks.  The view and ceremony were one of the most special things that \nI have experienced.  The POTUS, VP Cheney, Laura Bush all flew in by Helicopter to \nReleased by Chairman Rand Paul\n192Jan. 24, 2009 – Attended with Chris the Lido Civic Club Gala at the Capitol Hilton on \n16th and K Streets, N.W.  Have been going to these black tie Award Galas for a few \nyears.  It is where I met Gen. Peter Pace and Judge Sam Alito. Lido is an Italian \nAmerican Civic Club with a long history in DC.  It started giving awards almost 100 \nyears ago to people like Fiorello LaGuardia, etc.  This year the awardees were Gen. Pace \n(former Chair of the Joint Chiefs of Staff and Deputy Mayor of DC Dan Tangherlini.  It \nwas good to meet Dan since I will soon be dealing with him and DC Mayor Adrian Fenty \nto launch a “Test and Treat program for AID in DC (more later). Also at the party were \nMajor Fenty’s mother and father.  She is an Italian-American and he is an African-\nAmerican.  Gen Pace is a truly nice man and accepted his award with a moving speech \nabout his parents and grandparents and the men he served with in the marines from the \ntime he was a rifle platoon leader in Viet Nam through Somalia, Iraq, Afghanistan, etc.  \nAlso seated at our table was an Army Sergeant (Joe Hauser) who had his right leg blown \noff in Balard, Iraq (where I had visited in 2003).  Paul Wolfowitz and his girlfriend Shaha \nRiza (World Bank) were also at our table.  Recall that there was a “social scandal” when \nPaul was head of the World Bank and had to leave because it was felt that he was \nshowing favoritism to Shaha who was an employee and was also living with him. Paul \nand I reminisced about when we worked together on biodefense when he was Deputy \nSecretary at the Dept. of Defense.\nJan. 30, 2009 – Comment on the firing of Mark Dybul as head of OGAC (Office of \nGlobal AIDS Coordinator) .  It is a shame the way Mark was handled.  I am attaching a \nNY Times article covering this.  Mark is back in my office until his retirement.\nNY Times article::\nThe abrupt departure of the State Department’s global AIDS coordinator has led to \ndebate over who should run what may be President Bush’s greatest legacy: his \ncommitment of billions of dollars to fighting AIDS overseas.\nThe position — U.S. Global AIDS Coordinator and director of the President’s \nEmergency Plan for AIDS Relief, which is known as Pepfar — is a State Department \npost with ambassador’s rank that had been held by Dr. Mark R. Dybul, a Bush \nadministration appointee. \nOn Jan. 9, Dr. Dybul circulated a memo saying he had been asked by President Obama ’s \ntransition team to stay on the job temporarily. But on Jan. 22, one day after Hillary \nClinton  was confirmed as secretary of state, her staff announced that Dr. Dybul had \nresigned. \nNo reason was given, but he was reported to have packed up his office and said an \nemotional goodbye to his staff that afternoon. Dr. Dybul did not return phone messages, \nbut he has told friends that he does not even know on whose orders he was dismissed.\n“He deserved better,” said a friend who asked not to be identified for fear of jeopardizing \nhis government job. “He didn’t want to stay, but he was asked to.” \nReleased by Chairman Rand Paul\n193The ambassador disburses Pepfar’s funds; Congress authorized $15 billion over five \nyears in 2003, and the fund has since paid for AIDS drugs for about two million people, \nmostly in Africa. Last year, after a bitter fight between liberal and conservative \nlawmakers over what the money could be spent on, the fund was renewed as part of a law \nauthorizing $48 billion over five years for combating AIDS, tuberculosis and malaria.\nThe question of who should run the program seems to be a legacy of that fight. Several \nnames have been discussed as possible candidates, but AIDS activists say they know of \nno one who has been seriously vetted for the job by the Obama transition team since \nNovember.\nA day after Dr. Dybul’s resignation, word began to circulate among AIDS activists that \nthe job had been offered to Dr. Eric Goosby, the director of AIDS policy in Bill Clinton’s \nadministration, who now runs a San Francisco foundation devoted to fighting AIDS.\nAccording to a member of an anti-AIDS group speaking on the condition of anonymity, \nSenator John Kerry approached Mrs. Clinton, seeking the job for Dr. Jim Yong Kim, a \nHarvard medical school professor and former World Health Organization AIDS chief, \nand was told that she had offered it to Dr. Goosby. \nThrough a spokesman, Dr. Goosby declined to confirm or deny that he had been offered \nthe job, and Dr. Kim did not return phone calls seeking comment. Senator Kerry’s \nspokesman said he would not discuss the senator’s personal conversations with Mrs. \nClinton. \nBoth men had been discussed as possible candidates, along with Dr. Nils Daulaire, \npresident of the Global Health Council; Dr. Wafaa El-Sadr, an epidemiologist at the \nColumbia School of Public Health; and Warren W. Buckingham III, Pepfar’s director in \nKenya, who is openly gay and taking AIDS drugs himself. \nDr. Daulaire declined to be interviewed, Dr. El-Sadr said she had not heard that her name \nwas among those being discussed, and Mr. Buckingham said he knew his name had been \nsuggested by others but had not lobbied for the job and had not been contacted by either \nthe Obama or Clinton teams. \nThe abruptness of Dr. Dybul’s departure and the secrecy of the process to replace him has \nupset some AIDS policy specialists. \nOn Monday, a coalition of 68 anti-AIDS groups sent a letter to Mrs. Clinton asking her \nnot to fill Mr. Dybul’s post immediately but to convene a committee to identify top \ncandidates and get many viewpoints, including theirs.\nOne of its authors, Brian Hennessey of the Vineeta Foundation, expressed his irritation at \nhow the request was ignored.\nReleased by Chairman Rand Paul\n194“Goosby is not bad,” he said. “There are plenty of people who want Goosby — but \nthey’ll be damned if the job is filled this way. This isn’t the truth-in-advertising of the \nObama campaign.”\nDr. Dybul’s departure was both celebrated and condemned.\nJodi Jacobson, a former head of the Center for Health and Gender Equity, which wants \nfinancing for all aspects of women’s reproductive health, including abortion , wrote a blog \npost titled “Dybul Out: Thank You Hillary!!!” It argued that he had worked too closely \nwith the far right, and she accused him of lobbying to please the Roman Catholic Church \nby letting its relief groups opt out of distributing condoms.\nMichael Gerson, a former Bush speechwriter and Washington Post columnist, shot back \nthat “blogging extremists” like Ms. Jacobson had lied about Dr. Dybul’s record and that \nhis firing had left an important program without a leader.\nAt the heart of the debate was the difficult bipartisan compromise behind Mr. Bush’s \nAIDS plan. It is the darling of two groups that normally oppose each other: foreign policy \nliberals who want to help Africa and evangelical Christians who support mission \nhospitals there.\nDr. Dybul was straddling some personal fences too: he was one of the Bush \nadministration’s few openly gay officials, a doctor who had treated AIDS patients in San \nFrancisco and Africa, and he had donated to Democratic causes. His only predecessor, \nRandall L. Tobias, a former pharmaceutical executive, was promoted within the State \nDepartment, then ousted in the D.C. Madam scandal after acknowledging he had received \nescort-service massages — a development that led to derision over the fund’s abstinence \npolicies.\nMr. Tobias and Dr. Dybul surprised many with two early decisions that activists had \nexpected fights over: Pepfar has paid for millions of condoms, and it buys cheap generic \ndrugs from India, despite the pharmaceutical lobby’s opposition.\nBut conservatives in Congress imposed other restrictions: one-third of the money spent \non prevention had to be used for teaching abstinence until marriage. Groups getting \nfunds, including those helping prostitutes, had to sign a pledge condemning prostitution. \nAnd no money could be spent on clean needles for drug addicts.\nThese issues were divisive not just for liberals and conservatives, but also between \nliberals. For example, some feminists think women needing money have a right to engage \nin prostitution, while others oppose it, saying it contributes to human trafficking and child \nrape.\nIn separate studies, the Government Accountability Office and the Institute of Medicine \nboth found that the abstinence earmark unnecessarily tied the hands of fund recipients, \nespecially in countries where AIDS was concentrated among drug users and prostitutes.\nReleased by Chairman Rand Paul\n195Dr. Dybul defended the teaching of abstinence, especially to young children, because it \ncan be effective among deeply religious rural Africans.\nAnd he argued that countries could get funds for prohibited uses, like clean needles, from \nother donors like the Global Fund for AIDS, Tuberculosis and Malaria or European \ncountries.\nAlthough the restrictions have been criticized, no one has presented scientific evidence \nthat they cost any lives.\nAnd although there was grumbling in 2003 when the Bush administration created its own \nAIDS program rather than simply contributing to the Global Fund, Rajat Gupta, chairman \nof the Global Fund’s board, said Thursday in Davos that Pepfar was “one of the truly \ngreat contributions of the last administration.”\nJan. 30 – Feb. 20 – Stock market continues to crash with DOW in the 7500 range.  Thus \nfar I have lost on paper more than $1 million of my wealth.\nTom Daschle had to drop out of running for the Secretary of HHS because of concern \nover unpaid taxes for private car and driver that was loaned to him for 3 years without \ncharge by a friend.  He did not claim it as taxable income, which it is.  Also, he made $5 \nmillion on influence peddling (access to people in government) since he stepped down as \nSenator.  Too bad since he is a very good person and would have made a great Secretary.  \nI still think that I would fit for that job, but I really do not want to leave what I am doing \nand besides, no one in the administration has asked me.  They apparently only would \nwant me for NIH Director and I do not want that at all.\nFeb. 21, 2009- Had great time receiving the Science and Medicine Award at the 15th \nAnnual Steve Chase Humanitarian Awards Gala at Palm Springs, CA sponsored by the \nDesert AIDS Project  It was an amazing and enjoyable glitzy affair at the Palm Springs \nConvention Center with Red Carpet arrival similar to the Academy Awards (which \nactually took place the next day (Sunday) in LA.   Star-studded Affair with Linda Gray \n(“Dallas TV Series), Donna Mills (Knots Landing) and Morgan Fairchild (old friend \nfrom AmFar days) MC’d the event.  Other Awardees were Bebe Neuwirth (Broadway \nstar) and Kristin Chenoweth (Broadway Star) for Arts and Activism; Harriet Goldberg \nwon the 100 Women Award; Bill Jones won the Partner for Life Award;  Barry Manilow \nwon the Silver Anniversary Community Service Award.  He came with Suzanne Somers \nwho was wonderful with me and had been following my career for years. She said that \nshe knew all about me because she was a “doctor junky”.  She has written several book \non Health for Women.  Best was Morgan Fairchild who made sure that I was introduced \nto everyone and also partook in my introduction on stage to receive the award. She really \nwas wonderful and friendly.  The main introducer of me was Regan Hofmann (Editor of \nPOZ Magazine).  She was beautiful and very nice.  Donna Mills seemed a bit artificial \nand had a forced smile, but everyone else was great.\nReleased by Chairman Rand Paul\n196March 4, 2009 – Over the past few weeks the stock market continues to plunge with no \nend in sight.  The Dow is now at 6500 down from 14,000 in Oct., 2007.  I have lost a \nSUBSTANTIAL portion of my savings including the money form HPIM, Prizes, etc. – \nwell over $1 million.  The retrospectoscope is always right, but the fact is, I always had \nserious concerns about the vicissitudes of the market and always said that I would rather \nnot lose money that try to make it since my salary + book + prizes get me a lot of money.  \nJohn Katkish, who is a good man and conservative convinced me otherwise and here we \nare – trapped since we cannot sell now since the losses would be phenomenal.\nOn the evening of March 4, I attended the annual Friends of Cancer Awards night \nreception at the Hotel Monaco on 4th and F Street, N.W.  Ellen Sigal and Marlene Malek \nrun this group and always invite me.  The awardees were Steny Hoyer, Sen, Judd Gregg, \nLisa Paulsen of the Motion Picture Industry Foundation and Janet Woodcock of the FDA.  \nUsual DC glitterati of politics there.  Steny was most gracious to me in accepting the \naward and went on about what a great man and scientist I am and how we go back so \nmany years.  He brought up (again) the story of how George H. W. Bush called me his \nhero in the 1988 Presidential Debates.  Also, had good conversation with Sen. Gregg and \ntold him that I respected his action of dropping out of contention for Secretary of \nCommerce since he felt he could not go along with the Obama fiscal policy for the \n“Bailout”.  During the evening, go to have good conversations with Obama White House \npeople such as Dr. Kavita Patel who is assistant to Valerie Jarrett (closest person and \nfriend to the POTUS) and Neerha Tandem who formerly was with Hillary Clinton and is \nnow Special Assistant to the POTUS.  Both said that they would get me to do some WH \nbriefings and briefings of the HHS Secretary designee – Gov. Kathleen Sibelius of \nKansas, whom I have never met.  Zeke Emanuel was there and is establishing himself at \nOMB as the Health policy person since there are few other people who know about \nhealth.\nMarch 5, 2009 – Zuckerman Fellows reception at the home of Beth and Ron Dozoretz – \n3005 – 45th Street, N.W. (around the corner from my house).  Clear, nice night.  Usual \nimpressive event with Dave Gergon and Mort Zuckerman hosting the Fellows who are in \ntown for the week to get a glimpse of how USG is run.  I will lecture to them tomorrow.  \nMet the usual crew from DC and had nice conversations:  Tom Daschle – I expressed my \nsorrow at his misfortune of having to drop out of contention for HHS secretary.  Wolf \nBlitzer (CNN), Nora O’Donnell (MSNBC), Gloria Borger (CNN), former Sec. Dan \nGlickman, Gen. George Casey, Ambassador from Israel, etc.  The young people there \nwas amazing:  wounded vets of the Iraq war now going to Harvard Business School; \nPhysicians studying economics, health people in government schools.  You feel good \nabout USA when you see these people.\nMarch 7, 2009 – Very interesting dinner at Café Milano thrown by Catherine and Wayne \nReynolds for about 10 – 12 couples in the private room.  Unseasonably warm (70 F) and \nclear (stars and moon) night.  Guests include Gen. George and Sheila Casey (Army \nChief-of-Staff). I sat between him and Marlene Malek (who was there with husband \nFred).  Also in attendance: Don Graham and Dana Priest (Washington Post); Beth and \nRon Dozoretz; Francis Collins; Rick Atkinson (War Historian and best-selling author); \nReleased by Chairman Rand Paul\n198died in Jan., 2009 of hep. B/Cirrhosis-related hepatoma.  I was very involved with Brenda \nin his terminal care and attempts to get him a liver transplant – it was too late for the \nlatter.\n    It was an cloudy, cool and damp day in SF.  The ceremony was held in the Eureka \nCommunity Center at 100 Collingwood, around the corner from the hub of the Castro \nDistrict – 18th Street and Castro.  Big time déjà vu as I walked the streets of the Castro \nsince I got there a bit early (ceremony at 4:30 PM).  I had flown in from DC in the AM \nand took the red-eye back to DC that night.  The streets of the Castro were crowded with \npeople bustling around.  The usual crowd plus the fact that it was St. Patrick’s Day and \nthe parade had just ended.  I recall back in the mid-80s when I visited the Castro several \ntimes.  It looked like the “walking dead” were in the street.  So many cachectic people.  \nToday, everyone looks healthy, but the typical protease inhibitor and other drug “facies” \nwere evident with lose of facial fat pads..  You could tell that such a substantial \nproportion of the people were infected, but now, in contrast to the 80s, they were doing \nvery well on drugs.  Gave me a bittersweet feeling of how much we had accomplished \nover these 27.5 years.  The ceremony went well – packed with people from the Castro \nwho were so happy that I was there.  I was the only government or health official there – \na shame since he was such a great man and contributed so much.\nFauci Eulogy for Martin Delaney\nEulogy for Martin Delaney\nby\nAnthony S. Fauci, M.D.\nDirector\nNational Institute of Allergy and Infectious Diseases\nNational Institutes of Health\nMarch 14, 2009\nSan Francisco, CA\nReleased by Chairman Rand Paul\n199Ladies and Gentlemen, friends of Marty Delaney,  \nI feel extremely honored and privileged to be here to celebrate the life of Marty \nDelaney and to have been asked to express a few brief reflections about Marty and his \nextraordinary work on behalf of people with and at risk for HIV/AIDS.  I knew Marty \nDelaney for 24 years.  I first heard about him in early 1985 through some of my staff and \nHIV researchers who were actually quite intimidated by him, mostly because he was, as \nthey said, ”making trouble for them” regarding the design of clinical trials. He certainly \nwas a big-time headache for the FDA.  Actually, the problem for them was that Marty \nwas so smart, articulate and well-informed to the point that he knew more about \nHIV/AIDS and the complexities of treatment access, patient education, and a sound \nresearch agenda than some of them did.  As they soon found out, he was correct most of \nthe time.  \nNow, confrontational and theatrical activism certainly has its place and has been \nvery effective in calling attention to important problems, notably HIV/AIDS.  But \nMarty’s brand of AIDS activism was somewhat different.  As I recently described him,   \nhe was analytical, well-informed, passionate, articulate, persistent, tough-minded, \ngracious, transparent, fair, and above all a thoroughly decent human being. He did not \nconfront just for the sake of confrontation.   I became very interested in learning more \nabout this person whom I had not yet met. And so I began to read what he had written \nand I examined press reports about him and what he was doing in San Francisco and \nthroughout the country. Furthermore, when I found out that he was formerly a Jesuit \nSeminarian, I decided I absolutely had to meet him personally since for better or worse I \nhad experienced 8 years of Jesuit education in high school and college. And so I \nimagnied that we might have a lot in common\nHe beat me to the punch me by calling me up and saying that we needed to get \ntogether to talk about patient access to experimental drugs within the context of highly \nrestrictive clinical trials.  Although he was well-aware that I was not with the FDA, he \nwanted my support in confronting the FDA about accelerated approval of drugs for HIV \nand its opportunistic complications. We soon met and began one of the most \nextraordinary relationships that I have ever had with a colleague and a peer. When we \nboth realized that we were fighting for the same thing, but we were just wearing different \nuniforms, we developed a respect for one another that gradually morphed into a genuine \nfriendship that got stronger as the years went by.  He never hesitated when he felt it \nnecessary and appropriate to nudge me, critique me, advise me, scold me, and point out \nthings that were not yet on my radar screen.  He was an extraordinary source of \ninformation regarding the community needs:  Where was the pain? Where was the \nanxiety? When was the time right to get out into the trenches and talk to specific people?  \nIt was in this context that our collaboration was born, specifically in my speaking \npublicly for the Parallel Track program despite the resistance on the part of the FDA and \nmany AIDS clinical researchers.  Other activists, including Jim Eigo and his colleagues at \nACT-UP in New York, also were pushing for a parallel track of accessibility for drugs in \nclinical trial.  However, it was Marty who pleaded with me -- successfully -- to come to \nSan Francisco and see firsthand patients from the Castro who were suffering physically \nand psychologically more than they should have been because the doors of access to \ndrugs were shut to them.  He then arranged the Town Hall meeting where I was to speak  \nand as I was getting ready to go out on stage, he looked me in the eye and said, “Tony, do \nReleased by Chairman Rand Paul\n202Anthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nThe information in this e-mail and any of its attachments is confidential and may contain \nsensitive information.  It should not be used by anyone who is not the original intended \nrecipient.  If you have received this e-mail in error please inform the sender and delete it \nfrom your mailbox or any other storage devices.  The National Institute of Allergy and \nInfectious Diseases (NIAID) shall not accept liability for any statements made that are the \nsender's own and not expressly made on behalf of the NIAID by one of its representatives.  \nFrom:  Zuzu [mailto:zuzu77@gmail.com ] \nSent: Tuesday, March 17, 2009 1:07 AM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Re: Favor\n \nAnd on a completely unrelated note, Martin was so proud of the friendship he had with \nyou.  I spoke at his retirement event and I wanted to make sure I mentioned things that \nwere important to him, so I sat down and talked to him about what he felt was most \nimportant and what he was most proud of.  He started by speaking generally, about the \nquality of relationships he was able to build in different sectors - he was proud that \npeople would come to him seeking advice and equally proud that he would give it, \nhonestly, even when it was unpopular.  But after a few minutes, he settled down to say he \nwas most proud of the relationship and the friendship that he'd built with you over these \nyears.  \nI mentioned briefly in my remarks that Martin stole my partner, Ed, for Sci Fi night every \nFriday.  I, however, was persona non grata because I wouldn't agree not to talk through \nthe programming.  Ed said, however, \"the only exception is when Tony called, then he'd \npause the program for upwards of a half hour and I'm glad I had my iPhone.\"  There was \na place for you in his life that took precedent over nearly everything.  \nI know how present you were for him and when he had moments of clarity in those final \ndays I would tell him I was consulting with you, that you were speaking to his doctor, \netc., and he would smile and I know he felt like you were present with him and I know he \nfelt well attended to.  I know he felt the presence of your friendship.\nMartin's death is an unspeakable loss for me.  He has been family to me and it breaks my \nheart that my daughter will only know him through the stories that we tell and not the \nReleased by Chairman Rand Paul\n203gestures of the way our lives intersect.  Holidays won't be the same.  I will miss our \nwalks, going to movies, having dinner, going to lunch... I will miss the projects we would \nhave launched and the fun we would have had and I will even miss how frustrated I \nwould get with him because of his stubborness.  He could be terribly stubborn in the most \nirrational ways.\nHe had seven vaccuum cleaners and there was little evidence he used any of them.  He \nhad a garage full of car cleaning products, many (most) duplicates, and he paid to have \nhis car detailed.  They were all unopened.  (He said he \"liked\" buying them.. just in \ncase...)  When we had dinner at his house, he'd create and re-create the recipes several \ntimes before the actual evening and everything was perfect - he loved to cook.  He would \nsay (often) that there was more evidence and likelihood) of alien life than the existance of \nGod - he was staunchly aetheist despite his sister's protestations.  And he adored his sister \n(though he specifically noted he wanted a non-religious service in San Francisco and for \nthe life of her she wasn't able to honor that... but I think he knew she couldn't and on \nsome level he'd be okay with that.)  I would get more emails each week about alien \ntechnology than I would about HIV/AIDS in recent years.  There is nothing he would \nwant more than to be rocket launched into space with Gene Roddenberry and his wife... \nIt's all the little, seemingly inconsequential things, that I'll miss... anyways.\n-Brenda\nOn Mon, Mar 16, 2009 at 9:28 PM, Zuzu <zuzu77@gmail.com> wrote:\nTony,\nYes, March 21, sorry I mis-spoke.   It was good to see you too, though I'm sorry it was \nunder these circumstance and also sorry it was so brief.  I hope your travels home were \nswift and otherwise uneventful.  \nYour advice is sage, as always.  I'll have Dan's Heath Care Agent speak with his \nphysician.\nThanks again,\nBrenda\n \nOn Mon, Mar 16, 2009 at 3:00 PM, Fauci, Anthony (NIH/NIAID) [E] \n<AFAUCI@niaid.nih.gov> wrote:\nBrenda:\n    It was good to see you at Marty’s Memorial.  With regard to Dan Cusik’s case, I assume you \nmean that the UCSF transplant committee will discuss the case on March 21 (not February 21 – \nin other words, they still have not decided).  Having said that, it might be best if the committee \nReleased by Chairman Rand Paul\n204solicits my opinion about the risk of exacerbation of PML associated with immune suppression for \nprevention of transplant rejection.  It might seem presumptuous for me to pre-emptively call \nthem.  If Dan’s private physician could suggest to them that I would be happy to discuss this issue \nwith them, this would be fine.  Then it would be up to them to decide if they are interested in my \nopinion.  My expeerience has been that if you impose yourself on people, they get offended and \nclearly ignore you.\nBest regards,\nTony\n \nAnthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nThe information in this e-mail and any of its attachments is confidential and may contain \nsensitive information.  It should not be used by anyone who is not the original intended \nrecipient.  If you have received this e-mail in error please inform the sender and delete it \nfrom your mailbox or any other storage devices.  The National Institute of Allergy and \nInfectious Diseases (NIAID) shall not accept liability for any statements made that are the \nsender's own and not expressly made on behalf of the NIAID by one of its representatives.  \nFrom:  Zuzu [mailto:zuzu77@gmail.com ] \nSent: Monday, March 16, 2009 12:35 PM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Favor\n \nTony - \n case is being heard by the UCSF transplant committee on February \n21st.  Other than  history of PML (diagnosed in early '96, went on potent, high dose \ncombination ARV therapy, quadruple dose saquinavir (early version, not terribly \nbioavailable), 1200 mg AZT, double dose 3TC and something else, I can't remember - \nPML went into remission and has remained in remission since then.  His CD4+ cell count \nnever dropped below 400) he is eligible for transplantation.  He responded well to RFA \nReleased by Chairman Rand Paul\n\n205(they say his lesions, 'disappeared'), but I understand that there might be growth of a new \nlesion.  But again, from my understanding, he's still eligible for transplantation (other \nthan the prior history of PML) and has a MELD score of 17.  \nAt any rate, I think the issues before the transplant committee are a few .. 1) protocol \nexception (for the HIV transplant project), 2) off protocol transplant and 3) do they want \nto potentially \"waste\" a liver on someone who could, theoretically, have rapid PML \nprogression and die shortly after transplantation.  The case of PML progression following \ntransplantation that I'm aware of was in a person without a prior history of PML.. why \nthis person developed PML and progressed when nearly everyone has the JC virus is \nunknown, of course.   PML has been resolved for 10+ years.  I know arguing that \nlast point is the challenge, but any way(s) that you could weigh in on this would be \nvalued greatly.  Let me know if you have ideas.\nThank you!\n-Brenda\n \n Mar. 14 – April 7, 2009 – Incredible activity in the Administration in trying to revitalize \nthe economy with bailouts and takeovers of companies such as GM, AIG, etc.  Stack \nMarket still volatile, but seems to have settled between 7000 and 8000 down from 14,000 \nin Oct. 2007.\nMar. 8, 2009 – Had my first entry into interactions with the new Administration. \nBackground is that there have been recent reports of the terrible situation in Washington, \nD.C. regarding prevalence of HIV/AIDS with 3% of the population infected and 6.5% of \nblack men.  This is worse than 22 countries in sub-Saharan Africa. We at NIAID and \nNIH (Fauci, Dieffenbach, and Henry Masur) have been putting together a collaborative \nprogram with DC Department of Health (Shannon Hader) to address this issue with a \ncombined research-care program that also involves the recently promoted “test and treat” \nconcept.  This model (appeared in Lancet on Nov. 27, 2008) suggests that if you test \neveryone 1X per year and treat people immediately regardless of their CD4+ T cell count \nor viral load, you could decrease the level of virus in the community so that you could \nconceivably get the Ro to <1, which would in essence shut off the AIDS epidemic.  Such \na concept would require the answering of questions of safety, efficacy, adherence, access \nto people for testing, benefit to individual versus community, cost effectiveness, etc.  We \ncould help to district by making this “test and treat” research agenda a part of our \ncollaborative effort with the District.  While this is going on, Zeke Emanuel is now \ndetailed to OMB as an assistant to OMB Director Peter Orzag to handle health related \nissues.  Zeke heard about the initiative and feels that it would be a good idea to get the \nWH and the POTUS involved in an announcement of such a program for the District.  \nThus, I was called down to the OMB in Room 263 in EEOB to present the program. Zeke \nwas present as was Jeff Crowley, the new WH AIDS Coordinator and Director of the \nOffice of National AIDS Policy.  Connected by phone was Jenny Backus (HHS Public \nReleased by Chairman Rand Paul\n\n206Affairs Director), Dora Hughes (General Counsel to the Secretary, HHS),  Nick ?.   I \npresented the proposal and they asked good questions and were very excited about it.  We \nwill proceed with rolling it out after nailing down a few details.\n   While at the EEOB, I ran into Peter Orzag who greeted me as if we were friends.  He \nclearly knew who I was from seeing me down the hall.  Good news that this WH at least \nis up on what is going on in AIDS and health in general.  Let us see how things evolve.\nApril 16, 2009 – My Op-Ed on “Policy Cocktail for HIV” appeared in Washington Post.  \nGot many nice comments.  I am starting to get on the radar screen of the Obama people.\nApril 17-18, 2009 – First cases of an “untypeable”influenza noticed in California and \nidentified by CDC as a swine influenza of H1N1 type.\nApril 21, 2009 – Had lunch at the Oval Room across from Lafayette Park with Michael \nGerson (Washington Post, Council of Foreign relations) to catch up on some of the \nprojects that I am involved in re; Global Health issues.  Mike was very influential in \nhelping me during the Bush 43 years with PEPFAR and the President’s Malaria Initiative.  \nI told him about my pushing for PrEP, Test and Treat, and Eradication of HIV (my new \n“Big Three” for control of HIV).  Nice time at lunch.  He is a very, very sharp guy and \nwe have become good friends over the years – recall he invited me to private dinner with \nGeorge and Laura Bush at his home last year.  I had turkey Club; Mike had asparagus \nsoup.  Whether was sunny with threatening rain.\nApril 23-24, 2009 – First days of public awareness of the “swine flu” pandemic with the \n“quadruple reassortant H1N1 influenza A.  Around the clock conference calls and \nmeetings.  In “battle mode” at HHS.  I am handling everything for NIH, but there is \nsomething strange regarding relationship with HHS (see below re: Jenny Backus.)\nApril 25-27, 2009 – Intense weekend with the potential pandemic evolving.  Started in \nMexico and now person-to-person spread evolving in USA.  At first only in TX and CA \nand now beginning to spread throughout USA in small numbers that are growing.  \nUnclear why disease seems to be more severe in Mexico than in USA.  Likely due to \nlarger undetected denominator in Mexico for some time and we are only seeing the \nsevere cases, whereas in USA with better surveillance, we see more mild cases.  Also \nspreading to Europe with several countries reporting cases, almost all related to trips to \nMexico or contact with people with Mexico exposure.\nApril 28, 2009 – Testified with Rich Besser (CDC) at Senate Committee on \nAppropriations, Subcommittee on Labor, Health and Human Services, Education and \nrelated Agencies with Tom Harkin as Chair.  Went well.  Great praise for me by Senators \ndespite the fact that the Department is only letting Rich Besser and CDC out on TV or \nany media.\nApril 29, 2009 – Testified with Anne Schuchat (CDC) at the Senate HELP Committee \nwith Sherrod Brown as Chair.  Again, great praise for me for being there during crises \nReleased by Chairman Rand Paul\n207such as AIDS, SARS, Anthrax, and bird flu by Sen. Mikulski, Brown, Chris Dodd, etc.  \nhearing went very well.\nApril 30, 2009 – Real problems with the HHS public affairs people – Jenny Backus.  It is \nclear that I am being muzzled to speak to any major Press.  Reasons unclear (see above).  \nBig issue today in that on the NBC Today Show, which Jenny reluctantly agreed to put \nme on, the VP was quoted as saying that he would not want his family to go to any \ncrowded places like riding on a subway, in an airplane or in a crowded arena because of \nthe danger of people coughing on them and giving them the flu.  I was on next and said \ncalmly that this is not the CDC Public Health policy and calmed the waters, etc.  Jenny \nhad tried to have me call her 1 minute before I was on the air, but I did not see her e-mail.  \nAfter the show (in which everyone said I did a great job) we connected by phone and she \ncritiqued my answer to a question about the WHO increasing the phase of the potential \npandemic from 4 to 5 and asked me if I thought that it would go to 6.  I said that based on \nwhat the WHO was saying and the evolving nature of the epidemic, I would not be \nsurprised if they did boost it to 6.  Jenny said I should not be making policy ahead of the \nCDC and WHO – give me a break!.  In any event, FOX National News wanted me today \nand the subject of interview would surely be the VP’s misstatement.  Surprisingly, Jenny \napproved it and she said I should change the subject when they ask about the VP.  She \nsent me a statement from the VP’s office saying that when the VP was asked what he \nwould tell a family member if they planned a trip to Mexico, he would say not to fly and \nthat I should refer the press to his statement.  The statement is a flat-out lie and they \nwanted me to explain what the VP meant.  I decided not to go on FOX and get caught in \nthat nonsense.  Jenny is blocking me on all of the networks and cable shows that are good \nand allowing me to do very little and so I am reaching the point where I do not want to be \ninvolved with them.\nApril 30 – May 3, 2009 – Continued evolution of epidemic/pandemic with continued \nreal issues with Jenny Backus and me.  She refuses to let me on TV and even yanked me \nat last minute after agreeing that I would do Good Morning America today.  I got to \nstudio and found out that overnight, she had substituted Rich Besser for me.  The ABC \nproducers were horrified and apologetic.  Also, Wolf Blitzer, Lou Dobbs, Bob Bazell and \nothers are getting pissed that they are not allowed to interview me.  Even David Gregory \nnoted that it is surprising that I am not being seen on TV at all.\nMay 4-5, 2009 – Epidemic seems to be stabilizing and looking like a classical seasonal \nflu , but out of season.  Big issue is will it go underground over the summer and then re-\nemerge with a vengeance next Fall and Winter just like in 1918.\nMay 6, 2009 – Testified before House Committee on Foreign Affairs, Subcommittee on \nAfrica and Global Health with Anne Schuchat and a USAID person.\nMay 6 – 16, 2009 – It is apparent that the epidemic is “stabilizing’ in that it is looking \nlike a typical seasonal flu, only out of season in the Northern Hemisphere.  Only \nexception is Mexico, where the apparent severity is not explained compared to the rest of \nthe world.  It still could be an issue of the “denominator, i.e. there may be very many \nReleased by Chairman Rand Paul\n208undetected mild cases in Mexico and so we are only seeing the severe cases and are \nassuming that the disease is more sever in Mexico.  As of May 15, there have been 4714 \nconfirmed and probable case in the USA in 46 states with 173 hospitalizations and 5 \ndeaths.   Internationally, there have been 7520 confirmed cases in 34 countries.  Clearly \nthis is different from the “swine flu” situation in 1976 where the virus infected 230 \nsoldiers in Fort Dix, NJ with one death, but the infection never spread outside of Fort \nDix.  This has important implications  in the intense planning that is going on in HHS \nregarding the production and administration of a vaccine.  I am part of the “vaccine team” \nat HHS made up of Bruce Gellin, Robin Robinson of HHS’s BARDA, me, Jesse \nGoodman and Josh Scharfstein of FDA with input from CDC (Rich Besser et al.).  We \nare being very careful to uncouple the decisions about going ahead to produce the vaccine \nfor administration next Fall and Winter from the decision to actually administer the \nvaccine next Fall and Winter.  We will have to observe what the virus does this summer \nhere and in the Southern Hemisphere (their winter flu season).  This drama is eerily \nunfolding like the situation in 1976.\n   Thomas Frieden, Commissioner of NYC Dept. of Health,  announced as Obama choice \nfor CDC Director.  Interesting in that many people thought that the choice would be Rich \nBesser because of the amazing public exposure he was getting, and the very nice job he \ndid,  during the flu crisis (every major network every day).  Just goes to show you – sic \ntransit glory or welcome to Washington!\nMay 27, 2009 – Went to Sons of Italy Awards Gala at the National Building Museum.  \nSat next to VP Joe Biden and his granddaughter Naomi who goes to Sidwell Friends.  \nAlso at table was his wife Jill (whose father is a Sicilian).  Had nice conversations over \nthe evening with the VP – very amiable person with whom I have interacted several times \nin the past re: anthrax, AIDS, SARS bird flu, etc.  He was very complimentary to me \nduring his speech.  He received the NELA Award for Leadership and Achievement in \nPublic Service (I received the NELA award for science in 1992).  NELA = National \nEducation Leadership Award.  \nMay 28 – June 2, 2009 – Continued activity working with HHS on flu preparedness.  \nLittle press associated with this and Jenny Backus has not been heard from for weeks \nsince the press stuff has calmed down.  Tom Freiden has been appointed as CDC Director \nand so Richard Besser is completely out of the picture.  He did a good job, but see above \nregarding Jenny Backus.  It is too bad, but my experience with Backus has seriously \nsoured me on HHS and everyone there. They seem to have no idea who I am and \ncertainly do not treat me with the reverence and respect that all other HHS people have \nfor the past 25 years.  I do not think that Sebelius even knows my history and who I am.\nJune 3-4, 2009 – Received honorary Doctorate of Science at Harvard University in \nCambridge, MA.  Wonderful honor.  Other awardees were Steven Chu (Secretary of \nEnergy and the Commencement Speaker), Pedro Almodovar (Famous Spanish \nfilmmaker), author Joan Didion, religious historian Wendy Doniger, legal philosopher \nRonald Dworkin, anthropologist Sarah Hrdy, engineer Robert Langer, musician Wynton \nMarsalis, and political scientist Sidney Verba.  The night before the ceremonies (June 3) \nReleased by Chairman Rand Paul\n209we had a festive banquet in Annenberg Hall.  I remember when Chris and I first delivered \nJenny to Harvard for her 1st year, we walked through Annenberg Hall.  It looks like the \ngreat hall from Harry Potter books.\nJune 16-17, 2009 – Gave Keynote Address at the Pacific Health Summit in Seattle on TB \nresearch.  It went over extremely well. Many people said that the talk was “historic” and \n“transforming”.  I gave a passionate plea for pushing research on TB into the 21st Century \nand making it transforming and not just incremental.  Patty Conrad came with me to \nSeattle to help out with the press and she enjoyed the trip greatly.  Her first trip with me \nin 2 years since she began working at NIAID.\nJune 22, 2009 – Back to the West Wing of the White House for the first time since the \nObama Administration began.  Met in the Situation Room in meeting jointly run by \nLaura Petrou (COS for Sec. Sebelius) and Heidi Avery (HSC) to discuss planning for \nresponse (vaccine program) to H1N1 Swine flu.\nJune 30, 2009 – Had an interesting day of H1N1 flu “stuff”.  Harvey Fineberg and I \nconstituted a panel that discussed the lesson of the Swine Flu affair in 1976 and its \nrelationship to what is going on today with the swine H1N1 2009.  Sponsored by CSIS \n(Center for Strategic and International Studies) and Kaiser with Steve Morrison and \nJennifer Kates presiding.  Held in Room B339 in Rayburn Building.  Standing room only \ncrowd.  Went quite well.\n   Later in the afternoon, went to the Roosevelt Room of the White House to have a \nsimilar discussion of lessons learned from 1976. Present were John Brennan (HSC), Sec. \nSebelius – (finally got a chance to chat with her and she congratulated me on my \nhonorary doctorate from Harvard a few weeks ago,  Apparently, she was in the audience \nat Commencement since her son graduated from the Business School); Jane Lute (Deputy \nSec. – DHS), Arne Duncan (Sec. Educ.), Peggy Hamburg (FDA), Ann Schuchat (CDC), \nDavid Senser (former director of CDC who was fired in 1977), Harvey Fineberg, David \nMatthews (Sec. HEW during 1976), David Hamburg, Walter Dowdle (old friend from \nCDC), Peter Orszag (Director, OMB).  President Obama joined the group for about 30 \nminutes.  He clearly recognized me and greeted me warmly. The entire discussion went \nfrom 3:30 to 5:10 PM.  Warm, humid summer day in DC\nJuly 2, 2009 – Another flu panel, this time at the AAAS at 12th and H Street, N.W.  \nChaired by Harvey Fineberg.  Other panelists were Anne Schuchat, Ken Bernard and Ken \nCole (US Navy).  Good crowd, good discussion.  War DC Summer day. Took taxi back \nto NIH because of horrific delays on Metro’s Red Line related to tragic crash that \noccurred last week where 9 people died.\nJuly 9, 2009 – Participated as a major speaker at the “Flu Summit” held at NIH run by \nHHS.  Speakers were Sec. Sebelius, Janet Napolitano, Arne Duncan (Education), John \nBrennan (HSC).  Pres. Obama called in from the G-8 conference in L’Aquila, Italy with a \n“Buon Giorno”.  Much press at the conference.  Still much activity going on.  Weather \nhas been spectacular for July here in DC – very unusual – no humidity – cool in the AM.\nReleased by Chairman Rand Paul\n210July 10, 2009 – Important meeting at the Pooks Hill Marriott to discuss the \ntransformation of our AIDS clinical trials network into a network that would be \n“pluripotential” in that we would study a host of other diseases within the infrastructure, \ni.e. TB, malaria, NTDs, flu, etc.  There is obviously some resistance to this, but it is the \nway to go.  \n     Getting prepared for trip on July 16 – 22 to Cape Town for the IAS meeting where I \nhave several speaking roles (see below).\nJuly 14, 2009 – Senator Carl Levin called me to ask my advice about the qualifications \nand temperament of Tara O’Toole who has been nominated by Pres. Obama as an \nAssistant Secretary in the Dept. of Homeland Security.  He is Chair of the Senate \nHomeland Security Committee responsible for approving her nomination. He has heard \nconcerns that she is somewhat of a zealot for Biodefense.  I explained that I knew her and \nthat although she is a bit out there in thinking that there is Al Qaeda is every corner, she \nstill is quite competent and I would recommend that he approve her.\nJuly 15, 2009 – Went with Patty Conrad to the book signing of D.A. Henderson’s book \non the history of smallpox eradication sponsored by Tommy Thompson of Aikin Gump \n(his law firm).  Tommy was very moved that I was there and introduced me when I came \nin as “the person who discovered the AIDS virus” (ha!).  When I corrected him he said, \n“Well, Tony is the world’s greatest scientist”.  Nice party.  Some of Tommy’s old crew \nwas there:  Stewart Simonson, Kevin Keane, Bill Pierce, Ladd Wiley, etc.  Patty and I \nwent out to dinner at McCormick and Schmick’s on 19th Street afterwards.\nJuly 16 -  21, 2009   Trip to Cape Town, South Africa to the International AIDS Society \n(IAS) Conference on Pathogenesis, treatment and Prevention held at the Cape Town \nConvention Center from Sunday, Sept. 19 to Wed, Sept 22.  I left USA on Thursday, July \n16 and arrived in Cape Town on Friday evening.  Came DC with fuel stop at Dakar, then \nto Johannesburg and on to cape Town.  Exhausting 20 hour trip.  Stayed at Cullinan Hotel \n(Southern Sun)\nOn Saturday AM, July 18 gave the Keynote Address at the HIV/TB research Meeting at \nthe Desmond Tutu HIV Center  of the University of cape Town.  Lecture extremely well \nreceived.  I spoke of the same critical needs for TB (together with HIV) research that I \nspoke about a few weeks before at the Pacific Health Summit in Seattle.   \nDuring the afternoon of July 18 drove down to Cape Point with Gray Handley.  Clearly \nCape Town and the Western Cape is one of the most beautiful cities/areas in the world.  It \nlook so much like the California coast from San Francisco down to Monterrey/Carmel.  \nWeather was stunningly beautiful with crisp clear skies and temperatures about 65-70.  \nThis is most unusual at this time of years since this is SA’s winter.\nIn the evening of July 18, met with Julio Montaner (Pres. IAS) and co-chair of meeting \nand Craig Mc Clure (Exec. Director of IAS) and Robin Gorna upcoming President of IAS \nto discuss the possibility of holding the 2012 IAS meeting in Washington, D.C.  They \nReleased by Chairman Rand Paul\n211know that I am pushing to have the immigration ban lifted in time to make the decision to \nhave the meeting in DC.  The ban has been lifted by law and is now in public comment \nfor final lifting by HHS.  Also, they wanted me to help get Michelle Obama or the \nPOTUS to open the meeting in 2012.\nNight of July 18, went to terrific dinner at a vineyard (Stillness Manor) hosted in my \nhonor by Linda-Gail Bekker.  Linda Gail turned out to be fantastic as a major player in \nthe Cape Town (and all of SA) AIDS clinical trials network that NIAID supports.  Met \nwith many South Africans to whom I told the story of PEPFAR.  Only a few of them \nactually knew how it started:  John Hargrove, Robin Wood (Linda-Gail’s husband), Brian \nWilliams, Brian Brink, Des Martin, among others.\nSunday, July 19,  took tour of Robben Island with Gray Handley.  It was an incredibly \nmoving experience.  The tour guide was a person who was imprisoned there for 5 ½ \nyears.  I saw Nelson Mandela’s cell, the quarry where he worked at hard labor and the \nplace where he planted his garden in the exercise courtyard of the prison.  That evening, I \nattended the opening ceremony of the IAS Conference.\nMonday, July 20.  Visited the Township of Gugulethu and participated in the launching \nof the SAAVI102/HVTN 073 vaccine trial, which is a collaboration between the NIAID \nand the South Africans on a DNA prime MVA boost vaccine. The South Africans \ninvolved are Linda-Gail in CT and Glenda Gray in Durban (KwaZulu-Natal) \nCollaboration also with VRC (Gary Nabel).  Big ceremony at the launching with the \nMinister of Science and technology (Dr. Pandor – woman),  Anthony (Tony) Mbewu – \nhead of SA MRC, and Minister of Health Matsoaledi.  I was very moved by the terrible \nconditions of poverty in the Township of Gugulethu, but was equally impressed with \nwhat was being accomplished by the roll-out of PEPFATR by Linda-Gail in this setting.  \nThe extraordinary overlap and burden of disease with TB here and in Masiphumelele (see \nbelow) was staggering. 30% of patients on the PEPFAR program were diagnosed and \nwere on treatment for TB when they entered program. Another 20% were diagnosed with \nTB when they got there and another 10% developed TB during the time that they were \nthere.\nIn the  early afternoon (1:00 PM I gave the Plenary Keynote at the meeting on the subject \nof “US Sponsored HIV/AIDS Research and Prevention: Science and Policy”.  Following \nmy talk was a talk by Eric Goosby, the new head of the Office of Global AIDS \nCoordinator (OGAC).  The session was devoted to AIDS science and policy in the new \nObama administration.  My talk was very well received.  I emphasized the science but \nalso stressed that the needle exchange ban would soon be over as would be the \nimmigration constraints, as would be abstinence only.  I clearly stated that abstinence \nonly does not work.  The crowd loved it.\nThat night had reception at the Consul-General’s (Alberta Mayberry) home (amazingly \nbeautiful view of CT from her terrace. All the implementers of PEPFAR were there from \nUSAID, CDC, and South Africans.  I gave a short speech sincerely thanking them for \ntheir work, and told them the story of PEPFAR.  Eric Goosby also gave a speech\nReleased by Chairman Rand Paul\n212Tuesday, July 21.  I visited with Linda-Gail the Township of Masiphumelele.  Again, I \nwas deeply moved by the poverty and physical nature of the place.  Like Gugulethu, there \nwere small huts made of corrugated tin and cardboard thast were stuck to each other in a \n“wall-to-wall” fashion for acres and acres.  One could barely walk between the huts.  \nAgain, the work that the South African health personnel were doing was inspiring.  The \nsame numbers and problems with HIV and TB as in Gugulethu.\nTuesday night we flew back to DC and arrived early (6:00 AM) on Wednesday, July 22\nJuly 22, 2009 – I rolled out the NIAID plan for the clinical trials of H1N1 vaccine to be \nperformed in the NIAID’s VTEUs.  We will start in early August and do trials on healthy \nadults, elderly, children to determine immediate safety, immunogenicity, dosage and \nnumber of doses, and sequence of administration vis-à-vis seasonal flu vaccine.  Much \npress associated with this, i.e. appearances on ABC Evening News, CNN Situation room \nwith Wolf Blitzer, (on July 23)  much print and radio (NPR, etc). \nJuly 24, 25, 26, 2009 – Went to the Aspen Health Forum where I gave talks and served \non 4 panels: 1) Sex and health, 2) ARRA funds and how we spend them; 3) Swine flu; \nand 4) Vaccines.  My brief talks and panel appearances were extremely well received.  I \nmostly “ad-libed” and they loved it. Typical Aspen scene with many terrific people to \ninteract with: Tom Daschle, Walter Isaacson, Billy Tauzin, Mehmet Oz, Rick Stengel \n(managing editor of Time), Jeff Kluger (senior editor of Time), Susan Denzler, Nancy \nSynderman of MSNBC and a host of others.  Excellent discussion, setting and exposure.  \nBeautiful place.  Also had dinner at the Mr. and Mrs. Greenwald.\nJuly 27, 2009 – Had a nice appearance on MSNBC with Dr. Nancy Snyderman \ndiscussing H1N1 Swine flu.  She was in Aspen (where I had just spent some time with \nher) and I was in the studio at NIH.\nJuly 28, 2009 – ACIP will recommend to CDC regarding vaccination program.  I \nappeared on ABC World News Tonight\nJuly 29, 2009 – Big issue with release of data and paper in lancet showing that pregnant \nwomen have significant increased risk of hospitalization and death from flu. I  appear on \nGood Morning America and MSNBC.  On the latter, I spared with Arianna Huffington \nwho feels that we should not vaccinate children or pregnant women or even adults.  Dr. \nNancy Snyderman (of MSNBC) was on program and complimented me and disagreed \nwith Arianna.  CDC held press briefing after ACIP recommendations to first vaccinate \npregnant women, then caregivers of infants (<6 months old), then HCW, then young \npeople, then non-elderly with underlying conditions.  \nI appear on BBC TV and then on NBC Nightly News with Bob Bazell and Brian \nWilliams.  Press stuff starting to heat up.  I think that the HHS and Jenny finally realize \nwhat I can do with the press.\nReleased by Chairman Rand Paul\n213July 30, 2009 – Appeared on MSNBC today with Dr. Nancy Synderman and a vaccine \nnihilist named Diane Miller.  She was a nerd who said we should not vaccinate anyone \nwith flu vaccines since they do not work and they are dangerous.  Nancy and I \nannihilated her.\nJuly 31, 2009 – Got called by Mike Gerson who is getting very interested in needle \nexchange programs and will do a piece on it in The Washington Post..  He called from the \nmobile unit that goes around DC doing needle exchange.  He was very excited in a \npositive way telling me that he is now converted to a “true believer’ in favor of needle \nexchange.  He wanted to know from me what the scientific data are.  I told him the story \nof the Shalala Committee that I was on with Harold Varmus, David Satcher, Alan \nLeschner, etc. where Donna asked us to do a “meta-analysis”-type look at the literature \non needle exchange and ask 2 questions: 1) does needle exchange promote drug abuse \nand 2) does needle exchange decrease incidence of HIV infection among drug users.  We \nfound clearly that it did not promote drug use and did decrease HIV infection.  We \npresented the data to Donna who strongly recommended a federally funded needle \nexchange program and called the WH to indicate this.  To all of our dismay, the WH \nrejected this for political reasons.  Drug Tsar McCaffrey did not want it; neither did \nprominent black Congressmen like Charlie Rangel (Charlie thought that it might be \ninterpreted as a signal that we had given up on the black community).  In any event, Mike \nwas thrilled that the science backed up his impression.  As a background, the Congress \njust recently lifted the ban on federally funded needle exchange, only with the proviso \nthat such programs cannot be implemented within 1000 feet of school, park, recreational  \nfacility, etc.  This is silly since it blocks out most of the entire city in most places.\nAugust 1 – 10, 2009  Much press regarding the beginning of the vaccine trials for H1N1.  \nI was on ABC, MSNBC, multiple radio shows, Diane Rehm Show, etc. discussing the \nH1N1 issues.  \nAugust 5, 2009 -  Mike Gerson wrote an editorial in the Washington Post describing his \nimpression about the importance of needle exchange programs. He quoted his \nconversations with me.  Also, Chris and I had dinner over Mark Dybul’s and Jason \nClaire’s home on Wallace Place is NW DC.  Josh Bolten was there with his partner Dede \nand her daughter Rachel.  Josh had just spent a couple of months in Africa (The Gambia) \nwith the Maryknoll priests.  We reminisced about the White House days and PEPFAR.\nAugust 6, 2009 – Appeared on Diane Rehm show with Bruce Gellin discussing H1N1\nAugust 7, 2009 – First patients injected with H1N1 vaccine in NIAID sponsored VTEU \nclinical trials.  Much media attention.\nAugust 8, 2009 – Appeared on Good Morning America to describe the H1N1 clinical \ntrials.\nAugust 9 – 24, 2009 – Our clinical trials with the VETUs on the H1N1 vaccine in adults, \nelderly for dose (15 versus 30 ug) and number of doses (1 vs 2, 21 days apart) began on \nReleased by Chairman Rand Paul\n215     In any event, now finally Jenny Backus is “putting me out there” with my leading the \nHHS press conference on August 11 to make the announcement with the Secretary and \ndoing all of the press, i.e. Newshour, CNN Situation Room, front page NY Times, \nmultiple NPR interviews (“All Things Considered” , etc) Washington Post, all print from \neverywhere, NBC Today Show, CBS Evening and Morning News, MSNBC, NBC \nNightly News, etc.  Still and amazingly, she did not allow me to comment on the NIH \ndata on the evening of Sept. 9th when the NEJM data from the companies came out since \nwe were scheduled for a Secretarial Press briefing at 1:00 PM Friday.  When the press \ncalled me on the night of Sept.. 9 and heard that I could comment on the NEJM papers, \nbut not our data, they went nuts saying that the HHS were crazy and that the story is \ntonight for tomorrow and not tomorrow for the next day.  The Editors needed to know \nwhether the NIH data corroborated the company data; otherwise they were reluctant to \nplay it up. Finally, I e-mailed Jenny, Laura Petrou, and Niki Lurie telling how crazy this \nwas.  Jenny finally relented and let me call back the print people to tell them only that \n“our data corroborate the companies’ data”, without giving details.  Jenny is stupid and \nnuts.  She refused to allow me to go on TV until tomorrow afternoon.  Wolf Blitzer \nwould have none of this and on his Situation Room evening show on Aug. 9, he called \nme directly in my office and put me on TV as a phone-in voice interview.  I did not know \nthat he was going to do this until a minute before he did.  Jenny was pissed. Yet, the next \nafternoon and evening and on Sept. 12, Jenny let me do everything.\n    There was, however, a big blowup with crazy Jenny who attacked Patty Conrad and \nothers at NIH since she claimed that we were blaming her for not letting Fauci go on the \nair (Duh!!!! That is the truth; that is what she is doing).  She wrote a vicious e-mail \nsaying that she was very angry because we were “throwing her under the bus” with the \npress since then they will think that she is muzzling me…..which she is.  She really is a \ncrazy lady.\nAlso, we got great news on Sept. 11 that the Thai canarypox (ALVAC) + AIDSVAX \n(gp120) HIV vaccine trial showed a 31% efficacy that was clearly statistically significant.\nSept 12 – 17, 2009 –Still an extraordinary amount of attempt to “control messaging about \nH1N1 on the part of HHS and particularly Jenny Backus.  They just have a different \nphilosophy that they control message and a person can only speak about what their \nofficial responsibility is, i.e. I cannot talk about trends of disease since this is a CDC \nissue – the most ridiculous thing I have ever heard of.  Also, quite insulting to me sine I \nhave been talking broadly about ID issues for 25 years to national press\n   Obama having real trouble selling his health care reform plan.\nSept. 17, 2009 – Went to State Department for swearing-in of Eric Goosby as the new \nhead of the Office of Global AIDS Coordinator (PEPFAR+).  Took place at 4:00 PM in \nFranklin Room, presided over by Secretary Hillary Clinton.  She recognized me in the \naudience and made a comment during her official remarks about the great work that I \nhave been doing for so many years with HIV/AIDS.  Got a chance to chat with her after \nthe ceremony.\nReleased by Chairman Rand Paul\n216Sept. 21, 2009 – More good news. Pediatric H1N1 clinical trials showed good responses \nat 8 to 10 days with 1 dose of 15 ugs in kids 9 to 17 and lesser response in kids younger – \njust like seasonal flu vaccine.  I led a press briefing.\nSept. 24, 2009 – Roll-out of the Thai trial results.  31.2% efficacy; p – 0.039.  16,000 in \nrandomized trial in relatively low risk heterosexuals in Thailand.  74 infections in \nplacebo, 51 infections in vaccines.  Press ate it up.  The usual suspects who wrote the \n2004 Science letter criticizing my decision to fund the trial made comments either for \nattribution or “anonymously” that they were not impressed and probably thought that it \nwas a fluke (John Moore, Ronald Desrosiers, etc.)  I was very reserved in putting it into \nperspective as this not at all being the “end game”, but an important start since this was \nthe first time in over 2 decades that we have gotten even the slightest positive signal in \nany HIV/AIDS vaccine.  The lack of major immune parameters, i.e. neutralizing abs and \nCTLs tell me what I suspected all along that we are probably not looking at the right \nmeasures of immunity.  Of note the vaccine had no effect on viral load of those that did \nget infected. \n    Since this was not H1N1 and since Jenny Backus probably does not even know what \nHIV is, I was given blanket clearance for the Press.  I had the most media exposure that I \nhave had since the anthrax situation.  Front page or prominent coverage in all major print \nmedia (NY Times, Wash Post, AP, Reuters, etc.  Also, prominent appearances on every \nTV outlet – NBC Nightly News with Bob Bazell, CBS Evening News; ABC World News \nTonight, Wolf Blitzer Situation Room on CNN; Fox News; Canadian TV; BBC; \nBloomberg;  World News with Katty Kay; Radio – NPR – All Things Considered; \nWTOP\nSept. 29, 2009 – Bono/U2 concert at FedEx stadium.  Logistic disaster for me.  I was \ninvited by Bono to attend the concert and be present at a reception in the “Round Room” \nof the FedEx stadium before he was scheduled to go on at 8:30 PM.  I was very busy in \nthe office preparing for the visit to the NIH the next day of Sec. Sebelius and President \nObama.  By the time Chris and I drove to the stadium we got caught in 2 hours of traffic \nand a disaster trying to get parking in the stadium lots.  I missed the reception, did not see \nBono.  He probably thought that I did not show and so he did not do what he has done \nseveral times with concerts and appearances which is to point me out in the audience and \npraise me.  Too bad, but that is the way it goes sometime.\nSept. 30, 2009 – Wonderful day at NIH.  POTUS came in the AM with the Secretary, \nBill Corr (Deputy Secretary) and Francis. Marston Linehan and I showed him a lab in the \nnew CRC.  First Marston spoke about the genetics of renal cancer and then Francis spoke \nabout the cancer genome atlas.  I then spoke to the POTUS about the history of HIV \nresearch here in the Clinical Center.  I spoke about how I admitted the first AIDS patients \nin 1981 and how they all died.  I then spoke about the major advances in antiretroviral \ndrug development and testing that has transformed the treatment and survival of HIV-\ninfected individuals.  I spoke about the recent results of the Thai HIV vaccine trial.  He \nwas very engaging, pleasant, funny but serious about the subject.  He definitely now has \nfixed in his mind who I am.  When I told him that I had been here since 1968, he joked \nReleased by Chairman Rand Paul\n218Oct. 10, 2009 – Chris and I had a great dinner in the Placido Domingo room of Café \nMilano as guests of Kathryn and Wayne Reynolds on the occasional of Derek and \nBeverly Joubert’s visit.  They are award-winning film-makers for National Geographic \nwho photograph and film lions, leopards, and cheetahs in the wild.  Typical enjoyable \nReynolds dinner with many famous guests including: Gen James Jones, Terry McAuliffe, \nSam and Jan Donaldson, Tom Daschle, Brendan Sullivan, Fred Hiatt, Tom Friedman, \nAlexandra Cousteau (Jacques’s granddaughter), \nOct. 13, 2009 – Still extremely intensive media exposure with national media \nappearances a few times per week and heating up.  Had dinner at Zeke Emanuel’s home \nin DC with Chris.  Corby Kummer was there as was Rahm Emanuel and his children.  \nOther government people whose names I unfortunately forget.\nOct. 14, 2009 – Flew to NYC to give Parker Memorial Lecture to the Dept. of \nMicrobiology and Immunology at Columbia Medical School.  Gave the a4B7 lecture that \nwas very well received.\nOct. 16, 2009 – Went to White House for top secret meeting and counterintelligence \nbriefing by FBI and CIA.  Apparently, Russians are monitoring the evolution of our \nBiodefense campus at Fort Detrick.  As usual, a lot of soft stuff.  I certainly would expect \nthat they would be doing this since they suspect that we are doing offensive bioterrorism \nas opposed to defensive biodefense.\nOct. 18, 2009 – Take off to Paris with Patty Conrad for the 2009 AIDS Vaccine meeting \nof the IAS and Vaccine Enterprise.  Extremely successful meeting in many ways.  The \nRV144 (Thai trial) results were formerly presented coinciding with the online publication \nof the results in the NEJM.  There was significant controversy surrounding the role-out of \nthis vaccine a couple of weeks ago (see above).  The complete data showed that the effect \nwas modest, but real.  Apart from a few remaining skeptics, the  issue now is to learn \nfrom this by examining any correlates of immunity.\n     I gave the closing talk on Oct. 22 together with Francois Barre-Sinoussi.  My talk was \nextremely well-received as being visionary.  I thoroughly enjoyed preparing and \ndelivering the talk.  I discuss the Thai trial, but also the need to pursue low-dose mucosal \nchallenge models in the non-human primate (NHP).  Also, I spoke about the importance \nof studying the early events in HIV infection for insight into the type of immune response \nthat we need to elicit.  Also, spoke of the differences in the transmitting versus the \nchronically replicating virus.\nOct. 23 – 25, 2009 – Things really heating up with the press jumping all over the USG \nfor “overpromising” the number of doses of vaccine that would be available.  In fact, \ndespite my warnings, BAARDA (Robin Robinson – nice guy, but naïve) believed the \npharmaceutical companies that they would have 160 million doses by October 15.  In fact \nthey had 11 million and instead of ultimately getting 250 million, we are lucky if we get \n140 million.  Big gap between supply and demand with long lines for vaccine and \nwidespread flu activity in 46 states.  Perfect storm.\nReleased by Chairman Rand Paul\n219 I have been as much media as in the anthrax days.  Just on October 23-25 I was on 11 \nmajor networks and cable trying to explain the vaccine supply problem – Today Show, \nNBC Nightly News, multiple MSNBCs, CNN Situation Room, CNN American Morning, \nCharlie Rose, NPR, WTOP, Good Morning America, Jim Lehr’s The NewsHour, BBC, \netc.\nOct. 25, 2009 – Reception and dinner in Georgetown 1692- 31st Street, N.W., hone of \nSusan and David Axelrod to view live the “60 Minutes” show about their ordeal with \ntheir daughter Lauren’s epilepsy that she has had from birth and that now at 28 years old \nhas left her with significant brain damage.  They are wonderful people and have started \nthe organization called CURE (Citizens United for Research in Epilepsy) to do research \non epilepsy.  Typical high-powered DC gathering: Rahm Emanuel, VP Joe Biden and Jill \nBiden, Gen. James Jones, Mort Kondrake, Al Hunt, Bruce Reed, Linda Douglas (ABC), \nBob Bennett, and many, many others.\nOct. 26, 2009 – Media Frenzy continues – Lou Dobbs, Campbell Brown (CNN), BBC\nOct. 27, 2009 – Extensive interview with Dan Rather for his Cable show “Dan Rather \nReports”.  Very nice person.  We related well and he told his producer (Patty heard the \nconversation) that I was a “superstar”.\nOct. 28-29, 2009 – Press is jumping all over HHS for delay in vaccine distribution.  Front \npage stuff and all networks.  They are calling it “Obama’s Katrina”.\nNov. 3, 2009 – I continue to be all over the press – last night CBS Evening News; today \nCBS Morning News to explain the complex issues of why we do not have a lot of vaccine \nat hand – the virus just is not growing very well in eggs and much against my advice, \nHHS (BARDA, Jenny Backus) promised that we would have a certain number of doses \nand now we do not.  They relied on and believed the projections from the pharmaceutical \ncompanies when I told them not to.  They wanted to give a crisp message (they were still \nin campaign mode) and I told them not to.  Now, everyone looks to me for what to do and \nthey are putting me out on all of the shows.  Actually NIAID is the only one giving good \nnews sine our pregnancy trials and pediatric trials are giving good data – only 1 dose of \n15 ugs for pregnant women is required for robust response and we proved that 1 dose for \nolder kids (10 – 17 years) is good and 2 doses for younger kids (6 months to 9 years is \nrequired).  I announced this at a press briefing at HHS yesterday.  This is in conflict with \nWHO who say that we should give 1 dose to all kids.\nNov. 4, 2009 – Major House Appropriations briefing/Hearing chaired by David Obey.  \nWitness – me, Tom Frieden (CDC), Niki Lurie (ASPR) and health commissioner from \nAlabama and ?.  Tough questions by members and staff regarding availability of \nvaccines.  I came out looking good, but it was a intense hearing.  Next day (Nov. 5) big \npicture of me on page 3 of both the Washington Post and the NY Times.  \nNov. 5, 2009 – Image and message issues continue to deteriorate when it was announced \ntoday that workers from Goldman Sachs, Citibank and other Wall Street firms had gotten \nReleased by Chairman Rand Paul\n220H1N1 vaccine as pregnant women wait in line. The CDC is being blamed since they are \nresponsible ultimately for distribution.  In fact, CDC takes orders from States and locals \nand then distributes the vaccines through a contract with McKesson Corp, which sends to \nover 150,000 distribution sites within the states according to how the cities and states \ndecide to distribute based on their best judgment.  Since the Wall Street firms have large \nclinics, they can easily distribute vaccine to their pregnant employees and those with \nunderlying conditions.  It was Mayor Bloomberg’s choice, but the image did not look \ngood and the CDC took flak for it.\n    Still getting massive (couple of times daily) media exposure.  Media interest paused for \na few days due to the terrible tragedy at Fort Hood (Texas) army base where a crazed \nArmy MD psychiatrist who trained at USUHS and Walter Reed and is a Muslim (born in \nUSA) went on a shooting rampage and killed 13 and wounded 30 soldiers getting ready \nto deploy to Afghanistan.\n  Am extremely busy and very fatigued!\nNov. 10, 2009 – CDC and HHS still getting hammered by the press because of the delay \nin availability of vaccine.  Press frenzy continues.  I am coming across relatively \nunscathed because of my long-standing credibility.  Briefed the editorial board of the \nWashington Times yesterday and today my picture was on the front page of the \nWashington Times. Also, continue on TV and NPR.\nNov. 11, 2009 – Pressure and press frenzy continues.  Hurricane Ida flooding the mid-\nAtlantic.  Been raining here with no real hurricane for days.  Pre-taped the “Power \nPlayer” segment for FOX News that will show on Sunday – 11-15-09.\nDinner at Richard Ben-Veniste and Donna grill’s home.  Present were:  Gerry and Ellen \nSigal,  and 2 friends of Richard’s and Donna from LA.  Terry and Denise – \nenvironmentalists.\nNov. 12, 2009 – Two day of Science Management Working Group (SMWG) of which I \nam a member of the Intramural and Clinical Center Subcommittee.  This evolved out of \nthe NIH Reauthorization Act of 2006 to look at the structure and function of the NIH.  \nChaired by Norman Augustine. On MSNBC and Fox News today.\nNov. 13, 2009 – More of the same.  Things getting very testy with the press and the \nRepublicans blasting the Administration as having another “Katrina” with the H1N1 flu.  \nStill long lines and contradictory issues of ½ people do not want to vaccine because that \nthink it is not safe and ½ are waiting on line for it.  Lose-lose from a PR standpoint.  \nPicture on page B1 of the Post (Metro Section) for the NIH-DC AIDS initiative.  On \nNBC Nightly News.\nNice dinner at Ambassador Nancy Brinker’s home (Ritz-Carlton Apartments in \nGeorgetown in honor of Mark Dybul. Nancy was Chief of White House protocol under \nPres. George W. Bush.  Beautiful Apartment overlooking Georgetown and the Potomac \nReleased by Chairman Rand Paul\n221River.  About 16 people.  Nancy is the President /Director of the Susan G. Komen \nInstitute named after her sister who died of breast cancer.  Nancy is now interested in \nGlobal Health, particularly cancers (breast mostly) in women in developing countries. \nInteresting guests.  I particularly liked speaking with Kathleen Parker, syndicated \ncolumnist and frequent Sunday News Show commentator and guest. Also, there were \nPamela Stevens (former White House Press person) and other global health people.\nNov. 14, 2009 – Presented my NIAID “update” to the Board of the AAAAI at the Hyatt \nCapitol Hill. Ali’s NCS Cross Country Team wins the Maryland State Championship.  \nAli is one of the Senior Captains of the Varsity of which she is one of the starting 7.\nNov. 15, 2009 – Amazing Sunday.  Appeared on NBC Today Show in the AM, Fox \nNews highlighted me as “Player of the Week” with a several minute segment.  Did “The \nForum” with Dean Sam Lloyd at the National Cathedral.  Big success with big crowd.  \nConsists of a “conversation” between Dean Lloyd and me about my life and work \nfollowed by questions from the audience. Also did CBS Evening News.  Exhausted at \nend of day.\nNov. 17, 2009 – Went to NYC to receive the Accordia Award for Public Service.  This is \nthe new version of the Infectious Diseases Institute started by merle Sande and funded by \nPfizer. Mark Dybul, Julie Gerberding and others were there.  Was in NYC anyway for the \nDDCF Board of Trustees meeting in the AM and went up to see Megan at Columbia for a \ncouple of hours.  It is always wonderful to see Megan and I always have a great time \nwhen I visit her.  We had a nice lunch.\nNov. 20, 2009 – Had dinner with Chris over Francis and Diane Collins’s house with \nRegina Benjamin, the newly appointed Surgeon General.  Pleasant, but I believe that she \nis going to be a non-entity.  She is a bit over her head.\n     The H1N1 pandemic is starting to die down with widespread disease going from 48 \nstates to around 30 states.  Much less press interest.  A lot more vaccine now available.\nNov. 23, 2009 – Went to NYC to give remarks at the Healthright international dinner at \nthe Mandarin Hotel.  My remarks were honoring Jonathan Mann.  Gave a warm speech \nabout him and his character. His daughter Naomi was there and was very touched by my \npresence and remarks.  She admitted publicly in her remarks that everyone in the family \n(even when she was a young girl) knew who “Tony” was since Jon would often speak of \nme.  She said that she realized that Jon and I sometimes disagreed but that her father \nalways greatly respected me.  Nice evening.  After dinner I went up to Columbia to see \nMegan for an hour.  As usual, it was great to see her.\nNovember 24, 2009 – Briefed the Foreign Press Core on AIDS at the National Press \nClub.\nReleased by Chairman Rand Paul\n222Nov. 30, 2009 – Attended a World AIDS Day event at the White House (South Court \nAuditorium.  Sec. Clinton and Sec. Sebelius were there as was Eric Goosby.  They spoke \nabout PEPFAR.  Of note, striking difference from last year when anyone at White House \nmentioned PEPFAR, they would recognize me in the audience as the main architect of \nthe Program.  No one did that this time even though Hillary Clinton saw me and warmly \nwaved at me from the stage.  I believe that the new administration speech-writers and \nstaff just have no idea who I am.  Sic transit Gloria.  Sebelius was her usual cold self and \ndid not even make eye contact with me.  Also, (amazingly) when she was with me a day \nor 2 later actually asked me as we were on the Hill together to speak with the \nCongressional Black Caucus (who never showed up – ugh!) “now just what do you do \nand what is your official title”.  When I told her, she smiled and said: “I just think of you \nas “the vaccine guy”.  She did not mean any harm, but she is really clueless….or actually \nuninterested in any interpersonal relationship at this level.\nDec. 2, 2009 – Had dinner with Peggy Hamburg at Indique Restaurant on Connecticut \nAvenue.  Just to catch up on how she is doing as Commissioner of FDA.  Really nice \nperson; has not changed.\nDec. 5, 2009 – Went to Holiday Party at Sam and Jan Smith Donaldson’s home in \nMcLean.  Usual warm and enjoyable time.  Chris was in Istanbul teaching a course in \nBioethics and so I went alone.  Usual cast of characters:  Colin Powell, General Casey, \nBen Bradlee, Lee Hamilton, Antonin Scalia, Nina Totenberg, Bill Plante, John and \nDebbie Dingle, George Will, Terry McAuliffe, etc. etc.\nDec. 9, 2009 – Time Magazine came out with a list of the 10 most important Medical \nbreakthroughs of 2009.  #2 was an “AIDS Vaccine” (the Thai trial) and #4 was an H1N1 \nvaccine.  Of note, I played a significant role in the development of both of these.\nDec. 12, 2009 – Wonderful Holiday sit-down dinner party at the Academy of \nAchievement Town House on 16th Street (Black Tie) hosted by Wayne and Catherine \nReynolds.  Usual cast of stars at the dinner – Senators, Congressmen, Media, etc.  \n“Mystery” gust entertainer was Tony Bennett.  The Reynolds’s have been very generous \nto regularly include us at these functions.\nDec. 13, 2009 – Holiday Season in full swing with parties, etc.  Today parties at Nicki \nLurie and Jesse Goodman’s; Bill Haseltine’s and Hugh and Mimi Auchincloss’s.  Flu \nactivity really slowing down with sharp drop in cases.  More vaccine now available and \nso push to vaccinate.\nDec. 14, 2009 – Gave big talk at CSIS on new treatment approaches to HIV/AIDS at their \nheadquarters on 18th and K Streets, NW.  Evening reception at Stone house for Julio \nFrenk.  Good guy.  I knew him slightly when he was Minister of Health for Mexico.\nDec. 15, 2009 – Much activity at HHS level to get the “team” to work on pushing vaccine \nsince much is now available.  HHS is getting anxious (Jenny Backus, Laura Petrou, etc.) \nabout possible “end-of-the-year” news stories that might criticize HHS and USG for \nReleased by Chairman Rand Paul\n223doing a poor job with H1N1.  Had an interesting 90 minute with Washington Post \nEditorial Board (Fred Hiatt and Jonathan Capehart) to discuss the response to H1N1.  \nMeeting was me, Peggy Hamburg, Tom Frieden, and Jenny Backus.  \nDec. 17, 2009 – Continuing on with the HHS push to try to get a final positive spin for \nend of 2009 on our response to H1N1.  They arranged a Press Briefing at the National \nPress Club with me, Secretary Sebelius, Tom Frieden, Peggy Hamburg, Nicki Lurie, Jess \nGoodman, etc. to explain what we have done in response to H1N1.\nDec. 24, 2009 – Traditional “great” dinner for my birthday at sister Denise’s home.  Over \nthe years, Jenny, Megan and Ali have come to treasure this tradition similar to some of \nthe family traditions that Denise and I treasured like dinner over Grandma Abys’s home \nfor the holidays.  In the AM had my traditional birthday breakfast hosted by Chris and the \ngirls at the Silver Diner on Connecticut Avenue.\nDec. 30, 2009 – Lunch at the White House mess with Heidi Avery.  She is Deputy to \nJohn Brennan at the National Security Council at the White House.  She is former CIA \nand Counter Terrorist Unit Chief.  She want to talk to me about how we should broadly \nhandle “all threats to the public health” instead of going incident by incident as with \npandemic flu.  She wanted to speak with me because she heard that I was a visionary \nabout these issues.  Very enjoyable conversation.  Obviously, WH sources know about \nme despite the sometimes discouraging relationships that I have had with HHS and their \nlack of appreciation about who I am and what I have done over the years.\nJan. 6, 2010 – Big Global Health Research Summit held at NIH (Fisher’s Lane) with big \nhitters attending.  Convened by Francis Collins to flesh out suggestions for his Global \nHealth Initiative as one of the 5 pillars of his tenure.  Jack Lew from State was there as \nwere Eric Goosby, Zeke Emanuel representing WH, and many, many global health stars.  \nGood meeting.\nJan. 12, 2010 – Finally had the launch of the DC – NIH HIV/AIDS Partnership.  Went to \nAnacostia for a inauguration and press conference with me, Mayor Fenty, Councilman \nDavid Catania, Shannon Hader and Pierre Vigilance from DC Dept. of Health.  Got good \npress with Channel 5 FOX News.  Also, had good and lengthy interview with Wolf \nBlitzer on “The Situation Room” that evening on National Influenza Vaccination Week \n(Jan. 10-16).  Again, the latter is part of the push to get people vaccinated.  Of note, all \nover Europe there are tens of millions of doses of vaccine that countries like France, \nGermany, Italy are turning back to the company since they are unused.  Interesting issue \nmight arise about the companies no longer wanting to respond to crises since they make a \nlot of vaccine an then countries cancel the orders.  More to come on this.\nJan. 19, 2010 – Heidi Avery (see Dec. 30, 2009) called a meeting this evening (7:00 to \n8:45 PM) in the Situation Room of the West Wing to discuss the broad plans to handle all \npublic health threats, i.e. existing, naturally emerging and deliberately emerging.  Present \nat the meeting was Zeke Emanuel, Nicki Lurie, Peggy Hamburg, Tom Frieden by phone \nfrom Atlanta, Jesse Goodman, Brian Kamoe, George Korch, Richard Hatchett, James \nReleased by Chairman Rand Paul\n224Lawlor (latter 2 are my employees detailed to Heidi), Mike Kurilla, among others.  Heidi \nhad asked us (NIH, CDC, FDA, HSS) through Nicki Lurie to prepare a 1-pager on this \ninitiative from each of our perspectives.  Nicki consolidated the 1-pagers and we \npresented the concept to Heidi.  Heidi is aiming to get the POTUS to announce some sort \nof initiative in the State of the Union Address on January 27.  I am very impressed with \nHeidi and her no-nonsense style of getting to the point and the question at hand.  Heidi \nmentioned to me as we left the Situation Room that she was relying on my “vision” to \nhelp get this going.  Let us see what comes of this.\nJan. 21, 2010 – Has long meeting in my office and private dinner at Trattoria Sorrento in \nBethesda with Eric Goosby, the Ambassador at Large in charge of PEPFAR and the new \nChief of the OGAC (Office of Global AIDS Coordinator) to discuss the future of \nPEPFAR.  Recall that Eric was one of the people that I flew in the put the icing on the \ncake of convincing the White House in 2002 that I was right about starting PEPFAR.  In \nany event, we discussed the issues of broadening the mandate of PEPFAR and integrating \nit in a more comprehensive health systems partnership with the developing countries.  \nUnlike in the past, he is in favor of “operational” or “Implementation” research to \ndetermine best practices associated with PEPFAR mission.  He confided in me the issues \nin the Department of State in putting the President’s Global Health Initiative (GHI) under \nUSAID with new Director Raj Shah.  Since PEPFAR in included within and is the major \npart ($51 Billion out of $63 Billion) of the GHI, the question remains will Hillary Clinton \nput PEPFAR under USAID.  Given the ineptitudes of USAID, I told Eric that he should \nnever accept that.  He agrees and actually said that he would resign if that happened.  I do \nnot think that things will happen that way.\nJan. 25, 2010 – Had strategy meeting in Building 31, Room 7A24 and subsequent dinner \nat Positano restaurant in Bethesda to determine the Institute’s strategy for vaccine \nresearch following the RV144 Thai trial results.  I called in a small group to hash out the \nissues in intense deliberations.  Present were: Larry Corey, Bart Haynes, Gepi Pantaleo, \nLouis Picker, Cliff Lane, Carl Dieffenbach, Peggy Johnston, Hugh Auchincloss, Carol \nHudgings, Patty Conrad.  General consensus is to continue with basic discovery, but to \ngo ahead with other Phase 2B trials, particularly a poxvirus (likely NYVAC) prime and a \nprotein boost (Clade C) in Africa.   Will continue this discussion next week with the \nAIDS Vaccine Research Subcommittee (AVRS).\nJan. 26, 2010 – Another meeting with Heidi Avery at the Situation Room in the West \nWing of the WH to further discuss the new initiative to counter all public health threats \nincluding bioterror, but also all emerging and existing Health threats.  Mike Kurilla and I \nhave been fine tuning the NIH component.  Present at the meeting was the same group as \non January 19, 2010 (see above0 .  Also present was the POTUS’s science advisor John \nHoldren.  We now have a 1-pager that Heidi has discussed with the POTUS and that is \nbeing considered for a brief comment in the State of the Union  (SOTU) Address.\nJan. 27-28, 2010 – Went to Boston to be the Bulfinch Visiting Professor at \nMassachusetts General Hospital and Harvard Medical School at the invitation of Denny \nAusiello (Chair of Medicine).  Great visit, particularly interactions with House Staff and \nReleased by Chairman Rand Paul\n225Fellows. Gave the Bulfinch Lecture on Pandemic Influenza; extremely well-received by a \nstanding room only crowd.  On the trip home when I landed at DCA, I bought a hot dog \nsince In was starving.  I immediately ran into Nina Tottenberg and her husband David \nwho god-naturely chastised me for eating the hot dog.  With a minute I walked to a news-\nstand to buy a Washington Post.  I ran into Karl Rove who jokingly said he would tell the \nworld that the great Dr. Fauci was caught eating a hot dog.  We had a good laugh.\n  On evening of Jan. 27 POTUS mentioned the sentence that I crafted for Heidi in the \nSOTU Address: “And we are launching a new initiative that will give us the capacity \nto respond faster and more effectively to bioterrorism or an infectious disease — a \nplan that will counter threats at home and strengthen public health abroad.”  This is \nthe second SOTU Address where my words were included.  Other was the PEPFAR and \nProject BioShield statements in the Jan. 28, 2003 SOTU address by Pres. Bush.\nJan. 29, 2010 – Met at the White House (EEOB 234) with Heidi Avery, Zeke Emanuel \nand several Pharma people whom Zeke had called in to ask the question of what would \nthey need to work with us on this project that Heidi and the rest of us have been \ndeveloping regarding developing a transforming approach to developing countermeasures \nfor all public health threats.  Present at the meeting were:  Peter Kim (Merck), Lloyd \nKlickstein (Novartis), Rob Mashal (NKT Therapeutics), Sandy Hecker (Hecker and \nAssociates), Lynn Marks (GSK), Richard Hatchett.\nFeb. 1, 2010 – Another meeting in the Situation Room of the WH with Heidi Avery with \nthe usual cast of characters.  For the past 2 meetings, Andy …. From DoD has joined as \nhas John Holdren from PCAST.  There is tension building where the HHS people \n(particularly Nicki Lurie and to some extent Jesse Goodman, Peggy Hamburg and Tom \nFrieden are getting nervous about the boldness of the proposal and whether we can \n“deliver” on the promises.  Heidi is trying here best to explain that we need a bold \ninitiative and if we are not bold and transforming, we will get nowhere. They are \nconcerned that this is moving quickly particularly since Heidi is talking about possible \nface-time with the POTUS to have him accept and sanction this bold “new initiative’. I \nam leaning much more towards Heidi and have served as somewhat of an intermediary to \ntry to alleviate their concerns.  They are somewhat in the weeds.  Heidi has been calling \nme up at night to get my confidential feedback about how we can get the HHS group \nfrom being so conservative.\nFeb. 2, 2010 – Had AIDS Vaccine Research Subcommittee (AVRS) meeting at the \nBethesda North Marriott Hotel to discuss the way forward following the Thai trial \n(RV144).  We discussed the same issues that I discussed at the smaller meeting of my \n“Kitchen Cabinet” on Jan. 25.  As usual, people had insecurities about pursuing a path \nthat was not their path.  In addition to the Jan. 25 group, also present were Dennis Burton, \nBruce Walker, Nelson Michael, Jerome Kim, Debbie Birx (now at CDC).  I made it clear \nto them in no uncertain terms that they needed to speak up openly and not stay silent and \nthen after the meeting say they disagreed with the conclusions.  It turned out to be a good \nmeeting since they obviously heard what I said.\nReleased by Chairman Rand Paul\n226Feb. 4, 2010 – Opened the Genomics Blue Ribbon Panel at the Bethesda North Marriott \nto plan the direction of genomics research for NIAID.  All the stars were there – Ian \nLipkin, Eric Lander, etc. Eric gave a great speech. About the use of genomics in \ninfectious diseases.  That evening presented my usual “State of NIAID” talk to the ASM \nExecutive Committee.\nFeb. 5 and 6 and Feb and Feb 9 and 10 – 2 worse snow storms in the history of \nWashington, DC.  Shut down schools and government for a week – it was a 0ne (32 \ninches at IAD) – two (20 inches in DC) punch.  During this time we intensified the \ndevelopment of the PHEMCE (Public Health Emergency Medical Countermeasure \nEnterprise) Initiative via Heidi Avery.  Getting hot and heavy in that the HHS folks are \ngetting cold feet.  Although good friends of mine – Nicki Lurie appears afraid and over \nher head.  Jesse Goodman is forever in the weeds.  Peggy Hamburg is cautious but just \nnow is starting to realize that this train is moving.\nFeb. 8, 2010 – Whole city is socked in with snow, but we still had meeting in Sit Room \nwith the usual cast of characters.  Heidi has obtained 1 hour face time for us with the \nPOTUS, but the HHS crew is afraid.  Issue  is that they think that the concept is too bold \nand Nicki Lurie is afraid that it will supersede the IOM-led review of the enterprise that \nSec. Sebelius has ordered for Feb. 22-23 and that must report to her by March 31.  Heidi \nwants to leap over all of the nonsense and get the POTUS buy in.  The pillars of her \ntransforming plan are : 1) Multi-use principle – NIAID has already been pushing for this \nin the sense of partnering with industry to develop multi-use products and advance new \nplatform technologies; 2) Collaborations, Partnerships and Cooperatives; 3) regulatory \ninnovation and Advancement of regulatory Science; 4)Product Development and \nmanufacturing services; 5) End-to-end Multidisciplinary Project Management (see entire \ndocument in records of My Documents).\nFeb. 10, 2010 – We (the HHS team) brief Bill Corr (Deputy Secretary).  Again \nconservative concern.  I am all for Heidi’s initiative.  These people just do not understand \nhow important it is to get personal support of the POTUS (remember PEPFAR).\nAgain, multiple conference calls with Heidi fine-tuning the document.  Richard Hatchett \n(who actually works for me in DAIT, but is detailed to Heidi) and Heidi often call me late \nat night for help in getting this group off their asses.  They are afraid that she will \npromise too much.  She keeps saying (and I totally believe her) that we are not going to \npromise the POTUS anything, we just need to get his buy-in and then we will implement \nwhat we can.\nFeb. 11, 2010 – HHS team briefs Secretary Sebelius over the phone.  She is smart, but \nclueless about what all this means.  Nicki Lurie is inarticulate in explaining it to her.  \nNonetheless Heidi is going to give it a go with the POTUS even though she is terribly \nfrustrated with the HHS people except for me. My time has been totally consumed with \nthis despite the shutdown of everything with the snow.\nReleased by Chairman Rand Paul\n227Feb. 12, 2010 – Meet with the POTUS from 2:00 to 3:00 in the Situation Room.  Richard \nand Heidi present and the HHS team answered questions.  I was not shy in telling the \nPTUS what I thought.  He said “Are we making this more complicated than it should we?  \nWhy not contract out for the relatively limited number of countermeasures that we have \nIntel. On that could be threats”.  I reminded him that in his SOTU address he said that we \nwould develop an initiative to counter all threats to public health even naturally emerging \ninfections.  I then told him that the dual use and new platform technologies were essential \nto get industry involved since they would not take the investment risk unless we helped \nthem with the technology, etc.  He agreed.  He recognized who I was without even an \nintroduction and called me “Tony”. All in all, the meeting went well and he said that he \nendorsed the plan.   Parenthetically, The traffic was horrible getting to the WH via the \nGW parkway by Taxi.  I took a taxi because the METRO Red Line shut down due to a \nderailment.  Stressful getting there, but great to have 1 hour face time with the POTUS.  \nThis is now the 5th POTUS that I have personally advised via serious face-time.\nFeb. 15-17, 2010 – Went to annual CROI meeting in San Francisco.  Gave Opening \nSession Plenary on “The HIV/AIDS Research Agenda:  A View from NIAID”.  Gave a \nbold and provocative talk about the high risk, high impact, potential “game-changer” \nresearch that we plan to do over the next few years.  The 3 “pillars” of this research are 1) \nAggressively seek, test and treat infected individuals.  However, the math tells us that the \ntreatment paradigm in a vacuum will never end the AIDS pandemic since more people \nget infected than get put on treatment.  Hence we need to do something different such as \ngetting people who are on therapy off therapy by developing a 2) CURE for HIV – tough \nchallenge.  Also we need to 3) Prevent new infections by a) ARVs as prevention – ARV \ncontaining microbicides; PrEP; test and treat; and b) vaccine.   Beautiful days in SF.  \nStayed at the Westin St. Francis.  Many people said that it was the best and most \ninspiring talk that I have ever given – “bold and challenging”.\nOn Feb. 17, I briefed by teleconference the PCAST working group about the POTUS \ninitiative and gave them background info.  On the call were co-chairs Harold Varmus and \nEric Lander.  Also, David Baltimore, Ed Penhoelt, Emilio Emini, Harvey Fineberg, \namong others.\nFeb. 18, 2010 – Another meeting at the Sit Room of the WH from 4:00 to 5:30 PM with \nHeidi Avery and the “team”.  Getting ready for the various meetings next week of IOM \n(Secretary’s review), PCAST, and National Biodefense Science Board (NBSB).  I \nbrought up that reports from these other meetings may confuse people regarding the \nPOTUS’s initiative to transform PHEMCE.  Heidi will likely let the other meeting \nhappen, incorporate some ideas from them and still have the POTUS initiative be the \ndriving force of policy.\nDuring the day prior to the WH had a visit from Rick Klausner.  I had been talking to \nRock about these issue for awhile and he is very much in agreement with my stand on \nhow we need to transform the way the USG interacts with industry in the development of \nproducts.\nReleased by Chairman Rand Paul\n228Feb. 23, 2010 – Continued activity in trying to dissect out what went right and/or wrong \nwith the response to H1N1 flu.  Still considerable tension between Heidi Avery who \nwants  s “to transform” the system and make some leaps and the slow, careful (and \nactually incompetent) response of the HHS people. Had the PHEMCE review led by \nNicki Lurie under the auspices of the IOM.  Held at the House of Sweden on 2900 K \nstreet by the Georgetown Waterfront.  I presented a lively endorsement of the Avery plan.  \nL felt that it made the HHS people nervous.  This reminds me of 25 years ago when I was \npushing HHS to accept the AIDS activists and they were conservatively reluctant.  They \nare not bold at all.\nFeb. 25, 2010 – As per the “review”, a PCAST meeting c—chaired by Harold Varmus \nand Eric Lander was held at the Carnegie Institution on 1530 P Street, N.W. with David \nBaltimore, Tom Monath, Robert Coffman, Emilio Emini and others present.  Their \npurpose was to look at the response to H1N1 and report back to the POTUS.  I presented \nmy theme of the absolute importance of developed a new paradigm of close interaction \nbetween USG and industry whereby USG pushes and shares to risk of developing \ninnovative technologies (new platforms for vaccines and drugs) that industry can use for \ntheir own profits while the USG then has it available to respond to public health threats \n(existing, emerging and deliberate). I was very well received. \nMarch 1, 2010 – Regular Monday evening meeting in the Situation Room of the White \nHouse led by Heidi Avery with the usual cast of characters.  Still inertia on HHS part and \nagitation by Heidi.  Couple of days later (~ March 3 or 4) Heidi called me at home at \naround 10:00 AM very discouraged at the inertia and lack of imagination of HHS people, \nparticularly Peggy Hamburg, Nicki Lurie and Jess Goodman.  Asked for my help in \ngetting the initiative going or she even said that it might be hopeless with this cast of \ncharacters.  She felt that Nicki was in over her head and that she was afraid of losing her \ncommand of the situation instead of capitalizing on what Heidi wants to do.  Heidi also \nfeels that Peggy is missing the big picture and that Jesse is hopelessly garbled in his \nthought and expression.  I will try to help her by formulating a plan with her to get this \ninitiative rolling.\nMarch 5, 2010 – Gave my yearly talk to the Zuckernman Fellows led by Mort \nZuckerman and David Gergen.    Then had the usual receptions that evening at Ronald \nand Beth Dozoretz’s home at 3005 45th Street, N.W. (right around the block from my \nhouse.  Usual stars were there – Sonya Sotamayor, Desiree Rogers (Social Secretary at \nthe WH), Justice Breyer, Dave Gergen, Wolf Blitzer, Andrea Mitchell, etc/\nMarch 6, 2010 – Under the continued generosity of Wayne and Catherine Reynolds to \nChris and me, we were their guests at the premier showing of the Opera “War and Peace” \nat the Opera House of the Kennedy Center.  Special elegant dinner before hand in the \nAtrium followed by the opera.  Guests were the usual DC lists of famous people:  few \nexamples – Gen James Jones, Sen. Tom Daschle, Marcus Brauchli (editor of Washington \nPost), many media people – Dana Priest, Wolf Blitzer, Sam Donaldson, etc.  Long opera!\nReleased by Chairman Rand Paul\n229March 16, 2010 – Research Amer!ca Awards Gala at the Andrew Mellon Auditorium on \nConstitution Avenue.  Usual cast of characters.\nMarch 17, 2010 – For the past 2 Mondays have had the usual Situation Room White \nHouse meetings with Heidi Avery .  Same theme – she is pushing HHS and I am very \nmuch on her side. Looks like a plan is taking shape.  I am impressed with the relative \nincompetence of the HHS group.  They seem clueless and short on leadership.  Tom \nFrieden of CDC shines in my mind as an independent thinker with good ideas and a \nperson who marches to the beat of his own drum.  \n       Gave talk to the NIAID Fellows on a “Career at NIH Monday, 15 March.  They \nloved it.\nRadio and TV Correspondents Association Dinner – Black tie at Convention Center.  \nTerrific night.  Went alone but met with wide range of the usual cast of characters:  Chris \nWallace (Fox News – they invited me); multiple Senators, etc.\nMarch 19 – 22, 2010 – Contamination of Rotarix (Rotavirus vaccine from GSK) with \nporcine circovirus (PCV-1).  Spent many hours on conference calls over the weekend \nwith FDA, CDC and HHS to determine roll-out.  Difficult issue here is the message.  \nThere is no indication that there is a safety concern here since PCV-1 does not cause \ndisease in pigs or in man; yet this virus should not be in the vaccine.  It was at high \nconcentrations even in the seed stock.  The message is that the FDA recommends putting \na hold on administration of the vaccine  (without pulling it from the market) until the \nsituation can be examined more closely.  The potential downside is that this vaccine is \nused mainly in the developing world and if the vaccinations stop, kids will die of \nrotavirus disease.  Merck makes Rotatec, which is used mainly in the USA and so the \nFDA recommends that where possible, clinicians switch from Rotarix to Rotatec.  We \nfully understand that this might not be possible in the developing world and so we \nunderstand if they continue to use Rotarix.\nMarch 24, 2010 – Continue intense WH meetings with Heidi Avery in Sit Room tonight.  \nI finally put together my version of how the USG should take responsibility for the \nadvanced development, preferably in a physical facility that we buy or rent.  The facility \nat Texas A & M is a good model.  Heidi really likes the idea.   Laura Petrou called me \nand said that she heard that I was more forward looking about all of this than the FDA \n(Peggy), CDC (Tom) and HHS (Nicki) and wanted to hear from me about my ideas.  She \nwas actually receptive.  The issue here is really that HHS does not want the WH (Heidi) \nto get in front of the Secretary.  Yet the HHS process is slow, too cautious and \nbureaucratic.  Heidi still calls me off line for my ideas. \nMarch 27, 2010 – Phone call on Saturday with Heidi.  She wants to get more money for \nNIAID to help in the process of bringing investigators from concept to very early \ndevelopment in order to increase the pipeline of products in addition to all of the things \nthat we have been talking about regarding “advanced” development.\nReleased by Chairman Rand Paul\n230Mar. 29, 2010 – Continue with the Monday evening weekly meetings with Heidi Avery \nat the WH Sit. Room.  Usual suspects.  Still Heidi pushing and everyone but me pushing \nback.  Peggy Hamburg seems her usual spacey self often not even having read the \ndocuments that Heidi distributes for comment.  Jesse Goodman (wonderful guy) \ncontinues to be reserved and cautious in typical FDA fashion, but cannot articulate well.  \nNicki Lurie is a good person, but over her head.  In fairness to her, she is caught between \na rock and a hard place in trying not to let this get ahead of the Secretary who in my mind \nis distracted or does not really care about this.  Nicki keeps pushing back on Heidi’s \n“transforming initiative”.  Zeke Emanuel comes to most of the meetings and is with Heidi \nand me in wanting to push this.  In typical Zeke fashion, he is brilliant, but shoots often \nfrom the hip.  Mike Kurilla is doing a great job with me and probably understands the \nproposed process better than anyone in the room. Andy Weber of DoD (assistant \nSecretary) is a good guy, but he is just trying to keep the DoD in the “game”\nMar. 31, 2010 -  Meet with Alan Bernstein (Executive Director of the “Global HIV \nVaccine Enterprise” (see above comments about my negative reaction to this unnecessary \ngroup).  Alan is a good guy, but is heading a superfluous organization.  In any event, his \nmultiple layers of “working Groups” has come up with a Strategic plan for the \n“Enterprise”.  Peggy Johnston is all over this and so she shields me from the week-by-\nweek dealings of this organization (I am one of the Founding Council Funders).  Meeting \nin my office with Alan since wants me very much to approve of the plan since NIAID is \nthe major world funder of HIV vaccine research. Meeting In NYC next week of the \nEnterprise Council and so he is here to pay respects and make sure that I am on board.  \nThe Plan is OK, but NIAID will do what we think is best for vaccine development.\nLater in the day, the HHS Flu team (me, Nicki Lurie, Jesse Goodman, Peggy Hamburg, \nTom Frieden, Laura Petrou, Jenny Backus, etc) meets with Sebelius in her private \nconference room.  We present the supposedly penultimate draft of the MCM Review that \nshe ordered and that we have been working on for weeks trying to reconcile it with \nHeidi’s initiative.  Nicki gives a terrible presentation; Sebelius is confused as to the \n“scope” of the review that she ordered – was it a review only of medical countermeasure \n(MCM) development or a review of end-to-end process of responsdng to health crises, \nincluding flu.  I tried to clarify for Nicki, and Sebelius agreed with me. We need to keep \nit focused.   Back to the drawing board on a few issues.  One issue is how much money \nshould we ask for in the 2010 flu supplement and the 2011 budget to fulfill some of the \ngaps identified in the review and in what is proposed by Heidi.\nApril 5, 2010 – After Action Review of the H1N1 response in Nicki and Jesse’s home in \nBethesda (near the Palisades section).  Beautiful home with magnificent view of the \nPotomac and the opposite Virginia shore.  Beautiful sunny day.  Present – Nicki, Jesse, \nRobin, Steve Redd, Anne Schuchat, Laura Petrou, Makala Ross (OS).  Good discussions.\nApril 6-7, 2010 – Went to NYC night before and had great dinner and time with Jenny \nand Meg.  I stayed at “W” hotel at Union Square.  Went for run on April 5 evening past \nLarry Kramer’s Apartment; called, but found out later that he was asleep on his couch \nand did not hear the phone.  In front of Larry’s Apt. (2 Fifth Avenue – right across the \nReleased by Chairman Rand Paul\n231street from Washington Square Park), ran into Bob Bazell (NBC News), who live in the \nsame apartment.\n       Next AM (April 7) went to Enterprise headquarters and met with the leadership to \ndiscuss the “Plan”.  Beautiful day.  I stayed for AM.  Present were Alan, Tachi Yamada, \nPeter Piot (new Chair of Council), Manuel Romaris (EU), Catherine (Kate) Hankins \n(UNAIDS-WHO). Seth Berkley (IAVI), Jose Esparza (BMGF), Peggy Johnston, Yves \nLevy (INSERM), Rafi Ahmed (Emory and chair of the Scientific Committee).  Good \ndiscussions.  I kept them on track about what NIAID would or would not agree to).\nApril 14, 2010 – Dedicated the Special Unit at the Clinical Center for vaccine studies.  \nHonored Stewart Simonson for the role he played in pushing through the red tape to get \nthis done.  Had nice ceremony with Cliff, John Gallin, Gen Jim Gilman (USAMRIID), \nStewart, etc. Group went to Black’s restaurant on Woodmont Avenue – Bethesda) for \ndrinks on the outdoor terrace (pretty cold).\n    We continue to have endless meetings with ASPR  on the Medical Countermeasure \n(MCM)  review led by Nicki Lurie with Laura Petrou and Jenny Backus involved.  I now \nattend by conference call since it is a waste of time to go down town for these drawn out \ndiscussions.  Theme is post-mortem on the pandemic flu response and how do we \nincorporate what Heidi Avery wants into the Secretary’s (HHS) MCM review.  The \nincompetence and amateurishness of HHS crew in general is noteworthy.   I love Jesse \nGoodman, but he just does not get it that the FDA is a major part of the problem; and he \nis one of the very best FDA people.\nApril 17, 2010 – Was at the Georgetown Harbor near Thompson’s Boat House watching \nAli’s Varsity Crew Boat compete in a regatta.  Nice Spring day on the Potomac.  Chris \nand I were with the usual parents group including our good friends Liz and David Hayes \nwhose daughter Molly is Ali’s “best” friend and boat-mate.  Both will attend Stanford in \nSeptember.  There had been a terrible explosion in an off shore deep-water oil rig a few \ndays ago with no apparent oil leak despite the fact that the platform was destroyed, 11 \npeople died and scores injured.  It was the British Petroleum (BP) Horizon Deepwater \nwell.  David Hayes is the Deputy Secretary of the Department of the Interior.  In the \nmiddle of the regatta, David got a phone call from the White House communications \npeople.  Apparently, there is considerable amount of oil leaking from a broken pipe line.  \nThey were saying that the leak is minimal and David was caught in the middle in having \nspoken to the press and saying that this was serious.  The White House communications \npeople were concerned that he said that we have a bigger problem than exists. They were \napparently giving him some “shit” about this.   David, who recently (last year) had a \ncardiac arrest associated with a myocardial infarction on a golf course, looked shook and \ndistracted. I encouraged him to not worry about what the communications people think.  I \nknow something about the WH trying to control the “message”. Little did either of us \nknow that over the subsequent months would unfold the worst oil spill in history and the \nworst environmental disaster in the history of the USA.\nReleased by Chairman Rand Paul\n232April 19, 2010 – Went to the Lasker Board of Directors dinner at the Citronelle \nRestaurant in Georgetown at the invitation of Maria Freire.  Sat next to Al Somer.  Good \nevening, but ridiculous situation where the government people (me, Peggy Hamburg, \nJohn Gallin, Harvey Alter actually had to pay for our own meal due to misguided conflict \nof interest rules.\nApril 21, 2010 – Continue to have weekly meetings in the Situation Room of WH led by \nHeidi Avery.  Continued frustration on Heidi’s part about the lack of cooperation on part \nof Nicki Lurie and HHS.  Heidi wants transformation and HHS is conservative, only \nconcerned about the Secretary, and “stuck in the mud”.  What a sorry crew.  These \nmeeting are started to take a toll on my schedule with having to take the METRO down \nand back and the Red Line being barely functional with amazing slowness and frequent \nmishaps.\nApril 27, 2010 – Another Sit Room WH meeting to discuss budget and implementation \nof MCM initiative.  Continued tension.  I am with Heidi.\nApril 28, 2010 -  Busy day.  Two Congressional (House) Hearing in the Rayburn \nBuilding: 1) Appropriation Subcommittee chaired by David Obey.  I accompanied \nFrancis Collins along with Tom Insel (NIMH) and Griff Rogers (NIDDK) to testify.  \nFriendly Hearing but budget is depressing – flat.  2) in the late afternoon – House Energy \nand Commerce Health Subcommittee Hearing on Antibiotic Resistance chaired by Frank \nPallone (D-NJ).  Testified with Tom Frieden.  Typical posturing back and forth between \nDems and GOPs about Health Care Reform (nothing to do with the subject of the \nHearing).  We did well.\nApril 29, 2010 – ICD retreat  - at the Cloisters.  I spoke on the MCM initiative of the \nWH and the NIAID role in this.  Others spoke on translational research.  Much of \nmeeting was on translational research.  Clearly the NIH (under Francis) is heading in that \ndirection.\nApril 30, 2010 – Did Congressional Briefing on AIDS research sponsored by AMFAR at \nthe Rayburn Building.  Susan Blumenthal chaired it.  Also there was Wafaa El-Sadr.\nMay 1, 2010 –Went to Saturday Brunch gala at The Haddad/Greenberg residence at 4852 \nHutchins Place, N.W. as a pre- WH Correspondence Ball function.  Featured Susan \nAxelrod of CURES (for epilepsy).  Many of the usual DC glitterati, media and \nHollywood Stars there.  Saw my old friend Dana Delaney and practically every media \nperson I know – David Gregory, Wolf Blitzer, Chris and Kathleen Matthews, etc.\nMay 2, 2010 -  Annual McLaughlin (now together with Reuters) Sunday Brunch after the \nWH Correspondents’ ball.  Hel at the usual Rooftop of the Hay-Adams Hotel.  Met with \nand spoke with Dennis Quaid who is an advocate of eliminating “Hospital errors”.  His \nchild was the victim of a medication error involving a heparin line through which the \ninfant was given 10,000 times the dose of heparin.\nReleased by Chairman Rand Paul\n233May 5, 2010 – At his request, had meeting in my office with J. Craig Venter.  He wanted \nto brief me and get my advice on how to handle the rollout of his upcoming Science \npaper on Synthetic Biology.  He has made a major advance in synthesizing from the \nsequence in a computer the 1.1 million base pairs of Mycoplasma mycoides  and inserted \nit into a Mycoplasma capricolum bacteria.  The synthetic mycoides then began to code \nfor the proteins of the bacterial cell wall so that after several replications there was a \nbacteria with a synthetic genome and all of the protein coded for by the synthetic \ngenome, thus a synthetic cell.  I advised him to be very transparent at this and present it \nto the NAS, the OSTP, among others.  He has lined up some embargoed press in \nanticipation of the release next week of the paper on May 13. He very much wanted me \nto do heavy press with him likely to add a greater degree of credibility to it as well as \nbecause I explain science so well.  From today until the House Hearing on May 27, HHS \nand the White House completely muzzled me for ridiculous reasons.  Despite the fact that \nJohn Holdren submitted my name to the WH as the best person to do TV, radio and print, \nthe WH muzzled all government comment on this.  They were “afraid to elevate it \npublicly by having well-known government figures speak about it since they did not want \nflack from the “right” that the government was involved in “creating” life.  \nUnbelievable!!   Rick Weiss who is communications director for OSTP is extremely \ndistraught about the muzzling.  Of note, this has happened to me throughout the H1N1 flu \npandemic.  Apparently, besides Jenny Backus, more importantly, David Pfeiffer at the \nWhite House is now behind the muzzling.\nMay 6, 2010 – We have been pushing the issue of more resources and activity on \nNeglected tropical Diseases (NTDs) here at NIAID.  Peter Hotez from GW has been a \nleader in this field.  Recently, Zeke Emanuel at OMB has been pushing it as part of the \nPOTUS Global Health Initiative (GHI).  Zeke called a meeting of all of the players in the \nfield including me, Hotez, Eric Goosby, Raj Shah (Head of USAID), Raj’s assistant Amy \nBatson and many others to discuss the future agenda. The meeting involved research, \npolicy, implementation.   NIAID will sponsor a purely scientific meeting later in the year \n(Dec., 2010).\nMay 7, 2010 - “Big Think” meeting at the Natcher Building of Outside consultants to \ndiscuss 3 of Francis’s pillars: 1) high throughput technology; 2) Translational Research; \n3) Research involved in enhancing health care reform.  All day.  Francis Collins clearly is \ntrying to steer the NIH towards his themes. “Everybody wants to be somebody.”  The \nmeeting was geared to figure out how to spend Common Fund Money and how to move \nmore towards translational research.  Actually a good meeting.  Francis is smart, very \nhard working, but it is all about Francis.\nMay 13, 2010 – Gave Keynote at the NIAF Public policy Forum at the Rayburn \nBuilding.  Typical of similar Italian functions.  Again, continual activity at WH with \nMCM and Heidi.\nMay 14, 2010 – Phenomenal reception/dinner at the Academy of Achievement on 16th \nStreet, N.W. hosted by Wayne and Catherine Reynolds.  Usual stars of DC were there: \nEric Holder, media people, Gen. James Jones, Bob Barnett, etc., etc.  It was a Tribute to \nReleased by Chairman Rand Paul\n234Hal David, master lyricists and team member with Burt Bacharach.  “Mystery” \nentertainers were B.J. Thomas singing “Raindrops keep falling on my head” and the \namazing Dionne Warwick.   I helped Dionne a few months ago by referring her friend to \na neurologist for MS.  We had a pleasant conversation after her performance.\nMay 18, 2010 – Science Management Working Group (SMRG) meeting in Building 31 \nto discuss the clinical center issues and the proposition to open it to the extramural \ncommunity in exchange for the inflationary increases being paid for out of the total NIH \nbudget instead of just the IRP budget.  Still pending what the decision will be.\n     That night had dinner at Assaggi in Bethesda with Mark Harrington, Gregg Gonsalves \nand David Barr to discuss the underfunding of PEPFAR and what to do about it.  In this \nregard, big issue looming among the international and national AIDS advocacy \ncommunity about the POTUS GHI that includes PEPFAR, but funds PEPFAR at almost \nlevel instead of the expected increases by the community.  POTUS wants to expand GHI \nbeyond just PEPFAR and include, child health, maternal health, women’s health, NTDs, \netc.  Thus, PEPFAR is somewhat competing with others for a limited pot of money.  \nMany African health officials such as Peter Mugyenyi are openly complaining about this \nand getting agitated.  Obama is looking in the eyes of the activists as anti-AIDS, which he \nis not.  However, it is clear that AIDS is not his highest priority.\n     Earlier in the day I appeared on the Diane Rehm show on just this topic of short-\nfunding of PEPFAR.  On with me was Stephen Lewis (former UN envoy at large for HIV \nand Peter Mugyenyi and Eric Goosby.  Lewis as usual was sanctimonious.\nMay 21, 2010 – Waxman’s House Energy and Commerce committee want me to testify \non May 27 with Craig Venter and others on synthetic biology and the science paper that \njust came out.  White House is balking.  I spoke with staffers Naomi Seiler and Steve \nCha.  Both really want me to testify.\nMay 25, 2010 – Received the Joel A. Toubin Award for Advocacy on Behalf of HIV \nInfected People from the Whitman Walker Clinic at the Embassy of Sweden at 2900 K \nstreet on the Georgetown Waterfront.  Amazingly beautiful day.  Reception on the \nrooftop with panoramic views of the Potomac, Watergate, the Key bridge, etc.  Check out \nmy speech\nMay 26, 2010 – Met with Francis Collins, Harold Varmus (recently announced as new \nNCI Director, John Burklow (OC for OD), Kathy Hudson, and Pat White (Leg for NIH \nOD) regarding the disturbing Administration policy of “muzzling” NIH and other \ngovernment scientists (see discussions above).  Conclusion is that we must strongly \nsuggest to John Holdren (POTUS Science Advisor) that he directly tell the POTUS that \nscientists, particularly at NIH are being muzzled by the WH  and HHS communications \npeople.\nReleased by Chairman Rand Paul\n235    The evening (beautiful, warm Spring DC evening) went to the Annual National \nEducation and Leadership Awards (NELA) Gala at the Omni-Shoreham Hotel given by \nthe Sons of Italy Foundation.  Bill Clinton received the Lifetime Award for Public \nService.  Came 1 hour late, but gave a great speech on public service.  Also awarded was \nCaptain Anthony Odierno who lost his left arm to an RPG attack on his Humvee in \nBagdad.  His father General Raymond Odierno introduced his son.  Tear-jerker for sure.  \nAlso awarded was Lewis Merletti, former WH Secret Service detail and ultimately Chief \nof the Secret Service; decorated Viet Nam vet (Bronze Star).  Patty Conrad knew him \nwhen she worked in the Bush 41 WH.  Says he was a very nice person.  Sat at the table \nwith Bob Gallo and Phil Piccigallo.  It is interesting that after all these years I have \nbecome somewhat of an icon to the older and younger Italian men and women, many of \nwhom wanted their picture taken with me.\nWhite House finally clears me to testify tomorrow\nMay 27, 2010 – testify before House Energy and Commerce Committee on synthetic \nbiology related to the Science paper by Venter et al on the synthesis of Mycoplasma \nmycoides and insertion into a Mycoplasma capricolum to ultimately have a totally \nsynthetic bacteria.  Testified with Craig Venter, Jay Kiessling (Berkley), Greg Kraebnick \n(Hastings), Drew Endy (Stanford).  Hearing went extremely well.  Some posturing by \nGOPs on Health Care reform, but in general, we all did very well.\nJune 5, 2010 – Met with Rick Klausner at my house for catch-up.  He is in town to meet \nwith OSTP regarding preparedness issues similar to the types that I have been working on \nwith Heidi Avery.\nJune 8-11, 2010 – Visited RML for the BSC review.  Went with Patty Conrad, Kathyu \nZoon, Karyl Barron etc. Had very nice time.  Went fishing twice with Marshall Bloom \nand Patty and a great guide named Jack Mauer.  Fishing not good due to high water from \nrain.  Nonetheless, it was a wonderful time.\nJune 12, 2010 – Flag day at NCS.  Alii took the Science, Math and Spanish Prizes.  She \nwould have won the Flag (for highest GPA over 3rd and 4th year) but an English teacher \nwho is a known asshole gave her an  A-.\nJune 13, 2010 – Graduation Day at NCS.  Feeling very sad that my baby (Ali) will be \nleaving us for Stanford in the Fall.\nJune 15, 2010 – Had dinner at the home of the Italian Ambassador to the USA (Villa \nFirenze – 2800 Albermarle Street, N.W.)   I wanted to do this since he is the new \nambassador and I have over the years become variably friends with the Ambassador.  The \nprevious one was Giovanni Castanaletta.  The current one is Giulio Terzi di Sant’Agata.  \nI was fortunate enough to sit next to him at the dinner table and so got to know him.  \nSpoke about a wide variety of subjects from Afghanistan to the Oil spill in the Gulf of \nReleased by Chairman Rand Paul\n236Mexico to the economy to science in Italy versus the USA.  Very nice guy.  Also at the \ndinner were Bob and Mary Jane Gallo, Susan Blumenthal and a bunch of Italian Pharma \npeople and diplomats.\nJune 17, 2010 – Met with Minister of Health of Taiwan today to discuss potential \nscientific collaborations.  He said that I was “famous” in Taiwan….interesting.  Jean \nWilliam (Bill) Pape visited from Haiti today and gave lecture at Masur Auditorium.   He \nis a good friend and invited Megan to visit Haiti.  He is in DC to receive an award for the \namazing work that he has done in Haiti related to the earthquake.\nJune 24, 2010 – Met with Minister of Health of India Ghulam Nabi Azad to discuss \ncollaborations.  Sharp guy – enjoyed discussion.\nJune 29, 2010 – Went with Chris to South Lawn of the White House to celebrate her \nelection to the Bioethics Commission.  Turned out it was a massive get together on a very \nhot day for all Presidential appointees.  They were completely disorganized in getting \npeople cleared through the gates and it was a logistic disaster.  The delay was probably \nrelated to multiple checking of IDs related to the “gate-crashing” of a WH party a few \nmonths ago.\nJuly 11, 2010 – Went to Atlanta for the day  (Sunday) to give plenary at the CDC \nsponsored international Conference on Emerging Infectious Diseases.  Hot July day.  I \nshared the Plenary opening evening addresses with Tom Frieden and Kevin DeCock.  \nGood camaraderie among CDC people and me.  Came back to DC that night.\nJuly 12, 2010 -  Attended swearing in of Harold Varmus as the new Director of the \nNational Cancer Institute.   Starting to do a lot of press in anticipation of the International \nAIDS Meeting in Vienna next week.   Am looking forward to this meeting since I am \ngiving a Plenary Lecture on Pathogenesis of HIV Disease: Opportunities for \nInterventions.   \nJuly 18, 2010 – Leave for Vienna (Sunday) – Disaster for travel – flight cancelled on the \nrunway, switch from direct flight to Vienna (Austrian Airlines) to United to Frankfurt \nconnecting to Vienna.  United flight sits on IAD runway for 2 hours due to thunder \nstorms – miss connection in Frankfurt.   Finally get the Vienna on Monday afternoon \n(19th July).  Trying to stay cool and un-ruffled.   Good to have Johanna McDonough meet \nme at airport.  She had rescheduled me from IAD to get me to Vienna.  She is a life-\nsaver.\nJuly 19-21, 2010 – Really great meeting in Vienna.  My talk was a knockout.  Also, very \ngood press from Vienna – PBS Newshour, CNN, WTOP, CBS radio, also NY Times, \nWashington Post, etc.   Meeting was a complete success.  We announced the results from \nthe CAPRISA microbicide trial.   First success with topical microbicides.  \nJuly 22-23, 2010 – Good press follow-up from meeting – NPR Science Friday among \nothers.   Note that we have been going through a record breaking heat wave on the East \nReleased by Chairman Rand Paul\n237Coast with a concentration in DC.   Temps between 92 and 101 F for the past several \nweeks.   Welcome to Washington!\n    Also, over the past 2 weeks I have been informed that I have won the Paul Janssen \nPrize from Belgium ($100,000.00) (cannot take the money since the prize is sponsored by \nJ & J – what bullshit).  Also won the Will Roger Prize for $50,000.00 (yes, I can accept \nthe money).  To be given to me in LA – am looking forward to this.\nThis has been a very busy, hot, exciting summer.   Am chronically tired, but good things \nare happening, particularly in the lab (a4B7) and with commentary papers that I am \nwriting including some really nice ones with Gary Nabel on HIV vaccine and universal \nflu vaccine.\nAug. 4, 2010 – Memorial service for Bob Chanock, giant in virology for 50 years at \nNIAID.     Major figure in virology \nresearch – discovered M. pneumonia; several parainfluenza viruses, his groups also \ndiscovered norovirus (Norwalk agent), made vaccine for rotavirus and hepatitis A, etc.  I \ngave one of the eulogies at his service.\nAug. 5, 2010 – Dinner with Larry Corey who has just been offered and accepted \nPresident and CEO of the Fred Hutchinson Cancer Research Center in Seattle, where he \nhas worked for many years.   Big career decision regarding his future role in helping lead \nthe HIV vaccine effort as PI of the HVTN.\nAug.  18, 2010 – Big controversy regarding the conflicting studies of the role of XMRV \n(xenotropic mouse leukemia virus-related virus) in chronic fatigue syndrome (CFS).   2 \npapers coming out almost simultaneously from FDA (Shy-Ching Lo)/NIH (Harvey Alter) \nin PNAS and the CDC in Retrovirology. FDA/NIH finds correlation (86% vs 8.% in \nnormals), while CDC finds no correlation.   I have been involved in trying to get to the \nbottom of this prior to publication of the discordant results since we knew of the data \nbefore the papers were published.   I believe that the FDA/NIH study is contaminated and \nI do not believe Shy Lo since in the late 1980s he had claimed with what appeared to be \nfool-proof data that AIDS was associated with a new species of mycoplasma (M. \nfermentans) as a co-factor.   The data proved to be spurious,, but people seem to have \nforgotten about this.  I have convinced Ian Lipkin from Columbia (Mailman School of \nPublic Health) to referee coded sample examination of FDA looking at negative samples \nfrom CDC study.   The exercise was somewhat inconclusive.   Lo does not want to do \nanother study starting with identical CFS samples that are coded together with known \nnormals and known spiked samples to really settle this.   The issue is that highly \nemotional CFS crowd now wants to treat CFS people with anti-retroviral drugs, despite \nno evidence of causality and several negative studies besides the CDC study.\nAug. 19, 2010 – Finally had formal roll-out of the Medical Countermeasure (MCM) \nreview and initiative together with PCAST Report re: 2009 pandemic flu.  Roll-out was \nat HHS led by Secretary Sebelius.   I presented the NIH component of the 5 part initiative \nwhich is the Concept Acceleration Program (CAP) and the Strategic Investment (SI) \nprogram (a 501 3(c) similar to a venture capitol firm).  Other initiatives were regulatory \nScience for FDA, manufacturing capacity, enhance influenza capability (potency assays, \nReleased by Chairman Rand Paul\n\n238sterility assays, etc.).   All of this evolved greatly from the many meetings that we had \nover the past year in the White House Situation Room with Heidi Avery.  We finally \ncame to some compromise in the tension between the WH (Avery) and HHS (Lurie-\nSebelius).\nNov. 2, 2010 – Mid-term Elections!  In a strong repudiation of what some consider the \nover-reaching liberal policies of President Obama, the Republicans take of the House by \nwinning 60+ seats and lick up many in the Senate.   Pelosi out as Speaker and John \nBoehner (R-Ohio) in.   Much upheaval with some Tea Party Candidates winning seats.\nNov. 8, 2010 – Visited Holy Cross College to deliver the Inaugural Joseph E. Murray, \nM.D. Distinguished Lectureship in Medicine.   Joe Murray (class of ’40) had won the \nNobel Prize for performing the first kidney transplant.   I gave the lecture to a full house \nat the Hogan Campus Center at Holy Cross in Worcester.  Write-ups in Boston Globe and \nWorcester Telegram.   Old friends came to see the lecture from my class of 1962 – Bob \n(and Peggy) Curran, Jim Mulvihill, Pete Deckers.  Best part of the evening was the \nappearance (stayed for dinner and the lecture) of Bob Cousy who had said that he was so \nproud of what I had done for the country and the world that he wanted to come to meet \nme and hear my lecture.   He was attentive and engaged for the entire lecture in the first \nrow.   During the day before the dinner and lecture, I met for hours with students (almost \nall pre-med and mostly women).   They were great and we had fun.   They said that I was \n“cool” and “awesome”\nNov. 23-24, 2010 – Big advance in HIV prevention research.  The iPrEx study results for \npre-exposure prophylaxis (PreP) for prevention of HIV infection in MSM came out on \n11/23/10 in the NEJM showing 44% decreased risk in Truvada arm versus placebo.   \nImportantly, for those who took the drug 90% or more of the days, decreased risk was \n73%.  For those with blood levels of Truvada vs those without blood levels, the risk was \ndecreased by 92%.   Big media days for me – Front page of NY Times, CNN Situation \nRoom with Suzanne Malveaux, multiple print medias, Canadian and European TV, Local \nFox News, several NPRs including “Talk of the Nation”;  The NewsHour. This will be an \nimportant addition to the toolkit of prevention methods.\nMegan spending the first semester of 3rd Year in Morocco.   Somewhat stressful, but \nextraordinary experience.   She is an amazing young woman.  I am actually in awe of her \ncourage and adventurous spirit.\nDec. 1, 2010 – World AIDS Day – Gave presentation at The White House and \nparticipated in panel led by Eric Goosby together with Chris Collins, Ada Adamora, \nJennifer Cates.   My thene was 1)  Optimizations of Therapy; 2) Go for a cure; and 3) \nMaximize prevention.\nDec. 1, 2010 through Jan. 19, 2011 – In general, nothing overwhelming.  Economy \nrecovering; still strident partisanship in Washington, D.C.   Health care reform passed, \nand no Republicans voted for it – amazing.   NIH budget looking bad.\nReleased by Chairman Rand Paul\n239Dec. 8, 2010 – Science Management Review Board (SMRB) of NIH (of which I am a \nmember) has been and continues to discuss Francis Collins’ intention of merging NIDA \nand NIAAA, dissolving NCRR, as well as and more importantly creating a National \nCenter for the Advancement of Translational Science (NCATS) at NIH to include the \nCTSAs and CAN RAID TRND and Molecular libraries.  Francis is dead set on starting a \nnew center and is using the SMRB to endorse it.   I have made it clear that I do not think \nthat this is a good idea since it is redundant (nothing broke).  Also, bad idea at a time of \nflat, if not decreasing, NIH budget.\nDec. 9, 2010 – Major breakthrough in NIH prevention with the results of the PrEP study \n(iPrex) showing that daily Truvada to uninfected MSM decrease acquisition of HIV \ninfection by 44% and in those who take the meds every day, it decreases acquisition by \n90%.   I did much media on this\nDec. 13, 2010 – Major outbreak of Cholera in Haiti.  Traced to contaminant of a river \n(used for drinking and washing in rural part of Haiti) by UN Nepalese soldier with \nasymptomatic cholera.  I appear of Diane Rehm show discussing cholera.\nDec. 17, 2010 – I deliver the Walter Dzau lecture at Brigham and Women’s Hospital \n(invited by Paul Farmer) on “30 Years of HIV/AIDS:  A Personal Journey”.  \nOverwhelming hit with prolonged applause.   I spoke of my involvement from first day \nand told the story of the “Birth of PEPFAR”.\nJan. 14, 2011 – Appeared on Anderson Cooper 360 on CNN in NYC for a special on “30 \nYears of AIDS”.   There will likely be increasing media events this year since this is \nindeed the 30th Anniversary of the recognition of AIDS.\nJan. 15-16, 2011 – Was Keynote Speaker at a Keystone Meeting in Vancouver, BC on \nTuberculosis.   Large (~800) audience, mostly post-docs.  Very well received.\nFeb. 15-16, 2011 – Went to San Juan to deliver the Opening Keynote at the \nNIAID/CDC/PAHO-sponsored Dengue Symposium.  Great time.  In accordance with my \nexpanding to more emphasis on Global Health and Emerging Diseases.\nFeb. 24-26, 2011 – Parents’ Weekend at Stanford.   Absolutely wonderful time to see Ali \nin her beautiful school setting.   Spent prior night in SF with Chris at the Queen Anne’s B \n& B and went to Jackson-Fillmore Restaurant.   Days at Stanford were great.  Saw \nwomen’s basketball team clinch the PAC -10 championship for the 11th year in a row by \ndefeating Oregon.   Also, saw #1 ranking woman tennis player (Barte) and men’s \nvolleyball (ranked 4th in Nation).\nMar. 7, 2011 – Town Hall meeting for non-HIV clinical trials network.  Sensitive issue \nin that Carol Heilman still is not enthusiastic about it.  However, I made it clear exactly \nwhat we are going to do.\nReleased by Chairman Rand Paul\n240Mar. 9, 2011 – Gave opening lecture at NTD Workshop at Natcher Building.  Continue \nto stress Global Health.\nMar. 15, 2011  -  White House communications people at it again.   Last week (Mar. 11, \n2011) a terrible tragedy hit Japan with a 9.0 scale earthquake in the NE part of the \ncountry almost immediately followed by perhaps the worst tsunami in recorded history of \nJapan destroyed much of the NE Coast.   Importantly, it knocked out the cooling system \nof the Fukushima Daiichi Atomic Power Plant leading to multiple explosions and \nmeltdowns with radiation spillage and leakage.  As of today (4 days later) the extent of \nthe potential disaster is still not known, i.e. how much radiation exposure will occur.   \nThus, we (NIH and me personally) are getting the expected calls from the press regarding \nthe medical aspects of acute radiation syndrome (ARS) – what it is and how you treat it.  \nThe White House is not granting any clearances for me or anyone at this point to talk to \nthe Press.   Amazing!!   Same as with the Pandemic Flu early on.\n    \nMar. 21, 2011 – Was invited by the Bush family to a Kennedy Center event which was \n“The Points of Light Institute TRIBUTE – All together Now – A Celebration of Service”.   \nBush 41 sent me a hand-written note thanking me for my meager $150.00 donation. At \nthe event were Presidents George H.W. Bush, George W. Bush, Jimmy Carter and Bill \nClinton.   Clinton gave an amazingly moving talk about his friendship and love of Bush \n41.  Entertainment was terrific: Garth Brooks, Kid Rock, Cee Lo Green, Carrie \nUnderwood, Darius Rucker, among others.   Brought back very fond memories of my \ninteractions with Bush 41 as well as other Presidents during the past 30 plus years.\nMar. 29, 2011 -  Appeared on the Colbert Report.  Great success!   Had a great  time and \nreceived hundreds of e-mails and calls and personal mention of how good the \nperformance was.   Reason for the appearance was the approaching 30th anniversary of \nfirst cases of AIDS.\nApril 7, 2011 – Gave World Health Day remarks at PAHO for Secretary Sebelius.\nApril 10, 2011 – Dinner at Mark Dybul and Jason Claire’s home at 1340 Wallach Place, \nN.W. with Tom Sietsema (Washington Post Food Critic), Zeke Emanuel, Chris, etc.\nApril 12, 2011 – Gave Solomon Berson Lecture at Mt. Sinai in NYC – “30 Years of \nHIV/AIDS:  A Personal Journey”.   Got prolonged standing ovation.   Will be stressing \nthis in coming weeks as we approach June, 2011\nApril 15, 2011 – Went to Charlottesville, VA to see Danny Hultzen pitch against Duke.   \nHe was great.  7 innings shutout.. ERA now 1.19.   Sure thing for 1st Round MLB draft \npick\nMay 1, 2011 – Navy Seal Unit 6 kills Osama Bin Laden in a compound right next to a \nPakistani Military base is Abbottabad.  Big rift now between USA and Pakistan sine we \nbelieve they were either incompetent or knew all along where he was.\nReleased by Chairman Rand Paul\n241May 11, 2011 -  Senate Appropriations Subcommittee Hearing for the 2012 NIH budget.   \nReally bad budget times with the feeling that we are doing really well with only a 1.9% \nincrease from 2011 for the PB.   Republicans (most Tea Party people) trying to cut \ndiscretionary spending back to 2008 level, which would be devastating for NIH.   Francis \nCollins trying to push the NCATS (National Center for Advancing Translational \nScience).   I think this is a big mistake (“everybody wants to be somebody”).   This is no \ntime to initiate this, but  some  of the pols, some in the scientific community who are \nclueless, and others think this is a good idea.   Harold Varmus and I have grave \nreservations about this (me particularly) since I believe that it will have the unintended \nconsequence of sucking money away from standard NIH research to out into a Center \nthat is Francis’s baby.   We are already doing $6 Billion in translational research at NIH.\nMay 12, 2011 – Big announcement of early stopping of HPTN 052, which is randomized \ntrial among 1763 heterosexual discordant couples to see if immediate treatment with \nARVs (350-550 CD4 counts) versus delayed treatment (wait until fall to 250 or AIDS-\ndefining illness) has an effect on transmission.   Overwhelming response.   27 infections \nin delayed arm and 1 transmission in immediate arm  (p <0.0001).   I held press briefing \nand got front page in all major papers – NY Times.Wash Post, WSJ; appeared on NBC \nNightly News, CBS Evening News, CNN International, etc.\nMay 17, 2011 – The press, scientific, public health and general public interest in the \nHPTV-052 results in becoming huge.   I appeared on New Hour (interviewed alone by \nRay Suarez) as well as NBC Today Show.  Have done taped interviews with Mark \nSchoofs that will appear on the Website of WSJ.\nMay 18-26, 2011 -  Much activity and interest (real buzz) on part of global activists to \nuse the 052 data to pressure the USA (Obama and USAID/PEPFAR) to increase funding \nand re-prioritize the emphasis on treatment since it is also prevention as well as emphasis \nthose prevention modalities that have been scientifically proven to work such as \ncircumcision (which is now effective at 68% at 40 months into the follow-up study in \nRekai, Uganda).   I am speaking mre openly on interview about pressing the \nadministration to give more money.   Feels like the old days of the beginning of PEPFAR \nwhen OMB ridiculed me for asking for so much money and then everything broke lose \nwith PEPFAR.\n    On May 26, I met at the headquarters of the WH Office of the Global AIDS \nCoordinator (OGAC) with Eric Goosby, Reinhard Schwartzlander (UNIADS), Carl \nDieffenbach, Tom Frieden (by phone), Debbie Birx (CDC- GAP Prgram), people for \nUSAID, and State.   I made the argument that there is an elephant in the room and that is \nthat we MUST put more resources into treatment since we now know that it is in fact \nprevention and we will either pay now or pay more later.  Eric Goosby was so pleased \nthat I backed what he really wants and needs but since he is a POTUS appointee, he \ncannot be too up front about.   See below his email of May 26, 2011  to me after the \nmeeting:\nReleased by Chairman Rand Paul\n242Tony:\nYou achieved what we needed for OMB and State leadership get a feel of the \nbreakthrough and the context of the O52 findings, largely due to your clarity , candor and \nauthenticity…  thanks my friend\nEric\n \nPERSONAL \nThis email is UNCLASSIFIED. \nMay 27, 2011 – Taped  interview with the WSJ appeared   today .   Long and excellent \ninterview.\nMay 29, 2011 -  My Editorial appeared in the Sunday Opinions Section of the \nWashington Post entitled “30 Years of AIDS”.   Many people e-mailed and called about \nit.   Again, the momentum building up about a change in paradigm to support universal \nvoluntary testing and universal access to treatment and care.\nMay 31, 2011 -  Delivered lecture at NIH on “30 Years of HIV/AIDS:  A personal \nJourney” in Masure Auditorium.   It likely was the most widely attended lecture in NIH \nhistory.  Julie Marquardt ()NIAID) kept track.   The attendance completely filled Masur \nAuditorium (492 people), overflow completely filled Lipsett Auditorium (260) and 1130 \npeople watched  on Webcast.  In total, 1947 people watched the presentation live, either \nin person or via webcast..   Incredible amount of attention to the 30th Anniversary.   As I \nhave said, the press attention to me and my field varies from intensity to very low levels.   \nThis is one of the periods of extreme intensity.\nJune 1, 2011 – Took Amtrak to NYC to give Commencement Address at Albert Einstein \nCollege of Medicine Commencement at Lincoln Center.   Incredibly hot and sunny day in \nNYC and DC – up to mid-90s.   Came back home to find the air conditioning in my \nhouse broke – Oy!\nJune 2-5, 2011 – Press interest continues.  Was on NBC Nightly News on June 5 and \nFox Local News as well as Canadian Broadcasting System (CBC)\nAlso, big outbreak of Shiga-Toxin producing E.Coli (STEC) diarrhea and Hemolytic \nUremic Syndrome in Germany and other countries in EU related to contamination of \nbean sprouts.   >1600 people affected with ~600 HUS and 22 deaths.  Was on BBC with \nKatty Kay discussing this.\nJune 6, 2011 -  Had my BSC review for LIR.   Rating was “Outstanding” all around.\nJune 7, 2011 – Much activist activity brewing regarding the upcoming UN Special \nSession on AIDS this week.   Funding countries are refusing to commit to putting up the \nresources to get 13 to 15 million people on treatment by 2015.   On the basis of HPTN -\nReleased by Chairman Rand Paul\n243052 (see above) I have been arguing forcibly that we need to make the investment now or \nelse not only will lives be lost, but we will have to pay more later for the infections that \nwe could have prevented.   See my interview published  today  in Nature with Erika \nCheck Hayden\nDrug treatment for HIV infection is effective in preventing its spread, but implementing \nthis fully will require more resources, says leading NIH scientist.\nErika Check Hayden \nAnthony FauciBloomberg News/Landov/Photoshot\nThis week, political leaders meet in New York for a United Nations summit that will \nframe the ongoing fight against HIV/AIDS. The conference comes a decade after the UN \nmeeting at which heads of state committed the first major funding to the battle; as a \nresult, 6.6 million people are now receiving antiretroviral drug therapy to keep their HIV \ninfection under control — 22 times the number in 2001, according to estimates by the \nJoint UN Programme on HIV/AIDS (UNAIDS).\nBut 9 million people who need treatment are still not getting it, and global economic \nwoes threaten to weaken international AIDS programmes. Anthony Fauci, head of the US \nNational Institute of Allergy and Infectious Diseases, explains what scientists hope the \nUN meeting will achieve.\nHow is the research landscape different going into this meeting than it was a decade \nago? \nA considerable number of people have been put on therapy. But for every person who \ngoes on therapy, two or two-and-a-half people get newly infected, so there's been this \nquestion of the balance between treatment and prevention. \nA real game changer occurred just a few weeks ago with the clear demonstration in \nheterosexual couples that when you start treatment earlier rather than later, you not only \nbenefit the person infected, but that person is also 96% less likely to transmit the virus to \nReleased by Chairman Rand Paul\n244their uninfected partner than if they were not treated (see 'HIV treatment shown to \nprevent spread of virus'). So people can say with a good deal more confidence that \ntreatment is prevention.\nWhat does that imply for global AIDS policy? \nWe have now so many types of prevention in our armamentarium, including treatment. \nSo rather than have the tension between treatment and prevention, as there was \npreviously, let's try to seek out, test, and treat as many people as we possibly can, because \nwhen you treat people, you are doing prevention. So that brings up the big question — \nwhich is that it's going to require a lot of resources.\nHow do you frame that question? \nThe fundamental policy decision is: is it better to make investments now, even with the \nrestricted resources we have available, and slow down or even get control of the \npandemic, rather than not making the investment now, and only having to pay down the \nline, and possibly paying more. \nThe UN wants countries to commit to treating 13 million people by 2015 at a cost of $22 \nbillion, but this would not even treat all the people who will need it by that time. Is this \nwhere we should aim, given what we know about treatment as prevention?\nIt's a reasonable goal. The issue at hand — the big elephant in the room — is are the \nparties responsible able to come up with the resources to make this happen? We have a \nconfluence of enormous opportunity to turn around the global pandemic at the same time \nthat we have an almost unprecedented constraint on resources. This is going to be the \nsubject of some serious discussion in New York. Despite the constraints on resources, we \nhave a real opportunity not only to save a lot of lives, but in the long run, to save money. \nMany researchers are now saying that we have the tools needed for effective \nprevention, and social phenomena are the main obstacle to slowing the spread of \nHIV (see Comment: ' Stigma impedes AIDS prevention'). What more can \nresearchers do to solve this problem? \nIt isn't as if we're going to be able to access every individual immediately, but there are \nprogrammes that can be enhanced that will allow us to penetrate into those areas of \nsociety that have been difficult to reach. Can we do this tomorrow? No, but we don't have \nto. We can start doing it over the next couple of years and we'll get better and better at it. \nWhat are researchers looking for out of the meeting? \nWhat I'm going to do in New York is put the data on the table. There's no more doubt that \ntreatment can serve as prevention. My purpose is to say to policy makers: here are the \ndata; you have to make up your mind about whether you want to implement the \nReleased by Chairman Rand Paul\n245programmes that have been proved to work — to make it almost scientifically obvious to \nthem what they need to do. \nJune 8 – July 1, 2011 -   Much activity and excitement around my coming out publicly \npushing for more resources for expanded treatment and prevention for global HIV/AIDS.   \nThe activist community is delighted.   I will past in  below the editorial that I wrote in \nScience that was published by agreement with the Science editors to be ready for the \nInternational AIDS meeting in Rome as well as the note that Gregg Gonsalves sent to his \nlist-serve (every activist in the world) regarding my note.\nScience 1 July 2011: \nVol. 333 no. 6038 p. 13 \nDOI: 10.1126/science.1209751 \n \nEDITORIAL:\nAIDS: Let Science Inform Policy\n1.Anthony S. Fauci\n+ Author Affiliations\n1. Anthony S. Fauci is director of the National Institute of Allergy and Infectious \nDiseases, U.S. National Institutes of Health, Bethesda, MD. \n1. E-mail: afauci@niaid.nih.gov. \nCREDIT: NIH \nThirty years have passed since the first cases of acquired immune deficiency syndrome \n(AIDS) were reported by the U.S. Centers for Disease Control and Prevention. How does \nthis anniversary compare to the 20th or the 10th? The differences are considerable, \nbecause we now have an unprecedented opportunity, based on solid scientific data, to \ncontrol and ultimately end the AIDS pandemic. \nReleased by Chairman Rand Paul\n246More than 60 million people have been infected with human immunodeficiency virus \n(HIV) worldwide. More than 30 million have died, and 34 million are currently living \nwith HIV infection. In 2009, the most recent year for which data are available, 2.6 \nmillion people became newly infected. The burden of HIV/AIDS is overwhelmingly felt \nin resource-poor countries, especially in sub-Saharan Africa, which are least equipped to \ndeal with the disease. Although the toll is staggering, the scientific progress in HIV/AIDS \nresearch over 30 years has been extraordinary, particularly in the development of \nantiretroviral therapy (ART), which has proven to be life-saving to many millions. \nCREDIT: FOTOSEARCH \nFor decades, the idea of ending or even controlling the pandemic was a distant aspiration \nbecause we lacked sufficient evidence-based tools to convert the hope to reality. At this \n30th anniversary, the situation has dramatically changed: We finally have scientifically \nvalidated prevention modalities that clearly work, suggesting that ending the pandemic is \nfeasible. Older, proven prevention tools include the proper use of condoms, needle \nexchange programs for injection drug users, and antiretroviral treatment of HIV-infected \npregnant women to prevent transmission of the virus to their newborn infants. Building \non this foundation, recent HIV prevention research also has provided strong scientific \nevidence that adult male circumcision is highly effective in preventing infection in \nheterosexual men, that an antiretroviral-based topical gel prevents infection in \nheterosexual women, and that pre-exposure prophylaxis with ART in men who have sex \nwith men is effective at preventing infection. And in May 2011, a randomized controlled \nclinical trial demonstrated that early initiation of ART by the infected partner in \nheterosexual couples, where one partner is HIV-infected and the other not, is highly \neffective in decreasing transmission of HIV to the uninfected partner. \nThe fact that treatment of HIV-infected adults is also prevention gives us the \nwherewithal, even in the absence of an effective vaccine, to begin to control and \nultimately end the AIDS pandemic. Of course, the development of an AIDS vaccine \nwould be the ultimate game-changer, and efforts toward this goal are intense. However, \nthe existing armamentarium of scientifically proven interventions immediately offers an \nunprecedented opportunity to make major gains in the fight against HIV/AIDS. Global \nimplementation of HIV interventions, including scale-up of the delivery of ART, must be \naccelerated, and this will be costly. Certainly, there are many competing priorities for \nscarce resources in the global health arena, such as other infectious diseases, maternal \nReleased by Chairman Rand Paul\n247and child health, and tobacco control. But if one accepts the tenet that science should \ninform policy, then the scientific data are speaking loud and clear. Global policy-makers \nmust seriously consider these new data in their priority-setting and decision-making. \nLast month, world leaders at the United Nations General Assembly Meeting on AIDS \ncalled for providing ART for 15 million people in low- and middle-income countries by \n2015, an increase from the 6.6 million currently receiving therapy, plus additional efforts \ntoward universal access to HIV prevention, treatment, and care. An estimated $22 billion \nto $23 billion annually will be needed by 2015; current spending is approximately $16 \nbillion. Such targeted investments could prevent 12 million infections and 7.4 million \nAIDS-related deaths by 2020. For the first time in the history of HIV/AIDS, controlling \nand ending the pandemic are feasible; however, a truly global commitment, including \ninvestments by those rich and middle-income countries whose contributions have thus far \nbeen limited, is essential. Major investments in implementation now will save even \ngreater expenditures in the future; and in the meantime, countless lives can be saved. \nJuly 1, 2011 – E-mails from Gregg Gonsalves:\n-----Original Message-----\nFrom: Gregg Gonsalves [mailto:gregg.gonsalves@gmail.com] \nSent: Friday, July 01, 2011 6:55 AM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Brilliant Science Piece\nI think it will go down as one of the most important pieces written in \nthese past 30 years. It will either begin a new push to vanquish the \ndisease from the Obama Administration and other world leaders, or seen \nas Cassandra's last warning, where even despite the science, the \nevidence, the world turns their back on this opportunity.\ng\n--\nGregg Gonsalves\n100 York Street\nUniversity Towers, 10-D\nNew Haven, CT 06511\nEmail: gregg.gonsalves@gmail.com or gregg.gonsalves@yale.edu\nMobile: +1-203-606-9149\n-----Original Message-----\nFrom: Gregg Gonsalves [mailto:gregg.gonsalves@gmail.com] \nSent: Friday, July 01, 2011 7:22 AM\nSubject: Fauci in Science: Ending the Pandemic is Feasible\nhttp://www.sciencemag.org/content/333/6038/13.full (scroll down for \ntext) This is one of the most important pieces to be written on \nHIV/AIDS in a very, very long time. Dr. Fauci is a cautious scientist \nand for him to step out so publicly, so unequivocally in this way, \nReleased by Chairman Rand Paul\n248particularly when he works for an Administration, which is unlikely to \nheed his words, is a tremendous statement of moral and political \ncourage.\nI am not quite sure what we do now here to ensure that Tony's words \naren't just a call-in-the-wilderness.\nThe big AIDS organizations in the USA don't have the inclination or \neven the ability to take on the President or the Congress.  Both \nbranches of government know we're a paper tiger: a movement with a few \nloud voices, a few people willing to put their bodies on the line, but \nwith little ability to affect their political lives. Unless the big US \nAIDS organizations step up at this moment they will continue their \nmarch into irrelevance for history.  They can continue to issue press \nreleases about how much the President has done and continue to kiss the \nass of those in power, but that makes them sycophants, not leaders.\nThe rest of us have to get to work: we need to mobilize and get our \ngovernments to make a new, substantial and sustained commitment to \nHIV/AIDS, to TB, to maternal and child health, to global health.  We \nneed to meet with parliamentarians, legislators, ministers and mayors.\nWe need to write in our local papers about what Tony's words mean now \nfor us: we can end this epidemic or beat it back deep into the corner.\nThis is our year.  The legacy we leave behind will either be our \nvictory or an epidemic without end, passed down to our children and our \nchildren's children, a plague upon their houses.\nGregg\nScience 1 July 2011:\nVol. 333 no. 6038 p. 13\nDOI: 10.1126/science.1209751\nEDITORIAL\nAIDS: Let Science Inform Policy\nAnthony S. Fauci\nAnthony S. Fauci is director of the National Institute of Allergy and \nInfectious Diseases, U.S. National Institutes of Health, Bethesda, MD.\nE-mail: afauci@niaid.nih.gov.\nThirty years have passed since the first cases of acquired immune \ndeficiency syndrome (AIDS) were reported by the U.S. Centers for \nDisease Control and Prevention. How does this anniversary compare to \nthe 20th or the 10th? The differences are considerable, because we now \nhave an unprecedented opportunity, based on solid scientific data, to \ncontrol and ultimately end the AIDS pandemic.\nMore than 60 million people have been infected with human \nimmunodeficiency virus (HIV) worldwide. More than 30 million have died, \nand 34 million are currently living with HIV infection. In 2009, the \nmost recent year for which data are available, 2.6 million people \nbecame newly infected. The burden of HIV/AIDS is overwhelmingly felt in \nresource-poor countries, especially in sub-Saharan Africa, which are \nleast equipped to deal with the disease. Although the toll is \nstaggering, the scientific progress in HIV/AIDS research over 30 years \nhas been extraordinary, particularly in the development of \nantiretroviral therapy (ART), which has proven to be life-saving to \nmany millions.\nFor decades, the idea of ending or even controlling the pandemic was a \ndistant aspiration because we lacked sufficient evidence-based tools to \nconvert the hope to reality. At this 30th anniversary, the situation \nReleased by Chairman Rand Paul\n249has dramatically changed: We finally have scientifically validated \nprevention modalities that clearly work, suggesting that ending the \npandemic is feasible. Older, proven prevention tools include the proper \nuse of condoms, needle exchange programs for injection drug users, and \nantiretroviral treatment of HIV-infected pregnant women to prevent \ntransmission of the virus to their newborn infants. Building on this \nfoundation, recent HIV prevention research also has provided strong \nscientific evidence that adult male circumcision is highly effective in \npreventing infection in heterosexual men, that an antiretroviral-based \ntopical gel prevents infection in heterosexual women, and that pre-\nexposure prophylaxis with ART in men who have sex with men is effective \nat preventing infection. And in May 2011, a randomized controlled \nclinical trial demonstrated that early initiation of ART by the \ninfected partner in heterosexual couples, where one partner is HIV-\ninfected and the other not, is highly effective in decreasing \ntransmission of HIV to the uninfected partner.\nThe fact that treatment of HIV-infected adults is also prevention gives \nus the wherewithal, even in the absence of an effective vaccine, to \nbegin to control and ultimately end the AIDS pandemic. Of course, the \ndevelopment of an AIDS vaccine would be the ultimate game-changer, and \nefforts toward this goal are intense. However, the existing \narmamentarium of scientifically proven interventions immediately offers \nan unprecedented opportunity to make major gains in the fight against \nHIV/AIDS. Global implementation of HIV interventions, including scale-\nup of the delivery of ART, must be accelerated, and this will be \ncostly. Certainly, there are many competing priorities for scarce \nresources in the global health arena, such as other infectious \ndiseases, maternal and child health, and tobacco control.\nBut if one accepts the tenet that science should inform policy, then \nthe scientific data are speaking loud and clear. Global policy-makers \nmust seriously consider these new data in their priority-setting and \ndecision-making.\nLast month, world leaders at the United Nations General Assembly \nMeeting on AIDS called for providing ART for 15 million people in low- \nand middle-income countries by 2015, an increase from the 6.6 million \ncurrently receiving therapy, plus additional efforts toward universal \naccess to HIV prevention, treatment, and care. An estimated $22 billion \nto $23 billion annually will be needed by 2015; current spending is \napproximately $16 billion. Such targeted investments could prevent 12 \nmillion infections and 7.4 million AIDS-related deaths by 2020. For the \nfirst time in the history of HIV/AIDS, controlling and ending the \npandemic are feasible; however, a truly global commitment, including \ninvestments by those rich and middle-income countries whose \ncontributions have thus far been limited, is essential. Major \ninvestments in implementation now will save even greater expenditures \nin the future; and in the meantime, countless lives can be saved.\n--\nGregg Gonsalves\n100 York Street\nUniversity Towers, 10-D\nReleased by Chairman Rand Paul\n250New Haven, CT 06511\nEmail: gregg.gonsalves@gmail.com or gregg.gonsalves@yale.edu\nMobile: +1-203-606-9149\n--\nGregg Gonsalves\n100 York Street\nUniversity Towers, 10-D\nNew Haven, CT 06511\nEmail: gregg.gonsalves@gmail.com or gregg.gonsalves@yale.edu\nMobile: +1-203-606-9149\nJuly 16-22, 2011\nGave Plenary Address at the IAS Meeting in Rome on “30 Years of HIV/AIDS: A \nScientific Journey and Look to the Future”.   I emphasized at the end that “Science \nshould inform policy” as per my recent Science Commentary.   I received a prolonged \novation from the crowd of >4000.   Clearly one of my best plenary talks ever.\nAug. 4, 2011 -   During a trip to NYC to give a lecture at Columbia on “30 years of \nHIV/AIDS:  A Personal Journey”, Ian Lipkin arranged a closed pre-screening of the new \nmovie :Contagion” at the Warner Brothers headquarters in NYC.   Ian served as the \ntechnical advisor and wanted to get my take on the movie.   Also at the screening were \nSanjay Gupta (CCN), the dean of Columbia Mailman School of Public Health, the \nCommissioner of Health of NYC and other notables.   The press asked  me my opinion, \nwhich was that it was an excellent film that was quite accurate scientifically.   I was \nwidely quoted  in blogs about this.\nAugust 23, 2011 -    Unusual experience – 5.9 Richter Scale earthquake hit Mineral, VA \nwith severe shaking of Building 31 such that some of my plaques fell off of the shelves.   \nShock was felt as far North at Cape Cod.   Jenny, Ali and Denise and Jack were in NYC \nand they felt it.\nAugust 226, 2011 – Washington, D.C. hit by Hurricane Irene that went up the entire east \ncoast.   Much damage.   We were lucky in that although many trees came down, our \nhouse and cars were spared.   However, I stayed up until 4:00AM nervously looking out \nthe window at the large oak tree in my back neighbors yard  whose branches were \nshaking violently.   Importantly, I was very concerned about the 2 giant tulip poplars that \nare in my front yard  whose branches were also shaking wildly.   Luckily we made it \nthrough the night.   Storm also hit NYC where Jennifer is living.\n    Amazing coincidence that during the same week in DC, we got an earthquake and a \nhurricane.   Odds of that must be 1 in several million.\nSept. 11, 2011 – 10th Anniversary of “9/11”.  Much commemoration going on in NYC \nand DC.   Of note last week on Sept. 9 went to meeting in White House EEOB 530 with \nReleased by Chairman Rand Paul\n251Eric Goosby, Gayle Smith  and David Lane, Jeff Crowley and Dana DeRuiter (White \nHouse); Lois Quam (USAID), Ariel Pablos-Mendez (USAID), Tom Frieden on the \nphone; Nils Daulaire and Howard Koh (DHHS) and others.   Purpose of the meeting was \nto plan a strategy that the WH and the POTUS should take in addressing and utilizing the \nrecent scientific advances associated with HIV prevention, particularly treatment as \nprevention (HPTN-052) in turning around the HIV pandemic.   In essence it was a \nmeeting to figure out how we can implement what I proposed in Rome at the IAS \nmeeting in July, 2011.   Eric Goosby and Gayle Smith want me to directly brief the \nPOTUS on this.   It remains to be seen whether this happens.  Clearly, the activists want \nmore money to go to PEPFAR for treatment and prevention.   However, there are major \nbudget constraints.   The WH is afraid of demonstrations during the upcoming IAS \nmeeting in Washington in the summer of 2012 – right before the election.   They have to \nwalk a fine line between promising more money, which will inflame the right and doing \nnothing, which will inflame the left.   It seems that they are calling me in to help them \nwith this.   More later……\nSept. 13 -14, 2011 – Beautiful crisp sunny day in DC.   Started 09/13/11 with breakfast at \nthe Four Seasons in Georgetown at 7:00 Am with Bill Gates. Also present from the Bill \nand Melinda Gates Foundation (BMGF) was Stefano Bertozzi.   The theme was that Bill \nis reluctant to fund (with NIAID) the proposed South Africa (RSA) and Thailand vaccine \ntrial for licensure since he thinks that the companies are charging too much money for the \nprotein (env – made by Novartis).   In addition, he does not think that the results will lead \nto a marketable product.  However, we need the private sector or else we will never get a \nvaccine made for HIV.   The quid pro quo for us is that if we go with a regulatory \n(licensure) trial in RSA and Thailand, the companies (Sanofi-Pasteur and Novartis) will \nwork with us on a research trial of comparing several products in RSA, which is what we \nreally want.  I convinced Bill that this was a necessary evil and that although it was an \nimperfect situation, it is still the only deal around since the product – Pox  Vector + \nProtein boost was the one that gave the only positive result in a vaccine trial to this point \n(RV144 – conducted in Thailand 2 years ago).   In addition, there are some possible \ncorrelates of immunity associated with RV144.   We ended the breakfast with a mutual \ncommitment to work together on this.   Also, Bill had some interesting a  bit “off the \nwall” ideas about making a universal virus vector into which you can insert genes of \nimportant neutralizing antibodies for different microbes that can be an instantaneous \nantibody factory for bioterror organisms as well as for HIV, merely by changing the \ninsert.   Also, Bill does not believe in treatment as prevention from a practical or logistic \npoint of view.\n     Went on to participate in a 2 day meeting run by the George W. Bush Presidential \nCenter –  “The Summit to Save Lives” held at the Mellon Auditorium on Constitution \nAvenue, N.W.   I was on the panel to discuss the leveraging of PEPFAR resources and \ninfrastructure to do screening and treatment of cervical cancer in Africa and Latin \nAmerica.  I studied up on HVP and cervical cancer and we the “scientific expert” on the \npanel that included Eric Goosby (PEPFAR), Grosbeck Parham (C0-Director of Cervical \nCancer Prevention program, Zambia), Dr. Beatrice Wiaffe Addai – president of Breast \nCare International.  Panel Chaired by Jennifer Griffin, National Security Correspondence, \nReleased by Chairman Rand Paul\n253together for HRC on the same subject that I spoke on in Rome – “The Science has now \nshown that we can end the AIDS pandemic – we need to implement”   Only difference is \nthat she will say that we can do it by increasing efficiencies PLUS  having other partners \n(donors and host countries) put in a greater share. I said that we should put in more \nresources.   The speech spins off the document mentioned above that we were asked to \nput together following the Sept. 9 meeting (see above).  The main issue is that we will \nraise our goal of 4 million on treatment through PEPFAR by 2013 to 6 million by 2013.   \nWith much input from me and CDC, Eric Goosby put together a nice document \nexplaining the importance of increasing this goal and having certain host countries such \nas South Africa and Rwanda assume more of the cost of treatment so that we can \nconcentrate on countries with less resources such as DRC, Cameroon, Malawi, \nZimbabwe.  Also, we can use more bulk purchases etc.\nTODAY – (10/13/11) we had an important meeting in the Situation Room of the White \nHouse from 4:00 to 5:30 PM.   Gayle Smith instigated the meeting.   It was a Deputies \nMeeting chaired by Denis McDonough (Deputy National Security Advisor – Deputy to \nThomas Donilon).   He was very good and sympathetic to our goal.   Also there were: \nCheryl Mills, Eric Goosby, Tom Frieden, Steve Kosiak from OMB, Ariel Pablos-Mendez \nNancy-Ann deParle, Dana DeRuiter from NSS, Samantha Power (NSS), Charles Hohman \n(OGAC).  They called upon me to explain the scientific basis for our pushing to do more \nto turn around the trajectory of the Pandemic.   I explained the details of HPTN-052.   \nGreat meeting – this may lead to an acceleration of our efforts.  Also, Denis McDonough \nasked us to put together a “Blue Sky” proposal that would ask for more resources in \naddition to the increased efficiencies that we are already planning. We may not get more \nmoney, but we can probably show the leadership to inspire others to invest more, i.e. \nother rich countries.   More later…….\nOct. 17-19, 2011 Eric and I among others worked on a paper that gave 2 options: \nScenario 1 – increase efficiencies and have host countries take more responsibility and \nthus shift PEPFAR money to treatment as prevention.   This ill raise the bar for goals to 6 \nmillion people on PEPFAR-paid Tx by 2013 and 8 million by 2015.   Scenario 2 – get \n$2.5 billion more money from 2013-2015 and raise goal to 8 million on treatment by \n2013 and 10 million by 2015.   Mathematically modeled (done by CDC), this would “tip” \nthe curve (of incidence) of the pandemic more sharply downward and would also have \nmany secondary benefits of saving lives and hospitalization.   Denis McDonough now \nrefers to this as the “Fauci curve”.\nOct. 20, 2011 – Met again in WH Situation Room with Denis McDonough chairing and \nthe same people there with Tom Frieden by videoconference.   Continued discussion \nabout “Blue Sky”.   I again vigorously defended the concept of  our golden opportunity at \nthis point.  Problem is that OMB feels that we will never get new money passed through \nCongress and State might have to “eat” the $2.5 billion if we actually pursue  Blue Sky.   \nI suggested getting group of CEOs involved (as per my upcoming WSJ – CEO Council \nmeeting that I will chair on Nov. 15).   Denis thought that it was a great idea and will \nbring it to the POTUS.   Again, budget problems may stand in the way of a visionary \nbreakthrough of “tipping” the pandemic.\nReleased by Chairman Rand Paul\n254Oct. 24, 2011 – Met again at the WH (EEOB 439) with the usual cast of characters.   \nGayle Smith chaired the meeting.  Denis McDonough not there.   Main issues again is the \nreluctance of USAID (Ariel) to buy into the idea of expanding treatment as a way to “tip \nthe curve”.   He suggested moving the money from the efficiencies of PEPFAR treatment \n(see above) to non-treatment prevention modalities.   Eric Goosby tried to explain that the \nnon-treatment prevention modalities (PMTCT, AMMC – adult medical male \ncircumcision) are already maxing out and any increasing or not are due to other issues \nbesides resources.   I arguing strongly against  Ariel and reminded people that this was a \nPOTUS initiative to increase Tx.   Below is an e-mail that I sent to Gayle Smith after the \nmeeting clarifying my stance on this.\nGayle:\n   Thanks for running an important and sometimes contentious meeting today. You do it \nmasterfully.   Please read my comments below and then you can either accept them or \nthrow them out if you wish and I will still be your  friend.   Here goes…    Eric,  Ariel, \nand I, and hopefully Tom Frieden will get together by phone tomorrow to try and hash \nout and hopefully resolve the issues that were brought up today regarding standard \nprevention versus  treatment as prevention.  It appears that Ariel and USAID feel that in \nan arena of a flat budget, the money saved by efficiencies in treatment should be turned \nover to standard prevention modalities as opposed to expanding the number of people on \ntreatment (which is also prevention).  As Eric will explain to Ariel tomorrow on our \nphone call, the model that has been developed  takes all of these issues into account and \nthe standard prevention modalities such as adult male circumcision and PMTCT to which \nAriel is referring can be maximized in a number of ways without significant increases in \nresources, whereas putting more people on treatment clearly requires more money.   You \ncan treat the same number of people with less money by efficiencies, but the only way to \nget more people on treatment with a flat budget is to use the savings from \nefficiencies.  As we have been discussing, this will have the effect of preventing more \ninfections at the same time as saving the lives of the infected people who would now be \nreceiving treatment.  This also results in other economic and social benefits.  Although \nyou are trying to be fair to all points of view, in my humble opinion, if we go to the \nPrincipals giving them  a choice of the two approaches, we will confuse them. I believe \nthat they need to look at  a single proposal that we have already agreed upon in our \ndiscussions and decide if they are comfortable with it.  Another point that seems to have \ngotten lost by some in today’s discussion in the fact that, as I mentioned at the end, we \nare talking about a potential game changing initiative by the POTUS that could be a \nlegacy.   We are not talking about  competition for limited money that might go to other \nareas.   Another issue is that the activist community would support the POTUS in an \ninitiative with no new money, but that includes a plan to increase the numbers of people \non treatment by the mechanisms that we had discussed with you and Denis.   If he comes \nout with a plan to divert savings from treatment efficiencies to  non-treatment programs, \nthe constituencies will be infuriated.  Sorry for taking your time with this e-mail.   I just \nfelt that I needed to express my thoughts to you.  Talk to you soon.\nBest regards,\nTony\nReleased by Chairman Rand Paul\n255Oct. 25, 2011 – Raj Shah (Administrator of USAID) called me at 1:30 PM to get a better \nfeel of my position on treatment as prevention.   I thought that he would have a problem \nwith it, but he was really asking if it was better to target people with very early infection \nsince they are most likely to spread infection.   I explained to him that although this was \nthe case, they represent a relatively small fraction of infected people and they are very \ndifficult to identify at this early stage.\n    I found out later in the day from Cheryl Mills (Chief-of –Staff to Hillary Clinton) that \nBill Gates had told Hillary that treatment as prevention was a waste of money and would \nnot work.   Hillery (HRC) heard from Eric that Bill Gates is probably the only person in \nthe world who felt this way and that is exactly what I told Cheryl (see my breakfast with \nBill Gates above).  It seems that HRC is to meet with Raj today to get his opinion and so \nthat is why Raj called me.   Also, HRC will come to NIH on my suggestion to give \nspeech on this subject on Nov. 8.   I helped drafting her speech.\nOct. 26, 2011 – Conference call with Eric, Ariel, me, Charles Holman and various people \nfrom USAID, PEPFAR, and CDC (Tom Frieden) trying to hash out the difference \nbetween Eric/me/Tom and USAID.   It appears (maybe) that we have convinced Ariel \nthat our model is valid.   More to come.\nOct. 31, 2011 – Another WH (EEOB 430A) meeting regarding above topic.   Chaired by \nGayle Smith.   Also there was Amy Batson (USAID), Lois Quam, and Tom Frieden by \nphone.  Cold crisp day in DC.   Fall is here!   Again the tension between USAID goals \nand PEPFAR goals become clear.   USAID is trying to enhance their own agenda, which \nin my opinion has failed with their spending millions on prevention messages that do not \nwork.   They are trying to derail the PEPFAR “scale up by efficiencies” initiative.   Ariel \nis turning out to either be naïve or nefarious.   I always heard that he was a good guy, but \nhe and USAID team keep insisting that the efficiency money should go either to a \nbroader GHI or to enhancing the non-treatment prevention agenda (PMTCT, AMMC, \ncondoms, etc.).   The PEPFAR/Fauci/CDC agenda is to use the efficiencies to scale up  \nTx from 4.2 million by 2013 to 6+ million by 2013.   This should reach 8 million by 2015 \nwithout any additional funds.   If you go to “blue Sky” of +$2.5 billion from 2013 to \n2015, you will go from 8 million in 2013 to 10 million in 2015.   The PEPFAR model \nalso assumes and enacts a maxing out of the non-treatment prevention modalities.   \nUSAID disagrees and want to use efficiency money to favor non-treatment as Prevention.   \nThis is what Ariel is saying.   After meeting with Eric Goosby, Ariel seems more \nconvinced that the PEPFAR model may be OK.   However, what does Raj Shah \nthink????\nNov. 1, 2011 – Dinner with Rick Klausner at Matisse Restaurant on", "summary": "Watcher-discovered document from paul-readingroom (2026.07.27_Diary-Prequel-.pdf), auto-indexed 2026-08-05.\n\nExcerpt: NIH Director decision and Bush said, “why not just  appoint Tony Fauci”.  Jay agreed.  Jay now casually mentioned that Karl Rove was  against my candidacy.  He did not say why.  I could be that he was against the “dual”  appointment or perhaps he was influenced by Sen. Brownback’s concern about my stance  on fetal tissue and stem cell research.  I guess that I will never know. Dec. 6, 2008 – Annual Christmas Party at Sam and Jan Donaldson’s home.  As usual,  great time with the standard cast of characters some of whom are: Colin Powell, Wolf  Blitzer (CNN), Bob Barnett, George Will, Ellen and Gerry Sigal (told me that Francis  Collins is “aggressively” campaigning for the job of NIH Director.  I told her that I  preferred to stay at NIAID.), Bob  Mueller (FBI), Gen. James Jones (new…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.27_Diary-Prequel-.pdf", "pdf_url": "/archive-docs/fauci-files/c1dee44b66471ea95f8e8154b109f914/pdf", "doc_date": "2026-08-05", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-07-27-diary-prequel"], "part_number": 4, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 5 of 8)", "content": "Wisconsin Avenue \nand Fessenden.   Discuss the Qatar initiative, see above and below.  But, conversation \nturned to Raj Shah and the PEPFAR/USAID story.  Bottom line is that Raj has been \ntalking with Rick and it appears from Rick and my prior conversation with Raj that Raj is \nnot against treatment as prevention (TAP); however, he does not like the model and want \nto do it differently.   (More on Qatar later – stick with USAID/PEPFAR for now)\nReleased by Chairman Rand Paul\n256Nov. 2, 2011 – 7:30 AM Get call from Rick Klausner who is having breakfast with Raj \nShah and Rick wants to set up teleconference with the 3 of us at 11:00 AM to discuss the \nabove issues.   On the call Raj dances around a bit, but what he really wants is a big \ninitiative using PEPFAR money.   He does not say so explicitly, but that is really what he \nwants.   He does not want the efficiency money to pay for 6 million of TAP by 2013; he \nwant 5.5 million for TAP and the rest for a full-court-press initiative to see in a selected 3 \ncountries if maximizing both non-TAP and TAP prevention will actually end the \npandemic.   I explain that there is not enough money to do this, and besides, the \nexpectation is to TAP, not do a study to prove that it could be done.   He agrees with me \nthat we should do both within the constraints of budget.  He is sure that the POTUS will \nlike this initiative since it is a scientifically-based approach (give me a break!!!).   The \nbig elephant in the room is that USAID has been wasting $100s of millions on prevention \napproaches (like behavior change) that do not work.   They should use this $ to do their \nproof of concept full-court-press approach, not try to siphon off PEPFAR money (I did \nnot say that, but this clearly was the elephant).   Raj wants the have Eric, himself and I \nput together another proposal to this effect.\n      After the call Rick e-mailed me and asked for a follow-up call.   On that call Rick \nexplained that what Raj really wants is to spend all of the efficiency money on the 3 \ncountry demonstration project and that this would be the POTUS initiative.   They (Rick \nand Raj) just do not believe that PEPFAR/CDC model.  Also, (amazingly), Raj admits to \nRick that the USAID has been wasting $100s of millions, but he is not up to taking on the \nUSAID bureaucracy.   Rick is disappointed in him and thinks that he is being weak and \nhas told him so.   However, rick is in favor of the concept since he has issues with \nPEPFAR.\nBased on this, I arranged a teleconference with Tom Frieden (at Atlanta airport), Eric, \nCharles Holmes, and some PEPFAR people and CDC people to discuss all of this.   Tom \nFrieden was furious at USAID.   He says that they have been wasting $ for years and now \nthey question what CDC proposes, when CDC has been saying for years that they should \nhave been scaling up AMMC and PMTCT instead of wasting money on behavior.   \nClearly, Raj is a young, brilliant guy who is extremely ambitious (that is OK), but he \nwants control of PEPFAR resources.  Frieden is dead against this PEPFAR is obviously \nagainst this.   So am I.  The original question was to use efficiencies to scale up TAP, not \nto try something that USAID should have been doing all along with their own $.   The \nidea of nailing down whether we can end the pandemic with a full-court press (FCP) is a \ngood one, but there are no resources available.   I propose that we do both the PEPFAR \nplan and the FCP, the latter with $ that we get from additional sources.  \n     White House meeting scheduled for Nov. 9.   Everyone wants me there, but HHS will \nhave to decide who the “Plus one” is with Sebelius.  Of note, I am scheduled to go to \nSeattle on Nov. 9 for a town hall meeting and a seminar sponsored by Lee Hood and the \nInstitute for Systems Biology.\nBill Gates is trying to undermine the initiative on upscaling TAP.   See e-mail below \nfrom MSF to me sent on 11/02/11:\nDr. Fauci, \nReleased by Chairman Rand Paul\n257Congratulations on getting NIH-supported HIV research the airing it \ndeserves at the highest levels of government. We are all looking \nforward to Secretary Clinton's speech at the NIH next week.\nWe are trying to use the USG momentum to leverage new commitments from \nthe UK for World AIDS Day. So far DfID and other government actors are \ninterested in a \"step up\" initiative that we have also been pitching to \nUSG, South Africa, and Germany to pay for implementation of accelerated \ntreatment.\nToday we had a bit of a minor set back: the Secretary for Development \nAndrew Mitchell just heard from Bill Gates at a Tory event \"Friends of \nInternational Development\" that HPTN 052 will not yield great effects \nand the role of ART in limiting incidence is more limited than what is \nbeing portrayed. It was unfortunate.\nIt would help greatly if the policy makers in government could hear the \nscience themselves. If the All-Party Parliamentary Group on AIDS \ninvited you to give a briefing, and we arranged for high-level \nmeetings, could you attend? Would an invitation by civil society and \nMSF suffice? And, hardest question of all-- do you have any free days \nwhere you could be in London in November?\nThank you,\nSharonann\n--\nSharonann Lynch\nHIV/AIDS Policy Advisor\nAccess to Essential Medicines Campaign\nMédecins Sans Frontières (MSF)\nTel: +1.646.824.3066\nEmail: sharonann.lynch@msf.org\nAlso see below e-mail from Nov. 3 from Michael Iskowitz describing what \nthe community actually is hearing about.   It is amazing how things \nleak sinceI have told no one what I am doing regarding USAID, PEPFAR \nand the WH.\nFinally, tonight (11/02/11) went to Book Signing party at Hay-Adams \nHotel for Chris Matthews on his new book “Jack Kennedy – Elusive Hero”.   \nAnother example of the A group of Washington.   It is clear that at age \n70, being on the public/political/media scene for >30 years, I am \nextremely well-known and even friends with so many public figures, who \nmerely on the basis of my being on TV/Radio/newspapers, etc. and the \nfact that we run into each other at so many of these functions have \ngotten to know me well.   Just a sampling of people at event: Andrea \nMitchell; Alan Greenspan; Sens. Chris Dodd, John Kerry; Rep. Ed Markey, \nJim Moran; Howard Feinman; Murrey Jacobson; Luke Russert; Gloria \nBorger; Joe Scarborough; etc.   Had animated conversation with my \nfriend Ed Markey regarding the disgraceful conduct of the Banking \nIndustry and Wall Street.   The “Occupy Wall Street” movement is \ngaining momentum.  The Republican scramble for the nomination is hot \nand heavy\nReleased by Chairman Rand Paul\n258Nov. 3, 2011 – Incredible day.  Theme is my trying to hold together the \nevolving proposal to scale up combination prevention with treatment as \nprevention (TAP) being a major component of the scale-up as described \nabove.  Tension is USAID and Raj want to spend most of the efficiency \nmoney on concentrating and ending the epidemic in 3 chosen countries as \nopposed to going with the PEPFAR/CDC/FAUCI plan of scaling up \ncombination prevention across the board and doing a demonstration full \ncourt press (FCP)in selected pockets of the countries that we have \nselected: Botswana for CDC; Zambia and South Africa for NIH; Tanzania \nfor USAID.  Spent all day on calls individually with Tom Frieden, Eric \nGoosby, Mark Dybul, Raj Shah (in the evening).   Raj call was at the \nsuggestion of Rick Klausner who says that I am the only person who can \nbroker a deal between PEPFAR and USAID.   We need USAID to support our \nproposal at the WH meeting next week (Nov. 8 – the evening of \nSecretary’s Clinton’s speech at NIH.   I have cancelled Seattle to ne \nat the WH meeting.   WH house wants me and Frieden to represent HHS, \ni.e. “plus 2”.   Mark Dybul agrees somewhat with the need to have a \nbold announcement as per Raj, but we all know that there is no new \nmoney.   Rick also feels that way.   However, what neither of them \nfully appreciate is that the “demonstration project” described above is \nin reality a FCP in a selected group within countries.   I had \nimportant call with Raj.   I leveled with him and said that although he \nis proposing putting all of the PEPFAR efficiencies towards a FCP in 3 \ncountries and scrapping the PEPFAR Plan, he should look to “clean his \nown house” and create efficiencies within USAID and use that money to \nscale up the 3 country approach and make it more of a FCP, i.e. I am \nproposing a “hybrid” of the PEPFAR plan and the USAID plan since we all \nneed each other and we need to provide the POTUS with a proposal that \nis scientifically sound, bold, yet not unrealistic, and that does not \nrequire significant new money.   Of note, Hillary Clinton will propose \n$60 million of her money to beef up that “demonstration project”  I \ncalled for a meeting tomorrow to see if Raj, Eric, Tom and I could \nfigure out a compromise with me as the referee.\nAlso see below e-mail from Nov. 3 from Michael Iskowitz describing what \nthe community actually is hearing about.   It is amazing how things \nleak since I have told no one what I am doing regarding USAID, PEPFAR \nand the WH.\ntony dearest.  \ni just wanted to thank you for helping to create and drive another landmark moment in AIDS \nhistory. \ni continue to do consulting with eric -- who remains forever grateful for your friendship and \nextraordinary leadership. \ni am honored to have have many decades now of watching you work your magic -- forever urging \nthat if we remain steadfast and\nfollow the science, together we will win. \nbless you for -- behind the scenes and in front of the cameras -- shaping another historic \nmoment. \nknow that i talk with eric frequently and if there is anything i can for you directly -- please know i \nalways stand ready.  \nthank you for being you and for all you do for the world, \nif i am not at the NIH on tuesday -- i am certainly there in spirit!\nmuch love,\nmichael \nReleased by Chairman Rand Paul\n259Nov. 4, 2011 – I cancelled most of my AM calendar to attend meeting at \n8:00 AM in Eric’s OGAC (Office of Global AIDS Coordinator) office at \n2100 Pennsylvania Ave, N.W. (suite 200).   At meeting was the 4 of us.  \nAfter about 90 minutes I got everyone to accept the “Fauci hybrid \nplan”.   Raj agreed (as I suggested last evening) that he come up with \nabout a few hundred million in efficiencies from USAID.   Eric will try \nto find more efficiencies from the PEPFAR “Pipeline”, all to beef up \nthe demonstration project and perhaps include another country such as \nNigeria.  However, we will all need to see if our respective \ndemonstration projects could effectively absorb an additional few \nhundred million $.   We will work on this over the weekend.  More to \ncome.\nAlso today met with Dr. Abdelali Haoudi, VP for Research of the Qatar \nFoundation at the recommendation of Rick Klausner with whom I had \ndinner on Nov. 1.   Great meeting with Abdelali.  Introduced him to JJ \nMcGowan, Kathy Zoon and Marv Kalt to help him with using the NIAID \nmodel to get his Qatar intramural and extramural program set up.   I \nthink that we could turn out to be friends.\nNov. 5-6, 2011 – Continued strain between USAID (Raj) and PEPFAR (Eric \nand Charles) in that Raj just does not want to give in about pushing \nfor “doing things differently”.   Nov. 5-6 is the weekend and \nDepartment of State (Lorrie McHugh – communications) as well as Cheryl \nMills are lining up people (activists, etc.) to write blogs in \nanticipation of Sec. Clinton’s Speech at NIH.  Her speech (which I have \nbeen deeply involved in writing follows the PEPFAR model, not the USAID \nmodel.  They have asked me to do an editorial for the NY Times giving \nthe scientific basis HRC’s speech.  I worked all weekend and got a \ngreat piece which I have circulated to Cheryl Mills, Burklow (NIH), \nHHS, etc.\nNov. 7, 2011 -  Full court press in preparing for Clinton visit and \nspeech.   Again, I get call from Raj Shah wanting me to support his \n“doing things differently”.   I believe that he really does not fully \nunderstand what PEPFAR is trying to do.   He wants to scale up heavily \nin high impact countries and not go for just scaling up prevention and \nTAP. We are too far down the pike to change now even if we decided to \nchange.  Hillary’s speech is tomorrow as is the White House Principal’s \nmeeting in the Situation Room.   Ariel Ramos seems more convinced that \nthe PEPFAR model will work now that he has examined the models more \nclosely; however, Raj is still skeptical.\nNov. 8, 2011 -   Beautiful, crisp, sunny Fall day!   Fabulous event \nwith Clinton visit.   Francis and I greeted her at the South entrance \nof the NIH Clinical Center.   Also waiting in background was Harold \nVarmus and Nora Volkow.   Warm and engaging conversation with HRC.   I \nshowed her a picture of her and me at the Clinical Center during her \nfirst visit in Feb., 1994.   I welcomed all of the dignitaries to the \nMasur Auditorium, said some warm words (see files) about the \nrelationship between HRC and me and then introduced Francis Collins who \nintroduced her.  She gave a great delivery of the speech that I helped \nwrite.   Overwhelmingly positive response from audience and press and \nbloggers immediately after.   I sent in my Op-Ed to the NY Times (see \nReleased by Chairman Rand Paul\n260files) and then went to White House for Principals Meeting in Situation \nRoom at 3:45 PM.   Present were: Hillary Clinton, Jack Lew (OMB), Denis \nMcDonough (NSS), Chaired by Tom Donoline, Samantha Powers, Tom Frieden, \nRaj Shah, Eric Goosby, Gayle Smith, Ariel Pablos-Mendez, etc.   We \nagreed upon Option #2, which is greater efficiencies to provide more $ \nand scale-up of non-Tx prevention as well as increasing the PEPFAR \ntarget for prevention  to 6 million by 2013 and 8 million by 2015.  I \nstressed to Tom Donoline that the POTUS should strongly call upon more \ninvolvement by other donors, particularly China.   He agreed.   Of \nnote, Susan Rice teleconferenced in from NYC and she voted strongly for \nOption $3 (Blue Sky), which would require an additional $2.5 Billion.   \nThis is a good sound bite, but Jack Lew pointed out that given the \nbudget situation, the POTUS would have to back off on commitments that \nhe has already made to other programs in order to do this.  Hillary \npointed out that this was not tenable.   She also pointed out that we \nneeded to address the ADAP waiting lists.\nAmazing situation.   After returning from the White House, I heard from \nCourtney Billet and Greg that HHS contacted us and said that although \nthey had no problem with the Op-Ed (see above) and actually cleared us \nto send it to NY Times, the “White House” told HHS to have recall the \nOp-Ed since it is “off message”.   Still not sure what they mean since \nState, HHS and everyone else approved it.   Could be because I called \nfor more resources as well as more “efficiencies”\nAnother amazing situation – At around 7:00 PM, Raj Shah calls me up and \nasks me to call a meeting with him, Eric and me to see if we could \nmodify the proposal that was agreed upon at Principal’s Meeting!!!.. He \nstill insists that the POTUS needs to come out with something \n“different” and suggests using “pipeline” money from PEPFAR/USAID.   He \nwanted me to broker the meeting.   I contacted Eric and bless his \nheart, he is willing to meet.   Meeting scheduled for 8:30 AM in Eric’s \noffice tomorrow.\nNov. 9, 2001 – Still no information on why the WH ordered me to recall \nmy Op-Ed.   Have e-mailed Gayle Smith (NSS).  I will explain situation \nto her tomorrow and see if she has any insight.\nMeeting did not occur at 8:30 AM because of scheduling issues.  Will \ntry to do a call tomorrow\nNov.10, 2011 – Got some insight from Gayle, but am afraid she is not \ntelling me everything.  She claims that she heard discussion about my \nOp-Ed at the WH, but not by WHCOMS.   Issue was whether it was a good \nidea to put it out right after HRC’s speech since it already got  great \nPR and so why waste a Fauci Op-ED.   Perhaps better to wait until the \nPOTUS does World AIDS Day.   This could be true, but who knows?   Gayle \ndid say that the OMB people might have been concerned by the couple of \nwords that said we need significant increases in resources, including \nfrom other donor countries.  This implies needing more USG resources, \nwhich would obviously bother OMB.   However, I could easily have \nchanged this to say we need significant new resources FROM other donor \ncountries.   In any event, Gayle assured me that the Op-Ed was not “off \nmessage” in the substance of its content.   We will hold onto it for \nnow.   Having said this, here is another example of the ridiculous need \nto control the “message” on the part of this White House.\nReleased by Chairman Rand Paul\n261Back to the Raj Shah intrigue.   On Raj’s suggestion, Yesterday’s \nscheduled meeting now a phone call among me, Eric, Raj, Tom Frieden.   \nRaj wanted to again bring up the possibility of doing something ”big” \nsince he feels that the POTUS will not have another opportunity.  After \nmuch discussion we explained to Raj again that “Blue Sky”, i.e. $2.5 \nbillion will never get by OMB or the Congress and even so, the best way \nforward according to the models is not to just pick out a few countries \nand full-court-press.   Raj goes along and we think it is over.\nApparently, immediately after the call, Raj calls Rick Klausner asking \nhim to convince me to not give in and adopt his plan.  Rick calls me on \nmy way to The Inn at Little Washington for my delayed 70th birthday \npresent from Denise from last December.  We are in the limo (rented by \nDenise) and Rick tries to convince me to re-convene the group.   He \nsays that Raj feels that I am the only one who could do this.  Raj just \ndoes not want to give up.   However, out of want to go the extra mile, \nI will call up Eric and Tom.\nNov. 11, 2011 – I call Eric and Tom and explain situation with Raj.   I \nconvince them to give it one more try. Both are extremely skeptical, \nimpatient and wary of Raj.  However, I indicate that we must ask Raj to \nbe very specific in what he wants to do and how he wants to do it and \nwhere are we going to get the money.   Raj has always been very vague \nabout all of these issues.   He just keeps saying that what Eric is \nproposing is old stuff and incremental and that he wants to suggest to \nthe POTUS something big and transforming.   I will write an e-mail and \ndetail the conditions of another teleconference and/or meeting.\nNov. 15, 2011 – At the invitation of Alan Murray (Senior Editor of Wall \nStreet Journal) I spoke at the Wall Street Journal-sponsored CEO \nCouncil event at The Four Seasons in Georgetown.   My purpose was to \nconvince the CEOs to get involved in supporting financially and \notherwise the Global AIDS Pandemic activities.  They were OK, but \nsomewhat clueless about the importance of global AIDS.   In retrospect, \nbillionaire philanthropists would be a better audience.\n     That evening went to a reception at Bill Heseltine’s house for \nGeena Davis.   She remembered our prior discussions during her visit to \nNIH.   She is lovely – very tall, but lovely.\nNov. 19, 2011 – Gave Keynote Address at the Caribbean AIDS Conference \nin The Bahamas.   The Atlantis Hotel is surrealistic.\nNov. 21 – 30, 2011 – Spent hours on the phone trying to address the \nADAP waiting list since we (HHS/PEPFAR) felt that if the POTUS \nannounces a scale-up of treatment for PEPFAR, then the logical question \nis what are we doing about the ADAP waiting list?   Tom Frieden \nsuggested that we engage the drug companies.   Since I know Jim Rooney \nfrom Gilead, I made the initial contact which led to many phone calls \ninvolving Jim and people from Gilead; people from HHS – me, Tom \nFrieden, Mat Wakefield (HRSA), Sally Howard (chief-of-staff to \nSebelius), Dora Hughes as well as people from NASTAD and Welvista.   \nImportant issues is the Gilead agreed to greatly lower their prices for \npeople on ADAP waiting list\nDec.1, 2011 – World AIDS Day (WAD).  A very special day.   The White \nHouse has decided that the venue for the POTUS statement on WAD would \nbe George Washington University in a program sponsored by One and RED, \nReleased by Chairman Rand Paul\n262Bono’s organizations.  Sanjay Gupta was the MC.   We had Presidents \nBush and Clinton by live video conference and President Obama delivered  \nthe speech that Eric Goosby, Tom Frieden and I and others wrote for \nhim.   As expected, he went with Option #2 (see above – Nov. 8, 2011).  \nIn addition, he included an additional $15 million (for Clinics) + $35 \nmillion (for States) = $50 million for ADAP total.   Again, Tom Frieden \nand HHS people (see above) have been working on the “domestic option” \nfor the past couple of weeks to offset criticism that we were paying \nattention to global, but not domestic AIDS.\n    Following the POTUS speech, there was a panel moderated by Sanjay \nconsisting of Bono, Alecia Keys, Kay Warren, Rep. Barbara Lee, Sen. \nMarco Rubio and a few others.   I was told a few days prior that Sanjay \nwould turn to me with a question sometime during the program.  Right \nafter Pres. Clinton’s live video speech, Sanjay said that you cannot \nhave a discussion about HIV/AIDS without including Tony Fauci (who is \nin the audience) and his perspective on the science and he turned to me \nto speak.   I spoke for a few minutes about the fact that the \nscientific data were overwhelming (circumcision; treatment as \nprevention, etc.) and the task now was to implement the science.   The \nstatement was similar to what I had said at the IAS meeting in Rome in \nJuly.   Right after my comment, Bono said that he must tell a funny \nstory and he proceeded to describe the night when he came to my house \nfor dinner to discuss what we could do to push the global AIDS agenda.   \nHe was cute.  He said that his friend Bobby Schriver told him that the \nonly person that could break the logjam on Global AIDS programs was \nTony Fauci.  He finished by calling me a “proper hero”. A YouTube \nrecord of this statement by Bono is available for Dec. 1.  Also, I had \na chance to say a few words to Pres. Obama as he was “working the line” \nfollowing his speech.   He congratulated me for the great work that we \nwere doing and that he has been hearing about.   All in all, a really \ngood day!!\nOf note, Gregg Gonsalves wrote a scathing letter to Raj Shah (that went \nviral on the internet) scolding him for obstructing the treatment as \nprevention initiative (see above discussions re: Raj).   Unclear to me \nhow Gregg found out about all of this.\nDec. 2,, 2011 – Finishing off WAD activities, went to Harvard on a \nbeautiful crisp clear December day and participated in the AIDS@30 \nInternational Symposium.   I gave the keynote “Perspective” on vaccines \nand participated in a panel Chaired by Bruce Walker and consisting of \nBob Gallo, Nelson Michael, Jerry Sadoff, and Julie McElrath.   Flew up \nto Boston with Eric Goosby and flew back to DC with Nelson Michael.   \nAll good.\n  \nDec. 2 thru 21, 2011 -  Significant issues regarding dual use research.  \nCheck press from Dec. 20-21, 2011.   Briefly, NIAID funded 2 studies – \nsubcontract via CEIRS (Centers of Excellence for Influenza Research and \nSurveillance) to Erasmus University in Netherlands (Ron Fouchier) and \ngrant to Yoshi Kawaoka at Wisconsin to study feasibility and mechanism \nof getting the highly lethal (60%), but poorly transmissible H5N1 (bird \nflu) that has been smothering in SE Asia since 1997 to become \ntransmissible and maintain lethality in a mammal model (ferret).   \nRationale for the study was to determine – Can it happen (in mammals) \nsince many people reasonably assume that it cannot since it has not \ndone this in nature despite being around in chickens and rarely in \nhumans since 1994?   Also, if it does become transmissible by point \nReleased by Chairman Rand Paul\n263mutations followed by passaging in ferrets (the experimental \nmethodology), then what is the signature of it so that health officials \nin the field could do better surveillance and also design better \ndiagnostics, therapies and possibly vaccine.  Both papers (with slight \ndifferences found that relatively few mutations (~5) followed by serial \npassage in ferrets led to virus that had better transmissibility and \nkept virulence. Kawaoka paper showed increased transmissibility but not \nmaintenance of virulence, while Fouchier paper showed both.  Papers \nsubmitted to Nature (Kawaoka) and Science (Fouchier).  Program staff \n(NIAID), Fouchier and editors asked (because of possibility of dual \nuse) the NSABB to examine the results and advise if it was OK to \npublish. Kawaoka was asked by NIAID to do the same.  To everyone’s \nsurprise, the NSABB recommended that the papers be published with the \nconclusions, but with redaction of the key results, mutations and \nmethodologies.   I believe that this was group think and “cover your \nass”.   Decision was to do this and provide a link in the paper whereby \npeople (health officials, legitimate scientists, PHARMA, etc) who have \na need to know can have access to the data.   This was a precedent \nsetting recommendation that was virtually impossible to ignore even \nthough I disagreed with it since the complexity of influenza \nadaptability is extremely complex and it is unlikely that terrorists \ncould replicate this work largely because it is unlikely that if that \nthis model just simply predicts that it will maintain these \ncharacteristics if taken from ferret to human. Furthermore and more \nimportantly, since the data had already been presented (by Fouchier) at \nan international meeting in Malta and the papers were reviewed by \nseveral reviewers and known by many, the data are already “out their” \nand would be virtually impossible to “restrict” the access to the full \npapers by a “vetting” mechanism of people who “apply” for the \nunredacted papers.  Journal editors were disappointed (Bruce Alberts – \nScience and Phil Campbell – Nature) as were many flu scientists.   \nHowever, we heard the usual hysteria from people like Ebert and \nIngelsby who complained that the experiments should never have been \ndone in the first place.  Also, Mike Osterholm who is a member of the \nNSABB was practically hysterical that the NSABB recommendations should \ngo out right away so that he could “answer all of the press calls” that \nhe was getting.   In reality, the only press that was agitating was – \nyou guessed it – Laurie Garrett. Of note, Mike Osterholm is the Head of \nthe CIERS group that subcontracted through the Mount Sinai group to \nFouchier to conduct these experiments.   Osterholm now (incredibly) \nsays that he never thought that this situation would arise when he knew \nabout the contract and actually was given updates through the CIERS on \nthe actual data.   Yet, he is the loudest one saying we should now lock \ndown all experiments and treat this like BSL-4.   Problem here is that \nas I predicted, the White House is now involved and they want the USG \nto examine all research that is ongoing and that is proposed for its \ndual use potential and to put restrictions on it if it has such \npotential.   What they do not understand it that in the “discovery of \nscience” you cannot always predict what will be dual use and the danger \nis that scientific work and importantly the normal open discourse of \nscience will suffer because some uninformed people who live for \n“intrigue” are acting out their own agenda.   More later. \nDec.22, 2011 to Jan. 7, 2012 -  Situation has escalated with wall-to-\nwall conference calls with HHS and a variety of WH folks about what to \ndo.   Major issues are that Bruce Alberts and Phil Campbell are willing \nto publish a redacted version of the papers in Science and Nature, \nReleased by Chairman Rand Paul\n264respectively; however, they insist that the USG have in place a link or \nsome mechanism that they can publish with the redacted versions of the \npaper that would allow legitimate scientists and Public Health \nofficials to have access to the entire manuscript.   I found out \nthrough painful probing that recommendations from NSABB   guidelines    \nUSG policy should have been in place years ago to deal with the \nupstream (prior to the start of experiments) and downstream (progress \nreports and communication of results) issues of Dual Use Research of \nConcern (DURC).  Problem is that the recommendations of the NSABB as to \nthe “7 deadly sins” of DURC never got “clearance” from the multiple \nagencies to which NSABB officially reports (DoD, DHS, DoS, DoJ, \nintelligence community) in order for it to get the Public Comment in \nthe Federal Register to give the scientific community the opportunity \nto weigh in on the feasibility of controlling or not such research at \nthe same time a preserving the fundamental basis of open scientific \ndiscourse.   I believe that Amy Patterson should have shown some \ngreater strength of leadership to make sure that this process moved \nalong, when in fact it just froze. The NSABB sent in their \nrecommendations in 2007 (NSABB started in 2004) that should have become \nguidelines  USG Policy that ultimately could guide the local \ninstitutional Biosafety Committees (IBCs) to monitor this at the local \nlevel.   Irony is that now the papers have been reviewed, the Fouchier \npaper was presented in an international meeting in Malta and multiple \npeople have seen the data. BTW, Fouchier has been acting like a jerk in \nhis cavalier attitude about disseminating the results. Now NSABB and \nthe journals above all want a mechanism is a few days (to coincide with \nthe publication dates of the papers (Jan. – Feb. 2012) that they have \nnot been able to do in 4-5 years.   All of the demagogues have weighed \nin. People thinking that the world is not in danger of a terrorist \nmaking a “killer virus” that spreads easily.  What is at stake is the \nproper balance of doing microbial research that has DU potential with \nsecurity issues.   Of, note, I wrote an opinion piece in the Dec. 31, \n2011 issue of the Washington Post on the value of the science. The \nsecurity people do not understand the scientific enterprise, although I \ncan understand their concerns.  This whole thing has destroyed my \nChristmas Holidays.  It still is not over.   Divergent opinions in the \nscientific community ranging from 1) this work should never have been \ndone in the first place (Ebright; Ian Lipkin) to 2) we should not \nrestrict publication of any of the data and should just let it out \n(Racaniello; Peter Palese) to 3) we should publish only redacted \nversion (which is ridiculous since the data are out already) to 4) we \nshould destroy the virus (D.A. Henderson).    Please note that the \ncomplexities of species adaptability to virus transmission and \nlethality is so complex that just because multiple induced mutations \nfollowed by passaging in ferrets of 1 strain of H5N1 does not mean that \nthis virus would do the same in humans or that anyone else could \nreplicate the experiment. Of great importance is the fact the Fouchier \nfound out (but DID NOT submit it with his paper to Science – he wants \nto put it into a second paper)that if you take these 5 mutations and go \nback and put them into the wild-type H5N1, you do not get increased \ntransmissibility, which proves my point (and that of Jeff Taubenberger) \nthat transmissibility is a multi-genic process that is strongly \n“context-dependent”.  In other words, just knowing these 5 mutations \nmay have little impact on someone’s ability or not to repeat these \nexperiments.  Let me be clear, I believe that we need to now once and \nfor all get the process going of a SOP for evaluating dual use research \nReleased by Chairman Rand Paul\n265of concern (DURC) before the experiments are performed to evaluate the \nrisk/benefit of even doing the experiments and to periodically look at \nthe data to determine whether the data should be shared (presented or \npublished) before one presents it or submits it to a journal. I think \nthat there was major multifaceted failure here of NSABB covering their \nasses with the recommendation; researchers wanting attention for their \nwork; failure of Amy Patterson’s shop to get their job done over years; \npanic and hubris on the part of USG agencies who know nothing about \nscience.   I can go on and on.  The problem that we are facing now is \nthat we (USG) is being put in an untenable position of be involved in \nand associated with restricted (or as some say “censoring”) scientific \ninformation when it is already out there.   The process sets a bad \nprecedent and it evokes all kinds of conspiracy theories and makes us \nlook foolish.   My choice at this point would be to admit that it is \ntoo late in the process – we should publish the unredacted papers and \nmake this an “Asilomar moment” to make sure that we are not in this \nposition again.\n    Of note, on Jan. 7, 2012 a NY Times (written by Phil Boffey – \nunsigned – I know because he called me about it) came out with an \ninappropriately alarmist editorial entitled “Engineered Doomsday” \ncalling into question the rationale for the research and asking for \nlock down of virus in BSL-4 and ultimate destruction of virus.   He got \nmost of his information from Ian Lipkin (my good friend) who feels \nstrongly about this and was nice enough to tell me that he was going to \ndo this.   This editorial has only inflamed the hysteria and posturing. \nJan. 15, 2012 – I still believe that there is no reason for the \nJournals insisting that the papers (redacted) need to be published by \nend of Jan/early Feb.  Why not wait until this mess in openly discussed \nin an “Asilomar-like” setting.\nJan. 16 – 21, 2012 - Major development pushed by my decision to be much \nmore proactive in this process.   Too many people were posturing and \nplaying the “sound bite game” – Richard Ebright (who is a complete \nasshole), Mike Osterholm (with whom I am becoming progressively more \ndisillusioned with due to his hysteria) and other well-meaning people \nwho just like to comment, like D.A. Henderson. I never liked the fact \nthat the journals (Science and Nature) were on a fast track to publish \nwhen we still did not know how we were going to develop a system to get \nthe unredacted manuscripts only to “those who had a legitimate \nscientific need to know”.  We were getting significant pressure from \nthe White House via HHS to make sure that there are no surprises with \nother such projects appearing.   In addition, additional data were \nleaking out from Ron Fouchier’s group having WH/HHS asking whether we \nshould be shutting off their funding.   I became concerned over the \npossibility that outside (non-scientific) influences would force us to \nset a bad precedent and stop funding these flu projects.   Therefore, I \ntook the bull by the horns and contacted Fouchier and strongly \nsuggested that he and the flu scientists call a moratorium (60 days) on \nall work dealing with increased transmissibility and/or virulence of \nhighly pathogenic H5N1 virus.   At first, Fouchier was reluctant to do \nso since he felt that this would be an admission that what he did was \ndangerous and that he was backing down.   He totally disagrees with the \nNSABB recommendations.  In addition, I felt and told this to many in \nthe press that we need to get more international involvement in this \nsituation with WHO playing a major role.   I felt that people were \nconcerned that this was too much of a USA-centric situation and the USG \nReleased by Chairman Rand Paul\n266was driving things that affect many others outside of USA.   I agree.   \nTherefore I agitated and accomplished that WHO (Keiji Fukuda) should \nhold a meeting in Geneva to add an international component to this \nsituation.\nImportantly, on Wednesday, Feb. 18 I called Ron Fouchier in his home in \nRotterdam (actually I e-mailed him and asked him to call me) at 4:30 PM \nDC time – 10:30 PM Rotterdam time.   I strongly suggested that he call \na moratorium on this work and encourage his flu colleagues to also do \nso.   He was not totally convinced and said that he would consult with \nthe others tomorrow (Feb. 19) AM and get back to me.   I emphasized \nthat it is likely if he does not do it voluntarily that forces beyond \nour control (i.e. the security people) would force us to defund the \nwork.   The next morning he called me and said that they had agreed to \ncall a moratorium for 60 days and see what the Geneva meeting brings. \nFurthermore, Francis Collins and I called Bruce Alberts (Science) and \nPhil Campbell (Nature) and convinced them to delay the publication \nuntil at least March.  Fouchier came out with a press statement on Feb \n20 and Francis Collins and I came out with an NIH statement the same \nday applauding their decision.   This was a good example of my having \nto take the bull by the horns since things were not going in the right \ndirection.   Now we wait to see what happens.  There was wide coverage \nin the press about this “breakthrough” in negotiations with big stories \nin Washington Post, NY Times, Wall Street Journal, etc.\nJan. 23, 2012 - Went to Situation Room in the White House at 3:15 PM.   \nCold, very damp, gray day.   Purpose to discuss the H5N1 situation and \nbrief the National Security Staff (NSS) about my upcoming trip to the \nGeneva meeting scheduled for Feb. 16-17, 2012.   Present at the \nmeeting:  John Brennan (Chief, NSS), Heidi Avery (Deputy Chief), \nFrancis Collins, Amy Patterson, Bill Corr (Deputy Secretary-HHS), Sally \nHoward (Chief-of-Staff to Sebelius), Bill Shultz (OGC-HHS).   NSS \nconcern was what we would agree to or not at the Geneva meeting.   I \ntried to explain that the information was already out there and \nmultiple papers have already described the methodology.   I explained \nthat what I wanted to get out of the meeting was a transparency to \nothers about what we are trying to do in order to get away from this \nUSA-centric perception.   Of note, after the meeting, Heidi sent an e-\nmail to Bill Corr saying that there are certain “redlines” that we \nshould not give in to at the meeting.  I fear that she is not fully \ngetting what I want to accomplish at the meeting.   Also, of note, she \nmentioned in her e-mail that she does not want total unbridled \navailability of the information in the papers (her “redline”) even \nthough she knows that certain USG scientists do not agree with her.  I \nam certain that she is referring to me.\nFeb. 11, 2012 – The past couple of weeks have been intensively involved \nin discussion about the H5N1 issue.  Extraordinary “legal” issues come \nup about what can and cannot be discussed in public.   I pushed for and \nit will happen next week for a WHO meeting to make all of this more \ntransparent and international.   The issue is what can and cannot be \ndiscussed at this meeting.   There are 2 options to allow discussion at \nthe meeting: 1) an “export control license” from the Dept. of Commerce \nthat restricts discussion to the people listed on the license, i.e. all \nthe attendees at the meeting or; 2) An advisory opinion from the dept. \nof Commerce saying that the information is intended to be published by \nthe journals and therefore the expert control requirement does not \nexist. Some subterfuge has gone on with HHS in getting the journals to \nReleased by Chairman Rand Paul\n267say that they have every intention of publishing the papers without \nrestrictions (which is not true) just so that they can get an advisory \nopinion.   The problem is that since Commerce grants both the export \ncontrol (which assumes restriction) as well as advisory opinion (which \nassumes open publication without restriction) you cannot have it both \nways.   Bottom line is that based on the journals declaring that they \nintend to publish an advisory opinion will be granted.  I expressed my \nconcern that this was not entirely honest, but it went ahead anyway.   \nThis is something that I do not control.  I leave for Geneva on Feb. 14 \nfor a meeting on Feb. 16-17, 2012.\nFeb. 13, 2012  -  You really cannot make this up if you tried.   They \n(HHS, DoC, White House) have finally decided that we all need export \ncontrol licenses to go to Geneva.  The DoC and HHS are working \nfeverishly to get them on time before we all (me, Nancy Cox, Paul Keim \n– representing NSABB) leave for Geneva.  The entire process has been \nludicrous with regard to the concern over security as well as the \ncraziness of the laws related to export control licenses.   Export \ncontrol was originally designed as a multinational agreement to protect \nagainst the shipment of sensitive products such as computer chips, \nweapons, etc. to countries with whom we (USG) or other countries have a \nproblem with.   In this case (uniquely), the export control applies to \nshipping of information or even being in a room where information \n(sensitive) is shared.   In this case, the information is the H5N1 \nunredacted manuscripts.   I need an export control license (even though \nI am not taking anything with me) to go to Geneva and I must name on \nthe license everyone who will be at the meeting.   I cannot do this \nsince the WHO will not release the names of the attendees until the day \nof the meeting and so DoC cannot put in for a license for me.  OK, we \nget the names and then Tom Countryman from State has deep concern that \nwe are even going to such a meeting to discuss potentially sensitive \ninformation.   We calm him down and then the White House (John Brennan \nand Heidi Avery) do not want Fouchier to discuss the 9 mutations that \nare capable of giving the ferrets transmission/lethality without the \nrequirement for passage among ferrets (more below on that).  They only \nwant him to discuss what is in the unredacted paper (5 mutations + \npassage).   They (through Sally Howard of HHS) want me to call Ron \nFouchier to ask him to not mention the 9 mutations and to restrict his \ndiscussion to the paper.   The discovery of the non-passaged virus’s \nability with 9 mutations by reverse genetics to allow \ntransmission/lethality is not contained in the paper.   Now here I am \n(very uncomfortably) asking Ron to voluntarily withhold any information \nboth during the question period and the discussion about the other 4 \nmutations that together with the original 5 make a wild type H5N1 \ntransmissible/lethal in ferrets without the requirement of passage.   \nRon reluctantly agreed because he wants the meeting to occur and the \nWhite House said that the meeting will be nixed if we discuss the 9 \nmutations.   Here is the irony of this all.   The meeting was called by \nWHO to add “transparency” to the process and to preserve the PIP \nagreement so that the Indonesians and Vietnamese do not feel that we \nare withholding information from them and a White House condition for \nsupporting the meeting and allowing me to go is that Ron “withholds” \ninformation if asked about the obvious questions that any virologist \nwould ask, i.e. if you took a wild-type H5N1 (cloned) and only inserted \nthe 5 mutations, would it transmit in ferrets – answer = no.   Then \nwhat did you do?   Ron would answer that the virus after 5 mutations \n(commonly known in the literature) + 12 passages obviously also \nReleased by Chairman Rand Paul\n268accumulated other mutations besides the original 5 (3 + 2).  Ron then \ndid deep sequencing of the transmissible virus and by reverse genetics \nfigured out that you needed the 5 + an additional 4 (now he says less \nthan 4).   This was not in the original manuscript (unredacted).   \nWhite House does not understand that the 5 mutations + Passage = the \nunpassaged 9 mutations.  They fixate about not mentioning the precise 9 \nmutations when anyone can just take any quasispecies and get a \ntransmissible virus after many passages.   You just need a virus and \nsome ferrets.   I again am very uncomfortable in asking Ron to hold \nback this information and told him that this would be his choice and he \nwould have to play it by ear at the meeting, but he will try his best \nto be vague about the 9.   Another ludicrous happening is that this \nexport control issue must also get input from the iPC (interagency \nPolicy Committee) which includes DoD.   The night before I am leaving \nfor Geneva (tomorrow on 5:47 PM flight) DoD says that they want to know \nwhen I am leaving since they are not sure that I can go since they want \nthe WHO to disinvite the Chinese (where the disease is occurring) since \nwe (USG) do not share restricted information with them.  They fail to \nrealize that Margaret Chan (Director General of WHO) is Chinese!!!!!    \nYou cannot make this up.\n    DoD is examining this issue tonight and will let me know tomorrow \nif I can go to Geneva. \nFeb. 14, 2012 – Approved at the last minute (literally) that I can go \nto Geneva and was granted an Export Control License for me, Barbara \nJasny (representing Bruce Alberts of Science), Paul Keim (Chair, \nNSABB), and Yoshi Kawaoka (author of Nature article)\nFeb. 16-17, 2012 – Geneva – Astounding!! During Ron’s presentation of \nthe data, I asked the “transforming” question that exposed the \nconfusion that has been propagated regarding the study.   It relates to \nthe uncoupling of the issue of aerosol transmission from deadly \npathogenesis.   Bottom line is that the aerosol-transmitted virus when \ntransmitted to uninfected ferret, not only does not kill them, it does \nnot even cause significant disease.   At worst, some mild flu like sxs.   \nSee below for my detailed description of the data gathered from the \npapers, the Geneva presentation together with discussions during the \nGeneva meeting including a dinner at Keiji’s home with Ron, AB \nOsterhaus, Keiji Fukuda, and Yoshi on the evening of Feb. 15 (more on \nthat later) as well as extensive discussion by phone with Ron after I \nreturned to USA on Feb. 19 and 20, 2012. Recommendation (consensus) of \nthe WHO-convened group was to 1) respect the PIP agreement; 2) extend \nthe voluntary pause (“moratorium”) on H5N1 \ntransmissibility/pathogenicity research; 3) Delay publication of the 2 \nmanuscripts until the safety and security issues of such research could \nbe solidified for others.   General agreement that the experiments of \nYoshi and Ron were carried with safety and security that met or \nexceeded the guidelines; 4) After meeting conditions in #3, then \npublish the manuscripts in full; 5) discussion that the publishing of \nredacted manuscripts with mechanism for vetting and distributing to \nthose with a need to know was completely impractical.   This point was \nfortified by the almost unbelievable and counterintuitive requirements \nof Export Control Licenses.   There was a unanimous recommendation for \neverything except the recommendation to publish.   Nancy Cox did not \ncomment, but Paul Keim and I stood by the recommendations of the NSABB.   \nIn the roll-out after the meeting in Geneva, Keiji at first messed up \nand said that everything was “unanimous consensus”, which is an \nReleased by Chairman Rand Paul\n269oxymoron.   Christ Feig is a former CNN producer and old friend of mine \nand is the communications director for WHO.   I noticed the slip-up and \nshe got Keiji to correct while still on the TV press conference.   E-\nmails were going back and forth from me to HHS (Bill Hall) to some of \nthe NSS people when he made this mistake, but everyone calmed down \nafter he corrected it.   I was in the unusual position of officially \nsticking with the NSABB recommendation while being the one who actually \nled the WHO discussion to come to this point.  The smart reporters like \nJon Cohen and Helen Branswell picked this up and were sympathetic.   \nThe decision was written up on the front page of the NY Times by Denise \nGrady on Sunday.   It was interesting how she quoted me with an \narticulate explanation of why the WHO group came to this decision at \nthe same time that she mentioned that I stuck by the NSABB \nrecommendations.   Anyone with insight could figure out what I did.  Of \nnote, Paul Keim did not realize that the aerosol-transmitted H5N1 did \nnot make the animals ill, much less kill them!!! There was a media \nstorm after the decision was announced. See below for summary of \nmeeting:   \nSunday, February 19, 2012\nSummary of discussion at the WHO Geneva Meeting on Feb. 16-17, 2012 plus additional \ndiscussion with Ron Fouchier and Yoshi Kawaoka.\nAnthony S. Fauci, M.D.\nFouchier Experiments (Science)  and related information:\nFouchier worked with a high pathogenicity (HP) H5N1 influenza virus obtained from a patient in \nIndonesia (A/Indonesia/5/05).   He had been working for 4 to 5 years on trying to study the \ntransmissibility of H5N1 for the purposes of determining the molecular aspects of increased \ntransmissibility.  His attempts at developing an H5N1 with increased transmissibility in a \nmammalian model have failed up to now.\nRecently, he used the already existing literature to identify the mutations that have been \nreported to be associated with the emergence of previous pandemics (1918 H1N1, 1957 H2N2, \n1968 H3N2, 2009 H1N1 and other non-pandemic outbreaks, e.g. 1977 H1N1).  He analyzed \nthese and determined the 3 mutations that statistically seemed to be associated most closely \nwith emergence of pathogenic pandemic viruses.  Again, these mutations have already been \nreported in many published papers.\nWith regard to the “technique” of passaging in ferrets, there are many papers that have \nappeared in the literature for decades (since the 1930s) describing the ferret passage technique \nto increase transmissibility.   This is similar to passage techniques widely used to adapt a virus to \na particular species.   It has been done in mice, monkeys, etc.   Usually (not always), when \nviruses are passaged in a particular species, as they gain transmissibility, i.e. species-specific \nadaptation, they develop decreased pathogenicity, i.e. attenuation.\nReleased by Chairman Rand Paul\n270Fouchier took these 3 mutations and inserted them into a wild type (WT) HPH5N1 (see above). \nThis technique is widely used in molecular virology.  He then passaged the virus 10 times in \nferrets.  “Passaged” means inserting the virus into the nose of the animal, getting the animal to \nget infected, then taking virus from the nasal passages of the infected animal and inserting it \ninto the nasal passage of the next animal in the sequence, and so on.   The endpoint that is \naimed at is to get a virus that is then able to be transmitted by aerosol (i.e. not relying on direct \ninsertion into the nasal passage).  Since ferrets sneeze when they are infected, one determines \n“aerosol transmission” by housing an infected ferret in a cage next to a separate cage of an \nuninfected ferret that is constructed such that an aerosol can get from one cage to the other \ndue to “holes” in the barriers between cages.   The virus resulting from the passaging was able \nto be transmitted by aerosol and was a “quasi-species”, i.e. it contained different “versions” of \nthe mutated virus.  The viruses that were transmitted by aerosol were then sequenced and all of \nthese viruses had 5 mutations in common:  the 3 mutations that were inserted by reverse \ngenetics and 2 additional ones.  In addition, the viruses had 4 to 7 variable mutations (this latter \nsequencing information was not ready for reporting in the original manuscript).   This virus \nisolate was used in the pathogenesis studies reported in the manuscript.  It was the isolate with \nthe minimal number of mutations (9 mutations  -  5 common mutations  + 4 variable mutations).  \nAfter submission of the manuscript the authors took a wild-type H5N1 clone and inserted this \nminimal number of mutations to develop a virus that was transmissible without the need for \npassage.  The pathogenesis studies with this cloned virus were identical to those of the isolate \nreported in the manuscript (see below).  \nIt is EXTREMELY IMPORTANT to point out that the animals that got infected by aerosolized virus \ndescribed above did not die nor did they get sick. They were followed for 14 days.  A few got \nminor flu-like symptoms, all recovered, they then were sacrificed since logistically the author \ncould not house them indefinitely.  Thus, the “engineered” virus that was made transmissible, \ndid not kill or make the animals sick when exposed in the manner that flu in transmitted in \nhumans.\nPATHOGENICITY.  The classic way that influenza virus pathogenicity is established (well-\ndescribed in the literature) for the ferret model is by direct insertion of the virus into the nasal \ncavity and/or directly into the trachea.  Fouchier did both nasal and tracheal insertion of the \nviruses.\nIn the nasal insertion studies , 106 (1 million) infectious doses of virus is inserted into the nose.  \nThis is a dose that far exceeds a dose that one gets through aerosolized virus (i.e. sneezing).  \nWhen this dose of the pandemic  2009 H1N1 virus (not considered a particularly pathogenic \nvirus, particularly in people who have been exposed to H1N1 over years by infection or \nvaccination - children who are naïve to this virus have had more problems) is inserted into the \nferret, the animals develop flu-like symptoms but do not die.  When HPH5N1 is inserted the \nanimals essentially all get neurovirulence, they recover, none die. When the modified (aerosol-\ntransmitted) H5N1  virus is inserted, there is some neurovirulence, but actually less \nneurovirulence than with the wild typeH5N1.  Again, all recover and none die.\nReleased by Chairman Rand Paul\n271In the tracheal insertion studies, 106 virus is inserted directly into the trachea.  Again, this is a \ndose and a situation that would be extremely difficult, if not impossible, to achieve by \naerosolized transmission.  In these experiments, when this amount of wild type (unmodified) \nHPH5N1 is inserted into the trachea, all animals die on day 3.   Similarly, when the modified \nH5N1 is inserted, all animals die on day 3.   However, and importantly, when 2009H1N1 that \nwas shown to be a mild pathogenicity virus was inserted under the same conditions, it killed \nsome, but not all the animals.  Although, this was a qualitative and not a quantitative study, it \nstrongly suggests that in this model, the modified H5N1 is not dramatically different from the \n2009 H1N1 in pathogenicity.   Also, it should be pointed out that in the ferret model, 2009 H1N1 \nis much more transmissible (100% transmission on day one) than is the modified H5N1.   \nSpecifically, transmission with the modified H5N1 does not occur until day 3 to 4 and even then \nit is only 75% transmissible.   This suggests that the R 0 may be less than 1.   This is important with \nregard to concerns over the potential catastrophic effects of lab accident and the known \nconditions that are needed for the start of an epidemic/pandemic.   In this regard, there should \nbe serious discussion of how pandemics occur.  Nancy Cox can elaborate.\nFerrets are naïve to influenza virus, i.e. they have no pre-existing immunity.   Humans do have \npre-existing immunity to influenza viruses due to repeated exposures (except in young children) \nand/or vaccinations.  It is EXTREMELY IMPORTANT to point out that if you vaccinate the ferrets \nwith seasonal H1N1, they are not protected against death from tracheal insertion of high dose \n(106 infectious doses) modified or wild type H5N1.   Fouchier did not test the effect on \ntransmission yet (moratorium).  However , if you pre-infect ferrets with seasonal H1N1, let them \nrecover and then insert high dose H5N1 into their trachea, this fully protects against disease and \nno ferrets die.   This strongly suggests that pre-existing immunity due to prior infection with \nseasonal influenza A protects against serious disease with this modified virus (heterosubtypic \nimmunity).  This could be a possible explanation for why so few people get infected with H5N1 \nin the wild.\nYoshi Kawaoka Experiments ( Nature).   The studies of this investigator are very similar to those \nof Fouchier except that Kawaoka took the HA from the HPH5N1 and did random mutations from \nwhich he selected those that enhanced transmissibility when this HA was reassorted with the \n2009 H1N1to make a hybrid of the H5N1 and the 2009 H1N1.  This is something that we are \nconcerned could happen in the wild.   He then did similar passages as described above.   \nKawaoka’s results differed from the Fouchier study in that although his virus was transmissible, \nit was not any more pathogenic than the 2009 H1N1 influenza.\nEPIDEMIOLOGICAL DATA:   With regard to the importance of these data for the real and present \ndanger of the evolution of H5N1 in the wild, as well as for the impact on surveillance, Kawaoka \nand Fouchier have done some epidemiological “mapping” of their modified virus with what is \ngoing on in the wild.   Viruses were studied that were obtained from chickens in Japan, \nMongolia, Nepal, and Egypt as well as viruses from people infected with H5N1 in Egypt.   Some \nof the mutations that Fouchier and Kawaoka described involving the PB2 gene (627 K) and the \nreceptor binding genes (HA) were present in 100% of the H5N1 viruses that infected humans \nReleased by Chairman Rand Paul\n272and only in 30% of the chicken viruses.  This suggests that the viruses that accumulate the \nmutations in question are the ones that transmit from chickens to humans. In addition, many of \nthe viruses circulating in chickens are only 2 to 3 mutations away from the mutations described \nby Fouchier in their modified viruses. \nPeople will argue that knowing mutations cannot help predict or alert public health officials to \nwhat will emerge as a pandemic.  They state that since viruses have several routes to get to \nwhere they want to go, i.e. to be able to be transmitted, the studies in question should not even \nhave been performed.    However,  historically, after pandemic viruses emerge and infect people \nand then you go back and trace what was evolving in birds, or (more importantly) in mammals \nyou see a pattern where you could have actually traced and connected the dots pointing to the \nemergence of a pandemic.  This was clearly the case where the pandemic  2009 H1N1 virus was \nevolving in pigs for at least 10 years and was “working its way” towards human transmissibility.   \nIf there had been better surveillance in both pigs and humans as to what was evolving, then as \nTom Frieden has said, we could have had a major head-start on the 2009 H1N1 virus.  What the \nFouchier and Kawaoka viruses tell us is that the virus in the wild is creeping towards a virus that \nthey have shown is capable of transmission in mammals, presumably including humans.  \nWhether the virus ultimately uses that precise pathway or those precise mutations is not clear, \nbut clearly these studies are critical to understand the process of evolution and adaptability of \nviruses that are a real threat of working their way to transmissibility in humans.   Not making \nthese data freely available to scientists only slows down the necessary work and the incentive to \nget more scientists involved, and does not really provide a serious terrorist with any additional \nadvantage since these techniques have been widely available for years.  An uninformed terrorist \nwould not be able to do this.  An informed virologist-terrorist just needs to go to PubMed to \neasily figure out what was done and how it was done.   Not publishing the work may do more \nharm than good by discouraging legitimate scientists from getting involved.   Clearly, there \nneeds to be assurance of biosafety and biosecurity in the laboratories that work with \ntransmissibility of H5N1.  The laboratories in question (Fouchier and Kawaoka) have met or \nexceeded our standards for these types of studies.\nRedacted versus Unredacted:  The impracticality of redacted versus unredacted manuscripts \nwas clear to everyone at the Geneva meeting and the likelihood of the unredacted manuscripts \nultimately reaching the internet were important factors in the consensus at WHO to publish in \nfull after a pause to assure biosafety and biosecurity and to have a better articulation of the \nbenefits of the research as described above.\nThe way forward. People are making incendiary statements without really having discussed \nwith the investigators the precise details of the experiments as described above.  The \ninteraction of the NSABB with the investigators (Fouchier and Kawaoka) was on a relatively brief \nconference call.   Much additional information that was available during the intensive 2 day \ndiscussion in Geneva was not available to the NSABB.   My recommendation is to reassemble \nthe working group of the NSABB for a face-to-face meeting with the investigators, security \nReleased by Chairman Rand Paul\n273people, international public health people (similar to the WHO meeting) and a larger number of \ninfluenza experts with hands on expertise in such studies.  \nPost- Geneva:     Have spent the past few days explaining the above summary to HHS, White \nHouse NSS X 2.   Could not comment too much to the press.  \nFeb. 22, 2012 -   Briefed the NSS in the Situation Room with Heidi Avery leading (I had pre-\ncontacted her explaining that I had to do the briefing and she agreed), Laura Holgate and Brian \nKamoi from NSS, Kris Beardsley (more of her later), Francis Collins, Amy Patterson, Nancy Ann \nDe Parle, Bill Shultz (HHS OGC), Bill Corr (Deputy HHS Sec.).\nFeb. 21-24, 2012 – had conversations and e-mail exchanges with Ron Fouchier trying to work \nout that he re-submit a manuscript and that the NSABB reconvene to review with the new data \nand the clarifications from Geneva.   Also, spoke with Journal editors to try and get them to \nagree (which they did) to hold off on publication, but agree to quickly consider a revised \nmanuscript.    Of note, during the Feb. 22 Situation Room meeting, I outted Kris Beardsley as a \n“leak” to the NSABB.   Paul Keim had asked how things were going right after we returned from \nGeneva (see e-mails on file).   I told him that I was about to brief the WH on Feb. 22.   He said \ngood luck and that he already had spoken to Kris Beardsley.   I did not return e-mail, but I was \nastounded.  She is NSS!!!.   Now it became clear that the NSABB people were directly trying to \nget to and agitate the WH through Kris and also with Mike Osterholm getting to Rick Weiss, the \nPress person for John Holdrin at OSTP.  Rick is a former Washington Post reporter.   I believe \nthat Paul Keim is OK, but it is incredible that Kris Beardsley and Rick Weiss are doing this.   In \norder to make sure that Kris would not undermine my presentation to Heidi and the NSS, I \nstarted my explanation (see summary above) by saying that I know that Paul Keim has briefed \nKris about part of this a day or so ago, but I will give a little more information since I spoke with \nRon after the WHO meeting and Paul did not.   Kris almost fell through her chair and Heidi gave \nher a very mean look followed by a statement that we have only one point of contact with \nNSABB and that is Fauci.   Clearly Heidi not only was not briefed by Kris, she had no idea and was \nextremely pissed that Kris had spoken about this with Paul.   Paul is advisory to HHS and NIH and \nNOT to the White House.\nBTW, I have been completely wearing myself down by this getting virtually no sleep and doing \n1000 things at a time that are very heavy, i.e. White House stuff, Press misinterpretation. Mike \nOsterholm acting in his usually hysterical manner, Laurie Garret getting it wrong as usual.\nOF GREAT IMPORTANCE:  How is it possible that everyone got it wrong?   Why did not anyone \never ask the “Fauci question” that I asked in Geneva of Ron.    This includes the reviewers of the \npapers, the entire NSABB including the Chairman Paul Keim, the outside influenza expert called \nto advise the NSABB (Rob Webster), the editors of the Journal.   After I briefed him, Bruce \nReleased by Chairman Rand Paul\n274almost comically stated. “You know, I knew there was something funny here when I read the \npaper and found that after aerosol transmission, blood samples were taken from the ferrets for \n12 days.   If the ferrets all died in 3 days, did they take samples from dead animals?”   Clearly his \nown editorial staff did not pick it up.   There is plenty of blame to go around.  Clearly Ron did not \nsay in the manuscript that the aerosol-transmitted animals died, but he never said in the \nmanuscript that they did not die.   Clearly he was doing what many scientists do, i.e. play up \ntheir own data to make it seem exciting.   Yet, he knew that the media were clearly getting it \nwrong.   He will say that he was never given the chance to explain this to the NSABB and his only \ncomments to the press that they clearly misunderstood were before the NSABB and he did not \nrealize that they misunderstood.   However, after the decision of the NSABB, he still spoke to the \npress, yet never made it explicit what really happened.  He could claim that at that point he \ncould not discuss the data since it was confidential and the press could not ask the specific \nquestion sine they did not see the data.  It is clear to me that a lot of people are embarrassed for \nnot asking the Fauci question and as human nature goes, people are running for cover and/or \nlooking to blame someone.   Ron is in danger of getting thrown under the bus when the press \nfinds out that he never clarified things.   As an example, ABS World News on Saturday PM, Feb \n18 had a piece showing all aerosol-infected animals dying schematically on the screen with the \never-present Laurie Garret commenting that “This virus just should not be allowed to exist”.\nSee Important e-mails below:\nThursday, Feb. 24, 2012 11:26 AM\nRon:\n    In follow-up of our previous conversations,  it is important for you to revise and \nexpand your manuscript to include the important new data that were presented in \nGeneva.   In addition (and this is critical), you need to make exceptionally clear the \ndifferences between the transmission studies and the pathogenicity studies, i.e. the \nresponse that you gave to me when I asked that direct question in Geneva whether there \nwas any illness or death in the animals that had been infected by aerosol with the \nengineered highly pathogenic H5N1.   You responded that some of these animals \ndeveloped flu-like symptoms, all recovered, none got seriously ill and none died.   This \nseems to be the key point about which many people were and are confused.   It would be \nvery important to make this exceptionally clear in the manuscript. There are also other \nimportant data that we discussed that would be important to include in a revised \nmanuscript.   I believe that the best course of action would be to resubmit this revised \nmanuscript  to the NSABB so that they have the opportunity to have all of the data that \nwe discussed in Geneva  in front of them as well as to directly question you in person in \norder to clarify any important points.   Amy Patterson will request that the NSABB meet \nand review this manuscript.   As I had mentioned to you, Francis Collins and I have \nspoken to Bruce Alberts about the importance of your having enough journal space to add \nthe  new data and a broader discussion of the issues.  In our initial conversations with \nhim, he seemed amenable to this approach.    Obviously, we cannot know for sure what \nthe journal decision will be.  Francis and I will be speaking to Bruce again today (I hope) \nReleased by Chairman Rand Paul\n275and we will bring this up to him.   However, the important issue is that the NSABB have \nthe opportunity to see the expanded manuscript as described above.\n    I would be happy to discuss this further with you.   Please give my office a call at your \nconvenience at (301) 496-2263.   I am not available between 12:00 and 12:30 PM and \n3:30 – 4:00 PM   Washington time.\nBest regards,\nTony\nAnthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \n______________________________________________\nTuesday, Feb. 21, 2012 to Paul Keim\nPaul:\n   Line-up and tasks sound good to me.   We should strategize by phone on how to handle \ndiscussion of the WHO meeting.   I have a meeting at the White House tomorrow to brief \nthe security people on the WHO meeting and the outcome of those discussions may \nimpact our decision on how to handle this.  We should talk after that.\nBest regards,\nTony\nTuesday, Feb. 21, 2012 from Paul Keim referencing Kris bearsdley\nGood luck with the meeting. I've prepping Kris today on the issues. \nPaul Keim, PhD \nTGen/NAU\nOn Feb 21, 2012, at 5:41 PM, \"Fauci, Anthony (NIH/NIAID) [E]\" \n<AFAUCI@niaid.nih.gov> wrote:\nPaul:\n   Line-up and tasks sound good to me.   We should strategize by phone on how to handle \ndiscussion of the WHO meeting.   I have a meeting at the White House tomorrow to brief \nthe security people on the WHO meeting and the outcome of those discussions may \nimpact our decision on how to handle this.  We should talk after that.\nBest regards,\nReleased by Chairman Rand Paul\n276Tony\nFeb. 23, 2012 -   Finally, a pleasant evening.   Attended reception at the Jefferson Hotel \nfor the Global Health Corps (GHC) created and led by Barbara Bush, George W’s \ndaughter.   Great reception.   It was a fund raiser for the fellows of the GHC.  Laura Bush \nwas there and she and Barbara during the speeches called me out for praise for all that I \nhave done for AIDS research.   All the GHC fellows were so happy to meet me since they \nhad been hearing about me for years and now were meeting me.   I met Marvin Bush, \nGeorge’s brother.  The usual crew was there – Mark Dybul (host), Eric Goosby, Stephen \nHadley former National Security advisor to GWB.   Many other luminaries.   The \nAmbassador for Woman’s issues of DoS mentioned in her speech how much Sec. Clinton \nadmired me.\nFeb. 25, 2012 – Went to a (now commonplace for me) dinner at Café Milano hosted by \nCatherine and Wayne Reynolds in honor of Gov. Jerry brown (D-CA) and his wife Anne.   \nBrown in DC for Governor’s Convention.   Sat next to Anne and got major insight into \nthe Gov.   He was known as Governor “Moonbeam” in the  70s during the hippy years \nwhen he dated Linda Ronstadt.   However, he is an amazing person in that he just tells the \ntruth without an obvious ideology.   Anne told me that Pres. Obama completely shuns \neven other Democrats such as Democratic Governors.   Obama has never once asked \nJerry for any advice about anything.   It was a lively evening talking about the \nRepublican Primaries and the ridiculousness of it with Romney vs Paul vs Gingrich vs \nSantorum. Other usual notables at dinner. Chris and Kathleen Matthews, Supreme Court \nJustice Anthony Kennedy.   I sat next to his wife Mary who is extremely conservative \nand not too bright (scary),   Also there was Bob Barnett and his wife.   NPR Nina \nTotenberg and husband David, Peter Agre, etc.\nFeb. 27, 2012 – Briefed the senior, but sub-Interagency Policy Committee on the Geneva \nmeeting. Chaired by Laura Holgate from NSS (National Security Staff).  Also present \nwere Brian Kamoi (NSS – he has lost about 90 lbs. and looks great); Sally Howard \n(Chief-of-Staff to Sec. Sebelius); Kevin….. from Commerce; a bunch of representatives \nfrom the various US Government departments.  Tom Countryman from State Department \nis really a jerk, pompous and uninformed.   I alleviated the anxieties of the group \nregarding the studies by clarifying the difference between transmission and virulence in \nthe Fouchier study.   I strongly suggest that we reconvene the NSABB to allow them to \nsee the new data and hear the clarification of the old data.\nFeb. 28, 2012 – Ron Fouchier flew in from Rotterdam to be on a panel tomorrow AM \n(Feb. 29) organized by American Society of Microbiology (ASM) to discuss this issue.   \nInvited Ron over my house for dinner (rigatoni and sausage with tomato sauce) with Cliff \nLane and Hugh Auchincloss to discuss the approach for tomorrow.  Ron related to me \nthat the NSABB never gave him a chance to explain his experiments and that he met \nthem via teleconference.   Clearly they were hostile to him and when his interview was \nover, Mike Osterholm started speaking before Ron signed off and Mike said (without \nknowing that Ron was still on the line) that Ron was a “liar”.   Ron stayed on the line in \nReleased by Chairman Rand Paul\n277secret and described what sounded like a major ad hominem to Ron.   After intense \ndiscussion with me before and during the dinner, Ron Finally got it that he has to be very \nclear tomorrow that the ferrets who got infected by aerosol transmission did not get very \nill (flu-like sxs at worst), all recovered and NONE died.  Only animals who got 1 million \ninfectious doses of H5N1 directly inserted into the trachea died.  It is clear that everyone \nNSABB, all the pundits who commented (Laurie Garret, Tom Ingelsby, Richard Ebright, \nD.A. Henderson, etc.) and the press thought that after aerosol transmission, the ferrets \ndied.  We had long discussions about future experiments and upcoming issues.   Later in \nthe dinner, Bruce Alberts (Editor of Science) flew in from San Francisco, called my cell \nphone to let me know he arrived, and I invited him over for the remainder of the dinner.\nFeb. 29, 2012 – ASM panel at 7:15 to 8:15 at Omni-Shoreham in D.C.   Standing room \nonly, fed live on Website with many reporters tuned in.   Paul Keim chaired panel that \nincluded Ron Fouchier, me, Bruce Alberts, and Mike Osterholm.  Everything was \nclarified and most people asked the question that I have been asking all along – how \ncould this pervasive misunderstanding have occurred.  It was clear, but no one wanted to \nembarrass anyone, that the NSABB missed this major point.\nMarch 1 and 2, 2012 – Much press coverage going on trying to decide what went wrong.  \nJon Cohen from Science is coming close to figuring it out.   However, when he asked \nseveral members of NSABB to answer some questions, it become clear that they are \nbeing defensive and saying that it is the mere fact of making the virus “transmissible” \nthat prompted them to recommend against publication, even if it was not clear that the \naerosol-transmitted virus did not kill the ferrets.   We are going to reconvene the NSABB \nASAP to review the revised manuscripts from Ron and Yoshi to that they can see the \nadditional and clarified data.   I am afraid that they will not change their minds because \nthey need to save face that they actually dropped the ball badly.   I believe that Mike \nOsterholm and to some extent David Relman aggressively persuaded the others to vote \nnot to publish.   HOWEVER, I believe if the other members of NSABB  knew that the \naerosol transmission did not result in death of the ferrets, they would not have been \nconvinced by the histrionics of Mike who told the press that this was equivalent to \n“thermonuclear war” if this virus gets out.\nMarch 5, 2012 – It is starting to become clear that the NSABB are saying that the basis \nfor their recommendation is the fact that the virus was made transmissible and the \ndecision had little or nothing to do with whether or not the virus was lethal via aerosol \ntransmission.   I just cannot believe this.   I believe that most of the NSABB group did \nnot know enough about flu to know the importance of this distinction.   They now are \nembarrassed that they missed this and are likely covering their asses.   Interesting that the \nN.Y. Times (Phil Boffey) editor wrote another Sunday editorial yesterday (May 4, 2012) \ncriticizing the process and implying that “the NIH, whose reputation is at stake…..” is \nsomehow at fault.   He clearly is taking the side of the NSABB calling them fiercely \nindependent.   He wrote me an e-mail prior to the Sunday editorial giving me a “heads-\nup”.   He implied in his e-mail that I was trying to have him retract his prior editorial \nbased on information from Geneva.   He is totally missing the point.   I do not want him \nto retract anything nor do I want to influence the NSABB to change their minds.   I \nReleased by Chairman Rand Paul\n278merely want them to reconvene so that they can have all of the information that was \npresented in Geneva and at the ASM meeting on Feb. 29, 2012 in Washington.   Things \nthat they almost certainly did not know at the time of their December, 2011 \nrecommendation:  1) aerosol transmitted H5N1 does not kill ferrets; 2) engineered H5N1 \nis poorly transmissible, i.e. it takes 3 to 5 days after exposure to transmit to 75% of ferrets \ncompared to 2009 N1N1 that transmits in 100% of animals within 1 day; 3) pre-infecting \nferrets with either seasonal H1N1 or H3N2 and letting them recover and then instilling 1 \nmillion infectious doses of H5N1 into their tracheas completely protects the ferrets from \ndisease and death.   If they still feel after they hear this that the papers should be redacted, \nthen so be it.   I believe that they are incorrect and were driven by the hysteria of Mike \nOsterholm, the know-it-all of David Relman and the lack of understanding of the rest of \nthe NSABB.\nMar. 8, 2012 – Went to special premier showing of the movie “Game Changer” about \nSarah Palin starring Julianne Moore, Ed Harris and Woody Harrelson.   All the usual DC \nglitterati were there, both political and media.   Tammy Haddad was responsible for my \ninvite.   Went with Chris.\nMar. 9, 2012 – PCAST meeting at the Carnegie Endowment for International Peace.   \nPresented on a panel with Paul Keim (Chair of NSABB), Bruce Alberts (Science editor-\nin-chief), Peter Palese (Mt. Sinai) regarding the H1N1 manuscript controversy.   Chaired \nby John Holdren and Eric Lander.   Reviewed the pros and cons of publication.   I gave \npresentation similar to my ASM presentation on Feb. 29.\nMar. 12, 2012 – Gave my yearly talk to the Zuckerman Fellows on “A Career in Public \nService”.   Very engaged group; was told by conveners that the fellows loved the talk and \nfound it the best among many talks by White House people, and other government \nofficials.   Usual cocktail reception and dinner at the home of Ron and Beth Dozoretz.  \nMingled with the usual DC glitterati – Andrea Mitchell and Alan Greenspan, Mort \nZuckerman, David Gergen, Chris Matthews, etc.\nMar. 20, 2012 – House Appropriations Subcommittee Hearings – Rayburn Building.   \nUnusual situation that the Hearing was confined to a discussion about NCATS.   Only \nofficial witnesses were Francis Collins and Tom Insel (Director NIMH) who was there in \nhis capacity as Acting Director of NCATS.   Harold Varmus and I were there as “token” \nattendees for rest of NIH.   It was a disgrace that the Hearing was only NCATS.   \nChairman Dennis Reyberg is not the brightest bulb on the porch.\nMar. 22, 2012 – Small intimate dinner at Café Milano sponsored by Wayne and \nKatherine Reynolds.   Dinner in honor of Susan Hockfield the retiring President of MIT.   \nUsual glitterati – Rick Atkinson (author), Head of National Geographic, etc.\nMar. 25, 2012 -  Went to Baltimore to present John Bartlett with an award from AIDS \nAction Baltimore.  He was delighted at my laudation.   It was run by AIDS activist and \nfriend of mine – Lynda Dee..\nReleased by Chairman Rand Paul\n279Mar. 26, 2012 – Gave my Nifty-Fifty Lecture on a “Career in Public Service” TO Walter \nJohnson High School in Bethesda.   It was fun since the students were so engaged with \nme.\nMar. 27, 2012 – Went to National Portrait Gallery to have historical filming of my \nexperience with HIV and my career.   It is part of the National Portrait Project to film the \nhistories of important Americans who have made major contributions.\nMar. 28, 2012 – Senate Appropriations Subcommittee Hearing for NIH.   Francis \nCollins, me, Varmus, Griffin, Insel, Hodes.   Too bad that these hearing are only a total of \n2 hours when we used to have 2 hours for NIAID alone.   I got questions on the H5N1 \nissue.\nMar. 29-30, 2012 – Intense meeting for 1 ½ days of the NSABB to re-visit the decision \nregarding publication of the 2 manuscripts – Fouchier (Science) and Kawaoka (Nature).   \nIt was clear that the driving forces to still block full publication were Mike Osterholm \nand David Relman.   Surprisingly, Arturo Casadevall was also adamant.   I spent the \nentire 2 days in the room and gave rationale argument why the manuscripts should be \npublished without my being too aggressive.   At the end of the meeting it was voted 18 – \n0 to publish the Kawaoka manuscript and 12 – 6 to publish the Fouchier manuscript.   \nThus, the NSABB reversed themselves.   Several factors went into this.  First was \n(although they were reluctant to admit it) was the fact that although the Fouchier \nmanuscript was not clearly written and Ron himself had given the impression that these \nwere really dangerous results, the fact is the NSABB completely misinterpreted the \ntransmission experiments (see above regarding Geneva meeting of Feb. 16-17).   They \nhad thought that the animals that had been infected by aerosol had actually died when \nthey did not.   They only died when 1 million IDs were inserted directly into the trachea \nof the ferrets.   In addition, some epidemiology data were presented that showed that in \nthe wild in Chickens and even in some infections in people (in Egypt), the virus was \nassimilating some of the mutations described and engineered by Fouchier and Kawaoka.\n     An interesting note:  in typical bullshit fashion that I have seen before, Mike Imperiale \nand Lynn Enquist (NSABB members told May Patterson that they wanted me to declare \nright before the 2nd day that since I was a funder of the research that I had a conflict of \ninterest in the discussions even though I had every right to be there since I am an ex \nofficio member of the Board.   They actually felt that I might not give grants to people \nwho were funded by NIAID and who voted to not publish the \nmanuscripts……..absolutely amazing bullshit!   In any event, I merely said at the \nbeginning of the second day that as everyone knows I am the funder of the research, but \nthat I respect greatly the members of the board and their opinions and this was “nothing \npersonal, but strictly business”.    You could tell that the good people on the Board had no \nidea why I was saying this, but it apparently satisfied the “cowards” on the Board.   If \nthey are not strong enough to stand up for what they feel, they should not be on a USG \nAdvisory Board.\n    It will be interesting to see what the press such as Laurie Garrett who was blogging \nlike crazy regarding how “courageous” the board was in standing up to the self-interest of \nthe influenza research community when, in fact< she had no idea what the data showed – \nReleased by Chairman Rand Paul\n280typical Laurie Garrett.   Also, I wonder what Phil Boffey is thinking.   He was skeptical \nof me on our phone conversations when I said that he went too far with his alarmist \nEditorial in the NY Times on “Engineered Doomsday”.   He sort of rebuked me saying \nthat the NSABB was a Board of “Top Scientists” and how could I be so at odds with \nthem.   I could not tell him at the time that they had completely mis-read the manuscript.   \nInteresting and unprecedented situation.\n    Also, on the first day of the meeting (March 29), the USG (mainly NSS) came out with \nthe official DURC Policy that guides how we should approach DURC.  \nApril 5, 2012 – Appeared on Channel 8 “Capitol Insider” to discuss the NSABB \nsituation.\nApril 11, 2012 – Amazing shit.   Mike Imperiale (mostly likely him) of the NSABB \ncalled a New Editor from Nature (Brendan Maher) and told him that he felt nervous \nabout voting against publication of the manuscripts since he was afraid that I would not \nfund his grants if he did.   I cannot believe the pettiness and cowardice of some people in \nScience.\nApril 12, 2012 – I called Paul Berg is Stanford today to get his perspective since he was \nso involved in a leadership role in the Asilomar situation in the 1970s.  We had a great \nconversation as we discussed the similarities and differences between then and now.   I \npointed out and he agreed that there is still today “scientific hubris” on the part of some \npeople.   Ron Fouchier showed that early on.   Hopefully now he is “cured”.   However, \nPaul emphasized (as I feel) that the issue with bioterrorists is really a non-issue.   He is \nconcerned about sloppy science and public trust.   He said that in the 1970s there was \nlittle concern about “germ warfare”.   I told him that that is the biggest difference from \ntodfay when biodefense and biosecurity is a cottage interested with people (Ingesbly et \nal) and Agencies (DHS) who think about and work on this full time.   In addition, there \nare the biodefense “Beltway Bandits”.   This “Biosecurity intimidation” matches the \n“Scientific Hubris”.\nMore amazing shit.   Mike Osterholm wrote a letter to Amy Patterson with a cc to the \nentire NSABB membership excluding the ex officio members saying that he feels that the \nNSABB meeting was “rigged’ by us to come up with the outcome that happened.   I truly \nbelieve that he is traying to cover his ass that the NSABB completely missed the point of \nthe transmissibility.   This is similar to the Nature issue from yesterday.   In addition, he \ndisingenuously mentioned to Amy in the e-mail that he does not want this to be a public \nstatement and does not want it to leak even though he copied about 50 people.   Give me \na break!!!!   See letter below.\nNSABB letter final \n41212.pdf\nReleased by Chairman Rand Paul\n281April, 13, 2012 – It has leaked 12 hours after it was sent.   There is no way that Mike did \nnot know it would leak since he sent it to so many people.   It has appeared on the Nature \nwebsite and in and “Science Insider” article by Jon Cohen.   It is clear to me that Mike \nOsterholm is bipolar.   If you look at the letter, it is crazy.   He keeps referring to \n“anonymous” influenza researchers who are not involved in transmissibility research who \nsay that the research should not have been done.   In the Science Insider piece, Susan \nEhrlich, another NSABB member says that she agrees with Mike.   She is a complete \ngoof-ball, having spoken with her at the NSABB meeting.    Mike goes on in the letter to \nsay that the NIH did not invite any experts on surveillance or non-transmission influenza \nexperts, even though he requested this.   We checked all of the files and he never made \nany such requests.   He asked for a security briefing that said that there was no credible \nterror threat with H5N1.   This is not what he wanted to hear and so he said that the \nbriefing was useless.   BTW, it was given by the CIA and the NIA.   He also states that \naccording to discussions at the March 29-30 NSABB meeting, Ron Fouchier already has \nthe necessary mutations to create a ferret-transmissible virus that do not require passage.   \nSince Mike absolutely knew that this letter would leak, he has egregiously violated the \nconfidentiality agreement of the NSABB.   This together with the paranoid statement of \nMike Imperiale that he was uncomfortable because he thought that the NIAID would not \nfund his grant if he voted to not publish makes me certain that the NSABB as it is \npresently constituted is fatally flawed.   As you can imagine, the press and bloggers are \nhaving a field day with this.   I am astounded that Helen Branswell (Canadian Press) was \nmore interested in why she was not given the leaked document than she was in the fact \nthat the very leaking of the document reflects the craziness of some people on the \nNSABB.\n     This whole process has circumvented our plan to coordinate with the Dutch our \nrelease of the NSABB recommendations since Mike in effect has made public the \n“minority vote” before the actual majority vote to publish. Remember, the committee \nvoted 18-0 to publish the Kawaoka manuscript and 12-6 to publish the Fouchier \nmanuscript.\nApril 14, 2012 – Went over John and Elaine Gallin’s to first have John and I fish in the \nPotomac and then have dinner.   Unfortunately, John backed out of his garage going very \nfast without looking in his rear view mirror and smashed the rear-end of my car.   \nDamages = >$5000.00.  More later.\nApril 18, 2012 – Went to Palo Alto to give the Thomas C. Merigan Lecture at Stanford.   \nGreat day.   Lectured on “Ending the AIDS Pandemic” and had several long Qs and As \nsessions with students, fellows and faculty.   I thoroughly enjoyed it.   Got me out of the \ncraziness of the Washington scene with H5N1 (see below).   Of note, Stan Falkow wrote \nme a terrific note of how amazing I was with the fellows and students.  It was important \ncoming from him since he had been one of the people who were against me 10 years ago \nwhen we began the $1.5 billion biodefense program.   He wrote me an e-mail after the \nMerigan Lecture and said that he knew that I loved my job as NIAID Director, but I am \ntruly a great “professor” and teacher in the classic sense. Several students and faculty told \nme it was the best lecture that they had ever heard there and the best interaction with \nstudents/faculty.   Also, had dinner with Ali the night before at “Cuccina Italiana” in Palo \nReleased by Chairman Rand Paul\n282Alto.   It was great seeing her.   She is amazing – getting great grades in Computer \nScience and rowing stroke on the II Varsity 8 boat.   She is a walk on to the Stanford \nnationally ranked Division I  crew team and last year started on the Varsity 4 and now \nshe is stroke on the II Varsity 8.   Last year and this year she was given a $24,000 athletic \nscholarship.\nApril 13-23, 2013 -   For the past several weeks there has been intense activity regarding \nthe situation with H5N1.   General press not really involved, but Helen Branswell \n(Canadian Press) and Laurie Garrett as well as some bloggers are stoking the flames and \ncoming up with mischief.   USG (NIH/HHS/Amy Patterson) have put together a letter \npoint-by-point countering the crazy accusations in Mike Osterholm’s letter.   Big \ndiscussion at HHS/NSS about whether to have Sec. Sebelius officially accept the NSABB \nrecommendations about publishing the 2 papers.   Out of respect for the Dutch, State \nDepartment wants to wait until the April 23-24 meeting of the Dutch for the \nannouncement.  Real circus → White House (Heidi Avery) want us to release the \nacceptance now; Dutch are now saying that they may not allow Fouchier to resubmit the \nrevised manuscript to Science without an export control license; Fouchier says that this is \nbasic research that is not controlled by export control and so threatens to release it to \nScience anyway.   He can theoretically face a fine and 6 years in jail.   HHS releases \nSecretary Sebelius’s acceptance on Friday afternoon, April 20; however, in order to half-\nway not offend the Dutch, they have Francis Collins announce on the NIH Website that \nthe Secretary has accepted the recommendations of the NSABB to publish without her \nactually saying it.   Meanwhile, the bloggers (Helen Branswell and others) are accusing \nthe USG of releasing it on a slow news time (Friday afternoon).  I know that this is \nclearly not the case since they have been trying to get it out for days, but the bureaucracy \nhas held it up.   I have a Senate Hearing coming up on April 26 where much of this will \nget hashed out.  \n       I am getting extremely stressed by all of this since the really bad outcome would be \nif biomedical research on dual use issues will be severely impeded by somewhat \nhysterical responses to things that really are non-issues.   Most of the people (scientists or \nnot) really do not understand the issues of ferret experiments and their limitations and the \nextremely unlikely possibility of a bioterror attack with flu compared to the importance \nof doing and communicating science to prepare against the natural emergence of \npandemic influenza.\n      \n         Just to reiterate, there have been so many aspects of this “perfect storm” \nsurrounding the manuscripts: 1) Ron Fouchier’s original over-selling the scary nature of \nthis “I have here one of the most dangerous viruses in the world” likely and innocently \ntrying to push his research and the paper. 2) The NSABB amazingly mis-reading the \npapers to believe that the aerosol-transmitted virus actually killed the animals upon \naerosol transmission instead of only after intra-tracheal insertion of 1 million IDs. 3) The \ndemagoguery of Mike Osterholm and his probable bi-polar hysteria leading the \nuninformed NSABB members.   4) The relative lack of influenza expertise of the \nNSABB members. 5) The scientific “hubris” of the influenza community, i.e. Peter \nPalese who believes (correctly) and says (unfortunately) that the non-influenza people are \nclueless. 6) The relative weakness of Paul Keim (good guy) as a Chairperson. 7) The \nReleased by Chairman Rand Paul\n283opportunistic news people (Branswell – Canadian Press and Phil Boffey – NY Times). 8) \nThe occasional incompetency of Amy Patterson in dealing with the NSABB even though \neveryone in the USG thinks that she is doing a great job. 9) The “bioterror-industrial \ncomplex”   who sees bioterrorists everywhere and whose jobs depend on the fear of \nbioterror (Thomas Ingelsby – think tank; Tara O’Toole – DHS; multiple Beltway bandit \ncompanies, etc.).\nApr. 25, 2012 – Went down to Hart Building to brief Sens. Harken and Roger Wicker in \npreparation for their trip to Africa (South Africa and Namibia) where they will visit CDC \nand NIH-funded sites.   Also briefing them were Julia Martin of PEPFAR (Eric’s Deputy) \nand Debbie Birx from CDC.   This is mostly a boondoggle for the Senators.\nApr. 26, 2012 – The heat is still on and the focus high (in some circles) regarding the \nH5N1 issue.   I testified before the Senate Homeland Security and Government Affairs \nCommittee today.   Chair – Joe Lieberman and ranking minority – Susan Collins (R-\nMaine).   Other witnesses were Dan Gerstein (DHS), Paul Keim (NSABB) and Tom \nInglesby (Univ. of Pittsburgh).   Lieberman started the Hearing by stating that I was his \n“hero”.   Paul Keim more and more is making me believe that he is a poor Chair of \nNSABB and a weak person in that he continuously says that Mike Osterholm is off base \nwith his letter to Amy and then he defends him strongly at the Hearing.   He wants it both \nways.\nThe media (mostly bloggers like Laurie Garrett and others such as Helen Branswell) keep \nthinking that the USG is acting in some sort of conspiratorial manner regarding letting \nout information such as Amy’s response to Mike Letter.   In this regard, I mentioned to \nLieberman when he asked about the accusations in Osterholm’s letter to Amy that I \ncompletely disagreed with most of what was in Mike’s letter and that Amy had written a \ncomprehensive refutation of Mike’s points and that I would make this letter available to \nthe Committee if they wished.   The press picked this up to mean that we were releasing \nthe letter to the public.   That was not the case, but eventually ( a couple of days later) \nwhen HHS Legisl. Affairs sent the letter to Lieberman, then HHS released the letter.\nMade nice remarks at Memorial for Frank Neva at the Audubon Society in Bethesda.\nApr. 29, 2012 – Went to Annual Brunch given by John McLaughlin on the roof of the \nHay-Adams Hotel in celebration of the White House Correspondence Ball the night \nbefore.   It has been several years since I was invited to the Ball.   Usual DC celebrities at \nthe Brunch.\nMay 1, 2012 – Partook in NAS Workshop Panel on 20 F Street on H5N1.   This was part \nof the NAS Annual Meeting.  Controversy continues.   At the meeting, Richard Roberts \n(1993 Nobel Laureate and known Gadfly) came to the microphone and said that many \nvirologists who disagree with Francis Collins and me about doing DURC are afraid to \nspeak up because they fear retribution and will not get their grants funded – Holy Shit!!  \nThe epitomy of paranoia.   This is not the first time that I have heard this.   I blew him out \nof the water (nicely) by saying that if anyone has even a slight awareness of the NIH peer \nReleased by Chairman Rand Paul\n284review system, they would know that this was impossible even if we wanted to do this, \nwhich we clearly do not.\nMay 2, 2012 – Went to and spoke at a “Garden Party” at the home of Ellen and Gerry \nSigal in honor of Mark Harrington and the 20th Anniversary of the Treatment Action \ngroup (TAG).   I honored him and reminisced about the activist years in the late 1980s \nand early 1990s.   Also speaking was Peggy Hamburg.\nMay 3, 2012 – Spoke at the Lasker Board Dinner held at the Howard Hughes Medical \nInstitute Headquarters on Jones Bridge Road.   Spoke about H5N1 issue.\nMay 10, 2012 – Met with old friend Ron Dellums (Former Chair of House Armed \nServices Committee and former Mayor of Oakland).   He has retired from politics and \nwanted to chat with me about opportunities in consulting in global Health.   He had come \non the original trip with Tommy Thompson in 2002 to Africa.   I referred him to Stewart \nSimonson.\n     Reviewed data with Ian Lipkin over the phone of study that he coordinated.   Data \nshowed that the prior studies from Judy Vitkovits and Harvey Alter/Shy Lo indicating a \nconnection with XMRV/MLV and Chronic Fatigue Syndrome were in fact artifact and \nthere is no connection.\n     Appeared on The NewsHour interviewed by Ray Suarez on the positive \nrecommendation of the FDA Advisory Committee to approve Truvada as PrEP.\nMay 11, 2012 – Flew to Miami for U of M Commencement and had dinner with \nawardees and commencement speakers for the entire University.   Donna Shalala \n(President of U of M) was my sponsor.   Dinner at amazingly palatial home of Leonard \nand Jayne Abess.   Formerly home of Sylvester Stallone.   Susan Rice (US Ambassador \nto the UN) was also there.   She had given Commencement Address to the Law School \nthat day.  Sat next to Stuart Miller who had donated $200 million to the U of M Medical \nSchool, which is now named after him.   Stayed at Biltmore Hotel in Coral Cables and \nwent on nice long, warm run\nMay 12, 2012 – Received honorary Doctor of Science at University of Miami and \ndelivered Commencement Address.   Beautiful and enjoyable day.\nMay 14-16, 2012 – Megan’s graduation.   Arrived evening of May 14 and had dinner \nwith Meg, Jen, Chris, and Amanda at Gazala restaurant (Israeli) on Columbus Avenue \nand 78th Street.  Great time.   Day of May 15 – Megan’s College of Arts and Sciences \nCommencement.   Megan graduates Summa Cum Laude!!!!   Amazing kid.   Dinner that \nnight at a Vegan restaurant.   Stayed at Denise and Jack apartment.   May 16 – full \nUniversity graduation.   Columbia president Bollinger gave address.   Of note, President \nObama gave commencement address at Barnard 2 days before, much to the dismay of the \nColumbia Community.\nReleased by Chairman Rand Paul\n285May 16, 2012 – Barry Bloom sends me pre-print of Commentary that will appear in \nScience at the same time as my and Francis Collins’ article.   Barry’s co-author is the ever \ncrazy Lone Simonson.   They are proposing that the USG create an Interagency \nCommittee with final authoritative power to decide what DURC experiments can and \ncannot be done.  There really are well meaning people who just do not understand this \nissue and it worries me.   There is a real danger of inadvertently hindering science in \nInfectious Diseases by censoring it.\nMay 17, 2012 – Appeared on “Talk of the Nation” on NPR on the recommendation of \nthe FDA Advisory Panel to Approve Truvada as PrEP and the OraQuick test for HIV.\nMay 18, 2012 – Spoke at the NAS/IOM President’s Circle Annual Meeting on the H5N1 \nissue.   This is still hot among certain circles.   Meeting took place at the House of \nSweden at 2900 K Street, N.W. in Georgetown.\nGave talk to IDSA Fellow at Bethesda Hyatt on “A Career at NIH”.\nMay 21, 2012  - Met with Sanaria people including Steve Hoffman today about an update \non the work he is doing with his vaccine for malaria.\nMay 23, 2012  -  Had a great and moving evening at the Annual Sons of Italy National \nEducation Leadership Awards Gala at the National Building Museum.   I presented a \nscholarship to a student who will be going to Harvard next year.   Various awards went to \ndifferent people.   Hillary Clinton got if for a Lifetime of Public Service and responded \nby video.   Most moving moment of the night was when Tony Odierno (son of Gen. Ray \nOdierno), who lost his left arm in Iraq due to an RPG presented an award to Gen. Peter \nPace, who is a Brooklyn boy and with whom I received the Presidential of Freedom and \nso I know him.  Pete told the story of his first soldier whom he commanded who was \nkilled in action in Viet Nam when Pete was a 22 year old 2nd Lieutenant.  His name was \nLance Corporal Guido Farinaro.   Pete was incredibly moving and mentioned how \nthroughout his entire military career he carried a picture of LCP Farinaro with him.   \nAlso, a little drama at the dinner.   I was called to see and take care of the famous tenor \nMichael Amante who sings often at the Galas.   Mike had recently (3 months) lost his \nwife to a cerebral hemorrhage.   Mike is 49 years old.   He is left caring for 3 children – \n9, 7, and 5 years old.   He is overwhelmingly stressed, did not sleep the night before and \nwas clearly dehydrated.  He is on several meds for hypercholesterolemia and high BP.   \nHe felt woozy and “spaced out”.   I tanked him up with fluids and he responded quickly \nand well.   He resting heart rate went from 88 to 70.   He then sang beautifully and at the \nend of the medley he pointed his finger at me (seated at a Table in the front).  \nMay 24, 25, 26, 2012 – Drove up to Princeton with Chris to watch Ali compete in the \nWomen’s NCAA National Championships.   Ali had recently been promoted from the 2V \nboat to rowing Stroke for the 1V Eight boat!!!!    Stanford had a mishap in the first heat \nwhen their rudder broke.   Ali and her team were not to be put aback.   They had the \nopportunity to row again in the reportage race and came out 1st among 7 boats and so \nentered the semi-finals.   Their time of 6 min. 47 seconds was their best time yet this \nReleased by Chairman Rand Paul\n286year.   Unfortunately, they missed out in the semis even though they broke their own time \nrecord by rowing a 6 min. 22 second race.  They were in a heat with the top 3 teams in \nthe country – Virginia, Cal, and USC.   She rows tomorrow in the “petite final”.\nMay 30-31, 2012 – Went to NYC  to give Commencement Address at Brooklyn College \nand receive an honorary degree.   Bright sunny day.   I lot of déjà vu driving from \nManhattan to Brooklyn through Atlantic Avenue and then Bedford Avenue.   God bless \nBrooklyn College, they tried (for the first time in their history) have all 1600 graduates \nfrom all of their schools come on the stage to shake the hand of the President – Karen \nGould.   My co-recipient of an honorary doctorate was the jazz legend Cecil Taylor, a \nfeeble old man, but very gentle.   Sen. Chick Schumer came and said a few words to the \ngraduates.  Brooklyn Borough President gave a hilarious speech about Brooklyn.   Had \ndinner with Jenny the night before.   Went to Kefi restaurant on 85th and Columbus \nAvenue.   I never really appreciated the West Side of Manhattan when I lived for so many \nyears on the East Side.   Jenny is an amazing young woman who is trying to figure out \nwho she is and what she wants in life.   She is currently a graduate student at Teachers \nCollege of Columbia University getting a Masters in Developmental Psychology.\nOn May 30 right before I left for NYC, CNN’s Wolf Blitzer’s producer called and said \nthat Wolf wanted me on CNN Situation Room to discuss a recent paper by Peter Hotez \n(formerly of GW and now at Baylor) who wrote a paper in PLoS  journal saying that \nChagas disease was the new HIV/AIDS.   I like Peter, but I had to contradict this \npotentially misleading statement.   I could not appear live and so CNN did a telephone \ninterview and showed me testifying at a Congressional Hearing at the same time that they \nplayed my voiced interview.   Nice trick.\nJune 1, 2012 - NIAID had our annual spring policy retreat at the Hilton Hotel in \nRockville which was a meeting between our group and the Bill and Melinda Gates \nFoundation (BMGF) in order to determine possibilities of strengthening current \ncollaborations and forging new collaborations.  Present at the meeting were the senior \nleadership of the Institute together with Trevor Mundel (President of the Global Health \nProgram for the BMGF), Nina Russell, Dan Hartmann, Chris Wilson and Jan…..   The \ndiscussions went very well and I feel that our collaborations will strengthen.   I was \nimpressed by the sincerity of Trevor.\nIn the early evening, paid tribute to Ed Tramont at a symposium in his honor at the \nUSUHS across the street from NIH.    Tornadoes and thunderstorms hit the DC area \nduring the late afternoon and early evening.\nJune 9, 2012 – Went with Chris to Annual Garden Party at the home of Jamie Gorelick \nand Rich Waldron.   Usual good time with the usual Washington elite there, i.e. Ruth \nMarcus, Chris Matthews, etc.  Always good to see Jamie and Rich.  Wonder whether \nJamie will ever get back into USG.\nJune 12, 2012 – Had dinner over my house with the 3 week-day bachelors (i.e. their \nwives live and work in different cities): Harold Varmus (Connie in NYC); Gary Nabel \nReleased by Chairman Rand Paul\n287(Betsy in Boston); and Eric Goosby (Nancy in San Francisco).   I served a Ziti pasta with \ngrilled shrimp and tomato sauce.   Had great time – good friends all.\nJune 14, 2012 – At the invitation of Larry Kramer, I attended the “official” opening of \n“The Normal Heart” at the Arena Stage Theater.   Had dinner with Larry and NYC and \nDC theater notables in the absolutely beautiful new atrium in the new Arena Stage \n(totally different from when Chris and I had season tickets decades ago).   The play was \namazing – truly moving.   Had reception afterwards and met the cast and the Director \n(George C. Wolfe) who, according to Larry, is the top Director on Broadway today.\nJune 15, 2012 – Went to a cocktail reception honoring Larry Kramer at the home of Don \nand Ann Brown at 3005 Audubon Terrace, N.W.; Washington, DC).   Ann is a childhood \nand high school friend of Larry from when he lived in DC.   Larry went to Woodrow \nWilson High School.   Amazingly elegant home.   Brought Chris as well as Megan and \nAli, who was in DC for 3 days between Stanford (just finished her exams) and Seattle \n(summer job with Microsoft).   Also met Larry’s partner – David Webster – really nice \nman.  Good that Megan and Ali and Chris got to see Larry.   I explained to Meg and Ali \nwhat an iconic and controversial figure Larry was and is.\nAlso, for past months I have been preparing for and putting together my Plenary Talk for \nthe IAS on July 23.   Need to get it done since I go to the big Harrison’s meeting in \nMartha’s Vineyard for 9 days right before the IAS meeting and need to get my talk \nfinished and out of the way before I go to the Vineyard.\nJune 22, 2012 - In Boston today to participate in the 200th Anniversary Celebration of the \nNew England Journal of Medicine.   I had been asked to write one of about 12 articles \nover the year 2012 (NEJM started in 1812) summarizing the advances in a given field.   \nObviously, my assignment was Infectious Diseases.   My article came out a few months \nago – co-author was David Morens.   The symposium today was reflection on 30+ years \nof HIV.   I gave the opening overview lecture and then there were comments from David \nHo, Bob Massie, Beatrice Hahn, and Paul Farmer.   Moderator was Marty Hirsch and \nPanel discussion followed.   Held at Joseph Martin Auditorium across the street from \nHarvard medical School on 77 Louis Pasteur Avenue.   Hot, hot June day over >95 \ndegrees.   Nice conference.   Audience filled with medical students from all over the \nworld who won essay-writing competition.\nJune 28, 2012 – Supreme Court with Chief Justice Roberts pulling an amazing maneuver \nactually confirms the constitutionality of the Affordable Care Act, but calls the Individual \nMandate a “tax”.  Everyone thought that he would be the deciding vote against, but he \nwas the deciding vote for the Law.  Nonetheless, by calling the mandate a “tax” he makes \nObama look bad since Obama has always insisted that it was not a tax.\nJune 29, 2012  Had a historic thunderstorm with winds up to 80 to 90 miles an hour on \nthe night of June 29. Major power outages were experienced throughout the area. No \nmajor damage to my house but again we have several days and up to a week of power \noutages.  Incredible how PEPCO can let outages go for 1 week.\nReleased by Chairman Rand Paul\n288July 3, 2012 – Saw “Normal Heart” again at Arena Stage.  Wonderful play.   Many \npeople in audience recognized me and thanked me for my work.\nJuly 9-18, 2012 – Went to Martha’s Vineyard (MV) for the “Big” meeting of the \neditorial Board of HPIM-19 with the McGraw-Hill people.   Great meeting, great \nweather.   Chris and Megan came for 2 days on July 14-15.  Went sailing with Dennis \nKasper on his boat on July 14.  Great time. Democratic National Committee also has \nmeeting on island.   Met and chatted a few times with Sen. Sherrod Brown (D-OH).   \nGood guy.   I know him for years.\n     Left 1 day early.  July 18, 2012.  Good that I did since at the airport at MV I got a call \nfrom CNN that Wolf Blitzer wanted me on the show tonight to discuss the FDA approval \nof Trivia as Prep   I accepted and had a scare since the plane took off late from MV and \nthen circled DCA for 25 minutes before landing.   I had intended to go home and change \nfirst from my casual clothes to TV clothes.   However, there was no time and CNN send \nlimo to airport to pick me up and go directly to CNN studio for the live shot.   Had just a \nfew minutes to change into shirt and tie.   All went well. Also did WTOP News, local \nChannel 9 TV, and ABC radio.   Looking forward to IAS meeting in DC this coming \nweek.\nJuly 20 – 28, 2012 – Most amazing week leading up to and during the XIX International \nAIDS Society (IAS) Conference. 25,000 people attended (largest AIDS meeting in \nhistory). I am including as an attachment my schedule for this week and I will comment \nbelow on some salient issues.\nASF DC 2012 FINAL \nSchedule - July 27.do\nTruly amazing.   The theme of the meeting was “Turning the Tide Together”.   I \nDelivered the Opening Scientific Plenary Lecture on Monday, July 23, the morning after \nthe Opening ceremony (see below).  My talk was entitled: “Ending the HIV/AIDS \nPandemic: From Scientific Advances to Public Health Implementation”.   The DC \nConvention Center main lecture hall was packed with approximately 10,000 people.   It \nwas one of the best Plenary Lectures that I have ever given and I have spoken as a  main \nspeaker at every one of the 19 IAS meetings.   The number of kudos I got regarding my \ntalk was incredible.   The amount of press coverage of the event was astounding.  Jon \nCohen did a feature on me in Science that came out right before the meeting started and \neveryone was talking about it.   It was a story he wrote after spending an entire day with \nme at NIH.  In addition, there were several articles that I wrote (usually with Greg \nFolkers) that came out right before or during the meeting such as a piece in Health \nAffairs, JAMA, JAIDS, etc.   In a separate piece in Health Affairs, John Donnelly wrote a \nhistory of PEPFAR and described my involvement.   He also interviewed Mark Dybul \nand Mark made it seem that he played a greater role at the White House level than he \nreally did although Mark’s role behind the scene was incredibly important during the \ncreation of the blueprint for PEPFAR.   But, who cares?   It was a good article although \nGary Edson got pissed off at it when he saw it since he knows exactly how PEPFAR \nReleased by Chairman Rand Paul\n289happened. Gary sent me an e-mail saying there were only 2 important people for \nPEPFAR – me and pres. Bush.    There was major Press and very interesting and \nentertaining social events.\n A few comments on my Press appearances:  CNN with Wolf Blitzer (The Situation \nRoom) on July 16 (days before the meeting started) associated with the FDA approval of \nTruvada for PrEP; Diane Rehm Show on July 24 (day after my Plenary); Op-ed by me in \nthe Washington Post on the last day of the meeting (Friday July 27); MSNBC with \nAndrea Mitchell on July 27; Bloomberg News on July 24.  Also, about 30 appearances on \nblog videos.  Also, multiple radio interviews (CBS, ABC, NPR, etc.)  Mentioned in NY \nTimes Editorial the day after the meeting. On Tuesday, July 24, spoke at panel at \nWashington Post for 1 hour.\nWith regard to the social events, it was amazing.   At a ONE –sponsored event at the \nEisenhower Theater at the Kennedy Center on July 21 (night before the opening of the \nmeeting), I was asked to give a few remarks from the stage concerning an AIDS-Free \ngeneration.   I paired up with Kay Warren, wife of Rick Warren the pastor of Saddleback \nChurch.  Others who presented to the audience and whom I interacted with and talked \nbackstage were:   Alysia Keyes, Annie Lennox, Herbie Hancock, Nancy Pelosi, \nCongresswoman Barbara Lee, among many others.  Annie Lennox gave a smashing \nrendition of her classic song “Sweet Dreams”.  Right before that, I was invited to an \nAwards Dinner hosted by AMFAR for Bill Gates (I also had a 1-on-1 meeting with Bill \non Monday, July 23).  At the dinner, I met and chatted with Anderson Cooper, Sharon \nStone among others.   During the Opening Plenary Session, I led it off, followed by Phill \nWilson of Black AIDS Institute, followed by Hillary Clinton.   \n      Big deal social event (July 24) that I really enjoyed was reception given by Open \nSociety Foundation and Syringe Access Fund at the Open Society Foundation D.C. \nHeadquarters in honor of Elton John.   I had never met Sir Elton, but he specifically \nrequested that I introduce him at the reception together with his partner David Furnish \nwho is Chairman of the Elton John AIDS Foundation.   Got great pictures of Elton and \nme and he was very moved by my introduction.   I had just finished reading his new book \n:Love is the Cure” focused on how his relationship with Ryan Whyte turned Elton’s life \naround for good as he was at the time an egregious cocaine addict and alcoholic and \nbulimic.   He has been clean for 22 years.   Really nice guy who clearly understands what \nI have done.\n    Signed Letter of Intent with the French (Jean Francois Delfraissy and Yves Levy) for \ncollaboration on a “cure” on Monday, July 23.   Parenthetically, the cure people at the \nmeeting were really egregiously promoting their results with “flushing out the virus” \n(David Margolis from UNC and Steve Deeks from UCSF).   Margolis used to be at \nNIAID and he really in barely mediocre and is using the enthusiasm for a cure as a means \nto get new money. Their over-exaggeration is really pissing me off.\n     Thursday, July 26 – called to White House by Heidi Avery for a different issue.   I am \ngoing to NYC for the Centers of Excellence for Influenza Research and Surveillance \n(CEIRS) meeting of influenza scientists to discuss the lifting or not of the moratorium on \ngain-of-function work on transmissibility/pathogenesis of H5N1 (see above).   White \nHouse, including the POTUS is concerned about a misleading story by Nell Greenfield \nReleased by Chairman Rand Paul\n290Boyce of NPR that said that I was going to expedite the lifting of the moratorium at the \nNYC meeting and the White House is worried that people will react to my “rushing” \nthings.   I told Heidi that this was nonsense and that in the NPR interview I meant that I \nwanted to expedite a conversation among the flu scientists to try to make their case, but \nthey are not the only voice.   We need input from the general public, other non-flu \nscientists, biosecurity and biosafety people and the global community before we again \nembark on experiments that some in the rest of the world may perceive could endanger \nthem without input from them.   Bottom line is that I told Heidi that I was going to \nrecommend to the CEIRS scientists NOT to lift the moratorium.   I suggested she tell the \nWH staff and the POTUS not to worry and that I will not sanction lifting the moratorium,\nAlso on July 26, Pres. Obama held a reception at the White House East Room for \nHIV/AIDS “players” and stakeholders.   I went straight from Heidi’s office to the East \nRoom.    Obama gave his usual pep talk.  Of note, he thanked the usual people (Pelosi, \netc.) and also Eric Goosby (clearly deserved it) and Grant Kolfax the new WH AIDS \ncoordinator who has been on the job for a couple of months.   The POTUS speechwriter \nclearly is out of touch since he did not call me out is his speech to the amazement of \nmany in the room.   However, as Obama looked around the room as he was talking from \nnotes, he saw me and clearly recognized me, but obviously could not remember my name \nand so stuttered a bit apart from his notes and thanked “people from NIH for their good \nwork”.   I do not blame him for forgetting my name but his staff clearly is out of it.   \nSpeaking of names, Bush never would have forgotten.   Just shows Obama’s weak \nconnection to the AIDS issue.   But, to his credit, as he walked the “line” shaking hands \nafterward, he shook my hand and pointed to me saying “nice job”.   Whatever….\nAll in all a truly amazing week.   Weather was sunny and hot all week.   No rain; typical \nsunny, hot DC week.\nJuly 31, 2012 – Controversy continues regarding CEIRS investigators and the \n“moratorium” on H5N1 research (see immediately above meeting with Heidi Avery).   I \nwent to NYC to the Marquis Marriott Hotel on 46th and Broadway to address the \ninvestigators of the CEIRS (Centers of Excellence on Influenza research and \nSurveillance).   We opened it to the Press and NPR (Nell Greenfield Boyce) and Science \nand Nature were there.   I insisted that my presentation (25 minutes) be fully recorded as \nwith the Qs and As so that there would be no misquotes.  I made a firm argument for \ncontinuing the moratorium.   The usual people opposed it such at Ron Fouchier, Danny \nPerez, Peter Palese; however they respected my opinion.   They still do not “get it’ and \nthink with all the public furor that they can just go on and do these DURC experiment \nwithout full public by-in and comment.   See my written remarks file for July 31, 2012.   \nAlso, I got great kudos from many investigators (see Arturo Casadevall’s e-mail below).   \nAlso, great stories in NPR radio the next AM (Aug. 1) and in various blogs and Science, \nNature, etc.\nFrom:  Arturo Casadevall [mailto:arturo.casadevall@einstein.yu.edu] \nSent: Tuesday, July 31, 2012 1:29 PM\nReleased by Chairman Rand Paul\n291To: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Awesome speech at flu meeting\nDear Tony,\nI feel bad adding one more line to your inbox but I must tell you were terrific today – \nclear, powerful, articulate, logical.  My ‘take’ is that it was a very successful \npresentation.  You are a great scientist and public servant.  It is an honor to know you.\nArturo\nArturo Casadevall MD, PhD\nProfessor and Chair\nLeo and Julia Forchheimer Chair\nDepartment of Microbiology & Immunology\nAlbert Einstein College of Medicine\n1300 Morris Park Ave\nBronx, New York 10461\nAugust 31, 2012 -   Slow month of August in D.C. Summer.   On Aug. 8, 2012 did a \n“Science in the Cinema” performance at the AFI Theater in Silver Spring with Ian Lipkin \nfor the movie “Contagion”.   Fun being with Ian.   Always a character.\nProblem over past 2 weeks with the PR associated with Klebsiella pneumonia – \ncarbapenam-resistant organism (KPC) in the NIH Clinical Center.   The Clinical Center  \n(CC) and NHGRI people published a paper in Science Translational Medicine on the \ngenetic analysis by deep sequencing of a KPC the originated from an index case in the \nCC and then infected spread by people or fomites to 17 other people in the CC – 11 \ndeaths – 6 from KPC bacteremia.   The PR people at CC did not handle it well.  They got \nso absorbed in the science of the paper that they did not realize that the community \nreaction would be “Why did not anyone tell us about this outbreak – even though there \nwas no actionable information here since the organism does not bother healthy people \nand the man-on-Wisconsin Avenue is at no risk.\nAug 15 to 25, I had bad URI with fever and malaise that took 2 weeks to resolve.\nOver the past few weeks, I have become enamored/obsessed with the Washington \nNations baseball team.   I feel like I felt when I was 12 years old and knew the batting \naverages of all of the N.Y. Yankees.   The Nats are 7 ½ games in first place and they have \nthe best pitching staff in baseball – Steve Strasburg, Gio Gonzales, Jordan Zimmerman, \nRoss Detwiler, Erwin Rodriguez.   There hitters are amazing.   Bryce Harper (19 years \nold) is pounding the ball and he runs and throws and fields like Mickey Mantle.   Also, \nJason Werth, Adam La Roche, Ryan Zimmerman, Michael Morse, Ian Desmond, Danny \nEspinoza – all very good hitters.\nReleased by Chairman Rand Paul\n292Sept. 7, 2012 -  As part of the kick-off of the “Celebration of Science” weekend here in \nD.C. and at NIH sponsored by Michael Milken, I was on a 2 man panel run by Greg \nSimon, formerly of  Faster Cures”.   The panel (filmed for TV) was on the science and \nreal world of HIV/AIDS.   My co-panelist was Magic Johnson.  It was a fun experience.   \nHe is a wonderful guy with an amazingly infectious smile.  He commented to the \naudience during the panel that he wanted to go on a “road show” with me since I explain \n“stuff” so well.  He said that I “…really get it and can speak to the common man”.  We \nspoke about basketball and baseball. We spoke about our children. His son is at NYU, \nand loves NYC as do Jenny and Megan.   He has another son who works for him in his \nCompany/Foundation.  His daughter is a High School student in L.A.   He is part-owner \nof the L.A. Dodgers and we spoke about how good the Washington Nationals are this \nyear (see above).\nSept 8-12, 2012 – The past few days have been very intense, but exciting. Following the \nCelebration of Science meeting in Washington DC,  I immediately went up to Boston to \ndeliver the opening plenary lecture at the 2012 AIDS vaccine meeting. It was extremely \nwell received.  Following my talk Gov. Deval Patrick got up and welcomed the audience \nto Boston and made the comment that it was an honor to be on the same stage with Dr. \nTony Fauci and the thanked me for my service to the country.\nOver the past few days that has been continued activity concerning the dual use research \nof concern issue particularly regarding highly pathogenic H5N1  influenza virus.   I had a \nconversation with Heidi Avery of the National Security Staff on September 12 during \nwhich she encouraged me to continue to try and find the right balance between safety and \nsecurity as well as the benefits of doing such research. Heidi has always been a very good \nfriend to me and she informs me that she will be leaving the national security staff to go \nback to her major post at the CIA.  We have a major meeting coming up in December, \n2012 to discuss the moratorium on H5N1 research. This should be an important meeting \nto set general principles of the types of research that should or should not be done.   I \nhave really enjoyed working with Heidi over the past few years.\nSept. 12, 2012 -  Conversations with Heidi Avery continued – Heidi called my office \nwhen I was out running on an absolutely beautiful September day.   My office contacted \nme and I came up to office and called Heidi with my running clothes on.   Bottom line is \nthat Heidi re-confirmed her strong feeling that the NSABB or any other advisory body \nshould not be dictating to the USG what we can or cannot do, particularly when it comes \nto national security.   She wanted to emphasize that she does not want NSABB making \nany pronouncements about the general “straw man” principles about what H5N1 \ninfluenza research should or should not be done.   When I explained to her how the \nNSABB (which is scheduled to meet in October) was insistent that they determine the \nprinciples, Heidi was adamant.   She finally said (in good spirits since we are good \nfriends) that no way did she want any pronouncement about the general principles about \nconducting research (particularly from Mike Osterholm – she has his number) from the \nNSABB BEFORE THE NOV. 6 ELECTION.  I told her that I understood.   This will \nreally be dicey since we have to figure out a way out of the October NSABB meeting \nand/or a way to get them off this subject.   Heidi also confided in me that Leon Panetta \nReleased by Chairman Rand Paul\n293really wanted her back at CIA for a “special assignment”   (remember, she was counter-\nterrorism before coming to NSS).   Also, I finally told Heidi that there is definitely a \ndirect leak from IPC (likely Kris Beardsley) to Mike Osterholm.   Heidi said she knew \nthis all along and she knows exactly who it is, although I am not entirely certain.   More \nlater, since we now have to decide whether to cancel the October NSABB meeting which \nwill cause an uproar among some of them or take the chance of their coming up with \nsomething that Heidi does not want to see happen.\nSept. 15, 2012 – Exceptionally pleasant and enjoyable evening.   Bob and Deborah Seder \ninvited Chris and me to join them for the Bruce Springsteen concert at Nationals \nStadium.   He arranged an amazing group of 10 people for the event.   It included Bob \nWoodward and his wife Elsa Walsh, a couple Christen (executive director of the Four \nSeasons Hotel in DC) and his wife Meg (? last name), Bob (very wealthy entrepreneur) \nand wife Alison (? Last name) Bob and Deborah, Chris and me.   We met at Café Milano \nand had a great meal; a van took us to Nat’s Stadium and back.  The concert was truly \namazing.   Springsteen and his E Street band gave the best musical performance that I \nhave ever experienced.   We had seats on the infield right in front of the stage that was set \nup on where the outfield is for baseball games.   However, we did not sit since everyone \nwas standing.   Springsteen played for 3 hours and 45 minutes without stopping for a \nminute.   He went from one song to another.  The crowd absolutely loved it.   It was a \nbeautiful “Indian Summer” evening at around 70 degrees.  Got to know Bob Woodward \nwith prolonged conversations about what I do and what he does.  He feels passionate \nabout what he wrote in his latest book (came out this week) entitled “The Price of \nPolitics”.   He is a good guy and it was fun getting to know him.\nSept. 18, 2012 – Pleasant surprise.   Received an inscribed copy of Bob Woodward’s new \nbook “The Price of Politics” with a note written in the first page – “To Tony Fauci and \nChristine Grady – What a great night it was! – With greatest regards, Bob Woodward”.\nSept. 19, 2012 – Received “The Starlight Award” together with Roy Vagelos from the \nChildren’s Inn at NIH.   I received it for the “Science” and Roy for his extraordinary \ninfluence on building of the Inn in 1990 with Merck money when he was at the time the \nCEO of Merck.   Ceremony held at the Liaison Hotel at 415 New Jersey Avenue, N.W.  \nMany notables from Congress and entertainment at the event.  To name a few:   \nCongressmen Chris van Hollen, John Dingle, Barney Frank, Doris Matsui; Sens. Frank \nLautenberg, Roy Blunt; TV Anchor Gordon Peterson.   MC was Cokie Roberts.  Twenty-\neight year old former AIDS patient Hydeia Broadbent gave speech and I was praised for \nhelping to develop the drugs that saved her life when she came to the Inn and NIH at age \n6 years old with advanced AIDS and now she is healthy and happy – many tears in the \naudience.\nSept. 25, 2012 – Meeting in the Situation Room of the White House (1:30 to 3:00 PM) \ncalled by Heidi Avery.   Discussed the issues around DURC and how we are going to \naddress the voluntary (on the part of the scientists) moratorium on gain-of-function for \ntransmissibility in mammals research on highly pathogenic avian  H5N1 influenza.   We \n(ASF, May Patterson, Francis Collins, Larry Tabak and the HHS crew led by Sally \nReleased by Chairman Rand Paul\n294Howard,  Chief-of-Staff to Sebelius and Bill Corr, Deputy Secretary, HHS)  have been \nworking for several weeks on a meeting-working group-consultation (to take place \nhopefully in December, 2012) to develop principles for making decisions regarding \nfunding  (mostly by HHS) for these types of H5N1 experiments.   These principles could \nthen serve as the basis for guidelines for DURC that go well beyond H5N1.   The \nEuropeans (mostly the Dutch with Ron Fouchier) want to end the moratorium now.   I \nhave written a commentary to appear soon in mBio (online Journal of the ASM) that asks \nfor keeping the moratorium on H5N1 gain-of-function until the abovementioned \nDecember meeting.   The NSABB people, particularly Mike Osterholm, Mike Imperiale, \nand David Relman are continuing their somewhat hysterical comments in and out of the \npress about how dangerous these experiments are and how they should never be \nperformed.   \n     Heidi is adamant that they could be very important to do these experiments for the \nnational security and she does not tolerate any “advisory group” such as NSABB \ndictating to the USG what it can or cannot do in the line of National Security.   I love \nHeidi; she is a tough CIA operative and unfortunately for us will return to the CIA soon.  \nShe confided this to me a week or so ago.   Apparently, Leon Panetta has some important, \nsecret assignment for her.   As always, she e-mails me or calls me after an important \nWhite House meeting to get my take on it.   I am inserting below an e-mail she sent me \n(10:15 PM – Sept. 25, 2012) the evening after the White House meeting:\nTony,\nJust to say thank you for your time today, along with your NIH colleagues.  I am very \nsorry for how tedious parts of the discussion became.  We were not all on the same page \nbefore the meeting.  Hopefully you agree we identified a path forward.  I will not be \naround to see this through, but very much hope success is achieved in terms of HHS \nguidelines enabling researchers to be comfortable moving forward with this important \nwork.  Really is a national security imperative.\nBest regards, Heidi\nSept. 27, 2012 – Attended World Leaders Forum at the Low Library at Columbia \nUniversity.   On a panel with Wafaa El-Sadr, Eric Goosby and Michel Sidibe (Director, \nUNAIDS).   Very enjoyable.   Jenny attended.   Discussed the potential end of AIDS.\nOct. 6 – 10, 2012 – trip to South Africa mainly to participate in the opening of the \nKwazulu-Natal Research Institute for TB and HIV (K-RITH) in Durban.   Flew to \nJohannesburg and gave special lecture on Ending the AIDS Pandemic to the University \nof Witwatersrand.   Then drove to Pretoria to participate in the 10th Anniversary of the \nPHIDISA project with the South Africa National Defense Force (SANDF).   This \nprogram largely championed by Cliff Lane.   Then flew to Durban to Open the K-RITH.  \nAmazing architecture of the new building.   Many luminaries present at the opening – \nRon Daniels (Pres. of JHU), Pres. Of Mass. General, Rob Tjian – President of HHMI \nReleased by Chairman Rand Paul\n295who funded the project.  NIAID funds Bill Safai (PI of KRITH).   Great dinner at the \nOyster Box Hotel.  I gave some after dinner remarks.\nOct. 12, 2012  - Lunch at the Italian Ambassador’s (Amb. Bisogniero) home (Villa \nFirenze) on Albermarle Street, N.W.   Lunch in honor of former Italian Ambassador, now \nForeign Minister of Italy Giulio Terzi di Sant’Agata.   \nOct. 15, 2012 - Attended the Elton John AIDS Foundation Benefit Gala at Cipriani’s \nRestaurant on Wall Street by special invitation of Sir Elton John whom I had met at the \nIAS meeting in DC in July, 2012.   The entertainment by Stevie Nicks was amazing.   \nMany people came up to me thanking me for my work.   Most of these I had never met \nbefore.   Heavy representation of donors and business luminaries.\nOct. 16, 2012 – Spoke at the Annual Meeting of the Institute of Human Virology (Bob \nGallo’s Institute) held at the Marriott Waterfront Hotel in Baltimore.   Took train from \nNYC (Elton John Gala) directly to Baltimore.\nOct. 17, 2012 – Participated at the National Press Club in the launching of the WHO \nGlobal TB Report.   Panel moderated by Jeanne Meserve (old friend from CNN, now \nwith WTOP) and neighbor.   On panel was Mario Raviglione (WHO), Ken Castro \n(CDC), someone from USAID, someone from PEPFAR.\nOct. 18-19, 2012 – Went to Cornell Medical School Reunion and gave Keynote Lecture \non Ending the AIDS Pandemic.   Went up night before (Oct. 18) and had dinner with \nJenny at Gazala Restaurant.   Great time with her.   On the evening of Oct. 19, had class \nof 1966 reunion dinner at Nino’s Restaurant on 1st Avenue between 72 and 73rd Street.   \nReally great to see some of the old crew, many of whom have retired.   They were all \nvery gracious in saying how proud they were to have been my classmates.   Great to see \nPatty Downs, Suzie Stewart, Mark Kaplan, Mike Dosik, Dave Fraser, David Tucker, Jim \nMcSweeney, Carmine Bedotto, Frank Duggan, Randy Bell, among many others.\nOct. 23, 2012 – Met with Howard Koh (Assist. Sec. for Health) and Deputy Ron \nValdesarri in my conference room 7A-24.  They wanted to discuss and were actually \nputting pressure on me/us at NIH to put together a guidelines panel for treatment of HCV.  \nThey clearly are getting pressure from constituents.   Since we (NIH) have done such a \ngreat job on the HIV treatment guidelines for HHS, they wanted us to do the same for \nHCV.   Problem is that if we start doing guidelines for HCV, then other diseases would \nwant us to do guidelines and we should not be in the guidelines business.   Howard was \nfriendly and somewhat fawning over me.   Ron Valdesarri in my opinion is somewhat of \na jerk.\nOct. 26, 2012 – Participated in a panel on Global Health and award ceremony at \nGeorgetown.   Mark Dybul was given the Timothy Healy Award.   Panel consisted of me, \nMark, Eric Goosby and Barbara Bush (daughter) with Marty Federov moderating.   Good \ntime and enjoyable to do this with good friends.\nReleased by Chairman Rand Paul\n296Oct. 27, 2012 – Spoke at Panel of the Annual Meeting of the Academy of Achievement.  \nPanel held at Top of the Hay Adams in the Hay-Adams Hotel.   I led off the panel \nspeaking on Ending the AIDS Pandemic and an AIDS-Free Generation.   Followed by \nPulitzer Prize winning Poet Louise Gluck   and Nobel Laureate Roger Tsien.\nNight of Oct. 27 went to Gala Dinner of the Academy at the Willard Hotel – Reception is \nCrystal Room; Black Tie Dinner in Willard Room.  Typical classy Catherine and Wayne \nReynolds Affair.  Great entertainment topped off by Aretha Franklin.   Again, Catherine \nand Wayne gave Chris and me the best tables right in front of the stage.   Usual terrific \nguests.   Wolf Blitzer MC’d.  Colin Powell was dancing on stage with Aretha Franklin.   \nLots of fun.  At my Table – Chris and Kathleen Matthews, Bill Cohen and wife Janet \nLanghart; current USA Poet Laureate Natasha Threthewey, economist (?) and his \ngirlfriend Heather Hughes (29 yrs old and amazingly beautiful and friendly), Attorney \nGeneral Eric Holder and wife Dr. Sharon Malone.\nOct. 29, 2012 – Beginning of monster hurricane “Sandy”.   Supposed to be the worst \nstorm in memory with convergence of a true Atlantic Ocean Hurricane with a Nor-Easter \ncoming from Canada and the West.   All airports (DCA, IAD LGA  Kennedy, etc) and \npublic ground transportation (Amtrack, METRO, NYC subways) up the entire East Coast \nof USA pre-emptively closed prior to the storm.   Storm scheduled to peak here in DC \ntonight and into tomorrow.   I came to work since there is an almost 100% chance that \nmy house will lose power since even lesser storms cause power outages in my \nneighborhood.   Likely will sleep here at NIH tonight.   Stay tuned……\nOct. 30 – Nov. 3, 2012– “Sandy” totally devastated parts of the East Coast, particularly \nNYC and New Jersey shore.   One of the worst, if not the worst “natural” disasters to \nstrike NYC.   Wall Street under water.   Flooding of the Brooklyn-Battery tunnel and all \nNYC subway tunnels.   Con Ed plant exploded and all of lower Manhattan without \npower.   Had to evacuate Bellevue-NY University Hospital.  Atlantic City destroyed.   \nTruly historic.\nNov. 6, 2012 – As I had predicted over and over again, Obama won re-election handily \nwith 330 electoral votes.\nNov. 7-8, 2012 -   Went to San Francisco to give Keynote at 25th Anniversary of CFAR \nand 25th Anniversary of FDA approval of AZT.   Great trip. Went to Stanford during the \nday to see Ali before going to SF.\nNov. 19, 2012 – Appeared on ABC’s ONLINE TV show hosted by Christianne \nAmanpour on the subject of the ongoing dengue epidemic in India as well as in Madeira \nand Puerto Rico.   These ONLINE shows are fast becoming the new type of news outlets.   \nA cross between regular TV and a blog.\nNov. 27, 2012 – I present the C. Everett Koop HIV/AIDS Public Health Leadership \nAward to Rep. Henry Waxman at the Mayflower Hotel.   The award is given by the \nForum for HIV/AIDS chaired by Veronica Miller.   I gave a nice laudation with slides \nReleased by Chairman Rand Paul\n297praising Henry who has become an old “warrior” friend of mine over the years.   I have \ntestified before Committees that he either chaired or was minority about 25 times over the \npast 28 years.   He was very appreciative of my presentation.\nNov. 29, 2012 – Big day today.   It was the official celebration of World AIDS Day \n(WAD) and there was a celebration at the State Department from 10:30 to 11:30 AM.   \nHillary Clinton unveiled the “Blueprint” for PEPFAR to end the AIDS Pandemic.  It took \nplace in the Franklin Room of the State department.   She called me out from the \naudience and thanked me for being the scientific leader that got us to where we are.   \nBeautiful chilly Fall day with bright sun.\nAfter the State event, went to the White House to celebrate WAD.   Program of several \nspeakers.   I was the final speaker giving a talk about the scientific basis of being able to \nend the AIDS pandemic.   Extremely well-received.   Other speakers include:  Valeria \nJarrett; Michel Sidebe; Eric Goosby; Sec. Sebelius; a panel chaired by Rosie Perez.\nNov. 30, 2012 -   Viewed a screening at the State Department of the acclaimed movie \n“How to Survive a Plague” about the HIV activist movement.  Host was the director of \nthe movie, David France.  After the movie I was on a panel with Mark Harrington and 2 \nothers to discuss the movie and answer questions from David France who moderated and \nfrom the audience.   Went very well.   Have seen the movie before, but it still brings me \nto tears.   I was seen several times in the movie looking extremely young from the 1980s.   \nAlso, very poignant features of Peter Staley, Mark Harrington, David Barr, Spencer Cox, \nJim Eigo, Larry Kramer and many others from “the old days”.\nIn the afternoon I taped a World AIDS Day segment that showed that evening on the PBS \nNewsHour hosted by Ray Suarez.   I thought that it was one of the best segments that I \nhave done . \nDecember 1, 2012  - had dinner over Mark Dybul's home on Wallach Place in northwest \nDC together with Chris Grady,  Jason Claire, Kristen Silverberg (former assistant to \nPresident George W. Bush and an old friend of mine from that administration (see above \n(2002) and her husband, and other guests. We celebrated the appointment of Mark to be \nthe executive director of the Global Fund for AIDS, Tuberculosis, and Malaria. \nDecember 3, 2012 - had a town hall meeting with the Vaccine Research Center principal \ninvestigators and other staff to reassure them that they have nothing to worry about \nrelated to the departure of Gary Nabel to Boston to work at Sanofi. Gary left the VRC \nsolely because his wife Betsy Nabel took the job 3 years ago as President of the Brigham \nand Women’s Hospital in Boston.   Gary has been commuting ever since to be with her \non weekends and it is wearing him out.   Unfortunately, Gary is leaving the best job in the \nworld at the VRC and he has done a spectacular job.   He is clearly damaging his \nscientific trajectory of his career by making this move.  I told them (the VRC PIs)  that I \nwas extremely satisfied with the performance of the VRC and would do everything in my \nReleased by Chairman Rand Paul\n298power to maintain the momentum and culture of the VRC.   I would not hire someone to \nreplace Gary that would possibly damage this culture. \n December 4, 2012 -   That evening had a senior staff dinner in which I discussed my \ndesire to tighten up the work ethic of the front office.   The work load is being \ndisproportionately falling on me, and particularly Greg Folkers who is killing himself \ntrying to polish up the sometimes sloppy work of others, particularly David Morens, who \nis a good guy, but will have to be let go.   We met at Positano’s restaurant in Bethesda \n(Fairmont Avenue) with Cliff Lane, Hugh Auchincloss, and JJ McGowan. Good \ndiscussion.  \nDecember 7, 2012 - went to dinner at the home of Connie Milstein on 3210 – R Street, \nN.W. in Georgetown.   Connie is the owner of the Jefferson Hotel in Washington DC.  \nThe occasion of the event was a fund raiser for the organization called Key to the Cure \n2012. This is an organization aimed at curing epilepsy.  It is run by Susan and David \nAxelrod who have a child with epilepsy. It was an extraordinary evening with all the \nglitterati of Washington DC at the meeting including a visit from VP Joe Biden. I had the \nopportunity to chat a bit with the vice president and discuss our work with HIV-AIDS.  \nHe clearly knew who I was since I have met him several times when he was in the Senate \nand he was present at the East Room ceremony when I received the presidential Medal of \nFreedom.  In addition there were number of other known media and political stars \nincluding Alex Castellanos, the Republican Strategist. The joke of the evening is that \nDavid Axelrod had just shaved off his mustache to raise money for the CURE.   He had \nbeen joking on TV Sunday Talk Shows that he would shave off his mustache is Obama \nlost the election.   Obviously, Obama won, but now David shaved it off for a cause.   \nAlex Castellanos now promised to shave off his moustache to raise money for the CURE. \nDecember 8, 2012 - Saturday morning spent an hour on C-SPAN television (National \nJournal) in Washington DC (400 North Capitol Street) discussing seasonal flu and other \ninfectious disease issues.   I was on the show with my friend Tom Frieden, Director of the \nCDC. \nDecember 11, 2012 - engaged in a National Academy of Sciences Symposium in \nWashington DC at the Keck Building on 5th St., NW to discuss emerging infectious \ndiseases and the 20th anniversary of the 1992 IOM report on emerging infectious \ndiseases. Later in the day I gave a talk at the treatment action group (TAG) event run by \nMark Harrington at the Fairfax Embassy Row Hotel on Massachusetts Avenue in DC. \nThe subject of the meeting was ending the HIV pandemic in the United States. This \nmeeting was put together in order to emphasize that we have a significant problem in the \nUnited States even at the same time as we are making enormous progress globally with \nhaving the end of the AIDS pandemic globally in sight, which was the topic of the \nInternal AIDS meeting in DC in July (see above) and the recent World AIDS Day events \nat the White House and the State Department.\nDecember 13, 2012  - travel to New York City to give the keynote lecture at the Drugs \nfor Neglected Diseases Initiative (DND1) symposium run by Medicins Sans Frontiere \nReleased by Chairman Rand Paul\n299(MSF, aka Doctors Without Borders) entitled  “Lives in the Balance: Delivering Medical \nInnovations for Neglected Patients and Populations” I spoke on the research issues \nrelated to neglected infectious diseases.  My talk was very well received it took place at \nMount Sinai Hospital on Madison Avenue and 99th St. The evening before I had dinner \nwith my daughter Jennifer at Café Vida on Amsterdam Avenue and 97th Street. \nThat evening when I got home I discussed the newly formed Office of Global Health \nDiplomacy with Eric Goosby.   He wanted to give me a heads-up about the fact that \nSecretary Clinton would make an announcement the following day about the formation of \nthis new office and that she would appoint Eric Goosby as the director of the new office \nwhile simultaneously maintaining his position as the director of PEPFAR.   In typical \nmanner, Eric is such a good person and friend that he wanted to keep me in the loop. \nDecember 14, 2012 - attended Lessons and Carols at the National Cathedral in \nWashington DC at 7:00 to 9:00 PM. This is a tradition which our family has done for all \nthe years that are children attended the National Cathedral School. It was lovely and \nnostalgic.  Megan and Ali attended with Chris and me.   Jenny was still in NYC and \nwould come down for Christmas in a few days.\nDecember 15, 2012  - had dinner with Wayne and Catherine Reynolds at the Adour \nRestaurant at the St. Regis Hotel on Connecticut Avenue in Washington DC.  As usual \nWayne and Catherine put together a very interesting group for dinner. This time it \nincluded my friend Rick Atkinson the Pulitzer Prize winning author as well as Buzzy \nKrongaard and his flakey wife Cheryl.  Buzzie was formally the Executive Director of \nthe CIA.   We were joking about the smash TV Showtime hit series called “Homeland” \nstarring Claire Danes as Carrie Mathieson (a bipolar CIA agent tracking terrorists) and \nDamien Lewis as Sarg. Nicholas Brody (a marine turned reluctant terrorist, turned back \nto good).   Buzzie was saying that the CIA could never act domestically the way it was \nportrayed in the series.   That would have to be FBI.   Other guests included Francis \nCollins, Congressman John Dingell and his wife Debbie and others. \nDecember 17, 2012 - We had an “international consultation” on the problem of gain of \nfunction research on H5N1 highly pathogenic avian influenza (HPAI) (see above \ndiscussions).  The meeting took over two days from December 17 to December 18 and \nwas conducted at the Natcher Auditorium at the National Institutes of Health.  This is a \ncontinuing issue and a source of great discussion about what experiments should or \nshould not be funded by the National Institutes of Health on this topic. I gave the opening \nkeynote which everyone felt very clearly defined the issues.  We will now finalize the \ndraft of “Framework” for addressing the issue of what grants and contracts we should or \nshould not fund that relate to a gain of function regarding respiratory transmissibility in \nmammals of the HPAI H5N1 influenza.  I am trying to get myself out of this argument \nwhich has consumed a considerable amount of my time over the past 14 months.\nDec. 30, 2012 – Interesting and potentially bad news regarding Sec. Hillary Clinton.   A \ncouple of weeks ago she reportedly fell and had a “concussion” that kept her out of the \npublic eye for ~ 3 weeks.   Report today that she was admitted to NY Presbyterian \nReleased by Chairman Rand Paul\n300Hospital for a “clot” and is supposed to be receiving anticoagulation.   Her staff are being \nvery close-to-the-vest about his.   Cannot figure out if she just has thrombophlebitis or if \nshe had a pulmonary embolus.   Certainly could not have had a subdural hematoma since \none would never anticoagulant under these circumstances.  Turned out she had a venous \nthrombosis of a skull vein, not involving the brain\nJan. 3, 2013 – A lot of influenza activity exploding throughout the country with H3N2 \nthat matches the vaccine.   Early start and big spike with widespread activity throughout \nthe country.   Appeared on Fox Local News this evening.\nJan. 7, 2013 -  Interesting telephone call with Paul Stoffels today.   Paul is CEO of \nJohnson and Johnson that owns Janssen Pharmacueticals as well as Crucell.   He is \nexcited about the Dan Barouch HIV candidate using Adenovirus 26/35 + MVA boost and \nwants to develop it as an HIV vaccine.  He wants to partner with me and NIAID in this \nendeavor.   This is relevant to the meeting tomorrow night in Building 31\nJan. 8, 2013 – Flu activity accelerating.   Appearing on WUSA – Channel 9 today.  Also, \nappeared this evening on Wolf Blitzer “Situation Room” regarding the flu epidemic.  \nWent very well\n This evening meeting of the P5 vaccine consortium in Building 31, 7A-24. Successful \nmeeting involving all of the players from Gates Foundation (Trevar Mundell, Stefano \nbertozzi, Peggy Johnston, Nina Russell), the Army (Nelson Michael, Jerome Kim), \nHVTN (Larry Corey, Peter Gilbert, etc.) See pdf for full contingent.\nimage.pdf\nMain purpose of the meeting was to re-group and summarize where we are in the \nplanning of the P5 (Pox Protein Public Private Partnership) for HIV vaccine).   \nPresentation by Larry Corey, Gepi Pantaleo, Peter Gilbert, Julie McElrath, Glenda Gray \n(RSA) on the NYVAC  +/- DNA +  protein approach; and by Dan Barouch, Hanneke \nSchuitemaker (Crucell) on the Adenovirus (Ad 26/35 + protein + adjuvant) approach.  \nOne of the problems is that Novartis, who is supposed to supply the envelope protein for \nthe Corey trial will be about 1 year late in delivering the protein.   Many of us are angry \nwith them about this since they have not been forthcoming.   Also, the correlates of \nimmunity from the RV144 (Thai) trial indicate that protection might be related to \nresponse against the V2 loop of the envelope and specifically against residue 169 in this \nregion.   Problem is that the envelope used in both proposed trials will not even address \nthis.   The envelope that grows well in cell cultures will be used.   Balance of empiric \nwith scientific.   Gepi Pantaleo, Larry Corey and I went to dinner in Bethesda at \nGrapeseed Restaurant after the meeting (5:30 to 7:45 PM) to reflect and commiserate.   It \nwill be largely my responsibility to decide go-no go from Phase 1 (starts in mid-end of \n2014) to Phase IIa/b (2015 - 2016), the latter costing over $100 million and so this will be \nan important decision based on a combination of science and best guess.   Stay tuned.\nReleased by Chairman Rand Paul\n301Jan. 9, 2013 – Appeared on C-SPAN (TV) and on WTOP radio early this AM to talk \nabout the erupting influenza epidemic.\nJan. 9, 2013 -  Attended an important dinner at the home of John Monahan and his wife \nAnnie at 3340 -  Runneymede Place, N.W., Washington, D.C.  to discuss the relationship \nbetween PEPFAR and USAID with regard to the new Office of Global Health \nDiplomacy.  John formerly worked in the Clinton Administration and for the past 4 years \nhas been Counselor to Secretary Sebelius in HHS and Acting Director of the Office of \nGlobal Health Affairs at HHS.  He recently moved to the State Department to help with \nthe Global Health issues there.   Hillary Clinton had just established this Office of Global \nHealth Diplomacy and made Eric Goosby (Director of PEPFAR)  the Director of the \nOffice  with Ambassador Louise Rowe as Deputy.  Apparently Raj Shah and the USAID \nare trying to take control over this new initiative that has just been put out by the Obama \nadministration. Raj has been trying to take over PEPFAR for some time now without \nsuccess. I have been backing Eric Goosby from the very beginning since I believe that \nRaj is driven by ambition on the background of a terrible track record of USAID. In the \nsecond Obama administration the people in the State Department and in the White House \nare trying to create a legacy for Pres. Obama with regard to global health. They believe \nthat this new office of Global Health Diplomacy could be the vehicle to do that. Right \nnow it appears that we are engaged in the struggle Raj Shah and USAID wanting to take \nover the process. The dinner included a number of people with knowledge in the field. \nParticipants included John Montague his wife Annie, Francis Collins, Tom Frieden, \nPeggy Hamburg, a woman from the State Department (Laurie) who worked in the \nClinton Administration, Nils Daulaire, and a number of other people. The plan discussed \nat the meeting was to help support Eric Goosby is trying to make the office of global \nhealth diplomacy a productive and viable enterprise and to ward off any attempts on the \npart of USAID to take it PEPFAR and the new office. Tomorrow I will go to the State \nDepartment for the first of the number of meetings that will address this issue.   More to \nfollow on this subject.\nJan. 10, 2013 – Did CNN Situation Room with Wolf Blitzer regarding the Flu outbreak.   \nI made casual statement in response to a question by Wolf that the outbreak had passed \nthe epidemic threshold (which was true (7.3% with threshold at 7.2%).   Anderson \nCooper later on in his CNN show “Anderson Cooper 360” made announcement that NIH \nOfficial Dr. Anthony Fauci has now declared the influenza outbreak “an epidemic”.   The \nCDC was coming out with their weekly report with a big press briefing the following day \n(tomorrow) and this must have gotten them pissed with their usual jealousy of my being \non TV and the media in issues that they think they own.\nJan. 11, 2103 – Did morning CNN and Soledad O’Brien on CNN and further discussed \nthe flu situation.   Much, much press interest.   As expected, Bill Hall (HHS Press office) \nwrote a note to Courtney Billet, Greg Folkers and John Burklow saying that from now on \nthe CDC should handle press on the flu and I should only do local media and national \nmedia only when they want to talk about research associated with flu like universal flu \nvaccine.   This has shades of Jenny Backus.  Almost certainly a result of a complaint \nfrom CDC.   We (NIH/NIAID) are trying not to clash with them, but this is really \nReleased by Chairman Rand Paul\n302insulting and we will have to see how this plays out and how we should push back on \nthis.\nJan. 12, 2013 – Did WJLA – Channel 8 news on flu on this Saturday AM.   Also, \nreceived request that Soledad O’Brien wants me again on her show on Monday AM.   \nThis will be the test regarding my above comment concerning Bill Hall.\nJan. 14, 2013 – HHS turned me down on requests from CNN Wolf Blitzer and Soledad \nO’Brien.   I asked John Burklow to call up Bill Hall and find out what the heck is going \non and what the reason for all of this is.   John told me that CDC complained to Bill Hall \nand HHS that I was getting all of the publicity on an issue (influenza “tracking”) that they \nconsidered was their issue.   I do not know who at CDC did this.   It could be anyone \nfrom Tom Frieden (I doubt this) to more likely Tom Skinner (CDC PR person).   In any \nevent, it has nothing to do with my use of the word “epidemic” on Wolf Blitzer Show and \neverything to do with pure jealousy that I am a “rock star’ stealing their thunder.  Shame \non the CDC.    Bill Hall promised John Burklow that as the epidemic stabilizes, I will be \nallowed to do the big shows and that starting now, I can do anything that has to do with \nthe science and vaccine development.  In this regard, see below – tomorrow\nJan. 15, 2013 – Appeared on the “Situation Room” (CNN) in a piece that featured the \nquest for a universal flu vaccine.   I did the interview from the NIAID Vaccine Research \nCenter.   John Mascola also appeared as we showed the CNN crew around the VRC.   \nVery nice piece.  Tomorrow I do a 1 hour call in show on WTOP.\nJan. 16, 2013 – Did a very successful 1 hour show with call-in on WTOP at 10:00 to \n11:00 AM.   Rainy day in Washington, D.C.   Also, local NBC News and WUSA \nChannel 29 filmed me during the radio show and I gave on camera interview to them \nafter the show.\nJan. 17-23, 2013 -  As expected, due to the beginning of drop-off of influenza cases, \neven though we are in the middle of the influenza season, the press interest has almost \ncompletely dropped off the radar screen.   Almost no stories this week on the 2012-2013 \ninfluenza outbreak.\nJan. 23, 2013 – The “60 day moratorium” on gain-of-function research on respiratory \ntransmission of HPAI H5N1 influenza in mammals has been lifted by the scientists who \noriginally signed to moratorium.   The moratorium actually lasted just over one full year.   \nWe at HHS and NIH have been developing a framework for making funding decisions \nfor this type of research (see above – Dec. 17, 2013).   The framework should be ready \nfor implementation in a few weeks and so we can start making funding decisions.   Much \npress coverage today (I was in NY Times, Wall Street Journal, AP, etc.).  The nay-sayers \nwho feel this research should not be done at all (David Relman, John Roberts (Nobel \nPrize winning ass-hole) or should not be published (Mike Osterholm) are still out there \nbad-mouthing the decision to lift the moratorium.\nJan. 25, 2013 – Appeared on CNN “The Situation Room” with Wolf Blitzer to discuss \nthe ongoing breakout of norovirus in the USA.   Good interview.   There are about 20 \nReleased by Chairman Rand Paul\n303million cases of norovirus in the USA each year with 70,000 hospitalizations and ~800 \ndeaths.\nFeb. 3, 2012 – Super Bowl night. Ravens beat 49ers 34-31.  Nonetheless spent the \nevening at a dinner and panel discussion at the Fairmont Hotel (24th and M Street, N.W.), \nColonnade Room. Occasion was a pre-Summit dinner for the Global Women’s Cancer \nSummit to take place the following week.   Panel discussion between David Rubenstein \n(Carlyle group) and Wolf Blitzer (CNN) with Mark Dybul contributing.   Sat a dinner \ntable with David Rubenstein (who is still trying to get me to work for him at Carlyle \nbecause he thinks that I am “…the smartest person in the world”), Laura Bush, Wolf \nBlitzer, Agnes Binagwaho (Minister of Health of Rwanda), Nancy Brinker, Mark Dybul, \nJulie Gerberding.   Great discussion about transforming events in global health.   Chatted \nwith Laura about President George W. who recently had back surgery as well as about \nPresident George H.W. who is slowly recovering from bronchitis hospitalization.\nFeb. 14, 2013 – Valentine’s Day.   Very interesting and enjoyable evening.  Chris and I \nwere invited by Wayne and Catherine Reynolds to a dinner in the Adams Room of the \nHay Adams Hotel to honor Ehud Barak, Defense Minister and former Prime Minister of \nIsrael.   He is in the USA for a meeting with Leon Panetta (Secretary of Defense).  Great \ntime.   Usual A crowd of DC, which this time included David Petraeus and his wife \nHolly.   Had the chance to speak with Petraeus and mentioned that I often said Hi to him \nas we passed running on the C & O Canal.   He said he recognized me, which was \nprobably just being polite.   I thanked him for his years of service to the country.   He was \nvery gracious.  Obviously, some degree of awkwardness in the crowd given the Paula \nBroadwell scandal and his wife being there on “Valentine’s Day”.   Also present among \nmany other were Bob Barnett and wife, Ed Markey (soon to run for Senator from \nMassachusetts) and wife Susan Blumenthal, Rick Atkinson (Pulitzer Prize winner \nauthor), Lyric Winik and husband Jay, Ben Carson and wife Candy, Josh Bolten and his \nnew girlfriend (?name), Bill Cohen (former Sec. of Defense) and wife Janet, etc.\n     Barak gave a very insightful speech on the challenges facing Israel in the context of \nthe Arab Spring, Syria, and Iran.\nFeb. 25, 2013 – Still no solution to the impending sequestration deadline of March 1, \nwhich will result in across-the-board cuts to Pentagon and discretionary spending \n(including NIH).   The POTUS is doing some severe posturing that this is all the fault of \nthe Republicans and is having all of the Cabinet members out there saying how disastrous \nthe cuts will be.   Meanwhile, Bob Woodward points out in an editorial in the \nWashington Post on Feb. 24 that the POTUS “moved the goal posts” on the GOP by \nwanting to bring up tax increases even though the original discussions surrounding the \nbudget deal of a few months ago is that the Bush tax cuts were allowed to expire and so \ntaxes are “off the table”.   Woodward says the POTUS now wants to put them back in \nplay.   Looks like sequestration will occur.\nSad day in that former Surgeon General C. Everett (Chick) Koop dies at age 96.   I had \nthe pleasure of giving the laudatios at his 80th and 90th birthdays.  My quotes appeared in \nmany newspapers regarding his amazing life and also on local FOX TV.\nReleased by Chairman Rand Paul\n304Mar. 1, 2013 – Sequester kicked in and so spending cuts are in effect.   Incredible \nposturing on part of GOP as well as the POTUS who is stating that the “world will come \nto an end” and the GOP is to blame since they refuse to raise taxes.   This is pitiful \ngovernment.   \n     Also, interesting finding being presented at CROI meeting in Atlanta in a couple of \ndays of an infant who was treated (not prophylaxed) with ARVS within 30 hours of birth \nsince his mother who was infected had no anti-natal care and obviously no ARVs.   She \npresented in an ER in Mississippi at labor.   The physicians felt that since the risk was so \nhigh for the baby that they treated the infant before the tests for HIV came back.   They \nusually take several days to come back.   Right choice.   The baby was infected and \nstayed on ARVs for 18 months.   Then lost to follow up and mother D/C’d the ARVs for \n10 months and reappeared.   Only now the baby is well and no evidence of replicating \nvirus (some probably dead residual DNA by PCR.   Also, immune response to HIV \ndisappeared (not surprising in the absence of persistent virus).   This may be the first real \ncase of a cure, not the “Berlin Patient” whom I always thought was totally non-feasible \nfor scale up and danger.   Of note, I have been saying for years that the best bet for a cure \nwas to treat as early as possible to prevent establishment of a large reservoir and to \nprevent destruction of immune system by persistent viral replication over months to \nyears.   The best scenario for this is to treat a child at birth.  Perhaps there are other \nchildren on therapy who received ARVs relatively early (not necessarily within hours) \nwho are in fact cured and do not know it.   Much study to be done.\nMar. 4, 2013 – The media interest in the “cured” baby has been as intense or more than \nanything I have experienced here at NIH.   Yesterday I did WUSA 9 nightly news and \ntoday I did: CBS Morning News with Charlie Rose and Nora O’Donnell; WTOP Radio; \nFax Morning News; CBS Radio LA; Fox Radio News; NBC News and NBC Nightly \nNews; ABC Evening News; BBC World Service Radio; Canadian Broadcast (CBC) TV; \nCNN International with Christianne Amanpour; CNN Situation Room with Wolf Blitzer; \nWLS radio; PBS NewsHour with Ray Suarez; BBC Radio; Canada CNN Radio; CNN \nAnderson Cooper 360; Al Jazeera.   Quite a day.   I stressed that we must be careful since \nthis is only a single case in very unusual circumstances.   All media went very well.\nMar. 5, 2013 – Media frenzy continues.   I have now gone over the data from the Hannah \nGay and Persaud presentation at CROI and I have some doubts that the child was ever \ntruly infected in the first place.   Tough to really tell whether the virus that was detected \nand ultimately disappeared on ARVs was the virus from the mother or really infected \nbaby cells making virus.   The authors claim that the 2 phase decay of virus on ARVs is \ncharacteristic of the response to active virus replication.   Cliff Lane pointed out that the \ndecay curve has very few points and is also compatible with a single phase decay.   In \nany event, I have been taking the conservative approach of emphasizing that this is just a \nsingle case and it needs to be replicated and validated and importantly, it has little to do \nwith infection in the adult where reservoirs are firmly established prior to the start of \nARVs.\n       Nonetheless, the media frenzy continues with interview for Men’s health, Huffington \nPost, NPR- San Francisco (KQED), Boston Globe.\nReleased by Chairman Rand Paul\n305Mar. 6, 2013 – When it rains, it pours.  CDC came out with a “Vital Signs” alert out of \nMMWR about the growing threat of Carbapenem-resistant Enterobacteriacea (CRE), \nwhich includes Klebsiella pneumonia carbapenem-resistant (KPC) that gave the NIH \nClinical Center the outbreak of 18 cases (11 deaths, 7 of which were due to the KPC) in \n2011.  Another media frenzy starts with me on NBC Nightly News X2.\nMar. 7, 2013 – CRE media with Diane Rehm Show,   Briefed Laura Friedel of Senate \nMinority Staff at Appropriations (Staffer to Ron Moran)\nMar. 8, 2013 – Guest on Geraldo Rivera Show for “cure” baby; CNN tape for tomorrow \non CRE; the Washington Post “The Fold” (online TV) on HIV.\nMar. 11, 2013 – Flew to Boston for the day to give Keynote Lecture at the dedication of \nthe new building for the Ragon Institute of MGH, Harvard, and MIT.  Held at 400 \nTechnology Square in Cambridge, MA.  Orchestrated by Bruce Walker who is amazing \nat raising money for his biomedical research.   Terry and Susan Ragon (software \nbillionaires) gave Bruce $10 million per year for 10 years and now an additional $30 \nmillion to renovate the building for the Ragon Institute.   I spent a few hours interacting \nwith the Ragon scientists, gave my Keynote and then had dinner at the “Catalyst” \nrestaurant in Cambridge.   Many Boston scientific and other luminaries at lecture and \ndinner including Bob Kraft, owner of the New England Patriots, and his family (wife and \nson Jonathan).   Also at lecture and at dinner and with whom I had great conversations \nwere Drew Faust (President of Harvard), Raphael Reif (President of MIT), Ray Slavin \n(President of MGH) among others. We discussed the potential effects of the \n“sequestration”  Very nice visit.\nMar. 13, 2013 – Did nice interview at Biocentury (WUSA – Channel 29) on the \nSequestration.   \n    That evening went to Research America Gala at Mellon Auditorium on 13th Street and \nConstitution Avenue, N.W.   I sat at the Duke University Table with Congressman \nGeorge Holding, Victor Tzau, and others.   My friend Diane Rehm (NPR Diane Rehm \nShow) received one of the awards.\nMar. 15, 2013 – Have received indications from Judith Shamir (Exec Sec of IOM) the \nAlan Leschner, Chair of IOM President Search Committee is very interested in my \nsubmitting my application for the job.  I told her that I was not interested, but I would let \nher know.   I called current President, Harvey Fineberg, and asked his opinion.   He said \nthat I would be fantastic for the job.   I explained that I was not that interested.  The only \nreason (weak) to take the job is that I could start writing my book in that job, which I \ncannot really do now since I would have so much more time in that much-less-demanding \njob compared to NIAID Director.   \nMar. 18, 2013 – Met with Congressman Andy Harris (R-MD) in Building 1 together \nwith Francis Collins, Griff Rogers, Gary Gibbons.   Harris is a Tea Party person who is \nsecond rank on House Appropriations Subcommittee behind Chairman Kingston.   Funny \ninterchange since Harris brightened up when I introduced myself, saying that he was \nReleased by Chairman Rand Paul\n308Latest count of H7N9 in China today is 78 cases and 16 deaths.\nApril 17, 2013 – Went to Princeton to deliver the Gilbert Omenn Lecture at the \nWoodrow Wilson School of Public and International Affairs.  Spoke on “Ending the \nHIV/AIDS Pandemic:  From Scientific Advances to Public Health Implementation”.  \nHosted by Cecilia (Ceci) Rouse formerly on the economic team in the Clinton and \nObama White House.\nApril 19, 2013 -  Terrorists identified by surveillance cameras.   Tamerlan and Dzhokhar \nTsarnaev.   Two Muslim brothers born in Chechnya.   Older one recently spent about 6 \nmonths in Chechnya, likely getting trained in terrorism.   Most intensive manhunt in US \nhistory around Boston Area.   Entire city of Boston shut-down.   Wild car chases and gun \nbattles. Terrorist murder campus policeman at MIT and seriously wound another \npoliceman.  Tamerlan shot dead; Dzhokhar escapes, seriously wounded, ultimately \ncaptured in Watertown MA.\nApril 21, 2013 – Informed by Francis Collins that he spoke with Bill Corr (Deputy HHS \nSecretary) about the issue of my being muzzled, almost certainly because Tom Frieden \nand the CDC want the spotlight on the H7N9 story.   Corr agrees with Francis that I \nshould always be allowed to speak to Press (Print/TV/Radio) when they directly ask for \nme.   Let us see how this turns out.  Also, it is clear now that I have joined the 2x/week \nconference calls with HHS that CDC really wants to be in control even though I believe \nthey are missing important stuff.   For example, they are claiming that they cannot detect \nthe virus in chickens, likely because the PCR assay is specific, but not sensitive.   I just \nfound out from the CEIRS people (including Mike Osterholm) that the Chinese are \nlooking in the wrong place.  The cloacal swabs are negative, but there are tons of virus in \nthe trachea swabs.   Case now well over 100 and counting.   The Chinese need to start \nmassive culling of chicken or the virus might adapt itself to humans after many dead-end \njumps.\nApril 22, 2013 – Cases of H7N9 continue to accumulate.   First case in Taiwan. HHS is \nnow clearing me for press (see above); however, there have not been any requests from \nmajor network and so still not clear what will happen.   I have decided without question \nto defy them if they try to muzzle me, which I do not believe they will now that Francis \nhas spoken with Bill Corr; but we shall see.\nHad dinner with Bob Gallo tonight and discussed the upcoming Paris meeting sponsored \nby the Pasteur institute (Francois Barre-Sinoussi) to celebrate 30th Anniversary of \ndiscovery of HIV by the French.   Bob is scheduled to give an after dinner speech.   I \nstressed that he should behave and not re-hash old issues.   Also, Bob told me that he and \nJoe O’Neill are writing a book about the history of AIDS and they want to devote a \nchapter to me.   This is nice, but now it is clear that I must write my book and do it soon.   \nWill get advice from David Willman (L.A. Times) and Rick Atkinson (author of World \nWar II books) – both Pulitzer Prize winners on how to proceed.   Also, will contact Ari \nEmanuel’s Book person.\nReleased by Chairman Rand Paul\n309April 25, 2013 – Went to reception at the home of Sen. Jay and Sharon Rockefeller to \ncelebrate 10 years of service and retirement of Amy Lawson as CEO of DC Prep (where \nJenny taught).   Amazing home – 2121 Park Road, N.W.   Had chance to chat with the \nSenator about NIH.\nApril 26, 2013 – Had important discussion with Eric Goosy by phone about whether we \n(NIH and PEPFAR) should fund the Africa START study proposed by Wafaa El Sadr \nand Kevin DeCock.   Eric is skeptical about doing this since he feels that very soon many \nin Africa will be starting therapy at below 500 CD4+ T cells and the study may not be \nable to be done.\nApril 27, 2013 – Went with Chris to White House Correspondence Garden Brunch at \nBeall-Washington House on 2920 R Street, N.W.    Tammy Haddad as usual MC’d it.  \nSponsored by CURE Epilepsy and the Miss America Foundation.   Great party.   \nFantastic weather – bright sun and 70 degrees.   Usual cast of celebrities – political, \nmedia and Hollywood.   Ran into old friends David Axelrod, Sharon Stone, Nora \nO’Donnell, Charlie Rose, Gordon Peterson.  Discussed NIH budget with Eric Cantor.  \nHad most fun meeting and taking picture with Navid Negahban who played the arch-\nterrorist Abu Nazir on “Homeland” (Showtime).  We told him how much we admired his \nwork.   He sort of recognized me but not quite.   After a few minutes, he came over to me \nand said how impressed he was about how many lives I have saved and as he was saying \nit, he choked up.   He clearly had asked someone who I was.   Seems like a fine human \nbeing.\nApril 29, 2013 – Went to dinner at Matisse Restaurant on Wisconsin Avenue and \nFessenden Avenue, N.W.   I took out Richard (Rick) Atkinson to dinner to get his advice \non writing my book (autobiography).   He was extremely helpful on how to approach this \nand gave me several names of agents, editors, historians, etc.  he encouraged me to “shop \naround” for the best people.   He confirmed what Edwin Grosvner and Ari Emanuel said \nthat I clearly have a NY Times bestseller and possibly Pulitzer Prize autobiography in me \nand encouraged me strongly to pursue this.   \nI am very excited (almost agitated) about doing this.   I have a worrisome feeling that the \nUSG will not allow me to do this.  Even though it is MY autobiography, most of it relates \nto my government service.   I will probe this and see what happens.\nParenthetically, the Washington Nationals, who are supposed to win the World Series this \nyear on the basis of pure talent have gotten off to a bad start.   The only people that are \ndoing great thus far are Bruce Harper and Jordan Zimmerman.\n***H7N9 continues to occur in China from chickens to human → 126 cases and 24 \ndeaths.   Still confined to China.   Need to keep an eye on this.   \nMay 1, 2013 – Attended the “Heroes of Military Medicine Awards at the Mellon \nAuditorium on 13th Street and Constitution Avenue N.W.   I was present because Lt. Col. \nReleased by Chairman Rand Paul\n310Nelson Michael (my old friend) was receiving one of the awards and I had been part of \nthe video that was shown at the event that honored him.  Nice affair.  Inspiring keynote \naddress by Admiral William H. McRaven, Commander of United States Special \nOperations Command (the group – Seal Team 6 that got Osama bin Laden).  Other \nawardees besides Nelson were USAF Lt. Col. Raymond Fang – Trauma surgeon with \nmultiple tours in Iraq and Afghanistan.   He spoke by video since he is currently deployed \nin Afghanistan.   Also Hospital Corpsman 1st Class Darrel L. Enos – 3rd Marine Special \nOperations Battalion who received it posthumously – killed in action.   Entire evening \nvery moving.   Special awards to Marine Staff Sergeant Johnny Joseph (Joey) Jones who \ngot his legs blown off while trying to dismantle and IED in Helmand Province, \nAfghanistan.   I was in tears after his speech.  Also talks by Gen. Jack Keane (USA- \nretired), Gen. James Amos (USMC).  Special Award to Gen Joseph F. Dunford (USMC), \nCommander of Forces in Afghanistan who spoke in video from Afghanistan.  General \nAmos introduced him.   Gen. James Peake, Former US Army Surgeon General and \ncurrently Sec. of Department of Veteran Affairs received a special award.   He fought as \na combat platoon leader in Viet Nam and was highly decorated with Silver Star, Bronze \nStar with V device and Purple Heart.   After war, went to Cornell Medical School, \nbecame a cardiac surgeon – quite a guy.   I have known him for years.   Mistress of \nCeremonies was Jennifer Griffin of FOX News Channel.   When she called out \n“notables” in the audience, she mentioned my name.   I was embarrassed to be called out \ntogether with General McRaven, Amos, Peake and others.   The evening made me proud \nto be an American.\nMay 6, 2013 – H7N9 still smoldering, but with the closing of some of the open bird \nmarkets in China, the pace of new cases has slowed.   130 cases and 31 deaths total.   \nHHS is now allowing me to do press on this without hassle.   Francis Collins meeting \nwith Bill Corr has apparently worked (see above).\nWent to cocktail reception/book signing for Paul Farmer’s new book – “To Repair the \nWorld” at home of Greg and Derry Craig on 3155 Highland Place, N.W.; also co-\nsponsored by Tim Broas.   Paul, as usual, was very generous in his remarks about my \naccomplishments in being the architect of PEPFAR and the influence that I had on his \ncareer.   Several notables there including Kathleen Matthews and Paul Wolfowitz.   Had \ngood conversation with Paul about how we worked together when he was Deputy \nSecretary of Defense.  Paul gave 2 signed books to me – one for Chris and me and one \nfor Jenny.  Also, I spoke with Paul about getting one of his acolytes to come work for me \nas my assistant at NIAID.  (Turns out I contacted one Hillary Marston who will be \njoining me in August – see below))\nMay 7, 2013 – Went to the Capitol with Francis Collins to meet with the House Majority \nWhip – Congressman Kevin McCarthy (R-CA).   Kevin is very interested in the problem \nof Valley Fever (Coccicioidomycosis) in his district of Bakersfield.   We discussed \nhaving a workshop and partnering with CDC in doing clinical trials of new drugs such as \nNippo Z and developing a vaccine.   Good idea to cultivate relationship with McCarthy, \ngiven his position.\nReleased by Chairman Rand Paul\n311May 8, 2013 – Appeared on NPR Morning Edition radio with Richard Knox regarding \nH7N9 flu.   Also, gave Opening Keynote Address at the Annual Meeting of the \nHPTN/IMPAACT Networks held at Marriott Wardman Hotel on Calvert Street, N.W.   \nMyron (Mike) Cohen presented me with a basketball signed to me from Roy Williams, \nhead coach at UNC.  Mike gave it to me to “neutralize” the signed basketball that I \nreceived years ago from Duke Head Coach Mike K.\nMay 9, 2013 – Had Congressional visit here at NIH in the Clinical Center medical Board \nRoom on 4th Floor of Building10.   Delegation led by Eric Cantor (R-VA).   Also present \nwere Congressmen Andy Harris (R-MD), Elliot Engel (D-NY), Ted Yoho (R-FL), Chaka \nFattah (D-PA), Renee Ellmers (R-NC). Tim Murphy (R-PA), Earl Blumenauer (D-OR).   \nNIH was represented by me, Francis Collins, Gary Gibbons, Eric Green, Chris Austin, \nLarry Tabak, Kathy Hudson, John Gallin.   We were trying (successfully) to familiarize \nthem with the NIH and what we do.   Also, to impress on them the damage due to \nsequestration.   I spoke about the major advances in treatment of HIV and the possibility \nof a universal Influenza vaccine.   All in all it was a very good meeting.\nWent to Book party at the home of Bob and Deborah Seder in honor of Andrea Redmond \nwho co-authored book called “Rwanda, Inc.” about entrepreneurship in Rwanda and the \neffect on the economy.   Had long conversation with my good friend Cheryl Mills, \nFormer Chief-of-Staff to Sec. Hillary Clinton and long-time Counselor to Clinton about \nthe “scandal” associated with the Benghazi incident where the Republicans are trying to \nattack the Administration and especially Hillary Clinton for negligence/incompetence in \nnot protecting and responding in time to the Sept. 11, 2012 terrorist attack on the US \nEmbassy in Benghazi, Libya in which the US Ambassador was killed.   Cheryl says that \nthe whistle-blower Greg Hicks is clearly not telling the story as it happened with regard \nto the State Department responding or not to the threats against the embassy.   I obviously \nbelieve Cheryl.\nMay 13, 2013 – Slow down of activity on H7N9; uptick of activity with MERS Corona \nvirus (Middle East Respiratory Syndrome).  I appeared today on WTOP and BBC \ntelevision discussing MERS CoV.\nMay 15, 2013 – Testified at the Senate Appropriations Subcommittee Hearing for NIH \ntoday.   Testified with Francis Collins, Harold Varmus, Story Landis, Richard Hodes and \nGary Gibbons.   Friendly Hearing.   Asked me questions about DURC, Antibiotic \nresistant bacteria, H7N9 influenza pre-pandemic, universal flu vaccines and \nautoimmunity.   As mentioned many times above, the Hearings are very different from \n10-20 years ago.   We had 2 hours for the entire NIH, when back then we had a week of \nHearing with individual half-days for the big institutes.\nMay 17, 2013 – Interesting dinner with my friends Catherine and Wayne Reynolds at \nAdour Restaurant at the St. Regis Hotel on 16th and K Streets, N.W.   Other guests were \nJohn Rogers who was Assistant to the President during the Reagan Administration.   He \nremembered me from back then.   He went off to be Deputy to Jim Baker when Baker \nbecame Secretary of State for Reagan.   His wife Deborah was charming and a nice \nReleased by Chairman Rand Paul\n313June 1, 2013 – Ali’s II Eight boat came in 2nd in the Petit Final and 8th overall in the \ntournament – Great job, Ali!  Ali ultimately makes 1st Team All-Pac-12 Academic All-\nAmerican (for second year in a row).  She has the highest grade point average (4.05) of \nany Pac-12 athlete.\nJune 3, 2013 – Press interest continues regarding MERS-CoV.   Was on daytime CNN \ntoday plus lately other TV media “feeds” such as AP, VOA, Reuters.\nDavid Morens, Jeff Taubenberger and I just got Commentary accepted in NEJM on \nH7N9 – to come out Online on June 5.\nJune 4, 2013 – Had dinner at Matisse with Bob Bazell, 38 year TV medical reporter for \nNBC.   He is leaving NBC to join Yale Faculty.   He is a trained microbiologist before \nworking for NBC.   He must have interviewed me hundreds of times over the 30 + years \nof HIV/AIDS.   We have become friends and he wanted to have a catch-up dinner and tell \nme of his plans.\nJune 6, 2013 – See e-mail below from  to me and my forward note to Chris, \nmy children and Denise.   It describes my role as physician at NIH in the pre-AIDS days.   \nImportant historical perspective.\n-----Original Message-----\nFrom: Fauci, Anthony (NIH/NIAID) [E] \nSent: Thursday, June 06, 2013 6:19 PM\nTo: Grady, Christine (NIH/CC/BEP) [E]; Jenny Fauci \n(jennyfauci@gmail.com); Alison Fauci (ali.fauci@gmail.com); Megan Fauci \n(megan.fauci@gmail.com); Denise Scorce\nSubject: FW: Personal from \nFolks:\n   \n \n   They call it \"of childhood\" because patients never lived \nbeyond childhood.   I first started taking care of her  at NIH when she \nwas 6 years old.  These patients die of fungal and other infections.   \nI kept her alive for several years until she had had so many liver \nabscesses that when she was 12 years old, she had another liver abscess \nwith Aspergillus, a deadly fungus.   The surgeons refused to drain it \nbecause they said that the surgery would kill her and they did not want \nto have someone die in the operating room.  I wanted to keep her alive \nin hope that  we could some day find a therapeutic approach that might \nsave her.   I told the surgeons that she definitely would die if they \ndid not operate on her and that this tradition that \"no one should die \nin the operating room\" was frankly \"b--s--t\".  They still would not \noperate.   I kept pushing and pushing them until they reluctantly \ncomplied.   She survived the operation and then a couple of years \nlater,  treatment (gamma interferon) was found (by John Gallin) to \nprevent her infections.   Several years later she \"grew out\" of her \ndisease and now she does not require any therapy. She has 3 children, \none boy and 2 girls.   She named the boy Anthony, after me.  Life is \ngood.\nReleased by Chairman Rand Paul\n\n314Dad/Tony/Anthony\n-----Original Message-----\nFrom: cdean002@cfl.rr.com [mailto:cdean002@cfl.rr.com ] \nSent: Thursday, June 06, 2013 2:59 PM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Personal from Carla Heeke-Dean\nJust a note to say, Hi.\nI reached a milestone today that some thought I would never reach.  \nToday is my 50th birthday, not bad for my parents being told I wouldn’t \nlive to 18?  I want to thank you for all the times you have stood up \nfor me even when others didn’t believe I would survive. Thank you for \nall the long hours and every time you went beyond the call of duty.  I \ntruly love my life with my family and friends, and know I wouldn’t have \nit without you.  Enjoy this day, because I am!\nAll I have for you is admiration and thanks.\nLove,\nCarla Heeke-Dean\nJune 9, 2013 – Had dinner with the Heads of International Research \norganizations (HIRO) at the Hyatt Bethesda Hotel.   Francis Collins is \nthe Chair this year and so they meet in the USA.   Francis asked me to \nbe the after dinner speaker with Eric Goosby.   I spoke about the \nthreat of MERS-CoV and H7N9 Influenza and Eric spoke about PEPFAR.\nJune 10, 2013 – Met with Tim Hallett (of the UK’s London School of \nTropical Health and Hygiene) and Eric Goosby in Eric’s office to \ndiscuss Tim’s mathematical model for", "summary": "Watcher-discovered document from paul-readingroom (2026.07.27_Diary-Prequel-.pdf), auto-indexed 2026-08-05.\n\nExcerpt: Wisconsin Avenue  and Fessenden.   Discuss the Qatar initiative, see above and below.  But, conversation  turned to Raj Shah and the PEPFAR/USAID story.  Bottom line is that Raj has been  talking with Rick and it appears from Rick and my prior conversation with Raj that Raj is  not against treatment as prevention (TAP); however, he does not like the model and want  to do it differently.   (More on Qatar later – stick with USAID/PEPFAR for now) Released by Chairman Rand Paul 256Nov. 2, 2011 – 7:30 AM Get call from Rick Klausner who is having breakfast with Raj  Shah and Rick wants to set up teleconference with the 3 of us at 11:00 AM to discuss the  above issues.   On the call Raj dances around a bit, but what he really wants is a big  initiative using PEPFAR money.   He does not say so…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.27_Diary-Prequel-.pdf", "pdf_url": "/archive-docs/fauci-files/c1dee44b66471ea95f8e8154b109f914/pdf", "doc_date": "2026-08-05", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-07-27-diary-prequel"], "part_number": 5, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 6 of 8)", "content": "concentrating PEPFAR’s efforts on \n“Hot Zones” of infection within a given country as opposed to targeting \nwhole countries or regions.   Mark Dybul is very much in favor of this \napproach and since he is now Executive Director of the Global Fund, he \nwanted me to convince Eric that PEPFAR should take this approach.   \nHence, Mark arranged this meeting of me, Tim, and Eric.   Eric in his \nusual good careful approach is somewhat skeptical of “Models”\nJune 14, 2013 – Please see hyperlink to historical AIDS posters from \nACT-UP:\nhttp://huff.to/10fto8L\nJune 17, 2013 – Met with Senate Democratic Majority Leader Harry Reid \n(D-NV) in Building 10, Room 5-1608 to discuss the exciting things in \nresearch such as universal flu vaccine.   Also there was Francis \nCollins, Story Landis and Gary Gibbons.  We must have done some good \nsince the next day Sen. Reid came out with a statement that the \nsequester should exclude NIH.\nJune 18, 2013 – Good Day.   Went to the 10th Year Anniversary \nCelebration of PEPFAR at the Dean Acheson Auditorium in the State \nDepartment.   Sen. Kerry presided and in his introduction called me out \nvery generously.   Below is the text of his statement.   It is clear \nthat my friend Eric Goosby helped his staff write it:\nReleased by Chairman Rand Paul\n315Remarks at the President's Emergency Plan for AIDS \nRelief (PEPFAR) 10th Anniversary Celebration\nRemarks\nJohn Kerry\nSecretary of State\nDean Acheson Auditorium\nWashington, DC\nJune 18, 2013\nThank you very, very much everybody. What a pleasure to be here. This is a really great \ncelebration. This is special. And if anybody here – I know you’re here because you are \ntouched by it – but what a wonderful thing to celebrate the 10-year anniversary of this \nremarkable intervention that represents the best of the human spirit, and also I think in \nmany ways, the best of American leadership. It’s something we can really be proud of, \nand we can be possibly not prouder at all of any effort by any individual than the \nremarkable effort, the amazing job of developing the PEPFAR programs and taking on \none of the greatest health challenge crises of our time. I cannot thank enough the \nleadership of Ambassador Eric Goosby, who has been spectacular in this effort. \n(Applause.) Thank you. Thank you.\nAnd I want to thank Tatu. Thank you so much for being here with us. I couldn’t be more \npleased than to welcome you and your daughter, Faith, here to the State Department. I \nthink you are an inspiration to everybody in this room and to everybody who knows your \nstory, which everybody will learn more of. But you’re a living example of the impact and \nmeaning of this program, and we thank you for coming here to share with us.\nAlso, when it comes to vision and leadership, I’d be remiss if I did not recognize Dr. \nTony Fauci. Tony has been there since the very beginning, and he has taught us all that if \nwe follow the science, we can truly achieve an AIDS-free generation. And I’m not sure \nthere would be a PEPFAR today if it were not for the leadership of Tony, and we owe \nhim all our thanks, so thank you very much. (Applause.)\nAnd I know full well after 29 years on the Hill that without the right senators and \ncongressmen and women behind this kind of effort, it doesn’t happen. And when this \nstarted up, it started up with a lot of courage by individuals who were willing to step up. \nIt didn’t exactly have the unanimous consent not only of the people in the Congress \ninitially, but in the country. So I want to thank Senators Mike Enzi and Ben Cardin for \ntheir leadership, and thanks for being here today; I know you’re going to hear from them. \nAnd I also want to thank my good friend and colleague Senator Johnny Isakson and the \nother members of Congress who are here. We salute you all for coming and sharing in \nthis celebration, and that is what it is.\nReleased by Chairman Rand Paul\n316Everybody knows that as you look at Congress today, not every day produces the kind of \nexceptional bipartisan cooperation that created the celebration we’re here to enjoy today. \nThis is one issue where I can happily say that partisanship has really almost always taken \na backseat. And in fact, the success of this effort shows what can happen when you reach \nacross the aisle and you do wind up working together.\nI want to thank Richard Nchabi Kamwi for – he’s the Health Minister from Namibia – I \nwant to thank him for being here with us today. Namibia has been hugely impacted by \nthis disease, but through the Minister’s efforts, and our partnership with his country, we \nare seeing extraordinary progress.\nAnd to everyone else here, I know that so many of you here are the stakeholders in this \neffort and you’ve worked hard on it, and I thank you for what you’ve done and I welcome \nyou here at the State Department on this tremendous occasion.\nI want to acknowledge one person who, sadly, is not here today, and that’s Michael \nTaylor Riggs. Michael was a former congressional staffer whose hard work and \ndedication helped to make PEPFAR a reality. And as many of you know, Michael passed \naway last month at the age of 42. And we miss him, and we thank him for his leadership. \nAnd while we celebrate today’s anniversary, I think all of us are thinking of Michael as \nwell as the millions whose lives this terrible disease touched: the mothers and fathers who \nlost children, the children who were left orphaned, the friends and loved ones left behind, \nthe communities that were devastated, from San Francisco to Soweto.\nI met a number of these young people who were affected by this disease when Teresa, my \nwife and I, visited the Umgeni Primary School outside of Durban. And I’ll never forget \nthe visit, walking around these mud huts with a grandmother who was coughing badly \nfrom HIV infection, and young kids whose – the only – the gap between them was \ngenerations wide. And we saw these orphans who were robbed of their parents, who were \nforced to take on the burden of adulthood at the age of 13, 14, 15, and caring for their \nyounger siblings.\nWe were heartbroken at hearing what these children had been through, and you couldn’t \nhelp but feel this agony and this total disruption of the way life is supposed to be. But we \nwere also inspired. We saw in their faces the amazing resilience of humanity, and it said \nsomething about all of us, and to all of us as well. Because when we all looked lost, when \nthis disease appeared to be unstoppable, history will show that humanity and individual \nhumans rose to the challenge. Action was taken. Innovations were discovered. Hope was \nkindled, and generations were saved.\nThe success of PEPFAR, as well as efforts by the entire global community, including the \ngreat work done by the Global Fund, represents in truth a victory for the human spirit. \nAnd with the Global Fund replenishment happening this year, now is the time for all \ndonors to join with the United States to support and strengthen the fund. The fight against \nHIV and AIDS shows what we can accomplish when we make the effort together, join \nhands, overcome the ideology and the politics, and really dedicate our hearts to win.\nReleased by Chairman Rand Paul\n317None of this was easy, and frankly it’s really worth remembering for a moment how \nbleak things looked at a certain point in time. A decade ago, when the world finally began \nto reckon with the full magnitude of this crisis, many experts thought it was too late, and \nwith nearly 30 million people infected with HIV/AIDS in 2002, an entire generation \nseemed lost. When I looked at the enormity of the challenge at that point in time, \ncandidly it was hard not to be overwhelmed to some degree, and perhaps even a tiny bit \npessimistic.\nBut I also felt that we had to do something, and so did many of my fellow senators, I am \nso happy to tell you, especially Bill Frist and ultimately Jessie Helms. I was proud to \nserve with Senator Frist as a founding co-chair of the bipartisan HIV/AIDS taskforce, a \ngroup that was instrumental in helping us to be able to prepare and lay the groundwork \nand pass the first AIDS legislation in the United States Congress – unanimously, I might \nadd, in the Senate, thank to Jesse Helms’ and Bill Frist’s efforts – so that that was signed \nby President Bush in 2003. That translated ultimately into PEPFAR.\nThis landmark legislation created the world’s largest and most successful foreign \nassistance program, and today a disease that seemed unstoppable is in retreat. Globally, \nnew HIV infections have declined nearly 20 percent over the past decade. In Sub-Saharan \nAfrica, both the number of new infections and AIDS-related deaths are down by almost \none-third over the last decade. Last year alone, PEPFAR supported HIV testing and \ncounseling for nearly 50 million people, and while just 300,000 people in low and middle \nincome countries were receiving anti-retroviral treatment 10 years ago, today PEPFAR is \ndirectly supporting more than 5 million people on treatment.\nBecause of these successes, I am honored to make a very special announcement today, an \nannouncement that we could literally only have dreamed about 10 years ago. Thanks to \nthe support of PEPFAR, we have saved the one millionth baby from becoming infected \nwith HIV. That is a remarkable step. (Applause.)\nAnd as you know, preventing mother-to-child transmission has been a central pillar of \nour fight against this disease, and just this month we reached the truly landmark moment \non the HIV/AIDS timeline. Imagine what this means – one million babies, like Tatu’s \ndaughter Faith, can grow up happy and healthy, go to school, realize their dreams, break \nout of this cycle, maybe even have sons and daughters of their own, free from the burden \nand the fear of HIV.\nThat is not the only good news. I’m also pleased to report that in 13 countries, we have \nnow passed a programmatic tipping point. Today, more people are newly receiving \ntreatment than are newly infected. We are at this point, thanks to the combined and \ncoordinated efforts of all partners in the fight of global – against global AIDS. That is \nwhat has brought us to this moment.\nBut in order for more countries to pass this tipping point and keep going in the right \ndirection, we still need to reach those who are at the greatest risk of HIV infection. That’s \nwhy last July, the United States announced the creation of a new $20 million fund to \nReleased by Chairman Rand Paul\n318support key populations, people who are too often stigmatized, at risk, and neglected. \nAnd that means particularly men who have sex with men, it means people who inject \ndrugs, and it means sex workers. And it’s my pleasure today to announce that the \nrecipients of this funding, Cambodia, Ghana, Nepal, Senegal, Swaziland, Zimbabwe, and \ntwo regional programs, are going to have the benefit of this going forward.\nThis has been a decade of remarkable progress, my friends. But obviously, our work is \nnot done. Millions still become infected every year and millions are still dying. But we \ncan now say with confidence something we could perhaps only have dreamed of before, \nas I said, and that is we can achieve an AIDS-free generation, and that is within our grasp \nnow.\nSo to get there we’re going to have to stay at it. Under President Obama’s leadership, we \nhave redoubled our efforts. Through PEPFAR, the U.S. now directly supports three times \nmore people on antiretroviral drugs today than we did in 2008.\nWhere we once saw a situation spiraling out of control, today we see a virtuous cycle \nbeginning to form, with more people receiving treatment and fewer people passing on the \nvirus. Fewer infections means it is now easier to actually focus treatment efforts. And \nwith fewer people sick and dying, we are seeing healthier, more productive populations. \nThat’s the virtuous cycle. The economies of Sub-Saharan Africa are growing at a \nsubstantial rate, and a generation is now able to look to the future with hope.\nAs the progress continues, PEPFAR, over its next decade, will gradually evolve as our \nfight against this disease evolves, and that is going to happen both by necessity and by \ndesign. Achieving an AIDS-free generation is a shared responsibility and it is going to be \na shared accomplishment. That is why PEPFAR is working to gradually and \nappropriately transfer responsibilities to host countries. This means that PEPFAR will \nshift from merely providing aid to co-investing in host countries’ capacity.\nTen years after this program began, rest assured that the commitment of President \nObama, the State Department, myself, this country’s commitment to fighting HIV/AIDS \nis as undiminished as our work is unfinished. Our commitment has only been \nstrengthened by the progress that we’ve made and the lives that we’ve saved and this \nstory that we are able to tell today. This story compels us to continue.\nWhat has been achieved here is a lesson for all of us. And I think it is, in fact, a lesson \nthat people should believe in humanity. To never doubt what we can achieve is one of the \nlessons of today, to know that we can do the remarkable, that we can find solutions to \nwhat seems to be unsolvable, that we can overcome the insurmountable and we can leave \npolitics and ideology at the wayside in order to choose life and possibilities for people \neverywhere.\nBecause of this faith, because of this program, because of your efforts, because a mother \nlike Tatu could live to see her child grow up to change the world – that is why we will \ncontinue\nReleased by Chairman Rand Paul\n320Aug. 1, 2013 – Underwent review of my performance as NIAID Director over past 3 \nyears since my last review in 2007.  Reviewers were Laurie Glimcher, Adel Mahmoud, \nDennis Kasper, and Diane Griffin.   Went extremely well.\nAlso, Secretary Sebelius visited NIH today and I was part of the delegation that met with \nher.   I discussed with her the potential for a universal influenza vaccine.\nAug. 2, 2013 – Met with a delegation from the country of Georgia.   I had previously met \n2X over the years with the First Lady of Georgia.   Today met with the Minister of Health \nand the Georgian Ambassador to the USA.   Good meeting.\nAug. 5, 2013 – Had removal of parathyroid adenoma at GW Hospital by Dr. Stanley \nKnoll.   Went very well and was back at work 2 days later.  Very little pain.\nAug. 6 – 8, 2013 -  Papers came out in Science, Nature, BMJ, etc. that generated major \npress interest.   First was Bob Seder’s and Steve Hoffman’s malaria vaccine paper in \nScience; another was a report in BMJ of human-to-human transmission of one case of \nH7N9 from father (60 y.o.)  to daughter (32 y.o.); finally, Fouchier and Kawaoka wrote a \nstatement in Science/Nature giving their reasons why they want to go ahead with gain-of-\nfunction (GOF) research on H7N9 and other influenzas.   They respect the concerns of \nHHS and say they will recognize restrictions.   HHS wrote a letter to Science stating the \nHHS position that GOF function experiments with H7N9 that increase transmissibility by \nrespiratory route in mammals will go to additional level of review at the HHS level \n(Framework Approach – see above).   For the latter, I was quoted liberally by AP in page \nA3 of the Washington Post on Aug. 8.   Also, regarding the daughter transmission, I was \non WTOP on Aug. 7 and appeared on CNN Wolf Blitzer Situation Room on Aug. 7.  \nAlso, on August 8, Al Jazeera, China News Service, was on NPR All Things Considered \nfor the malaria vaccine as well as BBC and on Aug. 9, NPR Science Friday.   Regarding \nthe statement by Fouchier and Kawaoka, this generated the usual push-back from the \npeople who feel that these experiments should not be done – Mike Osterholm, Ebright, \nAdel Mahmoud, Mike Imperiale, etc.    My quote was measured and emphatic in the Post \nthat said that added level of review was necessary.\nAug. 10, 2013 -  Had long talk at home over phone on Saturday (today) with Mike \nGerson who will write a Washington Post column on the successful malaria vaccine trial \nthat we conducted at the Clinical Center (paper published in Science with Bob Seder as \nfirst author.   His article will appear on August .\nAug. 16, 2013 -   Taped a tribute to Ted Kennedy and Vicki Reggi Kennedy for a Susan \nKomen event honoring them that will take place at the Kennedy Center in September.\nAug. 20, 2013 – Met with Deputy Minister for Health of the Kingdom of Saudia Arabia – \nDr. Ziad Memish.   He is visiting with regard to establishing scientific collaborations with \nNIH and CDC on the MERS-CoV.   He has admired me for years and was very happy to \nmeet and interact with me.\nReleased by Chairman Rand Paul\n321Aug. 22, 2013 – Nice piece on me and my “Leadership” in the ONLINE version of the \nWashington Post.   Will also appear in print version soon.\nSept. 7, 2013 (Saturday)– Went to an “A-List” party at the home of Jane and Calvin \nCafritz on R and 29th Street, N.W.   Usual glitterati there with Senators (Markey), \nGenerals (Casey) many ambassadors.   Very enjoyable night.   During the evening, \nAmbassador Walter Cutler (former Ambassador to Saudi Arabia) had a vas0-vagal attack \nand they called for a physician.   I attended to him and the story made it into the Style \nsection of the Washington Post on the following Monday.\nSept. 3 – 10, and beyond) – Obama threatening to attack Syria since Assad used \nChemical weapons (Sarin Gas) against his own citizens.  At first the POTUS said he \nwould attack imminently.   Then, after it was clear that there was not universal support \ndomestically or internationally for this approach, Obama hesitated and said he would go \nto Congress to get “authorization” even though he claims that he already has \nauthorization to attack Syria.   He is definitely giving a garbled message.   New slant is \nthat Russia who would veto any UN resolution against Syria is trying to broker a deal that \nif we do not attack, Syria will allow international control of their Chemical weapons.   \nMore Later.\nSept. 10, 2013 – Went to Rooftop Recption dinner hosted by the Friends of the National \nLibrary of Medicine at 101 Constitution Avenue, N.W. with a breath-taking view of the \nCapitol.   I gave laudation/award to Ray Schinazi for his discover of Lamivudine, \nEmtricitabine, and sofosbuvir.  Very enjoyable night.\nSept. 11, 2013 – Gave Great Teacher’s Lecture at the Masur Auditorium in the Clinical \nCenter as part of celebration of 60th Anniversary of the NIH Clinical Center.   Spoke of \nEnding the AIDS Pandemic; however spent first part of talk on ny history in coming to \nand working in the Clinical Center for over 40 years.   Packed house in Masur and over-\nflow in Lipsett Auditorium.  Amazing how time flies by.   I remember the first day that I \narrived and parked in the lot diretly in front of the CC and bumped into Alba Cosenza.\nSept. 19, 2013 – I called an important Summit that took place at Bethesda North \nMarriott.   Purpose was to discuss the advisability of using Adenovirus vectors for HIv \nvaccines given the failures of Ad5 vectors in 3 vaccine trials, but more importantly the \nfact that there were “trends” in each study that showed an enhancing effect on acquisition \nof infection in the vaccines who received the Ad5 vector.  Meta-analysis of the 3 studies \nshowed a significant (<0.01) 32% enhancement of infection.   Big question is that there \nare ongoing plans to use other vectors (Ad26, among others) in future HIV vaccine trials \nas well as in non-HIV vaccine trials (malaria, TB, etc.) in populations that might be at \nrisk for HIV.   Seems to me that any vaccine that activates cells that might migrate to the \nmucosal surface can have an enhancing effect that is seen if the vaccine is not efficacious.   \nIf the vaccine is efficacious, then the enhancing effect is masked as might have been the \ncase with the 31% efficacy of the RV144 trial.   Important issue is to try to get the \nefficacious vaccine and not do a trial on an Ad vector unless it shows an immune \nresponse that would be better than any other vaccines that we have tried.\nReleased by Chairman Rand Paul\n322Sept. 20, 2013 – Went to Lasker Lunch at the Pierre Hotel in NYC.  Beautiful Fall Day.   \nBill and Melinda Gates won the Bloomberg-Lasker Award for Public Service that I had \nwon a few years ago.   Nice event.   Bill and I discussed briefly the challenges of the P5 \nvaccine agenda.\nSept. 23, 2013 – Went to Friends of Cancer Research Awards reception on the roof of the \nHay-Adams hotel.   Beautiful Indian Summer nuight and spectacular view of White \nHouse.   Invited by Ellen Sigal.   She seated me in first row of award ceremony after \nreception.   Present were Governors Martin O’Malley of MD and Robert McDonnel of \nVA.  Got to chat with both.  Usual glitterati reception.\nSept. 27, 2013 – Had great typical dinner with Wayne and Catherine Reynolds at the \nJefferson Hotel.   Intimate setting with about 20 people at dinner – Rick Atkinson and \nwife Jane (Rick is strongly encouraging me to get going in writing my book); Gen. James \nJones and wife; Gen. Colin Powell and Alma Powell; John Rogers (Goldman Sachs and \nwife Deborah Lehr); Ben Carson and wife Candy; journalist Dana Priest; Steve \nRosenberg and wife Alice, among others.   Stimulating conversation regard imminent \nshutting down of the USG due to  stalemate on budget between Republicans (who want \nto defund Obamacare) and Democrats (who want a clean bill to keep government going \non a CR without touching Obamacare).   Difficult to predict what will happen on Monday \n(Sept. 30) at midnight, when the current fiscal year ends.   During dinner varied \ndiscussion.   I spoke passionately about the stupidity of across the board cuts in \nBiomedical research as part of the sequester and how this will damage our standing as the \nworld leader in biomedical research.\nSept. 28-30, 2013 – Threat of US government shutdown due to impasse in discussions \nbetween Republicans (Speaker Boehner – driven by T Party extremists) and Democrats \n(POTUS and Sen. Leader Harry Reid).   GOP wants to negotiate defunding Obamacare or \nat least modifying (delaying) individual mandate before they pass a CR to keep \ngovernment open after Sept. 30.   POTUS refused to negotiate “with a gun to my head”.  \nHe says: “pass CR and then we negotiate; also raise debt limit without conditions”.  I \nhave prepared a video tape of my Opening Keynote for the Barcelona AIDS Vaccine \nmeeting on Oct. 7 in preparation for possibility that I will not be able to travel to Spain.   \nRule is that if USG shuts down, then no USG employee travels.\nOct. 1, 2013 – Government shut down.   NIH begins to furlough 70+% of our work force.\nOct. 7, 2013 – I obviously did not leave for Spain.  Was scheduled to leave on Oct. 5 to \narrive on Oct. 6.   My video was played on this evening.   I put an extraordinary amount \nof time over the previous 5 weeks preparing this talk and it was one of the best that I have \ndone.   It was received with overwhelming praise as many people e-mailed me after the \nvideo was shown (7:00 PM Barcelona time – 1:00 PM DC time).   People were tweeting \neven during the lecture.   Gepi Pantaleo e-mailed me right after the lecture and said that \n“it was amazing”.   \nReleased by Chairman Rand Paul\n323Our government is dysfunctional with neither side giving any indication of negotiating.   \nLikely to be shut down until and beyond the debt ceiling deadline of October 17.   This \nwill mean that I will miss several other talks including the upcoming award that I am \nsupposed to receive in San Francisco from the SF AIDS Foundation (SFAF) on Saturday, \nOct. 12.  Stay tuned.\nOct. 8, 2013 – Bill Gates was supposed to deliver the Barnes Lecture and tour the NIH \nyesterday, but it was cancelled because of USG shutdown.  Francis Collins, Harold \nVarmus and I went to the Gates office in DC at 1300 I Street, N.W. to meet with him at \n9:00 AM.   Francis, Harold and I met at Starbuck’s at 1225 – I Street, N.W. at 8:20 AM \nto plan strategy.   Visit with Bill went very well.   I have met previously with Bill several \ntimes including at his home in Seattle.  The conversation today focused mostly on \ncollaborations that I and NIAID have with the Bill and Melinda Gates Foundation \n(BMGF) including the P5 vaccine trials, the HIV antibody – immunogen studies, the \nSanaria malaria project, etc.   Excellent discussions and we will expand NIH - BMGF \ncollaborations.  \nOct. 12, 2013 – Government still shut down.   POTUS refuses to negotiate under threat \nof shut-down and debt ceiling debate.   House GOP (Speaker Boehner)  refusing to let \nvote go to floor to open USG and raise debt ceiling since the combination of moderate \nrepublicams and Democrats in the House would pass it.    I miss the trip to SF to get \naward from SFAF.\nOct. 16, 2013 -   Still shut down.  Senate agrees on Bill to open USG and raise debt \nceiling.   Waiting on House and Boehner.\nWent to dinner at Villa Firenze (home of Italian Ambassador to the USA, Claudio \nBisogniero) at 2800 Albermarle Street, N.W. to honor visit of Italian Prime Minister \nEnrico Letta (recently elected, 47 year old).  Festive  occasion with many of the usual DC \nglitterati.   Had nice conversation with: Wolf Blitzer (CNN), Valerie Jarrett (White \nHouse), Susan Rice (National Security Advisor), Nancy Pelosi, Sen. Ed. Markey, Phil \nPiccagallo (Suns of Italy).   Sat next to Maj. Gen. Giovanni Fantuzzi, Military Attache for \nthe Italian Embassy, Linda Douglas (formerly of network TV and White House who was \nwith husband, the newly appointed Ambassador to Italy, Amb. Philip.   The opening of \nthe USG was announce as we were at the dinner when Nancy Pelosi and Ed Markey \nreported that a deal was reached.\nOct. 17, 2013  -  USG opens and debt ceiling raised temporarily until Jan.   Likely a \nsimilar battle will occur in January.\nOct. 18, 2013 – Terrific meeting today.   Paul Stoffels, Chief Scientific Officer of \nJanssen research Foundation, part of Johnson & Johnson called me months ago asking to \nhave a meeting since he wanted to support and develop the Ad26 vector – HIV mosaic \ninsert vaccine candidate of Dan Barouch.   I have always liked working with Paul since \nhe is the real deal as an honest scientist and smart drug developer/businessman.  He came \nin from Belgium with a team from Crucell company that was recently purchased by \nReleased by Chairman Rand Paul\n325Following the visit to Larry I went back to my hotel which was the Hotel Excelsior on \n81st St. between Columbus Avenue and Central Park West. The ceremony at the \nMuseum of Natural History was stunning in the positive sense. I completely \nunderestimated the importance of this particular function. The annual function makes \nReleased by Chairman Rand Paul\n326three major awards to biotech companies, pharmaceutical companies, and companies that \ndevelop devices. It is essentially the Academy Awards of pharmaceutical/biotech \ncompanies. I gave the keynote address associated with my receiving the Pro Bono \nHumanum Award.   This award is given every year.   Over the past 3 years it has been \nwon by Francis Collins, Paul Farmer, and Bill Clinton.   The dinner gala was held in the \nWhale Room of the Museum of Natural History. All the elite of the biotech world, the \npharmaceutical world, and the academic world were in the audience, which consisted of \nabout 500 people I gave an address on “Ending the HIV/AIDS Pandemic:   From \nScientific Advances to Public Health Implementation.  Importantly I was introduced and \npresented the award by Elie Wiesel. It was an extraordinary honor to receive the award \nby him. I returned to Washington DC first thing in the morning to a very busy week.\nOctober 27, 2013 – Went to reception and showing of a movie by famed young Indian \nactor, director, producer Aamir Khan at Jefferson Hotel at invitation of Catherine and \nWayne Reynolds.   Film was on female fetocide in Indian culture.   Quite moving.  Khan \nis a multi-millionaire visionary and pioneer for human right causes.\nOctober 28, 2013 – Appeared via teleconference at a NY State AIDS Institute \nConference in NYC organized by Mark Harrington and TAG.   They wanted my input on \nhow we can truly put an end to the AIDS epidemic in NY State.   Mark Dybul phoned in \nafter me from Geneva and the Global Fund.   \nOctober 31, 2013 – Been in press over past few days regarding recent papers in Science \nand other journals on the HIV envelope resolution by cryo-EM by Ian Wilson, Dennis \nBurton, John Moore.   Also on WTOP today regarding polio in Syria.  \nNov. 3, 2013 – Went to San Francisco for day – flew in the AM, gave Keynote at the \nLancet/Cell Conference on “Achieving an AIDS-Free World”.   My talk was widely \nquoted and praised for its comprehensive analysis of the opportunity and challenges in \nachieving an AIDS-Free world.   Richard Horton (Editor of The Lancet) praised me in \nseveral subsequent commentaries and editorials.   This is now a highly visible and much-\ndiscussed issue of an AIDS-free generation.   I am leading the discussion, but with the \nusual caveats that it is not yet time for a “victory lap” since much needs to be done and \ndespite great scientific and implementation advances, this is not on automatic pilot.   I \nflew back on “red eye”.   Hence 12 hours in the air and about 10 hours in SF.   This is my \nlife.\nNov. 11-16, 2013 -   Great trip with Christine to visit Oxford and give the Unither Baruch \nBlumberg Lecture at Oxford on “Ending the HIV/AIDS Pandemic:  From Scientific \nAdvances to Public Health Implementation”.  Met with Raymond Dwek and other \ncolleagues.   Visited historic sites within Oxford and enjoyed seeing places where Willis \n(Circle of Willis), Harvey (circulation) and Francis bacon lived and went to school.   I am \nnot usually moved by these things, but this was good.\nOn Nov. 13-14, went to Berlin to receive the Robert Koch Gold Medal.   Great honor.   \nJeffrey Gordon of Washington University received the Robert Koch Prize for his work on \nReleased by Chairman Rand Paul\n327microbiome.   My Medal was for lifetime achievement in medical science.   Peter Palese \ngave the best introduction of me ever.   He seriously compared my career to that of \nRobert Koch in that I attacked a brand new disease (HIV/AIDS) in the same manner that \nKoch approached and studied Anthrax, TB, etc.   It was a humbling and exciting visit.   I \ngave the Robert Koch Lecture at the Max Planck Institute and reacted with many \nstudents.  Also saw old friends Stefan Kaufman (nominated me), Fritz Melchers, \nHermann Wagner, etc.   Visited Checkpoint Charley, Brandenburg Gate, The Reichstag.  \nGreat honor and enjoyable visit.\nNovember 19, 2013 -  Yesterday I appeared on Local TV Station WUSA – Channel 9 \nNews  at 7:00 PM to discuss the recent outbreak of meningococcal meningitis at \nPrinceton University. Since March, 2012 that have been a total of seven cases of \nmeningitis among Princeton students. Six of the cases were among resident students and \none was a case from a visitor. The type of the meningitis was meningococcal type B, \nwhich is not contained in the vaccine that is distributed generally among students and \nyoung people in United States. The standard vaccine contains types A, C, Y, and W-135.. \nNone of the students died from the meningitis. I will be appearing today on the radio \nWTOP to discuss the situation. The FDA has given approval for importation of type B \nvaccines from Novartis Company in Switzerland. It still remains to get approval from the \ninstitutional review board of the CDC. As usual HHS Public affairs has balked at my \ngoing on the media because they consider this a CDC issue. This time with support from \nJohn Burklow, we asked for permission, they said no, and I went on TV last night \nanyway. I am going to appear on radio this morning again. This is a turning point in our \nrelationship with HHS who continue in a completely crazy way to rty to block our going \non the media in situations that they feel belong to CDC even though the Media \nspecifically ask for me.\nNovember 20, 2013 – This was one of the most magical evenings that I have had in \nWashington in the 40 years that I have been here. I was invited with Christine to go to a \nCelebration of the 50th anniversary of the conferring of the Presidential Medals of \nFreedom. The event was held at the Smithsonian Museum of American History on 1300 \nConstitution Ave. NW., District of Columbia. The event was in celebration of several \nthings. It commemorated the 50th anniversary of the assassination of Pres. John F. \nKennedy. It also was the 50th anniversary of the establishment of the Presidential Medals \nof Freedom by Pres. Kennedy. We found out in a historical examination of the situation \nthat Kennedy established the Presidential Medal of Freedom in February of 1963. He was \nintending to give out the first metals in December of 1963. However, as we know, sadly \nhe was assassinated on November 23, 1963. Pres. Lyndon B. Johnson went ahead and \nconferred the medals one month after the death of Pres. Kennedy. He conferred the \nMedal to Pres. Kennedy post-humously and gave it to Jacqueline Kennedy who received \nit on her deceased husband's behalf. The reception and dinner that was held at the \nMuseum of American History was extraordinary. Virtually everyone who is anybody in \nWashington, DC was there and it was highly populated by people who in the past had \nreceived the Medal. I had the opportunity to speak with Pres. Obama, President Clinton, \nas well as a nice conversation with Hillary Clinton. It was also the first time that I had the \nopportunity to speak with first lady Michelle Obama. The number of celebrities that were \nReleased by Chairman Rand Paul\n328brought together for a group picture of all the former Medal winners as well as the people \nwho recently won this year including people like Ben Bradley, Ernie Banks and others. It \nwas truly an extraordinary evening. I mingled and talked with Ernie Banks and Hank \nAaron,  Bill Russell, generals, statesmen, et cetera. The evening was highlighted by a \nspeech by Pres. Obama regarding the legacy of Pres. John F. Kennedy. In a poignant \npoint in the evening, Pres. Obama was introduced in his speech by Jack Schlossberg who \nis the son of Caroline Kennedy and the grandson of Pres. Kennedy. Sitting at my table \nwas former CIA director and FBI Dir. Bob Webster, Doug Kramer who is the former \nstaff secretary to the President and currently General Counsel for USAID. Sitting right \nnext to Christine was the legendary race car driver Richard Petty. All in all it was a truly \nspectacular evening there was entertainment by one of this year's Medal winner, Cuban \nmusician Arturo Sandoval who was a protégé of Dizzy Gillespie. He gave one of the \nmost extraordinary trumpet performances that I have ever heard in addition to \nextraordinary singing ability and a phenomenal piano piece that he played. Again this \nwas truly an extraordinary evening.   It was black tie, elegant setting.  Military regalia as \nper the presence of the POTUS.   The night was chilly, crisp and clear.\nLIST OF ATTENDEES AT GALA on Nov. 20:\nExpected Attendees at the Dinner in Honor of Presidential Medal of Freedom Awardees  The White House.mht\nNovember 21, 2013 - Funding of PEPFAR and Replenishment of Global Fund to \nFight Aid TB and Malaria (GFATM) – Over the past several days there has been \nconsiderable activity about the issue facing the funding of PEPFAR for 2015. The \nactivists are pushing to have 12 million people on therapy by 2016. The global goal is 15 \nmillion people on therapy by 2015. The Obama administration will not give additional \nfunding for PEPFAR that would allow them to reasonably achieve the goal of 12 million \npeople on therapy by 2016. Therefore, the State Department and the people at PEPFAR \nare struggling with how to message something that would be disappointing when you \nlook at the numbers. I've had pre-calls with Deborah VonZinkernagel and today (Nov. \n21, 2013) we had a call with three people from the State Department – Daniella Ballou-\nAares, Lorrie McHugh-Wytkind, Eric Goosby and Deborah.  I was up in NYC for the day \nto appear on an Atlantic Magazine-sponsored panel and Webinar on a similar subject: \n“Talk is Cheap: Saving Lives, Ending AIDS and Putting Our Money Where Our Mouth \nIs”.  As an aside, other participants in that Atlantic Magazine panel where Peter Staley, \nNancy Mahon (MAC Cosmetics), Jeffrey Sachs (Columbia), Phill Wilson (Black AIDS \nInstitute), Luis Loures (UNAIDS).  Stephen Lewis (AIDS-Free World), Wafaa El-Sadr, \nDanny Resnic (Origami Condoms) and Deborah Persaud (Hopkins).  The Session was a \nbig hit.\nBack to the telephone conversation with PEPFAR and State.  I made the strong \nsuggestion that the PEPFAR people and the Department of State bite the bullet and tell \nReleased by Chairman Rand Paul\n329the truth about what they can and cannot do. One of the problems is that if they stick by \nthe promised numbers without the resources to achieve those numbers it will turn out that \nthey will overpromise something that they cannot deliver on. Note the similarity to the \nroll-out of the Affordable Care Act – a true mess-up).  I warned them as to the danger of \nthis. They should suggest to the White House that they assume a leadership role in getting \nthe entire global community to increase their support of the treatment goals. We cannot \nget to that goal ourselves since we do not have the resources. I feel that it would be \nappropriate for us to put more resources in. However, OMB refuses to put any more than \njust about $150 million more into the 2015 PEPFAR budget. The phone call went well \nand I hope that they take my advice. More to come.\nAnnouncement was made today that David Ho and I have won the Prince Mahidol \nAward from Thailand.   We will receive it for medical research and Peter Piot and Jim \nKim will receive it for Public Health.   Ceremony will take place in Bangkok on January \n28, 2014\nNovember 26, 2013 – We here at NIH have been working on the schedule for the visit of \nBill Gates to the NIH on December 2, 2013. There was considerable concern that this \nmight conflict with the annual World AIDS Day celebration at the White House which \nwould involve Pres. Obama that might be scheduled on December 2. However the White \nHouse announced that they will have the celebration on December 3 which avoided a \nconflict with the Bill Gates visit. Considerable planning went into the scheduled Gates \nvisit with my playing a major role in showing him around and leading discussions.  \nHowever I just heard literally minutes ago from the White House that the World AIDS \nDay ceremony will take place on Monday, December 2. This directly overlaps and \nconflicts with the Bill Gates visit. This will be very disruptive and upsetting to both Bill \nGates and the NIH since the last time Bill Gates was scheduled to visit the NIH was the \ntime that the government shut down in October, 2013. I will wait further instructions \nfrom the White House since I have been assigned a major speaking role at the World \nAIDS Day celebration at the White House. I am supposed to speak on the “Care \nContinuum” and the road to a “cure” for HIV/AIDS.  More to follow.\nDecember 2, 2013 – Monday and cold cloudy day is DC.   Celebration of World AIDS \nDay (WAD) today since December 1 was a Sunday.   Also, Bill Gates visited NIH to \ndeliver Barnes Lecture and to be shown around NIH:\nGates – Francis Collins, I, and Clif Barry showed Bill Gates around the BSL-3 \ncontainment facility in Building 33 where we do experiment on marmosets with drug-\nresistant TB.   Clif does drug screening.   We suited up with all the contained gear \n(“space suits”) and had a good time showing Bill around.   This was followed by a \nroundtable discussion with certain IC Directors (me, Varmus, Pettigrew, Guttmacher, \nGlass, Somerman and Collins.   I know Bill well from multiple interactions over the years \nand I spoke with him about our ongoing collaboration with the Bill & Melinda Gates \nFoundation (BMGF) over the years.   I did not remain for his lecture since I had to rush \ndown to the White House for the WAD ceremony\nReleased by Chairman Rand Paul\n330White House – Ceremony in the South Court Auditorium of the WH.   Speeches by \nPOTUS, Sec. Kerry, Sec. Sebelius, Valerie Jarrett, Cecilia Munoz (Domestic policy \nCouncil).   Panel with Collins, Gates, Dybul, Chris Beyrer (Hopkins), Amanda Castel \n(GWU), Kali Lindsey (National Minority Council), and Dr. Ngozi Okonjo-Iweala \n(Minister of Finance of Nigeria).   POTUS had announced a reprogramming from within \nAIDS budget at NIH $100 million over 3 years for a “Cure Initiative”.   I was asked and \ngave the final talk of the ceremony on the links between the care continuum and a cure.   \nVery well received.   I, of course, am somewhat cynical about a “cure initiative” with no \nnew money.\nGlobal Fund Replenishment – Today and tomorrow are the 2 big days for countries to \nmeet here in DC to pledge for the next 3 year cycle of the Global Fund to Fight AIDS, \nTB, and Malaria.  I attended meeting at Willard Hotel where Sec Kerry gave a terrific \nspeech.\nDec. 3, 2013 – Hectic but very good day.   Started early in AM and went to Reserve \nOfficers Association at one Constitution Avenue, N.E. for a Friends of the Global Fight \nAgainst AIDS, TB, and Malaria had a breakfast.   Multiple speeches; Moderated by Mike \nGerson; several speakers called me out for my “pioneering work on HIV/AIDS” \nincluding Bill Gates, Nancy Pelosi, Mike Gerson and others.   I left the meeting at 9:00 \nAM, went to the AAI Council meeting in Rockville as I do every year to update them on \nNIAID and then immediately went to DCA to fly to NYC to attend as guest of Bob Seder \nand Debbie Harmon the Women for Women Gala in honor of Hillary Clinton at the \nAmerican Museum of Natural History at W 79th Street and Central Park West.   I stayed \nat the Excelsior on W 81st.   It was an amazing evening.   I was among about 12 people \nwho greeted and had special ‘audience” with Hillary Clinton.   At my table (#18) was my \n“dinner date” Cheryl Mills (we are becoming good friend), Virginia Moseley (VP and \nDeputy Bureau Chief of CNN), Marty Edelman (Counsel to real estate practice – big \ncontributor to Wounded Warriors project), Norma Kamali (Fashion designer – flakey and \ninteresting lady who wants me to come to NYC again and talk to her “health group” \nabout immune enhancing), Nella Domenici (Daughter of Sen. Pete Domenici and sister-\nin-law to Cheryl Mills), Ngozi Eze Nigeria Country Director for Women for Women), \nSusan Goldberg (Exec. Editor of Bloomberg News).   Also met with Sheryl Sandberg \n(“Lean in” and COO of Facebook).   Also, importantly met Jeff Zients who fixed the \ncomputer catastrophe of the role out of Obamacare. Jeff will likely become Economic \nAdvisor to Obama.  All-in-all a very festive evening.   Clinton gave a great speech.\nReturned to DC on 6:00 AM on Dec. 4 shuttle in time to be on panel at Georgetown \nUniversity Copley Lounge of the Global Fund.   Was on panel with Eric Goosby, Tom \nFrieden, Admiral Tim Ziemer (head of the President’s Malaria Initiative).   My panel \nmoderated by Larry Gostin.   Mark Dybul gave very moving speech as Keynote.\nDec. 5, 2013 – Meningococcal meningitis breakout among a few students at Princeton \nand then at UC Santa Barbara.   Was on WTOP radio today to discuss.  Was Group B for \nwhich we do not have an FDA approved vaccine for in the USA.   Used in Europe and \nAustralia.   FDA giving emergency use authorization for use in Princeton.\nReleased by Chairman Rand Paul\n331Had dinner with Danny Hultzen and Chris Hultzen.   Danny had significant operation on \ntorn labium and rotator cuff in his left (pitching) arm.   On rehabilitation now.   Amazing \nthat he was 5 and 1 with a 2.3 ERA in AAA ball pitching at 93 mph with torn shoulder \nligaments.   Hopefully he will fully recover since he was slated to go up to MLB last \nyear.\nDec. 14, 2013 – Had quick trip to NYC on Saturday for Editorial Board meeting of \nHPIM.   Big issue is the decreased sales of the printed book, particularly domestically.   \nReason clearly is that students and others are not using print books very much to study \nand learn and look up material.   Almost all online.   We need to emphasize more out \nonline versions, i.e. iPAD, HOL, HP, etc.   Good to see the other editors.\nDec. 17, 2013 – Grant Colfax, the White House AIDS person and Directors of the Office \nof Nation AIDS Policy (ONAP) called me to give me heads-up that he was stepping \ndown.  Interesting since he has been on the job for only 1.5 years.  Not sure what his \nreason was for stepping down.   He is returning the San Francisco.\nDec. 27, 2013 – Influenza season starting to spike with predominance of 2009 H1N1.   \nInteresting that ever since 2009, the 2009 H1N1 has bumped H3N2 off as the major strain \nthat circulates during seasonal flu.   \nI appeared on CNN “The Lead”.   Interviewed by Joe Johns who was subbing for Jake \nTapper.\nDec. 28, 2013 – Jan. 8, 2014 -  Children home for the holidays.   Unusual to have all 3 \ntogether, particularly since Ali has been at Stanford.\nInfluenza activity (mostly H1N1) starting to crank up.   Have been on WTOP radio and \nAl Jazeera America TV talking about the seasonal flu.\nJan. 9, 2014 – Was on panel at The World Bank at 1818 H Street, N.W. to discuss Social \nand structural determinants to combat HIV/AIDS and poverty.   All the usual \ninternational AIDS players were there.\nJan. 10, 2014 – Went to White House for farewell reception for Grant N. Colfax, head of \nthe Office of National AIDS policy (ONAP).   He had been at the job for 1 ½ years.   He \nis returning to be in San Francisco with his partner and family.   He is a good guy who \ndid a good job.   During the speeches, he called me out as “a legend in HIV/AIDS” and \nsaid how wonderful it was to work with me.\nJan.14, 2014 – Seasonal influenza is beginning to peak and I am doing the usual media.  \nDid FOX News.\nJan. 24 – Feb. 1, 2014 – Prince Mahidol Award – Bangkok.  See attachment for daily \nschedule:\nReleased by Chairman Rand Paul\n332\nMahidol - Bangkok \n2014.doc\nIn summary, I received the 2013 Prince Mahidol Award in Medicine together with David \nHo.   Peter Piot (Director, London School of Public Health and Hygiene) and Jim Yong \nKim (President, World Bank) received the Prince Mahidol Award in Public Health.  It \nwas a most extraordinary trip. We were hosted by the Royal Family of Thailand and we \nwere afforded luxurious treatment. Indicative of this treatment was the fact that we were \npicked up at the airport in Bangkok by a representative of the royal family and was driven \nto our hotel with a double police escort. By double police escort I mean a motorcycle \npoliceman leading the motorcade followed by a police car followed by a brand-new \nMercedes which carried me, my wife Christine and Gray Handley, my associate director \nfor global affairs, at NIAID. We spent an entire week in Thailand. The center of the \nactivities was the award ceremony at the Palace of the royal family. The pomp and \ncircumstance was most extraordinary. I received a gold medal and a check for $50,000 \nfrom the Princess of Thailand. In addition to the extraordinary ceremony followed by a \nfestive dinner at the Palace, we were treated to police escorted tours of several of the \nother palaces, the Emerald Buddha, as well as other historic places. In addition Chris and \nI and Gray toured the famous Thai canals on a boat as well as went to the major market in \nBangkok, which is the largest open market in the world. Our hotel was lavish. I also did a \nconsiderable amount of work giving two official lectures, a panel discussion together \nwith David Ho, Peter Piot, and Jim Kim, when he was present. Jim was only there for \npart of the time since he had just come back from Burma where, as President of the \nWorld Bank, he gave $2 billion to Burma. In addition, I visited this Siriraj hospital, the \nThai Red Cross and anonymous clinic, the CDC facility, the Silom clinic, and other \nfacilities (see attached agenda) where we discussed some of the NIAID sponsored clinical \ntrials on HIV. Of particular interest was the study that was done in collaboration with the \nArmed Forces Research Institute of Medical Science (AFRIMS) on acute HIV infection. \nI met some outstanding people from the CDC including Mitchell Wolfe Tim Holtz and  \nMarcel Curlin. In addition I was accompanied throughout the entire trip by Lieut. Col. \nRobert O'Connell. Rob works with Nelson Michael and Jerome Kim, is the liason to the \nUS Embassy and was an extraordinary asset to the trip. Christine and I flew back and \nforth first class from Washington to London (United) and then from London to Bangkok \n(Thai Airways). There were many perks associated with the trip. One that stood out was \nthe fact that the royal family arranged for Chris and I to have a professional Thai massage \nat the spa at Bangkok airport on our way home.  Of note was the fact that there was \nconsiderable political unrest in Thailand during our visit. I learned a lot about the \npolitical situation from observing and listening to my Thai colleagues. Apparently, the \ncurrent Prime Minister (Yingluck Shinawatra)  is the sister of the recently deposed Prime \nMinister who is in exile. He was exiled because he of corruption (he paid off members of \nParliament to support him). However, much of the Thai population at least in Bangkok \nand certainly among the academics, feels that his sister is merely an extension of him and \nalthough she was democratically elected, they feel that she should be put out of office and \na special council run the country until the corruption is cleared up. This creates a \nReleased by Chairman Rand Paul\n333considerable dilemma for the United States Embassy since they want to side with \ndemocracy; however, everyone knows that the democratically elected person is steeped in \ncorruption. I actually wound up meeting the Prime Minister at the award ceremonies at \nthe Royal Palace. There were several demonstrations while I was there in anticipation of \nthe elections which took place after we left on February 2. The demonstrators wanted to \nblock the election because they wanted to have reforms before the election. It is likely \nthat the election will not come to majority vote and that a new government will have to \nbe formed. There was a small amount of violence while I was there including someone \nthrowing a hand grenade into a crowd of demonstrators as well as a person murdering \none of the leaders of demonstrators. We were never in any danger as we were always \naccompanied by a police escort. I also learned a lot about Prince Mahidol, who was the \nfather of the current king, who is very ill.   Prince Mahidol started off as a naval officer \n(trained in Germany, but then when he realized the poor health conditions in his country, \nhe wanted to do something about it.   He wanted to learn Medicine first and so he went to \nHarvard Medical School and graduated cum laude.    He is considered the father of health \ncare in his country. This was truly a memorable trip from so many standpoints.\nFeb. 3, 2014 – Just back from Thailand and extremely jet-lagged and also somewhat ill \nwith URI.  Probably got it form Chris who had been sick as well as the fact that I was \ntravelling for over 24 hours in a plane.\n     Did interview with Washingtonian magazine regarding my opinion of the movie \n“Dallas Buyer’s Club”, great movie starring Matthew McConaughey about an HIV-\ninfected individual in the early 1980s who did not want to take AZT because he felt that \nit was too toxic and started a buyer’s club to buy and sell unproven drugs.   Great \nperformance (likely an Oscar – did win Golden Globe already).  They called me because \nI was there when it happened and also I was the one that started the AZT distribution \nsystem through a contract paid for by NIAID.\n       Met in Building 10 with Sen. Durbin (D-IL) and then a separate meeting with \nCongressman Pitts (R-PA) regarding NIH accomlishments and implications of a bad \nbudget.   Durbin is new Chair of the Defense Approp. Subcommittee and unfortunately \nhe wants to get more money for biomedical research for Dod.   Menas well but does not \nappreciate that it may not be well-spent.\nFebruary 5, 2014 – went to the NIH FDA leadership Council meeting at the new FDA \nheadquarters in Silver Spring. I presented the NIAID strategic approach towards \nantimicrobial resistance research. The FDA presentation was made by Dr. Peter Lurie. In \nattendance were Dr. Francis Collins, Dr. Peggy Hamburg, members of the FDA, as well \nas members of the NIH. This is an initiative in which we will be engaging industry in \ntrying to get expedited approval for antibiotics against resistant organisms. \nFebruary 7, 2014 – went to the American Society of Microbiology annual Public and \nScientific Affairs Board meeting at their headquarters on 1752 – N Street, NW., \nWashington, DC.  I do this every year and update the group on activities of NIH and \nNIAID.  As usua,l my presentation was extremely well received by the group. These are \npeople who are great supporters of me and my role as the director of and NIAID.\nReleased by Chairman Rand Paul\n335however, Francis shunned him.   Issue is that John wrote into the report language of the \nNIH appropriations that we should have a “strategic plan” and Francis refuses to do a top \ndown plan. Francis is completely correct on this, but he should compromise and agree on \na “communications plan” since that is all the Committee wants is a document to refer \nconstituents to when they inquire about what NIH is doing and why.\nFeb. 24, 2014 – Did the “Nifty-Fifty” talk at Montgomery-Blair High School in Silver \nSpring.   Great group of kids with many questions and interest.   I spoke on my career in \npublic service at NIH.\nSen. Mikulshy visited NIH and gave “pep talk” about the budget.\nFeb. 25, 2014 – Went to NYC for the day to the DDCF Board meeting.   Always like this \n– seeing Nan Koehane, Jim Gill, Ed Henry, Peter Nadoscy, John Zuccotti et al.  \nSomeday, I might even be able to take the honorarium \nFeb. 26, 2014 – Dinner with Larry Corey at Cesco Osteria in Bethesda.   Extremely cold \nstreak of weather in DC over past few weeks.  We spoke of Larry concern about DAIDS, \nthe vaccine program, esp. Mary Marovich, whom he feels is a poor substitute for Peggy \nJohnston.   I am also hearing this from Gepi.  They worry that Mary and her staff have no \nleadership and cannot make decisions.   Feel that they do not represent me well as did \nPeggy.\nFeb. 27, 2014 – Break-in at my house.  Stole only change on my dresser and Euros in my \ndrawer (~$200 worth).   Looks like inside job of someone who had key.   Perhaps one of \nmany people that we had lent the key to over the years.   Have now changed lock on front \ndoor.   They likely exited out back (porch) door since this was unlocked when I came \nhome at night.\nFeb. 28, 2014 – CROI meeting coming up next week and a few paper out in NEHM.   \nMany print media interviews on CCR5 gene editing.\nMarch 4, 2014 – Gave Keynote Lecture at Global Vaccine and Immunization Research \nForum at the Bethesda Hyatt Hotel.  Big audience of Decade of the Vaccine crowd, i.e. \nGAVI, BMGF, WHO, etc.   Well-received. \nMuch press associated with CROI meeting and new baby cure questions and Carl June \ngene editing for CCR5.\nJim Lehrer (Newshour) contacted me for advice about his granddaughter Olivia who has \njuvenile idiopathic arthritis.   I spoke with him and his wife Kate and made some \nrecommendations and just chatted with them about the disease.   Jim was very grateful.  \nDiane Rehm had originally suggested to Jim that he contact me.\nMarch 5, 2014 – Lunch at Bethesda Hyatt with Margaret Chan, Director General of \nWHO.   Margaret is old friend since mid-1990s with the original H5N1 situation in Hong \nKong where she was Commissioner of Health at the time.   Pleasant wide-ranging \ndiscussions.  Present were Lee Hall, Hilary Marston, and a couple of people from WHO.\nReleased by Chairman Rand Paul\n336March 6, 2014 – Much, much media today surrounding a NEJM paper on CCR5 (see \nabove – Carl June’s paper) as well as a second baby who might be cured as well as \nmonkey studies on long-acting PreP (David Ho).  I was on WTOP; ABC Morning News \n(bumped because of Ukraine-Russia crisis, but likely will be shown this weekend); \nNewsHour with Jeff Green; NPR- All Things Considered – Audie Cornish; Al Jazeera; \nVOA; tomorrow we do MSNBC and NPR Science Friday with Ira Flatow.  Also, \nmultiple printed press including NY Times.\nMarch 7, 2014 – The Dalai Lama visited NUH and I went to hear him speak at the \nNatcher Auditorium.   I could barely understand what he was saying due to his strong \naccent and bad acoustics.   However, he won everyone over with his smile and infectious \nlaugh.\nMarch 10, 2014 – Appeared on NPR “On Point” talking about the recent AIDS stories. \n(see above).\nMarch 13, 2014 – Salim (“Slim”) Abdool Karim visited from Sotuh Afrtica at my \ninvitation to deliver the John la Montagne Lecture in the Lipsett Auditorium.  Slim had \ntake the job as the Director of the South Africa MRC to essentially shake up the place \nand fire a bunch of dea wood.   He took the job on a contingency that he would leave is 2 \nyears.   He has done a great job of “cleaning up”.  He will be replaced by another friend, \ni.e. Glenda Gray.\nMarch 14, 2014 – Spoke with Rick Atkinson today to update him on the progress of my \nmemoirs and to ask his advice about whether I should engage Bob Barnett for advice \nabout the legality of my writing my memoirs while I am a USG worker.   Recall that Bob \nBarnett has offered to be my agent when I write my book.   He offered to do this years \nago.\nMarch 20, 2014 -  Received horrible news tonight at around 9:30 PM from Howard \nBoltansky who called my cell phone.   My dear friend and physician for 16 years, David \nJacobs died suddenly in Las Vegas today where he was with his brother to watch the \nNCAA Tournament (March Madness).   David had shown me an MRI of his abdomen.   \nAbout 6 years ago he was struck by a car while running his daily run down by the Mall.   \nHe got badly bruised up, but there was no concussion and so other ‘apparent” injuries \nexception getting banged up badly.   About 6 months later on a routine medical \nexamination and MRI, they found a major tear the length of the aorta with clotted blood \nstably keeping everything in place.   Amazingly, his renal vessels and femoral arteries \nwere being perfused, but the tear and clot was extensive.   Clearly, this happened at the \ntime of the accident.   He had gone to several vascular surgical consultants who told him \nthat this was not repairable and that if they attempted to repair it, he had a very high \nlikelihood of dying on the OR table.   They told him that he could live 30 years or he \ncould die suddenly at any time.   No way to predict and so he has lived with this hanging \nover him.   In my conversations with his, he was always in good spirits and seemed to \naccept the risk.   Unfortunately, this has happened.   I am terribly saddened.   I loved \nDavid and he took such good care of me.   I had trained him when he was an NIAID \nReleased by Chairman Rand Paul\n338Was on WTOP for the NYC measles outbreak.\nMarch 25, 2014 – Appeared on Diane Rehm Show on WMAU with Anne Ginsberg and \n…. To discuss TB for World TB day.\nMarch 26, 2014 – Testified at the House Appropriations Subcommittee Hearing with \nFrancis Collins, Harold Varmus, Story Landis, Gary Gibbons.   Chairman Kingston \nstayed for 10 minutes and then handed Chair to Dr. Andy Harris (R-MD).   Harris \nquestioned me on why we are spending so much money on AIDS given the decreased \ndeaths compared to diabetes, CVD, cancer, etc.   I explained that we are still in the \nmiddle of a pandemic.\n Appeared on Al Jazeera regarding Ebola in Guinea.\nMarch 27, 2014 – Dennis Kasper flew in from Boston to work for 2 hours with me on \npreparing me to present his NAS nomination.\nMet with Debbie Birx who is waiting for Senate Approval for head of PEPFAR (OGAC).   \nTo my dismay, the White House has not submitted her to the Senate for final approval.   \nShe has already had her hearing and did very well.\nApril 1, 2014 – Ebola still raging in Guinea.  Appeared on BBC TV with Katty Kay to \ndiscuss as well as BBC radio to discuss pandemics and gave interview with SLATE \nMagazine on Antimicrobial Resistance\nApril 2, 2014 – testified at the Senate Appropriations Subcommittee Hearing in 192 \nDirksen Building.   Witnesses were Francis Collins, me, Harold Varmus, Gary Gibbons, \nStory Landis and Chris Austin.   Chaired for last time (historic) by Sen. Tom Harken (D-\nIO).   I have been testifying before Sen. Harken for every one of the 25 years that he has \nbeen in the Senate as a member, Chair, or Ranking Minority of this committee.  Present \nwere Sen. Mikulski, Shelby (ranking minority of full committee), Moran (R-KS).   It was \na love fest for NIH, but there is not going to be any new money for NIH (~0.7% increase \nover 2014) because of budget constraints on discretionary spending.\nApril 3, 2014 – Nice visit from Paul Huijts – Director General for Public Health in The \nNetherlands.   He is very interested in antimicrobial resistance.   We in USA and NIH are \naccelerating our efforts in this area due to increasing concern over this emerging problem.\nApril 8, 2014 – Went to Princeton for the day to give “Public Lecture” at the Woodrow \nWilson School of Public and International Affairs.  Invited by Dean Cecilia Elena Rouse \n(formerly with Hillary Clinton).   Met with students (lunch), chaperoned by Adel \nMahmoud, gave lecture on pandemic influenza preparedness with many questions.   \nGood visit.   Ran into my old high school friend and college roommate – Lou LoBosco.\nReleased by Chairman Rand Paul\n339April 9, 2014 – Larry Corey flew in from Seattle to see me.   He is still dissatisfied with \nMary Marovich – Vaccine person at DAIDS.   He feels she cannot make a decision and \nshows no leadership.\nApril 14, 2014 – Continued smoldering of cases of Ebola in Guinea (and spread to \nLiberia) has sustained media interest.   I appeared on NBC Nightly News for this tonight \nApril 15, 2014 - I appeared on WTOP radio for MERS-CoV and Ebola\nApril 17, 2014 – Went to Harvard School of Public Health to appear on their web \nbroadcast of “Senior Leadership Series”.   Nice experience.   Hosted by David Hunter \nand Dean Julio Frenk present.   Many good questions about my accomplishments and \nleadership style.  Broadcast on web throughout the world.\nApril 18-24, 2014 – Preparing by phone with Bart Haynes and Dennis Kasper, whom I \nam presenting for nomination for National Academy of Sciences next week.\nApril 24, 2014 – Went to private dinner at café Milano to celebrate swearing in \ntomorrow of Deborah Birx as Ambassador in charge of PEPFAR.\nApril 25, 2014 – Swearing in of Deb Birx at Franklin Room of the State Department.   \nBig crowd and festivity.\nImmediately after swearing in, went to PAHO (a block away) to give talk at the 10th \nAnniversary of the Sabin Vaccine Institute.   Many old friends there – Peter Hotez, D.A. \nHenderson, Ciro deQuadros, etc.\nApril 26, 2014 – Went to Chicago to deliver after dinner speech at the AAP Dinner at the \nFairmont Hotel.   AAP President Larry Jamison invited me.   Spoke on The HIV/AIDS \nSaga:   Science and Policy”.   Spoke of my experience with 5 Presidents.   Big hit.\nApril 28, 2014 – Went to NAS meeting at Fairmont Hotel in DC to defend Haynes and \nKasper for membership.   Response to them (in voting) was only fair to good.\nApril 30, 2014 – Spoke at amfAR event at Kennedy Caucus Room at Senate Russell \nBuilding.   Big affair.   Sen. Harkin praised me; Kenneth Cole (fashion designer) \nintroduced me. Many people there:  Douglas Brooks (new head of ONAP); Jim Kim \n(World Bank); Paul Farmer was interviewed on stage by Judy Woodruff (NewsHour).\nMay 2, 2014 – Still smoldering concern about MERS-CoV with 1st USA imported case \nfrom Saudi Arabia to Indianapolis.   I appeared on Fox5 TV and AP TV.\nMay 3, 2014 – Big social day.   White House Correspondence Brunch at Katherine \ngraham’s old house at 2920 R Street, N.W. hosted by Tammy Haddad, Steve and Jean \ncase, etc.   Many, many celebrities. Had fun with cast of “House of Cards”, particularly \nReleased by Chairman Rand Paul\n340Sebastian Arcelus who plays Lucas Goodwin on the show.   Very nice guy.   His wife \n(Stephanie Block) was very taken up by the fact that I worked on HIV/AIDS.\nThat evening attended White House Correspondence Dinner as gust of AP (Cynthia \nSharp).   Much fun.   President Obama was hilarious as was comedian Joel McHale.   \nGreat evening.\nMay 8, 2014 – First MERS-CoV case in Lebanon.  Total numbers up to 495 with 141 \ndeaths.   I appeared on CNN International tonight.\nMay 10. 2014 – Elizabeth Sherwood-Randall (National Security Staff, White House and \nSpecial Assistant to the President, Coordinator  for Defense Policy, Countering WMD, \nand Arms Control had met me at a Wayne and Catherine Reynolds function some time \nago and took the initiative to invite Chris and me for dinner at her home at 4920 Indian \nLane, N.W. her husband Jeff is a neurosurgeon in Bay Area near SF.   He is on faculty at \nUSCF.   Children (Richard and William go to STA and heard my recent lecture there).   \nAlso at dinner was Al Hunt (Bloomberg News – wife Judy Woodruff could not attend – \nwas giving Commencement Address at Alleghany College).   Also present was  Diana \nFarrell (recently Deputy Director, National Economic Council at White House and \ncurrently CEO of Kinsey. Inc.).   Very pleasant and fun evening.\nMay 14, 2014 – Yesterday was 2nd imported case of MERS-CoV from Saudi Arabia – a \nhealth worker at a Saudi hospital.   Went from Ryaad to London to Boston to Atlanta to \nOrlando.\nWent to University of Pennsylvania to give the 12th Annual Neal Nathan son Lecture on \n“Ending the HIV/AIDS Pandemic:   From Scientific Advances to Public Health \nImplementation”.   Spent whole day meeting with people many old friends – George \nShaw, Beatrice Hahn, Larry Jameson.   Megan had just decided last week to go to Penn, \nhaving also been accepted to Cornell, Columbia, Michigan, Hopkins, among others.   \nPenn p [people are excited about Megan coming there.   Had dinner at great restaurant \n(Bukkadan) in Philly before taking 9:10 PM Amtrak back to DC\nDid radio interview on new Guidelines for PrEP  with CBS Radio in Men’s room of the \n30th Street Station in Philadelphia while I was waiting for the 9:10 PM train back to DC.\nMay 15, 2014 – More MERS cases.   Did CNN with Jake Tapper at 4:30 PM on the  \nissuance by CDC of Level 2 alert for travelers to mid-East and airport alerts to pilots to \nreport people with fevers and illness on mid-east flights.   HHS now becoming more \nflexible in not giving us grief about being on TV for issues that they inappropriately think \nare CDC topics.   CNN specifically said they wanted me and NOT CDC.\nMay 16, 2014 – Did Al Jazeera TV on recent CDC guidelines for PrEP.   I am becoming \n“the darling” of Al Jazeera.  Producers really like my style and they keep coming to me.\nReleased by Chairman Rand Paul\n341May 18, 2014 – First transmission of infection (sero-conversion) from the Indiana \nimported case to someone who had “handshake” contact.   Again, news blow up.   I taped \nsegment for the Today Show (NBC) to appear on May 19.\nMay 19, 2014 – MSNBC wants me this AM.   Return of the “problem”.   CDC \ncomplaining to HHS that I am on TV for MERS-CoV even though the producers are \nspecifically asking for me.  They do not want me talking about “their issue”.   Amazing!! \nTypical situation where HHS says no to me, MSNBC cannot contact CDC and arrange in \ntime and so now nobody from HHS is on TV and the slot goes to a health official from \nIllinois.   The communications people from HHS are truly idiots to listen to CDC and \nback them.   Courtney Billet blows HHS (Bill Hall, Sye Tait, Ira ?) away with several e-\nmails telling them how ridiculous this approach is.   CDC is totally paranoid.   I really \nwonder if Tom Frieden knows about this or if it is just the Communications people.\nAlso did AP TV today for wide distribution to networks.\nAlso, White House very interested in Antimicrobial Resistance and they are putting \ntogether a White paper through NSS, PCAST, OSTP.   We are obviously playing role in \nits being drawn up\nMay 20, 2014 – Travelled to Los Angeles to receive the “Heroes in the Struggle” award \nfrom the Black AIDS Institute (BAI).   Phill Wilson (President of the BAI) presided.   \nCo-awardees were Mo’Nique (actress/comedian who won Academy Award in 2009 for \nActing in the film “Precious”) and Jamar Rogers (entertainer formerly on The Voice). \nRed Carpet ceremony before the awards held at the Director’s Guild of America on \nSunset Boulevard.   Jamal Rogers was a beautiful young man who was so thankful to me \nfor “my saving his life by developing drugs for AIDS”.   He found out he was HIV \ninfected (drug use in the South Bronx) a few years ago.   He is a very popular entertainer \nwith beautiful voice.  All-around good time.   Stayed at the old Hollywood hotel – \nMillennium Biltmore. \nMay 21, 2014 – Went to Thai Embassy on 1024 Wisconsin Avenue to a reception in my \nhonor and in honor of co-awardee Jim Kim (World Bank President) for our winning the \nPrince Mahidol Award last January.   Megan and Christine came.   Of note, the next day, \nthe Thai army pulled a military coup to take over the government of Thailand.\nMay 22, 2014 – Gave Commencement Address at Hopkins Medical School and then \ndrove immediately back from Baltimore to attend the Sons of Italy NELA Awards Gala \nDinner at the National Building Museum.   Usual good time.   Seated at my table was \nLeon Panetta, Gen. James Jones, Franco Nuschese.  Also we schmoozed with General \nRay Odierno (Chairman of the Joint Chiefs of Staff), Nancy Pelosi, Sen. Chris Dodd \n(now president of Motion Picture Academy), Master of Ceremonies Joe Montegna.\nMay 25, 2014 – The HBO movie “The Normal Heart” played tonight.  Larry Kramer’s \nplay about the early years of AIDS.   I say the play X2 and now the movie was terrific.   \nMark Ruffalo played Ned Weeks and Julia Roberts played the polio physician.\nReleased by Chairman Rand Paul\n342May 28, 2014 – Gave the John E. Enders Lecture at Boston Children’s Hospital/Harvard \nMedical School.  Great audience, SRO.  Extremely well-received.   Spent entire day \nmeeting with faculty and students.   They are so young, I feel like some historic figure to \nthem. Some were not even born yet when the AIDS epidemic was recognized in 1981.  I \nspoke on “Ending the HIV/AIDS Pandemic:   From Scientific Advances to Public health \nImplementation”.   Went up the night before and had dinner with Jenny in the North End.   \nShe is doing great.   Just finished the first year of her 6 year Ph.D program at Boston \nCollege in Clinical Psychology.   Had tough year following her bicycle accident that \nresulted in a severe concussion.  Recovery had been slow, but she is much improved now \nwith some residual headaches.\nMay 30 – June 1, 2014 – Went to Indianapolis to watch Ali row for Stanford Varsity 1 \nboat in the NCAA Women’s crew Championship Tournament.   Went with Chris and \nMegan and met Jenny coming from Boston at the Indianapolis Airport.   Stanford and Ali \nhave been amazing this year.  Stanford was not expected to get to NCAA tournament, yet \nthey won the “Big Row” against arch-rival Cal-Berkeley.   Then they won the PAC-12 \nTournament and now they are in NCAA.   Ali was selected as the Scholar-Athlete of the \nYear in the PAC-12 for Women’s Crew!!   This is huge since she was first among all \nwomen crew members in the PAC-12.  She had the highest GPA (4.05) of all athletes in \nany sport in the PAC-12.  Also, she was chosen for the 3rd year in a row as the first team \nAcademic All-PAC-12 team. She also was voted as “most inspirational” by her team \nmates  In the NCAA tournament they won the semi-finals by 4/100ths of a second.  Had a \nsomewhat disappointing Grand Finals Race coming out 6th in the race (started off slow \nand could not catch up) and 4th overall for the tournament.  Ali was obviously \ndisappointed, but what a year she had!\nJune 3, 2014 – Together with Robin Robinson, I briefed Senate HELP staff (Harkin, \nAlexander, Burr, etc.) on MERS.   Did it is the Dirksen Building.\nJune 9, 2014 – Partook in CSIS conference on TB at their headquarters at 1616 Rhode \nIsland Avenue, N.W.   Good symposium.  Shared panel with my dear friend Eric Goosby\nJune 12, 2014 – Went to San Francisco to give Grand Rounds at Moffett (invited by \nMarcia Glass (Kat Glass’s sister).  Timed the trip to coincide with Ali’s graduation from \nStanford on June 13-15.   Great time; extremely well-received by UCSF community.   \nVisited with Eric Goosby, Jaime Sepulveda and others from UCSF; spent time with \nstudents and fellows.\nChris and Megan flew to SF with me – I went north to UCSF and they went south to Palo \nAlto.   That evening met in SF for dinner.   Great time.   Drove back to Palo Alto that \nnight\nJune 13-15, 2014 – Magnificent time at Stanford graduation events.   Ali received \nmultiple academic honors in addition to sports honors.   Graduated “with distinction” , \nwhich means summa cum laude.  Also, received Engineering Award and inducted into \nSchool of Engineering Honor Society.\nReleased by Chairman Rand Paul\n343Socially, had great time.   Dinner at NOLA sponsored by Chris and me and the parents of \nseveral of the seniors on Ali’s boat – Ad Bax, Dawson’s, etc..   Present at dinner were all \nthe seniors on the boat – Anna Dawson (Olympian), Daphne Martschenko (All-\nAmerican), Kayla Cornale, Christina Bax, etc.  Wonderful, joyous meal.\nOn Thursday night Chris, Jenny, Megan, Ali and I drove to Half Moon Bay and had \ndinner at Miramar Restaurant by the sea – open pit fireplace and dining by the beach - \ngreat wine, calamari, etc.   Seems not to get any better than this – so wonderfully proud \nof Ali who is truly a superstar – self-effacing, but a real superstar.\nHas another great lunch with the Ayers on Sunday afternoon before I took the “red-eye” \nback to DC.   \nThe formal graduation on Sunday had Bill and Melinda Gates as co-commencement \nspeakers.   They were good , but a bit self-congratulatory.   I viewed the famous Stanford \n“Wacky Walk” entrance of the seniors.   Ali and friends were dressed as “cars”.  Really \nfun.\nJune 24-25, 2014 – Went to Aspen Ideas Festival.   Gave 2 minute “Big Idea “during \nOpening Ceremony and was on panel on Emerging IDs with Tom Frieden and Yu Wang \nof China CDC.   Moderated by Rich Besser (ABC News).   Good panel.  Many \ncompliments for this and Big Idea.   Met the usual DC glitterati at the festival – Walter \nIsaacson, Barbara Bush, Bill Frist, Corby Kumar, etc.\nJune 29, 2014 –  Interesting spin-off of my “Big Idea” at the Aspen Ideas Festival.   My \nidea was that we can end the AIDS pandemic in 10 years (by 2024 – theme of festival – \nglobal health by 2024 and we were asked what single thing (big idea) do  we think would \ngreatly influence global health by 2024).   Gov. Andrew Cuomo has stated that he wants \nto end the AIDS pandemic in NY State in 6 to 10 years.   The NY Times wrote this up in \nthe Sunday Times and quoted me since the reporter had heard about my Big Idea from \nthe Aspen Festival.   The article had me praising Gov. Cuomo and my saying that NY \ncould be a model for the rest of the country.\nJuly 3, 2014 – The Ebola outbreak in Guinea, Sierra-Leone and Liberia is getting out of \ncontrol.   Latest number are 759 cases and 476 deaths (63% fatality) making this the \nlargest outbreak of Ebola on record.   Net highest was in 2000 in Uganda with ~400 \ncases.  Major concern since it is now spreading in the cities of these countries and the \npopulation is not cooperating in containing it by ignoring the recommendations about \nhow to handle patients and dead bodies.   Also, major ignorance causing population to \nattack and stone doctors and nurses from Doctors without Borders and WHO, saying that \nthere is a conspiracy on the part of the government to deplete the population.\nI appeared on CNN today to discuss the situation.\nReleased by Chairman Rand Paul\n344July 4-8, 2014 – Interesting 4th of July weekend.  Found out from Deb Persaud and \nHannah Gay that the “Mississippi baby” rebounded at 27 months following D/Cing of \nART.   Baby is 46 months old.   Unfortunately,  so much for the “cure” baby.   We are \nsequencing the virus now to determine if this is not a “new” infection, i.e. abuse from an \nHIV-infected person.   More on this later.\nAlso, heard (and spent many hours on conference calls) that an FDA employee who was \ncleaning out a cold room in Building 29A (FDA building on NIH campus) found a \ncardboard box that contained 6 glass undisturbed vials labelled “variola”.  Likely there \nunnoticed since the 1950s.   CDC and FBI notified.   Good news is that leaks did not \noccur and within a couple of days, the CDC came up to NIH, area secured by FBI, and \nmaterial flown down to CDC  on FBI plane.   Examined there by Select Agent people and \nPCR’d to confirm smallpox.   Will determine if viable within 1 week and will be \ndestroyed as witnessed by WHO.   Technically, the presence of this material in Building \n29A was a violation of an international agreement to destroy all smallpox samples except \nfor 2 aliquots kept at CDC and at VICTOR in Russia. \nJuly 9, 2014 – PCR confirms that the Mississippi Baby has indeed rebounded with virus \nat 16,000 and 10,000 copies RNA per ml.  Baby has been off cART for 27 months and is \n46 months of age.   Disappointing, but raises many questions.   The baby had no \ndetectable immune response for these many months.   Since the virus was obviously there \nin a reservoir somewhere, what then was the mechanisms that was preventing it from \nrebounding.   Will hold press conference with Deb Persaud, Hannah Gay, and Katherine \nLuzuriaga on Thursday  (tomorrow).\nHad interesting rounds today to see our first patient (Phil Diers) that received an \nallogeneic PBMC transfer from a HLA-B27 HIV-infected Elite Controller donor.   \nRecipient has CD4+ T cell count of 0-4 and >150,000 copies of HIV on cART (resistant \nvirus).   Hope is that the immune response of donor cells will impact in some way the \ninfected cells of the recipient.   More to come.   Way out chance of a graft versus infected \ncell effect that might eliminate reservoir (too much to ask for).   See picture below of me \non Rounds the day after the allogeneic transfer.\nReleased by Chairman Rand Paul\n345July 10, 2014 – Press briefing with Deb, Hannah and Katherine today (Thursday – \nthunderstorms).  Followed by major press that appeared tonight and tomorrow (July 11) \nwith my quoted or appearing on TV or radio tonight or tomorrow:\nAP TV that subcontracted to BBC TV seen  in Italy by Bruce Gellin (sent me e-mail); \nCBS Evening News\nJuly 11, 2014 – Front page NY Times and Washington Post.  My picture and front page \nLA Times; Wall Street Journal, USA Today and all major print papers and many, many \nblogs including CNN\nBBC Radio; BBC TV; NewsHour with Jeff Borwn; VOA, Reuter’s TV, NPR.   \nI make the point that this is disappointing and not a “setback” since we are still in the \nearly discovery phase of cure research and this is what happens when you are in this \nstage.\nJuly 13, 2014 – Had conference call today on Sunday with Francis Collins and Tom \nFrieden of the CDC. Tom has a significant problem in that they have been multiple lapses \nat the CDC with people not adhering to protocol in the experiment with a transfer of \nselect agents such as anthrax,  Brucella and influenza. He wanted to run this by Francis \nand me so that the NIH and CDC could be on the same page. We had the problem \ndescribed above with the smallpox discovery in a cold room in building 29a and so his \nissue and ours are somewhat aligned. He is under pressure to decrease the number of \nReleased by Chairman Rand Paul\n346investigators throughout the country who are working with select agents. The rationale \nfor this is the fact that if the CDC could make mistakes like this, then virtually anyone \ncan. This is aligning with the issue of many people wanting to put a clamp on gain of \nfunction research, particularly with influenza. More to come.\nJuly 14, 2014 – More press on Mississippi Baby (Al Jazeera TV) as well as fluff over the \nWHO coming out with recommendation that MSM who practice unsafe sex should take \nPrPE (Truvada).   Press misinterpreted this (partly fault of WHO) to mean that all gay \nmen should be on Truvada as PrEP.  I had to clarify this on Al Jazeera and in the NY \nTimes (article soon to appear).\nPreparing to go to Melbourne for the IAS International AIDS meeting.\nJuly 16, 2014 – The situation is heating up considerably with regard to the three \ninfractions that have occurred in HHS concerning potentially lethal microbes. The first \nwas the finding of the smallpox vials in the FDA building (29A) on the NIH campus. The \nnext was the egregious dysfunction of the teams involved in dealing with selective select \nagent research down at the CDC and third was the contamination at the CDC of a highly \npathogenic influenza virus (H5N1) with a nonpathogenic influence virus (H7N9). This \nhas been all over the media in a very intense way. The White House as well as the \nDepartment of Health and Human Services is involved.  Francis Collins and I received a \nletter from Nobel laureates Paul Berg and Richard Roberts to discuss how we might \naddress this escalating issue. They have been consistently against gain-of-function \nresearch, especially on influenza.  In addition Francis and I together with Peggy Hamburg \nand Tom Frieden were called to a meeting this evening at HHS with Secretary Sylvia \nBurwell to discuss the HHS plan as well as the fact that Sylvia will be meeting with the \nPOTUS on Friday, July 18 to discuss the matter and she needed to be briefed by us. I \nhave suggested to Francis and he agrees that we call a temporary moratorium on all gain \nof function research on influenza and the MERS virus involving increasing pathogenesis \nand increasing transmissibility by the respiratory route. Also, Francis and I brought up \n(clearly my idea for some time now) to re-invigorate the NSABB and get them much \nmore in the mix of recommendations and involvement.  We had a good meeting with \nSylvia Burwell in her office tonight that lasted from 7 PM to 9 PM. Francis and I will be \ntalking over the phone tomorrow with Richard Roberts and Paul Berg about a plan for the \nfuture. Also, today Barry Bloom called me from the Harvard School of Public Health to  \nask whether or not he could help us in addressing this new and emerging political \nproblem. In addition,  I received a call from Michael Osterholm to warn me, as he is often \ndoing, that there will be problems “for me” that he wants to help. I get concerned when \nMichael wants to “help” me.   He generally gets hysterical about microbial threats and \nloves to be in the press.\nJuly 17, 2014 – Francis Collins and I had conference call with Richard Roberts and Marc \nLipsitch regarding the above issues.  Great conversation.  We told them that changes \nwere going to occur and that we cannot give details, but we are going to look carefully at \nall the issues.  In particular, I told them that we were going to re-examine the risk/benefit \nratio of doing gain-of-function research in influenza, in particular.  They were pleased.\nReleased by Chairman Rand Paul\n347July 17 – July 23, 2014 – Attended the 2014 International AIDS Society  Meeting in \nMelbourne, Australia. Before I left, I became aware of a terrible tragedy that had \noccurred on July 17 the day that I left the NIH to travel to Melbourne. Malaysian Airlines \nflight 17 from Amsterdam to Melbourne via Kuala Lumpur was shot down by a surface \nto air missile likely fired by Ukrainian separatists/terrorists. This was to totally dominate \nthe international news over the next days to weeks.  I was quoted in most outlets.   297 \npeople were killed including over 100 Dutch.  Lost on the flight were six individuals who \nwere flying to the meeting that I attended. Prominent among them was my longtime \nfriend Joep Lange an Infectious Diseases/AIDS researcher from Amsterdam  and his wife \nJacqueline van Tongeren. In addition, well-known public health advocate and WHO \nspokesman Glenn Thomas and AIDS action group activist Martíne De Shutter were also \non the plane in addition to AIDS activist Pim deKuijer and Dr. Lucie van Mens. I gave a \nnumber of media interviews discussing the terrible tragedy and the loss of our colleagues. \nThis appeared in multiple media outlets. In particular, I was interviewed by David \nGregory on Meet the Press on Sunday, July 20. The topic of the interview was the mood \nof the meeting and some personal reflections on Joep Lange. \n My Plenary Lecture was extremely well received and from my own vibrations of how \nthe audience reacted, as well as how I felt, it clearly was one of the best lectures that I \nhad given. The subject of the lecture with the scientific challenges of an HIV Cure and an \nHIV vaccine. There were a number of events of note throughout the meeting. \nSaturday, July 19 – Stayed at Crown Metropol Hotel (very elegant – on of nicest and \nmost confortable hotels on all my international trips).  I attended a dinner at a place called \nRasheen which is an old and historic building in Melbourne that was formerly the \nresidence of the Archbishop of Melbourne.  The dinner was given by the Pratt foundation \nand the host was Ambassador John Berry, the United States ambassador to Australia. \nWith him was his husband Curtis. I have to leave towards the end of the dinner in order \nto give an interview live on WTOP radio that was broadcast back in Washington. The \ninterview was about the plane tragedy.  \nSunday, July 20 - I made a presentation on TB HIV followed by a panel discussion at \nthe Crown Promenade Hotel where I was staying during the meeting. In addition, on that \nSunday I made some opening remarks at a Point of Care Symposium that discussed rapid \npoint of care diagnostics for viral load. That evening I went to the Opening Session of the \nconference which was really not very well done since there were many boring speeches. I \nhad to leave towards the end in order to do the taped version for Meet the Press. Of note, \nMelbourne is 14 hours ahead of Washington DC. Therefore, even though I taped the \nMeet the Press session on what was Sunday evening in Melbourne, it was actually early \nmorning in Washington DC. Went to Global Leaders reception at The Cargo Hall on the \nWharf after the Opening Ceremony\n Monday, July 21 -  I gave my plenary lecture. In addition I did a filming in celebration \nof the opening of the Doherty Institute for Infection and Immunity. This is an Institute \nnamed after Peter Doherty, the Nobel prize-winning Australian immunologist. Peter was \nthe other speaker at my symposium earlier that day. On Monday night I went to a \nreception at the Red Desert Dreaming Art Gallery at the Hilton Hotel. The reception was \nReleased by Chairman Rand Paul\n348co-sponsored by CSIS with Stephen Morrison, together with Amb. John Berry. That \nnight on Monday, July 21, I went to dinner with Mark Dybul at the Spice Temple \nRestaurant along the wharf. We discussed broad aspects of the AIDS pandemic and I \ncame up with an interesting idea of providing resources to do phenotypic tracing of virus \nin hotspots in various regions including southern Africa and Washington DC. The \npurpose of the phenotypic tracing of viral transmissions was to determine if you test and \ntreat and completely control the epidemic in any given region or location, would virus \nspill over back into that region and if so could one trace where it was coming from. This \nhas particular relevance with regard to whether or not we would truly be able to end the \nAIDS pandemic and if we do would, we be able to end it in one region at the same time \nthat it is raging in another region. I will go back to Washington and discuss with Carl \nDieffenbach the possibility of funding such studies. \nTuesday, July 22, 2014 – I did a Voice of America panel at the Convention Center on \nHIV AIDS stigma which was in association with a documentary film that was narrated by \nElton John. I had a number of other meetings that dayincluding with Wayne Koff who \ntried to convince me to give major support of NIAID to his “Human Vaccines Project”, \nwhich I am very skeptical about since it smacks of the old HIV Vaccine Enterprise.   The \nlatter was nothing more than a time sink.   I was straight with Wayne and told him of my \nskepticism.  I told him that I would watch to unfolding of the “project”, but I cannot lend \nNIAID support at this time since I do not know what “it” really is and I really do not see \nany purpose for it.   He understood, but he needs NIAID support for it to work.   We left \nit amicably.\n Of particular note was a reception at the Club 23 in the Crown Towers Southbank of the \nCrown Hotel. The reception was hosted by the Kirby Institute and discussed the Test and \nTreat in Indonesia concept which Cliff Lane and I had been working with and have \nconvinced the Minister of Health Dr. Mboi of Indonesia to go ahead with the study. In \nher remarks at the reception, Minister Mboi credited me with this idea and said it would \nnot have happened had I not brought it up to her. This was very nice of her. On Tuesday \nevening we had the international AIDS Society Dinner at this Stokehouse City \nRestaurant, an elegant location in downtown Melbourne. The dinner was sponsored by \nSharon Lewin and Françoise Barre-Sinoussi. It was an excellent time. After that I went to \na birthday party for Jen Kates and Judy Auerbach in a saloon in the Provincial Hotel. \nWednesday, July 23, 2014 - Departed on the extraordinarily long 26 hour trip back to \nWashington DC. I went from Melbourne to Sydney, Sydney to Los Angeles, and then \nLos Angeles to Washington DC. I traveled with Richard Koup and it was an uneventful \ntrip. The day that I left, President Clinto arrived for his keynote.\nThursday, July 24, 2014 – Continued press on the MH17 tragedy mixed with interest \nabout the IAS Meeting in Melbourne.   I appeared on NPR Radio “Tell Me More” with \nMichelle Martin.   Of note, there has been a recent recommendation from WHO and prior \nto that from CDC that certain groups (MSM at high risk; discordant couples; \nheterosexuals who practice risk behavior) should use PrEP (Truvada), which has recently \nbeen approved by FDA for PrEP.   There is a growing controversy about whether use of \nPrEP will actually lead to more risky behavior.   Data say that it will not.   Recent study \nReleased by Chairman Rand Paul\n349presented in Melbourne by Bob Grant from UCSF (the OLE study – Off Line Extension \nof iPrEX) indicated that there was no increased in risky behavior with PrEP and people \nwho took PrEP had less infections that those who did not and use condoms only.  I \nappeared on NPR “Science Friday” to discuss this and other topics.\nJuly 25-28, 2014 – Major expansion of problem with Ebola outbreak in West Africa.   \nCases now up to >1100 with over 600 deaths in Guinew, Sierra Leone and Liberia.   Of \nnote, 3 MDs (one died)  and one health worker (1 MD and health worker from USA) \nhave been infected. Clearly there is breakdown of PPE even among good people who are \ntrained.   One patient left Liberia after his sister died of Ebola and he got on plane to \nLagos, Nigeria and got sick and died in Nigeria.   Massive presss interest now going on.   \nAl networks (CNN, George Stephanopoulos, etc.) wanted me on TV but the ridiculous \nHHS and White House wanted to “define the message” before they let me or CDC on the \nair.   \nJuly 29, 2014  Now HHS is allowing me to go on the air after all the major networks \nhave already reported the Ebola situation.  However, more to come.  Did WTOP radio \nthis AM and will do Canadian TV and Al Jazeera this evening.\nJuly 30, 2014 – Ebola situation really heating up.   Now there are 1300 cases with 730 \ndeaths.   The person who got infected from his sister in Liberia and flew from Liberia to \nNigeria and then got sick and died in Nigeria was an American citizen   \nThe Peace Corps is bringing  home 340 volunteers from the 3 countries.   Two volunteers \nhave been exposed to an Ebola patient and are in  isolation.  Today was on MSNBC, \nNBC Nightly News, CNN and CNN with Jake Tapper, and Al Jazeera tonight.  I have \nbeen invited to go on 3 Sunday Shows:   This Week with George S.; Face the Nation; and \nState of the Union with Candy Crowley.   White House still has not cleared any of these 3 \nand so I have no idea whether I will be able to do them.   The WH communication people \nare really a bunch of assholes in that they try to “control the message” even though there \nreally is not a complicated message here.   The Networks want me for my medical \nexpertise and because I am good on TV.   What is the problem??\nJuly 31, 2014 – Major media blitz red hot on two concurrent issues.   The Israel invasion \nof Gaza due to the incessant shelling by rockets of Israel cities by Hama from Gaza and \nthe exploding Ebola situation.   Was on CNN New Day this AM.   Then did Diane Rehm \nwith Laurie Garrett, Dan Lucey (Georgetown), Billy Fischer (UNC).   After that did CNN \nwith Jim Sciutto (Regis Graduate), then BBC radio “The World” and multiple print.   In \naddition, to above Sunday Shows, now Fox News Sunday with Chris Wallace wants me.   \nStill no response from the White House \nAugust 1, 2014 – Samaratan’s Purse (Charity Organization in Liberia) has decided to fly \nKent Bartley and Nancy Whitebol (infected health workers) from Liberia to Emory \nUniverity in Atlanta.   Emory has a CDC-designated Unit to take care of Ebola.   They \nare on their way.  Public blogs quite concerned about danger of this transporting to USA>   \nI think that it sis dangerous for the patient’s health for them to fly.   I am assuring public \nanyway that it is safe, even though for the patient’s sake, I would not have transferred \nReleased by Chairman Rand Paul\n\n351of Building 31); CNN New Day with Sanjay Gupta; MSNBC with Chick Todd; WTOP \nRadio; NPR “Here and Now”; BBC radio; MSNBC; Hearst TV.   Tonight I do MSNBC \nagain at 8:15 PM from Nebraska Avenue and BBC Radio at 10:15 PM.\nMuch discussion from the media about the role of “NIH scientists” in getting the ZMapp \nto Brantley.  They are referring to Lisa Hensley.   We needed to clear up her role in that \nCDC (Kevin DeCock) asked her to point Samaritan’s Purse in the direction of the people \nwho had the antibody.   There was some feeling that there was some “government \nconspiracy”.   I will discipline Lisa when she returns from Liberia because she got out of \nher lane by getting involved in the procurement of the antibody.\nI am exhausted from media.\nAugust 5, 2014 – Media, particularly CNN and Sanjay Gupta still pursuing the issue of \nan NIH scientist (Lisa Hensley) who they claim actively pursued and obtained the zMapp \nantibodies for the 2 American patients.   Lisa returns today and we must get the truth.   \nShe claims that she just steered Samaritan’s Purse (SP) people to the individuals/groups \nthat had interventions and SP decided to obtain the zMapp from Gary Kobinger (Canada) \nwho apparently brought a dose to Sierra Leone.   As it turns out, Lisa got on a helicopter \nprovided by the State Department to pick up the zMapp from Sierra Leone and bring it \nback to Liberia.   When she got to SL, she found out that SP had already obtained a \nhelicopter themselves and had already picked up the zMapp and brought it to the patients \nin Liberia.   I find out today that the helicopter that Lisa flew in was a CIA helicopter!   \nThe State department will deny any role in this since the CIA is not supposed to be \noperating out of the Embassy.  However, the Embassy certainly “tried to” facilitate the \ntransport of zMapp.   I will straighten all of this out and get to the truth after we question \nLisa.\nGetting exhausted by media.   Today I did: CNN Squawk Box; MSNBC; CTV News; \nCNN with Sanjay Gupta; Fox News; Reuters TV; CNN International; Al Jazeera; BBC \nTV; Fox News with Lou Dobbs; CNN Anderson Cooper; MSNBC with Larry O’Donnell.\nAugust 6, 2014 – Some of the events that occurred today are very important. Lisa \nHensley, an NIAID employee (Ph. D) is a NIAID scientist who reports to Peter Jahrling \nat Fort Detrick.  She was in Liberia to give technical assistance.   She had informed Cliff \nthat her role in Samantha's Purse (SP) getting the zMapp antibodies for Dr. Brantley and \nNancy Writebol was only peripheral and facilitating.  Lisa has been called back by Cliff \nand returned from Liberia last night and Cliff Lane gathered a considerable amount of \ninformation from her. It appears that she has been much more active in assisting the \npeople from SP in procuring the zMapp antibodies from Gary Kobinger of the Canadian \nHealth Agency. In addition to just pointing the SP people in the right direction, she was \nactively involved in organizing an attempt to procure the antibodies and deliver them to \nthe patients. The CDC was actively involved also in the person of Kevin DeCock who put \nLisa in contact with SP. In addition, the United States Embassy in Monrovia, Liberia was \nvery actively involved in this process. With regard to the latter the embassy provided a \nUN helicopter to take Lisa and the military attaché from the embassy to the border of \nReleased by Chairman Rand Paul\n352Sierra Leone and Liberia to pick up the package of monoclonal antibodies. However, SP \nhad already chartered their own helicopter and picked up the material themselves. \nNonetheless, our prior determination and announcement to the media that the NIH as well \nas the federal government played only a minor role in the procurement of these antibodies \nis technically not correct. When I found out about this, I felt it was very important to alert \nHHS Secretary Sylvia Burwell. I briefed her on the fact that the original statement from \nthe Department of Health and Human Services regarding the role of NIH was not \ntechnically correct. She agreed and indicated that we would have to let the White House \nknow particularly the General Counsel. The reason why this is important is that \ntechnically speaking SP has broken the law by bringing in a drug from Sierra Leone to \nLiberia without the permission of the health officials of Liberia. In addition, there is also \nthe issue of ethics in procuring a drug for one individual when there is very short supply. \nAnd so the question is asked how can one get drug for American doctors and health \nworkers when hundreds of Africans are dying from the disease. We will have to face this \nissue in the press even though technically speaking NIH did not procure the drug. The \nappearance is that we at least assisted the SP in getting it. It is important to emphasize \nthat Lisa Hensley was acting on her own accord without asking permission from any of \nher superiors and so she was really not representing the NIH.  It appears now that this \nwas what Sanjay Gupta of CNN was talking about when he told me by phone that he had \ne-mails that indicated that an NIH person was actively involved in procuring zMapp \nantibodies for SP and that the US Embassy was also involved and that he could not show \nme the e-mails since the person who gave them to him had a lawqyer who advised against \nit.   I believe that the secret party who gave Sanjay the e-mails is SP who are now afraid \nthat they have broken the law and are trying to say that the USG helped them and so how \ncould it be wrong.  It will be interesting to see how this all plays out.\nBilly Fischer from UNC visited NIH to help the Clinical Center get ready for the \npossibility of admitting Ebola patients since the CDC is sending 50 people to West Africa \nand there is the possibility that they may get infected and might need care.   Billy spent \ntime in Sierra Leone directly taking care of patients.  He was great!\nAgain, much press today →  CBS Morning Show with Charlie Rose and Norah \nO’Donnell; NBC Channel 4 Local News; CNN with Jake Tapper.\nAugust 7. 2014 – Re-visit of part of the African Delegation that is visiting DC.   Francis \nCollins and I and other IC Directors briefed them in Medical Board Room of the Clinicial \nCenter at 11:15 AM.   Present were Mali President Kweita and Zambia Vice president \nGuy Scott and his wife Charlotte.  I presented information about NIAID activities \nrelevant to their countries (Mali – malaria; Zambia – HIV, TB).\nMedia frenzy continues with Gaza war and Ebola.  Ebola dialogue now focusing on the \nethics of distribution of scarce interventions during medical crisis.   Triggered by the \navailability of zMapp for the 2 American patients.\nPress today CNN New Day; MSNBC with Ronan Farrow; CNN International; Sirius \nRadio (Fox) with Marc Siegel\nReleased by Chairman Rand Paul\n353August 8, 2014 – Frenzy continues.  Press includes WTOP Radio, WNYC Brian Lehrer \nRadio, Fox Business TV, NPR Los Angeles.\nGaza + Ebola – now ISIS is taking over Iraq and the USA in now bombing their advance \nto a Kurdish city where American diplomats are holed up.   The USA wants to avoid \nanother Benghazi.   Because of this the White House is not allowing any government \npeople to go on Sunday AM TV and so I had to cancel invitation from This Week with \nGeorge Stephanopoulos and “Face the Nation”.   White House is in the controlling the \nmessage mode.\nAugust 8, 2014 – (Saturday) - Having daily Secretary and NIH (Collins) call.  Issue is \nthat we are trying to expedite going into phase 1 trials of interventions that have only \nbeen in pre-clinical.  These include zMapp, the Canadian VSV vaccine, the VRC \nChimpAd3 vaccine.   Emory is making “side deals” with Mapp for zMapp and Canada \nfor VSV to get pre-exposure prophylaxis for doctors at Emory.   Potential problem is an \n“optics” problem in that USG is helping Westerners get interventions that Africans \ncannot get.\nThis is all getting very intense and similar to the Anthrax issues from 2001.   Sylvia is \nstarting to see more clearly what I can do regarding leadership on the phone calls.\nAugust 11, 2014 – The frenzy around Ebola still continues with the major issue being the \nethics of getting experimental drugs to the two Americans, and most recently to a Spanish \npriest who was flown from West Africa to Madrid and who received the experimental \nzMapp cocktail of monoclonal antibodies. The media are pushing the story of favoritism \ntowards the West and developed nations as opposed to the Africans who are suffering \nfrom the disease. They fail to understand that there is no evidence that zMapp actually \nworks, and the fact is that there are only three doses left in the possession of the company \nthat owns it, i.e. MAPP Biopharmaceuticals. Of note, the President of Liberia has \ncontacted the White House to see if the United States can expedite either transfer of two \nsick Liberian doctors to the United States for care and/or obtain doses of zMapp for them. \nIt is interesting that Larry Zeitlin, the CEO of MAPP Biopharmaceuticals, has contacted \nCliff Lane telling Cliff that he wants to get rid of the three doses of zMapp that he has in \nhis possession because of the pressure on him to distribute it to a number of people in \nAfrica who need it.   He does not want to be put in this ethically difficult position.  He \nwants to give it to either WHO or MSF. However, he does not want the US government \nto react negatively to this. He wants to make sure that we do not criticize his giving the \ndoses to another entity, thereby making them responsible for its distribution. We have \nbeen having a daily conference call including this past weekend on Saturday and Sunday \nwith Sec. Sylvia Burwell to keep up with the rapidly evolving E bola situation. During \nthat call yesterday (Sunday), Secretary Burwell suggested that since we helped the \nAmerican doctors to get doses of zMapp that we might suggest to Larry Zeitlin that he \ngive the doses to the Liberians. This would accomplish two goals: 1) it would allow \nPresident Obama to respond to the Liberian president, and;  2) it which show the world \nthat we do not just favor Westerners, but that we are helping to make drugs available to \nAfricans.\nReleased by Chairman Rand Paul\n354We had a conference call yesterday (Sunday) with Canadian health authorities to inquire \nabout the availability of their experimental VSV  Ebola vaccine. On the call were our \nHHS team with me, Cliff Lane, Hilary Marston, Nicki Lurie, Dawn O’Connell (Sec. \nBurwell’s Chief-of-Staff), Tom Frieden and CDC folks, Robin Robinson, Leslie Dasch \n(Counsellor to Burwell).  On the Canadian side there was Gregory Taylor (Deputy Chief \nPublic Health Officer), Judith Bosse (Assistant Deputy Minister, Infectious Diseases \nprevention and Control Branch), Theresa Tam (Branch Head, Health Security \nInfrastructure branch) and Supriya Sharma (Assoc. Assist. Deputy Minister, health \nProducts and Food Branch).   The Canadians are still in preclinical studies and have not \nyet gone into humans. There is an ongoing disagreement between me and Tom Frieden. \nTom wants to give the vaccine to health workers in Africa even before it has gone into a \nphase 1 trial (I believe that he has been speaking with his CDC people who are preparing \nto go to Africa and are understandably concerned about their risk). I do not believe that \nTom understands the clinical trial process since he says that we are “ethically obliged” to \nallow the healthcare workers to make the decision themselves about whether they are \nwilling to take a potentially unsafe, potentially ineffective vaccine.  If this were a drug to \nbe given to a desperately ill patient, then that is one thing about going directly from pre-\nclinical to human treatment.   However, this is a vaccine to be given to a healthy person.  \nOn the call with the Canadians, I pointed out our experience with the HIV vaccine which \nwas effective in monkeys, but in humans it actually significantly increased the risk of \nacquisition of HIV infection. In order to expedite things Cliff Lane will organize a quick \nphase 1 trial at the NIH Clinical Center to test the safety of the Canadian vaccine.\nOnce again, I have been all over the press. Last night I was on CNN with Jim Sciutto as \nwell as on CNN International. Today I will do the Diane Rehm Show.\nAugust 12, 2014 – We are having a daily (including Saturday and Sunday) conference \ncall with Secretary Burwell and a separate call among NIHers with Francis Collins.   \nPress interest in dying down somewhat (I was only on Colombian (Bogotá) radio and \nCzech Radio only.   The issues are centering now around the ethics of using experimental \ndrugs (we actually have none available) and vaccines (getting ready to go into Phase 1 \nwith the NIH (VRC) Chimp Ad3 vector with Ebola env gene inserts) prior to proof of \nsafety and efficacy.   The Canadians also have 2 VSV Ebola vaccines.  There is no more \nZMapp left – 2 courses went to Brantley and Rightbol, 1course went to the Spanish priest \nwho died, and 2 courses were sent to Liberia to treat 2 Liberian doctors who contracted \nEbola caring for patients (President of Liberia appealed to President Obama.   The USG \nput Liberia in touch with Larry Zeitlin and MAPP Biopharmaceuticals.\nAugust 13, 2014 – My invited Perspective on Ebola came out online at 5:00 PM in the \nNew England Journal of Medicine .  Cliff Lane and I are trying to reconcile the need for \ndata of safety and efficacy of the NIH vaccine and the need to get it to people who need \nit.   We drew up a proposal for a Randomized Clinical Trial (RCT) to take place in the \ncountries in Africa right after the Phase 1 here at the NIH.   This would settle the ethics \nissue (randomization is “fair” and also would collect data to prove efficacy and safety.   I \nReleased by Chairman Rand Paul\n355will propose this at the next Secretary’s call.   The logistics of this will be difficult due to \nthe lack of infrastructure in the 4 African countries.\nDid WBAI Radio in NYC and Al Jazeera TV today.\nLatest numbers for Ebola – 1900+ cases and 1050 deaths\nAugust 14, 2014 – Things quieting down a bit in the press.  Still struggling with ethics \nissues and clinical trials issues.   Canada has “hot-dogged” by announcing that they are \n“donating” 400-800 doses of their vaccine for use in Africa.   Of course, that is exactly \nwhere we will give it when we show that it is safe.   Also Jeremy Farrar, the head of \nWelcome Trust is grandstanding a bit saying we must not just “sponge down the patients \nand let them die”.   Give me a break.   Now WHO wants to use the Phase 1 doses of \nvaccine to vaccinate their people who are going to Africa.   They want 200 doses to do a \n“phase 1 trial” in their staff.   200 doses is a product distribution program, not a phase 1 \ntrial.\nDid CBS News and AP TV today.\nAugust 15, 2014 – Went up to Philadelphia to see the White Coat Ceremony at the \nUniversity of Pennsylvania Medical School where my daughter Megan is beginning her \nfirst year of medical school.   Beautiful day and wonderful ceremony.   We are so proud \nof Megan and hope that she will be happy.   I know that she will do well having \ngraduated summa cum laude from Columbia and then excelling in the Post-Bacc pre-med \nyear at Hopkins.  \nAugust 16-19, 2014 – Media blitz stopped, but the epidemic still rages.   The West \nAfrican countries are instituting quarantines and border closings, which may slow down \nthe epidemic, but there is the beginning of a humanitarian crisis to get food, water and \nsupplies to the quarantined areas. \nTom Frieden and I are working out how we can reconcile the issue discussed above about \nthe balance of open access of vaccine following phase 1 versus the need to know by RCT \nwhether the vaccine actually works and whether it might actually do harm, as per the Ad5 \nHIV vaccine enhancement of HIV acquisition  in a former clinical trial a couple of years \nago.   The department was clearly concerned (Andrea Palm – chief-of-staff to Burwell-  \npissed me off on a conference call by acting annoyed with Tom and me in our discussions \non the daily conference call) about the disagreement between Tom and me; however, \nTom and I are now trying hard to work it out behind the scenes.\n \nAugust 20, 2014 – Ebola still on an upswing.  No explosion yet in Nigeria following the \ninfection of cluster (8 to 11) health care workers who took care of  \n(Liberian/American) who flew from Liberia to Nigeria).\nTom Frieden and I still trying to work out an agreement/compromise regarding the \ndistribution of Ebola vaccine (RCT versus expanded access) following the Pahe 1 trials \nthat will begin in September and have data by November on Safety and immunogenicity.\nReleased by Chairman Rand Paul\n\n356Press low level but consistent.   For me → Federal News Radio; Canadian TV; VOA TV \n– “Straight Talk Africa Show – 1 hour); \nISIS (Islamic State in Iraq and Syria) taking over parts of Iraq\nGaza still a mess with rocketing of Israel and retaliatory air strikes by Israel.\nAugust 21, 2014 – 2 secondary cases of Ebola (beyond cluster of health care workers) \nfrom the index in Nigeria.  Getting close on agreement with Tom Frieden.  Cliff Lane \nvery helpful; in hammering out details with CDC people – Tim Uyeki and Steve Redd \n(Steve is a rally good guy with whom I dealt during the Flu issues).\nContinued press →  MSNBC; WTOP radio; CNN with Lou Dobbs; BBC Newsday \nRadio.\nAugust 22, 2014 – Situation same with epidemic.   Good news – have come to agreement \nwith Tom Frieden on approach to Ebola vaccine following Phase1 trials.   Agree to go for \nRCT with control group as first choice.   There well may be obstacles on the ground to \nthis approach including perception of keeping interventions from those who need it (even \nthough we still do not know whether the vaccine is either safe or effective).   This may \nnecessitate a modified RCT without a control group or even skipping an RCT and going \nto emergency open access.   The plan is to do a “rolling” approach staring with RCT → \nmodified RCT → open access in priority order.  I will present this to Secretary’s call next \nweek.\nTom Leaves for West Africa over the weekend.\nPress still active → Fox 5 WTTG; CNN International; BBC Radio – The World; WNEW \nCBS Radio – NYC; PRI (BBC) – Boston – “The World” with Marco Werman\nAugust 23 – 27, 2014 -  Still escalating Ebola situation. Now a secondary case in Nigeria \nwith  having infected a person who took care of him.   That person (who \nrecovered) then infected a doctor in Port Harcourt. The doctor died, but the doctor’s wife \nis now infected.  The numbers are going up.   Tom Frieden now in Liberia to assess the \nsituation.  He is saying that it is catastrophic and out of control in a press conference from \nMonrovia.  People on the Secretary’s 3x per week call have criticized him for being \n“hyperbolic”.   How should they know – he is there and they are here.   Typical \ngovernment cover-your-ass bullshit.   Still getting modest press.\nAugust 28, 2014 – Our big press teleconference announcing the beginning of the Ebola \nvaccine Phase 1 trial of the Chimp Adenovirus 3 vector with the Ebola GP bivalent gene \ninsert.   Trial to start on September 2 at NIH Clinical Center.  Also coinciding with \nslightly later start of monovalent identical vaccine in the UK with Oxford, Wellcome \nTrust and extension into Mali and the Gambia.  Also, we announced our collaboration \nwith NewLink and Public Health Agency of Canada (PHAC) in a Phase 1 trial (in Silver \nSpring, MD with WRAIR) of the VSV – Ebola vaccine.\nReleased by Chairman Rand Paul\n\n357Much press interest today with appearances on:  Fox News Radio; Hearst TV; WTOP; \nMSNBC with Ronan Farrow; NBC Nightly News; The NewsHour; Cox TV; 24/7 \nNational News Radio; CNN Anderson Cooper; Local Channel 9 News; AP TV.\nAugust 29, 2014 – UK raises terror threat to Level 4 (of 5) due to activity of ISIS in \nSyria and Iraq, who are threatening the West.   They have been brutally assassinating free \nSyrians (beheadings) and have shown a beheading of an American journalist (James \nFoley) on You Tube.\nEbola – outbreak raging.  Tom Frieden is obviously distraught.  I am concerned about \nhim as he is having a very emotional reaction to this.   He wrote me an e-mail yesterday \nfrom Liberia saying that the situation is completely out of control and that health care \nworkers are getting infected and we should distribute the vaccine even without Phase 1 \nsafety data.   This is not correct.   We have to do at least a modicum of safety data before \nwe distribute it.\nI am beginning to get concerned that transmissibility is not just confined to people who \ntake care of sick people and who have “direct contact with bodily fluids such as Feces, \nVomitus, blood, and urine”.   There have been some situations that have me believe that \nfomites and hand contact inadvertently with fomites outside of the “direct” healthcare \nsetting might also spread the virus.   Some examples:   Dr. Brantley and Nancy Brighthol \nwere both infected and Brantley was experienced in PPE.   Of note, no MSF person who \nused PPE has ever gotten infected over years of taking care of Ebola patients.   Nancy \nnever directly took care of Ebola patients.    the WHO person, likely got infected \nwhile taking care of patients, but did not tell anyone he was feeling poorly.   He went to \nmeetings with people from WHO, MSF, and other organizations and two of these people \ngot sick and they did not breach any PPEs.    got sick from his sister in \nLiberia, got on a plane and flew to Nigeria.   Got sick in Nigeria and several health care \nproviders who took care of him without PPE (~12) got sick and 8 died.   One of the \npeople who did not know he was sick went to Port Harcourt, got sick saw a physician.   \nThe physician got infected and ultimately died, but not without infecting his wife.   The \nAugust 28, 2014 Nature paper on deep sequencing by Pardis Sabeti from the Broad in \nBoston showed phylogenetic origin of virus as a single point source.   In the paper, the \nwoman who brought the virus from Guinea to Sierra Leone got is at a funeral where she \ntended to a body; however, 12 people from that funeral got infected from 2 lineages, \nprobably all having gotten infected at the funeral.   It seems to me that these women did \nnot all touch “macroscopically visible feces, blood or vomitus on the body.   Someone or \nmore initially cleaned the body, but certainly some kissed or otherwise touched what \nappeared to be a clean body and got infected.   Conclusion, it is likely than microscopic \ncontamination with residual bodily fluids on what appears to be clean skin or surfaces \ncould spread the virus.   Hypothetical scenario → person is infected and in early stage, \nget diarrhea and wipes his anal area, contaminates his hands with microscopic fecal \nmaterial and virus, washes or not his hands, but virus remains and he then shakes \nsomeone’s hands, serves someone food, etc. and transmission occurs    I do \nnot believe at all that it is transmitted by the respiratory route; however, inadvertent \nReleased by Chairman Rand Paul\n\n358contamination of hands outside of the classical hospital setting should in my mind at least \nbe considered as a potential route of transmission.\nPress interest continues with: Columbia (Bogota) Radio; VOA TV; NPR Weekend \nEdition with Scott Simon; NPR Science Friday; CNN with Jake Tapper; Reuters TV\nAugust 30, 2014 – Case from Guinea went to Dakar, Senegal and lied about exposure.   \nTook bus and stopped in 2 health care facilities.   Contact tracing now going on in \nSenegal.\nSpoke with Tom Frieden who is in Liberia.   Trying to get him to appreciate that giving \nVSV Ebola vaccine as post-exposure prophylaxis (PEP) is risky due to the induction of \ncytokines by the live VSV, which might actually enhance the acquisition upon exposure \nsince cytokine dysregulation plays a negative and potentially positive role in Ebola virus \ndisease.  He wants to pre-position VSV vaccine for PEP and TKM drug (siRNA – not yet \nis phase 1) at all Ebola treatment Units (ETUs). I understand the desire to protect the \nCDC and other health care workers on the front lines, but we must be concerned about \ngiving drugs/PEP vaccines BEFORE they have even been in the earliest Phase 1 trials.   \nYesterday CDC evacuated a WHO worked who had a low risk needle stick (clean needle \nthrough potentially contaminated gloves) and they gave the person TKM drug and \nwanted to give VSV, but could not get it.   That is why he now wants to pre-position it.\n See below my e-mail to Tom Frieden sent to him on Sunday, August 31 while he was in \nLiberia:\nTom:\n    I am including a few attachments: 1) 2 slides (from Nancy Sullivan \nwho does our pre-clinical Ebola studies)  that summarize the issue of \n\"cytokine dysregulation\" in Ebola disease and potentially following \nvaccination; 2) 2 reprints (referred to in the 2 slides) on the types \nof cytokine responses in Ebola disease and following vaccination with \ndifferent vaccine platforms; and 3) the Heinz Feldmann paper with which \nyou are familiar and which shows that in the monkey model of Ebola \nvirus disease, the VSV Ebola vaccine used as post exposure prophylaxis \n(PEP) protected 50% of the monkeys from lethal challenge with Ebola if \nadministered 20-30 minutes following the challenge.\n   Getting back to our discussion and your question concerning the \nissue of any risk of administering VSV as PEP, I certainly would not \ncharacterize the inflammation following VSV vaccine administration as \n\"cytokine storm\".   It certainly induces inflammation and can cause \nfever.  Note that the only human to my knowledge who received this \nvaccine was the laboratory worker in Germany who had a needle stick \ninjury and she got a fever following vaccination.   Inflammation that \nresults in fever will virtually always induce secretion of cytokines of \nvarious sorts.  Since VSV in the NewLink vaccine is a replicating \nvirus, it will almost certainly induce the secretion of \ncytokines.   The reason that this might be important is that a whole \narray of cytokines are important in the pathogenesis of Ebola virus \ndisease.   It certainly can kill you (advanced cytokine storm) and it \nis almost certainly involved in protection and recovery from Ebola \ninfection.  It is a delicate balance that we do not fully \nReleased by Chairman Rand Paul\n359understand.    At this time, we are unclear about the positive versus \nnegative effects of cytokine secretion (or call it dysregulation) \nrelated to the precise cytokines in question and the timing of their \nsecretion vis-à-vis Ebola infection (see first bullet in the first of 2 \nslides in the first attachment.\n   In my mind, this does not mean that one should not provide VSV as \nPEP for your people (or others); however, if administered to them, it \nshould be made clear to the recipients that 1) VSV Ebola vaccine \nprovided 50% protection in monkeys if given 20-30 minutes following \nexposure.   I would mention that monkey models are somewhat different \nfrom human Ebola (see 3rd and 4th bullet of 2nd slide in first \nattachment) and so direct extrapolation to humans should be made with \ncaution at this point in time;  and 2) importantly, the vaccine \nrecipients should clearly understand that there is a theoretical \npossibility that the VSV, due to the complexities of the cytokine \ndysregulation that accompanies Ebola infection and the perturbation of \nthis cytokine network that might occur with a live virus vaccine (VSV) \nthat induces inflammation and fever, might actually cause them harm by \ndisturbing their normal inflammatory/immune response to Ebola \ninfection.   If they understand these caveats, then it would be their \nchoice to receive the vaccine with informed consent.\n    Finally, as you certainly know better than anyone, the FDA will \nhave to be involved in the approval of allowing this pre-positioning \nand potential use of an experimental vaccine by whatever is  the \nappropriate regulatory mechanism.   I hope that this information is \nhelpful to you in your deliberations about PEP.   I look forward to \ndiscussing these issues with you.\nBest regards,\nTony\n-----Original Message-----\nFrom: Frieden, Thomas (Tom) (CDC/OD) \nSent: Sunday, August 31, 2014 3:49 AM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Cytokine \nI had heard of cytokine storm with tekmira but not with VSV.  Can you \nconfirm?\nDid MSNBC\nSept. 1, 2014 – Labor Day – had usual call with Secretary Burwell (SMB) this AM at \n8:30 AM.   Clear and muggy day.   We are going around in circles.   I am concerned that \nthe Secretary is a really smart and very competent person, but she is surrounded by \npeople who may be good at management, but who have never been in a situation like this \nand who really do not have a clue how to address it →  Leslie Dach (formerly of \nWalmart); Andrea Palm (have no idea where she came from).   Bill Corr (Deputy \nSecretary) is the only one with corporate memory of former crises and he has been \ncompletely marginalized by the new kids in town.\nReleased by Chairman Rand Paul\n360There really is no command and control at a higher level.   At my suggestion, Francis \nsent a note to SMB suggesting that we bump this up to the White House level (perhaps \nthe VP) in order to get DoD, USAID, HHS, and NSC working together.   She has not yet \nresponded to him.   I mentioned on the call today that Tom Frieden is dealing with \nAssistant Secretary Lumpkin of DoD.  He is a good person, but nothing is happening \nwith the promise for mobile hospital beds.   They are still quibbling about a 25 bed \nhospital when they really need 1000 beds.   Plans for 5 X 100 beds have gone nowhere.   \nMy experience with the DoD is that they are well-meaning, but the culture and chain-of-\ncommand is such that you never know when you are speaking with someone who really \nhas the authority to actually do what they are talking about.   Something strange about the \nmilitary culture in that they will never say “you are speaking to the wrong person; I \ncannot help you”.  They will try to help (although they cannot) and all that happens is that \ntime is wasted.   I tried to make that point on the conference call.\nImportantly, WHO is saying that the epidemic could reach 20,000 cases.   In fact, \nmathematical models that came out in ScienceInsider today from a physicist named \nAlessandro Vespignani showed that the curve is exponential, not linear, which means that \nthere could be 10,000 cases by September 24.\nThis is turning into a total catastrophe.   Just spoke with Dawn O’Connell (Counsellor to \nSMB) and explained to her that the situation is out of control and that we need a higher \ncommand and control.   I also explained to her the importance of the “exponential” curve \nof the epidemic.   Dawn is really trying to be helpful.\nSept. 2, 2014 – Tom Frieden back from West Africa, gives press conference and says that \nthe situation is out of control and could result in 100,000 cases!   HHS people concerned \nthat he is being hyperbolic; I do not think that he is hyperbolic.  Worrisome things – an \nAmerican missionary M.D. got infected while got infected in Liberia in a hospital that \nwas not for Ebola patients.   Turns out he was doing an OB-GYN exam on a woman who \nwas infected, but did not know it and did not tell the missionary that she had been \nexposed.   Big problem – people are not telling the truth for fear of stigma.   \nEpidemiological curves are now exponential.   A lot of planning, but not much action.   I \nam supporting Tom in the press and at HHS even though he still thinks that we should \npre=position TKM drug (siRNA) and VSV vaccine for PEP for health workers in the \nETUs even though they have not been in Phase 1 yet.\nDid Panel at CSIS on 1616 Rhode Island Avenue.   Very hot muggy day.   Panel on \nGlobal Health issues in the context of Larry Gostin’s new Book of Global Health Law.   \nPanel was me, Larry and Tim Evans of World Bank.   Ebola was a major topic.\nImportant – Secretary Sylvia Burwell called my cell phone at 2:30 PM to ask my opinion \nof whether we were not doing enough or were doing it wrong.   I told her that \nquantitatively we are not doing enough.   But as the epidemic grows exponentially, then \nthe quantitative defect transforms into a qualitative defect and then we are doing it wrong \nsince doing the same thing minimally while the epidemic grows, then becomes doing it \nwrong.    She also tasked me to find out whether there are options to improve the tobacco \nReleased by Chairman Rand Paul\n361plant yield of the ZMapp antibodies or as suggested by some, that we go to CHO cells.   \nShe wanted me to contact the Agriculture people at the BMGF where she used to work to \nget their opinion.  I called and spoke with Susan Hellmann (President of BMGF), Chris \nElias (BMGF), Rob Horsch (Ag expert at BMGF), Larry Zeitlin (CEO of Mapp \nBiopharmaceutical to get their opinion.   Consensus is that it will take too long to fix the \npoor yield in tobacco and that we should go for CHO in 2 of the 3 antibodies.   The 3rd \ndoes not do well in CHO and so stick with tobacco on that one.   I wrote a long e-mail to \nSylvia explaining this.\nPress – CNN with Erin Burnett\nNews still dominated by ISIS who beheaded another USA journalist; Russia invading \neastern Ukraine; Gaza and Ebola\nSept. 3, 2014 – Big meeting at World Bank Headquarters on 18th Street, N.W. to exam \nand discuss the response to Ebola.   Jim Kim (President of World Bank) specifically \ninvited me (as did Paul Farmer),   Discussed the WHO Roadmap and David Nabarro’s \nUN Plan.   Present at meeting were: Tom Frieden, Jim Kim, Tim Evans (Senior Director, \nGHNDR), Jan Eliasson (Deputy Secretary General, UN), Margaret Chan (Director-\nGeneral, WHO), Gayle Smith (by phone – Special Assistant to the POTUS at NSC), \nMark Dybul (by Phone), Keiji Fukuda (WHO), Raj Panjabi (Harvard), Ariel Pablos-\nMendez (USAID), Jimmy Kolker (HHS), Joia Mukhajee (PIH)Sri Mulyani Indrrawati \n(World Bank), Olusoji Adeyi (World Bank), and other World Bank people.\nJim Kim took the lead and emphasized that we need to translate “planning” into action \nand took Margaret Chan to task for not exercising her authorities under the International \nHealth Regulations (IHR) to take the lead.   Despite Jim Kim’s strong urging, it still \nappears that we are not headed to great action.   David Nabarro had some action items \nwith no way to actually act.   I mentioned gently to Margaret that she should not say that \n“We plan to have to Epidemic under control in 6 months”   since this would signal to the \nworld that we actually have a way of ending it in 6 months, when in fact we have no idea \nwhen it will end given the exponential nature of the increase in cases.   I also told story of \nwhen Colin Powell and I went to the UNGASS in the early 2000s and he declared the \nAIDS pandemic a global security threat and this got the attention of everyone.   We \nshould do the same thing with Ebola.\n Press – MSNBC with Peter Alexander; Fox News with Lou Dobbs.\nSept. 4, 2014 -   After discussions with me and having me see and edit his column, Mike \nGerson wrote a scorching editorial in today’s Washington Post criticizing the world and \nthe White House for not doing more for the Ebola situation.   In my discussions with \nMike, he indicated that when he was in the WH with Josh Bolton as Chief-of-Staff, they \nwould have pushed George W. Bush and he would have responded to do something \ndramatic to help West Africa.   Mike sent me a note that Denis McDonough (Obama \nChief-of-Staff) sent to Mike in response to Mike sending Denis a copy of the article.   \nDenis note to Mike below:\nReleased by Chairman Rand Paul\n362Tony,\nIn confidence, this is the note Denis sent back to me when I sent him the link to the \ncolumn.  I thought you might be interested.  \nThanks, Michael.  It is good to hear from you, and I look forward to reading your column (which I \nhave not yet had the chance to do but will soon).\n \nI did think it was worth mentioning that the President had a good – if alarming – discussion with \nDr. Frieden on Monday after Tom returned from the region where he went to get a candid view \nof how this is progressing.  Tom was concerned with what he saw, and the President was \nconcerned with the same.  As a result, POTUS directed even more aggressive action than we \nhave been taking so as to treat this like the national security challenge it is. \n \nLisa, who is leading this effort, and John may have additional thoughts.  But we feel this urgency \n– deeply.\n \nThanks again for the note,\nDenis.\nPress – MSNBC with Ronan Farrow, \nSept. 5, 2014 – Got note from Tait Sai saying that my interview in Newsweek where I \nsaid that the Epidemic was “completely out of control” was “10% too hyperbolic”.   Lots \ngoing on.   USAID assigned Nancy Lindborg to run their shop.   She is pretty good.   Jim \nKim is exercised that WHO is not doing enough.   Tom Frieden says that the DoD is \nuseless since they can never commit to anything.   This is interesting since Cliff Lane \nthinks that they are the only ones that can control this with Command, Control and \nCommunications.  \nJim Kim wants to engage me, Paul Farmer, Mark Dybul to see to the clinical care issue \nand incorporating clinical trials into the picture.\nSpoke with Tom Frieden today and Tom feels better those things are now moving with \nthe $75 million that USAID is putting in.   I believe that Tom was told to tone down the \nrhetoric about this outbreak being totally out of control and that is why he is saying that \nthings are on track.   This coincides with Tait telling me that I am 10% too hyperbolic\nDid boat-load of print media today.\nSept. 7, 2014 – POTUS said on Meet the Press today the following:\nPOTUS on Ebola on Meet the Press, 9/7/14:\n*Americans should not be concerned about prospects of contagion here in US, short-\nterm, because it is not airborne disease like the flu.  \nReleased by Chairman Rand Paul\n363*No public health infrastructure in Liberia/SL/Guinea.\n*What should be containable problem is breaking loose, because people aren't being \nquarantined properly, people aren't being trained properly, not enough public health \nworkers. \n*We have to make this a national security priority. Mobilize international community, get \nresources in there, get US military assets just to set up isolation units and equipment, and \nprovide security for public health workers surging from around the world.\n*If we do that, still going to be months before this problem is controllable in Africa. But \nit shouldn't reach our shores. \n*If we don't make that effort now, and this spreads, not just through Africa, but other \nparts of the world. There is the prospect the virus mutates, it becomes more easily \ntransmittable. And then it could be serious danger to US. \n*This is example of where US leadership is important in dealing with crisis. But, also \nargument for when I go before Congress, and say let's give some public health aid to \nLiberia. Short term investments now, pay off in the future. \nIt now remains to be seen what actually happens.   The POTUS is getting beaten up in the \npolls and by the GOP for his inaction.   He let the Left down by delaying action on \nimmigration reform until after the November Congressional elections in a purely political \ncave-in.  He is paralyzed in inaction on bombing ISIS in Syria and in doing nothing to \nstop Putin and the Russians from taking over part of Ukraine.    He is having a bad \nsummer.\nYesterday, Mike Gerson contacted Francis Collins in the same manner that he had \ncontacted me, asking Francis what he thinks should be done.   Francis responded as I did \nthat we should bring in the DoD for their Command, Control and Communications \ncapability.   Also, someone needs to be in charge.   John Podesta (Counsellor to the \nPOTUS) contacted Mike Gerson asking him what he thinks we should do.   John was \ntaken aback by Mike’s Post editorial the other day.   Mike asking Francis/me who should \nbe put in charge at the WH.   I suggest any of the following:   David Petraeus, Stanley \nMcCrystal, Colin Powell, and Bill Frist.   I doubt if they will choose any of these.   They \nprobably will ask Lisa Monaco – head of NSC.   We really need a General.\nI believe that we are missing the boat.   USA is missing an opportunity of saving many \nlives and coming across as the savior of West Africa, much like George W. Bush saved \nall of Africa with PEPFAR.\nAm getting e-mail from Jim Kim and Paul Farmer asking for my help/advice should they \nget more heavily involved.\nReleased by Chairman Rand Paul\n364Sept. 8, 2014 - The situation is evolving rapidly where the Department of HHS is now \ntelling us (NIH and others) that things are now going in the right direction and that we do \nnot need to have daily phone calls anymore and could probably move them to every week \nor every other week. This is stunning to me since I do not see that anything has really \nchanged and it appears to me that they are trying to paint a rosy a picture when things are \nactually getting worse. The reason for this is unclear. It could be that the White House \nhas told them to tone down the rhetoric since they do not want to put pressure on the \nPresident. Also amazing is the fact that even Tom Frieden has told me on the phone that \nthings seem to be going in the right direction now and they have work streams and points \nof contact and he is much more optimistic. I cannot believe that he has completely \nchanged from the passionate person demanding an overwhelming amount of resources \nand beds to someone who now says everything seems to be going okay. There is \nsomething very fishy here.   I suspect that HHS has promised him that resources are on \nthe way and have told him to cool it.   I will find out what is going on.\nAppeared on Diane Rehm show today with Sheri Fink from the New York Times as well \nas Sophie Delaunay from MSF and Mvemba Dizolele from the Democratic Republic of \nthe Congo.    Dvemba said that he has been reading about me since he was 16 years old \nand that I was his hero.   He made me feel rather old despite the flattering comment (he is \nright about the age ).  The host was Steve Roberts and we spoke about the drastic \nsituation in West Africa. Also appeared on BBC radio. WTOP radio and Reuters TV.  \nAlthough the President has said on Meet the Press that the military will now be involved, \nreports and news outlets such as Reuters quote officers at the level of Colonel saying that \nthe military will deliver the 25 bed hospital to Liberia; however, there will not be “boots \non the ground” of military personnel staffing the hospital. As far as I can see, this is no \ndifferent than what was going on before the President's announcement. There were \nalready plans to get a 25 bed hospital shipped by military aircraft to Liberia. I think this is \na smoke and mirror game in which nothing will get done.\nSeptember 9, 2019 - There is a considerable disagreement going on about the role of \nrandomized placebo-controlled clinical trials (RCTs) in determining the efficacy and true \nsafety of the GSK/NIH chimp adenovirus vaccine. The British in the form of Jeremy \nFarrar Head of Wellcome Trust as well as the WHO (Marie-Paule Kieny) seem to want to \ndistribute the vaccine outside of a clinical trial. They are responding to what is an \nemotional need to get some intervention out there even though we have experience to \nindicate that the worst thing that can happen is the widespread application of the vaccine \nor other interventions that  either do not work or actually paradoxically make things \nworse as we have seen with the HIV vaccine experience where a HIV vaccine that looked \ngood in preclinical as well as in phase 1 actually increased the risk among the vaccinees \nof HIV acquisition by up to 41%.  This is the worst thing that could happen in the Ebola \nsituation. Cliff Lane and I are trying hard to strike a delicate balance between making our \nvaccine available following phase 1 trials which have just started here at NIH and \ncontinuing to pursue the scientific path of determining if it works and is safe without a \nparadoxical effect of harming.\nReleased by Chairman Rand Paul\n365Had an extraordinary conversation with Tom Frieden tonight. Tom had been at a National \nSecurity Council meeting at the White House today hoping that he would guess an \nindication that they would be many more resources to address the Ebola outbreak. He had \nbeen secretive about the meeting; I can understand that since I have been at many WH \nmeetings where they wanted to keep things secret until they made a decision.  He \nobviously was very disappointed after the meeting since he called me on my cell phone in \nmy car as I was driving home late tonight from the NIH. Tom was more animated and \ndistressed that I have ever seen him. I knew this to be the case since he used foul \nlanguage (“Fucking ….”) and I have never heard Tom used foul language before. He was \ncompletely frustrated by the fact that his meeting with the National Security Council and \nrepresentatives from USAID as well as the secretary's office indicated to him that nothing \nnew was going to happen and this whole idea about getting the military involved was \nreally more PR than anything else. He also found out that Cliff Lane in his role as a \nmember of the Defense Medical Board will actually be meeting with Gen. Martin E. \nDempsey, Chairman of the Joint Chiefs of Staff, tomorrow (Wednesday, September 10) \nand he essentially implored me emotionally to get Cliff to emphasize to the Chairmen \n(General Dempsey) that it is absolutely essential that we have a major military presence \nin approaching the epidemic in West Africa. We need plans, thousands of beds, trained \npersonnel, Command and control, etc.  Without these assets, Tom feels that the epidemic \nwill remain out of control and spread to many countries in West Africa and throughout \nAfrica as well as to other countries outside of the African continent. He also indicated to \nme that some people who he did not name were telling the military that they need not get \ninvolved since vaccines and ZMapp will soon end the epidemic before they even get their \nplanes in the air. This is obviously complete nonsense and Tom knows it. He emphasized \nthe need to please tell Cliff Lane to tell the Joint Chiefs of Staff that this is not the case. \nFinally, Tom indicated to me that the military are afraid of getting infected because they \nhear that so many healthcare workers are getting infected. He implored me to tell Cliff \nthat with proper personal protective equipment there really has been no infections among \nindividuals from MSF. This is turning into a very interesting scenario we will see what \nhappens tomorrow on September 10 when Cliff actually meets with the Joint Chiefs of \nStaff. I assured Tom that Cliff and I strongly feel the way he does and we both have been \npushing hard behind the scenes to get the military involved.   In fact, I have been talking \nwith Mike Gerson (as has Francis Collins) about approaching John Podesta in the WH to \nget the POTUS to agree to military intervention.   I spoke again with Mike Gerson about \nthis today.   After my call with Tom Frieden, I called Cliff and related the story.   I did \nnot need to encourage Cliff to say these things since I knew that he would.   I got back to \nTom and told him that things were on track with Cliff for tomorrow and Tom felt better \nand thanked me for my help. \nIn addition today I had conversations on the phone with Paul Farmer who was very \nwilling to set up more facilities in West Africa via Partners in Health (they are already in \nLiberia with Raj Punjabi) together with Jim Kim of the World Bank so that we can do \nsome good clinical work as well as clinical research. Paul indicated that I did wonders \nwith PEPFAR, and that he would like to partner with me to do some good with Ebola.\nReleased by Chairman Rand Paul\n366Sept. 10, 2014 - The debate still continues as to whether or not we will have military \nassistance in dealing with the Ebola epidemic in West Africa. There is a disturbing lack \nof transparency between HHS and us here at NIH in that they are obviously negotiating at \nthe level of the National Security Council and the Department of Defense about what to \ndo in the epidemic without telling Francis Collins or me what is actually going on. In the \nmeantime, Cliff Lane as a long-term member of the Medical Defense Board of the \nDepartment of Defense has met with Gen. Martin E. Dempsey, chairman of the Joint \nChiefs of Staff today. Cliff relates to me that Gen. Dempsey seemed quite receptive to \nCliff's pleading for a massive military logistic support for the Ebola situation in West \nAfrica. Also at that meeting with the Joint Chiefs was Laurie Garrett, because of her prior \nexperience with Ebola epidemics. According to Cliff, Laurie also pleaded for a massive \nmilitary effort.\n      It should be noted that today another important event occurred in which the President \nannounced at a TV appearance that he will initiate a scaled up military attack on ISIS (he \ncalls it ISIL)  including their assets in Syria. He declared that ISIS is a threat to the \nMiddle East, the surrounding regions, and the United States and Europe, largely due to \nthe fact that they have publicly said that they will attack Western nations. This is a \nparticularly important problem because many Westerners with Western passports and \nVisas including those from the United States have joined ISIS. The President stated that \nhe would not include ground troops in this effort. However it is clear that Special Forces \nwill be needed to guide the air attacks. The press is sharply criticizing the POTUS for \nhaving no plan, missing prior opportunities, and now doing too little, too late.  More later. \nI bring this up because this is certainly a complicating issue when you are also asking the \nmilitary to help with Ebola outbreak.\nHad a momentous evening today in that I gave a keynote lecture at the PhRMA Research \nand Hope Awards Gala at the Mellon Auditorium on Constitution Ave. It was particularly \nimportant because the other speaker was former Pres. George W. Bush. We resumed our \nwarm personal relationship in that when he entered a small room of VIPs to shake hands \nand take pictures as soon as he walked into the room he caught my eye and said out loud \nfor everyone to hear: “Hey, Tony it's great to see you”. He gave me a big hug; we took \npictures; chatted a bit and then when he was on the stage for his talk which was actually a \nconversation with a moderator, the first thing he said is that:  “We have with us tonight \nmy friend Tony Fauci. I gave Tony the Presidential Medal of Freedom several years ago. \nI did that because you should know that he is one of the most important American heroes \nof our time.”   It was extraordinarily flattering, but this is exactly the way he has been \ntreating me for years. The talk that I gave was entitled ending the HIV-AIDS pandemic: a \nrealistic goal. Overall the evening was very pleasant. I sat down next to my old friend \nform NIH director Elias Zerhouni and the evening was full of warm praise by many \npeople for me and what I have been doing with HIV over the last many years. \nSept. 14, 2014 - A lot has happened over the past few days. There has been a \nconsiderable amount of disorganization, diffusion, and lack of direction at the level of \nHHS as well as the rest of the USG (USAID, DoS, etc.). It has been announced that the \nPresident will visit the CDC on Tuesday, September 16. It is anticipated that he will \nannounce that the United States military will get heavily involved in the response to \nReleased by Chairman Rand Paul\n367Ebola by providing up to 1700 hospital beds as well as the logistics for transportation and \nprovision of equipment. However, it is very clear that they will not provide medical \npersonnel in the form of doctors and nurses. This might leave us with the situation in \nwhich we have equipment but the inability to implement it. HHS (Leslie Dach) is \ndesperately trying to figure out ways to recruit and train medical personnel to man the \nhospitals.   Of note, it might take up to 8 weeks to get these hospitals operational, if in \nfact, the US military decides to send them. \n      The situation in the West African countries is still dire. I have been on the phone \ndiscussing this on multiple occasions over the past few days with Paul Farmer and Mike \nGerson.   Paul will be leaving tomorrow, September 15, for Liberia in order to set up \nhospitals under the auspices of Partners in Health, the organization that Paul and Jim Kim \nfounded many years ago. Francis Collins, Cliff Lane, and I are still pushing HHS to \nsuggest that there be a person in the White House who would be the overall Director and \npoint person for the government's Ebola efforts. I have suggested to Francis and Francis \nhas suggested to the secretary that that person either be someone like Gen. David \nPetraeus, Gen. Stanley McCrystal, or even former majority Senate leader Bill Frist. \nAgain, I am concerned about the lack of organization, direction, and commitment on the \npart of the department as well as the White House. The President is having a very \ndifficult time in that he is being pressured to respond firmly to the threat of ISIS in the \nMiddle East. I feel that this pressure may make him and the administration less \nenthusiastic about getting heavily involved with the Ebola issue.\n     Nicki Lurie, who is a good person and a friend, is making things more confusing by \ntrying to suggest how to do clinical trials, train people and other tasks when she knows \nlittle about these issues.   She is an Assistant Secretary and so officially she outranks us \nall (me, Peggy Hamburg, Francis Collins, Tom Frieden); yet, she gets in the way more \noften than not.   Had a long conversation about this with Peggy Hamburg on the phone \ntoday.   Paul Farmer is encouraging me to continue to push the envelope to get the USG \nto do more.   Paul is showing an amazing amount of faith in me that I can fix this.   He is \nbasing this on his experience with me with PEPFAR.   However, this is different since \nthere are so many “cooks” in this process.\nSept. 15, 2014 – Mike Gerson called me up again this AM wanted to find out if I knew \nanything more about the POTUS planned announcement at CDC tomorrow regarding \nincreased resources (DoD) for Ebola.   Mike is driven by his deep humanitarian values \nand wanting to nudge the administration to do more.  Mike will speak with Lisa Monaco \ntoday about administration plans.   I gave him a few questions to ask Lisa, i.e. who is in \ncharge?\nSept. 16, 2014 – I helped Mike gerson last night on certain elements of his column which \nappeared today in the Washington Post. Mike used several of my phrases and called for \nan escalated effort in various areas of need including US Military command-and-control, \ntransportation, logistics, and supplies. Last night the White House sent out an embargoed \nfact sheet about what the President will announce today at the CDC. He will make the \nannouncement at 4:45 PM. I will be testifying before the Senate  HELP committee and \nthe Senate Appropriations Subcommittee from 2:30 PM until about 4:30 PM. There are a \nlarge number of press including CNN with Wolf Blitzer,Hhardball with Chris Matthews, \nReleased by Chairman Rand Paul\n368an MSNBC who want to speak to me about the President's announcement and the \nimplications of the announcement. As usual the White House is very nervous about \nhaving anybody speaking to the press before or on the day that the president makes an \nannouncement. Therefore I am getting a lot of grief from the communications people \ndowntown and at the White House about all of the requests for me to appear on the \nmedia. By grief I mean that they are not clearing me nor are they refusing me. They are \njust keeping me hanging, which usually means that the requests will be withdrawn by the \nmedia people themselves and they will find someone else. This is typical stupidity on the \npart of the White House and HHS.\nWith regard to the announcement of the President, he is proposing many of the things that \nI and several of my colleagues have been pushing for. This includes 3000 personnel, a \ncommand-and-control center in Monrovia, Liberia, a US Army general in charge of the \nprocess. The supply of 17 Ebola Treatment Units  consisting of 100 beds per unit, much \npersonal protective equipment, an education program, home health care kits, home test \nkits, among many other things that are much needed. Hopefully, this will turn around the \ntrajectory of the epidemic. However it will depend on how quickly they get this material \non the ground. I am off to the congressional committees. More later.\nSept. 17, 2014 – Big day yesterday.   POTUS announced military involvement in Ebola \nat CDC at the same time that I was testifying before a joint Senate Hearing of the HELP \nCommittee and the Appropriations Committee.   I testified with Beth Bell from CDC \n(Tom Frieden was at CDC with the POTUS visit), and Robin Robinson.   I was \nquestioned on the POTUS plan, the scope of the epidemic and the possibility of \nrespiratory/aerosol spread of the virus.   The latter was triggered by Mike Osterholm’s (as \nusual provocative and attention-getting) statement that the virus could mutate and spread \nby respiratory and that would be the end of the world.   Typical Mike Osterholm.   I have \nbeen countering this with a reality check about likelihood versus hypothetical.   Senators \nat the Hearing were Dems: Tom Harkin, Patty Murray, Dick Durbin, Jack Reed, Mark \nPryor, Barbara Mikulski, Bob Casey, Al Franken, Sheldon Whitehouse, Tammy Baldwin, \nChris Murphy and Elizabeth Warren  and GOPs:  Jerry Moran, Thad Cochran, Lamar \nAlexander, Richard Burr, Johnny Isaacson, John Boozman.   Kent Brantley was witness \non second panel.\nAnother example of the WH and HHS press people messing up.   They would not let me \ngo on the many press requests (CNN, NBC, etc.) since they wanted Lisa Monaco (NSC) \nto go on.   As it turned out, she was with the POTUS in his motorcade in Atlanta and so \nno one from USG went on and the media was saturated with the usual suspects (Laurie \nGarrett, Mike Osterholm, etc.)   The WH and HHS press people are truly a bunch of idiot \namateurs.\nSept. 18, 2014 – Yesterday had Hearing before the House Subcommittee on Foreign \nAffairs (Africa) chaired by Chris Smith.   On the GOP side were: Stockman, meadows, \nBurgess, Royce (Chair of Full Committee).   On Dems side was:  Bass, Cicilline, Engel, \nand McCollum.   My co-witnesses were Nancy Lindborg (USAID), Luciana (Lu) Borio \n(FDA), Beth Bell (CDC).   Recurring question was “Who is in charge?”    Real answer is \nReleased by Chairman Rand Paul\n369that multiple agencies/people are in charge depending whether it is health, infection \ncontrol, logistics, etc.   Kent Brantley again was on the second panel.   \nStill much interest and interviews with written press and blogs over the ongoing \n“disagreement” between Osterholm and me on the issue of the virus mutating to \nrespiratory spread.   Ian Lipkin gave an interview on CNN agreeing with me and putting \ndown Osterholm.\n \nMeanwhile, the House voted to give POTUS authority to arm the Syrian Free Army to \nfight ISIS.\nThe situation continues to heat up with various mathematical models projecting anywhere \nfrom 20,000 to 100,000 to a soon to be published CDC model that would indicate if we \ndo not have a highly effective control program, the number of cases could reach 500,000 \nwithin several months.\n September 19, 2014 - I continue to do small amount of press (as the press is getting \nsome fatigue with the same story) with Swedish National TV interview as well as a FOX \nnews appearance. Of note is the fact that the White House communications people are \nacting in a very bizarre way. During the past week I have been receiving requests for \nappearances on a variety of TV shows for the upcoming weekend including CNN and \nMSNBC on Saturday, September 20, as well as Face the Nation and Fox news on \nSunday, September 21. The White House has refused to say yes or no to clearance and \ndespite multiple requests on the part of our communications people, namely, Courtney \nBillet and Patty Conrad, we have not received a positive or negative reply for clearance. \nThis has gone on into the late evening of Friday, September 19 despite the fact that the \nprogrammers were waiting for me to be on shows on Saturday. This is an absolute \nunacceptable disgrace.  The White House because of their inability to decide what should \ngo out on the weekends and their extraordinary and unexplainable need to control all \nmessages is putting all of us in the embarrassing position of being unresponsive to \nlegitimate media requests to discuss things that are not in conflict with anything else the \nadministration is doing. This is unequivocally the worst administration I have ever dealt \nwith when it comes to the need to control the media.\nThis evening I had a very intense and somewhat poignant conversation with Tom Frieden \nat 9 PM to 10 PM concerning how we are going to approach the issue of vaccines. Tom \nstill has considerable concern about a truly randomized controlled trial to determine the \nefficacy of the vaccine when the control is not one of the vaccines themselves. He \ncontinues to struggle with the fact that we are not going to be able to get efficacy data \nunless we do have a control arm which conflicts with the emotional need to get vaccine to \neveryone as soon as possible. The difficulty here is that we might in fact truly need an \neffective vaccine if the epidemic continues to expand and reaches the CDC projected \nmodel of 500,000 cases within the next several months. Under those circumstances we \nwill absolutely need an effective vaccine and if we do not know if it is effective it will be \nvery difficult to widely distribute it. This is a painful dilemma that hopefully we can work \nout.\nReleased by Chairman Rand Paul\n370I have been discussing this by e-mail with Paul Farmer who is currently in Monrovia, \nLiberia. Paul is very sensitive to the fact that we need to do research to determine the \nefficacy of the vaccine and feels that we can pull this off in Liberia with a properly run \ntrial. In this regard, the Minister of Health of Liberia has actually requested collaboration \nwith the NIH in doing research on therapeutics and vaccines. It is going to be a difficult \nstruggle to reconcile the emotional need of many people (in some respects including Tom \nFrieden) to distribute vaccine at the same time that we are not sure if it actually works or \neven paradoxically causes harm. I will continue to pursue discussions of clinical trial \ndesigns that might be able to get us where we need to be, i.e. proving efficacy at the same \ntime as making vaccine available as quickly as possible.\nSept. 20, 2014 – Went to reception tonight at the home of Hilary Rosen (Democratic \npundit) at 4835 Hutchins Place, N.W. to welcome Megan Smith former VP at Google as \nthe White House Chief Technology Officer.   All the usual Washington glitterati were \ntheir (some examples: Judy Woodruff, Al Hunt, Andrea Mitchell, Bob Barnett, Tammy \nHaddad, Hunter and Kathleen Biden, etc.   Megan is very impressive (MIT grad; Google \nexec) and we discussed the potential use of technology to address the Ebola epidemic – \ncell phone distribution, GPS tracking devices.  Hopefully, she can help.\nIndeed, neither a yes or no from the WH and HHS regarding the requests for my \nappearances on TV over the weekend and so I did not appear.   Instead, Face the Nation \nhad Richard Schaffner from Vanderbilt and MNNBC had Laurie Garrett.   This \nadministration are a bunch of idiots.\nSept. 21, 2014 -  Had call at home from Leslie Dach wanting my opinion about a \n“dispute’ between USAID and Tom Frieden about home care versus community based \ncare of people with Ebola or suspected of Ebola in situations where the ETUs are full.  I \nbacked Tom who feels that doing it at home would be counter-productive.   Leslie now \nrelying on me as “the adult in the room” according to Peggy Hamburg.\nSept. 22, 2014 – Tait Sye from HHS not giving me clearance to appear on CNN-Wolf \nBlitzer because “CDC will be putting out an MMWR today”.   What morons!!   I just \ncannot believe this administration.   I must write about this in my book.  They so \ninappropriately try to control “messages” that they are laughable.\nPOTUS decides to bomb ISIS in Syria.   Ebola numbers expanding.\nHad another night time call with Tom Frieden trying to iron out the RCT issue.   Also, \nTom is very frustrated with Nicki Lurie, saying that having her around and involved in \nconversations is always counter-productive.   Also, he is frustrated with Sec. Burwell, \nfeeling that she seems only to want to “check the boxes” instead of getting involved in \nimportant decisions.\nSept. 23, 2014 -  Still working with Tom Frieden in trying to get agreement on whether \nto conduct an RCT of the vaccine.   Tom remains concerned about a true control \nReleased by Chairman Rand Paul\n371(placebo) arm and wants to do a Stepped-Wedge trial of sequentially vaccinated different \ncohorts without the simultaneous double blind control group.\nThis evening went to the Annual Friends of cancer Research Awards Ceremony on the \nroof of the Hay-Adams Hotel.   Gov. Deval Patrick of Massachusetts and Gov. Bobby \nJindal of Louisiana received awards.   Had good conversation with Gov. Patrick.\nSept. 24, 2014 - On the last Secretary’s call, Burwell tasked me to get the HHS team \ntogether and fashion out a consensus about the way forward following ending of phase 1 \nvaccine trial at NIH.   I had long conversation with Tom Frieden this AM and he is \nstarting to come around.   Seems he will be OK with an RCT simultaneously done with a \nStepped-Wedge Trial.  I arranged a conference call at 5:30 PM with me, Tom, Nicki \nLurie, Peggy Hamburg, Lu Borio, and Anne Schuchat.   We came to agreement that we \nwill do the two trials (RCT + Stepped Wedge) simultaneously.   CDC (Anne and Tom) \nfeel that the RCT may be so difficult to implement that the Stepped-Wedge approach \nmight give us some information, while the RCT could fail.   Cliff and I feel just the \nopposite.   However, in order to get things moving, we came to a compromise.   I will \nreport this to the HHS Secretary’s call tomorrow.\nContinue to have press interest:  Bloomberg News TV; WTOP Radio; pre-show interview \nwith CBS 60 Minutes for future show.\nSept. 25, 2014 – Did MSNBC this AM as a commentary immediately following the \nPOTUS statement before the UN on Ebola.   He gave his speech and then I was asked to \ncomment.   Of course, I supported what he said (since he said the right things – all \nnations must pitch in).\nSept. 26, 2014 – Learned at 4:00 PM this afternoon that the NIH Clinical Center will be \naccepting for observation in our special studies unit an American physician who had a \nmoderate risk exposure to Ebola in Sierra Leone (clean needle puncture through a \ncontaminated glove).  We scrambled around over the evening preparing press statements \nand plans.  Patient will arrive on Sunday, Sept. 28.\nSept. 27, 2014 – Did FOX News and CNN today (Saturday) on regular Ebola issues.  \nAlso, much press coming in since the press release went out today on the patient arriving \nfrom Sierra Leone.   In this regard, I did CBS Radio News; NPR background; WUSA –\nChannel 9 TV; various print outlets.   Likely much more tomorrow.\nSept. 28, 2014 – Patient arrived this afternoon (~3:00 PM) from Sierra Leone.   State \nDepartment arranged his transportation.   He was given the VSV vaccine as a post-\nexposure prophylaxis, which neither Cliff nor I would necessarily have done since it \ninduces a fever and can complicate matters.   Indeed, he developed a fever 24 hours after \nreceiving the VSV vaccine.    The Patient, Dr. Lewis Rubinson, is admitted to the Special \nStudies Unit of the Clinical Center on the 5th Floor.      Very little of the circus that we \nsaw when Dr. Brantley and Nancy Rightbol were admitted to Emory, i.e. no helicopters \nor TV trucks.   I did do a few interviews (some pre-scheduled even before the patient was \nReleased by Chairman Rand Paul\n372known to come to NIH.   Did interviews for: MSNBC, NBC Network, NPR Radio; Fox5 \nTV, CBS Radio\nSept. 29, 2014 – No evidence of infection in the patient.  Much press today:  CNN; \nWeather Channel TV; USA Today TV and ONLINE; 1 hour at the WTOP Studio with \nquestions from staff Deborah Feinstein and Bruce Alan; CBS Radio; FOX5 TV; CBS \nTV; AP TV; Channel 8 News TV\nSept. 30, 2014 – Word from the WHO meeting in Geneva is that people are starting to \ncome around to our (Cliff, me, Lu Borio) idea about the necessity of conducting an RCT \nrather than open access for the Ebola vaccine.   A story about me with picture appeared in \nUSA today with my saying that it is critical to greatly accelerate our efforts or else the \nEbola epidemic will evolve into the “worst case scenario” of the CDC prediction of 1.4 \nmillion cases by early 2015.\nOct. 1, 2014 – Big news!   A patient  from Liberia got on a plane on \nSept. 19, arrived in USA (Texas) on Sept. 20 without sxs.  On Sept. 24 developed sxs; on \nSept. 26 went to an ER in Dallas and was given Z-pack and sent home; on Sept. 28 taken \nto Texas Health Presbyterian Hospital (Dallas) in critical condition.   Ebola dx confirmed.   \nThis is first patient to come to USA with Ebola who did not know he/she had Ebola.   \nSoemthing that I have been predicting all along.  \nOn conference call with Secretary Burwell, I indicated that after Tom Frieden’s press \nconference at 5:30 PM yesterday (Sept. 30) there were many requests from the press.   On \nthe phone a CDC person said that this is Tom’s responsibility.   Burwell snapped at the \nperson saying that we need Tony out there and this is no time to be arguing about \n“people’s lanes”.   Finally, someone put an end to that bullshit.   Thanks, Sylvia!   Sylvia \nasked me on the phone to cancel my planned trip for today to San Francisco to partake in \na Gala to celebrate UCSF’s Global Health program.   Also, I was going to see Ali.  I, of \ncourse, obliged and Sylvia said that she wanted me to take the lead in “Calming the \nCountry” that will certainly panic about this. She asked me to lead a teleconference last \nnight at 9:00 PM with HHS to discuss the clinical aspects of what this means. \n And so there is much press today:  Bloomberg News TV by phone; AP Radio; CNN \nNew Day; FOX News TV; NPR Here and Now; multiple print media and blogs → AFP; \nNew York Daily News; Washington Post., BuzzFeed; Wall Street Journal;  Also, Doctor \nradio with Marc Siegel; Time Magazine; The Guardian; The Huffington Post; CNN \nInternational (I was cut off by satellite issue); Bloomberg TV; CNN “The Lead” with \nJake Tapper; WBZ/CBS Radio Boston; MSNBC Hardball with Chris Matthews; NBC \nNightly News; FOX with Lou Dobbs; CNN Anderson Cooper 360; WUSA Channel 9.\nAs it turns out, and this was discussed at length on my TV interviews, on the Sept. 26 \nvisit of to the ER, a nurse took a travel history and  explicitly said that he \ntold the nurse that he had just arrived from Liberia.  The nurse wrote this down, but the \nclinical team either did not see it or ignored it.   It is being played up on TV as a major \nmis-step on the part of the local health system.  I continue to “calm the country” by \nReleased by Chairman Rand Paul\n\n373stressing that contact tracing with appropriate isolation if a contact develops sxs will \nprevent an outbreak from occurring.\nOct. 2, 2014 – Media frenzy continues.   The Texas patient continues to dominate the \nnews.  The media is really pouncing on the Texas hospital for dropping the ball in \nsending the patient home with Z-Pack even though the patient explicitly told the nurse \nthat he had just arrived from Liberia and had sxs of Ebola.   Also, the system is being \ncriticized because they are unable to remove the waste from the hospital (license and \ncontract issues) as well as from the room where slept with his girlfriend and her \nchildren.   Amazingly, the girlfriend and children are being legally quarantined (armed \nguard at door) in the room with the soiled sheets and towels still in the room unable to be \nremoved.   Texas is being blasted by the media.   I am trying to add some rationale calm \nto the dialogue.\nToday’s media:  MSNBC with “Morning Joe”; CNN “New Day”; MSNBC – Jose Diaz-\nBelart; LBC (UK) radio; Hearst TV; MSNBC Reid report; Reuters TV; Fox News; BBC \nRadio; BBC World News with Katty Kay; CNN Wolf Blitzer; Canadian TV; MSNBC \nwith Rachel Maddow\nRachel Maddow was wonderful on the interview.   After I signed off, she told the \naudience how honored she was that I went on her show and what an amazing person I \nwas.\nOct. 3, 2014 – Had very interesting day today.   Sylvia Burwell and Leslie Dach asked \nme to join Sylvia at a Press Conference at the White House Press Room at 4:30 PM to \ncalm the country’s increasing fear and anxiety around Ebola , particularly related to the \nmess-ups in Texas (see above).   I was on the podium with Sylvia Matthews, Raj Shah, \nLisa Monaco (Director, NSC) and Gen David Rodriguez of Africa Command.   I received \nmany, many e-mails commending me on my performance as a straight talker while the \nothers were perceived as typical political appointees.   I actually thought that Sylvia did a \nvery good job.   Lisa was a little double talking.   \nAlso, Mike Leavitt (former Secretary of HHS) called me to be briefed on Ebola.\nDid much press, but had to cancel Wolf Blitzer and Jim Sciutto from CNN because of \nunexpected conflict with the WH Press Conference.\nPress included:  FOX News; CBS TV; CNN with Sanjay Gupta; Chris Hayes at MSNBC\nOct. 4, 2014 – Some drama today.  A 35 year old man and his 5 yo daughter (Liberian \nGreen card lives in New Jersey) flying from Monrovia on United Airlines to Brussels and \nthen United to Newark.   Man throws up on the Brussels – Newark flight.  When plane \nlands CDC person on the ground judges that the person does not have Ebola and \nrecommends that he be taken to hospital for checkup and releases the other passengers.   \nTo Tom Frieden’s great dismay, the White House (Lisa Monaco) and Sylvia Burwell \nover-rule CDC decision and have Hazmat remove man and daughter to hospital and call \nReleased by Chairman Rand Paul\n\n374back the released passengers who were already either on the way home or boarding \nconnecting flights in order to get their contact information and pass out forms telling \nthem what to do if they get fever or sxs.   Sylvia asked me to be on conference call \ndiscussing this with Lisa Monaco, Sec. Jay Johnson of DHS, Leslie Dach, Jennifer \nPalmieri of White House Comms and NSC Rand Beers and Ned Price.   Decision on first \ncall was to find out the clinical judgment of the hospital staff as to whether this person \nmight have Ebola.   If they felt there was a risk, they would do Ebola PCR, which would \ntake 2 hours for primary result and up to 72 hours for confirmation.  Decided to wait for \nsecond call in 2 hours.   In between calls I called Tom Frieden to offer to help him out.   \nHe was greatly distressed that the WH and Sylvia over-ruled CDC and called the \npassengers back since the CDC person on the ground felt that the man did not have \nEbola.   He said he cannot do his job if he is being second-guessed by the Secretary and \nher team.   He even spoke about resigning.   I told him that this was ridiculous and that I \nwould try to help him by speaking with Leslie and Sylvia.   Also, Sylvia and Sec. \nJohnson (DHS) want to institute entry screening with questioning and temperature-\ntaking.   There is already exit screening at the West African airports and Tom is against \nrepeating things just to make people feel good.   Sylvia and Leslie want my opinion and I \nwill speak with Leslie tonight about this.   \n     On the second call at 5:30 PM (beautiful Fall day in DC with clear skies and 70 F), it \nwas disclosed that the Jersey hospital found that the patient had no fever or abnormal \nlabs; felt good; and had had an episode of vertigo.   The patient will be released without \nrestrictions and the passengers will be told that all is clear.    Tom is beside himself.\nAlso had long conversation with Mike Gerson today briefing him on story he is writing \nabout the complexities of doing a vaccine trial for Ebola – scientific and ethical issues.\nPress today →  NBC Today Show Weekend Edition; MSNBC with Alex Witt; PBS \nNewsHour Weekend Edition\nOct. 5, 2014 – It is interesting that with the 24 hour News Cycle has created its own \ndynamic.   Today (Sunday) the national news was totally dominated by Ebola.   Now the \nquestions center around whether we should do entry screening as passengers get off the \nplane from West Africa even though there is exit screening at the west African airports \nwith temperature taking and questionnaires.   DHS and some Congressmen want \ntemperature taking at the entry level also, which would only cut the window of \nvulnerability down by hours that the person is on the plane.   Yet, there will be a meeting \nat the White House today to discuss entry screening.  Frieden is against it, but he is going \nto lose the argument.   Leslie Dach and Sylvia asked me yesterday what I thought about \nit.   I told them that it would be for PR reasons only since it really substantively makes no \ndifference.   \nI went on the Sunday Shows today with FOX News with Chris Wallace and face the \nNation.   Tom Frieden did This Week and Meet the press and State of the Union.   \nQuestions were related to Rand Paul and Bobby Jindal saying that we should shut down \nflights from West Africa.   I totally disagreed.   Also, there was concern on Rand Paul’s \npart that our 3000 to 4000 troops that we are sending to West Africa will get infected and \nReleased by Chairman Rand Paul\n375bring Ebola back to the USA.  Ridiculous.   I got many congratulatory e-mails from \npeople telling me how well I did on the Sunday Shows.   In the evening, I did CNN.\nOct. 6, 2014 – White House meeting discussed increased entry screening, but no firm \nrecommendations to date.   Big 24 hour News topic is whether to close the borders to \nWest African flights.   I have been very vocally against this (as had Tom Frieden) since it \nwill only isolate the West African countries and make them less able to deal with the \nepidemic.   It could cause political instability and even government collapse.   In my \ninterviewers over the past 2 days I have said that to interviewers as good as Chris \nWallace and as less experiences as Elizabeth Hasselbeck of FOX News.   Two things \nhave resulted:1) I am getting a lot of hate mail from crazy neo-Nazi types who say that \nwe should not care about dysfunctional black Africans.   In addition, bloggers are \ncheering me on about taking on the right wing news people about closing the borders.   I \ndo not feel that I have “taken them on”; I have just told them my opinion.   Bloggers have \nbeen particularly hard on Elizabeth Hasselbeck saying she was completely over-matched \nin her interview with me.   I did not know beforehand, but she apparently has been a star \non “Survivor” and “The Voice” TV Shows.  She clearly is very beautiful, and I do not \nthink that she is stupid the way the bloggers are saying.\nPress appearances today:  CNN New Day; Fox and Friends (Elizabeth Hasselbeck); \nDiane Rehm Show; MSNBC; PBS The NewsHour (Jeff Green)\nSeems that we (Cliff and I) have won the battle to convince people that we need to do an \nRCT for an Ebola Vaccine.\nOct. 7, 2014 – Continued media frenzy.   Each day they pick something else to hammer \ninto the ground.   Topic today is the POTUS considering increasing the level of screening \nby possibly introducing “entry” screening with temperature and questionnaire.  \nDiscussions divided along ideological lines.   Right wing saying to close borders; execute \nor euthanize African patients.   I have been on the air stressing the lack of rationale for \nclosing the borders of African countries not permitting travel.   For the first time since the \nold AIDS days, I am getting hate mail telling me to go “rot in hell”.   Also, the right wing \nbloggers who comment online after my TV clips are shown online are trashing me calling \nme a liberal asshole selling out to Obama and his socialist views and liberal leanings.   \nVery weird stuff here.\nMore press today →  CNN New Day; Wilson Center teleconference (call in); WTOP \nRadio; MSNBC (Ronan Farrow); WCBS radio New York; FOX with Lou Dobbs; Alan \nColmes Radio Show\nOct. 8, 2014 – Media frenzy continues.   White House came out today and indicated \nincreased layer of screening at airport on the arrival/entry level with: 1) temperatures; 2) \nquestionnaire about contacts; 3) presence of sxs; 4) quarantine if necessary.   The White \nHouse in its ridiculous need to control the message will not let Tom Frieden or I do any \nTV today (OK for tomorrow) since they only want DHS out there delivering the message.\nHate mail continues as well as just criticism from far right.\nReleased by Chairman Rand Paul\n376Somewhat embarrassing AM phone call today on the HHS teleconference with Sylvia, \nTom Frieden, Peggy Hamburg, me, Nicki Lurie, etc.   Tom was concerned that with the \nPOTUS announcement at 3:00 PM that they would not be able to implement the 4 items \n(see above) at the chosen airports of Kennedy, O’Hare, Dulles, Atlanta, and Newark \nwithin the next couple of days.   He expressed this to Sylvia and she argued that they \nwould have to do it since they told the White House at the last meeting with them that \nthey would.   Tom said that this was not his understanding and he was afraid that there \nmight be some embarrassing slip-ups.   Sylvia was not pleased and in her usual gentle \nway made it clear that CDC would have to make it happen.   Very awkward moment on \nthe phone.\nOct. 9, 2014 – Mor of the same.   Dallas patient) died today.   Black \ncommunity led by Jesse Jackson saying that he go suboptimal care because he is black \n(surprise, surprise for Jesse).  Ton Frieden mad a statement at a World Bank meeting that \nEbola could be the next AIDS.  The press is jumping all over that and I am trying to bail \nhim out by saying that there are very many dissimilarities and the major similarity is the \nfear associated with the early years of AIDS.  \nMuch Press today – CNBC (Sqwauk Box); FOX Business with Varney and Company; \nMSNBC with Andrea Mitchell; CNN with Wolf Blitzer X 2; AP TV.\nOct. 10, 2014 – Sylvia Burwell calls me at 7:45 AM concerned about the media coverage \nof Tom Frieden’s statement comparing Ebola to HIV/AIDS.   Wants me to speak with \nTom to get him to understand the problem with this statement.   Called Tom right away \nand discussed with him.   He now gets it and realizes that he should not have said it that \nway.   I told him that the comparison is strong regarding the fear, but the magnitude and \nother aspects are very different.\n  Continued doing much press → WTOP Radio; MSNBC with Craig Melvin; PBS \nCharlie Rose;\nHas interesting dinner hosted at the Fiola Mare (on 3050 K Street, N.W.) by Catherine \nand Wayne Reynolds.   Usual DC Glitterati there.   Had great conversation with ex-CIA \nDirector Mike Hayden about what is going on with ISIS.   He joked that the Ebola \nsituation and me on TV is bumping ISIS of the media coverage.   Great idea by Wayne \nReynolds.   Wolf Blitzer was at the dinner and Wayne (at the end of the dinner right \nbefore dessert had Wolf “interview” me in front of the people sitting at dinner just as if \nwe were on the CNN TV set.   The dinner crowd loved it.   It was fun.\nOct. 11, 2014 – Saturday conference call with Sylvia.  Implementation of additional \nscreening started at JFK Airport.   Issue of a nurse who took care of  may be \ninfected.   More later on that.   Typical situation of what we will see more of especially as \nwe approach the flu season.   Everyone who has a fever, exposed or not thinks that they \nhave Ebola.\nPress →  NBC Today (Weekend); MSNBC with Alex Witt; PBS The NewsHour \n(Weekend)\nReleased by Chairman Rand Paul\n\n377Oct 12, 2014 (Sunday)  - A very important issue that arose this weekend. Very early in \nthe morning at approximately 5:45 t0 6:00 AM, I received an e-mail from Leslie Dach \nthat there would be a conference call with Sylvia, Lisa Monaco, White House Comms \n(Palmieri), Tom Frieden, me, etc.  about a breaking situation. A nurse (turned out to be \n – see below) who had been caring for  at the Dallas hospital \nreported to be ill. It is felt that there was likely an innocent, inadvertent breaking of \nprotocol on the part of the nurse. She had taken direct care of  during very \nserious parts of his illness including hemodialysis, intubation, and insertion of a rectal \ntube. The nurse became febrile on Friday evening, reported to authorities on Saturday, the \npreliminary Ebola test was done on Saturday and the results came back positive on \nSunday (today), subsequently confirmed by CDC.   I was just getting ready to go on the \nSunday morning shows today  when the phone call came to discuss what approach we \nwould take. This ignited an extraordinary media frenzy in which Tom Frieden.  I was \nvirtually on every show. I was on \"This Week\" on ABC as well as \"Meet the Press\" as \nwell as CNN \"State of the Union\" as well as evening CNN. There is now considerable \nconcern in the country that the United States government keeps saying that we are \nprepared and then something like this happens which creates a credibility gap. I have \nbeen intensively emphasizing on my interviews that we need to distinguish between the \nunlikelihood that there will be an outbreak which still does not change since the contact \ntracing that has been done with the  case is working and there is a good umbrella \nover and identification of the people who were contacts and they are currently being \nmonitored either actively or on their own. This needs to be distinguished from a \ninadvertent breach of protocol in which a healthcare worker has gotten infected which is \nbad for health care workers but really has nothing to do with an outbreak in the country. I \nhave been continually expressing this in my interviews.  \nOne issue that has come up is a concern on the part of nurses throughout the country that \nthe use of the term \"breach\" in protocol implies that the nurses are to blame and this \nnurse in particular was to blame. I have been very active in emphasizing that this is not \nthe case that this is an inadvertent, innocent, \"breach\" of protocol and that we need to \nintensify the training for the nurses. The nurses themselves have said that they are \ninadequately trained and although the protocol might be a good protocol, they are not \ntrained to implement the protocol. The CDC has responded by being very proactive in \nincreasing their training with webinars, conference calls, and active visits on the part of  \nCDC staff to the involved hospital in Dallas as well as to anywhere else where this \nsituation might arise.\nPress - This Week (ABC); Meet the Press, CNN State of the Union; CNN evening.\nOct.13, 2014 – One of the busiest press days that I have had.   Media frenzy at high pitch.   \nMuch, much criticism of the USG and CDC is particular saying that the USG and CDC \nkeep telling us we have everything under control and still there are many mis-steps.  I \nhave been calmly explaining on TV and radio that people should not conflate what is \nworking, i.e. the lack of an outbreak because of the proper implementation of isolation \nand care of Ebola patients and the infection of a health care worker.   Clearly, HCWs are \nnot implementing the CDC PPE protocol.   CDC people went down to Dallas and the \nHCWS are doing a lot of things incorrectly.  Thus, the ability of our hospital to recognize \nReleased by Chairman Rand Paul\n\n378(dropped the ball with  on the first ER visit) and treat Ebola safely (infected \nhealth care worker) is not working well.   Clearly, HCWs have not really been properly \ntrained and although they believe that they are following protocol, they are not.   The \noutbreak still rages in West Africa.\nToday (Oct. 13) a second nurse who had taken care of  had a couple of days \nago flown home to Cleveland and had not had any sxs or fever.   While is Cleveland, she \ndeveloped a temperature of 99.3 F.   The CDC cut-off is 101 F.   The nurse (Amber \nVinson) called the CDC and asked if she could fly home and the CDC person cleared her \nto fly.   When she got to Dallas, it was clear that she was febrile and that theoretically, \nshe had exposed the passengers on the flight from Cleveland back to Dallas.   Major, \nmajor lapse in judgment on the part of CDC in letting her fly since she did not fulfill the \nprecise definition of febrile.   Now a massive contact tracing of the passengers is taking \nplace with many of them already having taken connecting flights.   This is causing a \nmajor crisis of confidence in the CDC and specifically for Tom Frieden.\n The fact that the CDC gave her permission to fly back to Dallas was made public on \nOct. 15\nSylvia called me on my cell after a TV show and asked me to help her prepare over the \nphone for her media interviews the next day.   She also tasked me to write 2 memos for \nher to the POTUS to explain why PCR screening at airports is not a good idea (Bill Gates \nsuggested this to the POTUS) and also the explain to the POTUS what we are doing with \ntherapies (a Senator told him that HHS is not doing enough on therapies.\nPress →   CNN New Day; WTOP radio; Fox and Friends; NBC News; MSNBC with \nAndrea Mitchell; CBS Evening News; MSNBC Hardball with Chris Matthews; CNN \nwith Wolf Blitzer; FOX News with Megyn Kelly; Good Morning America with Robin \nRoberts.\nOct. 14, 2014 – USG criticism high.   Bill O’Reilly calling for resignation of Tom \nFrieden.  I meet by phone with the New York Times Editorial Board.   Also, I do NBC \nNightly News, Fox News", "summary": "Watcher-discovered document from paul-readingroom (2026.07.27_Diary-Prequel-.pdf), auto-indexed 2026-08-05.\n\nExcerpt: concentrating PEPFAR’s efforts on  “Hot Zones” of infection within a given country as opposed to targeting  whole countries or regions.   Mark Dybul is very much in favor of this  approach and since he is now Executive Director of the Global Fund, he  wanted me to convince Eric that PEPFAR should take this approach.    Hence, Mark arranged this meeting of me, Tim, and Eric.   Eric in his  usual good careful approach is somewhat skeptical of “Models” June 14, 2013 – Please see hyperlink to historical AIDS posters from  ACT-UP: http://huff.to/10fto8L June 17, 2013 – Met with Senate Democratic Majority Leader Harry Reid  (D-NV) in Building 10, Room 5-1608 to discuss the exciting things in  research such as universal flu vaccine.   Also there was Francis  Collins, Story Landis and Gary…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.27_Diary-Prequel-.pdf", "pdf_url": "/archive-docs/fauci-files/c1dee44b66471ea95f8e8154b109f914/pdf", "doc_date": "2026-08-05", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-07-27-diary-prequel"], "part_number": 6, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 7 of 8)", "content": "with Greta Van Susteren and MSNBC with Rachel Maddow.   \nAfter I got off the air, Rachel tells her audience how proud she was of herself to have \ngotten me on her show since I was such an icon in medicine and public health.\nOct. 14 -21, 2014 - From October 14 through October 21, the situation was so intense \nthat I do not have time to document historical notes on a day by day basis. I am only \ndoing this retrospectively now and will give dates as I recall. However over this period of \ntime in light of the crisis of confidence against CDC and Tom Frieden related to a \nnumber of issues culminated by the fact that  was allowed to fly back from \nCleveland to Dallas, this was clear that Tom Frieden was in significant trouble over \nseveral days Sec. Burwell would call me usually in the late evening and nighttime asking \nfor my advice about what we should do the CDC. At one point, I believe on October 14 \nor 15, she called me at night as I was in my car driving home. I parked the car in front of \nmy house and continued to speak with her. Approximately 9 o'clock at night. She asked \nme what I thought about the possibility of removing Frieden from the job and wanted my \nReleased by Chairman Rand Paul\n\n379advice about who could be a leading global health figure who could take Tom's place. I \ndiscussed forcibly with her that I believe that Tom was an outstanding public health \nofficial and a man of great integrity. However, I told her that I have to frankly tell her that \nTom's staff is not serving him well. For example many of the people from CDC who of \ngone to Dallas to oversee the situation in the care of  are people who know \nEbola from behind the desk but left even never taking care of the patient or have done so \nmany years ago. I told her to give Tom a chance and that I would try to speak to Tom \nabout relying less on advice from his staff and more on his own judgment.\nAgain during this time I have had multiple conversations, on a daily basis usually late at \nnight with Tom Frieden. I will refer  to these specifically below.  In general, I was trying \nto convince him that it is possible that the CDC protocols as they exist on their website \nare not adequate for the tertiary care setting that we have in large hospitals such as Texas \nPresbyterian and elsewhere in the United States. Tom keeps on insisting that the CDC \nprotocols have worked for decades in the field in Africa and that his staff tells him that \nthe reason why the Dallas nurses got infected was likely be cost they had some breach in \nthe protocol. I literally begged him over the phone that he should not say this and that we \nshould re-examine the CDC protocols.  This will all become clear after  we admit  \n to NIH Special Clinical Studies Unit (SCSU) at the NIH Clinical Center on Oct. \n16, 2014 (see below).\nOct. 15, 2014 – Media frenzy continues.   I do CNN New Day, Morning Joe early in the \nAM.  Talk of shipping patients out of Texas Presbyterian Health Hospital since they have \nhad 2 infections of their nurses and they expect possibly more infections due to exposure \nof other hospital staff.   Since  got infected, others who were doing the \nsame things that they were doing might also wind up infected and they wanted to clear \n out and transfer them.\nToday it is made public that CDC told Vinson she could fly back to Dallas from \nCleveland.   Very bad press for CDC and Tom.\nOct. 16, 2014 - A truly transforming and  important day here at NIH. First I testified \nbefore the House Committee on Energy and Commerce, Subcommittee on Oversight and \nInvestigations chaired by Mr. Timothy Murphy (R-PA). Tom Frieden testified with me as \ndid Luciana Borio of FDA, Robin Robinson of BARDA, and someone from Customs and \nBorder Protection.  Tom got hammered somewhat by the committee and was not strong \nand firm in his answers. He continues unfortunately to give a poor public appearance \nsuggesting that he is not in control of the situation. He has shown the same slow \ndeliberative response in the media which is costing him dearly since it is making him out \nto be less than he really is, which in my opinion is quite good.\nHowever, the most important event of the day was the fact that at 11:54 PM today, \nThursday, October 16, 2014, Dallas nurse and now patient  was transferred by \nair evacuation from Dallas to the NIH Clinical Center to be taking care of by us in the \nSpecial Clinical Studies Unit (SCSU). I had stopped off at Accura automobile showroom \non Wisconsin Avenue where Diane Baker, Francis Collins's wife, was hosting a Friends \nReleased by Chairman Rand Paul\n\n382correctly; you are not at risk of infection.”.   I was horrified to hear this.  Now comes the \nrevelation.\nCliff Lane and I stop off at Chris Grady’s office on 1st floor of the Clinical Center, now \nlate at night and I tell Chris the story about the CDC person.   While Cliff and I are \ntalking, Chris pulls up the CDC website and to my amazement she reads what its \nguidelines are for PPE.   It is exactly what said she was wearing including the fact \nthat it resulted in open skin.   And so the CDC recommendations are much less stringent \nthan the MSF and the NIH PPEs.  In other words, the CDC guideliens are in fact \ninadequate and  was following them when she likely got infected.   I got goose-\nbumps.   I was incorrectly assuming that the CDC guidelines were like the NIH strict \nPPEs.   In fact they are not.\nThat night I e-mail Tom Frieden to call me and I explain the situation and he says that his \npeople tell him that if you follow the guidelines even with that PPE protocol, the \nexperience in Africa says that you are protected unless you break protocol.  He then says \nthat we really cannot tell exactly how and when  got infected.  We could \nnot distinguish between the first 2 days and the days after they went to more stringent \nprotocols.   I went ballistic over the phone.   I begged him to please not listen to his staff.   \nI told him frankly as a friend and as someone who care about him that his staff “had no \nfucking idea of what they were talking about since none of them who are advising him \nhave ever taken care of a patient, or if they have it was 10 years ago”.   I pleaderd with \nhim not to say that the nurses must have had a breach of protocol and to realize that the \nCDC protocol was entirely inadequate for a tertiary hospital intensive care setting which \nis where  got infected.  I told him that common sense tells you that open \nskin is much more dangerous than full PPE and that it is essential to change the CDC \nrecommended PPE to insist on no open skin.  He agreed somewhat reluctantly and said \nhe would have to check with his staff.   I told him that I love him, but I really do not give \na shit what his staff says, he must change the protocol.   In fact, within the next couple of \ndays with help from me and Cliff and others, the CDC did change the protocol.\n \nOct. 21, 2014 – Jey Johnson, Secertary of DHS, announces that all flights from Liberia, \nSierra leone and Guinea must now enter the USA at one of the 5 designated airports \n(O’Hare, Newark, IAD, JFK and Atlanta) that are now having entry screening.\nCDC issues the new PPE guidelines emphasizing the 3 principles that I have insisted \nupon during my many discussions with CDC (Frieden): 1) Training and drilling in \nprocedure of donning/doffing; 2) no exposed skin anywhere; 3) trained monitors for \ndonning and especially a WATSAN for doffing.\nDid Weill Cornell Grand Rounds by video to an SRO audience. \nAlso, the White House now wants me to instruct physicians around the country on Ebola \nvia White House run teleconferences.   Now I am a press coach.   Did one today and now \nthey want me to do one tomorrow or next day. On the call were Rich Carmona, Zeke \nReleased by Chairman Rand Paul\n\n383Emanuel, among others.   It actually worked out quite well and was well-received.   \nInteresting how history repeats itself.   First, the White House gets the standard people \nout such as CDC, HHS on health emergencies and the PR is horrible.   Example is my \nfriend Tommy Thompson with the Anthrax attacks of 2001 (he said it could come from \ndrinking water from a stream  - bad briefing from CDC).   Another example was Jeff \nCoplan, then Diretor of CDC who arrogantly refused to brief Tommy Thompson or even \nanswer his calls.  Recall that  Stewart Simonson, who subsequently became my very \nclose friend convinced Tommy to fire Coplan and then I was the PR face of the USG to \n“calm the nation” together with Julie Gerberding who replaced Coplan as CDC Director.   \nNow, after all of the misteps and the poor performance of Tom Frieden in the press and at \nHearings, the White House is falling all over themselves to get me on TV and elsewhere \neducating the public and validating what the administration is doing.   Hence, my “Full \nGinsburg” on all of the Sunday TV Shows last weekend (October 8)\nGetting many, many e-mails from colleagues around the country telling me how proud \nthey are of me and what an amazing job I am doing in the press with calming the country \nand bringing scientific rigor to the situation in my explanations.\nI get into Contact PPEs and visit  in her room with Cliff and Rick Davey. She was in \ngood spirits.   She is so sweet I told her that she looked good and she came back with \n“You look great, yourself, Dr. Fauci.”   She was obviously glad to see me.   I believe it is \nthe happiness of knowing that she is getting better.   If note, her Ebola PCR is now \ncompletely undetectable, and importantly, her Ebola specific IgM is >1600.   It had \npreviously been <400, which is actually undetectable.   The IgM means that she is in \nimmunological protection area.   Also, her LFTs are coming down.   We feel the \nhepatotoxicity is due to the Brincidofovir. We move her out of isolation room tomorrow \nand hopefully, home on Friday. Her labs are contained  below:\nReleased by Chairman Rand Paul\n\n384\nReleased by Chairman Rand Paul\n385No press today since HHS and White House wanted nothing on but the announcement of \nthe new PPEs by CDC and the DHS announcement of the 5 airports only.\nReleased by Chairman Rand Paul\n387might ultimately lead to collapse of the structure of the country and spread to other West \nAfrican countries. We repeat what we have said many times that the best way to protect \nAmericans from Ebola is to suppress the epidemic at its source in West Africa.\nI went over to see  and her family including sister Kathy and mother Diane in \nour special clinical studies unit at around 6:30 PM. As I have done every day, I was \naccompanied by Rick Davey and Cliff Lane. has had four consecutive negative \nPCRs and so we made the decision to move her out of the strict isolation room and put \nher in a room where there was no need for contact isolation. In other words and we could \nwear regular clothes and visit her.  Also, her dog Bentley had been shown to be PCR \nnegative at USAMRIID. On a visit tonight we began to plan her discharge exit from the \nhospital and discussed just what course we would take regarding public announcements \nand a press conference. I emphasized to  and her family that the choice was entirely \nup to her and that we would help her to implement any decision that she makes. She is \nleaning towards making a public announcement in front of the Clinical Center and having \na written statement that she reads and that she does not answer any questions. Hopefully \nwe will discharge her on Friday, 24 October.\nOct. 23, 2014 - Today was another hectic day regarding the possibility of implementing a \nrandomized controlled trial for a Ebola vaccine. As mentioned several times above there \nis a nefarious attempt on the part of Jeremy Farrar of the Wellcome Trust  to derail plans \nfor an RCT of vaccine in Liberia. Cliff Lane has known him for a long time from when \nhe was in Vietnam with the Pasteur Institute. Jeremy feels that we should do open access \nfor distribution of vaccines particularly to healthcare workers without doing a controlled \ntrial. Jeremy has been a self-promoter and in my mind a hypocritical advocate for fairness \nin global health. He completely does not get the fact that if we widely distribute a vaccine \nto a black African country we run the risk of never knowing if it works and possibly \nhaving a paradoxical harmful effect similar to what we saw in the STEP trial of an HIV \nvaccine where the trial looked good in phase 1 following good animal data and when we \nwent into a double-blind, placebo-controlled trial, we found out that the people who \nreceived the vaccine had a 41% greater chance of getting infected with HIV. If the same \nhappened with Ebola this would be a catastrophe. Yet the WHO, mostly in the form of \nMarie-Paule Kieny, are acting in an extraordinarily unscientific way, even going so far as \nto say that a randomized controlled trial is unethical. In fact, we feel that a wide \ndistribution of an unproven and potentially harmful vaccine would in fact be unethical. In \naddition, they want to give it to the healthcare workers on open access and then possibly \ndo a randomized controlled trial on the rest of the people at  risk such as family members. \nI cannot imagine how they do not realize that this in and of itself is unethical and violates \nethical equipoise. There is a big struggle going on with the USA led by Cliff Lane the \nFDA, and Glaxo Smith Kline to be able to do a randomized controlled trial to as quickly \nas possible determine efficacy so that we can ultimately distribute the vaccine to the \npeople who need it. WHO, who was been wrong on almost everything they have done \nwith this epidemic, is arguing that we really should distribute the vaccine according to \nhow they want to do it. We already have designed a phase 2/3 trial and it is ready to go. \nWe have buy-in from the Ministry of Health of Liberia. Glaxo Smith Kline is on board. \nYet WHO wants to be deeply involved in deciding how we do it vaccine trial. There is a \nReleased by Chairman Rand Paul\n\n390\nReleased by Chairman Rand Paul\n391\nReleased by Chairman Rand Paul\n392Oct. 24, 2014 - Today was an extraordinary day in the history of NIH. We discharged our \npatient  via a densely attended press conference outside the north entrance of \nReleased by Chairman Rand Paul\n\n393the Clinical Research Center. It was a beautiful fall day, crisp air and 60° and sunny. At \n12:30 PM, I walked out of the Clinical Center with my arm around and \naccompanied by her sister Kathy and her mother Diana. Also, accompanying us was Dr. \nFrancis Collins, Dr. Cliff Lane, Dr. Richard Davey, and the nurses and technicians from \nthe Special Clinical Studies Unit of the NIH Clinical Center. Francis introduced me and I  \nannounced to the world that was Ebola free. I gave a shout-out to the physicians and \nnurses at Texas Presbyterian for taking such good care of her while she was there patient, \nand I thanked our own staff of doctors and nurses for also taking extraordinary care of \nI have come to become very fond of as she is such a sweet human being who \nwas so brave in taking care of the patient with a deadly disease caused by an infection she \ncontracted while taking care of him ( ). Over the past couple of days \nwhile she was in the Unit, we would talk a lot about how she wants to exit the hospital \nand she finally decided that she would give a very brief statement that we would help her \ncraft. She would give her own ideas and we would  put it in prose for her. It worked out \nvery well. They were in essence her own words and they were heartfelt. As I called her \nup to the podium, I gave her a warm embrace in front of all the cameras. This embrace \nwas ultimately on the front page of the Washington Post the next day (Saturday, Oct. 25), \nand on hundreds of newspapers, blogs, and Tweets and other social media.   It went \ncompletely “viral”.    In addition, she gave me a ribbon of the colors of the nursing school \nfrom which she graduated, Texas Christian University School of Nursing. And so I gave \na shout out to all the nurses of the world  as personified by the nurses at Texas Christian. \nI answered a bunch of questions from the press after the press conference.\nAnd then following the press conference something extraordinary also happened. \nPresident Obama invited , and I(together with \nRick Davey and Cliff Lane) to the White House for a photo shoot as well as to talk and \nchat with the President. The President was charming as usual, and gave her a public hug \nin front of his photographers. We met for several minutes in the Oval Office with the \nPresident and Sylvia Burwell.  Then Ronny Jackson, the President's physician showed us \naround the White House and gave us a tour of the medical clinics in the White House.   \nThe White House transportation group picked us up at the Clinical Center, drove us to the \nWhite House, and then drove  her mother, his sister to a private plane in Baltimore \nwhich flew her to her mother's home in Fort Worth, TX. It was a bittersweet goodbye \nsince we have become so fond of her and her family. I gave  and her family my \ncontact information including my cell phone number and told her to make sure if there \nwas any issues that they want to talk to me about that I am available to them 24 hours a \nday.\nI returned to the NIH completely exhausted but ready to get back to work of crafting \npolicies related to the emerging situation with healthcare workers returning from West \nAfrica infected as did Craig Spencer last night.\nOct. 25, 2014 -  An important meeting today Situation Room of White House. We \ndiscussed the topic of what the movement and monitoring protocol would be for the \nUnited States Government regarding HCWs who are returning from service in the 3 \nAfrican countries. . The CDC has been changing their guide old journals and in a 27 June \nReleased by Chairman Rand Paul\n\n394two lines trying to keep up with the evolving situation. I heard from the White House and \nSylvia Burwell that the White House and Sylvia herself were very keen on my being at \nthe meeting at the White House in order to help develop a coherent policy. This was in \ngun just a wallpapers response to the fact that , a Doctors Without \nBorders emergency medicine physician working in Guinea had come back to New York \nand was self-monitoring for symptoms and fever according the MSF protocol. This is the \nongoing protocol if someone at low but nonzero risk for infection returns to their country \nof origin after serving in West Africa taking care of Ebola patient. However since there \nwere previous infections in the Ebola treatment unit where he worked, the evolving \nguidelines put him in the category of a high risk person. Nonetheless, he was following \nthe doctors without Borders protocol which means that when you come back to your \ncountry of origin after being in a West African country you should monitor yourself with \nfever and symptoms and if you develop a fever call MSF and then report yourself to state \nhealth authorities. As it turned out,  felt fatigued the previous day but \nnonetheless went out for a run. The following day as mentioned above he took several \nNew York City subway rides to Brooklyn where he bowled and then went back and ate at \na restaurant in Manhattan. The next day he developed a fever of 103 F.  Technically he is \na for you you just tell me and I can't go to a and the same thing you stop. Exposed 2 \nfriends at the bowling alley and the Uber driver who drove him back to his apartment in \nHarlem. . Once he got a fever, proper protocol of hazmat transportation to Bellevue took \nplace as mentioned above. However, because of the concern about risk to New Yorkers \nand people from New Jersey, Gov. Christie of New Jersey and Gov. Cuomo of New York \nState surprised and shocked the New York City public health authorities as well as the \nCDC and the US government (including President Obama) by declaring an absolute \nquarantine on all healthcare workers coming back to the United States through New York \nor Newark airports who had any contact with an Ebola patient. They either did not think \nthis out fully or it was a pure political move. This violates all of the principles that \nindicate that people without symptoms are clearly not of danger or inffectious to others. \nThis is becoming a political issue without a doubt since both Governors Christie and \nCuomo are up for reelection and there is an outcry that we are worried too much about \npeople's rights than we are about the safety of the public. However, as I have had to \nemphasize multiple times in the Press the danger of transmitting from an infected but \nasymptomatic individual is vanishingly small. However the President asked Lisa Monaco \nand Chief of Staff Denis McDonough to hold a principals policy committee meeting to \nsort out what kind of response we should have to this declaration of quarantining by the \ngovernors. This was a very important meeting for me to be at since it is very clear that we \nneed to do more than just passive monitoring since there needs to be some clinical \njudgment and whether or HCWs, as well-meaning as they are, should actually leave their \napartment and enter into public transportation such as subway, bus or even airplane.\nAnd so the PC meeting was held in the Situation Room at 2:30 PM on a beautiful crisp \nfall day. At the meeting besides me and Tom Frieden by video from Atlanta, Chief of \nStaff Denis McDonough, John Podesta, Gayle Smith, Leslie Dach, Sylvia Burwell, Susan \nRice, Defense Secretary Chuck Hagel, Ron Klain, USAID administrator Rajiv Shah, \nAttyorney General Eric Holder, Amb. Samantha Power, DHS Sec. Jeh Johnson, Amb. \nPowell from the Department of State, Presidential Counsel Eggleston, Valerie Jarrett, \nReleased by Chairman Rand Paul\n\n395Larry Kerr, among others. The discussions centered around modifying the guidelines for \nmonitoring and movement of returning health care providers who have served in West \nAfrican countries. The CDC continues to be shakey. They in my mind are not definitive \nor clear enough with their guidelines. However, at the meeting,we at least decided that \nwe would have to scale up from passive monitoring to active monitor and in many cases \nultimately to direct monitoring.  The definitions of these are as follows: passive \nmonitoring - you take your temperature and evaluate your symptoms and do not tell \nanyone unless there is a problem; active monitoring - you do the same as passive but you \ntell someone; direct active monitoring is when you have someone else visit you at least \nonce a day and folow-up with a phone call, take your temperature evaluate your \nsymptoms and make a determination has to the degree of restriction that you might have \non a daily basis.  In this way, you have a repetitive clinical judgment concering restriction \nas opposed to a broad sweeping quarantine for evryone.  We all decided that we need to \npoint out that healthcare workers are heroes and that if we in fact quarantine them \nindiscriminately regardless of their stratification of risk that we would clearly \ndisincentivize them for wanting to volunteer as well as stigmatize them, which is already \noccurring anyway.\n The White House has decided that I will be the face of the administration in explaining \nthis to the public and have now put me out today (Sunday) on all five major Sunday \nmorning shows. This includes ABC This Week (Martha Raddatz), CBS Face the Nation \n(Charlie Rose), Fox News with Chris Wallace, CNN State of the Union with Candy \nCrowley, and Meet the Press ( Chuck Todd). It is interesting and ironic after all of the \naggravation I have received from media people that I am now their hero and they want \nme out there. This includes Jen Palmieri the head of White House communications, \nAndrea Purse the director of media broadcast of the White House, and this gets translated \nnow down to the HHS level. There is still a lingering distrust by the public in the \ngovernment largely because of the missteps and lack of firm, definitive, clear, concise \nand understandable guidelines of the CDC. I feel very badly for Tom Frieden since he is \nan extraordinarily fine person and an outstanding public health official. However I \nbelieve that his staff does not serve him well and the White House and HHS are now \ngiving me the extra burden of having to check their documents which makes it very \ndifficult since I have a lot of work to do and I am getting quite exhausted by all of this.   \nOct. 26, 2014 - Today I did all five of the Sunday morning TV shows. As indicated \nabove this is referred to as the \"Full Ginsburg\" related to the fact Ginsburg, the \nlawyer/family friend for Monica Lewinsky at the time that she blew the whistle on \nPresident Clinton related to the now famous sex scandal appeared on all 5 Sunday TV \nshows. I did this last week.   Since I had done a \"Full Ginsburg\" last week several of the \nproducers of the TV shows told me that this is the first time in their memory that any \nindividual has done all five TV shows for two weeks in a row. And so they are now \nreferring to this as a \"Full Fauci\". The shows went very well;  however, it became clear \nthat I was at odds with what Gov. Christie and Gov. Cuomo had done two days ago by \ninitiating a full quarantine for flights into New Jersey and New York. On each of the \nshows I articulated two fundamental principles: 1) the safety of the American people \ncomes first and is the major goal; 2) all of our policy decisions relating monitoring \nReleased by Chairman Rand Paul\n396movement and restrictions should be based on sound scientific principles and scientific \nevidence. I reiterated that all scientific data show that a person who is without symptoms \ndoes not transmit Ebola and that one must come into contact with bodily fluids of a \nperson who is sick with Ebola in order to contract people. Therefore, the principles \nleading to a broad general quarantine for returning health care workers is deeply flawed. \nImmediately following the shows, other shows and blogs and tweets pitted me against \nChristie and Cuomo. In my discussions on the five TV shows, I did not criticize them. I \nmentioned that I understood why they may feel that this is the best way to go; however, I \nmentioned that if they had asked my advice I would have told them not to institute a \nbroad sweeping quarantine. I am being praised by people who are standing up for \nscientific evidence and data and I'm getting hate mail from people who feel I am trying to \nprotect Obama. I am listing below cuts and pastes from a couple of representative e-mails \nthat I have received:\n-----------------------------------------------------\nFrom: M G <libssuckitraw@yahoo.com>\nDoctor,\nAs you parrot the bullshit that came out of The Obomination, it makes you sound like a \nmoron. \nNo quarantining these infected boobs because it might hamper them volunteering? Are \nyou fucking serious? Do you KNOW how STUPID that sounded?\nYeah, we should just let them walk around, coughing, spewing,. sweating, touching other \npeople until we have a serious Ebola outbreak in the USA! If pray that if Ebola DOES \nbreak out in the USA that somehow it only attacks dumbass liberals like you and removes \nyou from your misery. Idiot.\nNo wonder you're a member of Ovomit's Kakistocracy.\n------------------------------------------------------------------\nFrom: Unarmed Civilian <wes_t-one1@outlook.com>\nWhere did you get your degree from North Korea? You love Africa and Ebola so much \nyou go there. And don't come back. NO QUARANTINES....its the answer you'd expect \nfrom a government agency whose greatest accomplishments are in the areas of corruption \nand incompetence.\nDoes half of America have to come down with Ebola and be standing there bleeding from \nthere eyes before the EXPERTS know they are wrong.\nFuck you and Fuck your Opinions. Go take your expertise somewhere else.\nLD \n-----------------------------------------------------------------------\nReleased by Chairman Rand Paul\n397It is really rather disturbing that people feel so strongly about this, with all the undertones \nof racism and what clearly is  Hate for president Obama.\nDuring the times between shows, I exchanged e-mails with  checking on how \nshe was doing.   Below are some of those e-mails:\nFrom Sunday, 26 Oct., 2014 at 10:41 AM:\nReleased by Chairman Rand Paul\n\n398I just saw you on Meet the Press! You did so great :) I will definitely keep you posted \nwith everything. \nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n401Following the five TV shows I was invited to a meeting in the Situation Room with \nPresident Obama and senior cabinet officials and other staff.   The attendees at the \nmeeting were:\nFrom: Esquivel, Hilda V. [<mailto:Hilda_V._Esquivel@nsc.eop.gov>] \nSent: Saturday, October 25, 2014 03:58 PM\nTo: DL-NSS_ExecSec_Coordination <DL-NSS_ExecSec_Coordination@nsc.eop.gov \n<mailto:DL-NSS_ExecSec_Coordination@nsc.eop.gov>> \nSubject: INVITATION: HSC Meeting on SUNDAY, 10/26, 12:30 - 1:30 p.m. \n \nA Homeland Security Council meeting on Ebola Response with the President has been \nscheduled for Sunday, October 26, 2014, from 12:30 - 1:30 p.m. in the White House \nSituation Room.  The following are invited to attend.  Please confirm attendance to DL-\nNSS_ExecSec_Coordination@nss.eop.gov <mailto:DL-\nNSS_ExecSec_Coordination@nss.eop.gov> as soon as possible.  If you have any \nquestions, you may reach our office at  (202) 456-9461.\nThank you.\n•         The Vice President\n•         John Kerry, Secretary of State\n•         Jack Lew, Secretary of the Treasury\n•         Chuck Hagel, Secretary of Defense\n•         Eric Holder, Attorney General\n•         Sylvia Burwell, Secretary of Health and Human Service +1 (Leslie Dach, Senior \nCounselor)\n+CDC:  Thomas Frieden, Director of the Center for Disease Control and Prevention\n+NIH:  Anthony Fauci, Director of the National Institute of Allergy and Infectious \nDisease \n•         Jeh Johnson, Secretary of Homeland Secretary\n•         Denis McDonough, Assistant to the President and Chief of Staff\n•         Shaun Donovan, Director of the Office of Management and Budget\n•         Amb. Samantha Power, Representative of the United States of America to the United \nNations\n•         Valerie Jarrett, Senior Advisor and Assistant to the President for Intergovernmental \nAffairs and Public Engagement\n•         John Podesta, Counselor to the President\n•         Susan Rice, Assistant to the President for National Security Affairs\n•         Neil Eggleston, Assistant to the President and Counsel to the President\n•         John Holdren, Assistant to the President for Science and Technology and Director of \nScience and Technology Policy\n•         Antony Blinken, Assistant to the President and Deputy National Security Advisor\n•         Lisa Monaco, Assistant to the President for Homeland Security and Counterterrorism\n•         Benjamin Rhodes, Assistant to the President and Deputy National Security Advisor \nfor Strategic Communications and Speechwriting\nReleased by Chairman Rand Paul\n402•         Katie Fallon, Assistant to the President and Director of the Office of Legislative \nAffairs\n•         Jennifer Palmieri, Assistant to the President and Director of Communications \n•         Rajiv Shah, Administrator of the U.S. Agency for International Development\n•         Suzanne George, Deputy Assistant to the President and Executive Secretary and \nChief of Staff of the National Security Council\n•         Rand Beers, Deputy Assistant to the President and Deputy Homeland Security \nAdvisor\n•         Ron Klain, Ebola Response Coordinator\n•         Amy Pope, Special Assistant to the President and Senior Director for Energy and \nClimate Change\n•         Gayle Smith, Special Assistant to the President and Senior Director for Development \nand Democracy\n•         Caroline Tess, Special Assistant to the President and Senior Director for Legislative \nAffairs\n•         Corey Gruber, Senior Director for Preparedness Policy\n•         Edward ‘Ned” Price, Assistant Press Secretary for National Security Affairs\n•         Larry Kerr, Director for Medical Preparedness and Policy Rajiv Shah, Administrator \nof the U.S. Agency for International Development\nThe discussion centered around developing a policy of direct, active monitoring to \npreserve the scientific principles as well as to avoid the issue of a broad quarantine that \nhad been initiated by Christie and Cuomo as indicated above. There was a two and one \nhalf-hour discussion at a meeting that was supposed to take one hour. When the President \nfirst came in he appeared extremely tired and somewhat detached. However, he quickly \nperked up and got involved in discussion. There was some disagreement around the room \nwith Jeh Johnson of DHS feeling uncomfortable with just a direct, active monitoring \nsince he felt that there would soon be many more healthcare workers entering the country \nand the social issues of public fear and concern would not be satisfied by just a direct \nactive monitoring. Chuck Hagel has already indicated that returning military personnel \nfrom West Africa would be confined to barracks for 21 days following return from West \nAfrica. However this is a much different story than civilians since military have the \ncapability of easily confining personnel to barracks and providing them with all the \nnecessary comforts and not demeaning them or stigmatizing them. I articulated several \ntimes, and the P resident referred to me and asked me questions multiple times regarding \nmy recommendation that a direct active monitoring guided by matching the stratified risk \nexperienced by the healthcare worker to a stratified stringency of restriction we could \nfunctionally accomplish the same thing as a broad quarantine for everyone. The president \nagreed mostly with what I said but he felt we should go a little bit further and encourage \nthe healthcare workers to restrict themselves to some degree even if technically they were \ncleared to move around. Samantha Power was connected to the meeting by \nteleconference from Guinea where she had just landed. She mentioned that the West \nAfricans there were very concerned about a possible quarantine.   We had been with her \nthe day before at the prior PC meeting. Again, Tom Frieden was relatively reserved \nduring the discussion; however, it was tough since he was connected by teleconference. \nThe final decision which has not yet been implemented since it awaits a document from \nReleased by Chairman Rand Paul\n403the CDC that hopefully would state that  the clinical judgment of the monitor would \ndecide on a day by day basis what the restrictions of the healthcare worker would be. We \nwant to make sure that an overly strict health official would not just say no to everything \nthat has to do with freedom of movement. In this regard, we suggested that we put down \nsome fundamental principles and guidelines which the public health official acting as the \ndirect monitor could use in his/her decision-making process.\nThe president commented towards the end of the discussion that we really need to have \nsome clarity to this and not keep chasing after things.   He bemoaned that over the past 3 \nweeks he has spent literally most of his time on this issue of Ebola and Ebola has killed \none person in the USA, at the same time that he is dealing with ISIS, Iran, Ferguson \nshooting, ACA, border children and just 2 days ago (Friday) a deranged high school \nstudent in Washington State killed 2 fellow students, wounded several others and then \nshot himself.   And so the POTUS was quite frustrated in his classically “calm” way\nHopefully, we can get some crisp guidelines out soon. I continued to get a lot of hate mail \nrelated to the position that I articulated on the TV shows. After the White House meeting \nI went on a power walk with Christine had something to eat, and am now trying to catch \nup on the pounds of work and hundreds of e-mails that have piled up.\nOn another issue, Marie-Paule Kieny and WHO are up to mischief again and trying to \ntake over, or at least greatly influence the conduct of the randomized controlled trial for \nEbola vaccine that Cliff has put together. It is truly extraordinary. First they said that such \na trial was unethical. Now that we have agreement on the part of many parties including \nthe companies as well as the Ministry of Health of Liberia, the WHO wants to butt in \nagain and be involved in the design of the trial. I will have to get Sylvia Burwell involved \nin trying to block this egregious interference in an area which they have no expertise. \nThey can always play their trump card and say with self-righteousness that they are only \ninterested in the well-being and safety of Africans. However, we all know that that is not \ntheir motivation. They have been trying to block this trial and they have not been \nsuccessful. Here again they want to insert themselves now that the trial is almost on its \nway. Cliff and I and Peggy Hamburg will likely seek Sylvia Burwell's help in getting to \nMargaret Chan, Dir. Gen. of WHO, to have her tell the WHO people to back off.\nOct. 27, 2014 – Furor against Governors’ decision on quarantine.   I am in the eye of the \nstorm due to my 5 appearances on Sunday TV giving scientific reasons against blanket \nquarantine.   2 days ag, nurse  returned to Newark from West Africa after \ntaking care of Ebola patients.  She got caught in the quarantine issue and was put in an \nold hospital tent in New Jersey and (as she says) was treated like a criminal/prisoner.  \nOfficials at airport initially thought that she had fever since they did a skin tem while she \nwas flushed.   Turned out she had no fever and ultimately tested negative.   Christie \nlooking real bad on this one.   She is playing it out by suing and being very vocal that her \nhuman rights were violated.   Ultimately, she was let go to drive to Maine to see her \nboyfriend.  \n    Cuomo now backing off a bit and leaning towards direct, active monitoring. CDC \nrevising M and M document.  Tom and I want the “direct” part of the monitoring to be \nReleased by Chairman Rand Paul\n\n404able to be done by Skype or Face Time.   However, Ron Klain thinks that the POTUS and \nJeh Johnson want actual physical presence of monitor (health official, nurse, etc.).   \nTrying to reconcile.  \nHad important conversation with Jen Cohn of MSF Switzerland who kindly got on a \nteleconference reps from MSF of many countries (Brussels, Paris, Geneva) to discuss the \nRCT Ebola vaccine trial that Cliff is actively planning to start in Monrovia in December \nfollowing completion of the Phase 1 trial that started in Maryland in Sept. (ChAd3) and \nOct (VSV).   Looks like MSF wants to be helpful.   They are asking good questions about \nsupply for post-trial distribution, etc.   They seem to not be against an RCT.\nCDC came out with new interim guidelines for Monitoring and Movement of people \n(including HCWs) returning from West African Ebola countries.   Now based a lot on \nwhat I and Tom have been articulating at the recent White House meetings.   First \nstratification of risks to the person; and then matching the risk to the degree of \nmonitoring and then using clinical judgment when needed to determine level of \nrestriction.   All based on knowledge of how virus is spread.   Risks:  high, some, low but \nnot zero.  Monitoring: passive – take your own temperature and sxs and no need to \nactively tell anyone; active – take your own temp and sxs and report to a health official; \ndirect, active – someone else takes your temp at least 1x per day and evaluates sxs and \nthen makes clinical judgment as to your restriction on a daily basis\nImmediately following their release of guidance and the press briefing by Tom Frieden, \nthe White House put my out on all the evening TV shows that were either taped or live \nfrom studio in Building 10:  PBS NewsHour; CNN Situation Room; ABC, CBS, and \nNBC Evening News.\nOct. 28, 2014  - The political issues are heating up around Ebola with the elections only 1 \nweek away. Gov. Christie is standing firm in saying that the US government, particularly \nthe CDC, are playing catch-up with Ebola and that his initiation of a quarantine for 21 \ndays for healthcare workers and other travelers returning from West Africa is the way to \ngo. I have been on multiple television programs specifically indicating that I respect the \nopinion of the governors and that I understand that they are trying in good faith to do the \nbest for their constituents. However, several TV commentators have now pitted me \nagainst Gov. Christie, feeding him with somewhat out-of-context quotes from TV \ninterviews indicating that I am directly challenging him as being unscientific. He is \nlashing back saying that I am just defending the administration. He sometimes mixes me \nup with CDC. However, he has mentioned me by name several times in discussions on \nTV interviews. I am very concerned about this politicizing of an important global health \nproblem. I was on Good Morning America with George Stephanopoulos, CNN with \nSanjay Gupta, and MSNBC with Morning Joe early this morning. In fact the ABC \nproducer came all the way into the NIH to make sure that the interview with George \nStephanopoulos went well. Immediately after I appeared on GMA, Gov. Christie \nappeared and Matt Lauer was instigating him telling him that scientists like me was \nsaying that he \"got it wrong on\" thus instigating Christie to lash back at the scientific and \npublic health community including me. This is really a very unfortunate evolution of \nReleased by Chairman Rand Paul\n405events since as has always been the case, I stay out of politics and try to just do the right \nthing for public health.\nI appeared via Skype on the Diane Rehm Show this AM and made it clear that I was not \ncriticizing Christie.\nThe POTUS made a brief speech in front of Marine 1 as he was about to take off re-\naffirming what I said on Sunday TV (without invoking my name) that we are driven by \nscience and not by fear and so there is no reason to do a blanket quarantine on all \nreturning HCWs since they are heroes and we do not want to discourage them from \nvolunteering.\nBen Bradlee died at age 93 a few days ago and I have been invited to the service at \nNational Cathedral and to the family reception at Ben and Sally Quinn’s home in \nGeorgetown.   However, with the Ebola AM calls and the fact that I have to be at the WH \nlater for the POTUS greeting and honoring the HCWs (see below), I cannot make the \nservice.   Too bad.   I really liked Ben.\nI am completely exhausted now and I have hundreds and hundreds of e-mails to catch up \non. It feels like I'll never catch up since the White House, the department, and the media \nare making extraordinary demands on me. The White House has decided because of my \nability to be quick on my feet and articulate a clear and concise message in front of the \nTV camera that they are putting me out on TV for virtually every issue that comes up \nregarding Ebola. What a change of pace from just a short while ago when for one reason \nor another HHS and/or the White House never approved any big TV for me. Now they \nactually set  up shows and have Andrea Purse working closely with me. Such is life.\n \nThe POTUS came out today and reiterated the reasons (my reasons) for following the \nscience and not having a quarantine for returning HCWs.   Typically, HHS shut me down \non the many requests for TV appearances for me since they never let anyone out there \nwhen the POTUS speaks.   Believe it or not, I am glad since I am exhausted.\nToday and yesterday, there have been a considerable number of false alarms with people \nfrom West Africa (just arriving) having fever, vomiting, etc. and getting worked up only \nto have any of a number of other diseases from malaria to rhinovirus.   \nStill getting much hate mail!\nGot e-mail from Andrea Purse asking about the safety of returned HCWs  from West \nAfrica (USA people) who have been invited to the WH tomorrow to be congratulated by \nthe POTUS (with handshakes).  Some came back less than 21 days ago and so they \nwanted to be sure it was OK.   Cannot violate our own principles, but people are \nsomewhat nervous.   I looked at list and said it was OK.   Then Sylvia Burwell called me \nup and wanted me to speak with Ronny Jackson to make sure that Ronny asks them if \nthey were in high risk category.\nReleased by Chairman Rand Paul\n406Oct. 29, 2014 - Eventful day today with another visit to the White House and once again \nmeeting with the President. The President wanted to show his support for health care \nworkers who have returned from West Africa, those who will be going soon to West \nAfrica, and the NIH nurses and doctors who had taken care of  There were \nseveral events. At approximately 3 PM the president met in the Green Room with Kent \nBrantly, myself, and a group of healthcare workers including Dan Chertow from NIH \nwho had returned from Liberia about 1 month ago, people from Hopkins, people from \nSamaritan's purse, as well as three NIH nurses – Glory Inwang, and Anitra Fitzgerald-\nMonroe, and Kimberly Jeffries. He congratulated everyone, took individual pictures with \neach of us and then went into the East Room where he was introduced by Brantly and \ngave a compassionate speech on how healthcare workers were heroes, and how we \nshould treat them with respect and how we should monitor and allow them to move about \naccording to principles consistent with the scientific data. This was obviously a \nreiteration of what he had said before and what I have been saying continually on \nnational TV. However, it was clearly also a thinly veiled jab at Gov. Christie who has \ninstituted the quarantine of returning health care workers in New Jersey. Following the \nceremony I adjourned to the Roosevelt Room with Raj Shah, Sylvia Burwell, Gayle \nSmith, and Ron Klain, to meet with the cohort of healthcare workers for the purpose of \nlearning from them about their experiences in getting suggestions from them about how \nto improve our effort in response to the Ebola epidemic in Africa and at home.\nI had interesting discussions with .   He told me that there was no way the he \ngot infected while in the ETUs treating Ebola patients since he was completely covered \nwith PPEs, he is experienced and there were no breaches.   He believes that he got \ninfected when he was called to the ER to see a potential Ebola patient (woman).   He was \ndressed in “contact” dress (not full PPE) but he did not touch the patient and called for a \nnurse to admit the patient since she clearly had Ebola.   Accompanying the woman was \nher adolescent daughter who was crying and very upset that her mother was sick.    \ntook the girl outside to comfort her.   He took off his gloves so as not to contaminate the \ngirl and put his arm around her shoulder.   When he looked at her, it became clear that \nshe was likely also sick.  She ultimately ran away and was never documented to have \nEbola, but  feels that this was the likely incident that go him infected, i.e. touching \nwithout gloves an Ebola patient.   He did not fully realize this until he later reflected on \nthat incident in the ER.\nAfter that I came back to the NIH and I practiced putting on personal protective \nequipment with Rick Davey. The purpose of the practice was because we are hosting a \ngroup of TV doctors tomorrow brought to the NIH by the White House to demonstrate to \nthem our Special Clinical Studies Unit and how we Don and Doff our PPE's. It should be \na good day tomorrow.\nOct. 30, 2014 – Started the day with a 6:40 AM interview on WTOP. Another interesting \nday today. I was a panelist at the  Washington Ideas Forum sponsored by The Atlantic \nmagazine that took place at the Harmon Center for the Performing Arts on F and 6th \nStreet, N.W.  I was interviewed on stage by David Brooks, well-known columnist for the \nNew York Times. The panel was broadcast live on C-SPAN as well as streamed online \nReleased by Chairman Rand Paul\n\n407on their website. Of the people involved in this forum were Secretary of State John \nKerry, Chris Matthews of NBC, and a large number of other notables. \nAfter that I went back to the NIH and hosted a whole group of network producers with \nfull camera TV coverage on the process of donning and doffing for personal protective \nequipment. I demonstrated to them what we do in the process of taking care of patients \nwith Ebola, in this case specifically  Following the demonstration which was \ndone by nurse specialist Kevin Barrett and hospital epidemiologist Tara Palmore, I did a \nlong series of TV interviews with the cameras that were there during my step-by-step \ndemonstration of the donning and doffing.   Clips appeared on a variety of news outlets.\nAn extraordinary situation occurred last night in which the state of Louisiana made an \nannouncement that certain scientists and others who were planning to attend the annual \nmeeting of the American Society of Tropical Medicine and Hygiene during the first week \nof November in New Orleans would not be allowed to attend the meeting. In essence they \nsaid that these people need to be quarantined if they came from a West African country or \nif they had taken care of the patient with Ebola within the last 21 days. This is an \nextension of the quarantine craziness that was started by Governors Christie and Cuomo.   \nIn essence, they are barring scientists from a meeting where their expertise and \nexperience is most needed.\nFinally, I have been informed that I have been named in the civil action lawsuit against \nPres. Obama, me, Thomas Friedman, Secretary Burwell, and DHH Secretary Jeh Johnson \nfor promoting terrorism and discrimination. They are accusing us of colluding with \npresident Obama who is a Muslim citizen of Kenya and trying to destroy African \ncountries by introducing Ebola into society. You just cannot make this stuff up.\nReceived a note today (dated Oct. 16, 2014) from Hilary Rodham Clinton  saying that \nshe was thinking of me and cheering me on saying that “The American people are \nfortunate to have your leadership at NIH as we face the challenge of Ebola”.\nOct. 31, 2014 – Jeff Drazen, Editor of NEJM, contacted me to put him in touch with \nsome of the trusted AIDS activists with whom I have worked over the years to get them \nto write a piece in the NEJM on the similarities between the stigma of HIV/AIDS and the \ncurrent “stigma” against HCWs (regarding the quarantine discussed above).   I pointed \nhim to Peter Staley and Gregg Gonsalves and they are willing to do this.\nKaci  Hickox  still defying orders from the Governor of Maine to remain in quarantine.   \nA court judge upheld her right to not be quarantined.   I did an interview for yahoo.com \nand refused to get into the battle between Kaci and the State of Maine.\nHHS does not want me to do TV since the news is focused on Kaci and it would be better \nfor me not to get into that battle.\nNov. 1, 2014 – Things calming down.   Reports of decreased infections in Liberia, \nparticularly Monrovia.   Not sure if this is real or if the infections are now occurring in \nReleased by Chairman Rand Paul\n\n408remote areas without good reporting.   Also, the issue of second waves in Guinea and \nSierra Leone.   CDC having to put much effort into investigating Person Under \nInvestigation (PUIs).   These are people who are from West Africa who get a fever or \nnausea or vomiting for any of a number of benign reasons.   Since they are from West \nAfrica, these are being investigated, sometimes using PPEs, which is an “abundance of \ncaution”, but a major investment (?waste) of effort.\nCliff Lane is in Monrovia doing spade work for the hopefully upcoming RCT for the \nEbola vaccine.\nHeard on Secretary’s call this AM (8:30 AM on Saturday) that now WHO (likely Marie-\nPaule Kieny) wants WHO to be responsible for the DSMBs of all clinical trials in West \nAfrica.   This is an egregious attempt on the part of WHO to stay “relevant” in an area in \nwhich they have no expertise.   It is “stunning” to me how they just want to insert \nthemselves into things where they quite frankly are incompetent.  They already have \nmade it clear that they just want to distribute unproven interventions (vaccines and \ntreatments) and even though we seem to be winning the argument, they keep coming \nback in insidious ways to try to derail the scientific clinical trials process.   Amazing!!\nNov. 2, 2014 – Quiet Sunday.   Trying to catch up on piles on my desk.  Election on \nTuesday.   Concern that the GOP will take the Senate, which means Obama is in trouble \nwith both House and Senate in GOP control.\nDespite reports that the number of cases in Liberia are decreasing rapidly, new reports \ntoday indicate that the cases in Sierra Leone are sharply increasing.   I have warned that \nEbola comes in waves and that we should not be complacent and the WH should refrain \nfrom saying that things are “turning around”.\nNov. 3, 2014 – Ron Klain visited NIH today (He had visited CDC last week).   He \nwanted to familiarize himself with what the various components of government were \ndoing in Ebola.   I made a presentation to him in the VRC, showed him the lab where \nNancy Sullivan works and where she developed the ChAd3 Ebola vaccine.   Then we \ntook him over to the Clinical Center to see Julie Ledgerwood’s vaccine clinic where the \nphase 1 trial took place.   Then we showed him the SCSU and the room where we took \ncare of    Ron was impressed and wants me to come to the WH on Friday to \ngive a shortened version of my presentation at a meeting where the POTUS is hosting \ncertain Congressional leaders.\nTom Frieden spontaneously called me up to thank me for being so supportive of him.   I \nhave been continually serving as a late night (by phone or e-mail) sounding board for him \nin his attempts to negotiate his having to deal with some many factions (ASPR, HHS, \nUSAID, etc.)   Last night I helped him out by strongly suggesting that he not listen to the \nmodelers who tell him “exactly” how many news cases of Ebola to expect in the USA \nover a period of time.   I warned him that the models are based on assumptions and \nmultiple variables and can be very misleading and he should not “own” data that comes \nReleased by Chairman Rand Paul\n\n409from models or else it will come back to bite him.   I urged him to totally resist such \npredictions.   He was very grateful for my advice.\nNov. 4, 2014 – GOP takes control of the Senate in today’s elections.   Frenzy calming \ndown.   Little press interest – like shutting off the faucet.\nNov. 5, 2014 – Preparing for Hearings of the Senate Full Appropriations Committee \n(Mikulski).   Tom Frieden and I will testify together with Sylvia Burwell.   POTUS \npublicly requests $6.18 Billion in “emergency” funds for Ebola.   We will dwefend this at \nHearing on Nov. 12.\nNov. 6, 2014 – Still calm.  No Ebola Press.   Did Hearing prep by teleconference with \nSylvia.\nNov. 7-11, 2014 – Still calm.   Mostly  preparing for Senate Appropriations Hearing on \nNov. 12.   POTUS  asking for $6.18 Billion in emergency funding for Ebola (Domestic \nand International).   NIH portion is $238 million.  Went to EEOB on Nov. 10 to rehearse \nfor Hearing with Ron Klain.\n \nNov. 11 – very good meeting in Building 10, 4th Floor Medical Board Room with clinical \ninvestigators who took care of Ebola patients at Emory, Nebraska, NIH.   Also, DoD and \nHHS present with presentation of individual clinical data from the USA patients.  It \nbecame clear to me that it is impossible to determine if any of the experimental drugs \ngiven to the patients (ZMapp, Brincidofovir, favipiravir, convalescent sera, TKM-Ebola) \nhelped or did harm (likely did some harm.   Decision was to develop a clinical protocol \nfor future USA patients and also to be used as prototype for Africa.   Protocol should be \nRCt with standard medical care (fluid and electrolyte replacement) as the control arm.   \nThe data also suggested to me that if you keep patients alive with medical care, that the \nbody’s immune system will almost always clear the virus (likely without experimental \ndrugs).\nNov. 12, 2014 – Successful Hearing today before the Full Senate Appropriations \nCommittee chaired by Barbara Mikulski with Richard Shelby as Ranking Minority.   \nSylvia Burwell, Jeh Johnson (DHS), Michael Lumpkin (DoD), Heather Higginbottom \n(DoS) testified and then accompanying witnesses went to the Table.   Tom Frieden and I \nwere the “accompanying” witnesses for Sylvia.   All went well. About 18-20 Senators \nappeared.  Tom Harkin made a statement that this was his last official Hearing and he \nwanted to specifically call me out as a great public servant with whom he has worked on \nthis committee for 30 years.   This elicited a round of applause from the audience.   \nPatrick Leahy also remarked that he has been working with me “forever”.   All-in-all, a \nvery good Hearing.\nNov. 13, 2014 – Difficult situation arising regarding the conduct of the Phase 2/3 trials of \nEbola vaccine in Liberia/Sierra Leone.   The companies (first GSK; now also J & J, who \ndo not even have a candidate ready) are balking at going ahead with the trials unless they \nget “global indemnification”.   This is unprecedented to demand for a Phase 2/3 trial \nReleased by Chairman Rand Paul\n410since we (NIH) are the sponsors and we are liable.   Nonetheless, GSK feels that although \nthe PREP act would protect us and indirectly them, they feel that in international courts \nGSK (even though they are not the sponsors of the trial) could be sued given the sensitive \nnature of the situation (African countries, instability in the countries, brand new vaccine \nplatform for them –Cad3 vector -, accelerated development with questions regarding lot \nconsistency (because of the fast pace of development).  This would be terrible if the trials \nare stalled because of this.   I have phone call today with Moncef Slaoui, Chairmen of \nGSK for Global Vaccines.\nAlso, despite our conclusions from meeting on Nov. 11 (see above) the Oxford/Wellcome \nTrust people are working with MSF to start “open label” trials with various therapeutics \nwithout a control arm.   What the hell is going on here?   I am very disappointed in the \nBrits, especially the Wellcome Trust and Oxford people who clearly are grandstanding.\nCall with Moncef Slaoui went well.   Reasonable discussion.  I stated that the USG could \nnever give “global indemnification” since it would invite frivolous lawsuits.   Moncef felt \nthe same about our providing insurance for them since it would also invite lawsuits.   We \nagreed upon some form of a process that provides for limited liability and cpas on \nsettlements.   I will follow-up with summary e-mail to Moncef with copy to Ron Klain \nwith who I spoke tonight and relayed to him the conversation with Moncef.   Ron is \nflexible, but said that we cannot “guarantee” anything to Moncef, but we will proceed in \ngood faith to find a solution.\nNov. 15, 2014 –  Sierra Leone surgeon, resident of Maryland, green \ncard resident, married to US Citizen hospitalized at University of Nebraska having gotten \ninfected in Sierra Leone.  He is critically ill and may not survive.   He entered Nebraska \nHospital with Creatinine of 16, pH of 7.1 and K+ of 2.0.  NIH is thus up next for a \npatient.\nNov. 17, 2014 –  dies at Nebraska Medical Center.\nNov. 19, 2014 - Today I testified before a  Congressional Hearing of the House \nCommittee on Commerce and Energy, Health Subcommittee chaired by Congressman \nPitts from Pennsylvania with Dr. Burgess of Texas as the vice chair, and Mr. Henry \nWaxman of California as the ranking member. It was a lively hearing that went very well \nbut with some interesting sharp interchanges between me and Dr. Cassidy from \nLouisiana. He is a physician who tried to show off about his medical knowledge in the \nhearing; however, during the exchange it became clear that he really did not know what \nhe was talking about. In addition, Congressman Tim Murphy somewhat attacked me \nsaying that I have been condescending to people who question the issue of conmtrolled \ntrials with placebo limb, transmission, patient isolation and quarantine. I did not have the \nopportunity to refute him; however, after he had left when Mr. Burgess who took over the \nchair of the committee when Mr. Pitts left gave us the opportunity of a summary \nstatement, I question Mr. Murphy's characterization of me as being condescending and \nclearly stated that our most important goal with interventions is to first do no harm and \nthen hopefully benefit people and although many individuals feel that this is insensitive, \nReleased by Chairman Rand Paul\n\n411in fact it is not insensitive, but is the time-honored way of determining the safety and \nefficacy of interventions. In addition, after she had left I countered the somewhat snide \nremark of Mrs. Blackburn who had also made a statement without giving me the \nopportunity to respond. She said that we were negligent in not getting countermeasures \ndone quickly and that industry can do better than we can. I stated after she left that we \nhave been trying to get partnerships with industry for over 10 years in the development of \nEbola vaccines and that only recently were pharmaceutical companies willing to partner \nwith us.\nAll in all it was a very positive Hearing.\nNov. 20, 2014 – Did Newsmaker Luncheon talk at the National Press Club on Ebola.   \nGot much play in the printed press.   Things still calm regarding Ebola with attention \nswitching from the threat in the USA to background issues like the $6.18 billion request \nfrom the POTUS (see above Senate Hearing).   Also, some increasing noise from \nCongressman Tim Murphy (R-PA) regarding his pushing for the leaders of the 3 Ebola \nhospitals (NIH, Emory, Nebraska) to quarantine for 21 days their staff that took care of \nEbola patients and not allow them to see other patient for 21 days.   We are all adamantly \nagainst this and I have been the vocal one saying that we must stick with the science and \nthe CDC recommendation of stratification of risks to HCWs balanced by the stratification \nof monitoring and restrictions.   Murphy is not happy with me.\nHad dinner with Danny Hultzen and his father Chris.   Discussed the situation with his \nshoulder injury.   He feels good and looks great.   I have a strong feeling that if his \nshoulder holds out, he will make it to the MLB with the Seattle Mariners.\nNov. 25, 2014 – Did Webcast for Harvard School of Public Health on Ebola.  Panel \ndiscussion with Barry Bloom and others.\nNEJM paper to come out of Thursday (Thanksgiving) reporting on the results of the \nphase 1 trial of the NIAID/GSK Ebola vaccine (Ledgerwood et al).  Embargoed until \nWednesday (Nov 26) at 5:00 PM.   And so press starting to get excited about it.\nThus, did CBS Evening News tape for Friday PM?  Also, Medscape Interview. And \nplenty of embargoed print interviews.   As expected, the Brits (Wellcome Trust, Adrian \nHill from Oxford) are downplaying the study saying the required dose is too high and the \ndurability is low without a booster.  They are amazing.\nNov. 26, 2014 – Much press associated with the NEJM paper.   Did AP TV, BBC TV, \nCox TV, Bloomberg print, Reuters print, BBC radio and then later at night BBC TV \nagain.\nPOTUS comes out with White House statement congratulating “Francis Collins and Tony \nFauci and their teams….” On the successful phase 1 trial of an Ebola vaccine and \nannounces that he will visit NIH on Dec. 2 to congratulate the NIH teams and to \nemphasize the need for the requested $6.18 billion supplemental for Ebola.\nReleased by Chairman Rand Paul\n412Nov. 27, 2014 (Thanksgiving) – Again, still interest in the NEJM paper.   Did BBC TV \nvia phone plus my photo, CNN International via phone plus my photo.  Also did \nNewsHour with Judy Woodruff.   WETA picked me up with an Uber car and promised to \ntake me to the studio in Arlington, do interview, and get me back in time for \nThanksgiving visit and dinner at 4:00 PM at Joanne and Jim’s house.   They did it on \ntime.\nNov. 30, 2014 – Did CNN International discussing Ebola vaccine\nDec. 1, 2014 – World AIDS Day.   Went to White House and gave main lecture at the \nWAD ceremonies in the South Court Auditorium.   My talk went over so well that they \nstarted clapping at the final sequence of slides of the maps of USA and the world \nbecoming free of AIDS even before my talk ended.   Also speaking were Susan Rice, \nSecretary of State John Kerry (shouted out to me), Secretary Burwell (many shout outs to \nme), Gayle Smith (also praised me), Bishop Yvette Flunder (gave moving \nsermon/speech).   Then panel with Debbie Birx, Mark Dybul, Greg Millett, Helene Gayle \n– chaired by Sylvia Burwell.\nCame back to NIH to do walk-through for the POTUS visit to NIH tomorrow.\nDid CNN International and NPR Morning Edition radio with Scott Horsley.\nDec. 2, 2014 - Today was most extraordinary day. Began with a  presentation that I made \ntogether with Debbie Birx (PEPFAR) at the Russell Senate office building.  We made a \ndual presentation in celebration of world AIDS Day to a group of Senate and House \nstaffers. It went over very well. I rushed back to the NIH in time to do an interview with \nAndrea Mitchell on MSNBC about the successful phase 1 Ebola vaccine trial conducted \nhere at NIH that was recently published in the New England Journal of Medicine. When I \ngot back to NIH we began the preparation for the 4:00 PM visit by Pres. Obama. It was \nan extremely  successful visit. I led him on a tool of the Vaccine Research Center, gave \nhim a brief introduction of the history of the center, telling him the story about my \nconversation with Pres. Clinton in December of 1996 when Clinton promised me that he \nwould have a vaccine center built for us on the NIH campus. Nancy Sullivan presented to \nhim on the 2nd Floor of the VRC her work on the development of an Ebola vaccine. We \nthen took him to the 5th floor where Mario Roederer showed him the intricacies of the \nFACS machine.  The President was very relaxed, warm, and highly complementary of me \nand the NIH. Following the tour of the VRC, I rode with the president in the presidential \nlimousine from the VR across campus to Building 10 where he addressed an overflow \ncrowd of the entire NIH community in Masur auditorium. He thanked me specifically \nseveral times during the talk and he thanked various components of the NIH community \nfor their work on Ebola and other important diseases. He specifically gave a shout out to \nthe VRC people, the people who conducted the phase 1 trial, and to the nurses and staff \nwho took care of  in October.  During his talk to the NIH community, the \npresident gave me many compliments and shout outs. In particular he joked about how \nhad told me how to use FaceTime. In addition, he joked that \"Tony and I were \nfindly reminiscing about SARS and H1N1\". He then said after a big laugh \"that's what \nReleased by Chairman Rand Paul\n\n413these guys do for fun\".  The President mentioned my name multiple times during the talk. \nIt was a great day for NIH.\nFollowing the visit, I rushed downtown to the Mellon Auditorium on 13th St. and \nConstitution Avenue to participate in the dinner given by the Friends of the Global Fight, \nchaired by Mike Gerson (Washington Post).  On the panel with me were Mark Dybul and \nDeborah Birx. I ran into many people who I know and like at the dinner. These include \nPeter Staley who I am very fond of from our many experiences over the years in the \nactivist days. Peter looked bright and alert but rather thin and drawn likely due to his \nmany years of being on antiretroviral therapy.   They showed a short clip of his icon \nspeech at the International AID Meeting in San Francisco in 1990 when he said that \nsomeday people will speak of the deadly plague and how some stood up to confront it.   I \ncry every time I hear that speech.   In 1990, I gave a speech at the meeting right after \nPeter.  Former Sen. Chris Dodd gave me several shout outs about the work that I have \ndone over decades, calling me a national hero. Nancy Pelosi gave a talk in which he \nmentioned several times our extraordinary relationship over the years in fighting HIV \nAIDS.  All this praise was quite moving and gave me an added perspective about the \nmany years (decades) that I have been involved in this struggle.  All in all it was a great \nevening.   The following day the story with my picture (with the POTUS, Nancy \nSullivan, and Sylvia Burwell) were in the Washington Post and New York Times as well \nas on the Evening News programs.\nDec. 3, 2014 – At his request, went to the Rayburn Office Building office of Chairman \nTimothy Murphy (R-PA).  Murphy was upset with me at a recent Hearing (see above) \nwhen he said that I was making condescending statements about quarantine and why we \nshould not have quarantines.   He invited me down to his office to discuss further at a \n10:00 AM meeting.  With him was Committee Staffer Alan Slobodin (of past outside \nactivity investigation fame) and Murphy’s Chief of Staff Susan Mosychuk and his \nlegislative Director Brad Grantz.   Murphy had also been giving Tom Frieden grief about \nthe same issue.   Meeting actually went well – cordial, respectful.   The underlying theme \nwas still the need in his mind for quarantining of all West African entrants to USA or \nbetter restrict travel of West Africans (3 countires0 to USA and provide an “air bridge” to \nbring in USA HCWs.   Also, he was concerned that with the latest proposal for 32 \nadditional Ebola-ready hospitals in the USA that we should quarantine the USA HCWs \nafter seeing Ebola patients.  He was OK with just direct, active monitoring of the NIH, \nEmory and Nebraska HCWs, but he felt that since the other 32 hospitals were less trained \nand so would likely have a greater chance of getting infected, then they should be \nquarantined since (as a former Clinical Psychologist) he feels that people deny sxs and so \nhe does not trust them.   He is against the part of the $6.18 billion supplemental request \nfor Ebola on the grounds that we do not needs all the additional hospitals (I actually do \nnot entirely disagree with him as I have expressed to our own people).   The meeting \nended cordially.\nDec. 4, 2014 – Gave Ebola talk at the new FDA facility in White Oak.   Quite a place!  \nHuge!   They loved the talk.   Also,  new infectious diseases issue.   The H3N2 \ncomponent of the 2014-2015 influenza vaccine is mismatched to the early circulating \nReleased by Chairman Rand Paul\n414strain of H3N2, which is predominant over H1N1 and B, the latter of which match the \nvaccines.   The match for H3N2 is only 48%.   I was on WTOP explaining this.   Could \nbe a bad influenza winter.\n \nDecember 5, 2014 - I participated with Ron Klain at a Georgetown University event \nchaired by Pres. Jack DiGoia in Gaston Hall at the Healey Building. We discussed \nvarious aspects of the Ebola outbreak. I have grown to become truly fond and respectful \nof Ron Klain since he assumed the position as the Ebola Response Coordinator for the \nUSG. He will be leaving the USG employment and will return to his position as CEO of \nCase Holdings and General Counsel for Revolution, L.C. \nAlso did some press with the London Times print and Bloomberg TV today.\nHad a call with Jack Whitescarver. I am concerned with him since he does not appear \nwell. His hematocrit is low and he is short of breath. I believe he is having a slow \ngastrointestinal bleed and is likely experiencing mild to moderate congestive heart \nfailure.\nDecember 6, 2014  - I participated at the PRIM&R conference in Baltimore where I gave \nthe keynote address on ethical considerations in HIV/AIDS. This was on a Saturday \nmorning. Christine is a major player in this organization and spent the weekend there. I \ndrove to Baltimore on Friday night and had dinner with Chris at the Baltimore Hilton \nHotel Bar (lots of fun) and stayed with her in her hotel room that night. The following \nmorning (Sat. Dec. 6) gave my talk to an audience of around 2500 people and got a \nstanding ovation.  \nDrove back to DC and had dinner with Alec Whyte at Matisse restaurant.   Caught up on \nstuff.   Always great to see Alec\nDecember 8, 2014 -  I am getting particularly concerned with what I feel is noncollegial \nbehavior on the part of the UK, particularly Dame Sally Davies (Chief Health Officer of \nUK) as well as the Oxford group personified by Adrian Hill and Jeremy Ferrar who are \nbad mouthing our randomized controlled trial idea behind our backs. However, this is the \nstuff that we deal with all the time.\n I am also getting concerned that the incidence of infection of Ebola in Liberia is so low \nthat this may have an issue with our conduct of the randomized controlled trial in Liberia. \nCliff will leave Dec. 10 for Liberia for the third time in 5 weeks. We have to consider the \npossibility of doing a trial also in Sierra Leone.\nHad contentious IC Director meeting concerning the issue of presenting reports (that I \nbelieve are flawed) to the Advisory Committee to the Director (ACD) on the Intramural \nresearch Program (IRP) and the AIDS Portfolio.   Issue is that some outside group (ACD) \nwant to homogenize the IRP to make it “trans-NIH” as opposed to being directed to the \nmandate of the IC in question.   I am totally against this since this flies in the face of the \nNIAID mandate of being a “strike force” for emerging IDs such as AIDS, SARS, and \nReleased by Chairman Rand Paul\n415Ebola.   People like Eric Green (NHGRI) disagree with me.   I do not like or trust Eric as \nI believe that he resents me because he is intimidated by my accomplishments and \nnotoriety.   That is life.  Also, the “elephant” in the room with the distribution of the \nAIDS money by OAR that no one wants to address is that NIDA is spending about $180 \nmillion on drug abuse issues when ~7% of USA cases are drug abuse and one can stop \nthis with needle exchange.   I feel they should get some money, but not that much when \nwe do not have enough to conduct vaccine trials that could end the pandemic.\nDec. 9, 2014 – Participated in the The Atlantic STEM summit at GW (cold and rainy \nday).   Was interviewed by my old media friend Frank Sesno (formerly of CNN and \nNPR) who now heads the Public Affairs Institute at GW.   Nice crowd, good questions, \nwell-received.\nDec. 10, 2014 – Gave talk at Italian Embassy on Ebola followed by being interviewed by \nTed Koppel, my old buddy from “Night Line”.   Great interview.   Ted praised me as a \nnational hero.   Today “Time” magazine named the “Ebola HCWs” as “Persons of the \nYear”   great choice as they put themselves in serious harm’s way.\nDec. 11, 2014 – Will receive new patient at SCSU.  nurse ftrom San \nFrancisco volunteering in Sierra Leone with NGO got needle stick injury taking care of \ndocumented critically ill Ebola patient.   High risk exposure.  Flying in today.\nWoods_MedEvacFile.\ndocx\nSaw  this evening.  Donned and doffed just droplet precautions since she is \nasymptomatic.   Showered out anyway.  is comfortable, received VSV post-exposure \nprophylaxis.  Presented Ebola talk to ACD (Advisory Committee to the Director) of NIH.   \nGreat reception.   Moncef Slaoui (GSK) is member of ACD and he was cordial and \nagreed completely about the need for an RCT for Ebola Vaccine.   Ian Lipkin (also on \nACD) strongly felt against it and wants open access.   Am surprised at Ian since I thought \nhe was more of a scientist.   Note that he is not a clinical investigator; he is a good friend \nof mine.   He is moved by all the suffering and death.\nThe Swiss Phase 1 trial on VSV has been put on hold due to 4 cases out of 39 of \n“arthritis” (mild).   We have seen arthralgias and myalgias (expected) in our VSV trial at \nthe Clinical Center, but not arthritis even at 10x the dose of the Swiss study.  Puzzling….\nGave entrance interview with producer from CBS who wants to do a profile on me.\nDec. 12, 2014 – Went to White House today for meeting 1:45 PM to 3:00 PM in the \nRoosevelt Room.   Crystal clear, crisp and cold December day.   Meeting was to review \nthe situation with the Ebola-ready hospitals and Assessment Hospitals in the USA and to \ndiscuss the shifting of resources from Liberia (low infection rate now) to Sierra Leone \n(rising infection rate).   Present at the meeting were:  POTUS, VP Biden, Lisa Monaco, \nReleased by Chairman Rand Paul\n\n416Susan Rice, Denis McDonough, Ron Klain, Sylvia Burwell, Chairman, Joint Chiefs \nMartin Dempsey, Tom Frieden by teleconference from Atlanta, Samantha Powers by \nteleconference from NYC – UN, Assistant Secretary Heather Higginbottom from State, \nNancy Lindborg from USAID, Raj Shah – USAID.   Ron Klain asked me to review for \nthe POTUS the status of the vaccine plans as well as to explain the situation with the \nVSV adverse event of arthritis (see above).   POTUS asked a few other questions of me.   \nHe referred a few times to his trip to NIH.   Good meeting\nDid WTOP today\nDecember 12 – 14, 2014 – Cliff Lane has now gone to Liberia for the fourth time in \norder to set the stage for the upcoming randomized, placebo controlled, double-blind, \nclinical trial for the GSK/NIAID and the VSV vaccines. We are still getting nefarious \ncomments and undermining of our efforts by the people from the UK, particularly Jeremy \nFarrar and Adrian Hill among others. They continue to inappropriately talk about the \ninadequacy of our vaccine efforts even though they are working with the same vaccine. It \nis unbelievable to me how nefarious they can be when the main goal should be to develop \na vaccine to save the lives of so many unfortunate people in the West African countries. \nNonetheless we will forge on and hopefully prove the safety and efficacy of this vaccine.\nDecember 15, 2014 -  traveled to George Washington University to give a lecture for \nBopper Deyton’s course given at the Marvin Center at GW. It was an inspiring crowd of \nfirst-year medical students who were very excited to hear from me about the history of \nHIV and my involvement in it. That afternoon I participated by teleconference in an \nEbola meeting that took place at the IOM sponsored dually by the IOM and the \nRockefeller Foundation. The meeting was chaired by Secretary-General of the WHO, Dr. \nMargaret Chan. Many players were there in person or by phone including Paul Farmer \nfrom Liberia, as well as several Liberian and Sierra Leoneon and Guinean health \nofficials.  I presented the efforts in the development of vaccines and therapeutics\nDecember 16, 2014. Participated in a panel discussion on Ebola vaccines and \ntherapeutics at the Center for Strategic and International Studies (CSIS) at 1616 Rhode \nIsland Ave. NW. The panel was chaired by Steve Morrison. Other panelists included \nJulie Gerberding of Moncef Slaoui of GSK, Johan Von Hoof (Janssen and J & J), and \nRohit Malpani (MSF).   Good discussion about response to the epidemic.\n December 17, 2014 -  Feature article about me including a picture on the Federal Page \nof the Washington Post. I gave credit in the article to many of the people involved in \nEbola effort. It is noteworthy that although I saved Tom Friedman's job by convincing \nSylvia Burwell not to fire him during the missteps by the CDC,  Time magazine included \nTom Friedman as one of the Persons of the Year in their “Ebola Fighters” issue. They did \nnot even mention my name once.   Years ago – Time did the same thing with making \nDavid Ho “Man of the Year” and now this.  Such is life…\nDecember 19, 2014 – The puzzle of why Adrian Hill (and Jeremy Farrar) have been bad-\nmouthing the NIH/GSK approach of a high dose prime without the necessity of a boost.   \nReleased by Chairman Rand Paul\n418early years (1981-1984) when he was Director.   He was gay, but closeted.   KLarry \nKramer outted him and said that his closet status prevented him from asking for more \nAIDS money.   I succeeded Richard and immediately asked for more money.\nJan 8, 2015 – Did a 1 hour interview of a prolife on me by Brian Lamb to show in 2 \nweeks on C-SPAN.\nJan. 15, 2015 – Number of cases very low in Liberia.   Surge in cases in Sierra leone \nstarting to come down.  Liberian vaccine trial getting ready to start at end of January, \nbeginning of February.   Cliff Lane in Liberia now.   I will go within a few weeks (likely \nearly February).\nReceived award today at the Willard Hotel of 2014 Washingtonian of the Year from \nWashingtonian magazine.   Seven other winners including Gerry Sigal and Arch \nCampbell.\nTo White House tomorrow to update the “Deputies” on the upcoming vaccine trials in \nWest Africa.\nOver past week terrible tragedy of terrorism in Paris with Jihadists murdering 12 people \nat the Charlie Hebdo satirical magazine offices.   Today another thwarted terrorist attempt \nin Belgium.   Europe on high alert.\nJan. 16, 2016  - White House (EEOB – 374) meeting with Deputies chaired by Ron \nKlain.   Subject matter was vaccine trials and if there is any change in approach now that \ninfections are so low, particularly in Liberia.   Also discussed indemnification, liability \nand compensation for trials.  Also discussed the need (or not) for 46 hospitals to be \n“ready” to receive Ebola patients (see above).   I have always been against this since, in \nmy mind, most of the hospitals that have volunteered to be “Ebola treatment Units” in the \nUSA are really after the government funds that go with it.   The Deputies group was \ndiscussing reluctance to tell other hospitals that 46 is enough and we will not support any \nmore.   I made myself clear that we should just stop recruiting hospitals that we do not \nneed and that could likely not be able to handle an Ebola patient if they had to.\nAlso, met in the AM with Delegation from India (“Vijay) to discuss NIAID – India \ncollaborations, particularly the Vaccine Action program (VAP), which has been onging \nfor many years. and importantly, a delegation from Liberia and Sierra Leone.   The \ndeputy Minister of Sierra Leone (SL) is Dr. Madina Rahman.   She definitely “gets it” \nabout the advantage of a RCT and wants to have us conduct such a trial in SL.   This is \nkey, since SL is where all the infections are right now with very few in Liberia.   I will \nhook her up with Cliff Lane who is on his way back to USA from Liberia.\nJan. 17, 2015 – Writer and photographer from Financial Times (of London)  came to my \nhome today (Saturday) to do story on personal aspects of me.\nJan. 20, 2015 – Visit to NIH of Chairman Tom Cole (R-OK) of the Appriopriations \nSubcommittee.   Accompanied by Rosa DeLauro, Nita Lowy, Andy Harris , Dent, \nWomack.   I presented work on universal flu vaccine, Ebola, Antimicrobila resistance.   \nReleased by Chairman Rand Paul\n420Jan. 29, 2015 – Here comes a sticky issue.   The CDC (Anne Schuchat) give press \nconference updating on measles situation.   Today I got several requests to go on TV with \nCNN (Anderson Cooper), Bloomberg, other networks such as CBS Morning Show.   Sara \nBaldauf at HHS tells Patty and Courtney to hold on all TV appearances since “CDC has \nthe lead”.   Yet, I have been on multiple shows over the past couple of weeks on measles.   \nThis idiot Sara is stuck on the Obama Administration theme that you can only have one \nmessage and one Federal official talking about anything.    She does not understand that \nthe press want me.\nJan. 30, 2015 – Happens again.   Martha Raddatz wants me for ABC This Week on \nSunday and other Sunday shows.    She says no.   Courtney calls up and asks for an \nexplanation.   Sara says CDC has lead.   As usual, Courtney says but the Shows are \nasking specifically for Tony and there was an agreement between Francis Collins and Bill \nCorr that when networks and cable ask for me they can get me.   Sara says she does not \nknow anything about this agreement. Sara also says, I am not really saying no to Dr. \nFauci, I am just saying that you should give it to CDC.   Courtney insists that “You are in \nfact saying no to Dr. Fauci”.  \nI must include in my book this unbelievable controlling theme for the Press of the HHS \nand Obama Administration.   They would rather have a jerk out there than violate their \ninexplicable rule of various lanes for various topics.   Truly a bunch of assholes.  \nJan. 31 – Feb. 1, 2015 – Francis Collins sent an e-mail to Sylvia Burwell explaining the \nsituation with ASPA and my media appearances.   Sylvia says that she will ask Leslie to \ntake care of it and that there should not be any restrictions on me.   However, over the \nweekend, approval for several requests for me are delayed making it very inconvenient \nfor Patty Conrad to arrange them, and some requests are denied.   Also, Sarah Baldauf \nnow sends me talking points on things that are actually scientific issues!!   Unbelievable.   \nShe monitors my TV appearances and comments on them to me via e-mail. She even \nmakes suggestions on scientific issues.  I told Francis and he agrees that this must stop. \nHe spoke to the ASPA today and he will speak with Leslie Dach.\n   (Feb. 1) -The big feature on me in the Sunday “Home” section of the Financial Times \ncame out today.   Many tweets and e-mails from people all over the world who loved the \npiece.   It was a feature about me as a person and my home with great pictures of the \nvarious rooms in the house and the deck, which they described as my favorite \n“object/thing”.   That is what they do with all of these features – they ask the “celebrity’ \nwhat his/her favorite thing is.   Mine was my deck.\n      Also, today (Sunday – Feb. 1) the crew from “CBS- Sunday Morning” visited my \nhouse and filmed the last part of what will be an hour feature on me within the next few \nweeks.   Producer is Emmy-nominated Sari Aviv and famous NPR correspondent (now \ndoing CBS) Scott Simon.  They filmed Chris and I running on the track at American \nUniversity and then back in the kitchen making a typical Sunday breakfast.   \n      Also, BBC is doing a feature on me similar to the CBS feature.  Theirs will show \nglobally.   They followed me around NIH and interviewed a bunch of people including \nactivists.\n   \nReleased by Chairman Rand Paul\n421Feb. 2, 2015 – Now Governor Chris Christie is saying that parent should have the choice \nof not vaccinating their children.   He said this juxtaposed against the POTUS saying on a \nSunday Morning Show that parents should vaccinate their children and “there really is no \ngood reason not to”.   Now the media are playing up the conflict between Christie and the \nPOTUS similar to the quarantine for Ebola issue.   Everyone wants me on the press to \ncomment.   I am picking and choosing with whom I speak since the press definitely wants \nto put me between Christie and Obama.\n     Was on NBC Nightly New and NPR with Richard Harris about the measles issue.  \nThis is becoming the media hype similar to the Ebola issue.   Now Rand Paul is weighing \nin saying parents should decide about vaccinations.   Mike Gerson did a great job in his \nPost column describing the issue.   He quoted me directly.   Chris Wallace of Fax News \nSunday wants me to debate Rick Perry or Carla Fiorina.   We shall see.\n     Cooked dinner tonight at my house (Linguine with scampi and marinara sauce) for \nHarold Varmus and Chris.   I have Harold over the house and cook dinner for him about \n4X per year.   Also, used to do this with Gary Nabel when Gary was Director of VRC \nbefore he went to Boston to Sanofi to be with his wife Betsy Nabel who is CEO of \nBrigham and Women’s Hospital.   I do this since Harold is alone in DC without his wife \nConnie who stayed in NYC when Harold came down to be Director of NCI.   He stays in \nDC in an apartment on Connecticut Avenue near the Zoo on Monday-Thursday and then \ntakes Amtrak back to NYC for Thursday night through Sunday night.  Always an \nenjoyable evening.\nFeb. 3, 2015 – Testified today at Congressional Hearing of Commerce and Energy \noversight Committee (Tim Murphy (R-PA) Chair on Influenza and why the match of \nvaccine was wrong.   Multiple things putting me at the forefront – measles, Ebola, bad flu \nseason.\nWill do Rachel Maddow Show tonight.   Measles is all over the news.   Also, ISIS sent a \nvideo where they burned alive a captive Jordanian pilot.\nSee e-mail below from Cliff.   Serious problem with integrity of the Welcome trust \npeople and Chimerix.   The Welcome trust Oxford group were the ones that criticized us \nfor wanting to do RCTs.   We insisted that it was the safest and best way to determine \nefficacy or harm.   They said we were unethical.   They are unethical and we cannot say \nanything because of “confidentiality”.\nFrom:  Lane, Cliff (NIH/NIAID) [E] \nSent: Tuesday, February 03, 2015 5:08 PM\nTo: Borio, Luciana (FDA/OC); Fauci, Anthony (NIH/NIAID) [E]\nCc: Margaret Hamburg\nSubject: Re: Daily Mail: Low infection rate halts Ebola vaccine trials in Liberia\nConfidential - \nReleased by Chairman Rand Paul\n422This is a complete distortion. The trial was stopped because patients died and the FDA \nsent a threatening letter to the company.  Questions on this will undoubtedly come up as \nwe launch the ZMapp trial.  These same individuals accused us in print of being unethical \nfor doing RCTs.  \nLu - I need to know what I (or Tony) can say publicly.  For the first time in a 35 year \ncareer at the NIH I am taking my gloves off.\nTony - I intend to severe any and all collaborations we have with the Wellcome Trust \nover what I consider to be completely unethical behavior and lack of integrity. \nPeggy - if I had not worked with you when you were a special assistant in Tony's off ice \nthere is no chance I would see such a note to the FDA Commissioner.  I apologize in \nadvance.\nSomewhere in HHS we need to move from political correctness and deference to our \ncolleagues in other agencies to doing the right thing and trying our best to identify \neffective countermeasures for Ebola virus disease.  It is possible my judgement is being \nskewed by spending too much time in West Africa.  In fact, however, it  I think it has \nbeen honed.  I think we need a blunt meeting with the Secretary and Leadership of FDA, \nCDC and NIH to put the cards on the table face up. \nCliff\nOn Feb 3, 2015, at 7:27 PM, Doepel, Laurie (NIH/NIAID) [E] \n<LDOEPEL@niaid.nih.gov> wrote:\nLow infection rate halts Ebola vaccine \ntrials in Liberia\nBy Afp \nPublished: 14:17 EST, 3 February 2015 | Updated: 14:17 EST, 3 February 2015 \nBritain's Wellcome Trust said that clinical trials it was funding for a new \nEbola vaccine in Liberia were halted on Tuesday due to a fall in new \ncases.\n\"The current position is that there is no realistic prospect of the trial \nenrolling sufficient patients to be able to reach a conclusion about the \nReleased by Chairman Rand Paul\n423efficacy of the drug,\" the Wellcome Trust, Britain's biggest scientific \nresearch charity, said in a statement.\n\"Therefore the trial has been terminated,\" it added.\nThe Wellcome Trust said the decision was taken on Tuesday after the \npharmaceutical company Chimerix, which manufactures the brincidofovir \nvaccine, said it was withdrawing from the trial on Friday.\nThe first large-scale trials of two other Ebola vaccines -- \nGlaxoSmithKline's Chad3-EBO-Z and rVSV-ZEBOV, manufactured by \nMerck and Newlink -- began in Liberia on Monday.\nTuesday's decision was taken by the Trial Steering Committee, which \nincludes scientists from Liberia, the University of Oxford and Medecins \nSans Frontieres.\n\"We're delighted that infections are falling, but fewer patients makes it \nmore difficult to carry out the robust scientific studies needed,\" Peter \nHorby from the University of Oxford, who was leading the trial, said in a \nstatement.\nJeremy Farrar, director of the Wellcome Trust, which is funding a multi-\nmillion pound therapeutics platform for experimental Ebola treatments, \nsaid it was \"disappointing\" that the trial could not continue.\n\"It is essential that other studies of potential treatments and vaccines \ncontinue and hopefully will still be able to deliver meaningful results for \nthis and the inevitable future epidemics of Ebola,\" he said.\nStephen Kennedy, a study investigator from the Pacific Institute for \nResearch and Evaluation in Liberia added: \"The scientific community will \nmove on without any clear evidence regarding the role of brincidofovir in \nthe management of Ebola.\"\nWeekly Ebola infections in west Africa have dropped to below 100 for \nthe first time in more than six months, the WHO said last week, raising \nhopes the worst-ever outbreak of the virus is coming to an end.\nReleased by Chairman Rand Paul\n424The World Health Organisation said it had now shifted its efforts in \nGuinea, Liberia and Sierra Leone -- the countries worst-hit by the \nepidemic -- from slowing the spread to stamping it out completely.\n \nFeb. 4, 2015 – Max Cooper gave WALS Lecture at NIH.   Went to dinner with him and \nChris last night at Cesco Osteria on Woodmont Avenue in Bethesda.  Still great press \ninterest in the Measles situation now that Presidential hopefuls Chris Christie, Rand Paul \nand others have commented on it.   Rand Paul put his foot in his mouth by saying that \nthere are reports of children who walk and talk normally before MMR and then \nimmediately after, they can no longer walk, talk, and are autistic.\nGood experience on Rachel Maddow Show last night.   We stuck to the science and did \nnot get involved with the politics, although she dumped all over Christie and Paul.   Ran \ninto Gov. Howard Dean in the NBC Green Room and he was very critical of Paul.\nDid Geraldo Rivera Radio Show today and Jose Diaz Belart on MSNBC.   The Sunday \nShows want me on several times.   Let us see if HHS allows it vis-a-via prior discussions.\nISIS burns alive and shows the video on the internet a Jordanian jet fighter pilot shot \ndown over Syria.   The Jordanians are outraged and execute Al-Qaeda prisoners in \nretaliation.  Big news\nFeb. 5, 2015 –  Media continues over measles.   Was on Fox National news.  Also, \nBuzzfeed print; Wall Street Journal.   Gave talk on Ebola at the Columbia Country Club \nin Bethesda on Connecticut Avenue.   Biggest crowd they have ever had at these events \n(Distinguished Lecture Series)\nFeb. 6, 2015 – HHS approving all my media now.   Today did CNN New Day; The Hill.  \nAlso did radio interview with John Castamidas for  his NYC Sunday Show.  Was \nsupposed to do MSNBC with Andrea Mitchell and another ABC Show but was cancelled \nbecause Jordanian aircraft bombed ISIS in Syria and the ISIS claims that the bombs \nkilled and American woman whom ISIS had kidnapped and was holding hostage.   Now \nall news stations are covering this.\nFeb. 7, 2015 – Measles still hot.   Emerging reaction by press and bloggers against \nmothers who do not vaccinate their children.\nI appear on CNN with Poppy Harlow about measles\nFeb. 8, 2015 – Appear on Sunday TV “Face the Nation” with Bob Shieffer.   Appear with \nCBS Dr. Jon LaPook.\n  Fly to Austin, TX for LaMontagne Lecture tomorrow.\nFeb. 9, 2015 – Give Inaugural John Ring La Montagne Lecture at University of Texas.  \nJohn did undergraduate and Masters at U of T.  His widow Elaine was present and his \nbrother Greg.   Freezing weather in DC and major historic snow storms in New England \nReleased by Chairman Rand Paul\n426I so rarely go out to lunch -- so I was completely crushed that I \nmissed the extraordinary moment when one of the world's leading doctors \npaid me a house call.  Thank you so much for the wonderful letter and \nincredible gift.  I can tell people now that while infamously do NOT \nhave a medical degree I DO have a certificate from the NIH!!!!\nOn a serious note, I cannot tell you how grateful I am personally for \nyour counsel, candor and wisdom during my tenure at the White House.  \nAnd as an American, I can't tell you how grateful I am for your \nleadership for our country and the world.  \nI hope our paths cross again some day.  Until then, I am your greatest \nfan and admirer....\nWith thanks,\nRon\nSent from my iPhone\nFeb. 20, 2015 – Outbreak of CRE (Carbapenem-resistant enterobacteriaceae) infections \nat UCLA related to a contaminated duodenoscope for ERCP (endoscopic retrograde \ncholangiopancreatography).\nWent on WTOP to discuss the CRE situation at UCLA.   Never a dull moment!\nFeb. 21, 2015 – Went on CNN to discuss the 7 cases of CRE that occurred with 2 deaths \nat UCLA in association with contamination of duodenoscope used for ERCP.   Press is \ntrying to blame FDA since FDA knew about the problem with duodenoscope \ncontamination for a few years.   I did not throw FDA under the bus since there is not \nmuch they can do about it except to alert hospitals to clean the instruments as best as \npossible.   Cannot pull the 20,000 or so instruments (made by Olympus) since 500,000 \nprocedures are done in the USA each year and many are life-saving and avoid serious \nsurgery.   It is a risk/benefit issue.   Peggy Hamburg ran into Chris in Safeway and Peggy \nmust have seen the CNN interview since she told Chris to thank me for not throwing \nFDA under the bus.\nFeb. 23, 2015 – I am finally convincing Tom Frieden not to oppose the therapeutic RCT \nfor ZMapp that Cliff wants to expand from Liberia to Sierra Leone since there are very \nfew cases of Ebola in Liberia and still several new cases each day in Sierra Leone.   The \nRCT for the vaccine trial is coming along well in Liberia.  I was supposed to go to \nLiberia yesterday, but have postponed the trip since my back is hurting badly and also \nbecause the president of Liberia (Ellen Johnson Sirleaf) is visiting HHS and I need to be \nthere to help greet her.\nMeasles still in the press.  Will discuss live tonight on BBC TV with Katty Kay\nFeb. 24, 2015 – Went to NYC for the DDCF Board of Trustees Meeting.  Good to see the \nBoard.   Have missed a couple of meetings due to the Ebola crisis.\nReleased by Chairman Rand Paul\n427Big breakthrough in food allergy published in the NEJM.   NIAID funded the study.   \nShowed that early age consumption of peanut products in children with diathesis for \nallergic reaction significantly decreases incidence of peanut allergy after 60 months.\nI appeared and was interviewed by Jeff Green on The NewsHour to discuss it.\nFeb. 27, 2015 – Still in an amazing cold wave in Washington, D.C.   A few days ago it \nwas 2 below at IAD.  \nWent to Humphrey Building today at 8:00 AM to meet with Liberian President Ellen \nJohnson Sirleaf.   Hosted by Sylvia Burwell.   Her staff included Liberian Minister to the \nUSA, among others.   On our side was Peggy Hamburg, Cliff Lane, Francis Collins, Tom \nKenyon (CDC).   Has good conversation about our efforts in Liberia, particularly the \nvaccine trial and the ZMapp trial that was announced today in Liberia.   The President \nprofusely thanked us for helping out with their Ebola issue.   She is a very sharp lady.\nFeb. 28, 2015 – Had another one of those great dinners hosted by Catherine and Wayne \nReynolds at the Book Room of the Jefferson Hotel.   Freezing weather.   Great guests \nincluding Vernon Jordan and his wife Ann; David Petraeus and wife Molly, Jim Johnson \nand his date Heather (?), Buffy Cafritz.   Interesting discussions by Jordan on the political \narena of Hilary Clinton and her candidacy.  Petraeus spoke about the ISIS treat, Iraq and \nthe Middle East.   One of the best of the Reynolds’s dinners.   Chris could not be there.   \nShe was in Northern California cheering on Ali who was running a marathon in the Napa \nValley.\nMarch 3, 2015 – Testified before the House Labor – HHS Appropriations Subcommittee \nfor the NIH budget.   As usual for the past few years, it was only a 2 hour Hearing with \nFrancis Collins testifying and me backing him up at the table together with Gary Gibbons \n(NHLBI), Tom Insel (NIMH), Nora Volkow (NIDA) and Jon Lorsch (NIGMS).   Hearing \nstarted early (8:30 AM)   since Benjamin Netanyahu was speaking before a Joint Session \nof Congress at the invitation of Speaker Boehner and against the wishes of Obama.  He \nwas making the argument that the USA was making a “bad deal” with Iran on nuclear \ncontrol versus sanctions.\n     During the Hearing Congressman Andy Harris (R-MD) made the point that he felt that \nwe were spending too much on AIDS compared to other diseases with much more of a \nmorbidity and mortality impact on the USA.   He wants to allocate money strictly \naccording the disease burden in the USA.   Hence, this would destroy funding for malaria \nand TB and greatly hurt funding for AIDS.   Obviously, I will be opposing this.\n     Still record cold weather and lots of snow in DC.\nMarch 5, 2015 – Was supposed to go to Boston yesterday evening in order to speak at an \nEbola Forum at Harvard today.   However, a big snow storm was forecast for DC for \ntoday and I was afraid that I would get stuck in Boston. I wisely, did not go and actually \ngave my talk and Panel discussion via “GoToMeeting”, which worked very well.   Paul \nFarmer was on the panel in Boston.   Good thing that I did not go since DC got 8 inches \nReleased by Chairman Rand Paul\n428of snow and all flights were cancelled from Boston to DC.  I would have been stuck \nthere.\nMarch 6, 2015 – Met with Nina Russell and Emilio Emini from the Bill and Melinda \nGates foundation (BMGF),  Emilio is taking over as the Director of Global Health for \nBMGF and he wanted to review our mutual commitments for the AIDS vaccine plans \n(i.e. the P5 follow-up of the RV144 study).   He wanted to re-examine the criteria for \nmoving forward with candidates.   Emilio generaly thinks that he knows everything; \nhowever, on this one he has a valid point and so we will do this together.\nCliff Lane in Liberia (also Sierra Leone) now for the 7th time in a few months trying now \nto expand the RCT vaccine trial to Guinea and also expand the therapeutic trials with \nZMapp to Sierra Leone and possibly Guinea since there are virtually no patients in \nLiberia.   Cliff and I had phone call early (6:30 AM) with Cliff in Sierra Leone, me in DC \nat home, and Yves Levy and Jean-Francois Delfraissy in Paris to try and get a \ncollaboration going in Guinea for the trials since the French have a presence in Guinea.\nMarch 9, 2015 -  Went downtown today to be the BBC studio to do the final taping of \nthe segment that they will be doing on HIV/AIDS were I am the moderator and narrator. \nIn the afternoon, I attended the FDA/NIH Leadership Council meeting to discuss better \nways of collaboration between the NIH and FDA. \nMarch 10, 2015 -  Gave the after dinner talk at the Project Hope Board meeting at the \nWillard Hotel in Washington DC. I spoke on Ebola: The Perfect Storm. It was extremely \nwell received and the evening was pleasant. Ran into former Secretary of HHS Louis \nSullivan.\nMarch 11, 2015 -  Was Visiting Professor at the John's Hopkins Hospital and Medical \nSchool. Gave two major talks: 1) a formal lecture on Ebola, and 2) a lecture to the \nstudents and fellows on my career as a scientist, clinician, policymaker. \nMarch 12, 2015 - There was a considerable misunderstanding involving a situation in \nSierra Leone. Cliff Lane is trying to expand the randomized controlled trial of ZMapp \nversus standard of care in countries in addition to Liberia with the protocol he has already \nstarted. As it turns out the commanding general in charge of the British military hospital \nin Sierra Leone, Brig. Gen. Tim Hodgetts, was under the misimpression regarding the \nprotocol was standard of care to see ZMapp + standard of care versus standard of care \nalone . And so he said that this trial was unethical and refused to participate in it. The \nreason why this is important  is because an American citizen who works for Partners in \nHealth became infected while working in Sierra Leone. We had made arrangements to air \nevacuate the patient to the NIH clinical Center as soon as possible. Because the patient \nwas in the British facility, we wanted to start the randomization to one or the other arm of \nthe protocol while the patient was still in Sierra Leone before flying back the United \nStates. Brigadier General Hodgetts stated that he would give ZMapp as a compassionate \nuse but would not participate in the randomized protocol. He felt it was unethical to delay \nthe flight to the USA by giving the person a placebo if in fact the person randomized to \nReleased by Chairman Rand Paul\n430did not see any droplets coming out of his mouth as he coughed; however,  I remember \nthinking thank goodness for the PPE. This experience brought into sharp relief for me the \nreason for the high case fatality of Ebola and why so many HCWs get infected. If were in \nWest Africa, would be dead and Rick, Anthony and I would have gotten infected \ntaking care of him if we did not have the state-of-the-art PPE.  After an hour and 45 min. \nwe doffed and waited for his parents.  \nThey came with Bible in hand to visit their son. Rick Davey, Cliff \nLane, and I spent well over an hour with them explaining the situation and the \nseriousness of it. We then brought them into the nurse’s station where they were able to \nspeak with their son through video link. They could see him but he could not see them. \nOf note before we brought them into the nurse’s station to see him through the video,  we \nmentioned to that we were going to bring them into the room. He got very \nconcerned that he wanted to get cleaned up from the diarrhea that soiled his bed and was \nover parts of his leg. In addition, his PIC line was bleeding around site and so that needed \nto be cleaned up. It took the nurses about 45 min. to an hour to get him perfectly clean so \nthat he could feel comfortable talking to his parents even though his parents would not be \nable to see any of the soiled linen or pajamas from the distance that they were at the video \nlink. It was a very moving conversation between the parents and  \nended up the conversation by reading a passage from the Old Testament. And then he \nturned to us in the room and said “what a wonderful country we live in that would put so \nmuch effort into the saving the life of one person - our son. There was not a dry eye in the \nroom.\nI went home that night completely exhausted and went with Christine to Bourbon Steak \nbar and restaurant at the Four Seasons Hotel in Georgetown to unwind.\nMarch 15, 2015. Came into work again today which is Sunday. The day has turned into a \nvery bright sunny day with a brisk wind. Again, I went to the SCSU and Rick Davey and \nI went in together to take care of . Some lab parameters are better and some are \nworse. The most worrisome of all is his respiratory situation. We have corrected what we \nbelieve is over hydration by cutting down on his fluids and giving him a diuretic. \nHowever his temperature is still 39 and he is still breathing at 35 to 40 breaths per \nminute. Of particular concern is the fact that on 2 L/min of nasal oxygen, his oxygen \nsaturation is still only about 88%. Also, on call is Bob Danner from the ICU. Bob \nincreased the nasal oxygen to 4 L/min and we had a discussion about the possibility that \nwe might need to intubate the patient since he will likely soon get soon very tired from \nbreathing at 35 to 40 breaths per minute. Cliff Lane was on a phone conversation with the \npeople from Emory and Nebraska and they mentioned that even when they thought that \nthey had very good control of intake and output of fluids, around day 8 to 10 of illness, \npatients often had unexplained accelerated respiratory difficulty requiring prolonged \nintubation. I hope that it does not come to that with  however, it is entirely \nconceivable that it will. I will go over to the SCSU again tonight for a conference with all \nof the team to make these decisions.\nDrama tonight in the SCSU.        Some change in status.  All metabolic \nnumbers, BP and cardiovascular, kidneys etc. were fine and even improving.   However, \nReleased by Chairman Rand Paul\n\n431he continued to be tachypneic at 35-38 resp/min.  During the day, his OxSats were in the \nlow nineties and he responded first to increasing nasal O2 from 2 to 4L/min.   However, \nas we got into the evening, his OxSats dropped into the high 80s.  His resp. rate was 38-\n40.  We considered elective intubation at that point, but watched him for another hour to \nsee if he would stabilize.   Instead, his OXSats dropped to 78-80 despite increasing the \nnasal O2.  His resp. rate went to 40+.  At that point we did an elective intubation \nperformed by Bob Danner of the Clinical Center ICU.   It was uneventful and now he is \nparalyzed with deep sedation and on the respirator.   His OxSat is now 99-100% and the \nmachine  is set at 15; he is breathing on his own at 20/min.   We spoke to our colleagues \nat Emory and Nebraska who had taken care of Ebola patients in an intensive care setting.   \nThey said that this was exactly what they had seen, i.e. a patient seems to be doing well \nwith good numbers and then goes into an ARDS picture.   They intubated them and after \na variable period of time, the patients (2 in number) recovered.   Hopefully, that is what \nwe will see with   He went through the night without incident.\nMarch 16, 2015 – Spent 2 hours in the SCSU “Hot Zone” with Bob Danner (ICU \nspecialist) and Kwan (ID Fellow).   went into renal shutdown likely due to Acute \nTubular Necrosis (ATN).  We spent the time trying to balance the pushing of fluids with \ngiving Lasix diuretic.  Now at 24 hours after intubation, his pulmonary situation is \nfine.   He is on 35% with 5 PEP and his Sats are 95-100%.   His BP and cardiovascular \nfunction are fine.  Labs are all about the same and a little better except for one disturbing \ntrend.   His creatinine has gone from 0.8 to 1.0 to 1.3 to 1.6 to 1.9 just 1 hour ago.   From \n6:00 to 7:00 PM he put out no urine after having put out about 40 cc the prior hour.   We \npushed fluids and he has only put out about 25 cc/hour over the past 3 hours.  Diarrhea is \nstill profuse.   We are going to continue to push fluids to see if he opens up.   Looks like \nATN, which is puzzling since he has always had good perfusion with good BPs.   The \npeople at Emory tell us that this is exactly what they saw with their sickest patient, i.e. \npatient’s numbers look good, then unexpected ARDS, the latter corrected by \nintubation/respirator, then unexplained ATN requiring dialysis, followed by prolonged \nand slow recovery.   Strange disease this Ebola.   We will continue to push fluids during \nthe night and then (depending on his creatinine), consider the option of \ndialysis.   Hopefully, we will not have to go there.\nMarch 17, 2015 – Went to morning report at 8:00 AM.   Bob Danner reviewed what \nhappened after I left the Unit last night.   Creatinine now up to 2.5.   Patient clearly in \nrenal shutdown.  \nLarry Altman gave very nice James C. Hill Memorial Lecture at the Lipsett Auditorium \non the Journalistic Hx of AIDS.\nDecided not to go to the Wilson Center for the Tom Daschle/Bill Frist dinner since \nrenal function continues to deteriorate and I want to go to the “sign off” \nmeeting in the SCSU at 6:30 PM.   At SCSU, Creatinine up to 3.3.   .   I am looking for a \nsilver lining, but the upward trajectory of the creatinine is slightly less than it was \nyesterday.   We may need to dialyze him, but I am hoping that his creatinine stabilizes at \n3.7 to 3.9 and then starts to slowly come down without dialysis.   Having said that, we \nReleased by Chairman Rand Paul\n\n432will not hesitate to dialyze him.  Also, he has some strange neurologic manifestations \nwith an atypical tonic/clonic movements, but no other manifestations of brain or cord \ndisease.  There is a whole new chapter of Ebola disease manifestations to be written now \nthat we can keep people alive who otherwise would have died days ago if there were in a \nUnit in West Africa without the equipment and manpower that we have.   Last night there \nwere 6 of us in the room with him.   The good news is that his AST is starting to come \ndown and the best news is that his CT value is now 29.96, which means to me that his \nimmune system is starting to control the virus replication.    If the downward trend of his \nvirus continues and we can just keep him stable for the next 4 or 5 days, I believe and \nhope that we can get him through this.\nMeeting more ICU docs including Parker Ruhl from NHLBI.   She is on call tonight and \nchecked with her at 10:00 PM by phone.   \n     Also, am doing nightly e-mail reports to Paul Farmer who is in Peru with his daughter \nCatherine.\nMarch 19, 2015 -    All non-renal numbers going in the right direction.   Still in acute \nrenal failure; however, the rise in creatinine is perhaps a bit less “steep” – creatinine 5.9 \nand BUN 111.  We may well have to start dialysis today.   Decision to be made mid-day \ntoday.   His cycle (CT) is now up to 31.5 and so his immune system is certainly clearing \nthe virus.  Persistent fever prompting broad antibiotic coverage.   Had a scary episode last \nnight.   As we were tapering him off heavy sedation it appeared that he was calm and \ndoing well with the taper.  However with two nurses in the room and the rest of us \n(physicians, nurses, WatSans, et al) taking evening report, he abruptly woke up in a \ndelirium flailing his arms and legs despite soft restraints (he is 6’2” and very strong).   He \npulled out his PIC line and pulled out the tubing to his endotracheal tube.    It was a \nnightmare for the 2 nurses in the room who had to simultaneously press down with a \ntowel on the bleeding PIC line site, bag him through the endotracheal tube, hold him \ndown and try to get Versed into him.   We all got up and scrambled to Don but this took \n(even going at light speed) about 5 minutes leaving the 2 nurses in the room with 5 \nminutes of terror. Dan Chertow, Rick Davey and Tara Palmore went in and Bob Danner \nand I manned the nurses station and read the monitor to the people in the room.   We \ndecided that it would ne dangerous and non-productive to have everyone in the \nroom.   Real scare came when Neil (head nurse on that shift), who was one of the 2 \nnurses with Kim, doffed, he noticed when he took off his inner glove that his hand was \nbleeding.  As you can imagine, the trauma of the prior 5 minutes and now a bloody hand \nbrought us all, particularly Neil, over the top.   Luckily, the blood was his (injured his \nhand against bed rail when holding down patient) and his gloves were intact.   Tara \nPalmore checked his gloves by filling them with water and there were no leaks.   We \nsoon got everything under control and he is now the same as pre-event, only now under \nheavy sedation, which we would have had to do anyway if we ultimately decide to \ndialyze him.   PIC line was replaced by VAT (Vascular access Team).\nMarch 20, 2015 – Patient stable this AM.   First day of Spring today and we have snow \nin DC.   What a winter – Ugh!  Went in again today to go over patient with Dan Chertow.   \nIn for about 65 minutes.  Making morning (8:00 AM) and evening (6:30 PM) report now \nevery day with the Unit staff.\nReleased by Chairman Rand Paul\n433March 21, 2015 - Good news. Creatinine stabilized for 3 determinations in a row at \naround 6 with BUN at around 115. We may get away without having to dialyze. Main \nproblem now is meningoencephalitis. Avi Nath (NINDS- neurologist) helping out with \nneuron-management.   He can only do so by history and video since he is not trained to \nenter room. We cannot fully evaluate this until we lighten up his sedation, given what \nhappened the other night, we will do this very slowly. We have started low dose heparin \nnow that his platelets are coming up. CT (Cycle threshold) is now 34.5!   All we need to \ndo is avoid PEs and bleeding. More later.\nNow the Norwegians and to some extent the Canadians (much less so) are getting upset \nwith us since we are working with the Guineans via INSERM (Delfraissy/Levy) and the \ninteraction between the Liberians and Guineans to expand the vaccine RCT to Guinea, \nwhere there are still cases.   The Norwegians are trying to do a “Ring Vaccination” study \naround cases similar to what was done with smallpox.   However, the smallpox situation \nwas using a proven, highly effective vaccine.   You do not “test” a vaccine in a ring \n“study”.   The Norwegians are concerned that our introduction of an RCT where they are \ndoing a Ring study would be a problem.   I can understand what their concern is; \nhowever, the elephant in the room is the fact that there study is not a study.   It is a \n“distribution” of an unproven product.   This is the same European mentality that just \nbecause this is a serious disease, then there is no room for research; just distribute what \nyou have.   This same mentality led to Guinea adopting Favipiravir as standard of care \nbased on an open access study that claimed benefit; however, when the data was \npresented at the CROI meeting, it was clear that there was no indication of efficacy since \nthe outbreak incidence was shifting during the study and historical controls were not \nvalid.   God bless Cliff for sticking to his guns about RCT and good science.   In this \nregard, my old friend Tore Godal from Norway e-mailed me with concern about our \nstudy since he is one of the Norwegians who are pushing the Ring study.  Of note, in their \ncommunications, nowhere are there any Guineans.   Sounds like the old paternalism.\nMarch 22, 2015 (Sunday)– Spent all of the day at NIH and hours in the SCSU in with \npatient and doing AM and PM rounds.   Danny Jaswal was the ICU attending and Tuan \nwas the ID person.   Avi Nath did neuro exam and actually wwent into the room after \ngetting trained in PPE\nMarch 23, 2015 - .   I have some good news.   His renal function continues to improve \nwith a creatinine today of 3.6.  He is in the polyuric phase of ATN with a urine output \nafter stopping Lasix over the past 24 hours of >100 cc/hr. His LFTs have \nnormalized.   His cardiopulmonary function is good.   On neuro exam today, his board-\nlike stiff neck can now bend by 45 degrees and his sustained clonus is now down to 5 \nbeats.   We had our  ophthalmologist (Rachel Bishop) examine him today with a neat \ngadget hooked onto a cell phone, which together with a hand lens gave us a good look at \nhis retina.    Good news is that he has no papilledema and no evidence of clinically \nsignificant uveitis.   Tomorrow morning we will attempt to stop his ketamine and \nfentanyl and gradually taper off his propofol.   If he wakes up without being combative \nand is stable for a period of time, we will consider pulling his endotracheal tube.  His CT \nis 37 and so he is almost cleared of virus from his blood. Fingers crossed.  \nReleased by Chairman Rand Paul\n434Paul Farmer called my cell phone as I was getting ready to do today and I gave him a \nsummary of  progress.   \nHaving “political issues” with the Norwegians getting upset that Cliff and I want to \nextend our RCT vaccine trial to Guinea since they are doing the ring vaccination there.   \nSee my comments above.\nMarch 24, 2015 – Same political issues regarding the potential NIH RCT in Guinea.   \nKai Kupferschmidt from Nature wanting to do a story about “rivalry among scientists.  \nLike the Peter Duesberg situation decades ago, they are “equating” us with Marie-Paul \nKieny of WHO.   I cannot say to Kai, but Marie-Paul is an idiot.   Had long 3-way \nconversation over the phone:  Kai who just flew in from berlin for the Filovirus Meeting \nin DC tomorrow is connected from his hotel here in DC; Cliff from his home and me \nfrom my home (10:00 PM).   We try to explain to Kai that we are not trying to interfere \nwith the “Ring” trial; we just want to get the correct answer for the good of all of West \nAfrica.   He keeps pushing that they started off with Guinea and now that Liberia has \nfew/no infections, we want to go to Guinea and “ruin” their study.   Nonsense.   You can \ndo 2 studies simultaneously in as large a country as Guinea.   Besides, ring vaccination is \nnot a study; it is vaccine distribution of an unproven vaccine.\nMarch 25, 2015 - Good news at SCSU:   We extubated  uneventfully! Went in to \nsee him and he is emotionally very grateful for what our team did for him.   Paul Farmer \ncame up from Haiti to visit as well as the other PIH personnel (contacts to \n who are “nested” in the Maryland area for observation in case they develop sxs.  \nOrgan system function markedly improving.  Creatinine 1.4!!  Still some muscle \nweakness.   Will leave urinary catheter in tonight and keep him NPO since his voice is \nvery weak and his trachea is irritated.  CT is 39+; however, his CT of his trachea aspirate \nis 26.   Could there be sequestration of virus in tracheal secretions or is this just \naccumulation of dead virus\nKai (above) is still agitating with questions to Cliff about our upsetting the Norwegian \nstudy.\nMet with Morgan Fairchild in my office today at 3:30 PM to discuss what NIAID could \ndo for Chronic Fatigue Syndrome, now re-named Severe Exertion Intolerance Disease \n(SEID).\nWill give talk tomorrow at the Filovirus Meeting in DC and so will miss Harold \nVarmus’s last IC Director meeting.   Said goodbye to him and Connie today.  I will miss \nhim greatly.\nMarch 26, 2015 – I have been chosen by Fortune magazine as one of the world’s 50 \ngreatest leaders.   Also, I am on Time magazine list for voting “100 of the world’s most \ninfluential people”\nPatient doing well.   \nReleased by Chairman Rand Paul\n\n435Gave talk at the 7th International Filovirus Meeting at Marriott Hotel at Metro Center run \nby Heinz Feldmann.   Talk went over very well.   Kai Kupferschmidt was in audience and \nwas blown away when I showed slides of me in PPE taking care of    He came \nover afterwards and is writing a short online blog on how incredible it is that a director of \na large research institute who is 74 years old is taking care of an Ebola patient.\nSpent a full hour with  in the SCSU.   He is now very talkative; however, he does \nhave a slight expressive aphasia.   His strength is coming back and he is taking a soft diet \n(apple sauce, etc.).   Creatinine now 1.2.   CT around 39.   May still have some virus in \ntracheal secretions.   He has an occasional cough that is dry; may be slightly aspirating \ndue to pharyngeal muscle weakness.  Paul Farmer heading out tomorrow to go back to \nWest Africa via Boston.\nMarch 27, 2015 - Today was a very interesting day. The patient is wide-awake all of his \nchemistry numbers are normal. I spent a full hour in the room with him speaking with \nhim about a variety of subjects. He clearly is in somewhat of a hypomanic state. He \ncontinually speaks and in a pressured manner.  We now know that he has a depressive \ndisorder on meds and this hypomanic state could be a combination of our inadvertently \ntaking him off his psychotropic meds (although his ketamine, etc.) would substitute for \nthat) and his developing a manic phase to his underlying depression as a result of the \namazing stress of his illness.  As far as his organ system function goes he is doing very \nwell except for some residual weakness and conjunctivitis in his right eye. We hope that \nthis is not Ebola uveitis. He will be seen by ophthalmology tomorrow.\nCliff Lane and I had a very disturbing conversation today with Yves Levy (President of \nINSERM) who is in Paris. It is becoming very clear that Marie-Paule Kieny (WHO) for \npolitical reasons in order to show that the World Health Organization was doing \nsomething for Ebola has been pushing a ring vaccination trial in Guinea together with the \nNorwegians. Cliff and I (mostly the hard work of Cliff) are working with the Guineans to \nexpand our Liberian RCT vaccine trial to Guinea where there are still infections going \non.   WHO and the Norwegians do not want us to start the RCT in Guinea and are leaking \nto the press that we are trying to “derail” their trial.   In fact, the Norwegian government \nhas complained to our State department about our trying to start the RCT in Guinea.   The \nFrench (Levy and Delfraissy) agree with Cliff and I that the ring vaccination in Guineas \nwill not be able to determine efficacy.   Of note, both Levy and Delfraissy are on the \nscientific advisory board for that trial even though they do not believe that it is \nscientifically sound.   I gently chastised Yves on the phone telling him that he should \nresign from the board.   Bottom line is that he told Cliff and me that this is politically \nsensitive since Marie-Paule is pushing the ring trial purely for “political reasons” in \ntrying to show that WHO is “doing something and leading something”.   For some \ninexplicable reason, she has gotten the Norwegians (John-Arne…) to buy into this.   Yves \nknows as do Cliff and I that Marie-Paule is close to being incompetent and knows \nnothing about the research method of clinical trials.   First, there should not be a ring \nvaccination since ring approach assumes that the vaccine works.  We are trying to \ndetermine scientifically if it works.   Everyone knows that an RCT is the “gold standard” \nReleased by Chairman Rand Paul\n\n436to determine safety and efficacy.   We are convinced that the Guineans would go along \nwith the best scientific approach.   Yet, WHO is trying to block the initiation of our trial \nuntil they have finished their trial that everyone with any sense knows that the ring trial \nwill be inadequate.   This is “politics” at its worst.   Marie-Paule should really be fired.  If \nwe were the type to leak this to the press such as to Jon Cohen or Kai Kupferschmidt \nfrom Science, this would be a scandal for WHO.\nFinally, in the arena of incompetence and politics, the “Favipiravir study” in Guinea done \nby MSF and the French is claiming to show that it works (see above) even though there is \nno control group except an “historical control”.   Now the French are telling us that the \nGuineas are making Favi part of their standard of care (SOC).   Thus, is we want to \nextend out ZMapp study to Guinea (where there are infections), then we would not be \nable to compare SOV versus SOC + ZMapp as we are doing in the USA and Liberia, and \nnow Sierra Leone.   The FDA and we feel that FAVI should not be SOC and if fact might \nbe harmful.  We will try to work with the health and political types in Guinea to get a \nproper ZMapp study going.   Truly amazing politics, ignorance, and LACK of \nINTEGRITY on the part of people including people in WHO.   MSF just does not know \nmuch about doing clinical research, even though they are “heroes” for their clinical care \nwork.\nMarch 28, 2015 – Unusually cold, clear day for Spring in Bethesda.  Around 28 in the \nAM.  Patient continues to do well.   Still hypomanic and not getting any sleep.   We are \nreluctant to medicate him too much due to concern about prolonged QTC.\nCliff and I continued our conversation by phone with Yves Levy in Paris and us in Cliff’s \nconference Room on the 4th Floor of the ACRF in Building 10.  Yves now agrees with \neverything that I indicated in note from March 27 (above).   He will work to help get the \nRCT done in Guinea and we will work together with the RCT therapy trial in that the \nFrench will try to do the SOC + FAVI Versus SOC+FAVI+ZMAPP and we will do  SOC \nversusSOC + ZMapp.\nMarch 29, 2015 – Sat up about 45 minutes with today (Sunday – sunny but very \ncold for end of March in DC – 23 degrees F).   Continues to improve markedly.  Moving \nall extremities well.   Left arm issue resolving.   Conjunctivitis improving.   Sitting up \nand eating progressive diet.   Speaking every day with his mother and friend who come \nup from Houston where he lives.   We are considering changing status to “Fair”.   Of \nnote, we still get very weak PCR signal from sweat, saliva and urine one or more of \nwhich alternates on different days from weakly positive to negative.   This will have \nimplication for his release and for broad policy given that the Liberian woman got \ninfected (and died) from her sex partner who was an Ebola patient in the 100+ day of \nrecovery.     Interesting to see how this will all play out.\nMarch 30, 2015 –  getting much better with strength and neuro approaching \nnormal.   Still too weak to get out of bed, but can stand for 1 minute.   Eating voraciously; \nmaybe too much since he has been having Gatorade, pizza, ham sandwiches and actually \nvomited.   After this he felt fine.   Have upgraded his condition from “serious” to “fair”.  \nReleased by Chairman Rand Paul\n\n437CT in blood is negative (40 CT)   Also, urine, saliva is negative.   Interesting issue is that \naxillary sweat is persistently positive (~32 CT).\nCliff and I will meet with the US Ambassador to Guinea at the State department \ntomorrow to try and work out the issue with performing an RCT vaccine trial in Guinea.\nMarie-Paule Kieny is truly a fraud and acting purely on political motives.   The WHO \ndoes not want us or anyone to start an RCT in Sierra Leone with ZMapp until they finish \ntheir TKM-EBOV open access trial (treat one ETU) and compare it historically to \nanother ETU.  This stance even though the pre-clinical data on ZMapp are infinitely more \npromising than those from TKM-EBOV.   They would rather finish their study and delay \nthe start of a trial with a promising drug just because they “politically” want to be a \nplayer.\nAlso, in the vein of everybody wants to be somebody, various groups including Welcome \nTrust, and even the BMGF want to start the Global Research Collaboration for Infectious \nDiseases Preparedness (GloPID-R) – a network of funding organizations in the area of \ninfectious Diseases research.   Obviously, we are the major player and these other \norganizations have little to ad, but they want a network that would require us to go to \nendless meetings and give them a say of what the direction of the research would be.   \nUgh!   Been there, done that with the HIV Vaccine Enterprise, etc.\nMarch 31, 2015 –  continues to improve with increased strength.   Need to figure \nout way to get him back to Dallas where his parents live.   He lives in Houston.  \nTechnically, since he is now PCR negative X2, he can fly commercial; however, the \noptics will be bad – people get hysterical if they find out he is an ex-Ebola patient.   And \nso wrote to Paul Farmer to see if PIH will pay for a charter for him to fly from DC to \nDallas.\n Cliff and I went down to State Department to meet with US Ambassador to Guinea – \nAlexander Mark Laskaris to get his help in smoothing the way for us to do the RCT for \nthe Ebola vaccine in Guinea since Guinea is where the infections are and the Norwegians \nand WHO clearly do not want us to do the trial there (see above).   Laskaris totally gets \nthat WHO are the “bad” guys and have lost all credibilityand he will support us.\nChris and I took out Denise and jack to Fiola Mare restaurant in Georgetown for jack’s \n80th birthday.\nBelow is final communication between Harold Varmus in his last official day as NCI \nDirector and me.   He has been a dear friend as NIH Director and over the past 5 years as \nNCI Director:\nFrom:  Varmus, Harold (NIH/NCI) [E] \nSent: Tuesday, March 31, 2015 3:51 PM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Re: Nice article \nReleased by Chairman Rand Paul\n\n438Tony, thanks.   I had hoped to stop  by your office for a farewell in person today, but events overtook \nthat possibility.   (I had meetings all morning and then other distractions up to train time.   Besides, \nyou were probably suited up on the Ebola ward!)\nI expect to see you in NYC very soon; this time I will cook for you (or take you to one of our \nneighborhood hot spots).\nBest to you and Chris.   You got me through some crises of confidence and intention, even without \nrealizing what you had done and I am now eager for my new life.\nHV\nFrom: <Fauci>, Anthony Fauci <AFAUCI@niaid.nih.gov>\nDate: Tuesday, March 31, 2015 at 3:43 PM\nTo: Harold Varmus <harold.varmus@nih.gov>\nSubject: Nice article \nHarold:\n    I cannot let these waning hours of your final day as an official NIH- ER go by without again \nbidding you a fond farewell, a farewell from NIH, but not from our friendship. Hope to see you again \nsoon.\nBest,\nTony\nApril 1, 2015 – continues marked improvement.   Sitting up in cardiac chair; off \nfull PPE and now on contact isolation only.   He walked with help from the hot zone \nroom to the contact isolation room.   even played an April Fool’s joke on Rick \nDavey by feigning severe illness when Rick came in the room.   claimed that he \ndid not know who Rick was or who Nurse Megan was.   Parents delighted.\nTom Burton of Wall Street Journal is digging into the story about the conduct of \nWelcome trust, WHO and Chimerix (brincidofavir).   He is a smart reporter and is \ncatching on to the scandalous conduct of these parties.\nApril 2, 2015 – Gave Q and A-type lecture on 7th floor of Humphrey Building hosted by \nBill Schultz the General Counsel of HHS.   Big crowd of all the OGC people from the \ndepartment.   I told the story (via questions from Bill) about my dealings with multiple \nadministrations.\nAfter the session 12:30 PM to 1:30 PM, Sylvia Burwell had asked to see me in her office.   \nShe had just come back from the White House.   She profusely thanked me and the NIH \nteam for all we are doing with  and with the vaccine trials.   Apparently Tom \nFrieden had told her that he did not want to CDC to “move into Guinea” because of the \ninstability.   A bit puzzling since the CDC is already there.   We still plan to extend the \nRCT vaccine trial to Guinea.\nReleased by Chairman Rand Paul\n\n439 up and walking.   Unfortunately, despite 3 negative CT’s for blood, he reverted \n(after one negative) to positive in his left axilla sweat/skin.\nApril 3, 2015 – doing great.  Dilemma is the persistently weakly + PCR of \naxillary sweat.   Has resting tachycardia that might be subclinical cardiomyopathy.   Has \nbeen seen in other recovered patients in the USA (Emory/Nebraska).\nGregg Gonsalves (old ACT-UP and TAG) who is now a Ph.D. student at Yale has \nbrought to NIH (7A-24) a few (three) Yale students to interview me on a piece that they \nare writing on the issues with unnecessary quarantine of people working with Ebola.   \nThey are interviewing me because of the stand that I took in opposition of Gov. Cuomo \nand Christie a few months ago.\nApril 5, 2015 (Easter Sunday) – CBS ran their Sunday AM special profile of me in a Q \nand A with Scott Simon (NPR).   It turned out magnificently.   I received scores and \nscores of e-mails of congratulations, many-fold more than even when I did 2 “Full \nGinsberg’s” a few months ago.   E-mails from as diverse people as Gary Edson, Josh \nBolton, Lisa Monaco (NSC), Catherine and Wayne Reynolds, old friends from NY \nHospital, etc., etc.\nWill have to make decision about doing a single PCR on  axilla and if negative, \nthen stop testing rather than looking for 2 consecutive negatives.   This is unchartered \nwaters, since he has already had multiple negative blood PCRs.\nApril 6, 2015 – Axillary sweat PCR now negative.   We will take him out of isolation \ntomorrow and have upgraded his condition from “fair” to “good”.   Plan to do MRI of \nheart (still has sinus tachycardia at rest) and brain and then discharge him sometime this \nweek.\nApril 7, 2015 –  now out of isolation due to negative blood and axillary sweat.  \n semen specimen shows high level of PCR signal – 18 CT!   Clearly the semen \nis a privileged site for the virus since his blood has been consistently negative.\nPreparations for extending the RCT vaccine trial to Guinea coming along.   Cliff doing \nyeoman’s work with the French (Yves Levy – INSERM and Jean Francois Delfraissy).   \nFrench are intent on showing that they are taking the lead in this.  This relates to their \ntraditional relationship with Guinea.\nWill go to White House tomorrow to discuss with the POTUS and NSC  “getting to zero \nin Guinea”.\nApril 8, 2015 – Larry Kramer’s new book is out.  See review from the NY Times  below \nand see yellow highlight:\nReleased by Chairman Rand Paul\n\n440Larry Kramer’s Novel ‘The American \nPeople’ Adds a Gay Dimension to History\nBy ALEXANDRA ALTER APRIL 7, 2015 \nPhoto \nLarry Kramer, the author of a hefty new novel (or, as he would have it, history) of the \nUnited States. He is working on a second volume. Credit Todd Heisler/The New York \nTimes \nFourteen years ago, the playwright and activist Larry Kramer was preparing to die. His \nliver was failing, and the prognosis was grave.\nReleased by Chairman Rand Paul\n441He summoned an old friend, Will Schwalbe, editor in chief of Hyperion Books, and made \nhim the steward of his novel in progress, a rambling history of homosexuality and AIDS \nin the United States. He told Mr. Schwalbe to self-publish it if necessary, using money \nfrom Mr. Kramer’s estate.\nIt didn’t come to that. Mr. Kramer survived a liver transplant and finished the book, a \nproject he had begun more than 30 years ago. Now, at 79 and against all odds and \nexpectations, he has lived to see it published. The first volume, “The American People, \nVolume 1: Search for My Heart,” weighing in at 775 pages, comes out Tuesday from \nFarrar, Straus and Giroux. Mr. Kramer has already thrown himself into finishing the \nsecond volume, which is to come out in 2017.\n“Larry lives to write,” said Mr. Schwalbe, who is now an executive vice president at \nMacmillan. “There’s no doubt in my mind that Larry’s writing is what keeps him alive.”\nPhoto \nMr. Kramer, 79, defied the odds and lived to see the publication of “The American \nPeople.” Credit Todd Heisler/The New York Times \n“Magnum opus” doesn’t seem like a robust enough phrase to describe the scope of “The \nAmerican People,” which stretches back to the prehistoric swamps of the Everglades and \nconcludes, in the second volume, in contemporary New York City. When Farrar acquired \nthe two volumes in 2010, the narrative had swelled to around 4,000 pages.\nBlending farce and tragedy, autobiography and fiction, it opens as Fred Lemish, a stand-\nin for Mr. Kramer, is struggling to finish writing a book titled “The American People,” a \nfar-reaching historical exposé that describes Alexander Hamilton, George Washington, \nAbraham Lincoln, Mark Twain and other major historical figures as gay. “He’s been \nstruggling with this history for many years,” Mr. Kramer writes of his fictional \ncounterpart.\nReleased by Chairman Rand Paul\n442Mr. Kramer said he was driven to write the book because he had long felt that gays had \nbeen excluded from history books, written out or ignored. “Most history is written by \nstraight people, and they don’t have gaydar,” Mr. Kramer said during an interview at his \napartment in Greenwich Village. “People say, ‘Can you prove to me that George \nWashington was gay?’ and I say, ‘Can you prove to me that he wasn’t?’ ” (As evidence, \nMr. Kramer notes that Washington “was surrounded by men, and he designed all their \nuniforms himself.”)\nIn the novel, and in conversation, Mr. Kramer criticizes historians and scholars like Stacy \nSchiff, Ron Chernow and Doris Kearns Goodwin for glossing over homosexuality in \nAmerican history. If he had had his way, he would simply have called the book a work of \nhistory rather than fiction, he said.\n“Farrar Straus said call it a novel, that way the lawyers will leave you alone,” he said. \n“But I believe everything in the book is true. It may look like fiction, but to me, it’s not.”\nMr. Chernow, the author of a well-regarded 2004 biography of Alexander Hamilton, said \nhe was surprised to be called out in Mr. Kramer’s novel, particularly as he brings up in \nhis book the possibility that Hamilton might have been bisexual. “I’m glad that Larry \nKramer is raising the issue, I’m just mystified at why he’s attacking me, when I thought \nhe would have applauded the fact that I take this seriously,” Mr. Chernow said. “It’s a \nlegitimate issue for historians or novelists, but we also have to be careful not to ransack \nhistory in service of a political agenda.”\nAs for Mr. Kramer’s theory about Washington, Mr. Chernow countered that it was \ncommon in that era for generals to design soldiers’ uniforms. If conflicting early reviews \nare any indication, “The American People” is likely to be as polarizing and controversial \nas Mr. Kramer’s other works. While Kirkus Reviews praised the novel as “breathtakingly \nwell-written,” others have taken a dimmer view. “To call it a rough read at times would \nbe an understatement,” a reviewer wrote in Publishers Weekly.\n“It’s like being hit by a truck, the book is so all over the place,” the novelist Andrew \nHolleran, who has known Mr. Kramer since the 1970s, said of the book. “What I admired \nas a writer was the imaginative energy and the amount he takes on.”\nJonathan Galassi, the president and publisher of Farrar, Straus and Giroux, said the book \nstruck him as ambitious and provocative, both as a work of literature and as an act of \nprotest.\n“This book is, in a way, a culmination of all his artistic activity,” he said. “Larry is a great \npolemicist and a fighter, and this book is part of his polemic about gay history and the \nroles of gays in our society. He’s still fighting and he’s using art to do it.”\nMr. Kramer never set out to be a political activist and said that in some ways he was ill-\nsuited to the role. “They say I’m obnoxiously noisy and angry, but I’m actually a bit of a \nshy person,” he said.\nReleased by Chairman Rand Paul\n443Early in his career, Mr. Kramer wanted to write comedy. After graduating from Yale, he \nworked in the film industry, and was nominated for an Oscar for his screenplay \nadaptation of the D. H. Lawrence novel “Women in Love” (1969). In 1978 he published a \ncontroversial novel, “Faggots,” a satire of rampant drug use and promiscuity among gays \nin New York. “It’s meant to be a comic novel — it made me laugh,” he said.\nHis mission changed in the early 1980s, when H.I.V. and AIDS began spreading rapidly \namong gays and claimed the lives of two friends. He was a founder of the Gay Men’s \nHealth Crisis, a nonprofit support organization for those affected by the disease, and later \nstarted Act Up, a protest group that brought attention to the AIDS crisis. His activism \nspilled into his writing, with plays like “The Normal Heart” and “The Destiny of Me,” \nwhich center on gay characters confronting the AIDS epidemic and take aim at \nindifferent politicians and institutions.\nMr. Kramer’s activism was closely and messily intertwined with his personal life. In \n1989, he learned he was H.I.V. positive and suffering from liver damage, the result of \nhepatitis B. He credits Dr. Anthony Fauci, director of the National Institute of Allergy \nand Infectious Diseases, for being among a handful of doctors who saved him by giving \nhim experimental drugs. Mr. Kramer once vilified Dr. Fauci in print, calling him “an \nincompetent idiot” and a murderer, for his early approach to fighting the spread of AIDS. \n“The man who I criticize for allowing the virus to spread is the man who saved my life,” \nMr. Kramer said.\nMr. Kramer’s acerbic and belligerent style has often alienated friends and supporters. He \nand the playwright Tony Kushner had a blowout over Mr. Kushner’s screenplay for the \nSteven Spielberg movie “Lincoln” (2012), because Mr. Kramer felt that Mr. Kushner \nshould have depicted Lincoln as a gay man. “He and I had a major falling out over this,” \nMr. Kramer said. “I so wanted him to put that in the movie.” (In “The American People,” \nMr. Kramer strikes back with his own fictional Lincoln, who has a male lover and often \nlustily utters “mighty fine” after their encounters.)\nThese days, Mr. Kramer seems much less bellicose, though no less passionate. He speaks \nin a tremulous near-whisper and relies on a hearing aid and a cane. He spent much of last \nyear in hospitals being treated for abdominal infections and almost died twice, he said. \nHe was bedridden in 2013 when he and his longtime partner, the architect David \nWebster, were finally married in the intensive care unit of NYU Langone Medical \nCenter.\nMr. Kramer’s writing has taken on a greater urgency lately. He has been writing for five \nor six hours every day, seven days a week. His progress is visible in the towering stacks \nof manuscript pages that cover a large table in his living room, which doubles as a work \nspace. He is also working on a screenplay for a sequel to “The Normal Heart” and is the \nsubject of an HBO documentary, “Larry Kramer: In Love and Anger,” which will be \nshown in June, just after his 80th birthday.\nReleased by Chairman Rand Paul\n445take them back to Dallas, TX.   He could have flown commercial; however, we wanted to \navoid the ignorant panic if anyone found out that he did so.\nVery cold day here in Bethesda/DC.   Went doe to HHS to reception honoring retiring \nDeputy Secretary Bill Corr.   He was very pleased that I came down there.   Bill was \nChief-of-Staff to Donna Shalala for 8 years and then 6 years with this administration as \nDeputy Secretary.   A fine man and excellent Public Servant.\nAmazing thing happened to Dan Chertoff who has been a leading player in the care of \n   Dan wore himself out taking day call every day in the SCSU (as well as coming \nin at night during the crisis periods).   To make matters worse, his father passed away \nduring all of this.   And so now that it is over, he took his wife Jessica and his child for a \nvacation in the Dominican Republic.   His went through all of the appropriate \nnotifications of travel via our OMS, the State of Maryland, the CDC, and the embassy of \nDominican Republic.   Somewhere along the way, someone, including the CDC, dropped \nthe ball and did not inform him that the DR has a policy of not accepting people who \nhave taken care of Ebola patients even though by our criteria, he is “low, but not zero \nrisk” and so should have no travel restrictions.   Bottom line is that the DR kicked him \nout of DR soon after he landed.   They were waiting for his at his hotel and with \napologies, put him and his family on a plane at their expense and sent him back to the \nUSA.   Amazing bullshit!   Truly unbelievable how stupid they are and how incompetent \nwere the people that should have warned Dan.\nApril 10, 2015 – Jack Whitescarver and Wendy Wertheimer sent in to Francis Collins \ntheir letter of resignation from the OAR.   Jack is 78 and wanted to stay until he reached \n80.   However, he and Francis have not been getting along since Francis feels that Jack \nhas been too slow and non-specific in shifting the AIDS money to focus on the high \npriority areas such as vaccine, prevention, cure and co-morbidities.  The relationship has \nsoured and so Jack feels that it is time to go.  I, myself, love Jack, but am not satisfied \nwith how they are handling the re-distribution of the AIDS money.   Clearly there is too \nmuch AIDS money in NIDA and in NCI that is not being used for AIDS projects and to \ncall it AIDS-related is a stretch.   We had a meeting in my library today with Larry \nTabak, Wendy W. and Jack to discuss this issue.   I got pissed off at Wendy since she \nessentially accused me of saying (which I did not) that behavioral research grants were \nnot good science.   That is not what I said.   I said that we were doing proportionately too \nmuch behavioral research out of NIDA and that the Congress (Rep Andy Harris R-MD et \nal) are trying to decrease the AIDS budget (see above) and we had better be spending it \nall on research that is high priority such as vaccine and cure; otherwise, they will have an \nexcuse to cut the budget.   Larry Tabak is totally in my corner and even Jack admitted \nthat he agreed.   However, the behavioralist community keeps pushing to do a lot of \nbehavioral research.   Clearly, the studies might be sound, but they do not contribute to \nthe end of the pandemic.   You can study behavior when it comes to AIDS; however, it \nhas been very difficult to “change” behavior.\nApril 11, 2015 – Went to Reception/dinner at Jamie Gorelick (former assistant attorney \ngeneral in Clinton Adm) and Rich Waldron’s home in Chevy Chase in honor of Roger \nReleased by Chairman Rand Paul\n\n446Glass winning the Sabin Medal for developing a rotavirus vaccine.  Mostly NIH people \nand some of Roger’s old friends.\nApril 13, 2015 – Washington Nationals getting off to a very bad start.   Many errors and \nno hitting.   Also, their excellent pitching staff is getting blasted.\nWent to Tyson’s Corner Ritz-Carlton at invitation of David Rubenstein (CEO of Carlyle \nGroup) to talk to their annual meeting (~600 top CEO managers of Carlyle activities).   \nFormat was David interviewing me on Stage 1-on-1 right after lunch.   David obviously \nis very taken up by me and really likes me (likewise).   Remember, he tried to recruit me \nto Carlyle several years ago for $1 million flat salary plus commissions.   Many in the \ngroup said to me that I was the best invited speaker at any of the former annual meetings.   \nBesides, they pay the others a handsome honorarium.\nAAAS (new CEO Rush Holt) chose me to be one of a couple of people to give the \nlaudation for Alan Leshner who is retiring as CEO of AAAS.   Very elegant function at \nthe Women’s Museum of the Arts on New York Avenue and 12th Street, N.W.   Alan was \nvery moved by my remarks.\nApril 15, 2014 – Testified at a House Appropriations Subcommittee Hearing at 10:00 \nAM in Room 2358B of the Rayburn Building.   Topic was Ebola response.   I represented \nNIH.  Also testifying was Nicki Lurie (ASPR), Tom Frieden and Robin Robinson \n(BARDA).   I did well, but Nicki and Tom caught some criticism for the fact that the \nETUs that they recommended got built and only 2 of 11 actually admitted a patient and of \nthe 2 that admitted patients, only 25 patients were seen.   Criticism was the lack of \nflexibility to stop the building when it became clear that the epidemic was decreasing \nrapidly as they were building the ETUs.   Committee nevertheless complimented us on \nthe Ebola response.   Rep. Harris (R-MD) was a bit snarky with Tom Frieden saying that \nhis daughter is an ICU nurse at Hopkins and she does not know how to don PPE and that \nreflects a lack of planning on the part of the USG.   He is misguided.\nHad disturbing meeting with Francis Collins, Larry Tabak, Jim Anderson, and Kathy \nHudson in Building 1, Room 116 concerning the re-prioritization of the AIDS budget \nthrough OAR.   It is now clear that Francis not only wants to assure that the highest \npriority AID research is done with AIDS dollars, he actually wants to decrease the \namount of money going for AIDS research and redirect it to non-AIDS, i.e. decrease the \nAIDS allocation.   He is using the review of the AIDS portfolio as an excuse for this.   I \nwarned him that this is not a good idea and will be met with pushback from the \ncommunity.   I also believe that Francis might be trying to ingratiate himself with the \nGOP since he may be covering his bets in case a Republican becomes POTUS and he \nwants to keep his job as NIH Director.   Just a thought.\nApril 17, 2015 – Had meeting at HHS in Room 305A in Humphrey Building with the \nPresidents of Liberia (Ellen Johnson Sirleaf), Sierra Leone (Ernest Koroma) and Guinea \n(Alpha Conde) to discuss the status of the Ebola outbreak.   Much good will with \nexpressions of cooperation and collaboration.   The Presidents insisted (appropriately) \nReleased by Chairman Rand Paul\n447that we cannot rest until the cases go to zero.   Also, they spoke of developing sustainable \ninfrastructure that will be available for the next outbreak of Ebola or any other disease.   \nPresident Koroma spoke of his desire to establish an African CDC.   I described for \nPresident Sirleaf the successful implementation of the RCT for vaccine (in Liberia) and \nthe RCT for ZMapp (in Liberia and Sierra Leone).   She obviously already knew about \nthis since we had briefed her previously and she knew that we were also helping to \nrenovate clinics in Redemption Hospital and JFK Hospital in Monrovia.   Of note, when \nPresident Conde heard that we were doing these trials in Liberia he expressed (through a \nFrench translator) his strong desire for us to do such trials in Guinea.   Obviously, this is \ngood news for Cliff who is trying to get around the nonsense of the Norwegians and \nWHO regarding their trying to stop us from doing the trial (see above).   Meeting ended \nvery well.\nApril 19, 2015 (Sunday) – Was inducted in the Washington, D.C. Hall of Fame \n(Historical Society of the District of Columbia).   Category of Science and technology.   \nBlack tie affair at the Liason Hotel on New Jersey Avenue, N.W.   DC Mayor Muriel \nBowser was present and ceremony MC’d by Former DC mayor Sharon Pratt.   Of note is \nfact that I was the only white person to be inducted (total of 12 inductees for various \ncategories (arts, literature, law, business, etc.).   Also, of the approximately 300 people in \nthe ballroom, except for one other person, Chris and I were the only white people – all \nwere African-American.\nApril 21, 2015 – Pat White who now works for “ACT for NIH” got Chris and I invited to \nan affair at the Eisenhower Theater at the Kennedy Center.   It was an interview \nconducted on stage by Bob Shieffer (CBS Face the Nation) with Bill Clinton and Colin \nPowell.   The evening was MC’d by Norah O’Donnell (NBC).   Great interview.   Elegant \ndinner followed upstairs in the Atrium.   Had opportunity of nice conversations with \nPresident Clinton and especially Colin Powell who is always extremely friendly with me.   \nAlso chatted with Nancy Pelosi, Majority Whip Kevin McCarthy, Mack McCarty, Sen. \nRichard Durbin among others.   Really a fun evening.\nDuring the day, met with Mike Gerson who is interested in partnering with a producer to \nmake a documentary of the global response to HIV, concentrating on the PEPFAR story.   \nAnd so he met with me in my office for 1 hour to discuss various aspects of the historical \nevolution of PEPFAR.\nApril 23, 2015 – Conference call with MSF (Joanne Liu and Sophie Delaunay), Tom \nFrieden and Cliff Lane about”BioBank” and study of specimens that had been stored \nfrom Ebola patients.   Interesting that MSF, who has never been interested in research \nand who often put down research since that focused on care now want to lead the effort.   \nJoanne and Sophie are good people and this manifests the dichotomy and heterogeneity \nof MSF.   Many conflicts within their ranks.   Bottom line is that we agreed since we all \nare interested in this that we do the best possible science with true transparency and that \nabove all, the data belong to the West Africans.\nReleased by Chairman Rand Paul\n448April 25, 2015 – Went with Chris to the Annual Garden Party at the Beall-Washington \nHouse at 2920 – R Street, N.W. that precedes the White House Correspondents’ Dinner \ntonight.   Usual DC scene of TV stars and Hollywood stars such as Michael Kelly from \n“House of Cards” among others.   Many people commented about my performance on \nTV during the Ebola crisis this past Fall.  The Brunch was sponsored by Steve and Jean \nCase, Tammy Haddad, Mark Ein, etc..\nThat evening went to WH Correspondents’s Dinner at the Washington Hilton on \nConnecticut Avenue and Florida Avenue.   Was guest of Tom Burton and the Wll Street \nJournal.   President Obama gave good comedy show followed by Saturday Night Live’s \nCecily Johnson.  She was not particularly funny, but OK.\nApril 26, 2015 – Went to the Annual NAS Garden Party at NAS Headquarters on C \nStreet and 22-23rd Street, N.W.   Usual scene of seeing old friends.  As always, great to \nsee Max and Rosalie Cooper.\nApril 28, 2015 – Wonderful evening at the home of Ambassador Esther Coopersmith \n(2230 S Street, N.W.) who gave “A List” party in honor of Barbra Streisand who is a \nstrong advocate of the Women’s Heart Alliance, an organization calling attention to the \nunrecognized burden of heart disease among women.   Beautiful DC Spring evening \n(magical) – perfect temperature, crystal clear sky.   I had the pleasure of spending much \nface-to-face time with Barbra.   She clearly knew who I was when introduced.  She knew \nthe connection to Larry Kramer as she was supposed to produce “The Normal Heart” for \nHollywood, but did not as it went to HBO.   I was seated directly across from her at a \nnarrow table and right next to Esther Coopersmith, the hostess.   Amazing crowd with \nmany politicians – Nita Lowy and Rosa DeLauro (who kept shouting me out in their \nremarks); Ed Markey who gave a short speech and said “Wow, what a party – I am sitting \nhere with Tony Fauci!”; Sen John McCain, Chris Dodd, Lloyd Hand, James Brolin \n(Barbra’s husband and father of Josh Brolin), Kathleen Kennedy Townsend, Gary \nGibbons (the only other NIH person), Catherine and Wayne Reynolds, Diane Rehm, \nhenry Waxman, Irene Pollin, Anita Mcbride, Rima Al-Sabah, Sen. Franken, Debbie \nDingel, and many other notables.   Barbra was amazingly nice – warm, sincere, funny, \nfriendly.   I was surprised since Harold Varmus had told me that on a prior visit by \nBarbra to NIH when he was Director and I was not present, Harold said that Barbra was \naloof and not friendly.   Totally opposite tonight.   You get the feeling you could really be \nher friend.\nApril 30, 2015 – testified before the Senate Appropriations Subcommittee with Francis \nCollins, Gary Gibbons, Tom Insel, Jon Lorsch, and Doug Lowy.   Committee now \nchaired by Roy Blount (R-MO).   Hearing went well.   Concomitantly with Hearing has \nbeen the drafting and revising of the 21 Century Cures Act developed by Fred Upton (R-\nMN) and Diane DeGette (D-CO).   Clearly, Francis Collins (who denies it) had a lot to do \nwith this since it authorizes (and appropriates – weird for an authorization committee) $2 \nbillion per year for 5 years to NIH Director to ONLY be spent on Precision Medicine, \nyoung investigators, and “other research” TBD.   This is a bad idea to earmark that much \nmoney in the NIH budget.\nReleased by Chairman Rand Paul\n449May 2, 2015 – Went to Children’s Inn Gala at the Ritz-Carlton at Tyson’s Corner.   Big \nshout out for me by the MC for my Ebola and other work.  \nMay 5, 2015 – Dedicated Building 4 today as the Lowell Weicker Building.   I gave the \nmain laudatio and Lowell loved it as did his wife Claudia, who I knew from the old days \nwhen she was his staffer.   He divorced his wife to marry Claudia.   Nice ceremony \nattended by Sen. Tom Harkin, Rep. Dave Obey, Tim Schriver. \nWas visited today by Harry Jaffe the National Editor at The Washingtonian.   Harry \nwants very much for me to write a book.   Says he has been following my career and that \nI have a “couple of books in me”.   He wants to help as an editor, co-writer and/or agent.   \nHe has written several books himself, including the best seller “Dream City” about \nMarion Barry.\nMay 6, 2015 – Went to Detroit to receive honorary doctorate of LAWS from Wayne \nState Univerity.  President Roy Wilson whom I know from his years ta NIH and he was \non the Search Committee that I co-chaired with Gary Gibbons for the Director of \nNIMHD.  Very nice trip.   Absolutely beautiful weather – 50-60 and bright sun.  Had \nvery pleasant dinner in Roy spectacular apartment near Wayne State Univ.   Roy was \nborn in Japan of African-American father (officer in Air Force) and Japanese mother.   \nHe is fit and handsome guy.   His apartment was a combination of modern American and \nKyoto-like Japanese décor.   Really nice.\nMay 7, 2015 -  Received degree today from WSU.   On plane back, zsat behind an \nAfrican American man and his wife/girlfriend.   He looked around 60 years old and in \ngreat shape.   I helped him open the upper luggage bin and our eyes met.   He looked \nstraight at me and said with a big smile: “Did you dye your hair gray so that a young man \nlike you would look more distinguished?”.   I told him that unfortunately it was age.   He \nasked me how old I was and I told him 74.   He smiled and said he was 69 and gave me a \nfist pump.   I noticed a massive diamond-studded ring on his finger.   He pointed to it and \nsaid: “Do you know what this is?”   I said no and he said it was a Hall of Fame Ring.   I \nlooked at him and apologized and said I am very sorry, but I do not recognize you.   He \nsaid:   I am Lem Barney, Hall of Fame cornerback for the Detroit Lions from 1967 \nthrough 1977, and you are that wonderful doctor who does so much for the world.   I told \nhim how much I admired his play over so many years with the Lions.   We hugged and \nshook hands for a long time.   Wonderful encounter!\nMay 9, 2015 – Chris has been in Zimbabwe and South Africa for the past 2 weeks giving \nlectures on Ethics.   She wrote me a wonderful 30th Anniversary letter:\nDear Tony.docx\nMay 2015\nReleased by Chairman Rand Paul\n450Dear Tony:\nHappy 30th Anniversary!  Thank you for a wonderful 30 years. I have had a little time to reflect \nand so wanted to share some thoughts with you.\nIn my view, these have been 30 great years.  Thirty years seems like a long time, and yet I cannot \nimagine life without you. It has actually gone by pretty quickly.  We love each other and work \nand play together- all of which I hope will continue for many years to come.  We have three \nincredible kids, a comfortable and enjoyable life, and good health.  We can talk to each other \nabout the mundane, the philosophical, the political, and the speculative.  We laugh and cry \ntogether.  We run and cook and even (lately) play tennis together. \nI am only one of many many who have great admiration and respect for all that you have done \nand continue to do. You have done remarkable things at work and made amazing contributions \nto science and to your country.  I hope that my support and encouragement have been helpful \nto you and that I have not interfered with your many successes.   \nMy hope is that over these following years we will find time to enjoy life as much as possible.  \nThere is so much to learn and do and see.  It would be fun to do it together. \nThank you for being my lover, my friend, my advisor, my companion, my critic.  Thank you for \nputting up with the bags under my eyes and the weight of the world on my shoulders.  Thank \nyou for being a great father and husband. \nI look forward to celebrating our anniversary together.\nI love you.\nChristine  \nMay 11, 2015 – Liberia now declared Ebola free (no cases in 42 days – double the \nmaximum incubation period of 21 days.\nMay 12, 2015 –  is back today and yesterday for his follow-up visit.   I \nflew back from DDCF meeting early to catch him before he left hospital.   He came to \nmy office with Rick Davey to say hello.   He looks great.   Feels good except for some \neasy fatiguing.   His brain MRI shows some improvement.   The CT on semen is now up \nto 27-29 from 18 previously.   Hence, virus clearing from semen.   Still on eye drops for \nEbola uveitis.   Tears negative.\nWhen he visited in my office in Building 31, we hugged and had a great conversation.   \nHe gave me a letter that was very moving.  Letter below:\nReleased by Chairman Rand Paul\n\n451\nThis is what makes it worthwhile!!\nReleased by Chairman Rand Paul\n452May 14, 2015 - I am very disturbed by the situation regarding the conflict of principles \nbetween scientists (ourselves) and certain health officials in Europe concerning the \nconduct of randomized controlled clinical trials in the Ebola outbreak in West Africa. I \nam absolutely astounded by the lack of scientific rigor demonstrated by people like \nJeremy Farrar the head of the Wellcome Trust and certain scientists at Oxford University \nincluding Peter Horby and Adrian Hill. I am also surprised that Peter Piot is also sharply \ncriticizing any placebo-controlled trials particularly of drugs. We have considerable \nexperience with HIV and in other arenas where the artificial show of compassion in a \nserious disease that results in wide distribution of unproven drugs leads to a double \njeopardy of never proving that an intervention works or not, and more importantly misses \nthe possibility that they are actually harming people. The British and as well as people at \nWHO and Doctors without Borders by taking somewhat of a self-righteous approach that \nany research done in the setting of an Ebola outbreak is unethical are actually hurting \npeople.   The Oxford group actually covered up that several patients given open access to \nBrincidofavir died and they never reported it.   They said that the study was stopped \nbecause there were no more infections, when this was a blatant misrepresentation. There \nhave been dueling criticisms in the press between our approach and theirs about this. A \nrecent Wall Street Journal article by reporter Tom Burton analyzed this carefully and \nblasted the Europeans for giving out medicines in an open access manner while likely \nhurting people with drugs that have clear toxicity that have really no pre-clinical \nindication that they would work. In my mind Cliff Lane is a true hero in this as he is \ndesigned and implemented randomized controlled trials for vaccines in Liberia as well as \ncontrolled randomized trials without a placebo for certain drugs like ZMapp.\nI am terribly disappointed with Tom Frieden who continues to insist that you cannot do a \nrandomized controlled trial of the vaccine in countries like Guinea because this would \ninterfere with the public health effort of getting the epidemic down to zero. Clearly, as \nwell-meaning as he may be, he does not have a clue about how to design or implement a \nclinical trial. Again I am really very disappointed with him, with the WHO, with the \nWellcome Trust, and with individual characters such as Jeremy Farrar and Marie-Paule \nKieny at WHO. They really should be ashamed of themselves.\nMay 17, 2015 – Received honorary doctorate of Public Service from George Washington \nUniversity in a beautiful ceremony on the National Mall right in front of the Washington \nMonument.   Commencement Speaker was Tim Cook, CEO of Apple.   At the ceremonial \ndinner the night before at the Corcoran Gallery of Art on 17th Street, N.W., a student \nmember of the Board of Trustees got a piece of meat stuck in his throat and was choking.   \nI did a Heimlich maneuver and dislodged the piece of steak.   Obviously, the crowd was \ndelighted and gave me a big round of applause.  The next day (today) at the graduation \nceremony, President Knapp mentioned this in his citation for my honorary doctorate.   It \nalso got tweeted around.\nMay 19-21, 2015 -   Honorary doctorates at Columbia University in NYC (Doctor of \nScience) on May 20 and The Johns Hopkins University in Baltimore (Doctor of Humane \nLetters) on May 21.\nReleased by Chairman Rand Paul\n454Elijah Cummings – Congressman from Baltimore gave very moving comments (in his \nwonderful preacher fashion) about the recent riots in Baltimore related to the police \nkilling of Freddie Gray.  He spoke of his own growing up and still living in the \nneighborhood where the riots took place.  \nLeon Fleisher – world renowned concert pianist.   He was wonderful and they showed a \nclip of his playing the piano.   He gave words of wisdom.   “Listen and do not be afraid of \nsilence.”   Also, “Procrastination saves time”\nEdwin Catmull, the CEO of Pixar Animation Studio.   Produced the first computer \nanimated film “Toy Story” and also “Frozen”.   Has won 5 Academy Awards.\nMay 21, 2015 – Received the Special Recognition Award for Science and Medicine at \nthe Sons of Italy Foundation Gala at the National Building Museum.   Phil Piccigallo \ngave a very nice and warm laudation of me with many old photos of me in different \n“historic” situations.   Also, met at the dinner;  Anita McBride (former chief-of-Staff to \nLaura Bush), General Ray Odierno and his wounded warrior son Anthony (arm blown off \nby an IED in IraQ).\nMay 26, 2015 – Gave an “Interview” talk with Joe Palca (NPR) at the Ripley Center of \nthe Smithsonian.  Good crowd, good questions.\nMay 27, 2015 – Hosted 30 Staff members from the Senate Appropriations and Oversight \ncommittees at the Special Clinical Studies Unit (SCSU) at the Clinical Center where we \ntook care of  and    I did for them the complete donning and \ndoffing procedure, which they absolutely loved.   Many questions.\nDid a telebriefing for the release of the START study data (DSMB recommended \nstopping the study due to highly positive results).   Clearly starting ARVs at greater than \n500 CD4+ T cell count was much more beneficial (p <0.001) than waiting until counts \ndrop to 350.   Got much attention.   Front page of NY Times with my picture in ONLINE \nversion of Times.   Also the next night (May 28), I appeared with Judy Woodruff on the \nNewsHour.\nMay 28, 2015 – Went to UN to participate in Panel at ECOSOC Council (Economic and \nSocial Council), chaired by Paul Farmer to discuss sustainable health systems in light of \nthe Ebola outbreak.   Bill Clinton gave the Keynote and we shook hands and exchanged \npleasantries.   On the panel with me was the actor Jeffrey Wright (“Angels in America”   \n“Boardwalk Empire”.   He has won an Emmy, a Golden Globe and a Tony.   Very nice \nman.   Says that he has been a fan of mine for years.   He is working to improve the \nconditions of miners in Sierra Leone.\nJune 1, 2015 – Gave lecture at the Sulgrave Club on Dupont Circle.   Upper Crust old \nwomen’s club.   Quite charming and elegant Building between P and Massachusetts Ave, \nright on DuPont Circle.   Spoke on Ebola.   Adoring crowd.   Met John Quinnan with \nReleased by Chairman Rand Paul\n\n455whom I did my first research project in the summer between my 1st and 2nd year at \nCornell – the summer that I met Lynne Williams.\nJune 2, 2015 – Spoke with Doug brooks (ONAP) about setting up a meeting with him, \nme, Valeria Jarrett and Denis McDonough to discuss possibility of starting a PEPFAER \nfor the USA to end the AIDS pandemic here.\nJune 3, 2015 – Chris and I went to function in the Mansfield Room of the US capitol as \ngusts of Wayne and Catherine Reynolds in one of their usual wonderful social events.   \nThey were honoring Congresswoman Debbie Dingel, Sens. Roy Blount, Thad Cochrane \nand Diane Feinstein for their contribution to the Arts.  I introduced Debbie Dingel.   \nGreat crowd.   I chatted with old friends Fred Hiatt of Washington Post, Rick Atkinson, \nChris Matthews, Bob Barnett, etc.   Great evening.\nJune 5, 2015 – Things heating up with MERS in South Korea.   Now at 40 cases and 4 \ndeaths – largest outbreak outside of the Arabian Penisula.   Index case is a 68 year \nKorean man who travelled in the Arabian Penisula (KSA, Qatar, UAE, etc) came back to \nKorea was hospitalized and set off a chain of infections among people in same room and \neven on same ward as well as family members and HCWs.\nI appeared on Wolf Blitzer (CNN) to discuss the situation.\nJune 6, 2015 – Steve Holland admitted a patient (25 year old woman from India) with \nXDR TB today.   NSC heard about it and as usual pushed the panic button and wanted us \nto provide a press statement and Qs and As.   We did and this triggered much press \ninterest.\nJune 8, 2015 – Did my BSC presentations or LIR Overview and Immunopathogenesis \nSection accomplishments.   My primary reviewers were Arturo Casadevall and Larry \nCorey.   Review went extremely well.\nPress interest now heating up for both MERS and the XDR patient here at NIH.\nDid interview with Katty Kay for BBC on MERS.\nJune 9, 2015 = Did WTOP interview on MERS and XDR TB.   Also, for XDR TB did \nMSNBC with Andrea Mitchell, NBC Nightly News, CBS Nightly News and Telemundo \nTV, Channel 8 News, ABC Nightly News\nHarold Varmus came back to Bethesda and visited with me.   He is doing fine at Weill-\nCornell.   Came down for a dinner with Francis Collins, Shirley Tilghman, Marc \nKirschner, and Ron Daniels to discuss the systemic problems with the biomedical \nresearch enterprise related to the paper that Harold, bruce Alberts, Kirschner and \nTilghman wrote in PNAS.\nReleased by Chairman Rand Paul\n456June 10, 2015 -   Long interview with me on XDR TB patient by Denise Grady appeared \ntoday in the NY Times.   Also, did FOX Channel 25 Local News this AM.\nGot report from BSC and was told that “Outstanding” was not a sufficient adjective to \ndescribe how good my laboratory and my section was.   Praised my leadership and it was \nthe first time that every single person in a given laboratory got “outstanding”.  Called the \nlab a “National Treasure”.\nJune 12, 2015 – Did Bloomberg TV on MERS, which is still going on in South Korea.   \nNow up to 133 cases and 14 deaths.   We here at level of HHS are already having the \nusual conference calls of preparedness regarding development of therapeutics and \nvaccines.\nJune 15, 2015 – had dinner over my house with Eric Goosby and Chris – the now \ntraditional sausage and rigatoni dinners that I have had with Eric, Harold Varmus, and \nGary Nabel over the years.   Eric is in town for and IOM workshop.   He also is seeking \nmy assistance in obtaining a grant from the DDCF and also NIH now that he is out of \ngovernment and pursuing global health issues.  Of note, he has recently been appointed as \nthe UN Secretary General’s Special Envoy for TB.\nTom Frieden is balking at supporting the proposal for the IOM Study on lessons learned \nin the Ebola response.   I will be supporting the study with NIAID funds.  Tom still is not \nreally on the same page with me about what went on during the response.   He is still \nfixating on have the IOM study focus on “alternative clinical trial designs” instead of the \nRCT.  Also, he is still against Cliff trying to extend the RCT to Guinea.   Tom feels that \nthe Guineans will react badly to a trial and be paranoid that we are trying to kill them.   \nThis conflicts with the fact that the WHO is already doing a ring vaccination (poor \ndesign) study in Guinea.   Anyway, conversation with Tom are still very cordial and I like \nhim – just disagree with him sometimes.\nJune 16, 2015 - I am in the midst of preparing my talk for the International AIDS Society \nto take place in Vancouver. As usual I am taking this very seriously and doing multiple \ndrafts.\nCliff Lane and I had a teleconference with individuals from Drs. Without Borders (MSF); \nin particular, we spoke with Sophie Delaunay along with Jennifer Cohen of MSF. The \ndiscussion was the interest on the part of MSF to be a major player in the development of \na Biobank for specimens in West Africa related to the Ebola outbreak. Cliff and I are \nsomewhat skeptical about this issue since MSF rarely, if ever, gets involved in \nbiomedical research, and when they do, we have had concerns about their capability in \nthis regard. CDC (Tom Frieden) agrees completely with us on this and has skepticism \nabout their involvement.  They are a wonderful organization when it comes to taking care \nof patients; however, we have had some difficult experiences with their inability to really \nappreciate the importance of the scientific method when doing research.\nReleased by Chairman Rand Paul\n457Today I had the first meeting for the search committee for the director of the division of \nintramural research to replace Kathy Zoon.   The Committee is co-chaired by Cliff Lane \nand Gary Gibbons.\nJune 17, 2015 -  I gave a talk at the HPTN/IMPAACT meeting at the Crystal Gateway \nMarriott Hotel on Jefferson Davis Hwy. in Crystal City, Virginia. This was an important \ntalk because I introduced to the investigators the difficulty that we are having now with \ncertain members of Congress wanting to decrease the AIDS budget and even move \nmoney out of the AIDS bucket into other institutes. I showed the audience a C-SPAN clip \nof my debating with Senator Cassidy (R-Tea Party) from Louisiana where he was talking \nabout matching allocation of funds with the number of disability adjusted life years  \n(DALYs) in this country. If this approach were followed, it would have a serious negative \nimpact on all global health research, particularly research on infectious diseases. I \narticulated well my objection to this. Some people have picked this up and put it on \nYouTube, and the clip has gone viral. In addition, I spoke to the group about future \ndirections of focusing the AIDS research specifically on ending the epidemic so that \nultimately we will not have to spend any money on AIDS.  This would be an important \npublic health accomplishment, and it would silence the people who want to take money \nfrom AIDS prematurely before we have ended the AIDS epidemic. \nTonight, I flew to Atlanta to participate in the Charles C Shepard Science Award \nCeremony in Atlanta at the CDC headquarters.\nJune 19, 2015 -  I gave a lecture at the CDC on the subject of \" Ending the HIV AIDS \npandemic: From scientific advances to public health implementation\". The lecture was \nextremely well accepted by the CDC community. I had time to chat with my dear friend \nTom Frieden about a number of issues of mutual interest. I was shown around the \nabsolutely beautiful new CDC campus that I had not been on for several years. The \ncampus has been completely transformed by beautiful, architecturally creative buildings. \nIt is very clear that I am highly respected and revered by the CDC community. Tom \nintroduced mew as a “living legend”.   It was a great visit that I enjoy very much and it \ncemented my relationship with our colleagues at the CDC.\nJune 20, 2015 -  I viewed the preview of the soon to be shown on HBO documentary on \nLarry Kramer entitled “Larry Kramer: In Love and Anger”. It was played at the Naval \nHeritage Center on 701 Pennsylvania Ave. NW. The documentary is a moving story of \nLarry Kramer's complicated life. I was prominently featured in the documentary \ninteracting on multiple occasions with Larry.\nJune 22, 2015  - I gave a lecture at Georgetown University O’Neill Institute at the Law \nSchool on New Jersey Avenue, NW Summer Program on Infectious Diseases and the \nLaw. Again very well received by the group there.\nWe are in the middle of an extraordinary heat wave now in Washington DC with \ntemperatures reaching 95- 100° with sunny skies during the day and massive \nthunderstorms at night.\nReleased by Chairman Rand Paul\n458June 23, 2015 -  I had a very nice breakfast meeting at the American City Diner with Bill \nSchultz who is the general counsel for the Department of Health and Human Services. I \nmet with Bill at the suggestion of Pulitzer Prize winning author and close friend of mine \nRick Atkinson. Rick was concerned if I got involved with Don Fehr, who offered to be an \nunofficial agent for me and read over my manuscript as well as tell me how to write a \nbook proposal for an editor, that this informal arrangement could spell out to the a legal \nissue later.  This arrangement might also be something that is frowned upon by the \ndepartment. And so Rick recommended that I meet with Bill and get his legal advice. My \nmeeting with Bill was terrific. He was extremely encouraging to me about writing my \nbook. He agreed with Rick that I should hold off making even any informal arrangements \nwith anyone and I should just go ahead and continue to write my chapters and when I am \nready to leave the government to then put together my proposal and “shop” it around to \ndifferent publishers and agents. I will take his advice and go that way.\nThis evening I gave a presentation to the AIDS Clinical Trials Group (ACTG) annual \nmeeting at the Renaissance Hotel Downtown at 999 – 9th Street Northwest. The talk was \nvery similar to what I gave to the HPTN/IMPAACT group.\nJune 24, 2015 -  I participated with the NIH and CDC team here at NIH in Wilson Hall \nof Building 1 as well as in Room 151 in the meeting with the Vice Premier of China Jiu \nYandong.  The meeting was hosted by Sylvia Burwell (Sec., HHS).  I presented a talk on \nthe role of NIH in the response to the Ebola Outbreak.   I interacted with several of my \nChinese colleagues including the Director of the Chinese CDC.   An agenda of the \nmeeting is given in the PDF below:\ndraft agenda.pdf\nJune 25 – June 27, 2015 -  I travel to Aspen, Colorado to be a participant in the 2015 \nAspen Ideas Festival, Spotlight health. It was a most enjoyable experience as I attended \nseveral of the panels on areas that were of my own interest and expertise, and even some \nareas that are not my areas of expertise. With regard to my direct participation, on the \nmorning of Friday, June 26 , I participated in a “Tutorial Session” which was a panel on \nthe topic of “Be Preared: Infectious diseases are here to stay”. On the panel with me were \nLarry Brilliant, Neeraj Mistry, and Storn Kabuluzi of Malawi.  The Panel was chaired by \nJudy Woodruff of The NewsHour (PBS). Judy is an old friend and it was a very lively \npanel. An added plus for the experience was that I finally got to meet Larry Brilliant who \nis one of the icons of global health, having participated actively in the eradication of polio \nfrom India during his time at WHO. He is the kind of person who I think could be a really \ngood friend. He obviously has an incredible amount of respect for me. The panels that I \nenjoyed watching were the health and Healthcare session on the morning of June 26, \nwhich was a breakfast session right before my session. The speakers with Tom Daschle, \nHenry Waxman, Bill Frist and the panel was chaired by Steve Clemons, Editor-at-Large \nfor Atlantic magazine. It was a most joyful time for so many of us in Aspen because the \nReleased by Chairman Rand Paul\n459Supreme Court had voted by 6 to 3 to uphold the Affordable Care Act and the tax credit \nfor those who live in states that do not have their own exchanges. In addition, the \nfollowing day the Supreme Court ruled by 5 to 4 to strike down the prohibition on gay \nmarriage. The Obama administration has had an amazing couple of days. \nOn Friday evening of June 26 it was a wonderful reception at the home of Gail and Al \nEngelberg who live on a beautiful mansion overlooking the mountains of Aspen and \nAspen Valley. The reception was in honor of former secretaries of Health and Human \nServices. These included David Matthews, Kathleen Sebelius, Donna Shalala, Tommy \nThompson.  It was great to see Tommy Thompson again as well as all of the others. Of \nnote Donna Shalala wanted to talk to me in her new capacity as the CEO of the Clinton \nFoundation.  Apparently Chelsea Clinton had been approached by people from MSF and \nWHO to help fund the controversial “ring vaccination” study of the Ebola vaccine that \nthey are conducting in Guinea. As I had mentioned, both Cliff and I feel that this is a \nflawed study since it has no control group. Donna wanted to know whether the Clinton \nFoundation should get involved. I recommend strongly to her that they do not support \nthis study and if, in fact, Chelsea Clinton feels that she wants to support it, then it is \nimportantfor the Clinton Foundation to get an outside group to look seriously at the \ndesign of the study, which I have a lot of trouble with, as well as to examine the data that \nis a ready been collected. Donna thanked me for :”Covering my back as you always do”.\nThe reception was idyllic in that views were breathtaking, the skies were crystal clear and \nthe weather was warm without any humidity. I met many wonderful people at the \nreception including a nice conversation with my old friend Ashley Judd, who looked \nabsolutely beautiful. She complimented me on “how great I looked”  and on the \nimportant work that I have been doing for so long. She was with a little dog and was \nbarefoot. She is an amazing looking woman and a really devoted global health advocate. \nShe was there to talk about her reflections on global health on the following day. One of \nthe people I ran into who was very complimentary was a Zoe Baird, who called me the \nepitome of the true public servant. She said that I was incomparable in what I have done \nover so many years for the people of the country in the world. It was a very moving and \nsincere compliment to me. The following day on Saturday, June 27,  I participated in a \npanel on the “Looming Antibiotic Crisis”.  On the panel with me was Peggy Hamburg \nand Ramanan Laximinarayan, who heads the Global Network for Neglected Tropical \nDiseases.   He is a terrific guy with whom I had the opportunity to fly back to Denver \nwith that same morning. All in all it was one of the best trips that I had taken in that the \natmosphere was beautiful, the social interactions were in extremely positive, and I got the \nopportunity to do my thing in front of a lot of important people who have also become \nover the years good friends.\nJune 29, 2015 - I had two interesting encounters today by telephone with very interesting \npeople", "summary": "Watcher-discovered document from paul-readingroom (2026.07.27_Diary-Prequel-.pdf), auto-indexed 2026-08-05.\n\nExcerpt: with Greta Van Susteren and MSNBC with Rachel Maddow.    After I got off the air, Rachel tells her audience how proud she was of herself to have  gotten me on her show since I was such an icon in medicine and public health. Oct. 14 -21, 2014 - From October 14 through October 21, the situation was so intense  that I do not have time to document historical notes on a day by day basis. I am only  doing this retrospectively now and will give dates as I recall. However over this period of  time in light of the crisis of confidence against CDC and Tom Frieden related to a  number of issues culminated by the fact that  was allowed to fly back from  Cleveland to Dallas, this was clear that Tom Frieden was in significant trouble over  several days Sec. Burwell would call me usually in the late…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.27_Diary-Prequel-.pdf", "pdf_url": "/archive-docs/fauci-files/c1dee44b66471ea95f8e8154b109f914/pdf", "doc_date": "2026-08-05", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-07-27-diary-prequel"], "part_number": 7, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 8 of 8)", "content": "on very interesting subjects:\n1) Mark Zuckerberg, the CEO and founder of Facebook was introduced to me a few \nweeks ago by e-mail by Susan Desmond Hellman, the current CEO of the Bill and \nMelinda Gates Global Foundation. We arranged to have a teleconference between \nMark and me today to discuss the issue of Mark wanting to get involved in a \nReleased by Chairman Rand Paul\n460philanthropic  way with promoting biomedical science. The call lasted one hour \nfrom 4 PM to 5 PM on an absolutely brilliantly beautiful day in Washington with \nclear skies and relatively no humidity(an unusual event in the summer in \nWashington). Mark was very engaging and we went over the multiple possible \nways that he may contribute.  He asked probing, highly insightful questions about \nhow we fund biomedical research through grants in the extramural program and \nby funding the investigators in the intramural program. He was very interested in \nthe concept of funding projects versus funding people. We went over several \nmodels of how research is funded. We discussed the issue of creating an institute \nthat is an infrastructure with walls like the Rockefeller University. We also \ndiscussed the possibility of an institution that makes grants like the Howard \nHughes Medical Institute. He asked a lot of questions about the NIH and he \nwanted to continue the conversation at a later date after he thought a bit about \nwhat I had told him. I found him to be a very engaging, highly intelligent young \nman.\n2) Gary Nabel, who is currently at Sanofi in Boston, called me on my cell phone to \ntell me that he had just been in California and had a conversation with Gov. Jerry \nBrown. The California State Assembly has put a Bill on the desk of Gov. Jerry \nBrown that would prohibit exemptions from vaccinations on religious and \nphilosophical grounds. Gov. Brown had spoken to Gary when he was in \nCalifornia today about this since he finds this to be a difficult decision as to \nwhether or not he should sign the bill.   Gary spoke to him about me and my \nknowledge of the subject and Gov. Brown gave Gary his cell phone number to \ngive to me to have me call him. I did so and had about a half an hour conversation \nwith Gov. Brown in which I explained to him the reasons why I feel that he \nshould sign the bill prohibiting religious and philosophical exemptions from \nvaccinations in the state of California. He asked probing questions. We had a very \ngood conversation and he thanked me heartily for giving him the time. Based on \nthe discussion, I believe that he will sign the bill. We shall see.\nThe TedMed people got back to me and really like my draft.   They have made some \nsuggestions that are easy.\nJune 30, 2015 – I must have been convincing to Gov. Brown yesterday – he signed into \nlaw the California vaccine legislation (see above).\nJuly 1, 2015 – The California law has attracted some attention.   I appeared on CNN with \nJake Tapper to discuss it.\nJuly 2, 2015 - Today I appeared on the Diane Rehm Show where I did somewhat of a \ndebate with Dr. Robert Sears, a pediatrician from California who was concerned about \nthe law recently signed by Gov. Brown in California. On the show with me was Liz \nSzabo from the newspaper USA Today. In addition, there was a pediatrician who is an \nexpert in parental response to vaccines for their children. Her name is Dr. Allison Kemp. \nThe show went very well and it was clear that Dr. Sears misrepresented certain facts and \nReleased by Chairman Rand Paul\n461cherry-picked information for his own advantage. Following the interview, when I got \nback to my office, I received several e-mails telling me that I did a very nice job in being \nbalanced in my approach.\nThere has been an additional case of Ebola in Liberia. A 17-year-old boy was found dead \nand was shown by PCR to have had Ebola. Since then, there has been an additional case \nor two. Therefore, we are concerned that this may be the beginning of another outbreak in \nLiberia and perhaps in other West African countries. \nDrew Faust, President of Harvard had e-mailed me a couple of days ago to ask me for \nsuggestions for Dean of Harvard School of Public Health to replace Julio Frenk who had \nleft to become President of University of Miami.   I gave her several names and then she \nresponded this AM thanking me and telling me that she had just watched “Larry Kramer:   \nIn Love and Anger “ (HB0) and this was her comment to me:\n  I spent the evening tonight watching the Larry Kramer HBO documentary in which you \nfigure so prominently—and impressively.  The footage throughout is amazing, (I kept \nthinking what it would be like to have such a record of the Civil War…), and the story \nboth tragic and triumphant.  I was powerfully struck by your comment towards the end \nabout how Act Up permanently changed everything in how officials, the state and \norganized medicine deal with patient communities. The film will remain in my mind for a \nlong time…\nVery best, Drew\nJuly 7, 2015 – Met with team from Gilead Sciences who presented data on their new \ncompound GS 5734 that has impressive preclinicakl activity against Ebola.   They want \nour help in testing it in West Africa.   It is an RNA Polymerase with activity against \nMERS, and likely RSV, Chik, and others.   We will help them and do a trial in West \nAfrica after we finish the ZMapp trial that is moving along well (47 subjects thus far) in \nSierra Leone and soon in Guinea.   Infections persist in both countries.   Also, last week \nthere was an infection in Liberia with 2 secondary cases.\nThe Gilead people were: Andrew Chang (Head of HIV Therapeutics & Development \nOperations; William Lee (Head of research); Howard Jaffe (Senior Advisor); and Tomas \nCihlar (Head of Discovery Virology).\nAlso, Cliff is back from Guinea and it looks like (despite the continued objections of tom \nFrieden), we will expand the RCT Vaccine trial into Guinea where there are persistent \ncases.\nHad diner tonight at Grapeseed restaurant in Bethesda with the BMGF people who are in \ntown for our yearly joint gates/NIH meeting.   Francis Collins and I and Doug owy were \nthe senior NIH people there and Trevor Mundel, Emilio Emini, Chris Carp, Chris Wilson \nwere senior Gates people among others.\nReleased by Chairman Rand Paul\n463  \nReleased by Chairman Rand Paul", "summary": "Watcher-discovered document from paul-readingroom (2026.07.27_Diary-Prequel-.pdf), auto-indexed 2026-08-05.\n\nExcerpt: on very interesting subjects: 1) Mark Zuckerberg, the CEO and founder of Facebook was introduced to me a few  weeks ago by e-mail by Susan Desmond Hellman, the current CEO of the Bill and  Melinda Gates Global Foundation. We arranged to have a teleconference between  Mark and me today to discuss the issue of Mark wanting to get involved in a  Released by Chairman Rand Paul 460philanthropic  way with promoting biomedical science. The call lasted one hour  from 4 PM to 5 PM on an absolutely brilliantly beautiful day in Washington with  clear skies and relatively no humidity(an unusual event in the summer in  Washington). Mark was very engaging and we went over the multiple possible  ways that he may contribute.  He asked probing, highly insightful questions about  how we fund biomedical…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/07/2026.07.27_Diary-Prequel-.pdf", "pdf_url": "/archive-docs/fauci-files/c1dee44b66471ea95f8e8154b109f914/pdf", "doc_date": "2026-08-05", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-07-27-diary-prequel"], "part_number": 8, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 1 of 7)", "content": "From: \"Fauci, Anthony (NIH/NIAID) [E]\"\n</O=NIH/OU=NIHEXCHANGE/CN=NIAID/CN=AFAUCI>\nTo:\"Fauci, Anthony (NIH/NIAID) [E]\" <AFAUCI@niaid.nih.gov>\nSubject: history\nDate: Sat, 11 Jul 2015 17:50:16 -0400\nImportance: Normal\nAttachments: historical_record_of_A.S._Fauci.docx\nReleased by Chairman Rand Paul\n1 HISTORICAL RECORD OF HIV/AIDS\nAnthony S. Fauci, M.D.\nDirector\nNational Institute of Allergy and Infectious Diseases\nNational Institutes of Health\nThis written record will start today (April 11, 2001) and will state some events \nretrospectively.  I have other records including 2 dictated tapes that should be noted. The event \nthat precipitated this written record, which I hope that I can regularly contribute to is the tidal \nwave of activity concerning the possibility of treating HIV-infected individuals in developing \nnations and in sub-Saharan Africa specifically.\nTowards to end of the Clinton Administration, Leon Fuerth who was the National \nSecurity Advisor to VP Al Gore had set into motion a Task Force on which I was included (see \nother records) to develop a plan to “treat infected Africans and provide some infrastructure, \nprevention, etc. The group involved USAID, CDC, NIH, White House, State Department and \nothers.  After the election, obviously, this dissolved.  However, with the new George W. Bush \nadministration, Secr. of State Colin Powell and Secr of DHHS, Tommy G. Thompson became \nvery interested.  Starting from the end of March I began intensive briefings of Secretary. \nThompson and members of his staff, particularly Terrell Halaska (Deputy Chief of Staff, DHHS) \nand William Steiger (Special Assistant for International Affairs at DHHS) trying to convince \nthem of the need for USA involvement in the rapidly growing international interest in developing \na forum for treating Africans with HIV.  Also, I had several interactions with Anne Phelps of the \nDomestic Policy Council at the White House.  During all of this, I had turned down the offer to \nbe Director of NIH.  I was asked by Ed. Moy (Director of Presidential Personnel at the White \nHouse) and by Secr. Thompson.  My reason was that I wanted to concentrate of Global Health \nproblems, particularly HIV/AIDS in developing nations such as sub-Saharan Africa.  They \nregretted my not taking the job, but were enthusiastic and quite flattering about my work on \nAIDS and encouraged to take a leadership role in pushing the AIDS (as well as TB and malaria) \nglobal agenda.  This was especially true of Secr. Thompson with whom I was rapidly developing \nan excellent relationship.\nMarch 2, 2001 – meet with Anne Phelps at White House to discuss global AIDS and other \nissues.\nApril 3, 2001 – Extensive briefing of Secr. Thompson’s staff (Halaska, Steiger, Ann Agnew) \nregarding International AIDS.  Secretary Thompson dropped by and spent most of the hour.  \nAfter the meeting he called me into his office to speak in private (Bob Woods (Chief of Staff) \nand Brett Davis (Special Assistant to the Secretary) were there.  Thompson said he wanted me to \nbe his point man on AIDS and to spearhead our international endeavors.  Stated that he and Colin \nPowell would lead a Task Force on International AIDS and he wanted me to be the “go-to \nperson”.\nApril 4, 2001 -  I was asked to prepare talking points on AIDS for Secretary. Thompson for his \nupcoming plane trip with Pres, Bush to (?).  I did so.  Thompson’s staff was so impressed with \nReleased by Chairman Rand Paul\n2the talking points that they mentioned that Thompson wanted me to accompany his staff to the \nWhite House the next day to develop a white paper for Powel and Thompson to use in upcoming \nmeeting with the POTUS.  \nApril 5, 2001 -  Several hour meeting in the Situation Room of the White House chaired by Gary \nEdson (Condoleeza Rice’s Deputy) of NSC.  Meeting attended by…..  Bill Steiger charged with \ndeveloping paper.\nApril 8 – 10, 2001 – I exchanged several drafts of white paper with Steiger and make significant \nchanges and input.  It was clear that much of the paper included material from my talking points \nfor Thompson (see above).\nApril 11, 2001 – Attached below is the document and some comments.  \n---------------------- Forwarded by Millicent H. Schwenk/NSC/EOP on\n04/11/2001 11:16 AM ---------------------------\nGary R. Edson\n04/10/2001 09:00:45 PM\nRecord Type:   Record\nTo:   Millicent H. Schwenk/NSC/EOP@EOP\ncc:\nSubject:\nMillie: I haven't reviewed this to see what;'s changed, but you should look\nat it.\n---------------------- Forwarded by Gary R. Edson/NSC/EOP on 04/10/2001\n09:01 PM ---------------------------\n                                                                  \n (Embedded                                                        \n image moved   steigerw@usa.net                                   \n to file:      04/10/2001 07:05:59 PM                             \n PIC07622.PCX)                                                    \n                                                                  \nReleased by Chairman Rand Paul\n3Record Type:   Record\nTo:   Gary R. Edson/NSC/EOP\ncc:   terrell.halaska@hhs.gov\nSubject:\nmy hhs dial-up e-mail is down tonight.  i wanted to send you a slightly\nmodified version after receiving additional comments from dr. fauci. i am\nsending in the body of the e-mail because i am not certain the attachment\nwill\ngo through.  let me know if you have any questions or need me to do\nanything\nelse.  thanks, steiger\nDraft\nPrivileged and Confidential\nFor Official Use Only\nInfectious diseases, including HIV/AIDS, malaria, and tuberculosis, are\nravaging developing nations, causing 25 percent of all deaths worldwide and\neroding recent gains in economic growth, education, and life expectancy.\nTuberculosis accounted for 1.7 million deaths last year, while malaria\nkilled\nmore than one million, mostly children in Africa. At the same time, the\nspread\nof HIV/AIDS is triggering a crisis in international public health, the full\nscope of which we are only beginning to recognize. The Joint United Nations\nProgramme on HIV/AIDS (UNAIDS) estimates that 36 million people are now\nliving\nwith HIV or AIDS, 70 percent of them in sub-Saharan Africa, where the\ndisease\nis now the leading cause of death.  Nearly 60 million people have become\ninfected with HIV since the beginning of the epidemic in the 1970's and\nover\n22 million of them have already died from AIDS.\nThe U.S. has been the leader in research and assistance to battle these\ndiseases, and the President?s recent proposed budget increase for the\nNational\nInstitutes of Health (NIH) reaffirms that commitment.  NIH spent an\nestimated\n$90 million on international HIV/AIDS research in FY 2000, a number that is\nexpected to rise to $130 million by the end of FY 2001.  The U.S. is the\nReleased by Chairman Rand Paul\n4largest single donor to UNAIDS and the largest contributor to international\nHIV/AIDS treatment and prevention programs, a total of more than $460\nmillion\nin FY2001. The Centers for Disease Control and Prevention (CDC) spent over\n$100 million on HIV/AIDS prevention in FY 2001.  The U.S. Government has\nalso\ndramatically increased its investment in international malaria and\ntuberculosis efforts to $110 million in FY 2001.\nOur programs for taking care of our own population affected by HIV/AIDS and\ntuberculosis are also world leaders.  HHS is providing over $10 billion in\nFY\n2001 for HIV/AIDS-related assistance. This includes $795 million for\nprevention services through the CDC and other agencies, $1.8 billion for\nRyan\nWhite medical and related support services for individuals and families\nwith\nHIV/AIDS, including the AIDS Drug Assistance Program; $2.2 billion for\nNIH-funded HIV/AIDS research, including $280 million in vaccine research;\n$4.3\nbillion for HIV/AIDS-related coverage for Medicare and Medicaid\nbeneficiaries.\nOver the last several years the scope of the infectious disease crisis in\nthe\ndeveloping world has led the U.S and other industrialized nations to make\ninternational public health an important item on their foreign policy\nagendas.\n In Okinawa in July of 2000, the U.S. and our G-8 partners committed to\npromoting investments and partnership to prevent and control HIV/AIDS,\ntuberculosis and malaria and to accelerate the development of new vaccines.\nMore recently, wider public attention has turned to the challenges posed by\nthese diseases as pharmaceutical manufacturers have announced price\nreductions\nin developing countries for their main anti-retroviral drugs.  These price\ncuts are a significant step forward and have sharpened debate on the\nquestion\nof how best to provide treatment to the populations most affected by the\nHIV/AIDS epidemic, malaria, and tuberculosis.\nAs Senator Bill Frist (R-TN) has recently suggested, the U.S. has a moral\nobligation to provide leadership in mobilizing additional resources for\ninternational health.  Stopping the spread of infectious diseases is also\nin\nour own enlightened self-interest, given the threats HIV/AIDS and other\nmaladies now pose to the political and economic stability of Africa and\nother\nimportant regions of the world.  It is in our public health interest to\naddress tuberculosis as well, since 43 percent of U.S. TB cases are among\nReleased by Chairman Rand Paul\n5foreign-born persons.  We also believe the U.S. has a duty to ensure that\nthose resources go to efforts that are medically and scientifically sound\nand\nwill contribute to the development of a sustainable health infrastructure\nin\nthe most affected countries so that they can meet their challenges\nthemselves\nover time.\nProviding drugs at or below cost is only part of the solution.  It is\nestimated that approximately 50 percent of HIV-infected people in the U.S.\nmeet the HHS treatment guidelines for beginning antiretroviral therapy.\nWhat\nthis percentage might be in developing nations is unclear.  However,\nperhaps\nas important as providing antiretroviral drugs in some circumstances is\ntreating opportunistic infections and providing nutrition and clean water.\nYet even if enough drugs to treat every single infected person were sent,\nfree\nof charge, to the African continent, an adequate surveillance\ninfrastructure\nfor testing for HIV infection and an adequate health care delivery system\nfor\nadministering the drugs do not exist in many countries.  Furthermore, the\ncapability of monitoring patients to insure they are taking these complex\nregimens of drugs properly and  to determine the spectrum of toxicity and\nthe\neffect of treatment on the spread of the disease There is no existing\nsurveillance capability to ensure that patients follow extremely\ncomplicated\ndrug regimens accurately, or to monitor what effect the treatment has on\nthe\nspread of the disease is sorely lacking in many places.  We should begin to\nhelp create the basic system to provide needed medications for\nopportunistic\ninfections and symptomatic care, while also building the more complex\nsystems\nneeded to provide antiretrovirals and other medicines safely and\neffectively\nto avoid creating resistant strains, a lesson we have learned from efforts\nto\ncontrol tuberculosis.\nAt the same time, we must continue to focus our efforts on prevention ? a\nproven strategy that is cost-effective.  Government accountability,\nindividual\nbehavior change and abstinence-based approaches (where they are culturally\nappropriate) must be part of prevention efforts.  We have found that\nReleased by Chairman Rand Paul\n6working\nwith local organizations, such as missionary hospitals and clinics, is an\neffective way to lessen the impact of the epidemic on individuals, families\nand communities.  We should also encourage countries to adopt\ncomprehensive,\nevidence-based national strategies to ensure the resources we devote to\nthis\nchallenge are well-managed to produce the results we seek.\nThis is not, however, an issue that the U.S. Government can -- or should --\nsolve single handedly.  We must reach out to a number of partners: our\nallies,\nthe international community, pharmaceutical manufacturers, non-profits like\nthe Gates Foundation, and the faith-based community that has infrastructure\non\nthe ground in the developing world.  A successful strategy to reduce the\nimpact of infectious disease requires close donor cooperation to achieve\nmaximum efficiency and avoid competition and duplication of efforts.  The\nBush\nAdministration stands ready to contribute to a comprehensive plan to\nimprove\nthe public health delivery system in Africa and other parts of the world\nwhere\nHIV is rapidly expanding, an effort that should include prevention of new\ninfections, care for the sick, provision of drugs, and training of medical\nprofessionals.\nTo this end, we appeal to the world to join us in establishing a new,\nmulti-lateral Global Fund to Fight Infectious Diseases, an international\npublic-private partnership to provide grants for prevention and health\ninfrastructure development focused on fighting HIV/AIDS, malaria, and\ntuberculosis.\nWe believe the fund should operate under the following series of core\nprinciples:\n?    Our goals are to prevent new HIV infections and treat those already\nafflicted, to build the infrastructure for health care and disease control,\nand to develop and train human resources.\n?    We seek to support a community-driven process that identifies the\nneeds of\naffected areas and allows communities themselves to develop an appropriate,\ncomprehensive set of medical, social and support services.\n?    We must build on already established institutions and networks in\nlocal\nareas, including research relationships, to ensure we are creating human\nand\nphysical capacity that is sustainable over the long run.\n?    We support an integrated approach focusing on prevention, delivery,\ncare and\nReleased by Chairman Rand Paul\n7treatment.  We also wish to include components for health infrastructure\nimprovement, surveillance of epidemics and care for orphans.\n?    We will outline and agree to fund a core menu of ?best practice?\nprograms,\naccording to certain quality standards and experience with evidence-based\nmodels proven to work in developing countries.\n?    We will solicit letters of intent from governments and\nnon-governmental\norganizations (NGOs), especially faith-based groups, that describe plans to\nimplement one of more of our core models in local areas.\n?    We will require demonstration of local leadership and adherence to\ninternational standards of financial accountability and transparency.  We\nwill\ngive preference to comprehensive plans that involve governments and civil\nsociety working together.\n?    We will link our efforts in health to expanded programs in the areas\nof\neducation and nutrition in an international parallel to the\nAdministration?s\ncampaign to ?Leave No Child Behind.?\n?    We are committed to a policy of promoting intellectual property\nprotection,\nincluding for pharmaceutical patents, because of its critical role in the\nrapid innovation, development, and commercialization of effective and safe\ndrug therapies and vaccines.  Financial incentives are needed to develop\nnew\nmedications.  No one benefits if research on such products is discouraged.\nWith more than 50 years of experience with health projects and a proven\ninstitutional capacity to manage large financial transactions, the World\nBank\nshould serve as the fiscal agent for the Fund.  As trustee, the Bank would\nnot\nbe involved in matters of policy, but would serve as the repository for\ncontributions from both governments and private donors and ensure the\nprompt\ndisbursement of grants.  A small Executive Secretariat housed at the Bank\nand\njointly staffed by the Bank, UNAIDS and the World Health Organization would\nundertake the day-to-day management of the trust fund, including soliciting\ngrant proposals.\nA high-level Governing Council would provide the overall strategic\ndirection\nfor the fund.  Donors that contribute at least $xx million and\nrepresentatives\nof the developing world (serving in their own personal capacity and not as\nthe\nReleased by Chairman Rand Paul\n8emissaries of any particular state) would form the membership of this\nboard.\nThe Council would fully control all fund decisions, including determining\nprogrammatic allocations, operational rules and procedures, policies and\nstrategies, approving financial plans and work programs, and attracting\nadditional donations.  In addition, the Council would make the final\ndetermination of the list of ?best practice? models the fund would\nunderwrite\nand the criteria necessary to win approval of letters of intent.  The\npresident of the World Bank, the Director General of UNAIDS and the\nDirector\nGeneral of WHO would be ex officio, non-voting members of the Council.\nMuch like a university endowment, the fund would have a two-tiered\nfinancial\nstructure.  The \"core fund\" would comprise a pool of resources that could\nbe\nsupport any activity falling within the work program and eligibility\ncriteria\napproved by the Governing Council (except for limited restrictions by\ndonors).\n At the same time, however, the fund would permit donors to earmark\ncontributions for use on their particular priorities, as long as they fell\nwithin the overall purposes and priorities of the trust fund.  Both ?core?\nand\ndedicated resources would be combined in each grant in a way transparent to\nthe recipient.\nComposed of international scientific, medical, public health and\ndevelopment\nexperts, a Scientific and Public Health Review Committee would perform a\nrigorous technical peer review process to assess the grant applications.\nDrawn from developing and developed countries and international\norganizations,\nwith experience in the affected countries, such as UNAIDS and WHO, the\nCommittee will make final decisions about the feasibility and\nsustainability\nof proposed programs according to criteria for each ?best practice? model\nprescribed by the Governing Council.  The Committee will also operate under\nbroad guidelines that spell out the recommended ratio of expenditures on\nprevention, treatment, and research the Council would prefer projects\nfollow.\nThe models we might support could cover primary prevention and education\nprograms up to more sophisticated, comprehensive efforts that could involve\nbasic care and treatment, controlled delivery of antiretroviral therapy,\nmedical training, and clinical trials.  Applicants will determine which one\nof\nthe approved packages would be most appropriate and useful for the local\nReleased by Chairman Rand Paul\n9context.  Some might ask for resources to upgrade or build health centers\nto\ndeliver basic HIV/AIDS or tuberculosis care and prevention programs.\nOthers\nmight want help with such programs plus training for physicians, lab\nworkers,\nnurses, community health volunteers, and pharmacists.  Still others might\nintegrate both models with the provision of complex drug treatment.  Every\nfunded model will also include localized monitoring to assure the efficacy\nof\nthe grant and to help inform the selection of proposals in the future.  We\nwill also emphasize technical assistance to those countries and\norganizations\nthat are unable to satisfy our criteria in their letters of intent, so that\nover time they might also be able to participate.\nThe Administration is committed to making the fight against the global\nHIV/AIDS epidemic and other killers a priority, and we ask our friends and\npartners to join with us in a single, worldwide effort.\n____________________________________________________________________\nGet free email and a permanent address at http://www.amexmail.com/?A=1\nApril 11, 2001 – Attached below is what is to be the final document:\nDraft\nPrivileged and Confidential\nFor Official Use Only\nInfectious diseases, including HIV/AIDS, malaria, and tuberculosis, are ravaging developing \nnations, causing 25 percent of all deaths worldwide and eroding recent gains in economic \ngrowth, education, and life expectancy.  Tuberculosis accounted for 1.7 million deaths last year, \nwhile malaria killed more than one million, mostly children in Africa. At the same time, the \nspread of HIV/AIDS is triggering a crisis in international public health, the full scope of which \nwe are only beginning to recognize. The Joint United Nations Programme on HIV/AIDS \n(UNAIDS) estimates that 36 million people are now living with HIV or AIDS, 70 percent of \nthem in sub-Saharan Africa, where the disease is now the leading cause of death.  Nearly 60 \nmillion people have become infected with HIV since the beginning of the epidemic in the 1970's \nand over 22 million of them have already died from AIDS. \nThe U.S. has been the leader in research and assistance to battle these diseases, and the \nPresident’s recent proposed budget increase for the National Institutes of Health (NIH) reaffirms \nReleased by Chairman Rand Paul\n10that commitment.  NIH spent an estimated $90 million on international HIV/AIDS research in \nFY 2000, a number that is expected to rise to $130 million by the end of FY 2001.  The U.S. is \nthe largest single donor to UNAIDS and the largest contributor to international HIV/AIDS \ntreatment and prevention programs, a total of more than $460 million in FY2001. The Centers \nfor Disease Control and Prevention (CDC) spent over $100 million on HIV/AIDS prevention in \nFY 2001.  The U.S. Government has also dramatically increased its investment in international \nmalaria and tuberculosis efforts to $110 million in FY 2001. \nOur programs for taking care of our own population affected by HIV/AIDS and tuberculosis are \nalso world leaders.  HHS is providing over $10 billion in FY 2001 for HIV/AIDS-related \nassistance. This includes $795 million for prevention services through the CDC and other \nagencies, $1.8 billion for Ryan White medical and related support services for individuals and \nfamilies with HIV/AIDS, including the AIDS Drug Assistance Program; $2.2 billion for NIH-\nfunded HIV/AIDS research, including $280 million in vaccine research; $4.3 billion for \nHIV/AIDS-related coverage for Medicare and Medicaid beneficiaries.\nOver the last several years the scope of the infectious disease crisis in the developing world has \nled the U.S and other industrialized nations to make international public health an important item \non their foreign policy agendas.  In Okinawa in July of 2000, the U.S. and our G-8 partners \ncommitted to promoting investments and partnership to prevent and control HIV/AIDS, \ntuberculosis and malaria and to accelerate the development of new vaccines.  \nMore recently, wider public attention has turned to the challenges posed by these diseases as \npharmaceutical manufacturers have recently announced price reductions in developing countries \nfor their main anti-retroviral drugs.  These price cuts are a significant step forward and have \nsharpened debate on the question of how best to provide treatment to the populations most \naffected by the HIV/AIDS epidemic, malaria, and tuberculosis.\nAs Senator Bill Frist (R-TN) has recently suggested, the U.S. has a moral obligation to provide \nleadership in mobilizing additional resources for international health.  Stopping the spread of \ninfectious diseases is also in our own enlightened self-interest, given the threats HIV/AIDS and \nother maladies now pose to the political and economic stability of Africa and other important \nregions of the world.  It is in our public health interest to address tuberculosis as well, since 43 \npercent of U.S. TB cases are among foreign-born persons.  We also believe the U.S. has a duty to \nensure that those resources go to efforts that are medically and scientifically sound and will \ncontribute to the development of a sustainable health infrastructure in the most affected countries \nso that they can meet their challenges themselves over time.  \nReleased by Chairman Rand Paul\nProviding drugs at or below cost is only part of the solution.  Only a portion of the total HIV-\ninfected population will meet criteria for beginning antiretroviral therapy.  Far more need \ncommunity support and basic care for opportunistic infections, such as tuberculosis, and for \nprevention, care and treatment of sexually transmitted diseases.  Yet even if enough drugs to \ntreat every single infected person were sent, free of charge, to the African continent, an adequate \ninfrastructure to deliver them does not exist. There is no existing surveillance capability to \nensure that patients follow extremely complicated drug regimens accurately, or to monitor what \neffect the treatment has on the spread of the disease.  We should begin to help create the basic \nsystem to provide needed medications for opportunistic infections and symptomatic care, while \nalso building the more complex systems needed to provide antiretrovirals and other medicines \nsafely and effectively to avoid creating resistant strains, a lesson we have learned from efforts to \ncontrol tuberculosis.  \nAt the same time, we must continue to focus our efforts on prevention – a proven strategy that is \ncost-effective.  Individual and government accountability, behavior change and abstinence-based \napproaches that are culturally appropriate must be part of prevention efforts.  We have found that \nworking with local organizations, such as missionary hospitals and clinics, is an effective way to \nlessen the impact of the epidemic on individuals, families and communities.  We should also \nencourage countries to adopt comprehensive, evidence-based national strategies to ensure the \nresources we devote to this challenge are well-managed to produce the results we seek. \nThis is not, however, an issue that the U.S. Government can -- or should -- solve single handedly.  \nWe must reach out to a number of partners: our allies, the international community, \npharmaceutical manufacturers, non-profits like the Gates Foundation, and the faith-based \ncommunity that has infrastructure on the ground in the developing world.  A successful strategy \nto reduce the impact of infectious disease requires close donor cooperation to achieve maximum \nefficiency and avoid competition and duplication of efforts.  The Bush Administration stands \nready to contribute to a comprehensive plan to begin building a public health delivery system in \nAfrica and other parts of the world where HIV is rapidly expanding, an effort that should include \nprevention of new infections, care for the sick, provision of drugs, and training of medical \nprofessionals.\nTo this end, we appeal to the world to join us in establishing a new, multi-lateral Global Fund to \nFight Infectious Diseases, an international public-private partnership to provide grants for \nprevention and health infrastructure development focused on fighting HIV/AIDS, malaria, and \ntuberculosis.  \nWe believe the fund should operate under the following series of core principles:\n•Our goals are to prevent new infections and treat those already afflicted, to build the \ninfrastructure for health care and disease control, and to develop and train human resources.\n•We seek to support a community-driven process that identifies the needs of affected areas \nand allows communities themselves to develop an appropriate, comprehensive set of \nmedical, social and support services.\nReleased by Chairman Rand Paul\n12•We must build on already established institutions and networks in local areas, including \nresearch relationships, to ensure we are creating human and physical capacity that is \nsustainable over the long run.\n•We support an integrated approach focusing on prevention, delivery, care and treatment.  We \nalso wish to include components for health infrastructure improvement, surveillance of \nepidemics and care for orphans.\n•Our intent is to start with a relatively limited number of projects, to research which \napproaches work best and are adaptable to local conditions, before scaling up over the next \nfew years.\n•We will outline and agree to fund a core menu of “best practice” programs, according to \ncertain quality standards and experience with evidence-based models proven to work in \ndeveloping countries.\n•We will solicit letters of intent from governments and non-governmental organizations \n(NGOs), especially faith-based groups, that describe plans to implement one of more of our \ncore models in local areas.\n•We will require demonstration of local leadership and adherence to international standards of \nfinancial accountability and transparency.  We will give preference to comprehensive plans \nthat involve governments and civil society working together.\n•We will link our efforts in health to expanded programs in the areas of education and \nnutrition in an international parallel to the Administration’s campaign to “Leave No Child \nBehind.”\n•We are committed to a policy of promoting intellectual property protection, including for \npharmaceutical patents, because of its critical role in the rapid innovation, development, and \ncommercialization of effective and safe drug therapies and vaccines.  Financial incentives are \nneeded to develop new medications.  No one benefits if research on such products is \ndiscouraged.\nWith more than 50 years of experience with health projects and a proven institutional capacity to \nmanage large financial transactions, the World Bank should serve as the fiscal agent for the \nFund.  As trustee, the Bank would not be involved in matters of policy, but would serve as the \nrepository for contributions from both governments and private donors and ensure the prompt \ndisbursement of grants.  A small Executive Secretariat housed at the Bank and jointly staffed by \nthe Bank, UNAIDS and the World Health Organization would undertake the day-to-day \nmanagement of the trust fund, including soliciting grant proposals. \nA high-level Governing Council would provide the overall strategic direction for the fund.  \nDonors that contribute at least $xx million and representatives of the developing world (serving \nin their own personal capacity and not as the emissaries of any particular state) would form the \nmembership of this board.   The Council would fully control all fund decisions, including \nReleased by Chairman Rand Paul\n13determining programmatic allocations, operational rules and procedures, policies and strategies, \napproving financial plans and work programs, and attracting additional donations.  In addition, \nthe Council would make the final determination of the list of “best practice” models the fund \nwould underwrite and the criteria necessary to win approval of letters of intent.  The president of \nthe World Bank, the Director General of UNAIDS and the Director General of WHO would be \nex officio, non-voting members of the Council.\nMuch like a university endowment, the fund would have a two-tiered financial structure.  The \n\"core fund\" would comprise a pool of resources that could be support any activity falling within \nthe work program and eligibility criteria approved by the Governing Council (except for limited \nrestrictions by donors).  At the same time, however, the fund would permit donors to earmark \ncontributions for use on their particular priorities, as long as they fell within the overall purposes \nand priorities of the trust fund.  Both “core” and dedicated resources would be combined in each \ngrant in a way transparent to the recipient.\nComposed of international scientific, medical, public health and development experts, a \nScientific and Public Health Review Committee would perform a rigorous technical peer review \nprocess to assess the grant applications.  Drawn from developing and developed countries and \ninternational organizations, with experience in the affected countries, such as UNAIDS and \nWHO, the Committee will make final decisions about the feasibility and sustainability of \nproposed programs according to criteria for each “best practice” model prescribed by the \nGoverning Council.  The Committee will also operate under broad guidelines that spell out the \nrecommended ratio of expenditures on prevention, treatment, and research the Council would \nprefer projects follow.\nThe models we might support could cover primary prevention and education programs up to \nmore sophisticated, comprehensive efforts that could involve basic care and treatment, controlled \ndelivery of antiretroviral therapy, medical training, and clinical trials.  Applicants will determine \nwhich one of the approved packages would be most appropriate and useful for the local context.  \nSome might ask for resources to upgrade or build health centers to deliver basic HIV/AIDS or \ntuberculosis care and prevention programs.  Others might want help with such programs plus \ntraining for physicians, lab workers, nurses, community health volunteers, and pharmacists.  Still \nothers might integrate both models with the provision of complex drug treatment.  Every funded \nmodel will also include localized monitoring to assure the efficacy of the grant and to help \ninform the selection of proposals in the future.  We will also emphasize technical assistance to \nthose countries and organizations that are unable to satisfy our criteria in their letters of intent, so \nthat over time they might also be able to participate.\nWe believe the nearly complete drive to eliminate polio offers us a model to develop a strategy \nto control HIV/AIDS and the other major killer infectious diseases.  The Administration is \ncommitted to making the fight against the global HIV/AIDS epidemic and other killers a priority, \nand we ask our friends and partners to join with us in a single, worldwide effort.\nBullets for above document are listed below:\nDraft—For Official Use Only\nReleased by Chairman Rand Paul\n14Global Fund to Fight Infectious Diseases\nBush Administration response to the crisis HIV/AIDS and other diseases have triggered in \ninternational public health.\nMulti-lateral, international public-private partnership to provide grants for prevention and \nhealth infrastructure development focused on fighting HIV/AIDS, malaria, and tuberculosis. \nComprehensive plan to begin building a public health delivery system in Africa and \nelsewhere, an effort that should include prevention of new infections, care for the sick, \nprovision of drugs, and training of medical professionals.\nCooperation by many partners: our G-8 allies, the international community, pharmaceutical \nmanufacturers, non-profits like the Gates Foundation, and the faith-based community that has \na presence on the ground in the developing world.\nGoals\n•Prevent new infections, treat those already afflicted, build infrastructure for health care and \ndisease control, and develop and train medical personnel.\n•Identify the needs of affected areas and allow communities themselves to develop an \nappropriate, comprehensive set of medical, social and support services.\n•Build on already established institutions and networks in local areas, including research \nrelationships to ensure countries can sustain the fight on their own over time.\nApproach\n•Integrated approach focusing on prevention, delivery, care and treatment, along with \ncomponents for health infrastructure improvement, surveillance of epidemics and care for \norphans.\n•Start with a relatively limited number of projects, to research which approaches work best \nand are adaptable to local conditions, before scaling up over the next few years.\n•Link our efforts in health to expanded programs in the areas of education and nutrition in an \ninternational parallel to the Administration’s campaign to “Leave No Child Behind.”\n•Work cooperatively with major pharmaceutical companies to ensure greater availability of \naccess to key drug treatments.\n•Continue to promote intellectual property protection, including for pharmaceutical patents, \nbecause of its critical role in the rapid innovation, development, and commercialization of \neffective and safe drug therapies.\nStructure\n•World Bank as trustee-- not involved in matters of policy, but repository for contributions \nfrom both governments and private donors\n•Small Executive Secretariat jointly staffed by the Bank, UNAIDS and the World Health \nOrganization to undertake day-to-day management of the trust fund, including soliciting \ngrant proposals. \n•Two-tiered financial structure like a university endowment:  \n•\"core fund\" of resources to support any activity falling within the work program and \neligibility criteria \nReleased by Chairman Rand Paul\n15•donors could also earmark contributions for use on their particular priorities, as long as they \nfell within the overall purposes and priorities of the trust fund.  \n•Both “core” and dedicated resources combined in each grant in a way transparent to the \nrecipient.\nGovernance\n•High-level Governing Council to provide overall strategic direction.  \n•Donors and representatives of the developing world (serving in their own personal capacity);\n•President of the World Bank, Director General of UNAIDS and Director General of WHO as \nex officio, non-voting members.\n•Council to fully control all fund decisions, including determining programmatic allocations, \noperational rules and procedures, policies and strategies, approving financial plans and work \nprograms, and attracting additional donations. \nGrant-Making\n•Governing Council to outline and agree to fund core menu of “best practice” programs, \naccording to certain quality standards and experience with evidence-based models proven to \nwork in developing countries.\n•Fund to solicit letters of intent from governments and non-governmental \norganizations (NGOs), especially faith-based groups, that describe plans to \nimplement one of more of core models in local areas.\n•Applicants to determine which approved packages most appropriate and useful for \nlocal context. \n•Models could range from simple prevention and education programs to more \nsophisticated, comprehensive efforts that could involve basic care and treatment, \ncontrolled delivery of anti-HIV therapy, medical training, and clinical trials.\n•Emphasis on individual and government accountability, behavior change and \nabstinence-based approaches.\n•Technical assistance to countries and organizations unable to satisfy our criteria in their \nletters of intent, so that over time they might also be able to participate.\n•Scientific and Public Health Review Committee to perform rigorous technical peer review \nprocess to assess letters of intent.\n•International scientific, medical, and development experts drawn from developing and \ndeveloped countries and international organizations\n•Empowered to make final decisions about feasibility and sustainability of proposed programs \naccording to criteria for each “best practice” model prescribed by the Governing Council.  \n•Broad guidelines that spell out the recommended ratio of expenditures on prevention, \ntreatment, and research the Governing Council would prefer projects follow.\n•Demonstration of local leadership and adherence to international standards of financial \naccountability and transparency required.  \n•Preference given to comprehensive plans that involve governments and NGOs working \ntogether.\nReleased by Chairman Rand Paul\n17well. If you have a few moments, please take a look below. Do you have answers\nfor my questions? Feelings about these issues?\n I welcome responses......Hey, I'm a reporter: I ask questions and hope to get\nthoughtful answers.\nThanks very very much for your time and thoughtful attention.\nLaurie Garrett\nlgarrett@newsday.com\n***************************************************************\nGregg,\nDid you see Newsday's editorial two days ago? Total support for your position\nregarding treatment access.\nLast night I was in a screaming match with a  doc who does work in South Africa. An\nAmerican. He actually said, \"I don't give a fuck about microbicides! I don't\ngive a fuck about prevention! Fuck all you public health assholes! This is about\nwhat is morally right --- treating. Fuck everything else! Bitch!\"\nUnbelievable.\nIt is absolutely amazing to me that the classic Public Health v Organized\nMedicine dichotomy has so deeply divided the AIDS community all of a sudden.\nCorrection: the do-gooder community of Westerners. I haven't heard many African\nvoices chiming in on this one.\nWhy the hell is there any dichotomy? Haven't we learned anything from all the\nmistakes made with TB, drug resistant bacteria, vaccine campaigns......? Jesus!\nI have never seen a moment so desperately in need of leadership. Somebody needs\n----   IMMEDIATELY  ---  to call an emergency scientific meeting, with a very\nvery focused agenda, super-fast.  We need:\n-  Assessment of the validity of the Harvard model. And of other HAART treatment\nmodels. With emphasis on AFRICAN reactions and desires to said model (and not\njust five African academics who have been collaborating with Americans or\nEuropeans for years. REAL people, who toil in thankless jobs in horrible clinics\nall over the continent.)\n- Assessment of the questionable validity of a few assumptions in that report,\nincluding:\n     - HAART is a public health measure because is lowers transmissability (oh\nreally? ALL studies of the    matter at the Human Retrovirus meeting showed that\nthere was no clear correlation between blood       viral load and semen or\nReleased by Chairman Rand Paul\n18vaginal viral loads. Do we really know this is true? We have ONE study ---  The\nRakai survey. That's it.)\n     - HAART will, to quote Sachs, \"save millions of lives\". Really? But we now\nhave 3 studies on large       patient pops. showing the life expectancy benefit\nof HAART in USA and Europe is perhaps as little, on     average, as 1.5 years,\nno more than 5 years. That's not even a \"saved life\" in cancer terms, as in \"5\nyear survival rates\".  When grim data came out a year ago critics charged that\nthe high failure rates   were due to large populations of Americans who were\ngetting diagnosed and treated in late stage HIV    infection. Well, now we have\nchanged the treatment reccommendations to specifically say that later\nstage treatment is preferable --- so much for that explanation, no?  What\nreally, truely, is the statistically valid efficacy of HAART?\n- In terms of the pentultimate concern that I believe (I hope) is the bottom\nline for all sides --- SAVING LIVES --- what would be the impact of a massive\nspending commitment aimed at:\n     - cleaning up the blood supply (less than 10% of which globally, according\nto WHO, is currently          screened for Hep B, C and HIV)\n     - global large scale distribution of autodestruct nonreuseable syringes and\nMANDATORY coupling of    all injectable drug and vaccine products with such\nsyringes. In other words, if a vial of measles          vaccine contains 10\nchild doses, if should be vaccum sealed to a slab of cardboard on which are 10\nautodestruct syringes. Talk about immorality! How in the world can ANY\nhumanitarian, medical or UN   agency POSSIBLY justify distributing vaccines in\ncountries with greater than 5% HIV rates without        attaching enough\nautodestruct syringes to ensure that EVERY SINGLE CHILD receives a sterile\ninjection? I have seen this with my own eyes ---nobody can BS this one. I have\nbeen in African villages      where 20 kids were vaccinated with the same\n\"single use\" plastic syringe. And I have been in        Ukarianian hospitals\nwhere syrgines were passed from child to child like candy. Consider these\npoints:\n          - Russia estimates that by 2006 12% of her population will be HIV+,\nand nearly all the infected        will be under 29 years of age, IVDUs. It's\nnot a sexual epidemic --- YET --- in Eastern Europe          and ex-USSR. The\nopportunity to stop that part of the pandemic COLD is there. It's easy. It's\n     mass access to autodestruct syringes. And it's this question: which\nsocietal concern should       guide HIV policy --- hatred of narcontics users,\nor fear of the virus? Am I wrong about this?\n          - CDC just released a report indicating there were 19 BILLION (yup)\nmedical injections last       year globally, some 90% of which were\nunnescessary. And 80% in Asia were nonsterile, 75%           in SS Africa and\n70% in ex-USSR. PHYSICIAN DO NO HARM: why the hell hasn't anybody\nasked what %age of this pandemic is nosocomial, iatragenic?????\nReleased by Chairman Rand Paul\n19     - creating a prize --- say, $10 million --- as incentive to the first\nscientific team that develops a truely safe   and effective vaginal microbicide\nthat can be affordably mass produced. (Total global current\nmicrobicide R&D is now less than $50 million, as far as I can tell.) Would that\nwork? Just how large an  intellectual problem is anti-HIV microbicides? Isn't it\na helluva lot easier than coming up with a 90+%    effective preventive vaccine?\nSo, we're working on that vaccine --- FINALLY. Why not a serious\ncommitment to the microbicides, too? (Is it the word \"vaginal\"?)\n     - linking treatment tightly with prevention education, in a quid pro quo\nmanner (tax payers are        subsidizing your HAART, and you are free to live\nwithout prejudice or discrimination, stay healthy and   continue to have a rich,\nfull life. BUT, you must in return understand you have a social responsibility,\nand cannot knowingly do anything that might spread your virus to others. This\nincludes females, who,   you African males disdain and consider subhuman. This\nincludes male & female prostitutes who you    pay to accept risk.) I know of no\nrigorous case controlled study done anywhere in the world that asks    whether\nor not this will work. Have I missed them?  But clearly, in the USA and Europe,\na very         significant %age of HAART recipients feel NO social obligation\n---- why else would we have resurgent    syphilis, gonorrhea, HIV and a national\n14% DRUG RESISTANT HIV rate?\n     What I'm really asking here is whether the fine difference between\n\"treatment\" and \"cure\" can be fully      understood, and integrated into\nbehavior, without intense counseling, etc. Obviously we have           problems\nwith comprehension here in the richest country in the world, especially among\ncollege        educated white middle class males.\n     - reassessing the results of the Levine Report and the seeming tendency for\neverything at NIH to          revert. Would a serious recommittment to\naddressing long unanswered basic science questions be in     order right now?\n     - before we start mass distributing HAART, do we know:\n          - which of the drugs are heat sensitive? What is the half life of a\nprotease inihibitor that is stored            under a tin roof in 90% humidity\nat consistent ambient temperatures above 90 degrees F? Are        there Cold\nChain issues with any aspects of HAART or OIs treatment?\n          - which of the drugs have interactions with antimalarials? With\nantiparasitics? With rotgut              booze? with other drugs that have\nundergone chemical change due to storage in above                 conditions?\n          - what percentage of the target populations have TB, and what %age of\ndeaths in the local           HIV pop are due to TB? Do we know everything we\nneed to know to guide co-treatment of TB           and HIV with TB-DOTS and\nHIV_DOTS?\n          - why TB DOTs has largely failed globally, resulting in MDR-TB strains\nsurfacing in 112              nations over the last 6 years (when it was limited\nReleased by Chairman Rand Paul\n20to less than 10 countries before then)? Do we           really know how much of\nthat failure is due to insufficient monetary support, how much to\ninfrastructural failure and how much to the DOTs model, itself, in varying\ncultural and political        settings?\n          - which HAART combos are least likely to lead to multiple drug\nresistance, or cross resist-       ance and how that compares with the cheap\ncombos proposed by CIPLA and MSF, etc?\n          - what key factors have, for the last decade, prevented distribution\nof the Essential Drugs lists       in most African countries? (Hint: it aint got\ncrap to do with the cost of the drugs, prices set by              manufacturers\nor WHO policies. It has everything to do with corruption, black markets,\n     Russian mob,  bad roads, lack of ship off-loading capacity at ports,\nwarehousing in                high heat, etc etc.)\n     - WHY AFRICA? OK, I'm asking a rhetorical question here. But if global\ndistribution of HAART makes sense for ssAfrica, why not also for Vietnam?\nUkraine? Cambodia? Russia? Estonia? Is it a question of a certain cut-off, such\nas \"societies with greater than 10% HIV+ rates?\"  Or 5%? Who has the right to\nmake that decision? What are the moral issues here? Do white doctors from\nAmerica  and Europe get to choose which HIV poor populations on earth get to\nhave freebie drugs? Does WHO decide? MSF? YOU??????  (If I were an AIDS doc in\nBombay or Kiev right now I would be mighty pissed off....).\n     - If, indeed, Senegal, Uganda, Thailand and Brazil have not only lowered\ntheir mass HIV rates, but sustained lowered levels, what worked? (From my\nobservations in Uganda I would say the lowering was transient, and it is now\nresurging in much of the country. It was not sustained. Senegal never did have a\nhigh rate: why? All of west Africa has lower rates....why? Many believe it has\nlittle to do with prevention programs or drug access, and everything to do with\nmale/female power balance issues and female access to the cash economy.)  Jon\nMann for ages had a mantra: if a prevention effort works, why? and why isn't it\nimmediately replicated elsewhere?\n     - Why were all the questions raised in opposition to phase 3 vaccine trials\nnot raised for largescale HAART? Remember when NIAID decided to can Phase 3\nvaccine studies? The reasons were not so much about the likelihood the vaccines\nwould work (nobody thought they would), but concerns that people who received\nthe vaccines would then put themselves and their partners at higher risk, based\non the assumption that they were at least somewhat protected. That was shouted\nfrom the rafters, and continues to be a huge issue. NIH and CDC have spent loads\nof money trying to figure out how to counsel vaccine volunteers, what to say\nabout safe sex, etc. It has been an ENORMOUS concern in the vaccine arena ---\nwell in advance of actually having a product worth testing. But with HAART?\nBupkiss. Nada. Zilcho. This seems a glaring contradiction bordering on mass\nhypocrisy.\nReleased by Chairman Rand Paul\n21OK, that's my venting for the day.\nI try to report the truth. I strive for balance. It's getting harder because\neverybody is fudging the truth now. Everybody is letting their agendas guide\npolicy ---NOT the science. For the most part, as far as I can tell, the science\nhas never really been done. Please, prove to me that I've merely missed it.\nLaurie\nApril 15 – 20 – Trip to Uganda\nTRIP TO UGANDA\nApril 15 – 20, 2001\nApril 15 – Leave Washington, DC\nApril 16 – Arrive Entebbe/Kampala at 7:00 PM \nApril 17 – Spent the day  touring medical facilities and making patient rounds at various \nhospitals and facilities in Kampala.  Jack Killen (Director, Division of AIDS, NIAID) \nwas my traveling partner.\nStarted the day off by meeting with Nelson K. Sewankambo (Dean, University of \nMakerere School of Medicine.  Went off to the Mulago Hospital Antenatal Clinic \nescorted by Professor F. Mmiro, a charming and enthusiastic 50-ish OB-GYN doc and \nLaura Guay, a pediatrician.  This was a most extraordinary experience. I witnessed and \ninteracted with  large numbers of Ugandan women who come to the clinic for antenatal \ncare.  If they request, they are screened for HIV infection and counseled.  Most of them, \nalthough they come to the antenatal clinic, deliver at home unless there are complications \nsuch as twinning or toxemia.  The percentage of HIV-positivity among them used to be \n>40 percent.  Now it is approximately 20 percent.  The physical nature of the clinic was \nthat of open rooms connected to outside virandas.  The clinic was packed. Many women \nlooked healthy, but several clearly had HIV disease.  Since no treatment is available, no \none from among the clinic patients gets treated for HIV.  If they can pay something, they \nget treatment for OIs and many get prophylactic Bactrim.  Patients who can pay fully will \nget reasonable care. I had to hold back my tears.\nNext we went  on to the Makerere University (MU)-Johns Hopkins University \n(JHU) Project that is heavily funded by NIAID.  We were shown around by Laura Guay \nand Phillip Musoke  Mudido, a Ugandan physician.  Laura is extraordinary.  She is an \nAmerican woman who has been in Uganda for 13 years.  She is single and has adopted \n(or at least supports) a few Ugandan children who are AIDS orphans.  They showed me \naround their clinical research projects.\nNext went to the U.S. Embassy to meet with Ambassador Martin Brennan, a 40-\nish man who appeared extremely interested and knowledgeable about HIV in Uganda.  I \nReleased by Chairman Rand Paul\n22discussed with him the NIAID initiatives as well as my recent interactions with Secretary \nThompson, the State Department, NSC, Domestic Policy Council, and the White House \nconcerning the development and implementation of a White House and US Government \npolicy and plan of action for treatment of HIV in Africa and AIDS care in Africa. At the \nmeeting was Ms. Dawn Liberi, USAID Chief for Uganda and Jonathan Mermin, a CDC \nperson assigned to the US Embassy.  Excellent meeting.  Extraordinary security related to \nthe terrorist attack on the Nairobi Embassy last year. We could not even take cell phones \ninto the ambassador’s office.\nNext went on to the Joint Clinical Research Center (JCRC) escorted by Peter \nMugenyi and Cissy Kityo.  Like Nelson Sewankambo, Peter is clearly an important \nphysician in Uganda and the JCRC does much clinical research on HIV/AIDS.  It was \nunclear how patients get put on a protocol and are followed at JCRC versus getting \nadmitted as a regular patient to Mulago Hospital.  The JCRC is the source of many of the \nimportant clinical studies that have come out of Kampala.  I was impressed by the \nsophisication of their operation.  Many Africans and some expatriots (mostly Americans) \nwork here and also at other facilities that I visited including the Rakai Project (see \nbelow).  Most Staff (PH.Ds, MDs, MPHs and even technicians have spent some time \nlearning techniques and theory in the USA.\nNext went on to make Ward Rounds in the Department of Medicine at Mulago \nHospital with Roy Mugerwa and Harriet Mayanja.  This was clearly one of the defining \nmoments of the trip for me and changed the way I think about the reality and potential of \nAIDS care and health care in general in Uganda and Africa since Uganda is considered \none of the best.  The wards were packed; people were lying in hallways, in open air \nvirandas, and some were waiting with their families to gain admission.  Most looked \nextremely ill and cachectic.  Others were reasonable fit, but obviously acutely ill. I have \nrounded on thousands of patients over the years, but I have never seen anything like this \nexcept maybe when I made rounds at the King Edward Hospital at the University of \nNatal in Durban, South Africa in July, 2000.  The difference here is that virtually no one \ngets treated specifically for their disease because of lack of anti-retrovirals and inability \nto pay even for drugs for OIs, TB and malaria.  The rule (with few exceptions is that if \nthe patients cannot pay something (even a dollar or 2), then they get no specific \ntreatment. If they can pay, but are poor, they do “cost sharing” whereby they pay for part \nof what is to be done (i.e. chest x-ray, medications, etc.); however, it is severely limited \nby the amount which they cost share. If you are relatively wealthy and can pay, you go to \na different ward and anything is possible diagnostically (chest x-ray, CT, blood work) \nand therapeutically (ARV, OI treatment, etc.).  I saw patient after patient with HIV \ndisease (mostly diagnosed not by serology since ELISA was too expensive - $4.00) and \nOIs.  Overwhelmingly, patients had active TB.  Here again, diagnosis was made \nclinically without chest x-ray and frequently without sputum smear and culture.  \nCertainly, no CTs, bronchoscopies etc.  I remember specifically a 17 year girl who had \nHIV disease (diagnosed by wasting and oral thrush) and likely cryptococcal meningitis \n(dx made clinically); they were considering doing an India ink stain on CSF, but decided \nnot to since they could not do anything for her anyway since she could not afford \namphotericin or fluconazole.  The plan for the patient was hydration, analgesia and \nReleased by Chairman Rand Paul\n23discharge home to her mother.  It was tragic!  Again, I could barely hold back tears. A \nsimilar case was that of a man in his 30s with obvious HIV disease and likely \ndisseminated TB.  Again, no specific therapy.  It hit me like a truck!  We were here in \nUganda talking about the possibility of AIDS care now that drugs would likely be \navailable at markedly reduced prices for Africa (see other discussion regarding tidal wave \nof movement to provide drugs).  The problem that was clear to me was that even in the \nMulago Hospital, which is one of the best in Africa there was not even basic health care!  \nImagine (see below) in the rural areas where there are hardly any doctors.  In addition, \nwhat kind of training were the house staff getting when they could not definitively \ndiagnose and certainly only rarely treat anyone?  It became clear to me that we must use \nthe enthusiasm about providing AIDS drugs to Africans to catalyze an effort to address \nfundamental health care in Africa.  Even in the best of places (Uganda), there is hardly \nany health care infrastructure.\nApril 18 -  Visit to Rakai. Went with Jack Killen (who was with me throughout the entire \ntrip).  Leading the trip was Nelson Sewankambo, David Serwadda, T Lutalo, and F. \nWabwire.  This was one of the highlights of the trip.  NIAID funds, in collaboration with \nMakerere University, Columbia University, and Johns Hopkins, a project in the Rakai \ndistrict of Uganda (southwest of Kampala towards the border with Tanzania and \nRwanda).  The project has been going on for about 13 years and has been the source of \nmany major papers including most of Tom Quinn’s work on the role of STDs in HIV \ntransmission, the relationship between viral load and transmission in discordant couples, \nand the protective effect of circumcision on transmission of HIV, among other studies.  \nThe site was inspiring, particularly the dedication of the staff who were mostly young \nUgandan MDs, PH.Ds, technicians, nurses, etc.  Also included among them were a few \ndedicated American expatriots who were either permanent or doing a fellowship (usually \nout of Hopkins).  Of note, were Noah Kiwanuka, a Ugandan, born in Rakai, who went to \nmedical school in Kampala and received his MPH from Hopkins.  He was as good as \nthey get and clearly was in command of the project.  Also of note was Mary Meehan, an \nAmerican wife, mother of 3, and a scientist who had been living with her journalist \nhusband in Uganda and working at both the Uganda Virus Institute in Entebbe and the \nRakai project. \nOf particular note on the trip was the level of available care in this district, which \nmade Mulago look modern.  I visited the Kalisizo hospital as well as a “subdistrict” anti-\nnatal and general medical clinic.  There was almost no physical access.  The best of the \nroads were almost impassable.  There were large ruts and gigantic potholes in the \nunpaved road.  Even with a four-wheel drive van, we barely made it since it was the rainy \nseason and segments of the road were partially washed away.  I will never forget the \npatients that I saw at Kalisizo and the rural clinic.  There were benches full of patients \nwaiting to be registered and hallways full of people waiting to be seen.  Some patients \nwere tended to by their families and were lying on the walkways and hallways or on the \nlawn without a bed.  The pediatric ward had 2 children per bed.  I was told that among \ntheir other diseases such as HIV and TB, the majority of the people in the wards, \nespecially the children, had malaria.  I say several children being transfused for malaria-\ninduced anemia.  Now in 2001, the blood supply is well-screened.  I can only imagine \nReleased by Chairman Rand Paul\n24how many children got HIV-infected years ago before blood screening by these \ntransfusions given for malaria.  The faces of the patients were haunting.  They were very \nquiet; no one made a sound, even the most ill.  The Kalisizo hospital was staffed by 3 \nMDs whose training was medical school and 1 to 2 years of house staff training.  These \npeople did everything that did not absolutely require secondary and tertiary care.  They \nperformed deliveries, Caesarean sections, abdominal surgery (including bowel resection \nand anastomosis), fractures and other trauma as well as some types of chest surgery.  \nWith all due respect to their dedication, I thought at the time and still do now that despite \nthe fact that on-the spot training is critical, these people could not be highly skilled \nsurgeons since the only formal training that they had before they came to this place was a \ncourse in “surgical techniques” in medical school.  This involved resecting bowels of \nsheep and other animals.  There was no senior attending here supervising them.\nAn important point about the visit was the extraordinary sophistication and \ndedication of the staff of the Rakai Project.  They were amazingly organized in their \nsystem of following patients on study. They had a large number of counselors and field \nworkers who went out into the field and tracked and counseled their patients.  They went \nout by truck, motorcycle or on foot.  They were mostly young Ugandans who were \nclearly dedicated.  The success of the projects clearly depended on them.\nApril 19 – The meeting entitled “AIDS Care in Africa” started today and I gave a brief \nopening address that I had carefully prepared with a written statement and slides that I \nhad asked Greg Folkers to immediately post on the NIAID Website after the talk (please \nsee copy of speech).  Given the tidal wave of enthusiasm of getting antiretroviral drugs to \nAfricans, there was in the global community immediately prior to this meeting a major \ndichotomy between those who were concerned that providing treatment would suck off \nresources from prevention and other activities and those who felt that we should proceed \nvigorously towards treating African with anti-retrovirals now that the prices of drugs \nwere markedly decreased.  It was clear to me from my reflections before the meeting (see \nmy speech) and from my 2 days of observing first-hand the situation in Kampala that \nthere needed to be a balance between treating Africans and accelerating the prevention \nmeasures.  Also, and extremely important was the fact that as mentioned above, there was \nhardly any health care infrastructure in Uganda (which was better than most African \ncountries).  I stressed that we must act in a comprehensive manner by building \nsustainable health care and research infrastructure and by also considering other basic \nhealth care issues such as clean water; treatment and prophylaxis for malaria, TB; \nvaccinations against childhood diseases; treatment of diarrheal and acute respiratory \ndiseases.  My remarks were extremely well received and clearly the meeting organizers \nand participants were pleased that I was there and were looking to me for sober \nleadership in this difficult problem.\nAn interesting event transpired at the morning session.  Ugandan President \nMuseveni was scheduled to speak immediately before my talk.  He was late and so I gave \nmy talk and chaired the session for about 1 ½ hours.  Just at the end of the question \nperiod, the President walked into the Ballroom of the Sheraton Hotel where the meeting \nwas held.  He was accompanied by his Chief Deputy Dr. Ruhakana Rugunda.  Everyone \nincluding myself left the stage to make way for the President.  I took a seat in the first \nrow of the audience.  Just then, Dr. Rugunda stepped down from the stage, grabbed my \nReleased by Chairman Rand Paul\n25arm and led me to the stage saying that the President very much wanted me to sit down \nnext to him during his speech.  I was told that the President has long been an admirer of \nme and respected all that I had done for AIDS.  The President greeted me with a \nhandshake and began his speech by recognizing me to the audience.  After his speech, Dr. \nRugunda asked me to say some words.  I extemporaneously spoke into the microphone \ndirectly to the President and told him that he was a model of African leadership and that \nhe was highly respected in the USA and throughout the world for his sensitivity, insight \nand leadership in the fight against AIDS, and that we often refer to the “Uganda Model”.  \nI told him that when I returned to the USA part of my responsibility was to report back to \nmy Minister of Health, Secretary of DHHS, Gov. Tommy Thompson and the staff of the \nWhite House.  I said that I would tell them that what we have heard about President \nMuseveni was true and that you were indeed an inspired leader and that we look forward \nto continuing to work with him. He was obviously very pleased with my remarks and \ngave me a hearty handshake and a very warm smile.\nAt dinner that night, The Rockefeller Foundation hosted a working dinner for \nseveral of the participants to discuss the meeting.  I was asked to serve as rappateur for \nmy table and we had lively discussions about where we go next in this process.\nApril 20, 2001 -  Last day of meeting and my day of departure.  Discussions continued \nand we all realized how difficult it would be to accomplish this lofty goal of providing \nantiretroviral therapy for Africans.  There was good news during the meeting that the \nconsortium of drug companies had withdrawn their ill-advised lawsuit against South \nAfrica for trying to distribute drugs outside of patent restrictions.  Now the South African \ngovernment (which has been extremely problematic at best with President Mabeki \nshowing bizarre behavior regarding whether HIV causes AIDS) would have to move to \nstart treating their people since the drug companies could no longer be considered the \nobstacles.\nLincoln Chen of the Rockefeller Foundation gave a very nice summary of the \nmeeting as the last speaker and used many of my direct quotes from my talk and my \ndiscussions to make important points.  One in particular was my warning to beware of the \n“ethical police” who would only want us to do studies in Africa that would be acceptable \nand relevant in the USA.  This centers around the issue of the Declaration of Helsinki \nwhich states that the control arm of any trial in a developed country (or anywhere) would \nhave to be the best possible therapy for the disorder.  By “best possible therapy”, they \nmean best anywhere.  This would make research to answer questions that are relevant to \nAfrica virtually impossible.  We all agree that high ethical standards are necessary; but to \ndemand the best therapy anywhere as the control arm in a nation where there is virtually \nno health care and which would not be relevant to Africa is unrealistic.  Everyone in the \naudience agreed and gave me a long applause.\nAfter the meeting, we drove to the Uganda Virus Institute in Entebbe on the way \nto the airport to visit Dr. Sylester Sempala, a well known Ugandan virologist whom I had \nmet previously at a meeting in Naples, and Mary Meehan.  It was a nice facility (by \nAfrican standards) and the view was magnificent.  It was perched overlooking the shores \nof Lake Victoria.\nReleased by Chairman Rand Paul\n26This was an extremely important trip for me in that it gave me a first-hand \nappreciation of the dire situation in Africa, not only with regard to HIV/AIDS, but also \nwith regard to heath care in Africa in general.  I believe that this trip will change me \ndramatically towards a direction that I have already been heading for the past couple of \nyears.  This direction is towards a greater effort and interest on my part in global health.\n  \nApril 24, 2001 – Spent 30 minutes on the phone with Secretary Tommy Thompson \nbriefing him on my trip to Uganda.  Thompson is getting ready to brief the Cabinet and \nconvince them that the USA should take a leadership role in the AIDS in Africa initiative.  \nHe mentioned that he will rely very heavily on me to help him accomplish this important \ngoal.\nMay 5, 2001 – Important conference call with DHHS.  On call was Art Lawrence \n(Acting ASH), Eric Goosby, Helene Gayle, ASH-Designate Claude Allen, Jeff Copeland, \nTerrell Halaska, Bill Steiger.\nWe (Me, Jeff Copeland, Terrell Halaska, Bill Steiger)  had been working for \nweeks on putting together a position paper for Secretary Thompson on the response to the \nchallenge of AIDS in Africa.  UN Secretary General Kofi Annan will come out with a \nproposal for a Global Trust Fund for AIDS in Africa in June at a Special Session of the \nUN General Assembly.  The White House used our White paper as background to get out \nfront on the issue and announce that the USA would contribute to the Global Trust Fund.  \nWe were told on the call that the Cabinet Council met with Pres. Bush.  The Cabinet \nCouncil consisted of Secr. Thompson, Secretary Colin Powell, Carl Rove, OMB Director \nMitch Daniels, Domestic Policy Council Margaret La Montagne, Pres. Counsel \nRodriguez and members of VP Cheney’s office.  The decision was made for Pres. Bush \nto announce on May 9, 2001 that the USA would contribute in FY 2002 $200 million to \nthe Trust Fund.  However, of great relevance to me and NIH, there would be no new \nmoney.  It would all be budgetary offsets.  Of the $200 million, HHS would give $100 \nmillion, Dept. of State would give $60 million and $40 million would come from the \nexisting AIDS trust fund.  Of the $100 million from HHS $95 million would come from \nNIH as a transfer.  $65 million would come from B & F, $25 million from NIAID, $5 \nmillion from NIH OD and $5 million from cyber security.  Of considerable note is that \nBill Steiger mentioned on the call that he was very “grateful for the generosity of Tony \nFauci who has offered to provide the $25 million from his FY 2002 appropriation.  Since \nNIAID will get a 14.2% increase, when you subtract the $25 million, this means we \nwould still get a $260 million increase in our >$2 billion budget.  It would not be taken \nout of the base, but would be a one time transfer.”.  The fact is that I had offered to help a \nfew weeks earlier in my conversation with Terrell Halsaka.  By “help” I was not referring \nto the Trust fund; I was referring to putting more research money into the AIDS effort in \nAfrica.  There was no way that I offered $25 million for the trust fund.  However, I did \nnot object over the phone since it was obviously a done deal and the President was going \nto announce it.  It would look very bad if I objected.   There was nothing that I could do \nbut turn this “challenge” into an “opportunity”.  In the end, it really is the right thing to \ndo since it shows leadership in an important cause and our base was not impacted.  I will \nprobably take some heat from our constituencies.  However, who can cogently argue \nReleased by Chairman Rand Paul\n29August 2, 2001 – Had meeting at NIH (Building 31, 7A-24 Conference room called by \nRichard Falkenrath of the National Security Council who is Ambassador to the Biological \nWeapons Convention.  Present at the meeting were:  John La Montagne, Thomas Monath \n(Acambis Co.- Vice Pres. For Research and Med. Affairs), Stuart Nightingale (DHHS), \nRobert Mikulak (Director, Office of Chemical & Biological Weapons Convention, Dept. \nof State), Carole Heilman (DMID/NIAID), George Poste, Matthew Meselson (Harvard), \nMargaret Hamburg, Joshua Lederberg.\nPurpose of meeting was to review a White Paper that had been put together as an \ninternal document for President Bush.  The President had just rejected signing the \nrenewal of the Biological Weapons Convention (BWC) on the basis that it was \nunenforceable.  Falkenrath was tasked with putting together a briefing document that was \nan expression of our interest in the problem, but was an alternative approach to the BWC.  \nWe crafted something that was a “high road” approach indicating that since we cannot \nenforce restrictions among committed users and abusers, then at least we can support \nbiomedical research to provide better diagnostics, therapeutics and vaccines.  At worst, \neven if it does not help with bioterrorism, it would be useful for mankind.\nAugust 9, 2001 -  After much deliberation and soul searching, President Bush decided \nand announced that Federal funding would be allowed for research on embryo-derived \nstem cells.  However, funding would be restricted to work on embryonic stem cell lines \nthat had either already been established or were in the process of being established (i.e. \nthe stem cells had already been removed from the embryo as of August 9, 2001).  NIH \n(mostly in the form of Lana Skirboll) had canvassed the world and found that 60 such \nlines were in existence, many in the private sector.  The lines were growing robustly and \nwere established according to the 4 points that President Bush mentioned in his speech, \ni.e. they had to be in vitro fertilized embryos that fulfilled the following criteria: 1) \ninformed consent; 2) in excess of clinical need; 3) not done as a result of financial \ninducement; 4) embryos not established for the purpose of research.\nThe public response was that the far right felt that the President had betrayed his \npledge not to fund research on embryonic stem cells.  Several scientists felt that he had \nnot gone far enough since he restricted granting of Federal funds for further (after August \n9) use of embryos to derive stem cells.  I felt that Bush went as far as he could go \npolitically since on the one hand, if he disallowed any work on embryonic stem cells, the \nfar right would have been happy, but it would not be a sustainable position for the general \npublic.  On the other hand, if he allowed the unrestricted use of embryos that had been \nestablished for in vitro fertilization (even though this was what I hoped he would do), the \nconservatives would have damaged him politically.  In other words, I believe that he went \nas far as he could go.\nAugust 10, 2001 – Secretary Tommy Thompson came to NIH to hold a press conference \nto discuss the embryonic stem cell decision.  He requested that I be with him on stage \nalong with Claude Lenfant, Lana Skirboll, Ruth Kirschstein, and Audrey Penn (acting \nDirector of NINDS).  When he asked me to speak, I made a statement thanking him for \nhis leadership (since he favored allowing funding all along) and also thanked the \nPresident for his courage in making a difficult choice, but one that will allow us to go \nReleased by Chairman Rand Paul\n30forward and do some good for mankind.  I also pointed out the important fact that now \nwe can do head-to-head comparisons of stem cells derived from embryos versus adults \nversus fetal tissue.  My comments appeared on the front page of the New York Times on \nAugust 11 and a clip of my comments was shown on the Lehr Newshour on the evening \nof August 10.  I am sure that some scientists will criticize me for saying that the decision \nwas a positive thing.  However, it is clear to me that these types of people are clueless \nwhen it comes to the world of Washington, D.C.  Furthermore, the far right will also be \nupset since I favored the use of embryonic stem cells at all.  I care even less about what \nthey think of my position.  All in all, I believe that this was a good day for biomedical \nresearch.  Lana Skirboll deserves much create for turning the President around.\nAugust 12, 2001 – CNN in association with Time Magazine ran a special program on \n“America’s Best in Science and Medicine”.  I was featured in an 11 minute segment \nalong with 4 other scientists.  This was in association with Time Magazine naming me \none of 18 scientists as “America’s Best in Science and Medicine”.  This feature appeared \nin the August 26 edition of Time that reached the newsstands on August 13.\nAugust 13, 2001 – Bob Wood (Chief of Staff for HHS Secretary Thompson) phoned and \nsaid that Secr. Thompson and President Bush have been discussing my turning down of \nthe NIH Director’s job and they want me to reconsider and to name my own conditions \nincluding maintaining my Directorship of NIAID and virtually anything else I wanted.\nAugust 14, 2001 – Terrell Halaska (Deputy Chief of Staff to Secr. Thompson) called \nwith almost identical pleas as that of Bob Wood (see above).  She mentioned that I am \nfrequently mentioned at the White House and that the President wanted very much for me \nto be NIH Director.  I told Terrell that I did not want to do this and explained to her that \nmy reasons were similar to those 12 years ago when I said no to President Bush (the \nelder), i.e. I wanted to work fulltime on the AIDS epidemic and on Global Health and \nInfectious Diseases.  She was very understanding and was quite complimentary to me, \nsaying what an honor it was to work with me.  Clearly, the phone call went well.\nAugust 15, 2001 – As I had promised, I called back Bob Wood and told him exactly \nwhat I had told Terrell Halaska.  Bob also was very understanding.\nAugust 20, 2001 – Secr. Thompson spends entire day at NIH as part of his week at NIH.  \nI presented to him on Global Health and Vaccine Development at NIH.  Also, Gary \nNabel and I gave him a tour of the NIAID Vaccine Research Center.\nAugust 21, 2001 – Attended a meeting at the White House of the Policy Coordinating \nCommittee of the Biological Weapons Conference group.  Chaired by Robert Joseph \n(Special asst. to the President) and Richard Falkenrath (Deputy to Condolezza Rice).  \nPresent at meeting was Ambassador Donald Mahley, Special Negotiator at State \nDepartment for Chemical/Biological Weapons, as well as representatives from Justice \nDept., State, DOD, DHHS (me, John La Montagne, William Steiger), etc.  Purpose was \nto review document that the group put together (White Paper) as a policy that the \nPresident will articulate in association with the USA refusing to re-certify the Biological \nReleased by Chairman Rand Paul\n31Weapons Conference.  The paper takes a high road approach about how to handle this \nproblem, while recognizing that much of what was contained in previous agreements was \nunenforcible.  John La Montagne and I had contributed to the scientific components of \nthe white paper.\nAugust 23, 2001 – Secr.Thompson on a visit to NIH again offered me the position as \nNIH Director and said that the President wanted me and that I could indeed be NIH \nDirector, NIAID Director, and keep my Lab.  I told him that I wanted to remain doing \nwhat I was doing at full speed and so refused his offer.  He was extremely gracious and \nquite complimentary to me.  He said that I was the most outstanding person that he had \never met ….really.  He said that he would not ask me again unless I brought it up.\nSept. 11, 2001 – Day of infamy. I was in New York City at the time of the attack on the \nWorld Trade Center.  Below is a note that I sent to Andy Saxon (in response to his \nconcern for the safety of me and my family) after returning to Washington, D.C. that \nexplains what happened:\nDear Andy:\nThanks for the note.   I was actually in New York City about 30 \nblocks from the World Trade Center in a taxi cab getting ready to go to \na meeting of the Doris Duke Charitable Foundation at the precise time \nthat the first plane hit.  By the time I got to the meeting in mid-town \nManhattan and went into the building, I saw on TV the second plane hit.  \nIt was the most horrible day of my life.  I was not hurt nor was I ever \nin any danger; however, it is an experience that I will never forget. \nAs you know, my father lives alone in New York, but his apartment is \nabout 70 blocks uptown from the WTC and he is fine.  Also, as you know, \nmy girls go to school in Washington, D.C; however, they are reasonably \nfar from the Pentagon.  They saw the smoke from their classrooms on the \ngrounds of the National Cathedral and as expected were emotionally \ntraumatized.  All DC schools were immediately dismissed and the \nchildren went home.  However, Jenny, Megan, and Alison (not to mention \nChris) were very frightened since they knew that I had just left for \nNew York City that morning.  I could not phone to tell them that I was \nOK since all of the cell phones and fixed phones were jammed.  Finally, \nI got through to them and they were obviously very relieved. I feel \nvery fortunate. I was stranded in NYC for a while, but finally caught a \nlate night train out to DC.\nWashington is an eerie town right now.  Military police are all \nover downtown, National Airport is closed INDEFINITELY, and F-16 jets \nare flying in combat formation all day and night over the city.  The \nNIH has concrete barricades at every entrance and if your car does not \nhave an NIH sticker and you do not have an NIH ID, you could be the \nPope and you will not get on campus.  This is true of all Federal \nBuildings.  As you probably know from the News, the FBI now knows that \nthere are several cells of terrorists still in the USA with plans to \nexecute terrorist attacks, and Washington, D.C. is the prime target.  I \ndo not think that things will be the same around here. What a terrible \nsituation for us and the world.\nAgain, thank you for your concern.\nBest regards,\nTony\nReleased by Chairman Rand Paul\n32September 17 – 20 , 2001  - I have been called to several top secret meetings over a 4 \ndays period at the White House with the National Security Council (NSC) in a group \nchaired by Richard Falkenrath (see other notes) to discuss short and long range plans for \nhow to handle a bioterrorism attack, particularly one of smallpox.  Also, several meeting \nin top secret format were held at DHHS in the Humphrey Building.  People at the DHHS \nmeetings include Stewart Simonson (Chief of Staff to Claude Allan), Scott Lillibridge, \nClaude Allan (deputy Secretary), Tom Month of  Acambis company that is making \nsmallpox vaccine, D.A. Henderson (Hopkins), Kathy Zoon (FDA), Ann Agnew (Exec \nSec. OD/DHHS, John La Montagne (NIAID), James Meegan (NIAID), Bill Raub \n(DHHS), and others.  Check files.  At the White House (Chaired by Richard Falkenrath, \nDeputy to Condi Rice) there was Avis Bohlen (State), J.D. Crouch (Defense), Kenneth \nJustice )Commerce, Kathy Zoon (FDA), John La Montagne (NIAID), Bill Steiger \n(DHHS), Don Mahley (State), Michael Chertoff (Justice), General John Parker (Defense), \nPeter Jahrlin (Defense) and others.  Check with John La Montagne and other notes.  We \ndiscussed and provided ‘White Papers”  a) to justify our not agreeing to the renewal of \nthe 1992 Bioweapons Convention because it is un enforcible and would also hinder our \nlegitimate scientists workiing on biomedical research on these organisms. b) justification \nfor not destroying the smallpox stores since we need them to do research to counter \neffects of a smallpox terrorism attack with diagnostics, vaccines, and therapy.c)  Short \nand long range plans for countering an immediate or distant bioterrorism attack.\nSeptember 17, 2001 – While I was at DHHS for the smallpox meetings, Secretary \nThompson called me in his office and said that although he had said that he would not \nask me again to be NIH Director unless I brought it up, he said that he had to do so now \nsince “…the country needs me, particularly during these stressful times.  I want you very \nmuch and President Bush wants me very much”.  Although I had been resisting this for \nmonths (and years) (see above), I felt that I could not refuse this call to duty.  Thompson \nsaid to name my conditions.  I wrote them down and deliver them to him the next day on \nSept. 18.  The conditions were: 1) Dual roles as NIH Director and NIAID Director; 2) \nAdditional staff; 3)  Direct access to him; 4) Good faith discussions regarding plans that \nhe has to do administrative restructuring (centralizing) at NIH OD and away from the \nindividual institutes such as budget, human resources, etc.  I felt that particularly budget \nand to a lesser extent HR centralization would not work; 5)  $300,000.00 salary ; 6) \nContinue to do editing with royalties (especially HPIM) and remain on Board of Trustees \nof the Doris Duke Charitable Foundation.  The Secretary agreed on all of these except he \ndecreased the salary number to $295,000.00.  I told him that I accept the offer.  He will \nsend all of this to the White House to clear that they also accept these conditions.  I do \nnot expect anything to happen soon given that we are headed to war and likely additional \nterrorist attacks.\nSeptember 24, 2001 – Yet another visit to the White House, this time to review the final \ndocument  on Biological Weapons Convention (BWC) Alternative Concepts.  We agreed \non the document to be sent forward to Condoleezza White and Colin Powell.(see hard \ncopy files).  Attending the meeting were:  Robert Joseph (WH), Avis Bohlen (State), J,D, \nCrouch (DOD), Kenneth Juster (Commerce), Claude Allen (DHHS), Tony Fauci (NIH), \nReleased by Chairman Rand Paul\n33Bill Steiger (DHHS), John La Montagne (NIH), Kevin Chilton (Joint Staff), Ken Baker \n(DOE), Alan Foley (CIA), Don Mohley (State), Michael Chertoff (Justice)\nSeptember 24 – Oct.10 – Multiple meetings at White House and DHHS regarding \nresponse to Bioterrorism.  Anthrax cases (3 thus far) identified in Florida.  USA on \n“heightened alert”.  \nOct. 10, 2001 – Met at St Regis Hotel in Washington, D.C. with Secretary Thompson; \nSecretary of State for Health, UK Mr. Alan Milburn; Minister of Health of Canada, Mr. \nAllan Rock; Secretary of Health of Mexico, Julio Frenk to discuss international \ncollaborations in Public Health related particularly to the response to bioterrorism.  \nClaude Allen and Tommy Thompson appoint me chair of a committee to advice on \ntechnical matters related to smallpox vaccine manufacture, testing and application.\nOctober 8-21, 2001 – Historic, breaking news every day.  New York City, Washington, \nD.C., Florida are targets of mail-related anthrax cases.  As of Oct. 21 there have been 9 \ncases of anthrax – 1 death from inhalation, 2 serious inhalation anthrx and 6 cutaneous \nanthrax with about 40 documented “exposures:.  Check news clips for accuracy.  \nSecretary Thompson appointed me Chair of the Vaccine Technology Team to determine \nthe scientific and technical feasibility of upscaling the production of smallpox vaccine – \nsee Memo of October 17 (Wednesday) from ASF to Claude Alan (Deputy Secretary, \nDHHS).  \nWithin this period of time there has been major inconsistencies regarding the \n“grade” of the anthrax involved in the above exposures.  I have spoken with USAMRIID \ncurrent and former scientists, particularly Co. Peter Jahrling.  He has examined the \nmaterial from Sen. Daschle’s office and finds that it clearly is finely milled and what he \nwould consider “weapon grade”.  He told me that it was better than any bioweapon of \nanthrax that the USA has ever made.  He believes that it was from Iraq.  To my \namazement, Gov. Ridge (Penn) was recently appointed to the Cabinet-level post of \nDirector of the Office of Homeland Security and he went on television stating that he was \ntold by scientists (likely CD and/or Army people that this was “garden-variety” anthrax; \nthat is was sensitive to all antibiotics and that it was definitely not weapon grade.  I was \nfloored.  I called back Peter Jahrling and he said that he looked at under low power and it \nlooked like a clump, which would suggest that is was crude and not weapon grade.  \nHowever, when he looked under electron microscope he saw pure spores that were finely \nmilled.  He hydrated the system and the spores became totally suspended and remained \nso which is the definition of weaponized.  Clearly, someone is intentionally not telling \nGov. Ridge the truth or he is masking the truth.  The obvious potential reason is that the \nUSA does not want to deal right now with the obvious conclusion that the material came \nfrom Iraq.  I have been trying to cry the warning.  I mentioned this to Terrell Halaska \n(Deputy Chief of Staff to Tommy Thompson) as well as to Stuart Simonson of \nOGC/OS/DHHS.  I also hinted to Tim Russert, Sen Lieberman and Sen John McCain \nwho were my co-guests on “Meet the Press” on Sunday, Oct. 21, 2001.\nI believe that there will be hell to pay when the American public realizes that they \nhave not been dealt with in a totally open manner.\nReleased by Chairman Rand Paul\n34Oct. 8 - 17, 2001 – Thompson asks me to chair a “Vaccine Technology Team” to provide \nscientific and technical feasibility with pros, cons, and recommendations on how to \nexpand the existing smallpox vaccine stores and develop new, additional stores.  See my \nOct. 17 memo to Thompson.\nOct. 21 – 22, 2001 – More cases of inhalation anthrax, most recently in a DC Postal \nworker who did not touch the Daschle letter, but who was only in the central Post Office \nBuilding where the letter was initially sorted.  I am convinced that this is very high grade \nmaterial.  I in good conscience cannot refrain from bringing this to the attention of DHHS \nforcefully.  I spoke to Stu Simonson (Oct. 21) and told him that he must tell Secretary \nThompson of my concerns.  I also mentioned this to Frank Sesno (CNN) who has called \nme at home because of the concern that there may have been an exposure at CNN since \nthey have contracted a private environmental firm to monitor their offices.  They received \na tentative positive ID for anthrax in the environment and called me.  I told Frank that he \nmust report this to the CDC and gave him the appropriate number.  He did so and is now \nworking with the CDC.  On Oct. 22 at a CNN morning appearance, I saw Frank Sesno \nagain and he wanted to pursue our conversation.  I strongly urged him to explicitly ask \nGov. Ridge just from whom he is getting information that this is not weaponized \nmaterial.  I believe that it is of weapons grade given my conversations with Peter Jahrling \nat USAMRIID.\nAlso, I received a phone call from Sen. Bill Frist who was in NYC.  We had both \nbeen on the Diane Rehm Show this AM and he called to ask advice on how to get the \ncorrect message out.  I also implored Sen. Frist to look into the weaponizing situation in \nthe same manner that I did with Frank Sesno.  Hopefully this will get straightened out \nbefore all credibility is lost.\nSee New York Times article of October 22, 2001 by Judith Miiler and Sheryl \nStolberg.\nOct. 23, 2001 – Major problem in that DC Postal workers are enraged that they were not \ngiven CIPRO.  They feel that there was not enough care in surveying their Brentwood \nmail facility.  See news accounts around this time.  I directly and forcefully told Sec. \nThompson that Gov. Ridge had either been mislead or was misleading the American \npeople (which I doubt) regarding the quality of the anthrax spores that had been obtained \nfrom the Daschle letter (see above).  I strongly suggested to him that he meet with the \nPresident and with Gov Ridge to emphasize that we cannot serve the public well with \nregard to the Public Health if we are not given correct information.  Someone at that \nmeeting leaked this to the NY Times and Sheryl Stolberg called me and heard that I had \n“angrily confronted the FBI for withholding information”.  I refused to comment; \nhowever, off the record I mentioned that the FBI was not in the room at that meeting and \nthat I was trying to get Sec. Thompson to demand the truth.\nOct. 24, 2001 – Called to emergency meeting at DHHS.  Thompson in a very concerned \nstate of mind; asked for my help and counsel.  We now have reliable intelligence that the \nUSA will be hit with a major bioterrorism attack within the next several days (from \npresent to Oct. 31).  He appointed me in charge of all vaccines.  It was clear that the CDC \nwas not responding adequately.  I was amazed at the disconnect between that CDC and \nReleased by Chairman Rand Paul\n36Stewart Simonson, Michael Osterholm, Margaret Hamburg, C.J. Peters, William Patrick, \nJames LeDuc, Phil Russell, Les Caudell, Co. Edward Eitzen.\nOct. 31, 2001 – NYC “outlier” women dies of inhalation anthrax.  Still no connection \nwith postal cases.  Could this be an outlier of the existing paradigm or the sentinel case of \nan entirely new paradigm?  Did major media today with The Today Show with Katie \nCouric, Grand Rounds at NIH covered by all networks, CBS Evening News, Jim Lehr \nNewshour, etc.\nNov. 1, 2001 – Had extraordinary briefing of Democratic Senate Caucus on bioterrorism.  \nPresent among others were Sens. Lieberman, Daschle, Boxer, Mikulski, Cleland, \nHollings, Wellstone, Jeffords, Biden, Wydan, Levin, etc.  In all there were about 30 \nsenators.  They were extraordinarily complimentary to me for my public leadership on \nbioterrorism, calling me an “American hero”, a national treasure, etc.  I thoroughly \nbriefed them.  They felt strongly that I should lead the nation’s efforts. I politely \nsuggested that I prefer my present job.\nNov. 2, 2001 – Important Senate Hearing of the Labor, HHS Subcommittee chaired by \nTom Harkin.  Also present were Sens. Spector, Byrd, and Stevens.  Hearing on smallpox.  \nI was able to communicate to Specter that NIAID was not allowed to put in a request in \nthe $1.6 billion supplement of DHHS for bioterrorism.  In other words we needed $153.7 \nmillion additional to the PB, but we were not allowed to submit for the supplement by \nOMB.  I “busted” the budget by telling Specter after the Hearing what we needed.  He \npromised to put it into our appropriation.\nNov. 3, 2001 – There was a spoof on me and Attorney General Aschroft on “Saturday \nNight Live”.  No new cases of anthrax.  Kathy Nguyen case in NYC still a mystery.\nNov. 4, 2001 – I appear on “Face the Nation” with Sen. Ted Kennedy and others; also on \nCSPAN’s Washington Journal and CNN Special.  No new issues.\nNov. 5-12, 2001 – relatively quiet re: bioterrorism.  No new cases.\nNov. 13, 2001 – Went to an extraordinary dinner at the home of the Saudi Ambassador to \nthe USA (Prince Bandar bin Sultan bin Abdul Aziz) Sat at table with his wife Princess \nHaifa Al Faisal (Late King Faisal’s daughter).  Also at the table was CIA Director George \nTenet and Sen. Ted Stevens.  Dinner in honor of Nelson Mandela.   The Princess \nspecifically mentioned me as a very honored guest when she introduced the program.  \nNov. 13- Dec.1, 2001 –   At \nfirst no connection with spores in mail  However, careful detective work has indicated \nthat this might be a tertiary mail contamination that gave inhalational anthrax, which is \nnot supposed to happen.  Letter that passed through Trenton with the Leahy letter got \ncontaminated and went to a post office in CT.   may have gotten a letter that \nwas next to the secondary contaminated letter.  Check news stories for details.  I appeared \nReleased by Chairman Rand Paul\n\n37in virtually every newspaper and TV with statements.  Washingtonian Magazine choses \nme as one of Washington’s “Best and Brightest” – Dec, 2001 issue.\nSecretary Thompson told me that over the past week and ½ he has spoken to Pres. Bush  \nabout appointing me Director, NIH.  Apparently, there is some resistance by Sen. \nBrownback who is a born-again Christian and right winger.  He is pushing Bob Redfield \nand other strict conservatives.  Apparently, he believes that I am too liberal because of \nmy association with gays in the AIDS work and because of my statements about the \nscientific need for embryonic stem cell research.  Thompson re-iterates my conditions for \ntaking the job.  Science advisor Jack Marburger is against my doing dual job.\nOn Nov. 27 and 29 I appeared before 2 Senate committees.  On Nov. 29, I testified that \nwe needed $200 Million (professional judgment) more than the PB. Jeff Koplan (CDC \nDirector) testified with me that CDC needed an additional $2 Billion for bioterrorism \nresearch.  We both made big NY Times and Washington Post coverage.  My picture in \nNY Times on Nov. 30.\nWeekend of Dec. 1 & 2 – Thompson asked me to prepare talking points for him in his \nvisit to the Pres. To argue against reneging on the promise to give NIH $4 Billion in \nFY2003 to complete the doubling trajectory.\nDec. 4, 2001 -   Probably one of the most significant days for NIH and me regarding the \nbudget of the institution.  Word was that the “pass back” for NIH would be $0.5 billion, \nwhich would be devastating for NIH (no new initiatives and $275 shortfall on Type 5s). I \nentered into intensive negiations with Tommy Thompson over a 2-3 hour period in his \noffice during which time he frequently called the White House discussing our \nnegotiations.  The bottom line is that Tommy and the President wanted to give the NIH a \npass back that I would be able to publicly defend to the constituents, the Press, and the \nCongress.  I laid down some strict conditions of this support.  It was $2.0 billion for NIH \nexcluding bioterrorism.  I calculated that it would take $1.3 billion to reach current \nservices, $200 million for maintenance of campus (including security).  This would leave \nabout $500 for new initiatives. On top of that I needed 1.0 billion for bioterrorism.  They \nwanted to know my opinion of whether the constituents would accept this “almost” \nmeeting the doubling trajectory.  I told Tommy to tell the President that I would \ndefinitely defend this pass back since it actually was a great deal given the constraints on \nbudget due to the demands of the war and the bioterrorism (BT) defense.  I gave him my \nword that I would support him and the President.\nTommy also informed me that a few people in OMB were very pissed off at me \nbecause I testified at the 2 Senate Hearings (especially the Specter Appropriations \nHearing) that we needed $200 million more in FY2002 for BT.  He also re-affirmed that \nSen. Brownback was not in favor of my nomination for NIH Director because he felt that \nI was too liberal and he wanted his candidate who is Bob Redfield, a born-again \nChristian.  Tommy said that the President wanted me , but was getting pressure from the \nfar right.  I am perfectly comfortable with this situation.  I am what I am.  Take me or \nleave me.  I am happy with what I am doing now.\nReleased by Chairman Rand Paul\n38 Dec. 7, 2001 -  Negotiated with Ed Sontag (Asst Secr. For Management at DHHS) \nregarding restructuring and consolidation of the NIH from an administrative standpoint, \ni.e. Budget, HR, Legislation, Procurement, Public Affairs, Grants Management, IT, etc.  I \nhad an agreement with Tommy Thompson that Budget should be sacrosanct and should \nstay in the ICDs as opposed to consolidating at the level of NIH.  Ruth Kirschstein \n(Acting Director, NIH) almost gave away the farm in the negotiations.  I stepped in and \ntook over the meeting for NIH.  Ruth was about to agree to give up 850 FTEs.  I insisted \nthat we could not cut down by any more than 200.  Sontag came down to 275; we agreed \nupon 250.  Also, Sontag was concerned that the new Clinical Research Center was \nprojected to be $142 million over.  Ed asked how we were going to handle it and Ruth \nsaid that this did not happen on her watch and that it was someone else’s fault at NIH and \nshe would see that this person (Steve Ficca) would be held responsible (?fired).  She gave \nno indication how she would handle the real problem except to say that she would take it \nout of the IRP.  I insisted that we would need major flexibility from the Department \nregarding how we could make up this money and that we could not hurt the IRP so \nabruptly and severely.  Sontag agreed to help.  Poor Ruth is in way over her head.  I will \nhave to make some difficult decisions if I become NIH Director about keeping her on as \nDeputy.  I may need to appoint another Deputy and have her keep her title, but not her \nresponsibilities.\nDec. 8, 2001 – Thompson tried to call me at home last night (Friday), but I was out.  He \ncalled me on Saturday in my office and told me that President Bush has agreed to appoint \nme NIH Director.  Thompson wants me to speak with Sen. Brownback to try and \nalleviate his concerns about my position on stem cells, embryos, etc.  I will set up to meet \nhim next week.  Thompson wants to make announcement before Christmas.\nDec. 12, 2001 – Met with Sen. Brownback and his aide Rob Wassinger.  Brownback was \nconcerned about statements that I made 13 years ago! Concerning the then new SCID \nmouse that could be reconstituted with fetal tissue to regenerate a human immune system \nin a mouse.  I stated at an ACT-UP meeting in NYC that this was a promising area of \nresearch and that it would require the use of fetal tissue.  At the time there was the \nbeginning of a moratorium by President Reagan and later Bush on the use of fetal tissue \nfor transplantation into humans.  I apparently (reported in the press) urged the ACT-UP \npeople to make their concerns known so that this could be taken into consideration by the \nadministration and lawmakers.  Brownback and Wassinger said that several “right-to-\nlifers” had called them very concerned that I was being considered for NIH Director \nwhen I had been a vocal advocate for the use of fetal tissue.  \nI had a lengthy (1 ½ hour) discussion with Sen. Brownback about embryonic stem \ncells, fetal tissue, etc.  I believe that the conversation went as well as could be expected.  \nHe was very cordial, but concerned about “how I would advise the President if I were \nNIH Director”.  I told him that I do not advise the President on Ethical or Moral issues \nsince I trust that the President has his own strong moral compass.  I mentioned that I am a \nscientists and that I merely give him accurate scientific facts and he can make up his own \nmind within the framework of his own values.  I think that Brownback respected that \nanswer.  We left with his still being concerned about me, but I do not think that he will \ntry to block me.\nReleased by Chairman Rand Paul\n39Dec. 14, 2001 – Spoke with Rick Klausner about his perception about NIH Director.  \nRick feels that the WH is not leveling with Thompson since he has heard that they think \nthat doing both jobs (NIH and NIAID) is a “non-starter” and they are against it.  There is \na disconnect here since Thompson feels that they (WH) will accept this, and he merely \nneeds to get the Brownback issue out of the way.  Something is strange here since \nThompson is talking about getting the President to announce me before Christmas and \nRick says the “rest of the WH” is against this.  Stay tuned.\nDec.15, 2001 – Sat. meeting at NAS regarding recommendations of giving anthrax \nvaccine to people who were exposed to anthrax and who are just finishing their 60 course \nof antibiotics.  I, Jeff Koplan, D.A. Henderson, and Kathy Zoon (FDA) playing major \nrole of setting policy and advising the Secretary.\nDec. 16-19, 2001 – Much controversy and last minute scrambling in getting the consent \nform and the protocol out for the discretionary use of anthrax vaccine in exposed people \nwho had been receiving antibiotics, but who are coming off their 60 day course.  The \nCDC is really relinquishing their responsibility of doing a good job with the informed \nconsent. They handed us a piece of junk as a draft.  Stewart Simonson (Counsel to Secr. \nThompson) has asked me to help get it right.  I had been working all day and into the \nnight on Dec.16-19 revising the consent forms and helping people get straight why \nDHHS is offering the vaccine to people.  The Press are very suspicious and as usual \ncritical of the Administration.  I have exhaustively reviewed the data (with Cliff Lane as a \ngreat help) and come to the conclusion that vaccine + antibiotics is no better than \nantibiotics alone for post-exposure.  Yet, Dr. John Eisold (the Navy physician who takes \ncare of Capitol Hill people) is insisting that the Senate staffers also get the vaccine.  We \nare in a dilemma.  It is true that there is a “theoretical” reason to make the vaccine \navailable in that animal studies show persistence of spores weeks after antibiotics and \nthere is a fear that after antibiotics are discontinued the disease will occur.  I would not \ntake antibiotics.  However, Eisold and the Senate Staffers are demanding that they get the \nanthrax vaccine.  In fact, I received a phone call from Ms. Laura Petrou from Senator \nDaschle’s staff on Dec. 19, 2001 enraged that we were taking so long in getting the \nvaccine to the staffers.  Apparently, D.A. Henderson and Tommy Thompson had told \nDaschle that the vaccine would be available 2 days ago.  They were insistent. The blacks \nin the postal service are quite skeptical.  I have insisted that if I am going to help we must \nnot “recommend” the vaccine since the data in animals show that it is not better than \nantibiotics alone. The difficult situation is that politically we essentially have to give it to \nthe Senate staffers since they are demanding it.  If we give it to them and do not offer it to \nthe postal workers, we will be accused of racism and not treating the postal workers \nequally. Remember that they were outraged that the Senate staffers got antibiotics right \naway and the postal workers only got antibiotics after 2 people at Brentwood died.  \nTherefore, we are offering, but not recommending the vaccine for any of the 9000 people \nwho were put on 60 antibiotic course.  We are not explicitly telling the public that this is \nreally the rationale for what is going on. There is some confusion as to why we are not \nrecommending it and if we are not recommending it, why are we even offering it.  I have \nReleased by Chairman Rand Paul\n40tried to articulate this to the public as I did on a Dec. 19 appearance on Jim Lehr’s News \nHour.\nDec. 19-24, 2001 – As expected, publicity went bad for HHS on the anthrax vaccine \nstory.  Washington Post writer Ceci Connelly keeps blasting HHS and particularly \nTommy Thompson and the CDC for lack of clear guidelines.  The mostly black postal \nworkers for the most part refuse the vaccine, saying that they do not trust the government \nand do not want to be “guinea pigs”.  They completely miss the point that no one really is \ntelling them that they should take the vaccine.  In contrast, the staffers from Daschle’s \noffice have a high % of people who are taking the vaccine.\nDec. 27, 2001 – Receive a letter from Sen Brownback dated Dec. 19, 2001 in which he \nstates that he is “deeply concerned by your inability to define the entity created after the \nsuccessful procedure referred to by some as human somatic cell nuclear transfer \n(SCNT)…”  He wants me to respond.  I do not want to put anything in writing and so I \ncall his office and ask to speak with the Senator.  His unbelievably right wing staffer, Rob \nWassinger, answers and says that they will not put the call through to the Senator and that \nI should answer the questions in writing.  Clearly, they are trying to trap me and clearly \nWassinger is an asshole.\nJan. 6 – 22, 2001 – Clearly, it is unclear what is going on with the White House and my \nnomination. Secretary Thompson keeps pushing the President to appoint me and the \nPresident defers to Clay Johnson, Director of White House Personnel, who has actually \nnever interviewed me.  I get word indirectly from Scott Whitaker, Bob Charrow and \nothers that there really is a political battle going on in the WH with a strong anti-\nThompson faction led by Clay Johnson who does not want to appoint me because he \nwants to put down Thompson who is pushing me.  On the other hand, there are those who \nclearly want me, but are less aggressive in pushing any agenda since they are assuming \nthat I will get appointed.  It is unclear what role Sen Brownback is playing in influencing \nClay Johnson.  I hear from Rick Klausner that the issue is just that they are reluctant for \nme to do two jobs simultaneously.  I doubt this and believe that there is something else \ngoing on.\nJan.22, 2001 – Finally, I get called to the West Wing of the WH to meet with Clay \nJohnson and Ed Moy (Johnson’s deputy) to discuss the job.  Johnson was cold and \nabrupt.  He said that the President was getting confused messages about my “conditions” \nfor the job and the POTUS had asked Johnson to clarify things.  Johnson coldly and \nabruptly asked how I can do 2 jobs simultaneously.  I explained about the extraordinary \noverlap in what the NIH Director must know and do with what the Institute Directors \nmust know and do and tell him that I feel that I will have no problem doing this.  He \nclearly was not convinced.  Then he wanted to know why I wanted 2 full salaries, i.e. the \nNIH Director’s salary and the NIAID Director’s salary.  I explained that this was not the \ncase, and that I merely did not want to lose money by relinquishing my retention bonus \nthat I could not take as NIH Director as well as several outside activities that I could not \ndo as NIH Director.  He acted (coldly) like he understood that.  As soon as I answered \nthese 2 questions, he abruptly said: “Well, you answered my questions and told me what I \nReleased by Chairman Rand Paul\n41need to know.  Thanks a lot and have a nice day”, whereupon he ended the meeting.  \nNever did he even approach asking what my vision for the NIH was or other related \nsubstantive questions.  Clearly he had made up his mind before the meeting and was only \nmeeting because the President had asked him to.  \nJan 24, 2001 – Tommy Thompson calls me at home at 9:30 PM (he was sequestered in \n“the bunker” for security reasons) and tells me that he spoke with Clay Johnson today \nand Johnson told him that he was going to recommend someone else and not me to the \nPresident.  Thompson was clearly very angry and sad.  I am more convinced now that this \nis a Clay Johnson agenda working here.\nJan. 26, 2001 – I go to the Annual Alphalfa Dinner at the Capitol Hilton as a Guest of \nRobert Wood (“Woody”) Johnson IV.. Amazing scene!  Virtually every important \ngovernment official (the entire Cabinet, military leaders, etc) was there.  At the reception, \nI met Barbara Bush who was very warm with a hug and kiss and told me that she is \n“pulling for me”.  I did not pursue this since this is not my style.  I then met former \nPresident Bush who was his usual wonderful self with me, hugging me and telling guests \nwho were standing around that I had won the 1988 election for him when he told the \nworld that I was his hero.  I mentioned that we had just received the President’s Budget \nfor FY2003 this week and that the President has fulfilled the promise to double the NIH \nbudget and had given NIAID and additional $1.5 billion for bioterrorism research.  I told \nBush that this was similar to what he, himself, had done with me in the 1980s when he \nincreased my AIDS budget, but that this was on a much larger scale.  I told him how \nmuch I appreciated this. He told me to make sure that I tell the POTUS this.\nI also saw Tommy Thompson at the dinner and walked into the ballroom with \nhim.  He seemed very sad and troubled.  He again said that he was going to see the \nPOTUS next week and will tell him that I am not only the best person, but the “only” \nperson for the NIH Director’s job, regardless of what Clay Johnson will tell him.\nAt the dinner Woody Johnson brought me over to the head table to say hello to \nthe POTUS.  Bush greeted me warmly (he clearly knew who I was).  I thanked him for \nthe BT money and he asked about our efforts; I briefly told him.  He then surprised me by \nasking whether I had seen Clay Johnson yet, and so he knows that the meeting was set \nup.  I told him that I did see him a couple of days ago.  The POTUS said “Good, I will \ntouch bases with Clay next week”.  Later on I met Laura Bush and she too complimented \nme on my work and we had a very nice conversation.  In none of these encounters did I \nmentioned the NIH Director’s job.  My feeling at this time is confirmed that the President \nreally does not know the situation except that he has heard a lot about me, but this is \nconfounded by the fact that it is clear that Clay Johnson does not want me.  Is it really \nbecause he is against 2 jobs, or is there some hidden agenda.  I feel strongly that it is the \nlatter.  We shall see….maybe.\nFeb. 4, 2002 – An editorial in the Washington Post calls for President Bush to \nappointment me as the NIH Director.\nFeb. 5, 2002 – Spectacular day!  I traveled on Air Force One with President Bush to \nPittsburgh to spin his FY2003 budget on Bioterrorism and to visit scientists at Univ. of \nReleased by Chairman Rand Paul\n42Pittsburgh who are working on a novel early warning system for BT.  I met the group at \nAndrews Air Force Base and flew up at 11:00 AM.  Did not see the President on the \nflight up; however, spent considerable time with him in Pittsburgh.  The motorcade trip to \nand from the Pittsburgh airport was exciting.  I was in a van about 4 cars behind the \nPresident and the motorcade was heavy with Secret Service and Police.  The President \nwas extremely complimentary to me during the visit as he spoke to other people about me \nin front of me.  He specifically thanked me for my great work in his speech that was \ncovered by CNN.  During the flight back to DC he called me to his state room and spent \nthe entire flight back speaking with me!!!  In the room were Gov. Ridge, Secretary \nThompson, and D.A. Henderson.  Thompson mentioned to me in Pittsburgh that they \nspent much of the trip going up to Pittsburgh talking about me and the work that I have \nbeen doing.  Tommy is pushing hard with the President to appoint me.\nFeb. 8, 2002 – Sheryl Stolberg suggests in the New York Times that Bush should appoint \nme.  She mentions that the sticking point is my requirement to do both jobs.\nFeb. 15, 2002 – Laura Meckler wrote a piece for AP on the right wing Family Research \nCouncil opposing my nomination for NIH Director based on my philosophy on fetal \ntissue and stem cells.  They refer to my comments in 1988 about the utility of the SCIDhu \nmouse model.\nFeb. 23, 2002 – Article in New York Times by Sheryl Gay Stolberg telling the story as it \nhappened saying that I am no longer a candidate for NIH Director’s job. She states that \nthe White House says that the reason is the objection to the 2 jobs, while the social \nconservatives say that my views on abortion and stem cells make me unacceptable to \nthem.  Also, mentions the Sen. Brownback story.  Key article since it is factually correct.\nMar. 5, 2002 – Secretary Thompson called me today and said that he was very upset, but \nI will not be asked to be NIH Director.  He said that he was being forced by the White \nHouse to submit Dr. Elias Zerhouni’s name and that he was not happy at all about this.  \nHe stated that as far as he was concerned, I was his number one person at the NIH and he \nwas looking forward to working with me in the future.\nMar. 9, 2002 – Attended Gridiron Club dinner in Washington, D.C.  Spent time speaking \nwith President Bush, Karl Rove, Clay Johnson, Donna Shalala, Tim Russert, Sam \nDonaldson, John Neroponte, Cokie Roberts, etc.  The topic was often concern and \ndismay on the part of people (non-White House) that Bush was not going to offer me the \nNIH job.  Most felt that it really was the litmus test issue and not the 2 jobs issue.  Clay \nJohnson, who I believe is behind all of this, actually volunteered to me that ”Dr. Zerhouni \nis no Tony Fauci, but then again, there really is only 1 Tony Fauci”.  It is tough for me to \nfigure out just how much the Social Conservative/Sen. Sam Borwnback issue played in \nClay Johnson’s insistence to the president that I not be NIH Director.\nMar. 26, 2002 – I went to White House ceremony where Pres. Bush announced Elias \nZerhouni as nominee for NIH Director.\nReleased by Chairman Rand Paul\n43Mar. 27, 2002 – Went to NYC for Press Conference for the announcement of my \nreceiving the Albany Medical Center Prize in Medicine, which is the largest prize in \nMedicine in America and the second largest in the world to the Nobel Prize.  Amount = \n$500,000.00. \nMar. 28, 2002 – Big press conference at DHHS for the announcement of the publication \nin NEJM of the dilution studies for smallpox vaccine.  Also, in same issue of NEJM was \nmy editorial calling for an open dialogue as to whether there should be pre-emptive \nvaccination of ”first responders” or even of the enitre population on a voluntary basis.  \nD.A. Henderson is not particularly happy about my editorial since he continually has \ntrouble admitting that a smallpox attack is a danger.  Clearly this is related to the fact that \nhe has devoted much of his professional life to trying to eliminate smallpox.\nMar. 31 – April 6, 2002 – Went on a terrific trip to Africa with Sec. Thompson and a \ndelegation listed below.  We visited Mozambique, South Africa, Botswana, and Cote \nD’Ivoire.  The trip was designated a Presidential Mission and so we received the royal \ntreatment.  Flew over on an Air Force jet and were received at each country with Secret \nService protection and local military and police escourts via motorcades etc.  Visited \nCDC and NIH funded facilities.  Met with President Joaquim Chissano of Mozambique.  \nLong conversation with South African Health Minister Manto Tshabalala-Msimang \nregarding reluctance of South African government to provide nevirapine to prevent \nmother to child transmission (MTCT). I disagree with her stance, but respect the difficult \nsituation that she is in.  She is driven by a need to decide things for herself since she was \none of the original ANC members who were in exile during apartheid and she does not \ntrust anyone but her own people. She, however, told me that President Tabo Mbeki \nrespected me greatly and frequently speaks highly of me,  During the Stay in South \nAfrica the Supreme Court of SA ruled that the government must supply nevirapine to \npregnant infected mothers and their newborns according to ACTG protocol 012.  Met \nwith President Festus Mogae of Botswana.  He too had heard about me. Met with Prime \nMinister of Cote D’Ivoire.  Representative people on the trip that I developed good \nfriendships with in addition to Sec. Thompson and his staff of Bill Steiger, Terrell \nHalaska, Dave Boyer, Corina Gardner, Matt Bluhm and others were: Former \nCongressmen Ronald Dellums and Ray McGrath, Scott Evertz of the White House, \nCongresswomen Barbara Lee (D-CA) and EB Johnson (D-TX), Michael Miller of NSC, \nAnne Peterson of USAID, Bill Roper and others.\nApril 25-30, 2002 – During the trip to South Africa, I spent about 1 ½ hours at dinner \ntrying to convince her to help President Mbeki change his stance on treatment of HIV-\ninfected people including pregnant women (see above).  Of note, just this week the South \nAfrican government has made a major change in their stance.  They now allow treatment \nfor rape victims and soon will start treating infected pregnant women.  It is entirely \nconceivable that my discussions played some role in this turnaround.\nMay 23, 2002 – For the past 2 weeks, Mark Dybul, Terrell Halaska and I have been \nworking on a proposal for prevention of mother-to-child-transmission (MCTC) in \ndeveloping nations to present to president Bush who wants to use this as an \nReleased by Chairman Rand Paul\n44announcement of a major initiative at the G-8 Conference this summer in Ottawa.  Terrell \nasked me to put it together for her and I enlisted Mark Dybul who did a great job with \nme.  I and Terrell had several pre-meetings at the White House Conference Center on \nJackson Place during early May and then today Mark, Terrell and I met with Gary Edson \nand Jay Lefkowitz of the WH. To present our plan to save 146,000 babies from being \ninfected per year for a cost of about $100,000,000 per year. Gary and Jay loved the plan \nand will present it to the President within a couple of days. It was a great meeting and \nthey were very impressed at how we organized the data and the presentation.\nMay 29, 2002 – I briefed President Bush in the Hamilton Room of the West Wing on the \nMCTC plan.  Present were Josh Bolton (Deputy Chief of Staff), Andrew Card (Chief of \nStaff),  Karl Rove, Mr Calio, Gary Edson, Secretary Thompson, Andrew Natsios \n(USAID), Terrell Halaska, Christen Silverberg, Jay Lefkowitz and others.  The President \nliked very much our plan, which I presented to him succinctly, but completely.  The \nbackground of the initiative is that Sens. Frist/Kerry are trying to get through a \nsupplemental Bill on adding more money to the Global AIDS Fund.  The President is \nagainst this since he feels that the Fund has no plan and the money will be wasted.  This \nis the reason that he wants to seize the opportunity of the Congress throwing more money \nat us to put forth his own initiative on a concrete proposal as opposed to the vagaries of \nthe Fund.  He accepted my proposal.  Interesting dynamics at the meeting in that Andrew \nNatsios was upset that this was an HHS proposal and started (quite inappropriately in \nfront of the President) getting into a turf war where he pointed out that he has an MOU \nwith the CDC that with regard to AIDS in Africa, USAID has the lead.  The President \npicked up on this discord and said that the only thing that he knows is that he likes \n”Tony’s plan” and that HHS and USAID should work out (with Gary Edson as referree) \nhow it is going to be implemented.  He stated, however, that he wants ”a person” to be \nheld accountable for the success or failure of the project.  To say the least, Sec. \nThompson was angry with Natsios.  From my standpoint, the meeting was a great success \nsince our plan was accepted by the President and he was extremely friendly to me.\nJune 6, 2002 – I found out at National Airport that President Bush was establishing a \nDepartment of Homeland Security (DHS) that would encompass 160,000 employees with \na budget of >$30 billion by consolidating all activities related to terrorism, including \nbioterrorism in one Department.  This would mean that $1.748 billion of NIAID money \nfor FY 2003 would go to DHS.\nJune 6 – 12, 2002 – Spending a lot of time working with the DHHS and th White House \nin trying to hash out the details of legislation that would create the DHS.  Everyone \nseems to agree that the research would still be done at NIAID under my direction; \nhowever, the money likely will first go to DHS and thenn be passed through or contracted \nto me to perform the research.\nAlso, the President is planning to announce the MTCT program that I helped to \nput together in a few days.\nReleased by Chairman Rand Paul\n45June 10, 2002 – Had breakfast with Treasury Sec. Paul O’Neill this AM to discuss the \nentire concept of AIDS in Africa. We related very well and he received my advice, \nconsultation very enthusiastically.\nJune 13, 2002 – Received a call from Richard Falkenrath at the White House who said \nthat he had heard that I was concerned about the $1.748 Billion going to Department of \nHomeland Security (DHS).  We wanted to assure me that the money would come directly \nto me from DHS and the research would be directed by me.  He agreed that the research \nshould be incorporated completely into the emerging diseases research agenda of NIAID \nand not fragmented out.  He said that Sen. Kennedy mentioned to the WH that I was \nconcerned and they wanted to alleviate my concerns.\nInteresting intrigue going on.  I just got a call from Sue Hardesty of Sen. Richard \nDurbin’s office who said that the Senator had heard from Bono (of U2 fame) that I was \nagainst the global AIDS fund and had convinced President Bush not to support it.  The \nSen. wanted to know if this were true.  In addition, Sue told me that Sen. Frist had said \nthat he changed his mind and decided not to support the Global AIDS Fund because he \nhad heard that I was against it.  I believe that if this is true about Frist, then he is covering \nhis ass since he backed down on his promise to support the extra money for the fund.  I \nknow that he backed down because Bush told him to.  Now he is trying to make it look \nlike I am the one against it.  It is interesting that rumors are forming that I am involved in \nconvincing the Pres. that we should not invest in the Fund.  I believe that this results from \nmy being involved in putting together the MTCT plan, which some feel that the Pres. \nactually wants to substitute for the increase in the Fund.  Of note, Jeff Sachs called me \nfrom Rome last night asking about the same issue.  Welcome to Washington!!!\nJune 13 – 18, 2002 – Extremely busy with putting the finishing touches on the MTCT \nproposal that the Pres. is planning to annouce soon.  I am trying and succeeding (I \nbelieve) in having them do it correctly, i.e. this is not a substitute for the Global Trust \nFund, but as a comlement to it.  Have been working very hard with Terrell Halaska and \nMark Dybul in getting the Pres. speech written and his talking points arranged for the \nannouncement.\nSimultaneously with this going on, I have been working with Stewart Simonson \nin trying to get the correct authorization language written for the proposed bill for the \nnew Department of Homeland Security (DHS).  The WH wants me to be comfortable \nwith it; however, they seem inflexible in that they clearly want the $1.748 billion of NIH \nmoney to go to the new DHS and they want the perogative to set the research agenda.  \nRichard Falkenrath of DHS assures me that despite this, they want me to run the program \nfrom NIH.\nJune 19, 2002 – Most extraordinary day!!  The POTUS requested that I join him and \nSecs, Thompson, O’Neill, and Powell and Sen. Frist and Andrew Natsios at the Rose \nGarden Ceremony to announce the MCTC plan that Mark and I essentialy created.  I met \nwith the Pres for about 10-15 minutes in the Oval Office before the announcement.  He \nwas extremely gracious and complimentary.  During the announcement, he specifically \nthanked me for all that I have done with the project.  \nReleased by Chairman Rand Paul\n46After the annoucnement, I went with Ari Fleischer and gave a press briefing in the \nWH press room on the program.\nImportantly, the Pres. asked Josh Bolten to meet with me and get my feel for the \nbig picture of what the Adminsitration should be doing with AIDS (domestic and global). \nPresent at the meeting were me, Josh, Margaret La Montagne Spellings, Robin \nCleveland, Jay Lefkowitz, Gary Edson, Kristen Silverberg, Allen Gilbert.  Josh asked \nwhether we should do a Manhattan Project for a vaccine and not invest in international \nprevention and treatment.  He said that I should assume that money was not an issues and \nI should tell them what is ”the right thing to do”.  I gave details about the importance of \nbuilding a sustainable (low tech) infrastructure of clinics and trained Africans.  This \ninfrastructure could then be used for HIV prevention and ulitmately treatment, but could \nalso be used for approaching malaria, TBC, and other important diseases.  I said that the \nUSA needs to be the world leader in making international health a driving force in our \nforeign policy.  If we lead, other countries will follow.  Josh seemed genuinely moved \nand agreed with me.  He even stated that it is his feeling that years from now, this \nAdministration will be judged by how it handled the International HIV/AIDS Pandemic.  \nHe stated that the Pres. was very sympathetic to me and what he has heard me say on \nvarious occasions, but there is a skepticism that money will be wasted if there is no \naccountability.  This is also fed by Paul O’Neill and Mitch Daniels.  I said that I agree \nthat we should not do it unless there was strict accountability. We need to have someone \nto run the program who could ”kick ass”.  Josh and I resonated very well.  I believe that \nthe WH will be calling upon me soon to help with such a strategic plan.  In fact, I am \ngoing to proceed to put one together and present to them pre-emptively.\nIt was a great day!!!  I may have accomplished more for global health on this day \nthan on many, many others put together.\nJuly 7-12, 2002 – XIVth International AIDS conference in Barcelona. – Very important \nconference.  The science was completely overshadowed by the policy, which in turn was \ndominated by the discussion of the incredible numbers and projections for the developing \nworld.  Latest figures are that approximately 40 million additional infections will occur \nworldwide by 2010 and up to 70 million dealths will occur by 2020 if serious \nintervention (prevention and therapy) are not implemented.\nI gave a highly scientific talk and used it to come to the conclusion that we must \nimplement treatment and prevention for the North and the South.  Please see records on \nmy speeches for the full text of the talk.  It was a Plenary Lecture on July 10.  I spent \nmuch time with Secretary Thompson and his team (Terrell Halaska, Tony Jewell, Bill \nSteiger et al).  There was an aggressive demonstration against Secretary Thompson \nduring his address on Tuesday, July 9.  I was with him and predicted to him exactly what \nwould happen.  I had heard from Gregg Gonsalves that ACTUP would demonstrate for \nawhile and then allow him to speak provided that he would meet with them afterwards.  \nHe agreed to meet, but they shouted him down and although (as per my suggestion) he \ncalmly finished his speech, the audience could not hear what he said.  This was unlike \nSecretary Sullivan in San Francisco when the TV and microphones allowed audiences \n(TV and present ) to at least here what he said. I helped Secretary Thompson with the \nPress (backstage)immediately after the shout-down.  There was an issue that I handled.  \nDuring the conference 2 days before the demonstration, at a Press Briefing during which \nReleased by Chairman Rand Paul\n47I sat next to the President, the Press asked about needle exchange.  Tommy G. Thompson \n(TGT) was not briefed on this issue and I told him briefly that we (Fauci, Jeff Koplan of \nCDC, David Satcher – Surgeon General, Alan Leschner – Director NIDA and others) had \nrecommended to Donna Shalala upon review of the scientific data that the Clinton Adm. \nallow Federal funding of needle exchange.  However, based on objections of Gen. \nMcAffrie (Drug Czar) and certain Black leaders, Clinton would not allow it. (Of note \nClinton was at the AIDS Conference in Barcelona and publicly stated that he regretted \nthat decision and wished that he had allowed needle exchange).  In essence, I told TGT \nthat Clinton did not allow it and we (current administration) are not allowing it.  This \ncreated a bit of a stir in the press since when asked at the press event (backstage) after the \ndemonstration, he seemed confused about the dichotomy between scientific data and \npolicy.  I had to come in and explain the issue.  I made it very clear that based on the \nscientific data, I had recommended that Clinton allow exchange.  TGT said that he would \nask Dr. Fauci to go over the data again, which the Press did not buy since they know the \ndata are absolutely conclusive.  It was a little awkward for TGT, but he is going to have \nto face the issue that the Bush Adminstration will likely do (and is doing) exactly what \nthe Clinton Administration did and follow a policy that contradicts the scientific data.\nAn important event at the meeting was a meeting that I arranged in my hotel (Fira \nde Palace) among myself, Mark Dybul, Cissy (?last name) and Peter Mugyenyi from \nUganda.  Peter is the Director of the Joint Clinical Research Center (JCRC) in Kampala.  \nHe is successfully treating many Ugandans with antiretroviral therapy (ART).  We (Mark \nand I) want to use his model to try to implement the plan that Josh Bolten asked me about \n(see above and below).  Peter showed us his plan of a main center with regional satelites \nand subgroups out of the satelites.  These are low-tech clinics and each cost about \n$30,000.00 which is much less that the proposals that we have heard.  I was very \nimpressed with this and plan to use this as a model to put together a program to present to \nthe WH (see below)\nIt was a great meeting for me in that I became even closer (if that is possible) to \nTGT.  He implicitly and explicitly trusts me and my opinion.  I appeared on the Aaron \nBrown Show on CNN during the conference and this went extremely well.\nJuly 14, 2002 – C-SPAN’s Washington Journal – I appeared for 45 minutes on the show \nthe morning after returning from the AIDS conference.  I had spent July 7-10 at the \nconference and July 11-12 in Genoa as Chair of the International Scientific Committee \nthat is reviewing the Gaslini Institute for Lorenzo Moretta (its Scientific Director)\nJuly 16, 2002 – Diane Rehm Show – Spent a terrific 1 hour alone on the show with \nDiane.  I went over the AIDS Conference highlights.  I explained about and defended \nSecretary Thomspon vis-a-vis the demonstration against him.  Also, I defended the \nAdministration in that I related that they actually are willing to greatly support \ninternational AIDS efforts, but that they require developing nations and others involved \nto put forth a strategic plan with accountability, endpoints, projected deliverables, etc.  I \nreceived excellent reviews for the show.  I have it on tape as a reference.\nJuly 17, 2002 – Meeting at the White House with Gary Edson and Jay Lefkowitz.  We \ndiscussed the details and implementation of the MTCT project.  Obviously, there will be \nReleased by Chairman Rand Paul\n48difficulties with USAID.  They are resentful that DHHS is getting involved in \ninternational AIDS issues.  Anne Peterson was at today’s meeting.  I have no confidence \nthat she or her staff are capable of successfully pulling off this program.  Mark Dybul \nalone can do better than their whole group.  Sorry for being so direct, but it is true. Of \nnote is that I brought up to Gary Edson and Jay Lefkowitz the issue that I had discussed \nwith Josh Bolten regarding the more Global plan of therapy, prevention for HIV and \nother diseases in a ”low-tech” manner.  I discussed my meeting with Peter Mugyenyi and \nCissy (?last name) from Uganda (see above).  I told Jay and Gary that I believe that we \ncould pull off a program based on the ”Mugyenyi model”.  He told me to put together a \nproposal in a very short time frame (before the WH leaves for August break ( i.e. <2 \nweeks).  They want to determine if the POTUS could bring this initiative with him on his \nupcoming trip to Africa in January, 2003.  I will work with Mark Dybul to do this.\nJuly 21, 2002 – Over the past few weeks important issues have evolved regarding \nBiodefense.  There is a major struggle going on in the Congress about the formation of \nthe new Department of Homeland Security (DHS).  At issue (among other important \nissues) is whether the $1.748 billion that is in the President’s budget for FY2003 will be \ntransferred over to the new DHS and who will actually be responsible for the strategic \nplan and prioritization for biodefense.  DHS people (Gov. Ridge and Richard Falkenrath) \nclearly state that they want the money and the responsibility, but that they will work very \nclosely with me.  The Congress and all of the scientific Societies (FASEB. ASM. Etc.) \nsay that they want the money and prioritization with me.  As usual, I must publicly \ndefend the President’s position, but I work behind the scenes with people like Sens. \nLieberman, Kennedy, and Frist to get language in the new authorizing Bill that will not \ntransfer the money or responsibility (let us see what actually happens).\nMeanwhile, VP Dick Cheney is pushing for a Manhattan Project approach to \nBiodefense. He mentioned this at his visit to CDC and told Julie Gerberding that he \nwould mention this to me also.  Of note, I was quite influential in supporting Julie for the \nCDC job.  We have CIA intelligence that Iraq has smallpox and everyone in DHHS and \nthe WH are scrambling to get together an immunization plan that will go well beyond \nwhat the ACIP is recommending (i.e. pre-emptively vaccinate only about 10,000 – \n20,000 health workers and rely on ring vaccination in the event of an attack).  Cheney is \npushing for a much wider vaccine plan.  TGT will present our plan to Cheney within a \nfew days, which recommends a staged (1,2,3) process that vaccinates about 500,000 \nhealth workers from Oct. 02, to December 02 and then from Jan. 03 through the end of 03 \nvaccinate up to 10 million responders (phsyicians, nurses, police, firefighters, EM people, \nprimary care personnel).  After that and depending on the adverse event rate and the \nperception of threat, we will make vaccine available for the entire USA population on a \nvoluntary basis.  One of the reasons for the push by Cheney is that he knows that Iraq has \nsmallpox and he is planning to push out Sadam Hussein either by direct invasion of Iraq \nor by funding the opposition.  He is afraid that Sadam will strike Israel or even us if his \nback is against the wall.  There will be very intense discussions over the next couple of \nweeks with the WH and DHHS that involve me regarding smallpox vaccine policy.\nThings are obviously very busy with my being involved simultaneously with \nBiodefense and International response to HIV/AIDS.  Both of these involve my direct \ninteraction with the White House.\nReleased by Chairman Rand Paul\n49July 22-24, 2002  - Went to the beach (Beach Haven) to link up with family.  In the car \non the way up and while I was there, I spent considerable time on the phone trying to \nwork out with Sen. Spector’s staff (Bettylou Taylor et al) language in the Lieberman Bill \non authorization of DHS that Spector could support.  They want to make sure that I am \ncomfortable with the language.  I am trying to get language that give DHS ultimate lead \nin the overall prioritization of the research on biodefense, but the money stays in DHHS \nand the research is executed by NIH, but the development of the research agenda in done \nby DHHS in consultation with DHS.  Finally we had a conference call (I took it in the \nkitchen of the beach house) among me, the White House (Richard Falkenrath) and the \nSenate staff that are marking up the bill.  Richard and I agreed upon what I listed above.  \nHopefully, the bill will get through with that language.  It was important to have the WH \non the phone since I was getting concerned that they might think that I was undermining \ntheir efforts to get the DHS going.  By hashing it out with them, we are doing it up front \nand honestly.\nJuly 25, 2002 – Had top secret conference call with Jerry Hauer (HHS), Phil Russell \n(HHS), Stewart Simonson (HHS), and Lester Crawford (FDA).  Subject – VP Cheney has \nindicated that we will hit Iraq soon and we expect retaliation with a smallpox attack on us \nor on Israel.  Cheney wants us to greatly accelerate the process of getting vaccine \navailable to vaccinate everyone if necessary.  I offered to accelerate studies to determine \nif we can dilute the Dryvax even more than 1:5 and whether we can also dilute the 77 \nmillion doses of Aventis Pasteur  WetVax.  Stay tuned.\nThe House and the Senate Committees have adapted the language that I had \nsuggested to Richard Falkenrath.  Therefore, at this time it appears that the money will go \nto DHHS, the overall prioritization will rest with DHS, the strategic plan and specific \npriorities will be the responsibility of DHHS in consultation with DHS and the research \nwill be executed by and through the NIH.  If this holds, I will have won a big victory.\nJuly 26, 2002 -  Got an e-mail from Gary Edson at the WH asking if I had completed the \nGlobal AIDS Treatment plan to present to him in order to determine if it is worth \npresenting to the President for him to announce in his upcoming (January) visit to Africa.  \nMark and I are finished and we set up a meeting at the WH for Wednesday, July 31.  Let \nus see what happens.\nHad an unusual meeting at the Rayburn Building with Chairman Kolbe (R-AZ) of \nthe House Foreign Relations Committee and his chief staffer Charlie Flichner. I \naccompanied Claude Allen (Deputy Secretary, DHHS). They are very upset at the White \nHouse, particularly Gary Edson, for having the President announce the MTCT initiative \nwithout first consulting with them.  They made disparaging remarks about Gary \n(”Emperor Edson”, ”President Edson”).  They were cautious about being disrespectful \nabout the President; however, they were pissed.  They also disparaged Tommy Thompson \nabout getting involved in International issues when this is not the purvue of DHHS.  \nActually, it is becoming the purvue of DHHS with the CDC’s GAP (Global AIDS \nProgram).  This clearly was a turf issue.  They are a powerful Committee and they are \npissed that the President made an announcement without consulting them.  Wait until \nthey hear about the Global AIDS Treatment package that we are presenting to Gary \nReleased by Chairman Rand Paul\n50Edson and Jay Lefkowitz on Wednesday, July 31.  I am going to have to relate to Gary \nthe essence of my meeting with Kolbe and Flichner.\nAugust 1, 2002 – Met at the White House with Gary Edson, Jay Lefkowitz, and Margaret \nLa Montagne Spellings to present the Dybul/Fauci plan for comprehensive treatment and \nprevention of HIV in African countries.  This was in response to the original request by \nJosh Bolten and then the specific request by Gary Edson to put together a plan based on \nthe ”Mugyenyi Model ” of Uganda (see July 17 above).  Also present at the meeting was \nTerrell Halaska, Joe O’Neill, Mark Dybul, and Allen Gilbert.  Gary, Jay and Margaret \nwas extremely pleased and excited about the plan.  They mentioned that we had done a \n”fabulous” job.  They asked us to respond to about 5-6 questions in writing. Clearly they \nare going to run it by the President when he returns from his August vacation in \nCrawford, Texas.  He may well want to make this a Presidential initiative similar to the \nMTCT proposal that we had put together for him.\nAugust 16, 2002 – Went back to White House to present the revised Global AIDS Plan \nto Gary Edson.  Also present were Terrell Halaska, Mark Dybul and Joe O’Neill, \nDirector of Office of National AIDS Policy (ONAP).  Gary again liked the revised plan \nand liked how we answered the questions that he and Margaret Spellings posed to us at \nthe last meeting concerning: a) impact on Domestic AIDS issues; b) development of a \nsharp sound bite for the State of the Union Address in case it comes to that; c) \nrelationship to Global AIDS Trust Fund; d) Inclusion of Russia, India, and China; e) \nreason why the Gates/Merck/Harvard/Univ of Penn initiative in Botswana has failed; f) \nadministrative structure of the program.  He asked me to revise the document by \ntightening it up to an Exec Summary, 5 pages of text and a group of tables. He wants us \npresent it to Josh Bolten when Josh gets back from vacation next week.  Mark and I can \nquickly make this revision.\nAugust 26, 2002 – Meeting at the White House with Gary Edson, Jay Lefkowitz, \nMargaret Spellings, Ken Thomas (ONAP), Jim Capretta, Robin Cleveland (OMB) and \nMark Dybul.  We presented the condensed version (see above) to Gary , Margaret, and \nJay.  Several minutes into the meeting Robin and Jim showed up and in a somewhat \noffhand manner without evening knowing the details of what we were presenting, Robin \nbecame very critical of the idea and the project.  She actually parroted words that we had \nheard weeks ago from the Kolbe Committee (Charlie Flichner) about how they were very \nskeptical that we could actually get ”twin pairs” of hospitals.  Also, she questioned \nwhether the Uganda model would work even though she knew virtually nothing about it.  \nI kept my cool, was subliminally sharp in response to her, but was very pissed inside.  \nGary intervened and defended what we had done and indicated that we would come back \nto Robin with more details about the Uganda model etc. (which we had already done \namong us previously).  Afterwards, Gary, Ken, Mark and I met for about 45 minutes in \nThe Situation Room and discussed further revising of the documents.  I would not be \nsurprised if Robin leaked all of this to USAID and the House Foreign Ops Committee.  I \ndid not like the way she acted at the meeting and I do not trust her.  She acted a bit \ndisrespectful to us in my mind; however, I believe that this was not her intent and she was \nreflecting the questions that the House Foreign Ops Committee was asking her.\nReleased by Chairman Rand Paul\n51August 26 – Sept. 5 – Much discussion about pre-emptively attacking Iraq to neutralize \nthem before they use or get capacity for ”weapons” of mass desctruction.  This is pushing \nour HHS team to be ready to vaccinate the USA population.  Our plan for ”staged” \nsmallpox vaccination of immediate first responders to broad first responders to voluntary \nvaccination of general public is ready to go.  We are waiting for word from the White \nHouse to roll out the plan.\nSept. 6, 2002 – Two meetings at the White House today:\n1) Meeting in Executive Office Building (EOB_ in OMB’s Robin Cleveland’s office \nwith Robin, Gary Edson, Joe O’Neill, and Mark Dybul.  We presented our re-\nenforced implementation with a beautiful computer model of accessibility to \ncentral medical centers (CMCs), primary, secondary and tertiary clinics in \nUganda as a prototype.  Robin was still not entirely satisfied with the presentation \nsince she was hung up on quarantees that this plan would work given failures in \nprevious endeavors in these countries.  She and Gary also wanted to flesh out the \ncomputer model on India, Mozambique and Guyana.  We will go back and try \nagain.  Next meeting likely will be with Josh Bolten.\n2) Meeting in EOB with General Bruce Lawlor (deputy to Gov. Ridge of OHS), Col \nKadlac (OHS), and Col Gerald Parker of Ft. Detrick for me to present to Lawlor \nthe NIAID plan for research including collaborations with DoD and facilities at \nFt. Detrick.  I presented the NIAID Strategic Plan and Research Agenda.  It was a \ngreat meeting.  Lawlor was extremely impressed and highly supportive.  We \npromised to work together and he offered to help in any way possible.  He is a \ntough, nice , straight shooter.  His background is that he commanded a tank \nbattalion in the Gulf War.\nSept. 17, 2002 – Another meeting at the White House on the President’s AIDS initiative.  \nThis time I presented the program to Josh Bolten in his office in the West Wing.  Also \npresent were Gary Edson, Jay Lefkowitz, Terrell Halaska, Mark Dybul, Joe O’Neill, \nRobin Cleveland, Kristen Silverberg, Carol Thompson.  We are definitely moving along.  \nClearly Josh wants to do it.  He thoroughly liked my presentation.  The problem will be \nOMB and the question of where we are going to get the money.  Issue also is if the \nPresident accepts it, when can we announce since the budget for 2002 has not even been \nsettled and 2003 has virtually decided.  We want to announce soon since WHO and other \norganizations are dancing around the question of an implementation strategy and we do \nnot want to President to lose the leadership edge.  Josh asked OMB (Robin) to work out a \nbudget scenario and get back to him.  They also will elevate it up one more notch to \nAndy Card, Condolezza Rice and Mitch Daniels. We will meet again soon.\nSept. 18, 2002 – Briefed Secretary Thompson about the upcoming smallpox vaccination \npolicy and role-out.  Also present were Julie Gerberding, Stewart Simonson, Michael \nOsterholm, Jerry Hauer, Les Crawford, Ann Agnew, Terrell Halaska, etc.  We are \nadvancing towards the 3 stage policy that ultimately would allow voluntary vaccination \nfor anyone who wants it.\nReleased by Chairman Rand Paul\n52Had briefing at the White House on the fact that West Nile Virus can now be spread via \nblood transfusions (and transplants).  We are in the midst of a major epidemic with about \n1641 cases and 80 deaths.  It has been clearly documentd now that blood transfusions can \ntransmit WNV.  We discussed how we would handle the press, etc.  I strongly suggested \nthat we avoid the mistakes of the early 1980s regarding HIV and the blood supply.  I \nsuggested that we obviously try to avoid panic, but that we make it clear that transfusions \nare NOT entirely risk free with regard to WNV as well as several other pathogens.  It is a \nquestion of relative risk of the transfusion versus not getting the transfusion.\nINCREDIBLE evening – Bono the lead singer of U-2 and the best selling musician in \nhistory had called my office yesterday (his chief-of-staff) to say that he wanted to talk to \nme by phone or preferably in person to discuss how we could partner and how he could \nhelp me in my work on trying to get AIDS treament and care and prevention to sub-\nSaharan Africa.  He had, this past year, gone to Africa in a much-publicized trip with \nTreasury Secretary Paul O’Neill.  At mid-day we got a call that Bono wanted to fly from \nChicago to speak with me in person that evening.  He did and we met at my house.  We \nhad wine, Chris cooked pasta and we had an amazing evening, talking for hours.  He is \nalsolutely fantastic, passionate and very intelligent.  He will try to help by supporting me \nand President Bush in the evolution of our implementation plan for Africa. Also visiting \nwas his staff Jamie Drummond, Lucy Matthew, and Katrina......  We promised to stay in \nclose touch and work together.  I did not tell Jenny, Megan and Alison that Bono was \ncoming to the house for dinner.  When he walked in the door, they were speechless; \nhowever, he was wonderful with them.  They (and I) will never forget this extraordinary \nnight.\nSept. 24, 2002 – Had CIA briefing and overall review of smallpox plan in Secr. \nThompson’s office with Gov. Ridge, Col. Bob Kadlac, Julie Gerberding, Jerry Hauer, and \na Ridge person .  Clearly Russia had modified smallpox and very likely Iraq has \nsmallpox.  We reviewed the pre-emptive plan for vaccination that will be presented to \nPres. Bush tomorrow by TGT in anticipation that he will make the policy decision soon.  \nWe will recommend the 3 stage proceedure of 500,000 to 10 million to the general \npopulation.  Word in the meeting is that we will definitely attack Iraq by January.\nSept. 26, 2002 – White House briefing with Carol Kuntz (Assistant to VP Cheney), \nKristen Silverberg, Stewart Simonson, Jerry Hauer, Bob Kadlac and others regarding \nsmallpox vaccination policy.  Carol was concerned that she was getting different signals \nfrom different people about varying toxicities among children versus adults, primary \nvaccinees versus re-vaccinees.  Apparently, D.A. Henderson has been very dogmatic with \nher (what else is new?).  I told her that one can go to the literature and analyze the \ninformation in many ways.  Since she questioned my numbers, I just kept quite and \npromised myself to get back to her.\nSept. 27, 2002  - Spoke with Carol Kuntz over the phone and explained some \ncalculations that I had done (see attachment).  She apologized for questioning me the day \nbefore and even made the comment that ”Who is she to go mano-a mano with Tony \nReleased by Chairman Rand Paul\n53Fauci” since I am ”a legend” in the White House.  I had a great conversation with her and \nsent the document shown below to her.\nSeptember 27, 2002\nNOTE TO CAROL KUNTZ\n                   \nFrom:  Anthony S. Fauci, M.D.\nDirector\nNational Institute of Allergy and Infectious Diseases\nNational Institutes of Health\nCarol:\nAs per your request, I will summarize below the information that I discussed with \nyou over the phone and will provide as attachments (1 through 5) some data sheets:\n1)  The question arises whether the rate of serious complications due to primary vaccinia \nvaccination is greater in children versus adults and whether, because children will be \nobviously excluded from the cohort of health worker and first responder vaccinees, this \nwill result in a lower than anticipated rate of complications for the first 2 stages of the \nvaccine program, i.e. up to 10,000,000 people.  My reference is Lane JM et al: \nComplications of smallpox vaccination, 1968.  National surveillance in the United States. \nN Engl J Med 281:1201, 1969.  I worked from Table 1 of the paper (attachment #1) and \nanalyzed the “Primary vaccinations”.  I divided the cohort into 2 groups of <1 yr to 9 yrs \nold and 10 through 20+ yrs old in order to compare the actual rate per million \ncomplications in each group. I found the following:\nThere were 4,900,000 individuals in the <1 to 9 yr olds and 694,000 individuals in the 10 \nto 20+ yr olds.  The rate of complications in the 2 groups were as follows:\n                                                            <1 – 9 y.o.                       10 – 20+ y.o.\n                                                                                 per million\nPostvaccinial encephalitis                          3                                     1\nVaccinia necrosum                                   0.4                                  4.0\nEczema vaccinatum                                   10                                   14\nGeneralized vaccinia                                  22                                   26\nAccidental inoculation                                26                                  10\nDeaths                                                           1                                1.44\nTherefore, one can conclude from this analysis that the younger group has a higher \nincidence of encephalitis, but the older group is similar, if not slightly worse off, when \nReleased by Chairman Rand Paul\n54compared to the younger group with regard to the other complications of primary \nvaccination.  HOWEVER, the critical issue as I see it is the major difference between \npreviously unvaccinated and previously vaccinated individuals with regard to the \nfrequency of vaccine-related complications.  Whether you look at the figures from the \n1969 paper referred to above (attachment #2) or the 2001 MMWR (attachment #3), the \nrate of complications in the previously unvaccinated group is considerably higher than \nthat in the previously vaccinated group. For example, in the Table 6 of the 1969 New \nEngland Journal of Medicine paper (attachment #2), the complications per million are as \nfollows comparing previously unvaccinated versus previously vaccinated: Encephalitis – \n2.9 versus 0; vaccinia necrosum – 0.9 versus 0.7; eczema vaccinatum 10.4 versus 0.9; \ngeneralized vaccinia – 23.4 versus 1.2.  The differences are even more impressive in the \nTable from the 2001 MMWR (attachment #3)\n2) Since the differences are so striking between previously unvaccinated and previously \nvaccinated individuals with regard to the incidence of serious adverse events associated \nwith smallpox vaccination, I calculated the percent of people in the work force that we \ncould predict would be previously vaccinated or not.  I used the most recent US Census \n(2000) (attachment #4).  I consider the work force to be individuals from 20 through 64 \nyears old (this corresponded to natural breaks in the census data).  In 2000, there were \n281,421,906 people in the USA.  I found that there were 59 million people or 21% of the \ntotal population and 36% of the work force between the ages of 20 and 34 years.  These \npeople will have not been previously vaccinated.  Routine vaccinations stopped in 1972 \nand most children would not have been vaccinated before age 5 and so 34 years old is the \ncut off point.  I further found that 107 million people between the ages of 35 and 64, i.e. \n38% of the population and 64% of the work force were likely vaccinated.  Thus, 64% of \nthe people that we would be vaccinating in the first responder/health care worker \ncategory would fall into a group that historically has a much lower rate of serious adverse \nevents than the previously unvaccinated group. I believe that this must at least be taken \ninto consideration in our policy decisions.\n3)  You asked a question about residual immunity in people vaccinated decades ago.  If \nyou look at laboratory immunity (i.e. antibody levels and cell-mediated immune \nfunction), there is no question that the vast majority of studies indicate that there are \nvariable levels of residual laboratory immunity in people who were immunized even \ndecades ago.  The question remains whether the laboratory immunity is totally reflective \nand correlated with clinical immunity to an actual exposure.  There are several studies \nthat indicate that previous immunization, even decades ago, provides real, but variable, \ndegrees of protection against death (i.e. lower case fatality rates) compared to \nunimmunized individuals. It is impossible to determine the effect on actual infection \nwithout death.  Some of these studies such as the 1902-1903 Liverpool outbreak study is \npartially flawed in that there was some smallpox circulating in the community that might \nhave boosted immunity.  However, several studies that are summarized in a paper by \nMack TM et al: Smallpox in Europe 1950-1971. J. Infect. Dis. Vol.125, number 2, Feb. \n1972 (attachment #5) indicate that case fatality rates are significantly less in individuals \nvaccinated even more than 2 decades before.  I personally do not believe that all of these \npeople were protected because that were intermittently boosted by naturally occurring \nReleased by Chairman Rand Paul\n55smallpox.  There just were not that many widespread smallpox outbreaks to boost the \npopulation of Europe consistently during that time frame.  In fact, from 1950 through \n1971, there were only 680 cases of smallpox in the countries in question.  Therefore, I \nwould have to conclude (not definitively, but likely) that previously immunized people \ndo have a variable, but significant, degree of residual protective immunity against death \nfrom smallpox.\nI hope that you find this information useful.  Please give me a call if you have any \nquestions at (301) 496-2263.  Thank you and best regards.\nSincerely,\nAnthony S. Fauci, M.D.\nSept. 29, 2002 – Received ICAAC Award and gave the ICAAC Award lecture in San \nDiego on “Bioterrorism in the spectrum of emerging and re-emerging diseases”.  \nAudience was 10,000 people and received rave reviews for the lecture.\nSept. 30, 2002 – Got another top secret briefing from the CIA.  Apparently Russia is still \nmaking genetically modified microbes for offensive use.  Also, was briefed on Iraq’s \ncapabilities.  It is my impression that the CIA information is really very soft.  They have \nsources, but they are difficult to validate.  \nOct. 4, 2002 – Engaged with Julie Gerberding, Jerry Hauer, Kevin Keane in a briefing of \nState and local Public Health officials on the likely roll out plan of  smallpox vaccination \nin3 stages (500,000 smallpox response teams and emergency personnel, then 10,000,000 \nhealth care workers, primary care people, police and fireman, etc. followed by making \nvaccine available to general public after the Acambis product is licensed in early 2004.  \nThis was followed by a press conference, which did not go well since Jerry Hauer said \nthat we were not going to make any “announcements”. Note that there have been many \nleaks about the 3 stage plan and the press was clearly annoyed that the press conference \nstarted with a statement that we were not going to tell them anything important.  \nHowever, Julie proceeded to get up and say that we recommended the above plan.  She \nleft the stage for a few minutes and I corrected her (politely) by saying that we are not \n“recommending” anything, we are merely giving a likely option.  The Secretary \nrecommends something to the President and that is confidential.  The reason for this is \nthat we do not want to put the President in the position of possibly going against his top \nhealth advisors, i.e. boxing in the President.  Julie returned and confirmed my correction.  \nThe press rightfully thought that we were sloppy (not me, but DHHS).  We called the \nmain players – Larry Altman, Laura Mackler of AP, Ceci Connolly of Washington Post \nand Sheryl Stolberg of NY Times to clarify the situation.  All of this is happening \nbecause the WH is taking so long to come out with a policy and we are compromised \nbecause if we do not say that we favor a certain plan, then it looks like we do not know \nReleased by Chairman Rand Paul\n56what we are doing.  How can we not favor a certain plan if we have been working on this \nproblem for months???\nOct. 10, 2002 – Had 2 important meetings at the White House today:\nFirst - meeting with Gary Edson, Jay Lefkowitz and Robin Cleveland about the \ncomprehensive AIDS implementation plan for prevention, treatment, and care for \ndeveloping nations  for possible consideration by the President.  This was in response to a \ncall from Jay about 1 week ago asking to spread out the plan from 5 years to 7 years and \nto calculate how much money would be spent for each prevention intervention, i.e. \ncondom distribution versus sex worker education versus needle exchange versus family \ncounseling.  The point is that they feel that the request might be too much for the 5 years \n(Total = $9.987 billion over 5 years, including up to $1.0 billion for the Global Fund).  \nThey want us to spread it out so that the early years will be less.  Also, they want us to \nassume that countries other than Russia, China, and India (which will contribute 50%) \nwould be contributing some proportion.  We figured Botswana and South Africa could \ncontribute 30% each Namibia and Guyana 20% and Uganda 10%.  Furthermore, they \nanticipate that the President is going to ask just what the money is going for and if it is \nfor Condoms, sex workers and IV drug users, he should at least know that.  Obviously, \nthe right wing in the WH would be against this.  We crunched the number and I presented \nthis.  Right off  Robin mentioned that Jim Capretta (OMB PAD) had mentioned to Mitch \nDaniels that something was cooking vis-à-vis international AIDS and that this would \nrequire new money.  Mitch immediately said no chance and that no matter what we give, \nwe will be criticized.  Robin then left for another meeting.  I suggested to Jay and Gary \nthat another alternative would be to do this through the Global fund with the stipulation \nthat they work from our plan with suggestions from them. My reason was as follows. The \nWHO group just met in Geneva with Bernard Schwartlander to try to galvanize a plan \nand support for a global program. Mark Dybul went to that meeting.  It appears that they \nwill ask for a 3 year plan to treat 3 million people at a cost of $10-15 billion with $4.6 \nbillion from USA. They want to announce this on World AIDS Day (Dec. 1).  This could \npre-empt the President.  In other words, we will be pressured to give $4.6 billion to do \nsomeone else’s plan. This would be less that our 5 year and 7 year plan. Why not \nannounce that we will give $4.6 million to the global fund if they coordinate their \nactivities through our plan?  The President could announce this and get credit for \nleadership as well as for contributing to the Global AIDS Fund.  Also, it would avoid the \nimpression that we Americans are going off on our own.  Gary and Jay liked the plan \nvery much and asked me to put together a 3-pager for Josh Bolten.  They made me swear \nto tell no one about this, not even Mark, Terrell or TGT.  I finally convinced them that I \nreally needed to tell Mark since he is necessary to put these things together.  I am very \nuncomfortable about not telling Terrell.\nSecond meeting was a briefing of Vice President Cheney’s Staff on the NIAID efforts on \nbiodefense, i.e. what is our “vision” for spending the $1.75 billion as well as our long-\nterm vision.  At the meeting were Carol Kuntz, Seth Carus and Noreen Hynes (all from \nCheney’s senior staff) and Jerry Hauer (from the DHHS).  The meeting went extremely \nwell.  I wowed them with a passionately delivered presentation. I told them that we at \nNIAID could transform the way the country deals with bioterrorism threat from a \nReleased by Chairman Rand Paul\n57research  and public health standpoint. They loved it and asked what powers I needed that \nI do not have to execute this.  I mentioned that we should have a fund to purchase \nvaccines and drugs so that the pharmaceutical industry would have an incentive to get \ninvolved.  Also, I said the FDA needed to be more flexible.\nOct. 17, 2002 – Sent down the 3-pager that Jay and Gary wanted (see above).  It calls for \nthe USG taking the lead and committing a considerable amount of money THROUGH \nthe Global Trust Fund, but under the stipulation that other countries join us and \nimplement our plan. The plan would cost approximately $18.8 billion of new money over \n5 years.  In the covering memo to Jay and Gary, I mentioned that I was uncomfortable \nabout not telling Terrell what we are doing since I am supposed to me representing her \nand TGT at these meetings.  Of note, Gary and Jay usually respond almost immediately \nto me when I send material such as this.  However, over the subsequent 2 days (Oct \n18,19), I have heard nothing from them.  I suspect that they are put aback by my \nmentioned my discomfort about not telling Terrell about this.  We shall see what \nhappens.\nAlso, received a call from Stewart Simonson who said that Vice-President Cheney \nwants a meeting with me about my Biodefence Research Vision on Wednesday, Oct . 23.  \nThe White House has set up the meeting.\nOct. 20, 2002 – Gary Edson contacted me and likes very much the revised document (see \nabove).  We are closing in on it and he will soon show it to Josh Bolten.\nOct. 8 – 22, 2002 – Washington, D.C. area being terrorized by a sniper who has already \nshot 12 people and killed 9.\nOct. 22, 2002 – Had a terrific visit and briefing of  Vice President Cheney in the West \nWing of the WH.  Present were the VP, “Scooter” Libby, Carol Kuntz, Noreen Hynes, \nSeth Carus, (Gen.) Phil Russell, and Stewart Simonson. I went over our NIAID Research \nAgenda and Strategic plan for biodefense.  As I did in my briefing of Carol Kuntz (see \nabove), I stressed that we can and will do the job.  I stressed that we needed help in \ngetting greater regulatory flexibility, having the power to sole source contracts, and we \nneed to provide major incentives for industry.  We must work more closely with industry \nthe same way that the automobile industry made our planes and tanks during World War \nII.  It was a very easy and enjoyable interaction with the VP.  Of note, when we discussed \nbriefly the policy for smallpox vaccination, it was clear that Libby is the driving force for \nmass vaccination sooner rather than later.  The VP seemed rather measured on the \nsubject.\nOn the way out of the WH, I ran into Gary Edson in Josh Bolten’s office (Josh’s \nassistant had seen me walking by and asked me to come in to say hello to Josh).  Josh and \nGary were actually working on the plan that Mark and I had just sent to them.  They like \nit very much and I think that something is going to happen with it.\nOct. 23, 2002 – Met with Bono again at the Jefferson Hotel for breakfast.  Also present \nwere Jamie Drummond, Lucy Matthew, Katrina and Erin Chapman. We spent almost 2 \nhours going over options for how we can drive the agenda for universal care, prevention \nReleased by Chairman Rand Paul\n58and treatment for HIV infected people worldwide.  I emphasized the importance of \nengaging Russia, India, and China because of the large populations in these countries in \nwhich a mere increase in prevalence from 1% to 2% in countries like India and China (I \nbillion people in each country) could quickly create a pool of infected people that would \nequal all of Africa.  He will be meeting with Condolezza Rice this afternoon to push for \nthe USA getting involved in a major way with money (billions) and leadership.  I am \nimpressed with Bono’s good intentions and his intelligence and energy.  I am \ndisappointed that I cannot tell him about the program that Mark Dybul and I have been \nworking on for the “comprehensive implementation” plan.  Hopefully, we can make this \npublic soon so that we can engage Bono’s assistance with his bully pulpit.\nOct. 29, 2002 -  Received today the written version of the oral history that Victoria \nHarden collected from me a few months ago.  See attached document.\nFauci on biodefense \n8-9-02.doc\nOct. 30 – Nov. 1 – Multiple conversations and e-mail exchanges with Gary Edson \nregarding the AIDS Project (see above).  I believe that finally we are getting this straight.  \nHistorically (see above), every time that we try to calculate the needed resources for a \ncomprehensive program, Robin Cleveland (OMB) or someone else says that it will not \nfly (see note of Oct. 10, 2002).  Now Gary calls me and says that our most recent package \nmight be low-balling it since he recently read an article by Jeff Sachs in The Economist \nthat we need $25 billion per year.  I finally told Gary that I had had enough.  The world is \ncalling for $10 billion per year for 5 years with an increase to $15 billion per year by \n2007.  They all say that the USA commitment should be 35% of this or $3.5 billion per \nyears for 5 years.  I told Gary that this is what we should propose as the President’s \ninitiative provided that the other countries put in the remaining 65% and that they use our \nimplementation plan.  I told Gary that he and Robin need to figure out how much of $3.5 \nbillion per year we (USA) will have already been spending in order to determine the \namount (% of $3.5 billion) that really would have to be new money.  Finally, he agreed \nand now we can stop all of this ridiculous back and forth with Robin and him.  We may \nbe getting close to presenting this to the President.  We just need to convince Josh Bolten\nNov. 1, 2002 – Had a great meeting with Carol Kuntz, Noreen Hynes, and Seth Carus \nregarding the request of the Vice President for me to list what added powers that I would \nneed to make the BioD program work at NIAID. Stewart Simonson and Phil Russell also \npresent I listed a group of these and Carol et al liked and agreed with them.  They were \nmostly sole source contracting authority, rapid grants, DARPA-like powers, etc.  Next \nstep is arranging a meeting with me, TGT, and Cheney.\nNov. 12, 2002 – See note of Oct. 30 – Nov. 1 above.  Gary Edson called me last week \nand said that they were on the verge of making the decision regarding whether we will go \nfor the major implementation plan.  However, there is skepticism on the part of OMB \nReleased by Chairman Rand Paul\n59(and likely others that he did not mention) concerning whether this can be done.  They \nneed to do due diligence and get some outside opinions and so they Gary has asked me to \ngather for a meeting at the WH a group of people who have actually done developing \ncountry implementation.  They want to speak with these people without my being there, \ni.e. to check up on me.  I suggested and they agreed to bring in the following:  Peter \nMugyenyi (Uganda), Jean (Bill) Pape (Haiti), Paul Farmer (Harvard-Haiti), Eric Goosby \n(Pangea Foundation and Rwanda).  Gary asked me on a Friday and I needed to contact \nthese people who were scattered all over the world to come to DC to see me and then \nhave a visit to the WH.  Gary insisted that I not reveal the plan to them and so I had to \nconvince them to travel within a 72 hours period merely on faith as a favor to me.  They \nall agreed and came: Mugyenyi from Uganda, Goosby from Rwanda, Farmer from \nGermany, and Pape from Haiti.  Still Gary insists (despite my asking him again and \nagain) that I cannot tell Terrell Halaska about any of this.  I pushed Gary and he checked \nwith Josh Bolten who said that this week we indeed will be able to tell Secretary \nThompson.\nOn another issue, things are heating up regarding possible war with Iraq.  This \nmakes compelling the imminent decision of policy regarding smallpox vaccination of \ncivilians.  The Pentagon will imminently announce that 250,000 to 500,000 troops will be \nvaccination with vaccinia (Dryvax).  The question of the availability and \nrecommendations for  civilians remains.  I am pushing for “recommending” that the \n500,000 and then the up to 10,000,000 health workers and first responders get \nvaccinating.  However, I feel that although we should make available the vaccine for the \ngeneral public, given that the threat assessment is very soft, we should recommend that \nthey not take the vaccine unless they feel very strongly that they do not want to take any \nchances.  This is different from the situation with the anthrax vaccine where the DHHS \nsaid that had no recommendation either way; they just made the vaccine available if \npeople wanted it.\nWent down to the White House to pre-brief Gary Edson and Jay Lefkowitz on \nMugyenyi, Goosby, Pape, and Farmer.  They both inquired as to what pretense I used to \nget these people to come to the USA.  I said that I asked them to come and advise me \nabout clinical trials in developing nations.\nHad dinner at the Trattoria Sorrento in Bethesda (Cordell Street) with the 4 \nvisitors and told them exactly why I called them in and explained what type of questions \nwould be asked of them at the WH.  They look upon me as a hero for what I am doing.\nNov. 13, 2002 – Multiple meetings in the DHHS to plan roll out of smallpox vaccination \nplan.  It is imminent. The President is planning on having to start bombing Iraq in the 2nd \nweek of January and wants to start vaccinating the 500,000 people smallpox response \nteams by December 1 and the 10,000,000 first responders by January in order to prepare \nfor a release of smallpox by Iraq.  Much discussion about timing the announcement of \nvaccinating the military with the announcement about the general population. Concern is \nthat if we do not link the 2, the people will react to vaccinating the military by saying \n“what about us?”  It looked like we were going to make the announcement on Friday, \nReleased by Chairman Rand Paul\n60Nov. 16.  However, at the WH, the President told the cabinet (including TGT) that he \nnow wants to wait until he comes back from a foreign trip (Nov. 27) since Osama bin \nLaden just released a tape yesterday indicating that he is still alive and threatened the \nUSA, UK, and Russia.  Bush does not want it to appear that we are panicking in response \nto the tape.  I am relieved that we decided to wait since I would have had to cancel my \ngoing to Los Angeles to receive the RAND Prize ($10,000.00) in order to remain in DC \nfor the Press.\nHeard that the WH meeting with the 4 visitors on the global AIDS plan went \nextremely well.  I believe that we are convincing the skeptics that we can effectively treat \nHIV in developing nations.  Of note, Robin Cleveland asked to have Nils Daulaire there \nfor his opinion.  It is my impressions that she is resentful of the NIH and me.  This is \nlikely due to the fact that her OMB account for which she is responsible includes USAID \nand there is obviously some competition in her mind given that NIH always does so well \nwith the budget.\nNovember 19, 2002 – Another meeting at the White House with Jay Lefkowitz, Gary \nEdson, Joe O’Neill, Mark Dybul and me to further discuss the potential for getting the \nPresident to accept our proposal for a comprehensive $50 billion over 5 year plan.  Gary \nand Jay want me to further refine the presentation and actually start finalizing it for \npresentation first to Mitch Daniels and then ultimately to President. Jay had shown me a \nmemo that Nils Daulaire had sent to Robin after the meeting with Mugyemnyi et al and it \nwas clear that Robin and Nils are working together.  Nils is a fine former public servant \nand is now in the private sector.  However, judging from his memo, he is dead wrong on \ncertain issues, i.e. he does not believe that Russia, China and India will surpass Africa \nwithin the next 5 years in AIDS impact.  Also, I am not happy that Robin previously told \nNils about the plan at the same time that Gary and Jay will not allow me to tell Terrell \nHalaska or Secretary Thompson about it.  Strange situation in this WH regarding secrecy \n– they are almost pathologic about it.  At the meeting, Jay and Gary asked me and Mark \nto prepare again even more material for an upcoming meeting with Mitch Daniels (see \nabove).  We got it to them within 1 day.\nNovember 21, 2002 – Another pre-roll out meeting at the Department to prepare for the \nupcoming announcement by the President on the Smallpox vaccination policy.  Meeting \nwas with Kevin Keane, Bill Hall, Jerry Hauer, and on teleconference  - Michael \nOsterholm, Julie Gerberding and an assortment of CDC public affairs people.  I have \nconvinced them that we should not recommend  to the general public that they take the \nvaccine give the non-quantifiable risk.  I am also convincing them that for the Stage 2 \n(10,000,000 first repsonders), we also should not make a blanket recommendation that \nthey get vaccinated.  Rather, we should say that as a group the vaccine should be offered \nto them, but since this is a heterogenous group, the actual recommendation to take it or \nnot should rely on discussions between the CDC and the State and local public health \nofficials in light of the particular needs and situation within a given jurisdiction.  Clearly, \nthe Stage 1 group (500,000 smallpox response teams) should have a recommendation to \ntake the vaccine voluntarily.\nReleased by Chairman Rand Paul\n61Nov. 22, 2002 – Gave keynote address at the Holy Cross function at The Supreme Court  \nfor “Lift the Cross High”. Justice Clarence Thomas was our host and was the other \nspeaker.  My remarks were very well received by all.  It was a very elegant evening \naimed ultimately at fund-raising for Holy Cross.  Thomas is also an alumnus.\nNov. 26, 2002 – Briefing of Vice President Cheney at the White House regarding Project \nBioshield (I made up the name) which is requesting his help in getting me special \nauthorities for Countermeasure Advanced Development.  Meeting included VP Cheney, \n“Scooter” Libby (both on teleconference from secret location), Secretary Thompson, \nStewart Simonson, Bill Raub, Carol Kuntz, Noreen Hynes, Seth Carus.  Bill Raub \npresented the need for a $1-2$ billion Vaccine Trust Fund. Meeting went extremely well.  \nVP was very supportive of my proposals and told Carol to set up a meeting between me, \nTGT, Stewart and Josh Bolten.\nAlso met later in the day with Richard Danzig (former Secretary of the Navy \nunder Clinton).  He is a private consultant under contract to the DoD for Biodefense and \nwanted to get to know me since he has “heard so much about me”.  He wants to start an \ninformal group of people linked by common interest in biodefense.\nDec. 3, 2002 – Still waiting for the President to decide on the announcement of the \nsmallpox vaccine policy.  Should be tomorrow or next day.  Also, a lot of back and forth \nbetween me, Jay Lefkowitz and Gary Edson.  I believe that we are moving towards a \nGlobal AIDS Initiative.  Jay will present our plan and budget to Mitch Daniels today.\nPhone call with Jay Lefkowitz and Keith Hennessey and Doug Badger called \nwanting to know why we needed a vaccine trust fund as opposed to other mechanisms to \nguarantee purchase of vaccines.  This is what Bill Raub presented to the VP (see above); \nhowever, they are asking me about it because of “my credibility” (according to Carol \nKuntz.  Carol was on the phone with Kristen Silverberg.  There is some concern as this \npasses through the WH that there is not enough justification for a “Trust Fund”.  Carol \nKuntz wants to set up a meeting at the WH for me to help explain this sometime later this \nweek or next week.\nDec. 4, 2002 – Amazing day.  I was at one time on 3 different lines with 3 different \npeople at the White House – Gary Edson, Jay Lefkowitz, Carol Kuntz.  There was an \nintense and critical issue with Gary and Jay.  Gary was getting ready to meet with Mitch \nDaniels regarding our AIDS plan and he heard through his WH grapevine that Mitch was \ngoing to try to “Steamroller” him by bringing up the Washington Post article from a \ncouple of days ago about the program in Botswana being a failure.  In other words, if \nBotswana failed, why did we believe that our program would succeed.  I explained to \nGary that the Botswana Program was “Top Down” government as opposed to local \nnetwork.  They were using high tech., approach instead of grass roots.  Gary asked me to \ncontact our African friends and get their opinion (in one half hour!!!!).  I contacted Peter \nMugyenyi, Sam Kibende, and Eric Goosby and they all agreed with me.  Peter mentioned \nthat the big mistake that the Gates Foundation and Merck went directly to the Botswana \nGovernment and asked them to put together a plan.  Botswana then employed the \nHarvard AIDS Institute who developed a high-tech USA Harvard like plan with CD-\nReleased by Chairman Rand Paul\n62ROMs for developing voluntary Counseling and Testing.  Peter said that it was doomed \nto failure.  I relayed this to Gary and he was satisfied.\nAlso, more delays in the announcement of the smallpox vaccine policy.  It will \nnot be this week and so I will be able to go to Albany to give a talk associated with my \nAlbany Prize from last Spring.\nDec. 4 – 10, 2002 – Incredible amount of action going on.  Many calls and interactions \nwith VP Cheney’s staff (Carol Kuntz, Noreen Hynes, Seth Carus) regarding Project \nBioShield.  The VP wants to come to NIH and have me show him around the Vaccine \nResearch Center (VRC) in the context of the “Advanced Project Development” of Project \nBioshield.  Project Bioshield has caught on with the VP and his staff.  Scooter Libby is \nbecoming a strong ally and fan of mine. \nAt the same time there is a lot of buzz as to when the President is going to \nannounce his vaccine policy.  Many leaks, interestingly most from the WH itself.  We are \nbusily preparing our Qs and As for the announcement.\nElias Zerhouni feeling a bit out of the loop.  I am trying to keep him informed, but \nthe WH and DHHS wants to deal directly with me.\nDec. 11, 2002 – A truly terrific day!  Cheney came to VRC and I presented an updated \nversion of Project Bioshield in the context of going from concept to product in the VRC.  \nPresent at meeting were: Cheney, Scooter Libby, Carol Kuntz, Noreen Hynes, Seth \nCarus, Elias Zerhouni, Tommy Thompson, Stewart Simonson, Phil Russell, Gary Nabel \nand his staff.  Cheney and Libby were “wowed” by my presentation and by the VRC  \nCheney instructed his staff to do whatever is necessary to facilitate what I am doing \nincluding giving me special authorities.\nImmediately after the VP visit, I rushed down to the WH to present “Project \nBioShield” to Josh Bolten in the context of the VP wants me to sell the concept to Josh.  \nPresent at the meeting were Josh, Kristen Silverberg, Richard Falkenrath, Tommy \nThompson, Scooter Libby, Stewart Simonson, et al.  Josh questioned the need for the \nvaccine purchase fund component of Project BioShield (good questions).  I defended it \neven though this really is not my bag (Bill Raub was the original designer of it).  At the \nend of the meeting, Josh seemed supportive of the entire project.  Clearly the VP is \ndriving this process.\nAnother amazing event.  The vaccine policy roll-out is under very close hold at \nthe WH.  Today I received one of my many calls from George Stephanopoulos of ABC. \nGeorge pointed out that the President gave an interview with Barbara Walters to view on \nDec. 13 in which he said that he would allow vaccination of the entire population on a \nvoluntary basis.  George thought that this constitutes the long-awaited announcement of \nthe policy.  I told George that the Pres. was probably just speaking in broad generalities \nsince I know that there will be a formal announcement with me involved at the WH.  \nGeorge seemed convinced; however, the ABC people pursued this and confronted the \nWH who inexplicably confirmed the story and said that the roll-out would be Friday \n(Dec. 13).  I heard about this when I was in Josh Bolten’s office presenting Project \nBioShield.  My phone rang and CBS said that ABC had broken the story on the policy on \nthe basis of the Barbara Walter interview.  They wanted me on their show to discuss.  I \nsaid that I knew nothing about this and therefore could not appear.  I", "summary": "Watcher-discovered document from paul-readingroom (2026.08.05_Diary-Prequel-_Redacted.pdf), auto-indexed 2026-08-06.\n\nExcerpt: From: \"Fauci, Anthony (NIH/NIAID) [E]\" </O=NIH/OU=NIHEXCHANGE/CN=NIAID/CN=AFAUCI> To:\"Fauci, Anthony (NIH/NIAID) [E]\" <AFAUCI@niaid.nih.gov> Subject: history Date: Sat, 11 Jul 2015 17:50:16 -0400 Importance: Normal Attachments: historical_record_of_A.S._Fauci.docx Released by Chairman Rand Paul 1 HISTORICAL RECORD OF HIV/AIDS Anthony S. Fauci, M.D. Director National Institute of Allergy and Infectious Diseases National Institutes of Health This written record will start today (April 11, 2001) and will state some events  retrospectively.  I have other records including 2 dictated tapes that should be noted. The event  that precipitated this written record, which I hope that I can regularly contribute to is the tidal  wave of activity concerning the possibility of treating HIV-infected…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/08/2026.08.05_Diary-Prequel-_Redacted.pdf", "pdf_url": "/archive-docs/fauci-files/b5b0ed807aff8eaf2c6607cc328a591e/pdf", "doc_date": "2026-08-06", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-08-05-diary-prequel-redacted"], "part_number": 1, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 2 of 7)", "content": "hung up and \nReleased by Chairman Rand Paul\n63mentioned this to Kristen Silverberg.  She knew nothing and immediately called Dan \nBartlett (WH Press Office).  I did not hear what they said; however, apparently what \nhappened is that the press confronted the WH with the Walters interview and the WH \ncaved in and admitted to the policy.  The crazy thing is that it has now hit the press, but \nthe WH will not let us talk about it since the President has not officially announced it.  \nWe still do not really know what the policy will be nor when it will be announced.  More \nlater!\nDec.12, 2002 – Much activity back and forth with the White House and the DHHS \nregarding putting the finishing touches on the President’s Statement and the policy in \ngeneral.  In particular, Kristen Silverberg and checked frequently with me.  In mid-\nafternoon she called me down to the White House with Stewart Simonson to go over \nword-for-word the President’s statement.  We were the only DHHS people asked to do \nthis.  Big surprise in the statement was the fact that we will make vaccine available to the \npublic before 2004 by allowing people who insist on vaccination to enter into an ongoing \nclinical trial (Cangene, Acambis, etc.) or by creating a special IND protocol  (using \nAventis-Pasteur).  Exciting few hours at the White House with Karl Rove, Andy Card, \nJosh Bolten, Mike Gerson (President’s speechwriter), Kristen, Susan Neeley (Public \nAffairs for Homeland Security), Dan Bartlett (Deputy to Ari Fleischer)Stewart and I \nhaving lively back and forth conversation.  I insisted that they emphatically emphasize \nthat we do not recommend vaccine to the general public; however, we will make it \navailable to those who feel they still want it even though it is not recommended.  I \nconsider this a great victory since I am concerned about tens of millions of people getting \nvaccinating, which will surely lead to some serious adverse events.\nAfter the WH, Stewart and I went to the Department and worked on Qs and As \nfor hours until around midnight.  Also, we briefed the Governors of the States and the \nState Health Officials by teleconference.\nDec.13, 2002 – Day of the announcement by the President.  The DHHS team including \nme went to the WH at 1:00 PM in preparation for the 2:15 PM announcement.  We met in \nthe Roosevelt room and discussed the policy with Ari Fleischer, Dan Bartlett, and others.  \nBill Winkenwerder represented the DoD.  Big surprise was that we learned the President \nwould get the vaccine himself since he felt that as Commander-in-Chief of the Armed \nForces, he could not order the troops to do something that he himself would not do.  He \nwill say that Laura and his children will not be vaccinated since they are part of the \ngeneral public.\nPresident makes announcement.  On stage with him was me, Tommy Thompson, \nGov. Ridge, Julie Gerberding, Bill Winkenwerder, someone from State Dept.  \nAfterwards, the President left and we all gave brief remarks and answered questions.  The \nrollout went extremely well.  I was on CNN and Julie and I were on the Jim Lehrer \nNewsHours together.  I had been scheduled by Ari Fleischer to go on all of the Sunday \ntalk shows with Tommy Thompson on Dec. 15; however, we were bumped by the \nbreaking news of Trent Lott facing forced resignation because of his “segregationist” \ncomments at the birthday party of Strom Thurmond.  Nonetheless, I got my picture in \nboth the NY Times and The Washington post standing next to the President and TGT.  \nReleased by Chairman Rand Paul\n64Also, over next few days I appeared on CNBC, WTOP radio and NPR – “Talk of the \nNation”\nDec. 18, 2002 – Another exciting day at the White House.  Clearly, Scooter Libby and \nthe VP are in favor of pushing for the Vaccine Trust Fund.  OMB and the WH economic \nadvisors have a problem with the concept of a trust fund.  As usual, Carol Kuntz has been \nvery supportive.  Was called down to a meeting at the WH with OMB people (Jim \nCapretta), the VP staff (Carol K., Seth Carus, Noreen Hynes), DHS people (Richard \nFalkenrath, et al), Kristen Silverberg, Ken Bernard, Stew Simonson, Phil Russell, Bill \nRaub.  We had to discuss the vaccine research plan.  Again, must concern as to why we \nneed a trust fund instead of an appropriation.  I explained that one (the fund) is \nmandatory and the other (appropriation) is discretionary.  Jim Capretta came up with the \nidea of a “Permanent and Definite Appropriation” that would be mandatory and multi-\nyear.  In the middle of the meeting, Scooter Libby called me on my cell phone and said \nthat he was going into a meeting with the VP and the President at 1:00 PM (it was now \n11:30 AM) and he needed for me to write a ½ pager on the concept of a mandatory fund \nfor vaccine (he said trust fund, but we subsequently hashed out a Perm. And Def. Appr.  \nHe also wanted a microbe by microbe breakdown with time-lines and costs – all by 12:55 \nPM. In addition, he wanted me to meet with the CEOs of “Big Pharma” to determine if \nthey would support this.  I rushed to the DHHS with Stew, Kerry Weems, Phil Russell \nand Bill Raub and put together a great package to e-mail and FAX to the VP’s office \n(Carol K.) arriving a few minutes before 1:00 PM.  They loved it.  We will wait to see \nwhat happens.\nDec. 19-22, 2002 – Still much activity with the VP continuing to push to help us get a \nPermanent and Definite Appropriation for purchase of countermeasures, particularly, but \nnot exclusively for vaccines.  There is much concern about botulism and acquiring \nbotulism anti-toxin.  Many phone calls and meeting with Stewart Simonson with whom I \nnow speak with and/or meet at least several times per day.  Carol Kuntz and Noreen \nHynes are trying to help us.  They asked us to put together a programatic assessment of \nour procurement needs for countermeasures without consideration of budget constraints.  \nWe had previously put together a $4.2 billion package concentrated mostly on MVA and \nrPA (anthrax) with only about $450 million over 10 years for other countermeasures.  We \npresented this several days ago to OMB people in the presence of Kristen Silverberg (see \nabove).  OMB was miffed that they had not seen these numbers before, when in fact the \nnumbers were contained in our budget submission for ’04, but were not specifically \ndesignated as purchase.  Clearly OMB is resisting the VP’s attempts to get this fund \nthrough.  The new “no budget constraint” package that we put together was \napproximately $15.0 billion over 3 years (FY04 – 06) with considerable amount now to \nother countermeasures such as botulism, plague, Ebola, tularemia, Rift Valley Fever, \nEEE/VEE/WEE, Staph. Enterotoxin, antibiotic resistance, pandemic flu, WNV, etc.  \nEven though this was put together by Phil Russell with help from DMID, the VP wants \nme to defend it to OMB since they are cashing in on my reputation and scientific \ncredibility.  The VP has set up a meeting for Dec. 23 at the WH with himself and Scooter \nLibby teleconferenced from Jackson Hole and me, Mitch Daniels, Nancy Dorm (OMB \nDeputy Director), Tommy Thompson, the VP’s staff, etc. (see below).\nReleased by Chairman Rand Paul\n65Dec. 23, 2002 – Critical meeting at the White House (see above).  Attending were VP \nCheney and Scooter Libby by teleconference from Jackson Hole; Stewart Simonson, Phil \nRussell, Kerry Weems (Budget, DHHS), Carol Kuntz, Noreen Hynes, Seth Carus, Nancy \nDorm (Deputy Director OMB), Tom Reilly and Jim Capretta (OMB).  Issue was that \nScooter and the VP had asked Carol Kuntz a couple of days ago to put together a threat \nrelated proposal for a wide range of microbes with no concern for budget to be used for \nprocurement of products.  It should be program and need driven.  Carol tasked me to do \nthis with Phil Russell.  I worked until late through the night of Dec. 22 fine-tuning this \nand learning it cold.  The proposal went beyond MVA, rPA, and included botulism, \nplague, tularemia, Ebola and other hemorrhagic fevers, pandemic flu, West Nile. Etc.  \nThe proposal came to $15 billion from FY’04 – ’06.  The OMB had agreed several days \nago to creating a “Permanent and Indefinite (first it was definite) appropriations authority \nto purchase vaccines for BioT for a total of $4.2 billion.  In typical OMB fashion, they \nwere against any new spending.  The intense interest of the VP was the reason why we \nwere being listened to.  Importantly, Carol Kuntz called OMB people to the meeting \n(Mitch Daniels was supposed to be there, but he was out of town) but did not warn them \nthat they would be faced with a $15 billion exercise in front of the VP.  I convinced Carol \nto let them know at least a few minutes before the meeting started.  They were mortified \nand enraged that they were not warned in advance.  As Nancy Dorm said, every time she \nsees me, it costs her billions of dollars.  The VP called upon me to present the proposal.  \nNancy did not get it.  She was tied down in process.  She insisted that the original \nagreement was for vaccines only and not what she called “countermeasures” such as \nbotulism antitoxin and Cidofovir, which were on the list.  She did not understand that \n“Countermeasures” is the big umbrella under which are vaccines, antitoxins, etc. Also, \nshe argued that we she not include in the purchasing authority anything that was not \nlicensed.  I proposed that we should include anything that was “licensable”, i.e. on the \nway to license by the FDA, but perhaps months away because of the FDA process.  The \nVP very clearly was on my side and did not hide it.  He even said to Nancy “ Do you \nexpect me to go to the President and the American people and say that we cannot provide \ncountermeasures against threats that we either know or strongly suspect that Iraq has \nbecause we do not want to broaden authorities and because the “process” will not allow \nit?”  She then said that she would work with us to get something out.  The VP was \nspectacular!  It was a  classic example of OMB not being able to get beyond process and \nmissing the entire point of the concept.  Amazingly, Nancy said that “look what happened \nwith the smallpox vaccine.  We bought it and now we are not even going to use it \nwidely”.  She considers the smallpox vaccine situation, which was one of the great \nsuccesses of the year to be a failure since many Americans would opt not to take it.  She \ndoes not understand that the fact that we have it is critical.  Amazing!\nThe meeting ended with the VP clearly in my corner.  My relationship with him, \nScooter and the whole staff, particularly Carol is getting very strong.\nDec. 24, 2002 – Nice surprise today.  At 1:00 PM, I received a call in my office.  I \nanswered the phone since everyone else had left for the ½ day Christmas eve.  On the \nother end someone sang the full verse of “Happy Birthday”.  It was Secretary Thompson \ncalling from Wisconsin on a cell phone from a shopping center.\nReleased by Chairman Rand Paul\n67discussed the need to establish a BAT team or biological anti-terrorist team to be \navailable to the President for advice and service in the event of a catastrophic attack. \nPresent was among many others: Julie Gerberding, David Franz, Lisa Gordon-Hagerty, \nJosh Lederberg, Richard Danzig, Bill Patrick.  Entire attendee list is in my files.\nJan. 13 or 14, 2003 – Meeting in the West Wing (Ward Room) of the White House with \nKristen Silverberg, Ken Bernard, Carol Kuntz, Amy Jensen, Sally Canfield (DHS), Jim \nCapretta, Tom Reilly, Richard Falkenrath, Stewart Simonson and others from WH \ncommunications to continue to fashion the precise language of the Project Bioshield \n(authorities, Procurement, FDA regs) in preparation for getting this into the President’s \nState of the Union (SOTU) address .  We wrangled a bit about the precise language.  We \nwill meet again in 2 days to finalize it.\nJan. 17, 2003 – Another meeting at the White House in Andy Card’s office (he was not \nthere).  Met with all of the above (Jan. 13/14) plus Patrick Aylward and minus Amy \nJensen, Jim Capretta, and Richard Falkenrath to continue discussion.  We went over \ncomments regarding draft legislation and discussed the role-out for the SOTU address. \nAlso, the WH has decided that soon after the address (around Feb. 3) the President will \nrole out Project Bioshield more formally at an event likely at DHHS or at NIH.  I will be \nthere and then will be called upon to do a lot of briefings of the Press and Congress.\nJan. 22, 2003 – Just heard from Ken Bernard at the WH that the President has decided to \ninclude Project Bioshield in the SOTU address.  Also, he plans to visit the NIH on Feb. 3 \nto roll out the plan.\nJan. 23, 2003 – Another important meeting in the White House with the same people as \non Jan. 17 plus Amy Jensen, Ginger Loper.  Putting the final touches on the 3 Bills (a) \nPermanent and indefinite authority, b) Special FDA authorization of products in \nemergency, and c) my special authorities.  Also, discussed plans for President’s visit to \nNIH.  After the meeting, went to see Josh Bolten to get a feel for what the President \nwould like to do during his visit.  Josh invited Kristen Silverberg and I into his office to \nmeet and talk with Mr. Sandy…… (Ambassador to China) and Bo Derek.  We discussed \nAIDS in China and then Josh and I went out of the room and talked about what the Pres. \nMight want to do.  Apparently he likes to observe technical things, but does not like to \n“sit down and be a prop”.  Went back to EEOB to a going away party for Seth Carus and \nNoreen Hynes.\nIt appears that Elias Zerhouni is getting uneasy and insecure about my dealings in \nBiot, particularly with the WH connection.  When I dutifully told him today that the Pres \nwas coming to NIH, he said that he really needed to become more visible in the arena of \nBiodefense.\nJan. 24, 2003 – More activity back and forth with Gary Edson, Jay Lefkowitz and me on \nthe AIDS issue.  It is still alive.  They now want me to bring back Peter Mugyenyi from \nUganda to meet with Mitch Daniels (and me). \nReleased by Chairman Rand Paul\n68Jan. 26, 2003 – Peter M. arrives from Uganda and Mark Dybul and I prep him for the \nWhite House visit.  We have late lunch-early dinner at Mark;s house to brief Peter. \nSuperBowl Sunday.\nJan 27, 2003 – We (Peter and I) meet with Mitch Daniels.  Mitch seems genuinely \nmoved by Peter’s description of AIDS in Africa and is very deferential to Peter and me.  \nGary and Jay ask that I plan to spend the entire day at the White House on Tuesday, the \nday of the State of the Union Address.  Something is up, not sure.  They even suggest that \nPeter might join a group of VIPs in a satellite site (i.e. White House or EEOB) to watch \nthe SOTU address.\nJan. 28, 2003 – One of the most amazing and important days of my life!  Spent the entire \nday (11 hours) at the White House. I arrive at the White House and Gary Edson and Jay \nLefkowitz inform me that the President has decided to adopt our AIDS Implementation \nplan – the full version!!!  $15 billion over 5 years starting with $2 billion in FY2004.  $10 \nbillion will be entirely new money including $1 billion to the Global Fund for HIV/AIDS \nTuberculosis and Malaria.  Peter Mugyenyi will sit next to Laura Bush in her box at the \nCapitol for the speech.  I spend the whole day at the WH proofing the SOTU, fact \nchecking, preparing and proofing Qs and As with Jay and Gary.  The WH personnel are \nall congratulating me for pulling this off.  Josh Bolten told me that I am his hero; Karl \nRove and Andy Card are generously congratulatory towards me.  Gary, Jay, Kristen, \nJosh, et al ask me to stay at the WH to have pizza with them and watch the SOTU \naddress. I had to leave at 7:00 PM to prepare for my Senate Hearing on Smallpox the next \nday.  The SOTU was fabulous.  He rolled out BOTH Project BioShield and the AIDS \ninitiative – 2 things conceived of and planned by me (with obvious help from many, \nparticularly with BioShield).  This has truly been an historic day!\nJan. 29, 2003 – Testified to the Senate Appropriations Subcommittee Hearing chaired by \nArlen Specter. Also present were Sens. Harkin and Murray Hearing on Smallpox \nvaccination plan.  Julie Gerberding and I testified.  Concern on the part of local health \nofficials and hospital people that the USG plan does not provide for compensation to \npeople injured by receiving the vaccine. Hearing went quite well. Spent the rest of the \nday at the WH doing post SOTU briefings and handling press calls.  I used Jay \nLefkowitz’s office.  We sent off Peter back to Uganda.  At the end of the day, I briefed \nAri Fleischer for 1 hour on Project Bioshield.\nJan. 30, 2003 – Testified at the Senate HELP (Health Education Labor and Pensions) \nSubcommittee Hearing with Julie Gerberding again on the subject of smallpox vaccine \nplan.  Issue of compensation came up again.  At the Hearing was Sens. Judd Gregg, Bill \nFrist, Alan Reed, Barbara Mikulski, Hiliary Clinton.  Hearing went well.  Spent rest of \nday at the Department are downtown doing Congressional Briefing to HELP committee \non Project BioShield and to Secr. Thompson on Smallpox.  Did the CNN Wolf Blitzer \nshow with Secr. Thompson, Julie G., Mark McClellan (FDA) and Jerry Hauer on the \nsubject of the HHS Biodefense Command Center.\nReleased by Chairman Rand Paul\n69Jan. 31, 2003 – Spent most of day at DHHS and the WH.  President gave absolutely \nwonderful speech at the WH to the PACHA (Presidential Advisory Committee of \nHIV/AIDS) and the African Ambassadors.  He truly reflected his commitment and \npassion concerning our moral obligation to do something about HIV/AIDS \ninternationally.  He mentioned me specifically.  Interesting that the activists who were \ncompletely trumped by the POTUS announcement, now can only complain that only $1 \nbillion of the $10 million new money is going to the Global Fund.\nFeb. 1-2, 2003 – Much preparation for the President’s visit to NIH and for the briefing of \nthe President on Feb. 3 on BioShield.  Many calls from WH I am asked by WH people to \nfact check things that he will say.  Also, they want me to be responsible for arranging the \ndetails of his visit to the Vaccine Research Center.  His advance people keep calling me \nand Kristen and others keep asking if everything is going OK.\nFeb. 3, 2003 – Another magical day!  In the AM, I brief the POTUS on Project \nBioShield.  Place = Roosevelt Room of the WW.  Present are POTUS, VP Cheney, Tom \nRidge, Tommy Thompson, Scooter Libby, Condi Rice, Karl Rove, Josh Bolten, Kristen \nSilverberg, Adm Abbott, Ari Fleischer, Dan Bartlett, Ken Bernard, Elias Zerhouni, Carol \nKuntz, etc.  I played major role in walking him through the Project.\nWe rush back to NIH to greet him (Flying in on Marine One) at the VRC.  We \ngive him a tour and he is smash hit with the staff.  We go over in motorcade to Natcher \nBuilding where he gives major address.  He specifically mentions me as an old friend and \nsomeone who he thanks on the part of the country because I have been for many years \nTHE general in war on AIDS.   His speech drew applause every time he would mention \nme, Zerhouni,  or AIDS in Africa Plan, but no applause when he spoke of the likely need \nto go to war with Iraq. He leaves and I spend rest of day and also Feb. 4 doing press calls \nto describe in detail Project BioShield.\nFeb. 4, 2003 – The world knows that the President’s Plan came from me and I am \nbriefing many people.  The WH refers all questions about Project BioShield and The \nPresident’s AIDS Plan to me  Got a call from Richard Feachem, President of the Global \nFund for AIDS, Tuberculosis, and Malaria, congratulating me on the Plan, but expressing \nconcern that since the USA only put $1 billion new money in the Fund over 5 years that \nnow the other countries would be reluctant to contribute more to the fund than the USA.  \nI told him emphatically, but in a nice way,  that I disagreed.  The original purpose of the \nGlobal Fund was not to replace bilateral agreements, but to complement them.  Feachem \nis essentially saying that the other $9 billion in new money does not really count in a \nmatching game since we did not put this in the Global Fund.  Unbelievable.  I have now \ntold people.  This is not about the Fund or about your particular choice of  how you give \nmoney.  It is about saying the lives of people in Africa and the Caribbean.\nAnother looming problem is the Mexico City Agreement which states that \nForeign NGO who counsels on abortions or who supports the performance (with funds) \nof abortions is not eligible for USG funding.  This might make the implementation of the \nPlan through NGOs difficult.  Also, I need to check with the US Trade Representative \nabout the generics and breaking patents.\nReleased by Chairman Rand Paul\n70Feb. 6, 2003 – Snow storm in DC.  Went out to dinner with Stew Simonson and driving \nback home from Etrusco’s restaurant on DuPont Circle I hit a patch of ice on Cathedral \nAve., spun around twice and broad sided a telephone pole. No other cars or people \ninvolved.  I was unhurt and drove my wrecked car home.  Luckily it still ran since only \nthe side doors (passenger side) were destroyed.\nFeb. 6 – 12, 2003 – Much briefing of White House and Congressional staff on Project \nBioShield and the President’s AIDS plan.  Much, much activity.  The WH wants me in \non all briefings.\nFeb. 13, 2003 – Delivered Plenary lecture at the 10th Conference on Retroviruses and OIs \nin Boston.  Spoke on Role of viremia in host abnormalities.  Very well received; it was \nhard core basic science, which was in sharp contrast to the publicity that I have been \ngetting for the policy issues.\nReturned in early afternoon to go to WH to brief Congressional leaders on Project \nBioShield.  Received secret briefing from CIA Torrey Froscher (Deputy Director, \nWINPAC, CIA).  Present were Admr Stephen Abbott, Tom Ridge, Tommy Thompson, \nJim Capretta, Kristen Silverberg, Chris Cox  and Ginger Poers (Special Assistants to the \npresident for Leg Affairs), Sens Gregg, Congressmen Burr, Turner Cox, Tauzin, Sen \nCollins; Sally Stansfield, Stewart Simonson, Carol Kuntz.  The President walked in \nduring the meeting and greeted the Congressmen and gave me a special warm greeting \nsaying that the “A” team was there.  He now has his special name for me.  It is not Tony \nor Dr. Fauci it is “Fauci”.\nFeb. 13, 2003 – Received wonderful FAX from Bono congratulating me on the AIDS \ninitiative.  Referred to us as “partners in crime”.  Did more briefings on the hill as well as \nbriefing of activists Paul Davis, Asia Russell, Rachel Cohen (MSF) on the Pres. initiative.  \nStill much concern out there that we did not put all of the money in the Global Fund.  \nYet, the Global Fund has not really done anything yet.\nAlso, issues such as generic drug purchase and the Mexico City Agreement \n(MCA) have come up.  Importantly, Jay Lefkowitz is supporting my view that even if \norganizations would not qualify to receive USG funds because they are not in accordance \nwith the MCA, i.e. they do counseling that encourages abortion or they actually do \nabortions, they can in fact receive funds as long as they use them for treatment and not \nabortion performance or counseling.  Major victory for me if Jay supports me since \notherwise many groups would be disqualified to participate in the  AIDS implementation \nplan.  Also, according to the TRIPS (Trade-Related Aspects of Intellectual Property \nRights) agreement, the WTO countries would not permit breaking of patents or use of \ngeneric.  However, in paragraph 6 of the Doha Ministerial Declaration on the TRIPS, \nmembers could use “compulsory licensing themselves or have a third party compulsory \nlicense for them to make drugs in the case of an epidemic emergency such as AIDS, \nmalaria, TB, cholera, Ebola, etc. so long as certain conditions are met such as this must \nbe in poor countries and drugs cannot be sold back to rich countries.  Thus, the TRIPS \nagreement will not interfere with our giving money to poor countries to buy generic or \ncompulsory licensed drugs.  Please refer to TRIPS and Doha documents.\nReleased by Chairman Rand Paul\n71Feb. 14 – Mar. 2 – I have been leading (with Stew Simonson and occasionally Mark \nMcClellan (FDA) many, many briefings of senators, Congressmen and staffers on Project \nBioShield.  The WH has proposed our legislation.  Zerhouni is acting extremely insecure \nand (I believe) inappropriate regarding the mentioning of NIAID in the authorizing \nlegislation for BioShield. He and Stew and having a terrible fight since Stew insists that \nNIAID remain in the language. I am trying not to get caught in the middle.  \nA few days ago, I presented the Jimmy and Rossalyn Carter Award of the NFID \nto former Congressman John Porter.\nMar. 3, 2003 – Had dinner with Senator Bill Frist in his Majority Leader’s Office in the \nCapitol.  He regularly (on Mondays) brings together people with whom he likes to \ndiscuss various topics.  This time it was bioterrorism.  Besides me was Herb Pardes, \nMark Halperin (NBC News), Stuart Taylor (Editor, National Journal), Georges Benjamin \n(Director, American Public Health Assoc), Bill Madia (Oak Ridge), Rev. Anthony Davis \n(Director, DC Black Church Initiative), Michael Byrne (Dept. of Homeland Security, \nCoordinator for DC, MD, and VA) and Ginny Wolfe (Counselor to Sen. Frist).\nMar. 3 – 10, 2003 – Many briefings on Project BioShield.  Most recent on Mar. 10 at the \nWhite House with the usual cast of people, i.e. Kristen Silverberg, Ken Bernard, Carol \nKuntz, Stew Simonson, Tom Reilly (OMB), some people from DHS and OMB.\nMar. 12, 2003 – Conference call with me connected to about 50 industry people \norganized by John Kelly of PhRMA to explain BioShield to them.  Always a concern \nabout anti-trust laws and so the General Counsel for PhRMA (Ken Ewing) made sure that \nno questions were asked by industry that would violate this.\n2003 March 12 \nTeleconference on Pr   \nStewart Simonson told me yesterday that he resigned because of serious clash \nwith Jerry Hauer.  I offered him a job at NIAID that he was very moved by.  Got a call \ntoday that Secretary Thompson insisted that he does not resign.  Stew gave in to TGT.\nMar. 13 – 16, 2003 – We are getting closer to war with Iraq.  The French, Germans, and \nRussians are threatening to block any attempt on the part of the USA to have the UN pass \na resolution that if Iraq does not immediately comply with Resolution 1441 and disarm, \nthe UN will use force to disarm them.  USA, Britain and Spain may go it alone.\nI am extremely concerned about the appearance in Asia (Hong Kong, Quangdong \nProvince in China, Vietnam, Thailand, Singapore of a mysterious acute respiratory \nsyndrome.  Thus far 400 people, 150 in last week, 9 deaths.  We have no idea what it is, \nbut the attack rate nosocomially is very high.  More than 30 health workers in Hanoi got \ninfected from a single patient.  Many people on respirators.  The new disease is called \nSevere Acute Respiratory Syndrome (SARS).\nOn evening of March 16, had a great dinner at Galileo’s in DC.  Host was Bono \nwho is in town to receive an award on St. Patrick’s day (March 17).  Small dinner at \nwhich Bono paid very kind tribute to me for putting together the President’s Emergency \nReleased by Chairman Rand Paul\n72Plan for AIDS Relief.  At dinner were Chris Grady, Bono, Sens. Leahy, Dodd, Santorum, \nSteve Case and wife Jean, Comedian Chris Tucker, Josh Bolten and girlfriend (?name), \nJamie Drummond, Bobbie Schriver, Cardinal ? from DC, Father Perry and others.\nMar. 17, 2003 – Gala St. Patrick’s Day dinner and Award Ceremony from The Ireland \nAmerican League at the National Building Museum.  Humanitarian Award to Bono.  \nChris and I sit at Bono’s Table as his guest. Bono recognizes me in his acceptance \nspeech.  \nPres. Bush gives Saddam Hussein 48 hours to leave Iraq or we will attack.\nMar. 18, 2003 – Senate passes Project BioShield Bill.  I hold meeting on \nMedical/Chemical Biodefense Research at the Bethesda Hyatt as a sequel to February 26 \nmeeting on Radiological Biodefense.  I am trying to frame the landscape of this to pursue \nan appropriate research agenda.\nMar. 19, 2003 – Bombing of Iraq begins.\nMar. 19-28, 2003 – Major focus on war. Push towards Bagdad; massive precision \nbombing; Iraqi irregulars have executed GIs on El Azeera TV to the horror and anger of \nUSA; \nSARS is getting out of control.  1500 cases and 53 deaths worldwide.  At first, \ninvestigators isolated a paramyxovirus (metapneumovirus) at first seen on EM.  \nHowever, this may have been a mistake since several groups led by CDC are now finding \nan unusual form of coronavirus (common cold).\nBriefed the VP on SARS and recent cardiac complication of smallpox vaccine via \nteleconference.\nMarch 27 – Testified with Secretary Thompson on Project BioShield at the House \nEnergy and Commerce Committee.  Several members (mostly Democrat) are balking at \nthe mandated appropriations authority.  They are reluctant to give up the power of the \npurse.\nMarch 28, 2003 - I gave a talk on Bioterrorism at the American Dental Association \nmeeting in DC on March 28.  The last person to come to the microphone to ask a \nquestion after my talk said that he had waited many years to publicly address me.  He \nrelated that in 1979, his 7 year old daughter was gravely ill on a respirator with a diffuse \nautoimmune-like disease that her doctors could not figure out.  She was moribund and \nthey were about to give up on her.  A doctor said that there was only one doctor in the \ncountry that he thought could come up with something and so they called me.  \nApparently, I spent over an hour on the phone walking through with them a plan for the \npatient that included plasmapheresis together with cytoxan and prednisone.  Within days, \nhis daughter began improving, got off the respirator, spent over a year in rehab, graduated \nhigh school, went to Barnard College, graduated first in her class, became a Ph.D. \npathologist, got married and had a child.  She is entirely well now.  He said that he just \nwanted to thank me publicly for “saving his daughter’s life”.  The audience gave me and \nhim a standing ovation.  It was one of the most moving things that I had experienced.\nReleased by Chairman Rand Paul\n73March 29 – April 1, 2003 – It is hitting the fan.  SARS is getting out of control.  More \nthan 1800 cases and 62 deaths worldwide.  3.6% mortality.  Clusters of cases appearing \nmostly in Hong Kong and China.  Now there are 17 countries.  USA has 72 cases in 27 \nstates – no deaths yet.  It appears that it is spread by respiratory droplets, but also recent \nevidence that by fine aerosal and objects – not unlike other coronaviruses.\nI will brief the POTUS this week on SARS.  The war in Iraq is raging with troops \nengaging the Republican guard close to Bagdad.  More myocarditis complications with \nsmallpox vaccine.  What a week so far!!!\nApril 4, 2003 – Big day!  US army captures Iraq International Airport.  I testify before \nthe House Government Reform Committee on the subject of Project BioShield.  Mark \nMcClellan testifies with me.  The House (Shays, Waxman, Chairman Case generally \nsupport the concept of BioShield, but have some concerns such as with the “permanent” \nand indefinite Appropriations Authority.  After the Hearing I, together with Julie \nGerberding and Tom Ridge, brief President Bush, Laura Bush, VP Cheney, and the \nsenior White House Staff on SARS and Smallpox vaccine program.  We bring executive \norder to the POTUS on quarantine for SARS and he signs it.  At meeting are Josh Bolten, \nKarl Rove, Ari Fleischer, Richard Falkenrath, Adm Steve Abbott,, etc.  POTUS and VP \nas usual very warm and complimentary to me and to Julie.  After the meeting, I spoke \nwith Josh Bolten and volunteered to go to Iraq for the President if the Iraqis use \nbiological, chemical or radiological weapons on our troops.  I offered this to allow a \npublic appreciation of the link (my being a civilian health authority) between Iraq and the \ndanger of bioterrorism against the USA civilian population.\nApril 5-9, 2003 – Incredibly busy.  I have testified at >6 Congressional Hearings over the \npast few days on SARS, Appropriations, AIDS, Biodefense, etc.  SARS is spreading.  \nHave been on many network TV shows discussing SARS – CNN (several different \nshows), Good Morning America, News Hour, CNBC, etc.  Iraq is falling; Bagdad \noccupied by US troops.\nApril 10, 2003 – Wonderful day.  Went with Chris ( my father, Denise and Jack Scorce \nwere also there) to Ellis Island to receive the Ellis Island Family Heritage Award.  Other \nawardees included Yogi Berra, Bob Hope, Cicely Tyson, Abie Abraham (hero of the \nBataan Death March).  It was a wonderful ceremony with a fantastic video of my history \nincluding the ship’s manifest with my grandfather Antonio Fauci’s name.\nApril 11 – 18, 2003 – Iraq war over as troops occupy essentially all of Iraq.  Saddam \nmissing as is most of Iraqi leadership.  Much attention now focusing on SARS.  Cases \nnow at 3400 with 175 deaths.  Much media interest.  For example, on April 17 alone I \nappeared on Channel 5 News, Diane Rehm Show, Charley Rose, CNN’s Aaron Brown, \nand CNN International in addition to several print media.\nApril 19, 2003 – Just an unrelated historical note to put all of this in perspective.  My \ndaughters are doing marvelously well in school and sports.  All 3 are virtual straight As \n(an occasional A-). Megan and Ali excel in gym and Jenny is doing extremely well in \nmultiple varsity sports.  She clearly is the best varsity diver at NCS.  She is on the first \nReleased by Chairman Rand Paul\n74team varsity for cross-country and just this year (junior year) has taken up crew.  She \nloves it and is a starter on the varsity 4 person lightweight boat.  Thus far, they are 3 for 3 \nin meets; I saw a meet at the Georgetown Harbor today.\nApril 20-28, 2003 – War is essentially over. Still no weapons of mass desctruction. Still \ndoing an incredible amount of press.  Did This Week with George Stephanopoulos on \nSunday, 27th April.\nApril 29, 2003 – Amazing day!!!  Spoke at a Republican leadership lunch at the Senate \ntogether with VP Cheney.  We were there to promote S-15 (the legislation for BioShield).  \nI was extremely warmly received by the Senators with many complements from Sens. \nFrist, Hatch, Stevens.  I presented my thing and then the VP got up and praised me for \nmy leadership on Project BioShield and made a few comments on the threats.  We \n(Ginger Loper and I) next took the WH limo to the WH for the President’s ceremony on \nthe Emergency Plan for AIDS Relief, aimed at drumming up support for the legislation \nfor the plan’s funding. The ceremony was supposed to be in the Rose Garden, but was \nmoved to the East Room because of weather. The President was wonderful to me, \nspecifically winking and saying “Hello Tony” as he was scanning the crowd.  He then \nmade the comment in his speech to the group that he wanted to specifically thank me for \nall of my work on behalf of mankind.  After the ceremony, he specifically came down to \ngreet people and put his arm around my shoulder and thanked me again for all that I have \ndone.  It was a terrific day.\nApril 30-May 1, 2003 – Much effort on my part in working the Congress (briefing \nSenators and Congressmen and staff) in support of Project BioShield.  Clearly the \nreluctance on the part of the Congress has to do with not wanting to give up the control of \nthe “purse” to a mandatory and indefinite appropriations authority.\nMay 2, 2003 – Did “Field Hearing” in Harrisburg, PA for Sen. Specter on SARS.  He is \nrunning for re-election and clearly wanted to impress his constituents.  It worked.\nMay 3, 2003 – Great evening.  I received the “Golden Plate Award” of the Academy of \nAchievement.  It was a Gala affair at the Mellon Auditorium in Washington, D.C. I was \non a panel chaired by Mike Wallace of “60 Minutes” during the day and had a black tie \ndinner in the evening.  Other awardees were Jose Carreras (did not show), Hillary \nClinton, Sen. Tom Daschle, Bob Dylan, author and Washington Post columnist Thomas \nFriedman, Rudy Giuliani, Donald Graham (CEO of Washington Post), Baroness Susan \nGreenfield, Dr. Robert Sanger, Leonard Lauder (CEO of Estee Lauder), Trent Lott, John \nMcCain, Simon Peres, Franklin Raines, Justice Antonin Scalia, Robert Strauss, \nArchbishop Desmond Tutu, Alvaro Uribe Velez, President of Columbia.\nThe banquet was attended by all of the Glitterati including President Clinton who \nwas the hit of the night, dancing away like crazy .  It was a wonderful time with \nincredible entertainment including Patti Austen, Ray Charles, Aretha Franklin, and \nChuck Berry who drove the house down.\nReleased by Chairman Rand Paul\n75May 3 to 13, 2003 – Spending almost full time working with White House on trying to \nshape the BioShield Legislation with the Senate and House.  I have daily been briefing \nsenators (such as Sen. Byrd) and staff of the House as well as members such as Henry \nWaxman, Chris Cox, Fred Upton, etc. on why they should support the President’s (Sen. \nJudd Gregg’s) Bill.  Congress is reluctant to make the purchase authority “Mandatory, \npermanent, and indefinite”  It seems now that we are winning the battle for mandatory, \nbut it is going to be tough to get permanent and indefinite.  We will have to settle for a \ncap according to the budget resolution and a sunset at 10 years.  People at the White \nHouse that I am working closely with are Ginger Loper, Candi Wolff, Carol Kuntz, Ken \nBernard, Chris Cox, Mike Allen et al.\nAlso, during this time I gave the Commencement Address at Emory in front of \n14,000 people and received an honorary degree.\nMay 14 – 20, 2003 – Continued doing Congressional briefings and Hearings on \nBioShield and SARS.  The epidemic is appearing to come under control.  Spent sometime \ntoday (May 20) helping the White House write the POTUS speech on the AIDS initiative. \nWonderful thing happened yesterday.  The WH is planning a signing ceremony for the \nAIDS Bill ($15 billion authorization).  It was originally schedule for May 28.  I wrote an \ne-mail to Gary Edson and Jay Lefkowitz saying that I had to give the Commencement \nAddress at SUNY Downstate on May 28 and if it occurred then, would they send my \nregrets to the POTUS.  Jay responded by e-mail that since I was the honored guest, they \nwill change the ceremony to May 27.  Amazing!\nMay 20 – 27, 2003 – Busy time for Bioshield and giving Commencement Addresses \n(Emory, Albany Medical, Univ. of MD and SUNY Downstate) and receiving honorary \ndegrees (Emory, Albany, Univ. MD, Yale).  Major article (feature piece) on me in the \nweekend edition of The Financial Times; mostly very flattering with the usual few \njealous comments from “unamed sources”.\nMay 28, 2003 – Historic day.  President Bush signs the Authorizing legislation for the \nPresident’s Emergency Plan for AIDS Relief in the Dean Acheson Auditorium of the \nState Department.  Again, he specifically thanked me in his speech for my work on AIDS \nand for being there.  I was given a “seat of honor” in the first row.  In his speech the \nPresident used word-for-word the sentence that I composed for him describing the \ninitiative as the “largest single up-front commitment in history to an international public \nhealth initiative involving a single disease”\nMay 31, 2003 – Extraordinary feature article on me in The Financial Times with full \npage picture and complimentary story.\nJune 8, 2003 – Feature story on me in the nationally syndicated Parade Magazine of The \nWashington Post. \nJune 8-18, 2003 – Continued activity and briefings, conference calls concerning the \nBioshield Legislation.  White House still relying me on pushing the prospect of \nReleased by Chairman Rand Paul\n76mandatory versus discretionary funding for Bioshield.  Also a number of network and \nCNN TV appearances on emerging disease including SARS and monkey pox.\nJune 18, 2003 – Went to West Wing of WH to brief General John Gordon the new \nDirector of the WH Office of Homeland Security and Special Assistant to the President \nfor Terrorism.  I briefed him on what the NIH Biodefense Research Agenda was.  Good \nguy.  We had a nice discussion.\nAlso, delivered a standing room only Grand Rounds at the Lipsett Auditorium on \nSARS.\nJune 19, 2003 – Appeared on a panel at the Council of Foreign Relations with Ted \nKoppel (Chair), Patti Stonesifer (Gates) and Senator Durbin to discuss “Are we prepared \nto deal with global pandemics?”.\nJune 20, 2003 – Appeared on CNN’s Lou Dobbs show to discuss emerging and re-\nemerging diseases.\nJuly 2, 2003 – Attended White House ceremony for the announcement of Randall Tobias \nas the Coordinator of the President’s Emergency Program for AIDS Relief.  Randy is \nformer CEO of Lilly.  Pres. (as usual) mentioned me and said that it was an honor to have \nme there.  I strongly recommended to TGT that Mark Dybul be appointed in the State \nDepartment to the new program to help Joe O’Neill who was clearly emerging as the \nsecond in command.\nJuly 2 – 7, 2003 – Much attention paid to post-war guerilla action in Iraq with several \nUSA service people getting killed in terrorist/guerilla action.\nJuly 8, 2003 – Attended meeting in Situation Room of the White House chaired by \nRichard Falkenrath. Attending were Deputies of all of the relevant agencies, Carol Kuntz, \nKen Bernard, Jorge Tavel, Bob Kadlac etc.  Purpose was to agree upon a long range Plan \nfor SARS called CONPLAN.  Also, discussed revamping the organizational structure \namong the various Agencies for a coherent Biodefense Agenda.\nAppeared on CNBC’s Capitol Report with Alan Murray and Gloria Borger to \ndiscuss the President Bushes Emergency Plan for AIDS Relief.  I had the opportunity to \npraise the POTUS for his leadership in this Plan.  \nJuly 9, 2003 – Visited new AIDS Coordinator for the Plan (Randall Tobias) at the State \nDept. and briefed him on how the President’s Plan came about and how I suggest he \nimplement it.  I strongly suggested that he get Mark Dybul to work for him since Mark \nwas so important in putting the details of the plan together.\nJuly 12-18, 2003 – Trip to Paris for the 2nd Annual International AIDS Society (IAS) \nmeeting.  I gave the “Extraordinary Plenary” lecture on Monday, July 14 on the topic of \n“HIV and AIDS: 20 Years of Science”.  I was immediately followed by Nelson Mandela \nwho gave a lecture on the societal aspects of 20 years of AIDS.  My talk was extremely \nwell received; many said that it was the best talk that they had ever heard me give.  There \nReleased by Chairman Rand Paul\n77were >5000 people in the main auditorium at the Palais de Congres in Paris.  Of \nparticular note was the fact that prior to leaving for Paris, Dr. Brian Brink who is the \nSenior Vice President for Health of  Anglo American Corporation, a gold mining firm in \nSouth Africa had contacted me.  Brian is an advisor to Mr. Mandela on HIV/AIDS and \nwas asked to write Mandela’s speech for the meeting.  Brian called me and asked for \nsuggestions about what Mandela should say.  I mentioned to Brian that Mandela had been \nseriously criticizing Pres. Bush for the Iraq war and that it would be very important for \nMandela to publicly congratulate and praise Bush for the $15 billion Emergency Plan for \nAIDS Relief.  I said that Mandela would lose credibility if he did not do this. I even made \nup a paragraph for him to put into the speech.  Brian agreed, but said there was no \nguarantee that Mandela would actually include it in the speech.  To my great pleasure, \nMandela included the paragraph practically word-for-word.  I let Jay  Lefkowitz  know \nabout this by e-mailing him from Paris.  Jay was very pleased and said that he would \nmention this to the President.\nJuly 19-30, 2003 – Have had a number of briefings with TGT as well as the VP’s staff \n(Carol Kuntz et al) on various subjects such as smallpox, anthrax, SARS, etc.  \nConstituencies still upset that NIAID will have to do advanced development and some \nprocurement of rPA anthrax vaccine to the tune of about $250 million even though the \nCongress removed the $250 million from our budget that OMB put in to do this.  Josh \nBolten (now OMB Director, replacing Mitch Daniels) has allowed us to spend this over 2 \nyears instead of 1 year.  Nonetheless it will be a burden.  There are philosophical \nquestions here regarding how much advanced development should be done by NIAID \nversus the drug companies.  We are trying to allow BioShield to pay for some of the \nadvanced development instead of limiting it just to the actual procurement of \ncountermeasures.\nAugust 1, 2003 – Briefing at the White House.  Two parts to the briefing.  Jorge Tavel \nand Heather Wingard of CIA briefed on threat assessments and I briefed on \nCountermeasure Development.  Present at briefing were:  Carol Kuntz, Stewart \nSimonson, Andrew Hallman (CIA), Heather Wingard (CIA), Dr. McCreary (DHS), Bill \nParrish (DHS), Parney Albright (DHS), Sally Stanfield (DHS), Ken Bernard (OHS), \nJorge Tavel (OVP), Richard Falkenrath (for while, OHS), Julie Gerberding (CDC)\nCarol was very pleased with my presentation as I touched on all of the points that \nwe had previously discussed with the Vice President such as genetically modified \norganisms, botulism, etc.\nAugust 1 – 21, 2003 – Summertime lull.  Usual issues.  Zerhouni pushing his “Roadmap” \nagenda .  Few people can figure out what it really is and how it will be implemented.  \nIOM report on the “Structure of NIH” came out.  As usual, they commented on things \nthat they were not asked to comment on.  They pushed having greater resources in the \nOffice of the NIH Director and having more “high risk” research to be managed out of \nthe OD as well as trans-NIH research planned out of the OD.  Seems like Zerhouni wrote \nthe report.  Also, and amazingly, they recommend 5 year term limits for IC Directors \nwith the possibility of only 1 five year renewal.\nReleased by Chairman Rand Paul\n79of having the NIH Recombinant DNA Advisory Committee (RAC) serve as a mechanism \nto provide a “culture of responsibility” among scientists similar to what was done in the \nmid-1970s. At the briefing was the usual people – Gen Gordon, Ken Bernard, Richard \nFalkenrath, Carol Kuntz, several DoE people, WH communications people, etc.  Decision \nwas to put together a briefing for the Secretaries.\nSept. 18 –19, 2003 – Went to NYC to give Plenary Lecture at the AIDS Vaccine 2003 \nmeeting.  While I was there, Hurricane Isabel hit Washington, D.C. and there was \nwidespread devastation with major power outages (3 million people in DC, VA, and MD \nwithout power).  Power not expected to be restored for at least 1 week. \nSept. 24, 2003 – Power back finally.\nSept. 25, 2003 – White House meeting with Jay Lefkowitz, Gary Edson, Mark Dybul, \nJoe O’Neill, Carol Thompson to discuss the controversy regarding $2 Billion versus $3 \nbillion in FY ’04 for the President’s $15 billion, 5 year plan.  Bono and other activists \nwant a full $3 billion in ’04.  However, if we did that, then we would put less in ’05, ’06, \netc.  I recommended to Jay et al to stick with the Plan and leave flexibility to match other \nfunds by 1/3.  See below my e-mail to Jay from 9/25/03:\nJay/Gary:\nJust a recap of my suggestion from this afternoon for your consideration.  Mark was on \nthe same page on this also. I believe that we must remind people and strongly underscore that \nthe President's Plan is a $15 billion program over 5 years involving 14 countries. Within the \ncontext of such a plan (we must emphasize this point), the best way to spend the money and \nthus to save the most lives is by phasing in with $2 billion in the first year and more than $3 billion \nper year in subsequent years.  We all realize that more money can be spent globally on AIDS and \nthus more lives can be saved. This is a no-brainer.  We never said that the President's Plan of \nitself would cover all of global AIDS.  We should not get into an \"absorptive capacity\" argument \nsince no matter how clear we are, people will confuse absorptive capacity in the President's Plan \nof 14 countries and absorptive capacity for the rest of the developing world.\nI suggest that we take a 2 pronged approach. 1) We stick with the President's Plan as it \nhas been outlined, and; 2) We publicly recognize that more money can indeed be spent on AIDS \nglobally.  We are hoping that other countries will follow the President's lead and put more money \ninto programs either bilaterally or through the Global Fund. In fact, we are willing to go the extra \nmile and to contribute 1/3 of the global effort if other countries rise to the occasion. In '03, the \nworld total was $3.6 billion with $1.4 billion by us (39%).  Since we are giving $2 billion in '04, the \nrest of the world should give $4 billion.  If the rest of the world gives more than $4 billion, we will \nmatch them by 1/3.  Thus, if they want us to give $3 billion in '04, the rest of the world must total \n$6 billion.  If this happens (which it will not), then we will put the additional money into a mix of \nGlobal Fund and other countries (beyond the original 14) bilaterally. In this way we show \nleadership and flexibility.  If no one else gives an additional penny, we still are committed to the \nPresident's Plan as we have outlined.  If other countries meet the above mentioned benchmarks, \nthen we are flexible enough to match them by 1/3.  Finally, if the Congress appropriates a couple \nof hundred million over the $2 billion and the President signs such a Bill, we would give that \nadditional money to the Global Fund and/or additional countries and back up our contention that \nour funding plan for the 14 countries is indeed sound.\nI would be happy to discuss this further with you.\nThanks,\nTony \nReleased by Chairman Rand Paul\n80Sept. 26, 2003 – White House meeting on Bioshield with the usual suspects – Stewart Simonson, \nJorge Tavel, Ken Bernard, Bill Winkenwerder, Larry Kerr, etc.  We are getting ready for finalizing \nthe legislation.  After the meeting in the EEOB, I went over to the West Wing to see Richard \nFalkenrath.  NIAID will be awarding 2 NBLs (BSL-4 labs) and  9 RBLs (BSL-3 labs) on Sept. 30.  I \nhave been getting incredible lobbying pressure from people like Sen. Hillary Clinton and others \nfor their state or district sites.  Chicago is in the running for an NBL and the President is going to \nChicago on Sept. 30.  The WH wants me to delay the announcement until 2:00 PM after the \nPresident leaves Chicago since Chicago got an RBL, but not an NBL and the WH wanted to \navoid any embarrassment for the President to be there when bad news arrived.\nOct. 7, 2003 – Briefing in the Situation Room of the White House for Andy Card on the \nCraig Venter issue of synthesizing microbes.  Also at the meeting were:  Tommy \nThompson, Spencer Abraham (Secr. Of DoE), Dan Bartlett; General Gordon; Ken \nBernard, Harriet Miers (Card’s Deputy), Bob Card from DoE, Ray Auerbach (DoE), \nBruce Alberts (NAS), Gerry Fink giving summary of Fink Report on “Biotechnology \nResearch in an Age of Terrorism”, which is an NAS/NRC report; Stewart Simonson; \nCarol Kuntz; Larry Kerr;   I have essentially been adopted by the WH to be the one who \nexplains the science of Venter’s work.  This, I was the major briefer. Also, I have been \nspearheading the NIH effort to create a subcommittee of the RAC to provide the “culture \nof responsibility” for the scientific community on these issue similar to the 1970s with \nthe RAC following the Asilomar Meeting in 1974.\nOct. 13, 2003 – Went to White House ceremony (President’s speech) and reception to \ncommemorate Columbus Day.  The President specifically greeted me in his remarks \nsaying how proud he was of how I was the General in the Global War on AIDS.  After \nthe ceremony, I ran into Josh Bolten in the hallway of the EEOB.  He asked about my \nopinion of the controversy of $2 billion versus $3 billion in FY ’04 for the President’s \nEmergency Plan for AIDS Relief.  Bono has been giving the WH a hard time saying that \nthe President was reneging on his promise when in fact he promised $15 billion over 5 \nyears staring with $2 billion in ’04 (see above).  He specifically asked my opinion of how \nRandy Tobias was doing as the new AIDS head of the program.  He indicated that he did \nnot think that there was anything wrong, but that he was getting the vague feeling that \nthings were not moving along as aggressively as he thought that they would be.  He asked \nme to quietly check it out.\nOct. 16, 2003 – Had breakfast (at his invitation) with Jay Lefkowitz at the White House \nMess to say goodbye.  He is leaving as Director of  Domestic Policy Council to return to \nhis law firm in its NYC branch.  He will likely return after 2 years for the President’s 2nd \nterm (if this occurs).  We had a great conversation in which he mentioned how honored \nhe was to work with me on the President’s Emergency Plan for AIDS Relief, the MTCT \nplan and to a lesser extent on the stem cell issue.  I sincerely told him that he was second \nto none in people that I have worked with at the WH over the past 19 years.  He asked my \nhelp in making sure that the AIDS Plan does not get derailed by the mischief of USAID \nin trying to lobby the legislation such that power is taken away from Randy Tobias and \nhe would not be given an independent account.\nOct. 17, 2003 – Went to going away reception in Indian Treaty Room of EEOB at White \nHouse in honor of Jay Lefkowitz.  Great time just talking to the White House crew and \nReleased by Chairman Rand Paul\n81others that I have gotten to know over the past 2+ years: Jay, Margaret Spelling, Kristen \nSilverberg (just back from Iraq and will replace Jay), Karl Rove, Scooter Libby, Josh \nBolten, Ginger Loper (WH Leg. Affairs), Terrell Halaska, Allen Gilbert, Mark McClellan \n(FDA), Scott Whitaker, Ladd Wiley, Alex Lazar, etc. \nOct. 24, 2003 – Met with Sen. Barbara Mikulski to try to convince her not to support \nRep. Chris Van Hollen’s attempt to block the construction of the biodefense building \n(Bldg. 33) on the NIH campus and move it to Ft. Detrick.  He keeps calling it a bioterror \nbuilding. She was sympathetic, but indicated that we must engage the community more.  \nFact is….we have been doing this, but a very recalcitrant few do not want to building on \ncampus no matter what.  This is the same group that did not want to fence put up around \nNIH.  This is a political issue since Van Hollen made 2 campaign promises: 1) no fence; \nand 2) no biodefense building. He already lost the first and does not want to lose the \nsecond.  We will try to work with him.  Also present at the meeting were several of \nMikulski’s staff, Elias Zerhouni, John La Montagne, and Marc Smolonsky.  Also, I \nhosted Julie Gerberding to deliver the NIAID Joseph Kinyoun Lecture and then took her \nto dinner with John La Montagne, Ed Tramont, Pamela McInnes.\nOct. 25, 2003 – Had biodefense strategizing meeting at Wye River Conference Center \nrun by Richard Danzig.  Discussed issues related to dealing with mass casualties.  The \nusual suspects were there – DA Henderson, Julie Gerberding, David Franz, Michael \nOsterholm, Bill Patrick, C.J. Peters, George Tavel, people from DoD, FBI, CIA, etc.\nOct. 27, 2003  - Had a Policy Coordinating Committee for an “end-to-end” analysis of \nbiodefense responsiveness at the White House EEOB.  Meeting run by Ken Bernard and \nBob Kadlec.  Attended by all the usual suspects from each agency – CIA, FBI, DHS, \nHHS, OMB, OVP, etc.\n     After the meeting I met with Bob Kadlec about the possibility of going to Iraq to \ninteract with the medical and research community.  Apparently, the copies of HPIM-15 \nthat I had sent to Iraq through Kristen Silverberg were a smash hit and the Iraqis want \nvery much for me to go to Iraq.  However, over the past few weeks there has been a great \nescalation of insurgency and terrorism with many suicide bombings and rocket and rocket \npropelled grenade attacks on both military and civilian targets.  It appears that the \nterrorists are targeting the Iraqis who are cooperating with the USA in trying to rebuild \nthe country.  Kadlec does not trust the security associated with the ministries of health to \nprovide for my safety.  He actually feels that if word gets out that I am coming that I \nwould be targeted by snipers.  He feels that if I go, he will arrange for CIA operatives to \nget me into the country and move around “under the radar” and that CIA operatives \nwould provide my security.  We decided to wait a few weeks before resuming plans \nabout going to Iraq and consider going in January/February.  Bob will have to go there at \nthis time anyway to continue search for weapons of mass destruction.\nOct. 29, 2003 – Met with Ray Gilmartin (CEO of Merck) and Adel Mahmoud (Merck) to \ndiscuss ways that Merck can collaborate with NIAID in AIDS and in biodefense.  Great \nmeeting.  Also, discussed how Merck can interact with BioShield process.\nReleased by Chairman Rand Paul\n83WH airspace.  WH was evaculated and many machine gun armed Federal police \nappeared.  After  a while they let us in, but the VP had already been scooped off to safety \nand so the meeting was cancelled and rescheduled for a few days from now.  President \nBush was in UK at the time.\nNov. 25, 2003 – Briefed the Vice President  today with Scooter Libby, Stewart \nSimonson, Carol Kuntz and Jorge Tavel in attendence.  I spoke about \nNuclear/Radiological countermeasures and our need for a strategic plan and the need for \nsomeone (us – DHHS/NIH) to take the lead in this since the effort is fragmented and \nDoD has been neglecting this area since the end of the Cold War.  I also gave him a \nprogress report on our microbial biodefense program.  He loved both presentations and \nrelated to Carol, (who told me) that the briefing was “very impressive, very impressive, \nin fact great!”  I am still having trouble with Zerhouni who is infuriated that the VP’s \npeople are “excluding him” from these briefings.  In fact, they merely maintain that the \nVP does not like crowds and he does not like the chain of command to be present on \nbriefings to him.  Zerhouni cannot accept that.  I am trying to explain this to Zerhouni, \nbut he is just plain angry.\nNov. 28, 2003 – Significant Influenza A activity already with a variant strain (Fujian) that \nis not contained in current vaccine. This is quite early for heavy burden of influenza \ncases. 4 deaths of children in Colorado.  Concern mounting that we will have a very bad \nyear.  I have been on CNN (X2) CNBC and Good Morning America over the past 2 days \nto talk about this.\nDec. 1 – 7, 2003  - Trip to Africa as part of Secr. TGT’s delegation.  Cameroon (fuel stop \n+ ambassador handshake), Zambia, Rwanda, Kenya and Uganda.  Most incredible visit. \nIncluded Julie Gerberding (CDC), Elias Zerhouni, Randy Tobias (Ambassador for \nPresident’s Emergency Program for AIDS Relief (PEPAR), Richard Feachim (Director \nof Global Fund for AIDS, Malaria, and TBC),  Peter Piot (UNAIDS), Amb. Richard \nHolbrooke (UN Ambassador for Clinton, now representing business coalitions), Bill \nWinkenwerder (DoD), Senator Don Nichols (R-OK), Congressman Dave Weldon (R-\nFL), Linda Conlin (Assist. Secr. For Trade Development, Dept. of Commerce, Ann \nPeterson (USAID), plus many other VIPs plus a large number of CEO-types in industry \nsuch as Hank McKinnel (CEO-Pfizer), CEO Peter Dolan of BMS, Chris Viehbacher \n(Pres., GSK), John Martin (CEO, Gilead), Per Wold-Olsen (Pres. Merck Europe/Middle \nEast/Africa), etc.  In addition, many people from faith-based organizations such as Father \nO’Brien (Pres. Les Aspin Center at Marquette) and Shepherd Smith (Institute for Youth \nDevelopment).  Christy Feig from CNN was on board as was Sabin Russell from San \nFrancsico Examiner and Marilyn Marchione from Milwaukee Sentinel. Purpose of the \nvisit was fact finding and to get industry involved in economic impact of AIDS in Africa.\n      So many incredible aspects to trip with the underlying theme that the Africans \n(particularly in Uganda) are showing that they are ready for implementing the PEPAR \nand the Global Fund (see below the experience in Tororo, Uganda). Also, many new \nfriends from the delegation.\nZambia (Dec. 1-2) –  Greeted by US Ambassador Martin Brennan and Zambian \nMinister of Finance and Economic Development Emmanuel Kasonde and Zambian \nReleased by Chairman Rand Paul\n84Minister of Health Brian Chituwo. Stayed at the Zambezi Sun Hotel at the evening had a \nlocal dinner (open pit outdoor barbecue) at a Boma. Also, walked down to Victoria Falls \nwhich was absolutely breathtaking. Looked across the Zambezi River to Zimbabwe. \nParticipated in a World AIDS Day parade through the city  center of Livingston. Many \nlocals came out to greet us. Visited a faith-based organization St. Francis Community \nHome-Based Care Center as well as LISCA Linda Center giving care to children – called \nLISCA. \n Rwanda (Dec 2-3)  On afternoon of Dec. 2, flew to Kigali, Rwanda and \nimmediately went to the Genocide Memorial.  Clearly this was one of the 2 most \nimportant parts of the trip.  I spoke with many Rwandans who suffered from the genocide \nand the enormity of it really is not appreciated by the world in general.  In 1994, over a 4 \nweek period in April, the majority Hutus slaughtered 800,000 to 1 million Tutsis while \nthe world watched and did nothing.  In fact, the French actually came in to protect the \nHutus against Paul Kigame’s  (Tutsi) rebel army that came in from Uganda to stop the \nmassacre.  I ultimately had an audience with now-President Paul Kagame in the \nPresidential Palace.  We also spoke with many Rwandans whose families escaped.  \n(Please refer to history books about the massacre).  Of not, as in my visit to South Africa \nin 2002 vis-à-vis Apartheid, the Rwandan Society in dramatically impacted by the \ngenocide.  Most ministers are people who fought together with Kagame to stop the \ngenocide.  Those who were there said that atrocities were unimaginable.  Machete-killing \nof tens of thousands of people, women, children per day until bodies cluttered the streets \nand the rivers.  Of note, 13% of the population of 8.2 million are infected with HIV and \nso AIDS potentially will kill more people than the genocide massacre. During visit, met \nwith US Ambassador Margaret McMillion. Visited Kabgayi Hospital 1 hour outside of \nKigali. TGT gave a gift of a cow named “Elroy” (after his hometown in Wisconsin). On \nthe previous night (Dec. 2) we had an extraordinary discussion among the delegation.  \nWe had just received a high red alert that there would be a terrorist attack against US \ninterests, particularly hotels and possibly ground to  air missiles at aircraft in Kenya the \nnext day. There was a frank discussion at dinner at the Milles-Collines Hotel among \ndelegates led by Jay Hodes (chief of DHHS Security) and TGT.  Decision was that \nanyone among government people could opt out and go straight to Uganda skipping \nKenya; however, all non-government people were bumped off and sent directly to \nUganda except for a very few like Sabin Russell and some others. I definitely wanted and \ndid stay with the group as did Julie Gerberding and Elias Zerhouni.  The Milles Collines \nHotel was where the Hutu Command post was during the genocide.\nThe next day we went to Kabgayi (see above), then flew to Entebbe Airport \nUganda, left off about 70 people and the remaining 25 – 30 went back to Kenya. We \nwere flying on a German Charter (same one as last year with German pilot Chris who \nformerly was a Luftwaffe Major).  On the approach to Nairobi airport, Chris slowed \ndown for about 15 minutes to “cool” the engine ( to decrease chance of hear-seeking \nmissiles) and then dove sharply to the landing field.  All went well.\nKenya (Dec 3-4).  In Kenya, we went to a rather boring Global Coalition Event \nand then had a reception at the residence of US Ambassador William Bellamy.  Security \nwas depressing. From the airport, we were escorted downtown by a truck-load of Kenyan \nArmy soldiers all with AK47s.  The entire perimeter of the hotel was blocked off to \nReleased by Chairman Rand Paul\n86husband and other brother-in-law.  She is not abused by her in-laws and states proudly \nthat they love her very much.  It was clear from their reaction that she was correct.\nAfter Tororo, we went to the Grandmother’s (JAJA/Mildmay) house in Jinja, \nUganda.  This was a beautiful facility that was more a referral facility that a primary care \nplace. \nNext day (Dec 6) went to Mulago Hospital grounds and visited the TASO Mulago \nCenter for a ribbon cutting of a new building largely built by Pfizer through  a donation \nfrom Hank McKinnel. It is a beautiful facility. After this we went to Entebbe and visited \nthe Uganda Viral Research Institute on Lake Victoria.  I gave a small speech.  The Rakai \ngroup supported by NIAID gave a booth presentation led by Noah Siwanuka (Spelling?).  \nAfter this we had dinner at the Lake Victoria Hotel in Entebbe and took off for Frankfurt \nright after midnight on Dec. 7 with a fuel stop in Larnaca, Cyprus.\nGeneral Comments: See above in Introduction.  Also, in Uganda, CDC program \ndirector Jonathan (Jono) Mierman was wonderful…very enthusiastic and good-\naggressive person. Also, interacted with Minister of Health Jim Muhwezi. He has an \ninteresting history.  He is trained as a lawyer, was a political activist against Idi Amin and \nMobutu.  Was jailed, shot himself (3 escaped and 1 was killed) out of jail, escaped to a \nhotel that was surrounded by hundreds of troops that were looking for him.  He dressed \nlike a woman and slipped away right in front of the soldiers.  He escaped to the North \nwhere he joined Museveni.  He became a Brigadier General in the Ugandan resistance \narmy and after Museveni won, he was made chief of intelligence.  After 10 years there, \nhe was made Minister Of Health.  Similar to the Kagane story in Rwanda, practically all \nof the ministers started off as fighters in the resistance army with the person who \nultimately became President, in this case Museveni.  None of these places are really a \ndemocracy since opposition parties are generally restricted.  It just happens that \nMuseveni is an enlightened President.\nBecame friends with Tommie Thompson, TGT’s daughter who is very nice.  \nAlso, developed beginnings of bonding relationships with many people including Sen. \nNichols, Cong. Weldon, Randy Tobias, Richard Holbrooke and many of the staff at HHS \nthat I already knew well, as well as Elias Zerhouni.\nAs experienced as I am, I was greatly moved by the trip.  I learned much and was \ndeeply moved by the experience in Tororo.  I felt so good and yet humbled about my role \nin developing the $15 billion PEPAR program.  It may turn out to be my greatest \naccomplishment.\nDec 7, 2003 – Major scandal at NIH with article in L.A. Times that shows that high NIH \nofficials including Steve Katz, John Gallin and others have made hundreds of thousands \nof dollars consulting for pharmaceutical and biotech companies.\nDec. 8-10, 2003 – Much media attention regarding the Fujian strain of influenza and the \nearly indications of a bad season with deaths of children in Colorado and elsewhere.  \nVaccine has run out and people are panicking.  83 million doses distributed.  I have \nalready been and will be on CNN multiple times, MSNBC, CNBC, CBS, etc.\nDec. 13, 2003 – Saddam Hussein captured by US Army outside of Tikrit, Iraq!!\nReleased by Chairman Rand Paul\n87Dec. 16, 2003 – Went to dinner reception at the home of Assistant Secretary of Defense \nfor Health Affairs William Winkenwerder in honor of Dr. Khudair Abbas, Health \nMinister of Iraq.  Present among others were Kristen Silverberg (who spent time in Iraq – \nsee above regarding the books of HPIM-15 that I sent to Iraq), Ken Bernard, Surgeon \nGeneral Richard Carmona, Congressman Fred Upton,  etc.  Iraqs really want me to go to \nIraq for moral support of the Iraqi medical establishment and health system.  They were \nall very appreciative of the books that I sent.  It is still very dangerous in Iraq, but I am \npursuing going with Secretary Thompson in Jan/Feb if possible.\nJan. 21, 2004 – Over the past month a number of issues have arisen.  There have been 3-\n4 cases of SARS in China.  The Fujian strain of Influenza A escalated and now is \ndeclining.  It may be that it was just a moderate year that peaked early and had people \nworrying about it being a catastrophic year.  It may turn out that it was not that bad.  Big \nworry is the appearance of H5N1 with 4-5 cases of jumping from chicken to man in Viet \nNam and massive chicken illnesses and deaths in Viet Nam, S. Korea and Japan.  We are \nall busy in planning for a potential pandemic flu.  No transmissions from person to \nperson.\nAlso, we had been working on the document in response to the IOM report on \n“dual use” microbes.  We (HSC, DHS, etc) established a Memorandum of agreement and \na Charter for the National Science Advisory Board for Biosecurity to advise the \nSecretary, HHS, the Director, NIH, and the Secretaries of all of the Agencies involved in \nthe conduct and support of potential dual use research in the life sciences.  I presented the \nMOA and the charter to the Deputies in the situation room in the White House.  It was \nwell received and will ultimately be signed by the Secretaries.\nOn the way out of the WH, I saw Margaret Spellings who said that the President \nwas talking about me today in that he wanted to be briefed by a group including me and \nJulie Gerberding on prevention of HIV/AIDS by abstinence, be faithful and condoms \n(ABC).\nJan. 21 – Feb. 25, 2004 – Very busy with many issues.  Two Congressional Hearings: 1) \nHouse Gov. Ops – Pandemic Flu; 2) Full Approp (Senate) on BSE.  Also, much stress \nwith situation of outside activities.  I was “interviewed” by Alan Slobodin as was Andy \nvon Eschenbach, Francis Collins, Don Lindberg and ethics offices about “lecture \nawards”.  Does not appear to be a problem for me, but they will likely force much greater \nrestrictions on outside activities.\nWhite House (Gary Edson) has asked me to put together a proposal for \neradication of a few “neglected diseases” in developing countries similar to what I did for \nthe PEPFAR.\nI was very persistent and finally got into TGT’s party to go to Iraq.  I feel almost \nan obligation to do this for my country even though I must admit it is a bit scary. It \nsounds corny, but it is the “Band of Brothers” feeling that I seem not to be able to get \naway from.  I am a visible public servant and this is what I do. This is probably the most \ndangerous situation I will have ever been in.  Will report details when I return.\nFeb. 26, 2004 – Leave for Iraq!\nReleased by Chairman Rand Paul\n88Feb. 26 – Mar. 1, 2004\nFeb. 26 – Left for Amman, Jordan – Iraq on a Gulf Stream air force aircraft from \nAndrews Air Force Base.  Trip purpose – “show the USA flag” in the context of health \nissues and determine whether the USG/DHHS/NIH can do more in the Middle East.  On \nthe trip was Secretary Thompson (TGT), Andy von Eschenbach, Bill Steiger, Press- \nSanjay Gupta, Christy Feig  and Joe Farre (CNN) and Mark Sherman (AP); Security – \nJay Hodes.  In Amman/Iraq we met Charles Curie (Head, SAMSA), Howard Zucker, Dr. \nDavid Smith (Humanitarian and Refugee Services), Andy Knapp and Mike Lonetto \n(Security advance), Adm Van der Wagner (USPHS).\nWe landed in Marka Airfield in Amman and almost immediately changed planes \nto an Air Force C-130 to Baghdad.  This would turn out to be one of the most memorable \ndays of my  life.  In the approach to Saddam Airport we did a sharp “corkscrew” landing \nin which it felt like the plane flipped over.  The airforce guys explained that this is the \nway that they avoid shoulder to air missiles as well as sporadic fire from AK 47s.  In \naddition, the airport gets randomly mortared every day.  These are just  pockets of \ninsurgents that rarely hit targets, the real targets are the convoys of troops accompanying \ncars (like ours) and isolated troops on patrol, as well as more recently, Iraqi police and \nofficials who are trying to rebuild the country.  We went from the airport to the “Green \nZone” (relatively safe with high security, despite the fact that rocket and mortar attacks \noccur on almost a daily basis; these usually do not hit specific targets, but do cause \ncasualties) in Baghdad with several car-loads of Special Forces and DoD Criminal \nInvestigation Division (CID) security people and 4 Humvees full of Military police \nmanning M-4s and fixed machine guns.  The ride to Baghdad was thrilling and \nfrightening.  The alignment of the motorcade was that every time we passed a person(s) \nwalking along the highway or a parked car or truck, the special forces car would insert \nthemselves between the suspects and TGT's car (I was riding with TGT).  When we \npassed an overpass or a car on our right, the Military police would aim their machine \nguns up at the overpass and swing around the turret of the machine gun as we passed the \noverhead.  The reason is that frequently insurgents drop grenades from overpasses and \nrun.  We passed cars driving with people or when cars pulled up alongside, the military \npolice and special forces would wave them over and point their guns directly at the \ndriver.  Reason – frequently, isolated cars drive by and shoot at the convoy.\nFirst stop – meeting with Ambassador Paul (Jerry Bremer) in his office in the \nimperial Palace formerly main palace of Saddam and now  headquarters of the Coalition \nProvisional Authority (CPA). Tom Foley (Bremer’s Deputy) was not present, but we met \nhim later on in the trip).  Had great discussion of the difficulties in transition to the \ngoverning council.  He made an interesting statement that democracy is a concept that is \nforeign to the Iraqis.  They are taking a lot of time with their constitution  and agreeing \non their form of government since they seek “consensus”.  Democracy means that the \nmajority rules, and as we see in the USA, the minority has much power and the balance \ncan and does changes. The Iraqis are not used to the majority winning a vote since \nhistorically, minorities get persecuted.  They need to understand that minorities are \nminorities for a particular idea/law/regulation and that Sunnis, Shia’s and Kurds can be \nminority, majority or both.  Sunnis and Shia’s can live together since there are many, \nmany mixed marriages.  Highly intellectual discussion.  Bremer is an impressive man.  \nReleased by Chairman Rand Paul\n89Also, met Jim Haveman who is the USA Health person (also impressive). Jim was with \nus for most of the remainder of the trip in Iraq and Jordan.   He thanked me for the books \nthat I sent to Iraq from McGraw-Hill.\nHad lunch at the home of MOH Khudair Abbas.  Present at the lunch  was Dr. \nEbrahim Al-Jafari, head of the Shiite Party and member of the Iraqi Governing  Council \n(IGC)and Dr. Rajaa Khuzai a women OB/GYN physician and also member of the IGC.  \nHad a very stimulating conversation regarding Iraqi politics, the history of Iraq medicine \nand how Iraq was the “jewel” of medical care and training in the 50s, 60s and early 70s.  \nWhen Saddam came into power, he diverted money to weapons and neglected health.  \nThe system deteriorated and now it is terrible.  They want to restore it.  I also heard first \nhand of the cruelty and true insanity of Saddam and his sons Uday and Qusai and how \nthey tortured and killed at will.  Many of the people at lunch lived in exile or remained in \nIraq, but had relatives who had been jailed, tortured or killed.\nThe defining experience of the day was the visit to IBN Sina Hospital which is the \ncombat (trauma) support hospital.  I had to constantly hold back tears.  Everyone carried \na weapon in the hospital, even the doctors and nurses performing procedures in the OR or \ntrauma rooms.  I say young kids (18-25 yo soldiers) with bullet wounds in the face.  \nCommon wound is a cheek-through-cheek bullet that either kills the victim or goes right \nthrough without hitting vital structures.  I am told that it is a common wound by snipers \nsince the troops wear body armor up to their neck and a helmet down to their eyes.  It is \none of the few exposed parts.  One such soldier was wheeled in as we were touring the \nhospital. He had just been shot.  I say shattered legs, abdominal wounds and Iraqi citizens \nshot in cross-fire and Iraqi insurgents getting x-rayed with a special forces person \npointing an M-4 at him in case he tried to escape.  I saw an Iraqi collaborator who was \nhelping the Special Forces in the North and another Iraqi came up to him when no one \nwas around and shot him in the back of the head.  The bullet miraculously went through \none posterior jaw and exited the face.  When taken to the hospital, he told the SF who the \nattacker was that left him for dead and the SF had just left the hospital to “take care of \nhim”.  Many army physicians and nurses recognized me either from TV or more often \nfrom Harrison’s. I ran into a young neurosurgeon – Major Koop who knew me from \nHPIM.\nUpon return to the airport via “ambush alley”, the 2 main Humvees of the 4 that \nescorted us back had young women at the machine guns.  I inquired about this to our SF \ndriver and he said that as of this week, women soldiers have more confirmed kills than \nmen soldiers.  Upon take off, we had the same corkscrew maneuver, but this time 2 \nairmen were at each window with radio contact with the cockpit in case they saw puffs of \nsmoke or flashes indicating a shoulder to air missile or Ak-47 , at which point they would \nalert the pilot to divert.\nLanded in Amman; we did not sleep at the Rasheed Hotel in Baghdad since it was \nrecently attacked with rockets while Paul Wolfowitz was staying there. Had a marvelous \ndinner at the home of the Jordanian MOH – Dr, Said. S. Darwazah.  Also present was our \nteam (minus the press), plus the US Ambassador to Jordan (Edward W. “Skip” Gnehm), \nDr. Samir Khleif, (NCI), Director of the King Hussein Cancer Center in Amman  and \nSaid’s brother Mazen and his father Samih.  We talked for hours about the complex \nissues of Israel and Palestinians and Iraq and USA.  It is clear that they want to live in \npeace with Israel, but they all feel that the USA in unfairly siding with Israel on not \nReleased by Chairman Rand Paul\n90disallowing settlements.  Clearly, one of the most stimulating evenings I have spent.  The \nJordanians are truly wonderful people and very friendly and affectionate to Americans. \nThe food was incredibly good.\nFeb. 28, 2004 – Visited the King Hussein Cancer Center in Amman. Dr. Samir Khleif \nshowed us around the modern facilities that have NIH-style telemedicine in real time.  \nToured the pediatric cancer wards with patients who had ALL, squamous cell carcinoma \nof ear and other tumors.  There is a Jordanian Program called Project Iraq in which \nselected patients are chosen from sick Iraqis and are transferred to the Cancer Center for \ntreatment.  We say several Iraqi mothers with their sick children.  Had a nice warm \nconversation with Princess Ghaida Salaam who is married to Prince Talal ibn Muhamed \n(Nephew of the late King Hussein) and Princess Dina who is also married to the nephew \nof the late king.  Both women were beautiful, articulate and spoke perfect English.  \nPrincess Ghaida  is the Chair of the Board of the Center and she recognized me from TV \nand said that she always wanted to meet me. I showed her my Harrison’s textbook in the \nKHCC library.  She spent years in DC and graduated from Georgetown in the 1980s.  \n  After the tour we had lunch and discussed  the various programs. Afternoon was free \nand we visited archeological ruins in Amman. \nThat evening, we had dinner at the home of Princess Ghaida.  This was a most \nunusual evening; I was incredibly impressed by the Princess’s husband Royal Prince \nTalal bin Muhamed.  He and Princess Ghaida both graduted from Georgetown in the \n1980s. He gave me a wonderful history of the Muhamed family that descended from \nKing Faisal I, hundreds of years ago.  The family split and one line took over Jordan and \nthe other first went to Syria and then Iraq.  He knew Sadam and his sons since he was a \nlittle boy and he feels that they were horrible sociopaths. He used to play with them as a \nchild during visits to Iraq and vice versa for Jordan.  Sadam gave him several guns as \ngifts.  In Arab countries, a gift of a gun is a show of respect and affection. Talal was the \nfavorite of his uncle King Hussein and told many stories of his loving relationship with \nthe King.  He proudly showed me his incredible gun collection (rifles, shotguns, and \npistols).  He was in the Jordanian paratroopers, is a polo player and rides motorcycles.  I \nfeel that this person could really be my friend if circumstances allowed.  Very intellectal \nand stimulating discussion at dinner regarding the war in Iraq and the Israel-Palastine \nsituation. He fees that the USA should have military rule in Iraq for 5 years before even \nconsidering handing over the government to the Iraqis. He said that the Iraqis would \nunderstand and respect this since what they want most is security.  He feels that a \nsituation similar to MacArthur and Japan would be desirable.  We discussed how this \nwould not be feasible politically in the USA, i.e. having a long-term occupation of Iraq.  \nHe is afraid of the instability that would follow in Iraq and the region if we handed the \ncontrol of the government over to a governing council (which he feels is made up of \nsome good people, but some people with no credibility such as Chalaby).  In addition, he \nfeels that the US military is so respected for their force and discipline, that this is the \nreason why the Iraqis fled.  He stated that the Iraqis are a “fierce” and proud people and if \nthe UN or the Poles and Spanish took over the security, the Iraqis would chew them up \nand anarchy would prevail.  He states that no Arab country wants the USA to leave any \ntime soon.\nReleased by Chairman Rand Paul\n91Feb. 29, 2004 – Last day in Iraq…mostly in the red zone.  Some very exciting and \nsomewhat scary moments with the convoy getting caught in traffic in  another “ambush \nalley” (narrow streets and high buildings where insurgents frequently shoot down on US \ntroops from roof-tops or windows). During several of these “stalls” in traffic, the special \nforces, military police escorts and the CID (criminal investigation division) of the army \njumped out of the cars and ran alongside with their M-4s pointed a the roofs and \nwindows.  They also ran up to cars that were blocking traffic and pointed drawn pistols \nand cocked M4s right into the cars to get people to move. Visited the MOH in the AM, \nthe Women’s clinic, had lunch with Iraqi health people.  This was all in the “red zone” \nand the SF had sniper observers on the roofs of the buildings surrounding the facility that \nwe were visiting. We then left for the airport had a wonderful dinner at Baghdad airport \n(Bob Hope Dining Hall)  with the troops of the 1st Armored Division, Military Police \nBrigade, the First Cavalry, and the 101st Airborne.  Our troops are incredible, including \nthe women.  They are extremely well disciplined, polite, good looking and nice.  General \nScaparroti (Chief of Combat maneuvers) brought TGT and me into the “classified” \ncommand room of the base and showed us how they track hostilities on a real time giant \ncomputerized map screen.  Met an incredible woman  Major Rogers who was a beautiful, \narticulate and smart, 35-ish deputy chief of intelligence for the command. Also met Col. \nFlake who was the combat coordinator – one tough looking soldier.  Also met Major \n(Doctor) John McGrath from the Medical Corps.  He knew me right away since his wife \nis a physician (Allergist/Immunologist) and always talks about me.  He asked for and got \na picture of us together. Finally, we flew on Blackhawk helicoptors to Balad AFB to \ncatch a C-17 to Rhein-Main AFB in Germany. The trip on the Blackhawk was tense and \nexciting.  I sat 2 feet from the machine gunner who was focusing on the ground looking \nfor flashes from small arms fire that happens all the time and usually misses the \nhelicoper.  As soon as they see a flash they immediately strafe the area with the M-50 \nmachine gun.  We flew all in the dark to avoid detection.  We landed at Balad, stayed for \nawhile and mixed it up with the troops and then flew to Rhein-Main AFB near Frankfurt.  \nFrom there we picked up the Gulfstream and flew back to Andrews AFB. We landed at \n6:00 AM, March 1, 2004.\nMarch 2-19, 2004 – Following the Iraq trip a number of relatively important issues have \narisen.  There is sweeping interest in the conflict of interest  arena with EZ forming a \nBlue Ribbon Panel on Conflict of Interest chaired by Norman Augustine and Bruce \nAlberts.  Also, the NIH Ethics Advisory Committee (NEAC) is now reviewing all out \nside activity requests (as well as any already approved ongoing outside activities) for \nhigh ranking NIH officials such as IC Directors, Deputies, Scientific Directors, Clinical \nDirectors, etc.  The NEAC is co-chaired by Raynard Kington and Michael Gottesman.  \nHappily they have approved my ongoing activities, including Harrison’s.  \nI met with the Blue Ribbon Panel and urged them to distinguish between outside \nactivities that could be conflictual such as consulting for drug companies and those that \nare purely academic such as writing, editing, lecturing (not on your immediate work) and \nawards.  They seem to “get it”.  I hope that their recommendations reflect this.  Several \ninvestigations will come including GAO, IG, and a least 2 Congressional Committees. \nAlso, the Congress is developing a subliminal hostility towards NIH because of the prior \nReleased by Chairman Rand Paul\n92doubling of the budget and because our advocates are still screaming for a 10% increase \nin FY2005 instead of the 2.5% increase of the PB.  Sen. Dominici called the NIHers \n“pigs” who are never satisfied.  Moral in quite low.\nGood stuff going on with Gary Edson and the “neglected diseases” project.  He \nreally likes the proposal that I put together for Lymphatic Filariasis (LF) and leprosy and \nmalaria.  We are going through the exercise now of several meetings back and forth in \ndeciding what to have the POTUS propose to the G-8 meeting in June in Sea Island.  \nThey want to have the POTUS show global leadership and urge the other G-8 countries \nto put up money and get involved; however, since we are already doing so much, he \nwants us to put up very little new money.  We will probably have to re-direct money – no \ngood deed goes unpunished.  Gary also wants me to explore the possibility of making the \nHIV Vaccine Enterprise a possible proposal.  He had spoken to Patty Stonesifer and she \nmentioned that Rick Klausner and I were working on this together.\nJohn Kerry won Democratic nomination prior to convention and he and Bush are \ngoing at it already.  The big issue is the terrorism that is going on in Iraq with foreign \nMuslim extremists with ties to Al Quaeda almost daily blowing up mostly Iraqis and \nsome US soldiers.  Massive terrorist attack in Madrid a few days ago with bombs in \ntrains; hundreds killed.  Muslim extremists claim responsibility and say that they did it \nbecause Spain has helped the USA in Iraq.  Incident occurred right before the Spanish \nelections and resulted in overthrow of the Party that supported Bush.\nMarch 24, 2004 – Had interesting and full day. Went to the National Defense University \nat Fort McNair, Washington, D.C. to participate in the DHS exercise of a hypothetical \naerosolized anthrax attack on Chicago.  It was for the benefit of press leaders.  Secretary \nRidge, Susan Neely (Assist. Sec. for Public Affairs, DHS), Ed Thompson (CDC) were \nthe main players.  It was exciting and the press totally enjoyed it and got engaged in \nactive Qs and As.  Virtually all of the senior producers and correspondents of networks, \nCNN, Fox, etc were present as were top print media.  Frank Sesno (CNN) moderated it \nand Aaron Brown (CNN) was present.  Tom Ridge relied virtually totally on me to \nanswer medical questions.\nAlso, had meeting at PEPFAR Headquarters (2100 Pennsylvania Avenue, N.W.) \nwith Gary Edson, Randy Tobias, Robin Cleveland (OMB), Mark Dybul, Joe O’Neill and \nAmbassador Lange to discuss how we can work an AIDS issue into the upcoming G-8 \nmeeting in June at Sea Island, GA.  Gary and I proposed the possibility of highlighting \nthe HIV Vaccine Enterprise that Rick Klausner and I have been working on for the past \nyear.  It would cost the USG virtually no new money since the “Enterprise” is a virtual \norganization that is proposing a strategic plan as described in our Science article.  The \nPOTUS can urge the G-8 countries to make a political commitment to make the \nEnterprise work.\nApril 2, 2004 – White House (Situation Room) -  Had meeting today as a culmination of \na series of PCC meetings related to preparedness against pandemic influenza.  We have \nbeen working with DHS, the VP’s office and DHHS to develop a white paper of needs \nReleased by Chairman Rand Paul\n93and plans.  Today we brought it to the PCC + deputies (Claude Allen of DHHS).  \nMeeting was chaired by Richard Falkenrath.  Present were several WH and departmental \npeople including Kristen Silverberg, Ken Bernard, Carol Kuntz, Bill Winkenwerder, \nStewart Simonson, Allen Gilbert.  We came to a good understanding of what we are \nultimately going to put before the full deputies and ultimately the Principals.\nApril 5, 2004 – White House (West Wing) – Met with Gary Edson. Attending were \nCarol Thompson, David Nelson and Gary’s assistant Martina Strong.  Discussed the G-8 \nissue regarding Gary’s concern that the other countries will bring up the issue of generics \nand PEPFAR, i.e. the false impression that we (USG) are against generics , particularly \nthe generic fixed dose combination of D4T, 3TC and nevirapine.  Gary does not want the \nPOTUS to be embarrassed if others blind side him with this.  The PEPFAR people \n(Tobias et al) should have straightened this out at a recent (March 29-30) meeting in \nBotswana.  There was a debate about WHO “pre-qualification” of these drugs and our \nconcern about the criteria and data upon which these drugs were pre-qualified.  Also, we \ndiscussed the issue of the POTUS proposing an endorsement of the HIV Vaccine \nEnterprise as our AIDS proposal for the G-8 meeting in June at Sea Island, GA.  We will \nwork with Gates (Patty Stonesifer) to endorse this, but the Gates Foundation is going to \nwant us to promise even more money for an AIDS vaccine.  Note that we are already \nspending>$500 million, vastly more than all other groups put together.  Gary will re-\nwrite the POTUS’s G-8 proposal regarding the Enterprise and run it by me, Kristen \nSilverberg, Secretary Thompson, Amb. Tobias before we launch it to the G-8.\nApril 6, 2004 – White House (EEOB) – Met with Kristen Silverberg, Robin Cleveland, \nRandy Tobias, Mark Dybul, Alan Gilbert, Press person from WH (?name, a woman), Joe \nO’Neill, and others to discuss issue of the bad press we are getting regarding the \nmisperception that the USG and PEPFAR will not buy generics, particularly the fixed \ndose combination (FDC) of D4T, 3TC and nevirapine that CIPLA and Ranbaxy are \nselling.  Decision was made to have Randy Tobias write and Op-Ed for The NY Times or \nthe Washington Post (I will review it for him) and then have me and Randy as necessary \ndo the TV circuit to get the truth out , i.e. that we will buy any drugs , even generics, so \nlong as they are of high quality (safe and effective) and the lowest possible price.\nApril 6-12, 2004 – Not much opportunity to implement issue above on April 6 because \nthe entire Press is consumed with the deteriorating conditions in Iraq.  Major insurgencies \nby both Sunnis (Fallujah) and Shiites (Baghdad) against American troops.  Several US \ntroops are getting killed each day and insurgents have resorted to kidnapping civilians \nfrom other countries who are working in Iraq, i.e. Japanese, Australians, UK, Chinese, \netc.  Bad situation that is getting worse.\nApril 13, 2004 – White House (West Wing) – 2 meetings.  First regarding the issue of \nthe HIV Vaccine Enterprise and whether we should make this an initiative for the \nPOTUS to present at the upcoming G-8 Summit in Sea Island, GA.  Present was Kristen \nSilverberg, Martina Strong (Gary Edson’s assistant), Joe O’Neill, Carol Thompson.  I \npresented the idea to Kristen and explained what Gary and I had been working on for the \npast several weeks. I explained how we wanted the POTUS to challenge the G-8 to \nReleased by Chairman Rand Paul\n94endorse and support the enterprise.  The USG is already investing for FY-04 about $488 \nmillion while the entire world’s contribution (including the USG) is about $600 to $640 \nmillion (these non-USG numbers are estimates.  Hence, most of the action is us. She \nliked the idea and wanted to pursue it.  She said that it would be a home run if we could \nspice it up with some new money.  She mentioned about $100 million.  I brought up that \nthe usual scenario would be that NIH would have to absorb this “new” money since there \nreally is no new money.  Kristen feels that if anyone can squeeze new money out of Josh \nBolten, it is me.  She is going to bring the issue up to Josh.\nThe second meeting was with Kristen, Joe O’Neill, Carole Thompson, Mark \nDybul, Randy Tobias, Jenday Fraser (new US Ambassador to South Africa).  Meeting \ntook place in Margaret Spellings office since it is one of the larger offices.  Margaret was \nnot there.  Discussion was regarding the options of how to address the FDC/generics \nsituation in the context of the PEPFAR.  We discussed a number of options.  Our goal is \nto get the lowest possible price for drugs that are clearly safe and effective.  Big issue \nwith FDA since they clearly will not approve a drug based only on “pre-qualification” by \nWHO.  There is much misunderstanding (see above) about the USG supposedly blocking \ngenerics since we are in the pocket of PHARMA.  This is nonsense since we are \nconcerned that we will be buying drugs that are not even generics; they are “knock-offs” \nfrom branded drugs.  I like the option of pressuring our drug companies to put 3 drugs in \na blister-pack (would take 1 month for the FDA to approve) to avoid the issue of \npotentially low quality Faces.  Other good option is to work with the FDA to speed \napproval (probably take 1 year since you would have to do some pharmacokinetics and \nbioavailability studies first) of FDCs contained the branded drugs.  Simultaneous option \nwould be to ask the South African Medicine Control Council (their FDA) to regulate the \nknock-off FDCs and to only buy it if they approve them.  This would be Africans making \ndecisions for Africans.  The only problem is that if they reject the drugs, it might look \nlike a typical erratic South African move, i.e. Mbeki and Shabalala Misemang are \nnotoriously weird.  Alternatively, if they accept the drugs with scrutinizing them and they \nare no good, we would be buying bad drugs.\nApril 14, 2004 – White House meeting (EEOB 476) with Gary Edson, Rick Klausner, \nRachel Ingram (Gates) and David Lane (Gates), Martina Strong, Carol Thompson to \ndiscuss the role of the Gates Foundation in the HIV Vaccine Enterprise.  Rick presented \nthe same case as I did and said that Gates would be willing to invest $100 million this \nyear and that the whole project would probably need $400 million per year for 10 years.  \nHe wanted the USG to try to put in more money.  Gary was concerned about the fact that \nwe have no new money, although he really likes the Enterprise concept.  After Rick left, \nGary and I discussed how much if any money would be feasible to invest as new money. \nAs opposed to just challenging the G-8 to join and endorse the process.  He wanted to \nthink about it more.  One of the issues that he brought up even when Rick was there was \nthe problem of doing something and then getting criticized the way that we have been \ncriticized about PEPFAR.\nApril 15-16, 2004 – Series of phone calls and e-mails involving Gary, Kristen and me.  \nApparently, Kristen really likes the idea about putting some substance (new resources) \ninto the POTUS proposal to the G-8 and Garry asked me to cost out a real center a virtual \nReleased by Chairman Rand Paul\n95center and also a vaccine production plant.  He sent it to Kristen who asked me for some \nclarifications and now will run it up to Josh Bolten.  This may be a go if we can convince \nJosh to get some new money.  I coasted a real center (with walls) at $55 million for \nconstruction and start-up and $47 million for annual operations.  I costed a virtual center \nas $15 million start up and $51 million annual operations.  Kristen asked me to brief Alex \nAzar (General Counsel for HHS) to see if we need any special authority/legislation \n(similar to BioShield) to make this work more quickly and smoother.  She will be out for \na week and then we will resume.  I handled these calls and e-mails while on a quick trip \nto Chicago to give a talk at the Clinical Research 2004 meetings.  I spoke on Emerging \nInfections.\nApril 19, 2004 – Extensive phone conversation with Josh Bolten (OMB Director), Jim \nCapretta and Tom Reilly (OMB) regarding the details of my proposal for the “virtual” \ncenter for HIV Vaccine as described above.  I described in detail the entire proposal to \nJosh. Josh was very supportive.  Issue was where to get the $15 million start-up costs for \n’05 and the $51 million yearly costs.  Josh indicated that he would figure out where to get \nthe money.  More than likely that we (NIAID) would have to absorb a portion of it. \nApril 20, 2004 – Had nice lunch with Jay Lefkowitz today at The Oval Room on \nConnecticut Avenue.  Beautiful warm Spring day.  Jay just wanted to catch up on things \nwith me.  We discussed the PEPFAR and the issues associated with it; and the new G-8 \nproposal that I was working on with Gary Edson. Kristen Silverberg, and now Josh \nBolten.  Also talked about war in Iraq and the POTUS.  Jay also inquired about what I \nwant to do differently if anything.  I told him that I wanted to remain in public service \nand the Secretary of HHS is a job that I would not strive for or promote myself for, but \nwould not refuse if asked. He is thoroughly enjoying his private sector life.   After lunch, \nhe invited a friend (Christine Carlisle Jones) to the table for coffee.  She is the CEO of a \ncompany that is working on freeze preserving eggs from women who might be getting \nchemo, and he wanted her to meet me.  Very attractive and intelligent woman in her 30s.  \nIt was great to spend time with Jay.  He has become a good friend.\nApril 21, 2004 – Busy day!  Beautiful sunny day.Testified at my House Appropriations \nSubcommittee (Chaired by Ralph Regula) in the AM , then rushed to brief Senate and \nHouse Staff (at Dirksen 116) from the Homeland Security and Appropriations \nSubcommittees on progress of Project Bioshield and its possible use to procure drugs for \npandemic influenza. Many people present such as Bettylou Taylor of Senate Majority \nAppropriations, Craig Stevens of House Majority Appropriations and a variety of staffers \nfrom Homeland Security Committees, the latter were as usual disdainful of DHS.  Bad \nnews relationships between DHS and their respective committees.  Also present were \nSally Stanfield of DHS (terrific person), Stewart Simonson, Michael        (WH Legisl), \nTom Reilly of OMB, Ken Bernard of WH Homeland Security Council\nAfter meeting, Ken and I rushed to OSTP on 1801 Pennsylvania Ave to meet with \nthe Weapons of Mass Destruction Medical Countermeasures Subcommittee.  I am on the \nSteering Committee of the National Science and Technology Committee (NSTC) \nSubcommittee on WMD Medical Countermeasures (Chaired by Bill Winkenwerder \n(DoD) and Phil Russell (HHS).  I rarely go to these meetings, but Ken Bernard wanted \nReleased by Chairman Rand Paul\n96me to be there for discussion of 1)Anthrax countermeasure development plan and 2) DoD \ndevelopment of butylcholinesterase (BC).  BC is unbelievable.  It is a naturally occurring \nplasma product that neutralizes the effects of VX and Sarin gas. It binds to the \nphosphogen cholinesterase inhibitors of the gas and protects animals from sarin and VX.  \nIt has no toxic side effects.  Taly Bar-Shalom from OSTP presented the data.  The DoD \npeople wanted NIH to do Phase 1 clinical trials on the plasma derived product and to pay \nfor the development of the recombinant product since they “had no money”.  The Phase 1 \ntrial would cost from $1 to 10 million depending on the design.  The development would \ncost a few million $.  I got up and chastized the army Colonels (Joe Perla et al) and told \nBill Winkenwerder that I was astounded that they had a countermeasure for a known \nthreat (Tokyo subway) that is completely effective in animals (rats, hamsters) and totally \nsafe, and yet they say that they do not have any money to develop it.  Unbelievable!  In \nsome fairness to them, the DoD money for Medical issues is so compartmentalized, that it \nis difficult for them to move $ from one silo to another.  They have no way near the \nflexibility that NIH has.  In addition, Bill Winkenwerder, who is Asst Secretary of DoD \nfor Health, really has no power or jurisdiction and cannot commit resources at a meeting \nlike this.  He is a very good guy and promised me that he would find the money.  I \noffered to share with them the effort and cost of a phase 1 trial.  In reality, if they drop the \nball on the clinical trial and development of recombinant product, I will pick it up.\nOn the way from the Rayburn to Dirksen building, I ran into Hillary Clinton on \nthe street and she gave me a big hug and kiss and we chatted for a few minutes (with her \nSecret Service people looking puzzled) about AIDS, etc.\nApril 23, 2004 – Went to dinner over Dan and Marina Ein’s home on Kenmore Drive in \nNW Washington.  Dinner was to bring together people in DC interested in bioterrorism \nand press folks who cover this.  Present among others was Bob Malsam (Head of DC \nHospitals) Dan Lucey (Medical Officer of DC DOH), Ceci Connelly (Washington Post), \nMike Iskowitz (Newsweek), Jerry Hauer (Biodefense Center at GW) and several others.  \nAmong topics that came up was the buzz around town of the recent intelligence that \nanother “big” terror attack will happen soon.  The weather was clearing or rain after a \nmajor thunderstorm.  I had wanted to go to the St. Albans vs Jefferson County (WV) \nHigh School baseball game, but it was cancelled because of rain.\nApril 28, 2004 – White House (West Wing) – Met in Kristen Silverberg’s office to \ndiscuss the FDC issue (see above).  Much discussion regarding our approach to FDCs in \nthe PEPFAR program. At meeting were the usual group: Kristen, Mark Dybul, Joe \nO’Neill, Mark McClellan, some FDA economists, Emit (FDA), Carol Thompson.\nI spoke with Kristen by phone after the meeting about my chose vis-à-vis options. \nApril 28-29, 2004 – Gary Edson called me and said that he had a “disturbing” \nconversation with Patty Stonsifer (Gates) in which she mentioned that the USG should \npromise NEW resources for the Enterprise proposal to the G-8.  Gary asked (and I did) \ncall Rick Klausner to get his take.  He is comfortable with our proposal.  Gary is \nconcerned that Gates will be lukewarm about our proposal and we will have another \nexample of the POTUS trying to do something good and then getting criticized for not \ndoing enough.\nReleased by Chairman Rand Paul\n97May 4, 2004 – White House (West Wing) – Me with Gary Edson and Patti Stonecifer \nregarding the HIV Vaccine Enterprise and the upcoming G-8 meeting in Sea Island, GA.  \nWe have come to an agreement that if the POTUS presenting the Enterprise proposal to \nthe G-8, Gates will soundly applaud the effort and work with us to get it going.  The USG \nwill not promise an new money over and above the $500+ million that we already spend \non HIV vaccine research (this is about 5/6 of the world’s total of $640 million).  \nHowever, we will challenge the other G-8 countries to endorse the Enterprise strategic \nplan and align current and future resources with the plan.\nMay 12, 2004 – Big White House day!  The President visited the NIH for a “No Child \nLeft Behind – Read First” ceremony.  It was held at NIH since the NICHD had some \nactivities in this area.  Ceremony held in Natcher Auditorium.  I sat in second row and the \nPOTUS recognized me from the stage and greeted me individually noting that I was in \nthe audience.  After his talk, he came down to “work the rails” and chatted with me for \nabout a minute on International AIDS.  He mentioned that he had just met with the \nHealth Minister of Angola.  He was as usual very complementary to me.\nIn the afternoon had a meeting in the WH with Kristen Silverberg, Allan Gilbert, \nRandy Tobias, Joe O’Neill, Mark McClellan, Lester Crawford and many others about \nfixed dose combination ARVs (FDCs) and the PEPFAR.  We have developed a plan and \na roll-out strategy.\nAfter the meeting, went to Indian Treaty Room and had a going away reception \nfor Richard Falkenrath of the Homeland Security Council (HSC).  Had nice chats with \nJohn Gordon (chief of HSC), Tom Ridge, Josh Bolten, Carol Kuntz, Clay Johnson and \nmany others.\nMay 19, 2004 – Good day!  Project BioShield legislation passed the Semate by a 99-0 \nvote.  The White House asked me to attend a press conference with Sens. Frist, Gregg, \nand Kennedy as well as Secretary Thompson at the Capitol.  We briefed the press and I \nanswered several questions. TGT called me the “father” of the BioShield Bill.\nMay 27, 2004 – Went to a nice retirement celebration at the White House (Indian Treaty \nRoom of EEOB) for Gen. John Gordon (Director of the Homeland Security Council).  I \nhave developed a very nice relationship with John over the past year or so and he was \nvery glad to see me there.  Attending were Andy Card, Condoleezza Rice, Karl Rove, \nHarriet Meiers, among others.\nGetting ready to go on June 8-10 to Savannah, GA for the G-8 conference at Sea \nIsland.  The White House (Gary Edson et al) wants me there to answer press questions \nregarding the HIV Vaccine Enterprise Proposal that the President will make to the G-8.  \nGary asked me to get Peter Piot (Director of UNAIDS) to write an editorial praising the \nproposal at about the time that it is announced.  I am working on this.\nJune 2, 2004 – Testified before the House Commerce Committee on Science chaired by \nMr. Bilirakis for the NIH Priority Setting in anticipation of reauthorization of NIH.  \nTestified with Elias Z., Andy VonEschenbach and Nora Volkow.  Tough questions, but \nReleased by Chairman Rand Paul\n98the Hearing went well.  Immediately went to brief an IOM Panel on Biodefense.  They \nwere very flattering of me and the work that we have done.\nJune 3, 2004 – Busy day.  Went to Ali’s Lower School Graduation and rushed to testify \nat House Select Committee on Homeland Security chaired by Chris Cox with Jim Turner \nas ranking minority.  Chris Hayes and Joe Barton were there.  Many tough questions \nsince the Presidential race is heating up and the Dems want to give the impression that \nthe Administration is not doing enough on Biodefense even though we have \naccomplished a lot.  I did very well.  \nImmediately after the Hearing I rushed to DHHS and briefed Sec. Thompson on \nthe G-8 meeting and the HIV Vaccine Enterprise.  Then I rushed to the White House for a \nmeeting called in the West Wing by Kristen Silverberg on the POTUS proposal (maybe) \nto facilitate vaccine development by addressing liability, intellectual property, tax \nbenefits, and monopoly issues.\nAfter WH rushed to go to Jenny’s Sports Banquet.  She received MVP for the \nDiving Team.\nJune 8-10, 2004 – Went to Savannah, GA (Sea Island) for the G8 Summit hosted by the \nUSA.  I was part of a White House Team that served as Presidential Surrogates to brief \nthe Press before, during and after the President’s proposals of initiatives to the G8 leaders \ngathered in Sea Island (UK – Tony Blair, France – Jacques Chirac, Germany – Gerhard \nSchroder, Italy - Berlusconi, Japan, Canada - , Russia - Putin, and USA). The other \nsurrogates on the Team were: Elliott Abrams (Special Assist. To the president and Senior \nDirector for Near-East and North African Affairs at NSC); Andrew Card (WH Chief of \nStaff); John R. Bolton (Under Secretary of State, Arms Control and International \nSecurity); James L. Connaughton (Chairman, Council on Environmental Quality); Glyn \nT. Davies (G8 Political Director); Kristen Forbes (Member, Council of Economic \nAdvisors); Jendayi E. Fraser (Special Assistant to the president and Senior Director for \nAfrican Affairs at NSC); Robert Joseph (Special Assistant to the president and Senior \nDirector for Proliferation Strategy, Counterproliferation and Homeland Defense); Alan P. \nLarson (Under Secretary of State, Economic, Business, and Agricultural Affairs); \nConstance Berry Newman (Assistant Administrator for Africa of USAID); Randall \nQuarles (Assistant Secretary of Treasury for International Affairs); Condoleezza Rice \n(National Security Advisor to the President); Frances Fragos Townsend (Assistant to the \nPresident and Homeland Security Advisor); Dan Bartlett (White House Communications \nDirector); Scott McClellan (Assistant to the president and White House Press Secretary); \nGordon Johndroe (Laura Bush’s Press Secretary); and Jim Wilkinson (Deputy National \nSecurity Advisor for Communications at NSC).  My job was to brief the press at formal \nand informal briefings on the Health Issues which were mainly the Global HIV Vaccine \nEnterprise (see above), the Polio Eradication Initiative, and to a much lesser extent, the \nFamine Initiative.  I also briefed on the progress of PEPFAR the Global Fund for AIDS, \nMalaria and TB and the issues on Fixed Dose Combination (FDC) and co-packaged anti-\nHIV drugs.  \nThe weather was beautiful and we stayed at the Westin Resort Hotel on \nHutchinson Island in Savannah.  All I did was work and did not get off the compound.  \nThe security to get on and off the compound was as tight as I have seen anywhere except \nReleased by Chairman Rand Paul\n99for Iraq. The Press center was adjacent to the Hotel. I spent most of the time in the White \nHouse press unit with White House staff led by Pamela Stevens, Paul Morrell, Jim \nWilkinson, Barry Bennett (Deputy of Communications, G8 Summit Planning \nOrganization, Colby Cooper, Dana Perino, M.C. Koch, Jana..?, Corey..? and others.  \nIt was exciting to be there and I ran into virtually all of my reporter friends on the \nWhite House Press Corps including among others, David Gregory, Terry Moran, Norah \nO’Donnell, Ann Compton, Bill Plant, John Roberts.  I had a great interview with an AP \nreporter Scott Lindlaw, whom I had not met before.  The initiatives were very well \nreceived.  However, as I have seen before, unpredictable events shape everything.  \nFormer President Ronald Reagan and died a few days before and the press was totally \nsaturated with Reagan history and funeral news to the point that the G8 issues were \nliterally pushed from the front page.  I appeared on TV only one time on CNN and that \nwas for an interview with Anderson Cooper on my impressions of Reagan’s legacy on \nAIDS, particularly during the early years when he did not even mention AIDS publicly.  I \nstated on camera that the criticism of this silence on the part of the activists was certainly \njustified; however, the activists are being too harsh (Larry Kramer wrote a piece calling \nhim worse than Hitler) since many things occurred behind the scenes that were good.  For \nExample he allowed me to go out and be proactive and speak on behalf of the gay \nconstituents.  Also, Surgeon General Koop was allowed to mail his report to every \nhousehold in the USA. I also got some press with interview in foreign TV such as VOA, \nAl Jazeera, Canada National TV, BBC, etc.  Also, a few mentions of my briefings in \nWSJ, and many papers that picked up the major AP story by Scott Lindlaw.  Otherwise, \nthere was much less press for the G8 in general and for me than would have occurred had \nnot Reagan died.\nJune 18, 2004 – Attended a farewell party at the White House for Gary Edson.  He is \nleaving NSC to work in the campaign.  His main job will be to prepare the POTUS for \nthe debates with Kerry.  I was the only non-WH person at the reception that was hosted \nby Condi Rice and Steve Hadley of NSC.  In her praising of Gary for his work, she \nmentioned 2 accomplishments among many: 1) the millennium account, and 2) the \nPEPFAR.  When she spoke of the PEPFAR, she caught my eye and said, “Oh Tony Fauci \nis here; they were the team that did this.  Tony was the brains and Gary was the brawn”.  \nJuly 9, 2004  -  2 meetings in West Wing.  First was a top secret briefing of Fran \nTownsend, the new Director of the Homeland Sceurity Council.  She replaced Gen. John \nGordon who retired in June (see above).  Present at the briefing were Ken Bernard, Bob \nKadlec, Larry Kerr, Kate Spitler (CIA) and some others.  Purpose was to brief Fran on \nthe experiments that were being proposed regarding genetically engineered monkeypox \nvirus to duplicate what was shown in the mousepox model where inserting the IL-4 gene \ninto mousepox made it lethal and elusive for both vaccine and therapy.  Debate was \nwhether to do experiments and whether to classify them.  Purpose of doing experiments \nwas to determine whether the mousepox work also applied to the monkeypox.  In \naddition, if it did, then we needed to develop countermeasurs such as anti-IL-4 drugs.\nFran was extremely complimentary to me saying that above all people, she \nwanted to know what my opinion was and she wanted me to explain the details and \nimplications of the experiments.\nReleased by Chairman Rand Paul\n100Next meeting was in the office of Faryar Shirzad (replaced Gary Edson on NSC; \nsee above). Present was Martina Strong.  Purpose was to plan the Fall meeting of the G-8 \nVaccine Enterprise as promised by the POTUS.  We discussed what the format of the \nmeeting should be and what level of representation from G-8 countries should be there.  I \nsuggested at least a top scientist from each country and then for formality, we should \nhave the Ministers of Health there after the strategic plan had been finalized.\nJuly 11 – 16, 2004 – Went to the XV th International AIDS Conference in Bangkok. The \ndepth of misunderstanding about the PEPFAR and the reason why the PEPFAR wants \nexpedited approval by FDA of the “copy” generics that are being used before USA \nmoney is used to buy them is huge.  The activists were out in full force disrupting Randy \nTobias’s speech with signs of “He’s Lying”.  Ultimately they let him speak, unlike the \nsituation in Barcelona in 2002.  There was an extraordinary amount of USA bashing by \nactivists, the liberal press and even by international figures such as Kofi Annan who \nstated that the USA was not showing leadership because we were not giving more to the \nGlobal Fund.  He seems to have selective amnesia regarding the PEPFAR’s $15 billion \nprogram.  Chirac made a similar statement.  Issues that were particularly misunderstood \nwere: 1) why the USA was not giving billions to the Global Fund; 2) why we wanted to \nhave an expedited approval of copy generics before the PEPFAR paid for these drugs; 3) \nWhy the DHHS only allowed 50 people from HHS to attend the meeting.  Most people \nclaimed that it was because the activists booed TGT at Barcelona and because we were \nupset that we were not controlling the agenda.  Before the meeting a group of far-right \nCongressmen wrote to the organizers of the meeting saying that they condemned the \nmeeting since more faith-based organizations were not given prominent roles in the \nmeeting and because not enough emphasis was placed on abstinence. This made the USA \nlook real bad.  Stupidly, the DHHS restricted the numbers of meeting participants \ngenerally without doing it by category and as it turned out, some scientists who were \nalready on the program had to cancel out.  Thus, the topic was this stupidity rather than \nall of the good things that were happening.  The activists were more misinformed than I \nhave ever seen. They had no idea what they were talking about.  All they wanted to do \nwas condemn the Bush Administration.  Bush asked the FDA (through Tobias, me, \nKristen Silverberg and others) to provide expedited review of these FDC products so that \nwe could have some guarantee of the safety and quality of the product before USA \ntaxpayer money paid for it.(see above).  This was the correct thing to do.  Can one \nimagine if we tried to give drug to Africans by a process that was “not good enough for \nAmericans””  We would all get killed by Congressional Committees and activists, some \nof which are the very ones who are crying for generic drugs right now. By the way, the \napproved drugs are now available for hundreds, not thousands of dollars in Africa.  The \nclaim of the generics companies that the drugs are available for $140 does not take into \naccount that it cost much more for shipping, storage, etc. and so the real price is not that \nfar away from the brand price.  Furthermore, no one is going without drug since it is not \nthe generics versus nothing.  The PEPFAR is buying the brand name drugs and \ndistributing them.  The response was that the administration is in bed with PHARMA \nsince we do not want to allow generics for fear of PHARMA losing money.  The generics \nare “pre-qualified” by the WHO.  However, the WHO is not a regulatory agency.  The \nFDA and Tobias and I pleaded that the generics companies submit the applications and \nReleased by Chairman Rand Paul\n101give the FDA a chance to show that they could give an expedited review.  We were \nasking for clinical data that Medicines Sans Frontiers already has and has published, plus \nbiochemical equivalency and pharmacokinetic data and plant inspection, all of which are \nreal easy to get.  However, no generic company has thus submitted applications.  They \nsay that they do not have to since WHO has prequalified them. The real reason is that \nthey are afraid that the FDA will actually find that the product may not be good.  I think \nthe product likely is fine, but the mistrust on the part of the rest of the world for FDA and \nthe USA is palpable.  This likely relates to the situation in Iraq. The other source of \ncontention is the situation of Global Fund versus PEPFAR.  I took great issue with the \nincredibly inappropriate public statement by Kofi Annan about the lack of USA \nLeadership in Global AIDS (Kofi, did you forget your leadership on the Rwanda \ngenocide??). I tactfully blasted him and this concept on BBC radio and TV and CNN. I \nwas quite discouraged by this Conference.  The science was irrelevant although my \nSpecial Lecture on HIV Pathogenesis went very well and was extremely well-received.  \nA major issue is that the USA is doing some stupid things like allowing the restriction of \nnumbers of scientists at the meeting and by having the far-right people act like they are \nrepresenting the USA.  However, this time, the activists and the international community \nare even worse.  They are totally misinformed about what is really going on, but they are \nlouder than ever.  This in turn feeds the far-right and it becomes a vicious cycle.\n \nThe following is a Washington Post article that summarizes the situation very well:\nSubject: [HEALTHGAP] WashPost: AIDS Activists Misfiring\nAIDS Activists Misfiring\nBy Sebastian Mallaby\nMonday, July 19, 2004; Page A17\nIn the past few years, global AIDS activists have worked miracles. They have shaken rich \ngovernments awake, causing international AIDS funding to rise 15-fold. They have \nbeaten back big pharma's jihad against cheap, non-brand medicines, creating an \nopportunity to treat millions of people in poor countries. But the activists, or at least some \nof them, are in danger of tipping from heroism into shrill anti-Americanism. The sound \nbites from last week's AIDS conference in Bangkok were straight out of a Michael Moore \nmovie.\nInconveniently for those who enjoy stereotypes, the Bush administration is far and away \nthe leader in the global AIDS fight. This year the United States will spend $2.4 billion on \nthe pandemic, nearly twice as much as all other donor governments combined; attacking \nthe Bush team for indifference to AIDS is like attacking it for inadequate defense \nspending. But when Randall Tobias, the U.S. global AIDS coordinator, addressed the \nBangkok gathering last week, he had to endure 10 minutes of furious heckling before he \ncould get a word in edgewise.\nReleased by Chairman Rand Paul\n102What triggers this hostility? The activists' first complaint is that U.S. AIDS spending will \nfinance programs to promote sexual abstinence and fidelity. Never mind that only 7 \npercent of the money will be spent this way; the abstinence agenda is derided as some \nkind of kooky anti-scientific plot cooked up by President Bush's evangelical supporters. \nYet the plotters actually include very un-evangelical people such as Edward Green, a \nHarvard medical anthropologist (and liberal Democrat) who's written a book on AIDS \nprevention. Green has shown how Uganda's success in cutting HIV infection rates from \n21 percent to 6 percent depended crucially on teaching abstinence. In the first half of the \n1990s, the number of young Ugandans engaging in premarital sex plummeted; by 1995, \nfully 95 percent of Ugandans reported that they were either abstaining or monogamous.\nElsewhere in Africa, experience also supports the Bush administration's desire to make \nabstinence and fidelity part of its prevention strategy. The evidence from Botswana, \nSouth Africa, Kenya and Zimbabwe suggests that there's no clear link between the \navailability of condoms and reduced HIV\nrates: All four countries have plenty of condoms yet plenty of infection. Meanwhile in \nSouth Africa, the single most promising development is that reported rates of teenage \nsexual activity have fallen for three years straight, disproving the notion that there's no \npoint in telling youths to change their behavior. In sum, it is not the Bush administration \nthat is ignoring the evidence. It is Bush's critics.\nThe activists' second complaint about the U.S. AIDS program is that it is hostile to \ngeneric medicines. Until recently, this was true: Perhaps because of its ties to the big \npharmaceutical companies that sell patented drugs, the administration has been \nscandalously slow to allow cheaper generic copies to be used in its programs. But in May \nthe Bush team finally announced that generics were okay, subject only to a six-week \nreview by the Food and Drug Administration to determine safety and efficacy.\nThe activists do not believe the FDA's change is for real, and their suspicions are \nreinforced by Cipla, a leading Indian producer of generic AIDS drugs. Cipla's charming \njoint managing director, Amar Lulla, explains to anyone who calls that he would love to \nget his drugs approved for distribution in U.S.-financed programs in the poor world but \nthat the Bush administration's fine print is cluttered with obstacles.\nOn close inspection, however, these obstacles aren't serious. For example, Cipla's best \nknown AIDS medicine is called Triomune; it combines three separate antiviral drugs in \none pill, simplifying treatment. Lulla says the FDA has not explained whether he needs to \ndemonstrate the safety of combining the drugs this way, in which case Cipla would have \nto conduct prohibitively expensive clinical trials. But if you go to \nwww.fda.gov/oc/initiatives/hiv/hivguidance.html, you'll find the explanation that Lulla \nsays he's waiting for. Attachment B lists three-drug cocktails that the FDA already \naccepts as safe, among them one combining stavudine, lamivudine and nevirapine, the \nthree constituents of Cipla's Triomune.\nCipla also says it worries that if it files an FDA application, it may be sued by U.S. patent \nholders. But the FDA's rules allow Cipla to file a statement certifying that its pills are \nReleased by Chairman Rand Paul\n103intended for sale outside the United States, a maneuver that would almost certainly \neliminate the risk of being sued for U.S. patent infringement.\nNone of this is to deny that the Bush administration panders to the religious right on some \nissues, or that it's cozy with pharmaceutical lobbyists. After misrepresentations on issues \nfrom tax policy to Iraq intelligence, the suspicion with which Team Bush is greeted is \npartly of its own making. And of course some criticisms of the administration's AIDS \nprogram remain fair, notably that it shortchanges multilateral efforts against the killer.\nAnd yet the bottom line on the Bush administration's AIDS initiative is that it is huge and \nserious. The AIDS activists at last week's conference, whose motives are doubtless \nhonorable as well, would do better to redirect their heckling to countries such as Japan \nand South Korea, which give shockingly little to their cause. When you're fighting an \nenemy that takes 8,000 lives a day, it pays to pick your targets wisely.\nmallabys@washpost.com\nJuly 19, 2004 – Appeared on the Jim Lehr Newshour defending the USA position on \nPEPFAR.  Steve Lewis from the UN was my “opponent” and we duked it out over the \nbilateral approach of PEPFAR versus the multilateral approach of the Global Fund.  I \nsaid both are good and working.  He feels that the USA should put all of its money into \nthe Global Fund.  He also did not understand the need to have some sort of approval for \ngeneric copy drugs (see above).  Everyone told me that I appeared cool and collected \nwhile Steve was shrill.\nJuly 21, 2004  -  Two visits to WH today.  The POTUS invited me to be at the signing \nceremony for the BioShield Legislation in the Rose garden.  I was asked to go up on the \nstage for the photo with the POTUS and the VP as well as Tom Ridge, Congressmen \nChris Cox and Waxman, House Speaker Dennis Hastert, Senators Ted Kennedy, Bill \nFrist among others.  Michael Allen of WH Legislative Affairs was my advocate to get me \non the platform.  The White House protocol women (?name) wanted Julie Gerberding on \nthe platform (even though she had nothing at all to do with BioShield) since there were \nno women there and she bumped me.  Michael insisted and they compromised by putting \nus both up there.  The POTUS, VP and Senators were very nice with me.  I now know all \nof these people very well.\nIn the afternoon, I briefed Carol Kuntz.  Ernie Takafuji accompanied me.  Carol is \ngreat, but she is going through one of her periodic periods of sadness and anxiety about \nher CML even though she is in a crisp remission on Gleevec.  I intermittently give her \nprivate psychotherapy and I did so that night.\nJuly 22, 2004 – Testified with Secretary Thompson and Julie Gerberding to the Senate \nCommittee on Health, Education, Labor and Pensions (HELP) on Public Health \npreparedness, surge capacity and medical countermeasures.  Present were Chairman Judd \nGregg, Ted Kennedy and Lamar Alexander.  It was a very friendly hearing and very \ncomplimentary to me and the others.\nReleased by Chairman Rand Paul\n104July 23, 2004 – West Wing – Had individual photo op with VP Cheney together with the \nentire “team” that worked on BioShield.  Many people there: Stewart Simonson, carol \nKuntz, Scooter Libby, Sally Canfield (DHS) (she just announced that she is leaving Tom \nRidge and going to work for Speaker Hastert), Mark McClellan, Ken Bernard, Michael \nAllen, Brenda Becker, Sharon…(Sen. Gregg’s staff), Noreen Hynes, Seth… (Noreen’s \nhusband), Vince Ventimiglia (Sen Gregg’s Committee Staff). I will provide full list later.  \nVery happy occasion.  Again, VP was very gracious towards me.\nAugust 11, 2004 – Met at EEOB Room 283 with Carol Kuntz and Bruce Miller and \nDorothy….  to discuss tentative plans to determine whether IL-4 gene inserted into \nmonkeypox would have the same effect as IL-4 inserted into mousepox virus, i.e. it \nwould suppress the immune response enough to allow lethal disease in the animal.  This \nrelates to concerns that terrorists will genetically engineer variola with IL-4 and so over-\nride vaccination and cidofovir.  Carol wanted to know which of several options for \nexperiments I would favor.  A White Paper was drawn up by the Office of Homeland \nSecrurity (Ken Bernard) with the various options.  Of note, I had previously briefed \nFrances Townsend in the White House Situation Room a couple of weeks ago (not \nrecorded above) on the same topic.  I favor Option #3 which is to conduct the research on \nIL-4-altered monkeypox in monkeys and do it as classified research.  However, we \nshould announce that we will be conducting such experiments so that people do not get \nsuspicious that we are totally hiding things.  We would keep the design, details and \nresults classified since if we found out that it did work in monkeys , but did not yet have a \ncountermeasure for it, then we would expose our vulnerabilities.\nSept. 1, 2004 – Had a interesting day.  Flew by helicopter from the Pentagon to Fort \nDetrick to visit USAMRIID with Deputy Secretary of DoD Paul Wolfowitz, Bill \nWinkenwerder, and a number of other DoD and DHS senior staff to hear presentations by \nGen Lester Martinez-Lopez and others regarding why the DoD should support the \nplanned new Biodefense Research Campus at Ft. Detrick.  The Army wanted me there \nsince they know that I am an articulate advocate of their cause.  The meeting went very \nwell and I finally got a chance to meet and intensively discuss with Wolfowitz.\nSeptember 13, 2004 – For the past few weeks, I have been involved in a number of \nbriefings of Carol Kuntz and Stewart Simonson regarding Biodefense and the concern \nabout the emergence of an H5N1 bird flu that has been smoldering in Asia (Thailand, \nViet Nam, China, Taiwan, etc) with jumping of cases from chickens to humans.  \nPresident Clinton had quadruple bypass surgery at Columbia-Presbyterian \nHospital related to unstable angina this past week.  I contacted Senator Clinton’s office to \nget his private e-mail address to send him my personal best wishes.\nToday, I had an official briefing at the White House for Carol Kuntz and Bruce \nMiller (her deputy) on research plans and strategy for countermeasures for “Genetically \nEngineered Microbes”.  The presentation was very well received.  Carol gave me a “red-\nlined” copy of the Bioshield Legislation that was signed by President Bush and VP \nCheney as a special gift from them to me due to my work on the development and \npassage of BioShield.\nReleased by Chairman Rand Paul\n105Oct. 4, 2004 – Meeting in the Situation Room of the White House to brief Ken Rapuano \n(Deputy to Fran Townsend) on the IL-4 – monkeypox experiment that is being proposed \nas a classified experiment to be performed by DHS.  I presented the rationale behind the \nexperiment.  Also present were Carol Kuntz, Ken Bernard, Stewart Simonson, Maureen \nMcCarthy, Gerry Parker, et al.  Although NIAID will not perform these experiments, \nFran Townsend wanted to make sure that I did the briefing since she trusts me.  The plan \nis for me to make the same presentation to Colin Powell and Donald Rumsfeld soon after \nthe election.\nOct. 5, 2004 – Historic day today with the UK regulatory agency suspending the license \nof  Chiron to ship out their influenza vaccine to the USA because of issues related to the \ninspection of the plant in Liverpool.  This is a huge issue for the USA since Chiron was \nscheduled to supply about 46-48 million doses or about 50% of our yearly requirement of \n100 million doses.  Only Aventis Pasteur  (50 millioin doses) and Medimmune (2 million \ndoses of Flumist) are available.  We heard about this abruptly this AM as we (Julie \ngerberding and I) were getting ready to testify at  House Hearing on Thimerasol in \nInfluenza vaccines.\nOct. 6, 2004  - Trip to Duke to honor retirment of Ralph Snyderman as Chancellor.  \nWhite House conference call at the airport in Raleigh-Durham on way back regarding the \ninfluenza vaccine issue.\nOct. 7, 2004 – Trip to Duke to honor the retirement of Ralph Snyderman.  Gave talk on \nEmerging Infectious Diseases.  White House conference call on Influenza issue (see \nabove).  Incredible amount of media appearances: radio, TV, print.  As much as I have \never done.\nOct. 8, 2004 – Big time Congressional Hearing on influenza vaccine problem before the \nHouse Government Reform Committee.  I testified with Julie Gerberding and Lester \nCrawford of FDA.  More media, White House Conference calls, and Jim Lehr NewsHour \nto finish the day.\nOct. 9, 2004 – Front page story in the Washington Post saying that the UK regulatory \nauthorities told our FDA about the problem at the end of August with the implication that \nthe FDA failed to act in preparing for the shortage.  Acting FDA Commissioner Lester \nCrawford explained on our regularly scheduled White House Conference Call that this is \nmisinformation.  As we (me, Julie and Les) have stated all along, Chiron kept reassuring \nus that there was a problem with about 4 million does due to contamination with Serratia \nmarcescens.  Never did anyone say to FDA or CDC (nor did Rino Rapualli say to me) \nthat there was a serious enough problem to suspend licensure.  John Kerry came out with \nugly statement saying that the Administration is covering up.\nOct. 10, 2004 – Things still hot and heavy with the Chiron/influenza situation. Had \nanother White House conference call with Margaret Spellings, Alan Gilbert, Phil Hall, \nHarriet Miers (Deputy Chief-of-Staff), Jon Burks, Ken Bernard, Trent Duffy, Scott \nReleased by Chairman Rand Paul\n106Whitaker, Julie gerberding, Les Crawford and Bruce Gellin.  Also more media \nappearances for me.\nOct. 12, 2004 – Important White House meeting at 1:00 PM in Roosevelt Room on the \nFlu situation.  Chaired by Margaret Spellings and Harriet Miers.  Also present were Fran \nTownsend (HSC), Joel Kaplan (OMB), Jack Marburger (OSTP), Alan Gilbert, Hobbs, \nLeitch, Montgomery, Jackson, Amit Sachdev (FDA), Stewart Simonson, Julie \nGerberding, Suzy DeFrancis (WH Communications), McGrath.  We  discussed strategies \nto handle problems.  I gave a background of flu vaccines in general together with the \nnature of the current problem.  Julie gave the plan for trying to get equitable distribution \nof the remaining doses from Aventis Pasteur that have not already been distributed.  The \nissue of the conflict in statements from our FDA and the British regulatory authorities \n(MHRA).  They said they told the FDA about the seriousness of the problem weeks ago \nand our FDA says no.  Our FDA is correct since I was hearing the same thing.  We \nbelieve the UK people have over-reacted and now it has caused a mess here in the USA \nand they are embarrassed to retract.  Important point that I brought up and again called \nMargaret Spellings about the evening of today was that John Kerry would likely try to \nembarrass the President in the debate on Oct. 13 by saying that the FDA knew and \ncovered up and that he believes the Brits.  I suggested to Margaret that the FDA come out \nwith a forceful statement BEFORE the debate declaring that the UK did not tell them \nabout the problem so that the President is not left hanging out there.  Margaret agrees and \nthey will do this on the morning of Oct. 13.\nOct. 13-14, 2004 – Multiple HHS and White House conference calls regarding the \ninfluenza vaccine crisis.  Report from FDA’s Jesse Goodman who just returned from UK \nis that the Liverpool plant  really did have some serious GMP problems and potential bio-\nburden problems.  Our FDA agrees with the findings of UK regulators, but not \nnecessarily with their action.  However, it is too close a call for us to say that we would \nhave released the lots.  Therefore, we will publicly say that the lots from Chiron are \nunusable.  We further discussed other issues about how we can get more vaccine from \nAVP or from Canada or from anyone else.  If we go with Canadian vaccine, this would \nhave to be done by an IND since it is not licensed by FDA.  Most we can get is 2-3 \nmillion doses.  Even this is a logistic nightmare to do under an IND.\nPresent on Conference call with WH are Spellings, Silverberg, Miers, Dan \nBartlett, Trent Duffy (Deputy Press Assistant), Alan Gilbert, and HHS team of Julie, \nStewart, Les Crawford, Scott Whitaker, and me.\nOct. 15 – 18, 2004 – Situation getting very hot and heavy.  Kerry campaign trying to \nmake this a political issue saying that the shortage is President Bush’s fault.  I have been \non every major TV show multiple times talking about the issues and what people need to \ndo.  Multiple (daily) White House Conference Calls. Almost constant briefings and press \ninteractions.  Will need to go on a New England bus tour this weekend from DC up the \ncorridor to Boston and fly back.  Very intense, at least as much as with the anthrax \nsituation, mostly because the election is 2 weeks away.\nReleased by Chairman Rand Paul\n107Oct 22-23, 2004 – Continued intensity of activity around the influenza vaccine shortage.  \nDaily White House Conference calls.  The DHHS team has broken up into several groups \nto “tour” the country in a bus for outreach and education to health authorities, the general \npublic and the Press.  I was part of a tour that went from D.C. to Philadelphia to Trenton, \nNewark, NYC, Hartford, Providence, Boston and back (Flew back from Boston).  Our \nteam was Claude Allen, myself, Howard Zucker (Deputy Asst Secretary of Health), Bill \nHall (DHHS Public Affairs), Sarah Greirich (Claude’s assistant), Kate (?).  It went well.  \nThis is becoming a serious political issue in that the Kerry Campaign is trying to paint the \nBush Administration as responsible for the Chiron mess.  President Bush in turn is \nclaiming that liability issues are the cause of Pharma not getting into the vaccine business \nand that Kerry supports trial lawyers who are the problem (VP candidate Edwards is a \nliability lawyer).\nOct. 25, 2004 – Went to LA to be Keynote Speaker at a USC conferenec on Multi-Sector \ninvolvement in research (Government, Industry, Academia).  Afterwards I gave a press \nconference with the Editorial Board of the LA Times.  The topic of influenza vaccine \ndominated the conversation.\nOct. 26- Nov. 8, 2004 – Daily White House conference calls on influenza situation.  \nTrying to get additional doses from Aventis, Medimmune and foreign sources.  \nBush re-elected.  Very good for me since the team stays in place.\nHorrible tragedy – John La Montagne, my beloved friend, colleague and Deputy \nDirector of NIAID dies suddenly on Nov. 2 after disembarking from flight from DC to \nMexico City (his birthplace) on passport line in Mexico City.  He had a pulmonary \nembolus, very likely from the flight with venous thrombosis.\nNov. 12, 2004 – Meeting in Roosevelt Room of WH to discuss the plans for influenza \npreparedness and for pandemic flu plans.  Major points are what we have been discussing \nfor the past few weeks about providing incentives for PHARMA to get involved and stay \nin flu vaccine field.  We (DHHS team) are proposing back end guaranteed purchases for \noverflow doses; liability protection, tax breaks, research to develop cell culture based and \nrecombinant DNA approaches to replace egg-based approaches; advanced purchase and \nstockpiling of vaccine for children.  TGT presented and I filled in.  Present were:  Karl \nRove, Josh Bolton, Margaret Spellings, Kristen Silverberg, Alex Azar, Scott Whitaker, \nGrant Dixton, David  Leitch, Harriet Miers, Alan Gilbert, Carol Kuntz and others.\nNov. 17, 2004 – House Hearing of Government Reform Committee on the flu crisis \ntoday.  I testified together with Julie Gerberding and Lester Crawford (Acting FDA \nCommisioner).  Mostly they slammed FDA for not acting more aggressively to monitor \nthe Chiron plant and pick up contamination.  \nBush shuffling around his Cabinet following election victory.  People that I know \nare moving out of positions where it was good to have a contact for me and into positions \nwhere it is also good to have a contact.  Condi Rice to State, Margaret Spellings to \nEducation.  Much rumor about TGT and whether he will go to DHS or whether it will be \nFran Townsend if Tom Ridge leaves.\nReleased by Chairman Rand Paul\n108Nov. 18, 2004 – Hearing today before House Commerce and Energy Investigations.  \nTogether with Julie and Les Crawford.\nNov. 19, 2004 – I arranged a meeting among Medimmune (Flumist), the FDA, and \nStewart Simonson to try to pursue ways to get broader approval and utilization of Flumist \nfor next year to make up for the anticipated shortages since Chiron will almost certainly \nnot be able to re-fill the gap by next year.  Present at the meeting were Medimmune CEO \nDavid Mott,  President Jim Young, VP of Reg Affairs Peter Patriarca, CMO Edward \nConnor, Sr. Director Scientific Affairs Kathleen Coelingh.  From FDA were Les \nCrawford (Acting Comm) and Jesse Goodman (head of CBER).  Also, Stewart \nSimonson, Bruce Gellin, Pamela McInnes, Ralph Tate.  I am trying to be the facilitator to \nhave FDA look at Medimmune data on 50 to 64 year old people sooner rather than later \nso that Medimmune can produce an extra 10 million doses for next year.  They need \napproval for this age group or else then cannot take the risk of making 10 million more \ndoses and not be able to sell them.\nNov. 30, 2004 – Memorial service hosted by me at Natcher Building at NIH for John La \nMontagne.  I delivered Eulogy (see speeches file).  I am only starting to come to grips \nwith the intense feeling of grief and sorrow at having lost John.  I really liked him very \nmuch.  He was such a fine human being.  Present at the Memorial Service were Secretary \nThompson, Margaret Spellings, Carol Kuntz, Stewart Simonson, Julie Gerberding, D.A. \nHenderson and hundreds of other friends of John.  I have appointed Cliff Lane as the \nActing Deputy Director of NIAID.\n Dec. 3, 2004 – Secretary Thompson resigns and asks me to come down to the \nDepartment as he makes his announcement.  He brought me into his office alone and with \nboth of us in tears he expressed his gratitude and admiration for my service to him, the \nDHHS and the country.  I expressed my mutual feelings for him.\nBelow is his resignation statement:\nDear Friends,\nThis morning, I submitted to President Bush my resignation\nas Secretary of Health and Human Services.\nIt was a difficult decision and one I did not make easily.\nBut after nearly 40 years of public service, it is time for\nme and my family to move onto the next chapter in our life.\nIt has been my honor and privilege to serve President Bush\nand the nation with each of you in this dynamic Department.\nAs I have often said, our 67,000-member family is home to\nthe finest employees in the federal government. When you\nwork at HHS, the greatest doctors, scientists and public servants in the world are your \ncoworkers. I am truly grateful for the opportunity to work with all of you in this noble \ncalling.\nReleased by Chairman Rand Paul\n109I am extremely proud of the work we did together at\nAmerica's Department of Compassion. President Bush set\nforth an ambitious agenda for our Department. And I love\na big challenge. Since the day I walked through the doors\nof this building, we have worked tirelessly to better the health and well-being of the \nAmerican people and our neighbors throughout the world.\nThanks to your work,\n        *       We delivered on our promise to modernize\n        Medicare with prescription drug coverage - the most\n        historic improvement to Medicare since it was created\n        in 1965. Now seniors and the disabled will get\n        substantial help paying for the modern medicines and\n        preventive services that extend and enhance their lives.\n        *       We're spending more in medical research than any\n        time in our history. And the President opened the door\n        to federal funding of groundbreaking stem cell research.\n        *       We're investing in our long-neglected public\n        health system, making our nation better prepared to\n        fight disease or biological attacks. We're improving\n        the safety of the food we eat and import.\n        *       We're developing the new medicines and vaccines\n        to protect our citizens from disease or bioterrorism.\n        *       Our children are healthier than ever, with health\n        coverage and immunization rates at record highs and\n        childhood drug usage going down.\n        *       We turned America's attention to disease\n        prevention, motivating Americans to eat better and\n        exercise more in order to improve their health and\n        quality of life.\n        *       And we're waging a bold new global fight against\n        HIV/AIDS, committing an unprecedented $15 billion toward\n        eradicating this scourge. This will be a jewel in the\n        President's legacy - and our years at HHS.\nTogether, we also faced challenges that were unpredictable and unimaginable.\n        *       HHS was among the first on the ground to care for\n        New York City residents and assist in the aftermath of\n        9/11.\n        *       From the day I arrived, we spoke of the need to\n        better prepare for bioterrorism, and together we helped\n        this nation weather the first biological attack on its\n        people with the anthrax letters.\n        *       We expanded our cache of smallpox vaccine, so we\nReleased by Chairman Rand Paul\n110        can now protect every man, woman in child if this vicious\n        disease were to return.\n        *       We protected America from SARS and we helped the\n        world understand this mysterious disease so we could\n        contain its spread.\n        *       We're leading the world to prepare for a world flu\n        pandemic and Avian flu.\n        *       And, together with our public health partners, we\n        have helped this nation manage an unexpected influenza\n        vaccine shortage.\nThat is quite a record in four short years. You all should be proud.\nAnd, best of all, we are working together more closely than ever before to better serve \nAmerican families. We truly are One Department - with the best and brightest working \ntogether across agencies to solve our nation's toughest problems. And we truly are the \nDepartment of Compassion.\nI will miss you all more than you can ever know. I will\nforever cherish the friendships I made here the last four years. And I will always be in \nawe of the talent, dedication and drive of the people of the Department of Health and \nHuman Services.\nKeep leading this nation forward. Keep putting the well-being of our people first. And \nkeep changing the status quo in search of a better way.\nYou will always be in my prayers and in my heart.\nWith gratitude and friendship,\nTommy G. Thompson\nDec. 20, 2004 – Terrible time over the past couple of weeks with a 4 part story by an AP \nreporter on the Jonathan Fishbein issue and the HIVNET 012 story.  Fishbein is a Title 42  \non a 2 year probation period in DAIDS.  His performance was terrible and Ed Tramont \nand Jon Kagan decided to remove him.  He got a high-priced whistleblower lawyer and \nclaimed whistleblower status despite the fact that he “blew the whistle” AFTER he was \ninformed that he would be removed.  He leaked internal documents regarding the \ntechnical difficulties with HIVNET 012 (use of nevirapine for prevention of mother-to-\nchild transmission (MTCT) of HIV.  In that landmark trial it was shown that the drug in a \nsingle dose was safe and effective for prevention of MTCT.  The use in these \ncircumstances has likely saved tens of thousands of children’s lives in developing \ncountries, particularly sub-Saharan Africa.  The paper appeared in Lancet in 1999 and \nseveral papers have corroborated the safety and efficacy of Nev. For MTCT prevention. \nSince the results of the trial (HIVNET 012) were so striking, the maker of Nev (BI) \ndecided to use the data from the trial to expand the licensed indication of Nev to MTCT \nReleased by Chairman Rand Paul\n111in the USA.  Upon inspection of the site and the data collection procedure, the FDA and \nan auditor ruled that there were “technical” problems that would not allow licensure.  Ed \nTramont decided to have a more comprehensive look at the “technical” difficulties and \nultimately found that the procedure was sloppy (not surprising for an inexperienced \nAfrican site); however, the data were sound, i.e. Nev is still safe and effective.  A low \nlevel person in DAIDS wrote a safety report that exaggerated (in Ed Tramont’s mind) the \nnegatives and indicted the entire trial. Ed used the report from the more comprehensive \naudit and changed the lower level report to indicate that there were technical difficulties, \nbut this does not change the results of the trial.\nFishbein in his attempt to not get fired for incompetence (totally unrelated and \nanteceding the issue of HIVNET 012) went to the Congress (Sen. Grassley – who never \nmet a whistleblower that he did not love) and finally the AP.  The AP story was \nincredibly misleading in that it published Fishbein’s “whistleblower” claims of \nwidespread misconduct in DAIDS, our (mine and others) failure to notify the president \nabout the problems with HIVNET 012 before he launched the $500 million MTCT \nprogram, and a variety of other charges.  This raised a lot a stink with and ABC Nightly \nNews show.  Surprisingly, the regular media did not take it up much, but it was all over \nthe internet circuit.  I worked hard to keep it off CNN, NBC, Washington Post, NY Times \nby pre-emptively discussing the truth with the reporters.  We are “hand-cuffed” in what \nwe can say since the Fishbein issue is a personnel matter and the Privacy Act is involved,  \nAlso, the Whistleblower statute (even though Fishbein is technically not a whistleblower \nsince he blew after he was fired).  Interesting how the laws protect the scoundrels.  Our \nmajor concern is that this publicity will cause the uninformed to stop using Nev for \nMTCT.  Of note, Rev. Jesse Jackson published his typical demagogue-like letter \ncondemning President Bush, accusing Ed Tramont of “crimes against humanity”, etc. \nWill give more follow-up soon.   \nDec. 20, 2004 to Jan. 14, 2005 – We have been occupied almost full time with doing \ndamage control against the Dec. 13, 14, 15, 2004 AP articles by John Solomon.  We have \nput on the NIAID Website a Q and A series that cogently addresses all of the allegations.  \nThis has apparently angered the reporter who is going after Cliff Lane and I now.  \nSomeone from the inside (Solomon said OGE, but I do not know whether I can believe \nhim) “blew the whistle” on Cliff and I with the preposterous allegations that we are \nreceiving hundreds of thousands of dollars from the IL-2 patent and that we are investing \nmillions of dollars of NIAID money to support IL-2 research.  Also, the whistle-blower \ntold Solomon that I made Cliff Clinical Director as a quid pro quo for his putting me on \nthe patent.  Also, he queried whether my wife Christine gave the ethics approval of the \nESPRIT IL-2 trial. This is nasty business.  Cliff was made Deputy Clinical Director in \n1986 and full Clinical Director in 1991.  The patent was done in 1997.  Chris has always \nrecused herself from any actions on NIAID business. The Bayh-Dole Act requires that \ngovernment employees file patents through the US Government on all inventions made \nduring official government business. I originally did not want to be on the patent because \nI am NIAID Director.  I was told by OGC and OTT that it was required since I was a \nclear inventor and to leave me off of the patent would make the entire patent subject to \ninvalidity.  I then queried of OGC as to whether royalties constituted a “financial \ninterest” and thus subject to conflict of interest laws under 18 USC, Section 208a.  I \nReleased by Chairman Rand Paul\n112found out that years ago the OGE ruled and the DoJ confirmed that royalties collected by \ngovernment employees on patents owned by the government on which the employee is an \ninventor cannot be considered as a financial interest and so cannot be a conflict.  The \nroyalties are considered government compensation similar to performance awards and \nsalaries.  I was still uncomfortable about taking royalties because of my high visibility \nand so I told Mark Rohrbough (OTT for NIAID at the time) to have the government NOT \nsend me the checks.  He related that they were legally required to give me the check in \norder to fulfill the requirements of the Federal technology Transfer Act (FTTA).  Thus, I \nhave given every penny of my royalties to charity – The Foundation for NIH, Inc.  Total \nroyalties since 1997 = $45,072.82.  Finally, I put the royalties on my financial disclosure \nstatement (SF278), but OGE told me to take it off since it was equivalent to government \nsalary that does not go on SF278. Nonetheless, Solomon wrote an article on the IL-2 \nstory on Jan. 9 with the theme that Cliff and I should have let patients know about the \n“conflict” (even though there was no conflict).  I believed that I saved the day by \nspeaking with the reporter and explaining all of the above.  It would have been better if \nmy name was not associated with any COI story, but at least he mentioned about giving \nthe money to charity as well as the fact that I tried to put the amount on my financial \nstatement.  The reporter has FOIA’ed our SF278s and so who knows what other smearing \nhe might try to do with misinformation.\nJan 15 – Feb. 3, 2005 – Story came out in AP about the IL-2 patent.  The reporter (John \nSolomon) did indeed mention that I was required to file a patent and that I tried not to \naccept the checks and ultimately gave the money to charity.  Also, he mentioned that I \nwas told to take off the entry of the money on my SF278.  In the end, it was not nice to \nhave a story about me with a implication that I did something wrong, when in fact, I went \nout of my way to avoid conflict.\nThe AP story led to CBS Evening News doing a story on the same thing on Feb.1.  \nHowever, their angle was that I was the hero/Saint in trying to avoid conflict, and the \nNIH would not let me do the right thing.  I came out looking good and the NIH looking \nfoolish.  In the end, it would have been better if the piece did not air.\nFishbein issue:  This abscess continues to fester.  Fishbein continually puts out \nmissives on his brother’s Website (honestdoc.org) about “widespread misconduct and \nscientific fraud at NIH” and plays the role of defender of the public health.  The Privacy \nAct (he is involved in a personnel matter) forbids us to respond.  We are faced with the \nimpossible situation of not being able to respond to this psychopathologic accusations.  \nHe can go public, but we cannot respond publicly.  This is untenable.\nInfluenza:  Avian flu (H5N1) is still percolating in Asia (mostly Viet Nam and \nThailand).  Most recent cluster of cases in Viet Nam.  We are continually having \nconference calls with the usual suspects on preparedness – Carol Kuntz, Julie Gerberding, \nme, Stewart Simonson, Lester Crawford, etc.  Had a meeting in the West Wing of the \nWH on Feb. 2 with Claude Allan who has replaced Margaret Spellings as Assistant to the \nPresident for Domestic Policy.  Present were Julie Gerberding, Stewart S., Allan Gilbert, \nBruce Gelling, Amit (FDA), etc.  We updated Claude who will brief President Bush.\nFeb. 3 – Mar. 8, 2005 – Another stress and crisis issue.  A microbiologist named Ebright \nfrom Rutgers circulated an open letter(to Elias Zerhoun) among all the microbiologists \nReleased by Chairman Rand Paul\n113stating that his analysis of study section data of non-biodefense grants over the past few \nyears shows a decrease at the same time as the biodefense funding shows an increase.  \nThe letter was published in Science, first as an e-publication and then almost 2 weeks \nlater (March 11) as a printed letter in Science.  Problem is that the data that he pulled was \nvia CRISP that is not designed to do comparative analysis of funding trends.  The letter \nwas signed by >700 microbiologists.  The hidden agenda of Ebright and a very small \ngroup of signees (like Stanley Falkow) was that they feel that we should not be spending \nany money on biodefense research.  They came to the conclusion in the letter that \nbiodefense research was “hurting” non-biodfense infectious diseases research by \ndiverting money away.  They released the letter to the press without ever calling us or \neven sending the letter to us.  This created a media storm and put us on the defensive to \nrespond to what turns out to be entirely misrepresentative data. They took information \nfrom 4 out of 30 study sections that really misrepresent the big picture.  The study \nsections involved mostly reflect activity in NIGMS that may be funding fewer “model \norganism” grants for reasons that have nothing to do with biodefense funding.  I was \nfurious!  Clearly some few individuals were pushing their anti-biodefense agenda and the \nrest of the microbiology community was following like sheep.  When several were asked \nabout this after the media storm, they were embarrassed (such as Barry Bloom) and said \nthat they really did not think that this was what they were signing on to.   Many \nnewspaper articles appeared and I led the rebuttal in the newspapers, NPR, and several \nspeeches.  EZ and I will write a letter in response to Science.  Clearly when you examine \nthe data correctly, non-biodefense has done as well or better at NIAID as the rest of NIH, \ni.e. when you compare the percent increases from year to year from 2001 to 2006.  Also, \nmuch of biodefense money is also spilling over to non-biodefense or “dual-use” projects \nsuch as innate immunity, influenza, SARS, diarhheal diseases, etc.  Clearly, the Ebright \nletter is misleading.  Problem is that since all money is now tight, people are acting as \nexpected, i.e. they want to blame someone or something for their personal and specific \nissues.  Now they are blaming biodefense resources with a sub-text of anti-Bush \nAdminstration and anti-Iraq war.  It is really ridiculous how they distort and I am in the \nmiddle of the fray.  However, this is one that I will not back down on.\nOn March 7, I met in my office with Michael Gerson, former top speech-writer \nfor President Bush and now senior advisor and Assistant to the POTUS.  Mike wanted to \ndiscuss ideas for addressing neglected or other diseases as an initiative for the POTUS to \nput before the G-8 summit.  This is very similar to last year’s activities (see above).  I \nwill work with him on a malaria intiative (see last year) and a TB in HIV disease \ninitiative.  Apparently Gary Edson and Josh Bolton sent him my way.  I will be \nsubmitting the malaria and TB proposals for the POTUS consideration.\nMarch 8 – March 27, 2005 – Continued concern about the H5N1 bird flu in Viet Nam, \nThailand, and Cambodia.  Most severe now in Viet Nam. Working closely with Stewart \nSimonson, Julie Gerberding and the DHHS on Pandemic Influenza Preparedness.\nMar. 27 – April 1 – Phenomenal vacation with Chris and the girls for Spring Break in \nCosta Rica.  First vacation that I have had unassociated with a lecture or other business in \n20 years since our honeymoon.  Went for 2 ½ days at Papaguyo Beach and 2 days in rain \nReleased by Chairman Rand Paul\n114forest and Arenal Volcano.  Did zip wire rides over the canopies.  One of the most \nexciting things that I have done.\nApril 4, 2005 – Amazing day at White House today.  Briefed the President on AIDS \n(domestic and International).  Reason for briefing was preparation by the WH for the \nreauthorization of the Ryan White AIDS Care Act originally passed in 1990.  The \nPOTUS wanted to make sure that we were not short-changing domestic AIDS in light of \nall of the money (PEPFAR) that we have recently been putting into international.  \nBriefing from 9:20 AM to 10:05 AM.  The POTUS walked into room and immediately \ngreeted me and although the briefing was supposed to be predominantly on Ryan White, \nhe asked me many questions for about 20  minutes.  It was a 2-way conversation between \nhim and me.  At the meeting also were VP Cheney, Scooter Libby, Andy Card, Karl \nRove, Dan Bartlett, Scott McClellan, Josh Bolten, Kristen Silverberg, Secretary Leavitt, \nClaude Allen, Joe O’Neill, Philo Hall, Tevi Troy.  Wonderful interaction between me and \nPOTUS…great day\nAlso, today I went to and presented a major lecture at the IOM Pandemic \nInfluenza meeting in honor of John La Montagne.  After that I got briefed by the IOM \ncommittee reviewing the HIVNET012 trial (see Fishbein above).  They totally agreed \nwith us and said the trial was effective, ethical, and safe.\nWent back to WH to brief Claude Allen on Influenza together with Stewart \nSimonson, Julie Gerberding, Philo Hall, Dean Casey, Tevi troy, Kristen Silverberg.  This \nwas in preparation of Secretary Leavitt and I briefing the POTUS on Wednesday , April \n6.  However, the POTUS meeting will be postponed until next week since the POTUS \nwill go to Rome for the Funeral of Pope John Paul II.\nApril 4 – 27, 2005 – More of the same with Fishbein situation.  IOM panel report came \nout very clearly supporting all that NIAID and we had been saying about HIVNET-012.  \nIn typical fashion, John Solomon of AP and Sen Grassley (who parrots everything that \nAP says) are claiming that the IOM panel report is invalid since some members of the \npanel receive NIH grants and so are conflicted.  The Fishbein/Grassley/AP axis is clearly \none of the most unethical and disgraceful situations that I have ever experienced.  They \nall have no integrity and absolutely no regard for the truth.  We are now working on a \npossible settlement with Fishbein to make this craziness go away.  He may well ask for \ntotally undeliverable conditions.  The DHHS is still reluctant to allow us to fire Fishbein \nbecause they are afraid of Grassley.\nApril 27, 2005 – Briefed the President about the potential for an H5N1 pandemic \ninfluenza.  At briefing were the POTUS, the VP, Karl Rove, Josh Bolten, Kristen \nSilverberg, Dan Bartlett, Scott McClellan, Fran Townsend, Michel Gerson, Claude Allen, \nJulie Gerberding, Sec. Leavitt, Scooter Libby, Philo Hall, Rajeev, etc.\nThe POTUS was very pleased with the briefing and asked the right questions.  He \nwas favorably disposed to our suggestion of considering having the USA public have kits \nof antimicrobials (Tamiflu, CIPRO, etc) in their homes in case of an emergency in order \nto get around the problem of distribution of drug to tens of millions of people in an \nemergency.  We are going to pursue this approach with Symposia to get the flavor of \nwhat the community thinks of it and then we will pursue it.\nReleased by Chairman Rand Paul\n115May 12, 2005 – Met today in Building 31, 7A-24 with the Ugandan Vice president \nProfessor Gilbert Bukenya, who is former Dean at Makerere University in Kampala.  We \nhad met previously when he was still in academics and now he is VP.  We discussed \ncollaborations between Uganda and NIAID.\nOver the past couple of weeks we are still engaged in trying to settle the Fishbein \nissue.  He continues to attack.  Cliff Lane is leading the arbitration effort for a settlement.  \nIt is clear that he, his brother Rand, his mother and their lawyer Steve Kohn are bad \npeople, well beyond the lawyer issue; they really suck without care for lives of people \nwhom their lying endangers.\nAlso, morale at NIH is the lowest that I have ever seen it.  House Chairman Joe \nBarton is trying to “reauthorize the NIH” by consolidating ICs and putting much more \nmoney into the NIH Director’s office.  We cannot tell if Barton is doing this on his own \nor if Zerhouni is behind it.  I tend to think that it is a bit of both, but that Barton is the \nmain driver.  Also, the conflict-of-interest issues have not been settled.\nMay 23 – 27, 2005 – Things again heating up with avian flu in Vietnam with press \nreports that the virus in evolving with possible resistance to Tamiflu and greater number \nof clusters in Vietnam.  Lesser virulence could mean that virus is adapting to humans \nbetter.  It is likely that all of this just reflects better surveillance and reporting as opposed \nto a significant degree of evolution of the virus. Nonetheless, the press has jumped on this \nand I have been on CNN a few times, Jim Lehrer Newshour, Lou Dobbs (CNN) and C-\nSPAN for a Congressional Hearing on Flu (Energy and Commerce with Chairman Deal).  \nAlso, several briefings at DHHS and the White House with the usual suspects.\nMay 30 – June 3, 2005 – Bird flu activities continue with briefing at DHHS a couple of \ntimes.  White House briefing on June 2 on purchases of Tamiflu versus vaccine in VP’s \nceremonial office in White House.  Present were: Carol Kuntz, Binita Ashar (Carol’s \nassistant, Tom Reilly (OMB), Norris Cochran, Jeremy Katz, Rajeev Venkkaya, Lance \nLeggitt, Stew Simonson, Bill Raub, Kerry Weems, Bruce Gellin, Laura Lawlor (by \nphone), Jesse Goodman, CDC by phone – Julie Gerberding, Charles Schable, Steve Bice, \nDavid Baden.  We are trying to reconcile the budget projects for FY 05 and 06  and 07 \nwith the purchase needs for stockpiles of H5N1 vaccine and tamiflu.  My role was \nimportant since we are doing the clinical trials with the H5N1 to determine the correct \ndose.  This will then determine whether we will buy and how much depending on the \nrequired dose.  We already have 2 million doses of vaccine in bulk and we plan to buy 20 \nmillion more vaccine doses. Also we are thinking of 20 million more treatment doses of \ntamiflu.  Also, White House briefing with Carol Kuntz on June 3 on biologics biodefense.\nJune 3 – 14, 2005 – I have not been recording events since I have been very busy, but \nover the past 10 days or so there has been considerable activity around the area of \npandemic flu, biodefense, etc.  I have briefed DHHS people as well as WH people.  In \naddition, on June 13 we had a Hearing of the House Government Reform Committee for \nBiodefense chaired by Rep. Christopher Shays.  I testified along with Stewart Simonson, \nDale Klein (DoD), Joe Vitko (DHS), and Ron Saldareni (formerly of American \nReleased by Chairman Rand Paul\n116Cyanamide and nowon an IOM Committee of Biodefense).  The Hearing was mostly \nblasting DoD for disorganization and “wasting money”.\nAlso, I went on my yearly trip to review the Gaslini Institute for Lorenzo Moretta \nfrom June 8 – 10.  \nWe are in the final stages of finally officially firing Jonathan Fishbein.  The issue \nis that Sen Grassley and his Committee will likely come after us for this since they \nalways take the side of whistleblowers, even though Fishbein is not really a \nwhistleblower as he blew the whistle after he was told that he would be fired for \nperformance.\nJune 14 – July 2, 2005 -  Many activities around briefings of White House, DHHS and \nCongressional Hearing continue.  Had 2 more Hearings within said period: 1) Senate \nForeign Relations on HIV Vaccines with actress Ashley Judd; 2) Hearing of House \nGovernment Reform Committee on Influenza Pandemic Threat.  I testified with Jim \nLeDuc (CDC) and Bruce Gellin (HHS).  Have been on CNN and all over C-SPAN.\nWe finally fired Jonathan Fishbein (on July 1) amid angry threats from Sen. \nGrassley’s staff.  I must include in my book how totally vicious and completely unethical \nthat crew is.  They are a disgrace to government.  They totally distort the Fishbein story \nand attack the NIH and everyone else, all in the name of protecting “whistleblowers” \neven though he is not a whisteblower.\nJuly 14, 2005 – Lots of stuff going on. Had more Congressional Hearings.  Today had \nHearing on success or failure of Project BioShield.  Testified before House Government \nReform Committee chaired by Tom Davis (R-VA) and Henry Waxman as Minority.  \nAlso, Chris Shays there and Congressman Issa, Davis, Issa, Cummings.  I testified with \nStewart Simonson, and Joe Vitko (DHS).  Interesting issues around current BioShield \n(BS) legislation.  The original Bill for BS was strong and contained indefinite authority to \npurchase for stockpile as well as other strong incentives for industry.  Remember when I \nwent around to the House and Senate at the behest of the VP to push BS, several Senators \nand Members, particularly Sen. Byrd tried to neuter the Bill since they did not want to \ngive big Pharma too much.  Now we have a Hearing where the Congress is chiding us \nsince we have not gotten enough products through BioShield.  The reason is that the big \ncompanies do not see any major advantage since they have no liability protection, no tax \nincentives and no patent advantages, and not a big pot of money.  This is an amazing \nirony.\nWent to White House for a regularly scheduled (have not been reporting on these) \nPCC on Pandemic Flu Preparedness.  Co-Chaired by Rajeev Venkayya (HSC) and Lance \nLeggitt (DPC).  Reps were there from every cabinet department, CIA, etc.  I presented \nthat we actually had a vaccine sine the results of the dosing shows a clear dose-response \ncurve for the prime-boost.  We tested 7.5, 15, 45, and 90 ugm and clearly 90 gave a good \nprotective response after 1 dose and an amazing response after 2 doses.  Now we have to \nfigure out the right dose sparing (adjuvant) strategy and/or the right combination of \nprime/boost.\nOn the way out of the WH, ran into Bob Woodward.  Of note, I had just read his \nnew book “Secret Man” about Deep Throat Mark Felt.  I congratulated Bob on the book \nand discussed it a bit.\nReleased by Chairman Rand Paul\n117Reauthorization language for the NIH has been circulating for comment.  It is \nincredible.  It give all of the power to the NIH Director by eliminating individual \nappropriations and by creating an IC within the NIH to “carry out” research.  Importantly \nand I must put this in the book.  Chairman Barton has threatened to a group of \nconstituency groups who had come to him objecting about the bill that if any NIH IC \nDirector publicly opposes the Bill, he will open an investigation of that IC until the \nperson begs for the legislation.  This is after they had “asked for comments”.  This is a \nclear case of blackmail and in my mind is unethical, and possibly illegal.  I was told this \nover the phone by his Committee Staffer Cheryl Jaeger.\nJuly 14-22, 2005 – Looks like the Reauthorization Bill is getting some opposition from \nconstituents; however, Barton is trying to ramrod it through.  Zerhouni testified at House \nHearing.  It is still unclear how specifically he orchestrated this.  My sense is that \nZerhouni inadvertently created this monster in that he declared the NIH “broken” when \nhe came in as Director.  All he wanted was a little more power and some money to “be \nsomebody”.  However, Barton seized on this to “be somebody” by radically changing the \nNIH.  Zerhouni may now be left with unintended consequences of his early attempts at \ngetting a bit more power.\nJuly 25 – 29, 2005 – One of the most extraordinary weeks that I have experiences \n(see below)\nJuly 25, 2005 – Briefed Secretary Leavitt on briefing that I will give tomorrow to VP \nCheney on Biodefense countermeasure development.  Leavitt will accompany me to the \nWhite House.  Real good team at the DHHS with Leavitt and Chief-of-Staff Rich \nMcKeown.  They are very good people.  NPR played the piece on “This I Believe” that I \nhad pre-taped for them.  I have received many verbal and e-mail comments from far and \nwide about how moved people were by the piece.\nJuly 26, 2005 – Briefed VP Cheney on Biodefense Countermeasure update for 1 hour.  I \nwas the primary and only briefer.  Present were Sec. Leavitt, Scooter Libby, Carol Kuntz, \nBruce Miller (Carol’s Deputy), Stewart Simonson.  We discussed progress since my last \nbriefing of the VP as well as some of the problems that we are facing with BioShield 1. \nThe Bill does not go as far as we had originally planned and the big companies are still \nnot incentivized enough.  We are left dealing with smaller companies like VaxGen, \nAcambis, and others when we really want to engage the Merck’s and Glaxo-Smith \nKline’s.  The VP loved the briefing and resonated very well with me and the group.\nWhile waiting in the upper West Wing Lobby to go into see the VP, I ran into \nSens. Ted Kennedy and John McCain. Kennedy and I have evolved into a very warm and \ncomfortable relationship over the years.  This is only the 3rd time that I had met McCain, \nbut I never really had a chance to talk to him before.  Had nice conversation about the \nbooks that they are writing.  Ted is writing a book about his dog.  \nJuly 27, 2005 – Busy, Busy day.  Briefed VP Cheney again for 1 hour, this time with Sec \nLeavitt on Pandemic Influenza.  Also, present were Carol Kuntz, Julie Gerberding, \nScooter Libby, Bruce Miller, Rajeev Venkayya,  and some others.  This is a prep for Sec. \nReleased by Chairman Rand Paul\n119predictive of protection.  This is obviously very good news in our comprehensive plan for \npandemic influenza preparedness.  This article in the Times kicked off a very positive \nmedia frenzy with front page articles in virtually every newspaper (it was on the Times \nweb page the night before and so other papers picked it up) including Washington Post, \nBaltimore Sun, Wall Street Journal (Web), AP, Reuters, etc, etc.  I appeared on ABC \nNightly News on Sunday night, NPR’s All Things Considered” on Sunday, CNN \nAmerican Morning on Monday AM.  Very positive “ink” weekend”.\nAugust 17, 2005 – Briefed Secretary of State Condoleezza Rice at the State Dept. on the \nthreat of Pandemic influenza.  Also present were Sec/ Mike Leavitt, Rich McKeown, Bill \nSteiger, Julie Gerberding, Bruce Gellin, Bill Raub, Dan Singer, and a few Assist. Secs in \nDoS.  We gave Dr. Rice a primer on Pandemic flu and also discussed the international \nimplications, particularly related to the recent findings that migratory birds have brought \nH5N1 to chicken flocks in Siberia, Russia, Mongolia, and Kazakhstan and flyways will \nlikely bring it to India and Europe.  She was very gracious and was glad to see me again \nsince I had briefed her a few times on HIV/AIDS and biodefense when she was at NSC\nAugust 19-28, 2005 – Very productive meeting of editorial board of Harrison’s \nPrinciples of internal Medicine (HPIM) – 17 and McGraw-Hill publishers at Spring \nCreek Ranch in Jackson Hole, WY to plan the 17th Edition that will be published in 2008. \nWe returned there after our 1991 planning meeting for a prior edition.  I am the editor-in-\nchief for the 17th and I picked Jackson Hole.  Great choice.  Beautiful weather and above \nall, Bob and Colleen Grady have  a beautiful home there and our girls stayed with them \nwhile Chris and I stayed at the Spring Creek Ranch.  Did fishing (caught several cutthroat \ntrout), hiking and just relaxing, although I worked every day (1 ½ day off) on the book.  \nVery frightening experience when Bob, Colleen, Chris and the girls took a (supposedly 6 \nhour) 12 mile hike on the Teton Crest trail.  A bit reckless on Colleen’s part in that we \nstarted late (1:45 PM) and would have cut it close to get to destination by nightfall.  Trail \nwe difficult, but incredibly beautiful.  Unfortunately, we got lost (wrong turn) and lost >2 \nhours.  We hiked the last hour+ in the dark.  Alison was totally frightened.  We saw up \nclose several bull moose, mountain lion tracks and wolf tracks.  Danger was being \nstranded in the woods overnight with temperatures going down to <40 F every night.  We \nfinally made it to the fire road and out by 9:25 PM.\n August 29, 2005 – Hurricane Katrina totally wrecked New Orleans, parts of Mississippi, \nAlabama and Florida.  Levies caved in  New Orleans and Lake Pontchartrain poured into \nNew Orleans together with the river.  May be biggest natural disaster in USA history.  \nThousands dead and stranded.  Hundreds of thousands of refugees living under terrible \nconditions unable to be rescued.  Cliff Lane and I are planning a consulting arrangement \nwith IDSA and RCEs for infectious diseases.  More to come.\nBird flu activities continue with migratory birds now infected in Russia, Siberia, \nKazakhstan.  Europe worried.\nSept. 2, 2005 – Interesting situation.  Congressman Henry Waxman might use an old \ndocument to help block the Bush nomination of John Roberts to the Supreme Court.  See \nletter in attachment:\nReleased by Chairman Rand Paul\n120\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n126 \nSept .7, 2005 -  Still major disaster in New Orleans, Mississsippi, Alabama.  Likely \nmajor repercussions about lack of ppreparedness on the part of State, local, and Federal \ngovernment in not heading warnings for years that the levees could not withstand a \ncategory 4 or greater hurricane.  In fact, the levees caved in and N.O. was flooded 80%.\nSept. 9, 2005 – Briefed Pres. Bush today in the Roosevelt Room on update in Pandemic \nInfluenza Preparedness.  This was in follow-up of our previous meeting on July 29.  I was \nwith Sec. Leavitt, Julie Gerberding, Bruce Gellin.  On the White House side was the \nPOTUS, VP Cheney, Scooter Libby, Josh Bolten, Scott McClellan, Andy Card, Attorney \nGeneral Alfred Gonzales, Harriet Meiers, Robert Zoellig from DoS, and others.  The \nPOTUS was very engaging.  Half- jokingly he said that “Tony will have to fix this \nproblem for us with his research…”   Another good and productive briefing of the \nPOTUS.  Mention was made about not repeating the errors of Hurricane Katrina \nresponse. \nSept. 14, 2005 – Briefed Carol Kuntz today on the DHHS $7 to 9 billion supplemental \nbudget request for FY2006 for Pandemic Influenza Preparedness.  She wanted my \nopionion so that she could transmit this to the Vice President who wants to know what I \nthink of the feasibility of the request\nSept. 15, 2005 – Accompanied Sec. Leavitt and Bruce Gellin and Julie Gerberding to \nbrief 3 cabinet secretaries today on Pandemic Flu.  Briefed Sec. of VA Jim Nicholson, \nEPA Administrator Steve Johnson and Treasury Secretary Snow.  Got an e-mail from \nFran Townsend of HSC who mentioned that the President has mentioned that he always \nfeels more comfortable when he knows that I am working on important health problems \n(see visit to the POTUS on Sept. 9).\nSept. 19, 2005 – Again, accompanied Sec. Leavitt, bruce Gellin, Julie Gerberding and \nBill Raub to brief Sec of  Agriculture Johanns and Admininstrator of USAID Andrew \nNatsios on plans for Pandemic Influenza Preparedness.\nSept. 23, 2005 – Had very interesting and enjoyable evening at a reception at the home of \nMark and Nicole Wallace in honor of Kristin Silverberg in celebration of her \nconfirmation (a couple of months  ago) as Assistant Secretary for International \norganizations in DoS as well as her birthday.  Present among many others were a number \nof White House personnel such as Michael Gerson, Josh Bolten, Michael Allen, Randy \nTobias (DoS), etc.  Interesting part of the evening were the in depth and intense \ndiscussions that I had with Josh Bolten and Mike Gerson about the difficulties in funding \nthe POTUS’s planned programs over the next few years given the fact that Hurricane \nKatrina will cost over $100 Billion and Hurricane Rita is still percolating in the Gulf of \nMexico.  Important dilemmas – Do you let the deficit explode? Do you cut domestic \nprograms (difficult to do since the amount would be trivial compared to what is needed)?  \nDo you defund the war in Iraq (impossible)?  Do you abandon all or (as I suggested) part \nof the Tax Cut program?  Very enjoyable and interesting evening. The Wallace’s live on \nReleased by Chairman Rand Paul\n1274434 – Hawthorne Street, which is 2 blocks from my house.  Christine Grady \naccompanied me.\nSept. 28, 2005 – Sec. Leavitt, Julie Gerberding, Bruce Gellin, General Gordon (CIA) and \nI briefed a groups of Senators on H5N1 influenza pandemic potential in a “top secret” \nbriefing at the Capitol.  Among the Senators were:  Ted Kennedy, Barrack Obama, Tom \nHarkin, Durbin, Reid, Patrick Leahy, Max Baucus as well as others.  Typical Washington \nphenomenon ensued – two days later they proposed an amendment to a Defense Bill for \n$4 billion dollars for H5N1 preparedness emphasizing buying Tamiflu instead of the \nbalanced Vaccine/Therapy approach that we had suggested.  In addition, they knew (we \ntold them) that we were preparing a big ($7-9 Billion) supplemental request for the HHS \nFY2006 budget for vaccines/drugs.  It was clear that they wanted to trump the \nAdministration since the bill was proposed by Democrats as well as Frist, who is clearly \npositioning himself to run for President in 2008.  I love it!!\nSept. 30, 2005 – Appeared again (many times now) on the Lou Dobbs CNN Show to \ndiscuss bird flu.  He obviously respects me very much.  Of note, lately the DHHS people \nin OC (Bill Hall, Suzy DeFrancis Christina Pearson, and mostly Patti Conrad– I am not \nsure who is the culprit) have been hijacking the media requests for me when we ask for \npermission (routine) to accept.  Usually these are “rubber stamp”; however they are \ntrying to insert the secretary on shows that specifically ask for me.  I feel that this is fine \nsince the Secretary should trump everyone.  However, they are lying about it since they \nare telling us that when they offer up the Secretary, the shows are glad to have the \nSecretary instead of me.  However, I heard directly from Wolf Blitzer of CNN that he had \nspecifically asked for me.  The DHHS people called him up and said that I could not do it \nsince I had a prior commitment and they suggest that the Secretary take my place.  We \nhad made it perfectly clear to the DHHS people that I was totally free and able to do it.  \nThey are really acting poorly.  Why do not they just say that they want to insert the \nSecretary and not lie about it and give the networks the choice of me versus the \nSecretary.  I guess I have no recourse.  At the end of the day it will backfire on them.\nOct. 6, 2005 – A fever pitch is on about the Pandemic Influenza preparedness related to \nthe heightened awareness of the potential, the fact that new cases were seen over the past \nfew weeks in Indonesia, the POTUS giving a speech before the UN General Assembly \nabout the need for international preparedness, the meeting of Sec. Leavitt and I and others \nwith CEO’s off pharmaceutical companies, and a series of briefings that Leavitt, Bruce \nGellin and I have been giving to members of Congress and Senators.\nMany media appearances by me despite the above steering to Leavitt.  Leavitt \nhimself has been terrific.  We are quite a team with the media and the briefings.  \nToday, Leavitt and I briefed the POTUS in the Oval Office at 1:00 PM.  Hot \nsticky day for October.  The POTUS had the usual extremely attentive and warm \nreceptions for me.  He joked that he had mentioned my name at a press conference that he \nheld yesterday and he does that whenever he wants to appear smart.  He just mentions my \nname and people assume that he knows what he is talking about.  We had a few laughs \nabout other things also.  At the briefing were the usual cast of characters including: the \nVP, Andy Card, Josh Bolten Scooter Libby, Dan Bartlett, Scott McClellan, Fran \nReleased by Chairman Rand Paul\n128Townsend, Tevi Troy, Rajeev Venkayya, Candi Wolff, etc.  We briefed him in \npreparation for the meeting that is will have tomorrow in the Roosevelt room with the \nCEOs of Pharma to encourage them to help us prepare for pandemic flu.\nOct. 7, 2005 – More media appearances, NBC, CNN, German TV, BBC, etc.  Leavitt and \nI helped POTUS in the Roosevelt room talk with the CEOs regarding how we can engage \nthem in building a vaccine production capacity.  The POTUS heard from them what I had \ntold him the previous day, i.e. that we much revitalize the production capacity not just for \nH5N1, but we must create a sustainable market and capacity for seasonal flu", "summary": "Watcher-discovered document from paul-readingroom (2026.08.05_Diary-Prequel-_Redacted.pdf), auto-indexed 2026-08-06.\n\nExcerpt: hung up and  Released by Chairman Rand Paul 63mentioned this to Kristen Silverberg.  She knew nothing and immediately called Dan  Bartlett (WH Press Office).  I did not hear what they said; however, apparently what  happened is that the press confronted the WH with the Walters interview and the WH  caved in and admitted to the policy.  The crazy thing is that it has now hit the press, but  the WH will not let us talk about it since the President has not officially announced it.   We still do not really know what the policy will be nor when it will be announced.  More  later! Dec.12, 2002 – Much activity back and forth with the White House and the DHHS  regarding putting the finishing touches on the President’s Statement and the policy in  general.  In particular, Kristen Silverberg and…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/08/2026.08.05_Diary-Prequel-_Redacted.pdf", "pdf_url": "/archive-docs/fauci-files/b5b0ed807aff8eaf2c6607cc328a591e/pdf", "doc_date": "2026-08-06", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-08-05-diary-prequel-redacted"], "part_number": 2, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 3 of 7)", "content": "that will \nthen provide a major head start in the event of a pandemic flu.  CEOs present were: \nDavid Mott of MedImmune, David Williams of Sanofi-Pasteur, JP Garnier of GSK, Dick \nClarke of Merck and Howard Pien of Chiron.  Again, the POTUS was very interactive \nwith me when he came in and left.  He concentrated heavily on the CEOs during the \nmeeting.  Afterwards, Scott McClellan had Leavitt and I give a press conference in front \nof the White House.  Multiple cameras, etc.  I will leave for SE Asia tomorrow with \nLeavitt to visit Thailand, Cambodia, Laos, Viet Nam, and Indonesia.\nOctober 8 – 18, 2005 – Trip to SE Asia as part of delegation of Secretary of HHS \nMichael Leavitt.\nCountries visited – Thailand, Cambodia, Laos, Viet Nam, and Indonesia.  Purpose of the \ntrip was fact-finding in association with the threat of an H5N1 pandemic influenza. \nDelegation included Michael Leavitt, Paula Dobriansky (Under Secertary of State for \nGlobal Affairs), Jong-Wook Lee (Director-General, WHO), Kent R. Hill (Acting \nAssistant Adm. For Global Affairs, USAID), James Butler (Deputy Under Secretary of \nAgriculture for Farm and Foreign Agriculture Service), Suzy DeFrancis (Assistant Sec. \nfor Public Affairs, DHHS), Julie Gerberding, Margaret Chan (Assistant Director general \nand Rep of WHO for Pandemic Influenza), H.E. Changchui (Assistant Dir.-Gen., Food \nand Agriculture Organization – FAO-), Alejandro Thiermann Pres. World Organization \nfor Animal Health – OIE ), Kenneth Bernard (Advisor to WHO Dir. Gen.), William \nSteiger, Kerry Weems (Deputy Chief-of-Staff, DHHS), Vaughan Turekan (Special \nAssistant to Paula Dobriansky), Allyson Bell (Director, Scheduling and Advance, \nDHHS), Jay Hodes and Michael Lonetto (Security).\nPlease see files for details of whom I met and when.  I will list some of my impressions \nbelow.\nMajor impression of the trip was the consistencies as well as the variabilities of \nthe 5 countries visited.  Thailand was certainly the most advanced.  They were taking \nvery seriously cleaning up and keeping clean the commercial poultry industry.  They \nexport chicken (mostly parts pre-cooked) all over the world.  The problem is with the \nsmall farmers who have variable number of chickens in their back yards.  \nThe most disturbing yet very interesting was Cambodia due to a society that was \nstill trying to recover from the Khmer Rouge genocide.  It is a beautiful people; very \nReleased by Chairman Rand Paul\n129sensual looking. Men almost effeminate.  The sexuality of both men and woman stood \nout. (This was also seen to some extent in Thailand.) The Institut Pasteur in Phnom Penh \nis the best science they have there.  \nI was very impressed with Laos.  I expected a stark, Communist-style society.  It \nwas very warm and friendly.  People seemed to look upon us as if we were normally \nthere.  They did not stare, nor did they smille too much.  They were “very normal” \nlooking.  Bill Steiger and I had a terrific time running around the track in the National \nStadium.  The Laotian National Track team was practicing there at dusk and we ran until \nit got dark.\nViet Nam was amazing.  Hanoi was a vibrant, bustling exciting-appearing city.  \nThe most amazing experience was trying to walk across the street with the motor scooters \nand cars going very fast and literally messing into each other from multiple different \ndirections. It was incredible that they did not hit each other continually.  The word from \nthe CDC folks who were with us was that you needed to just cross the street and not look \nor speed up or slow down.  Just cross at the same pace and the scooters and cars will \navoid you.  It was scary.  Haiphong was a different story.  It was more stark and gray.  \nThe Vietnamese women are incredibly beautiful.  We stayed at the Hanoi Hilton – \nbeautiful hotel, run by Vietnamese, but very western. It seems incredible now given the \nenergy, beauty and talent of these people that we could ever had been at war with them \nfor so many years.  Interestingly, they seemed to love Americans.  It appeared to be very \ngenuine.\nIndonesia was similar to what I imagine Hong Kong to be.  Many skyscapers in \nan Asian country.  The polluted stench in the air was similar to (but not quite as bad as) \nDelhi.  \nOct. 8, 2005  (Saturday)– Left IAD \nOct. 9, 2005 – Arrive Bangkok via Tokyo on commercial flight.  Met by Ambassador \nRalph (Skip) Boyce and Health Attaché Jordan Tappero.  Skip was terrific and we hit it \noff very well during the trip.  He knows Jim Huskey from prior DoS activities. He was in \nBeijing with Jim during the Tianman Square incident.  Stayed at Conrad Hotel.   Settled \nin at hotel.  Extremely hot and muggy.  This was just at end of rainy season and we \nexpected rain, but got very little throughout the trip.  However, I can remember the heat. \nVisited with deputy Prime Minister in the ornate, but beautiful Government House.  Of \nnote, the Deputy PM mentioned how happy he was that Thailand offered assistance to \nUSA during the Katrina Hurricane disaster.  Also met with Health Minister Suchai \nCharoenratanakul and Prat Boonyawongvirat Acting permanent Secretary.  Our CDC is \nnot entirely satisfied with the performance of the health ministry.  The Thais seemed to \nbe fixated on whether and how much Tamiflu the USA will give them for their stockpile.  \nWe celebrated the 25th Anniversary of the Thai MOPH – US HHS/CDC (TUC) \nCollaboration.  Had multiple meetings and luncheons with United Nations reps and \nNGOs.  Here and elsewhere, we had numerous Press Conferences.  Suzy DeFrancis \n(Assistant Secretary for Public Affairs) clearly did not want Julie or I in the spotlight (see \nabove comments).  She literally kept the press away from us so that they would \nconcentrate on the Secretary.  The Secretary was cool about everything; Suzy was the \nproblem.\nReleased by Chairman Rand Paul\n130    Had a great reception at Skip Boyce’s house.  Typical Ambassador’s house and party.\nOct. 11, 2005 - Next day we toured a typical commercial poultry farm – Charoen \nPokphand Foods PCL..  Much press.  We all suited up with protective gear (booties, caps, \ngowns, etc.).  The commercial farms are very careful about bird flu and are meticulous in \npreventing infections.  There was no history of infection in these flocks – all infections in \nbackyard and small farm flocks.  We visited a small poultry farm and saw the differences \nbetween commercial and small farms. Had lunch at airport restaurant and took off for \nPhnom Penh, Cambodia\nArrived at Cambodia and checked into Raffles Hotel in Phnom Penh.  Got a \n“Country Briefing” from U.S. Ambassador Joseph Adamo Mussomeli.  He is a very good \nguy – relaxed and friendly, but very competent.  That afternoon and evening we met with \nthe Cambodian Minister of Health – Nuth Sokhom and signed a memorandum of \nunderstanding.  Had a reception at the Raffles Hotel and then to bed.\nOct. 12, 2005 – Series of meetings with officials.  Met first with Minister of Agriculture, \nForestry and Fisheries.  It was clear that Cambodia was far less well-prepared than \nThailand for a bird and/or human pandemic.\n      Met with Deputy Prime Minister and Amb Mussomeli had a firm exchange with the \nDeputy Prime minister in which Joe objected to the fact that the Cambodians had arrested \na Cambodian Journalist for writing a story negative to the regime.\n     Next visited the Institut Pasteur in Phnom Penh.  The Institut Pasteur has 29 foreign \nsatellite institutes throughout the world.  Cambodian institute began in 1935, but was \nwiped out by the civil war and then by Khmer Rouge.  It was re-established in 1995.  \nSirenda Vong is a young scientists at the Institut Pasteur who made a very nice \npresentation about their work.  He is a rising star in my mind..  \n  Lasted only part of a day.\n     Met with King Norodom Sihamoni and toured the Imperial Palace.  The King is an ex-\nballet dancer.  He is single.  \n     Visited the Genocide Museum.  The story is horrible. 1.2 million people (10% of the \npopulation) were murdered, usually following torture over a 5 year period.  After the \nKhmer Rouge took over, they evacuated Phnom Penh and literally murdered anyone who \nwas middle class and/or educated.  They murdered people merely if they wore \neyeglasses.  They had this genocide maniac mentality (similar to the Nazis) of \ndocumenting everything that they did.  The walls of the museum showed thousands of \nphotos of people who were put into the prison (now museum) which was originally a \nhigh school.  They would photograph them, document their arrest, torture them and then \nkill them.  Either they died of the torture, starvation, etc. or they sent them to the killing \nfields to be hacked or bludgeoned to death.  They kept meticulous medical records of the \ndying and deaths of the prisoners.\nWe then visited with a group of NGOs who explained to us the problem of \ntrafficking in Cambodia.  It is a complex problem since the people who are trafficked are \nusually sold by their family because of poverty.\nThat afternoon, we flew to Vientiane, Laos and check into Lao Plaza Hotel.  Bill \nSteiger and I had a terrific evening run (right as the sun set) in the National Stadium \nwhere the Lao National Track Team was practicing.\nReleased by Chairman Rand Paul\n\n131Had a reception-dinner that night at the home of Amb. Patricia Haslach.\nOct. 13, 2005 – Spent day in Vientiane meeting with a variety of Ministers.  Met with \nMinister of Public Health Dr. Ponemek Daraloy.  He is a good person, well-regarded in \nhealth circles in SE Asia.  He is an old Pathet Lao.  Visited Mahoset Hospital and then \nvisited the Prime Minister and the Minister of Foreign Affairs..  Signed MOU.  Met with \nDr. Siene Saphangthong and then in mid-afternoon flew from Wattaya International \nairport to Hanoi, Viet Nam..\nArrived at Hanoi Noi Bai Airport.  Motorcade from airport to downtown Hanoi \nwas fascinating as we passed a bustling suburb with extremely interesting “vertical” \narchitecture of homes and offices.  Checked into the Hanoi Hilton Opera Hotel.\n         \nOct. 14, 2005 – Met with Minister of Health Tran Thi Tring Chien.  Then went to \nNational Institute of Hygiene and Epidemiology and met with its Director Dr. Nguyen \nTran Hien.  He is a terrific person and I sent him a signed copy of Harrison’s after I \nreturned home.\nAlso met with the Minister of Agriculture and Rural Development Cao Duc Phat.       \nAlso, met with Prime Minister Phan Van Khai in a very elaborate Government Palace at \n1 Bach Thao Street, Ba Dinh District with an enormous bust of Ho Chi Minh.  The Prime \nMinister was extremely impressive.  He spoke on all of the issues without notes.  He was \nwell-versed and clearly knowledgeable about specific issues.  Had dinner hosted by the \nMOH.\nOct. 15, 2005 – Great experience.  Visited the “wet markets” in Hanoi and got an great \nfeel for the bustling nature of this vibrant city.  \n     Drove 2 hours 15 minutes to Haiphong and visited Provincial Health Department.  We \nhad lunch at Van Tue Restaurant for Government Officials and then went to Viet Tiep \nHospital to visit their Clinics.  It was in this region that the cluster of cases occurred.  \nMOL visited with the family who got sick and who were featured on CNN a few weeks \nago.  Big difference between Haiphong and Hanoi in that Haiphong is clearly more \ndreary and less vibrant.\nOct. 16, 2005 – Flew to Tan Son Nhat International Airport in Jakarta, Indonesia. Stay at \nFour Seasons Hotel Jakarta.\nOct. 17, 2005 -   Visited NAMRU-2.  Was apparently a problem in that the Indonesian \ngovernment was threatening to cut off dealings with NAMRU-2 because they thought \nthat NAMRU-2 was being critical of them.  We finally sorted it out and at the end of the \nday got the president of Indonesia to endorse NAMRU-2.\n    We met with Coordinating Minister of people’s Welfare and Coordinating Minister of \nthe Economy.  There are issues in Indonesia of difficulty in transparency related to the \ndiffuseness of the country.  17,000 islands with a population of 220 million (4th largest \ncountry by population).\n     Met with President Yudhoyono. He was very impressive and knowledgeable.    \n     Flew from Jakarta to Tokyo on PM of Oct. 17 and arrived in Tokyo on Oct. 18\nReleased by Chairman Rand Paul\n132Oct. 18, 2005 – Flew Tokyo to Dulles Airport.\nOct. 19, 2005 – “Intrigue” at the White House\nUpon return from SE Asia, we have just heard that the overall responsibility for \nPandemic Influenza will be handed over to the Homeland Security Council (HSC) run by \nFran Townsend.  Also, DHS will be playing a more significant role.  We believe that this \nrelates to several factors: 1) the preparedness planning involves multiple agencies and so \nthere is a need for a coordinating entity. 2) The WH is concerned about the fact that it has \ntaken so long to get a plan out and now we realize that we need an Federal Plan (all \nagencies) as well as a National Plan (State, Local, Federal).  3) Anxiety about the failures \nof FEMA around Hurricane Katrina and the need to have centralized control over a \npotential disaster (in this case pandemic flu). 4) WH staff wanting to assert themselves\nAlso, it is becoming more and more obvious how the Public Affairs people at \nHHS are trying to block Julie Gerberding and me from being out front with the Press.  \nThey keep intercepting requests by the Press for me and Julie to put the Secretary out \nthere.  This was seen in SE Asia and again is seen here.  However, there is so much press \ngoing on that I am getting plenty.  They are, however, sucking off the good offers that I \nget (network TV).  In this regard, I am still doing a lot of CNN\nOct. 19, 2005 – Incredible evening.  U2 gave a concert at the MCI Center in D.C.  Bono \narranged for premier tickets for Chris and me.  We met with Bono in the hospitality suite \nbefore the concert and exchanged warm hugs and discussions.  Amazingly, in the middle \nof the concert in front of >25,000 people, Bono dedicated a song (“Miracle Drug”) to me.  \nHe praised me and said that I was doing wonderful things for HIV/AIDS globally and \nthen dedicated the song to me.  After the concert, he invited Chris and me to a private \nreception at his hotel  - The Ritz-Carlton in Georgetown – for drinks and discussion.  \nEveryone was bussing that he dedicated a song to me.  I thanked him and we discussed \nthe need to keep up the PEPFAR program and make sure that we do not stop drugs in \npeople because the program phases out.  There is no sign that the Administration will \nphase the program out after the 5 years are up.\nOct. 20, 2005 – Am wearing thn with exhaustion.  No sooner did I return from SE Asia \nthat I had to go to Chicago to receive the 2005 Scientist of the Year Award from R & D \nMagazine.  Took place at a black tie affair at the Navy Pier in Chicago.\nOct. 21, 2005 – Much press regarding trip and updating on pandemic flu.  The whole \nworld is getting exorcised.  Chickens now infected in Russia, KazakstanChina, Romania, \nTurkey.  Clearly, migratory birds are bringing the disease West.  Was on CNN, C-SPAN, \nNPR, Bloomberg News, etc.\nOct. 24 – 28, 2005 – Hectic week with bird flu and grand jury indictment of I. Lewis \n“Scooter Libby” for perjury, obstruction of justice and making false statements in the \nReleased by Chairman Rand Paul\n133investigation of the leak that Valerie Plame was a CIA agent.  She is the husband of Jim \nWilson who has been criticizing the war in Iraq.\nOct. 24 – briefing by me , Julie, Bruce Gellin and Secretary Leavitt (MOL from here-on) \nof several cabinet members in the Cabinet Liaison Office in EEOB.  Subject – pandemic \nflu.\nOct. 25, 26 – Boston to deliver Baruj Benacerraf Lecture at Harvard and Dana Farber \nCancer Center.  Nice dinner at Harvey Cantor’s house to celebrate Baruj’s 85th birthday.  \nSay Jenny in Cambridge after the dinner on Oct. 25.  Wonderful time with my amazing \ndaughter!\nOct. 27 – continue briefing of Hill members.  Briefed Tom DeLay, Steny Hoyer, and \nothers.  Incredible attention to pandemic flu in this country.\nOct. 28 – Briefed Speaker of the House Dennis Hastert.  The POTUS will unveil the \nPandemic Plan at NIH on Nov. 1.  I have been doing considerable press.\nNov. 1, 2005 – POTUS came to NIH to unveil the National Flu Pandemic Plan. Beustiful \nFall day with crystal clear skies and temperature around 65-70.  I along with Sec Leavitt, \nElias Zerhouni, Julie Gerberding, and others greeted him as he arrived.  During his \nspeech he specifally thanked me for my work.  Attending the speech in Natcher \nAuditorium were several Cabinet Secretaries including Coni Rice, Minetta, Mike \nChertoff, Johanns among others.  With the POTUS was Karl Rove, Fran Townsend \namong others.  POTUS gave a good speech.  Afterwards, I did a media blitch and \nappeared on CNN Wolf Blitzer, CNN Lou Dobbs, CBS Evening News, Charlie Rose and \ndid many print and radio interviews.  Ted Kennedy is concerned about the liability issue.  \nHe agrees that we should give liability protection to the pharmaceutical companies to \nkeep them in the business of influenza vaccine manufacturing.  However, he feels that we \nmust also provide compensation for those that might be injured by the vaccine.  He \nappealed to me to discuss this with the administration.  He followed this up 2 days later \nby having his staffer (David Bowen) call me and get more advice from me about how \nthey could tackle this problem.\nNov. 2 - 3, 2005 – Testified with MOL, Julie G., Bruce Gellin, and Bill Raub at both the \nSenate and House Appropriations Subcommittees for HELP.  We discussed the \nPresident’s Plan as well as the more detailed HHS Pandemic Plan.  We were generally \nwell received, but there was the usual partisan skepticism on the part of the Democratic \nregarding the fact that the Plan asks the States to put up about 75% of the cost for a \nportion of the Tamiflu that would go to them.  The point was made that the States do not \nhave enough resources to do this.  MOL makes the point that this is a co-pay situation \nsimilar to what is done for prescription drugs in Medicare and Medicaid.    Much press.\nBig stuff going on with the indictment of Scooter Libby.  The Democrats are \ntrying to drag in the VP and the entire WH, claiming that there was a wide conspiracy to \ncover-up the fact that the WH distorted intelligence to get us into a war with Iraq and that \nReleased by Chairman Rand Paul\n134Joe Wilson was smeared by outing his CIA wife in order to get back at him for \ndisagreeing with the evidence used for going to war with Iraq.\nNov. 3, 2005 – Top secret meeting at EEOB regarding conduct of certain experiments in \nthe area of developing countermeasures.  Cannot elaborate because of top secret nature of \ndiscussions.  More press regarding Pandemic flu  plan.\nNov. 4, 2005 – Tesitified before the House Government reform Committee with Tom \nDavis Chairing. Same cast = MOL, me, Julie, Raub, Gellin.  This was a tougher Hearing \nin that this Committee is generally tough.  Both the Republicans and Democrats gave \nsome heat to us.  As usual, the tough ones (Chris Shays, Dan Barton, Henry Waxman) \nwere quite deferential to me and so I did fine. Dennis Kucinich made a spectacle of \nhimself by pushing MOL on the issue of taking over Roche’s patent for Tamiflu.  \nKucinich wanted a government takeover and MOL argued that this would be a \ndisincentive for companies to ever make scarce products (MOL is absolutely correct).\nNov. 5, 2005 – Met Senator Bill Frist at the St. Alban’s – St.Stephen’s/St Agnes football \ngame (2:30 PM) at St. Albans field.  Beautiful Fall afternoon.  Temperature = 70 and \ntotally sunny. St. Albans won 42-20.  Frist’s son Brian plays for St. Albans (junior year – \nspecial teams and safety).  Frist discussed a whole range of issues, particularly pandemic \nflu.  He wanted my opinion on the budget bill for flu ($7.1 Billion).  Also, ran into Tim \nRussert at the game.  He told me that he wanted me for “Meet the Press” to talk about \nbird flu within the next couple of weeks.\nNov. 8, 2007 -  Testified before the House Commerce and Energy Committee (Joe \nBarton, Chair).  MOL, Julie, me, Bill Raub.  Topic = pandemic flu.  Somewhat different \ntwist.  Much discussion about funding.  Some Republicans such as Barton feel that we \nshould not have an emergency supplement, but that we should have offsets.  This is \ncontrary to what House Appropriations Chairman Jerry Lewis said at the Appropriations \nHearing (see above).  He feels that it should be new money.\nNov. 9, 2005 – Spirited Hearing before the Senate Foreign Relations Committee on \nPandemic Flu.  I testified along with Julie G., Andrew Natsios (USAID), and Paula \nDobriansky (DoS).  Committee chaired by Paul Lugar.  Present at Hearing were Sens. \nDodd, Biden, Obama, Sarbannes (all Dems.)  They kept pushing Julie and me about “who \nis in charge?”  We explained that it is primarily a health issue and in this regard, Sec. \nLeavitt is in charge.  In the sense that the issue may involve multiple Agencies, this is \ncoordinated through the Homeland Security Council and Fran Townsend is in charge.  \nThey did not like the latter and were pushing for a “Flu Czar”.  We said that this was a \nbad idea.  There was a lot of animated back and forth.\nAfter the Hearing, I met with Olafur Ragnar Grimsson, President of Iceland.  He \nwas referred to me by Congressman Ed Markey (D-MA).  He is sponsoring an Icelandic \nDrug Co (“Actavis”) that makes generics for HIV drugs and he wants to get Iceland \ninvolved in helping out with global AIDS by making 3-in-1 drugs available free to some \ncountries and sold at minimal prices to others.  He wanted my advice.  I strongly \nsuggested that he contact PEPFAR in the form of Mark  Dybul.  I also suggested that he \nReleased by Chairman Rand Paul\n135contact “Doctors without Borders” and Bono’s people (Jamie Drummond).  I will help \nthem out to connect.  They had already approached Bill Clinton and the Clinton \nFoundation, but felt that they did not really have a substantive network.\nNov. 10, 2005 – Frenetic activity continues.  Briefed together with Bill Raub and Julie G. \n(by phone) and Jerry Parker (Stewart Simonson’s Deputy at OEPHP) Secretary of \nCommerce Gutierrez (he is last of the Cabinet Secretaries to be briefed).  Bruce Gellin is \nin Geneva with Stewart for Global Planning meeting for Pandemic Flu.  They stopped in \nParis to visit Institut Pasteur.  This was in the middle of the riots around Paris by Muslim \nFrench Nationals who are enraged at poor living conditions and alleged prejudice in \nFrench Society against them.  \nWe also briefed the House Armed Services Committee and I gave a personal 1-\non-1 briefing to my old friend Sen. Barbara Mikulski.  She was gracious and very glad to \nsee me.  This evening Sec. Leavitt and I and Michael Osterholm (connected from \nMinnesota) did the Nightline Show with Ted Koppel from D.C.\nNov. 20, 2005 – Press still hot and heavy.  I appeared on “Meet the Press” with MOL, \nJulie Gerberding, and Mike Ryan (WHO) about bird flu.  Many e-mails saying that I gave \na great interview.\nNov. 23, 2005 – Press activity still very heavy.  I appeared today on the Diane Rehm \nShow and CNN’s “The Situation Room”.  \n     Michael Osterholm sent me an e-mail saying that he was concerned that I was saying \non the air that the probability of an H5N1 pandemic this winter is low.  He says that \n“health reporters” are e-mailing saying that I am giving confusing messages.  I am \nabsolutely certain that the “health reporter” in question is Laurie Garrett who is \ninherently hysterical.  I am disappointed in Michael since it is very clear that I am saying \nthat the probability of a pandemic (in the broad sense – any new virus) occurring is very \nhigh based on historical precedence.  However, the probability of there being an H5N1 \npandemic of the scale of the 1918 Influenza over the next month or two is low.  \nNONETHELESS, we must assume the worse case scenario and prepare as if it will \nhappen in its worse form and it will happen soon.  I have been very consistent about this.  \nI am actually asking the actuarial and probability people like Don Burke to figure out if \nwe can add some science to this concept.\nNov. 25, 2005 – HHS Flu Summit for States will take place on Dec. 5.  Julie Gerberding \nand I are at collegial “odds” with the DHHS people (Laura Lawlor and John Ogwanobi) \nin that we feel that the Department and the CDC specifically should be the first ones \ndiscussing the Plan.  The Agenda as of today has MOL (as appropriate) speaking and \nthen we bring on Rajeev from HSC, Jeff Runge from DHS, a person from DoA.  Julie \ndoes not come on until after lunch.  Even I (speaking on the science of flu as I usually do) \ncome on before Julie.  There is already concern in Congress and in the Press as to “who is \nin charge”.  I feel that the CDC should be right up front on this.  HHS and MOL are is \ncharge, but the major health instrument for preparedness and response is the CDC.\nReleased by Chairman Rand Paul\n136Nov. 26-30, 2005 – Media continues for me with Lou Dobbs, CNN Wolf Blitzer (The \nSituation Room), WTOP radio, CBS News, etc. regarding bird flu.  \n     The preparation of DHHS for the States Flu Summit on Dec. 5 is a major mess.  Laura \nLawlor somehow has taken over the preparation and it seems that no one knows what we \nare supposed to do.  MOL has taken  a major interest in a 75 city tour of himself, Julie, \nme and perhaps others to tell the States of their “responsibility” to be prepared locally for \na pandemic flu.  Every time this subject comes up, the States push back by saying that \nthey have no money and the Federal Government is giving them an unfunded mandate.  \nWhat I see is a clear example of a Secretary who is a good person who has gotten too \npersonally involved in an issue and who is doing some of the planning off the top of his \nhead and as a result there really is no one truly in charge of making sure something is \ndone correctly.  Everyone on his staff (John Ogwanobi, Suzy DeFrancis, Kerry Weems, \netc.) is afraid to say that the 50 states tour is likely to be a disaster.  They are like a Greek \nChorus telling him in this case that it is a good idea.  They do not know what the goal is \nor even why they are doing it.  I strongly suspect that Suzy DeFrancis deep-down thinks \nthat this is a campaign swing and , frankly, MOL does also to some degree.  I have told \nStewart Simonson and Bruce Gellin that I feel it would be a disaster.  I do not want to be \na part of it and have asked Stewart to tell Rich McKeown this.  Rich is the most sensible \none there and so hopefully I can get out of most or all of the tour.  They want me for my \ncredibility, but this is local and state public health stuff, which is not my area.  Also, I am \nhearing that the White House knows how disorganized they are and are getting anxious\n   The attacks in the press on Stewart Simonson seem to be winding down, but Sarah \nLuecke of the WSJ will be coming out with a big article.  I have spoken to her and \nhopefully she will give a balanced story.\nDec. 1, 2005 – World AIDS day.  I was invited by the White House to be a Principal at \nthe POTUS Speech (EEOB 450).  As with last year, the POTUS specifically recognized \nme as being in the audience for all of the work that I have done in AIDS.  Peter \nMugyenyi from Uganda was there as was an AIDS mother from South Africa and her 2 \nchildren who had benefited from the PEPFAR program.. \n    Had coffee with Julie Gerberding after the ceremony at Starbuck’s on Pennsylvania \nAvenue and she feels exactly the way I do about the States Summit and the “tour” (see \nabove).\nDec. 2, 2005 – Had pre-Table Top preparation at HHS with MOL, Julie Gerberding, \nStewart Simonson, Bill Raub, Bruce Gellin, Jesse Goodman, Rich McKeon and the entire \nDHHS staff.  I  have concern over these exercise since they are unrealistic and always \nmake everyone look bad.  I tried to interject some common sense into the discussions, but \nthere were too many people who were acting like they knew what they were talking \nabout.  I generally do not like those “group” briefings of the Secretary since everyone \ntrials to look smart and few people have a clue of what is going on.\n    That evening, went to an incredible affair at the Kennedy Center with Christine. It was \nthe Grand Opening of the Family Theater sponsored by the Catherine B. Reynolds \nFoundation Series for Artistic Excellence.  After the show which included extraordinary \nsuperstars, we had dinner on the stage of the Eisenhower Theater!!.  It was incredibly \nelegant and all the Washington Glitterati were there.  At my table with Chris was David \nReleased by Chairman Rand Paul\n137Rubenstein of the Carlyle Group, Super-Attorney Bob Barnett, UNICEF President Ann \nVeneman, Former Sen. John Breaux (D-La), Rita Braver (producer for CBS).  At the \ndinner were every media and politico you could imagine.  The dinner was amazing and \nwe all had a great time.\nDec. 5, 2005 – Big meeting (“Summit”) at the Grand Hyatt in DC to roll out the plan to \nvisit all 50 states to talk up pandemic flu preparedness.  Present were health officers of \nthe big cities and all the states.  Presentations by MOL, Julie Gerberding, me and the \nusual cast of characters.  I am very anxious since MOL wants to take me with him on the \ntour to visit 75 locations in all 50 states to talk up preparedness.  I just do not have time \nfor this.  Stewart Simonson and even Rich McKeown are aware of this and are trying to \nget me out of it.  However, MOL is so enamored of me that he wants me with him.\nDec. 6, 2005 – Strange article (Profile of me) on the front page of the Wall Street Journal \nby Bernie Wysocki.  It made it look like I have 100s of millions of dollars of biodefense \nmoney that I dole out at my whim to contractors.  The article was very likely (almost \ncertainly) instigated by the lobbyists from BioPort (AVA anthrax vaccine) and from \nHollis Eden (countermeasures for rad/nuc) who want contract money and did not get it.  \nThe article was extremely confusing since it mixed up what we do (research) and what \nHHS does (procure via BioShield).  Also, it made it look like there was no peer review \nand that I just hand out money to the “Fauci Club”.\nDec. 16, 2005  Paradoxically, mostly favorable responses to the WSJ article.  Most \npeople interpreted it as indicating that I was a powerful player.  Publicity dying down \nabout bird flu around holidays.  MOL went on the first of the State trips to Minnesota.  \nWith the help of Rich McKeown, I got out of the trip.  Julie Gerberding went and feels as \nI do that these series of trips will be a waste of time for us.\nArticle came out in WSJ by Sarah Lueck on Stewart Simonson with major quote \nby me defending him.  It was a fair article and will likely reverse the trend of bad press \nthat he has been getting as being the “Michael Brown of Public Health preparedness”.  \nWent to the VP’s mansion for a Christmas Party on Dec. 15 and then went to \nLessons and Carols at the National Cathedral right afterwards.  Took Stewart Simonson \nand his parents (who are in town for the holidays).\nDec. 16-31, 2005 – Reasonably calm.  Still doing press regularly related to pandemic flu. \nOn Dec. 27, 28, 29 did Today Show, Good Morning America, and CNN “The Situation \nRoom”, respectively.  Bush popularity polls going up slightly after a terrible year related \nto Iraq, prison abuses, Valerie Plume leak (Scooter Libby, Karl Rove), Katrina, etc.  \nPOTUS speaking more to the press and admitting more that certain things have not gone \nwell.  Am still trying to be low profile in requirement to travel with MOL on his 50 State \ntour.\nDec. 27-28, 2005 – Drove up to NYC with Chris and the girls to do Christmas \nsightseeing and to visit my father who does not travel down to DC/VA for the holidays \nthe way he used to do years ago.  Had a great time.  Went to Bryant Park around 42nd \nStreet and 5 Avenue (near NY Public Library and saw the Kenneth Cole tented exhibit in \nReleased by Chairman Rand Paul\n138the Park.  It was a series of photos and plastic molds of foot imprints of people who had \ndevoted themselves to fighting the AIDS epidemic.  My footprint was up there along with \nAngelina Joli, Brad Pitt, Whoopie Goldberg, Larry Kramer, Bono and a large number of \nother notables.\nDec. 31, 2005 – Carol Kuntz took Chris, me and the girls on a private tour of the West \nWing.  It was terrific.  I got an interesting new perspective of the place since I have been \nthere so many times over the past several years that I take it for granted and never really \n“look around”.  It was great to have a personal tour and take my time looking at rooms \nand furniture, some of which I have sat in when briefing the POTUS and others.\nJan. 4, 2006 – Met with David Rubenstein, Founder and CEO of The Carlyle Group.  He \nmade me an amazing offer to join the firm as head of a Medical Venture Capital \ncomponent of the Group. Compensation projected to be in the millions per year with a \nbase salary of $1 million!  Obvious question is whether I want to get out of the classical \nscientific/public servant arena.\nJan. 26-29, 2006 – Attended the World Economic Forum in Davos, Switzerland to \nparticipate in 2 events: 1) a dinner panel discussion on Pandemic Influenza and 2) a \nplenary panel moderated by Ira Flatow (NPR – “Science Friday”) on Pandemic Influenza.  \nOther panel members included David Nabarro of WHO, David Stout of Glaxo-Smith \nKlein, the Minister of Health of Spain.  The meeting was unexpectedly enjoyable in that I \nwent to “close-up” panel discussions, breakfasts etc with people like President \nMuschaaraf of Pakistan, President Karzai of Afghanistan, Bill Gates, Bono, Queen Rana \nof Jordan, Bill Clinton, a number of journalists, etc.  I was particularly impressed by \nleaders such as Karzai and Muschaaraf.\nThe activity and press interest in Pandemic Flu has calmed down somewhat with \nother issues in the news (Supreme Court Justice Sam Alito confirmation, Iraq, the Hamas \nelection victory in Palestine, etc.)  Yet I still did a few CNN broadcasts from Davos.\nFeb 3, 2006 – Attended Distinguished Lecture Series at Hilton Hotel with Chris.  Lecture \nby Bono to a crowd of several thousand in the Hilton Ballroom.  Bono spoke about his \nvision, etc.  He stopped during the talk to recognize me in the audience as a “hero” of his \nwho has done an enormous amount for global HIV/AIDS, particularly in being the main \nplayer working with President Bush in developing PEPFAR.  Then several times \nthroughout the speech when he mentioned global health or AID he would look in my \ndirection and mention my name saying something like “I am sure that Tony would agree \nthat….”  Bono has been incredibly generous to me in his public recognition of me.  He \nalso mentioned that the USA and the world should support his “One Campaign”.  Of \nnote, Jenny (Fauci) is a leader among the Harvard students in the One Campaign efforts.\nFeb. 3 – March 6, 2006 – Continued intensive interest in the potential for an H5N1 \npandemic influenza with several media appearances. Also, I testified on March 2, 2006 \nbefore the House Appropriations Subcommittee for Foreign Operations together with \nJulie Gerberding, Kent Hill (USAID) and Ambassador Nancy Powell (DoS).  Did Diane \nRehm show in addition to other media.  Spent an 90 minute lunch briefing the \nReleased by Chairman Rand Paul\n139Washington, D.C. Bureau of ABC News (particularly George Stephanopoulos’s people) \non bird flu.\nMar. 7, 2006 – Gave laudatio remarks at a reception in the Dirksen (430) Building at \n6:00 PM (beautiful crisp Winter day) in honor of Peter Piot who was celebrating 12 years \nat UNAIDS.  I reflected about his early days at Projet SIDA in Kinshasa, Zaire with Tom \nQuinn and Jonathan Mann.  Also, honored at the reception was Michael Iskowitz, \nformerly Sen. Kennedy’s Staffer, former White House AIDS Deputy Coordinator and \nrecently at AIDS Action.  He is entering a private consulting arena.  Met and spoke with \nSen. Hillary Clinton who recognized me specifically in her remarks.\nMar. 8, 2006 – Took quick trip to NYC to brief the NY Bureau of ABC News with \nDavid Westin (President) hosting me.  Afterwards, rushed back to DC to do a \nteleconference with the officials from all of the DC area (MD and VA) school officials \nfrom private high schools.\nMar. 12, 2006 – Had tea at the Four Seasons with members of the Mothers to Mothers to \nbe (M2M2B) an African Program founded by Dr. Mitchell Besser (Rich Besser’s brother) \nand involving HIV-infected South African women who have delivered babies (some \ninfected, others not) and who now work with other mothers to be who are HIV-infected \nto educate them, empower them and help them live a positive life.  They are visiting the \nUSA at the request of First Lady Laura Bush stemming from her trip last year to Africa \nwhere she met these women.  The Mothers Program is partially funded by PEPFAR.  I \nwill Chair a panel discussion at Georgetown tomorrow where the women will discuss \ntheir work.\nMarch 13, 2006 – Presentations at the White House (East Room) with Laura Bush and \nRandy Tobias followed by brunch in the State Dining Room. Mrs. Bush thanked me for \nserving as the Panel Chair.  Had good conversations with Kristen Silverberg, Randy \nTobias, Michael Gerson, Carol Thompson and other White House folks.\n   After the presentations at the White House we went to Georgetown (Healy Building – \nGaston Hall) for the panel discussion.  It was a beautiful sunny an unseasonably hot (84F) \nday for March 13.  Other members of the Program were Gene Falk and Robin Smalley.\nMar. 21, 2006 – First day of Spring 2006.  Had phone conversation with Carol Kuntz \ntoday and she was concerned that there have been “policy time” briefings with the \nPOTUS regarding pandemic flu involving Sec. Leavitt where she thought that I should \ndefinitely have been included.  The POTUS asked some questions that Rajeev Vankaaya \nand Leavitt could not answer that Carol knew for sure that I would have been able to \nanswer.  Carol asked whether I was having a problem with HHS.  I told her not at all, but \nI did mention to her my suspicion that HHS is trying to shed all of the light on Leavitt \n(probably because of his political aspirations) and having him share the spotlight with me \nor Julie Gerberding is something that makes HHS nervous.  We continually see this when \npress ask for me and HHS diverts them to Leavitt when we ask them for clearance for \nme.  Welcome to Washington!!\nReleased by Chairman Rand Paul\n140April 3, 2006 – Over the past 2 weeks, there has been continued medium-high interest in \nthe ever expanding bird flu situation with a constant low-level stream of new human \ncases and more countries getting either migratory birds or chicken flocks infected.   \nCurrent number are 188 infected and 103 dead.  Recently, there has been migratory birds \n(mostly swans) infected with H5N1 detected in Western Europe.  France as only country \nwith some domesticated chickens and turkeys infected.  They quickly handled it by \nculling.  Other countries such as Italy had migratory bird(s) infected, but no chickens and \nstill chicken sales in supermarkets and restaurants has plummeted by as much as 50 to \n60%.  My prediction is that infected migratory birds may (not definitely) make it to USA \nand that there will be very little contamination of chickens because of the agriculture \ncontrols.  Yet, it will affect (by misperception) the chicken industry.  \n    There has been some backlash among people in press about the over-hyping of the \nthreat.  I am in good shape here since I have always maintained that the threat, although \nnon-quantifiable, is likely low.  This is in contrast to others such as Rob Webster, who \nsays that there is a 50% chance that we will have a bird flu pandemic among humans with \nH5N1!!!   I have no idea how he came up with that number.  Also, my friend Michael \nOsterholm is also singing doom and gloom.\nApril 6, 2006 – Had dinner with Tara O’Toole of the Univ of Pittsburg Biodefense \nProgram.  She had just testified at the BioShield Hearing on the Hill and wanted to get \nmy perspective on how things were going with the Biodefense effort and if there was \nanything that she could do for me.  I explained to her that the reason the  current \nBioShield effort was not successful was that the Congress did not approve the Bill that I \nand VP Cheney and Scooter Libby had originally proposed.  The Congress limited the \nmoney to $5.6 Billion instead of an unlimited authorization to draw from the Treasury \nand the Appropriations Committees still controlled how much could be spent each year.  \nAlso, we could not do advanced development for products.  This put off the big \ncompanies (not enough money) and the little companies (advanced development) and so \nthe process has not been entirely successful.  We are attracting marginal companies like \nVaxGen that cannot get to the goal post. \nApril 8, 2006 – Attended the Annual Gala of the National Hospice Foundation at the \nHilton Hotel on Connecticut Avenue, N.W. where I presented the Global Vision Award \nto Ambassador Richard Holbrooke. At my table were Holbrooke, Margaret Warner from \nthe NewsHour, her husband John Reilly, Ann Morgan Vickery  and Bob Kyle of Hogan \nand Harston.  Usual gala-like atmosphere.  Has a chance to catch up with Richard \nHolbrooke, who is currently the President and CEO of the Global Business Coalition on \nHIV/AIDS.  We reminisced about our trip to Africa with Tommy Thompson in 2003.\nMay 2, 2006 – Dedicated Building 33 as the C.W. Bill Young Center for Biodefense and \nEmerging Infectious Diseases.  Terrific ceremonies with speakers being: me, EZ, \nSecretary Leavitt, Ralph Regula, Bill Young.  Tour of building, many festivities, \nbeautiful sunny day.  \nMay 24, 2005 – Have had continual trickling in of cases of human infections with H5N1 \nwith most recent count of 218 cases and 124 deaths.  Fifty countries now have birds \nReleased by Chairman Rand Paul\n141infected and 10 have birds and humans infected.  Of note that about 1-2 weeks ago it \nbecame apparent that there was a family cluster of 7 cases in Sumatra, Indonesia.  Recent \nevidence strongly indicates that this was human-to-human spread similar to the small \ncluster in Thailand in 2004 where 11 year old girl infected her mother and aunt who \nnursed her in the hospital before she died.  Similar situation in Sumatra where father \nnursed 10 year son and others in family slept in small room while one or 2 people were \ncoughing all night.  Bottom line was a media blitz.  I was asked by HHS and White \nHouse to go to “Pebble Beach” on the  White House grounds and do wall-to-wall \ninterviews to allay fears.  Fact is that the cluster looks like it is dead-ending.  I did \ninterviews with NBC Evening News, CBS Evening News ABC World News tonight, \nNightline, CNN Wolf Blitzer Situation Room, WTOP radio, MSNBC TV, etc.  Big time \nexposure.  HHS was very pleased with how I handled this volatile situation.\nMay 25, 2006 – I have not been recording this type of thing of late even though I have \ngone to several of these, but I went tonight to the 18th Annual National Education & \nLeadership (NELA) Awards Gala at the Omni-Shoreham given by the Sons of Italy.  I \nwas the guest of Chuck Conconi (Washingtonian Magazine, formerly columnist for \nWashington Post) and his wife Janelle.  At the Table were Ed Henry (CNN White House \nCorrespondent), Lloyd Hand, Mike Petruzzelo (Managing Director of Qorvis \nCommunications) and Mr. Thompson (?first name) African American billionare and his \ndate Cheryl Lee (CEO of BET).  Pres. Clinton and Hillery Clinton were guest speakers.  \nRan into the usual DC crowd – Sen Chris Dodd, Congresswoman Rosa DeLauro, Franco \nNuschese (Owner of Café Milano – who was also an awardee), etc.\nJune 11 – 17, 2006 –  Went to Tuscana with Chris and the girls for a few days and then \nwent on to Genoa for the annual review of the Gaslini Institute.  Wonderful time had by \nall.  Stayed in an amazing converted farm house (to a villa) owned by a friend of Jim \nHuskey’s from the Embassy in Florence.  The weather was amazing – warm and totally \nsunny during the day and cold at night requiring a fire in the fire-place and blankets in \nbed. Sunsets over the Tuscan hills with a glass of chianti was incredible.\nJune 20, 2006 -  Did a one hour face to face briefing of VP Cheny in his West Wing \noffice on pandemic flu.  Also present was Carl Kuntz, David Addington (new chief of \nstaff replacing Scooter Libby and Scott Diechman (new health person for the VP).  As \nusual, it was a lively briefing.  It is clear and Carol told me that the VP has said this that \nthe VP very much looks forward to being briefed by me.  The day was a typical hot \nsunny 90 degree day in DC.\nJuly 26, 2006 – Has been a busy few weeks with relatively mundane institute issues. \nWeather has been very hot - ~95+ degrees. Two days ago David Stout and Jean-Paul \nGarnier from Glaxo-Smith Kline called and briefed me on the great success of their \nH5N1 clinical trial using their proprietory adjuvant ASO3.  They got terrific results with \n3.8 micrograms X2 with adjuvant giving predictably protective responses in >80% of \npeople compared to the Sanofi study (see above) that gave predictably protective \nresponses at 90 micrograms X2 without adjuvant in only about 50% of people.\nReleased by Chairman Rand Paul\n142    I spent the greater part of July 26 with the press (mostly print – NY Times, \nWashington Post, USA Today, AP, Phil Inquirer, Bloomberg, Baltimore Sun, etc) as well \nas CNN (Christy Feig).  This is an important advance in trying to prepare for a pandemic \nflu since it seemingly overcomes the obstacle of a prohibitive requirement of high dose.\nJuly 27, 2006 – Went to NYC to participate in the Pandemic Flu Summit at City Hall.  \nPart of Secretary Leavitt’s program of visiting every state and some additional cities \nwithin states to talk about pandemic influenza preparedness.  Mayor Michael Bloomberg \nhosted us.  Secretary Leavitt spoke about the history of the 1918 pandemic in Utah and \nsaid that he came from a small town.  When it came to my turn to talk about the science \nof pandemic flu, I told the Mayor and the audience that I came from a small town called \n“Bensonhurst” and I brought the house down.  I mentioned that my father was born a few \nblocks away on Elizabeth Street and Grand Street in Little Italy.\nThe day was sweltering hot and sunny.  I got an exciting ride back to LaGuardia by an \nattractive young security woman named April who works in the regional office of the \nInspector General of HHS.  She got me through traffic with sirens and blinking lights to \ncatch my 3:30 PM Delta Shuttle in order to get to DC in time to pay respects at the \nretirement party of Carol Kuntz at the White House.  In her office in private, I gave her a \ngift of a statuette of Dr. Joseph Kinyoun with the inscription: “To Carol R. Kuntz With \nappreciation from your friends at NIAID”  She burst into tears.\nAugust 15-16, 2006 – Things have been fairly uneventful since last entry (July 27).  I \nwas one of the featured panelists at the 16th International AIDS Conference in Toronto on \nAugust 16.  The session was “25 Years of AIDS – Reflecting Back and Looking \nForward”.  Each of us gave a 7 minute presentation followed by a panel discussion.  I \nspoke on the “Scientific Response”.  Also presenting was Peter Piot of UNAIDS, H. \nBroadbent (AIDS patient), Gregg Gonsalves, and E. Madraa (African Community \nperson).  Session Moderated by Richard Horton, Editor of Lancet, and chaired by Mark \nWainberg and Helene Gayle (organizers of the conference).\n      There were 30,000 people at the conference and about 6000-7000 people in the \naudience for our session.  Of note, a group of USA activist wanted to protest the fact that \nthe USG was spending $90 million dollars on prevention this year and they thought that \nall that the USG was doing was purchasing the Orasure quicktest for HIV.  In fact, they \nwere incorrect and a good part of the $ was going for actual prevention education.  The \ngroup was very nice and almost apologized for disrupting my session.  They stormed on \nstage with the usual chanting and signs that said “George, listen to Tony” and “This is \nonly a test!” (referring to the Orasure test).  They disrupted me for the agreed-upon 2 \nminutes and then let me give my talk.  I started the talk by saying “Thank you for the \nkind introduction” and the audience laughed.  The talk was very well received.  The \nmajor theme of the meeting was “Time to Deliver”, but the real theme was prevention.  \nThe meeting was opened by Bill Clinton and Bill and Melinda Gates.  I did a lot of press \nduring the meeting and after I returned (Diane Rehm Show).\nAugust 28-29, 2006 – Went to Amsterdam for the AIDS Vaccine 2006 Annual Meeting.  \nInvited by Joep Lange.  On the evening of Aug. 28 I was part of a “Town Hall” – type \nmeeting in Amsterdam where we discussed “Viral Threats”  The panel consisted of Ab \nReleased by Chairman Rand Paul\n143Osterhaus of the University of Rotterdam, Marie-Paul Kieny from WHO, Jaap Goudsmit \nfrom Crucell.  It was moderated by a Dutch TV anchor.\n   I gave the Opening Ceremony Keynote lecture on the evening of Aug. 28 and provided \na “provocative” talk on “An AIDS Vaccine:  Will It Ever Fit the Classical Paradigm?”  It \nwas extremely well-received by an audience of about 1000.  Others that took part in the \nOpening Ceremony were Job Cohen (Mayor of Amsterdam), Hans Hoogervorst (Dutch \nMinister of Health), Princess Mabel van Oranje-Nassau (Director, EU Affairs, Open \nSociety Institute), Jean-Francois Rischard, Former VP of the World Bank, and David \nSalisbury (Director of Immunization, UK Department of Health).  We had a beautiful \nboat ride down the Amstel River to the Maritime Museum followed by dinner with all of \nthe speakers and Joep Lange at the Amstel Hotel.  Charming evening, but the weather \nwas raining and cool.\nSept. 3, 2006 – Had a most interesting dinner over Ellen and Gerry Sigal’s house in DC. \nGuest were Sherry Lansing (Hollywood producer – “Fatal Attraction”, Black Rain” and \nformer actress) and her husband, Billy Friedken (Multiple Academy Award winning \nProducer, Director and Writer – “Exorcist”, “The French Connection”, etc. )  He is now \nproducing (successfully) operas all over the world.  Also there were Joe Wilson, the \nambassador involved in the big Washington issue of the Administration “misleading” the \nAmerican public about WMDs in Iraq and his wife Valerie Plame , the CIA secret agent \nthat was “outted” by Robert Novack’s column and for which Scooter Libby has been \nindicted for perjury.  It was a most interesting discussion.  Valerie and Joe seemed like \nvery nice people despite being trashed by the Administration.  Valerie insisted that she \nwas still under cover despite the fact that it is reported that she had a desk job when she \nwas outted.  Joe, as he has said on TV multiple times, feels that the WH officials are all a \n“bunch of liars”.  Also present were Washington power-lawyer (Watergate, Whitewater, \n9/11 Commission) Richard Ben-Veniste and his wife Donna.\nSept. 12, 2006 – Went to farewell reception at the Atrium of the Equinox Restaurant in \nDC for Michael Gerson (former speechwriter and current Assistant to the President).  \nReception given by DATA (Bono’s group)  Saw old friends their such as Erin Chapman \nThornton and Jamie Drummond from DATA.  Mike is going to do a regular column for \nthe Washington Post and Newsweek.\n     Later in the evening went to an “Alliance for Aging Research” dinner and awards \nnight at the Four Seasons Hotel in Georgetown at the invitation of Allan Fox of FoxKiser \nLaw Firm (old friend – formerly of Jacob Javits and Ted Kennedy staff).  Dinner honored \nSens. Orin Hatch and Evan Bayh.  During Hatch’s remarks, he specifically mentioned \nthat he and I were dear friends and that I am one of the great heroes in medicine and \npublic health.\nSept. 13, 2006 – I played a major role in the 90th Birthday Party for Dr. C. Everett \n(Chick) Koop at the Cosmos Club.  I delivered remarks.  The 2 MCs were Hilary Clinton \nand Orin Hatch.  My friendship with Sen. Clinton grows as she continues to be very kind \nand warm towards me.  I roasted Chick a bit, and the audience loved it (see my written \nremarks).\nReleased by Chairman Rand Paul\n144Sept 25-27, 2006 – Trip to San Francisco for International Assoc. of Physicians for AIDS \nCare  (IAPAC) and ICAAC meetings and to speak at The Commonwealth Club.  I gave \ntalks on HIV/AIDS – the next 10 years (ICAAC); the decade of HAART (IAPAC) and \nemerging diseases (Commonwealth Club).  The talks and the trip was a roaring success.  \nGreat weather, spent Sunday with Bob and Colleen Grady and Matthew and my family \n(minus Jenny in Brazil).  Great hotel in SF – the “W” across the corner from the Mosconi \nCenter\nOct. 10, 2006 -  Attended the swearing in ceremony for Mark Dybul as the U.S. AIDS \nCoordinator with the Rank of Ambassador at the State Department (Benjamin Franklin \nRoom).  Presiding was Secretary Condi Rice with Laura Bush present.  I was given a \n“seat of honor” in the first row – sat next to Michael Gerson (former speech-writer for \nPres. Bush).  During her remarks, Condi specifically mentioned me – telling the story of \nhow this all started (PEPFAR) years ago when the POTUS had his staff including Condi \nin the Oval Office and the POTUS was told by Tony Fauci, who is here with us today, \nthat a lot of progress has been made in the treatment of HIV disease so that we could \nhave a global impact.\n    The day was a beautiful Fall day – bright sun and 75 F.\nOct. 19, 2006 – A lot of political maneuvering regarding the election of the next \nDirector-General of WHO  \n Kristen Silverberg (now at State as Assistant Secretary) asked me \nabout it at a dinner at Mark Dybul’s house the day before his swearing in (see above).  \nThe 2 candidates that I prefer are either Margaret Chan (Hong Kong) or Julio  Frenk \n(Minister of Health of Mexico).  Shigeru Omi from Japan, Bernard Kouchner from \nFrance (MSF), and Pascoal Mocumbi (Mozambique) are also among the contenders.  \nChristopher Murray from Harvard called me today to push for Julio Frenk since he feels \nthat he is the one who understands best the connection between science and public health.  \nHe knows that the White House has been and will contact me for my opinion and so that \nis why he called.\nOct. 20, 2006 – Served on a Panel at the Annual meeting of the White House Fellows \nFoundation and Association held at the Chamber of Commerce.  Subject was \n“Community Engagement and Preparedness” relating to terrorist and natural disaster \nthreats.  On panel with me was Lee Hamliton, former co-chair of the 9/11 Commission \nand Patricia McGinnis, President and CEO of the Council  for Excellence in Government.  \nHad nice conversation with Lee Hamilton who is the Director of the Woodrow Wilson \nCenter in DC (he has been a friend for a few years).  Lee has been asked by President \nBush to join with James Baker to come up with some alternative approaches to settling \nthe quagmire in Iraq, i.e. a mid-course correction.\nOct. 21, 2006 – Went to NIAF annual dinner at the Hilton Hotel with Chris.  Usual \ncelebrity show. Many friendly interactions with media (David Gregory of NBC; Sam \nDonaldson of ABC;  etc).  Hilarious impersonation of George W. Bush by comedian.  I \nreceived this award in 1994.  Major awardee tonight was Supreme Court Justice Samuel \nAlito.\nReleased by Chairman Rand Paul\n\n145Oct. 22, 2006 – Went to the Grand Opening of the House of Sweden (Swedish Embassy \nplus offices and art shows) on Georgetown Waterfront (right next to Sequoia restaurant).  \nKing Carl Gustav and Queen Sofia were greeting everyone.  Amazingly beautiful \nstructure with views of the canal and the Potomac. Crisp Fall night with bright stars.  Of \nnote, Queen Sofia asked specifically to speak with me after the greeting line finished \nsince she had been told of my work with HIV/AIDS.  She is committed to helping Russia \nwith its problem of HIV since she feels that the Russians would be more amenable to \ngetting help from the Swedes than from the USA.  She wanted to talk about how we (she \nand I ) could work together on this.  Had good discussion with Kristen Silverberg about \nthe problems the Administration is having.\nNov. 28, 2006 – Attended and spoke at the Aspen Symposium in DuPont Circle (DC).  It \nwas an unusual gathering of Iranian scientists meeting with various US officials, \nparticularly in the Dept. of State and HHS.  I was a main speaker and exchanged \ninformation with Iranians on HIV/AIDS, TB, and other diseases in Iran.  It was \nsurprisingly frank and open given the tense relations between USA and Iran surrounding \nthe Iranian nuclear program.  If fact, the Iranians who came to the USA were a bit \nnervous about the political fall-out for them.  I dealt with Kamiar Alaei and his brother \nArash Alaei on ID issues in Iran. Also present was Dr. Abolhassan Nadim, the Chair of \nthe Iranian Epidemiological Association.\nDec. 2, 2006 – Annual Christmas Party at Sam and Jan-Smith Donaldson’s House in \nMcLean.  Have been going to these parties for at least the past 10 – 15 years.  The usual \ninteresting and warm crowd was there.  This party is probably the most friendly of all of \nthe D.C. “glitterati” parties, mostly because of the warmth and friendliness of Sam and \nJan as well as the fact that the same people come every year +/- whoever is hot at that \ntime in the news. Over the years, we have run into virtually everyone who is “known” in \nDC.  Some highlights from this year.  Nice conversation with Colin Powell about AIDS \nin African-Americans.  The recent UNAIDS numbers are out showing that of the new \ninfections in the USA, among men, 50% are in Blacks and among women 65% are in \nBlacks.  On Nov. 30, I was supposed to be on the CNN Paula Zahn Show speaking about \nthis, but at the last minute, their producer (Marie….) cancelled because she said that they \nhave a guest who is really the “face of AIDS, since she got infected from her boyfriend \nby heterosexual sex”.  Turns out the guest is Regan Hoffman, the editor of POZ \nMagazine.  Regan is a beautiful, blond, blue-eyed WASP from Connecticut who clearly \naccidentally got infected from her white boyfriend who was almost certainly bisexual. \nFor every one of these, there are 10,000 poor black girls in an inner city area who got \ninfected from their drug-user boyfriends.  So there they were: beautiful, blond, blue-eyed \nand wealthy Paula Zahn speaking on TV with beautiful, blond, blue-eyed (likely also \nwealthy) Regan Hoffman smiling and saying how grateful she is that she has all the \nopportunities for treatment.  Her only “concern” is that the mother of her new boyfriend \nwas concerned that she was infected; but now all is well because the boy’s mother is an \n“educated person”.  I had watched this on TV and almost vomited.  This was as far from \nthe reality of what the “face of AIDS” is than I could ever imagine.  On Nov. 29 at a big \nHIV Prevention Meeting at the Mandarin Hotel in DC chaired by John Bartlett of \nReleased by Chairman Rand Paul\n146Hopkins and Ken Mayer of brown, one of the themes and the points that I made in the \npress conference is that AIDS in the USA was assuming the face of a young black \nwoman.  My good friend Phill Wilson (CEO of the Black AIDS Institute in LA) gave an \neloquent talk on this subject and he should have been with me on CNN instead of my \ngetting bumped by Regan.  I was pissed because that one 5-10 minute segment on Paula \nZahn likely undid by 100-fold the points that I and Phill were trying to make at the \nconference.  I had mentioned this to my CNN Producer friend Christy Feig and she was \nalso appalled and has since brought it up to the CNN Board.  In any event, at Sam’s \nParty, I was still pissed and discussed this with Powell who has been spending time on \nthe lecture circuit talking about prostate cancer, particularly in black men.  His comment \nwas “What do you expect?…. It is CNN.”   He promised that he would bring  up the issue \nof AIDS in Black America in his lectures.  I have known Colin for years from the time \nthat he was Secretary of State and I had briefed him on AIDS and went to the UN with \nhim during an UNGASS years ago.  Also, had discussions with my old friend Lee \nHamilton who is co-chairing the Iraq Study Group that will be giving their report to the \nCongress and the President in a few days.  It will be extremely critical of the execution of \nthe Iraq War and rebuilding. Also discussions with – Antonin Scalia, George Will (ABC), \nNina Tottenberg (NPR), Bob Shieffer (CBS), Bill Plante (White House correspondent) \nand many others.\nDec. 4, 2006 – Things mostly quiet on the NIH front.  Big problems in Iraq that are \ndominating the news with insurgency and civil war.  Bush is having a very hard time.  \nDemocrats have taken control of House and Senate, mostly by voter protest of the war in \nIraq.  Had World AIDS Day with usual press interest.  Secretary Leavitt wanted me to go \nto China with him from Dec. 6 to 13; I first said yes, but then backed out since I really do \nnot want to travel during this busy period and the purpose of the trip was secondary to my \ninterest and involvement, i.e. economic and trade considerations with only a side order of \nhealth. Jenny Fauci doing great in Brazil. She loves it and will return on Dec. 23.  I am \ngetting more and more involved in Global Health issues such as malaria, health care work \nforce support in developing nations through the DDCF, XDR tuberculosis, etc.  Have \ngiven many talks over the past few weeks on these issues.\nDec. 13, 2006 -  I hosted a press conference to announce the breakthrough study that was \nprematurely stopped by the DSMB.  Study was the use of medically supervised adult \nmale circumcision in Kenya (Kisumu) and Uganda (Rekai) to determine effect on HIV \ntransmission.  Results were striking.  Study was safe and led to a 48% (Uganda) to 53% \n(Kenya) decrease in transmission.  Big printed press coverage including front page of NY \nTimes.\nDec. 14, 2006 – Big White House Malaria Summit sponsored by Malaria No More and \nIntroduced by Laura Bush with the POTUS giving Keynote Lecture.  Held as ½ day \nmeeting at the National Geographic Society Headquarters on 17th Street in DC.  I had \nhelped Gary Edson who was consulting for Malaria No More in the scientific background \nfor the meeting which was mostly  talks by African Health Ministers, Melinda Gates, \nFaith-Based people (Rick Warren, etc.), Paul Wolfowitz, Margaret Chan (WHO DG).  I \nhad nice chats with each of these.   Purpose was to increase awareness of malaria and \nReleased by Chairman Rand Paul\n147how with little money we can dramatically reduce malaria, particularly in Africa.  Spoke \nof results in Africa of the President’s Malaria Initiative (PMI) that over the past 2 years \nwith $1.2 Billion for bed nets, indoor spraying with insecticides, and ACT (Artemisinin-\ncombination therapy)  malaria has been markedly decreased in certain countries.  MC \nwas Isaiah Washington of “Grey’s Anatomy” TV show.  I met and interacted with the \nusual cast.  Also included Sens. Pat Leahy, Bill Frist, etc.\n      VP Cheney’s Annual Christmas Party.  Chris did not come since she was setting up \nfor the reception following the Annual Lessons and Carols at the Cathedral (I went later).  \nUsual festivities with many people there.  Spent much time talking to Carol Kuntz.  Also, \nScooter Libby was there awaiting start of his trial for providing false information to the \nSpecial Investigator (Fitzgerald) about the Joe Wilson/Valerie Plame issue.  Spoke more \nwith Isaiah Washington.\nJan. 29, 2007 – Iraq war going very badly with civil war among Shia and Sunnis and \ninsurgency running wild.  Bush popularity in USA way down.  The war is dominating the \npolitical scene in USA and particularly DC including discussions by Presidential \ncandidates.  \nWent to an interesting dinner tonight at the Metropolitan Club hosted by Dr. Ward (Trip) \nCasscells in honor of the Surgeon General of the Armed Forces of Iraq  - Samir Abdullah \nHassan, M.D.  I sat next to him at dinner.  Good guy and smart and tough.  He explained \nthe disaster that USA inadvertently promulgated by dissolving the Iraqi military.  The \nProvisional government (Paul Bremer) dissolved the Iraqi medical corps and so now they \ndo not have any army hospitals or army doctors to take care of the wounded and sick \nIraqi soldiers.  Also told me that the entire bureaucracy in Iraq (sewer, transportation, \nutilities) was run by the military and so when Bremer dissolved the military he \ncompletely destroyed the infrastructure of the country.  Samir feels that this was an \namazing blunder.  Also, by dissolving the police, we now have anarchy in Iraq with \ncriminal elements running wild.\nFeb. 13, 2006 – Had dinner with Rahm Emanuel (Democratic Caucus Head and brother \nof Zeke Emanuel), Christine Grady, Zeke Emmanuel, Mary Richardson and a \nWashington Post reporter (?name) at Central Restaurant at 1001 Pennsylvania Ave, NW.  \nWe were in the middle of an ice storm that did not deter us.  Had very interesting and \nenjoyable conversations with Rahm about the Democratic Congress and the potential \nDemocratic candidates for President in 2008.  Rahm used to work for Bill Clinton when \nhe was POTUS and was part of Clinton’s original campaign team.  Rahm feels that \nHillary has the inside track because of the Clinton machine, her experience, and lots of \nmoney.  However, he feels that Barack Obama will give her a tough race.\nFeb. 14, 2007 – Briefed Bruce Miller (VP Cheney’s Chief of staff for biodefense) at the \nWhite House on AIDS, Pandemic Flu, Malaria, and biodefense in preparation for my \nfuture briefing of the VP that Bruce will set up.\nMarch 5, 2007 – Went to great memorial for Art Buchwald at the Eisenhower Theater of \nthe Kennedy Center at the invitation of Art’s son Joel and his wife Tamara.  Many VIPs \nReleased by Chairman Rand Paul\n148there including Ethel Kennedy, Ben Bradlee, Tom Brokow, Dave Barry, and most \nimportant people in the media in DC and nationally.  It was a warm and hilarious event \nfilled with stories about Art and film clips of him\nMarch 6, 2007 – Busy day.  Unfortunately, Scooter Libby was convicted today on 4 of 5 \ncounts of lying to FBI and grand jury in association with the Joe Wilson/Valerie Plame \nCIA leak.  Had House Appropriations Subcommittee Hearing today and it went well.  \nAlso, had a farewell dinner at Oceanaire in honor of Alex Azar who is stepping down as \ndeputy Secretary at HHS.  The old HHS crowd was there including former Secretary \nTommy Thompson.  Had a great conversation with him.  He has put his name in as a \ncandidate for Republican nominee for President.  He is optimistic about winning the Iowa \nCaucus.  He discussed with me the best plan that I have heard yet about how to handle \nthe dreadful Iraq situation.  Also, at the dinner were Janet Rehnquist, Stew Simonson, \nScott Whitaker, Bruce Gellin, Lester Crawford (recently convicted for lying on his \nfinancial disclosure when he was FDA Acting Commissioner), Paula Staudard, and \nothers.  Very cold day in DC with temps in the teens.\nMarch 13, 2007 – Briefed Vice President Cheney today in his WH office on second \nfloor.  Beautiful “pre-Spring” day with temps around 50 and sunny skies.  He wanted \nbriefing on Pandemic flu and biodefense.  I included a discussion about HIV/AIDS \nparticularly the great success of PEPFAR since I wanted him to know that this \nAdministration has done more than anyone in the world for Global AIDS.  The briefing \nwas as usual for the VP and me, i.e. very friendly and expressing multiple times how \npleased he was to get briefed by me since he enjoys it so much.  Also in the room were \nDavid Addington (Chief-of-Staff), Bruce Miller (Chief for Biodefense), Steve…? And \nScott Deitchman.\nMarch 16, 2007 – Have been preparing for a briefing of the POTUS on pandemic flu \npreparedness.  Interesting evolution of process.  The HSC staff (Joel Bagnell and Rajeev \nVenkaaya) want us (HHS) to present a major discussion of “gaps” in stockpiling and \nothers want us to just update the POTUS.  Friendly tension going on.  Today, we (me, \nBill Raub, Bruce Gellin and Eric Hargan – Deputy Secretary) briefed the Deputies in \nEEOB 208 in preparation to brief the Principals and then the POTUS.  Among them were \njunior staffers from WH as well as Rajeev, Joel Bagnell, Bruce Miller, Scott Deitchman, \nJeff  Runge.  Continued disagreement about what the Secretary (MOL) will ultimately \npresent to the POTUS.\nMarch 19, 2007 – MOL, Bill Raub and I briefed the principals today in final preparation \nfor the POTUS briefing.  Present were Fran Townsend, Michael Chertoff, Joel Kaplan \n(now Deputy Chief-of-Staff to Josh Bolten), Joel Bagnell, Bruce Miller, other cabinet \npeople.  Briefing went better than on March 16.  We are about ready to brief the POTUS.\nMarch 20, 2007 – Dinner at the Mellon Auditorium on Constitution Avenue, N.W. (13th \nStreet) for Research! America.  Usual DC Glitterati.  At my table was Susan Dentzer \n(Newshour), Sam and Jan Donaldson, Tenley Albright, Paul Rogers.  Awardees were \nDon Seldin, Joe Goldstein, Mike Brown, Mike Wallace, Sen. Orin Hatch among others.  \nReleased by Chairman Rand Paul\n149George Stephanopoulos was MC and I spent time catching up with him (knew him from \nClinton White House days).  Was a coldish night outside.  Chris and Meg and Ali went \noff to California (Big Sur/Monterey) for Spring break.  Wish I could have gone, but \nPOTUS briefing tomorrow.\nMarch 21, 2007 – Briefing of POTUS today at 2:30 – 3:30 PM in Roosevelt Room on \nPandemic Flu preparedness.  Secretary Leavitt, Bill Raub and I briefed him.  I did most \nof the formal briefing on state of the threat, vaccines, antivirals and diagnostics. Bill \nspoke on community mitigation strategy and the stockpile.  MOL spoke on overall \nresponsibility of the USG versus states.  Present were the POTUS, VP, Karl Rove, Josh \nBolten, Joel Kaplan, Dan Bartlett, Fran Townsend, Candi Wolff, Mike Chertoff, Paula \nDobriansky (Undersecretary of State), several people from Joint Chiefs of Staff, Rajeev \nVenkayya, Joel Bagnell.  \n    Briefing went very well.  POTUS was as usual very friendly and deferential to me.  \nWas at times serious and at times jocular with his characteristic joking around.  When he \ncame into the room, he looked at me and said “Fauci, glad to see you Tony.  I see we \nhave the first team here today”.  It was the first day of Spring and it was unseasonably \ncold out and cloudy.\nMarch 29, 2007 – Very interesting day. First, Megan received notification that she is \naccepted at Columbia, Barnard, and Yale with waiting list at Harvard and Dartmouth.  \nHer top choices are Columbia and Dartmouth and so she will wait to hear more from \nDartmouth before making choice.\nWent to a reception given by National Italian American Foundation (NIAF) given \nat a private home in Georgetown (3032 – N Street, N.W.) in honor of Mayor Adrian \nFenty.  Got to meet him again and chat.  Did not previously know this, but his mother is \nan Italian American.  Ran into my old idol from Brooklyn – Ken Aspromonte (brother of \nBobby Aspromonte also my idol from the old days), baseball great from Lafayette High \nSchool and Brooklyn sandlot baseball who then played in Major Leagues.  He was born \nand raised in Bensonhurst like me and we shared some warm discussions.  Beautiful \nSpring evening.\n          After the reception went to Café Milano and had dinner with the NIAF Board of \nTrustees.  Towards the end of the dinner, got up to go to men’s room and ran into Franco \nNuschese, owner of Café Milano (who has always been very warm towards me).  He \ninsisted on taking me into a private party in the restaurant that he was throwing for \nprominent blacks in DC and the nation.  I immediately ran into Secretary of State Condi \nRice and Colin Powell who were very warm and engaging with me.  This was \nparticularly true of Colin Powell who threw his arms around me and gave me a bear hug \nwith a kiss on the cheek.  Over the past couple of years, I have gotten to be friendlier and \nfriendlier with Colin, having seen him at various functions such as Sam Donaldson’s \nChristmas Party, etc.  All in all, a good evening.\nApril 17, 2007 – Scooter Libby contacted me and asked that I write a letter to Judge \nReggie Walton via Scooter’s lawyer William Jeffress to serve as a character reference for \nScooter.  Scooter has been found guilty of perjury and obstruction of justice in \nconnection with the Valerie Plame/Joe Wilson CIA leak (see above).  He is appealing the \nReleased by Chairman Rand Paul\n150case but may be sentenced to jail before his appeal is heard.  The purpose of the letter is \nto try and keep Scooter out of jail during the appeal.  I wrote him a very supportive letter.\nApril 18, 2007 – Testified before the House Committee on Homeland Security together \nwith Gerry Parker, Jesse Goodman (FDA) and Jeff Runge (DHS) on the successes and \nfailures of Bioshield.  Committee chaired by Jim Langevin.  Hearing called because \nseveral of the companies that were trying for Bioshield procurement contracts had failed, \ni.e. Vaxgen for rPA and Hollois Eden for Neumune (to protect and regenerate BM after \nradiation).  Richard Hollis testified against the USG and Dr. Davis from HGS (that makes \nAbThrax – monoclonal antibody against anthrax toxin) testified favorably towards the \nUSG.  Hollis looked like a whiner and the Hearing went fine.  It is clear that Bennie \nThompson, the overall Chair is in the pocket of the lobbyists as his questions reflected a \n“presumption” of failure on the part of DHHS and BioShield.\nApril 20, 2007 – Briefed Joel Bagnell and Rajeev Venkayya at the WH on the rolling out \nof justification for classified research.  Some friendly tension between Joel and me in that \nthey wanted us (CDC, FDA, HHS, NIH to sign off on the roll-out document and there \nwas a phrase in there that did not clarify that we do not do classified research.  It asked us \nto justify with all of our research why it should be unclassified making the default \nposition that everything should be classified.  I had them change it to read that we should \nexplain why it is not classified as opposed to justifying it as being unclassified.  We came \nto an agreement.\nApril 24, 2007 – Had lunch with Scooter Libby today at the Daily Grill in the Bethesda \nHyatt.  Hot muggy and sunny day.  Has been cold up until now.  Scooter looked very \nworn and down.  I gave him a big hug and he looked like he was going to have tears. I \nasked about the trial and he said that they really expected a not guilty verdict and that is \nwhy they did not pull out all of the stops and ask the VP to testify.  Also, it was clear that \nReggie Walton was “preening” for this since he had the courtroom wired for the press \nand bloggers which they never do.  He proclaimed complete innocence and is hoping that \nBush will pardon him.  He is sad that he has not been pardoned already and feels that \nperhaps if it looks like he will go to jail the POTUS will then pardon him.  He feels that \nthere are politicos in the WH who do not want the POTUS to pardon him since it will \nmake the Administration look even worse that the 30% approval ratings.  I told Scooter \nthat I could not imagine that the POTUS will allow him to go to jail, particularly with the \nVP pulling so hard for Scooter.  I spent the rest of the time briefing Scooter about \nbiodefense updates.\n   Also, had meeting at the White House called by Rajeev Venkayya and Mike Magan on \nXDR-TB including reps from CDC (Julie G. and Ken Castro), HHS (Craig \nVanderwagen, Gerry Parker) DoD, DHS, State, USAID, Mark Dybul.  Bottom line was \nto coordinate the multi-Agency efforts.  Good meeting. We (NIAID) has already put \ntogether a strategic plan as has CDC and so HHS looked good.  Mark Dybul mentioned \nthat the Policy Time with the POTUS on PEPFAR funding did not go well today.\nApril 25, 2007 – Had a lunch/reception at the White House followed by a presentation by \nLaura Bush and President Bush in the Rose Garden to celebrate the first ever Malaria \nReleased by Chairman Rand Paul\n151Awareness Day in the USA.  Day was sunny, hot and muggy.  I was given a reserved seat \nin the second row.  Had major and important conversations during the reception with \nRandy Tobias, Mike Gerson and Josh Bolten.  Apparently, at a meeting with the POTUS \nyesterday on PEPFAR funding, there was some opposition to maintaining the funding \nlevel.  Likely the major mover of  this restricted funding was Karl Rove.  Condi Rice is \nout of the country, but will be supportive of expanded funding.  Josh Bolten is supportive \nalso.  Josh asked me what I thought and I came on strong.  Josh pointed out that this was \nsupposed to be a $15 billion program with $3 billion per year for 5 years.  Josh said that \nat the time that I developed the program, I said that we could not absorb the entire $3 \nbillion in the first years and so we would do more in the later years.  Now the program is \nat $5 billion per year, which means that just to sustain it without increases would cost $5 \nbillion per year for 5 years or $25 billion.  Many conservatives would oppose this as a \nbottomless pit.  I also argued that we should get rid of the mandated 33% for abstinence \nof the 20% prevention money.  I am attaching an e-mail that I sent to Josh after getting \nback to my office in which I clarify my position:\nJosh:\n   It was good to see you at the Malaria event today and I appreciate your listening to Randy, Mike \nand me. I know that you are very much supportive of the full funding and even increase of the \ninitiative and I know that this view is not shared by all.  However, just to reiterate what I said to \nyou and what you already know, this is one of the most important things that this administration \nhas done and is doing.  The people of Africa look upon us with great admiration and gratitude \nbecause of PEPFAR.  We just cannot let it slip.  True, we cannot commit to treating every \ninfected person in the target countries, particularly since there are 4.3 million new infections \nworldwide each year, mostly in developing countries.  However, we are making significant \nprogress in prevention. I know that you are aware of how impressive the circumcision data are.  \nIn addition, although we are still years away from a vaccine, the most recent candidate has \nentered a phase 2 trial internationally (including Africa).  Even if it does not totally prevent HIV-\ninfection, there is a reasonable chance that it will slow the progression of disease if people do get \ninfected, and this will result in lower levels of virus in their bodies, which in turn makes \ntransmission to others less likely.  I tell you this because I believe that we are on the cusp of a \nslowing down of transmission, which would dampen the possibility of a \"bottomless pit\" of \ninfection in target countries for which we would feel obligated to treat.  Finally, with regard to \nprevention, I am sorry that I was at first not clear about my position on abstinence being \nmandated as one third of the 20% prevention piece of the pie.  We get enormous bad press (that \noften overshadows the enormous good that we are doing) because we mandate a specific \nnumber for abstinence.  The faith-based organizations are going to push abstinence with the \nprevention money that we give them anyway.  Therefore, abstinence will indeed be pursued \nthrough PEPFAR.  By mandating it, those who do not think that this is the way to go will only drop \nout of the funding stream and declare the program dysfunctional when it really is a breath-taking \nsuccess.  On balance, it is my opinion that if we remove mandated categories of prevention, \nabstinence programs will still go on in Africa and PEPFAR will be praised by everyone, \ndeservedly so.\n  I am sorry if I came on somewhat strong at the White House with you, but I feel deeply that \nPEPFAR is such an historically great program (that would not exist if it were not for you) and I \nwant it to function optimally.  As always, if you need me to pitch in on this and articulate my views \nto anyone, please call upon me.  I would jump at the chance.\nThank you and best personal regards,\nTony\nDuring the Rose garden ceremony, the POTUS actually got up and played the drums with \na troop of Senegalese/American dancers who provided entertainment on the stage in the \nReleased by Chairman Rand Paul\n152Rose Garden.  As he left the stage and went back to the Oval Office, we caught each \nother’s eyes and he said “Hi Denny”, walked a few steps, turned around, came back and \nsaid “What am I talking about,  Hi Tony”; he laughed and went on.\nApril 27, 2007 – Went to the National Cathedral this AM to see Megan receive the honor \nas one of 12 NCS girls to be inducted into the “Cum Laude Society” .  It was a beautiful \nceremony at the Cathedral.\n    Found out during the evening as I was on the way to a Nats Baseball game (call from \nGreg Folkers) with Bob Seder, Stewart Simonson, and Gary Nabel that Randy Tobias just \nabruptly resigned effective immediately.  There is a woman who runs an “escort service \nand sexual fantasy service” who is being charged with running a prostitution ring.  She is \na bit bizarre and is using as a defense that if her girls did prostitution, then they did it on \ntheir own.  For some unexplainable reason, she released the cell phone numbers of the \nclients of her girls and Randy’s number was on the list.  ABC News confronted Randy \nand he stated that he merely used the girls to get massages and had no sex, but he \nresigned anyway.  My impression is that unlike Attorney General Alberto Gonzales who \nwill not resign and keeps embarrassing the POTUS with his incompetence in handling the \nfiring of the Federal Attorneys, Randy does not want to cause more bad press for the \nPOTUS.  Irony is that Randy runs the AID Programs which require recipients of Federal \nFunds to condemn prostitution.  This is probably the reason that he resigned, i.e. the \nappearance of hypocracy.\nApril 28-May 6, 2007 – Just a very busy time for me preparing for the Board of \nScientific Counsellors Review of my Lab (LIR) to take place on June 4.  Weather turned \nabsolutely beautiful – typical DC Spring with sunny skies and balmy temperatures.  Have \nbeen following over the past several weeks the St. Alban’s baseball team.  They are \nhaving their best year in decades.  Danny Hultzen (pitcher/first base) is clearly the best \npitcher in the league and one of the best hitters.\nMay 7, 2007 – Went to the British Embassy for a Garden Party in honor of the visit to the \nUSA of Queen Elizabeth and Prince Philip.  Everyone who is anyone in DC was there.  \nSpent time speaking with Sen. Joe Lieberman, House Speaker Nancy Pelosi, Majority \nLeader of House Steny Hoyer, Columnist David Brooks, CNN’s Judy Woodruff, Fox \nNews Chief Editor Britt Hume, Former Mayor of Baltimore Schmoke, Harvey Fineberg \nof IOM, etc.  Spoke with Prince Philip who showed an astounding lack of understanding \nof what is biomedical research.  He asked me what I did and I explained.  He said “Of \nmedical stuff; that is statistics, i.e. numbers”.  I explained that we actually do research to \nanswer questions.  He insisted that it was all about statistics of diseases.  I said that the \nstatistics inform us of the extent of the problems, but then we do basic and clinical \nresearch to diagnosed, prevent and treat diseases.  He then said, “Oh yes, like I said, it is \nall about numbers”.  I hope that he was just jet-lagged.\nMay 10-14, 2007 – Had one of the most intensely busy weeks  in recent memory with \npreparations (rehearsals) for my upcoming Board of Scientific Counselors review of LIR, \nNIH Budget Retreat, NIH Roadmap Retreat, Commencement Address at Penn State, \nMajor talk in Miami to AAI,  NIAID National Advisory Council Meeting, and Senate \nReleased by Chairman Rand Paul\n153Appropriations Hearing Testimony – all in 5 working days.  It was exhilarating in a \nstrange sort of way.  Almost like being on call as an intern and having 5 admissions in a \nrow.  After a while, it does not make any difference how many they send you.  Weather \nhas been spectacularly beautiful – typical Washington Spring weather.  Sunny, dry, warm \nin day, cool at night.\nMay 19, 2007 – Gave Commencement Address at Penn State University College of \nScience\nMay 24, 2007 – Went to Sons of Italy Annual NELA (National Education Leadership \nAwards) dinner at the Washington Grand Hyatt Hotel on 10th and H Streets.  I took \nMegan with me and she really enjoyed it.  Sitting at our table was Nancy Pelosi and Rosa \nDeLauro.  Megan got to meet and speak with them as well as Hilary Clinton, Geraldine \nFerraro, Italian Ambassador Castellenata among others.  Megan was amazed as Sen. \nClinton was on her way out after having presented Geraldine Ferraro with an Award and \nwe thought that we would not have the opportunity to introduce her to Megan.  Hilary \nwalked past me, caught my eye and gave a big smile, and threw her arms around me in \ngreeting.  Megan could not believe it.  I introduced Megan and Clinton asked about her \nschool and her plans for next year.\nMay 24 – June 17, 2007 – Extremely busy:  \nSometime since last entry (May 24) I was informed by Jack Marberger (Science Advisor \nto the POTUS) that I would be receiving the National Medal of Science in a White House \nceremony in July.  I am humbled.\nAlso, Scooter Libby convicted by seemingly vengeful and self-absorbed Judge Reggie \nWalton and sentenced to 30 months – amazingly excessive!  Also, Walton published all \nof the letters written on Scooter’s behalf including mine.  Other letter writers were Paul \nWolfowitz, Donald Rumsfeld, General Pace, Henry Kissinger, etc.  Science magazine \n(Jon Cohen) wrote a small piece about my writing a letter.  He originally thought that I \nwould be in trouble since I did it on Government Stationary.  Sorry John – I got clearance \nby OGC – Ethics Division since the CFR says that I can do this.  Typical Jon, good  \nperson that he is, he is still trying to get me on something – the instincts of a reporter!\nJune 3, 2007 – Gave Commencement address to Megan’s NCS graduating class.  It was a \nthrill giving it from the main pulpit at the National Cathedral.  It was extremely well \nreceived; got many, many personal comments and e-mails. Please see text of speech in \nmy files.  Megan won many awards – Science Award, Community Service Award, Major \nAward voted by students as best all-around student, Major Award voted by faculty as \nbest all-around student (first time at NCS that same student got both)\nJune 4, 2007 – Underwent Board of Scientific Counselors 4 year review of my \nlaboratory – Laboratory of Immunoregulation.  I received the highest possible score \n(Outstanding).  I had been preparing for this review for almost 1 year since I wanted to \nnail it given that I am Director of NIAID and my review would be carefully scrutinized.\nReleased by Chairman Rand Paul\n154June 6, 2007 – Major, major world publicity regarding patient  who \nhad Extensively Drug resistant tuberculosis (XDR-TB) and traveled by plane to a number \nof countries in Europe despite somewhat bungled instructions by Georgia (he is from \nAtlanta) Health Officials and the CDC to not travel.  The CDC looking real clumsy on \nthis and the media continue to go after Julie Gerberding (Director, CDC) about this and \nother issues.  I believe that she is being treated unfairly by the press and the Congress.  In \nany event, I appeared with Julie and a customs official (Speaker crossed the border from \nCanada  to New York after secretly flying from Prague to Montreal) at a Senate \nAppropriations Committee Hearing (Tom Harkin, Chair) on the subject.  I was there to \ndiscuss the science of TB.  Julie got slammed by the Committee and Speaker was on the \nnext panel and said that the CDC was lying. What a mess.  I was on major media \nappearances for the next week – Nightline, NBC News, 20/20 (about Heimlich and \nmalaria treatment for HIV), NPR Morning Edition, WTOP Radio, CNN American \nMorning, etc)\nJune 18, 2007 – Informed by Don Koshland of the Lasker Foundation that I will be \nawarded the Lasker Award for Public Service in September ($150,000.00) – amazing.  \nThus, in 2007 I have won the Kober Medal for Physician Scientist, the National Medal of \nScience for Basic and Clinical Research and now the Lasker Award for Public Service.  I \nhave a lot to be thankful for!\n    Ironically, had dinner over Ellen and Gerry Sigal’s house last night with Joe Wilson, \nBill Wilson and Melody (Confidante of the Kennedy’s), Richard and Donna Ben-Veniste, \nJudge Judy who is trying the crazy $54 million “lost pants in the Dry Cleaners case and \nher husband Greg.  I mentioned to Ellen that if Joe was pissed at me because I wrote a \nletter for Scooter, then I would not come to the dinner.  Joe was very gracious and \ninsisted that I be there.  We had a good discussion and he said that he understood why I \nwrote the letter.  He, however, is filing a civil suit against VP Cheney, Karl Rove, and \nScooter and so it is not over yet.   Amazing how different are the perspectives of what \nhappened between Scooter and Joe/Valerie.  I am in the unusual situation of being friends \nwith both parties.\nJune 18, 2007 – Accompanied First Lady Laura Bush at Howard University Hospital for \na roundtable discussion of the implementation by Howard of the new CDC \nrecommendations for the “Routinization” of HIV testing.  Celia Maxwell (former NIAID \nfellow) led the discussion for Howard. Very cordial interactions with the First Lady and \nher staff, particularly Katy Montgomery.  She was engaged and interactive.  Very hot day \nin DC – sunny, slightly hazy and 94 degrees F.  I explained to her the benefits that are \ncoming out of this testing program as well as the PEPFAR program internationally.\nJune 21, 2007 – Met with Nancy Pelosi in her “Speakers Office” at the Capitol to discuss \nthe funding of the University of California at SF Center for AIDS Research (CFAR).  \nThey did not get the funding amount that they had hoped for and we finally worked it out \nto everyone’s satisfaction by getting some extra money from OAR and the NHLBI to \ngive them the additional $771,000.00 that they requested.  Nancy was satisfied.  I went \nwith Elias Zerhouni and Marc Smolonsky from OLA at NIH.  Her main staffer was Scott \nReleased by Chairman Rand Paul\n\n155Brule.  Nancy was as usual very warm and cordial to me.  We discussed a plan that she \nhad to get extra money to the NIH through a budget supplemental.  She felt that if we \nwrap in the cancer package, all of the Congress would be in favor even though it was \nunderstood that it would go way beyond cancer.  Elias and I and Marc will world on a \nstrategic plan for the initiative and get back to her.\n             Visited by USA Ambassador to Indonesia (just appointed) Cameron Hume.  I \nknow Cameron from time he was Ambassador to South Africa and we (Cliff Lane) \nestablished the Phidisa Project with the South African Military to treat HIV infection in \nthe military.  Cameron left South Africa and became (briefly) Ambassador to Sudan \n(during the Darfur crisis).  He is on his way to take over in Jakarta and wanted me to brief \nhim on Pandemic Influenza threat and what the USA is doing in this area.  Indonesia is a \nhot spot for recent cases of chicken to human H5N1\nChris and I had dinner tonight at the home of Australian Ambassador to the USA \nDennis Richardson and his wife Betty to celebrate the visit of immunologist Ian Frazer \n(wife Caroline) who is the 2006 Australian of the Year.  His research led to the \ndevelopment of the HPV vaccine with Merck (Gardasil).  Good food and conversation at \nthe beautiful Ambassador’s residence at 3120 Cleveland Avenue, N.W.  Balmy Spring \nnight in DC.\nJune 21 – July 4, 2007 – POTUS commuted 30 month jail sentence for Scooter Libby, \nbut did not pardon him.  The conservatives are enraged that the POTUS did not go far \nenough to pardon Scooter and the liberals are saying that the commutation was a \n“disgrace”.  \n     Went to the Gala Dinner of “The Golden Plate” with Chris.  Usual celebrity gala.  Met \nHillary Swank for the first time.  Others at the dinner were Alberto Gonzales, Margaret \nSpellings, David Rubenstein (Carlyle Group), and many many others.  Sitting at Table \nwith Chris and me were: Gen. Ralston (former Chairman of Joint Chiefs) Mac Macarty \n(former Chief-of-Staff to Pres. Clinton, Ann Venneman (UNICEF Director and former \nSec. Dept. of Agriculture.  Entertainment by Brooks and Dunn – country singers who \nwere fantastic (winner of many country music awards)\n     Went to a Cocktail Buffet at Jamie Gorelick’s house on June 30 and met with the \nusual cast of DC notables: Richard Ben-Veniste, Bill Jeffress (Scooter’s lawyer), David \nIgnatius of the Washington Post, Seth Waxman (lawyer), Judy Woodruff (PBS), Al Hunt \n(Bloomberg News), Mark Shields (Newshour), etc.  Living discussions about \nWashington Politics, including the fact that I wrote a letter for Scooter.\nJuly 5 – 7, 2007 – Went to the Aspen Ideas Festival in Aspen, CO.  Presented a session \non “Emerging and Re-Emerging Infectious Diseases:  The Perpetual Challenge to Global \nHealth”.  Beautiful mountain weather – warm, no humidity, clear skies.  Met and \ninteracted with many, many notable people: Colin Powell, Bob Hormats (Vice-Chairman \nof Goldman Sachs), Rahm Emanuel, Tim Wirth, Margaret Spellings, Dan Glickman \n(former Sec. Agriculture and current CEO of Motion Picture Association of America), \nWalter Isaacson (CEO of Aspen Institute), Jim Woolsey (Former Director CIA), Jim \nLehrer and his wife Kate (Lehrer NewsHour), and many, many more.  Very enjoyable \nexperience.  Perhaps started a friendship with Corby Kummer, whom I had not met or \nheard of before.  He is senior editor at The Atlantic magazine. He is one of the most \nReleased by Chairman Rand Paul\n158White Paper that we (NIAID) had contributed to a couple of months ago when we \nintroduced our Research Agenda for MDR/XDR-TB.  Beautiful Fall day (crisp and \nsunny).  Meeting from 9:00 to 11:00 AM followed by briefing from Tachi Yamada \n(Gates Foundation) who came from Seattle to present to us (USG) out of courtesy the \nnew $282 million Gates TB initiative.  In preparation for this I alerted Rajeev that we \nreally needed to coordinate the many USG activities on TB and present it in a vision \nformat so that the POTUS could claim the legacy of having addressed AIDS (PEPFAR), \nmalaria (President’s Malaria Initiative – PMI) and now TB.  It would be the 3rd leg in the \nstool of his Global Diplomacy program.  Rajeev agreed – unfortunately, he will be \nleaving government on Sept. 26.  It was great working with him over the past few years.  \nHis background is that he trained as an MD at Michigan and was actually Chief Medical \nResident when Tachi was Chairman of Medicine at Michigan.  In any event, we will \nupdate and sharpen our USG White Paper.\nSept. 20, 2007 – Another great crisp Fall day.  \nHeard real bad news regarding the Merck AIDS vaccine trial 502 in which adenovector \nHIV was immunogen.  Study done mostly on gay men and phase 2b was looked at by \nDSMB on usual periodic look.  Trial closed for “futility” in that the data showed that \nmore people got infected in vaccinate group versus unvaccinated group (19 vs 11 – not \nsignificant, but highly suggestive).  Also, viral set point exactly same in infected people \nwho were vaccinated versus those that were not.  Trail stopped – press releases imminent.  \nIt is going to be a hot time.  People will focus on whether we should proceed with the \nPhase IIb of PAVE 100 (Gary Nabel’s VRC trial).  The latter also was a adeno vector, \nbut is different in 3 ways: 1) it has a DNA prime; 2) it has envelope; 3) it is done also in \nheterosexuals.  More to come.\nWent to Gate-sponsored dinner at Le Paradou Restaurant at 678 Indiana Avenue, NW in \nhonor of retiring President of Botswana Festus Mogae.  I had met the President in 2002 \nwhen I went to Africa with Tommy Thompson in 2002 to develop PEPFAR.  At the \ndinner were: Todd Summer and Cheryl Scott (Gates), Jeff Struchio (Merck), Bobby \nPittman (NSC Director of African Affairs), Congresswoman Nita Lowey, Tommy \nThompson, Max Essex  (Harvard School of Public Health), Ambassador John Lange \n(former Amb to Botswana), Jendayi Frazer, Assistant Secretary of State for African \nAffairs.  Nice evening.  I commiserated with TGT about his failed attempt at Republican \nnomination for President.  Nice conversations with Nita Lowey about Iraq (Democrat \nviewpoint), and warm conversation with Mogae regarding my work on AIDS.\nSept. 25, 2007 – Was panelist at Science Magazine’s annual retreat of their staff at their \nheadquarters in Washington, DC.  Chaired by Editor Don Kennedy.  Lively discussion \nabout the future of science and biomedical research.\n    DSMB discontinues trial of Merck HIV vaccine based on Adenovirus vector.  Possible \nthat vaccine actually made things worse.  Big setback for HIV vaccinology.\nSept. 26, 2007 – Farewell reception at White House for Rajeev Venkayya (Deputy \nDirector – Homeland security Council).  I have worked closely with Rajeev for 5 years \non Biodefense.  He rose from WH intern to deputy Director in 5 years.  He is someone to \nReleased by Chairman Rand Paul\n159watch; good guy; physician trained at U of Michigan and UCSF.  Usual cast of WH \npeople, i.e. Fran Townsend, etc.\nSept. 27 – 28, 2007 – Glorious 2 days in NYC for the Lasker Awards.  Dinner on night of \nSept. 27 at La Grenouille (Mary Lasker’s favorite restaurant).  Lasker Lunch at Pierre \nHotel on Sept. 28.  Ralph Steinman received Basic Science Lasker; Alan Carpentier and \nAlbert  Starr (Starr-Edwards heart valve) received the Clinical Lasker; and I received the \nPublic Service Lasker.  On Friday, Sept. 28, the Washington Post did a very large piece \non me called “The Honored Doctor” talking about the Lasker, the National Medal of \nScience, the Kober Medal and other honors.  I have received literally several hundred \nletters and e-mails and greeting in person related to the Lasker and the Post article.  With \nme in NYC were Chris, Ali and Jenny.  Megan had to stay on Chicago with “City Year”.\nOct. 4 – 5, 2007 – Went to Aspen for the World Biomedical Forum.  Gave 4 to 5 talks on \nAIDS, Pandemic Flu, Emerging infections, etc.  Again, usual cast of notables there. Very \nnice time.  Weather in Aspen and DC has been spectacular for past couple of weeks.  \nSunny, Warm and no rain.\nOct. 11, 2007 – Featured speaker at a Global Health Symposium at the Italian Embassy \non Whitehaven Street in DC.  Spoke on “HIV/AIDS in 2007:  Much Accomplished, \nMuch To Do”.  Much congratulatory activity by the Italians related to the Lasker and the \nPost article.\nOct. 12, 2007 – Dinner at the Café Milano in association with the national Italian \nAmerican Foundation (NIAF) dinner the following night (Oct. 13).  Franco Luschese \nfound me a prime seat.  The whole restaurant was for the NIAF dinner.  I sat next to Jerry \nVale.  So many people who I knew from other such meetings were there:  Yogi Berra, \nTony LoBianco, Dion (and the Belmonts), Nancy Pelosi, etc. etc.  Great meal; nice time.\nOct. 13, 2007 – Took Ali to the Annual NIAF Gala at the Hilton.  She loved it since she \nwanted to meet Nancy Pelosi and Ellen Pompeio (star of TV’s Grey’s Anatomy).   She \ngot to meet and take picture of both.  Usual glitterati were there:  Antonin Scalia and Sam \nAlito; Nancy Pelosi; Yogi Berra; Dion; Jerry Vale;  George Tenet (I wanted to connect \nwith him, but we did not cross each other); Connie Stevens; Pater Pace; etc. etc.\nOct. 16-17, 2007 – Went to Seattle to participate (Panel) in the Bill and Melinda Gates \nMalaria Forum at the Sheraton Hotel at Union and 6th Streets in Downtown Seattle.  Mild \nand on and off rain.  Good meeting.  Just starting to see the galvanizing of interest and \nenthusiasm and finally even considering the possibility of eliminating and eradicating \nmalaria.  Melinda  and Bill gave an inspiring speech at 9:00 AM on Oct. 17.  All the \nmalaria people were very pleased that I was there to show the “flag”.  I have become \nincreasingly interested and supportive of malaria including my long-term support of \nStephen Hoffman (Sanaria) and his irradiated sporozoite vaccine.\n   Had a unique evening at dinner at the home of Bill and Melinda Gates on Oct. 16, \n2007. It was obviously a spectacular home, but I did not get the tour since while Melinda \nwas giving the other guests a tour, Bill wanted a private conversation with me.  He was \nReleased by Chairman Rand Paul\n160fascinated by how I have been running NIAID; said that he had heard so much about me \nand happy finally to meet me in person.  He wanted to know how I navigated the politics \nof DC, how I prioritized, how much flexibility I had in the budget, etc. etc.  It was a very \nnice conversation aimed at his wanted to get to know me and my responsibilities better.  \nPresent at the dinner were: me, Bill and Melinda Gates, Tachi Yamada, Regina \nRabinowitz, Margaret Chan (WHO), Michel Kazatchkine (Global Fund), Brian Chituwo \n(MOH of Zambia), Tedros Adhanom Ghebreyesus (MOH of Ethiopia), Michael Leavitt \n(Sec. HHS), David Mwakyusa (MOH of Tanzania), Ann Veneman (UNICEF),  also \nMOH of Mozambique Paolo Ivo Garrido and former MOH of Nigeria (Forgot her name).\nOct. 18, 2007 – Lectured in Building 31, Room C10 to the Mortimer Zuckerman Fellows \n.  This is a group funded through Harvard that takes medical, Law, and Business students \nfrom throughout the country and funds them for 1 – 2 year fellowship to study at either \nthe Kennedy School of Government, the Harvard School of Public Health or the Harvard \nBusiness School to learn other disciplines, i.e. medical students will go to the School of \nGovernment, and Law students will go to School of Public Health.  They wanted to hear \nabout me and how I got to where I am and my view of public service.  I lectured for 45 \nminutes and took over 1 hour of questions.  They were extremely enthusiastic about me \nand what I said.\nOct. 19, 2007 – Went to Boston to give Sheldon M. Wolff memorial lecture on \n“HIV/AIDS in 2007:  Much Accomplished, Much To Do”.  Largest crowd in the history \nof Tufts Grand Rounds (so I am told).  Saw Lila Wolff.  Got to Boston early (cloudy day, \nbut warm for October) and had breakfast with Jenny at Peet’s Coffee House in Harvard \nSquare.  Had first talk with Jenny about her personal “situation”.  Went very well.\n  That evening went to home of  Ron and  Beth Dozoretz for a reception for the Fellows.  \nThe fellows were so happy that I was there.  The Dozoretz’s live at 3005 – 45th Street, \nN.W. (2 blocks from my house).  At the party were many DC elites such as David Gergen \n(co-sponsor of event), Sandy Berger, Ron Carey (Newsweek), etc.\nOct. 26, 2007 – Gave talk at the opening of Sanaria’s new facility.  Sanaria is Biotech \ncompany making an irradiated sporozoite malaria vaccine.  Stephen Hoffman is the CEO \nand I have been very supportive of him over the past 20 years.  He recognizes this every \ntime he speaks in public.  Also at the Grand Opening were Congressman Chris Van \nHollen, Sen. Cardin (D- MD), Montgomery County Executive Ike Legget and others.\nOct. 27, 2007 – Great day.  Went to ISL/IAC cross country championship meet held at \nEpiscopal High in VA.  NCS and St. Albans won everything – JV and Varsity and under \n15.  In the NCS JV race the first 11 runners over the finish line were from NCS.  Ali \ncame out 6th in the race!\nOct. 29, 2007 – Went to dinner at Positano restaurant in Bethesda with Bob Gallo (part of \nour years long tradition of dinner in Bethesda to “catch up” on what is going on.  \nDiscussed the interesting topic of matching Bob, Luc Montagnier and me for nomination \nfor the Nobel prize for AIDS now that I have won the Lasker Award.  It could be helpful \nto Bob if I am on the “ticket” since there is no controversy connected with me and this \nReleased by Chairman Rand Paul\n161could make it a more desirable slate since the 2 of them alone always evokes memories of \ncontroversy.\nOct. 29 – Nov. 1, 2007 -  Full week of meetings with Ministers of Health from G-8 and \ntheir senior staff on topic of Global Health with an emphasis on Biodefense.  Ministers \nthat were present include: The Honorable Mike Leavitt, U.S. Secretary of Health and \nHuman Services The Honorable Michael Chertoff, U.S. Secretary of Homeland Security \nThe Right Honorable Tony Clement, MP, Minister of Health, Canada The Honorable \nMarkos Kyprianou, Esq. Commissioner for Health, European Commission The \nHonorable Ulla Schmidt, Federal Minister of Health, Federal Republic of Germany The \nHonorable José Angel Córdova-Villalobos, M.D., Secretary of Health, Mexico The Right \nHonorable Dawn Primarolo, MP, Minister of State for Public Health, United Kingdom \nDr. Donato Greco, Head, Department of Prevention and Communication, Ministry of \nHealth, Italy The Honorable Kenta Matsunami, Parliamentary Secretary for Health Labor \nand Welfare, Japan Dr. Anarfi Asamoah-Baah, Deputy Director-General, World Health \nOrganization.  I gave talk at VRC to the senior staff.  Had elegant receptions and dinners \nat the Corcoran Gallery (Oct. 31) and Library of Congress (Nov. 1).\nNov. 2, 2007 – Went to Boston to give Keynote at meeting of Harvard Business School \nAlumni Association – held at Harvard Medical School.  Spoke on Emerging Infections.  \nHad dinner with Jenny at Taranta’s restaurant in the North End on Friday night, Nov. 2. \nHad nice discussions about career options as she is now approaching graduation from \nHarvard.  She wants to take at least a year working at something that she loves (not sure \nyet what that is – could be a year in Cuba or a domestic political campaign) and then go \non to graduate school.\nNov. 7. 2007 – Ellen Sigal invited me and I attended the “Friends of Cancer” Awards \nnight at the Hotel George on Capital Hill (E Street).  “Leadership” Awardees were Ted \nKennedy, Sen,. Mike Enzi, and Bob Young (former NCA/Fox Chase).  Ted Kennedy \nexplicitly said that he would like me there and wanted to greet me.  He mentioned me \nwarmly in his acceptance speech.  Afterwards had dinner with a select few from the \nreception – Ellen Sigal, Marlene Malek, Sherry Lansing, John Porter, Amy McGuire \nPorter, Elias Zerhouni, Melody Miller (former staffer for Ted Kennedy).  Lively \ndiscussions (particular with Sherry Lansing who is a terrific person – she had been at my \nLasker Award ceremony).\nNov. 7 – 8 , 2007 – Very discouraging news from the Merck HIV vaccine trial (502/503 \n– STEP and Phambili Trials) using adenovirus 5 (Ad5) vector and gag, pol, nef inserts.  \nTook place in North and South America, Caribbean, Australia (STEP) and just beginning \nin Southern Africa (PHAMBILI).  First DSMB look stopped the trial on futility for 2 \nmajor endpoints (Acquisition and Viral Set Point).  Real problem is that it looks like \npeople with the higher underlying Ad5 titers had greater risk of acquisition in the \nvaccinated versus the placebo group.  Unclear why this is so but may be that giving Ad5 \nto people with underlying Ad5 immunity triggers robust activation providing vulnerable \ntargets for infection upon exposure to the virus.  This has important implications for \nReleased by Chairman Rand Paul\n162future trials with Ad vectors such as upcoming PAVE 100 trial – ethical issues.  Stay \ntuned.\n    On evening of Nov. 8 gave Keynote After Dinner talk to the Association of \nIndependent Schools of Great Washington (AISGW). Kathy and Dan Jamieson were \nthere as were heads of schools and senior officials for the DC/VA/MD independent \nschools.  Talk went very well – “Our Responsibilities as World Citizens:  Looking \nThrough the Lens of Global Health”.  I spoke at The Potomac School in Virgina.  Hugh \ncrowd.\nNov. 14, 2007 – Attended 60th Anniversary Gala for Meet the Press (invited by Tim \nRussert.  Held at 555 Pennsylvania Avenue, N.W. in the new Newseum Building.  \nAnother affair of all the glitterati of the Washington, D.C. press and politicians – John \nMcLaughlin, David Gregory, Norah O’Donnell, Fred Fielding, Ben Bradlee, Mike \nGerson, Sen. Kennedy, Kerry, Former Sen. McGovern,  Tom Ricks (Washington Post), \nAl Hunt, Dana Perino, Dana Priest, etc. etc.  Elegant affair, good food, plenty of cheer.\nNov. 30, 2007 – Chris an I attended a Holiday Dinner Party at the White House hosted by \nthe President and First Lady.  I had been at several Holiday receptions at the White \nHouse around Christmas Time, but this was the first time that I attended a Holiday \nDinner.  There were about 75 – 100 people in attendance.  Wonderful affair!  The \nPOTUS and First Lady circulated freely with guests as we had cocktails in the foyer \nadjourning the East Room.  Spent several minutes talking with the POTUS and First \nLady separately.  He and she had just finished an AIDS event in Mount Airy to \ncommemorate World AIDS Day (Dec. 1 – tomorrow).  The POTUS had a large 50 foot \nred AIDS Ribbon hung from the front portico of the White House and he was excited \nabout pointing it out to me.  The POTUS in his usual generous way with me kept \nintroducing me to people at the reception as one of the world’s greatest scientist who will \nget us an AIDS vaccine.  Again, as usual, he was very warm and friendly with me.  \nDinner was elegant – pumpkin soup, lamb, fine wines and champagne.  The evening was \ncrystal clear and cold (around 40 F). After dinner we had Christmas carols by the Army \nChoir and a trumpet and piano medley of Holiday Songs by 2 young black men from \nNew Orleans (?names).\nNov. 30 – Dec. 9, 2007 -  Pre-Iowa caucus heating up with Obama closing the gap with \nHillary Clinton who is front-runner. Romney and Giuliani neck in neck on the \nRepublican side.  Despite the fact that election is 1 year away, election politics is \ndominating the news.  The “surge” in troops in Iraq appears to be working in cutting \ndown the violence, but this is still a tenuous situation.  Latest NIE states that Iran \n(contrary to what was previously thought) has halted their nuclear weapons programs. \nLife  in DC as active and political as ever.\nDec. 9, 2007 – Invited by Catherine and Wayne Reynolds to attend a small private dinner \nwith Chris at Café Milano’s restaurant for Holiday Cheer.  Amazing night.  About 15 \npeople in the private Placido Domingo Room of Café Milano.  Attending among others \nwas VP and Mrs. Cheney, Bill Marriott, Sen. Thad Cochrane and his girlfriend, Elias and \nNadia Zerhouni, Chris Wallace (Fox News), Alma Wildenhorn, John and Debbie Dingell, \nReleased by Chairman Rand Paul\n163Mike and Meryl Chertoff, among others.  Spent nice time speaking with the VP about \nStephen Hayes’s book “Cheney” that I just finished 2 days ago.  We had fun since we \ndiscussed the parts of his earlier years from the book such as his sports in high school.  \nAlso discussed with Lynne Cheney the part about her giving him an ultimatum of shaping \nup in school or she would leave him as his girlfriend.  He had flunked out of Yale twice.\nDec. 11, 2007 – Another exciting Washington social night.  First visited home of Ellen \nand Gerry Sigal at 2909 – 44th Street, N.W. just 2 blocks from our house.  Occasion was \nbook signing party for Valeria Plame Wilson to celebrate publishing of her new book \n“Fair Game” about her outting as a covert CIA agent.  Chris and I have gotten to know \nher and her husband Joe Wilson over the past year, mostly through the Sigal’s.  \nInteresting irony (see previous notes) that I am friends with Joe and Valerie at the same \ntime as I am friends with Scooter Libby.  Had to leave party early to go to Italian \nAmbassador Giovanni Castellenata’s residence.  On way out as I apologized to Joe for \nleaving early, he joked “As long as you are not going to a party at the VP’s house”.  In \nfact, that is exactly what I am doing on Thursday (see below).\n   Function at Italian Ambassador’s house was fun.  Party to honor the visit of Italian \nPresident Enrico Napolitano.  Usual DC glitterati were there – Mike and Meryl Chertoff, \nColin Powell, Lee Hamilton, Frank Balducci (author),  D.C. Mayor Adrian Fenty and \nwife Michelle, former head of Italian CIA Carrado Cantatore (had nice conversation with \nhim about Italian covert ops in Iraq  - i.e. Italian Special Forces are still operating there \neven as Italian troops pull out), Sen. Pat Leahy, etc.  I sat next to my good friend Cecilia \nPiccione (Chief-of-Staff to the Ambassador).\nDec. 13, 2007 -  Two issues today:  Went down to White House with Mark Dybul to visit \nDan Price (new SHERPA for the upcoming G-8 meeting in July, 2008). Dan, at the \nsuggestion of Gary Edson, was looking for some bold initiatives for finish off the legacy \nof the POTUS over the next 11-12 months.  Gary mentioned to Dan how I had developed \nthe PEPFAR program.  We discussed various options.  I brought up several such as \nelimination of TB and malaria, and aggressively addressing neglected tropical diseases \n(NTDs).  Mark had the great idea of using the PEPFAR infrastructure that has been built \nup over the past 4 years to deliver the meds for NTDs.  The bulk of the costs for attacking \nNTDs is the delivery systems since the drugs are free (ivermectim) or very cheap.  In \naddition, Mark suggested major tax breaks for private sector corporations that donate \ntheir expertise such as computer programming, etc.  Mark and I were charged with \nputting together a proposal.  This matches nicely with what HHS, NSC, and HSC are \nasking me to do with putting a bold program together for TB together with CDC, FDA, \nUSAID, and DHS.  After talking to Dan, we walked over to Josh Bolten’s office and \ndescribed briefly the plan to him.  He likes it a lot and urged us to go forward.  Seems \nstrikingly similar situation to what we did with PEPFAR 5 years ago.\n   This evening I went to the Christmas Party at the Vice President’s mansion.  Chris is in \nBoston having given a lecture and ran into a big snow storm.  She is stranded in Boston \nand will have to take a train home that will get her in during the middle of the night.  I \ntook Ali to the VP party and she had an exciting time meeting the VP and such notables \nas David Addington (Chief-of-Staff to the VP),   Joel Bagnol (HSC), Bruce Miller (VP’s \nStaff, Carol Kuntz,  etc.\nReleased by Chairman Rand Paul\n166etc.   Highlight of the evening was the command private performance by Bernadette \nPeters, who was amazing – talented and beautiful at 60 years old (next month)!  I was \nstruck by how short she is in real life.  Google lists her as 5’3”, but she was about 1.5 \ninches shorter then I and she had spiked (3 inch) heels on – great looking woman and \nincredibly nice as we spoke with her after the performance.\nJan. 26, 2008 – Activity mostly centered around the Democrat and Republic primaries.  \nMcCain surging from way behind, Giuliani is out.  Obama closing in on Hillary.\nJan. 28, 2008 – Went to White House to nail down with Dan Price, Gary Edson, Patrick \nMarcham, Mark Dybul, Paul Brown, Bobby Pittman and others the various aspects of the \ninitiatives that the POTUS might want to announce at G-8, or the Upcoming (Feb) Africa \ntrip, or the DC Global Health Summit.  My TB vaccine initiative ($40 million) is in.  \nMalaria vaccine and drug discovery is likely out.  Neglected Tropical Diseases is in.\n   That night, in the SOTU Address, the POTUS asked for $30 billion for PEPFAR and \npraised the POTUS Malaria Initiative (PMI).\nFeb. 1, 2008 – Did dry run of my upcoming presentation to VP Cheney on Bruce Miller.  \nHe really liked it.  Will soon set up for the VP.\nFeb. 3, 2008 – NY Giants beat NE Patriots in an upset in the Super bowl played in \nPhoenix.  NY’s defensive line kept Tom Brady off balance all night and Eli Manning \nplayed incredibly well.\nFeb. 4, 2008 – CROI meeting in Boston.  Went to show the flag, meet with African \ninvestigators from Uganda (Rakai) and see vaccine presentations.  Ron Desrosiers gave \nhis talk about the imbalance between discovery and development in vaccine agenda and \nsaid there is no evidence that any existing vaccine candidate will work.  I do not \nnecessarily disagree; however, he was terribly gratuitous in saying that “The NIH has lost \nits way on vaccine research”.   It is easy to criticize and place blame…much easier than \nhaving creative ideas to solve the problem.  He is not a bad guy, but he was an asshole \ntoday.\nFeb. 6, 2008 – Had lunch at café Milano with Franco Nuschese (Owner of Café Milano) \nto discuss an issue with the United Arab Emirates (UAE).  He would like to bring the \nhealth minister to the USA and have me show him around the NIH.  Also, he wants me to \ngo to UAE and help them with advice about research programs, i.e. establish an NIH-like \nsystem in UAE.  Franco knows the Middle east well since he has many contacts there and \nwant to help the country develop their biomedical research enterprise.  He will arrange \nappropriate meetings.\nFeb 8-9, 2008 – Flew to San Francisco and took “red-eye” back to give the Merle Sande \nmemorial Lecture at the Gladstone Institute at SF General Hospital (Mission Bay \nCampus).  Warner Greene (Director, Gladstone) and Tom Quinn arranged the visit.  I \ngave a lecture of “HIV/AIDS in 2008” and paid tribute to merle.  Told some stories about \nour friendship and experiences on the NY Hospital House Staff together where he was \nReleased by Chairman Rand Paul\n168situation in Washington, D.C. re: HIV/AIDS.  He was shocked at the numbers – DC is \n9X the national average for prevalence; 5% of the entire DC population is infected.\nFeb. 20-21, 2008 – Went to University of Chicago to deliver interdisciplinary lecture on \nHIV/AIDS.  Had dinner with Megan at Volare restaurant.  Went over very well and then \nflew early on AM of 21 Feb to DC to go directly to the White House for meeting with \nDan Price, Gary Edson, Mark Dybul, Patrick Marcham, Paul Brown, Tim Ziemer to \ndiscuss malaria, TB, health care workers and other initiative.  I am pushing for the \ntripling of resources ($20 M to $60 M) for TB vaccine research.\n    We had a big week with the POTUS visit to Africa and receiving great praise and \naffection for the PEPFAR and PMI programs.  POTUS announced a $350 M, 5 year \nprogram on Neglected Tropical Diseases (NTDs) to include attempt to eradicate in 300 \nmillion people in certain African , Asian and Latin American countries – Lymphatic \nfilariasis, Onchocerciasis, Schistosomiasis, trachoma and ground worms (whipworm, \nhookworm, and roundworm).  This is the same program that Gary Edson and I proposed \n3 years ago and so our prior work has belatedly come to fruition.  Great news!\nFeb. 26, 2008 – My picture and a story concerning me (in part) appeared in the Science \nSection of the New York Times today.  It was related to the interview that I gave in \nToronto last summer to 2 small children with the theme of explaining HIV/AIDS to little \nchildren.  The filmakers were the children’s parents.\nMar. 3, 2008 – Participated in a State Department function for Jenna Bush on the \noccasion of celebrating her new book  “Ana’s Story:  A Journey of Hope”.  Took place in \nthe main auditorium of the State department.  I was the main speaker and spoke on “The \nGlobal Effects of HIV/AIDS and the origins of PEPFAR”.  Other speakers were Kristen \nSilverberg, Assistant Secretary of State for International Organization Affairs, and Karl \nZinmeister, Director of the White House Domestic Policy Council.  Got a chance to chat \na fair amount with Jenna Bush as we waited together for the affair to begin.  She is a very \nnice person who said that she was “in awe” of me because of all of the amazing things \nthat I have accomplished over the years.  She worked for UNICEF for a year in Jamaica \nand also spent time in Panama doing AIDS work.  Very nice person; has a smile exactly \nlike her father.  I gave a history of the origins of PEPFAR and a short summary of \nHIV/AIDS.  I showed the MMWRs from June 4 and July 5, 1981.  When Jenna got up to \nspeak, she remarked to the audience how impressed she was with me and my work over \nso many years and when I showed the 1981 slide, she was floored by the fact that I was \ninvolved in AIDS then and that was the year that she was born.\nMar. 5, 2008 – Meeting in White House (EEOB 445) led by Bob Kadlec of HSC..  Was \n“Top Secret” meeting on anthrax threat with emphasis on drug resistant and even vaccine \nresistant anthrax.  Based on supposed intelligence that Al Qaeda has been “talking about” \nanthrax and based on supposed documents captured from Al Qaeda.  We were briefed by \n2 CIA young women who provided the same vague, soft and even embarrassingly bad \nintelligence that I have been briefed on several times before by CIA.  One gets a very bad \nimpression of the quality of our intelligence based on meetings such as this.  Also present \nwere Julie Gerberding, Art Friedlander, Ben Petro, Gerry Parker and a whole bunch of \nReleased by Chairman Rand Paul\n169CIA, Counter-terrorist people, Defense intelligence people, etc.  Subject was how do we \nprotect against drug resistant anthrax and vaccine resistant anthrax.\nMar. 8, 2008 -  Busy and nice social evening.  Dropped in briefly to the NCS Annual \nSpring Festival “Casino Night” at the Athletic Center.  Said hello to the usual suspects \nand then went to the Newseum at 555 Pennsylvania Avenue to celebrate the 65th Birthday \nof Gerry Sigal.  Beautiful setting with bay window view of the Capitol Dome.  Great \nfood, drink and dancing.  Joe Wilson and Valerie Plame at our table.  Elias and Nadia \nZerhouni were dancing away with us on the dance floor.  DC was beautiful with crisp \ncold weather (upper 20s) and clear sky.\nMar. 10, 2008 – Another in a long string of Global Health initiative meetings at the \nWhite House (EEOB 374) led by Dan Price (see above) with Gary Edson, Mark Dybul, \nPatrick Marcham, Mike Magan, Paul Brown, Dana  DeRuiter.  Mainly discussed Dan \nplans for the upcoming G-8 meeting in Japan (he is USG Sherpa).  Issues are NTDs, \nheath workforce, HIV, Malaria, and TB.  I was there representing the malaria and TB \ninitiatives (see above).  Apparently Josh Bolten is enthusiastic about both, but HHS is not \nsupporting it since their priority in a bad budget year is pandemic flu and biodefense.  \nNonetheless, I am still going to these meetings and pushing the TB and Malaria agenda .  \nI can do this since Dan Price (with Josh Bolten’s approval) is including me in the process \neven though the HHS is against it.\nMar. 19, 2008 – A most amazing and unique evening.  Michael Gerson (former Bush \nspeech-writer and advisor) and current Washington Post columnist (see other discussions \nabove) invited Chris and me to his house for a private dinner with President and Laura \nBush.  Other guests were Fred and Barbara Barnes (Fred is Executive Editor of The \nWeekly Standard , Bill and Hara Haley (Bill is pastor of a DC Church and is interested in \nAIDS in Africa), and Mike and his wife Dawn.  Dinner was at Mike’s home at 2412 \nCrest Street, Alexandria.  It was somewhat surreal, but incredibly enjoyable.  The \noccasion was just that Mike is good friends with the POTUS and when he had breakfast \nwith the POTUS a few weeks ago he asked the POTUS if he would like to have dinner \nover his house some time with a few friends.  The POTUS gladly accepted and said that \nhe almost never goes out to private dinners at people’s homes because no one ever asks \nhim, likely because they would reasonably assume that he would not accept.  Evening \nstarted at 7:00 PM.  We had to get their earlier (^:45 PM) since the secret service closed \nthe roads (395) to make way for the motorcade.  We had about 45 minutes of cocktail \nhour (POTUS had non-alcoholic beer).  Very friendly chatting about a variety of subjects.  \nMy long-time impressions of the POTUS held true that he is a very warm, funny and \nconsiderate, self-effacing person. Laura was great also.  Laura and the POTUS \nspecifically thanked me for saying such nice things about him and Laura at Jenna Bush’s \nevent at the State Department (see Mar. 3 above).  POTUS said that Jenna saw him and \nLaura that night and told them how kind I was to them in explaining the POTUS role in \nPEPFAR.  He sounded very sincere in thanking me for “making my daughter proud of \nme”.\n   Dinner was terrific with nice wines, tomato soup, steak/potatoes, salad with bacon, and \nfruit dessert.  At dinner we discussed frankly a wide variety of topics including: War in \nReleased by Chairman Rand Paul\n170Iraq; his recent trip to Africa; his dealing with various Heads of State; the upcoming \nSummer Olympics in Beijing and why he really must attend despite the current \nmisbehavior of China in brutally suppressing the Tibetan call for freedom. He told a great \nstory of when former Prince and now King of Saudi Arabia visited him at his ranch in \nCrawford and negotiations about the Israel/Palestine problem came up.  They reached an \nimpasse since the POTUS thought that the Prince was being frankly anti-Semitic and the \ndiscussions stalled.  The POTUS would not yield on one point and the Prince announced \nthat he was leaving.  POTUS sent in Colin Powell to convince him not to but Colin cane \nback and told POTUS “Boss, I am getting nowhere with him; you have to step in”.  The \nPOTUS visited the Prince, perceived the “chilly” atmosphere in the room and said before \nwe discuss anything, let me tell you what my religion has done for me.  The prince \nagreed and then the POTUS asked the Prince to talk about what the Prince’s religion \nmeans to him.  This warmed up the chill and POTUS took him out on his pickup truck to \ntour the ranch alone.  As they were talking about the problem, a turkey hen jumped up in \nfront of the truck and just stayed in the road.  The POTUS said that he had never seen a \nturkey on the road before.  POTUS explained what a turkey was and how Ben Franklin \nalmost got the turkey to be the National bird, but the bald eagle won out.  The Prince said \nthat in his country god often speaks to people through birds and this is clearly a sign from \ngod.  After that, the negotiations flourished and POTUS and the king have been the best \nof friends.\n   The conversation also included discussions about us and our families.  The POTUS and \nLaura were very interested in Jenny’s thesis on women in the criminal justice system. I \nexplained what she was doing and how she decided on this topic.  He seemed very \nconnected and empathetic to the problems of young girls getting caught up in the system.  \nHe also expressed concern that black leaders are not speaking up more about black men \nabandoning their children after they have them leading to the incredible statistics of out-\nof-wedlock pregnancies among blacks.\n   POTUS also thinks that the Dems will go into the convention with Obama ahead and \nthat it will be a behind closed doors brokered convention.  He said, “if it is a behind \nclosed doors convention, there is no chance that Obama will out-maneuver the Clinton \nmachine.  She will be the nominee, split the party and McCain will win.\n After dinner we all went over an Photo album of the POTUS and First Lady’s recent \nvisit to Africa.  The President left at about 9:25 PM in a 6 to 8 car motorcade.\n  All in all it was an incredibly memorable evening.  \n     \n   Earlier in the day I briefed Ms. Sandra Roelofs, the First Lady of Georgia.  She is \nDutch and a nursing student.  She was interested is speaking to me because she had heard \nabout my AIDS work.  We spoke of TB, AIDS and other IDs.  She had earlier in the day \nhad lunch with Laura and Jenna Bush.  Actually, Laura mentioned this to me at Gerson’s \nhouse.\nMar. 25, 2008 – I organized and ran what might be an historic meeting today on the \nfuture of HIV Vaccine Research.  Ever since the disappointing results from the STEP \ntrial (Merck ad5 prime-boost – see above), there has been increasing pressure within \nourselves and in the scientific and certain activist communities to re-evaluate whether we \nshould turn the knob of support more towards basic discovery as opposed to clinical trials \nReleased by Chairman Rand Paul\n171of vaccine candidates for an HIV vaccine.  On Nov. 16, 2007 I received a letter from a \ngroup of basic scientist/animal model HIV researchers asking to meet with me following \nthe failed STEP trial in which vaccinated people with pre-existing Ad5 titers actually \nseemed to have an increased risk of HIV acquisition compared to placebo.  They felt that \nwe were wasting money on vaccine trials which they claimed had no basis to predict \nsuccess based on animal model data.  They were particularly concerned about going \nahead with Gary Nobel’s VRC trial –PAVE 100 that tested  3 DNA primes followed by \nan Ad5 boost.  However, others point out that the animal model has not been validated in \nthe human and so unfortunately, we are really flying blind.  In any event, in a manner \nsimilar to how I handled the AIDS activists >20 years ago in that same room (31/7A-24), \nI listened and suggested that we have HIV Vaccine Summit to discuss the direction of \nAIDS research.  Hence the meeting today.\n    Just a few days ago, a group called AIDS healthcare Foundation stated that we should \nstop ALL HIV vaccine research and put the money towards proven prevention activities.  \n   We had the Summit today and it was enormously successful.  I played an active \nleadership role in the process as opposed to just listening.  The meeting was chaired by \nWarner Greene and Adel Mahmoud and there were 3 panels: 1) basic discovery chaired \nby Jim Hoxie and Dennis Burton; 2) animal models chaired by David Watkins and \nMalcolm Martin; and 3) Clinical Research chaired by Scott Hammer and Julie \nOverbaugh.  \n   Great press coverage.  I concluded at end of meeting that we would indeed turn the \nknob more towards basic discovery research and promised an immediate $10 Million for \na broad RFA to come from moneys saved from truncating some of the clinical trial \nactivity such as a tighter PAVE 100.  Recall that our budget has been flat for the past 5 \nyears and so there is no extra money coming in.\n   Below is an article from the NY Times by Larry Altman from Mar. 26 that summarized \nthe Mar. 25 meeting:\nRethinking Is Urged on a Vaccine for AIDS \nBy LAWRENCE K. ALTMAN\nWASHINGTON — Researchers must go back to the drawing board before they can \ndevelop an effective vaccine against H.I.V., AIDS experts said at a scientific meeting on \nTuesday.\nAnd Dr. Anthony S. Fauci, the top federal official responsible for AIDS research, agreed \nthat more fundamental knowledge is needed about H.I.V. and the way the body and \nexperimental vaccines respond to it before the goal of a licensed H.I.V. vaccine can be \nreached. Dr. Fauci, the director of the National Institute of Allergy and Infectious \nDiseases, pledged to re-evaluate the use of all $1.5 billion his agency spends on AIDS \nresearch to come up with the necessary money.\n“Everything is on the table,” Dr. Fauci said at the one-day meeting, a Town Hall-type \ndiscussion for vaccine researchers on how best to spend federal H.I.V. vaccine money in \nlight of a budget that has been flat for several years.\nReleased by Chairman Rand Paul\n172“There is not an immediate solution to the problem,” Dr. Fauci said in an interview. But, \nhe also said, the budgetary constraints mean that “we are going to have to justify what we \nare doing” and determine what steps to take after further discussions in smaller meetings \nwith researchers.\nThe reassessment comes after last September’s widely publicized failure of what had \nbeen the most promising candidate for an H.I.V. vaccine. Many health officials believe \nthat an effective vaccine would be the most crucial weapon in stopping the H.I.V. \npandemic.\nScientists do not have a full understanding of why the vaccine failed, or why it was \npossibly harmful, in two large trials in the United States and South Africa. Dr. Fauci’s \ninstitute helped pay for the trials of the vaccine, which was made by Merck. Such failures \nhave led a number of scientists to challenge the direction of federal H.I.V. research.\nOn Tuesday, the AIDS Health Care Foundation called for the suspension of money for \nH.I.V. vaccine research and reallocating resources into effective H.I.V./AIDS prevention, \ntesting and treatment strategies.\nBut Dr. Fauci strongly rejected the proposal. “Under no circumstances will we stop AIDS \nvaccine research,” Dr. Fauci said at the conclusion of the meeting.\nDr. James Hoxie of the University of Pennsylvania echoed the belief of many other \nparticipants by saying, “we are not close to having a vaccine” and “there is a tremendous \nneed for innovation” in developing one.\nExperts at the meeting also said that Dr. Fauci’s agency needed to support efforts to \nfurther develop animal models of human H.I.V. The experts also urged greater \ncooperation between AIDS scientists who work on such animal models and those who \nare trying to develop an H.I.V. vaccine for humans.\nA crucial issue is supporting younger researchers to replace the cadre of veteran AIDS \nscientists, many of whom are working beyond traditional retirement age. Dr. Fauci said a \nfirst step would be to pare existing projects to immediately provide $10 million to $15 \nmillion for about 30 grants to be awarded to scientists who propose novel ideas. Some of \nthe grants would be used to support young researchers, he said.\nSome scientists support conducting large vaccine trials in humans before all the fine \npoints of the vaccine research are complete in animals because of the urgency of the \npandemic.\nOthers urge caution out of fear that failures could destroy confidence among uninfected \npeople most at risk who would be needed as volunteers in future trials.\nEqually vocal groups call for testing everything as soon as the research shows promise \nbecause of the urgent need for a vaccine.\nReleased by Chairman Rand Paul\n173Dr. Warner C. Greene, a co-chairman of the meeting and director of the Gladstone \nInstitute of Virology and Immunology in San Francisco, said he hoped that a century \nfrom now, historians looking back on the AIDS pandemic would view Tuesday’s meeting \nas a turning point. \nMar. 26, 2008 – Rave reviews coming in regarding “my leadership” during the Summit.  \nWent down to White House (NEOB 5235) to brief OSTP WH Science Advisor Jack \nMarburger and his staff together with staff from FLOTUS on the HIV vaccine situation, \nparticularly given all of the publicity.  I had appeared on NBC News, VOA, Bloomberg \nTV as well as articles in Washington Post, NY Times (see above) and WSJ.  Now we \nneed to follow-up with RFA’s etc.\nApril 1 and 2, 2008 – Visited Princeton University  to Deliver the Inaugural Adel \nMahmoud Lectureship and to participate in a Panel discussion with Bill Frist, Andrew \nMcGuire, and Beatrice Hahn at a Symposium on “No Country Left Behind:  \nTransforming Global Health given by the Woodrow Wilson School of Public and \nInternational Affairs.  Bill Frist spent some time telling the audience that if it were not for \nme PEPFAR would not have happened.  Had dinner at a Princeton mansion, went to Adel \nMahmoud’s and Sally Hodder’s home (where I stayed overnight – beautiful modern \nSalvatore Dali-like home) for after dinner cocktails with some of the Princeton Faculty.  \nWas very impressed with the commitment to teaching students that I saw among the \nfaculty as well as the competency and popularity of Shirley Tilghman (President).  Next \nday taught a class in the Dept. of Molecular Biology run by Leon Rosenberg and Adel \nMahmoud. Spoke about the evolution of my career.  Students were great.\n   On evening of April 2, had long interview with Meredith Wadman of Nature who is \ndoing a story on PEPFAR and wanted a bit of the history.\nApril 3 – June 10, 2008 – Very busy and eventful times.  Had virtually no time to enter \nevents into diary.  We try to summarize.  The Democratic primary loomed hot and heavy \nwith Hillary refusing to concede despite the fact that numerically it was impossible for \nher to pull ahead of Barack Obama.  Finally after the Oregon (Obama) and South Dakota \n(Clinton) primary, she begrudgingly conceded on June 6.\nApril 21 – Participated with Sec. Leavitt in a “Georgetown Conversations” function at \nthe home of April and John Delaney in Potomac, MD.  This series is sponsored by Meryl \nChertoff (Mike Chertoff’s wife) and Larry Gostin.  Bring together a bunch of prominent \npeople in an elegant home and make brief statement, followed by Qs and As and then \ndinner.  Very enjoyable.\nApril 26 – Went to Chicago for the AAP Annual Meeting to induct Bob Seder into the \nAAP (I sponsored him).  Saw Megan and had a nice brunch and then went to L.A. for the \nMilken Institute’s Annual Global Conference where I participated in 2 stimulating Panel \nDiscussions on Global Health.  Greg Simon (Al Gore’s former Chief-of-Staff) got me \ninvolved.  Met a lot of political financial backers at the meeting.  Had dinner at the L.A. \nmansion (Sunset Boulevard) of Lynda and Stewart Resnick and gave dinner remarks.\nReleased by Chairman Rand Paul\n175June 17, 2008 –   I will be attending \nhis memorial service at the Kennedy Center tomorrow.\n    Bono called me today to congratulate me on receiving the Presidential Medal of \nFreedom.  I caught him up on my family and mentioned that Megan was starting at \nColumbia in September.  His daughter Jordan (JoJo) is also starting Columbia.  He asked \nme to send him Megan’s contact information since he is worried that his daughter will be \nlonely since she is coming directly from Ireland.  Perhaps they will become friends.\nJune 18, 2008 – Attended the memorial service for Tim Russert at the Kennedy Center.   \nExtraordinary Washington affair with the total “A list” present.   Hosted by Tom Brokaw.   \nSee book published in 2013 called “This Town” by Marc Liebovich for full details of the \nceremony.\nJune 19, 2008 – Extraordinary day at the White House for the Presidential Medal of \nFreedom Ceremonies.  Crisp, clear blue sky, sunny and comfortable day.  A lot of joy in \nthe presentations (see my written file records of what was said about me by the POTUS).  \nVery good media coverage.   The presentations for everyone were very warm.  Lots of \nwonderful pictures.  Many guests (some of whom came for me) such as Justice Scalia, \nSam Donaldson, Cuba Gooding, Judge Merrick Arlen, Gen. Richard Meyers,, etc.  I had \nvery warm interaction with the POTUS.  When we approached him with my group of 10 \n(Chris, Jenny, Ali, Denise and Jack, Cliff Lane, Hugh Auchincloss, J.J. McGowan, Greg \nFolkers and Patty Conrad) to take a group Picture, the POTUS hugged me and put his lips \nto my ears and said, “I love you Tony, Thanks for all you do for our country and the \nworld”.  The ceremony took place in the east Room and the reception took place in the \nBanquet room of the East Wing.  After the ceremony we watched from the balcony as the \nPOTUS took off in Marine One for a tour of the flood damage in Iowa.\n   After the reception, Chris took off with Ali to fly to Chicago to bring home Megan \nfrom her year there.  Jenny is home after graduation trying to decide what she will do \nnext year.\nJune 21 – 29, 2008 – Extraordinary trip to Greece with Chris, Jenny, Megan and Alison.  \nI went first to Thessaloniki to deliver Keynote Address at the Immunocompromised Host \nSociety Chaired by Steve Holland.  Spoke on HIV/AIDS (of course).  Then met family in \nAthens where I received an honorary doctorate at the University of Athens sponsored by \nHaralampous (Harry) Moutsopoulos, my old friend from NIH days 30 years ago.  \nAbsolutely fabulous time, elegant hotel (Grand Bretagne), wonderful food, elegant \nceremony (very formal with old robes), sight-seeing at Acropolis, Agora, Old Olympic \nStadium.  Then spent 3 days on the island of Santorini (Ali picked the place) in a \nbeautiful, but understated beachfront Hotel with Harry and his wife Foteini.  Santorini is \na volcanic island of indescribable beauty.  Perfect weather – no clouds at all for 1 week in \nGreece.  Great hospitality, especially from Harris Roussos, an old and dear friend of \nHarry’s who runs the biggest hospital in Athens and who owns an elegant home in \nSantorini.  They threw a “Greek-Style” party for us one night.  Spent evenings eating \nReleased by Chairman Rand Paul\n\n176elegant meals at mountain cliff restaurant or on the beach.  Visited Oia, Fira – stayed at \nKamara Beach.  One of the best vacations (albeit brief) that I have ever experienced.\nJuly 3, 2008 – Gave lecture at the Ideas Festival at Aspen, CO on HIV/AIDS in 2025:  \nWill we have a vaccine and a cure by then?”.  Usual ambiance of Aspen with nice dinner \non the night of July 2 catered by the famous Alice Waters of Chez Panisse in Berkley, \nCA and narrated by Corby Kummer, renowned food critic of The Atlantic (also the \nperson who lent us his apartment in Boston for Jenny’s graduation (see above).  Met \nusual celebrities at dinner.  Spoke with Chris Jennings (Clinton’s Health person who is \nnow with the Obama Campaign since Obama won the primary.  He wants to get me \ninvolved as a person to advice the campaign informally about what they are on track with \ncertain issues.\nJuly 6, 2008 – Wonderful day.  Chris Hultzen arranged to have Danny and Joe Hultzen \nand their friend Austin do “batting practice” with me at STA field.  Danny pitched to me \nand it was terrific. I hit several line drives to outfield, but the distance was poor, nothing \nlike the fence shots that Danny and the others were hitting.  It is clear that my power is no \nwhere near Danny’s and the others.  I pitched to Danny and he hit some over the right \nfield fence.\nJuly 17, 2008 – Made what some are saying is a “landmark decision not to proceed with \nthe PAVE 100 HIV vaccine trial of the NIAID VRC product.  This followed weeks and \nmonths of committee meetings and recommendation such as the AIDS Vaccine Research \nSubcommittee (AVRS) who voted to proceed and the Strategic Working Group (SWG) \nwho voted not to proceed.  The issue was that the Merck STEP trial failed and actually \nhad some safety issues.  The PAVE trial is somewhat different (3 DNA primes and an \nAd5 boost containing env) from the STEP trial (3 Ad5s without env), yet the preliminary \nimmunological data from PAVE 100 was in my mind (some such as Gary Nabel \ndisagreed) not much better than those of STEP.  I received many e-mails from people \narguing for and against.  The decision was mine alone and I decided to reject the \nproposed PAVE trial of 2400 people since it was powered to do immunological correlates \non a subgroup who might seem to benefit even if the endpoint of the entire group was not \n“effective”, i.e. decrease in viral set point after infection.  I argue that if the trial failed, I \nam not interested in the immunological correlates in a subgroup since this has no \nstatistical value.  There was much activity in the Press about my decision and the \nfeedback was overwhelming that I had made the right choice.  I encouraged Larry Corey \nof HVTN and Scott Hammer the PI of PAVE to come back to me with a “leaner, meaner” \nprotocol that is less expensive, fewer people, less samples to ask if the product works.  If \nit does, then we will go back and do immune correlates.\nJuly 30, 2008 – Christine, Meg and Ali left for Rwanda to spend 2 weeks working with \nPaul Farmer in his Clinic.  More later.\nJuly 30, 2008 – Invited to the White House (East Room) to witness and celebrate the \nsigning by the POTUS of the reauthorization of PEPFAR at $48 Billion.  The law is \nofficially H.R. 5501 – The Tom Lantos and Henry J. Hyde United States Global \nReleased by Chairman Rand Paul\n177leadership Against HIV/AIDS, Tuberculosis and Malaria reauthorization Act of 2008.  \nThe usual cast of HIV-related characters was there.  It felt good to see the attention, \nsuccess and promise of a project that I developed. Now we need to make sure that this \nreauthorization ultimately turns into an appropriation.\nJuly 31 – Sept. 15, 2008 – Busy summer with little time with family.  Chris and girls \nwent to beach while I stayed for duties at work.  Chris, Megan and Ali went to Rwanda to \nwork with Paul Farmer for 2 ½ weeks.  I did not go since I had to give Keynote Lecture \nat the IAS Meeting in Mexico City (August 3-8).  I focused on a discussion of whether \nwe will ever have a “cure” or a vaccine for HIV.  It stirred much discussion and was well \nreceived.\n    We moved Megan into her dorm at Columbia last week in August.  It was great fun.  I \nhave a very good feeling about Columbia and hope Megan has a good experience.  \n   Jenny has taken a job teaching in a Charter School in the Brownsville Section of \nBrooklyn (adjacent to Bedford-Stuyvesant).  She is living in Prospect Heights-Crown \nHeights.  After my childhood growing up in Brooklyn, I never would have imagined that \nmy 22 year old daughter would be living in the toughest section of Brooklyn.  She loves \nteaching the children.\n   Amazing political season in Washington, D.C.  Sarah Palin has been chosen as John \nMcCain’s running mate and this has shifted the momentum (amazingly so) to the \nRepublicans since she has energized the far-right conservative base. I may be pre-\njudging, but she seems to be totally unqualified to be Vice-President (or President) of the \nUSA.\n   On Sept. 14, went to a great BBQ party at Sam Donaldson’s home in McLean, VA.  All \nthe usual suspects were there with whom I have become friends with over the years and \nwe talked election year politics:  Colin and Alma Powell, Lee Hamilton, Bob Barnett, \nFred and Marlene Maleck, John and Debbie Dingel, Bill and Janet Cohen, Wayne and \nCatherine Reynolds, Steve and Alice Rosenberg, Ben and Candy Carson, Birch and Kitty \nBayh, and many others.\n  On the evening of Sept. 15 Chris and I attended one of the spectacularly elegant \nreception/dinner parties hosted by Wayne and Catherine Reynolds at the Eisenhower \nTheater of the Kennedy center to celebrate the re-opening (after upgrading) of the \nTheater.  Again, all the usual suspects of Washington glitterati were there – most people \nfrom Sam Donaldson’s party the night before as well as many other media, government \nand military people: Gens. Jim Walston, Wesley Clark, James Jones, Colin Powell; the \nEisenhower grandchildren (Anne and Susan); journalists (Chris Wallace, Wolf Blitzer) \nand on and on.  Really a very relaxed evening with spectacular entertainment.  The \nreception was in the foyer outside the Theater and the dinner was right on the Theater \nStage with performances by dance troupes, Jane Alexander, the entire original cast of \n“Mame” right within a foot or two of the dinner tables.  Wayne and Catherine do it again!\nReleased by Chairman Rand Paul\n178Sept. 16, 2008 – Testified before Rep. Henry Waxman’s House Committee on Oversight \nand Government Reform in Rayburn House Building Room 2154. Topic = HIV \nprevention in light of the new numbers from CDC showing that the incidence in USA of \nHIV is worse than was previously calculated – 56, 300 versus 40,000.  Other main \nwitness was Julie Gerberding with Kevin Fenton of CDC and Tom Insel of NIH as back-\nups.  Hearing went very well – generally friendly.  Maxine Waters gave Julie Gerberding \na hard time about not acting with leadership in a “crisis”.  I stated that needle-exchange \nworks and that abstinence only does not work.  This may upset some ideologues in HHS \nor the WH.  Mild Fall day – slightly cloudy.\nSept. 23-30, 2008 – Major crisis on Wall Street and in the banking industry with big \nbanks and financial institutions failing – Lehman Brothers (Bankrupt), Fannie Mae and \nFreddie Mack taken over by the government, AIG bailed out by the government; many \nbuyouts and mergers, stock market plunged by 777 points in 1 day – largest drop ever.  \nCongress trying to agree on a $700 Billion bailout package for financial institutions to \nrestore the credit flow in the USA.  Big problems!!\nOct. 1, 2008 – On Sept. 23, 2008 Elias Zerhouni announced that he would step down as \nNIH Director at the end of October, right before the election to avoid any confusion about \npolitical issues and to call attention to the vacancy for the incoming transition.  I was \nasked to be Acting Director and refused; Steve Katz was considered but was rejected by \nthe WH because of the LA Times story on him and conflict of interest a few years ago.  \nBetsy Nabel either withdrew her name or was not asked because of an issue of a COI of \none of her recently hired Senior Advisors.  Raynard Kington (current deputy NIH \nDirector) should have been asked directly but was not.  Not clear why the DHHS and/or \nthe WH are uncomfortable with him.  One version is that he is not well known in the \nCongress and among constituencies; anther more cynical version is that the WH has a \nproblem with a gay man (he is married and has an adopted child).  The WH and/or DHHS \ntried to then get me to agree to be publicly appointed as a “Senior Advisor” to the Acting \nDirector to quell the concerns of the outside people and indicate that a strong, visible, \nexperienced person such as me was “watching the store” even though Kington would be \nappointed as the official Acting Director.  I told Elias and Jamie Burke (White House \nLiason Office) that this was impossible and no way would I do this.  I told them explicitly \nthat I did not want to do it in the first place; second – it was an insult to Kington and \nwould undermine his authority; third – people would come directly to me and circumvent \nKington’s authority; fourth – it looks stupid.  She actually agreed and so the decision was \nto appoint Kington cleanly and have me be available “behind the scenes with no \nannouncements” to advise him if he needed advice.\nOct. 2, 2008 – Gave Inaugural Ben Kean Lecture on Global Health at New York \nPresbyterian Hospital - Weill Cornell Medical Center.  Great déjà vu  feeling about my \nyears there.  Much adulation among house staff at lecture and morning report.\nOct. 3 – 4, 2008 – Went to Parent’s Weekend at Columbia for Megan.  Jenny (living in \nBrooklyn) joined Chris and me for a couple of dinners with Meg. Went to Columbia-\nReleased by Chairman Rand Paul\n179Princeton football game.  Great weekend.  Jenny, Meg and I watched the Sarah Palin – \nJoe Biden debate.  What an idiot Palin is!!\n      Stock Market is tumbling badly.  It is scary as it looks like it is crashing as a result of \nthe bank credit crunch that is causing anxiety of Wall Street.  When this settles, I will re-\nthink the advisability of my even being invested in Wall Street as opposed to safe Money \nMarket investment or T bills.\nOct. 6, 2008 – Big news today.  Nobel Prize in Medicine or Physiology given to \nFrancoise Barre-Sinoussi and Luc Montagnier for HIV and to Harald Zur Hausen for \nHPV discovery..  This is a big slight to Gallo, likely because of the controversy from the \n1980s.  The Committee could have given the 3 (limit) to HIV and save HPV for another \nyear; yet they combined them and thus Gallo was out since it is clear from the 1983 \nScience paper that Montagnier and Barre-Sinoussi discovered the virus first, although \nGallo proved cause effect one year later and discovered TCGF (IL-2) that allowed \neveryone to grow T cells in culture and hence grow the virus.\n     Gave the after dinner address at the Woodrow Wilson Internal Center for Scholars \nDinner for their Board of Trustees, Councilors, and Scholars at the Ronald Reagan \nBuilding in DC.  Cool, crisp night.  I was invited by Lee Hamilton. Many notable people \nthere including Sam and Jan Donaldson, Marvin Kalb, Robin Cook, etc.  I spoke on \nHIV/AIDS:  An Historical Perspective.  Talk extremely well received.\nOct. 11 – 16, 2008 – Traveled to Cape Town, South Africa to deliver a keynote address \nat the 2008 AIDS Vaccine Meeting on “An HIV Vaccine: Science and Policy”.  The talk \nwas very well received.  I spoke of the particular challenges of  HIV vaccinology \ncompared with “classical” vaccinology.  Weather was beautiful and the city was in my \nmind a cross between San Francisco and Rio de Janeiro.  We took a drive on Monday \nAM, Oct. 13 around the countryside to vineyards and around the historical parts of the \ncity.  Most disturbing to me was the conditions that I saw at the “townships” a few miles \noutside of the city.  Particularly disturbing was Khayelitsha township that seemed to go \non for miles with huts that were made of corrugated tin roofs and plywood and other soft \nmaterial.  The huts were smack next to each other with very little room between them to \neven walk outside.  Apparently they have electricity in some huts and common water \nsources and latrines, but I cannot imagine anyone living there.  The black South Africans \nsay that it is not as bad as it looks and they are gradually trying to phase them out and \nreplace them with regular housing.  I cannot judge since this is the first time that I have \nseen them, but I would flatten the whole thing now and build high-rises.  Problem is that \nhundreds of thousands of people live there and you cannot just displace them now \nwithout a facility to put them in.\n   I have some concern at this point that the Vaccine Enterprise in the person of Allan \nBernstein is looking for ways to change the direction of HIV vaccine research even \nthough he has been in the field only for months.  He is a very good guy, but I repeat my \nusual statement of “everybody wants to be somebody” and “beware of people who do not \nReleased by Chairman Rand Paul\n182Anthony Fauci\n \nOn the art of persuasion. There's more than one way to get to the goal that you want to \nget to, but once you compromise your own principles, then you're lost. You're really lost. \nYou just can't do that, even if it means that people are going to be disappointed in you \nand you might not find yourself in the inner circle. Every time I go to a meeting in the \n[White House's] Roosevelt Room or the Oval Office or in the chambers of Congress, I \nkeep in my mind that I may have to say something that will disappoint people, and if that \ndisappointment leads to my not getting asked back, so be it.\nOn being principled without destroying relationships. You maintain a respect for the \nother person, and you reflect that in how you deal with that person—although you may \ndisagree with them, you respect them and their right to have their view. I've had \ndiscussions with people who somehow just didn't get it. You never walk away in \nfrustration. Some people feel, you make your case, if they listen to you, fine, if they don't, \nthat's it. That's not what leadership is. Leadership is trying to continue to make a case.\n•Click here for more of America's Best Leaders \n•Click here for more on Anthony Fauci\nAmerica's Best Leaders 2008\nDavid Gergen: Obama Is a Leader of Great Potential, but He Can’t Do \nIt Alone \nThis year’s Best Leaders are the kind of people who can help him lead us out of our \ndoldrums.\nLance Armstrong \nCyclist and Advocate Making tireless efforts on behalf of cancer survivors like himself.\nDavid Baltimore  \nCalifornia Institute of Technology This Nobel-winning scientist leads with \"a little bit of \nchutzpah.\"\nReleased by Chairman Rand Paul\n183Regina Benjamin \nLe Batre Rural Health Clinic  She believes that living in a tiny rural town shouldn't mean \ngiving up big-city healthcare.\nJeff Bezos \nAmazon.com The founder of the massive online retailer is a true Internet pioneer.\nTerence Blanchard and Herbie Hancock \nThelonious Monk Institute Their Thelonius Monk Institute of Jazz brings music education \nto public schools.\nBenjamin Carson \nJohns Hopkins Hospital A talented pediatric neurosurgeon and activist for inner-city kids.\nManny Diaz \nMayor of Miami A son of Cuban immigrants, Diaz leads one of the nation's major \nmulticultural cities.\nMarian Wright Edelman  \nChildren's Defense Fund A civil rights pioneer and crusader on behalf of children.\nAnthony Fauci \nNational Institute of Allergies & Infectious Diseases A leader on HIV/AIDS and a \nstraight talker on key health issues.\nMike Feinberg and Dave Levin \nKnowledge Is Power Program Raising educational expectations in underserved \ncommunities.\nOpinion\nThe Financial Crisis Kills Trust in Leaders \nBill George: We must do more than fix the crisis; we need to fix the mindset that got us \ninto it.\nReleased by Chairman Rand Paul\n184Obama and American Followership \nBarbara Kellerman: At this moment in history, diffusion of power overwhelms \nleadership.\nRobert Gates \nSecretary of Defense Pentagon chief looks for uses of \"soft power\" in a hard power \nworld.\nFiona Harrison and Maria Zuber \nNASA scientists The first two women to head their own NASA robotic space missions.\nFreeman Hrabowski \nUniversity of Maryland-Baltimore County He helped turn a no-name commuter college \ninto a center for math and science.\nAmory Lovins \nRocky Mountain Institute  For this bright light in the field of alternative energy, it's all \nabout efficiency.\nAnne Mulcahy \nXerox In reforming a troubled company, she had the courage to say \"No\" to Wall Street.\nIndra Nooyi \nPepsiCo Karaoke-singing chief executive is taking Pepsi in an unlikely direction--toward \nhealthful foods.\nLinda Rottenberg \nEndeavor Her nonprofit seeks to build profitable small businesses on a global scale.\nJeffrey Sachs \nUnited Nations Millennium Project An academic who looks for real-world ways to beat \nglobal poverty.\nSteven Spielberg \nFilmmaker He addresses important issues on the big screen and through his philanthropy.\nReleased by Chairman Rand Paul\n185Michael Tilson Thomas \nSan Francisco Symphony  A maverick maestro is winning big crowds of new classical \nmusic fans.\nU.S. Junior Officers \nMilitary They are rising in the military ranks with a hard-earned wisdom forged by war.\n \nA New Leadership Style For America  \nJoseph S. Nye Jr.: It's time to retire the \"big man,\" heroic warrior model of leadership.\nLance Armstrong: Beatrice De Gea/ The New York Times/Redux; David Baltimore: \nManjunath Kiran/EPA/Corbis; Regina Benjamin: Charlie Archambault for USN&WR; \nJeff Bezos: Brian Smale/Redux; Terence Blanchard: David Butow/Redux for USN&WR; \nBenjamin Carson: Gurinder Osan/AP; Manny Diaz: Paul Sancya/AP; Marian Wright \nEdelman: Jeffrey MacMillan for USN&WR; Anthony Fauci: Charlie Archambault for \nUSN&WR; Mike Feinberg: Kevin Horan/Aurora for USN&WR; Robert Gates: Jeffrey \nMacMillan for USN&WR; Herbie Hancock: David Butow/Redux for USN&WR; Fiona \nHarrison: David Butow--Redux for USN&WR; Freeman Hrabowski: Jeffrey MacMillan \nfor USN&WR; Indra Nooyi: Neville Elder/Corbis; Dave Levin: Jim Lo Scalzo for \nUSN&WR; Amory Lovins: Ben Stechschulte/Redux; Anne Mulcahy: Ben Baker/Redux; \nLinda Rottenberg: Peter Dejong/AP; Jeffrey Sachs: Chip East/Reuters; Steven Spielberg: \nSteven Henry/Getty Images; Michael Tilson Thomas: Chris Gordon/Getty Images; U.S. \njunior officers serving in war zones: Joe Raedle/Getty Images; Maria Zuber: Bill \nIngalls/NASA\nNov. 21, 2008 – Went to dinner party at Ellen and Gerry Sigal’s home.  Present were \nChris Grady, Ellen, Gerry, Richard and Donna Benveniste, Bill and Melody Wilson, \nLarry and Carla Silverstein, Neera Tanden and husband Dan.  Neera is on the Obama \ntransition team and I am sure that Ellen in her quest to get me to become NIH Director set \nthis up for us to meet.  I am very reluctant to take the job and soon I will likely have to \ntell the Obama people “no” if they ask. \nPrior to the Sigal dinner party I gave remarks at the opening reception for the TAG \nWorkshop on Eliminating Viral Persistence and Eradicating HIV infection.  This is \nbecoming a very hot issue that I have been pushing in the sense of a “functional” cure.\nReleased by Chairman Rand Paul\n186Nov. 22, 2008 – Was invited by former President George H.W. Bush to attend the \nchristening of the new aircraft carrier USS George H.W. Bush at Norfolk , VA on Jan. \n10, 2009.  \nNov.24, 2008 – Breakfast and panel discussion at the National Press Club in association \nwith my (and others) receiving the recognition of America’s Best Leaders 2008 (24 \nLeaders Who are Making a Difference) by U.S. News & World Report and the Center for \nPublic Leadership of the John F. Kennedy School of Government at Harvard University.  \nDavid Gergon MC’d the affair and C-SPAN-2 covered it.  We also all appeared in the \nDec. 1-8, 2008 issue of U.S. News & World Report.  Other winners who were present \nwere: David Baltimore, Regina Benjamin, Benjamin Carson, Manuel Diaz (Mayor of \nMiami), Marian Wright Edelman, Fiona Anne Harrison, Freeman A. Hrabowski (Pres. U \nof MD, Baltimore County, Dave Levin (Founder of KIPP Foundation, Linda Rottenberg \n(CEO, Endeavor), Mike Feinberg (C0-founder of KIPP), Maria Zuber (MIT).  Awardees \nwho were not there: Lance Armstrong, Jeffrey Bezos (CEO, Amazon.com), Terence \nBlanchard and Herbie Hancock (Thelonius Monk Institute of Jazz), Robert Gates \n(Secretary of DoD), Amory Lovins, Anne Mulcahy (CEO Xerox), Indra Nooyi (CEO, \nPepsiCo.) Junior Officers DoD, Jeffrey Sachs, Steven Spielberg, Michael Tilson Thomas \nMusic Director, SF Symphony.\n     David Gergon asked each of us what we would recommend to President-Elect Obama \nas an area that he should pay attention to.  I stressed the need for support of biomedical \nresearch and also the importance and moral obligation that we have towards promoting \nGlobal Health and its potential for “Health Diplomacy”.\nNov. 25, 2008 – Received a call from Aaron Pickrell who is running the Obama \ntransition team for HHS and sub-agencies.  He said that my name is actively being \ndiscussed for NIH director and he wanted to know if I was interested.  I was frank and \nhonest with him saying that I wanted to remain as NIAID Director, but I want to be part \nof the Obama team and perhaps we could work out something informal (without title) or \nmore formal (?Special Assistant or Special Advisor to the POTUS) for issues on Global \nAIDS, Emerging infections, and Biodefense.  He said that he would run this up the ladder \nand see how people react.  My real desire is to stay where I am but to be called upon as I \nhave been for 20+ years on issues mentioned above.  I do not want to give up my solid \nbase of scientific credibility.  I hear that Francis Collins is aggressively campaigning for \nthe job of NIH Director – not surprising.\nNov. 29, 2008 – Had brunch with small group of people at Richard and Donna Ben-\nVeniste’s house.  He is a great guy with whom Chris and I have developed a nice \nfriendship.  He asked about the NIH Director job and suggested without my implying that \nI should tell the Obama people that I want to do both NIAID Director and NIH Director.  \nThis is what I agreed upon with Tommy Thompson 6 years ago, but the WH (Clay \nJohnson) blocked it and said that I could take one or the other.  I picked NIAID Director.  \nI actually do not think that doing both jobs would work, mainly because people would \njump on the “appearance” of conflict every time that I made a decision that they did not \nlike or if their grant did not get funded, and on and on.  Also at the brunch was Carl \nReleased by Chairman Rand Paul\n187Feldbaum, the IG of the DoD during the Carter Administration and his son Harley who is \nat Hopkins School of Public Health and is very interested in “Health Diplomacy”.  He has \nbeen an admirer of mine for years as a student.  I hope to help him and perhaps advise \nhim on career choices.\nNov. 30, 2008 – Sunday AM (pouring rain).  I had backed out of the Redskins- NY \nGiants game with Gene Elrod because my daughters were home for Thanksgiving \nweekend. Got a call from Jay Lefkowitz who is writing a brief history of PEPFAR for a \ntrade journal (forgot which one).  He wanted to do a historical fact check with me about \nthe timing of meetings that we had with Josh Bolton, Gary Edson, Kristen Silverberg in \nthe WH.  His version of events was strikingly close to my historical memory.  During the \nconversation he asked about the NIH Director job and we reminisced about the Bush \nyears.  Interesting fact that he dropped.  He related that he was having a conversation \nwith Bush during the time of the NIH Director decision and Bush said, “why not just \nappoint Tony Fauci”.  Jay agreed.  Jay now casually mentioned that Karl Rove was \nagainst my candidacy.  He did not say why.  I could be that he was against the “dual” \nappointment or perhaps he was influenced by Sen. Brownback’s concern about my stance \non fetal tissue and stem cell research.  I guess that I will never know.\nDec. 6, 2008 – Annual Christmas Party at Sam and Jan Donaldson’s home.  As usual, \ngreat time with the standard cast of characters some of whom are: Colin Powell, Wolf \nBlitzer (CNN), Bob Barnett, George Will, Ellen and Gerry Sigal (told me that Francis \nCollins is “aggressively” campaigning for the job of NIH Director.  I told her that I \npreferred to stay at NIAID.), Bob  Mueller (FBI), Gen. James Jones (new National \nSecurity Advisor for Obama; we spoke about the importance of biodefense and gave him \nmy card).  Great time was had!\n   After the Donaldson party went to the National Zoo (Amazonia) for the 50th Birthday \nparty for Greg Folkers thrown by his significant other Sheila Stinson.\nDec. 7, 2008 – (Sunday) – got e-mail asking me to call Mike Froman from the Obama \nTransition Team, wanting to know if I was interested in the NIH Director’s job.  He said \nthat Obama had mentioned my name to him and asked that he contact me.  I told him \nwhat I told Aaron Pickrell on Nov. 25 (above) that I felt that I could serve Obama, his \nadministration, and the American people better in my  current job and expressed a \nwillingness to work closely with them the way I have with the Bush and Clinton \nAdministrations.  He understood and asked if I would be willing to help vet names for \nthem as they narrow the search.  I told him that I would be happy to do that.\nDec. 9, 2008 – Chris and I went to the VP Mansion for the Annual Christmas Party.  \nBitter-sweet since this is the last one that I will have gone to the mansion for the Bush \nAdministration and maybe (who knows?) the last visit that I might make to the VP \nmansion.  Chris and I reminisced that the first time we came here was when George H.W. \nBush was VP in the early 1980s and how we returned several times for receptions and \nbrunches as the VP and I became friends.  Tonight there was the usual cast of people who \nI had the opportunity to talk to and thank for the years of working together and helping \nReleased by Chairman Rand Paul\n188each other out.  First and foremost was VP Cheney who expressed his appreciation for \n“all that I have done for our country” over the years that we had worked together and \nbeyond.  Also, reminisced with Bruce Miller (VP’s Chief for biodefense), David \nAddington (VP Counsel), Mike Chertoff, Mike Leavitt, Bob Kadlec.\nDec. 10, 2008 – On an unseasonably warm night for December, went to the Mandarin \nHotel in Washington, D.C. (12th and Maryland Avenue, SW) to receive the “25 Greatest \nPublic Servants” Award  from the Council for Excellence in Government.  It was \nsomewhat of a big deal.  Other awardees who were present were Everett Alvarez (Viet \nNam pilot POW), Lee Hamilton, Sen. Richard Lugar, Tom Ridge, Donna Shalala, Shirley \nJackson (President Rensselaer Polytechnic Institute).  Other awardees who were not there \nwere:  James Baker, Mayor Mike Bloomberg of NYC, Mayor Richard Daley of Chicago, \nFormer VP Al Gore, Tom Kean, Ted Kennedy, Congressman John Lewis, Wilma \nMankiller, Norman Pinetta, George Mitchell, Sandra Day O’Connor, Peter Peterson \n(Chairman, Council on Foreign Relations, Colin Powell, Alice Rivlin, Robert Rubin, \nGeorge Schultz, Paul Volker, John C. Whitehead Former deputy Secr. Of State.\nInteresting evening with a lot of friendly discussions about the Obama transition.  Clay \nJohnson of OMB was there and said a few words about the Bush Administration and told \nthe large dinner crowd that we are leaving the government and the country better than we \nfound it – the entire audience was struck silent.  You could feel the discomfort in the \nroom.  I sort-of like Clay (even though he screwed me years ago re: the NIH \nDirectorship), but he clearly proved how out-of-touch he and the Administration people \nare.\nDec. 10 – 26, 2008  – Jenny got home on Dec. 23 and Megan has been home since Dec. \n19.  Wonderful to have all 3 girls together in the house.  Jenny is as passionate as ever \nover the work that she is doing teaching science at a charter school in Brooklyn \n(Brownsville).  She lives in Park Slope.  I am a bit worried about her living in a tough \nsection of Brooklyn, but she is a careful young woman.  Interesting that she wound up in \nthe place on my birth.  Megan is somewhat sad and lonely in NYC even though she is \ndoing extremely well at Columbia (all As except for 1 A- and 1 A+).  She does not like \ncollege life, but I am sure that she will adjust since her main issue is she does not make \nfriends easily.\nDec. 26 – Jan. 1, 2009 – Had our every 3 ½ year big Editorial Board meeting of HPIM in \npreparation for HPIM-18 .  Meeting in Rio Grande (40 minutes West of San Juan). \nEnjoyed the stay, but Chris and the girls were there only from Dec. 28 (PM) until Dec. 31 \n(AM).  We had my 1 day off on Dec. 30 and spent day at beach with great weather (80 \nand sunny).  Chris and I and the girls together with the Hauser boys (Bennett, William \nand Stewart) went kayaking in an sea kayak out to a sand bar.  Spent the evening in Old \nSan Juan at a great outdoor restaurant in the old square near El Moro Fort.\nJan. 4, 2009 – Had our traditional New Years Eve dinner with the Gallin’s at their house \nthis time together with Ali and Megan since we missed the real New Years Eve as I was \nin PR.  \nReleased by Chairman Rand Paul\n189Jan 6, 2009 – Hectically busy since returning from PR.  Went to Philadelphia to receive \nthe Silver Award Lectureship at Children’s Hospital of Penn (CHOP).  Hosted by Steve \nDouglas.  Kept me very busy with lecture, dinner at a great restaurant (LaCroix) at the \nRittenhouse Hotel., multiple meeting with staff and fellows.\nJan. 7, 2009 – Dinner at the home (Villa Firenze on Albermarle Street, N.W.) Italian \nAmbassador to the USA Giovanni Castellenata and his wife Leila in honor of Dr. Enrico \nGaraci, the president of the Istituto Superiore della Sanita in Rome.  Also present were \nRuggero DeMaria Marchiano (Director of Research at the Institute), Frank Carlucci and \nwife, Daniel Daniello (Founding Partner of the Carlyle Group) Simone Bemporad (Senior \nVP, Media Relations and Intern. Affairs of Finmeccanica SPA), Michael Ansari (Pres \nand CEO MIC Industries), Francesco Celi of NIDDK, NIH.  Discussed what the Obama \nAdministration might mean for the future.\nJan. 9 – 10, 2009 – Most extraordinary 2 days.  Drive with Chris  to Norfolk, VA to \nwitness the commissioning ceremony of the USS George H.W. Bush  - CVN77.  This \nwas at the invitation of Bush 41.  Amazingly, I was given a “Red” pass which was for \n“super VIPs”.  Arrived on a Friday night (Jan. 9) and stayed at the Renaissance Hotel in \nPortsmouth, VA.  This was an overflow, yet superb hotel, since I send in my RSVP rather \nlate as I was somewhat ambivalent about driving 3 hours and 45 minutes to the \nceremony.  What a mistake that would have been not to go.  Patty Conrad used her \ninfluence and experience with White House social people to allow a late RSVP.  In fact, \nPatty was invited also related to her years in the Bush 41 White House as Advance Team \nmember.  Attended elegant reception and buffet on Friday night at the Marriott in \nNorfolk.  Met many of the Bush 41 and 43 people that I have known over the many years.  \nIncluded were Andy Card, Marlin Fitzwater, John Sununu (we reminisced about the day I \nsaid no the Bush 41 in the Oval Office when he offered me the NIH job). Also saw Phil \nBrady who worked for Bush 41 when he was VP, Tim McBride, David Demerest, Roger \nPorter, Kevin Moley, among others.  Bush 41 and Barbara Bush came to the reception \nand Bush made some comments.  Floods of people wanted to say hello.  I got to speak \nwith Mrs. Bush and she told me how proud she was of what I have been doing over these \nmany years and said that she and George H.W talk about me often when they see me in \nthe news.  Did not get a chance to say hello to Bush 41 since there were too many people \ncrowding him and I did not want to appear aggressive.  I will write him a note. Patty \nConrad was at the reception with Betsy Wilder and they saw many old friends from WH \ndays.\n     Saturday (Jan. 10) was glorious with clear blue skies and 45 to 50 degrees.  Chris an I \nwent on a nice run around the harbor in the AM and then took off for the ceremony.  The \nentire naval and naval air base of Norfolk/Portsmouth is immense and beautiful.  We \nwere fortunate to have red passes since there were 17,000 people at the commissioning \nand we zoomed right in.  We actually had seats on the side deck right across from the \nfront deck where Bush was.  We sat 1 row from W’s daughters Barbara and Jenna, both \nof whom I know (see notes above).  None of the ceremony took place on the top deck, all \nthe second level decks.  The view and ceremony were one of the most special things that \nI have experienced.  The POTUS, VP Cheney, Laura Bush all flew in by Helicopter to \nReleased by Chairman Rand Paul\n192Jan. 24, 2009 – Attended with Chris the Lido Civic Club Gala at the Capitol Hilton on \n16th and K Streets, N.W.  Have been going to these black tie Award Galas for a few \nyears.  It is where I met Gen. Peter Pace and Judge Sam Alito. Lido is an Italian \nAmerican Civic Club with a long history in DC.  It started giving awards almost 100 \nyears ago to people like Fiorello LaGuardia, etc.  This year the awardees were Gen. Pace \n(former Chair of the Joint Chiefs of Staff and Deputy Mayor of DC Dan Tangherlini.  It \nwas good to meet Dan since I will soon be dealing with him and DC Mayor Adrian Fenty \nto launch a “Test and Treat program for AID in DC (more later). Also at the party were \nMajor Fenty’s mother and father.  She is an Italian-American and he is an African-\nAmerican.  Gen Pace is a truly nice man and accepted his award with a moving speech \nabout his parents and grandparents and the men he served with in the marines from the \ntime he was a rifle platoon leader in Viet Nam through Somalia, Iraq, Afghanistan, etc.  \nAlso seated at our table was an Army Sergeant (Joe Hauser) who had his right leg blown \noff in Balard, Iraq (where I had visited in 2003).  Paul Wolfowitz and his girlfriend Shaha \nRiza (World Bank) were also at our table.  Recall that there was a “social scandal” when \nPaul was head of the World Bank and had to leave because it was felt that he was \nshowing favoritism to Shaha who was an employee and was also living with him. Paul \nand I reminisced about when we worked together on biodefense when he was Deputy \nSecretary at the Dept. of Defense.\nJan. 30, 2009 – Comment on the firing of Mark Dybul as head of OGAC (Office of \nGlobal AIDS Coordinator) .  It is a shame the way Mark was handled.  I am attaching a \nNY Times article covering this.  Mark is back in my office until his retirement.\nNY Times article::\nThe abrupt departure of the State Department’s global AIDS coordinator has led to \ndebate over who should run what may be President Bush’s greatest legacy: his \ncommitment of billions of dollars to fighting AIDS overseas.\nThe position — U.S. Global AIDS Coordinator and director of the President’s \nEmergency Plan for AIDS Relief, which is known as Pepfar — is a State Department \npost with ambassador’s rank that had been held by Dr. Mark R. Dybul, a Bush \nadministration appointee. \nOn Jan. 9, Dr. Dybul circulated a memo saying he had been asked by President Obama ’s \ntransition team to stay on the job temporarily. But on Jan. 22, one day after Hillary \nClinton  was confirmed as secretary of state, her staff announced that Dr. Dybul had \nresigned. \nNo reason was given, but he was reported to have packed up his office and said an \nemotional goodbye to his staff that afternoon. Dr. Dybul did not return phone messages, \nbut he has told friends that he does not even know on whose orders he was dismissed.\n“He deserved better,” said a friend who asked not to be identified for fear of jeopardizing \nhis government job. “He didn’t want to stay, but he was asked to.” \nReleased by Chairman Rand Paul\n193The ambassador disburses Pepfar’s funds; Congress authorized $15 billion over five \nyears in 2003, and the fund has since paid for AIDS drugs for about two million people, \nmostly in Africa. Last year, after a bitter fight between liberal and conservative \nlawmakers over what the money could be spent on, the fund was renewed as part of a law \nauthorizing $48 billion over five years for combating AIDS, tuberculosis and malaria.\nThe question of who should run the program seems to be a legacy of that fight. Several \nnames have been discussed as possible candidates, but AIDS activists say they know of \nno one who has been seriously vetted for the job by the Obama transition team since \nNovember.\nA day after Dr. Dybul’s resignation, word began to circulate among AIDS activists that \nthe job had been offered to Dr. Eric Goosby, the director of AIDS policy in Bill Clinton’s \nadministration, who now runs a San Francisco foundation devoted to fighting AIDS.\nAccording to a member of an anti-AIDS group speaking on the condition of anonymity, \nSenator John Kerry approached Mrs. Clinton, seeking the job for Dr. Jim Yong Kim, a \nHarvard medical school professor and former World Health Organization AIDS chief, \nand was told that she had offered it to Dr. Goosby. \nThrough a spokesman, Dr. Goosby declined to confirm or deny that he had been offered \nthe job, and Dr. Kim did not return phone calls seeking comment. Senator Kerry’s \nspokesman said he would not discuss the senator’s personal conversations with Mrs. \nClinton. \nBoth men had been discussed as possible candidates, along with Dr. Nils Daulaire, \npresident of the Global Health Council; Dr. Wafaa El-Sadr, an epidemiologist at the \nColumbia School of Public Health; and Warren W. Buckingham III, Pepfar’s director in \nKenya, who is openly gay and taking AIDS drugs himself. \nDr. Daulaire declined to be interviewed, Dr. El-Sadr said she had not heard that her name \nwas among those being discussed, and Mr. Buckingham said he knew his name had been \nsuggested by others but had not lobbied for the job and had not been contacted by either \nthe Obama or Clinton teams. \nThe abruptness of Dr. Dybul’s departure and the secrecy of the process to replace him has \nupset some AIDS policy specialists. \nOn Monday, a coalition of 68 anti-AIDS groups sent a letter to Mrs. Clinton asking her \nnot to fill Mr. Dybul’s post immediately but to convene a committee to identify top \ncandidates and get many viewpoints, including theirs.\nOne of its authors, Brian Hennessey of the Vineeta Foundation, expressed his irritation at \nhow the request was ignored.\nReleased by Chairman Rand Paul\n194“Goosby is not bad,” he said. “There are plenty of people who want Goosby — but \nthey’ll be damned if the job is filled this way. This isn’t the truth-in-advertising of the \nObama campaign.”\nDr. Dybul’s departure was both celebrated and condemned.\nJodi Jacobson, a former head of the Center for Health and Gender Equity, which wants \nfinancing for all aspects of women’s reproductive health, including abortion , wrote a blog \npost titled “Dybul Out: Thank You Hillary!!!” It argued that he had worked too closely \nwith the far right, and she accused him of lobbying to please the Roman Catholic Church \nby letting its relief groups opt out of distributing condoms.\nMichael Gerson, a former Bush speechwriter and Washington Post columnist, shot back \nthat “blogging extremists” like Ms. Jacobson had lied about Dr. Dybul’s record and that \nhis firing had left an important program without a leader.\nAt the heart of the debate was the difficult bipartisan compromise behind Mr. Bush’s \nAIDS plan. It is the darling of two groups that normally oppose each other: foreign policy \nliberals who want to help Africa and evangelical Christians who support mission \nhospitals there.\nDr. Dybul was straddling some personal fences too: he was one of the Bush \nadministration’s few openly gay officials, a doctor who had treated AIDS patients in San \nFrancisco and Africa, and he had donated to Democratic causes. His only predecessor, \nRandall L. Tobias, a former pharmaceutical executive, was promoted within the State \nDepartment, then ousted in the D.C. Madam scandal after acknowledging he had received \nescort-service massages — a development that led to derision over the fund’s abstinence \npolicies.\nMr. Tobias and Dr. Dybul surprised many with two early decisions that activists had \nexpected fights over: Pepfar has paid for millions of condoms, and it buys cheap generic \ndrugs from India, despite the pharmaceutical lobby’s opposition.\nBut conservatives in Congress imposed other restrictions: one-third of the money spent \non prevention had to be used for teaching abstinence until marriage. Groups getting \nfunds, including those helping prostitutes, had to sign a pledge condemning prostitution. \nAnd no money could be spent on clean needles for drug addicts.\nThese issues were divisive not just for liberals and conservatives, but also between \nliberals. For example, some feminists think women needing money have a right to engage \nin prostitution, while others oppose it, saying it contributes to human trafficking and child \nrape.\nIn separate studies, the Government Accountability Office and the Institute of Medicine \nboth found that the abstinence earmark unnecessarily tied the hands of fund recipients, \nespecially in countries where AIDS was concentrated among drug users and prostitutes.\nReleased by Chairman Rand Paul\n195Dr. Dybul defended the teaching of abstinence, especially to young children, because it \ncan be effective among deeply religious rural Africans.\nAnd he argued that countries could get funds for prohibited uses, like clean needles, from \nother donors like the Global Fund for AIDS, Tuberculosis and Malaria or European \ncountries.\nAlthough the restrictions have been criticized, no one has presented scientific evidence \nthat they cost any lives.\nAnd although there was grumbling in 2003 when the Bush administration created its own \nAIDS program rather than simply contributing to the Global Fund, Rajat Gupta, chairman \nof the Global Fund’s board, said Thursday in Davos that Pepfar was “one of the truly \ngreat contributions of the last administration.”\nJan. 30 – Feb. 20 – Stock market continues to crash with DOW in the 7500 range.  Thus \nfar I have lost on paper more than $1 million of my wealth.\nTom Daschle had to drop out of running for the Secretary of HHS because of concern \nover unpaid taxes for private car and driver that was loaned to him for 3 years without \ncharge by a friend.  He did not claim it as taxable income, which it is.  Also, he made $5 \nmillion on influence peddling (access to people in government) since he stepped down as \nSenator.  Too bad since he is a very good person and would have made a great Secretary.  \nI still think that I would fit for that job, but I really do not want to leave what I am doing \nand besides, no one in the administration has asked me.  They apparently only would \nwant me for NIH Director and I do not want that at all.\nFeb. 21, 2009- Had great time receiving the Science and Medicine Award at the 15th \nAnnual Steve Chase Humanitarian Awards Gala at Palm Springs, CA sponsored by the \nDesert AIDS Project  It was an amazing and enjoyable glitzy affair at the Palm Springs \nConvention Center with Red Carpet arrival similar to the Academy Awards (which \nactually took place the next day (Sunday) in LA.   Star-studded Affair with Linda Gray \n(“Dallas TV Series), Donna Mills (Knots Landing) and Morgan Fairchild (old friend \nfrom AmFar days) MC’d the event.  Other Awardees were Bebe Neuwirth (Broadway \nstar) and Kristin Chenoweth (Broadway Star)", "summary": "Watcher-discovered document from paul-readingroom (2026.08.05_Diary-Prequel-_Redacted.pdf), auto-indexed 2026-08-06.\n\nExcerpt: that will  then provide a major head start in the event of a pandemic flu.  CEOs present were:  David Mott of MedImmune, David Williams of Sanofi-Pasteur, JP Garnier of GSK, Dick  Clarke of Merck and Howard Pien of Chiron.  Again, the POTUS was very interactive  with me when he came in and left.  He concentrated heavily on the CEOs during the  meeting.  Afterwards, Scott McClellan had Leavitt and I give a press conference in front  of the White House.  Multiple cameras, etc.  I will leave for SE Asia tomorrow with  Leavitt to visit Thailand, Cambodia, Laos, Viet Nam, and Indonesia. October 8 – 18, 2005 – Trip to SE Asia as part of delegation of Secretary of HHS  Michael Leavitt. Countries visited – Thailand, Cambodia, Laos, Viet Nam, and Indonesia.  Purpose of the  trip was fact-finding…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/08/2026.08.05_Diary-Prequel-_Redacted.pdf", "pdf_url": "/archive-docs/fauci-files/b5b0ed807aff8eaf2c6607cc328a591e/pdf", "doc_date": "2026-08-06", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-08-05-diary-prequel-redacted"], "part_number": 3, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 4 of 7)", "content": "for Arts and Activism; Harriet Goldberg \nwon the 100 Women Award; Bill Jones won the Partner for Life Award;  Barry Manilow \nwon the Silver Anniversary Community Service Award.  He came with Suzanne Somers \nwho was wonderful with me and had been following my career for years. She said that \nshe knew all about me because she was a “doctor junky”.  She has written several book \non Health for Women.  Best was Morgan Fairchild who made sure that I was introduced \nto everyone and also partook in my introduction on stage to receive the award. She really \nwas wonderful and friendly.  The main introducer of me was Regan Hofmann (Editor of \nPOZ Magazine).  She was beautiful and very nice.  Donna Mills seemed a bit artificial \nand had a forced smile, but everyone else was great.\nReleased by Chairman Rand Paul\n196March 4, 2009 – Over the past few weeks the stock market continues to plunge with no \nend in sight.  The Dow is now at 6500 down from 14,000 in Oct., 2007.  I have lost a \nSUBSTANTIAL portion of my savings including the money form HPIM, Prizes, etc. – \nwell over $1 million.  The retrospectoscope is always right, but the fact is, I always had \nserious concerns about the vicissitudes of the market and always said that I would rather \nnot lose money that try to make it since my salary + book + prizes get me a lot of money.  \nJohn Katkish, who is a good man and conservative convinced me otherwise and here we \nare – trapped since we cannot sell now since the losses would be phenomenal.\nOn the evening of March 4, I attended the annual Friends of Cancer Awards night \nreception at the Hotel Monaco on 4th and F Street, N.W.  Ellen Sigal and Marlene Malek \nrun this group and always invite me.  The awardees were Steny Hoyer, Sen, Judd Gregg, \nLisa Paulsen of the Motion Picture Industry Foundation and Janet Woodcock of the FDA.  \nUsual DC glitterati of politics there.  Steny was most gracious to me in accepting the \naward and went on about what a great man and scientist I am and how we go back so \nmany years.  He brought up (again) the story of how George H. W. Bush called me his \nhero in the 1988 Presidential Debates.  Also, had good conversation with Sen. Gregg and \ntold him that I respected his action of dropping out of contention for Secretary of \nCommerce since he felt he could not go along with the Obama fiscal policy for the \n“Bailout”.  During the evening, go to have good conversations with Obama White House \npeople such as Dr. Kavita Patel who is assistant to Valerie Jarrett (closest person and \nfriend to the POTUS) and Neerha Tandem who formerly was with Hillary Clinton and is \nnow Special Assistant to the POTUS.  Both said that they would get me to do some WH \nbriefings and briefings of the HHS Secretary designee – Gov. Kathleen Sibelius of \nKansas, whom I have never met.  Zeke Emanuel was there and is establishing himself at \nOMB as the Health policy person since there are few other people who know about \nhealth.\nMarch 5, 2009 – Zuckerman Fellows reception at the home of Beth and Ron Dozoretz – \n3005 – 45th Street, N.W. (around the corner from my house).  Clear, nice night.  Usual \nimpressive event with Dave Gergon and Mort Zuckerman hosting the Fellows who are in \ntown for the week to get a glimpse of how USG is run.  I will lecture to them tomorrow.  \nMet the usual crew from DC and had nice conversations:  Tom Daschle – I expressed my \nsorrow at his misfortune of having to drop out of contention for HHS secretary.  Wolf \nBlitzer (CNN), Nora O’Donnell (MSNBC), Gloria Borger (CNN), former Sec. Dan \nGlickman, Gen. George Casey, Ambassador from Israel, etc.  The young people there \nwas amazing:  wounded vets of the Iraq war now going to Harvard Business School; \nPhysicians studying economics, health people in government schools.  You feel good \nabout USA when you see these people.\nMarch 7, 2009 – Very interesting dinner at Café Milano thrown by Catherine and Wayne \nReynolds for about 10 – 12 couples in the private room.  Unseasonably warm (70 F) and \nclear (stars and moon) night.  Guests include Gen. George and Sheila Casey (Army \nChief-of-Staff). I sat between him and Marlene Malek (who was there with husband \nFred).  Also in attendance: Don Graham and Dana Priest (Washington Post); Beth and \nRon Dozoretz; Francis Collins; Rick Atkinson (War Historian and best-selling author); \nReleased by Chairman Rand Paul\n198died in Jan., 2009 of hep. B/Cirrhosis-related hepatoma.  I was very involved with Brenda \nin his terminal care and attempts to get him a liver transplant – it was too late for the \nlatter.\n    It was an cloudy, cool and damp day in SF.  The ceremony was held in the Eureka \nCommunity Center at 100 Collingwood, around the corner from the hub of the Castro \nDistrict – 18th Street and Castro.  Big time déjà vu as I walked the streets of the Castro \nsince I got there a bit early (ceremony at 4:30 PM).  I had flown in from DC in the AM \nand took the red-eye back to DC that night.  The streets of the Castro were crowded with \npeople bustling around.  The usual crowd plus the fact that it was St. Patrick’s Day and \nthe parade had just ended.  I recall back in the mid-80s when I visited the Castro several \ntimes.  It looked like the “walking dead” were in the street.  So many cachectic people.  \nToday, everyone looks healthy, but the typical protease inhibitor and other drug “facies” \nwere evident with lose of facial fat pads..  You could tell that such a substantial \nproportion of the people were infected, but now, in contrast to the 80s, they were doing \nvery well on drugs.  Gave me a bittersweet feeling of how much we had accomplished \nover these 27.5 years.  The ceremony went well – packed with people from the Castro \nwho were so happy that I was there.  I was the only government or health official there – \na shame since he was such a great man and contributed so much.\nFauci Eulogy for Martin Delaney\nEulogy for Martin Delaney\nby\nAnthony S. Fauci, M.D.\nDirector\nNational Institute of Allergy and Infectious Diseases\nNational Institutes of Health\nMarch 14, 2009\nSan Francisco, CA\nReleased by Chairman Rand Paul\n199Ladies and Gentlemen, friends of Marty Delaney,  \nI feel extremely honored and privileged to be here to celebrate the life of Marty \nDelaney and to have been asked to express a few brief reflections about Marty and his \nextraordinary work on behalf of people with and at risk for HIV/AIDS.  I knew Marty \nDelaney for 24 years.  I first heard about him in early 1985 through some of my staff and \nHIV researchers who were actually quite intimidated by him, mostly because he was, as \nthey said, ”making trouble for them” regarding the design of clinical trials. He certainly \nwas a big-time headache for the FDA.  Actually, the problem for them was that Marty \nwas so smart, articulate and well-informed to the point that he knew more about \nHIV/AIDS and the complexities of treatment access, patient education, and a sound \nresearch agenda than some of them did.  As they soon found out, he was correct most of \nthe time.  \nNow, confrontational and theatrical activism certainly has its place and has been \nvery effective in calling attention to important problems, notably HIV/AIDS.  But \nMarty’s brand of AIDS activism was somewhat different.  As I recently described him,   \nhe was analytical, well-informed, passionate, articulate, persistent, tough-minded, \ngracious, transparent, fair, and above all a thoroughly decent human being. He did not \nconfront just for the sake of confrontation.   I became very interested in learning more \nabout this person whom I had not yet met. And so I began to read what he had written \nand I examined press reports about him and what he was doing in San Francisco and \nthroughout the country. Furthermore, when I found out that he was formerly a Jesuit \nSeminarian, I decided I absolutely had to meet him personally since for better or worse I \nhad experienced 8 years of Jesuit education in high school and college. And so I \nimagnied that we might have a lot in common\nHe beat me to the punch me by calling me up and saying that we needed to get \ntogether to talk about patient access to experimental drugs within the context of highly \nrestrictive clinical trials.  Although he was well-aware that I was not with the FDA, he \nwanted my support in confronting the FDA about accelerated approval of drugs for HIV \nand its opportunistic complications. We soon met and began one of the most \nextraordinary relationships that I have ever had with a colleague and a peer. When we \nboth realized that we were fighting for the same thing, but we were just wearing different \nuniforms, we developed a respect for one another that gradually morphed into a genuine \nfriendship that got stronger as the years went by.  He never hesitated when he felt it \nnecessary and appropriate to nudge me, critique me, advise me, scold me, and point out \nthings that were not yet on my radar screen.  He was an extraordinary source of \ninformation regarding the community needs:  Where was the pain? Where was the \nanxiety? When was the time right to get out into the trenches and talk to specific people?  \nIt was in this context that our collaboration was born, specifically in my speaking \npublicly for the Parallel Track program despite the resistance on the part of the FDA and \nmany AIDS clinical researchers.  Other activists, including Jim Eigo and his colleagues at \nACT-UP in New York, also were pushing for a parallel track of accessibility for drugs in \nclinical trial.  However, it was Marty who pleaded with me -- successfully -- to come to \nSan Francisco and see firsthand patients from the Castro who were suffering physically \nand psychologically more than they should have been because the doors of access to \ndrugs were shut to them.  He then arranged the Town Hall meeting where I was to speak  \nand as I was getting ready to go out on stage, he looked me in the eye and said, “Tony, do \nReleased by Chairman Rand Paul\n202Anthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \nThe information in this e-mail and any of its attachments is confidential and may contain \nsensitive information.  It should not be used by anyone who is not the original intended \nrecipient.  If you have received this e-mail in error please inform the sender and delete it \nfrom your mailbox or any other storage devices.  The National Institute of Allergy and \nInfectious Diseases (NIAID) shall not accept liability for any statements made that are the \nsender's own and not expressly made on behalf of the NIAID by one of its representatives.  \nFrom:  Zuzu  \nSent: Tuesday, March 17, 2009 1:07 AM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Re: Favor\n \nAnd on a completely unrelated note, Martin was so proud of the friendship he had with \nyou.  I spoke at his retirement event and I wanted to make sure I mentioned things that \nwere important to him, so I sat down and talked to him about what he felt was most \nimportant and what he was most proud of.  He started by speaking generally, about the \nquality of relationships he was able to build in different sectors - he was proud that \npeople would come to him seeking advice and equally proud that he would give it, \nhonestly, even when it was unpopular.  But after a few minutes, he settled down to say he \nwas most proud of the relationship and the friendship that he'd built with you over these \nyears.  \nI mentioned briefly in my remarks that Martin stole my partner, Ed, for Sci Fi night every \nFriday.  I, however, was persona non grata because I wouldn't agree not to talk through \nthe programming.  Ed said, however, \"the only exception is when Tony called, then he'd \npause the program for upwards of a half hour and I'm glad I had my iPhone.\"  There was \na place for you in his life that took precedent over nearly everything.  \nI know how present you were for him and when he had moments of clarity in those final \ndays I would tell him I was consulting with you, that you were speaking to his doctor, \netc., and he would smile and I know he felt like you were present with him and I know he \nfelt well attended to.  I know he felt the presence of your friendship.\nMartin's death is an unspeakable loss for me.  He has been family to me and it breaks my \nheart that my daughter will only know him through the stories that we tell and not the \nReleased by Chairman Rand Paul\n\n203gestures of the way our lives intersect.  Holidays won't be the same.  I will miss our \nwalks, going to movies, having dinner, going to lunch... I will miss the projects we would \nhave launched and the fun we would have had and I will even miss how frustrated I \nwould get with him because of his stubborness.  He could be terribly stubborn in the most \nirrational ways.\nHe had seven vaccuum cleaners and there was little evidence he used any of them.  He \nhad a garage full of car cleaning products, many (most) duplicates, and he paid to have \nhis car detailed.  They were all unopened.  (He said he \"liked\" buying them.. just in \ncase...)  When we had dinner at his house, he'd create and re-create the recipes several \ntimes before the actual evening and everything was perfect - he loved to cook.  He would \nsay (often) that there was more evidence and likelihood) of alien life than the existance of \nGod - he was staunchly aetheist despite his sister's protestations.  And he adored his sister \n(though he specifically noted he wanted a non-religious service in San Francisco and for \nthe life of her she wasn't able to honor that... but I think he knew she couldn't and on \nsome level he'd be okay with that.)  I would get more emails each week about alien \ntechnology than I would about HIV/AIDS in recent years.  There is nothing he would \nwant more than to be rocket launched into space with Gene Roddenberry and his wife... \nIt's all the little, seemingly inconsequential things, that I'll miss... anyways.\n-Brenda\nOn Mon, Mar 16, 2009 at 9:28 PM, Zuzu  wrote:\nTony,\nYes, March 21, sorry I mis-spoke.   It was good to see you too, though I'm sorry it was \nunder these circumstance and also sorry it was so brief.  I hope your travels home were \nswift and otherwise uneventful.  \nYour advice is sage, as always.  I'll have Dan's Heath Care Agent speak with his \nphysician.\nThanks again,\nBrenda\n \nOn Mon, Mar 16, 2009 at 3:00 PM, Fauci, Anthony (NIH/NIAID) [E] \n<AFAUCI@niaid.nih.gov> wrote:\nBrenda:\n    It was good to see you at Marty’s Memorial.  With regard to Dan Cusik’s case, I assume you \nmean that the UCSF transplant committee will discuss the case on March 21 (not February 21 – \nin other words, they still have not decided).  Having said that, it might be best if the committee \nReleased by Chairman Rand Paul\n\n206Affairs Director), Dora Hughes (General Counsel to the Secretary, HHS),  Nick ?.   I \npresented the proposal and they asked good questions and were very excited about it.  We \nwill proceed with rolling it out after nailing down a few details.\n   While at the EEOB, I ran into Peter Orzag who greeted me as if we were friends.  He \nclearly knew who I was from seeing me down the hall.  Good news that this WH at least \nis up on what is going on in AIDS and health in general.  Let us see how things evolve.\nApril 16, 2009 – My Op-Ed on “Policy Cocktail for HIV” appeared in Washington Post.  \nGot many nice comments.  I am starting to get on the radar screen of the Obama people.\nApril 17-18, 2009 – First cases of an “untypeable”influenza noticed in California and \nidentified by CDC as a swine influenza of H1N1 type.\nApril 21, 2009 – Had lunch at the Oval Room across from Lafayette Park with Michael \nGerson (Washington Post, Council of Foreign relations) to catch up on some of the \nprojects that I am involved in re; Global Health issues.  Mike was very influential in \nhelping me during the Bush 43 years with PEPFAR and the President’s Malaria Initiative.  \nI told him about my pushing for PrEP, Test and Treat, and Eradication of HIV (my new \n“Big Three” for control of HIV).  Nice time at lunch.  He is a very, very sharp guy and \nwe have become good friends over the years – recall he invited me to private dinner with \nGeorge and Laura Bush at his home last year.  I had turkey Club; Mike had asparagus \nsoup.  Whether was sunny with threatening rain.\nApril 23-24, 2009 – First days of public awareness of the “swine flu” pandemic with the \n“quadruple reassortant H1N1 influenza A.  Around the clock conference calls and \nmeetings.  In “battle mode” at HHS.  I am handling everything for NIH, but there is \nsomething strange regarding relationship with HHS (see below re: Jenny Backus.)\nApril 25-27, 2009 – Intense weekend with the potential pandemic evolving.  Started in \nMexico and now person-to-person spread evolving in USA.  At first only in TX and CA \nand now beginning to spread throughout USA in small numbers that are growing.  \nUnclear why disease seems to be more severe in Mexico than in USA.  Likely due to \nlarger undetected denominator in Mexico for some time and we are only seeing the \nsevere cases, whereas in USA with better surveillance, we see more mild cases.  Also \nspreading to Europe with several countries reporting cases, almost all related to trips to \nMexico or contact with people with Mexico exposure.\nApril 28, 2009 – Testified with Rich Besser (CDC) at Senate Committee on \nAppropriations, Subcommittee on Labor, Health and Human Services, Education and \nrelated Agencies with Tom Harkin as Chair.  Went well.  Great praise for me by Senators \ndespite the fact that the Department is only letting Rich Besser and CDC out on TV or \nany media.\nApril 29, 2009 – Testified with Anne Schuchat (CDC) at the Senate HELP Committee \nwith Sherrod Brown as Chair.  Again, great praise for me for being there during crises \nReleased by Chairman Rand Paul\n207such as AIDS, SARS, Anthrax, and bird flu by Sen. Mikulski, Brown, Chris Dodd, etc.  \nhearing went very well.\nApril 30, 2009 – Real problems with the HHS public affairs people – Jenny Backus.  It is \nclear that I am being muzzled to speak to any major Press.  Reasons unclear (see above).  \nBig issue today in that on the NBC Today Show, which Jenny reluctantly agreed to put \nme on, the VP was quoted as saying that he would not want his family to go to any \ncrowded places like riding on a subway, in an airplane or in a crowded arena because of \nthe danger of people coughing on them and giving them the flu.  I was on next and said \ncalmly that this is not the CDC Public Health policy and calmed the waters, etc.  Jenny \nhad tried to have me call her 1 minute before I was on the air, but I did not see her e-mail.  \nAfter the show (in which everyone said I did a great job) we connected by phone and she \ncritiqued my answer to a question about the WHO increasing the phase of the potential \npandemic from 4 to 5 and asked me if I thought that it would go to 6.  I said that based on \nwhat the WHO was saying and the evolving nature of the epidemic, I would not be \nsurprised if they did boost it to 6.  Jenny said I should not be making policy ahead of the \nCDC and WHO – give me a break!.  In any event, FOX National News wanted me today \nand the subject of interview would surely be the VP’s misstatement.  Surprisingly, Jenny \napproved it and she said I should change the subject when they ask about the VP.  She \nsent me a statement from the VP’s office saying that when the VP was asked what he \nwould tell a family member if they planned a trip to Mexico, he would say not to fly and \nthat I should refer the press to his statement.  The statement is a flat-out lie and they \nwanted me to explain what the VP meant.  I decided not to go on FOX and get caught in \nthat nonsense.  Jenny is blocking me on all of the networks and cable shows that are good \nand allowing me to do very little and so I am reaching the point where I do not want to be \ninvolved with them.\nApril 30 – May 3, 2009 – Continued evolution of epidemic/pandemic with continued \nreal issues with Jenny Backus and me.  She refuses to let me on TV and even yanked me \nat last minute after agreeing that I would do Good Morning America today.  I got to \nstudio and found out that overnight, she had substituted Rich Besser for me.  The ABC \nproducers were horrified and apologetic.  Also, Wolf Blitzer, Lou Dobbs, Bob Bazell and \nothers are getting pissed that they are not allowed to interview me.  Even David Gregory \nnoted that it is surprising that I am not being seen on TV at all.\nMay 4-5, 2009 – Epidemic seems to be stabilizing and looking like a classical seasonal \nflu , but out of season.  Big issue is will it go underground over the summer and then re-\nemerge with a vengeance next Fall and Winter just like in 1918.\nMay 6, 2009 – Testified before House Committee on Foreign Affairs, Subcommittee on \nAfrica and Global Health with Anne Schuchat and a USAID person.\nMay 6 – 16, 2009 – It is apparent that the epidemic is “stabilizing’ in that it is looking \nlike a typical seasonal flu, only out of season in the Northern Hemisphere.  Only \nexception is Mexico, where the apparent severity is not explained compared to the rest of \nthe world.  It still could be an issue of the “denominator, i.e. there may be very many \nReleased by Chairman Rand Paul\n208undetected mild cases in Mexico and so we are only seeing the severe cases and are \nassuming that the disease is more sever in Mexico.  As of May 15, there have been 4714 \nconfirmed and probable case in the USA in 46 states with 173 hospitalizations and 5 \ndeaths.   Internationally, there have been 7520 confirmed cases in 34 countries.  Clearly \nthis is different from the “swine flu” situation in 1976 where the virus infected 230 \nsoldiers in Fort Dix, NJ with one death, but the infection never spread outside of Fort \nDix.  This has important implications  in the intense planning that is going on in HHS \nregarding the production and administration of a vaccine.  I am part of the “vaccine team” \nat HHS made up of Bruce Gellin, Robin Robinson of HHS’s BARDA, me, Jesse \nGoodman and Josh Scharfstein of FDA with input from CDC (Rich Besser et al.).  We \nare being very careful to uncouple the decisions about going ahead to produce the vaccine \nfor administration next Fall and Winter from the decision to actually administer the \nvaccine next Fall and Winter.  We will have to observe what the virus does this summer \nhere and in the Southern Hemisphere (their winter flu season).  This drama is eerily \nunfolding like the situation in 1976.\n   Thomas Frieden, Commissioner of NYC Dept. of Health,  announced as Obama choice \nfor CDC Director.  Interesting in that many people thought that the choice would be Rich \nBesser because of the amazing public exposure he was getting, and the very nice job he \ndid,  during the flu crisis (every major network every day).  Just goes to show you – sic \ntransit glory or welcome to Washington!\nMay 27, 2009 – Went to Sons of Italy Awards Gala at the National Building Museum.  \nSat next to VP Joe Biden and his granddaughter Naomi who goes to Sidwell Friends.  \nAlso at table was his wife Jill (whose father is a Sicilian).  Had nice conversations over \nthe evening with the VP – very amiable person with whom I have interacted several times \nin the past re: anthrax, AIDS, SARS bird flu, etc.  He was very complimentary to me \nduring his speech.  He received the NELA Award for Leadership and Achievement in \nPublic Service (I received the NELA award for science in 1992).  NELA = National \nEducation Leadership Award.  \nMay 28 – June 2, 2009 – Continued activity working with HHS on flu preparedness.  \nLittle press associated with this and Jenny Backus has not been heard from for weeks \nsince the press stuff has calmed down.  Tom Freiden has been appointed as CDC Director \nand so Richard Besser is completely out of the picture.  He did a good job, but see above \nregarding Jenny Backus.  It is too bad, but my experience with Backus has seriously \nsoured me on HHS and everyone there. They seem to have no idea who I am and \ncertainly do not treat me with the reverence and respect that all other HHS people have \nfor the past 25 years.  I do not think that Sebelius even knows my history and who I am.\nJune 3-4, 2009 – Received honorary Doctorate of Science at Harvard University in \nCambridge, MA.  Wonderful honor.  Other awardees were Steven Chu (Secretary of \nEnergy and the Commencement Speaker), Pedro Almodovar (Famous Spanish \nfilmmaker), author Joan Didion, religious historian Wendy Doniger, legal philosopher \nRonald Dworkin, anthropologist Sarah Hrdy, engineer Robert Langer, musician Wynton \nMarsalis, and political scientist Sidney Verba.  The night before the ceremonies (June 3) \nReleased by Chairman Rand Paul\n209we had a festive banquet in Annenberg Hall.  I remember when Chris and I first delivered \nJenny to Harvard for her 1st year, we walked through Annenberg Hall.  It looks like the \ngreat hall from Harry Potter books.\nJune 16-17, 2009 – Gave Keynote Address at the Pacific Health Summit in Seattle on TB \nresearch.  It went over extremely well. Many people said that the talk was “historic” and \n“transforming”.  I gave a passionate plea for pushing research on TB into the 21st Century \nand making it transforming and not just incremental.  Patty Conrad came with me to \nSeattle to help out with the press and she enjoyed the trip greatly.  Her first trip with me \nin 2 years since she began working at NIAID.\nJune 22, 2009 – Back to the West Wing of the White House for the first time since the \nObama Administration began.  Met in the Situation Room in meeting jointly run by \nLaura Petrou (COS for Sec. Sebelius) and Heidi Avery (HSC) to discuss planning for \nresponse (vaccine program) to H1N1 Swine flu.\nJune 30, 2009 – Had an interesting day of H1N1 flu “stuff”.  Harvey Fineberg and I \nconstituted a panel that discussed the lesson of the Swine Flu affair in 1976 and its \nrelationship to what is going on today with the swine H1N1 2009.  Sponsored by CSIS \n(Center for Strategic and International Studies) and Kaiser with Steve Morrison and \nJennifer Kates presiding.  Held in Room B339 in Rayburn Building.  Standing room only \ncrowd.  Went quite well.\n   Later in the afternoon, went to the Roosevelt Room of the White House to have a \nsimilar discussion of lessons learned from 1976. Present were John Brennan (HSC), Sec. \nSebelius – (finally got a chance to chat with her and she congratulated me on my \nhonorary doctorate from Harvard a few weeks ago,  Apparently, she was in the audience \nat Commencement since her son graduated from the Business School); Jane Lute (Deputy \nSec. – DHS), Arne Duncan (Sec. Educ.), Peggy Hamburg (FDA), Ann Schuchat (CDC), \nDavid Senser (former director of CDC who was fired in 1977), Harvey Fineberg, David \nMatthews (Sec. HEW during 1976), David Hamburg, Walter Dowdle (old friend from \nCDC), Peter Orszag (Director, OMB).  President Obama joined the group for about 30 \nminutes.  He clearly recognized me and greeted me warmly. The entire discussion went \nfrom 3:30 to 5:10 PM.  Warm, humid summer day in DC\nJuly 2, 2009 – Another flu panel, this time at the AAAS at 12th and H Street, N.W.  \nChaired by Harvey Fineberg.  Other panelists were Anne Schuchat, Ken Bernard and Ken \nCole (US Navy).  Good crowd, good discussion.  War DC Summer day. Took taxi back \nto NIH because of horrific delays on Metro’s Red Line related to tragic crash that \noccurred last week where 9 people died.\nJuly 9, 2009 – Participated as a major speaker at the “Flu Summit” held at NIH run by \nHHS.  Speakers were Sec. Sebelius, Janet Napolitano, Arne Duncan (Education), John \nBrennan (HSC).  Pres. Obama called in from the G-8 conference in L’Aquila, Italy with a \n“Buon Giorno”.  Much press at the conference.  Still much activity going on.  Weather \nhas been spectacular for July here in DC – very unusual – no humidity – cool in the AM.\nReleased by Chairman Rand Paul\n210July 10, 2009 – Important meeting at the Pooks Hill Marriott to discuss the \ntransformation of our AIDS clinical trials network into a network that would be \n“pluripotential” in that we would study a host of other diseases within the infrastructure, \ni.e. TB, malaria, NTDs, flu, etc.  There is obviously some resistance to this, but it is the \nway to go.  \n     Getting prepared for trip on July 16 – 22 to Cape Town for the IAS meeting where I \nhave several speaking roles (see below).\nJuly 14, 2009 – Senator Carl Levin called me to ask my advice about the qualifications \nand temperament of Tara O’Toole who has been nominated by Pres. Obama as an \nAssistant Secretary in the Dept. of Homeland Security.  He is Chair of the Senate \nHomeland Security Committee responsible for approving her nomination. He has heard \nconcerns that she is somewhat of a zealot for Biodefense.  I explained that I knew her and \nthat although she is a bit out there in thinking that there is Al Qaeda is every corner, she \nstill is quite competent and I would recommend that he approve her.\nJuly 15, 2009 – Went with Patty Conrad to the book signing of D.A. Henderson’s book \non the history of smallpox eradication sponsored by Tommy Thompson of Aikin Gump \n(his law firm).  Tommy was very moved that I was there and introduced me when I came \nin as “the person who discovered the AIDS virus” (ha!).  When I corrected him he said, \n“Well, Tony is the world’s greatest scientist”.  Nice party.  Some of Tommy’s old crew \nwas there:  Stewart Simonson, Kevin Keane, Bill Pierce, Ladd Wiley, etc.  Patty and I \nwent out to dinner at McCormick and Schmick’s on 19th Street afterwards.\nJuly 16 -  21, 2009   Trip to Cape Town, South Africa to the International AIDS Society \n(IAS) Conference on Pathogenesis, treatment and Prevention held at the Cape Town \nConvention Center from Sunday, Sept. 19 to Wed, Sept 22.  I left USA on Thursday, July \n16 and arrived in Cape Town on Friday evening.  Came DC with fuel stop at Dakar, then \nto Johannesburg and on to cape Town.  Exhausting 20 hour trip.  Stayed at Cullinan Hotel \n(Southern Sun)\nOn Saturday AM, July 18 gave the Keynote Address at the HIV/TB research Meeting at \nthe Desmond Tutu HIV Center  of the University of cape Town.  Lecture extremely well \nreceived.  I spoke of the same critical needs for TB (together with HIV) research that I \nspoke about a few weeks before at the Pacific Health Summit in Seattle.   \nDuring the afternoon of July 18 drove down to Cape Point with Gray Handley.  Clearly \nCape Town and the Western Cape is one of the most beautiful cities/areas in the world.  It \nlook so much like the California coast from San Francisco down to Monterrey/Carmel.  \nWeather was stunningly beautiful with crisp clear skies and temperatures about 65-70.  \nThis is most unusual at this time of years since this is SA’s winter.\nIn the evening of July 18, met with Julio Montaner (Pres. IAS) and co-chair of meeting \nand Craig Mc Clure (Exec. Director of IAS) and Robin Gorna upcoming President of IAS \nto discuss the possibility of holding the 2012 IAS meeting in Washington, D.C.  They \nReleased by Chairman Rand Paul\n211know that I am pushing to have the immigration ban lifted in time to make the decision to \nhave the meeting in DC.  The ban has been lifted by law and is now in public comment \nfor final lifting by HHS.  Also, they wanted me to help get Michelle Obama or the \nPOTUS to open the meeting in 2012.\nNight of July 18, went to terrific dinner at a vineyard (Stillness Manor) hosted in my \nhonor by Linda-Gail Bekker.  Linda Gail turned out to be fantastic as a major player in \nthe Cape Town (and all of SA) AIDS clinical trials network that NIAID supports.  Met \nwith many South Africans to whom I told the story of PEPFAR.  Only a few of them \nactually knew how it started:  John Hargrove, Robin Wood (Linda-Gail’s husband), Brian \nWilliams, Brian Brink, Des Martin, among others.\nSunday, July 19,  took tour of Robben Island with Gray Handley.  It was an incredibly \nmoving experience.  The tour guide was a person who was imprisoned there for 5 ½ \nyears.  I saw Nelson Mandela’s cell, the quarry where he worked at hard labor and the \nplace where he planted his garden in the exercise courtyard of the prison.  That evening, I \nattended the opening ceremony of the IAS Conference.\nMonday, July 20.  Visited the Township of Gugulethu and participated in the launching \nof the SAAVI102/HVTN 073 vaccine trial, which is a collaboration between the NIAID \nand the South Africans on a DNA prime MVA boost vaccine. The South Africans \ninvolved are Linda-Gail in CT and Glenda Gray in Durban (KwaZulu-Natal) \nCollaboration also with VRC (Gary Nabel).  Big ceremony at the launching with the \nMinister of Science and technology (Dr. Pandor – woman),  Anthony (Tony) Mbewu – \nhead of SA MRC, and Minister of Health Matsoaledi.  I was very moved by the terrible \nconditions of poverty in the Township of Gugulethu, but was equally impressed with \nwhat was being accomplished by the roll-out of PEPFATR by Linda-Gail in this setting.  \nThe extraordinary overlap and burden of disease with TB here and in Masiphumelele (see \nbelow) was staggering. 30% of patients on the PEPFAR program were diagnosed and \nwere on treatment for TB when they entered program. Another 20% were diagnosed with \nTB when they got there and another 10% developed TB during the time that they were \nthere.\nIn the  early afternoon (1:00 PM I gave the Plenary Keynote at the meeting on the subject \nof “US Sponsored HIV/AIDS Research and Prevention: Science and Policy”.  Following \nmy talk was a talk by Eric Goosby, the new head of the Office of Global AIDS \nCoordinator (OGAC).  The session was devoted to AIDS science and policy in the new \nObama administration.  My talk was very well received.  I emphasized the science but \nalso stressed that the needle exchange ban would soon be over as would be the \nimmigration constraints, as would be abstinence only.  I clearly stated that abstinence \nonly does not work.  The crowd loved it.\nThat night had reception at the Consul-General’s (Alberta Mayberry) home (amazingly \nbeautiful view of CT from her terrace. All the implementers of PEPFAR were there from \nUSAID, CDC, and South Africans.  I gave a short speech sincerely thanking them for \ntheir work, and told them the story of PEPFAR.  Eric Goosby also gave a speech\nReleased by Chairman Rand Paul\n212Tuesday, July 21.  I visited with Linda-Gail the Township of Masiphumelele.  Again, I \nwas deeply moved by the poverty and physical nature of the place.  Like Gugulethu, there \nwere small huts made of corrugated tin and cardboard thast were stuck to each other in a \n“wall-to-wall” fashion for acres and acres.  One could barely walk between the huts.  \nAgain, the work that the South African health personnel were doing was inspiring.  The \nsame numbers and problems with HIV and TB as in Gugulethu.\nTuesday night we flew back to DC and arrived early (6:00 AM) on Wednesday, July 22\nJuly 22, 2009 – I rolled out the NIAID plan for the clinical trials of H1N1 vaccine to be \nperformed in the NIAID’s VTEUs.  We will start in early August and do trials on healthy \nadults, elderly, children to determine immediate safety, immunogenicity, dosage and \nnumber of doses, and sequence of administration vis-à-vis seasonal flu vaccine.  Much \npress associated with this, i.e. appearances on ABC Evening News, CNN Situation room \nwith Wolf Blitzer, (on July 23)  much print and radio (NPR, etc). \nJuly 24, 25, 26, 2009 – Went to the Aspen Health Forum where I gave talks and served \non 4 panels: 1) Sex and health, 2) ARRA funds and how we spend them; 3) Swine flu; \nand 4) Vaccines.  My brief talks and panel appearances were extremely well received.  I \nmostly “ad-libed” and they loved it. Typical Aspen scene with many terrific people to \ninteract with: Tom Daschle, Walter Isaacson, Billy Tauzin, Mehmet Oz, Rick Stengel \n(managing editor of Time), Jeff Kluger (senior editor of Time), Susan Denzler, Nancy \nSynderman of MSNBC and a host of others.  Excellent discussion, setting and exposure.  \nBeautiful place.  Also had dinner at the Mr. and Mrs. Greenwald.\nJuly 27, 2009 – Had a nice appearance on MSNBC with Dr. Nancy Snyderman \ndiscussing H1N1 Swine flu.  She was in Aspen (where I had just spent some time with \nher) and I was in the studio at NIH.\nJuly 28, 2009 – ACIP will recommend to CDC regarding vaccination program.  I \nappeared on ABC World News Tonight\nJuly 29, 2009 – Big issue with release of data and paper in lancet showing that pregnant \nwomen have significant increased risk of hospitalization and death from flu. I  appear on \nGood Morning America and MSNBC.  On the latter, I spared with Arianna Huffington \nwho feels that we should not vaccinate children or pregnant women or even adults.  Dr. \nNancy Snyderman (of MSNBC) was on program and complimented me and disagreed \nwith Arianna.  CDC held press briefing after ACIP recommendations to first vaccinate \npregnant women, then caregivers of infants (<6 months old), then HCW, then young \npeople, then non-elderly with underlying conditions.  \nI appear on BBC TV and then on NBC Nightly News with Bob Bazell and Brian \nWilliams.  Press stuff starting to heat up.  I think that the HHS and Jenny finally realize \nwhat I can do with the press.\nReleased by Chairman Rand Paul\n213July 30, 2009 – Appeared on MSNBC today with Dr. Nancy Synderman and a vaccine \nnihilist named Diane Miller.  She was a nerd who said we should not vaccinate anyone \nwith flu vaccines since they do not work and they are dangerous.  Nancy and I \nannihilated her.\nJuly 31, 2009 – Got called by Mike Gerson who is getting very interested in needle \nexchange programs and will do a piece on it in The Washington Post..  He called from the \nmobile unit that goes around DC doing needle exchange.  He was very excited in a \npositive way telling me that he is now converted to a “true believer’ in favor of needle \nexchange.  He wanted to know from me what the scientific data are.  I told him the story \nof the Shalala Committee that I was on with Harold Varmus, David Satcher, Alan \nLeschner, etc. where Donna asked us to do a “meta-analysis”-type look at the literature \non needle exchange and ask 2 questions: 1) does needle exchange promote drug abuse \nand 2) does needle exchange decrease incidence of HIV infection among drug users.  We \nfound clearly that it did not promote drug use and did decrease HIV infection.  We \npresented the data to Donna who strongly recommended a federally funded needle \nexchange program and called the WH to indicate this.  To all of our dismay, the WH \nrejected this for political reasons.  Drug Tsar McCaffrey did not want it; neither did \nprominent black Congressmen like Charlie Rangel (Charlie thought that it might be \ninterpreted as a signal that we had given up on the black community).  In any event, Mike \nwas thrilled that the science backed up his impression.  As a background, the Congress \njust recently lifted the ban on federally funded needle exchange, only with the proviso \nthat such programs cannot be implemented within 1000 feet of school, park, recreational  \nfacility, etc.  This is silly since it blocks out most of the entire city in most places.\nAugust 1 – 10, 2009  Much press regarding the beginning of the vaccine trials for H1N1.  \nI was on ABC, MSNBC, multiple radio shows, Diane Rehm Show, etc. discussing the \nH1N1 issues.  \nAugust 5, 2009 -  Mike Gerson wrote an editorial in the Washington Post describing his \nimpression about the importance of needle exchange programs. He quoted his \nconversations with me.  Also, Chris and I had dinner over Mark Dybul’s and Jason \nClaire’s home on Wallace Place is NW DC.  Josh Bolten was there with his partner Dede \nand her daughter Rachel.  Josh had just spent a couple of months in Africa (The Gambia) \nwith the Maryknoll priests.  We reminisced about the White House days and PEPFAR.\nAugust 6, 2009 – Appeared on Diane Rehm show with Bruce Gellin discussing H1N1\nAugust 7, 2009 – First patients injected with H1N1 vaccine in NIAID sponsored VTEU \nclinical trials.  Much media attention.\nAugust 8, 2009 – Appeared on Good Morning America to describe the H1N1 clinical \ntrials.\nAugust 9 – 24, 2009 – Our clinical trials with the VETUs on the H1N1 vaccine in adults, \nelderly for dose (15 versus 30 ug) and number of doses (1 vs 2, 21 days apart) began on \nReleased by Chairman Rand Paul\n215     In any event, now finally Jenny Backus is “putting me out there” with my leading the \nHHS press conference on August 11 to make the announcement with the Secretary and \ndoing all of the press, i.e. Newshour, CNN Situation Room, front page NY Times, \nmultiple NPR interviews (“All Things Considered” , etc) Washington Post, all print from \neverywhere, NBC Today Show, CBS Evening and Morning News, MSNBC, NBC \nNightly News, etc.  Still and amazingly, she did not allow me to comment on the NIH \ndata on the evening of Sept. 9th when the NEJM data from the companies came out since \nwe were scheduled for a Secretarial Press briefing at 1:00 PM Friday.  When the press \ncalled me on the night of Sept.. 9 and heard that I could comment on the NEJM papers, \nbut not our data, they went nuts saying that the HHS were crazy and that the story is \ntonight for tomorrow and not tomorrow for the next day.  The Editors needed to know \nwhether the NIH data corroborated the company data; otherwise they were reluctant to \nplay it up. Finally, I e-mailed Jenny, Laura Petrou, and Niki Lurie telling how crazy this \nwas.  Jenny finally relented and let me call back the print people to tell them only that \n“our data corroborate the companies’ data”, without giving details.  Jenny is stupid and \nnuts.  She refused to allow me to go on TV until tomorrow afternoon.  Wolf Blitzer \nwould have none of this and on his Situation Room evening show on Aug. 9, he called \nme directly in my office and put me on TV as a phone-in voice interview.  I did not know \nthat he was going to do this until a minute before he did.  Jenny was pissed. Yet, the next \nafternoon and evening and on Sept. 12, Jenny let me do everything.\n    There was, however, a big blowup with crazy Jenny who attacked Patty Conrad and \nothers at NIH since she claimed that we were blaming her for not letting Fauci go on the \nair (Duh!!!! That is the truth; that is what she is doing).  She wrote a vicious e-mail \nsaying that she was very angry because we were “throwing her under the bus” with the \npress since then they will think that she is muzzling me…..which she is.  She really is a \ncrazy lady.\nAlso, we got great news on Sept. 11 that the Thai canarypox (ALVAC) + AIDSVAX \n(gp120) HIV vaccine trial showed a 31% efficacy that was clearly statistically significant.\nSept 12 – 17, 2009 –Still an extraordinary amount of attempt to “control messaging about \nH1N1 on the part of HHS and particularly Jenny Backus.  They just have a different \nphilosophy that they control message and a person can only speak about what their \nofficial responsibility is, i.e. I cannot talk about trends of disease since this is a CDC \nissue – the most ridiculous thing I have ever heard of.  Also, quite insulting to me sine I \nhave been talking broadly about ID issues for 25 years to national press\n   Obama having real trouble selling his health care reform plan.\nSept. 17, 2009 – Went to State Department for swearing-in of Eric Goosby as the new \nhead of the Office of Global AIDS Coordinator (PEPFAR+).  Took place at 4:00 PM in \nFranklin Room, presided over by Secretary Hillary Clinton.  She recognized me in the \naudience and made a comment during her official remarks about the great work that I \nhave been doing for so many years with HIV/AIDS.  Got a chance to chat with her after \nthe ceremony.\nReleased by Chairman Rand Paul\n216Sept. 21, 2009 – More good news. Pediatric H1N1 clinical trials showed good responses \nat 8 to 10 days with 1 dose of 15 ugs in kids 9 to 17 and lesser response in kids younger – \njust like seasonal flu vaccine.  I led a press briefing.\nSept. 24, 2009 – Roll-out of the Thai trial results.  31.2% efficacy; p – 0.039.  16,000 in \nrandomized trial in relatively low risk heterosexuals in Thailand.  74 infections in \nplacebo, 51 infections in vaccines.  Press ate it up.  The usual suspects who wrote the \n2004 Science letter criticizing my decision to fund the trial made comments either for \nattribution or “anonymously” that they were not impressed and probably thought that it \nwas a fluke (John Moore, Ronald Desrosiers, etc.)  I was very reserved in putting it into \nperspective as this not at all being the “end game”, but an important start since this was \nthe first time in over 2 decades that we have gotten even the slightest positive signal in \nany HIV/AIDS vaccine.  The lack of major immune parameters, i.e. neutralizing abs and \nCTLs tell me what I suspected all along that we are probably not looking at the right \nmeasures of immunity.  Of note the vaccine had no effect on viral load of those that did \nget infected. \n    Since this was not H1N1 and since Jenny Backus probably does not even know what \nHIV is, I was given blanket clearance for the Press.  I had the most media exposure that I \nhave had since the anthrax situation.  Front page or prominent coverage in all major print \nmedia (NY Times, Wash Post, AP, Reuters, etc.  Also, prominent appearances on every \nTV outlet – NBC Nightly News with Bob Bazell, CBS Evening News; ABC World News \nTonight, Wolf Blitzer Situation Room on CNN; Fox News; Canadian TV; BBC; \nBloomberg;  World News with Katty Kay; Radio – NPR – All Things Considered; \nWTOP\nSept. 29, 2009 – Bono/U2 concert at FedEx stadium.  Logistic disaster for me.  I was \ninvited by Bono to attend the concert and be present at a reception in the “Round Room” \nof the FedEx stadium before he was scheduled to go on at 8:30 PM.  I was very busy in \nthe office preparing for the visit to the NIH the next day of Sec. Sebelius and President \nObama.  By the time Chris and I drove to the stadium we got caught in 2 hours of traffic \nand a disaster trying to get parking in the stadium lots.  I missed the reception, did not see \nBono.  He probably thought that I did not show and so he did not do what he has done \nseveral times with concerts and appearances which is to point me out in the audience and \npraise me.  Too bad, but that is the way it goes sometime.\nSept. 30, 2009 – Wonderful day at NIH.  POTUS came in the AM with the Secretary, \nBill Corr (Deputy Secretary) and Francis. Marston Linehan and I showed him a lab in the \nnew CRC.  First Marston spoke about the genetics of renal cancer and then Francis spoke \nabout the cancer genome atlas.  I then spoke to the POTUS about the history of HIV \nresearch here in the Clinical Center.  I spoke about how I admitted the first AIDS patients \nin 1981 and how they all died.  I then spoke about the major advances in antiretroviral \ndrug development and testing that has transformed the treatment and survival of HIV-\ninfected individuals.  I spoke about the recent results of the Thai HIV vaccine trial.  He \nwas very engaging, pleasant, funny but serious about the subject.  He definitely now has \nfixed in his mind who I am.  When I told him that I had been here since 1968, he joked \nReleased by Chairman Rand Paul\n218Oct. 10, 2009 – Chris and I had a great dinner in the Placido Domingo room of Café \nMilano as guests of Kathryn and Wayne Reynolds on the occasional of Derek and \nBeverly Joubert’s visit.  They are award-winning film-makers for National Geographic \nwho photograph and film lions, leopards, and cheetahs in the wild.  Typical enjoyable \nReynolds dinner with many famous guests including: Gen James Jones, Terry McAuliffe, \nSam and Jan Donaldson, Tom Daschle, Brendan Sullivan, Fred Hiatt, Tom Friedman, \nAlexandra Cousteau (Jacques’s granddaughter), \nOct. 13, 2009 – Still extremely intensive media exposure with national media \nappearances a few times per week and heating up.  Had dinner at Zeke Emanuel’s home \nin DC with Chris.  Corby Kummer was there as was Rahm Emanuel and his children.  \nOther government people whose names I unfortunately forget.\nOct. 14, 2009 – Flew to NYC to give Parker Memorial Lecture to the Dept. of \nMicrobiology and Immunology at Columbia Medical School.  Gave the a4B7 lecture that \nwas very well received.\nOct. 16, 2009 – Went to White House for top secret meeting and counterintelligence \nbriefing by FBI and CIA.  Apparently, Russians are monitoring the evolution of our \nBiodefense campus at Fort Detrick.  As usual, a lot of soft stuff.  I certainly would expect \nthat they would be doing this since they suspect that we are doing offensive bioterrorism \nas opposed to defensive biodefense.\nOct. 18, 2009 – Take off to Paris with Patty Conrad for the 2009 AIDS Vaccine meeting \nof the IAS and Vaccine Enterprise.  Extremely successful meeting in many ways.  The \nRV144 (Thai trial) results were formerly presented coinciding with the online publication \nof the results in the NEJM.  There was significant controversy surrounding the role-out of \nthis vaccine a couple of weeks ago (see above).  The complete data showed that the effect \nwas modest, but real.  Apart from a few remaining skeptics, the  issue now is to learn \nfrom this by examining any correlates of immunity.\n     I gave the closing talk on Oct. 22 together with Francois Barre-Sinoussi.  My talk was \nextremely well-received as being visionary.  I thoroughly enjoyed preparing and \ndelivering the talk.  I discuss the Thai trial, but also the need to pursue low-dose mucosal \nchallenge models in the non-human primate (NHP).  Also, I spoke about the importance \nof studying the early events in HIV infection for insight into the type of immune response \nthat we need to elicit.  Also, spoke of the differences in the transmitting versus the \nchronically replicating virus.\nOct. 23 – 25, 2009 – Things really heating up with the press jumping all over the USG \nfor “overpromising” the number of doses of vaccine that would be available.  In fact, \ndespite my warnings, BAARDA (Robin Robinson – nice guy, but naïve) believed the \npharmaceutical companies that they would have 160 million doses by October 15.  In fact \nthey had 11 million and instead of ultimately getting 250 million, we are lucky if we get \n140 million.  Big gap between supply and demand with long lines for vaccine and \nwidespread flu activity in 46 states.  Perfect storm.\nReleased by Chairman Rand Paul\n219 I have been as much media as in the anthrax days.  Just on October 23-25 I was on 11 \nmajor networks and cable trying to explain the vaccine supply problem – Today Show, \nNBC Nightly News, multiple MSNBCs, CNN Situation Room, CNN American Morning, \nCharlie Rose, NPR, WTOP, Good Morning America, Jim Lehr’s The NewsHour, BBC, \netc.\nOct. 25, 2009 – Reception and dinner in Georgetown 1692- 31st Street, N.W., hone of \nSusan and David Axelrod to view live the “60 Minutes” show about their ordeal with \ntheir daughter Lauren’s epilepsy that she has had from birth and that now at 28 years old \nhas left her with significant brain damage.  They are wonderful people and have started \nthe organization called CURE (Citizens United for Research in Epilepsy) to do research \non epilepsy.  Typical high-powered DC gathering: Rahm Emanuel, VP Joe Biden and Jill \nBiden, Gen. James Jones, Mort Kondrake, Al Hunt, Bruce Reed, Linda Douglas (ABC), \nBob Bennett, and many, many others.\nOct. 26, 2009 – Media Frenzy continues – Lou Dobbs, Campbell Brown (CNN), BBC\nOct. 27, 2009 – Extensive interview with Dan Rather for his Cable show “Dan Rather \nReports”.  Very nice person.  We related well and he told his producer (Patty heard the \nconversation) that I was a “superstar”.\nOct. 28-29, 2009 – Press is jumping all over HHS for delay in vaccine distribution.  Front \npage stuff and all networks.  They are calling it “Obama’s Katrina”.\nNov. 3, 2009 – I continue to be all over the press – last night CBS Evening News; today \nCBS Morning News to explain the complex issues of why we do not have a lot of vaccine \nat hand – the virus just is not growing very well in eggs and much against my advice, \nHHS (BARDA, Jenny Backus) promised that we would have a certain number of doses \nand now we do not.  They relied on and believed the projections from the pharmaceutical \ncompanies when I told them not to.  They wanted to give a crisp message (they were still \nin campaign mode) and I told them not to.  Now, everyone looks to me for what to do and \nthey are putting me out on all of the shows.  Actually NIAID is the only one giving good \nnews sine our pregnancy trials and pediatric trials are giving good data – only 1 dose of \n15 ugs for pregnant women is required for robust response and we proved that 1 dose for \nolder kids (10 – 17 years) is good and 2 doses for younger kids (6 months to 9 years is \nrequired).  I announced this at a press briefing at HHS yesterday.  This is in conflict with \nWHO who say that we should give 1 dose to all kids.\nNov. 4, 2009 – Major House Appropriations briefing/Hearing chaired by David Obey.  \nWitness – me, Tom Frieden (CDC), Niki Lurie (ASPR) and health commissioner from \nAlabama and ?.  Tough questions by members and staff regarding availability of \nvaccines.  I came out looking good, but it was a intense hearing.  Next day (Nov. 5) big \npicture of me on page 3 of both the Washington Post and the NY Times.  \nNov. 5, 2009 – Image and message issues continue to deteriorate when it was announced \ntoday that workers from Goldman Sachs, Citibank and other Wall Street firms had gotten \nReleased by Chairman Rand Paul\n220H1N1 vaccine as pregnant women wait in line. The CDC is being blamed since they are \nresponsible ultimately for distribution.  In fact, CDC takes orders from States and locals \nand then distributes the vaccines through a contract with McKesson Corp, which sends to \nover 150,000 distribution sites within the states according to how the cities and states \ndecide to distribute based on their best judgment.  Since the Wall Street firms have large \nclinics, they can easily distribute vaccine to their pregnant employees and those with \nunderlying conditions.  It was Mayor Bloomberg’s choice, but the image did not look \ngood and the CDC took flak for it.\n    Still getting massive (couple of times daily) media exposure.  Media interest paused for \na few days due to the terrible tragedy at Fort Hood (Texas) army base where a crazed \nArmy MD psychiatrist who trained at USUHS and Walter Reed and is a Muslim (born in \nUSA) went on a shooting rampage and killed 13 and wounded 30 soldiers getting ready \nto deploy to Afghanistan.\n  Am extremely busy and very fatigued!\nNov. 10, 2009 – CDC and HHS still getting hammered by the press because of the delay \nin availability of vaccine.  Press frenzy continues.  I am coming across relatively \nunscathed because of my long-standing credibility.  Briefed the editorial board of the \nWashington Times yesterday and today my picture was on the front page of the \nWashington Times. Also, continue on TV and NPR.\nNov. 11, 2009 – Pressure and press frenzy continues.  Hurricane Ida flooding the mid-\nAtlantic.  Been raining here with no real hurricane for days.  Pre-taped the “Power \nPlayer” segment for FOX News that will show on Sunday – 11-15-09.\nDinner at Richard Ben-Veniste and Donna grill’s home.  Present were:  Gerry and Ellen \nSigal,  and 2 friends of Richard’s and Donna from LA.  Terry and Denise – \nenvironmentalists.\nNov. 12, 2009 – Two day of Science Management Working Group (SMWG) of which I \nam a member of the Intramural and Clinical Center Subcommittee.  This evolved out of \nthe NIH Reauthorization Act of 2006 to look at the structure and function of the NIH.  \nChaired by Norman Augustine. On MSNBC and Fox News today.\nNov. 13, 2009 – More of the same.  Things getting very testy with the press and the \nRepublicans blasting the Administration as having another “Katrina” with the H1N1 flu.  \nStill long lines and contradictory issues of ½ people do not want to vaccine because that \nthink it is not safe and ½ are waiting on line for it.  Lose-lose from a PR standpoint.  \nPicture on page B1 of the Post (Metro Section) for the NIH-DC AIDS initiative.  On \nNBC Nightly News.\nNice dinner at Ambassador Nancy Brinker’s home (Ritz-Carlton Apartments in \nGeorgetown in honor of Mark Dybul. Nancy was Chief of White House protocol under \nPres. George W. Bush.  Beautiful Apartment overlooking Georgetown and the Potomac \nReleased by Chairman Rand Paul\n221River.  About 16 people.  Nancy is the President /Director of the Susan G. Komen \nInstitute named after her sister who died of breast cancer.  Nancy is now interested in \nGlobal Health, particularly cancers (breast mostly) in women in developing countries. \nInteresting guests.  I particularly liked speaking with Kathleen Parker, syndicated \ncolumnist and frequent Sunday News Show commentator and guest. Also, there were \nPamela Stevens (former White House Press person) and other global health people.\nNov. 14, 2009 – Presented my NIAID “update” to the Board of the AAAAI at the Hyatt \nCapitol Hill. Ali’s NCS Cross Country Team wins the Maryland State Championship.  \nAli is one of the Senior Captains of the Varsity of which she is one of the starting 7.\nNov. 15, 2009 – Amazing Sunday.  Appeared on NBC Today Show in the AM, Fox \nNews highlighted me as “Player of the Week” with a several minute segment.  Did “The \nForum” with Dean Sam Lloyd at the National Cathedral.  Big success with big crowd.  \nConsists of a “conversation” between Dean Lloyd and me about my life and work \nfollowed by questions from the audience. Also did CBS Evening News.  Exhausted at \nend of day.\nNov. 17, 2009 – Went to NYC to receive the Accordia Award for Public Service.  This is \nthe new version of the Infectious Diseases Institute started by merle Sande and funded by \nPfizer. Mark Dybul, Julie Gerberding and others were there.  Was in NYC anyway for the \nDDCF Board of Trustees meeting in the AM and went up to see Megan at Columbia for a \ncouple of hours.  It is always wonderful to see Megan and I always have a great time \nwhen I visit her.  We had a nice lunch.\nNov. 20, 2009 – Had dinner with Chris over Francis and Diane Collins’s house with \nRegina Benjamin, the newly appointed Surgeon General.  Pleasant, but I believe that she \nis going to be a non-entity.  She is a bit over her head.\n     The H1N1 pandemic is starting to die down with widespread disease going from 48 \nstates to around 30 states.  Much less press interest.  A lot more vaccine now available.\nNov. 23, 2009 – Went to NYC to give remarks at the Healthright international dinner at \nthe Mandarin Hotel.  My remarks were honoring Jonathan Mann.  Gave a warm speech \nabout him and his character. His daughter Naomi was there and was very touched by my \npresence and remarks.  She admitted publicly in her remarks that everyone in the family \n(even when she was a young girl) knew who “Tony” was since Jon would often speak of \nme.  She said that she realized that Jon and I sometimes disagreed but that her father \nalways greatly respected me.  Nice evening.  After dinner I went up to Columbia to see \nMegan for an hour.  As usual, it was great to see her.\nNovember 24, 2009 – Briefed the Foreign Press Core on AIDS at the National Press \nClub.\nReleased by Chairman Rand Paul\n222Nov. 30, 2009 – Attended a World AIDS Day event at the White House (South Court \nAuditorium.  Sec. Clinton and Sec. Sebelius were there as was Eric Goosby.  They spoke \nabout PEPFAR.  Of note, striking difference from last year when anyone at White House \nmentioned PEPFAR, they would recognize me in the audience as the main architect of \nthe Program.  No one did that this time even though Hillary Clinton saw me and warmly \nwaved at me from the stage.  I believe that the new administration speech-writers and \nstaff just have no idea who I am.  Sic transit Gloria.  Sebelius was her usual cold self and \ndid not even make eye contact with me.  Also, (amazingly) when she was with me a day \nor 2 later actually asked me as we were on the Hill together to speak with the \nCongressional Black Caucus (who never showed up – ugh!) “now just what do you do \nand what is your official title”.  When I told her, she smiled and said: “I just think of you \nas “the vaccine guy”.  She did not mean any harm, but she is really clueless….or actually \nuninterested in any interpersonal relationship at this level.\nDec. 2, 2009 – Had dinner with Peggy Hamburg at Indique Restaurant on Connecticut \nAvenue.  Just to catch up on how she is doing as Commissioner of FDA.  Really nice \nperson; has not changed.\nDec. 5, 2009 – Went to Holiday Party at Sam and Jan Smith Donaldson’s home in \nMcLean.  Usual warm and enjoyable time.  Chris was in Istanbul teaching a course in \nBioethics and so I went alone.  Usual cast of characters:  Colin Powell, General Casey, \nBen Bradlee, Lee Hamilton, Antonin Scalia, Nina Totenberg, Bill Plante, John and \nDebbie Dingle, George Will, Terry McAuliffe, etc. etc.\nDec. 9, 2009 – Time Magazine came out with a list of the 10 most important Medical \nbreakthroughs of 2009.  #2 was an “AIDS Vaccine” (the Thai trial) and #4 was an H1N1 \nvaccine.  Of note, I played a significant role in the development of both of these.\nDec. 12, 2009 – Wonderful Holiday sit-down dinner party at the Academy of \nAchievement Town House on 16th Street (Black Tie) hosted by Wayne and Catherine \nReynolds.  Usual cast of stars at the dinner – Senators, Congressmen, Media, etc.  \n“Mystery” gust entertainer was Tony Bennett.  The Reynolds’s have been very generous \nto regularly include us at these functions.\nDec. 13, 2009 – Holiday Season in full swing with parties, etc.  Today parties at Nicki \nLurie and Jesse Goodman’s; Bill Haseltine’s and Hugh and Mimi Auchincloss’s.  Flu \nactivity really slowing down with sharp drop in cases.  More vaccine now available and \nso push to vaccinate.\nDec. 14, 2009 – Gave big talk at CSIS on new treatment approaches to HIV/AIDS at their \nheadquarters on 18th and K Streets, NW.  Evening reception at Stone house for Julio \nFrenk.  Good guy.  I knew him slightly when he was Minister of Health for Mexico.\nDec. 15, 2009 – Much activity at HHS level to get the “team” to work on pushing vaccine \nsince much is now available.  HHS is getting anxious (Jenny Backus, Laura Petrou, etc.) \nabout possible “end-of-the-year” news stories that might criticize HHS and USG for \nReleased by Chairman Rand Paul\n223doing a poor job with H1N1.  Had an interesting 90 minute with Washington Post \nEditorial Board (Fred Hiatt and Jonathan Capehart) to discuss the response to H1N1.  \nMeeting was me, Peggy Hamburg, Tom Frieden, and Jenny Backus.  \nDec. 17, 2009 – Continuing on with the HHS push to try to get a final positive spin for \nend of 2009 on our response to H1N1.  They arranged a Press Briefing at the National \nPress Club with me, Secretary Sebelius, Tom Frieden, Peggy Hamburg, Nicki Lurie, Jess \nGoodman, etc. to explain what we have done in response to H1N1.\nDec. 24, 2009 – Traditional “great” dinner for my birthday at sister Denise’s home.  Over \nthe years, Jenny, Megan and Ali have come to treasure this tradition similar to some of \nthe family traditions that Denise and I treasured like dinner over Grandma Abys’s home \nfor the holidays.  In the AM had my traditional birthday breakfast hosted by Chris and the \ngirls at the Silver Diner on Connecticut Avenue.\nDec. 30, 2009 – Lunch at the White House mess with Heidi Avery.  She is Deputy to \nJohn Brennan at the National Security Council at the White House.  She is former CIA \nand Counter Terrorist Unit Chief.  She want to talk to me about how we should broadly \nhandle “all threats to the public health” instead of going incident by incident as with \npandemic flu.  She wanted to speak with me because she heard that I was a visionary \nabout these issues.  Very enjoyable conversation.  Obviously, WH sources know about \nme despite the sometimes discouraging relationships that I have had with HHS and their \nlack of appreciation about who I am and what I have done over the years.\nJan. 6, 2010 – Big Global Health Research Summit held at NIH (Fisher’s Lane) with big \nhitters attending.  Convened by Francis Collins to flesh out suggestions for his Global \nHealth Initiative as one of the 5 pillars of his tenure.  Jack Lew from State was there as \nwere Eric Goosby, Zeke Emanuel representing WH, and many, many global health stars.  \nGood meeting.\nJan. 12, 2010 – Finally had the launch of the DC – NIH HIV/AIDS Partnership.  Went to \nAnacostia for a inauguration and press conference with me, Mayor Fenty, Councilman \nDavid Catania, Shannon Hader and Pierre Vigilance from DC Dept. of Health.  Got good \npress with Channel 5 FOX News.  Also, had good and lengthy interview with Wolf \nBlitzer on “The Situation Room” that evening on National Influenza Vaccination Week \n(Jan. 10-16).  Again, the latter is part of the push to get people vaccinated.  Of note, all \nover Europe there are tens of millions of doses of vaccine that countries like France, \nGermany, Italy are turning back to the company since they are unused.  Interesting issue \nmight arise about the companies no longer wanting to respond to crises since they make a \nlot of vaccine an then countries cancel the orders.  More to come on this.\nJan. 19, 2010 – Heidi Avery (see Dec. 30, 2009) called a meeting this evening (7:00 to \n8:45 PM) in the Situation Room of the West Wing to discuss the broad plans to handle all \npublic health threats, i.e. existing, naturally emerging and deliberately emerging.  Present \nat the meeting was Zeke Emanuel, Nicki Lurie, Peggy Hamburg, Tom Frieden by phone \nfrom Atlanta, Jesse Goodman, Brian Kamoe, George Korch, Richard Hatchett, James \nReleased by Chairman Rand Paul\n224Lawlor (latter 2 are my employees detailed to Heidi), Mike Kurilla, among others.  Heidi \nhad asked us (NIH, CDC, FDA, HSS) through Nicki Lurie to prepare a 1-pager on this \ninitiative from each of our perspectives.  Nicki consolidated the 1-pagers and we \npresented the concept to Heidi.  Heidi is aiming to get the POTUS to announce some sort \nof initiative in the State of the Union Address on January 27.  I am very impressed with \nHeidi and her no-nonsense style of getting to the point and the question at hand.  Heidi \nmentioned to me as we left the Situation Room that she was relying on my “vision” to \nhelp get this going.  Let us see what comes of this.\nJan. 21, 2010 – Has long meeting in my office and private dinner at Trattoria Sorrento in \nBethesda with Eric Goosby, the Ambassador at Large in charge of PEPFAR and the new \nChief of the OGAC (Office of Global AIDS Coordinator) to discuss the future of \nPEPFAR.  Recall that Eric was one of the people that I flew in the put the icing on the \ncake of convincing the White House in 2002 that I was right about starting PEPFAR.  In \nany event, we discussed the issues of broadening the mandate of PEPFAR and integrating \nit in a more comprehensive health systems partnership with the developing countries.  \nUnlike in the past, he is in favor of “operational” or “Implementation” research to \ndetermine best practices associated with PEPFAR mission.  He confided in me the issues \nin the Department of State in putting the President’s Global Health Initiative (GHI) under \nUSAID with new Director Raj Shah.  Since PEPFAR in included within and is the major \npart ($51 Billion out of $63 Billion) of the GHI, the question remains will Hillary Clinton \nput PEPFAR under USAID.  Given the ineptitudes of USAID, I told Eric that he should \nnever accept that.  He agrees and actually said that he would resign if that happened.  I do \nnot think that things will happen that way.\nJan. 25, 2010 – Had strategy meeting in Building 31, Room 7A24 and subsequent dinner \nat Positano restaurant in Bethesda to determine the Institute’s strategy for vaccine \nresearch following the RV144 Thai trial results.  I called in a small group to hash out the \nissues in intense deliberations.  Present were: Larry Corey, Bart Haynes, Gepi Pantaleo, \nLouis Picker, Cliff Lane, Carl Dieffenbach, Peggy Johnston, Hugh Auchincloss, Carol \nHudgings, Patty Conrad.  General consensus is to continue with basic discovery, but to \ngo ahead with other Phase 2B trials, particularly a poxvirus (likely NYVAC) prime and a \nprotein boost (Clade C) in Africa.   Will continue this discussion next week with the \nAIDS Vaccine Research Subcommittee (AVRS).\nJan. 26, 2010 – Another meeting with Heidi Avery at the Situation Room in the West \nWing of the WH to further discuss the new initiative to counter all public health threats \nincluding bioterror, but also all emerging and existing Health threats.  Mike Kurilla and I \nhave been fine tuning the NIH component.  Present at the meeting was the same group as \non January 19, 2010 (see above0 .  Also present was the POTUS’s science advisor John \nHoldren.  We now have a 1-pager that Heidi has discussed with the POTUS and that is \nbeing considered for a brief comment in the State of the Union  (SOTU) Address.\nJan. 27-28, 2010 – Went to Boston to be the Bulfinch Visiting Professor at \nMassachusetts General Hospital and Harvard Medical School at the invitation of Denny \nAusiello (Chair of Medicine).  Great visit, particularly interactions with House Staff and \nReleased by Chairman Rand Paul\n225Fellows. Gave the Bulfinch Lecture on Pandemic Influenza; extremely well-received by a \nstanding room only crowd.  On the trip home when I landed at DCA, I bought a hot dog \nsince In was starving.  I immediately ran into Nina Tottenberg and her husband David \nwho god-naturely chastised me for eating the hot dog.  With a minute I walked to a news-\nstand to buy a Washington Post.  I ran into Karl Rove who jokingly said he would tell the \nworld that the great Dr. Fauci was caught eating a hot dog.  We had a good laugh.\n  On evening of Jan. 27 POTUS mentioned the sentence that I crafted for Heidi in the \nSOTU Address: “And we are launching a new initiative that will give us the capacity \nto respond faster and more effectively to bioterrorism or an infectious disease — a \nplan that will counter threats at home and strengthen public health abroad.”  This is \nthe second SOTU Address where my words were included.  Other was the PEPFAR and \nProject BioShield statements in the Jan. 28, 2003 SOTU address by Pres. Bush.\nJan. 29, 2010 – Met at the White House (EEOB 234) with Heidi Avery, Zeke Emanuel \nand several Pharma people whom Zeke had called in to ask the question of what would \nthey need to work with us on this project that Heidi and the rest of us have been \ndeveloping regarding developing a transforming approach to developing countermeasures \nfor all public health threats.  Present at the meeting were:  Peter Kim (Merck), Lloyd \nKlickstein (Novartis), Rob Mashal (NKT Therapeutics), Sandy Hecker (Hecker and \nAssociates), Lynn Marks (GSK), Richard Hatchett.\nFeb. 1, 2010 – Another meeting in the Situation Room of the WH with Heidi Avery with \nthe usual cast of characters.  For the past 2 meetings, Andy …. From DoD has joined as \nhas John Holdren from PCAST.  There is tension building where the HHS people \n(particularly Nicki Lurie and to some extent Jesse Goodman, Peggy Hamburg and Tom \nFrieden are getting nervous about the boldness of the proposal and whether we can \n“deliver” on the promises.  Heidi is trying here best to explain that we need a bold \ninitiative and if we are not bold and transforming, we will get nowhere. They are \nconcerned that this is moving quickly particularly since Heidi is talking about possible \nface-time with the POTUS to have him accept and sanction this bold “new initiative’. I \nam leaning much more towards Heidi and have served as somewhat of an intermediary to \ntry to alleviate their concerns.  They are somewhat in the weeds.  Heidi has been calling \nme up at night to get my confidential feedback about how we can get the HHS group \nfrom being so conservative.\nFeb. 2, 2010 – Had AIDS Vaccine Research Subcommittee (AVRS) meeting at the \nBethesda North Marriott Hotel to discuss the way forward following the Thai trial \n(RV144).  We discussed the same issues that I discussed at the smaller meeting of my \n“Kitchen Cabinet” on Jan. 25.  As usual, people had insecurities about pursuing a path \nthat was not their path.  In addition to the Jan. 25 group, also present were Dennis Burton, \nBruce Walker, Nelson Michael, Jerome Kim, Debbie Birx (now at CDC).  I made it clear \nto them in no uncertain terms that they needed to speak up openly and not stay silent and \nthen after the meeting say they disagreed with the conclusions.  It turned out to be a good \nmeeting since they obviously heard what I said.\nReleased by Chairman Rand Paul\n226Feb. 4, 2010 – Opened the Genomics Blue Ribbon Panel at the Bethesda North Marriott \nto plan the direction of genomics research for NIAID.  All the stars were there – Ian \nLipkin, Eric Lander, etc. Eric gave a great speech. About the use of genomics in \ninfectious diseases.  That evening presented my usual “State of NIAID” talk to the ASM \nExecutive Committee.\nFeb. 5 and 6 and Feb and Feb 9 and 10 – 2 worse snow storms in the history of \nWashington, DC.  Shut down schools and government for a week – it was a 0ne (32 \ninches at IAD) – two (20 inches in DC) punch.  During this time we intensified the \ndevelopment of the PHEMCE (Public Health Emergency Medical Countermeasure \nEnterprise) Initiative via Heidi Avery.  Getting hot and heavy in that the HHS folks are \ngetting cold feet.  Although good friends of mine – Nicki Lurie appears afraid and over \nher head.  Jesse Goodman is forever in the weeds.  Peggy Hamburg is cautious but just \nnow is starting to realize that this train is moving.\nFeb. 8, 2010 – Whole city is socked in with snow, but we still had meeting in Sit Room \nwith the usual cast of characters.  Heidi has obtained 1 hour face time for us with the \nPOTUS, but the HHS crew is afraid.  Issue  is that they think that the concept is too bold \nand Nicki Lurie is afraid that it will supersede the IOM-led review of the enterprise that \nSec. Sebelius has ordered for Feb. 22-23 and that must report to her by March 31.  Heidi \nwants to leap over all of the nonsense and get the POTUS buy in.  The pillars of her \ntransforming plan are : 1) Multi-use principle – NIAID has already been pushing for this \nin the sense of partnering with industry to develop multi-use products and advance new \nplatform technologies; 2) Collaborations, Partnerships and Cooperatives; 3) regulatory \ninnovation and Advancement of regulatory Science; 4)Product Development and \nmanufacturing services; 5) End-to-end Multidisciplinary Project Management (see entire \ndocument in records of My Documents).\nFeb. 10, 2010 – We (the HHS team) brief Bill Corr (Deputy Secretary).  Again \nconservative concern.  I am all for Heidi’s initiative.  These people just do not understand \nhow important it is to get personal support of the POTUS (remember PEPFAR).\nAgain, multiple conference calls with Heidi fine-tuning the document.  Richard Hatchett \n(who actually works for me in DAIT, but is detailed to Heidi) and Heidi often call me late \nat night for help in getting this group off their asses.  They are afraid that she will \npromise too much.  She keeps saying (and I totally believe her) that we are not going to \npromise the POTUS anything, we just need to get his buy-in and then we will implement \nwhat we can.\nFeb. 11, 2010 – HHS team briefs Secretary Sebelius over the phone.  She is smart, but \nclueless about what all this means.  Nicki Lurie is inarticulate in explaining it to her.  \nNonetheless Heidi is going to give it a go with the POTUS even though she is terribly \nfrustrated with the HHS people except for me. My time has been totally consumed with \nthis despite the shutdown of everything with the snow.\nReleased by Chairman Rand Paul\n227Feb. 12, 2010 – Meet with the POTUS from 2:00 to 3:00 in the Situation Room.  Richard \nand Heidi present and the HHS team answered questions.  I was not shy in telling the \nPTUS what I thought.  He said “Are we making this more complicated than it should we?  \nWhy not contract out for the relatively limited number of countermeasures that we have \nIntel. On that could be threats”.  I reminded him that in his SOTU address he said that we \nwould develop an initiative to counter all threats to public health even naturally emerging \ninfections.  I then told him that the dual use and new platform technologies were essential \nto get industry involved since they would not take the investment risk unless we helped \nthem with the technology, etc.  He agreed.  He recognized who I was without even an \nintroduction and called me “Tony”. All in all, the meeting went well and he said that he \nendorsed the plan.   Parenthetically, The traffic was horrible getting to the WH via the \nGW parkway by Taxi.  I took a taxi because the METRO Red Line shut down due to a \nderailment.  Stressful getting there, but great to have 1 hour face time with the POTUS.  \nThis is now the 5th POTUS that I have personally advised via serious face-time.\nFeb. 15-17, 2010 – Went to annual CROI meeting in San Francisco.  Gave Opening \nSession Plenary on “The HIV/AIDS Research Agenda:  A View from NIAID”.  Gave a \nbold and provocative talk about the high risk, high impact, potential “game-changer” \nresearch that we plan to do over the next few years.  The 3 “pillars” of this research are 1) \nAggressively seek, test and treat infected individuals.  However, the math tells us that the \ntreatment paradigm in a vacuum will never end the AIDS pandemic since more people \nget infected than get put on treatment.  Hence we need to do something different such as \ngetting people who are on therapy off therapy by developing a 2) CURE for HIV – tough \nchallenge.  Also we need to 3) Prevent new infections by a) ARVs as prevention – ARV \ncontaining microbicides; PrEP; test and treat; and b) vaccine.   Beautiful days in SF.  \nStayed at the Westin St. Francis.  Many people said that it was the best and most \ninspiring talk that I have ever given – “bold and challenging”.\nOn Feb. 17, I briefed by teleconference the PCAST working group about the POTUS \ninitiative and gave them background info.  On the call were co-chairs Harold Varmus and \nEric Lander.  Also, David Baltimore, Ed Penhoelt, Emilio Emini, Harvey Fineberg, \namong others.\nFeb. 18, 2010 – Another meeting at the Sit Room of the WH from 4:00 to 5:30 PM with \nHeidi Avery and the “team”.  Getting ready for the various meetings next week of IOM \n(Secretary’s review), PCAST, and National Biodefense Science Board (NBSB).  I \nbrought up that reports from these other meetings may confuse people regarding the \nPOTUS’s initiative to transform PHEMCE.  Heidi will likely let the other meeting \nhappen, incorporate some ideas from them and still have the POTUS initiative be the \ndriving force of policy.\nDuring the day prior to the WH had a visit from Rick Klausner.  I had been talking to \nRock about these issue for awhile and he is very much in agreement with my stand on \nhow we need to transform the way the USG interacts with industry in the development of \nproducts.\nReleased by Chairman Rand Paul\n228Feb. 23, 2010 – Continued activity in trying to dissect out what went right and/or wrong \nwith the response to H1N1 flu.  Still considerable tension between Heidi Avery who \nwants  s “to transform” the system and make some leaps and the slow, careful (and \nactually incompetent) response of the HHS people. Had the PHEMCE review led by \nNicki Lurie under the auspices of the IOM.  Held at the House of Sweden on 2900 K \nstreet by the Georgetown Waterfront.  I presented a lively endorsement of the Avery plan.  \nL felt that it made the HHS people nervous.  This reminds me of 25 years ago when I was \npushing HHS to accept the AIDS activists and they were conservatively reluctant.  They \nare not bold at all.\nFeb. 25, 2010 – As per the “review”, a PCAST meeting c—chaired by Harold Varmus \nand Eric Lander was held at the Carnegie Institution on 1530 P Street, N.W. with David \nBaltimore, Tom Monath, Robert Coffman, Emilio Emini and others present.  Their \npurpose was to look at the response to H1N1 and report back to the POTUS.  I presented \nmy theme of the absolute importance of developed a new paradigm of close interaction \nbetween USG and industry whereby USG pushes and shares to risk of developing \ninnovative technologies (new platforms for vaccines and drugs) that industry can use for \ntheir own profits while the USG then has it available to respond to public health threats \n(existing, emerging and deliberate). I was very well received. \nMarch 1, 2010 – Regular Monday evening meeting in the Situation Room of the White \nHouse led by Heidi Avery with the usual cast of characters.  Still inertia on HHS part and \nagitation by Heidi.  Couple of days later (~ March 3 or 4) Heidi called me at home at \naround 10:00 AM very discouraged at the inertia and lack of imagination of HHS people, \nparticularly Peggy Hamburg, Nicki Lurie and Jess Goodman.  Asked for my help in \ngetting the initiative going or she even said that it might be hopeless with this cast of \ncharacters.  She felt that Nicki was in over her head and that she was afraid of losing her \ncommand of the situation instead of capitalizing on what Heidi wants to do.  Heidi also \nfeels that Peggy is missing the big picture and that Jesse is hopelessly garbled in his \nthought and expression.  I will try to help her by formulating a plan with her to get this \ninitiative rolling.\nMarch 5, 2010 – Gave my yearly talk to the Zuckernman Fellows led by Mort \nZuckerman and David Gergen.    Then had the usual receptions that evening at Ronald \nand Beth Dozoretz’s home at 3005 45th Street, N.W. (right around the block from my \nhouse.  Usual stars were there – Sonya Sotamayor, Desiree Rogers (Social Secretary at \nthe WH), Justice Breyer, Dave Gergen, Wolf Blitzer, Andrea Mitchell, etc/\nMarch 6, 2010 – Under the continued generosity of Wayne and Catherine Reynolds to \nChris and me, we were their guests at the premier showing of the Opera “War and Peace” \nat the Opera House of the Kennedy Center.  Special elegant dinner before hand in the \nAtrium followed by the opera.  Guests were the usual DC lists of famous people:  few \nexamples – Gen James Jones, Sen. Tom Daschle, Marcus Brauchli (editor of Washington \nPost), many media people – Dana Priest, Wolf Blitzer, Sam Donaldson, etc.  Long opera!\nReleased by Chairman Rand Paul\n229March 16, 2010 – Research Amer!ca Awards Gala at the Andrew Mellon Auditorium on \nConstitution Avenue.  Usual cast of characters.\nMarch 17, 2010 – For the past 2 Mondays have had the usual Situation Room White \nHouse meetings with Heidi Avery .  Same theme – she is pushing HHS and I am very \nmuch on her side. Looks like a plan is taking shape.  I am impressed with the relative \nincompetence of the HHS group.  They seem clueless and short on leadership.  Tom \nFrieden of CDC shines in my mind as an independent thinker with good ideas and a \nperson who marches to the beat of his own drum.  \n       Gave talk to the NIAID Fellows on a “Career at NIH Monday, 15 March.  They \nloved it.\nRadio and TV Correspondents Association Dinner – Black tie at Convention Center.  \nTerrific night.  Went alone but met with wide range of the usual cast of characters:  Chris \nWallace (Fox News – they invited me); multiple Senators, etc.\nMarch 19 – 22, 2010 – Contamination of Rotarix (Rotavirus vaccine from GSK) with \nporcine circovirus (PCV-1).  Spent many hours on conference calls over the weekend \nwith FDA, CDC and HHS to determine roll-out.  Difficult issue here is the message.  \nThere is no indication that there is a safety concern here since PCV-1 does not cause \ndisease in pigs or in man; yet this virus should not be in the vaccine.  It was at high \nconcentrations even in the seed stock.  The message is that the FDA recommends putting \na hold on administration of the vaccine  (without pulling it from the market) until the \nsituation can be examined more closely.  The potential downside is that this vaccine is \nused mainly in the developing world and if the vaccinations stop, kids will die of \nrotavirus disease.  Merck makes Rotatec, which is used mainly in the USA and so the \nFDA recommends that where possible, clinicians switch from Rotarix to Rotatec.  We \nfully understand that this might not be possible in the developing world and so we \nunderstand if they continue to use Rotarix.\nMarch 24, 2010 – Continue intense WH meetings with Heidi Avery in Sit Room tonight.  \nI finally put together my version of how the USG should take responsibility for the \nadvanced development, preferably in a physical facility that we buy or rent.  The facility \nat Texas A & M is a good model.  Heidi really likes the idea.   Laura Petrou called me \nand said that she heard that I was more forward looking about all of this than the FDA \n(Peggy), CDC (Tom) and HHS (Nicki) and wanted to hear from me about my ideas.  She \nwas actually receptive.  The issue here is really that HHS does not want the WH (Heidi) \nto get in front of the Secretary.  Yet the HHS process is slow, too cautious and \nbureaucratic.  Heidi still calls me off line for my ideas. \nMarch 27, 2010 – Phone call on Saturday with Heidi.  She wants to get more money for \nNIAID to help in the process of bringing investigators from concept to very early \ndevelopment in order to increase the pipeline of products in addition to all of the things \nthat we have been talking about regarding “advanced” development.\nReleased by Chairman Rand Paul\n230Mar. 29, 2010 – Continue with the Monday evening weekly meetings with Heidi Avery \nat the WH Sit. Room.  Usual suspects.  Still Heidi pushing and everyone but me pushing \nback.  Peggy Hamburg seems her usual spacey self often not even having read the \ndocuments that Heidi distributes for comment.  Jesse Goodman (wonderful guy) \ncontinues to be reserved and cautious in typical FDA fashion, but cannot articulate well.  \nNicki Lurie is a good person, but over her head.  In fairness to her, she is caught between \na rock and a hard place in trying not to let this get ahead of the Secretary who in my mind \nis distracted or does not really care about this.  Nicki keeps pushing back on Heidi’s \n“transforming initiative”.  Zeke Emanuel comes to most of the meetings and is with Heidi \nand me in wanting to push this.  In typical Zeke fashion, he is brilliant, but shoots often \nfrom the hip.  Mike Kurilla is doing a great job with me and probably understands the \nproposed process better than anyone in the room. Andy Weber of DoD (assistant \nSecretary) is a good guy, but he is just trying to keep the DoD in the “game”\nMar. 31, 2010 -  Meet with Alan Bernstein (Executive Director of the “Global HIV \nVaccine Enterprise” (see above comments about my negative reaction to this unnecessary \ngroup).  Alan is a good guy, but is heading a superfluous organization.  In any event, his \nmultiple layers of “working Groups” has come up with a Strategic plan for the \n“Enterprise”.  Peggy Johnston is all over this and so she shields me from the week-by-\nweek dealings of this organization (I am one of the Founding Council Funders).  Meeting \nin my office with Alan since wants me very much to approve of the plan since NIAID is \nthe major world funder of HIV vaccine research. Meeting In NYC next week of the \nEnterprise Council and so he is here to pay respects and make sure that I am on board.  \nThe Plan is OK, but NIAID will do what we think is best for vaccine development.\nLater in the day, the HHS Flu team (me, Nicki Lurie, Jesse Goodman, Peggy Hamburg, \nTom Frieden, Laura Petrou, Jenny Backus, etc) meets with Sebelius in her private \nconference room.  We present the supposedly penultimate draft of the MCM Review that \nshe ordered and that we have been working on for weeks trying to reconcile it with \nHeidi’s initiative.  Nicki gives a terrible presentation; Sebelius is confused as to the \n“scope” of the review that she ordered – was it a review only of medical countermeasure \n(MCM) development or a review of end-to-end process of responsdng to health crises, \nincluding flu.  I tried to clarify for Nicki, and Sebelius agreed with me. We need to keep \nit focused.   Back to the drawing board on a few issues.  One issue is how much money \nshould we ask for in the 2010 flu supplement and the 2011 budget to fulfill some of the \ngaps identified in the review and in what is proposed by Heidi.\nApril 5, 2010 – After Action Review of the H1N1 response in Nicki and Jesse’s home in \nBethesda (near the Palisades section).  Beautiful home with magnificent view of the \nPotomac and the opposite Virginia shore.  Beautiful sunny day.  Present – Nicki, Jesse, \nRobin, Steve Redd, Anne Schuchat, Laura Petrou, Makala Ross (OS).  Good discussions.\nApril 6-7, 2010 – Went to NYC night before and had great dinner and time with Jenny \nand Meg.  I stayed at “W” hotel at Union Square.  Went for run on April 5 evening past \nLarry Kramer’s Apartment; called, but found out later that he was asleep on his couch \nand did not hear the phone.  In front of Larry’s Apt. (2 Fifth Avenue – right across the \nReleased by Chairman Rand Paul\n231street from Washington Square Park), ran into Bob Bazell (NBC News), who live in the \nsame apartment.\n       Next AM (April 7) went to Enterprise headquarters and met with the leadership to \ndiscuss the “Plan”.  Beautiful day.  I stayed for AM.  Present were Alan, Tachi Yamada, \nPeter Piot (new Chair of Council), Manuel Romaris (EU), Catherine (Kate) Hankins \n(UNAIDS-WHO). Seth Berkley (IAVI), Jose Esparza (BMGF), Peggy Johnston, Yves \nLevy (INSERM), Rafi Ahmed (Emory and chair of the Scientific Committee).  Good \ndiscussions.  I kept them on track about what NIAID would or would not agree to).\nApril 14, 2010 – Dedicated the Special Unit at the Clinical Center for vaccine studies.  \nHonored Stewart Simonson for the role he played in pushing through the red tape to get \nthis done.  Had nice ceremony with Cliff, John Gallin, Gen Jim Gilman (USAMRIID), \nStewart, etc. Group went to Black’s restaurant on Woodmont Avenue – Bethesda) for \ndrinks on the outdoor terrace (pretty cold).\n    We continue to have endless meetings with ASPR  on the Medical Countermeasure \n(MCM)  review led by Nicki Lurie with Laura Petrou and Jenny Backus involved.  I now \nattend by conference call since it is a waste of time to go down town for these drawn out \ndiscussions.  Theme is post-mortem on the pandemic flu response and how do we \nincorporate what Heidi Avery wants into the Secretary’s (HHS) MCM review.  The \nincompetence and amateurishness of HHS crew in general is noteworthy.   I love Jesse \nGoodman, but he just does not get it that the FDA is a major part of the problem; and he \nis one of the very best FDA people.\nApril 17, 2010 – Was at the Georgetown Harbor near Thompson’s Boat House watching \nAli’s Varsity Crew Boat compete in a regatta.  Nice Spring day on the Potomac.  Chris \nand I were with the usual parents group including our good friends Liz and David Hayes \nwhose daughter Molly is Ali’s “best” friend and boat-mate.  Both will attend Stanford in \nSeptember.  There had been a terrible explosion in an off shore deep-water oil rig a few \ndays ago with no apparent oil leak despite the fact that the platform was destroyed, 11 \npeople died and scores injured.  It was the British Petroleum (BP) Horizon Deepwater \nwell.  David Hayes is the Deputy Secretary of the Department of the Interior.  In the \nmiddle of the regatta, David got a phone call from the White House communications \npeople.  Apparently, there is considerable amount of oil leaking from a broken pipe line.  \nThey were saying that the leak is minimal and David was caught in the middle in having \nspoken to the press and saying that this was serious.  The White House communications \npeople were concerned that he said that we have a bigger problem than exists. They were \napparently giving him some “shit” about this.   David, who recently (last year) had a \ncardiac arrest associated with a myocardial infarction on a golf course, looked shook and \ndistracted. I encouraged him to not worry about what the communications people think.  I \nknow something about the WH trying to control the “message”. Little did either of us \nknow that over the subsequent months would unfold the worst oil spill in history and the \nworst environmental disaster in the history of the USA.\nReleased by Chairman Rand Paul\n232April 19, 2010 – Went to the Lasker Board of Directors dinner at the Citronelle \nRestaurant in Georgetown at the invitation of Maria Freire.  Sat next to Al Somer.  Good \nevening, but ridiculous situation where the government people (me, Peggy Hamburg, \nJohn Gallin, Harvey Alter actually had to pay for our own meal due to misguided conflict \nof interest rules.\nApril 21, 2010 – Continue to have weekly meetings in the Situation Room of WH led by \nHeidi Avery.  Continued frustration on Heidi’s part about the lack of cooperation on part \nof Nicki Lurie and HHS.  Heidi wants transformation and HHS is conservative, only \nconcerned about the Secretary, and “stuck in the mud”.  What a sorry crew.  These \nmeeting are started to take a toll on my schedule with having to take the METRO down \nand back and the Red Line being barely functional with amazing slowness and frequent \nmishaps.\nApril 27, 2010 – Another Sit Room WH meeting to discuss budget and implementation \nof MCM initiative.  Continued tension.  I am with Heidi.\nApril 28, 2010 -  Busy day.  Two Congressional (House) Hearing in the Rayburn \nBuilding: 1) Appropriation Subcommittee chaired by David Obey.  I accompanied \nFrancis Collins along with Tom Insel (NIMH) and Griff Rogers (NIDDK) to testify.  \nFriendly Hearing but budget is depressing – flat.  2) in the late afternoon – House Energy \nand Commerce Health Subcommittee Hearing on Antibiotic Resistance chaired by Frank \nPallone (D-NJ).  Testified with Tom Frieden.  Typical posturing back and forth between \nDems and GOPs about Health Care Reform (nothing to do with the subject of the \nHearing).  We did well.\nApril 29, 2010 – ICD retreat  - at the Cloisters.  I spoke on the MCM initiative of the \nWH and the NIAID role in this.  Others spoke on translational research.  Much of \nmeeting was on translational research.  Clearly the NIH (under Francis) is heading in that \ndirection.\nApril 30, 2010 – Did Congressional Briefing on AIDS research sponsored by AMFAR at \nthe Rayburn Building.  Susan Blumenthal chaired it.  Also there was Wafaa El-Sadr.\nMay 1, 2010 –Went to Saturday Brunch gala at The Haddad/Greenberg residence at 4852 \nHutchins Place, N.W. as a pre- WH Correspondence Ball function.  Featured Susan \nAxelrod of CURES (for epilepsy).  Many of the usual DC glitterati, media and \nHollywood Stars there.  Saw my old friend Dana Delaney and practically every media \nperson I know – David Gregory, Wolf Blitzer, Chris and Kathleen Matthews, etc.\nMay 2, 2010 -  Annual McLaughlin (now together with Reuters) Sunday Brunch after the \nWH Correspondents’ ball.  Hel at the usual Rooftop of the Hay-Adams Hotel.  Met with \nand spoke with Dennis Quaid who is an advocate of eliminating “Hospital errors”.  His \nchild was the victim of a medication error involving a heparin line through which the \ninfant was given 10,000 times the dose of heparin.\nReleased by Chairman Rand Paul\n233May 5, 2010 – At his request, had meeting in my office with J. Craig Venter.  He wanted \nto brief me and get my advice on how to handle the rollout of his upcoming Science \npaper on Synthetic Biology.  He has made a major advance in synthesizing from the \nsequence in a computer the 1.1 million base pairs of Mycoplasma mycoides  and inserted \nit into a Mycoplasma capricolum bacteria.  The synthetic mycoides then began to code \nfor the proteins of the bacterial cell wall so that after several replications there was a \nbacteria with a synthetic genome and all of the protein coded for by the synthetic \ngenome, thus a synthetic cell.  I advised him to be very transparent at this and present it \nto the NAS, the OSTP, among others.  He has lined up some embargoed press in \nanticipation of the release next week of the paper on May 13. He very much wanted me \nto do heavy press with him likely to add a greater degree of credibility to it as well as \nbecause I explain science so well.  From today until the House Hearing on May 27, HHS \nand the White House completely muzzled me for ridiculous reasons.  Despite the fact that \nJohn Holdren submitted my name to the WH as the best person to do TV, radio and print, \nthe WH muzzled all government comment on this.  They were “afraid to elevate it \npublicly by having well-known government figures speak about it since they did not want \nflack from the “right” that the government was involved in “creating” life.  \nUnbelievable!!   Rick Weiss who is communications director for OSTP is extremely \ndistraught about the muzzling.  Of note, this has happened to me throughout the H1N1 flu \npandemic.  Apparently, besides Jenny Backus, more importantly, David Pfeiffer at the \nWhite House is now behind the muzzling.\nMay 6, 2010 – We have been pushing the issue of more resources and activity on \nNeglected tropical Diseases (NTDs) here at NIAID.  Peter Hotez from GW has been a \nleader in this field.  Recently, Zeke Emanuel at OMB has been pushing it as part of the \nPOTUS Global Health Initiative (GHI).  Zeke called a meeting of all of the players in the \nfield including me, Hotez, Eric Goosby, Raj Shah (Head of USAID), Raj’s assistant Amy \nBatson and many others to discuss the future agenda. The meeting involved research, \npolicy, implementation.   NIAID will sponsor a purely scientific meeting later in the year \n(Dec., 2010).\nMay 7, 2010 - “Big Think” meeting at the Natcher Building of Outside consultants to \ndiscuss 3 of Francis’s pillars: 1) high throughput technology; 2) Translational Research; \n3) Research involved in enhancing health care reform.  All day.  Francis Collins clearly is \ntrying to steer the NIH towards his themes. “Everybody wants to be somebody.”  The \nmeeting was geared to figure out how to spend Common Fund Money and how to move \nmore towards translational research.  Actually a good meeting.  Francis is smart, very \nhard working, but it is all about Francis.\nMay 13, 2010 – Gave Keynote at the NIAF Public policy Forum at the Rayburn \nBuilding.  Typical of similar Italian functions.  Again, continual activity at WH with \nMCM and Heidi.\nMay 14, 2010 – Phenomenal reception/dinner at the Academy of Achievement on 16th \nStreet, N.W. hosted by Wayne and Catherine Reynolds.  Usual stars of DC were there: \nEric Holder, media people, Gen. James Jones, Bob Barnett, etc., etc.  It was a Tribute to \nReleased by Chairman Rand Paul\n234Hal David, master lyricists and team member with Burt Bacharach.  “Mystery” \nentertainers were B.J. Thomas singing “Raindrops keep falling on my head” and the \namazing Dionne Warwick.   I helped Dionne a few months ago by referring her friend to \na neurologist for MS.  We had a pleasant conversation after her performance.\nMay 18, 2010 – Science Management Working Group (SMRG) meeting in Building 31 \nto discuss the clinical center issues and the proposition to open it to the extramural \ncommunity in exchange for the inflationary increases being paid for out of the total NIH \nbudget instead of just the IRP budget.  Still pending what the decision will be.\n     That night had dinner at Assaggi in Bethesda with Mark Harrington, Gregg Gonsalves \nand David Barr to discuss the underfunding of PEPFAR and what to do about it.  In this \nregard, big issue looming among the international and national AIDS advocacy \ncommunity about the POTUS GHI that includes PEPFAR, but funds PEPFAR at almost \nlevel instead of the expected increases by the community.  POTUS wants to expand GHI \nbeyond just PEPFAR and include, child health, maternal health, women’s health, NTDs, \netc.  Thus, PEPFAR is somewhat competing with others for a limited pot of money.  \nMany African health officials such as Peter Mugyenyi are openly complaining about this \nand getting agitated.  Obama is looking in the eyes of the activists as anti-AIDS, which he \nis not.  However, it is clear that AIDS is not his highest priority.\n     Earlier in the day I appeared on the Diane Rehm show on just this topic of short-\nfunding of PEPFAR.  On with me was Stephen Lewis (former UN envoy at large for HIV \nand Peter Mugyenyi and Eric Goosby.  Lewis as usual was sanctimonious.\nMay 21, 2010 – Waxman’s House Energy and Commerce committee want me to testify \non May 27 with Craig Venter and others on synthetic biology and the science paper that \njust came out.  White House is balking.  I spoke with staffers Naomi Seiler and Steve \nCha.  Both really want me to testify.\nMay 25, 2010 – Received the Joel A. Toubin Award for Advocacy on Behalf of HIV \nInfected People from the Whitman Walker Clinic at the Embassy of Sweden at 2900 K \nstreet on the Georgetown Waterfront.  Amazingly beautiful day.  Reception on the \nrooftop with panoramic views of the Potomac, Watergate, the Key bridge, etc.  Check out \nmy speech\nMay 26, 2010 – Met with Francis Collins, Harold Varmus (recently announced as new \nNCI Director, John Burklow (OC for OD), Kathy Hudson, and Pat White (Leg for NIH \nOD) regarding the disturbing Administration policy of “muzzling” NIH and other \ngovernment scientists (see discussions above).  Conclusion is that we must strongly \nsuggest to John Holdren (POTUS Science Advisor) that he directly tell the POTUS that \nscientists, particularly at NIH are being muzzled by the WH  and HHS communications \npeople.\nReleased by Chairman Rand Paul\n235    The evening (beautiful, warm Spring DC evening) went to the Annual National \nEducation and Leadership Awards (NELA) Gala at the Omni-Shoreham Hotel given by \nthe Sons of Italy Foundation.  Bill Clinton received the Lifetime Award for Public \nService.  Came 1 hour late, but gave a great speech on public service.  Also awarded was \nCaptain Anthony Odierno who lost his left arm to an RPG attack on his Humvee in \nBagdad.  His father General Raymond Odierno introduced his son.  Tear-jerker for sure.  \nAlso awarded was Lewis Merletti, former WH Secret Service detail and ultimately Chief \nof the Secret Service; decorated Viet Nam vet (Bronze Star).  Patty Conrad knew him \nwhen she worked in the Bush 41 WH.  Says he was a very nice person.  Sat at the table \nwith Bob Gallo and Phil Piccigallo.  It is interesting that after all these years I have \nbecome somewhat of an icon to the older and younger Italian men and women, many of \nwhom wanted their picture taken with me.\nWhite House finally clears me to testify tomorrow\nMay 27, 2010 – testify before House Energy and Commerce Committee on synthetic \nbiology related to the Science paper by Venter et al on the synthesis of Mycoplasma \nmycoides and insertion into a Mycoplasma capricolum to ultimately have a totally \nsynthetic bacteria.  Testified with Craig Venter, Jay Kiessling (Berkley), Greg Kraebnick \n(Hastings), Drew Endy (Stanford).  Hearing went extremely well.  Some posturing by \nGOPs on Health Care reform, but in general, we all did very well.\nJune 5, 2010 – Met with Rick Klausner at my house for catch-up.  He is in town to meet \nwith OSTP regarding preparedness issues similar to the types that I have been working on \nwith Heidi Avery.\nJune 8-11, 2010 – Visited RML for the BSC review.  Went with Patty Conrad, Kathyu \nZoon, Karyl Barron etc. Had very nice time.  Went fishing twice with Marshall Bloom \nand Patty and a great guide named Jack Mauer.  Fishing not good due to high water from \nrain.  Nonetheless, it was a wonderful time.\nJune 12, 2010 – Flag day at NCS.  Alii took the Science, Math and Spanish Prizes.  She \nwould have won the Flag (for highest GPA over 3rd and 4th year) but an English teacher \nwho is a known asshole gave her an  A-.\nJune 13, 2010 – Graduation Day at NCS.  Feeling very sad that my baby (Ali) will be \nleaving us for Stanford in the Fall.\nJune 15, 2010 – Had dinner at the home of the Italian Ambassador to the USA (Villa \nFirenze – 2800 Albermarle Street, N.W.)   I wanted to do this since he is the new \nambassador and I have over the years become variably friends with the Ambassador.  The \nprevious one was Giovanni Castanaletta.  The current one is Giulio Terzi di Sant’Agata.  \nI was fortunate enough to sit next to him at the dinner table and so got to know him.  \nSpoke about a wide variety of subjects from Afghanistan to the Oil spill in the Gulf of \nReleased by Chairman Rand Paul\n236Mexico to the economy to science in Italy versus the USA.  Very nice guy.  Also at the \ndinner were Bob and Mary Jane Gallo, Susan Blumenthal and a bunch of Italian Pharma \npeople and diplomats.\nJune 17, 2010 – Met with Minister of Health of Taiwan today to discuss potential \nscientific collaborations.  He said that I was “famous” in Taiwan….interesting.  Jean \nWilliam (Bill) Pape visited from Haiti today and gave lecture at Masur Auditorium.   He \nis a good friend and invited Megan to visit Haiti.  He is in DC to receive an award for the \namazing work that he has done in Haiti related to the earthquake.\nJune 24, 2010 – Met with Minister of Health of India Ghulam Nabi Azad to discuss \ncollaborations.  Sharp guy – enjoyed discussion.\nJune 29, 2010 – Went with Chris to South Lawn of the White House to celebrate her \nelection to the Bioethics Commission.  Turned out it was a massive get together on a very \nhot day for all Presidential appointees.  They were completely disorganized in getting \npeople cleared through the gates and it was a logistic disaster.  The delay was probably \nrelated to multiple checking of IDs related to the “gate-crashing” of a WH party a few \nmonths ago.\nJuly 11, 2010 – Went to Atlanta for the day  (Sunday) to give plenary at the CDC \nsponsored international Conference on Emerging Infectious Diseases.  Hot July day.  I \nshared the Plenary opening evening addresses with Tom Frieden and Kevin DeCock.  \nGood camaraderie among CDC people and me.  Came back to DC that night.\nJuly 12, 2010 -  Attended swearing in of Harold Varmus as the new Director of the \nNational Cancer Institute.   Starting to do a lot of press in anticipation of the International \nAIDS Meeting in Vienna next week.   Am looking forward to this meeting since I am \ngiving a Plenary Lecture on Pathogenesis of HIV Disease: Opportunities for \nInterventions.   \nJuly 18, 2010 – Leave for Vienna (Sunday) – Disaster for travel – flight cancelled on the \nrunway, switch from direct flight to Vienna (Austrian Airlines) to United to Frankfurt \nconnecting to Vienna.  United flight sits on IAD runway for 2 hours due to thunder \nstorms – miss connection in Frankfurt.   Finally get the Vienna on Monday afternoon \n(19th July).  Trying to stay cool and un-ruffled.   Good to have Johanna McDonough meet \nme at airport.  She had rescheduled me from IAD to get me to Vienna.  She is a life-\nsaver.\nJuly 19-21, 2010 – Really great meeting in Vienna.  My talk was a knockout.  Also, very \ngood press from Vienna – PBS Newshour, CNN, WTOP, CBS radio, also NY Times, \nWashington Post, etc.   Meeting was a complete success.  We announced the results from \nthe CAPRISA microbicide trial.   First success with topical microbicides.  \nJuly 22-23, 2010 – Good press follow-up from meeting – NPR Science Friday among \nothers.   Note that we have been going through a record breaking heat wave on the East \nReleased by Chairman Rand Paul\n237Coast with a concentration in DC.   Temps between 92 and 101 F for the past several \nweeks.   Welcome to Washington!\n    Also, over the past 2 weeks I have been informed that I have won the Paul Janssen \nPrize from Belgium ($100,000.00) (cannot take the money since the prize is sponsored by \nJ & J – what bullshit).  Also won the Will Roger Prize for $50,000.00 (yes, I can accept \nthe money).  To be given to me in LA – am looking forward to this.\nThis has been a very busy, hot, exciting summer.   Am chronically tired, but good things \nare happening, particularly in the lab (a4B7) and with commentary papers that I am \nwriting including some really nice ones with Gary Nabel on HIV vaccine and universal \nflu vaccine.\nAug. 4, 2010 – Memorial service for Bob Chanock, giant in virology for 50 years at \nNIAID.     Major figure in virology \nresearch – discovered M. pneumonia; several parainfluenza viruses, his groups also \ndiscovered norovirus (Norwalk agent), made vaccine for rotavirus and hepatitis A, etc.  I \ngave one of the eulogies at his service.\nAug. 5, 2010 – Dinner with Larry Corey who has just been offered and accepted \nPresident and CEO of the Fred Hutchinson Cancer Research Center in Seattle, where he \nhas worked for many years.   Big career decision regarding his future role in helping lead \nthe HIV vaccine effort as PI of the HVTN.\nAug.  18, 2010 – Big controversy regarding the conflicting studies of the role of XMRV \n(xenotropic mouse leukemia virus-related virus) in chronic fatigue syndrome (CFS).   2 \npapers coming out almost simultaneously from FDA (Shy-Ching Lo)/NIH (Harvey Alter) \nin PNAS and the CDC in Retrovirology. FDA/NIH finds correlation (86% vs 8.% in \nnormals), while CDC finds no correlation.   I have been involved in trying to get to the \nbottom of this prior to publication of the discordant results since we knew of the data \nbefore the papers were published.   I believe that the FDA/NIH study is contaminated and \nI do not believe Shy Lo since in the late 1980s he had claimed with what appeared to be \nfool-proof data that AIDS was associated with a new species of mycoplasma (M. \nfermentans) as a co-factor.   The data proved to be spurious,, but people seem to have \nforgotten about this.  I have convinced Ian Lipkin from Columbia (Mailman School of \nPublic Health) to referee coded sample examination of FDA looking at negative samples \nfrom CDC study.   The exercise was somewhat inconclusive.   Lo does not want to do \nanother study starting with identical CFS samples that are coded together with known \nnormals and known spiked samples to really settle this.   The issue is that highly \nemotional CFS crowd now wants to treat CFS people with anti-retroviral drugs, despite \nno evidence of causality and several negative studies besides the CDC study.\nAug. 19, 2010 – Finally had formal roll-out of the Medical Countermeasure (MCM) \nreview and initiative together with PCAST Report re: 2009 pandemic flu.  Roll-out was \nat HHS led by Secretary Sebelius.   I presented the NIH component of the 5 part initiative \nwhich is the Concept Acceleration Program (CAP) and the Strategic Investment (SI) \nprogram (a 501 3(c) similar to a venture capitol firm).  Other initiatives were regulatory \nScience for FDA, manufacturing capacity, enhance influenza capability (potency assays, \nReleased by Chairman Rand Paul\n\n238sterility assays, etc.).   All of this evolved greatly from the many meetings that we had \nover the past year in the White House Situation Room with Heidi Avery.  We finally \ncame to some compromise in the tension between the WH (Avery) and HHS (Lurie-\nSebelius).\nNov. 2, 2010 – Mid-term Elections!  In a strong repudiation of what some consider the \nover-reaching liberal policies of President Obama, the Republicans take of the House by \nwinning 60+ seats and lick up many in the Senate.   Pelosi out as Speaker and John \nBoehner (R-Ohio) in.   Much upheaval with some Tea Party Candidates winning seats.\nNov. 8, 2010 – Visited Holy Cross College to deliver the Inaugural Joseph E. Murray, \nM.D. Distinguished Lectureship in Medicine.   Joe Murray (class of ’40) had won the \nNobel Prize for performing the first kidney transplant.   I gave the lecture to a full house \nat the Hogan Campus Center at Holy Cross in Worcester.  Write-ups in Boston Globe and \nWorcester Telegram.   Old friends came to see the lecture from my class of 1962 – Bob \n(and Peggy) Curran, Jim Mulvihill, Pete Deckers.  Best part of the evening was the \nappearance (stayed for dinner and the lecture) of Bob Cousy who had said that he was so \nproud of what I had done for the country and the world that he wanted to come to meet \nme and hear my lecture.   He was attentive and engaged for the entire lecture in the first \nrow.   During the day before the dinner and lecture, I met for hours with students (almost \nall pre-med and mostly women).   They were great and we had fun.   They said that I was \n“cool” and “awesome”\nNov. 23-24, 2010 – Big advance in HIV prevention research.  The iPrEx study results for \npre-exposure prophylaxis (PreP) for prevention of HIV infection in MSM came out on \n11/23/10 in the NEJM showing 44% decreased risk in Truvada arm versus placebo.   \nImportantly, for those who took the drug 90% or more of the days, decreased risk was \n73%.  For those with blood levels of Truvada vs those without blood levels, the risk was \ndecreased by 92%.   Big media days for me – Front page of NY Times, CNN Situation \nRoom with Suzanne Malveaux, multiple print medias, Canadian and European TV, Local \nFox News, several NPRs including “Talk of the Nation”;  The NewsHour. This will be an \nimportant addition to the toolkit of prevention methods.\nMegan spending the first semester of 3rd Year in Morocco.   Somewhat stressful, but \nextraordinary experience.   She is an amazing young woman.  I am actually in awe of her \ncourage and adventurous spirit.\nDec. 1, 2010 – World AIDS Day – Gave presentation at The White House and \nparticipated in panel led by Eric Goosby together with Chris Collins, Ada Adamora, \nJennifer Cates.   My thene was 1)  Optimizations of Therapy; 2) Go for a cure; and 3) \nMaximize prevention.\nDec. 1, 2010 through Jan. 19, 2011 – In general, nothing overwhelming.  Economy \nrecovering; still strident partisanship in Washington, D.C.   Health care reform passed, \nand no Republicans voted for it – amazing.   NIH budget looking bad.\nReleased by Chairman Rand Paul\n239Dec. 8, 2010 – Science Management Review Board (SMRB) of NIH (of which I am a \nmember) has been and continues to discuss Francis Collins’ intention of merging NIDA \nand NIAAA, dissolving NCRR, as well as and more importantly creating a National \nCenter for the Advancement of Translational Science (NCATS) at NIH to include the \nCTSAs and CAN RAID TRND and Molecular libraries.  Francis is dead set on starting a \nnew center and is using the SMRB to endorse it.   I have made it clear that I do not think \nthat this is a good idea since it is redundant (nothing broke).  Also, bad idea at a time of \nflat, if not decreasing, NIH budget.\nDec. 9, 2010 – Major breakthrough in NIH prevention with the results of the PrEP study \n(iPrex) showing that daily Truvada to uninfected MSM decrease acquisition of HIV \ninfection by 44% and in those who take the meds every day, it decreases acquisition by \n90%.   I did much media on this\nDec. 13, 2010 – Major outbreak of Cholera in Haiti.  Traced to contaminant of a river \n(used for drinking and washing in rural part of Haiti) by UN Nepalese soldier with \nasymptomatic cholera.  I appear of Diane Rehm show discussing cholera.\nDec. 17, 2010 – I deliver the Walter Dzau lecture at Brigham and Women’s Hospital \n(invited by Paul Farmer) on “30 Years of HIV/AIDS:  A Personal Journey”.  \nOverwhelming hit with prolonged applause.   I spoke of my involvement from first day \nand told the story of the “Birth of PEPFAR”.\nJan. 14, 2011 – Appeared on Anderson Cooper 360 on CNN in NYC for a special on “30 \nYears of AIDS”.   There will likely be increasing media events this year since this is \nindeed the 30th Anniversary of the recognition of AIDS.\nJan. 15-16, 2011 – Was Keynote Speaker at a Keystone Meeting in Vancouver, BC on \nTuberculosis.   Large (~800) audience, mostly post-docs.  Very well received.\nFeb. 15-16, 2011 – Went to San Juan to deliver the Opening Keynote at the \nNIAID/CDC/PAHO-sponsored Dengue Symposium.  Great time.  In accordance with my \nexpanding to more emphasis on Global Health and Emerging Diseases.\nFeb. 24-26, 2011 – Parents’ Weekend at Stanford.   Absolutely wonderful time to see Ali \nin her beautiful school setting.   Spent prior night in SF with Chris at the Queen Anne’s B \n& B and went to Jackson-Fillmore Restaurant.   Days at Stanford were great.  Saw \nwomen’s basketball team clinch the PAC -10 championship for the 11th year in a row by \ndefeating Oregon.   Also, saw #1 ranking woman tennis player (Barte) and men’s \nvolleyball (ranked 4th in Nation).\nMar. 7, 2011 – Town Hall meeting for non-HIV clinical trials network.  Sensitive issue \nin that Carol Heilman still is not enthusiastic about it.  However, I made it clear exactly \nwhat we are going to do.\nReleased by Chairman Rand Paul\n240Mar. 9, 2011 – Gave opening lecture at NTD Workshop at Natcher Building.  Continue \nto stress Global Health.\nMar. 15, 2011  -  White House communications people at it again.   Last week (Mar. 11, \n2011) a terrible tragedy hit Japan with a 9.0 scale earthquake in the NE part of the \ncountry almost immediately followed by perhaps the worst tsunami in recorded history of \nJapan destroyed much of the NE Coast.   Importantly, it knocked out the cooling system \nof the Fukushima Daiichi Atomic Power Plant leading to multiple explosions and \nmeltdowns with radiation spillage and leakage.  As of today (4 days later) the extent of \nthe potential disaster is still not known, i.e. how much radiation exposure will occur.   \nThus, we (NIH and me personally) are getting the expected calls from the press regarding \nthe medical aspects of acute radiation syndrome (ARS) – what it is and how you treat it.  \nThe White House is not granting any clearances for me or anyone at this point to talk to \nthe Press.   Amazing!!   Same as with the Pandemic Flu early on.\n    \nMar. 21, 2011 – Was invited by the Bush family to a Kennedy Center event which was \n“The Points of Light Institute TRIBUTE – All together Now – A Celebration of Service”.   \nBush 41 sent me a hand-written note thanking me for my meager $150.00 donation. At \nthe event were Presidents George H.W. Bush, George W. Bush, Jimmy Carter and Bill \nClinton.   Clinton gave an amazingly moving talk about his friendship and love of Bush \n41.  Entertainment was terrific: Garth Brooks, Kid Rock, Cee Lo Green, Carrie \nUnderwood, Darius Rucker, among others.   Brought back very fond memories of my \ninteractions with Bush 41 as well as other Presidents during the past 30 plus years.\nMar. 29, 2011 -  Appeared on the Colbert Report.  Great success!   Had a great  time and \nreceived hundreds of e-mails and calls and personal mention of how good the \nperformance was.   Reason for the appearance was the approaching 30th anniversary of \nfirst cases of AIDS.\nApril 7, 2011 – Gave World Health Day remarks at PAHO for Secretary Sebelius.\nApril 10, 2011 – Dinner at Mark Dybul and Jason Claire’s home at 1340 Wallach Place, \nN.W. with Tom Sietsema (Washington Post Food Critic), Zeke Emanuel, Chris, etc.\nApril 12, 2011 – Gave Solomon Berson Lecture at Mt. Sinai in NYC – “30 Years of \nHIV/AIDS:  A Personal Journey”.   Got prolonged standing ovation.   Will be stressing \nthis in coming weeks as we approach June, 2011\nApril 15, 2011 – Went to Charlottesville, VA to see Danny Hultzen pitch against Duke.   \nHe was great.  7 innings shutout.. ERA now 1.19.   Sure thing for 1st Round MLB draft \npick\nMay 1, 2011 – Navy Seal Unit 6 kills Osama Bin Laden in a compound right next to a \nPakistani Military base is Abbottabad.  Big rift now between USA and Pakistan sine we \nbelieve they were either incompetent or knew all along where he was.\nReleased by Chairman Rand Paul\n241May 11, 2011 -  Senate Appropriations Subcommittee Hearing for the 2012 NIH budget.   \nReally bad budget times with the feeling that we are doing really well with only a 1.9% \nincrease from 2011 for the PB.   Republicans (most Tea Party people) trying to cut \ndiscretionary spending back to 2008 level, which would be devastating for NIH.   Francis \nCollins trying to push the NCATS (National Center for Advancing Translational \nScience).   I think this is a big mistake (“everybody wants to be somebody”).   This is no \ntime to initiate this, but  some  of the pols, some in the scientific community who are \nclueless, and others think this is a good idea.   Harold Varmus and I have grave \nreservations about this (me particularly) since I believe that it will have the unintended \nconsequence of sucking money away from standard NIH research to out into a Center \nthat is Francis’s baby.   We are already doing $6 Billion in translational research at NIH.\nMay 12, 2011 – Big announcement of early stopping of HPTN 052, which is randomized \ntrial among 1763 heterosexual discordant couples to see if immediate treatment with \nARVs (350-550 CD4 counts) versus delayed treatment (wait until fall to 250 or AIDS-\ndefining illness) has an effect on transmission.   Overwhelming response.   27 infections \nin delayed arm and 1 transmission in immediate arm  (p <0.0001).   I held press briefing \nand got front page in all major papers – NY Times.Wash Post, WSJ; appeared on NBC \nNightly News, CBS Evening News, CNN International, etc.\nMay 17, 2011 – The press, scientific, public health and general public interest in the \nHPTV-052 results in becoming huge.   I appeared on New Hour (interviewed alone by \nRay Suarez) as well as NBC Today Show.  Have done taped interviews with Mark \nSchoofs that will appear on the Website of WSJ.\nMay 18-26, 2011 -  Much activity and interest (real buzz) on part of global activists to \nuse the 052 data to pressure the USA (Obama and USAID/PEPFAR) to increase funding \nand re-prioritize the emphasis on treatment since it is also prevention as well as emphasis \nthose prevention modalities that have been scientifically proven to work such as \ncircumcision (which is now effective at 68% at 40 months into the follow-up study in \nRekai, Uganda).   I am speaking mre openly on interview about pressing the \nadministration to give more money.   Feels like the old days of the beginning of PEPFAR \nwhen OMB ridiculed me for asking for so much money and then everything broke lose \nwith PEPFAR.\n    On May 26, I met at the headquarters of the WH Office of the Global AIDS \nCoordinator (OGAC) with Eric Goosby, Reinhard Schwartzlander (UNIADS), Carl \nDieffenbach, Tom Frieden (by phone), Debbie Birx (CDC- GAP Prgram), people for \nUSAID, and State.   I made the argument that there is an elephant in the room and that is \nthat we MUST put more resources into treatment since we now know that it is in fact \nprevention and we will either pay now or pay more later.  Eric Goosby was so pleased \nthat I backed what he really wants and needs but since he is a POTUS appointee, he \ncannot be too up front about.   See below his email of May 26, 2011  to me after the \nmeeting:\nReleased by Chairman Rand Paul\n242Tony:\nYou achieved what we needed for OMB and State leadership get a feel of the \nbreakthrough and the context of the O52 findings, largely due to your clarity , candor and \nauthenticity…  thanks my friend\nEric\n \nPERSONAL \nThis email is UNCLASSIFIED. \nMay 27, 2011 – Taped  interview with the WSJ appeared   today .   Long and excellent \ninterview.\nMay 29, 2011 -  My Editorial appeared in the Sunday Opinions Section of the \nWashington Post entitled “30 Years of AIDS”.   Many people e-mailed and called about \nit.   Again, the momentum building up about a change in paradigm to support universal \nvoluntary testing and universal access to treatment and care.\nMay 31, 2011 -  Delivered lecture at NIH on “30 Years of HIV/AIDS:  A personal \nJourney” in Masure Auditorium.   It likely was the most widely attended lecture in NIH \nhistory.  Julie Marquardt ()NIAID) kept track.   The attendance completely filled Masur \nAuditorium (492 people), overflow completely filled Lipsett Auditorium (260) and 1130 \npeople watched  on Webcast.  In total, 1947 people watched the presentation live, either \nin person or via webcast..   Incredible amount of attention to the 30th Anniversary.   As I \nhave said, the press attention to me and my field varies from intensity to very low levels.   \nThis is one of the periods of extreme intensity.\nJune 1, 2011 – Took Amtrak to NYC to give Commencement Address at Albert Einstein \nCollege of Medicine Commencement at Lincoln Center.   Incredibly hot and sunny day in \nNYC and DC – up to mid-90s.   Came back home to find the air conditioning in my \nhouse broke – Oy!\nJune 2-5, 2011 – Press interest continues.  Was on NBC Nightly News on June 5 and \nFox Local News as well as Canadian Broadcasting System (CBC)\nAlso, big outbreak of Shiga-Toxin producing E.Coli (STEC) diarrhea and Hemolytic \nUremic Syndrome in Germany and other countries in EU related to contamination of \nbean sprouts.   >1600 people affected with ~600 HUS and 22 deaths.  Was on BBC with \nKatty Kay discussing this.\nJune 6, 2011 -  Had my BSC review for LIR.   Rating was “Outstanding” all around.\nJune 7, 2011 – Much activist activity brewing regarding the upcoming UN Special \nSession on AIDS this week.   Funding countries are refusing to commit to putting up the \nresources to get 13 to 15 million people on treatment by 2015.   On the basis of HPTN -\nReleased by Chairman Rand Paul\n243052 (see above) I have been arguing forcibly that we need to make the investment now or \nelse not only will lives be lost, but we will have to pay more later for the infections that \nwe could have prevented.   See my interview published  today  in Nature with Erika \nCheck Hayden\nDrug treatment for HIV infection is effective in preventing its spread, but implementing \nthis fully will require more resources, says leading NIH scientist.\nErika Check Hayden \nAnthony FauciBloomberg News/Landov/Photoshot\nThis week, political leaders meet in New York for a United Nations summit that will \nframe the ongoing fight against HIV/AIDS. The conference comes a decade after the UN \nmeeting at which heads of state committed the first major funding to the battle; as a \nresult, 6.6 million people are now receiving antiretroviral drug therapy to keep their HIV \ninfection under control — 22 times the number in 2001, according to estimates by the \nJoint UN Programme on HIV/AIDS (UNAIDS).\nBut 9 million people who need treatment are still not getting it, and global economic \nwoes threaten to weaken international AIDS programmes. Anthony Fauci, head of the US \nNational Institute of Allergy and Infectious Diseases, explains what scientists hope the \nUN meeting will achieve.\nHow is the research landscape different going into this meeting than it was a decade \nago? \nA considerable number of people have been put on therapy. But for every person who \ngoes on therapy, two or two-and-a-half people get newly infected, so there's been this \nquestion of the balance between treatment and prevention. \nA real game changer occurred just a few weeks ago with the clear demonstration in \nheterosexual couples that when you start treatment earlier rather than later, you not only \nbenefit the person infected, but that person is also 96% less likely to transmit the virus to \nReleased by Chairman Rand Paul\n244their uninfected partner than if they were not treated (see 'HIV treatment shown to \nprevent spread of virus'). So people can say with a good deal more confidence that \ntreatment is prevention.\nWhat does that imply for global AIDS policy? \nWe have now so many types of prevention in our armamentarium, including treatment. \nSo rather than have the tension between treatment and prevention, as there was \npreviously, let's try to seek out, test, and treat as many people as we possibly can, because \nwhen you treat people, you are doing prevention. So that brings up the big question — \nwhich is that it's going to require a lot of resources.\nHow do you frame that question? \nThe fundamental policy decision is: is it better to make investments now, even with the \nrestricted resources we have available, and slow down or even get control of the \npandemic, rather than not making the investment now, and only having to pay down the \nline, and possibly paying more. \nThe UN wants countries to commit to treating 13 million people by 2015 at a cost of $22 \nbillion, but this would not even treat all the people who will need it by that time. Is this \nwhere we should aim, given what we know about treatment as prevention?\nIt's a reasonable goal. The issue at hand — the big elephant in the room — is are the \nparties responsible able to come up with the resources to make this happen? We have a \nconfluence of enormous opportunity to turn around the global pandemic at the same time \nthat we have an almost unprecedented constraint on resources. This is going to be the \nsubject of some serious discussion in New York. Despite the constraints on resources, we \nhave a real opportunity not only to save a lot of lives, but in the long run, to save money. \nMany researchers are now saying that we have the tools needed for effective \nprevention, and social phenomena are the main obstacle to slowing the spread of \nHIV (see Comment: ' Stigma impedes AIDS prevention'). What more can \nresearchers do to solve this problem? \nIt isn't as if we're going to be able to access every individual immediately, but there are \nprogrammes that can be enhanced that will allow us to penetrate into those areas of \nsociety that have been difficult to reach. Can we do this tomorrow? No, but we don't have \nto. We can start doing it over the next couple of years and we'll get better and better at it. \nWhat are researchers looking for out of the meeting? \nWhat I'm going to do in New York is put the data on the table. There's no more doubt that \ntreatment can serve as prevention. My purpose is to say to policy makers: here are the \ndata; you have to make up your mind about whether you want to implement the \nReleased by Chairman Rand Paul\n245programmes that have been proved to work — to make it almost scientifically obvious to \nthem what they need to do. \nJune 8 – July 1, 2011 -   Much activity and excitement around my coming out publicly \npushing for more resources for expanded treatment and prevention for global HIV/AIDS.   \nThe activist community is delighted.   I will past in  below the editorial that I wrote in \nScience that was published by agreement with the Science editors to be ready for the \nInternational AIDS meeting in Rome as well as the note that Gregg Gonsalves sent to his \nlist-serve (every activist in the world) regarding my note.\nScience 1 July 2011: \nVol. 333 no. 6038 p. 13 \nDOI: 10.1126/science.1209751 \n \nEDITORIAL:\nAIDS: Let Science Inform Policy\n1.Anthony S. Fauci\n+ Author Affiliations\n1. Anthony S. Fauci is director of the National Institute of Allergy and Infectious \nDiseases, U.S. National Institutes of Health, Bethesda, MD. \n1. E-mail: afauci@niaid.nih.gov. \nCREDIT: NIH \nThirty years have passed since the first cases of acquired immune deficiency syndrome \n(AIDS) were reported by the U.S. Centers for Disease Control and Prevention. How does \nthis anniversary compare to the 20th or the 10th? The differences are considerable, \nbecause we now have an unprecedented opportunity, based on solid scientific data, to \ncontrol and ultimately end the AIDS pandemic. \nReleased by Chairman Rand Paul\n246More than 60 million people have been infected with human immunodeficiency virus \n(HIV) worldwide. More than 30 million have died, and 34 million are currently living \nwith HIV infection. In 2009, the most recent year for which data are available, 2.6 \nmillion people became newly infected. The burden of HIV/AIDS is overwhelmingly felt \nin resource-poor countries, especially in sub-Saharan Africa, which are least equipped to \ndeal with the disease. Although the toll is staggering, the scientific progress in HIV/AIDS \nresearch over 30 years has been extraordinary, particularly in the development of \nantiretroviral therapy (ART), which has proven to be life-saving to many millions. \nCREDIT: FOTOSEARCH \nFor decades, the idea of ending or even controlling the pandemic was a distant aspiration \nbecause we lacked sufficient evidence-based tools to convert the hope to reality. At this \n30th anniversary, the situation has dramatically changed: We finally have scientifically \nvalidated prevention modalities that clearly work, suggesting that ending the pandemic is \nfeasible. Older, proven prevention tools include the proper use of condoms, needle \nexchange programs for injection drug users, and antiretroviral treatment of HIV-infected \npregnant women to prevent transmission of the virus to their newborn infants. Building \non this foundation, recent HIV prevention research also has provided strong scientific \nevidence that adult male circumcision is highly effective in preventing infection in \nheterosexual men, that an antiretroviral-based topical gel prevents infection in \nheterosexual women, and that pre-exposure prophylaxis with ART in men who have sex \nwith men is effective at preventing infection. And in May 2011, a randomized controlled \nclinical trial demonstrated that early initiation of ART by the infected partner in \nheterosexual couples, where one partner is HIV-infected and the other not, is highly \neffective in decreasing transmission of HIV to the uninfected partner. \nThe fact that treatment of HIV-infected adults is also prevention gives us the \nwherewithal, even in the absence of an effective vaccine, to begin to control and \nultimately end the AIDS pandemic. Of course, the development of an AIDS vaccine \nwould be the ultimate game-changer, and efforts toward this goal are intense. However, \nthe existing armamentarium of scientifically proven interventions immediately offers an \nunprecedented opportunity to make major gains in the fight against HIV/AIDS. Global \nimplementation of HIV interventions, including scale-up of the delivery of ART, must be \naccelerated, and this will be costly. Certainly, there are many competing priorities for \nscarce resources in the global health arena, such as other infectious diseases, maternal \nReleased by Chairman Rand Paul\n247and child health, and tobacco control. But if one accepts the tenet that science should \ninform policy, then the scientific data are speaking loud and clear. Global policy-makers \nmust seriously consider these new data in their priority-setting and decision-making. \nLast month, world leaders at the United Nations General Assembly Meeting on AIDS \ncalled for providing ART for 15 million people in low- and middle-income countries by \n2015, an increase from the 6.6 million currently receiving therapy, plus additional efforts \ntoward universal access to HIV prevention, treatment, and care. An estimated $22 billion \nto $23 billion annually will be needed by 2015; current spending is approximately $16 \nbillion. Such targeted investments could prevent 12 million infections and 7.4 million \nAIDS-related deaths by 2020. For the first time in the history of HIV/AIDS, controlling \nand ending the pandemic are feasible; however, a truly global commitment, including \ninvestments by those rich and middle-income countries whose contributions have thus far \nbeen limited, is essential. Major investments in implementation now will save even \ngreater expenditures in the future; and in the meantime, countless lives can be saved. \nJuly 1, 2011 – E-mails from Gregg Gonsalves:\n-----Original Message-----\nFrom: Gregg Gonsalves  \nSent: Friday, July 01, 2011 6:55 AM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Brilliant Science Piece\nI think it will go down as one of the most important pieces written in \nthese past 30 years. It will either begin a new push to vanquish the \ndisease from the Obama Administration and other world leaders, or seen \nas Cassandra's last warning, where even despite the science, the \nevidence, the world turns their back on this opportunity.\ng\n--\nGregg Gonsalves\n-----Original Message-----\nFrom: Gregg Gonsalves  \nSent: Friday, July 01, 2011 7:22 AM\nSubject: Fauci in Science: Ending the Pandemic is Feasible\nhttp://www.sciencemag.org/content/333/6038/13.full (scroll down for \ntext) This is one of the most important pieces to be written on \nHIV/AIDS in a very, very long time. Dr. Fauci is a cautious scientist \nand for him to step out so publicly, so unequivocally in this way, \nReleased by Chairman Rand Paul\n\n248particularly when he works for an Administration, which is unlikely to \nheed his words, is a tremendous statement of moral and political \ncourage.\nI am not quite sure what we do now here to ensure that Tony's words \naren't just a call-in-the-wilderness.\nThe big AIDS organizations in the USA don't have the inclination or \neven the ability to take on the President or the Congress.  Both \nbranches of government know we're a paper tiger: a movement with a few \nloud voices, a few people willing to put their bodies on the line, but \nwith little ability to affect their political lives. Unless the big US \nAIDS organizations step up at this moment they will continue their \nmarch into irrelevance for history.  They can continue to issue press \nreleases about how much the President has done and continue to kiss the \nass of those in power, but that makes them sycophants, not leaders.\nThe rest of us have to get to work: we need to mobilize and get our \ngovernments to make a new, substantial and sustained commitment to \nHIV/AIDS, to TB, to maternal and child health, to global health.  We \nneed to meet with parliamentarians, legislators, ministers and mayors.\nWe need to write in our local papers about what Tony's words mean now \nfor us: we can end this epidemic or beat it back deep into the corner.\nThis is our year.  The legacy we leave behind will either be our \nvictory or an epidemic without end, passed down to our children and our \nchildren's children, a plague upon their houses.\nGregg\nScience 1 July 2011:\nVol. 333 no. 6038 p. 13\nDOI: 10.1126/science.1209751\nEDITORIAL\nAIDS: Let Science Inform Policy\nAnthony S. Fauci\nAnthony S. Fauci is director of the National Institute of Allergy and \nInfectious Diseases, U.S. National Institutes of Health, Bethesda, MD.\nE-mail: afauci@niaid.nih.gov.\nThirty years have passed since the first cases of acquired immune \ndeficiency syndrome (AIDS) were reported by the U.S. Centers for \nDisease Control and Prevention. How does this anniversary compare to \nthe 20th or the 10th? The differences are considerable, because we now \nhave an unprecedented opportunity, based on solid scientific data, to \ncontrol and ultimately end the AIDS pandemic.\nMore than 60 million people have been infected with human \nimmunodeficiency virus (HIV) worldwide. More than 30 million have died, \nand 34 million are currently living with HIV infection. In 2009, the \nmost recent year for which data are available, 2.6 million people \nbecame newly infected. The burden of HIV/AIDS is overwhelmingly felt in \nresource-poor countries, especially in sub-Saharan Africa, which are \nleast equipped to deal with the disease. Although the toll is \nstaggering, the scientific progress in HIV/AIDS research over 30 years \nhas been extraordinary, particularly in the development of \nantiretroviral therapy (ART), which has proven to be life-saving to \nmany millions.\nFor decades, the idea of ending or even controlling the pandemic was a \ndistant aspiration because we lacked sufficient evidence-based tools to \nconvert the hope to reality. At this 30th anniversary, the situation \nReleased by Chairman Rand Paul\n249has dramatically changed: We finally have scientifically validated \nprevention modalities that clearly work, suggesting that ending the \npandemic is feasible. Older, proven prevention tools include the proper \nuse of condoms, needle exchange programs for injection drug users, and \nantiretroviral treatment of HIV-infected pregnant women to prevent \ntransmission of the virus to their newborn infants. Building on this \nfoundation, recent HIV prevention research also has provided strong \nscientific evidence that adult male circumcision is highly effective in \npreventing infection in heterosexual men, that an antiretroviral-based \ntopical gel prevents infection in heterosexual women, and that pre-\nexposure prophylaxis with ART in men who have sex with men is effective \nat preventing infection. And in May 2011, a randomized controlled \nclinical trial demonstrated that early initiation of ART by the \ninfected partner in heterosexual couples, where one partner is HIV-\ninfected and the other not, is highly effective in decreasing \ntransmission of HIV to the uninfected partner.\nThe fact that treatment of HIV-infected adults is also prevention gives \nus the wherewithal, even in the absence of an effective vaccine, to \nbegin to control and ultimately end the AIDS pandemic. Of course, the \ndevelopment of an AIDS vaccine would be the ultimate game-changer, and \nefforts toward this goal are intense. However, the existing \narmamentarium of scientifically proven interventions immediately offers \nan unprecedented opportunity to make major gains in the fight against \nHIV/AIDS. Global implementation of HIV interventions, including scale-\nup of the delivery of ART, must be accelerated, and this will be \ncostly. Certainly, there are many competing priorities for scarce \nresources in the global health arena, such as other infectious \ndiseases, maternal and child health, and tobacco control.\nBut if one accepts the tenet that science should inform policy, then \nthe scientific data are speaking loud and clear. Global policy-makers \nmust seriously consider these new data in their priority-setting and \ndecision-making.\nLast month, world leaders at the United Nations General Assembly \nMeeting on AIDS called for providing ART for 15 million people in low- \nand middle-income countries by 2015, an increase from the 6.6 million \ncurrently receiving therapy, plus additional efforts toward universal \naccess to HIV prevention, treatment, and care. An estimated $22 billion \nto $23 billion annually will be needed by 2015; current spending is \napproximately $16 billion. Such targeted investments could prevent 12 \nmillion infections and 7.4 million AIDS-related deaths by 2020. For the \nfirst time in the history of HIV/AIDS, controlling and ending the \npandemic are feasible; however, a truly global commitment, including \ninvestments by those rich and middle-income countries whose \ncontributions have thus far been limited, is essential. Major \ninvestments in implementation now will save even greater expenditures \nin the future; and in the meantime, countless lives can be saved.\n--\nGregg Gonsalves\nReleased by Chairman Rand Paul\n\n250--\nGregg Gonsalves\nJuly 16-22, 2011\nGave Plenary Address at the IAS Meeting in Rome on “30 Years of HIV/AIDS: A \nScientific Journey and Look to the Future”.   I emphasized at the end that “Science \nshould inform policy” as per my recent Science Commentary.   I received a prolonged \novation from the crowd of >4000.   Clearly one of my best plenary talks ever.\nAug. 4, 2011 -   During a trip to NYC to give a lecture at Columbia on “30 years of \nHIV/AIDS:  A Personal Journey”, Ian Lipkin arranged a closed pre-screening of the new \nmovie :Contagion” at the Warner Brothers headquarters in NYC.   Ian served as the \ntechnical advisor and wanted to get my take on the movie.   Also at the screening were \nSanjay Gupta (CCN), the dean of Columbia Mailman School of Public Health, the \nCommissioner of Health of NYC and other notables.   The press asked  me my opinion, \nwhich was that it was an excellent film that was quite accurate scientifically.   I was \nwidely quoted  in blogs about this.\nAugust 23, 2011 -    Unusual experience – 5.9 Richter Scale earthquake hit Mineral, VA \nwith severe shaking of Building 31 such that some of my plaques fell off of the shelves.   \nShock was felt as far North at Cape Cod.   Jenny, Ali and Denise and Jack were in NYC \nand they felt it.\nAugust 226, 2011 – Washington, D.C. hit by Hurricane Irene that went up the entire east \ncoast.   Much damage.   We were lucky in that although many trees came down, our \nhouse and cars were spared.   However, I stayed up until 4:00AM nervously looking out \nthe window at the large oak tree in my back neighbors yard  whose branches were \nshaking violently.   Importantly, I was very concerned about the 2 giant tulip poplars that \nare in my front yard  whose branches were also shaking wildly.   Luckily we made it \nthrough the night.   Storm also hit NYC where Jennifer is living.\n    Amazing coincidence that during the same week in DC, we got an earthquake and a \nhurricane.   Odds of that must be 1 in several million.\nSept. 11, 2011 – 10th Anniversary of “9/11”.  Much commemoration going on in NYC \nand DC.   Of note last week on Sept. 9 went to meeting in White House EEOB 530 with \nReleased by Chairman Rand Paul\n\n251Eric Goosby, Gayle Smith  and David Lane, Jeff Crowley and Dana DeRuiter (White \nHouse); Lois Quam (USAID), Ariel Pablos-Mendez (USAID), Tom Frieden on the \nphone; Nils Daulaire and Howard Koh (DHHS) and others.   Purpose of the meeting was \nto plan a strategy that the WH and the POTUS should take in addressing and utilizing the \nrecent scientific advances associated with HIV prevention, particularly treatment as \nprevention (HPTN-052) in turning around the HIV pandemic.   In essence it was a \nmeeting to figure out how we can implement what I proposed in Rome at the IAS \nmeeting in July, 2011.   Eric Goosby and Gayle Smith want me to directly brief the \nPOTUS on this.   It remains to be seen whether this happens.  Clearly, the activists want \nmore money to go to PEPFAR for treatment and prevention.   However, there are major \nbudget constraints.   The WH is afraid of demonstrations during the upcoming IAS \nmeeting in Washington in the summer of 2012 – right before the election.   They have to \nwalk a fine line between promising more money, which will inflame the right and doing \nnothing, which will inflame the left.   It seems that they are calling me in to help them \nwith this.   More later……\nSept. 13 -14, 2011 – Beautiful crisp sunny day in DC.   Started 09/13/11 with breakfast at \nthe Four Seasons in Georgetown at 7:00 Am with Bill Gates. Also present from the Bill \nand Melinda Gates Foundation (BMGF) was Stefano Bertozzi.   The theme was that Bill \nis reluctant to fund (with NIAID) the proposed South Africa (RSA) and Thailand vaccine \ntrial for licensure since he thinks that the companies are charging too much money for the \nprotein (env – made by Novartis).   In addition, he does not think that the results will lead \nto a marketable product.  However, we need the private sector or else we will never get a \nvaccine made for HIV.   The quid pro quo for us is that if we go with a regulatory \n(licensure) trial in RSA and Thailand, the companies (Sanofi-Pasteur and Novartis) will \nwork with us on a research trial of comparing several products in RSA, which is what we \nreally want.  I convinced Bill that this was a necessary evil and that although it was an \nimperfect situation, it is still the only deal around since the product – Pox  Vector + \nProtein boost was the one that gave the only positive result in a vaccine trial to this point \n(RV144 – conducted in Thailand 2 years ago).   In addition, there are some possible \ncorrelates of immunity associated with RV144.   We ended the breakfast with a mutual \ncommitment to work together on this.   Also, Bill had some interesting a  bit “off the \nwall” ideas about making a universal virus vector into which you can insert genes of \nimportant neutralizing antibodies for different microbes that can be an instantaneous \nantibody factory for bioterror organisms as well as for HIV, merely by changing the \ninsert.   Also, Bill does not believe in treatment as prevention from a practical or logistic \npoint of view.\n     Went on to participate in a 2 day meeting run by the George W. Bush Presidential \nCenter –  “The Summit to Save Lives” held at the Mellon Auditorium on Constitution \nAvenue, N.W.   I was on the panel to discuss the leveraging of PEPFAR resources and \ninfrastructure to do screening and treatment of cervical cancer in Africa and Latin \nAmerica.  I studied up on HVP and cervical cancer and we the “scientific expert” on the \npanel that included Eric Goosby (PEPFAR), Grosbeck Parham (C0-Director of Cervical \nCancer Prevention program, Zambia), Dr. Beatrice Wiaffe Addai – president of Breast \nCare International.  Panel Chaired by Jennifer Griffin, National Security Correspondence, \nReleased by Chairman Rand Paul\n253together for HRC on the same subject that I spoke on in Rome – “The Science has now \nshown that we can end the AIDS pandemic – we need to implement”   Only difference is \nthat she will say that we can do it by increasing efficiencies PLUS  having other partners \n(donors and host countries) put in a greater share. I said that we should put in more \nresources.   The speech spins off the document mentioned above that we were asked to \nput together following the Sept. 9 meeting (see above).  The main issue is that we will \nraise our goal of 4 million on treatment through PEPFAR by 2013 to 6 million by 2013.   \nWith much input from me and CDC, Eric Goosby put together a nice document \nexplaining the importance of increasing this goal and having certain host countries such \nas South Africa and Rwanda assume more of the cost of treatment so that we can \nconcentrate on countries with less resources such as DRC, Cameroon, Malawi, \nZimbabwe.  Also, we can use more bulk purchases etc.\nTODAY – (10/13/11) we had an important meeting in the Situation Room of the White \nHouse from 4:00 to 5:30 PM.   Gayle Smith instigated the meeting.   It was a Deputies \nMeeting chaired by Denis McDonough (Deputy National Security Advisor – Deputy to \nThomas Donilon).   He was very good and sympathetic to our goal.   Also there were: \nCheryl Mills, Eric Goosby, Tom Frieden, Steve Kosiak from OMB, Ariel Pablos-Mendez \nNancy-Ann deParle, Dana DeRuiter from NSS, Samantha Power (NSS), Charles Hohman \n(OGAC).  They called upon me to explain the scientific basis for our pushing to do more \nto turn around the trajectory of the Pandemic.   I explained the details of HPTN-052.   \nGreat meeting – this may lead to an acceleration of our efforts.  Also, Denis McDonough \nasked us to put together a “Blue Sky” proposal that would ask for more resources in \naddition to the increased efficiencies that we are already planning. We may not get more \nmoney, but we can probably show the leadership to inspire others to invest more, i.e. \nother rich countries.   More later…….\nOct. 17-19, 2011 Eric and I among others worked on a paper that gave 2 options: \nScenario 1 – increase efficiencies and have host countries take more responsibility and \nthus shift PEPFAR money to treatment as prevention.   This ill raise the bar for goals to 6 \nmillion people on PEPFAR-paid Tx by 2013 and 8 million by 2015.   Scenario 2 – get \n$2.5 billion more money from 2013-2015 and raise goal to 8 million on treatment by \n2013 and 10 million by 2015.   Mathematically modeled (done by CDC), this would “tip” \nthe curve (of incidence) of the pandemic more sharply downward and would also have \nmany secondary benefits of saving lives and hospitalization.   Denis McDonough now \nrefers to this as the “Fauci curve”.\nOct. 20, 2011 – Met again in WH Situation Room with Denis McDonough chairing and \nthe same people there with Tom Frieden by videoconference.   Continued discussion \nabout “Blue Sky”.   I again vigorously defended the concept of  our golden opportunity at \nthis point.  Problem is that OMB feels that we will never get new money passed through \nCongress and State might have to “eat” the $2.5 billion if we actually pursue  Blue Sky.   \nI suggested getting group of CEOs involved (as per my upcoming WSJ – CEO Council \nmeeting that I will chair on Nov. 15).   Denis thought that it was a great idea and will \nbring it to the POTUS.   Again, budget problems may stand in the way of a visionary \nbreakthrough of “tipping” the pandemic.\nReleased by Chairman Rand Paul\n254Oct. 24, 2011 – Met again at the WH (EEOB 439) with the usual cast of characters.   \nGayle Smith chaired the meeting.  Denis McDonough not there.   Main issues again is the \nreluctance of USAID (Ariel) to buy into the idea of expanding treatment as a way to “tip \nthe curve”.   He suggested moving the money from the efficiencies of PEPFAR treatment \n(see above) to non-treatment prevention modalities.   Eric Goosby tried to explain that the \nnon-treatment prevention modalities (PMTCT, AMMC – adult medical male \ncircumcision) are already maxing out and any increasing or not are due to other issues \nbesides resources.   I arguing strongly against  Ariel and reminded people that this was a \nPOTUS initiative to increase Tx.   Below is an e-mail that I sent to Gayle Smith after the \nmeeting clarifying my stance on this.\nGayle:\n   Thanks for running an important and sometimes contentious meeting today. You do it \nmasterfully.   Please read my comments below and then you can either accept them or \nthrow them out if you wish and I will still be your  friend.   Here goes…    Eric,  Ariel, \nand I, and hopefully Tom Frieden will get together by phone tomorrow to try and hash \nout and hopefully resolve the issues that were brought up today regarding standard \nprevention versus  treatment as prevention.  It appears that Ariel and USAID feel that in \nan arena of a flat budget, the money saved by efficiencies in treatment should be turned \nover to standard prevention modalities as opposed to expanding the number of people on \ntreatment (which is also prevention).  As Eric will explain to Ariel tomorrow on our \nphone call, the model that has been developed  takes all of these issues into account and \nthe standard prevention modalities such as adult male circumcision and PMTCT to which \nAriel is referring can be maximized in a number of ways without significant increases in \nresources, whereas putting more people on treatment clearly requires more money.   You \ncan treat the same number of people with less money by efficiencies, but the only way to \nget more people on treatment with a flat budget is to use the savings from \nefficiencies.  As we have been discussing, this will have the effect of preventing more \ninfections at the same time as saving the lives of the infected people who would now be \nreceiving treatment.  This also results in other economic and social benefits.  Although \nyou are trying to be fair to all points of view, in my humble opinion, if we go to the \nPrincipals giving them  a choice of the two approaches, we will confuse them. I believe \nthat they need to look at  a single proposal that we have already agreed upon in our \ndiscussions and decide if they are comfortable with it.  Another point that seems to have \ngotten lost by some in today’s discussion in the fact that, as I mentioned at the end, we \nare talking about a potential game changing initiative by the POTUS that could be a \nlegacy.   We are not talking about  competition for limited money that might go to other \nareas.   Another issue is that the activist community would support the POTUS in an \ninitiative with no new money, but that includes a plan to increase the numbers of people \non treatment by the mechanisms that we had discussed with you and Denis.   If he comes \nout with a plan to divert savings from treatment efficiencies to  non-treatment programs, \nthe constituencies will be infuriated.  Sorry for taking your time with this e-mail.   I just \nfelt that I needed to express my thoughts to you.  Talk to you soon.\nBest regards,\nTony\nReleased by Chairman Rand Paul\n255Oct. 25, 2011 – Raj Shah (Administrator of USAID) called me at 1:30 PM to get a better \nfeel of my position on treatment as prevention.   I thought that he would have a problem \nwith it, but he was really asking if it was better to target people with very early infection \nsince they are most likely to spread infection.   I explained to him that although this was \nthe case, they represent a relatively small fraction of infected people and they are very \ndifficult to identify at this early stage.\n    I found out later in the day from Cheryl Mills (Chief-of –Staff to Hillary Clinton) that \nBill Gates had told Hillary that treatment as prevention was a waste of money and would \nnot work.   Hillery (HRC) heard from Eric that Bill Gates is probably the only person in \nthe world who felt this way and that is exactly what I told Cheryl (see my breakfast with \nBill Gates above).  It seems that HRC is to meet with Raj today to get his opinion and so \nthat is why Raj called me.   Also, HRC will come to NIH on my suggestion to give \nspeech on this subject on Nov. 8.   I helped drafting her speech.\nOct. 26, 2011 – Conference call with Eric, Ariel, me, Charles Holman and various people \nfrom USAID, PEPFAR, and CDC (Tom Frieden) trying to hash out the difference \nbetween Eric/me/Tom and USAID.   It appears (maybe) that we have convinced Ariel \nthat our model is valid.   More to come.\nOct. 31, 2011 – Another WH (EEOB 430A) meeting regarding above topic.   Chaired by \nGayle Smith.   Also there was Amy Batson (USAID), Lois Quam, and Tom Frieden by \nphone.  Cold crisp day in DC.   Fall is here!   Again the tension between USAID goals \nand PEPFAR goals become clear.   USAID is trying to enhance their own agenda, which \nin my opinion has failed with their spending millions on prevention messages that do not \nwork.   They are trying to derail the PEPFAR “scale up by efficiencies” initiative.   Ariel \nis turning out to either be naïve or nefarious.   I always heard that he was a good guy, but \nhe and USAID team keep insisting that the efficiency money should go either to a \nbroader GHI or to enhancing the non-treatment prevention agenda (PMTCT, AMMC, \ncondoms, etc.).   The PEPFAR/Fauci/CDC agenda is to use the efficiencies to scale up  \nTx from 4.2 million by 2013 to 6+ million by 2013.   This should reach 8 million by 2015 \nwithout any additional funds.   If you go to “blue Sky” of +$2.5 billion from 2013 to \n2015, you will go from 8 million in 2013 to 10 million in 2015.   The PEPFAR model \nalso assumes and enacts a maxing out of the non-treatment prevention modalities.   \nUSAID disagrees and want to use efficiency money to favor non-treatment as Prevention.   \nThis is what Ariel is saying.   After meeting with Eric Goosby, Ariel seems more \nconvinced that the PEPFAR model may be OK.   However, what does Raj Shah \nthink????\nNov. 1, 2011 – Dinner with Rick Klausner at Matisse Restaurant on Wisconsin Avenue \nand Fessenden.   Discuss the Qatar initiative, see above and below.  But, conversation \nturned to Raj Shah and the PEPFAR/USAID story.  Bottom line is that Raj has been \ntalking with Rick and it appears from Rick and my prior conversation with Raj that Raj is \nnot against treatment as prevention (TAP); however, he does not like the model and want \nto do it differently.   (More on Qatar later – stick with USAID/PEPFAR for now)\nReleased by Chairman Rand Paul\n256Nov. 2, 2011 – 7:30 AM Get call from Rick Klausner who is having breakfast with Raj \nShah and Rick wants to set up teleconference with the 3 of us at 11:00 AM to discuss the \nabove issues.   On the call Raj dances around a bit, but what he really wants is a big \ninitiative using PEPFAR money.   He does not say so explicitly, but that is really what he \nwants.   He does not want the efficiency money to pay for 6 million of TAP by 2013; he \nwant 5.5 million for TAP and the rest for a full-court-press initiative to see in a selected 3 \ncountries if maximizing both non-TAP and TAP prevention will actually end the \npandemic.   I explain that there is not enough money to do this, and besides, the \nexpectation is to TAP, not do a study to prove that it could be done.   He agrees with me \nthat we should do both within the constraints of budget.  He is sure that the POTUS will \nlike this initiative since it is a scientifically-based approach (give me a break!!!).   The \nbig elephant in the room is that USAID has been wasting $100s of millions on prevention \napproaches (like behavior change) that do not work.   They should use this $ to do their \nproof of concept full-court-press approach, not try to siphon off PEPFAR money (I did \nnot say that, but this clearly was the elephant).   Raj wants the have Eric, himself and I \nput together another proposal to this effect.\n      After the call Rick e-mailed me and asked for a follow-up call.   On that call Rick \nexplained that what Raj really wants is to spend all of the efficiency money on the 3 \ncountry demonstration project and that this would be the POTUS initiative.   They (Rick \nand Raj) just do not believe that PEPFAR/CDC model.  Also, (amazingly), Raj admits to \nRick that the USAID has been wasting $100s of millions, but he is not up to taking on the \nUSAID bureaucracy.   Rick is disappointed in him and thinks that he is being weak and \nhas told him so.   However, rick is in favor of the concept since he has issues with \nPEPFAR.\nBased on this, I arranged a teleconference with Tom Frieden (at Atlanta airport), Eric, \nCharles Holmes, and some PEPFAR people and CDC people to discuss all of this.   Tom \nFrieden was furious at USAID.   He says that they have been wasting $ for years and now \nthey question what CDC proposes, when CDC has been saying for years that they should \nhave been scaling up AMMC and PMTCT instead of wasting money on behavior.   \nClearly, Raj is a young, brilliant guy who is extremely ambitious (that is OK), but he \nwants control of PEPFAR resources.  Frieden is dead against this PEPFAR is obviously \nagainst this.   So am I.  The original question was to use efficiencies to scale up TAP, not \nto try something that USAID should have been doing all along with their own $.   The \nidea of nailing down whether we can end the pandemic with a full-court press (FCP) is a \ngood one, but there are no resources available.   I propose that we do both the PEPFAR \nplan and the FCP, the latter with $ that we get from additional sources.  \n     White House meeting scheduled for Nov. 9.   Everyone wants me there, but HHS will \nhave to decide who the “Plus one” is with Sebelius.  Of note, I am scheduled to go to \nSeattle on Nov. 9 for a town hall meeting and a seminar sponsored by Lee Hood and the \nInstitute for Systems Biology.\nBill Gates is trying to undermine the initiative on upscaling TAP.   See e-mail below \nfrom MSF to me sent on 11/02/11:\nDr. Fauci, \nReleased by Chairman Rand Paul\n257Congratulations on getting NIH-supported HIV research the airing it \ndeserves at the highest levels of government. We are all looking \nforward to Secretary Clinton's speech at the NIH next week.\nWe are trying to use the USG momentum to leverage new commitments from \nthe UK for World AIDS Day. So far DfID and other government actors are \ninterested in a \"step up\" initiative that we have also been pitching to \nUSG, South Africa, and Germany to pay for implementation of accelerated \ntreatment.\nToday we had a bit of a minor set back: the Secretary for Development \nAndrew Mitchell just heard from Bill Gates at a Tory event \"Friends of \nInternational Development\" that HPTN 052 will not yield great effects \nand the role of ART in limiting incidence is more limited than what is \nbeing portrayed. It was unfortunate.\nIt would help greatly if the policy makers in government could hear the \nscience themselves. If the All-Party Parliamentary Group on AIDS \ninvited you to give a briefing, and we arranged for high-level \nmeetings, could you attend? Would an invitation by civil society and \nMSF suffice? And, hardest question of all-- do you have any free days \nwhere you could be in London in November?\nThank you,\nSharonann\n--\nSharonann Lynch\nHIV/AIDS Policy Advisor\nAccess to Essential Medicines Campaign\nMédecins Sans Frontières (MSF)\nAlso see below e-mail from Nov. 3 from Michael Iskowitz describing what \nthe community actually is hearing about.   It is amazing how things \nleak sinceI have told no one what I am doing regarding USAID, PEPFAR \nand the WH.\nFinally, tonight (11/02/11) went to Book Signing party at Hay-Adams \nHotel for Chris Matthews on his new book “Jack Kennedy – Elusive Hero”.   \nAnother example of the A group of Washington.   It is clear that at age \n70, being on the public/political/media scene for >30 years, I am \nextremely well-known and even friends with so many public figures, who \nmerely on the basis of my being on TV/Radio/newspapers, etc. and the \nfact that we run into each other at so many of these functions have \ngotten to know me well.   Just a sampling of people at event: Andrea \nMitchell; Alan Greenspan; Sens. Chris Dodd, John Kerry; Rep. Ed Markey, \nJim Moran; Howard Feinman; Murrey Jacobson; Luke Russert; Gloria \nBorger; Joe Scarborough; etc.   Had animated conversation with my \nfriend Ed Markey regarding the disgraceful conduct of the Banking \nIndustry and Wall Street.   The “Occupy Wall Street” movement is \ngaining momentum.  The Republican scramble for the nomination is hot \nand heavy\nReleased by Chairman Rand Paul\n\n258Nov. 3, 2011 – Incredible day.  Theme is my trying to hold together the \nevolving proposal to scale up combination prevention with treatment as \nprevention (TAP) being a major component of the scale-up as described \nabove.  Tension is USAID and Raj want to spend most of the efficiency \nmoney on concentrating and ending the epidemic in 3 chosen countries as \nopposed to going with the PEPFAR/CDC/FAUCI plan of scaling up \ncombination prevention across the board and doing a demonstration full \ncourt press (FCP)in selected pockets of the countries that we have \nselected: Botswana for CDC; Zambia and South Africa for NIH; Tanzania \nfor USAID.  Spent all day on calls individually with Tom Frieden, Eric \nGoosby, Mark Dybul, Raj Shah (in the evening).   Raj call was at the \nsuggestion of Rick Klausner who says that I am the only person who can \nbroker a deal between PEPFAR and USAID.   We need USAID to support our \nproposal at the WH meeting next week (Nov. 8 – the evening of \nSecretary’s Clinton’s speech at NIH.   I have cancelled Seattle to ne \nat the WH meeting.   WH house wants me and Frieden to represent HHS, \ni.e. “plus 2”.   Mark Dybul agrees somewhat with the need to have a \nbold announcement as per Raj, but we all know that there is no new \nmoney.   Rick also feels that way.   However, what neither of them \nfully appreciate is that the “demonstration project” described above is \nin reality a FCP in a selected group within countries.   I had \nimportant call with Raj.   I leveled with him and said that although he \nis proposing putting all of the PEPFAR efficiencies towards a FCP in 3 \ncountries and scrapping the PEPFAR Plan, he should look to “clean his \nown house” and create efficiencies within USAID and use that money to \nscale up the 3 country approach and make it more of a FCP, i.e. I am \nproposing a “hybrid” of the PEPFAR plan and the USAID plan since we all \nneed each other and we need to provide the POTUS with a proposal that \nis scientifically sound, bold, yet not unrealistic, and that does not \nrequire significant new money.   Of note, Hillary Clinton will propose \n$60 million of her money to beef up that “demonstration project”  I \ncalled for a meeting tomorrow to see if Raj, Eric, Tom and I could \nfigure out a compromise with me as the referee.\nAlso see below e-mail from Nov. 3 from Michael Iskowitz describing what \nthe community actually is hearing about.   It is amazing how things \nleak since I have told no one what I am doing regarding USAID, PEPFAR \nand the WH.\ntony dearest.  \ni just wanted to thank you for helping to create and drive another landmark moment in AIDS \nhistory. \ni continue to do consulting with eric -- who remains forever grateful for your friendship and \nextraordinary leadership. \ni am honored to have have many decades now of watching you work your magic -- forever urging \nthat if we remain steadfast and\nfollow the science, together we will win. \nbless you for -- behind the scenes and in front of the cameras -- shaping another historic \nmoment. \nknow that i talk with eric frequently and if there is anything i can for you directly -- please know i \nalways stand ready.  \nthank you for being you and for all you do for the world, \nif i am not at the NIH on tuesday -- i am certainly there in spirit!\nmuch love,\nmichael \nReleased by Chairman Rand Paul\n259Nov. 4, 2011 – I cancelled most of my AM calendar to attend meeting at \n8:00 AM in Eric’s OGAC (Office of Global AIDS Coordinator) office at \n2100 Pennsylvania Ave, N.W. (suite 200).   At meeting was the 4 of us.  \nAfter about 90 minutes I got everyone to accept the “Fauci hybrid \nplan”.   Raj agreed (as I suggested last evening) that he come up with \nabout a few hundred million in efficiencies from USAID.   Eric will try \nto find more efficiencies from the PEPFAR “Pipeline”, all to beef up \nthe demonstration project and perhaps include another country such as \nNigeria.  However, we will all need to see if our respective \ndemonstration projects could effectively absorb an additional few \nhundred million $.   We will work on this over the weekend.  More to \ncome.\nAlso today met with Dr. Abdelali Haoudi, VP for Research of the Qatar \nFoundation at the recommendation of Rick Klausner with whom I had \ndinner on Nov. 1.   Great meeting with Abdelali.  Introduced him to JJ \nMcGowan, Kathy Zoon and Marv Kalt to help him with using the NIAID \nmodel to get his Qatar intramural and extramural program set up.   I \nthink that we could turn out to be friends.\nNov. 5-6, 2011 – Continued strain between USAID (Raj) and PEPFAR (Eric \nand Charles) in that Raj just does not want to give in about pushing \nfor “doing things differently”.   Nov. 5-6 is the weekend and \nDepartment of State (Lorrie McHugh – communications) as well as Cheryl \nMills are lining up people (activists, etc.) to write blogs in \nanticipation of Sec. Clinton’s Speech at NIH.  Her speech (which I have \nbeen deeply involved in writing follows the PEPFAR model, not the USAID \nmodel.  They have asked me to do an editorial for the NY Times giving \nthe scientific basis HRC’s speech.  I worked all weekend and got a \ngreat piece which I have circulated to Cheryl Mills, Burklow (NIH), \nHHS, etc.\nNov. 7, 2011 -  Full court press in preparing for Clinton visit and \nspeech.   Again, I get call from Raj Shah wanting me to support his \n“doing things differently”.   I believe that he really does not fully \nunderstand what PEPFAR is trying to do.   He wants to scale up heavily \nin high impact countries and not go for just scaling up prevention and \nTAP. We are too far down the pike to change now even if we decided to \nchange.  Hillary’s speech is tomorrow as is the White House Principal’s \nmeeting in the Situation Room.   Ariel Ramos seems more convinced that \nthe PEPFAR model will work now that he has examined the models more \nclosely; however, Raj is still skeptical.\nNov. 8, 2011 -   Beautiful, crisp, sunny Fall day!   Fabulous event \nwith Clinton visit.   Francis and I greeted her at the South entrance \nof the NIH Clinical Center.   Also waiting in background was Harold \nVarmus and Nora Volkow.   Warm and engaging conversation with HRC.   I \nshowed her a picture of her and me at the Clinical Center during her \nfirst visit in Feb., 1994.   I welcomed all of the dignitaries to the \nMasur Auditorium, said some warm words (see files) about the \nrelationship between HRC and me and then introduced Francis Collins who \nintroduced her.  She gave a great delivery of the speech that I helped \nwrite.   Overwhelmingly positive response from audience and press and \nbloggers immediately after.   I sent in my Op-Ed to the NY Times (see \nReleased by Chairman Rand Paul\n260files) and then went to White House for Principals Meeting in Situation \nRoom at 3:45 PM.   Present were: Hillary Clinton, Jack Lew (OMB), Denis \nMcDonough (NSS), Chaired by Tom Donoline, Samantha Powers, Tom Frieden, \nRaj Shah, Eric Goosby, Gayle Smith, Ariel Pablos-Mendez, etc.   We \nagreed upon Option #2, which is greater efficiencies to provide more $ \nand scale-up of non-Tx prevention as well as increasing the PEPFAR \ntarget for prevention  to 6 million by 2013 and 8 million by 2015.  I \nstressed to Tom Donoline that the POTUS should strongly call upon more \ninvolvement by other donors, particularly China.   He agreed.   Of \nnote, Susan Rice teleconferenced in from NYC and she voted strongly for \nOption $3 (Blue Sky), which would require an additional $2.5 Billion.   \nThis is a good sound bite, but Jack Lew pointed out that given the \nbudget situation, the POTUS would have to back off on commitments that \nhe has already made to other programs in order to do this.  Hillary \npointed out that this was not tenable.   She also pointed out that we \nneeded to address the ADAP waiting lists.\nAmazing situation.   After returning from the White House, I heard from \nCourtney Billet and Greg that HHS contacted us and said that although \nthey had no problem with the Op-Ed (see above) and actually cleared us \nto send it to NY Times, the “White House” told HHS to have recall the \nOp-Ed since it is “off message”.   Still not sure what they mean since \nState, HHS and everyone else approved it.   Could be because I called \nfor more resources as well as more “efficiencies”\nAnother amazing situation – At around 7:00 PM, Raj Shah calls me up and \nasks me to call a meeting with him, Eric and me to see if we could \nmodify the proposal that was agreed upon at Principal’s Meeting!!!.. He \nstill insists that the POTUS needs to come out with something \n“different” and suggests using “pipeline” money from PEPFAR/USAID.   He \nwanted me to broker the meeting.   I contacted Eric and bless his \nheart, he is willing to meet.   Meeting scheduled for 8:30 AM in Eric’s \noffice tomorrow.\nNov. 9, 2001 – Still no information on why the WH ordered me to recall \nmy Op-Ed.   Have e-mailed Gayle Smith (NSS).  I will explain situation \nto her tomorrow and see if she has any insight.\nMeeting did not occur at 8:30 AM because of scheduling issues.  Will \ntry to do a call tomorrow\nNov.10, 2011 – Got some insight from Gayle, but am afraid she is not \ntelling me everything.  She claims that she heard discussion about my \nOp-Ed at the WH, but not by WHCOMS.   Issue was whether it was a good \nidea to put it out right after HRC’s speech since it already got  great \nPR and so why waste a Fauci Op-ED.   Perhaps better to wait until the \nPOTUS does World AIDS Day.   This could be true, but who knows?   Gayle \ndid say that the OMB people might have been concerned by the couple of \nwords that said we need significant increases in resources, including \nfrom other donor countries.  This implies needing more USG resources, \nwhich would obviously bother OMB.   However, I could easily have \nchanged this to say we need significant new resources FROM other donor \ncountries.   In any event, Gayle assured me that the Op-Ed was not “off \nmessage” in the substance of its content.   We will hold onto it for \nnow.   Having said this, here is another example of the ridiculous need \nto control the “message” on the part of this White House.\nReleased by Chairman Rand Paul\n261Back to the Raj Shah intrigue.   On Raj’s suggestion, Yesterday’s \nscheduled meeting now a phone call among me, Eric, Raj, Tom Frieden.   \nRaj wanted to again bring up the possibility of doing something ”big” \nsince he feels that the POTUS will not have another opportunity.  After \nmuch discussion we explained to Raj again that “Blue Sky”, i.e. $2.5 \nbillion will never get by OMB or the Congress and even so, the best way \nforward according to the models is not to just pick out a few countries \nand full-court-press.   Raj goes along and we think it is over.\nApparently, immediately after the call, Raj calls Rick Klausner asking \nhim to convince me to not give in and adopt his plan.  Rick calls me on \nmy way to The Inn at Little Washington for my delayed 70th birthday \npresent from Denise from last December.  We are in the limo (rented by \nDenise) and Rick tries to convince me to re-convene the group.   He \nsays that Raj feels that I am the only one who could do this.  Raj just \ndoes not want to give up.   However, out of want to go the extra mile, \nI will call up Eric and Tom.\nNov. 11, 2011 – I call Eric and Tom and explain situation with Raj.   I \nconvince them to give it one more try. Both are extremely skeptical, \nimpatient and wary of Raj.  However, I indicate that we must ask Raj to \nbe very specific in what he wants to do and how he wants to do it and \nwhere are we going to get the money.   Raj has always been very vague \nabout all of these issues.   He just keeps saying that what Eric is \nproposing is old stuff and incremental and that he wants to suggest to \nthe POTUS something big and transforming.   I will write an e-mail and \ndetail the conditions of another teleconference and/or meeting.\nNov. 15, 2011 – At the invitation of Alan Murray (Senior Editor of Wall \nStreet Journal) I spoke at the Wall Street Journal-sponsored CEO \nCouncil event at The Four Seasons in Georgetown.   My purpose was to \nconvince the CEOs to get involved in supporting financially and \notherwise the Global AIDS Pandemic activities.  They were OK, but \nsomewhat clueless about the importance of global AIDS.   In retrospect, \nbillionaire philanthropists would be a better audience.\n     That evening went to a reception at Bill Heseltine’s house for \nGeena Davis.   She remembered our prior discussions during her visit to \nNIH.   She is lovely – very tall, but lovely.\nNov. 19, 2011 – Gave Keynote Address at the Caribbean AIDS Conference \nin The Bahamas.   The Atlantis Hotel is surrealistic.\nNov. 21 – 30, 2011 – Spent hours on the phone trying to address the \nADAP waiting list since we (HHS/PEPFAR) felt that if the POTUS \nannounces a scale-up of treatment for PEPFAR, then the logical question \nis what are we doing about the ADAP waiting list?   Tom Frieden \nsuggested that we engage the drug companies.   Since I know Jim Rooney \nfrom Gilead, I made the initial contact which led to many phone calls \ninvolving Jim and people from Gilead; people from HHS – me, Tom \nFrieden, Mat Wakefield (HRSA), Sally Howard (chief-of-staff to \nSebelius), Dora Hughes as well as people from NASTAD and Welvista.   \nImportant issues is the Gilead agreed to greatly lower their prices for \npeople on ADAP waiting list\nDec.1, 2011 – World AIDS Day (WAD).  A very special day.   The White \nHouse has decided that the venue for the POTUS statement on WAD would \nbe George Washington University in a program sponsored by One and RED, \nReleased by Chairman Rand Paul\n262Bono’s organizations.  Sanjay Gupta was the MC.   We had Presidents \nBush and Clinton by live video conference and President Obama delivered  \nthe speech that Eric Goosby, Tom Frieden and I and others wrote for \nhim.   As expected, he went with Option #2 (see above – Nov. 8, 2011).  \nIn addition, he included an additional $15 million (for Clinics) + $35 \nmillion (for States) = $50 million for ADAP total.   Again, Tom Frieden \nand HHS people (see above) have been working on the “domestic option” \nfor the past couple of weeks to offset criticism that we were paying \nattention to global, but not domestic AIDS.\n    Following the POTUS speech, there was a panel moderated by Sanjay \nconsisting of Bono, Alecia Keys, Kay Warren, Rep. Barbara Lee, Sen. \nMarco Rubio and a few others.   I was told a few days prior that Sanjay \nwould turn to me with a question sometime during the program.  Right \nafter Pres. Clinton’s live video speech, Sanjay said that you cannot \nhave a discussion about HIV/AIDS without including Tony Fauci (who is \nin the audience) and his perspective on the science and he turned to me \nto speak.   I spoke for a few minutes about the fact that the \nscientific data were overwhelming (circumcision; treatment as \nprevention, etc.) and the task now was to implement the science.   The \nstatement was similar to what I had said at the IAS meeting in Rome in \nJuly.   Right after my comment, Bono said that he must tell a funny \nstory and he proceeded to describe the night when he came to my house \nfor dinner to discuss what we could do to push the global AIDS agenda.   \nHe was cute.  He said that his friend Bobby Schriver told him that the \nonly person that could break the logjam on Global AIDS programs was \nTony Fauci.  He finished by calling me a “proper hero”. A YouTube \nrecord of this statement by Bono is available for Dec. 1.  Also, I had \na chance to say a few words to Pres. Obama as he was “working the line” \nfollowing his speech.   He congratulated me for the great work that we \nwere doing and that he has been hearing about.   All in all, a really \ngood day!!\nOf note, Gregg Gonsalves wrote a scathing letter to Raj Shah (that went \nviral on the internet) scolding him for obstructing the treatment as \nprevention initiative (see above discussions re: Raj).   Unclear to me \nhow Gregg found out about all of this.\nDec. 2,, 2011 – Finishing off WAD activities, went to Harvard on a \nbeautiful crisp clear December day and participated in the AIDS@30 \nInternational Symposium.   I gave the keynote “Perspective” on vaccines \nand participated in a panel Chaired by Bruce Walker and consisting of \nBob Gallo, Nelson Michael, Jerry Sadoff, and Julie McElrath.   Flew up \nto Boston with Eric Goosby and flew back to DC with Nelson Michael.   \nAll good.\n  \nDec. 2 thru 21, 2011 -  Significant issues regarding dual use research.  \nCheck press from Dec. 20-21, 2011.   Briefly, NIAID funded 2 studies – \nsubcontract via CEIRS (Centers of Excellence for Influenza Research and \nSurveillance) to Erasmus University in Netherlands (Ron Fouchier) and \ngrant to Yoshi Kawaoka at Wisconsin to study feasibility and mechanism \nof getting the highly lethal (60%), but poorly transmissible H5N1 (bird \nflu) that has been smothering in SE Asia since 1997 to become \ntransmissible and maintain lethality in a mammal model (ferret).   \nRationale for the study was to determine – Can it happen (in mammals) \nsince many people reasonably assume that it cannot since it has not \ndone this in nature despite being around in chickens and rarely in \nhumans since 1994?   Also, if it does become transmissible by point \nReleased by Chairman Rand Paul\n263mutations followed by passaging in ferrets (the experimental \nmethodology), then what is the signature of it so that health officials \nin the field could do better surveillance and also design better \ndiagnostics, therapies and possibly vaccine.  Both papers (with slight \ndifferences found that relatively few mutations (~5) followed by serial \npassage in ferrets led to virus that had better transmissibility and \nkept virulence. Kawaoka paper showed increased transmissibility but not \nmaintenance of virulence, while Fouchier paper showed both.  Papers \nsubmitted to Nature (Kawaoka) and Science (Fouchier).  Program staff \n(NIAID), Fouchier and editors asked (because of possibility of dual \nuse) the NSABB to examine the results and advise if it was OK to \npublish. Kawaoka was asked by NIAID to do the same.  To everyone’s \nsurprise, the NSABB recommended that the papers be published with the \nconclusions, but with redaction of the key results, mutations and \nmethodologies.   I believe that this was group think and “cover your \nass”.   Decision was to do this and provide a link in the paper whereby \npeople (health officials, legitimate scientists, PHARMA, etc) who have \na need to know can have access to the data.   This was a precedent \nsetting recommendation that was virtually impossible to ignore even \nthough I disagreed with it since the complexity of influenza \nadaptability is extremely complex and it is unlikely that terrorists \ncould replicate this work largely because it is unlikely that if that \nthis model just simply predicts that it will maintain these \ncharacteristics if taken from ferret to human. Furthermore and more \nimportantly, since the data had already been presented (by Fouchier) at \nan international meeting in Malta and the papers were reviewed by \nseveral reviewers and known by many, the data are already “out their” \nand would", "summary": "Watcher-discovered document from paul-readingroom (2026.08.05_Diary-Prequel-_Redacted.pdf), auto-indexed 2026-08-06.\n\nExcerpt: for Arts and Activism; Harriet Goldberg  won the 100 Women Award; Bill Jones won the Partner for Life Award;  Barry Manilow  won the Silver Anniversary Community Service Award.  He came with Suzanne Somers  who was wonderful with me and had been following my career for years. She said that  she knew all about me because she was a “doctor junky”.  She has written several book  on Health for Women.  Best was Morgan Fairchild who made sure that I was introduced  to everyone and also partook in my introduction on stage to receive the award. She really  was wonderful and friendly.  The main introducer of me was Regan Hofmann (Editor of  POZ Magazine).  She was beautiful and very nice.  Donna Mills seemed a bit artificial  and had a forced smile, but everyone else was great. Released by…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/08/2026.08.05_Diary-Prequel-_Redacted.pdf", "pdf_url": "/archive-docs/fauci-files/b5b0ed807aff8eaf2c6607cc328a591e/pdf", "doc_date": "2026-08-06", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-08-05-diary-prequel-redacted"], "part_number": 4, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 5 of 7)", "content": "be virtually impossible to “restrict” the access to the full \npapers by a “vetting” mechanism of people who “apply” for the \nunredacted papers.  Journal editors were disappointed (Bruce Alberts – \nScience and Phil Campbell – Nature) as were many flu scientists.   \nHowever, we heard the usual hysteria from people like Ebert and \nIngelsby who complained that the experiments should never have been \ndone in the first place.  Also, Mike Osterholm who is a member of the \nNSABB was practically hysterical that the NSABB recommendations should \ngo out right away so that he could “answer all of the press calls” that \nhe was getting.   In reality, the only press that was agitating was – \nyou guessed it – Laurie Garrett. Of note, Mike Osterholm is the Head of \nthe CIERS group that subcontracted through the Mount Sinai group to \nFouchier to conduct these experiments.   Osterholm now (incredibly) \nsays that he never thought that this situation would arise when he knew \nabout the contract and actually was given updates through the CIERS on \nthe actual data.   Yet, he is the loudest one saying we should now lock \ndown all experiments and treat this like BSL-4.   Problem here is that \nas I predicted, the White House is now involved and they want the USG \nto examine all research that is ongoing and that is proposed for its \ndual use potential and to put restrictions on it if it has such \npotential.   What they do not understand it that in the “discovery of \nscience” you cannot always predict what will be dual use and the danger \nis that scientific work and importantly the normal open discourse of \nscience will suffer because some uninformed people who live for \n“intrigue” are acting out their own agenda.   More later. \nDec.22, 2011 to Jan. 7, 2012 -  Situation has escalated with wall-to-\nwall conference calls with HHS and a variety of WH folks about what to \ndo.   Major issues are that Bruce Alberts and Phil Campbell are willing \nto publish a redacted version of the papers in Science and Nature, \nReleased by Chairman Rand Paul\n264respectively; however, they insist that the USG have in place a link or \nsome mechanism that they can publish with the redacted versions of the \npaper that would allow legitimate scientists and Public Health \nofficials to have access to the entire manuscript.   I found out \nthrough painful probing that recommendations from NSABB   guidelines    \nUSG policy should have been in place years ago to deal with the \nupstream (prior to the start of experiments) and downstream (progress \nreports and communication of results) issues of Dual Use Research of \nConcern (DURC).  Problem is that the recommendations of the NSABB as to \nthe “7 deadly sins” of DURC never got “clearance” from the multiple \nagencies to which NSABB officially reports (DoD, DHS, DoS, DoJ, \nintelligence community) in order for it to get the Public Comment in \nthe Federal Register to give the scientific community the opportunity \nto weigh in on the feasibility of controlling or not such research at \nthe same time a preserving the fundamental basis of open scientific \ndiscourse.   I believe that Amy Patterson should have shown some \ngreater strength of leadership to make sure that this process moved \nalong, when in fact it just froze. The NSABB sent in their \nrecommendations in 2007 (NSABB started in 2004) that should have become \nguidelines  USG Policy that ultimately could guide the local \ninstitutional Biosafety Committees (IBCs) to monitor this at the local \nlevel.   Irony is that now the papers have been reviewed, the Fouchier \npaper was presented in an international meeting in Malta and multiple \npeople have seen the data. BTW, Fouchier has been acting like a jerk in \nhis cavalier attitude about disseminating the results. Now NSABB and \nthe journals above all want a mechanism is a few days (to coincide with \nthe publication dates of the papers (Jan. – Feb. 2012) that they have \nnot been able to do in 4-5 years.   All of the demagogues have weighed \nin. People thinking that the world is not in danger of a terrorist \nmaking a “killer virus” that spreads easily.  What is at stake is the \nproper balance of doing microbial research that has DU potential with \nsecurity issues.   Of, note, I wrote an opinion piece in the Dec. 31, \n2011 issue of the Washington Post on the value of the science. The \nsecurity people do not understand the scientific enterprise, although I \ncan understand their concerns.  This whole thing has destroyed my \nChristmas Holidays.  It still is not over.   Divergent opinions in the \nscientific community ranging from 1) this work should never have been \ndone in the first place (Ebright; Ian Lipkin) to 2) we should not \nrestrict publication of any of the data and should just let it out \n(Racaniello; Peter Palese) to 3) we should publish only redacted \nversion (which is ridiculous since the data are out already) to 4) we \nshould destroy the virus (D.A. Henderson).    Please note that the \ncomplexities of species adaptability to virus transmission and \nlethality is so complex that just because multiple induced mutations \nfollowed by passaging in ferrets of 1 strain of H5N1 does not mean that \nthis virus would do the same in humans or that anyone else could \nreplicate the experiment. Of great importance is the fact the Fouchier \nfound out (but DID NOT submit it with his paper to Science – he wants \nto put it into a second paper)that if you take these 5 mutations and go \nback and put them into the wild-type H5N1, you do not get increased \ntransmissibility, which proves my point (and that of Jeff Taubenberger) \nthat transmissibility is a multi-genic process that is strongly \n“context-dependent”.  In other words, just knowing these 5 mutations \nmay have little impact on someone’s ability or not to repeat these \nexperiments.  Let me be clear, I believe that we need to now once and \nfor all get the process going of a SOP for evaluating dual use research \nReleased by Chairman Rand Paul\n265of concern (DURC) before the experiments are performed to evaluate the \nrisk/benefit of even doing the experiments and to periodically look at \nthe data to determine whether the data should be shared (presented or \npublished) before one presents it or submits it to a journal. I think \nthat there was major multifaceted failure here of NSABB covering their \nasses with the recommendation; researchers wanting attention for their \nwork; failure of Amy Patterson’s shop to get their job done over years; \npanic and hubris on the part of USG agencies who know nothing about \nscience.   I can go on and on.  The problem that we are facing now is \nthat we (USG) is being put in an untenable position of be involved in \nand associated with restricted (or as some say “censoring”) scientific \ninformation when it is already out there.   The process sets a bad \nprecedent and it evokes all kinds of conspiracy theories and makes us \nlook foolish.   My choice at this point would be to admit that it is \ntoo late in the process – we should publish the unredacted papers and \nmake this an “Asilomar moment” to make sure that we are not in this \nposition again.\n    Of note, on Jan. 7, 2012 a NY Times (written by Phil Boffey – \nunsigned – I know because he called me about it) came out with an \ninappropriately alarmist editorial entitled “Engineered Doomsday” \ncalling into question the rationale for the research and asking for \nlock down of virus in BSL-4 and ultimate destruction of virus.   He got \nmost of his information from Ian Lipkin (my good friend) who feels \nstrongly about this and was nice enough to tell me that he was going to \ndo this.   This editorial has only inflamed the hysteria and posturing. \nJan. 15, 2012 – I still believe that there is no reason for the \nJournals insisting that the papers (redacted) need to be published by \nend of Jan/early Feb.  Why not wait until this mess in openly discussed \nin an “Asilomar-like” setting.\nJan. 16 – 21, 2012 - Major development pushed by my decision to be much \nmore proactive in this process.   Too many people were posturing and \nplaying the “sound bite game” – Richard Ebright (who is a complete \nasshole), Mike Osterholm (with whom I am becoming progressively more \ndisillusioned with due to his hysteria) and other well-meaning people \nwho just like to comment, like D.A. Henderson. I never liked the fact \nthat the journals (Science and Nature) were on a fast track to publish \nwhen we still did not know how we were going to develop a system to get \nthe unredacted manuscripts only to “those who had a legitimate \nscientific need to know”.  We were getting significant pressure from \nthe White House via HHS to make sure that there are no surprises with \nother such projects appearing.   In addition, additional data were \nleaking out from Ron Fouchier’s group having WH/HHS asking whether we \nshould be shutting off their funding.   I became concerned over the \npossibility that outside (non-scientific) influences would force us to \nset a bad precedent and stop funding these flu projects.   Therefore, I \ntook the bull by the horns and contacted Fouchier and strongly \nsuggested that he and the flu scientists call a moratorium (60 days) on \nall work dealing with increased transmissibility and/or virulence of \nhighly pathogenic H5N1 virus.   At first, Fouchier was reluctant to do \nso since he felt that this would be an admission that what he did was \ndangerous and that he was backing down.   He totally disagrees with the \nNSABB recommendations.  In addition, I felt and told this to many in \nthe press that we need to get more international involvement in this \nsituation with WHO playing a major role.   I felt that people were \nconcerned that this was too much of a USA-centric situation and the USG \nReleased by Chairman Rand Paul\n266was driving things that affect many others outside of USA.   I agree.   \nTherefore I agitated and accomplished that WHO (Keiji Fukuda) should \nhold a meeting in Geneva to add an international component to this \nsituation.\nImportantly, on Wednesday, Feb. 18 I called Ron Fouchier in his home in \nRotterdam (actually I e-mailed him and asked him to call me) at 4:30 PM \nDC time – 10:30 PM Rotterdam time.   I strongly suggested that he call \na moratorium on this work and encourage his flu colleagues to also do \nso.   He was not totally convinced and said that he would consult with \nthe others tomorrow (Feb. 19) AM and get back to me.   I emphasized \nthat it is likely if he does not do it voluntarily that forces beyond \nour control (i.e. the security people) would force us to defund the \nwork.   The next morning he called me and said that they had agreed to \ncall a moratorium for 60 days and see what the Geneva meeting brings. \nFurthermore, Francis Collins and I called Bruce Alberts (Science) and \nPhil Campbell (Nature) and convinced them to delay the publication \nuntil at least March.  Fouchier came out with a press statement on Feb \n20 and Francis Collins and I came out with an NIH statement the same \nday applauding their decision.   This was a good example of my having \nto take the bull by the horns since things were not going in the right \ndirection.   Now we wait to see what happens.  There was wide coverage \nin the press about this “breakthrough” in negotiations with big stories \nin Washington Post, NY Times, Wall Street Journal, etc.\nJan. 23, 2012 - Went to Situation Room in the White House at 3:15 PM.   \nCold, very damp, gray day.   Purpose to discuss the H5N1 situation and \nbrief the National Security Staff (NSS) about my upcoming trip to the \nGeneva meeting scheduled for Feb. 16-17, 2012.   Present at the \nmeeting:  John Brennan (Chief, NSS), Heidi Avery (Deputy Chief), \nFrancis Collins, Amy Patterson, Bill Corr (Deputy Secretary-HHS), Sally \nHoward (Chief-of-Staff to Sebelius), Bill Shultz (OGC-HHS).   NSS \nconcern was what we would agree to or not at the Geneva meeting.   I \ntried to explain that the information was already out there and \nmultiple papers have already described the methodology.   I explained \nthat what I wanted to get out of the meeting was a transparency to \nothers about what we are trying to do in order to get away from this \nUSA-centric perception.   Of note, after the meeting, Heidi sent an e-\nmail to Bill Corr saying that there are certain “redlines” that we \nshould not give in to at the meeting.  I fear that she is not fully \ngetting what I want to accomplish at the meeting.   Also, of note, she \nmentioned in her e-mail that she does not want total unbridled \navailability of the information in the papers (her “redline”) even \nthough she knows that certain USG scientists do not agree with her.  I \nam certain that she is referring to me.\nFeb. 11, 2012 – The past couple of weeks have been intensively involved \nin discussion about the H5N1 issue.  Extraordinary “legal” issues come \nup about what can and cannot be discussed in public.   I pushed for and \nit will happen next week for a WHO meeting to make all of this more \ntransparent and international.   The issue is what can and cannot be \ndiscussed at this meeting.   There are 2 options to allow discussion at \nthe meeting: 1) an “export control license” from the Dept. of Commerce \nthat restricts discussion to the people listed on the license, i.e. all \nthe attendees at the meeting or; 2) An advisory opinion from the dept. \nof Commerce saying that the information is intended to be published by \nthe journals and therefore the expert control requirement does not \nexist. Some subterfuge has gone on with HHS in getting the journals to \nReleased by Chairman Rand Paul\n267say that they have every intention of publishing the papers without \nrestrictions (which is not true) just so that they can get an advisory \nopinion.   The problem is that since Commerce grants both the export \ncontrol (which assumes restriction) as well as advisory opinion (which \nassumes open publication without restriction) you cannot have it both \nways.   Bottom line is that based on the journals declaring that they \nintend to publish an advisory opinion will be granted.  I expressed my \nconcern that this was not entirely honest, but it went ahead anyway.   \nThis is something that I do not control.  I leave for Geneva on Feb. 14 \nfor a meeting on Feb. 16-17, 2012.\nFeb. 13, 2012  -  You really cannot make this up if you tried.   They \n(HHS, DoC, White House) have finally decided that we all need export \ncontrol licenses to go to Geneva.  The DoC and HHS are working \nfeverishly to get them on time before we all (me, Nancy Cox, Paul Keim \n– representing NSABB) leave for Geneva.  The entire process has been \nludicrous with regard to the concern over security as well as the \ncraziness of the laws related to export control licenses.   Export \ncontrol was originally designed as a multinational agreement to protect \nagainst the shipment of sensitive products such as computer chips, \nweapons, etc. to countries with whom we (USG) or other countries have a \nproblem with.   In this case (uniquely), the export control applies to \nshipping of information or even being in a room where information \n(sensitive) is shared.   In this case, the information is the H5N1 \nunredacted manuscripts.   I need an export control license (even though \nI am not taking anything with me) to go to Geneva and I must name on \nthe license everyone who will be at the meeting.   I cannot do this \nsince the WHO will not release the names of the attendees until the day \nof the meeting and so DoC cannot put in for a license for me.  OK, we \nget the names and then Tom Countryman from State has deep concern that \nwe are even going to such a meeting to discuss potentially sensitive \ninformation.   We calm him down and then the White House (John Brennan \nand Heidi Avery) do not want Fouchier to discuss the 9 mutations that \nare capable of giving the ferrets transmission/lethality without the \nrequirement for passage among ferrets (more below on that).  They only \nwant him to discuss what is in the unredacted paper (5 mutations + \npassage).   They (through Sally Howard of HHS) want me to call Ron \nFouchier to ask him to not mention the 9 mutations and to restrict his \ndiscussion to the paper.   The discovery of the non-passaged virus’s \nability with 9 mutations by reverse genetics to allow \ntransmission/lethality is not contained in the paper.   Now here I am \n(very uncomfortably) asking Ron to voluntarily withhold any information \nboth during the question period and the discussion about the other 4 \nmutations that together with the original 5 make a wild type H5N1 \ntransmissible/lethal in ferrets without the requirement of passage.   \nRon reluctantly agreed because he wants the meeting to occur and the \nWhite House said that the meeting will be nixed if we discuss the 9 \nmutations.   Here is the irony of this all.   The meeting was called by \nWHO to add “transparency” to the process and to preserve the PIP \nagreement so that the Indonesians and Vietnamese do not feel that we \nare withholding information from them and a White House condition for \nsupporting the meeting and allowing me to go is that Ron “withholds” \ninformation if asked about the obvious questions that any virologist \nwould ask, i.e. if you took a wild-type H5N1 (cloned) and only inserted \nthe 5 mutations, would it transmit in ferrets – answer = no.   Then \nwhat did you do?   Ron would answer that the virus after 5 mutations \n(commonly known in the literature) + 12 passages obviously also \nReleased by Chairman Rand Paul\n268accumulated other mutations besides the original 5 (3 + 2).  Ron then \ndid deep sequencing of the transmissible virus and by reverse genetics \nfigured out that you needed the 5 + an additional 4 (now he says less \nthan 4).   This was not in the original manuscript (unredacted).   \nWhite House does not understand that the 5 mutations + Passage = the \nunpassaged 9 mutations.  They fixate about not mentioning the precise 9 \nmutations when anyone can just take any quasispecies and get a \ntransmissible virus after many passages.   You just need a virus and \nsome ferrets.   I again am very uncomfortable in asking Ron to hold \nback this information and told him that this would be his choice and he \nwould have to play it by ear at the meeting, but he will try his best \nto be vague about the 9.   Another ludicrous happening is that this \nexport control issue must also get input from the iPC (interagency \nPolicy Committee) which includes DoD.   The night before I am leaving \nfor Geneva (tomorrow on 5:47 PM flight) DoD says that they want to know \nwhen I am leaving since they are not sure that I can go since they want \nthe WHO to disinvite the Chinese (where the disease is occurring) since \nwe (USG) do not share restricted information with them.  They fail to \nrealize that Margaret Chan (Director General of WHO) is Chinese!!!!!    \nYou cannot make this up.\n    DoD is examining this issue tonight and will let me know tomorrow \nif I can go to Geneva. \nFeb. 14, 2012 – Approved at the last minute (literally) that I can go \nto Geneva and was granted an Export Control License for me, Barbara \nJasny (representing Bruce Alberts of Science), Paul Keim (Chair, \nNSABB), and Yoshi Kawaoka (author of Nature article)\nFeb. 16-17, 2012 – Geneva – Astounding!! During Ron’s presentation of \nthe data, I asked the “transforming” question that exposed the \nconfusion that has been propagated regarding the study.   It relates to \nthe uncoupling of the issue of aerosol transmission from deadly \npathogenesis.   Bottom line is that the aerosol-transmitted virus when \ntransmitted to uninfected ferret, not only does not kill them, it does \nnot even cause significant disease.   At worst, some mild flu like sxs.   \nSee below for my detailed description of the data gathered from the \npapers, the Geneva presentation together with discussions during the \nGeneva meeting including a dinner at Keiji’s home with Ron, AB \nOsterhaus, Keiji Fukuda, and Yoshi on the evening of Feb. 15 (more on \nthat later) as well as extensive discussion by phone with Ron after I \nreturned to USA on Feb. 19 and 20, 2012. Recommendation (consensus) of \nthe WHO-convened group was to 1) respect the PIP agreement; 2) extend \nthe voluntary pause (“moratorium”) on H5N1 \ntransmissibility/pathogenicity research; 3) Delay publication of the 2 \nmanuscripts until the safety and security issues of such research could \nbe solidified for others.   General agreement that the experiments of \nYoshi and Ron were carried with safety and security that met or \nexceeded the guidelines; 4) After meeting conditions in #3, then \npublish the manuscripts in full; 5) discussion that the publishing of \nredacted manuscripts with mechanism for vetting and distributing to \nthose with a need to know was completely impractical.   This point was \nfortified by the almost unbelievable and counterintuitive requirements \nof Export Control Licenses.   There was a unanimous recommendation for \neverything except the recommendation to publish.   Nancy Cox did not \ncomment, but Paul Keim and I stood by the recommendations of the NSABB.   \nIn the roll-out after the meeting in Geneva, Keiji at first messed up \nand said that everything was “unanimous consensus”, which is an \nReleased by Chairman Rand Paul\n269oxymoron.   Christ Feig is a former CNN producer and old friend of mine \nand is the communications director for WHO.   I noticed the slip-up and \nshe got Keiji to correct while still on the TV press conference.   E-\nmails were going back and forth from me to HHS (Bill Hall) to some of \nthe NSS people when he made this mistake, but everyone calmed down \nafter he corrected it.   I was in the unusual position of officially \nsticking with the NSABB recommendation while being the one who actually \nled the WHO discussion to come to this point.  The smart reporters like \nJon Cohen and Helen Branswell picked this up and were sympathetic.   \nThe decision was written up on the front page of the NY Times by Denise \nGrady on Sunday.   It was interesting how she quoted me with an \narticulate explanation of why the WHO group came to this decision at \nthe same time that she mentioned that I stuck by the NSABB \nrecommendations.   Anyone with insight could figure out what I did.  Of \nnote, Paul Keim did not realize that the aerosol-transmitted H5N1 did \nnot make the animals ill, much less kill them!!! There was a media \nstorm after the decision was announced. See below for summary of \nmeeting:   \nSunday, February 19, 2012\nSummary of discussion at the WHO Geneva Meeting on Feb. 16-17, 2012 plus additional \ndiscussion with Ron Fouchier and Yoshi Kawaoka.\nAnthony S. Fauci, M.D.\nFouchier Experiments (Science)  and related information:\nFouchier worked with a high pathogenicity (HP) H5N1 influenza virus obtained from a patient in \nIndonesia (A/Indonesia/5/05).   He had been working for 4 to 5 years on trying to study the \ntransmissibility of H5N1 for the purposes of determining the molecular aspects of increased \ntransmissibility.  His attempts at developing an H5N1 with increased transmissibility in a \nmammalian model have failed up to now.\nRecently, he used the already existing literature to identify the mutations that have been \nreported to be associated with the emergence of previous pandemics (1918 H1N1, 1957 H2N2, \n1968 H3N2, 2009 H1N1 and other non-pandemic outbreaks, e.g. 1977 H1N1).  He analyzed \nthese and determined the 3 mutations that statistically seemed to be associated most closely \nwith emergence of pathogenic pandemic viruses.  Again, these mutations have already been \nreported in many published papers.\nWith regard to the “technique” of passaging in ferrets, there are many papers that have \nappeared in the literature for decades (since the 1930s) describing the ferret passage technique \nto increase transmissibility.   This is similar to passage techniques widely used to adapt a virus to \na particular species.   It has been done in mice, monkeys, etc.   Usually (not always), when \nviruses are passaged in a particular species, as they gain transmissibility, i.e. species-specific \nadaptation, they develop decreased pathogenicity, i.e. attenuation.\nReleased by Chairman Rand Paul\n270Fouchier took these 3 mutations and inserted them into a wild type (WT) HPH5N1 (see above). \nThis technique is widely used in molecular virology.  He then passaged the virus 10 times in \nferrets.  “Passaged” means inserting the virus into the nose of the animal, getting the animal to \nget infected, then taking virus from the nasal passages of the infected animal and inserting it \ninto the nasal passage of the next animal in the sequence, and so on.   The endpoint that is \naimed at is to get a virus that is then able to be transmitted by aerosol (i.e. not relying on direct \ninsertion into the nasal passage).  Since ferrets sneeze when they are infected, one determines \n“aerosol transmission” by housing an infected ferret in a cage next to a separate cage of an \nuninfected ferret that is constructed such that an aerosol can get from one cage to the other \ndue to “holes” in the barriers between cages.   The virus resulting from the passaging was able \nto be transmitted by aerosol and was a “quasi-species”, i.e. it contained different “versions” of \nthe mutated virus.  The viruses that were transmitted by aerosol were then sequenced and all of \nthese viruses had 5 mutations in common:  the 3 mutations that were inserted by reverse \ngenetics and 2 additional ones.  In addition, the viruses had 4 to 7 variable mutations (this latter \nsequencing information was not ready for reporting in the original manuscript).   This virus \nisolate was used in the pathogenesis studies reported in the manuscript.  It was the isolate with \nthe minimal number of mutations (9 mutations  -  5 common mutations  + 4 variable mutations).  \nAfter submission of the manuscript the authors took a wild-type H5N1 clone and inserted this \nminimal number of mutations to develop a virus that was transmissible without the need for \npassage.  The pathogenesis studies with this cloned virus were identical to those of the isolate \nreported in the manuscript (see below).  \nIt is EXTREMELY IMPORTANT to point out that the animals that got infected by aerosolized virus \ndescribed above did not die nor did they get sick. They were followed for 14 days.  A few got \nminor flu-like symptoms, all recovered, they then were sacrificed since logistically the author \ncould not house them indefinitely.  Thus, the “engineered” virus that was made transmissible, \ndid not kill or make the animals sick when exposed in the manner that flu in transmitted in \nhumans.\nPATHOGENICITY.  The classic way that influenza virus pathogenicity is established (well-\ndescribed in the literature) for the ferret model is by direct insertion of the virus into the nasal \ncavity and/or directly into the trachea.  Fouchier did both nasal and tracheal insertion of the \nviruses.\nIn the nasal insertion studies , 106 (1 million) infectious doses of virus is inserted into the nose.  \nThis is a dose that far exceeds a dose that one gets through aerosolized virus (i.e. sneezing).  \nWhen this dose of the pandemic  2009 H1N1 virus (not considered a particularly pathogenic \nvirus, particularly in people who have been exposed to H1N1 over years by infection or \nvaccination - children who are naïve to this virus have had more problems) is inserted into the \nferret, the animals develop flu-like symptoms but do not die.  When HPH5N1 is inserted the \nanimals essentially all get neurovirulence, they recover, none die. When the modified (aerosol-\ntransmitted) H5N1  virus is inserted, there is some neurovirulence, but actually less \nneurovirulence than with the wild typeH5N1.  Again, all recover and none die.\nReleased by Chairman Rand Paul\n271In the tracheal insertion studies, 106 virus is inserted directly into the trachea.  Again, this is a \ndose and a situation that would be extremely difficult, if not impossible, to achieve by \naerosolized transmission.  In these experiments, when this amount of wild type (unmodified) \nHPH5N1 is inserted into the trachea, all animals die on day 3.   Similarly, when the modified \nH5N1 is inserted, all animals die on day 3.   However, and importantly, when 2009H1N1 that \nwas shown to be a mild pathogenicity virus was inserted under the same conditions, it killed \nsome, but not all the animals.  Although, this was a qualitative and not a quantitative study, it \nstrongly suggests that in this model, the modified H5N1 is not dramatically different from the \n2009 H1N1 in pathogenicity.   Also, it should be pointed out that in the ferret model, 2009 H1N1 \nis much more transmissible (100% transmission on day one) than is the modified H5N1.   \nSpecifically, transmission with the modified H5N1 does not occur until day 3 to 4 and even then \nit is only 75% transmissible.   This suggests that the R 0 may be less than 1.   This is important with \nregard to concerns over the potential catastrophic effects of lab accident and the known \nconditions that are needed for the start of an epidemic/pandemic.   In this regard, there should \nbe serious discussion of how pandemics occur.  Nancy Cox can elaborate.\nFerrets are naïve to influenza virus, i.e. they have no pre-existing immunity.   Humans do have \npre-existing immunity to influenza viruses due to repeated exposures (except in young children) \nand/or vaccinations.  It is EXTREMELY IMPORTANT to point out that if you vaccinate the ferrets \nwith seasonal H1N1, they are not protected against death from tracheal insertion of high dose \n(106 infectious doses) modified or wild type H5N1.   Fouchier did not test the effect on \ntransmission yet (moratorium).  However , if you pre-infect ferrets with seasonal H1N1, let them \nrecover and then insert high dose H5N1 into their trachea, this fully protects against disease and \nno ferrets die.   This strongly suggests that pre-existing immunity due to prior infection with \nseasonal influenza A protects against serious disease with this modified virus (heterosubtypic \nimmunity).  This could be a possible explanation for why so few people get infected with H5N1 \nin the wild.\nYoshi Kawaoka Experiments ( Nature).   The studies of this investigator are very similar to those \nof Fouchier except that Kawaoka took the HA from the HPH5N1 and did random mutations from \nwhich he selected those that enhanced transmissibility when this HA was reassorted with the \n2009 H1N1to make a hybrid of the H5N1 and the 2009 H1N1.  This is something that we are \nconcerned could happen in the wild.   He then did similar passages as described above.   \nKawaoka’s results differed from the Fouchier study in that although his virus was transmissible, \nit was not any more pathogenic than the 2009 H1N1 influenza.\nEPIDEMIOLOGICAL DATA:   With regard to the importance of these data for the real and present \ndanger of the evolution of H5N1 in the wild, as well as for the impact on surveillance, Kawaoka \nand Fouchier have done some epidemiological “mapping” of their modified virus with what is \ngoing on in the wild.   Viruses were studied that were obtained from chickens in Japan, \nMongolia, Nepal, and Egypt as well as viruses from people infected with H5N1 in Egypt.   Some \nof the mutations that Fouchier and Kawaoka described involving the PB2 gene (627 K) and the \nreceptor binding genes (HA) were present in 100% of the H5N1 viruses that infected humans \nReleased by Chairman Rand Paul\n272and only in 30% of the chicken viruses.  This suggests that the viruses that accumulate the \nmutations in question are the ones that transmit from chickens to humans. In addition, many of \nthe viruses circulating in chickens are only 2 to 3 mutations away from the mutations described \nby Fouchier in their modified viruses. \nPeople will argue that knowing mutations cannot help predict or alert public health officials to \nwhat will emerge as a pandemic.  They state that since viruses have several routes to get to \nwhere they want to go, i.e. to be able to be transmitted, the studies in question should not even \nhave been performed.    However,  historically, after pandemic viruses emerge and infect people \nand then you go back and trace what was evolving in birds, or (more importantly) in mammals \nyou see a pattern where you could have actually traced and connected the dots pointing to the \nemergence of a pandemic.  This was clearly the case where the pandemic  2009 H1N1 virus was \nevolving in pigs for at least 10 years and was “working its way” towards human transmissibility.   \nIf there had been better surveillance in both pigs and humans as to what was evolving, then as \nTom Frieden has said, we could have had a major head-start on the 2009 H1N1 virus.  What the \nFouchier and Kawaoka viruses tell us is that the virus in the wild is creeping towards a virus that \nthey have shown is capable of transmission in mammals, presumably including humans.  \nWhether the virus ultimately uses that precise pathway or those precise mutations is not clear, \nbut clearly these studies are critical to understand the process of evolution and adaptability of \nviruses that are a real threat of working their way to transmissibility in humans.   Not making \nthese data freely available to scientists only slows down the necessary work and the incentive to \nget more scientists involved, and does not really provide a serious terrorist with any additional \nadvantage since these techniques have been widely available for years.  An uninformed terrorist \nwould not be able to do this.  An informed virologist-terrorist just needs to go to PubMed to \neasily figure out what was done and how it was done.   Not publishing the work may do more \nharm than good by discouraging legitimate scientists from getting involved.   Clearly, there \nneeds to be assurance of biosafety and biosecurity in the laboratories that work with \ntransmissibility of H5N1.  The laboratories in question (Fouchier and Kawaoka) have met or \nexceeded our standards for these types of studies.\nRedacted versus Unredacted:  The impracticality of redacted versus unredacted manuscripts \nwas clear to everyone at the Geneva meeting and the likelihood of the unredacted manuscripts \nultimately reaching the internet were important factors in the consensus at WHO to publish in \nfull after a pause to assure biosafety and biosecurity and to have a better articulation of the \nbenefits of the research as described above.\nThe way forward. People are making incendiary statements without really having discussed \nwith the investigators the precise details of the experiments as described above.  The \ninteraction of the NSABB with the investigators (Fouchier and Kawaoka) was on a relatively brief \nconference call.   Much additional information that was available during the intensive 2 day \ndiscussion in Geneva was not available to the NSABB.   My recommendation is to reassemble \nthe working group of the NSABB for a face-to-face meeting with the investigators, security \nReleased by Chairman Rand Paul\n273people, international public health people (similar to the WHO meeting) and a larger number of \ninfluenza experts with hands on expertise in such studies.  \nPost- Geneva:     Have spent the past few days explaining the above summary to HHS, White \nHouse NSS X 2.   Could not comment too much to the press.  \nFeb. 22, 2012 -   Briefed the NSS in the Situation Room with Heidi Avery leading (I had pre-\ncontacted her explaining that I had to do the briefing and she agreed), Laura Holgate and Brian \nKamoi from NSS, Kris Beardsley (more of her later), Francis Collins, Amy Patterson, Nancy Ann \nDe Parle, Bill Shultz (HHS OGC), Bill Corr (Deputy HHS Sec.).\nFeb. 21-24, 2012 – had conversations and e-mail exchanges with Ron Fouchier trying to work \nout that he re-submit a manuscript and that the NSABB reconvene to review with the new data \nand the clarifications from Geneva.   Also, spoke with Journal editors to try and get them to \nagree (which they did) to hold off on publication, but agree to quickly consider a revised \nmanuscript.    Of note, during the Feb. 22 Situation Room meeting, I outted Kris Beardsley as a \n“leak” to the NSABB.   Paul Keim had asked how things were going right after we returned from \nGeneva (see e-mails on file).   I told him that I was about to brief the WH on Feb. 22.   He said \ngood luck and that he already had spoken to Kris Beardsley.   I did not return e-mail, but I was \nastounded.  She is NSS!!!.   Now it became clear that the NSABB people were directly trying to \nget to and agitate the WH through Kris and also with Mike Osterholm getting to Rick Weiss, the \nPress person for John Holdrin at OSTP.  Rick is a former Washington Post reporter.   I believe \nthat Paul Keim is OK, but it is incredible that Kris Beardsley and Rick Weiss are doing this.   In \norder to make sure that Kris would not undermine my presentation to Heidi and the NSS, I \nstarted my explanation (see summary above) by saying that I know that Paul Keim has briefed \nKris about part of this a day or so ago, but I will give a little more information since I spoke with \nRon after the WHO meeting and Paul did not.   Kris almost fell through her chair and Heidi gave \nher a very mean look followed by a statement that we have only one point of contact with \nNSABB and that is Fauci.   Clearly Heidi not only was not briefed by Kris, she had no idea and was \nextremely pissed that Kris had spoken about this with Paul.   Paul is advisory to HHS and NIH and \nNOT to the White House.\nBTW, I have been completely wearing myself down by this getting virtually no sleep and doing \n1000 things at a time that are very heavy, i.e. White House stuff, Press misinterpretation. Mike \nOsterholm acting in his usually hysterical manner, Laurie Garret getting it wrong as usual.\nOF GREAT IMPORTANCE:  How is it possible that everyone got it wrong?   Why did not anyone \never ask the “Fauci question” that I asked in Geneva of Ron.    This includes the reviewers of the \npapers, the entire NSABB including the Chairman Paul Keim, the outside influenza expert called \nto advise the NSABB (Rob Webster), the editors of the Journal.   After I briefed him, Bruce \nReleased by Chairman Rand Paul\n274almost comically stated. “You know, I knew there was something funny here when I read the \npaper and found that after aerosol transmission, blood samples were taken from the ferrets for \n12 days.   If the ferrets all died in 3 days, did they take samples from dead animals?”   Clearly his \nown editorial staff did not pick it up.   There is plenty of blame to go around.  Clearly Ron did not \nsay in the manuscript that the aerosol-transmitted animals died, but he never said in the \nmanuscript that they did not die.   Clearly he was doing what many scientists do, i.e. play up \ntheir own data to make it seem exciting.   Yet, he knew that the media were clearly getting it \nwrong.   He will say that he was never given the chance to explain this to the NSABB and his only \ncomments to the press that they clearly misunderstood were before the NSABB and he did not \nrealize that they misunderstood.   However, after the decision of the NSABB, he still spoke to the \npress, yet never made it explicit what really happened.  He could claim that at that point he \ncould not discuss the data since it was confidential and the press could not ask the specific \nquestion sine they did not see the data.  It is clear to me that a lot of people are embarrassed for \nnot asking the Fauci question and as human nature goes, people are running for cover and/or \nlooking to blame someone.   Ron is in danger of getting thrown under the bus when the press \nfinds out that he never clarified things.   As an example, ABS World News on Saturday PM, Feb \n18 had a piece showing all aerosol-infected animals dying schematically on the screen with the \never-present Laurie Garret commenting that “This virus just should not be allowed to exist”.\nSee Important e-mails below:\nThursday, Feb. 24, 2012 11:26 AM\nRon:\n    In follow-up of our previous conversations,  it is important for you to revise and \nexpand your manuscript to include the important new data that were presented in \nGeneva.   In addition (and this is critical), you need to make exceptionally clear the \ndifferences between the transmission studies and the pathogenicity studies, i.e. the \nresponse that you gave to me when I asked that direct question in Geneva whether there \nwas any illness or death in the animals that had been infected by aerosol with the \nengineered highly pathogenic H5N1.   You responded that some of these animals \ndeveloped flu-like symptoms, all recovered, none got seriously ill and none died.   This \nseems to be the key point about which many people were and are confused.   It would be \nvery important to make this exceptionally clear in the manuscript. There are also other \nimportant data that we discussed that would be important to include in a revised \nmanuscript.   I believe that the best course of action would be to resubmit this revised \nmanuscript  to the NSABB so that they have the opportunity to have all of the data that \nwe discussed in Geneva  in front of them as well as to directly question you in person in \norder to clarify any important points.   Amy Patterson will request that the NSABB meet \nand review this manuscript.   As I had mentioned to you, Francis Collins and I have \nspoken to Bruce Alberts about the importance of your having enough journal space to add \nthe  new data and a broader discussion of the issues.  In our initial conversations with \nhim, he seemed amenable to this approach.    Obviously, we cannot know for sure what \nthe journal decision will be.  Francis and I will be speaking to Bruce again today (I hope) \nReleased by Chairman Rand Paul\n275and we will bring this up to him.   However, the important issue is that the NSABB have \nthe opportunity to see the expanded manuscript as described above.\n    I would be happy to discuss this further with you.   Please give my office a call at your \nconvenience at (301) 496-2263.   I am not available between 12:00 and 12:30 PM and \n3:30 – 4:00 PM   Washington time.\nBest regards,\nTony\nAnthony S. Fauci, MD \nDirector  \nNational Institute of Allergy and Infectious Diseases  \nBuilding 31, Room 7A-03 \n31 Center Drive, MSC 2520 \nNational Institutes of Health \nBethesda, MD 20892-2520  \nPhone: (301) 496-2263 \nFAX: (301) 496-4409 \nE-mail: afauci@niaid.nih.gov \n______________________________________________\nTuesday, Feb. 21, 2012 to Paul Keim\nPaul:\n   Line-up and tasks sound good to me.   We should strategize by phone on how to handle \ndiscussion of the WHO meeting.   I have a meeting at the White House tomorrow to brief \nthe security people on the WHO meeting and the outcome of those discussions may \nimpact our decision on how to handle this.  We should talk after that.\nBest regards,\nTony\nTuesday, Feb. 21, 2012 from Paul Keim referencing Kris bearsdley\nGood luck with the meeting. I've prepping Kris today on the issues. \nPaul Keim, PhD \nTGen/NAU\nOn Feb 21, 2012, at 5:41 PM, \"Fauci, Anthony (NIH/NIAID) [E]\" \n<AFAUCI@niaid.nih.gov> wrote:\nPaul:\n   Line-up and tasks sound good to me.   We should strategize by phone on how to handle \ndiscussion of the WHO meeting.   I have a meeting at the White House tomorrow to brief \nthe security people on the WHO meeting and the outcome of those discussions may \nimpact our decision on how to handle this.  We should talk after that.\nBest regards,\nReleased by Chairman Rand Paul\n276Tony\nFeb. 23, 2012 -   Finally, a pleasant evening.   Attended reception at the Jefferson Hotel \nfor the Global Health Corps (GHC) created and led by Barbara Bush, George W’s \ndaughter.   Great reception.   It was a fund raiser for the fellows of the GHC.  Laura Bush \nwas there and she and Barbara during the speeches called me out for praise for all that I \nhave done for AIDS research.   All the GHC fellows were so happy to meet me since they \nhad been hearing about me for years and now were meeting me.   I met Marvin Bush, \nGeorge’s brother.  The usual crew was there – Mark Dybul (host), Eric Goosby, Stephen \nHadley former National Security advisor to GWB.   Many other luminaries.   The \nAmbassador for Woman’s issues of DoS mentioned in her speech how much Sec. Clinton \nadmired me.\nFeb. 25, 2012 – Went to a (now commonplace for me) dinner at Café Milano hosted by \nCatherine and Wayne Reynolds in honor of Gov. Jerry brown (D-CA) and his wife Anne.   \nBrown in DC for Governor’s Convention.   Sat next to Anne and got major insight into \nthe Gov.   He was known as Governor “Moonbeam” in the  70s during the hippy years \nwhen he dated Linda Ronstadt.   However, he is an amazing person in that he just tells the \ntruth without an obvious ideology.   Anne told me that Pres. Obama completely shuns \neven other Democrats such as Democratic Governors.   Obama has never once asked \nJerry for any advice about anything.   It was a lively evening talking about the \nRepublican Primaries and the ridiculousness of it with Romney vs Paul vs Gingrich vs \nSantorum. Other usual notables at dinner. Chris and Kathleen Matthews, Supreme Court \nJustice Anthony Kennedy.   I sat next to his wife Mary who is extremely conservative \nand not too bright (scary),   Also there was Bob Barnett and his wife.   NPR Nina \nTotenberg and husband David, Peter Agre, etc.\nFeb. 27, 2012 – Briefed the senior, but sub-Interagency Policy Committee on the Geneva \nmeeting. Chaired by Laura Holgate from NSS (National Security Staff).  Also present \nwere Brian Kamoi (NSS – he has lost about 90 lbs. and looks great); Sally Howard \n(Chief-of-Staff to Sec. Sebelius); Kevin….. from Commerce; a bunch of representatives \nfrom the various US Government departments.  Tom Countryman from State Department \nis really a jerk, pompous and uninformed.   I alleviated the anxieties of the group \nregarding the studies by clarifying the difference between transmission and virulence in \nthe Fouchier study.   I strongly suggest that we reconvene the NSABB to allow them to \nsee the new data and hear the clarification of the old data.\nFeb. 28, 2012 – Ron Fouchier flew in from Rotterdam to be on a panel tomorrow AM \n(Feb. 29) organized by American Society of Microbiology (ASM) to discuss this issue.   \nInvited Ron over my house for dinner (rigatoni and sausage with tomato sauce) with Cliff \nLane and Hugh Auchincloss to discuss the approach for tomorrow.  Ron related to me \nthat the NSABB never gave him a chance to explain his experiments and that he met \nthem via teleconference.   Clearly they were hostile to him and when his interview was \nover, Mike Osterholm started speaking before Ron signed off and Mike said (without \nknowing that Ron was still on the line) that Ron was a “liar”.   Ron stayed on the line in \nReleased by Chairman Rand Paul\n277secret and described what sounded like a major ad hominem to Ron.   After intense \ndiscussion with me before and during the dinner, Ron Finally got it that he has to be very \nclear tomorrow that the ferrets who got infected by aerosol transmission did not get very \nill (flu-like sxs at worst), all recovered and NONE died.  Only animals who got 1 million \ninfectious doses of H5N1 directly inserted into the trachea died.  It is clear that everyone \nNSABB, all the pundits who commented (Laurie Garret, Tom Ingelsby, Richard Ebright, \nD.A. Henderson, etc.) and the press thought that after aerosol transmission, the ferrets \ndied.  We had long discussions about future experiments and upcoming issues.   Later in \nthe dinner, Bruce Alberts (Editor of Science) flew in from San Francisco, called my cell \nphone to let me know he arrived, and I invited him over for the remainder of the dinner.\nFeb. 29, 2012 – ASM panel at 7:15 to 8:15 at Omni-Shoreham in D.C.   Standing room \nonly, fed live on Website with many reporters tuned in.   Paul Keim chaired panel that \nincluded Ron Fouchier, me, Bruce Alberts, and Mike Osterholm.  Everything was \nclarified and most people asked the question that I have been asking all along – how \ncould this pervasive misunderstanding have occurred.  It was clear, but no one wanted to \nembarrass anyone, that the NSABB missed this major point.\nMarch 1 and 2, 2012 – Much press coverage going on trying to decide what went wrong.  \nJon Cohen from Science is coming close to figuring it out.   However, when he asked \nseveral members of NSABB to answer some questions, it become clear that they are \nbeing defensive and saying that it is the mere fact of making the virus “transmissible” \nthat prompted them to recommend against publication, even if it was not clear that the \naerosol-transmitted virus did not kill the ferrets.   We are going to reconvene the NSABB \nASAP to review the revised manuscripts from Ron and Yoshi to that they can see the \nadditional and clarified data.   I am afraid that they will not change their minds because \nthey need to save face that they actually dropped the ball badly.   I believe that Mike \nOsterholm and to some extent David Relman aggressively persuaded the others to vote \nnot to publish.   HOWEVER, I believe if the other members of NSABB  knew that the \naerosol transmission did not result in death of the ferrets, they would not have been \nconvinced by the histrionics of Mike who told the press that this was equivalent to \n“thermonuclear war” if this virus gets out.\nMarch 5, 2012 – It is starting to become clear that the NSABB are saying that the basis \nfor their recommendation is the fact that the virus was made transmissible and the \ndecision had little or nothing to do with whether or not the virus was lethal via aerosol \ntransmission.   I just cannot believe this.   I believe that most of the NSABB group did \nnot know enough about flu to know the importance of this distinction.   They now are \nembarrassed that they missed this and are likely covering their asses.   Interesting that the \nN.Y. Times (Phil Boffey) editor wrote another Sunday editorial yesterday (May 4, 2012) \ncriticizing the process and implying that “the NIH, whose reputation is at stake…..” is \nsomehow at fault.   He clearly is taking the side of the NSABB calling them fiercely \nindependent.   He wrote me an e-mail prior to the Sunday editorial giving me a “heads-\nup”.   He implied in his e-mail that I was trying to have him retract his prior editorial \nbased on information from Geneva.   He is totally missing the point.   I do not want him \nto retract anything nor do I want to influence the NSABB to change their minds.   I \nReleased by Chairman Rand Paul\n278merely want them to reconvene so that they can have all of the information that was \npresented in Geneva and at the ASM meeting on Feb. 29, 2012 in Washington.   Things \nthat they almost certainly did not know at the time of their December, 2011 \nrecommendation:  1) aerosol transmitted H5N1 does not kill ferrets; 2) engineered H5N1 \nis poorly transmissible, i.e. it takes 3 to 5 days after exposure to transmit to 75% of ferrets \ncompared to 2009 N1N1 that transmits in 100% of animals within 1 day; 3) pre-infecting \nferrets with either seasonal H1N1 or H3N2 and letting them recover and then instilling 1 \nmillion infectious doses of H5N1 into their tracheas completely protects the ferrets from \ndisease and death.   If they still feel after they hear this that the papers should be redacted, \nthen so be it.   I believe that they are incorrect and were driven by the hysteria of Mike \nOsterholm, the know-it-all of David Relman and the lack of understanding of the rest of \nthe NSABB.\nMar. 8, 2012 – Went to special premier showing of the movie “Game Changer” about \nSarah Palin starring Julianne Moore, Ed Harris and Woody Harrelson.   All the usual DC \nglitterati were there, both political and media.   Tammy Haddad was responsible for my \ninvite.   Went with Chris.\nMar. 9, 2012 – PCAST meeting at the Carnegie Endowment for International Peace.   \nPresented on a panel with Paul Keim (Chair of NSABB), Bruce Alberts (Science editor-\nin-chief), Peter Palese (Mt. Sinai) regarding the H1N1 manuscript controversy.   Chaired \nby John Holdren and Eric Lander.   Reviewed the pros and cons of publication.   I gave \npresentation similar to my ASM presentation on Feb. 29.\nMar. 12, 2012 – Gave my yearly talk to the Zuckerman Fellows on “A Career in Public \nService”.   Very engaged group; was told by conveners that the fellows loved the talk and \nfound it the best among many talks by White House people, and other government \nofficials.   Usual cocktail reception and dinner at the home of Ron and Beth Dozoretz.  \nMingled with the usual DC glitterati – Andrea Mitchell and Alan Greenspan, Mort \nZuckerman, David Gergen, Chris Matthews, etc.\nMar. 20, 2012 – House Appropriations Subcommittee Hearings – Rayburn Building.   \nUnusual situation that the Hearing was confined to a discussion about NCATS.   Only \nofficial witnesses were Francis Collins and Tom Insel (Director NIMH) who was there in \nhis capacity as Acting Director of NCATS.   Harold Varmus and I were there as “token” \nattendees for rest of NIH.   It was a disgrace that the Hearing was only NCATS.   \nChairman Dennis Reyberg is not the brightest bulb on the porch.\nMar. 22, 2012 – Small intimate dinner at Café Milano sponsored by Wayne and \nKatherine Reynolds.   Dinner in honor of Susan Hockfield the retiring President of MIT.   \nUsual glitterati – Rick Atkinson (author), Head of National Geographic, etc.\nMar. 25, 2012 -  Went to Baltimore to present John Bartlett with an award from AIDS \nAction Baltimore.  He was delighted at my laudation.   It was run by AIDS activist and \nfriend of mine – Lynda Dee..\nReleased by Chairman Rand Paul\n279Mar. 26, 2012 – Gave my Nifty-Fifty Lecture on a “Career in Public Service” TO Walter \nJohnson High School in Bethesda.   It was fun since the students were so engaged with \nme.\nMar. 27, 2012 – Went to National Portrait Gallery to have historical filming of my \nexperience with HIV and my career.   It is part of the National Portrait Project to film the \nhistories of important Americans who have made major contributions.\nMar. 28, 2012 – Senate Appropriations Subcommittee Hearing for NIH.   Francis \nCollins, me, Varmus, Griffin, Insel, Hodes.   Too bad that these hearing are only a total of \n2 hours when we used to have 2 hours for NIAID alone.   I got questions on the H5N1 \nissue.\nMar. 29-30, 2012 – Intense meeting for 1 ½ days of the NSABB to re-visit the decision \nregarding publication of the 2 manuscripts – Fouchier (Science) and Kawaoka (Nature).   \nIt was clear that the driving forces to still block full publication were Mike Osterholm \nand David Relman.   Surprisingly, Arturo Casadevall was also adamant.   I spent the \nentire 2 days in the room and gave rationale argument why the manuscripts should be \npublished without my being too aggressive.   At the end of the meeting it was voted 18 – \n0 to publish the Kawaoka manuscript and 12 – 6 to publish the Fouchier manuscript.   \nThus, the NSABB reversed themselves.   Several factors went into this.  First was \n(although they were reluctant to admit it) was the fact that although the Fouchier \nmanuscript was not clearly written and Ron himself had given the impression that these \nwere really dangerous results, the fact is the NSABB completely misinterpreted the \ntransmission experiments (see above regarding Geneva meeting of Feb. 16-17).   They \nhad thought that the animals that had been infected by aerosol had actually died when \nthey did not.   They only died when 1 million IDs were inserted directly into the trachea \nof the ferrets.   In addition, some epidemiology data were presented that showed that in \nthe wild in Chickens and even in some infections in people (in Egypt), the virus was \nassimilating some of the mutations described and engineered by Fouchier and Kawaoka.\n     An interesting note:  in typical bullshit fashion that I have seen before, Mike Imperiale \nand Lynn Enquist (NSABB members told May Patterson that they wanted me to declare \nright before the 2nd day that since I was a funder of the research that I had a conflict of \ninterest in the discussions even though I had every right to be there since I am an ex \nofficio member of the Board.   They actually felt that I might not give grants to people \nwho were funded by NIAID and who voted to not publish the \nmanuscripts……..absolutely amazing bullshit!   In any event, I merely said at the \nbeginning of the second day that as everyone knows I am the funder of the research, but \nthat I respect greatly the members of the board and their opinions and this was “nothing \npersonal, but strictly business”.    You could tell that the good people on the Board had no \nidea why I was saying this, but it apparently satisfied the “cowards” on the Board.   If \nthey are not strong enough to stand up for what they feel, they should not be on a USG \nAdvisory Board.\n    It will be interesting to see what the press such as Laurie Garrett who was blogging \nlike crazy regarding how “courageous” the board was in standing up to the self-interest of \nthe influenza research community when, in fact< she had no idea what the data showed – \nReleased by Chairman Rand Paul\n280typical Laurie Garrett.   Also, I wonder what Phil Boffey is thinking.   He was skeptical \nof me on our phone conversations when I said that he went too far with his alarmist \nEditorial in the NY Times on “Engineered Doomsday”.   He sort of rebuked me saying \nthat the NSABB was a Board of “Top Scientists” and how could I be so at odds with \nthem.   I could not tell him at the time that they had completely mis-read the manuscript.   \nInteresting and unprecedented situation.\n    Also, on the first day of the meeting (March 29), the USG (mainly NSS) came out with \nthe official DURC Policy that guides how we should approach DURC.  \nApril 5, 2012 – Appeared on Channel 8 “Capitol Insider” to discuss the NSABB \nsituation.\nApril 11, 2012 – Amazing shit.   Mike Imperiale (mostly likely him) of the NSABB \ncalled a New Editor from Nature (Brendan Maher) and told him that he felt nervous \nabout voting against publication of the manuscripts since he was afraid that I would not \nfund his grants if he did.   I cannot believe the pettiness and cowardice of some people in \nScience.\nApril 12, 2012 – I called Paul Berg is Stanford today to get his perspective since he was \nso involved in a leadership role in the Asilomar situation in the 1970s.  We had a great \nconversation as we discussed the similarities and differences between then and now.   I \npointed out and he agreed that there is still today “scientific hubris” on the part of some \npeople.   Ron Fouchier showed that early on.   Hopefully now he is “cured”.   However, \nPaul emphasized (as I feel) that the issue with bioterrorists is really a non-issue.   He is \nconcerned about sloppy science and public trust.   He said that in the 1970s there was \nlittle concern about “germ warfare”.   I told him that that is the biggest difference from \ntodfay when biodefense and biosecurity is a cottage interested with people (Ingesbly et \nal) and Agencies (DHS) who think about and work on this full time.   In addition, there \nare the biodefense “Beltway Bandits”.   This “Biosecurity intimidation” matches the \n“Scientific Hubris”.\nMore amazing shit.   Mike Osterholm wrote a letter to Amy Patterson with a cc to the \nentire NSABB membership excluding the ex officio members saying that he feels that the \nNSABB meeting was “rigged’ by us to come up with the outcome that happened.   I truly \nbelieve that he is traying to cover his ass that the NSABB completely missed the point of \nthe transmissibility.   This is similar to the Nature issue from yesterday.   In addition, he \ndisingenuously mentioned to Amy in the e-mail that he does not want this to be a public \nstatement and does not want it to leak even though he copied about 50 people.   Give me \na break!!!!   See letter below.\nNSABB letter final \n41212.pdf\nReleased by Chairman Rand Paul\n281April, 13, 2012 – It has leaked 12 hours after it was sent.   There is no way that Mike did \nnot know it would leak since he sent it to so many people.   It has appeared on the Nature \nwebsite and in and “Science Insider” article by Jon Cohen.   It is clear to me that Mike \nOsterholm is bipolar.   If you look at the letter, it is crazy.   He keeps referring to \n“anonymous” influenza researchers who are not involved in transmissibility research who \nsay that the research should not have been done.   In the Science Insider piece, Susan \nEhrlich, another NSABB member says that she agrees with Mike.   She is a complete \ngoof-ball, having spoken with her at the NSABB meeting.    Mike goes on in the letter to \nsay that the NIH did not invite any experts on surveillance or non-transmission influenza \nexperts, even though he requested this.   We checked all of the files and he never made \nany such requests.   He asked for a security briefing that said that there was no credible \nterror threat with H5N1.   This is not what he wanted to hear and so he said that the \nbriefing was useless.   BTW, it was given by the CIA and the NIA.   He also states that \naccording to discussions at the March 29-30 NSABB meeting, Ron Fouchier already has \nthe necessary mutations to create a ferret-transmissible virus that do not require passage.   \nSince Mike absolutely knew that this letter would leak, he has egregiously violated the \nconfidentiality agreement of the NSABB.   This together with the paranoid statement of \nMike Imperiale that he was uncomfortable because he thought that the NIAID would not \nfund his grant if he voted to not publish makes me certain that the NSABB as it is \npresently constituted is fatally flawed.   As you can imagine, the press and bloggers are \nhaving a field day with this.   I am astounded that Helen Branswell (Canadian Press) was \nmore interested in why she was not given the leaked document than she was in the fact \nthat the very leaking of the document reflects the craziness of some people on the \nNSABB.\n     This whole process has circumvented our plan to coordinate with the Dutch our \nrelease of the NSABB recommendations since Mike in effect has made public the \n“minority vote” before the actual majority vote to publish. Remember, the committee \nvoted 18-0 to publish the Kawaoka manuscript and 12-6 to publish the Fouchier \nmanuscript.\nApril 14, 2012 – Went over John and Elaine Gallin’s to first have John and I fish in the \nPotomac and then have dinner.   Unfortunately, John backed out of his garage going very \nfast without looking in his rear view mirror and smashed the rear-end of my car.   \nDamages = >$5000.00.  More later.\nApril 18, 2012 – Went to Palo Alto to give the Thomas C. Merigan Lecture at Stanford.   \nGreat day.   Lectured on “Ending the AIDS Pandemic” and had several long Qs and As \nsessions with students, fellows and faculty.   I thoroughly enjoyed it.   Got me out of the \ncraziness of the Washington scene with H5N1 (see below).   Of note, Stan Falkow wrote \nme a terrific note of how amazing I was with the fellows and students.  It was important \ncoming from him since he had been one of the people who were against me 10 years ago \nwhen we began the $1.5 billion biodefense program.   He wrote me an e-mail after the \nMerigan Lecture and said that he knew that I loved my job as NIAID Director, but I am \ntruly a great “professor” and teacher in the classic sense. Several students and faculty told \nme it was the best lecture that they had ever heard there and the best interaction with \nstudents/faculty.   Also, had dinner with Ali the night before at “Cuccina Italiana” in Palo \nReleased by Chairman Rand Paul\n282Alto.   It was great seeing her.   She is amazing – getting great grades in Computer \nScience and rowing stroke on the II Varsity 8 boat.   She is a walk on to the Stanford \nnationally ranked Division I  crew team and last year started on the Varsity 4 and now \nshe is stroke on the II Varsity 8.   Last year and this year she was given a $24,000 athletic \nscholarship.\nApril 13-23, 2013 -   For the past several weeks there has been intense activity regarding \nthe situation with H5N1.   General press not really involved, but Helen Branswell \n(Canadian Press) and Laurie Garrett as well as some bloggers are stoking the flames and \ncoming up with mischief.   USG (NIH/HHS/Amy Patterson) have put together a letter \npoint-by-point countering the crazy accusations in Mike Osterholm’s letter.   Big \ndiscussion at HHS/NSS about whether to have Sec. Sebelius officially accept the NSABB \nrecommendations about publishing the 2 papers.   Out of respect for the Dutch, State \nDepartment wants to wait until the April 23-24 meeting of the Dutch for the \nannouncement.  Real circus → White House (Heidi Avery) want us to release the \nacceptance now; Dutch are now saying that they may not allow Fouchier to resubmit the \nrevised manuscript to Science without an export control license; Fouchier says that this is \nbasic research that is not controlled by export control and so threatens to release it to \nScience anyway.   He can theoretically face a fine and 6 years in jail.   HHS releases \nSecretary Sebelius’s acceptance on Friday afternoon, April 20; however, in order to half-\nway not offend the Dutch, they have Francis Collins announce on the NIH Website that \nthe Secretary has accepted the recommendations of the NSABB to publish without her \nactually saying it.   Meanwhile, the bloggers (Helen Branswell and others) are accusing \nthe USG of releasing it on a slow news time (Friday afternoon).  I know that this is \nclearly not the case since they have been trying to get it out for days, but the bureaucracy \nhas held it up.   I have a Senate Hearing coming up on April 26 where much of this will \nget hashed out.  \n       I am getting extremely stressed by all of this since the really bad outcome would be \nif biomedical research on dual use issues will be severely impeded by somewhat \nhysterical responses to things that really are non-issues.   Most of the people (scientists or \nnot) really do not understand the issues of ferret experiments and their limitations and the \nextremely unlikely possibility of a bioterror attack with flu compared to the importance \nof doing and communicating science to prepare against the natural emergence of \npandemic influenza.\n      \n         Just to reiterate, there have been so many aspects of this “perfect storm” \nsurrounding the manuscripts: 1) Ron Fouchier’s original over-selling the scary nature of \nthis “I have here one of the most dangerous viruses in the world” likely and innocently \ntrying to push his research and the paper. 2) The NSABB amazingly mis-reading the \npapers to believe that the aerosol-transmitted virus actually killed the animals upon \naerosol transmission instead of only after intra-tracheal insertion of 1 million IDs. 3) The \ndemagoguery of Mike Osterholm and his probable bi-polar hysteria leading the \nuninformed NSABB members.   4) The relative lack of influenza expertise of the \nNSABB members. 5) The scientific “hubris” of the influenza community, i.e. Peter \nPalese who believes (correctly) and says (unfortunately) that the non-influenza people are \nclueless. 6) The relative weakness of Paul Keim (good guy) as a Chairperson. 7) The \nReleased by Chairman Rand Paul\n283opportunistic news people (Branswell – Canadian Press and Phil Boffey – NY Times). 8) \nThe occasional incompetency of Amy Patterson in dealing with the NSABB even though \neveryone in the USG thinks that she is doing a great job. 9) The “bioterror-industrial \ncomplex”   who sees bioterrorists everywhere and whose jobs depend on the fear of \nbioterror (Thomas Ingelsby – think tank; Tara O’Toole – DHS; multiple Beltway bandit \ncompanies, etc.).\nApr. 25, 2012 – Went down to Hart Building to brief Sens. Harken and Roger Wicker in \npreparation for their trip to Africa (South Africa and Namibia) where they will visit CDC \nand NIH-funded sites.   Also briefing them were Julia Martin of PEPFAR (Eric’s Deputy) \nand Debbie Birx from CDC.   This is mostly a boondoggle for the Senators.\nApr. 26, 2012 – The heat is still on and the focus high (in some circles) regarding the \nH5N1 issue.   I testified before the Senate Homeland Security and Government Affairs \nCommittee today.   Chair – Joe Lieberman and ranking minority – Susan Collins (R-\nMaine).   Other witnesses were Dan Gerstein (DHS), Paul Keim (NSABB) and Tom \nInglesby (Univ. of Pittsburgh).   Lieberman started the Hearing by stating that I was his \n“hero”.   Paul Keim more and more is making me believe that he is a poor Chair of \nNSABB and a weak person in that he continuously says that Mike Osterholm is off base \nwith his letter to Amy and then he defends him strongly at the Hearing.   He wants it both \nways.\nThe media (mostly bloggers like Laurie Garrett and others such as Helen Branswell) keep \nthinking that the USG is acting in some sort of conspiratorial manner regarding letting \nout information such as Amy’s response to Mike Letter.   In this regard, I mentioned to \nLieberman when he asked about the accusations in Osterholm’s letter to Amy that I \ncompletely disagreed with most of what was in Mike’s letter and that Amy had written a \ncomprehensive refutation of Mike’s points and that I would make this letter available to \nthe Committee if they wished.   The press picked this up to mean that we were releasing \nthe letter to the public.   That was not the case, but eventually ( a couple of days later) \nwhen HHS Legisl. Affairs sent the letter to Lieberman, then HHS released the letter.\nMade nice remarks at Memorial for Frank Neva at the Audubon Society in Bethesda.\nApr. 29, 2012 – Went to Annual Brunch given by John McLaughlin on the roof of the \nHay-Adams Hotel in celebration of the White House Correspondence Ball the night \nbefore.   It has been several years since I was invited to the Ball.   Usual DC celebrities at \nthe Brunch.\nMay 1, 2012 – Partook in NAS Workshop Panel on 20 F Street on H5N1.   This was part \nof the NAS Annual Meeting.  Controversy continues.   At the meeting, Richard Roberts \n(1993 Nobel Laureate and known Gadfly) came to the microphone and said that many \nvirologists who disagree with Francis Collins and me about doing DURC are afraid to \nspeak up because they fear retribution and will not get their grants funded – Holy Shit!!  \nThe epitomy of paranoia.   This is not the first time that I have heard this.   I blew him out \nof the water (nicely) by saying that if anyone has even a slight awareness of the NIH peer \nReleased by Chairman Rand Paul\n284review system, they would know that this was impossible even if we wanted to do this, \nwhich we clearly do not.\nMay 2, 2012 – Went to and spoke at a “Garden Party” at the home of Ellen and Gerry \nSigal in honor of Mark Harrington and the 20th Anniversary of the Treatment Action \ngroup (TAG).   I honored him and reminisced about the activist years in the late 1980s \nand early 1990s.   Also speaking was Peggy Hamburg.\nMay 3, 2012 – Spoke at the Lasker Board Dinner held at the Howard Hughes Medical \nInstitute Headquarters on Jones Bridge Road.   Spoke about H5N1 issue.\nMay 10, 2012 – Met with old friend Ron Dellums (Former Chair of House Armed \nServices Committee and former Mayor of Oakland).   He has retired from politics and \nwanted to chat with me about opportunities in consulting in global Health.   He had come \non the original trip with Tommy Thompson in 2002 to Africa.   I referred him to Stewart \nSimonson.\n     Reviewed data with Ian Lipkin over the phone of study that he coordinated.   Data \nshowed that the prior studies from Judy Vitkovits and Harvey Alter/Shy Lo indicating a \nconnection with XMRV/MLV and Chronic Fatigue Syndrome were in fact artifact and \nthere is no connection.\n     Appeared on The NewsHour interviewed by Ray Suarez on the positive \nrecommendation of the FDA Advisory Committee to approve Truvada as PrEP.\nMay 11, 2012 – Flew to Miami for U of M Commencement and had dinner with \nawardees and commencement speakers for the entire University.   Donna Shalala \n(President of U of M) was my sponsor.   Dinner at amazingly palatial home of Leonard \nand Jayne Abess.   Formerly home of Sylvester Stallone.   Susan Rice (US Ambassador \nto the UN) was also there.   She had given Commencement Address to the Law School \nthat day.  Sat next to Stuart Miller who had donated $200 million to the U of M Medical \nSchool, which is now named after him.   Stayed at Biltmore Hotel in Coral Cables and \nwent on nice long, warm run\nMay 12, 2012 – Received honorary Doctor of Science at University of Miami and \ndelivered Commencement Address.   Beautiful and enjoyable day.\nMay 14-16, 2012 – Megan’s graduation.   Arrived evening of May 14 and had dinner \nwith Meg, Jen, Chris, and Amanda at Gazala restaurant (Israeli) on Columbus Avenue \nand 78th Street.  Great time.   Day of May 15 – Megan’s College of Arts and Sciences \nCommencement.   Megan graduates Summa Cum Laude!!!!   Amazing kid.   Dinner that \nnight at a Vegan restaurant.   Stayed at Denise and Jack apartment.   May 16 – full \nUniversity graduation.   Columbia president Bollinger gave address.   Of note, President \nObama gave commencement address at Barnard 2 days before, much to the dismay of the \nColumbia Community.\nReleased by Chairman Rand Paul\n285May 16, 2012 – Barry Bloom sends me pre-print of Commentary that will appear in \nScience at the same time as my and Francis Collins’ article.   Barry’s co-author is the ever \ncrazy Lone Simonson.   They are proposing that the USG create an Interagency \nCommittee with final authoritative power to decide what DURC experiments can and \ncannot be done.  There really are well meaning people who just do not understand this \nissue and it worries me.   There is a real danger of inadvertently hindering science in \nInfectious Diseases by censoring it.\nMay 17, 2012 – Appeared on “Talk of the Nation” on NPR on the recommendation of \nthe FDA Advisory Panel to Approve Truvada as PrEP and the OraQuick test for HIV.\nMay 18, 2012 – Spoke at the NAS/IOM President’s Circle Annual Meeting on the H5N1 \nissue.   This is still hot among certain circles.   Meeting took place at the House of \nSweden at 2900 K Street, N.W. in Georgetown.\nGave talk to IDSA Fellow at Bethesda Hyatt on “A Career at NIH”.\nMay 21, 2012  - Met with Sanaria people including Steve Hoffman today about an update \non the work he is doing with his vaccine for malaria.\nMay 23, 2012  -  Had a great and moving evening at the Annual Sons of Italy National \nEducation Leadership Awards Gala at the National Building Museum.   I presented a \nscholarship to a student who will be going to Harvard next year.   Various awards went to \ndifferent people.   Hillary Clinton got if for a Lifetime of Public Service and responded \nby video.   Most moving moment of the night was when Tony Odierno (son of Gen. Ray \nOdierno), who lost his left arm in Iraq due to an RPG presented an award to Gen. Peter \nPace, who is a Brooklyn boy and with whom I received the Presidential of Freedom and \nso I know him.  Pete told the story of his first soldier whom he commanded who was \nkilled in action in Viet Nam when Pete was a 22 year old 2nd Lieutenant.  His name was \nLance Corporal Guido Farinaro.   Pete was incredibly moving and mentioned how \nthroughout his entire military career he carried a picture of LCP Farinaro with him.   \nAlso, a little drama at the dinner.   I was called to see and take care of the famous tenor \nMichael Amante who sings often at the Galas.   Mike had recently (3 months) lost his \nwife to a cerebral hemorrhage.   Mike is 49 years old.   He is left caring for 3 children – \n9, 7, and 5 years old.   He is overwhelmingly stressed, did not sleep the night before and \nwas clearly dehydrated.  He is on several meds for hypercholesterolemia and high BP.   \nHe felt woozy and “spaced out”.   I tanked him up with fluids and he responded quickly \nand well.   He resting heart rate went from 88 to 70.   He then sang beautifully and at the \nend of the medley he pointed his finger at me (seated at a Table in the front).  \nMay 24, 25, 26, 2012 – Drove up to Princeton with Chris to watch Ali compete in the \nWomen’s NCAA National Championships.   Ali had recently been promoted from the 2V \nboat to rowing Stroke for the 1V Eight boat!!!!    Stanford had a mishap in the first heat \nwhen their rudder broke.   Ali and her team were not to be put aback.   They had the \nopportunity to row again in the reportage race and came out 1st among 7 boats and so \nentered the semi-finals.   Their time of 6 min. 47 seconds was their best time yet this \nReleased by Chairman Rand Paul\n286year.   Unfortunately, they missed out in the semis even though they broke their own time \nrecord by rowing a 6 min. 22 second race.  They were in a heat with the top 3 teams in \nthe country – Virginia, Cal, and USC.   She rows tomorrow in the “petite final”.\nMay 30-31, 2012 – Went to NYC  to give Commencement Address at Brooklyn College \nand receive an honorary degree.   Bright sunny day.   I lot of déjà vu driving from \nManhattan to Brooklyn through Atlantic Avenue and then Bedford Avenue.   God bless \nBrooklyn College, they tried (for the first time in their history) have all 1600 graduates \nfrom all of their schools come on the stage to shake the hand of the President – Karen \nGould.   My co-recipient of an honorary doctorate was the jazz legend Cecil Taylor, a \nfeeble old man, but very gentle.   Sen. Chick Schumer came and said a few words to the \ngraduates.  Brooklyn Borough President gave a hilarious speech about Brooklyn.   Had \ndinner with Jenny the night before.   Went to Kefi restaurant on 85th and Columbus \nAvenue.   I never really appreciated the West Side of Manhattan when I lived for so many \nyears on the East Side.   Jenny is an amazing young woman who is trying to figure out \nwho she is and what she wants in life.   She is currently a graduate student at Teachers \nCollege of Columbia University getting a Masters in Developmental Psychology.\nOn May 30 right before I left for NYC, CNN’s Wolf Blitzer’s producer called and said \nthat Wolf wanted me on CNN Situation Room to discuss a recent paper by Peter Hotez \n(formerly of GW and now at Baylor) who wrote a paper in PLoS  journal saying that \nChagas disease was the new HIV/AIDS.   I like Peter, but I had to contradict this \npotentially misleading statement.   I could not appear live and so CNN did a telephone \ninterview and showed me testifying at a Congressional Hearing at the same time that they \nplayed my voiced interview.   Nice trick.\nJune 1, 2012 - NIAID had our annual spring policy retreat at the Hilton Hotel in \nRockville which was a meeting between our group and the Bill and Melinda Gates \nFoundation (BMGF) in order to determine possibilities of strengthening current \ncollaborations and forging new collaborations.  Present at the meeting were the senior \nleadership of the Institute together with Trevor Mundel (President of the Global Health \nProgram for the BMGF), Nina Russell, Dan Hartmann, Chris Wilson and Jan…..   The \ndiscussions went very well and I feel that our collaborations will strengthen.   I was \nimpressed by the sincerity of Trevor.\nIn the early evening, paid tribute to Ed Tramont at a symposium in his honor at the \nUSUHS across the street from NIH.    Tornadoes and thunderstorms hit the DC area \nduring the late afternoon and early evening.\nJune 9, 2012 – Went with Chris to Annual Garden Party at the home of Jamie Gorelick \nand Rich Waldron.   Usual good time with the usual Washington elite there, i.e. Ruth \nMarcus, Chris Matthews, etc.  Always good to see Jamie and Rich.  Wonder whether \nJamie will ever get back into USG.\nJune 12, 2012 – Had dinner over my house with the 3 week-day bachelors (i.e. their \nwives live and work in different cities): Harold Varmus (Connie in NYC); Gary Nabel \nReleased by Chairman Rand Paul\n287(Betsy in Boston); and Eric Goosby (Nancy in San Francisco).   I served a Ziti pasta with \ngrilled shrimp and tomato sauce.   Had great time – good friends all.\nJune 14, 2012 – At the invitation of Larry Kramer, I attended the “official” opening of \n“The Normal Heart” at the Arena Stage Theater.   Had dinner with Larry and NYC and \nDC theater notables in the absolutely beautiful new atrium in the new Arena Stage \n(totally different from when Chris and I had season tickets decades ago).   The play was \namazing – truly moving.   Had reception afterwards and met the cast and the Director \n(George C. Wolfe) who, according to Larry, is the top Director on Broadway today.\nJune 15, 2012 – Went to a cocktail reception honoring Larry Kramer at the home of Don \nand Ann Brown at 3005 Audubon Terrace, N.W.; Washington, DC).   Ann is a childhood \nand high school friend of Larry from when he lived in DC.   Larry went to Woodrow \nWilson High School.   Amazingly elegant home.   Brought Chris as well as Megan and \nAli, who was in DC for 3 days between Stanford (just finished her exams) and Seattle \n(summer job with Microsoft).   Also met Larry’s partner – David Webster – really nice \nman.  Good that Megan and Ali and Chris got to see Larry.   I explained to Meg and Ali \nwhat an iconic and controversial figure Larry was and is.\nAlso, for past months I have been preparing for and putting together my Plenary Talk for \nthe IAS on July 23.   Need to get it done since I go to the big Harrison’s meeting in \nMartha’s Vineyard for 9 days right before the IAS meeting and need to get my talk \nfinished and out of the way before I go to the Vineyard.\nJune 22, 2012 - In Boston today to participate in the 200th Anniversary Celebration of the \nNew England Journal of Medicine.   I had been asked to write one of about 12 articles \nover the year 2012 (NEJM started in 1812) summarizing the advances in a given field.   \nObviously, my assignment was Infectious Diseases.   My article came out a few months \nago – co-author was David Morens.   The symposium today was reflection on 30+ years \nof HIV.   I gave the opening overview lecture and then there were comments from David \nHo, Bob Massie, Beatrice Hahn, and Paul Farmer.   Moderator was Marty Hirsch and \nPanel discussion followed.   Held at Joseph Martin Auditorium across the street from \nHarvard medical School on 77 Louis Pasteur Avenue.   Hot, hot June day over >95 \ndegrees.   Nice conference.   Audience filled with medical students from all over the \nworld who won essay-writing competition.\nJune 28, 2012 – Supreme Court with Chief Justice Roberts pulling an amazing maneuver \nactually confirms the constitutionality of the Affordable Care Act, but calls the Individual \nMandate a “tax”.  Everyone thought that he would be the deciding vote against, but he \nwas the deciding vote for the Law.  Nonetheless, by calling the mandate a “tax” he makes \nObama look bad since Obama has always insisted that it was not a tax.\nJune 29, 2012  Had a historic thunderstorm with winds up to 80 to 90 miles an hour on \nthe night of June 29. Major power outages were experienced throughout the area. No \nmajor damage to my house but again we have several days and up to a week of power \noutages.  Incredible how PEPCO can let outages go for 1 week.\nReleased by Chairman Rand Paul\n288July 3, 2012 – Saw “Normal Heart” again at Arena Stage.  Wonderful play.   Many \npeople in audience recognized me and thanked me for my work.\nJuly 9-18, 2012 – Went to Martha’s Vineyard (MV) for the “Big” meeting of the \neditorial Board of HPIM-19 with the McGraw-Hill people.   Great meeting, great \nweather.   Chris and Megan came for 2 days on July 14-15.  Went sailing with Dennis \nKasper on his boat on July 14.  Great time. Democratic National Committee also has \nmeeting on island.   Met and chatted a few times with Sen. Sherrod Brown (D-OH).   \nGood guy.   I know him for years.\n     Left 1 day early.  July 18, 2012.  Good that I did since at the airport at MV I got a call \nfrom CNN that Wolf Blitzer wanted me on the show tonight to discuss the FDA approval \nof Trivia as Prep   I accepted and had a scare since the plane took off late from MV and \nthen circled DCA for 25 minutes before landing.   I had intended to go home and change \nfirst from my casual clothes to TV clothes.   However, there was no time and CNN send \nlimo to airport to pick me up and go directly to CNN studio for the live shot.   Had just a \nfew minutes to change into shirt and tie.   All went well. Also did WTOP News, local \nChannel 9 TV, and ABC radio.   Looking forward to IAS meeting in DC this coming \nweek.\nJuly 20 – 28, 2012 – Most amazing week leading up to and during the XIX International \nAIDS Society (IAS) Conference. 25,000 people attended (largest AIDS meeting in \nhistory). I am including as an attachment my schedule for this week and I will comment \nbelow on some salient issues.\nASF DC 2012 FINAL \nSchedule - July 27.do\nTruly amazing.   The theme of the meeting was “Turning the Tide Together”.   I \nDelivered the Opening Scientific Plenary Lecture on Monday, July 23, the morning after \nthe Opening ceremony (see below).  My talk was entitled: “Ending the HIV/AIDS \nPandemic: From Scientific Advances to Public Health Implementation”.   The DC \nConvention Center main lecture hall was packed with approximately 10,000 people.   It \nwas one of the best Plenary Lectures that I have ever given and I have spoken as a  main \nspeaker at every one of the 19 IAS meetings.   The number of kudos I got regarding my \ntalk was incredible.   The amount of press coverage of the event was astounding.  Jon \nCohen did a feature on me in Science that came out right before the meeting started and \neveryone was talking about it.   It was a story he wrote after spending an entire day with \nme at NIH.  In addition, there were several articles that I wrote (usually with Greg \nFolkers) that came out right before or during the meeting such as a piece in Health \nAffairs, JAMA, JAIDS, etc.   In a separate piece in Health Affairs, John Donnelly wrote a \nhistory of PEPFAR and described my involvement.   He also interviewed Mark Dybul \nand Mark made it seem that he played a greater role at the White House level than he \nreally did although Mark’s role behind the scene was incredibly important during the \ncreation of the blueprint for PEPFAR.   But, who cares?   It was a good article although \nGary Edson got pissed off at it when he saw it since he knows exactly how PEPFAR \nReleased by Chairman Rand Paul\n289happened. Gary sent me an e-mail saying there were only 2 important people for \nPEPFAR – me and pres. Bush.    There was major Press and very interesting and \nentertaining social events.\n A few comments on my Press appearances:  CNN with Wolf Blitzer (The Situation \nRoom) on July 16 (days before the meeting started) associated with the FDA approval of \nTruvada for PrEP; Diane Rehm Show on July 24 (day after my Plenary); Op-ed by me in \nthe Washington Post on the last day of the meeting (Friday July 27); MSNBC with \nAndrea Mitchell on July 27; Bloomberg News on July 24.  Also, about 30 appearances on \nblog videos.  Also, multiple radio interviews (CBS, ABC, NPR, etc.)  Mentioned in NY \nTimes Editorial the day after the meeting. On Tuesday, July 24, spoke at panel at \nWashington Post for 1 hour.\nWith regard to the social events, it was amazing.   At a ONE –sponsored event at the \nEisenhower Theater at the Kennedy Center on July 21 (night before the opening of the \nmeeting), I was asked to give a few remarks from the stage concerning an AIDS-Free \ngeneration.   I paired up with Kay Warren, wife of Rick Warren the pastor of Saddleback \nChurch.  Others who presented to the audience and whom I interacted with and talked \nbackstage were:   Alysia Keyes, Annie Lennox, Herbie Hancock, Nancy Pelosi, \nCongresswoman Barbara Lee, among many others.  Annie Lennox gave a smashing \nrendition of her classic song “Sweet Dreams”.  Right before that, I was invited to an \nAwards Dinner hosted by AMFAR for Bill Gates (I also had a 1-on-1 meeting with Bill \non Monday, July 23).  At the dinner, I met and chatted with Anderson Cooper, Sharon \nStone among others.   During the Opening Plenary Session, I led it off, followed by Phill \nWilson of Black AIDS Institute, followed by Hillary Clinton.   \n      Big deal social event (July 24) that I really enjoyed was reception given by Open \nSociety Foundation and Syringe Access Fund at the Open Society Foundation D.C. \nHeadquarters in honor of Elton John.   I had never met Sir Elton, but he specifically \nrequested that I introduce him at the reception together with his partner David Furnish \nwho is Chairman of the Elton John AIDS Foundation.   Got great pictures of Elton and \nme and he was very moved by my introduction.   I had just finished reading his new book \n:Love is the Cure” focused on how his relationship with Ryan Whyte turned Elton’s life \naround for good as he was at the time an egregious cocaine addict and alcoholic and \nbulimic.   He has been clean for 22 years.   Really nice guy who clearly understands what \nI have done.\n    Signed Letter of Intent with the French (Jean Francois Delfraissy and Yves Levy) for \ncollaboration on a “cure” on Monday, July 23.   Parenthetically, the cure people at the \nmeeting were really egregiously promoting their results with “flushing out the virus” \n(David Margolis from UNC and Steve Deeks from UCSF).   Margolis used to be at \nNIAID and he really in barely mediocre and is using the enthusiasm for a cure as a means \nto get new money. Their over-exaggeration is really pissing me off.\n     Thursday, July 26 – called to White House by Heidi Avery for a different issue.   I am \ngoing to NYC for the Centers of Excellence for Influenza Research and Surveillance \n(CEIRS) meeting of influenza scientists to discuss the lifting or not of the moratorium on \ngain-of-function work on transmissibility/pathogenesis of H5N1 (see above).   White \nHouse, including the POTUS is concerned about a misleading story by Nell Greenfield \nReleased by Chairman Rand Paul\n290Boyce of NPR that said that I was going to expedite the lifting of the moratorium at the \nNYC meeting and the White House is worried that people will react to my “rushing” \nthings.   I told Heidi that this was nonsense and that in the NPR interview I meant that I \nwanted to expedite a conversation among the flu scientists to try to make their case, but \nthey are not the only voice.   We need input from the general public, other non-flu \nscientists, biosecurity and biosafety people and the global community before we again \nembark on experiments that some in the rest of the world may perceive could endanger \nthem without input from them.   Bottom line is that I told Heidi that I was going to \nrecommend to the CEIRS scientists NOT to lift the moratorium.   I suggested she tell the \nWH staff and the POTUS not to worry and that I will not sanction lifting the moratorium,\nAlso on July 26, Pres. Obama held a reception at the White House East Room for \nHIV/AIDS “players” and stakeholders.   I went straight from Heidi’s office to the East \nRoom.    Obama gave his usual pep talk.  Of note, he thanked the usual people (Pelosi, \netc.) and also Eric Goosby (clearly deserved it) and Grant Kolfax the new WH AIDS \ncoordinator who has been on the job for a couple of months.   The POTUS speechwriter \nclearly is out of touch since he did not call me out is his speech to the amazement of \nmany in the room.   However, as Obama looked around the room as he was talking from \nnotes, he saw me and clearly recognized me, but obviously could not remember my name \nand so stuttered a bit apart from his notes and thanked “people from NIH for their good \nwork”.   I do not blame him for forgetting my name but his staff clearly is out of it.   \nSpeaking of names, Bush never would have forgotten.   Just shows Obama’s weak \nconnection to the AIDS issue.   But, to his credit, as he walked the “line” shaking hands \nafterward, he shook my hand and pointed to me saying “nice job”.   Whatever….\nAll in all a truly amazing week.   Weather was sunny and hot all week.   No rain; typical \nsunny, hot DC week.\nJuly 31, 2012 – Controversy continues regarding CEIRS investigators and the \n“moratorium” on H5N1 research (see immediately above meeting with Heidi Avery).   I \nwent to NYC to the Marquis Marriott Hotel on 46th and Broadway to address the \ninvestigators of the CEIRS (Centers of Excellence on Influenza research and \nSurveillance).   We opened it to the Press and NPR (Nell Greenfield Boyce) and Science \nand Nature were there.   I insisted that my presentation (25 minutes) be fully recorded as \nwith the Qs and As so that there would be no misquotes.  I made a firm argument for \ncontinuing the moratorium.   The usual people opposed it such at Ron Fouchier, Danny \nPerez, Peter Palese; however they respected my opinion.   They still do not “get it’ and \nthink with all the public furor that they can just go on and do these DURC experiment \nwithout full public by-in and comment.   See my written remarks file for July 31, 2012.   \nAlso, I got great kudos from many investigators (see Arturo Casadevall’s e-mail below).   \nAlso, great stories in NPR radio the next AM (Aug. 1) and in various blogs and Science, \nNature, etc.\nFrom:  Arturo Casadevall [mailto:arturo.casadevall@einstein.yu.edu] \nSent: Tuesday, July 31, 2012 1:29 PM\nReleased by Chairman Rand Paul\n291To: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Awesome speech at flu meeting\nDear Tony,\nI feel bad adding one more line to your inbox but I must tell you were terrific today – \nclear, powerful, articulate, logical.  My ‘take’ is that it was a very successful \npresentation.  You are a great scientist and public servant.  It is an honor to know you.\nArturo\nArturo Casadevall MD, PhD\nProfessor and Chair\nLeo and Julia Forchheimer Chair\nDepartment of Microbiology & Immunology\nAlbert Einstein College of Medicine\n1300 Morris Park Ave\nBronx, New York 10461\nAugust 31, 2012 -   Slow month of August in D.C. Summer.   On Aug. 8, 2012 did a \n“Science in the Cinema” performance at the AFI Theater in Silver Spring with Ian Lipkin \nfor the movie “Contagion”.   Fun being with Ian.   Always a character.\nProblem over past 2 weeks with the PR associated with Klebsiella pneumonia – \ncarbapenam-resistant organism (KPC) in the NIH Clinical Center.   The Clinical Center  \n(CC) and NHGRI people published a paper in Science Translational Medicine on the \ngenetic analysis by deep sequencing of a KPC the originated from an index case in the \nCC and then infected spread by people or fomites to 17 other people in the CC – 11 \ndeaths – 6 from KPC bacteremia.   The PR people at CC did not handle it well.  They got \nso absorbed in the science of the paper that they did not realize that the community \nreaction would be “Why did not anyone tell us about this outbreak – even though there \nwas no actionable information here since the organism does not bother healthy people \nand the man-on-Wisconsin Avenue is at no risk.\nAug 15 to 25, I had bad URI with fever and malaise that took 2 weeks to resolve.\nOver the past few weeks, I have become enamored/obsessed with the Washington \nNations baseball team.   I feel like I felt when I was 12 years old and knew the batting \naverages of all of the N.Y. Yankees.   The Nats are 7 ½ games in first place and they have \nthe best pitching staff in baseball – Steve Strasburg, Gio Gonzales, Jordan Zimmerman, \nRoss Detwiler, Erwin Rodriguez.   There hitters are amazing.   Bryce Harper (19 years \nold) is pounding the ball and he runs and throws and fields like Mickey Mantle.   Also, \nJason Werth, Adam La Roche, Ryan Zimmerman, Michael Morse, Ian Desmond, Danny \nEspinoza – all very good hitters.\nReleased by Chairman Rand Paul\n292Sept. 7, 2012 -  As part of the kick-off of the “Celebration of Science” weekend here in \nD.C. and at NIH sponsored by Michael Milken, I was on a 2 man panel run by Greg \nSimon, formerly of  Faster Cures”.   The panel (filmed for TV) was on the science and \nreal world of HIV/AIDS.   My co-panelist was Magic Johnson.  It was a fun experience.   \nHe is a wonderful guy with an amazingly infectious smile.  He commented to the \naudience during the panel that he wanted to go on a “road show” with me since I explain \n“stuff” so well.  He said that I “…really get it and can speak to the common man”.  We \nspoke about basketball and baseball. We spoke about our children. His son is at NYU, \nand loves NYC as do Jenny and Megan.   He has another son who works for him in his \nCompany/Foundation.  His daughter is a High School student in L.A.   He is part-owner \nof the L.A. Dodgers and we spoke about how good the Washington Nationals are this \nyear (see above).\nSept 8-12, 2012 – The past few days have been very intense, but exciting. Following the \nCelebration of Science meeting in Washington DC,  I immediately went up to Boston to \ndeliver the opening plenary lecture at the 2012 AIDS vaccine meeting. It was extremely \nwell received.  Following my talk Gov. Deval Patrick got up and welcomed the audience \nto Boston and made the comment that it was an honor to be on the same stage with Dr. \nTony Fauci and the thanked me for my service to the country.\nOver the past few days that has been continued activity concerning the dual use research \nof concern issue particularly regarding highly pathogenic H5N1  influenza virus.   I had a \nconversation with Heidi Avery of the National Security Staff on September 12 during \nwhich she encouraged me to continue to try and find the right balance between safety and \nsecurity as well as the benefits of doing such research. Heidi has always been a very good \nfriend to me and she informs me that she will be leaving the national security staff to go \nback to her major post at the CIA.  We have a major meeting coming up in December, \n2012 to discuss the moratorium on H5N1 research. This should be an important meeting \nto set general principles of the types of research that should or should not be done.   I \nhave really enjoyed working with Heidi over the past few years.\nSept. 12, 2012 -  Conversations with Heidi Avery continued – Heidi called my office \nwhen I was out running on an absolutely beautiful September day.   My office contacted \nme and I came up to office and called Heidi with my running clothes on.   Bottom line is \nthat Heidi re-confirmed her strong feeling that the NSABB or any other advisory body \nshould not be dictating to the USG what we can or cannot do, particularly when it comes \nto national security.   She wanted to emphasize that she does not want NSABB making \nany pronouncements about the general “straw man” principles about what H5N1 \ninfluenza research should or should not be done.   When I explained to her how the \nNSABB (which is scheduled to meet in October) was insistent that they determine the \nprinciples, Heidi was adamant.   She finally said (in good spirits since we are good \nfriends) that no way did she want any pronouncement about the general principles about \nconducting research (particularly from Mike Osterholm – she has his number) from the \nNSABB BEFORE THE NOV. 6 ELECTION.  I told her that I understood.   This will \nreally be dicey since we have to figure out a way out of the October NSABB meeting \nand/or a way to get them off this subject.   Heidi also confided in me that Leon Panetta \nReleased by Chairman Rand Paul\n293really wanted her back at CIA for a “special assignment”   (remember, she was counter-\nterrorism before coming to NSS).   Also, I finally told Heidi that there is definitely a \ndirect leak from IPC (likely Kris Beardsley) to Mike Osterholm.   Heidi said she knew \nthis all along and she knows exactly who it is, although I am not entirely certain.   More \nlater, since we now have to decide whether to cancel the October NSABB meeting which \nwill cause an uproar among some of them or take the chance of their coming up with \nsomething that Heidi does not want to see happen.\nSept. 15, 2012 – Exceptionally pleasant and enjoyable evening.   Bob and Deborah Seder \ninvited Chris and me to join them for the Bruce Springsteen concert at Nationals \nStadium.   He arranged an amazing group of 10 people for the event.   It included Bob \nWoodward and his wife Elsa Walsh, a couple Christen (executive director of the Four \nSeasons Hotel in DC) and his wife Meg (? last name), Bob (very wealthy entrepreneur) \nand wife Alison (? Last name) Bob and Deborah, Chris and me.   We met at Café Milano \nand had a great meal; a van took us to Nat’s Stadium and back.  The concert was truly \namazing.   Springsteen and his E Street band gave the best musical performance that I \nhave ever experienced.   We had seats on the infield right in front of the stage that was set \nup on where the outfield is for baseball games.   However, we did not sit since everyone \nwas standing.   Springsteen played for 3 hours and 45 minutes without stopping for a \nminute.   He went from one song to another.  The crowd absolutely loved it.   It was a \nbeautiful “Indian Summer” evening at around 70 degrees.  Got to know Bob Woodward \nwith prolonged conversations about what I do and what he does.  He feels passionate \nabout what he wrote in his latest book (came out this week) entitled “The Price of \nPolitics”.   He is a good guy and it was fun getting to know him.\nSept. 18, 2012 – Pleasant surprise.   Received an inscribed copy of Bob Woodward’s new \nbook “The Price of Politics” with a note written in the first page – “To Tony Fauci and \nChristine Grady – What a great night it was! – With greatest regards, Bob Woodward”.\nSept. 19, 2012 – Received “The Starlight Award” together with Roy Vagelos from the \nChildren’s Inn at NIH.   I received it for the “Science” and Roy for his extraordinary \ninfluence on building of the Inn in 1990 with Merck money when he was at the time the \nCEO of Merck.   Ceremony held at the Liaison Hotel at 415 New Jersey Avenue, N.W.  \nMany notables from Congress and entertainment at the event.  To name a few:   \nCongressmen Chris van Hollen, John Dingle, Barney Frank, Doris Matsui; Sens. Frank \nLautenberg, Roy Blunt; TV Anchor Gordon Peterson.   MC was Cokie Roberts.  Twenty-\neight year old former AIDS patient Hydeia Broadbent gave speech and I was praised for \nhelping to develop the drugs that saved her life when she came to the Inn and NIH at age \n6 years old with advanced AIDS and now she is healthy and happy – many tears in the \naudience.\nSept. 25, 2012 – Meeting in the Situation Room of the White House (1:30 to 3:00 PM) \ncalled by Heidi Avery.   Discussed the issues around DURC and how we are going to \naddress the voluntary (on the part of the scientists) moratorium on gain-of-function for \ntransmissibility in mammals research on highly pathogenic avian  H5N1 influenza.   We \n(ASF, May Patterson, Francis Collins, Larry Tabak and the HHS crew led by Sally \nReleased by Chairman Rand Paul\n294Howard,  Chief-of-Staff to Sebelius and Bill Corr, Deputy Secretary, HHS)  have been \nworking for several weeks on a meeting-working group-consultation (to take place \nhopefully in December, 2012) to develop principles for making decisions regarding \nfunding  (mostly by HHS) for these types of H5N1 experiments.   These principles could \nthen serve as the basis for guidelines for DURC that go well beyond H5N1.   The \nEuropeans (mostly the Dutch with Ron Fouchier) want to end the moratorium now.   I \nhave written a commentary to appear soon in mBio (online Journal of the ASM) that asks \nfor keeping the moratorium on H5N1 gain-of-function until the abovementioned \nDecember meeting.   The NSABB people, particularly Mike Osterholm, Mike Imperiale, \nand David Relman are continuing their somewhat hysterical comments in and out of the \npress about how dangerous these experiments are and how they should never be \nperformed.   \n     Heidi is adamant that they could be very important to do these experiments for the \nnational security and she does not tolerate any “advisory group” such as NSABB \ndictating to the USG what it can or cannot do in the line of National Security.   I love \nHeidi; she is a tough CIA operative and unfortunately for us will return to the CIA soon.  \nShe confided this to me a week or so ago.   Apparently, Leon Panetta has some important, \nsecret assignment for her.   As always, she e-mails me or calls me after an important \nWhite House meeting to get my take on it.   I am inserting below an e-mail she sent me \n(10:15 PM – Sept. 25, 2012) the evening after the White House meeting:\nTony,\nJust to say thank you for your time today, along with your NIH colleagues.  I am very \nsorry for how tedious parts of the discussion became.  We were not all on the same page \nbefore the meeting.  Hopefully you agree we identified a path forward.  I will not be \naround to see this through, but very much hope success is achieved in terms of HHS \nguidelines enabling researchers to be comfortable moving forward with this important \nwork.  Really is a national security imperative.\nBest regards, Heidi\nSept. 27, 2012 – Attended World Leaders Forum at the Low Library at Columbia \nUniversity.   On a panel with Wafaa El-Sadr, Eric Goosby and Michel Sidibe (Director, \nUNAIDS).   Very enjoyable.   Jenny attended.   Discussed the potential end of AIDS.\nOct. 6 – 10, 2012 – trip to South Africa mainly to participate in the opening of the \nKwazulu-Natal Research Institute for TB and HIV (K-RITH) in Durban.   Flew to \nJohannesburg and gave special lecture on Ending the AIDS Pandemic to the University \nof Witwatersrand.   Then drove to Pretoria to participate in the 10th Anniversary of the \nPHIDISA project with the South Africa National Defense Force (SANDF).   This \nprogram largely championed by Cliff Lane.   Then flew to Durban to Open the K-RITH.  \nAmazing architecture of the new building.   Many luminaries present at the opening – \nRon Daniels (Pres. of JHU), Pres. Of Mass. General, Rob Tjian – President of HHMI \nReleased by Chairman Rand Paul\n295who funded the project.  NIAID funds Bill Safai (PI of KRITH).   Great dinner at the \nOyster Box Hotel.  I gave some after dinner remarks.\nOct. 12, 2012  - Lunch at the Italian Ambassador’s (Amb. Bisogniero) home (Villa \nFirenze) on Albermarle Street, N.W.   Lunch in honor of former Italian Ambassador, now \nForeign Minister of Italy Giulio Terzi di Sant’Agata.   \nOct. 15, 2012 - Attended the Elton John AIDS Foundation Benefit Gala at Cipriani’s \nRestaurant on Wall Street by special invitation of Sir Elton John whom I had met at the \nIAS meeting in DC in July, 2012.   The entertainment by Stevie Nicks was amazing.   \nMany people came up to me thanking me for my work.   Most of these I had never met \nbefore.   Heavy representation of donors and business luminaries.\nOct. 16, 2012 – Spoke at the Annual Meeting of the Institute of Human Virology (Bob \nGallo’s Institute) held at the Marriott Waterfront Hotel in Baltimore.   Took train from \nNYC (Elton John Gala) directly to Baltimore.\nOct. 17, 2012 – Participated at the National Press Club in the launching of the WHO \nGlobal TB Report.   Panel moderated by Jeanne Meserve (old friend from CNN, now \nwith WTOP) and neighbor.   On panel was Mario Raviglione (WHO), Ken Castro \n(CDC), someone from USAID, someone from PEPFAR.\nOct. 18-19, 2012 – Went to Cornell Medical School Reunion and gave Keynote Lecture \non Ending the AIDS Pandemic.   Went up night before (Oct. 18) and had dinner with \nJenny at Gazala Restaurant.   Great time with her.   On the evening of Oct. 19, had class \nof 1966 reunion dinner at Nino’s Restaurant on 1st Avenue between 72 and 73rd Street.   \nReally great to see some of the old crew, many of whom have retired.   They were all \nvery gracious in saying how proud they were to have been my classmates.   Great to see \nPatty Downs, Suzie Stewart, Mark Kaplan, Mike Dosik, Dave Fraser, David Tucker, Jim \nMcSweeney, Carmine Bedotto, Frank Duggan, Randy Bell, among many others.\nOct. 23, 2012 – Met with Howard Koh (Assist. Sec. for Health) and Deputy Ron \nValdesarri in my conference room 7A-24.  They wanted to discuss and were actually \nputting pressure on me/us at NIH to put together a guidelines panel for treatment of HCV.  \nThey clearly are getting pressure from constituents.   Since we (NIH) have done such a \ngreat job on the HIV treatment guidelines for HHS, they wanted us to do the same for \nHCV.   Problem is that if we start doing guidelines for HCV, then other diseases would \nwant us to do guidelines and we should not be in the guidelines business.   Howard was \nfriendly and somewhat fawning over me.   Ron Valdesarri in my opinion is somewhat of \na jerk.\nOct. 26, 2012 – Participated in a panel on Global Health and award ceremony at \nGeorgetown.   Mark Dybul was given the Timothy Healy Award.   Panel consisted of me, \nMark, Eric Goosby and Barbara Bush (daughter) with Marty Federov moderating.   Good \ntime and enjoyable to do this with good friends.\nReleased by Chairman Rand Paul\n296Oct. 27, 2012 – Spoke at Panel of the Annual Meeting of the Academy of Achievement.  \nPanel held at Top of the Hay Adams in the Hay-Adams Hotel.   I led off the panel \nspeaking on Ending the AIDS Pandemic and an AIDS-Free Generation.   Followed by \nPulitzer Prize winning Poet Louise Gluck   and Nobel Laureate Roger Tsien.\nNight of Oct. 27 went to Gala Dinner of the Academy at the Willard Hotel – Reception is \nCrystal Room; Black Tie Dinner in Willard Room.  Typical classy Catherine and Wayne \nReynolds Affair.  Great entertainment topped off by Aretha Franklin.   Again, Catherine \nand Wayne gave Chris and me the best tables right in front of the stage.   Usual terrific \nguests.   Wolf Blitzer MC’d.  Colin Powell was dancing on stage with Aretha Franklin.   \nLots of fun.  At my Table – Chris and Kathleen Matthews, Bill Cohen and wife Janet \nLanghart; current USA Poet Laureate Natasha Threthewey, economist (?) and his \ngirlfriend Heather Hughes (29 yrs old and amazingly beautiful and friendly), Attorney \nGeneral Eric Holder and wife Dr. Sharon Malone.\nOct. 29, 2012 – Beginning of monster hurricane “Sandy”.   Supposed to be the worst \nstorm in memory with convergence of a true Atlantic Ocean Hurricane with a Nor-Easter \ncoming from Canada and the West.   All airports (DCA, IAD LGA  Kennedy, etc) and \npublic ground transportation (Amtrack, METRO, NYC subways) up the entire East Coast \nof USA pre-emptively closed prior to the storm.   Storm scheduled to peak here in DC \ntonight and into tomorrow.   I came to work since there is an almost 100% chance that \nmy house will lose power since even lesser storms cause power outages in my \nneighborhood.   Likely will sleep here at NIH tonight.   Stay tuned……\nOct. 30 – Nov. 3, 2012– “Sandy” totally devastated parts of the East Coast, particularly \nNYC and New Jersey shore.   One of the worst, if not the worst “natural” disasters to \nstrike NYC.   Wall Street under water.   Flooding of the Brooklyn-Battery tunnel and all \nNYC subway tunnels.   Con Ed plant exploded and all of lower Manhattan without \npower.   Had to evacuate Bellevue-NY University Hospital.  Atlantic City destroyed.   \nTruly historic.\nNov. 6, 2012 – As I had predicted over and over again, Obama won re-election handily \nwith 330 electoral votes.\nNov. 7-8, 2012 -   Went to San Francisco to give Keynote at 25th Anniversary of CFAR \nand 25th Anniversary of FDA approval of AZT.   Great trip. Went to Stanford during the \nday to see Ali before going to SF.\nNov. 19, 2012 – Appeared on ABC’s ONLINE TV show hosted by Christianne \nAmanpour on the subject of the ongoing dengue epidemic in India as well as in Madeira \nand Puerto Rico.   These ONLINE shows are fast becoming the new type of news outlets.   \nA cross between regular TV and a blog.\nNov. 27, 2012 – I present the C. Everett Koop HIV/AIDS Public Health Leadership \nAward to Rep. Henry Waxman at the Mayflower Hotel.   The award is given by the \nForum for HIV/AIDS chaired by Veronica Miller.   I gave a nice laudation with slides \nReleased by Chairman Rand Paul\n297praising Henry who has become an old “warrior” friend of mine over the years.   I have \ntestified before Committees that he either chaired or was minority about 25 times over the \npast 28 years.   He was very appreciative of my presentation.\nNov. 29, 2012 – Big day today.   It was the official celebration of World AIDS Day \n(WAD) and there was a celebration at the State Department from 10:30 to 11:30 AM.   \nHillary Clinton unveiled the “Blueprint” for PEPFAR to end the AIDS Pandemic.  It took \nplace in the Franklin Room of the State department.   She called me out from the \naudience and thanked me for being the scientific leader that got us to where we are.   \nBeautiful chilly Fall day with bright sun.\nAfter the State event, went to the White House to celebrate WAD.   Program of several \nspeakers.   I was the final speaker giving a talk about the scientific basis of being able to \nend the AIDS pandemic.   Extremely well-received.   Other speakers include:  Valeria \nJarrett; Michel Sidebe; Eric Goosby; Sec. Sebelius; a panel chaired by Rosie Perez.\nNov. 30, 2012 -   Viewed a screening at the State Department of the acclaimed movie \n“How to Survive a Plague” about the HIV activist movement.  Host was the director of \nthe movie, David France.  After the movie I was on a panel with Mark Harrington and 2 \nothers to discuss the movie and answer questions from David France who moderated and \nfrom the audience.   Went very well.   Have seen the movie before, but it still brings me \nto tears.   I was seen several times in the movie looking extremely young from the 1980s.   \nAlso, very poignant features of Peter Staley, Mark Harrington, David Barr, Spencer Cox, \nJim Eigo, Larry Kramer and many others from “the old days”.\nIn the afternoon I taped a World AIDS Day segment that showed that evening on the PBS \nNewsHour hosted by Ray Suarez.   I thought that it was one of the best segments that I \nhave done . \nDecember 1, 2012  - had dinner over Mark Dybul's home on Wallach Place in northwest \nDC together with Chris Grady,  Jason Claire, Kristen Silverberg (former assistant to \nPresident George W. Bush and an old friend of mine from that administration (see above \n(2002) and her husband, and other guests. We celebrated the appointment of Mark to be \nthe executive director of the Global Fund for AIDS, Tuberculosis, and Malaria. \nDecember 3, 2012 - had a town hall meeting with the Vaccine Research Center principal \ninvestigators and other staff to reassure them that they have nothing to worry about \nrelated to the departure of Gary Nabel to Boston to work at Sanofi. Gary left the VRC \nsolely because his wife Betsy Nabel took the job 3 years ago as President of the Brigham \nand Women’s Hospital in Boston.   Gary has been commuting ever since to be with her \non weekends and it is wearing him out.   Unfortunately, Gary is leaving the best job in the \nworld at the VRC and he has done a spectacular job.   He is clearly damaging his \nscientific trajectory of his career by making this move.  I told them (the VRC PIs)  that I \nwas extremely satisfied with the performance of the VRC and would do everything in my \nReleased by Chairman Rand Paul\n298power to maintain the momentum and culture of the VRC.   I would not hire someone to \nreplace Gary that would possibly damage this culture. \n December 4, 2012 -   That evening had a senior staff dinner in which I discussed my \ndesire to tighten up the work ethic of the front office.   The work load is being \ndisproportionately falling on me, and particularly Greg Folkers who is killing himself \ntrying to polish up the sometimes sloppy work of others, particularly David Morens, who \nis a good guy, but will have to be let go.   We met at Positano’s restaurant in Bethesda \n(Fairmont Avenue) with Cliff Lane, Hugh Auchincloss, and JJ McGowan. Good \ndiscussion.  \nDecember 7, 2012 - went to dinner at the home of Connie Milstein on 3210 – R Street, \nN.W. in Georgetown.   Connie is the owner of the Jefferson Hotel in Washington DC.  \nThe occasion of the event was a fund raiser for the organization called Key to the Cure \n2012. This is an organization aimed at curing epilepsy.  It is run by Susan and David \nAxelrod who have a child with epilepsy. It was an extraordinary evening with all the \nglitterati of Washington DC at the meeting including a visit from VP Joe Biden. I had the \nopportunity to chat a bit with the vice president and discuss our work with HIV-AIDS.  \nHe clearly knew who I was since I have met him several times when he was in the Senate \nand he was present at the East Room ceremony when I received the presidential Medal of \nFreedom.  In addition there were number of other known media and political stars \nincluding Alex Castellanos, the Republican Strategist. The joke of the evening is that \nDavid Axelrod had just shaved off his mustache to raise money for the CURE.   He had \nbeen joking on TV Sunday Talk Shows that he would shave off his mustache is Obama \nlost the election.   Obviously, Obama won, but now David shaved it off for a cause.   \nAlex Castellanos now promised to shave off his moustache to raise money for the CURE. \nDecember 8, 2012 - Saturday morning spent an hour on C-SPAN television (National \nJournal) in Washington DC (400 North Capitol Street) discussing seasonal flu and other \ninfectious disease issues.   I was on the show with my friend Tom Frieden, Director of the \nCDC. \nDecember 11, 2012 - engaged in a National Academy of Sciences Symposium in \nWashington DC at the Keck Building on 5th St., NW to discuss emerging infectious \ndiseases and the 20th anniversary of the 1992 IOM report on emerging infectious \ndiseases. Later in the day I gave a talk at the treatment action group (TAG) event run by \nMark Harrington at the Fairfax Embassy Row Hotel on Massachusetts Avenue in DC. \nThe subject of the meeting was ending the HIV pandemic in the United States. This \nmeeting was put together in order to emphasize that we have a significant problem in the \nUnited States even at the same time as we are making enormous progress globally with \nhaving the end of the AIDS pandemic globally in sight, which was the topic of the \nInternal AIDS meeting in DC in July (see above) and the recent World AIDS Day events \nat the White House and the State Department.\nDecember 13, 2012  - travel to New York City to give the keynote lecture at the Drugs \nfor Neglected Diseases Initiative (DND1) symposium run by Medicins Sans Frontiere \nReleased by Chairman Rand Paul\n299(MSF, aka Doctors Without Borders) entitled  “Lives in the Balance: Delivering Medical \nInnovations for Neglected Patients and Populations” I spoke on the research issues \nrelated to neglected infectious diseases.  My talk was very well received it took place at \nMount Sinai Hospital on Madison Avenue and 99th St. The evening before I had dinner \nwith my daughter Jennifer at Café Vida on Amsterdam Avenue and 97th Street. \nThat evening when I got home I discussed the newly formed Office of Global Health \nDiplomacy with Eric Goosby.   He wanted to give me a heads-up about the fact that \nSecretary Clinton would make an announcement the following day about the formation of \nthis new office and that she would appoint Eric Goosby as the director of the new office \nwhile simultaneously maintaining his position as the director of PEPFAR.   In typical \nmanner, Eric is such a good person and friend that he wanted to keep me in the loop. \nDecember 14, 2012 - attended Lessons and Carols at the National Cathedral in \nWashington DC at 7:00 to 9:00 PM. This is a tradition which our family has done for all \nthe years that are children attended the National Cathedral School. It was lovely and \nnostalgic.  Megan and Ali attended with Chris and me.   Jenny was still in NYC and \nwould come down for Christmas in a few days.\nDecember 15, 2012  - had dinner with Wayne and Catherine Reynolds at the Adour \nRestaurant at the St. Regis Hotel on Connecticut Avenue in Washington DC.  As usual \nWayne and Catherine put together a very interesting group for dinner. This time it \nincluded my friend Rick Atkinson the Pulitzer Prize winning author as well as Buzzy \nKrongaard and his flakey wife Cheryl.  Buzzie was formally the Executive Director of \nthe CIA.   We were joking about the smash TV Showtime hit series called “Homeland” \nstarring Claire Danes as Carrie Mathieson (a bipolar CIA agent tracking terrorists) and \nDamien Lewis as Sarg. Nicholas Brody (a marine turned reluctant terrorist, turned back \nto good).   Buzzie was saying that the CIA could never act domestically the way it was \nportrayed in the series.   That would have to be FBI.   Other guests included Francis \nCollins, Congressman John Dingell and his wife Debbie and others. \nDecember 17, 2012 - We had an “international consultation” on the problem of gain of \nfunction research on H5N1 highly pathogenic avian influenza (HPAI) (see above \ndiscussions).  The meeting took over two days from December 17 to December 18 and \nwas conducted at the Natcher Auditorium at the National Institutes of Health.  This is a \ncontinuing issue and a source of great discussion about what experiments should or \nshould not be funded by the National Institutes of Health on this topic. I gave the opening \nkeynote which everyone felt very clearly defined the issues.  We will now finalize the \ndraft of “Framework” for addressing the issue of what grants and contracts we should or \nshould not fund that relate to a gain of function regarding respiratory transmissibility in \nmammals of the HPAI H5N1 influenza.  I am trying to get myself out of this argument \nwhich has consumed a considerable amount of my time over the past 14 months.\nDec. 30, 2012 – Interesting and potentially bad news regarding Sec. Hillary Clinton.   A \ncouple of weeks ago she reportedly fell and had a “concussion” that kept her out of the \npublic eye for ~ 3 weeks.   Report today that she was admitted to NY Presbyterian \nReleased by Chairman Rand Paul\n300Hospital for a “clot” and is supposed to be receiving anticoagulation.   Her staff are being \nvery close-to-the-vest about his.   Cannot figure out if she just has thrombophlebitis or if \nshe had a pulmonary embolus.   Certainly could not have had a subdural hematoma since \none would never anticoagulant under these circumstances.  Turned out she had a venous \nthrombosis of a skull vein, not involving the brain\nJan. 3, 2013 – A lot of influenza activity exploding throughout the country with H3N2 \nthat matches the vaccine.   Early start and big spike with widespread activity throughout \nthe country.   Appeared on Fox Local News this evening.\nJan. 7, 2013 -  Interesting telephone call with Paul Stoffels today.   Paul is CEO of \nJohnson and Johnson that owns Janssen Pharmacueticals as well as Crucell.   He is \nexcited about the Dan Barouch HIV candidate using Adenovirus 26/35 + MVA boost and \nwants to develop it as an HIV vaccine.  He wants to partner with me and NIAID in this \nendeavor.   This is relevant to the meeting tomorrow night in Building 31\nJan. 8, 2013 – Flu activity accelerating.   Appearing on WUSA – Channel 9 today.  Also, \nappeared this evening on Wolf Blitzer “Situation Room” regarding the flu epidemic.  \nWent very well\n This evening meeting of the P5 vaccine consortium in Building 31, 7A-24. Successful \nmeeting involving all of the players from Gates Foundation (Trevar Mundell, Stefano \nbertozzi, Peggy Johnston, Nina Russell), the Army (Nelson Michael, Jerome Kim), \nHVTN (Larry Corey, Peter Gilbert, etc.) See pdf for full contingent.\nimage.pdf\nMain purpose of the meeting was to re-group and summarize where we are in the \nplanning of the P5 (Pox Protein Public Private Partnership) for HIV vaccine).   \nPresentation by Larry Corey, Gepi Pantaleo, Peter Gilbert, Julie McElrath, Glenda Gray \n(RSA) on the NYVAC  +/- DNA +  protein approach; and by Dan Barouch, Hanneke \nSchuitemaker (Crucell) on the Adenovirus (Ad 26/35 + protein + adjuvant) approach.  \nOne of the problems is that Novartis, who is supposed to supply the envelope protein for \nthe Corey trial will be about 1 year late in delivering the protein.   Many of us are angry \nwith them about this since they have not been forthcoming.   Also, the correlates of \nimmunity from the RV144 (Thai) trial indicate that protection might be related to \nresponse against the V2 loop of the envelope and specifically against residue 169 in this \nregion.   Problem is that the envelope used in both proposed trials will not even address \nthis.   The envelope that grows well in cell cultures will be used.   Balance of empiric \nwith scientific.   Gepi Pantaleo, Larry Corey and I went to dinner in Bethesda at \nGrapeseed Restaurant after the meeting (5:30 to 7:45 PM) to reflect and commiserate.   It \nwill be largely my responsibility to decide go-no go from Phase 1 (starts in mid-end of \n2014) to Phase IIa/b (2015 - 2016), the latter costing over $100 million and so this will be \nan important decision based on a combination of science and best guess.   Stay tuned.\nReleased by Chairman Rand Paul\n301Jan. 9, 2013 – Appeared on C-SPAN (TV) and on WTOP radio early this AM to talk \nabout the erupting influenza epidemic.\nJan. 9, 2013 -  Attended an important dinner at the home of John Monahan and his wife \nAnnie at 3340 -  Runneymede Place, N.W., Washington, D.C.  to discuss the relationship \nbetween PEPFAR and USAID with regard to the new Office of Global Health \nDiplomacy.  John formerly worked in the Clinton Administration and for the past 4 years \nhas been Counselor to Secretary Sebelius in HHS and Acting Director of the Office of \nGlobal Health Affairs at HHS.  He recently moved to the State Department to help with \nthe Global Health issues there.   Hillary Clinton had just established this Office of Global \nHealth Diplomacy and made Eric Goosby (Director of PEPFAR)  the Director of the \nOffice  with Ambassador Louise Rowe as Deputy.  Apparently Raj Shah and the USAID \nare trying to take control over this new initiative that has just been put out by the Obama \nadministration. Raj has been trying to take over PEPFAR for some time now without \nsuccess. I have been backing Eric Goosby from the very beginning since I believe that \nRaj is driven by ambition on the background of a terrible track record of USAID. In the \nsecond Obama administration the people in the State Department and in the White House \nare trying to create a legacy for Pres. Obama with regard to global health. They believe \nthat this new office of Global Health Diplomacy could be the vehicle to do that. Right \nnow it appears that we are engaged in the struggle Raj Shah and USAID wanting to take \nover the process. The dinner included a number of people with knowledge in the field. \nParticipants included John Montague his wife Annie, Francis Collins, Tom Frieden, \nPeggy Hamburg, a woman from the State Department (Laurie) who worked in the \nClinton Administration, Nils Daulaire, and a number of other people. The plan discussed \nat the meeting was to help support Eric Goosby is trying to make the office of global \nhealth diplomacy a productive and viable enterprise and to ward off any attempts on the \npart of USAID to take it PEPFAR and the new office. Tomorrow I will go to the State \nDepartment for the first of the number of meetings that will address this issue.   More to \nfollow on this subject.\nJan. 10, 2013 – Did CNN Situation Room with Wolf Blitzer regarding the Flu outbreak.   \nI made casual statement in response to a question by Wolf that the outbreak had passed \nthe epidemic threshold (which was true (7.3% with threshold at 7.2%).   Anderson \nCooper later on in his CNN show “Anderson Cooper 360” made announcement that NIH \nOfficial Dr. Anthony Fauci has now declared the influenza outbreak “an epidemic”.   The \nCDC was coming out with their weekly report with a big press briefing the following day \n(tomorrow) and this must have gotten them pissed with their usual jealousy of my being \non TV and the media in issues that they think they own.\nJan. 11, 2103 – Did morning CNN and Soledad O’Brien on CNN and further discussed \nthe flu situation.   Much, much press interest.   As expected, Bill Hall (HHS Press office) \nwrote a note to Courtney Billet, Greg Folkers and John Burklow saying that from now on \nthe CDC should handle press on the flu and I should only do local media and national \nmedia only when they want to talk about research associated with flu like universal flu \nvaccine.   This has shades of Jenny Backus.  Almost certainly a result of a complaint \nfrom CDC.   We (NIH/NIAID) are trying not to clash with them, but this is really \nReleased by Chairman Rand Paul\n302insulting and we will have to see how this plays out and how we should push back on \nthis.\nJan. 12, 2013 – Did WJLA – Channel 8 news on flu on this Saturday AM.   Also, \nreceived request that Soledad O’Brien wants me again on her show on Monday AM.   \nThis will be the test regarding my above comment concerning Bill Hall.\nJan. 14, 2013 – HHS turned me down on requests from CNN Wolf Blitzer and Soledad \nO’Brien.   I asked John Burklow to call up Bill Hall and find out what the heck is going \non and what the reason for all of this is.   John told me that CDC complained to Bill Hall \nand HHS that I was getting all of the publicity on an issue (influenza “tracking”) that they \nconsidered was their issue.   I do not know who at CDC did this.   It could be anyone \nfrom Tom Frieden (I doubt this) to more likely Tom Skinner (CDC PR person).   In any \nevent, it has nothing to do with my use of the word “epidemic” on Wolf Blitzer Show and \neverything to do with pure jealousy that I am a “rock star’ stealing their thunder.  Shame \non the CDC.    Bill Hall promised John Burklow that as the epidemic stabilizes, I will be \nallowed to do the big shows and that starting now, I can do anything that has to do with \nthe science and vaccine development.  In this regard, see below – tomorrow\nJan. 15, 2013 – Appeared on the “Situation Room” (CNN) in a piece that featured the \nquest for a universal flu vaccine.   I did the interview from the NIAID Vaccine Research \nCenter.   John Mascola also appeared as we showed the CNN crew around the VRC.   \nVery nice piece.  Tomorrow I do a 1 hour call in show on WTOP.\nJan. 16, 2013 – Did a very successful 1 hour show with call-in on WTOP at 10:00 to \n11:00 AM.   Rainy day in Washington, D.C.   Also, local NBC News and WUSA \nChannel 29 filmed me during the radio show and I gave on camera interview to them \nafter the show.\nJan. 17-23, 2013 -  As expected, due to the beginning of drop-off of influenza cases, \neven though we are in the middle of the influenza season, the press interest has almost \ncompletely dropped off the radar screen.   Almost no stories this week on the 2012-2013 \ninfluenza outbreak.\nJan. 23, 2013 – The “60 day moratorium” on gain-of-function research on respiratory \ntransmission of HPAI H5N1 influenza in mammals has been lifted by the scientists who \noriginally signed to moratorium.   The moratorium actually lasted just over one full year.   \nWe at HHS and NIH have been developing a framework for making funding decisions \nfor this type of research (see above – Dec. 17, 2013).   The framework should be ready \nfor implementation in a few weeks and so we can start making funding decisions.   Much \npress coverage today (I was in NY Times, Wall Street Journal, AP, etc.).  The nay-sayers \nwho feel this research should not be done at all (David Relman, John Roberts (Nobel \nPrize winning ass-hole) or should not be published (Mike Osterholm) are still out there \nbad-mouthing the decision to lift the moratorium.\nJan. 25, 2013 – Appeared on CNN “The Situation Room” with Wolf Blitzer to discuss \nthe ongoing breakout of norovirus in the USA.   Good interview.   There are about 20 \nReleased by Chairman Rand Paul\n303million cases of norovirus in the USA each year with 70,000 hospitalizations and ~800 \ndeaths.\nFeb. 3, 2012 – Super Bowl night. Ravens beat 49ers 34-31.  Nonetheless spent the \nevening at a dinner and panel discussion at the Fairmont Hotel (24th and M Street, N.W.), \nColonnade Room. Occasion was a pre-Summit dinner for the Global Women’s Cancer \nSummit to take place the following week.   Panel discussion between David Rubenstein \n(Carlyle group) and Wolf Blitzer (CNN) with Mark Dybul contributing.   Sat a dinner \ntable with David Rubenstein (who is still trying to get me to work for him at Carlyle \nbecause he thinks that I am “…the smartest person in the world”), Laura Bush, Wolf \nBlitzer, Agnes Binagwaho (Minister of Health of Rwanda), Nancy Brinker, Mark Dybul, \nJulie Gerberding.   Great discussion about transforming events in global health.   Chatted \nwith Laura about President George W. who recently had back surgery as well as about \nPresident George H.W. who is slowly recovering from bronchitis hospitalization.\nFeb. 14, 2013 – Valentine’s Day.   Very interesting and enjoyable evening.  Chris and I \nwere invited by Wayne and Catherine Reynolds to a dinner in the Adams Room of the \nHay Adams Hotel to honor Ehud Barak, Defense Minister and former Prime Minister of \nIsrael.   He is in the USA for a meeting with Leon Panetta (Secretary of Defense).  Great \ntime.   Usual A crowd of DC, which this time included David Petraeus and his wife \nHolly.   Had the chance to speak with Petraeus and mentioned that I often said Hi to him \nas we passed running on the C & O Canal.   He said he recognized me, which was \nprobably just being polite.   I thanked him for his years of service to the country.   He was \nvery gracious.  Obviously, some degree of awkwardness in the crowd given the Paula \nBroadwell scandal and his wife being there on “Valentine’s Day”.   Also present among \nmany other were Bob Barnett and wife, Ed Markey (soon to run for Senator from \nMassachusetts) and wife Susan Blumenthal, Rick Atkinson (Pulitzer Prize winner \nauthor), Lyric Winik and husband Jay, Ben Carson and wife Candy, Josh Bolten and his \nnew girlfriend (?name), Bill Cohen (former Sec. of Defense) and wife Janet, etc.\n     Barak gave a very insightful speech on the challenges facing Israel in the context of \nthe Arab Spring, Syria, and Iran.\nFeb. 25, 2013 – Still no solution to the impending sequestration deadline of March 1, \nwhich will result in across-the-board cuts to Pentagon and discretionary spending \n(including NIH).   The POTUS is doing some severe posturing that this is all the fault of \nthe Republicans and is having all of the Cabinet members out there saying how disastrous \nthe cuts will be.   Meanwhile, Bob Woodward points out in an editorial in the \nWashington Post on Feb. 24 that the POTUS “moved the goal posts” on the GOP by \nwanting to bring up tax increases even though the original discussions surrounding the \nbudget deal of a few months ago is that the Bush tax cuts were allowed to expire and so \ntaxes are “off the table”.   Woodward says the POTUS now wants to put them back in \nplay.   Looks like sequestration will occur.\nSad day in that former Surgeon General C. Everett (Chick) Koop dies at age 96.   I had \nthe pleasure of giving the laudatios at his 80th and 90th birthdays.  My quotes appeared in \nmany newspapers regarding his amazing life and also on local FOX TV.\nReleased by Chairman Rand Paul\n304Mar. 1, 2013 – Sequester kicked in and so spending cuts are in effect.   Incredible \nposturing on part of GOP as well as the POTUS who is stating that the “world will come \nto an end” and the GOP is to blame since they refuse to raise taxes.   This is pitiful \ngovernment.   \n     Also, interesting finding being presented at CROI meeting in Atlanta in a couple of \ndays of an infant who was treated (not prophylaxed) with ARVS within 30 hours of birth \nsince his mother who was infected had no anti-natal care and obviously no ARVs.   She \npresented in an ER in Mississippi at labor.   The physicians felt that since the risk was so \nhigh for the baby that they treated the infant before the tests for HIV came back.   They \nusually take several days to come back.   Right choice.   The baby was infected and \nstayed on ARVs for 18 months.   Then lost to follow up and mother D/C’d the ARVs for \n10 months and reappeared.   Only now the baby is well and no evidence of replicating \nvirus (some probably dead residual DNA by PCR.   Also, immune response to HIV \ndisappeared (not surprising in the absence of persistent virus).   This may be the first real \ncase of a cure, not the “Berlin Patient” whom I always thought was totally non-feasible \nfor scale up and danger.   Of note, I have been saying for years that the best bet for a cure \nwas to treat as early as possible to prevent establishment of a large reservoir and to \nprevent destruction of immune system by persistent viral replication over months to \nyears.   The best scenario for this is to treat a child at birth.  Perhaps there are other \nchildren on therapy who received ARVs relatively early (not necessarily within hours) \nwho are in fact cured and do not know it.   Much study to be done.\nMar. 4, 2013 – The media interest in the “cured” baby has been as intense or more than \nanything I have experienced here at NIH.   Yesterday I did WUSA 9 nightly news and \ntoday I did: CBS Morning News with Charlie Rose and Nora O’Donnell; WTOP Radio; \nFax Morning News; CBS Radio LA; Fox Radio News; NBC News and NBC Nightly \nNews; ABC Evening News; BBC World Service Radio; Canadian Broadcast (CBC) TV; \nCNN International with Christianne Amanpour; CNN Situation Room with Wolf Blitzer; \nWLS radio; PBS NewsHour with Ray Suarez; BBC Radio; Canada CNN Radio; CNN \nAnderson Cooper 360; Al Jazeera.   Quite a day.   I stressed that we must be careful since \nthis is only a single case in very unusual circumstances.   All media went very well.\nMar. 5, 2013 – Media frenzy continues.   I have now gone over the data from the Hannah \nGay and Persaud presentation at CROI and I have some doubts that the child was ever \ntruly infected in the first place.   Tough to really tell whether the virus that was detected \nand ultimately disappeared on ARVs was the virus from the mother or really infected \nbaby cells making virus.   The authors claim that the 2 phase decay of virus on ARVs is \ncharacteristic of the response to active virus replication.   Cliff Lane pointed out that the \ndecay curve has very few points and is also compatible with a single phase decay.   In \nany event, I have been taking the conservative approach of emphasizing that this is just a \nsingle case and it needs to be replicated and validated and importantly, it has little to do \nwith infection in the adult where reservoirs are firmly established prior to the start of \nARVs.\n       Nonetheless, the media frenzy continues with interview for Men’s health, Huffington \nPost, NPR- San Francisco (KQED), Boston Globe.\nReleased by Chairman Rand Paul\n305Mar. 6, 2013 – When it rains, it pours.  CDC came out with a “Vital Signs” alert out of \nMMWR about the growing threat of Carbapenem-resistant Enterobacteriacea (CRE), \nwhich includes Klebsiella pneumonia carbapenem-resistant (KPC) that gave the NIH \nClinical Center the outbreak of 18 cases (11 deaths, 7 of which were due to the KPC) in \n2011.  Another media frenzy starts with me on NBC Nightly News X2.\nMar. 7, 2013 – CRE media with Diane Rehm Show,   Briefed Laura Friedel of Senate \nMinority Staff at Appropriations (Staffer to Ron Moran)\nMar. 8, 2013 – Guest on Geraldo Rivera Show for “cure” baby; CNN tape for tomorrow \non CRE; the Washington Post “The Fold” (online TV) on HIV.\nMar. 11, 2013 – Flew to Boston for the day to give Keynote Lecture at the dedication of \nthe new building for the Ragon Institute of MGH, Harvard, and MIT.  Held at 400 \nTechnology Square in Cambridge, MA.  Orchestrated by Bruce Walker who is amazing \nat raising money for his biomedical research.   Terry and Susan Ragon (software \nbillionaires) gave Bruce $10 million per year for 10 years and now an additional $30 \nmillion to renovate the building for the Ragon Institute.   I spent a few hours interacting \nwith the Ragon scientists, gave my Keynote and then had dinner at the “Catalyst” \nrestaurant in Cambridge.   Many Boston scientific and other luminaries at lecture and \ndinner including Bob Kraft, owner of the New England Patriots, and his family (wife and \nson Jonathan).   Also at lecture and at dinner and with whom I had great conversations \nwere Drew Faust (President of Harvard), Raphael Reif (President of MIT), Ray Slavin \n(President of MGH) among others. We discussed the potential effects of the \n“sequestration”  Very nice visit.\nMar. 13, 2013 – Did nice interview at Biocentury (WUSA – Channel 29) on the \nSequestration.   \n    That evening went to Research America Gala at Mellon Auditorium on 13th Street and \nConstitution Avenue, N.W.   I sat at the Duke University Table with Congressman \nGeorge Holding, Victor Tzau, and others.   My friend Diane Rehm (NPR Diane Rehm \nShow) received one of the awards.\nMar. 15, 2013 – Have received indications from Judith Shamir (Exec Sec of IOM) the \nAlan Leschner, Chair of IOM President Search Committee is very interested in my \nsubmitting my application for the job.  I told her that I was not interested, but I would let \nher know.   I called current President, Harvey Fineberg, and asked his opinion.   He said \nthat I would be fantastic for the job.   I explained that I was not that interested.  The only \nreason (weak) to take the job is that I could start writing my book in that job, which I \ncannot really do now since I would have so much more time in that much-less-demanding \njob compared to NIAID Director.   \nMar. 18, 2013 – Met with Congressman Andy Harris (R-MD) in Building 1 together \nwith Francis Collins, Griff Rogers, Gary Gibbons.   Harris is a Tea Party person who is \nsecond rank on House Appropriations Subcommittee behind Chairman Kingston.   Funny \ninterchange since Harris brightened up when I introduced myself, saying that he was \nReleased by Chairman Rand Paul\n308Latest count of H7N9 in China today is 78 cases and 16 deaths.\nApril 17, 2013 – Went to Princeton to deliver the Gilbert Omenn Lecture at the \nWoodrow Wilson School of Public and International Affairs.  Spoke on “Ending the \nHIV/AIDS Pandemic:  From Scientific Advances to Public Health Implementation”.  \nHosted by Cecilia (Ceci) Rouse formerly on the economic team in the Clinton and \nObama White House.\nApril 19, 2013 -  Terrorists identified by surveillance cameras.   Tamerlan and Dzhokhar \nTsarnaev.   Two Muslim brothers born in Chechnya.   Older one recently spent about 6 \nmonths in Chechnya, likely getting trained in terrorism.   Most intensive manhunt in US \nhistory around Boston Area.   Entire city of Boston shut-down.   Wild car chases and gun \nbattles. Terrorist murder campus policeman at MIT and seriously wound another \npoliceman.  Tamerlan shot dead; Dzhokhar escapes, seriously wounded, ultimately \ncaptured in Watertown MA.\nApril 21, 2013 – Informed by Francis Collins that he spoke with Bill Corr (Deputy HHS \nSecretary) about the issue of my being muzzled, almost certainly because Tom Frieden \nand the CDC want the spotlight on the H7N9 story.   Corr agrees with Francis that I \nshould always be allowed to speak to Press (Print/TV/Radio) when they directly ask for \nme.   Let us see how this turns out.  Also, it is clear now that I have joined the 2x/week \nconference calls with HHS that CDC really wants to be in control even though I believe \nthey are missing important stuff.   For example, they are claiming that they cannot detect \nthe virus in chickens, likely because the PCR assay is specific, but not sensitive.   I just \nfound out from the CEIRS people (including Mike Osterholm) that the Chinese are \nlooking in the wrong place.  The cloacal swabs are negative, but there are tons of virus in \nthe trachea swabs.   Case now well over 100 and counting.   The Chinese need to start \nmassive culling of chicken or the virus might adapt itself to humans after many dead-end \njumps.\nApril 22, 2013 – Cases of H7N9 continue to accumulate.   First case in Taiwan. HHS is \nnow clearing me for press (see above); however, there have not been any requests from \nmajor network and so still not clear what will happen.   I have decided without question \nto defy them if they try to muzzle me, which I do not believe they will now that Francis \nhas spoken with Bill Corr; but we shall see.\nHad dinner with Bob Gallo tonight and discussed the upcoming Paris meeting sponsored \nby the Pasteur institute (Francois Barre-Sinoussi) to celebrate 30th Anniversary of \ndiscovery of HIV by the French.   Bob is scheduled to give an after dinner speech.   I \nstressed that he should behave and not re-hash old issues.   Also, Bob told me that he and \nJoe O’Neill are writing a book about the history of AIDS and they want to devote a \nchapter to me.   This is nice, but now it is clear that I must write my book and do it soon.   \nWill get advice from David Willman (L.A. Times) and Rick Atkinson (author of World \nWar II books) – both Pulitzer Prize winners on how to proceed.   Also, will contact Ari \nEmanuel’s Book person.\nReleased by Chairman Rand Paul\n309April 25, 2013 – Went to reception at the home of Sen. Jay and Sharon Rockefeller to \ncelebrate 10 years of service and retirement of Amy Lawson as CEO of DC Prep (where \nJenny taught).   Amazing home – 2121 Park Road, N.W.   Had chance to chat with the \nSenator about NIH.\nApril 26, 2013 – Had important discussion with Eric Goosy by phone about whether we \n(NIH and PEPFAR) should fund the Africa START study proposed by Wafaa El Sadr \nand Kevin DeCock.   Eric is skeptical about doing this since he feels that very soon many \nin Africa will be starting therapy at below 500 CD4+ T cells and the study may not be \nable to be done.\nApril 27, 2013 – Went with Chris to White House Correspondence Garden Brunch at \nBeall-Washington House on 2920 R Street, N.W.    Tammy Haddad as usual MC’d it.  \nSponsored by CURE Epilepsy and the Miss America Foundation.   Great party.   \nFantastic weather – bright sun and 70 degrees.   Usual cast of celebrities – political, \nmedia and Hollywood.   Ran into old friends David Axelrod, Sharon Stone, Nora \nO’Donnell, Charlie Rose, Gordon Peterson.  Discussed NIH budget with Eric Cantor.  \nHad most fun meeting and taking picture with Navid Negahban who played the arch-\nterrorist Abu Nazir on “Homeland” (Showtime).  We told him how much we admired his \nwork.   He sort of recognized me but not quite.   After a few minutes, he came over to me \nand said how impressed he was about how many lives I have saved and as he was saying \nit, he choked up.   He clearly had asked someone who I was.   Seems like a fine human \nbeing.\nApril 29, 2013 – Went to dinner at Matisse Restaurant on Wisconsin Avenue and \nFessenden Avenue, N.W.   I took out Richard (Rick) Atkinson to dinner to get his advice \non writing my book (autobiography).   He was extremely helpful on how to approach this \nand gave me several names of agents, editors, historians, etc.  he encouraged me to “shop \naround” for the best people.   He confirmed what Edwin Grosvner and Ari Emanuel said \nthat I clearly have a NY Times bestseller and possibly Pulitzer Prize autobiography in me \nand encouraged me strongly to pursue this.   \nI am very excited (almost agitated) about doing this.   I have a worrisome feeling that the \nUSG will not allow me to do this.  Even though it is MY autobiography, most of it relates \nto my government service.   I will probe this and see what happens.\nParenthetically, the Washington Nationals, who are supposed to win the World Series this \nyear on the basis of pure talent have gotten off to a bad start.   The only people that are \ndoing great thus far are Bruce Harper and Jordan Zimmerman.\n***H7N9 continues to occur in China from chickens to human → 126 cases and 24 \ndeaths.   Still confined to China.   Need to keep an eye on this.   \nMay 1, 2013 – Attended the “Heroes of Military Medicine Awards at the Mellon \nAuditorium on 13th Street and Constitution Avenue N.W.   I was present because Lt. Col. \nReleased by Chairman Rand Paul\n310Nelson Michael (my old friend) was receiving one of the awards and I had been part of \nthe video that was shown at the event that honored him.  Nice affair.  Inspiring keynote \naddress by Admiral William H. McRaven, Commander of United States Special \nOperations Command (the group – Seal Team 6 that got Osama bin Laden).  Other \nawardees besides Nelson were USAF Lt. Col. Raymond Fang – Trauma surgeon with \nmultiple tours in Iraq and Afghanistan.   He spoke by video since he is currently deployed \nin Afghanistan.   Also Hospital Corpsman 1st Class Darrel L. Enos – 3rd Marine Special \nOperations Battalion who received it posthumously – killed in action.   Entire evening \nvery moving.   Special awards to Marine Staff Sergeant Johnny Joseph (Joey) Jones who \ngot his legs blown off while trying to dismantle and IED in Helmand Province, \nAfghanistan.   I was in tears after his speech.  Also talks by Gen. Jack Keane (USA- \nretired), Gen. James Amos (USMC).  Special Award to Gen Joseph F. Dunford (USMC), \nCommander of Forces in Afghanistan who spoke in video from Afghanistan.  General \nAmos introduced him.   Gen. James Peake, Former US Army Surgeon General and \ncurrently Sec. of Department of Veteran Affairs received a special award.   He fought as \na combat platoon leader in Viet Nam and was highly decorated with Silver Star, Bronze \nStar with V device and Purple Heart.   After war, went to Cornell Medical School, \nbecame a cardiac surgeon – quite a guy.   I have known him for years.   Mistress of \nCeremonies was Jennifer Griffin of FOX News Channel.   When she called out \n“notables” in the audience, she mentioned my name.   I was embarrassed to be called out \ntogether with General McRaven, Amos, Peake and others.   The evening made me proud \nto be an American.\nMay 6, 2013 – H7N9 still smoldering, but with the closing of some of the open bird \nmarkets in China, the pace of new cases has slowed.   130 cases and 31 deaths total.   \nHHS is now allowing me to do press on this without hassle.   Francis Collins meeting \nwith Bill Corr has apparently worked (see above).\nWent to cocktail reception/book signing for Paul Farmer’s new book – “To Repair the \nWorld” at home of Greg and Derry Craig on 3155 Highland Place, N.W.; also co-\nsponsored by Tim Broas.   Paul, as usual, was very generous in his remarks about my \naccomplishments in being the architect of PEPFAR and the influence that I had on his \ncareer.   Several notables there including Kathleen Matthews and Paul Wolfowitz.   Had \ngood conversation with Paul about how we worked together when he was Deputy \nSecretary of Defense.  Paul gave 2 signed books to me – one for Chris and me and one \nfor Jenny.  Also, I spoke with Paul about getting one of his acolytes to come work for me \nas my assistant at NIAID.  (Turns out I contacted one Hillary Marston who will be \njoining me in August – see below))\nMay 7, 2013 – Went to the Capitol with Francis Collins to meet with the House Majority \nWhip – Congressman Kevin McCarthy (R-CA).   Kevin is very interested in the problem \nof Valley Fever (Coccicioidomycosis) in his district of Bakersfield.   We discussed \nhaving a workshop and partnering with CDC in doing clinical trials of new drugs such as \nNippo Z and developing a vaccine.   Good idea to cultivate relationship with McCarthy, \ngiven his position.\nReleased by Chairman Rand Paul\n311May 8, 2013 – Appeared on NPR Morning Edition radio with Richard Knox regarding \nH7N9 flu.   Also, gave Opening Keynote Address at the Annual Meeting of the \nHPTN/IMPAACT Networks held at Marriott Wardman Hotel on Calvert Street, N.W.   \nMyron (Mike) Cohen presented me with a basketball signed to me from Roy Williams, \nhead coach at UNC.  Mike gave it to me to “neutralize” the signed basketball that I \nreceived years ago from Duke Head Coach Mike K.\nMay 9, 2013 – Had Congressional visit here at NIH in the Clinical Center medical Board \nRoom on 4th Floor of Building10.   Delegation led by Eric Cantor (R-VA).   Also present \nwere Congressmen Andy Harris (R-MD), Elliot Engel (D-NY), Ted Yoho (R-FL), Chaka \nFattah (D-PA), Renee Ellmers (R-NC). Tim Murphy (R-PA), Earl Blumenauer (D-OR).   \nNIH was represented by me, Francis Collins, Gary Gibbons, Eric Green, Chris Austin, \nLarry Tabak, Kathy Hudson, John Gallin.   We were trying (successfully) to familiarize \nthem with the NIH and what we do.   Also, to impress on them the damage due to \nsequestration.   I spoke about the major advances in treatment of HIV and the possibility \nof a universal Influenza vaccine.   All in all it was a very good meeting.\nWent to Book party at the home of Bob and Deborah Seder in honor of Andrea Redmond \nwho co-authored book called “Rwanda, Inc.” about entrepreneurship in Rwanda and the \neffect on the economy.   Had long conversation with my good friend Cheryl Mills, \nFormer Chief-of-Staff to Sec. Hillary Clinton and long-time Counselor to Clinton about \nthe “scandal” associated with the Benghazi incident where the Republicans are trying to \nattack the Administration and especially Hillary Clinton for negligence/incompetence in \nnot protecting and responding in time to the Sept. 11, 2012 terrorist attack on the US \nEmbassy in Benghazi, Libya in which the US Ambassador was killed.   Cheryl says that \nthe whistle-blower Greg Hicks is clearly not telling the story as it happened with regard \nto the State Department responding or not to the threats against the embassy.   I obviously \nbelieve Cheryl.\nMay 13, 2013 – Slow down of activity on H7N9; uptick of activity with MERS Corona \nvirus (Middle East Respiratory Syndrome).  I appeared today on WTOP and BBC \ntelevision discussing MERS CoV.\nMay 15, 2013 – Testified at the Senate Appropriations Subcommittee Hearing for NIH \ntoday.   Testified with Francis Collins, Harold Varmus, Story Landis, Richard Hodes and \nGary Gibbons.   Friendly Hearing.   Asked me questions about DURC, Antibiotic \nresistant bacteria, H7N9 influenza pre-pandemic, universal flu vaccines and \nautoimmunity.   As mentioned many times above, the Hearings are very different from \n10-20 years ago.   We had 2 hours for the entire NIH, when back then we had a week of \nHearing with individual half-days for the big institutes.\nMay 17, 2013 – Interesting dinner with my friends Catherine and Wayne Reynolds at \nAdour Restaurant at the St. Regis Hotel on 16th and K Streets, N.W.   Other guests were \nJohn Rogers who was Assistant to the President during the Reagan Administration.   He \nremembered me from back then.   He went off to be Deputy to Jim Baker when Baker \nbecame Secretary of State for Reagan.   His wife Deborah was charming and a nice \nReleased by Chairman Rand Paul\n313June 1, 2013 – Ali’s II Eight boat came in 2nd in the Petit Final and 8th overall in the \ntournament – Great job, Ali!  Ali ultimately makes 1st Team All-Pac-12 Academic All-\nAmerican (for second year in a row).  She has the highest grade point average (4.05) of \nany Pac-12 athlete.\nJune 3, 2013 – Press interest continues regarding MERS-CoV.   Was on daytime CNN \ntoday plus lately other TV media “feeds” such as AP, VOA, Reuters.\nDavid Morens, Jeff Taubenberger and I just got Commentary accepted in NEJM on \nH7N9 – to come out Online on June 5.\nJune 4, 2013 – Had dinner at Matisse with Bob Bazell, 38 year TV medical reporter for \nNBC.   He is leaving NBC to join Yale Faculty.   He is a trained microbiologist before \nworking for NBC.   He must have interviewed me hundreds of times over the 30 + years \nof HIV/AIDS.   We have become friends and he wanted to have a catch-up dinner and tell \nme of his plans.\nJune 6, 2013 – See e-mail below from  to me and my forward note to Chris, \nmy children and Denise.   It describes my role as physician at NIH in the pre-AIDS days.   \nImportant historical perspective.\n-----Original Message-----\nFrom: Fauci, Anthony (NIH/NIAID) [E] \nSent: Thursday, June 06, 2013 6:19 PM\nTo: Grady, Christine (NIH/CC/BEP) [E]; Jenny Fauci \n(jennyfauci@gmail.com); Alison Fauci (ali.fauci@gmail.com); Megan Fauci \n(megan.fauci@gmail.com); Denise Scorce\nSubject: FW: Personal from \nFolks:\n   \n \n   They call it \"of childhood\" because patients never lived \nbeyond childhood.   I first started taking care of   at NIH when  \nwas 6 years old.  These patients die of fungal and other infections.   \nI kept  alive for several years until  had had so many liver \nabscesses that when  was 12 years old,  had another liver abscess \nwith Aspergillus, a deadly fungus.   The surgeons refused to drain it \nbecause they said that the surgery would kill  and they did not want \nto have someone die in the operating room.  I wanted to keep  alive \nin hope that  we could some day find a therapeutic approach that might \nsave .   I told the surgeons that  definitely would die if they \ndid not operate on  and that this tradition that \"no one should die \nin the operating room\" was frankly \"b--s--t\".  They still would not \noperate.   I kept pushing and pushing them until they reluctantly \ncomplied.    survived the operation and then a couple of years \nlater,  treatment (gamma interferon) was found (by John Gallin) to \nprevent  infections.   Several years later  \"grew out\" of  \ndisease and now  does not require any therapy.  \n     Life is \ngood.\nReleased by Chairman Rand Paul\n\n314Dad/Tony/Anthony\n-----Original Message-----\nFrom:  \nSent: Thursday, June 06, 2013 2:59 PM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Personal from \n  \n \n   \n \n   \n \n  \nJune 9, 2013 – Had dinner with the Heads of International Research \norganizations (HIRO) at the Hyatt Bethesda Hotel.   Francis Collins is \nthe Chair this year and so they meet in the USA.   Francis asked me to \nbe the after dinner speaker with Eric Goosby.   I spoke about the \nthreat of MERS-CoV and H7N9 Influenza and Eric spoke about PEPFAR.\nJune 10, 2013 – Met with Tim Hallett (of the UK’s London School of \nTropical Health and Hygiene) and Eric Goosby in Eric’s office to \ndiscuss Tim’s mathematical model for concentrating PEPFAR’s efforts on \n“Hot Zones” of infection within a given country as opposed to targeting \nwhole countries or regions.   Mark Dybul is very much in favor of this \napproach and since he is now Executive Director of the Global Fund, he \nwanted me to convince Eric that PEPFAR should take this approach.   \nHence, Mark arranged this meeting of me, Tim, and Eric.   Eric in his \nusual good careful approach is somewhat skeptical of “Models”\nJune 14, 2013 – Please see hyperlink to historical AIDS posters from \nACT-UP:\nhttp://huff.to/10fto8L\nJune 17, 2013 – Met with Senate Democratic Majority Leader Harry Reid \n(D-NV) in Building 10, Room 5-1608 to discuss the exciting things in \nresearch such as universal flu vaccine.   Also there was Francis \nCollins, Story Landis and Gary Gibbons.  We must have done some good \nsince the next day Sen. Reid came out with a statement that the \nsequester should exclude NIH.\nJune 18, 2013 – Good Day.   Went to the 10th Year Anniversary \nCelebration of PEPFAR at the Dean Acheson Auditorium in the State \nDepartment.   Sen. Kerry presided and in his introduction called me out \nvery generously.   Below is the text of his statement.   It is clear \nthat my friend Eric Goosby helped his staff write it:\nReleased by Chairman Rand Paul\n\n315Remarks at the President's Emergency Plan for AIDS \nRelief (PEPFAR) 10th Anniversary Celebration\nRemarks\nJohn Kerry\nSecretary of State\nDean Acheson Auditorium\nWashington, DC\nJune 18, 2013\nThank you very, very much everybody. What a pleasure to be here. This is a really great \ncelebration. This is special. And if anybody here – I know you’re here because you are \ntouched by it – but what a wonderful thing to celebrate the 10-year anniversary of this \nremarkable intervention that represents the best of the human spirit, and also I think in \nmany ways, the best of American leadership. It’s something we can really be proud of, \nand we can be possibly not prouder at all of any effort by any individual than the \nremarkable effort, the amazing job of developing the PEPFAR programs and taking on \none of the greatest health challenge crises of our time. I cannot thank enough the \nleadership of Ambassador Eric Goosby, who has been spectacular in this effort. \n(Applause.) Thank you. Thank you.\nAnd I want to thank Tatu. Thank you so much for being here with us. I couldn’t be more \npleased than to welcome you and your daughter, Faith, here to the State Department. I \nthink you are an inspiration to everybody in this room and to everybody who knows your \nstory, which everybody will learn more of. But you’re a living example of the impact and \nmeaning of this program, and we thank you for coming here to share with us.\nAlso, when it comes to vision and leadership, I’d be remiss if I did not recognize Dr. \nTony Fauci. Tony has been there since the very beginning, and he has taught us all that if \nwe follow the science, we can truly achieve an AIDS-free generation. And I’m not sure \nthere would be a PEPFAR today if it were not for the leadership of Tony, and we owe \nhim all our thanks, so thank you very much. (Applause.)\nAnd I know full well after 29 years on the Hill that without the right senators and \ncongressmen and women behind this kind of effort, it doesn’t happen. And when this \nstarted up, it started up with a lot of courage by individuals who were willing to step up. \nIt didn’t exactly have the unanimous consent not only of the people in the Congress \ninitially, but in the country. So I want to thank Senators Mike Enzi and Ben Cardin for \ntheir leadership, and thanks for being here today; I know you’re going to hear from them. \nAnd I also want to thank my good friend and colleague Senator Johnny Isakson and the \nother members of Congress who are here. We salute you all for coming and sharing in \nthis celebration, and that is what it is.\nReleased by Chairman Rand Paul\n316Everybody knows that as you look at Congress today, not every day produces the kind of \nexceptional bipartisan cooperation that created the celebration we’re here to enjoy today. \nThis is one issue where I can happily say that partisanship has really almost always taken \na backseat. And in fact, the success of this effort shows what can happen when you reach \nacross the aisle and you do wind up working together.\nI want to thank Richard Nchabi Kamwi for – he’s the Health Minister from Namibia – I \nwant to thank him for being here with us today. Namibia has been hugely impacted by \nthis disease, but through the Minister’s efforts, and our partnership with his country, we \nare seeing extraordinary progress.\nAnd to everyone else here, I know that so many of you here are the stakeholders in this \neffort and you’ve worked hard on it, and I thank you for what you’ve done and I welcome \nyou here at the State Department on this tremendous occasion.\nI want to acknowledge one person who, sadly, is not here today, and that’s Michael \nTaylor Riggs. Michael was a former congressional staffer whose hard work and \ndedication helped to make PEPFAR a reality. And as many of you know, Michael passed \naway last month at the age of 42. And we miss him, and we thank him for his leadership. \nAnd while we celebrate today’s anniversary, I think all of us are thinking of Michael as \nwell as the millions whose lives this terrible disease touched: the mothers and fathers who \nlost children, the children who were left orphaned, the friends and loved ones left behind, \nthe communities that were devastated, from San Francisco to Soweto.\nI met a number of these young people who were affected by this disease when Teresa, my \nwife and I, visited the Umgeni Primary School outside of Durban. And I’ll never forget \nthe visit, walking around these mud huts with a grandmother who was coughing badly \nfrom HIV infection, and young kids whose – the only – the gap between them was \ngenerations wide. And we saw these orphans who were robbed of their parents, who were \nforced to take on the burden of adulthood at the age of 13, 14, 15, and caring for their \nyounger siblings.\nWe were heartbroken at hearing what these children had been through, and you couldn’t \nhelp but feel this agony and this total disruption of the way life is supposed to be. But we \nwere also inspired. We saw in their faces the amazing resilience of humanity, and it said \nsomething about all of us, and to all of us as well. Because when we all looked lost, when \nthis disease appeared to be unstoppable, history will show that humanity and individual \nhumans rose to the challenge. Action was taken. Innovations were discovered. Hope was \nkindled, and generations were saved.\nThe success of PEPFAR, as well as efforts by the entire global community, including the \ngreat work done by the Global Fund, represents in truth a victory for the human spirit. \nAnd with the Global Fund replenishment happening this year, now is the time for all \ndonors to join with the United States to support and strengthen the fund. The fight against \nHIV and AIDS shows what we can accomplish when we make the effort together, join \nhands, overcome the ideology and the politics, and really dedicate our hearts to win.\nReleased by Chairman Rand Paul\n317None of this was easy, and frankly it’s really worth remembering for a moment how \nbleak things looked at a certain point in time. A decade ago, when the world finally began \nto reckon with the full magnitude of this crisis, many experts thought it was too late, and \nwith nearly 30 million people infected with HIV/AIDS in 2002, an entire generation \nseemed lost. When I looked at the enormity of the challenge at that point in time, \ncandidly it was hard not to be overwhelmed to some degree, and perhaps even a tiny bit \npessimistic.\nBut I also felt that we had to do something, and so did many of my fellow senators, I am \nso happy to tell you, especially Bill Frist and ultimately Jessie Helms. I was proud to \nserve with Senator Frist as a founding co-chair of the bipartisan HIV/AIDS taskforce, a \ngroup that was instrumental in helping us to be able to prepare and lay the groundwork \nand pass the first AIDS legislation in the United States Congress – unanimously, I might \nadd, in the Senate, thank to Jesse Helms’ and Bill Frist’s efforts – so that that was signed \nby President Bush in 2003. That translated ultimately into PEPFAR.\nThis landmark legislation created the world’s largest and most successful foreign \nassistance program, and today a disease that seemed unstoppable is in retreat. Globally, \nnew HIV infections have declined nearly 20 percent over the past decade. In Sub-Saharan \nAfrica, both the number of new infections and AIDS-related deaths are down by almost \none-third over the last decade. Last year alone, PEPFAR supported HIV testing and \ncounseling for nearly 50 million people, and while just 300,000 people in low and middle \nincome countries were receiving anti-retroviral treatment 10 years ago, today PEPFAR is \ndirectly supporting more than 5 million people on treatment.\nBecause of these successes, I am honored to make a very special announcement today, an \nannouncement that we could literally only have dreamed about 10 years ago. Thanks to \nthe support of PEPFAR, we have saved the one millionth baby from becoming infected \nwith HIV. That is a remarkable step. (Applause.)\nAnd as you know, preventing mother-to-child transmission has been a central pillar of \nour fight against this disease, and just this month we reached the truly landmark moment \non the HIV/AIDS timeline. Imagine what this means – one million babies, like Tatu’s \ndaughter Faith, can grow up happy and healthy, go to school, realize their dreams, break \nout of this cycle, maybe even have sons and daughters of their own, free from the burden \nand the fear of HIV.\nThat is not the only good news. I’m also pleased to report that in 13 countries, we have \nnow passed a programmatic tipping point. Today, more people are newly receiving \ntreatment than are newly infected. We are at this point, thanks to the combined and \ncoordinated efforts of all partners in the fight of global – against global AIDS. That is \nwhat has brought us to this moment.\nBut in order for more countries to pass this tipping point and keep going in the right \ndirection, we still need to reach those who are at the greatest risk of HIV infection. That’s \nwhy last July, the United States announced the creation of a new $20 million fund to \nReleased by Chairman Rand Paul\n318support key populations, people who are too often stigmatized, at risk, and neglected. \nAnd that means particularly men who have sex with men, it means people who inject \ndrugs, and it means sex workers. And it’s my pleasure today to announce that the \nrecipients of this funding, Cambodia, Ghana, Nepal, Senegal, Swaziland, Zimbabwe, and \ntwo regional programs, are going to have the benefit of this going forward.\nThis has been a decade of remarkable progress, my friends. But obviously, our work is \nnot done. Millions still become infected every year and millions are still dying. But we \ncan now say with confidence something we could perhaps only have dreamed of before, \nas I said, and that is we can achieve an AIDS-free generation, and that is within our grasp \nnow.\nSo to get there we’re going to have to stay at it. Under President Obama’s leadership, we \nhave redoubled our efforts. Through PEPFAR, the U.S. now directly supports three times \nmore people on antiretroviral drugs today than we did in 2008.\nWhere we once saw a situation spiraling out of control, today we see a virtuous cycle \nbeginning to form, with more people receiving treatment and fewer people passing on the \nvirus. Fewer infections means it is now easier to actually focus treatment efforts. And \nwith fewer people sick and dying, we are seeing healthier, more productive populations. \nThat’s the virtuous cycle. The economies of Sub-Saharan Africa are growing at a \nsubstantial rate, and a generation is now able to look to the future with hope.\nAs the progress continues, PEPFAR, over its next decade, will gradually evolve as our \nfight against this disease evolves, and that is going to happen both by necessity and by \ndesign. Achieving an AIDS-free generation is a shared responsibility and it is going to be \na shared accomplishment. That is why PEPFAR is working to gradually and \nappropriately transfer responsibilities to host countries. This means that PEPFAR will \nshift from merely providing aid to co-investing in host countries’ capacity.\nTen years after this program began, rest assured that the commitment of President \nObama, the State Department, myself, this country’s commitment to fighting HIV/AIDS \nis as undiminished as our work is unfinished. Our commitment has only been \nstrengthened by the progress that we’ve made and the lives that we’ve saved and this \nstory that we are able to tell today. This story compels us to continue.\nWhat has been achieved here is a lesson for all of us. And I think it is, in fact, a lesson \nthat people should believe in humanity. To never doubt what we can achieve is one of the \nlessons of today, to know that we can do the remarkable, that we can find solutions to \nwhat seems to be unsolvable, that we can overcome the insurmountable and we can leave \npolitics and ideology at the wayside in order to choose life and possibilities for people \neverywhere.\nBecause of this faith, because of this program, because of your efforts, because a mother \nlike Tatu could live to see her child grow up to change the world – that is why we will \ncontinue\nReleased by Chairman Rand Paul\n320Aug. 1, 2013 – Underwent review of my performance as NIAID Director over past 3 \nyears since my last review in 2007.  Reviewers were Laurie Glimcher, Adel Mahmoud, \nDennis Kasper, and Diane Griffin.   Went extremely well.\nAlso, Secretary Sebelius visited NIH today and I was part of the delegation that met with \nher.   I discussed with her the potential for a universal influenza vaccine.\nAug. 2, 2013 – Met with a delegation from the country of Georgia.   I had previously met \n2X over the years with the First Lady of Georgia.   Today met with the Minister of Health \nand the Georgian Ambassador to the USA.   Good meeting.\nAug. 5, 2013 – Had removal of parathyroid adenoma at GW Hospital by Dr. Stanley \nKnoll.   Went very well and was back at work 2 days later.  Very little pain.\nAug. 6 – 8, 2013 -  Papers came out in Science, Nature, BMJ, etc. that generated major \npress interest.   First was Bob Seder’s and Steve Hoffman’s malaria vaccine paper in \nScience; another was a report in BMJ of human-to-human transmission of one case of \nH7N9 from father (60 y.o.)  to daughter (32 y.o.); finally, Fouchier and Kawaoka wrote a \nstatement in Science/Nature giving their reasons why they want to go ahead with gain-of-\nfunction (GOF) research on H7N9 and other influenzas.   They respect the concerns of \nHHS and say they will recognize restrictions.   HHS wrote a letter to Science stating the \nHHS position that GOF function experiments with H7N9 that increase transmissibility by \nrespiratory route in mammals will go to additional level of review at the HHS level \n(Framework Approach – see above).   For the latter, I was quoted liberally by AP in page \nA3 of the Washington Post on Aug. 8.   Also, regarding the daughter transmission, I was \non WTOP on Aug. 7 and appeared on CNN Wolf Blitzer Situation Room on Aug. 7.  \nAlso, on August 8, Al Jazeera, China News Service, was on NPR All Things Considered \nfor the malaria vaccine as well as BBC and on Aug. 9, NPR Science Friday.   Regarding \nthe statement by Fouchier and Kawaoka, this generated the usual push-back from the \npeople who feel that these experiments should not be done – Mike Osterholm, Ebright, \nAdel Mahmoud, Mike Imperiale, etc.    My quote was measured and emphatic in the Post \nthat said that added level of review was necessary.\nAug. 10, 2013 -  Had long talk at home over phone on Saturday (today) with Mike \nGerson who will write a Washington Post column on the successful malaria vaccine trial \nthat we conducted at the Clinical Center (paper published in Science with Bob Seder as \nfirst author.   His article will appear on August .\nAug. 16, 2013 -   Taped a tribute to Ted Kennedy and Vicki Reggi Kennedy for a Susan \nKomen event honoring them that will take place at the Kennedy Center in September.\nAug. 20, 2013 – Met with Deputy Minister for Health of the Kingdom of Saudia Arabia – \nDr. Ziad Memish.   He is visiting with regard to establishing scientific collaborations with \nNIH and CDC on the MERS-CoV.   He has admired me for years and was very happy to \nmeet and interact with me.\nReleased by Chairman Rand Paul\n321Aug. 22, 2013 – Nice piece on me and my “Leadership” in the ONLINE version of the \nWashington Post.   Will also appear in print version soon.\nSept. 7, 2013 (Saturday)– Went to an “A-List” party at the home of Jane and Calvin \nCafritz on R and 29th Street, N.W.   Usual glitterati there with Senators (Markey), \nGenerals (Casey) many ambassadors.   Very enjoyable night.   During the evening, \nAmbassador Walter Cutler (former Ambassador to Saudi Arabia) had a vas0-vagal attack \nand they called for a physician.   I attended to him and the story made it into the Style \nsection of the Washington Post on the following Monday.\nSept. 3 – 10, and beyond) – Obama threatening to attack Syria since Assad used \nChemical weapons (Sarin Gas) against his own citizens.  At first the POTUS said he \nwould attack imminently.   Then, after it was clear that there was not universal support \ndomestically or internationally for this approach, Obama hesitated and said he would go \nto Congress to get “authorization” even though he claims that he already has \nauthorization to attack Syria.   He is definitely giving a garbled message.   New slant is \nthat Russia who would veto any UN resolution against Syria is trying to broker a deal that \nif we do not attack, Syria will allow international control of their Chemical weapons.   \nMore Later.\nSept. 10, 2013 – Went to Rooftop Recption dinner hosted by the Friends of the National \nLibrary of Medicine at 101 Constitution Avenue, N.W. with a breath-taking view of the \nCapitol.   I gave laudation/award to Ray Schinazi for his discover of Lamivudine, \nEmtricitabine, and sofosbuvir.  Very enjoyable night.\nSept. 11, 2013 – Gave Great Teacher’s Lecture at the Masur Auditorium in the Clinical \nCenter as part of celebration of 60th Anniversary of the NIH Clinical Center.   Spoke of \nEnding the AIDS Pandemic; however spent first part of talk on ny history in coming to \nand working in the Clinical Center for over 40 years.   Packed house in Masur and over-\nflow in Lipsett Auditorium.  Amazing how time flies by.   I remember the first day that I \narrived and parked in the lot diretly in front of the CC and bumped into Alba Cosenza.\nSept. 19, 2013 – I called an important Summit that took place at Bethesda North \nMarriott.   Purpose was to discuss the advisability of using Adenovirus vectors for HIv \nvaccines given the failures of Ad5 vectors in 3 vaccine trials, but more importantly the \nfact that there were “trends” in each study that showed an enhancing effect on acquisition \nof infection in the vaccines who received the Ad5 vector.  Meta-analysis of the 3 studies \nshowed a significant (<0.01) 32% enhancement of infection.   Big question is that there \nare ongoing plans to use other vectors (Ad26, among others) in future HIV vaccine trials \nas well as in non-HIV vaccine trials (malaria, TB, etc.) in populations that might be at \nrisk for HIV.   Seems to me that any vaccine that activates cells that might migrate to the \nmucosal surface can have an enhancing effect that is seen if the vaccine is not efficacious.   \nIf the vaccine is efficacious, then the enhancing effect is masked as might have been the \ncase with the 31% efficacy of the RV144 trial.   Important issue is to try to get the \nefficacious vaccine and not do a trial on an Ad vector unless it shows an immune \nresponse that would be better than any other vaccines that we have tried.\nReleased by Chairman Rand Paul\n322Sept. 20, 2013 – Went to Lasker Lunch at the Pierre Hotel in NYC.  Beautiful Fall Day.   \nBill and Melinda Gates won the Bloomberg-Lasker Award for Public Service that I had \nwon a few years ago.   Nice event.   Bill and I discussed briefly the challenges of the P5 \nvaccine agenda.\nSept. 23, 2013 – Went to Friends of Cancer Research Awards reception on the roof of the \nHay-Adams hotel.   Beautiful Indian Summer nuight and spectacular view of White \nHouse.   Invited by Ellen Sigal.   She seated me in first row of award ceremony after \nreception.   Present were Governors Martin O’Malley of MD and Robert McDonnel of \nVA.  Got to chat with both.  Usual glitterati reception.\nSept. 27, 2013 – Had great typical dinner with Wayne and Catherine Reynolds at the \nJefferson Hotel.   Intimate setting with about 20 people at dinner – Rick Atkinson and \nwife Jane (Rick is strongly encouraging me to get going in writing my book); Gen. James \nJones and wife; Gen. Colin Powell and Alma Powell; John Rogers (Goldman Sachs and \nwife Deborah Lehr); Ben Carson and wife Candy; journalist Dana Priest; Steve \nRosenberg and wife Alice, among others.   Stimulating conversation regard imminent \nshutting down of the USG due to  stalemate on budget between Republicans (who want \nto defund Obamacare) and Democrats (who want a clean bill to keep government going \non a CR without touching Obamacare).   Difficult to predict what will happen on Monday \n(Sept. 30) at midnight, when the current fiscal year ends.   During dinner varied \ndiscussion.   I spoke passionately about the stupidity of across the board cuts in \nBiomedical research as part of the sequester and how this will damage our standing as the \nworld leader in biomedical research.\nSept. 28-30, 2013 – Threat of US government shutdown due to impasse in discussions \nbetween Republicans (Speaker Boehner – driven by T Party extremists) and Democrats \n(POTUS and Sen. Leader Harry Reid).   GOP wants to negotiate defunding Obamacare or \nat least modifying (delaying) individual mandate before they pass a CR to keep \ngovernment open after Sept. 30.   POTUS refused to negotiate “with a gun to my head”.  \nHe says: “pass CR and then we negotiate; also raise debt limit without conditions”.  I \nhave prepared a video tape of my Opening Keynote for the Barcelona AIDS Vaccine \nmeeting on Oct. 7 in preparation for possibility that I will not be able to travel to Spain.   \nRule is that if USG shuts down, then no USG employee travels.\nOct. 1, 2013 – Government shut down.   NIH begins to furlough 70+% of our work force.\nOct. 7, 2013 – I obviously did not leave for Spain.  Was scheduled to leave on Oct. 5 to \narrive on Oct. 6.   My video was played on this evening.   I put an extraordinary amount \nof time over the previous 5 weeks preparing this talk and it was one of the best that I have \ndone.   It was received with overwhelming praise as many people e-mailed me after the \nvideo was shown (7:00 PM Barcelona time – 1:00 PM DC time).   People were tweeting \neven during the lecture.   Gepi Pantaleo e-mailed me right after the lecture and said that \n“it was amazing”.   \nReleased by Chairman Rand Paul\n323Our government is dysfunctional with neither side giving any indication of negotiating.   \nLikely to be shut down until and beyond the debt ceiling deadline of October 17.   This \nwill mean that I will miss several other talks including the upcoming award that I am \nsupposed to receive in San Francisco from the SF AIDS Foundation (SFAF) on Saturday, \nOct. 12.  Stay tuned.\nOct. 8, 2013 – Bill Gates was supposed to deliver the Barnes Lecture and tour the NIH \nyesterday, but it was cancelled because of USG shutdown.  Francis Collins, Harold \nVarmus and I went to the Gates office in DC at 1300 I Street, N.W. to meet with him at \n9:00 AM.   Francis, Harold and I met at Starbuck’s at 1225 – I Street, N.W. at 8:20 AM \nto plan strategy.   Visit with Bill went very well.   I have met previously with Bill several \ntimes including at his home in Seattle.  The conversation today focused mostly on \ncollaborations that I and NIAID have with the Bill and Melinda Gates Foundation \n(BMGF) including the P5 vaccine trials, the HIV antibody – immunogen studies, the \nSanaria malaria project, etc.   Excellent discussions and we will expand NIH - BMGF \ncollaborations.  \nOct. 12, 2013 – Government still shut down.   POTUS refuses to negotiate under threat \nof shut-down and debt ceiling debate.   House GOP (Speaker Boehner)  refusing to let \nvote go to floor to open USG and raise debt ceiling since the combination of moderate \nrepublicams and Democrats in the House would pass it.    I miss the trip to SF to get \naward from SFAF.\nOct. 16, 2013 -   Still shut down.  Senate agrees on Bill to open USG and raise debt \nceiling.   Waiting on House and Boehner.\nWent to dinner at Villa Firenze (home of Italian Ambassador to the USA, Claudio \nBisogniero) at 2800 Albermarle Street, N.W. to honor visit of Italian Prime Minister \nEnrico Letta (recently elected, 47 year old).  Festive  occasion with many of the usual DC \nglitterati.   Had nice conversation with: Wolf Blitzer (CNN), Valerie Jarrett (White \nHouse), Susan Rice (National Security Advisor), Nancy Pelosi, Sen. Ed. Markey, Phil \nPiccagallo (Suns of Italy).   Sat next to Maj. Gen. Giovanni Fantuzzi, Military Attache for \nthe Italian Embassy, Linda Douglas (formerly of network TV and White House who was \nwith husband, the newly appointed Ambassador to Italy, Amb. Philip.   The opening of \nthe USG was announce as we were at the dinner when Nancy Pelosi and Ed Markey \nreported that a deal was reached.\nOct. 17, 2013  -  USG opens and debt ceiling raised temporarily until Jan.   Likely a \nsimilar battle will occur in January.\nOct. 18, 2013 – Terrific meeting today.   Paul Stoffels, Chief Scientific Officer of \nJanssen research Foundation, part of Johnson & Johnson called me months ago asking to \nhave a meeting since he wanted to support and develop the Ad26 vector – HIV mosaic \ninsert vaccine candidate of Dan Barouch.   I have always liked working with Paul since \nhe is the real deal as an honest scientist and smart drug developer/businessman.  He came \nin from Belgium with a team from Crucell company that was recently purchased by \nReleased by Chairman Rand Paul\n325Following the visit to Larry I went back to my hotel which was the", "summary": "Watcher-discovered document from paul-readingroom (2026.08.05_Diary-Prequel-_Redacted.pdf), auto-indexed 2026-08-06.\n\nExcerpt: be virtually impossible to “restrict” the access to the full  papers by a “vetting” mechanism of people who “apply” for the  unredacted papers.  Journal editors were disappointed (Bruce Alberts –  Science and Phil Campbell – Nature) as were many flu scientists.    However, we heard the usual hysteria from people like Ebert and  Ingelsby who complained that the experiments should never have been  done in the first place.  Also, Mike Osterholm who is a member of the  NSABB was practically hysterical that the NSABB recommendations should  go out right away so that he could “answer all of the press calls” that  he was getting.   In reality, the only press that was agitating was –  you guessed it – Laurie Garrett. Of note, Mike Osterholm is the Head of  the CIERS group that subcontracted…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/08/2026.08.05_Diary-Prequel-_Redacted.pdf", "pdf_url": "/archive-docs/fauci-files/b5b0ed807aff8eaf2c6607cc328a591e/pdf", "doc_date": "2026-08-06", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-08-05-diary-prequel-redacted"], "part_number": 5, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 6 of 7)", "content": "Hotel Excelsior on \n81st St. between Columbus Avenue and Central Park West. The ceremony at the \nMuseum of Natural History was stunning in the positive sense. I completely \nunderestimated the importance of this particular function. The annual function makes \nReleased by Chairman Rand Paul\n326three major awards to biotech companies, pharmaceutical companies, and companies that \ndevelop devices. It is essentially the Academy Awards of pharmaceutical/biotech \ncompanies. I gave the keynote address associated with my receiving the Pro Bono \nHumanum Award.   This award is given every year.   Over the past 3 years it has been \nwon by Francis Collins, Paul Farmer, and Bill Clinton.   The dinner gala was held in the \nWhale Room of the Museum of Natural History. All the elite of the biotech world, the \npharmaceutical world, and the academic world were in the audience, which consisted of \nabout 500 people I gave an address on “Ending the HIV/AIDS Pandemic:   From \nScientific Advances to Public Health Implementation.  Importantly I was introduced and \npresented the award by Elie Wiesel. It was an extraordinary honor to receive the award \nby him. I returned to Washington DC first thing in the morning to a very busy week.\nOctober 27, 2013 – Went to reception and showing of a movie by famed young Indian \nactor, director, producer Aamir Khan at Jefferson Hotel at invitation of Catherine and \nWayne Reynolds.   Film was on female fetocide in Indian culture.   Quite moving.  Khan \nis a multi-millionaire visionary and pioneer for human right causes.\nOctober 28, 2013 – Appeared via teleconference at a NY State AIDS Institute \nConference in NYC organized by Mark Harrington and TAG.   They wanted my input on \nhow we can truly put an end to the AIDS epidemic in NY State.   Mark Dybul phoned in \nafter me from Geneva and the Global Fund.   \nOctober 31, 2013 – Been in press over past few days regarding recent papers in Science \nand other journals on the HIV envelope resolution by cryo-EM by Ian Wilson, Dennis \nBurton, John Moore.   Also on WTOP today regarding polio in Syria.  \nNov. 3, 2013 – Went to San Francisco for day – flew in the AM, gave Keynote at the \nLancet/Cell Conference on “Achieving an AIDS-Free World”.   My talk was widely \nquoted and praised for its comprehensive analysis of the opportunity and challenges in \nachieving an AIDS-Free world.   Richard Horton (Editor of The Lancet) praised me in \nseveral subsequent commentaries and editorials.   This is now a highly visible and much-\ndiscussed issue of an AIDS-free generation.   I am leading the discussion, but with the \nusual caveats that it is not yet time for a “victory lap” since much needs to be done and \ndespite great scientific and implementation advances, this is not on automatic pilot.   I \nflew back on “red eye”.   Hence 12 hours in the air and about 10 hours in SF.   This is my \nlife.\nNov. 11-16, 2013 -   Great trip with Christine to visit Oxford and give the Unither Baruch \nBlumberg Lecture at Oxford on “Ending the HIV/AIDS Pandemic:  From Scientific \nAdvances to Public Health Implementation”.  Met with Raymond Dwek and other \ncolleagues.   Visited historic sites within Oxford and enjoyed seeing places where Willis \n(Circle of Willis), Harvey (circulation) and Francis bacon lived and went to school.   I am \nnot usually moved by these things, but this was good.\nOn Nov. 13-14, went to Berlin to receive the Robert Koch Gold Medal.   Great honor.   \nJeffrey Gordon of Washington University received the Robert Koch Prize for his work on \nReleased by Chairman Rand Paul\n327microbiome.   My Medal was for lifetime achievement in medical science.   Peter Palese \ngave the best introduction of me ever.   He seriously compared my career to that of \nRobert Koch in that I attacked a brand new disease (HIV/AIDS) in the same manner that \nKoch approached and studied Anthrax, TB, etc.   It was a humbling and exciting visit.   I \ngave the Robert Koch Lecture at the Max Planck Institute and reacted with many \nstudents.  Also saw old friends Stefan Kaufman (nominated me), Fritz Melchers, \nHermann Wagner, etc.   Visited Checkpoint Charley, Brandenburg Gate, The Reichstag.  \nGreat honor and enjoyable visit.\nNovember 19, 2013 -  Yesterday I appeared on Local TV Station WUSA – Channel 9 \nNews  at 7:00 PM to discuss the recent outbreak of meningococcal meningitis at \nPrinceton University. Since March, 2012 that have been a total of seven cases of \nmeningitis among Princeton students. Six of the cases were among resident students and \none was a case from a visitor. The type of the meningitis was meningococcal type B, \nwhich is not contained in the vaccine that is distributed generally among students and \nyoung people in United States. The standard vaccine contains types A, C, Y, and W-135.. \nNone of the students died from the meningitis. I will be appearing today on the radio \nWTOP to discuss the situation. The FDA has given approval for importation of type B \nvaccines from Novartis Company in Switzerland. It still remains to get approval from the \ninstitutional review board of the CDC. As usual HHS Public affairs has balked at my \ngoing on the media because they consider this a CDC issue. This time with support from \nJohn Burklow, we asked for permission, they said no, and I went on TV last night \nanyway. I am going to appear on radio this morning again. This is a turning point in our \nrelationship with HHS who continue in a completely crazy way to rty to block our going \non the media in situations that they feel belong to CDC even though the Media \nspecifically ask for me.\nNovember 20, 2013 – This was one of the most magical evenings that I have had in \nWashington in the 40 years that I have been here. I was invited with Christine to go to a \nCelebration of the 50th anniversary of the conferring of the Presidential Medals of \nFreedom. The event was held at the Smithsonian Museum of American History on 1300 \nConstitution Ave. NW., District of Columbia. The event was in celebration of several \nthings. It commemorated the 50th anniversary of the assassination of Pres. John F. \nKennedy. It also was the 50th anniversary of the establishment of the Presidential Medals \nof Freedom by Pres. Kennedy. We found out in a historical examination of the situation \nthat Kennedy established the Presidential Medal of Freedom in February of 1963. He was \nintending to give out the first metals in December of 1963. However, as we know, sadly \nhe was assassinated on November 23, 1963. Pres. Lyndon B. Johnson went ahead and \nconferred the medals one month after the death of Pres. Kennedy. He conferred the \nMedal to Pres. Kennedy post-humously and gave it to Jacqueline Kennedy who received \nit on her deceased husband's behalf. The reception and dinner that was held at the \nMuseum of American History was extraordinary. Virtually everyone who is anybody in \nWashington, DC was there and it was highly populated by people who in the past had \nreceived the Medal. I had the opportunity to speak with Pres. Obama, President Clinton, \nas well as a nice conversation with Hillary Clinton. It was also the first time that I had the \nopportunity to speak with first lady Michelle Obama. The number of celebrities that were \nReleased by Chairman Rand Paul\n328brought together for a group picture of all the former Medal winners as well as the people \nwho recently won this year including people like Ben Bradley, Ernie Banks and others. It \nwas truly an extraordinary evening. I mingled and talked with Ernie Banks and Hank \nAaron,  Bill Russell, generals, statesmen, et cetera. The evening was highlighted by a \nspeech by Pres. Obama regarding the legacy of Pres. John F. Kennedy. In a poignant \npoint in the evening, Pres. Obama was introduced in his speech by Jack Schlossberg who \nis the son of Caroline Kennedy and the grandson of Pres. Kennedy. Sitting at my table \nwas former CIA director and FBI Dir. Bob Webster, Doug Kramer who is the former \nstaff secretary to the President and currently General Counsel for USAID. Sitting right \nnext to Christine was the legendary race car driver Richard Petty. All in all it was a truly \nspectacular evening there was entertainment by one of this year's Medal winner, Cuban \nmusician Arturo Sandoval who was a protégé of Dizzy Gillespie. He gave one of the \nmost extraordinary trumpet performances that I have ever heard in addition to \nextraordinary singing ability and a phenomenal piano piece that he played. Again this \nwas truly an extraordinary evening.   It was black tie, elegant setting.  Military regalia as \nper the presence of the POTUS.   The night was chilly, crisp and clear.\nLIST OF ATTENDEES AT GALA on Nov. 20:\nExpected Attendees at the Dinner in Honor of Presidential Medal of Freedom Awardees  The White House.mht\nNovember 21, 2013 - Funding of PEPFAR and Replenishment of Global Fund to \nFight Aid TB and Malaria (GFATM) – Over the past several days there has been \nconsiderable activity about the issue facing the funding of PEPFAR for 2015. The \nactivists are pushing to have 12 million people on therapy by 2016. The global goal is 15 \nmillion people on therapy by 2015. The Obama administration will not give additional \nfunding for PEPFAR that would allow them to reasonably achieve the goal of 12 million \npeople on therapy by 2016. Therefore, the State Department and the people at PEPFAR \nare struggling with how to message something that would be disappointing when you \nlook at the numbers. I've had pre-calls with Deborah VonZinkernagel and today (Nov. \n21, 2013) we had a call with three people from the State Department – Daniella Ballou-\nAares, Lorrie McHugh-Wytkind, Eric Goosby and Deborah.  I was up in NYC for the day \nto appear on an Atlantic Magazine-sponsored panel and Webinar on a similar subject: \n“Talk is Cheap: Saving Lives, Ending AIDS and Putting Our Money Where Our Mouth \nIs”.  As an aside, other participants in that Atlantic Magazine panel where Peter Staley, \nNancy Mahon (MAC Cosmetics), Jeffrey Sachs (Columbia), Phill Wilson (Black AIDS \nInstitute), Luis Loures (UNAIDS).  Stephen Lewis (AIDS-Free World), Wafaa El-Sadr, \nDanny Resnic (Origami Condoms) and Deborah Persaud (Hopkins).  The Session was a \nbig hit.\nBack to the telephone conversation with PEPFAR and State.  I made the strong \nsuggestion that the PEPFAR people and the Department of State bite the bullet and tell \nReleased by Chairman Rand Paul\n329the truth about what they can and cannot do. One of the problems is that if they stick by \nthe promised numbers without the resources to achieve those numbers it will turn out that \nthey will overpromise something that they cannot deliver on. Note the similarity to the \nroll-out of the Affordable Care Act – a true mess-up).  I warned them as to the danger of \nthis. They should suggest to the White House that they assume a leadership role in getting \nthe entire global community to increase their support of the treatment goals. We cannot \nget to that goal ourselves since we do not have the resources. I feel that it would be \nappropriate for us to put more resources in. However, OMB refuses to put any more than \njust about $150 million more into the 2015 PEPFAR budget. The phone call went well \nand I hope that they take my advice. More to come.\nAnnouncement was made today that David Ho and I have won the Prince Mahidol \nAward from Thailand.   We will receive it for medical research and Peter Piot and Jim \nKim will receive it for Public Health.   Ceremony will take place in Bangkok on January \n28, 2014\nNovember 26, 2013 – We here at NIH have been working on the schedule for the visit of \nBill Gates to the NIH on December 2, 2013. There was considerable concern that this \nmight conflict with the annual World AIDS Day celebration at the White House which \nwould involve Pres. Obama that might be scheduled on December 2. However the White \nHouse announced that they will have the celebration on December 3 which avoided a \nconflict with the Bill Gates visit. Considerable planning went into the scheduled Gates \nvisit with my playing a major role in showing him around and leading discussions.  \nHowever I just heard literally minutes ago from the White House that the World AIDS \nDay ceremony will take place on Monday, December 2. This directly overlaps and \nconflicts with the Bill Gates visit. This will be very disruptive and upsetting to both Bill \nGates and the NIH since the last time Bill Gates was scheduled to visit the NIH was the \ntime that the government shut down in October, 2013. I will wait further instructions \nfrom the White House since I have been assigned a major speaking role at the World \nAIDS Day celebration at the White House. I am supposed to speak on the “Care \nContinuum” and the road to a “cure” for HIV/AIDS.  More to follow.\nDecember 2, 2013 – Monday and cold cloudy day is DC.   Celebration of World AIDS \nDay (WAD) today since December 1 was a Sunday.   Also, Bill Gates visited NIH to \ndeliver Barnes Lecture and to be shown around NIH:\nGates – Francis Collins, I, and Clif Barry showed Bill Gates around the BSL-3 \ncontainment facility in Building 33 where we do experiment on marmosets with drug-\nresistant TB.   Clif does drug screening.   We suited up with all the contained gear \n(“space suits”) and had a good time showing Bill around.   This was followed by a \nroundtable discussion with certain IC Directors (me, Varmus, Pettigrew, Guttmacher, \nGlass, Somerman and Collins.   I know Bill well from multiple interactions over the years \nand I spoke with him about our ongoing collaboration with the Bill & Melinda Gates \nFoundation (BMGF) over the years.   I did not remain for his lecture since I had to rush \ndown to the White House for the WAD ceremony\nReleased by Chairman Rand Paul\n330White House – Ceremony in the South Court Auditorium of the WH.   Speeches by \nPOTUS, Sec. Kerry, Sec. Sebelius, Valerie Jarrett, Cecilia Munoz (Domestic policy \nCouncil).   Panel with Collins, Gates, Dybul, Chris Beyrer (Hopkins), Amanda Castel \n(GWU), Kali Lindsey (National Minority Council), and Dr. Ngozi Okonjo-Iweala \n(Minister of Finance of Nigeria).   POTUS had announced a reprogramming from within \nAIDS budget at NIH $100 million over 3 years for a “Cure Initiative”.   I was asked and \ngave the final talk of the ceremony on the links between the care continuum and a cure.   \nVery well received.   I, of course, am somewhat cynical about a “cure initiative” with no \nnew money.\nGlobal Fund Replenishment – Today and tomorrow are the 2 big days for countries to \nmeet here in DC to pledge for the next 3 year cycle of the Global Fund to Fight AIDS, \nTB, and Malaria.  I attended meeting at Willard Hotel where Sec Kerry gave a terrific \nspeech.\nDec. 3, 2013 – Hectic but very good day.   Started early in AM and went to Reserve \nOfficers Association at one Constitution Avenue, N.E. for a Friends of the Global Fight \nAgainst AIDS, TB, and Malaria had a breakfast.   Multiple speeches; Moderated by Mike \nGerson; several speakers called me out for my “pioneering work on HIV/AIDS” \nincluding Bill Gates, Nancy Pelosi, Mike Gerson and others.   I left the meeting at 9:00 \nAM, went to the AAI Council meeting in Rockville as I do every year to update them on \nNIAID and then immediately went to DCA to fly to NYC to attend as guest of Bob Seder \nand Debbie Harmon the Women for Women Gala in honor of Hillary Clinton at the \nAmerican Museum of Natural History at W 79th Street and Central Park West.   I stayed \nat the Excelsior on W 81st.   It was an amazing evening.   I was among about 12 people \nwho greeted and had special ‘audience” with Hillary Clinton.   At my table (#18) was my \n“dinner date” Cheryl Mills (we are becoming good friend), Virginia Moseley (VP and \nDeputy Bureau Chief of CNN), Marty Edelman (Counsel to real estate practice – big \ncontributor to Wounded Warriors project), Norma Kamali (Fashion designer – flakey and \ninteresting lady who wants me to come to NYC again and talk to her “health group” \nabout immune enhancing), Nella Domenici (Daughter of Sen. Pete Domenici and sister-\nin-law to Cheryl Mills), Ngozi Eze Nigeria Country Director for Women for Women), \nSusan Goldberg (Exec. Editor of Bloomberg News).   Also met with Sheryl Sandberg \n(“Lean in” and COO of Facebook).   Also, importantly met Jeff Zients who fixed the \ncomputer catastrophe of the role out of Obamacare. Jeff will likely become Economic \nAdvisor to Obama.  All-in-all a very festive evening.   Clinton gave a great speech.\nReturned to DC on 6:00 AM on Dec. 4 shuttle in time to be on panel at Georgetown \nUniversity Copley Lounge of the Global Fund.   Was on panel with Eric Goosby, Tom \nFrieden, Admiral Tim Ziemer (head of the President’s Malaria Initiative).   My panel \nmoderated by Larry Gostin.   Mark Dybul gave very moving speech as Keynote.\nDec. 5, 2013 – Meningococcal meningitis breakout among a few students at Princeton \nand then at UC Santa Barbara.   Was on WTOP radio today to discuss.  Was Group B for \nwhich we do not have an FDA approved vaccine for in the USA.   Used in Europe and \nAustralia.   FDA giving emergency use authorization for use in Princeton.\nReleased by Chairman Rand Paul\n331Had dinner with Danny Hultzen and Chris Hultzen.   Danny had significant operation on \ntorn labium and rotator cuff in his left (pitching) arm.   On rehabilitation now.   Amazing \nthat he was 5 and 1 with a 2.3 ERA in AAA ball pitching at 93 mph with torn shoulder \nligaments.   Hopefully he will fully recover since he was slated to go up to MLB last \nyear.\nDec. 14, 2013 – Had quick trip to NYC on Saturday for Editorial Board meeting of \nHPIM.   Big issue is the decreased sales of the printed book, particularly domestically.   \nReason clearly is that students and others are not using print books very much to study \nand learn and look up material.   Almost all online.   We need to emphasize more out \nonline versions, i.e. iPAD, HOL, HP, etc.   Good to see the other editors.\nDec. 17, 2013 – Grant Colfax, the White House AIDS person and Directors of the Office \nof Nation AIDS Policy (ONAP) called me to give me heads-up that he was stepping \ndown.  Interesting since he has been on the job for only 1.5 years.  Not sure what his \nreason was for stepping down.   He is returning the San Francisco.\nDec. 27, 2013 – Influenza season starting to spike with predominance of 2009 H1N1.   \nInteresting that ever since 2009, the 2009 H1N1 has bumped H3N2 off as the major strain \nthat circulates during seasonal flu.   \nI appeared on CNN “The Lead”.   Interviewed by Joe Johns who was subbing for Jake \nTapper.\nDec. 28, 2013 – Jan. 8, 2014 -  Children home for the holidays.   Unusual to have all 3 \ntogether, particularly since Ali has been at Stanford.\nInfluenza activity (mostly H1N1) starting to crank up.   Have been on WTOP radio and \nAl Jazeera America TV talking about the seasonal flu.\nJan. 9, 2014 – Was on panel at The World Bank at 1818 H Street, N.W. to discuss Social \nand structural determinants to combat HIV/AIDS and poverty.   All the usual \ninternational AIDS players were there.\nJan. 10, 2014 – Went to White House for farewell reception for Grant N. Colfax, head of \nthe Office of National AIDS policy (ONAP).   He had been at the job for 1 ½ years.   He \nis returning to be in San Francisco with his partner and family.   He is a good guy who \ndid a good job.   During the speeches, he called me out as “a legend in HIV/AIDS” and \nsaid how wonderful it was to work with me.\nJan.14, 2014 – Seasonal influenza is beginning to peak and I am doing the usual media.  \nDid FOX News.\nJan. 24 – Feb. 1, 2014 – Prince Mahidol Award – Bangkok.  See attachment for daily \nschedule:\nReleased by Chairman Rand Paul\n332\nMahidol - Bangkok \n2014.doc\nIn summary, I received the 2013 Prince Mahidol Award in Medicine together with David \nHo.   Peter Piot (Director, London School of Public Health and Hygiene) and Jim Yong \nKim (President, World Bank) received the Prince Mahidol Award in Public Health.  It \nwas a most extraordinary trip. We were hosted by the Royal Family of Thailand and we \nwere afforded luxurious treatment. Indicative of this treatment was the fact that we were \npicked up at the airport in Bangkok by a representative of the royal family and was driven \nto our hotel with a double police escort. By double police escort I mean a motorcycle \npoliceman leading the motorcade followed by a police car followed by a brand-new \nMercedes which carried me, my wife Christine and Gray Handley, my associate director \nfor global affairs, at NIAID. We spent an entire week in Thailand. The center of the \nactivities was the award ceremony at the Palace of the royal family. The pomp and \ncircumstance was most extraordinary. I received a gold medal and a check for $50,000 \nfrom the Princess of Thailand. In addition to the extraordinary ceremony followed by a \nfestive dinner at the Palace, we were treated to police escorted tours of several of the \nother palaces, the Emerald Buddha, as well as other historic places. In addition Chris and \nI and Gray toured the famous Thai canals on a boat as well as went to the major market in \nBangkok, which is the largest open market in the world. Our hotel was lavish. I also did a \nconsiderable amount of work giving two official lectures, a panel discussion together \nwith David Ho, Peter Piot, and Jim Kim, when he was present. Jim was only there for \npart of the time since he had just come back from Burma where, as President of the \nWorld Bank, he gave $2 billion to Burma. In addition, I visited this Siriraj hospital, the \nThai Red Cross and anonymous clinic, the CDC facility, the Silom clinic, and other \nfacilities (see attached agenda) where we discussed some of the NIAID sponsored clinical \ntrials on HIV. Of particular interest was the study that was done in collaboration with the \nArmed Forces Research Institute of Medical Science (AFRIMS) on acute HIV infection. \nI met some outstanding people from the CDC including Mitchell Wolfe Tim Holtz and  \nMarcel Curlin. In addition I was accompanied throughout the entire trip by Lieut. Col. \nRobert O'Connell. Rob works with Nelson Michael and Jerome Kim, is the liason to the \nUS Embassy and was an extraordinary asset to the trip. Christine and I flew back and \nforth first class from Washington to London (United) and then from London to Bangkok \n(Thai Airways). There were many perks associated with the trip. One that stood out was \nthe fact that the royal family arranged for Chris and I to have a professional Thai massage \nat the spa at Bangkok airport on our way home.  Of note was the fact that there was \nconsiderable political unrest in Thailand during our visit. I learned a lot about the \npolitical situation from observing and listening to my Thai colleagues. Apparently, the \ncurrent Prime Minister (Yingluck Shinawatra)  is the sister of the recently deposed Prime \nMinister who is in exile. He was exiled because he of corruption (he paid off members of \nParliament to support him). However, much of the Thai population at least in Bangkok \nand certainly among the academics, feels that his sister is merely an extension of him and \nalthough she was democratically elected, they feel that she should be put out of office and \na special council run the country until the corruption is cleared up. This creates a \nReleased by Chairman Rand Paul\n333considerable dilemma for the United States Embassy since they want to side with \ndemocracy; however, everyone knows that the democratically elected person is steeped in \ncorruption. I actually wound up meeting the Prime Minister at the award ceremonies at \nthe Royal Palace. There were several demonstrations while I was there in anticipation of \nthe elections which took place after we left on February 2. The demonstrators wanted to \nblock the election because they wanted to have reforms before the election. It is likely \nthat the election will not come to majority vote and that a new government will have to \nbe formed. There was a small amount of violence while I was there including someone \nthrowing a hand grenade into a crowd of demonstrators as well as a person murdering \none of the leaders of demonstrators. We were never in any danger as we were always \naccompanied by a police escort. I also learned a lot about Prince Mahidol, who was the \nfather of the current king, who is very ill.   Prince Mahidol started off as a naval officer \n(trained in Germany, but then when he realized the poor health conditions in his country, \nhe wanted to do something about it.   He wanted to learn Medicine first and so he went to \nHarvard Medical School and graduated cum laude.    He is considered the father of health \ncare in his country. This was truly a memorable trip from so many standpoints.\nFeb. 3, 2014 – Just back from Thailand and extremely jet-lagged  \n as the fact that I was \ntravelling for over 24 hours in a plane.\n     Did interview with Washingtonian magazine regarding my opinion of the movie \n“Dallas Buyer’s Club”, great movie starring Matthew McConaughey about an HIV-\ninfected individual in the early 1980s who did not want to take AZT because he felt that \nit was too toxic and started a buyer’s club to buy and sell unproven drugs.   Great \nperformance (likely an Oscar – did win Golden Globe already).  They called me because \nI was there when it happened and also I was the one that started the AZT distribution \nsystem through a contract paid for by NIAID.\n       Met in Building 10 with Sen. Durbin (D-IL) and then a separate meeting with \nCongressman Pitts (R-PA) regarding NIH accomlishments and implications of a bad \nbudget.   Durbin is new Chair of the Defense Approp. Subcommittee and unfortunately \nhe wants to get more money for biomedical research for Dod.   Menas well but does not \nappreciate that it may not be well-spent.\nFebruary 5, 2014 – went to the NIH FDA leadership Council meeting at the new FDA \nheadquarters in Silver Spring. I presented the NIAID strategic approach towards \nantimicrobial resistance research. The FDA presentation was made by Dr. Peter Lurie. In \nattendance were Dr. Francis Collins, Dr. Peggy Hamburg, members of the FDA, as well \nas members of the NIH. This is an initiative in which we will be engaging industry in \ntrying to get expedited approval for antibiotics against resistant organisms. \nFebruary 7, 2014 – went to the American Society of Microbiology annual Public and \nScientific Affairs Board meeting at their headquarters on 1752 – N Street, NW., \nWashington, DC.  I do this every year and update the group on activities of NIH and \nNIAID.  As usua,l my presentation was extremely well received by the group. These are \npeople who are great supporters of me and my role as the director of and NIAID.\nReleased by Chairman Rand Paul\n\n335however, Francis shunned him.   Issue is that John wrote into the report language of the \nNIH appropriations that we should have a “strategic plan” and Francis refuses to do a top \ndown plan. Francis is completely correct on this, but he should compromise and agree on \na “communications plan” since that is all the Committee wants is a document to refer \nconstituents to when they inquire about what NIH is doing and why.\nFeb. 24, 2014 – Did the “Nifty-Fifty” talk at Montgomery-Blair High School in Silver \nSpring.   Great group of kids with many questions and interest.   I spoke on my career in \npublic service at NIH.\nSen. Mikulshy visited NIH and gave “pep talk” about the budget.\nFeb. 25, 2014 – Went to NYC for the day to the DDCF Board meeting.   Always like this \n– seeing Nan Koehane, Jim Gill, Ed Henry, Peter Nadoscy, John Zuccotti et al.  \nSomeday, I might even be able to take the honorarium \nFeb. 26, 2014 – Dinner with Larry Corey at Cesco Osteria in Bethesda.   Extremely cold \nstreak of weather in DC over past few weeks.  We spoke of Larry concern about DAIDS, \nthe vaccine program, esp. Mary Marovich, whom he feels is a poor substitute for Peggy \nJohnston.   I am also hearing this from Gepi.  They worry that Mary and her staff have no \nleadership and cannot make decisions.   Feel that they do not represent me well as did \nPeggy.\nFeb. 27, 2014 – Break-in at my house.  Stole only change on my dresser and Euros in my \ndrawer (~$200 worth).   Looks like inside job of someone who had key.   Perhaps one of \nmany people that we had lent the key to over the years.   Have now changed lock on front \ndoor.   They likely exited out back (porch) door since this was unlocked when I came \nhome at night.\nFeb. 28, 2014 – CROI meeting coming up next week and a few paper out in NEHM.   \nMany print media interviews on CCR5 gene editing.\nMarch 4, 2014 – Gave Keynote Lecture at Global Vaccine and Immunization Research \nForum at the Bethesda Hyatt Hotel.  Big audience of Decade of the Vaccine crowd, i.e. \nGAVI, BMGF, WHO, etc.   Well-received. \nMuch press associated with CROI meeting and new baby cure questions and Carl June \ngene editing for CCR5.\nJim Lehrer (Newshour) contacted me for advice about his granddaughter Olivia who has \njuvenile idiopathic arthritis.   I spoke with him and his wife Kate and made some \nrecommendations and just chatted with them about the disease.   Jim was very grateful.  \nDiane Rehm had originally suggested to Jim that he contact me.\nMarch 5, 2014 – Lunch at Bethesda Hyatt with Margaret Chan, Director General of \nWHO.   Margaret is old friend since mid-1990s with the original H5N1 situation in Hong \nKong where she was Commissioner of Health at the time.   Pleasant wide-ranging \ndiscussions.  Present were Lee Hall, Hilary Marston, and a couple of people from WHO.\nReleased by Chairman Rand Paul\n336March 6, 2014 – Much, much media today surrounding a NEJM paper on CCR5 (see \nabove – Carl June’s paper) as well as a second baby who might be cured as well as \nmonkey studies on long-acting PreP (David Ho).  I was on WTOP; ABC Morning News \n(bumped because of Ukraine-Russia crisis, but likely will be shown this weekend); \nNewsHour with Jeff Green; NPR- All Things Considered – Audie Cornish; Al Jazeera; \nVOA; tomorrow we do MSNBC and NPR Science Friday with Ira Flatow.  Also, \nmultiple printed press including NY Times.\nMarch 7, 2014 – The Dalai Lama visited NUH and I went to hear him speak at the \nNatcher Auditorium.   I could barely understand what he was saying due to his strong \naccent and bad acoustics.   However, he won everyone over with his smile and infectious \nlaugh.\nMarch 10, 2014 – Appeared on NPR “On Point” talking about the recent AIDS stories. \n(see above).\nMarch 13, 2014 – Salim (“Slim”) Abdool Karim visited from Sotuh Afrtica at my \ninvitation to deliver the John la Montagne Lecture in the Lipsett Auditorium.  Slim had \ntake the job as the Director of the South Africa MRC to essentially shake up the place \nand fire a bunch of dea wood.   He took the job on a contingency that he would leave is 2 \nyears.   He has done a great job of “cleaning up”.  He will be replaced by another friend, \ni.e. Glenda Gray.\nMarch 14, 2014 – Spoke with Rick Atkinson today to update him on the progress of my \nmemoirs and to ask his advice about whether I should engage Bob Barnett for advice \nabout the legality of my writing my memoirs while I am a USG worker.   Recall that Bob \nBarnett has offered to be my agent when I write my book.   He offered to do this years \nago.\nMarch 20, 2014 -  Received horrible news tonight at around 9:30 PM from Howard \nBoltansky who called my cell phone.   My dear friend and physician for 16 years, David \nJacobs died suddenly in Las Vegas today where he was with his brother to watch the \nNCAA Tournament (March Madness).   David had shown me an MRI of his abdomen.   \nAbout 6 years ago he was struck by a car while running his daily run down by the Mall.   \nHe got badly bruised up, but there was no concussion and so other ‘apparent” injuries \nexception getting banged up badly.   About 6 months later on a routine medical \nexamination and MRI, they found a major tear the length of the aorta with clotted blood \nstably keeping everything in place.   Amazingly, his renal vessels and femoral arteries \nwere being perfused, but the tear and clot was extensive.   Clearly, this happened at the \ntime of the accident.   He had gone to several vascular surgical consultants who told him \nthat this was not repairable and that if they attempted to repair it, he had a very high \nlikelihood of dying on the OR table.   They told him that he could live 30 years or he \ncould die suddenly at any time.   No way to predict and so he has lived with this hanging \nover him.   In my conversations with his, he was always in good spirits and seemed to \naccept the risk.   Unfortunately, this has happened.   I am terribly saddened.   I loved \nDavid and he took such good care of me.   I had trained him when he was an NIAID \nReleased by Chairman Rand Paul\n338Was on WTOP for the NYC measles outbreak.\nMarch 25, 2014 – Appeared on Diane Rehm Show on WMAU with Anne Ginsberg and \n…. To discuss TB for World TB day.\nMarch 26, 2014 – Testified at the House Appropriations Subcommittee Hearing with \nFrancis Collins, Harold Varmus, Story Landis, Gary Gibbons.   Chairman Kingston \nstayed for 10 minutes and then handed Chair to Dr. Andy Harris (R-MD).   Harris \nquestioned me on why we are spending so much money on AIDS given the decreased \ndeaths compared to diabetes, CVD, cancer, etc.   I explained that we are still in the \nmiddle of a pandemic.\n Appeared on Al Jazeera regarding Ebola in Guinea.\nMarch 27, 2014 – Dennis Kasper flew in from Boston to work for 2 hours with me on \npreparing me to present his NAS nomination.\nMet with Debbie Birx who is waiting for Senate Approval for head of PEPFAR (OGAC).   \nTo my dismay, the White House has not submitted her to the Senate for final approval.   \nShe has already had her hearing and did very well.\nApril 1, 2014 – Ebola still raging in Guinea.  Appeared on BBC TV with Katty Kay to \ndiscuss as well as BBC radio to discuss pandemics and gave interview with SLATE \nMagazine on Antimicrobial Resistance\nApril 2, 2014 – testified at the Senate Appropriations Subcommittee Hearing in 192 \nDirksen Building.   Witnesses were Francis Collins, me, Harold Varmus, Gary Gibbons, \nStory Landis and Chris Austin.   Chaired for last time (historic) by Sen. Tom Harken (D-\nIO).   I have been testifying before Sen. Harken for every one of the 25 years that he has \nbeen in the Senate as a member, Chair, or Ranking Minority of this committee.  Present \nwere Sen. Mikulski, Shelby (ranking minority of full committee), Moran (R-KS).   It was \na love fest for NIH, but there is not going to be any new money for NIH (~0.7% increase \nover 2014) because of budget constraints on discretionary spending.\nApril 3, 2014 – Nice visit from Paul Huijts – Director General for Public Health in The \nNetherlands.   He is very interested in antimicrobial resistance.   We in USA and NIH are \naccelerating our efforts in this area due to increasing concern over this emerging problem.\nApril 8, 2014 – Went to Princeton for the day to give “Public Lecture” at the Woodrow \nWilson School of Public and International Affairs.  Invited by Dean Cecilia Elena Rouse \n(formerly with Hillary Clinton).   Met with students (lunch), chaperoned by Adel \nMahmoud, gave lecture on pandemic influenza preparedness with many questions.   \nGood visit.   Ran into my old high school friend and college roommate – Lou LoBosco.\nReleased by Chairman Rand Paul\n339April 9, 2014 – Larry Corey flew in from Seattle to see me.   He is still dissatisfied with \nMary Marovich – Vaccine person at DAIDS.   He feels she cannot make a decision and \nshows no leadership.\nApril 14, 2014 – Continued smoldering of cases of Ebola in Guinea (and spread to \nLiberia) has sustained media interest.   I appeared on NBC Nightly News for this tonight \nApril 15, 2014 - I appeared on WTOP radio for MERS-CoV and Ebola\nApril 17, 2014 – Went to Harvard School of Public Health to appear on their web \nbroadcast of “Senior Leadership Series”.   Nice experience.   Hosted by David Hunter \nand Dean Julio Frenk present.   Many good questions about my accomplishments and \nleadership style.  Broadcast on web throughout the world.\nApril 18-24, 2014 – Preparing by phone with Bart Haynes and Dennis Kasper, whom I \nam presenting for nomination for National Academy of Sciences next week.\nApril 24, 2014 – Went to private dinner at café Milano to celebrate swearing in \ntomorrow of Deborah Birx as Ambassador in charge of PEPFAR.\nApril 25, 2014 – Swearing in of Deb Birx at Franklin Room of the State Department.   \nBig crowd and festivity.\nImmediately after swearing in, went to PAHO (a block away) to give talk at the 10th \nAnniversary of the Sabin Vaccine Institute.   Many old friends there – Peter Hotez, D.A. \nHenderson, Ciro deQuadros, etc.\nApril 26, 2014 – Went to Chicago to deliver after dinner speech at the AAP Dinner at the \nFairmont Hotel.   AAP President Larry Jamison invited me.   Spoke on The HIV/AIDS \nSaga:   Science and Policy”.   Spoke of my experience with 5 Presidents.   Big hit.\nApril 28, 2014 – Went to NAS meeting at Fairmont Hotel in DC to defend Haynes and \nKasper for membership.   Response to them (in voting) was only fair to good.\nApril 30, 2014 – Spoke at amfAR event at Kennedy Caucus Room at Senate Russell \nBuilding.   Big affair.   Sen. Harkin praised me; Kenneth Cole (fashion designer) \nintroduced me. Many people there:  Douglas Brooks (new head of ONAP); Jim Kim \n(World Bank); Paul Farmer was interviewed on stage by Judy Woodruff (NewsHour).\nMay 2, 2014 – Still smoldering concern about MERS-CoV with 1st USA imported case \nfrom Saudi Arabia to Indianapolis.   I appeared on Fox5 TV and AP TV.\nMay 3, 2014 – Big social day.   White House Correspondence Brunch at Katherine \ngraham’s old house at 2920 R Street, N.W. hosted by Tammy Haddad, Steve and Jean \ncase, etc.   Many, many celebrities. Had fun with cast of “House of Cards”, particularly \nReleased by Chairman Rand Paul\n340Sebastian Arcelus who plays Lucas Goodwin on the show.   Very nice guy.   His wife \n(Stephanie Block) was very taken up by the fact that I worked on HIV/AIDS.\nThat evening attended White House Correspondence Dinner as gust of AP (Cynthia \nSharp).   Much fun.   President Obama was hilarious as was comedian Joel McHale.   \nGreat evening.\nMay 8, 2014 – First MERS-CoV case in Lebanon.  Total numbers up to 495 with 141 \ndeaths.   I appeared on CNN International tonight.\nMay 10. 2014 – Elizabeth Sherwood-Randall (National Security Staff, White House and \nSpecial Assistant to the President, Coordinator  for Defense Policy, Countering WMD, \nand Arms Control had met me at a Wayne and Catherine Reynolds function some time \nago and took the initiative to invite Chris and me for dinner at her home at 4920 Indian \nLane, N.W. her husband Jeff is a neurosurgeon in Bay Area near SF.   He is on faculty at \nUSCF.   Children (Richard and William go to STA and heard my recent lecture there).   \nAlso at dinner was Al Hunt (Bloomberg News – wife Judy Woodruff could not attend – \nwas giving Commencement Address at Alleghany College).   Also present was  Diana \nFarrell (recently Deputy Director, National Economic Council at White House and \ncurrently CEO of Kinsey. Inc.).   Very pleasant and fun evening.\nMay 14, 2014 – Yesterday was 2nd imported case of MERS-CoV from Saudi Arabia – a \nhealth worker at a Saudi hospital.   Went from Ryaad to London to Boston to Atlanta to \nOrlando.\nWent to University of Pennsylvania to give the 12th Annual Neal Nathan son Lecture on \n“Ending the HIV/AIDS Pandemic:   From Scientific Advances to Public Health \nImplementation”.   Spent whole day meeting with people many old friends – George \nShaw, Beatrice Hahn, Larry Jameson.   Megan had just decided last week to go to Penn, \nhaving also been accepted to Cornell, Columbia, Michigan, Hopkins, among others.   \nPenn p [people are excited about Megan coming there.   Had dinner at great restaurant \n(Bukkadan) in Philly before taking 9:10 PM Amtrak back to DC\nDid radio interview on new Guidelines for PrEP  with CBS Radio in Men’s room of the \n30th Street Station in Philadelphia while I was waiting for the 9:10 PM train back to DC.\nMay 15, 2014 – More MERS cases.   Did CNN with Jake Tapper at 4:30 PM on the  \nissuance by CDC of Level 2 alert for travelers to mid-East and airport alerts to pilots to \nreport people with fevers and illness on mid-east flights.   HHS now becoming more \nflexible in not giving us grief about being on TV for issues that they inappropriately think \nare CDC topics.   CNN specifically said they wanted me and NOT CDC.\nMay 16, 2014 – Did Al Jazeera TV on recent CDC guidelines for PrEP.   I am becoming \n“the darling” of Al Jazeera.  Producers really like my style and they keep coming to me.\nReleased by Chairman Rand Paul\n341May 18, 2014 – First transmission of infection (sero-conversion) from the Indiana \nimported case to someone who had “handshake” contact.   Again, news blow up.   I taped \nsegment for the Today Show (NBC) to appear on May 19.\nMay 19, 2014 – MSNBC wants me this AM.   Return of the “problem”.   CDC \ncomplaining to HHS that I am on TV for MERS-CoV even though the producers are \nspecifically asking for me.  They do not want me talking about “their issue”.   Amazing!! \nTypical situation where HHS says no to me, MSNBC cannot contact CDC and arrange in \ntime and so now nobody from HHS is on TV and the slot goes to a health official from \nIllinois.   The communications people from HHS are truly idiots to listen to CDC and \nback them.   Courtney Billet blows HHS (Bill Hall, Sye Tait, Ira ?) away with several e-\nmails telling them how ridiculous this approach is.   CDC is totally paranoid.   I really \nwonder if Tom Frieden knows about this or if it is just the Communications people.\nAlso did AP TV today for wide distribution to networks.\nAlso, White House very interested in Antimicrobial Resistance and they are putting \ntogether a White paper through NSS, PCAST, OSTP.   We are obviously playing role in \nits being drawn up\nMay 20, 2014 – Travelled to Los Angeles to receive the “Heroes in the Struggle” award \nfrom the Black AIDS Institute (BAI).   Phill Wilson (President of the BAI) presided.   \nCo-awardees were Mo’Nique (actress/comedian who won Academy Award in 2009 for \nActing in the film “Precious”) and Jamar Rogers (entertainer formerly on The Voice). \nRed Carpet ceremony before the awards held at the Director’s Guild of America on \nSunset Boulevard.   Jamal Rogers was a beautiful young man who was so thankful to me \nfor “my saving his life by developing drugs for AIDS”.   He found out he was HIV \ninfected (drug use in the South Bronx) a few years ago.   He is a very popular entertainer \nwith beautiful voice.  All-around good time.   Stayed at the old Hollywood hotel – \nMillennium Biltmore. \nMay 21, 2014 – Went to Thai Embassy on 1024 Wisconsin Avenue to a reception in my \nhonor and in honor of co-awardee Jim Kim (World Bank President) for our winning the \nPrince Mahidol Award last January.   Megan and Christine came.   Of note, the next day, \nthe Thai army pulled a military coup to take over the government of Thailand.\nMay 22, 2014 – Gave Commencement Address at Hopkins Medical School and then \ndrove immediately back from Baltimore to attend the Sons of Italy NELA Awards Gala \nDinner at the National Building Museum.   Usual good time.   Seated at my table was \nLeon Panetta, Gen. James Jones, Franco Nuschese.  Also we schmoozed with General \nRay Odierno (Chairman of the Joint Chiefs of Staff), Nancy Pelosi, Sen. Chris Dodd \n(now president of Motion Picture Academy), Master of Ceremonies Joe Montegna.\nMay 25, 2014 – The HBO movie “The Normal Heart” played tonight.  Larry Kramer’s \nplay about the early years of AIDS.   I say the play X2 and now the movie was terrific.   \nMark Ruffalo played Ned Weeks and Julia Roberts played the polio physician.\nReleased by Chairman Rand Paul\n342May 28, 2014 – Gave the John E. Enders Lecture at Boston Children’s Hospital/Harvard \nMedical School.  Great audience, SRO.  Extremely well-received.   Spent entire day \nmeeting with faculty and students.   They are so young, I feel like some historic figure to \nthem. Some were not even born yet when the AIDS epidemic was recognized in 1981.  I \nspoke on “Ending the HIV/AIDS Pandemic:   From Scientific Advances to Public health \nImplementation”.   Went up the night before and had dinner with Jenny in the North End.   \nShe is doing great.   Just finished the first year of her 6 year Ph.D program at Boston \nCollege in Clinical Psychology.   Had tough year following her bicycle accident that \nresulted in a severe concussion.  Recovery had been slow, but she is much improved now \nwith some residual headaches.\nMay 30 – June 1, 2014 – Went to Indianapolis to watch Ali row for Stanford Varsity 1 \nboat in the NCAA Women’s crew Championship Tournament.   Went with Chris and \nMegan and met Jenny coming from Boston at the Indianapolis Airport.   Stanford and Ali \nhave been amazing this year.  Stanford was not expected to get to NCAA tournament, yet \nthey won the “Big Row” against arch-rival Cal-Berkeley.   Then they won the PAC-12 \nTournament and now they are in NCAA.   Ali was selected as the Scholar-Athlete of the \nYear in the PAC-12 for Women’s Crew!!   This is huge since she was first among all \nwomen crew members in the PAC-12.  She had the highest GPA (4.05) of all athletes in \nany sport in the PAC-12.  Also, she was chosen for the 3rd year in a row as the first team \nAcademic All-PAC-12 team. She also was voted as “most inspirational” by her team \nmates  In the NCAA tournament they won the semi-finals by 4/100ths of a second.  Had a \nsomewhat disappointing Grand Finals Race coming out 6th in the race (started off slow \nand could not catch up) and 4th overall for the tournament.  Ali was obviously \ndisappointed, but what a year she had!\nJune 3, 2014 – Together with Robin Robinson, I briefed Senate HELP staff (Harkin, \nAlexander, Burr, etc.) on MERS.   Did it is the Dirksen Building.\nJune 9, 2014 – Partook in CSIS conference on TB at their headquarters at 1616 Rhode \nIsland Avenue, N.W.   Good symposium.  Shared panel with my dear friend Eric Goosby\nJune 12, 2014 – Went to San Francisco to give Grand Rounds at Moffett (invited by \nMarcia Glass (Kat Glass’s sister).  Timed the trip to coincide with Ali’s graduation from \nStanford on June 13-15.   Great time; extremely well-received by UCSF community.   \nVisited with Eric Goosby, Jaime Sepulveda and others from UCSF; spent time with \nstudents and fellows.\nChris and Megan flew to SF with me – I went north to UCSF and they went south to Palo \nAlto.   That evening met in SF for dinner.   Great time.   Drove back to Palo Alto that \nnight\nJune 13-15, 2014 – Magnificent time at Stanford graduation events.   Ali received \nmultiple academic honors in addition to sports honors.   Graduated “with distinction” , \nwhich means summa cum laude.  Also, received Engineering Award and inducted into \nSchool of Engineering Honor Society.\nReleased by Chairman Rand Paul\n343Socially, had great time.   Dinner at NOLA sponsored by Chris and me and the parents of \nseveral of the seniors on Ali’s boat – Ad Bax, Dawson’s, etc..   Present at dinner were all \nthe seniors on the boat – Anna Dawson (Olympian), Daphne Martschenko (All-\nAmerican), Kayla Cornale, Christina Bax, etc.  Wonderful, joyous meal.\nOn Thursday night Chris, Jenny, Megan, Ali and I drove to Half Moon Bay and had \ndinner at Miramar Restaurant by the sea – open pit fireplace and dining by the beach - \ngreat wine, calamari, etc.   Seems not to get any better than this – so wonderfully proud \nof Ali who is truly a superstar – self-effacing, but a real superstar.\nHas another great lunch with the Ayers on Sunday afternoon before I took the “red-eye” \nback to DC.   \nThe formal graduation on Sunday had Bill and Melinda Gates as co-commencement \nspeakers.   They were good , but a bit self-congratulatory.   I viewed the famous Stanford \n“Wacky Walk” entrance of the seniors.   Ali and friends were dressed as “cars”.  Really \nfun.\nJune 24-25, 2014 – Went to Aspen Ideas Festival.   Gave 2 minute “Big Idea “during \nOpening Ceremony and was on panel on Emerging IDs with Tom Frieden and Yu Wang \nof China CDC.   Moderated by Rich Besser (ABC News).   Good panel.  Many \ncompliments for this and Big Idea.   Met the usual DC glitterati at the festival – Walter \nIsaacson, Barbara Bush, Bill Frist, Corby Kumar, etc.\nJune 29, 2014 –  Interesting spin-off of my “Big Idea” at the Aspen Ideas Festival.   My \nidea was that we can end the AIDS pandemic in 10 years (by 2024 – theme of festival – \nglobal health by 2024 and we were asked what single thing (big idea) do  we think would \ngreatly influence global health by 2024).   Gov. Andrew Cuomo has stated that he wants \nto end the AIDS pandemic in NY State in 6 to 10 years.   The NY Times wrote this up in \nthe Sunday Times and quoted me since the reporter had heard about my Big Idea from \nthe Aspen Festival.   The article had me praising Gov. Cuomo and my saying that NY \ncould be a model for the rest of the country.\nJuly 3, 2014 – The Ebola outbreak in Guinea, Sierra-Leone and Liberia is getting out of \ncontrol.   Latest number are 759 cases and 476 deaths (63% fatality) making this the \nlargest outbreak of Ebola on record.   Net highest was in 2000 in Uganda with ~400 \ncases.  Major concern since it is now spreading in the cities of these countries and the \npopulation is not cooperating in containing it by ignoring the recommendations about \nhow to handle patients and dead bodies.   Also, major ignorance causing population to \nattack and stone doctors and nurses from Doctors without Borders and WHO, saying that \nthere is a conspiracy on the part of the government to deplete the population.\nI appeared on CNN today to discuss the situation.\nReleased by Chairman Rand Paul\n344July 4-8, 2014 – Interesting 4th of July weekend.  Found out from Deb Persaud and \nHannah Gay that the “Mississippi baby” rebounded at 27 months following D/Cing of \nART.   Baby is 46 months old.   Unfortunately,  so much for the “cure” baby.   We are \nsequencing the virus now to determine if this is not a “new” infection, i.e. abuse from an \nHIV-infected person.   More on this later.\nAlso, heard (and spent many hours on conference calls) that an FDA employee who was \ncleaning out a cold room in Building 29A (FDA building on NIH campus) found a \ncardboard box that contained 6 glass undisturbed vials labelled “variola”.  Likely there \nunnoticed since the 1950s.   CDC and FBI notified.   Good news is that leaks did not \noccur and within a couple of days, the CDC came up to NIH, area secured by FBI, and \nmaterial flown down to CDC  on FBI plane.   Examined there by Select Agent people and \nPCR’d to confirm smallpox.   Will determine if viable within 1 week and will be \ndestroyed as witnessed by WHO.   Technically, the presence of this material in Building \n29A was a violation of an international agreement to destroy all smallpox samples except \nfor 2 aliquots kept at CDC and at VICTOR in Russia. \nJuly 9, 2014 – PCR confirms that the Mississippi Baby has indeed rebounded with virus \nat 16,000 and 10,000 copies RNA per ml.  Baby has been off cART for 27 months and is \n46 months of age.   Disappointing, but raises many questions.   The baby had no \ndetectable immune response for these many months.   Since the virus was obviously there \nin a reservoir somewhere, what then was the mechanisms that was preventing it from \nrebounding.   Will hold press conference with Deb Persaud, Hannah Gay, and Katherine \nLuzuriaga on Thursday  (tomorrow).\nHad interesting rounds today to see our first patient (Phil Diers) that received an \nallogeneic PBMC transfer from a HLA-B27 HIV-infected Elite Controller donor.   \nRecipient has CD4+ T cell count of 0-4 and >150,000 copies of HIV on cART (resistant \nvirus).   Hope is that the immune response of donor cells will impact in some way the \ninfected cells of the recipient.   More to come.   Way out chance of a graft versus infected \ncell effect that might eliminate reservoir (too much to ask for).   See picture below of me \non Rounds the day after the allogeneic transfer.\nReleased by Chairman Rand Paul\n345July 10, 2014 – Press briefing with Deb, Hannah and Katherine today (Thursday – \nthunderstorms).  Followed by major press that appeared tonight and tomorrow (July 11) \nwith my quoted or appearing on TV or radio tonight or tomorrow:\nAP TV that subcontracted to BBC TV seen  in Italy by Bruce Gellin (sent me e-mail); \nCBS Evening News\nJuly 11, 2014 – Front page NY Times and Washington Post.  My picture and front page \nLA Times; Wall Street Journal, USA Today and all major print papers and many, many \nblogs including CNN\nBBC Radio; BBC TV; NewsHour with Jeff Borwn; VOA, Reuter’s TV, NPR.   \nI make the point that this is disappointing and not a “setback” since we are still in the \nearly discovery phase of cure research and this is what happens when you are in this \nstage.\nJuly 13, 2014 – Had conference call today on Sunday with Francis Collins and Tom \nFrieden of the CDC. Tom has a significant problem in that they have been multiple lapses \nat the CDC with people not adhering to protocol in the experiment with a transfer of \nselect agents such as anthrax,  Brucella and influenza. He wanted to run this by Francis \nand me so that the NIH and CDC could be on the same page. We had the problem \ndescribed above with the smallpox discovery in a cold room in building 29a and so his \nissue and ours are somewhat aligned. He is under pressure to decrease the number of \nReleased by Chairman Rand Paul\n346investigators throughout the country who are working with select agents. The rationale \nfor this is the fact that if the CDC could make mistakes like this, then virtually anyone \ncan. This is aligning with the issue of many people wanting to put a clamp on gain of \nfunction research, particularly with influenza. More to come.\nJuly 14, 2014 – More press on Mississippi Baby (Al Jazeera TV) as well as fluff over the \nWHO coming out with recommendation that MSM who practice unsafe sex should take \nPrPE (Truvada).   Press misinterpreted this (partly fault of WHO) to mean that all gay \nmen should be on Truvada as PrEP.  I had to clarify this on Al Jazeera and in the NY \nTimes (article soon to appear).\nPreparing to go to Melbourne for the IAS International AIDS meeting.\nJuly 16, 2014 – The situation is heating up considerably with regard to the three \ninfractions that have occurred in HHS concerning potentially lethal microbes. The first \nwas the finding of the smallpox vials in the FDA building (29A) on the NIH campus. The \nnext was the egregious dysfunction of the teams involved in dealing with selective select \nagent research down at the CDC and third was the contamination at the CDC of a highly \npathogenic influenza virus (H5N1) with a nonpathogenic influence virus (H7N9). This \nhas been all over the media in a very intense way. The White House as well as the \nDepartment of Health and Human Services is involved.  Francis Collins and I received a \nletter from Nobel laureates Paul Berg and Richard Roberts to discuss how we might \naddress this escalating issue. They have been consistently against gain-of-function \nresearch, especially on influenza.  In addition Francis and I together with Peggy Hamburg \nand Tom Frieden were called to a meeting this evening at HHS with Secretary Sylvia \nBurwell to discuss the HHS plan as well as the fact that Sylvia will be meeting with the \nPOTUS on Friday, July 18 to discuss the matter and she needed to be briefed by us. I \nhave suggested to Francis and he agrees that we call a temporary moratorium on all gain \nof function research on influenza and the MERS virus involving increasing pathogenesis \nand increasing transmissibility by the respiratory route. Also, Francis and I brought up \n(clearly my idea for some time now) to re-invigorate the NSABB and get them much \nmore in the mix of recommendations and involvement.  We had a good meeting with \nSylvia Burwell in her office tonight that lasted from 7 PM to 9 PM. Francis and I will be \ntalking over the phone tomorrow with Richard Roberts and Paul Berg about a plan for the \nfuture. Also, today Barry Bloom called me from the Harvard School of Public Health to  \nask whether or not he could help us in addressing this new and emerging political \nproblem. In addition,  I received a call from Michael Osterholm to warn me, as he is often \ndoing, that there will be problems “for me” that he wants to help. I get concerned when \nMichael wants to “help” me.   He generally gets hysterical about microbial threats and \nloves to be in the press.\nJuly 17, 2014 – Francis Collins and I had conference call with Richard Roberts and Marc \nLipsitch regarding the above issues.  Great conversation.  We told them that changes \nwere going to occur and that we cannot give details, but we are going to look carefully at \nall the issues.  In particular, I told them that we were going to re-examine the risk/benefit \nratio of doing gain-of-function research in influenza, in particular.  They were pleased.\nReleased by Chairman Rand Paul\n347July 17 – July 23, 2014 – Attended the 2014 International AIDS Society  Meeting in \nMelbourne, Australia. Before I left, I became aware of a terrible tragedy that had \noccurred on July 17 the day that I left the NIH to travel to Melbourne. Malaysian Airlines \nflight 17 from Amsterdam to Melbourne via Kuala Lumpur was shot down by a surface \nto air missile likely fired by Ukrainian separatists/terrorists. This was to totally dominate \nthe international news over the next days to weeks.  I was quoted in most outlets.   297 \npeople were killed including over 100 Dutch.  Lost on the flight were six individuals who \nwere flying to the meeting that I attended. Prominent among them was my longtime \nfriend Joep Lange an Infectious Diseases/AIDS researcher from Amsterdam  and his wife \nJacqueline van Tongeren. In addition, well-known public health advocate and WHO \nspokesman Glenn Thomas and AIDS action group activist Martíne De Shutter were also \non the plane in addition to AIDS activist Pim deKuijer and Dr. Lucie van Mens. I gave a \nnumber of media interviews discussing the terrible tragedy and the loss of our colleagues. \nThis appeared in multiple media outlets. In particular, I was interviewed by David \nGregory on Meet the Press on Sunday, July 20. The topic of the interview was the mood \nof the meeting and some personal reflections on Joep Lange. \n My Plenary Lecture was extremely well received and from my own vibrations of how \nthe audience reacted, as well as how I felt, it clearly was one of the best lectures that I \nhad given. The subject of the lecture with the scientific challenges of an HIV Cure and an \nHIV vaccine. There were a number of events of note throughout the meeting. \nSaturday, July 19 – Stayed at Crown Metropol Hotel (very elegant – on of nicest and \nmost confortable hotels on all my international trips).  I attended a dinner at a place called \nRasheen which is an old and historic building in Melbourne that was formerly the \nresidence of the Archbishop of Melbourne.  The dinner was given by the Pratt foundation \nand the host was Ambassador John Berry, the United States ambassador to Australia. \nWith him was his husband Curtis. I have to leave towards the end of the dinner in order \nto give an interview live on WTOP radio that was broadcast back in Washington. The \ninterview was about the plane tragedy.  \nSunday, July 20 - I made a presentation on TB HIV followed by a panel discussion at \nthe Crown Promenade Hotel where I was staying during the meeting. In addition, on that \nSunday I made some opening remarks at a Point of Care Symposium that discussed rapid \npoint of care diagnostics for viral load. That evening I went to the Opening Session of the \nconference which was really not very well done since there were many boring speeches. I \nhad to leave towards the end in order to do the taped version for Meet the Press. Of note, \nMelbourne is 14 hours ahead of Washington DC. Therefore, even though I taped the \nMeet the Press session on what was Sunday evening in Melbourne, it was actually early \nmorning in Washington DC. Went to Global Leaders reception at The Cargo Hall on the \nWharf after the Opening Ceremony\n Monday, July 21 -  I gave my plenary lecture. In addition I did a filming in celebration \nof the opening of the Doherty Institute for Infection and Immunity. This is an Institute \nnamed after Peter Doherty, the Nobel prize-winning Australian immunologist. Peter was \nthe other speaker at my symposium earlier that day. On Monday night I went to a \nreception at the Red Desert Dreaming Art Gallery at the Hilton Hotel. The reception was \nReleased by Chairman Rand Paul\n348co-sponsored by CSIS with Stephen Morrison, together with Amb. John Berry. That \nnight on Monday, July 21, I went to dinner with Mark Dybul at the Spice Temple \nRestaurant along the wharf. We discussed broad aspects of the AIDS pandemic and I \ncame up with an interesting idea of providing resources to do phenotypic tracing of virus \nin hotspots in various regions including southern Africa and Washington DC. The \npurpose of the phenotypic tracing of viral transmissions was to determine if you test and \ntreat and completely control the epidemic in any given region or location, would virus \nspill over back into that region and if so could one trace where it was coming from. This \nhas particular relevance with regard to whether or not we would truly be able to end the \nAIDS pandemic and if we do would, we be able to end it in one region at the same time \nthat it is raging in another region. I will go back to Washington and discuss with Carl \nDieffenbach the possibility of funding such studies. \nTuesday, July 22, 2014 – I did a Voice of America panel at the Convention Center on \nHIV AIDS stigma which was in association with a documentary film that was narrated by \nElton John. I had a number of other meetings that dayincluding with Wayne Koff who \ntried to convince me to give major support of NIAID to his “Human Vaccines Project”, \nwhich I am very skeptical about since it smacks of the old HIV Vaccine Enterprise.   The \nlatter was nothing more than a time sink.   I was straight with Wayne and told him of my \nskepticism.  I told him that I would watch to unfolding of the “project”, but I cannot lend \nNIAID support at this time since I do not know what “it” really is and I really do not see \nany purpose for it.   He understood, but he needs NIAID support for it to work.   We left \nit amicably.\n Of particular note was a reception at the Club 23 in the Crown Towers Southbank of the \nCrown Hotel. The reception was hosted by the Kirby Institute and discussed the Test and \nTreat in Indonesia concept which Cliff Lane and I had been working with and have \nconvinced the Minister of Health Dr. Mboi of Indonesia to go ahead with the study. In \nher remarks at the reception, Minister Mboi credited me with this idea and said it would \nnot have happened had I not brought it up to her. This was very nice of her. On Tuesday \nevening we had the international AIDS Society Dinner at this Stokehouse City \nRestaurant, an elegant location in downtown Melbourne. The dinner was sponsored by \nSharon Lewin and Françoise Barre-Sinoussi. It was an excellent time. After that I went to \na birthday party for Jen Kates and Judy Auerbach in a saloon in the Provincial Hotel. \nWednesday, July 23, 2014 - Departed on the extraordinarily long 26 hour trip back to \nWashington DC. I went from Melbourne to Sydney, Sydney to Los Angeles, and then \nLos Angeles to Washington DC. I traveled with Richard Koup and it was an uneventful \ntrip. The day that I left, President Clinto arrived for his keynote.\nThursday, July 24, 2014 – Continued press on the MH17 tragedy mixed with interest \nabout the IAS Meeting in Melbourne.   I appeared on NPR Radio “Tell Me More” with \nMichelle Martin.   Of note, there has been a recent recommendation from WHO and prior \nto that from CDC that certain groups (MSM at high risk; discordant couples; \nheterosexuals who practice risk behavior) should use PrEP (Truvada), which has recently \nbeen approved by FDA for PrEP.   There is a growing controversy about whether use of \nPrEP will actually lead to more risky behavior.   Data say that it will not.   Recent study \nReleased by Chairman Rand Paul\n351of Building 31); CNN New Day with Sanjay Gupta; MSNBC with Chick Todd; WTOP \nRadio; NPR “Here and Now”; BBC radio; MSNBC; Hearst TV.   Tonight I do MSNBC \nagain at 8:15 PM from Nebraska Avenue and BBC Radio at 10:15 PM.\nMuch discussion from the media about the role of “NIH scientists” in getting the ZMapp \nto Brantley.  They are referring to Lisa Hensley.   We needed to clear up her role in that \nCDC (Kevin DeCock) asked her to point Samaritan’s Purse in the direction of the people \nwho had the antibody.   There was some feeling that there was some “government \nconspiracy”.   I will discipline Lisa when she returns from Liberia because she got out of \nher lane by getting involved in the procurement of the antibody.\nI am exhausted from media.\nAugust 5, 2014 – Media, particularly CNN and Sanjay Gupta still pursuing the issue of \nan NIH scientist (Lisa Hensley) who they claim actively pursued and obtained the zMapp \nantibodies for the 2 American patients.   Lisa returns today and we must get the truth.   \nShe claims that she just steered Samaritan’s Purse (SP) people to the individuals/groups \nthat had interventions and SP decided to obtain the zMapp from Gary Kobinger (Canada) \nwho apparently brought a dose to Sierra Leone.   As it turns out, Lisa got on a helicopter \nprovided by the State Department to pick up the zMapp from Sierra Leone and bring it \nback to Liberia.   When she got to SL, she found out that SP had already obtained a \nhelicopter themselves and had already picked up the zMapp and brought it to the patients \nin Liberia.   I find out today that the helicopter that Lisa flew in was a CIA helicopter!   \nThe State department will deny any role in this since the CIA is not supposed to be \noperating out of the Embassy.  However, the Embassy certainly “tried to” facilitate the \ntransport of zMapp.   I will straighten all of this out and get to the truth after we question \nLisa.\nGetting exhausted by media.   Today I did: CNN Squawk Box; MSNBC; CTV News; \nCNN with Sanjay Gupta; Fox News; Reuters TV; CNN International; Al Jazeera; BBC \nTV; Fox News with Lou Dobbs; CNN Anderson Cooper; MSNBC with Larry O’Donnell.\nAugust 6, 2014 – Some of the events that occurred today are very important. Lisa \nHensley, an NIAID employee (Ph. D) is a NIAID scientist who reports to Peter Jahrling \nat Fort Detrick.  She was in Liberia to give technical assistance.   She had informed Cliff \nthat her role in Samantha's Purse (SP) getting the zMapp antibodies for Dr. Brantley and \nNancy Writebol was only peripheral and facilitating.  Lisa has been called back by Cliff \nand returned from Liberia last night and Cliff Lane gathered a considerable amount of \ninformation from her. It appears that she has been much more active in assisting the \npeople from SP in procuring the zMapp antibodies from Gary Kobinger of the Canadian \nHealth Agency. In addition to just pointing the SP people in the right direction, she was \nactively involved in organizing an attempt to procure the antibodies and deliver them to \nthe patients. The CDC was actively involved also in the person of Kevin DeCock who put \nLisa in contact with SP. In addition, the United States Embassy in Monrovia, Liberia was \nvery actively involved in this process. With regard to the latter the embassy provided a \nUN helicopter to take Lisa and the military attaché from the embassy to the border of \nReleased by Chairman Rand Paul\n352Sierra Leone and Liberia to pick up the package of monoclonal antibodies. However, SP \nhad already chartered their own helicopter and picked up the material themselves. \nNonetheless, our prior determination and announcement to the media that the NIH as well \nas the federal government played only a minor role in the procurement of these antibodies \nis technically not correct. When I found out about this, I felt it was very important to alert \nHHS Secretary Sylvia Burwell. I briefed her on the fact that the original statement from \nthe Department of Health and Human Services regarding the role of NIH was not \ntechnically correct. She agreed and indicated that we would have to let the White House \nknow particularly the General Counsel. The reason why this is important is that \ntechnically speaking SP has broken the law by bringing in a drug from Sierra Leone to \nLiberia without the permission of the health officials of Liberia. In addition, there is also \nthe issue of ethics in procuring a drug for one individual when there is very short supply. \nAnd so the question is asked how can one get drug for American doctors and health \nworkers when hundreds of Africans are dying from the disease. We will have to face this \nissue in the press even though technically speaking NIH did not procure the drug. The \nappearance is that we at least assisted the SP in getting it. It is important to emphasize \nthat Lisa Hensley was acting on her own accord without asking permission from any of \nher superiors and so she was really not representing the NIH.  It appears now that this \nwas what Sanjay Gupta of CNN was talking about when he told me by phone that he had \ne-mails that indicated that an NIH person was actively involved in procuring zMapp \nantibodies for SP and that the US Embassy was also involved and that he could not show \nme the e-mails since the person who gave them to him had a lawqyer who advised against \nit.   I believe that the secret party who gave Sanjay the e-mails is SP who are now afraid \nthat they have broken the law and are trying to say that the USG helped them and so how \ncould it be wrong.  It will be interesting to see how this all plays out.\nBilly Fischer from UNC visited NIH to help the Clinical Center get ready for the \npossibility of admitting Ebola patients since the CDC is sending 50 people to West Africa \nand there is the possibility that they may get infected and might need care.   Billy spent \ntime in Sierra Leone directly taking care of patients.  He was great!\nAgain, much press today →  CBS Morning Show with Charlie Rose and Norah \nO’Donnell; NBC Channel 4 Local News; CNN with Jake Tapper.\nAugust 7. 2014 – Re-visit of part of the African Delegation that is visiting DC.   Francis \nCollins and I and other IC Directors briefed them in Medical Board Room of the Clinicial \nCenter at 11:15 AM.   Present were Mali President Kweita and Zambia Vice president \nGuy Scott and his wife Charlotte.  I presented information about NIAID activities \nrelevant to their countries (Mali – malaria; Zambia – HIV, TB).\nMedia frenzy continues with Gaza war and Ebola.  Ebola dialogue now focusing on the \nethics of distribution of scarce interventions during medical crisis.   Triggered by the \navailability of zMapp for the 2 American patients.\nPress today CNN New Day; MSNBC with Ronan Farrow; CNN International; Sirius \nRadio (Fox) with Marc Siegel\nReleased by Chairman Rand Paul\n353August 8, 2014 – Frenzy continues.  Press includes WTOP Radio, WNYC Brian Lehrer \nRadio, Fox Business TV, NPR Los Angeles.\nGaza + Ebola – now ISIS is taking over Iraq and the USA in now bombing their advance \nto a Kurdish city where American diplomats are holed up.   The USA wants to avoid \nanother Benghazi.   Because of this the White House is not allowing any government \npeople to go on Sunday AM TV and so I had to cancel invitation from This Week with \nGeorge Stephanopoulos and “Face the Nation”.   White House is in the controlling the \nmessage mode.\nAugust 8, 2014 – (Saturday) - Having daily Secretary and NIH (Collins) call.  Issue is \nthat we are trying to expedite going into phase 1 trials of interventions that have only \nbeen in pre-clinical.  These include zMapp, the Canadian VSV vaccine, the VRC \nChimpAd3 vaccine.   Emory is making “side deals” with Mapp for zMapp and Canada \nfor VSV to get pre-exposure prophylaxis for doctors at Emory.   Potential problem is an \n“optics” problem in that USG is helping Westerners get interventions that Africans \ncannot get.\nThis is all getting very intense and similar to the Anthrax issues from 2001.   Sylvia is \nstarting to see more clearly what I can do regarding leadership on the phone calls.\nAugust 11, 2014 – The frenzy around Ebola still continues with the major issue being the \nethics of getting experimental drugs to the two Americans, and most recently to a Spanish \npriest who was flown from West Africa to Madrid and who received the experimental \nzMapp cocktail of monoclonal antibodies. The media are pushing the story of favoritism \ntowards the West and developed nations as opposed to the Africans who are suffering \nfrom the disease. They fail to understand that there is no evidence that zMapp actually \nworks, and the fact is that there are only three doses left in the possession of the company \nthat owns it, i.e. MAPP Biopharmaceuticals. Of note, the President of Liberia has \ncontacted the White House to see if the United States can expedite either transfer of two \nsick Liberian doctors to the United States for care and/or obtain doses of zMapp for them. \nIt is interesting that Larry Zeitlin, the CEO of MAPP Biopharmaceuticals, has contacted \nCliff Lane telling Cliff that he wants to get rid of the three doses of zMapp that he has in \nhis possession because of the pressure on him to distribute it to a number of people in \nAfrica who need it.   He does not want to be put in this ethically difficult position.  He \nwants to give it to either WHO or MSF. However, he does not want the US government \nto react negatively to this. He wants to make sure that we do not criticize his giving the \ndoses to another entity, thereby making them responsible for its distribution. We have \nbeen having a daily conference call including this past weekend on Saturday and Sunday \nwith Sec. Sylvia Burwell to keep up with the rapidly evolving E bola situation. During \nthat call yesterday (Sunday), Secretary Burwell suggested that since we helped the \nAmerican doctors to get doses of zMapp that we might suggest to Larry Zeitlin that he \ngive the doses to the Liberians. This would accomplish two goals: 1) it would allow \nPresident Obama to respond to the Liberian president, and;  2) it which show the world \nthat we do not just favor Westerners, but that we are helping to make drugs available to \nAfricans.\nReleased by Chairman Rand Paul\n354We had a conference call yesterday (Sunday) with Canadian health authorities to inquire \nabout the availability of their experimental VSV  Ebola vaccine. On the call were our \nHHS team with me, Cliff Lane, Hilary Marston, Nicki Lurie, Dawn O’Connell (Sec. \nBurwell’s Chief-of-Staff), Tom Frieden and CDC folks, Robin Robinson, Leslie Dasch \n(Counsellor to Burwell).  On the Canadian side there was Gregory Taylor (Deputy Chief \nPublic Health Officer), Judith Bosse (Assistant Deputy Minister, Infectious Diseases \nprevention and Control Branch), Theresa Tam (Branch Head, Health Security \nInfrastructure branch) and Supriya Sharma (Assoc. Assist. Deputy Minister, health \nProducts and Food Branch).   The Canadians are still in preclinical studies and have not \nyet gone into humans. There is an ongoing disagreement between me and Tom Frieden. \nTom wants to give the vaccine to health workers in Africa even before it has gone into a \nphase 1 trial (I believe that he has been speaking with his CDC people who are preparing \nto go to Africa and are understandably concerned about their risk). I do not believe that \nTom understands the clinical trial process since he says that we are “ethically obliged” to \nallow the healthcare workers to make the decision themselves about whether they are \nwilling to take a potentially unsafe, potentially ineffective vaccine.  If this were a drug to \nbe given to a desperately ill patient, then that is one thing about going directly from pre-\nclinical to human treatment.   However, this is a vaccine to be given to a healthy person.  \nOn the call with the Canadians, I pointed out our experience with the HIV vaccine which \nwas effective in monkeys, but in humans it actually significantly increased the risk of \nacquisition of HIV infection. In order to expedite things Cliff Lane will organize a quick \nphase 1 trial at the NIH Clinical Center to test the safety of the Canadian vaccine.\nOnce again, I have been all over the press. Last night I was on CNN with Jim Sciutto as \nwell as on CNN International. Today I will do the Diane Rehm Show.\nAugust 12, 2014 – We are having a daily (including Saturday and Sunday) conference \ncall with Secretary Burwell and a separate call among NIHers with Francis Collins.   \nPress interest in dying down somewhat (I was only on Colombian (Bogotá) radio and \nCzech Radio only.   The issues are centering now around the ethics of using experimental \ndrugs (we actually have none available) and vaccines (getting ready to go into Phase 1 \nwith the NIH (VRC) Chimp Ad3 vector with Ebola env gene inserts) prior to proof of \nsafety and efficacy.   The Canadians also have 2 VSV Ebola vaccines.  There is no more \nZMapp left – 2 courses went to Brantley and Rightbol, 1course went to the Spanish priest \nwho died, and 2 courses were sent to Liberia to treat 2 Liberian doctors who contracted \nEbola caring for patients (President of Liberia appealed to President Obama.   The USG \nput Liberia in touch with Larry Zeitlin and MAPP Biopharmaceuticals.\nAugust 13, 2014 – My invited Perspective on Ebola came out online at 5:00 PM in the \nNew England Journal of Medicine .  Cliff Lane and I are trying to reconcile the need for \ndata of safety and efficacy of the NIH vaccine and the need to get it to people who need \nit.   We drew up a proposal for a Randomized Clinical Trial (RCT) to take place in the \ncountries in Africa right after the Phase 1 here at the NIH.   This would settle the ethics \nissue (randomization is “fair” and also would collect data to prove efficacy and safety.   I \nReleased by Chairman Rand Paul\n355will propose this at the next Secretary’s call.   The logistics of this will be difficult due to \nthe lack of infrastructure in the 4 African countries.\nDid WBAI Radio in NYC and Al Jazeera TV today.\nLatest numbers for Ebola – 1900+ cases and 1050 deaths\nAugust 14, 2014 – Things quieting down a bit in the press.  Still struggling with ethics \nissues and clinical trials issues.   Canada has “hot-dogged” by announcing that they are \n“donating” 400-800 doses of their vaccine for use in Africa.   Of course, that is exactly \nwhere we will give it when we show that it is safe.   Also Jeremy Farrar, the head of \nWelcome Trust is grandstanding a bit saying we must not just “sponge down the patients \nand let them die”.   Give me a break.   Now WHO wants to use the Phase 1 doses of \nvaccine to vaccinate their people who are going to Africa.   They want 200 doses to do a \n“phase 1 trial” in their staff.   200 doses is a product distribution program, not a phase 1 \ntrial.\nDid CBS News and AP TV today.\nAugust 15, 2014 – Went up to Philadelphia to see the White Coat Ceremony at the \nUniversity of Pennsylvania Medical School where my daughter Megan is beginning her \nfirst year of medical school.   Beautiful day and wonderful ceremony.   We are so proud \nof Megan and hope that she will be happy.   I know that she will do well having \ngraduated summa cum laude from Columbia and then excelling in the Post-Bacc pre-med \nyear at Hopkins.  \nAugust 16-19, 2014 – Media blitz stopped, but the epidemic still rages.   The West \nAfrican countries are instituting quarantines and border closings, which may slow down \nthe epidemic, but there is the beginning of a humanitarian crisis to get food, water and \nsupplies to the quarantined areas. \nTom Frieden and I are working out how we can reconcile the issue discussed above about \nthe balance of open access of vaccine following phase 1 versus the need to know by RCT \nwhether the vaccine actually works and whether it might actually do harm, as per the Ad5 \nHIV vaccine enhancement of HIV acquisition  in a former clinical trial a couple of years \nago.   The department was clearly concerned (Andrea Palm – chief-of-staff to Burwell-  \npissed me off on a conference call by acting annoyed with Tom and me in our discussions \non the daily conference call) about the disagreement between Tom and me; however, \nTom and I are now trying hard to work it out behind the scenes.\n \nAugust 20, 2014 – Ebola still on an upswing.  No explosion yet in Nigeria following the \ninfection of cluster (8 to 11) health care workers who took care of  \n(Liberian/American) who flew from Liberia to Nigeria).\nTom Frieden and I still trying to work out an agreement/compromise regarding the \ndistribution of Ebola vaccine (RCT versus expanded access) following the Pahe 1 trials \nthat will begin in September and have data by November on Safety and immunogenicity.\nReleased by Chairman Rand Paul\n\n356Press low level but consistent.   For me → Federal News Radio; Canadian TV; VOA TV \n– “Straight Talk Africa Show – 1 hour); \nISIS (Islamic State in Iraq and Syria) taking over parts of Iraq\nGaza still a mess with rocketing of Israel and retaliatory air strikes by Israel.\nAugust 21, 2014 – 2 secondary cases of Ebola (beyond cluster of health care workers) \nfrom the index in Nigeria.  Getting close on agreement with Tom Frieden.  Cliff Lane \nvery helpful; in hammering out details with CDC people – Tim Uyeki and Steve Redd \n(Steve is a rally good guy with whom I dealt during the Flu issues).\nContinued press →  MSNBC; WTOP radio; CNN with Lou Dobbs; BBC Newsday \nRadio.\nAugust 22, 2014 – Situation same with epidemic.   Good news – have come to agreement \nwith Tom Frieden on approach to Ebola vaccine following Phase1 trials.   Agree to go for \nRCT with control group as first choice.   There well may be obstacles on the ground to \nthis approach including perception of keeping interventions from those who need it (even \nthough we still do not know whether the vaccine is either safe or effective).   This may \nnecessitate a modified RCT without a control group or even skipping an RCT and going \nto emergency open access.   The plan is to do a “rolling” approach staring with RCT → \nmodified RCT → open access in priority order.  I will present this to Secretary’s call next \nweek.\nTom Leaves for West Africa over the weekend.\nPress still active → Fox 5 WTTG; CNN International; BBC Radio – The World; WNEW \nCBS Radio – NYC; PRI (BBC) – Boston – “The World” with Marco Werman\nAugust 23 – 27, 2014 -  Still escalating Ebola situation. Now a secondary case in Nigeria \nwith  having infected a person who took care of him.   That person (who \nrecovered) then infected a doctor in Port Harcourt. The doctor died, but the doctor’s wife \nis now infected.  The numbers are going up.   Tom Frieden now in Liberia to assess the \nsituation.  He is saying that it is catastrophic and out of control in a press conference from \nMonrovia.  People on the Secretary’s 3x per week call have criticized him for being \n“hyperbolic”.   How should they know – he is there and they are here.   Typical \ngovernment cover-your-ass bullshit.   Still getting modest press.\nAugust 28, 2014 – Our big press teleconference announcing the beginning of the Ebola \nvaccine Phase 1 trial of the Chimp Adenovirus 3 vector with the Ebola GP bivalent gene \ninsert.   Trial to start on September 2 at NIH Clinical Center.  Also coinciding with \nslightly later start of monovalent identical vaccine in the UK with Oxford, Wellcome \nTrust and extension into Mali and the Gambia.  Also, we announced our collaboration \nwith NewLink and Public Health Agency of Canada (PHAC) in a Phase 1 trial (in Silver \nSpring, MD with WRAIR) of the VSV – Ebola vaccine.\nReleased by Chairman Rand Paul\n\n358contamination of hands outside of the classical hospital setting should in my mind at least \nbe considered as a potential route of transmission.\nPress interest continues with: Columbia (Bogota) Radio; VOA TV; NPR Weekend \nEdition with Scott Simon; NPR Science Friday; CNN with Jake Tapper; Reuters TV\nAugust 30, 2014 – Case from Guinea went to Dakar, Senegal and lied about exposure.   \nTook bus and stopped in 2 health care facilities.   Contact tracing now going on in \nSenegal.\nSpoke with Tom Frieden who is in Liberia.   Trying to get him to appreciate that giving \nVSV Ebola vaccine as post-exposure prophylaxis (PEP) is risky due to the induction of \ncytokines by the live VSV, which might actually enhance the acquisition upon exposure \nsince cytokine dysregulation plays a negative and potentially positive role in Ebola virus \ndisease.  He wants to pre-position VSV vaccine for PEP and TKM drug (siRNA – not yet \nis phase 1) at all Ebola treatment Units (ETUs). I understand the desire to protect the \nCDC and other health care workers on the front lines, but we must be concerned about \ngiving drugs/PEP vaccines BEFORE they have even been in the earliest Phase 1 trials.   \nYesterday CDC evacuated a WHO worked who had a low risk needle stick (clean needle \nthrough potentially contaminated gloves) and they gave the person TKM drug and \nwanted to give VSV, but could not get it.   That is why he now wants to pre-position it.\n See below my e-mail to Tom Frieden sent to him on Sunday, August 31 while he was in \nLiberia:\nTom:\n    I am including a few attachments: 1) 2 slides (from Nancy Sullivan \nwho does our pre-clinical Ebola studies)  that summarize the issue of \n\"cytokine dysregulation\" in Ebola disease and potentially following \nvaccination; 2) 2 reprints (referred to in the 2 slides) on the types \nof cytokine responses in Ebola disease and following vaccination with \ndifferent vaccine platforms; and 3) the Heinz Feldmann paper with which \nyou are familiar and which shows that in the monkey model of Ebola \nvirus disease, the VSV Ebola vaccine used as post exposure prophylaxis \n(PEP) protected 50% of the monkeys from lethal challenge with Ebola if \nadministered 20-30 minutes following the challenge.\n   Getting back to our discussion and your question concerning the \nissue of any risk of administering VSV as PEP, I certainly would not \ncharacterize the inflammation following VSV vaccine administration as \n\"cytokine storm\".   It certainly induces inflammation and can cause \nfever.  Note that the only human to my knowledge who received this \nvaccine was the laboratory worker in Germany who had a needle stick \ninjury and she got a fever following vaccination.   Inflammation that \nresults in fever will virtually always induce secretion of cytokines of \nvarious sorts.  Since VSV in the NewLink vaccine is a replicating \nvirus, it will almost certainly induce the secretion of \ncytokines.   The reason that this might be important is that a whole \narray of cytokines are important in the pathogenesis of Ebola virus \ndisease.   It certainly can kill you (advanced cytokine storm) and it \nis almost certainly involved in protection and recovery from Ebola \ninfection.  It is a delicate balance that we do not fully \nReleased by Chairman Rand Paul\n359understand.    At this time, we are unclear about the positive versus \nnegative effects of cytokine secretion (or call it dysregulation) \nrelated to the precise cytokines in question and the timing of their \nsecretion vis-à-vis Ebola infection (see first bullet in the first of 2 \nslides in the first attachment.\n   In my mind, this does not mean that one should not provide VSV as \nPEP for your people (or others); however, if administered to them, it \nshould be made clear to the recipients that 1) VSV Ebola vaccine \nprovided 50% protection in monkeys if given 20-30 minutes following \nexposure.   I would mention that monkey models are somewhat different \nfrom human Ebola (see 3rd and 4th bullet of 2nd slide in first \nattachment) and so direct extrapolation to humans should be made with \ncaution at this point in time;  and 2) importantly, the vaccine \nrecipients should clearly understand that there is a theoretical \npossibility that the VSV, due to the complexities of the cytokine \ndysregulation that accompanies Ebola infection and the perturbation of \nthis cytokine network that might occur with a live virus vaccine (VSV) \nthat induces inflammation and fever, might actually cause them harm by \ndisturbing their normal inflammatory/immune response to Ebola \ninfection.   If they understand these caveats, then it would be their \nchoice to receive the vaccine with informed consent.\n    Finally, as you certainly know better than anyone, the FDA will \nhave to be involved in the approval of allowing this pre-positioning \nand potential use of an experimental vaccine by whatever is  the \nappropriate regulatory mechanism.   I hope that this information is \nhelpful to you in your deliberations about PEP.   I look forward to \ndiscussing these issues with you.\nBest regards,\nTony\n-----Original Message-----\nFrom: Frieden, Thomas (Tom) (CDC/OD) \nSent: Sunday, August 31, 2014 3:49 AM\nTo: Fauci, Anthony (NIH/NIAID) [E]\nSubject: Cytokine \nI had heard of cytokine storm with tekmira but not with VSV.  Can you \nconfirm?\nDid MSNBC\nSept. 1, 2014 – Labor Day – had usual call with Secretary Burwell (SMB) this AM at \n8:30 AM.   Clear and muggy day.   We are going around in circles.   I am concerned that \nthe Secretary is a really smart and very competent person, but she is surrounded by \npeople who may be good at management, but who have never been in a situation like this \nand who really do not have a clue how to address it →  Leslie Dach (formerly of \nWalmart); Andrea Palm (have no idea where she came from).   Bill Corr (Deputy \nSecretary) is the only one with corporate memory of former crises and he has been \ncompletely marginalized by the new kids in town.\nReleased by Chairman Rand Paul\n360There really is no command and control at a higher level.   At my suggestion, Francis \nsent a note to SMB suggesting that we bump this up to the White House level (perhaps \nthe VP) in order to get DoD, USAID, HHS, and NSC working together.   She has not yet \nresponded to him.   I mentioned on the call today that Tom Frieden is dealing with \nAssistant Secretary Lumpkin of DoD.  He is a good person, but nothing is happening \nwith the promise for mobile hospital beds.   They are still quibbling about a 25 bed \nhospital when they really need 1000 beds.   Plans for 5 X 100 beds have gone nowhere.   \nMy experience with the DoD is that they are well-meaning, but the culture and chain-of-\ncommand is such that you never know when you are speaking with someone who really \nhas the authority to actually do what they are talking about.   Something strange about the \nmilitary culture in that they will never say “you are speaking to the wrong person; I \ncannot help you”.  They will try to help (although they cannot) and all that happens is that \ntime is wasted.   I tried to make that point on the conference call.\nImportantly, WHO is saying that the epidemic could reach 20,000 cases.   In fact, \nmathematical models that came out in ScienceInsider today from a physicist named \nAlessandro Vespignani showed that the curve is exponential, not linear, which means that \nthere could be 10,000 cases by September 24.\nThis is turning into a total catastrophe.   Just spoke with Dawn O’Connell (Counsellor to \nSMB) and explained to her that the situation is out of control and that we need a higher \ncommand and control.   I also explained to her the importance of the “exponential” curve \nof the epidemic.   Dawn is really trying to be helpful.\nSept. 2, 2014 – Tom Frieden back from West Africa, gives press conference and says that \nthe situation is out of control and could result in 100,000 cases!   HHS people concerned \nthat he is being hyperbolic; I do not think that he is hyperbolic.  Worrisome things – an \nAmerican missionary M.D. got infected while got infected in Liberia in a hospital that \nwas not for Ebola patients.   Turns out he was doing an OB-GYN exam on a woman who \nwas infected, but did not know it and did not tell the missionary that she had been \nexposed.   Big problem – people are not telling the truth for fear of stigma.   \nEpidemiological curves are now exponential.   A lot of planning, but not much action.   I \nam supporting Tom in the press and at HHS even though he still thinks that we should \npre=position TKM drug (siRNA) and VSV vaccine for PEP for health workers in the \nETUs even though they have not been in Phase 1 yet.\nDid Panel at CSIS on 1616 Rhode Island Avenue.   Very hot muggy day.   Panel on \nGlobal Health issues in the context of Larry Gostin’s new Book of Global Health Law.   \nPanel was me, Larry and Tim Evans of World Bank.   Ebola was a major topic.\nImportant – Secretary Sylvia Burwell called my cell phone at 2:30 PM to ask my opinion \nof whether we were not doing enough or were doing it wrong.   I told her that \nquantitatively we are not doing enough.   But as the epidemic grows exponentially, then \nthe quantitative defect transforms into a qualitative defect and then we are doing it wrong \nsince doing the same thing minimally while the epidemic grows, then becomes doing it \nwrong.    She also tasked me to find out whether there are options to improve the tobacco \nReleased by Chairman Rand Paul\n361plant yield of the ZMapp antibodies or as suggested by some, that we go to CHO cells.   \nShe wanted me to contact the Agriculture people at the BMGF where she used to work to \nget their opinion.  I called and spoke with Susan Hellmann (President of BMGF), Chris \nElias (BMGF), Rob Horsch (Ag expert at BMGF), Larry Zeitlin (CEO of Mapp \nBiopharmaceutical to get their opinion.   Consensus is that it will take too long to fix the \npoor yield in tobacco and that we should go for CHO in 2 of the 3 antibodies.   The 3rd \ndoes not do well in CHO and so stick with tobacco on that one.   I wrote a long e-mail to \nSylvia explaining this.\nPress – CNN with Erin Burnett\nNews still dominated by ISIS who beheaded another USA journalist; Russia invading \neastern Ukraine; Gaza and Ebola\nSept. 3, 2014 – Big meeting at World Bank Headquarters on 18th Street, N.W. to exam \nand discuss the response to Ebola.   Jim Kim (President of World Bank) specifically \ninvited me (as did Paul Farmer),   Discussed the WHO Roadmap and David Nabarro’s \nUN Plan.   Present at meeting were: Tom Frieden, Jim Kim, Tim Evans (Senior Director, \nGHNDR), Jan Eliasson (Deputy Secretary General, UN), Margaret Chan (Director-\nGeneral, WHO), Gayle Smith (by phone – Special Assistant to the POTUS at NSC), \nMark Dybul (by Phone), Keiji Fukuda (WHO), Raj Panjabi (Harvard), Ariel Pablos-\nMendez (USAID), Jimmy Kolker (HHS), Joia Mukhajee (PIH)Sri Mulyani Indrrawati \n(World Bank), Olusoji Adeyi (World Bank), and other World Bank people.\nJim Kim took the lead and emphasized that we need to translate “planning” into action \nand took Margaret Chan to task for not exercising her authorities under the International \nHealth Regulations (IHR) to take the lead.   Despite Jim Kim’s strong urging, it still \nappears that we are not headed to great action.   David Nabarro had some action items \nwith no way to actually act.   I mentioned gently to Margaret that she should not say that \n“We plan to have to Epidemic under control in 6 months”   since this would signal to the \nworld that we actually have a way of ending it in 6 months, when in fact we have no idea \nwhen it will end given the exponential nature of the increase in cases.   I also told story of \nwhen Colin Powell and I went to the UNGASS in the early 2000s and he declared the \nAIDS pandemic a global security threat and this got the attention of everyone.   We \nshould do the same thing with Ebola.\n Press – MSNBC with Peter Alexander; Fox News with Lou Dobbs.\nSept. 4, 2014 -   After discussions with me and having me see and edit his column, Mike \nGerson wrote a scorching editorial in today’s Washington Post criticizing the world and \nthe White House for not doing more for the Ebola situation.   In my discussions with \nMike, he indicated that when he was in the WH with Josh Bolton as Chief-of-Staff, they \nwould have pushed George W. Bush and he would have responded to do something \ndramatic to help West Africa.   Mike sent me a note that Denis McDonough (Obama \nChief-of-Staff) sent to Mike in response to Mike sending Denis a copy of the article.   \nDenis note to Mike below:\nReleased by Chairman Rand Paul\n362Tony,\nIn confidence, this is the note Denis sent back to me when I sent him the link to the \ncolumn.  I thought you might be interested.  \nThanks, Michael.  It is good to hear from you, and I look forward to reading your column (which I \nhave not yet had the chance to do but will soon).\n \nI did think it was worth mentioning that the President had a good – if alarming – discussion with \nDr. Frieden on Monday after Tom returned from the region where he went to get a candid view \nof how this is progressing.  Tom was concerned with what he saw, and the President was \nconcerned with the same.  As a result, POTUS directed even more aggressive action than we \nhave been taking so as to treat this like the national security challenge it is. \n \nLisa, who is leading this effort, and John may have additional thoughts.  But we feel this urgency \n– deeply.\n \nThanks again for the note,\nDenis.\nPress – MSNBC with Ronan Farrow, \nSept. 5, 2014 – Got note from Tait Sai saying that my interview in Newsweek where I \nsaid that the Epidemic was “completely out of control” was “10% too hyperbolic”.   Lots \ngoing on.   USAID assigned Nancy Lindborg to run their shop.   She is pretty good.   Jim \nKim is exercised that WHO is not doing enough.   Tom Frieden says that the DoD is \nuseless since they can never commit to anything.   This is interesting since Cliff Lane \nthinks that they are the only ones that can control this with Command, Control and \nCommunications.  \nJim Kim wants to engage me, Paul Farmer, Mark Dybul to see to the clinical care issue \nand incorporating clinical trials into the picture.\nSpoke with Tom Frieden today and Tom feels better those things are now moving with \nthe $75 million that USAID is putting in.   I believe that Tom was told to tone down the \nrhetoric about this outbreak being totally out of control and that is why he is saying that \nthings are on track.   This coincides with Tait telling me that I am 10% too hyperbolic\nDid boat-load of print media today.\nSept. 7, 2014 – POTUS said on Meet the Press today the following:\nPOTUS on Ebola on Meet the Press, 9/7/14:\n*Americans should not be concerned about prospects of contagion here in US, short-\nterm, because it is not airborne disease like the flu.  \nReleased by Chairman Rand Paul\n363*No public health infrastructure in Liberia/SL/Guinea.\n*What should be containable problem is breaking loose, because people aren't being \nquarantined properly, people aren't being trained properly, not enough public health \nworkers. \n*We have to make this a national security priority. Mobilize international community, get \nresources in there, get US military assets just to set up isolation units and equipment, and \nprovide security for public health workers surging from around the world.\n*If we do that, still going to be months before this problem is controllable in Africa. But \nit shouldn't reach our shores. \n*If we don't make that effort now, and this spreads, not just through Africa, but other \nparts of the world. There is the prospect the virus mutates, it becomes more easily \ntransmittable. And then it could be serious danger to US. \n*This is example of where US leadership is important in dealing with crisis. But, also \nargument for when I go before Congress, and say let's give some public health aid to \nLiberia. Short term investments now, pay off in the future. \nIt now remains to be seen what actually happens.   The POTUS is getting beaten up in the \npolls and by the GOP for his inaction.   He let the Left down by delaying action on \nimmigration reform until after the November Congressional elections in a purely political \ncave-in.  He is paralyzed in inaction on bombing ISIS in Syria and in doing nothing to \nstop Putin and the Russians from taking over part of Ukraine.    He is having a bad \nsummer.\nYesterday, Mike Gerson contacted Francis Collins in the same manner that he had \ncontacted me, asking Francis what he thinks should be done.   Francis responded as I did \nthat we should bring in the DoD for their Command, Control and Communications \ncapability.   Also, someone needs to be in charge.   John Podesta (Counsellor to the \nPOTUS) contacted Mike Gerson asking him what he thinks we should do.   John was \ntaken aback by Mike’s Post editorial the other day.   Mike asking Francis/me who should \nbe put in charge at the WH.   I suggest any of the following:   David Petraeus, Stanley \nMcCrystal, Colin Powell, and Bill Frist.   I doubt if they will choose any of these.   They \nprobably will ask Lisa Monaco – head of NSC.   We really need a General.\nI believe that we are missing the boat.   USA is missing an opportunity of saving many \nlives and coming across as the savior of West Africa, much like George W. Bush saved \nall of Africa with PEPFAR.\nAm getting e-mail from Jim Kim and Paul Farmer asking for my help/advice should they \nget more heavily involved.\nReleased by Chairman Rand Paul\n364Sept. 8, 2014 - The situation is evolving rapidly where the Department of HHS is now \ntelling us (NIH and others) that things are now going in the right direction and that we do \nnot need to have daily phone calls anymore and could probably move them to every week \nor every other week. This is stunning to me since I do not see that anything has really \nchanged and it appears to me that they are trying to paint a rosy a picture when things are \nactually getting worse. The reason for this is unclear. It could be that the White House \nhas told them to tone down the rhetoric since they do not want to put pressure on the \nPresident. Also amazing is the fact that even Tom Frieden has told me on the phone that \nthings seem to be going in the right direction now and they have work streams and points \nof contact and he is much more optimistic. I cannot believe that he has completely \nchanged from the passionate person demanding an overwhelming amount of resources \nand beds to someone who now says everything seems to be going okay. There is \nsomething very fishy here.   I suspect that HHS has promised him that resources are on \nthe way and have told him to cool it.   I will find out what is going on.\nAppeared on Diane Rehm show today with Sheri Fink from the New York Times as well \nas Sophie Delaunay from MSF and Mvemba Dizolele from the Democratic Republic of \nthe Congo.    Dvemba said that he has been reading about me since he was 16 years old \nand that I was his hero.   He made me feel rather old despite the flattering comment (he is \nright about the age ).  The host was Steve Roberts and we spoke about the drastic \nsituation in West Africa. Also appeared on BBC radio. WTOP radio and Reuters TV.  \nAlthough the President has said on Meet the Press that the military will now be involved, \nreports and news outlets such as Reuters quote officers at the level of Colonel saying that \nthe military will deliver the 25 bed hospital to Liberia; however, there will not be “boots \non the ground” of military personnel staffing the hospital. As far as I can see, this is no \ndifferent than what was going on before the President's announcement. There were \nalready plans to get a 25 bed hospital shipped by military aircraft to Liberia. I think this is \na smoke and mirror game in which nothing will get done.\nSeptember 9, 2019 - There is a considerable disagreement going on about the role of \nrandomized placebo-controlled clinical trials (RCTs) in determining the efficacy and true \nsafety of the GSK/NIH chimp adenovirus vaccine. The British in the form of Jeremy \nFarrar Head of Wellcome Trust as well as the WHO (Marie-Paule Kieny) seem to want to \ndistribute the vaccine outside of a clinical trial. They are responding to what is an \nemotional need to get some intervention out there even though we have experience to \nindicate that the worst thing that can happen is the widespread application of the vaccine \nor other interventions that  either do not work or actually paradoxically make things \nworse as we have seen with the HIV vaccine experience where a HIV vaccine that looked \ngood in preclinical as well as in phase 1 actually increased the risk among the vaccinees \nof HIV acquisition by up to 41%.  This is the worst thing that could happen in the Ebola \nsituation. Cliff Lane and I are trying hard to strike a delicate balance between making our \nvaccine available following phase 1 trials which have just started here at NIH and \ncontinuing to pursue the scientific path of determining if it works and is safe without a \nparadoxical effect of harming.\nReleased by Chairman Rand Paul\n365Had an extraordinary conversation with Tom Frieden tonight. Tom had been at a National \nSecurity Council meeting at the White House today hoping that he would guess an \nindication that they would be many more resources to address the Ebola outbreak. He had \nbeen secretive about the meeting; I can understand that since I have been at many WH \nmeetings where they wanted to keep things secret until they made a decision.  He \nobviously was very disappointed after the meeting since he called me on my cell phone in \nmy car as I was driving home late tonight from the NIH. Tom was more animated and \ndistressed that I have ever seen him. I knew this to be the case since he used foul \nlanguage (“Fucking ….”) and I have never heard Tom used foul language before. He was \ncompletely frustrated by the fact that his meeting with the National Security Council and \nrepresentatives from USAID as well as the secretary's office indicated to him that nothing \nnew was going to happen and this whole idea about getting the military involved was \nreally more PR than anything else. He also found out that Cliff Lane in his role as a \nmember of the Defense Medical Board will actually be meeting with Gen. Martin E. \nDempsey, Chairman of the Joint Chiefs of Staff, tomorrow (Wednesday, September 10) \nand he essentially implored me emotionally to get Cliff to emphasize to the Chairmen \n(General Dempsey) that it is absolutely essential that we have a major military presence \nin approaching the epidemic in West Africa. We need plans, thousands of beds, trained \npersonnel, Command and control, etc.  Without these assets, Tom feels that the epidemic \nwill remain out of control and spread to many countries in West Africa and throughout \nAfrica as well as to other countries outside of the African continent. He also indicated to \nme that some people who he did not name were telling the military that they need not get \ninvolved since vaccines and ZMapp will soon end the epidemic before they even get their \nplanes in the air. This is obviously complete nonsense and Tom knows it. He emphasized \nthe need to please tell Cliff Lane to tell the Joint Chiefs of Staff that this is not the case. \nFinally, Tom indicated to me that the military are afraid of getting infected because they \nhear that so many healthcare workers are getting infected. He implored me to tell Cliff \nthat with proper personal protective equipment there really has been no infections among \nindividuals from MSF. This is turning into a very interesting scenario we will see what \nhappens tomorrow on September 10 when Cliff actually meets with the Joint Chiefs of \nStaff. I assured Tom that Cliff and I strongly feel the way he does and we both have been \npushing hard behind the scenes to get the military involved.   In fact, I have been talking \nwith Mike Gerson (as has Francis Collins) about approaching John Podesta in the WH to \nget the POTUS to agree to military intervention.   I spoke again with Mike Gerson about \nthis today.   After my call with Tom Frieden, I called Cliff and related the story.   I did \nnot need to encourage Cliff to say these things since I knew that he would.   I got back to \nTom and told him that things were on track with Cliff for tomorrow and Tom felt better \nand thanked me for my help. \nIn addition today I had conversations on the phone with Paul Farmer who was very \nwilling to set up more facilities in West Africa via Partners in Health (they are already in \nLiberia with Raj Punjabi) together with Jim Kim of the World Bank so that we can do \nsome good clinical work as well as clinical research. Paul indicated that I did wonders \nwith PEPFAR, and that he would like to partner with me to do some good with Ebola.\nReleased by Chairman Rand Paul\n366Sept. 10, 2014 - The debate still continues as to whether or not we will have military \nassistance in dealing with the Ebola epidemic in West Africa. There is a disturbing lack \nof transparency between HHS and us here at NIH in that they are obviously negotiating at \nthe level of the National Security Council and the Department of Defense about what to \ndo in the epidemic without telling Francis Collins or me what is actually going on. In the \nmeantime, Cliff Lane as a long-term member of the Medical Defense Board of the \nDepartment of Defense has met with Gen. Martin E. Dempsey, chairman of the Joint \nChiefs of Staff today. Cliff relates to me that Gen. Dempsey seemed quite receptive to \nCliff's pleading for a massive military logistic support for the Ebola situation in West \nAfrica. Also at that meeting with the Joint Chiefs was Laurie Garrett, because of her prior \nexperience with Ebola epidemics. According to Cliff, Laurie also pleaded for a massive \nmilitary effort.\n      It should be noted that today another important event occurred in which the President \nannounced at a TV appearance that he will initiate a scaled up military attack on ISIS (he \ncalls it ISIL)  including their assets in Syria. He declared that ISIS is a threat to the \nMiddle East, the surrounding regions, and the United States and Europe, largely due to \nthe fact that they have publicly said that they will attack Western nations. This is a \nparticularly important problem because many Westerners with Western passports and \nVisas including those from the United States have joined ISIS. The President stated that \nhe would not include ground troops in this effort. However it is clear that Special Forces \nwill be needed to guide the air attacks. The press is sharply criticizing the POTUS for \nhaving no plan, missing prior opportunities, and now doing too little, too late.  More later. \nI bring this up because this is certainly a complicating issue when you are also asking the \nmilitary to help with Ebola outbreak.\nHad a momentous evening today in that I gave a keynote lecture at the PhRMA Research \nand Hope Awards Gala at the Mellon Auditorium on Constitution Ave. It was particularly \nimportant because the other speaker was former Pres. George W. Bush. We resumed our \nwarm personal relationship in that when he entered a small room of VIPs to shake hands \nand take pictures as soon as he walked into the room he caught my eye and said out loud \nfor everyone to hear: “Hey, Tony it's great to see you”. He gave me a big hug; we took \npictures; chatted a bit and then when he was on the stage for his talk which was actually a \nconversation with a moderator, the first thing he said is that:  “We have with us tonight \nmy friend Tony Fauci. I gave Tony the Presidential Medal of Freedom several years ago. \nI did that because you should know that he is one of the most important American heroes \nof our time.”   It was extraordinarily flattering, but this is exactly the way he has been \ntreating me for years. The talk that I gave was entitled ending the HIV-AIDS pandemic: a \nrealistic goal. Overall the evening was very pleasant. I sat down next to my old friend \nform NIH director Elias Zerhouni and the evening was full of warm praise by many \npeople for me and what I have been doing with HIV over the last many years. \nSept. 14, 2014 - A lot has happened over the past few days. There has been a \nconsiderable amount of disorganization, diffusion, and lack of direction at the level of \nHHS as well as the rest of the USG (USAID, DoS, etc.). It has been announced that the \nPresident will visit the CDC on Tuesday, September 16. It is anticipated that he will \nannounce that the United States military will get heavily involved in the response to \nReleased by Chairman Rand Paul\n367Ebola by providing up to 1700 hospital beds as well as the logistics for transportation and \nprovision of equipment. However, it is very clear that they will not provide medical \npersonnel in the form of doctors and nurses. This might leave us with the situation in \nwhich we have equipment but the inability to implement it. HHS (Leslie Dach) is \ndesperately trying to figure out ways to recruit and train medical personnel to man the \nhospitals.   Of note, it might take up to 8 weeks to get these hospitals operational, if in \nfact, the US military decides to send them. \n      The situation in the West African countries is still dire. I have been on the phone \ndiscussing this on multiple occasions over the past few days with Paul Farmer and Mike \nGerson.   Paul will be leaving tomorrow, September 15, for Liberia in order to set up \nhospitals under the auspices of Partners in Health, the organization that Paul and Jim Kim \nfounded many years ago. Francis Collins, Cliff Lane, and I are still pushing HHS to \nsuggest that there be a person in the White House who would be the overall Director and \npoint person for the government's Ebola efforts. I have suggested to Francis and Francis \nhas suggested to the secretary that that person either be someone like Gen. David \nPetraeus, Gen. Stanley McCrystal, or even former majority Senate leader Bill Frist. \nAgain, I am concerned about the lack of organization, direction, and commitment on the \npart of the department as well as the White House. The President is having a very \ndifficult time in that he is being pressured to respond firmly to the threat of ISIS in the \nMiddle East. I feel that this pressure may make him and the administration less \nenthusiastic about getting heavily involved with the Ebola issue.\n     Nicki Lurie, who is a good person and a friend, is making things more confusing by \ntrying to suggest how to do clinical trials, train people and other tasks when she knows \nlittle about these issues.   She is an Assistant Secretary and so officially she outranks us \nall (me, Peggy Hamburg, Francis Collins, Tom Frieden); yet, she gets in the way more \noften than not.   Had a long conversation about this with Peggy Hamburg on the phone \ntoday.   Paul Farmer is encouraging me to continue to push the envelope to get the USG \nto do more.   Paul is showing an amazing amount of faith in me that I can fix this.   He is \nbasing this on his experience with me with PEPFAR.   However, this is different since \nthere are so many “cooks” in this process.\nSept. 15, 2014 – Mike Gerson called me up again this AM wanted to find out if I knew \nanything more about the POTUS planned announcement at CDC tomorrow regarding \nincreased resources (DoD) for Ebola.   Mike is driven by his deep humanitarian values \nand wanting to nudge the administration to do more.  Mike will speak with Lisa Monaco \ntoday about administration plans.   I gave him a few questions to ask Lisa, i.e. who is in \ncharge?\nSept. 16, 2014 – I helped Mike gerson last night on certain elements of his column which \nappeared today in the Washington Post. Mike used several of my phrases and called for \nan escalated effort in various areas of need including US Military command-and-control, \ntransportation, logistics, and supplies. Last night the White House sent out an embargoed \nfact sheet about what the President will announce today at the CDC. He will make the \nannouncement at 4:45 PM. I will be testifying before the Senate  HELP committee and \nthe Senate Appropriations Subcommittee from 2:30 PM until about 4:30 PM. There are a \nlarge number of press including CNN with Wolf Blitzer,Hhardball with Chris Matthews, \nReleased by Chairman Rand Paul\n368an MSNBC who want to speak to me about the President's announcement and the \nimplications of the announcement. As usual the White House is very nervous about \nhaving anybody speaking to the press before or on the day that the president makes an \nannouncement. Therefore I am getting a lot of grief from the communications people \ndowntown and at the White House about all of the requests for me to appear on the \nmedia. By grief I mean that they are not clearing me nor are they refusing me. They are \njust keeping me hanging, which usually means that the requests will be withdrawn by the \nmedia people themselves and they will find someone else. This is typical stupidity on the \npart of the White House and HHS.\nWith regard to the announcement of the President, he is proposing many of the things that \nI and several of my colleagues have been pushing for. This includes 3000 personnel, a \ncommand-and-control center in Monrovia, Liberia, a US Army general in charge of the \nprocess. The supply of 17 Ebola Treatment Units  consisting of 100 beds per unit, much \npersonal protective equipment, an education program, home health care kits, home test \nkits, among many other things that are much needed. Hopefully, this will turn around the \ntrajectory of the epidemic. However it will depend on how quickly they get this material \non the ground. I am off to the congressional committees. More later.\nSept. 17, 2014 – Big day yesterday.   POTUS announced military involvement in Ebola \nat CDC at the same time that I was testifying before a joint Senate Hearing of the HELP \nCommittee and the Appropriations Committee.   I testified with Beth Bell from CDC \n(Tom Frieden was at CDC with the POTUS visit), and Robin Robinson.   I was \nquestioned on the POTUS plan, the scope of the epidemic and the possibility of \nrespiratory/aerosol spread of the virus.   The latter was triggered by Mike Osterholm’s (as \nusual provocative and attention-getting) statement that the virus could mutate and spread \nby respiratory and that would be the end of the world.   Typical Mike Osterholm.   I have \nbeen countering this with a reality check about likelihood versus hypothetical.   Senators \nat the Hearing were Dems: Tom Harkin, Patty Murray, Dick Durbin, Jack Reed, Mark \nPryor, Barbara Mikulski, Bob Casey, Al Franken, Sheldon Whitehouse, Tammy Baldwin, \nChris Murphy and Elizabeth Warren  and GOPs:  Jerry Moran, Thad Cochran, Lamar \nAlexander, Richard Burr, Johnny Isaacson, John Boozman.   Kent Brantley was witness \non second panel.\nAnother example of the WH and HHS press people messing up.   They would not let me \ngo on the many press requests (CNN, NBC, etc.) since they wanted Lisa Monaco (NSC) \nto go on.   As it turned out, she was with the POTUS in his motorcade in Atlanta and so \nno one from USG went on and the media was saturated with the usual suspects (Laurie \nGarrett, Mike Osterholm, etc.)   The WH and HHS press people are truly a bunch of idiot \namateurs.\nSept. 18, 2014 – Yesterday had Hearing before the House Subcommittee on Foreign \nAffairs (Africa) chaired by Chris Smith.   On the GOP side were: Stockman, meadows, \nBurgess, Royce (Chair of Full Committee).   On Dems side was:  Bass, Cicilline, Engel, \nand McCollum.   My co-witnesses were Nancy Lindborg (USAID), Luciana (Lu) Borio \n(FDA), Beth Bell (CDC).   Recurring question was “Who is in charge?”    Real answer is \nReleased by Chairman Rand Paul\n369that multiple agencies/people are in charge depending whether it is health, infection \ncontrol, logistics, etc.   Kent Brantley again was on the second panel.   \nStill much interest and interviews with written press and blogs over the ongoing \n“disagreement” between Osterholm and me on the issue of the virus mutating to \nrespiratory spread.   Ian Lipkin gave an interview on CNN agreeing with me and putting \ndown Osterholm.\n \nMeanwhile, the House voted to give POTUS authority to arm the Syrian Free Army to \nfight ISIS.\nThe situation continues to heat up with various mathematical models projecting anywhere \nfrom 20,000 to 100,000 to a soon to be published CDC model that would indicate if we \ndo not have a highly effective control program, the number of cases could reach 500,000 \nwithin several months.\n September 19, 2014 - I continue to do small amount of press (as the press is getting \nsome fatigue with the same story) with Swedish National TV interview as well as a FOX \nnews appearance. Of note is the fact that the White House communications people are \nacting in a very bizarre way. During the past week I have been receiving requests for \nappearances on a variety of TV shows for the upcoming weekend including CNN and \nMSNBC on Saturday, September 20, as well as Face the Nation and Fox news on \nSunday, September 21. The White House has refused to say yes or no to clearance and \ndespite multiple requests on the part of our communications people, namely, Courtney \nBillet and Patty Conrad, we have not received a positive or negative reply for clearance. \nThis has gone on into the late evening of Friday, September 19 despite the fact that the \nprogrammers were waiting for me to be on shows on Saturday. This is an absolute \nunacceptable disgrace.  The White House because of their inability to decide what should \ngo out on the weekends and their extraordinary and unexplainable need to control all \nmessages is putting all of us in the embarrassing position of being unresponsive to \nlegitimate media requests to discuss things that are not in conflict with anything else the \nadministration is doing. This is unequivocally the worst administration I have ever dealt \nwith when it comes to the need to control the media.\nThis evening I had a very intense and somewhat poignant conversation with Tom Frieden \nat 9 PM to 10 PM concerning how we are going to approach the issue of vaccines. Tom \nstill has considerable concern about a truly randomized controlled trial to determine the \nefficacy of the vaccine when the control is not one of the vaccines themselves. He \ncontinues to struggle with the fact that we are not going to be able to get efficacy data \nunless we do have a control arm which conflicts with the emotional need to get vaccine to \neveryone as soon as possible. The difficulty here is that we might in fact truly need an \neffective vaccine if the epidemic continues to expand and reaches the CDC projected \nmodel of 500,000 cases within the next several months. Under those circumstances we \nwill absolutely need an effective vaccine and if we do not know if it is effective it will be \nvery difficult to widely distribute it. This is a painful dilemma that hopefully we can work \nout.\nReleased by Chairman Rand Paul\n370I have been discussing this by e-mail with Paul Farmer who is currently in Monrovia, \nLiberia. Paul is very sensitive to the fact that we need to do research to determine the \nefficacy of the vaccine and feels that we can pull this off in Liberia with a properly run \ntrial. In this regard, the Minister of Health of Liberia has actually requested collaboration \nwith the NIH in doing research on therapeutics and vaccines. It is going to be a difficult \nstruggle to reconcile the emotional need of many people (in some respects including Tom \nFrieden) to distribute vaccine at the same time that we are not sure if it actually works or \neven paradoxically causes harm. I will continue to pursue discussions of clinical trial \ndesigns that might be able to get us where we need to be, i.e. proving efficacy at the same \ntime as making vaccine available as quickly as possible.\nSept. 20, 2014 – Went to reception tonight at the home of Hilary Rosen (Democratic \npundit) at 4835 Hutchins Place, N.W. to welcome Megan Smith former VP at Google as \nthe White House Chief Technology Officer.   All the usual Washington glitterati were \ntheir (some examples: Judy Woodruff, Al Hunt, Andrea Mitchell, Bob Barnett, Tammy \nHaddad, Hunter and Kathleen Biden, etc.   Megan is very impressive (MIT grad; Google \nexec) and we discussed the potential use of technology to address the Ebola epidemic – \ncell phone distribution, GPS tracking devices.  Hopefully, she can help.\nIndeed, neither a yes or no from the WH and HHS regarding the requests for my \nappearances on TV over the weekend and so I did not appear.   Instead, Face the Nation \nhad Richard Schaffner from Vanderbilt and MNNBC had Laurie Garrett.   This \nadministration are a bunch of idiots.\nSept. 21, 2014 -  Had call at home from Leslie Dach wanting my opinion about a \n“dispute’ between USAID and Tom Frieden about home care versus community based \ncare of people with Ebola or suspected of Ebola in situations where the ETUs are full.  I \nbacked Tom who feels that doing it at home would be counter-productive.   Leslie now \nrelying on me as “the adult in the room” according to Peggy Hamburg.\nSept. 22, 2014 – Tait Sye from HHS not giving me clearance to appear on CNN-Wolf \nBlitzer because “CDC will be putting out an MMWR today”.   What morons!!   I just \ncannot believe this administration.   I must write about this in my book.  They so \ninappropriately try to control “messages” that they are laughable.\nPOTUS decides to bomb ISIS in Syria.   Ebola numbers expanding.\nHad another night time call with Tom Frieden trying to iron out the RCT issue.   Also, \nTom is very frustrated with Nicki Lurie, saying that having her around and involved in \nconversations is always counter-productive.   Also, he is frustrated with Sec. Burwell, \nfeeling that she seems only to want to “check the boxes” instead of getting involved in \nimportant decisions.\nSept. 23, 2014 -  Still working with Tom Frieden in trying to get agreement on whether \nto conduct an RCT of the vaccine.   Tom remains concerned about a true control \nReleased by Chairman Rand Paul\n371(placebo) arm and wants to do a Stepped-Wedge trial of sequentially vaccinated different \ncohorts without the simultaneous double blind control group.\nThis evening went to the Annual Friends of cancer Research Awards Ceremony on the \nroof of the Hay-Adams Hotel.   Gov. Deval Patrick of Massachusetts and Gov. Bobby \nJindal of Louisiana received awards.   Had good conversation with Gov. Patrick.\nSept. 24, 2014 - On the last Secretary’s call, Burwell tasked me to get the HHS team \ntogether and fashion out a consensus about the way forward following ending of phase 1 \nvaccine trial at NIH.   I had long conversation with Tom Frieden this AM and he is \nstarting to come around.   Seems he will be OK with an RCT simultaneously done with a \nStepped-Wedge Trial.  I arranged a conference call at 5:30 PM with me, Tom, Nicki \nLurie, Peggy Hamburg, Lu Borio, and Anne Schuchat.   We came to agreement that we \nwill do the two trials (RCT + Stepped Wedge) simultaneously.   CDC (Anne and Tom) \nfeel that the RCT may be so difficult to implement that the Stepped-Wedge approach \nmight give us some information, while the RCT could fail.   Cliff and I feel just the \nopposite.   However, in order to get things moving, we came to a compromise.   I will \nreport this to the HHS Secretary’s call tomorrow.\nContinue to have press interest:  Bloomberg News TV; WTOP Radio; pre-show interview \nwith CBS 60 Minutes for future show.\nSept. 25, 2014 – Did MSNBC this AM as a commentary immediately following the \nPOTUS statement before the UN on Ebola.   He gave his speech and then I was asked to \ncomment.   Of course, I supported what he said (since he said the right things – all \nnations must pitch in).\nSept. 26, 2014 – Learned at 4:00 PM this afternoon that the NIH Clinical Center will be \naccepting for observation in our special studies unit an American physician who had a \nmoderate risk exposure to Ebola in Sierra Leone (clean needle puncture through a \ncontaminated glove).  We scrambled around over the evening preparing press statements \nand plans.  Patient will arrive on Sunday, Sept. 28.\nSept. 27, 2014 – Did FOX News and CNN today (Saturday) on regular Ebola issues.  \nAlso, much press coming in since the press release went out today on the patient arriving \nfrom Sierra Leone.   In this regard, I did CBS Radio News; NPR background; WUSA –\nChannel 9 TV; various print outlets.   Likely much more tomorrow.\nSept. 28, 2014 – Patient arrived this afternoon (~3:00 PM) from Sierra Leone.   State \nDepartment arranged his transportation.   He was given the VSV vaccine as a post-\nexposure prophylaxis, which neither Cliff nor I would necessarily have done since it \ninduces a fever and can complicate matters.   Indeed, he developed a fever 24 hours after \nreceiving the VSV vaccine.    The Patient, Dr. Lewis Rubinson, is admitted to the Special \nStudies Unit of the Clinical Center on the 5th Floor.      Very little of the circus that we \nsaw when Dr. Brantley and Nancy Rightbol were admitted to Emory, i.e. no helicopters \nor TV trucks.   I did do a few interviews (some pre-scheduled even before the patient was \nReleased by Chairman Rand Paul\n372known to come to NIH.   Did interviews for: MSNBC, NBC Network, NPR Radio; Fox5 \nTV, CBS Radio\nSept. 29, 2014 – No evidence of infection in the patient.  Much press today:  CNN; \nWeather Channel TV; USA Today TV and ONLINE; 1 hour at the WTOP Studio with \nquestions from staff Deborah Feinstein and Bruce Alan; CBS Radio; FOX5 TV; CBS \nTV; AP TV; Channel 8 News TV\nSept. 30, 2014 – Word from the WHO meeting in Geneva is that people are starting to \ncome around to our (Cliff, me, Lu Borio) idea about the necessity of conducting an RCT \nrather than open access for the Ebola vaccine.   A story about me with picture appeared in \nUSA today with my saying that it is critical to greatly accelerate our efforts or else the \nEbola epidemic will evolve into the “worst case scenario” of the CDC prediction of 1.4 \nmillion cases by early 2015.\nOct. 1, 2014 – Big news!   A patient  from Liberia got on a plane on \nSept. 19, arrived in USA (Texas) on Sept. 20 without sxs.  On Sept. 24 developed sxs; on \nSept. 26 went to an ER in Dallas and was given Z-pack and sent home; on Sept. 28 taken \nto Texas Health Presbyterian Hospital (Dallas) in critical condition.   Ebola dx confirmed.   \nThis is first patient to come to USA with Ebola who did not know he/she had Ebola.   \nSoemthing that I have been predicting all along.  \nOn conference call with Secretary Burwell, I indicated that after Tom Frieden’s press \nconference at 5:30 PM yesterday (Sept. 30) there were many requests from the press.   On \nthe phone a CDC person said that this is Tom’s responsibility.   Burwell snapped at the \nperson saying that we need Tony out there and this is no time to be arguing about \n“people’s lanes”.   Finally, someone put an end to that bullshit.   Thanks, Sylvia!   Sylvia \nasked me on the phone to cancel my planned trip for today to San Francisco to partake in \na Gala to celebrate UCSF’s Global Health program.   Also, I was going to see Ali.  I, of \ncourse, obliged and Sylvia said that she wanted me to take the lead in “Calming the \nCountry” that will certainly panic about this. She asked me to lead a teleconference last \nnight at 9:00 PM with HHS to discuss the clinical aspects of what this means. \n And so there is much press today:  Bloomberg News TV by phone; AP Radio; CNN \nNew Day; FOX News TV; NPR Here and Now; multiple print media and blogs → AFP; \nNew York Daily News; Washington Post., BuzzFeed; Wall Street Journal;  Also, Doctor \nradio with Marc Siegel; Time Magazine; The Guardian; The Huffington Post; CNN \nInternational (I was cut off by satellite issue); Bloomberg TV; CNN “The Lead” with \nJake Tapper; WBZ/CBS Radio Boston; MSNBC Hardball with Chris Matthews; NBC \nNightly News; FOX with Lou Dobbs; CNN Anderson Cooper 360; WUSA Channel 9.\nAs it turns out, and this was discussed at length on my TV interviews, on the Sept. 26 \nvisit of to the ER, a nurse took a travel history and  explicitly said that he \ntold the nurse that he had just arrived from Liberia.  The nurse wrote this down, but the \nclinical team either did not see it or ignored it.   It is being played up on TV as a major \nmis-step on the part of the local health system.  I continue to “calm the country” by \nReleased by Chairman Rand Paul\n\n373stressing that contact tracing with appropriate isolation if a contact develops sxs will \nprevent an outbreak from occurring.\nOct. 2, 2014 – Media frenzy continues.   The Texas patient continues to dominate the \nnews.  The media is really pouncing on the Texas hospital for dropping the ball in \nsending the patient home with Z-Pack even though the patient explicitly told the nurse \nthat he had just arrived from Liberia and had sxs of Ebola.   Also, the system is being \ncriticized because they are unable to remove the waste from the hospital (license and \ncontract issues) as well as from the room where slept with his girlfriend and her \nchildren.   Amazingly, the girlfriend and children are being legally quarantined (armed \nguard at door) in the room with the soiled sheets and towels still in the room unable to be \nremoved.   Texas is being blasted by the media.   I am trying to add some rationale calm \nto the dialogue.\nToday’s media:  MSNBC with “Morning Joe”; CNN “New Day”; MSNBC – Jose Diaz-\nBelart; LBC (UK) radio; Hearst TV; MSNBC Reid report; Reuters TV; Fox News; BBC \nRadio; BBC World News with Katty Kay; CNN Wolf Blitzer; Canadian TV; MSNBC \nwith Rachel Maddow\nRachel Maddow was wonderful on the interview.   After I signed off, she told the \naudience how honored she was that I went on her show and what an amazing person I \nwas.\nOct. 3, 2014 – Had very interesting day today.   Sylvia Burwell and Leslie Dach asked \nme to join Sylvia at a Press Conference at the White House Press Room at 4:30 PM to \ncalm the country’s increasing fear and anxiety around Ebola , particularly related to the \nmess-ups in Texas (see above).   I was on the podium with Sylvia Matthews, Raj Shah, \nLisa Monaco (Director, NSC) and Gen David Rodriguez of Africa Command.   I received \nmany, many e-mails commending me on my performance as a straight talker while the \nothers were perceived as typical political appointees.   I actually thought that Sylvia did a \nvery good job.   Lisa was a little double talking.   \nAlso, Mike Leavitt (former Secretary of HHS) called me to be briefed on Ebola.\nDid much press, but had to cancel Wolf Blitzer and Jim Sciutto from CNN because of \nunexpected conflict with the WH Press Conference.\nPress included:  FOX News; CBS TV; CNN with Sanjay Gupta; Chris Hayes at MSNBC\nOct. 4, 2014 – Some drama today.  A 35 year old man and his 5 yo daughter (Liberian \nGreen card lives in New Jersey) flying from Monrovia on United Airlines to Brussels and \nthen United to Newark.   Man throws up on the Brussels – Newark flight.  When plane \nlands CDC person on the ground judges that the person does not have Ebola and \nrecommends that he be taken to hospital for checkup and releases the other passengers.   \nTo Tom Frieden’s great dismay, the White House (Lisa Monaco) and Sylvia Burwell \nover-rule CDC decision and have Hazmat remove man and daughter to hospital and call \nReleased by Chairman Rand Paul\n\n374back the released passengers who were already either on the way home or boarding \nconnecting flights in order to get their contact information and pass out forms telling \nthem what to do if they get fever or sxs.   Sylvia asked me to be on conference call \ndiscussing this with Lisa Monaco, Sec. Jay Johnson of DHS, Leslie Dach, Jennifer \nPalmieri of White House Comms and NSC Rand Beers and Ned Price.   Decision on first \ncall was to find out the clinical judgment of the hospital staff as to whether this person \nmight have Ebola.   If they felt there was a risk, they would do Ebola PCR, which would \ntake 2 hours for primary result and up to 72 hours for confirmation.  Decided to wait for \nsecond call in 2 hours.   In between calls I called Tom Frieden to offer to help him out.   \nHe was greatly distressed that the WH and Sylvia over-ruled CDC and called the \npassengers back since the CDC person on the ground felt that the man did not have \nEbola.   He said he cannot do his job if he is being second-guessed by the Secretary and \nher team.   He even spoke about resigning.   I told him that this was ridiculous and that I \nwould try to help him by speaking with Leslie and Sylvia.   Also, Sylvia and Sec. \nJohnson (DHS) want to institute entry screening with questioning and temperature-\ntaking.   There is already exit screening at the West African airports and Tom is against \nrepeating things just to make people feel good.   Sylvia and Leslie want my opinion and I \nwill speak with Leslie tonight about this.   \n     On the second call at 5:30 PM (beautiful Fall day in DC with clear skies and 70 F), it \nwas disclosed that the Jersey hospital found that the patient had no fever or abnormal \nlabs; felt good; and had had an episode of vertigo.   The patient will be released without \nrestrictions and the passengers will be told that all is clear.    Tom is beside himself.\nAlso had long conversation with Mike Gerson today briefing him on story he is writing \nabout the complexities of doing a vaccine trial for Ebola – scientific and ethical issues.\nPress today →  NBC Today Show Weekend Edition; MSNBC with Alex Witt; PBS \nNewsHour Weekend Edition\nOct. 5, 2014 – It is interesting that with the 24 hour News Cycle has created its own \ndynamic.   Today (Sunday) the national news was totally dominated by Ebola.   Now the \nquestions center around whether we should do entry screening as passengers get off the \nplane from West Africa even though there is exit screening at the west African airports \nwith temperature taking and questionnaires.   DHS and some Congressmen want \ntemperature taking at the entry level also, which would only cut the window of \nvulnerability down by hours that the person is on the plane.   Yet, there will be a meeting \nat the White House today to discuss entry screening.  Frieden is against it, but he is going \nto lose the argument.   Leslie Dach and Sylvia asked me yesterday what I thought about \nit.   I told them that it would be for PR reasons only since it really substantively makes no \ndifference.   \nI went on the Sunday Shows today with FOX News with Chris Wallace and face the \nNation.   Tom Frieden did This Week and Meet the press and State of the Union.   \nQuestions were related to Rand Paul and Bobby Jindal saying that we should shut down \nflights from West Africa.   I totally disagreed.   Also, there was concern on Rand Paul’s \npart that our 3000 to 4000 troops that we are sending to West Africa will get infected and \nReleased by Chairman Rand Paul\n375bring Ebola back to the USA.  Ridiculous.   I got many congratulatory e-mails from \npeople telling me how well I did on the Sunday Shows.   In the evening, I did CNN.\nOct. 6, 2014 – White House meeting discussed increased entry screening, but no firm \nrecommendations to date.   Big 24 hour News topic is whether to close the borders to \nWest African flights.   I have been very vocally against this (as had Tom Frieden) since it \nwill only isolate the West African countries and make them less able to deal with the \nepidemic.   It could cause political instability and even government collapse.   In my \ninterviewers over the past 2 days I have said that to interviewers as good as Chris \nWallace and as less experiences as Elizabeth Hasselbeck of FOX News.   Two things \nhave resulted:1) I am getting a lot of hate mail from crazy neo-Nazi types who say that \nwe should not care about dysfunctional black Africans.   In addition, bloggers are \ncheering me on about taking on the right wing news people about closing the borders.   I \ndo not feel that I have “taken them on”; I have just told them my opinion.   Bloggers have \nbeen particularly hard on Elizabeth Hasselbeck saying she was completely over-matched \nin her interview with me.   I did not know beforehand, but she apparently has been a star \non “Survivor” and “The Voice” TV Shows.  She clearly is very beautiful, and I do not \nthink that she is stupid the way the bloggers are saying.\nPress appearances today:  CNN New Day; Fox and Friends (Elizabeth Hasselbeck); \nDiane Rehm Show; MSNBC; PBS The NewsHour (Jeff Green)\nSeems that we (Cliff and I) have won the battle to convince people that we need to do an \nRCT for an Ebola Vaccine.\nOct. 7, 2014 – Continued media frenzy.   Each day they pick something else to hammer \ninto the ground.   Topic today is the POTUS considering increasing the level of screening \nby possibly introducing “entry” screening with temperature and questionnaire.  \nDiscussions divided along ideological lines.   Right wing saying to close borders; execute \nor euthanize African patients.   I have been on the air stressing the lack of rationale for \nclosing the borders of African countries not permitting travel.   For the first time since the \nold AIDS days, I am getting hate mail telling me to go “rot in hell”.   Also, the right wing \nbloggers who comment online after my TV clips are shown online are trashing me calling \nme a liberal asshole selling out to Obama and his socialist views and liberal leanings.   \nVery weird stuff here.\nMore press today →  CNN New Day; Wilson Center teleconference (call in); WTOP \nRadio; MSNBC (Ronan Farrow); WCBS radio New York; FOX with Lou Dobbs; Alan \nColmes Radio Show\nOct. 8, 2014 – Media frenzy continues.   White House came out today and indicated \nincreased layer of screening at airport on the arrival/entry level with: 1) temperatures; 2) \nquestionnaire about contacts; 3) presence of sxs; 4) quarantine if necessary.   The White \nHouse in its ridiculous need to control the message will not let Tom Frieden or I do any \nTV today (OK for tomorrow) since they only want DHS out there delivering the message.\nHate mail continues as well as just criticism from far right.\nReleased by Chairman Rand Paul\n376Somewhat embarrassing AM phone call today on the HHS teleconference with Sylvia, \nTom Frieden, Peggy Hamburg, me, Nicki Lurie, etc.   Tom was concerned that with the \nPOTUS announcement at 3:00 PM that they would not be able to implement the 4 items \n(see above) at the chosen airports of Kennedy, O’Hare, Dulles, Atlanta, and Newark \nwithin the next couple of days.   He expressed this to Sylvia and she argued that they \nwould have to do it since they told the White House at the last meeting with them that \nthey would.   Tom said that this was not his understanding and he was afraid that there \nmight be some embarrassing slip-ups.   Sylvia was not pleased and in her usual gentle \nway made it clear that CDC would have to make it happen.   Very awkward moment on \nthe phone.\nOct. 9, 2014 – Mor of the same.   Dallas patient) died today.   Black \ncommunity led by Jesse Jackson saying that he go suboptimal care because he is black \n(surprise, surprise for Jesse).  Ton Frieden mad a statement at a World Bank meeting that \nEbola could be the next AIDS.  The press is jumping all over that and I am trying to bail \nhim out by saying that there are very many dissimilarities and the major similarity is the \nfear associated with the early years of AIDS.  \nMuch Press today – CNBC (Sqwauk Box); FOX Business with Varney and Company; \nMSNBC with Andrea Mitchell; CNN with Wolf Blitzer X 2; AP TV.\nOct. 10, 2014 – Sylvia Burwell calls me at 7:45 AM concerned about the media coverage \nof Tom Frieden’s statement comparing Ebola to HIV/AIDS.   Wants me to speak with \nTom to get him to understand the problem with this statement.   Called Tom right away \nand discussed with him.   He now gets it and realizes that he should not have said it that \nway.   I told him that the comparison is strong regarding the fear, but the magnitude and \nother aspects are very different.\n  Continued doing much press → WTOP Radio; MSNBC with Craig Melvin; PBS \nCharlie Rose;\nHas interesting dinner hosted at the Fiola Mare (on 3050 K Street, N.W.) by Catherine \nand Wayne Reynolds.   Usual DC Glitterati there.   Had great conversation with ex-CIA \nDirector Mike Hayden about what is going on with ISIS.   He joked that the Ebola \nsituation and me on TV is bumping ISIS of the media coverage.   Great idea by Wayne \nReynolds.   Wolf Blitzer was at the dinner and Wayne (at the end of the dinner right \nbefore dessert had Wolf “interview” me in front of the people sitting at dinner just as if \nwe were on the CNN TV set.   The dinner crowd loved it.   It was fun.\nOct. 11, 2014 – Saturday conference call with Sylvia.  Implementation of additional \nscreening started at JFK Airport.   Issue of a nurse who took care of  may be \ninfected.   More later on that.   Typical situation of what we will see more of especially as \nwe approach the flu season.   Everyone who has a fever, exposed or not thinks that they \nhave Ebola.\nPress →  NBC Today (Weekend); MSNBC with Alex Witt; PBS The NewsHour \n(Weekend)\nReleased by Chairman Rand Paul\n\n377Oct 12, 2014 (Sunday)  - A very important issue that arose this weekend. Very early in \nthe morning at approximately 5:45 t0 6:00 AM, I received an e-mail from Leslie Dach \nthat there would be a conference call with Sylvia, Lisa Monaco, White House Comms \n(Palmieri), Tom Frieden, me, etc.  about a breaking situation. A nurse (turned out to be \n – see below) who had been caring for  at the Dallas hospital \nreported to be ill. It is felt that there was likely an innocent, inadvertent breaking of \nprotocol on the part of the nurse. She had taken direct care of  during very \nserious parts of his illness including hemodialysis, intubation, and insertion of a rectal \ntube. The nurse became febrile on Friday evening, reported to authorities on Saturday, the \npreliminary Ebola test was done on Saturday and the results came back positive on \nSunday (today), subsequently confirmed by CDC.   I was just getting ready to go on the \nSunday morning shows today  when the phone call came to discuss what approach we \nwould take. This ignited an extraordinary media frenzy in which Tom Frieden.  I was \nvirtually on every show. I was on \"This Week\" on ABC as well as \"Meet the Press\" as \nwell as CNN \"State of the Union\" as well as evening CNN. There is now considerable \nconcern in the country that the United States government keeps saying that we are \nprepared and then something like this happens which creates a credibility gap. I have \nbeen intensively emphasizing on my interviews that we need to distinguish between the \nunlikelihood that there will be an outbreak which still does not change since the contact \ntracing that has been done with the  case is working and there is a good umbrella \nover and identification of the people who were contacts and they are currently being \nmonitored either actively or on their own. This needs to be distinguished from a \ninadvertent breach of protocol in which a healthcare worker has gotten infected which is \nbad for health care workers but really has nothing to do with an outbreak in the country. I \nhave been continually expressing this in my interviews.  \nOne issue that has come up is a concern on the part of nurses throughout the country that \nthe use of the term \"breach\" in protocol implies that the nurses are to blame and this \nnurse in particular was to blame. I have been very active in emphasizing that this is not \nthe case that this is an inadvertent, innocent, \"breach\" of protocol and that we need to \nintensify the training for the nurses. The nurses themselves have said that they are \ninadequately trained and although the protocol might be a good protocol, they are not \ntrained to implement the protocol. The CDC has responded by being very proactive in \nincreasing their training with webinars, conference calls, and active visits on the part of  \nCDC staff to the involved hospital in Dallas as well as to anywhere else where this \nsituation might arise.\nPress - This Week (ABC); Meet the Press, CNN State of the Union; CNN evening.\nOct.13, 2014 – One of the busiest press days that I have had.   Media frenzy at high pitch.   \nMuch, much criticism of the USG and CDC is particular saying that the USG and CDC \nkeep telling us we have everything under control and still there are many mis-steps.  I \nhave been calmly explaining on TV and radio that people should not conflate what is \nworking, i.e. the lack of an outbreak because of the proper implementation of isolation \nand care of Ebola patients and the infection of a health care worker.   Clearly, HCWs are \nnot implementing the CDC PPE protocol.   CDC people went down to Dallas and the \nHCWS are doing a lot of things incorrectly.  Thus, the ability of our hospital to recognize \nReleased by Chairman Rand Paul\n\n378(dropped the ball with  on the first ER visit) and treat Ebola safely (infected \nhealth care worker) is not working well.   Clearly, HCWs have not really been properly \ntrained and although they believe that they are following protocol, they are not.   The \noutbreak still rages in West Africa.\nToday (Oct. 13) a second nurse who had taken care of  had a couple of days \nago flown home to Cleveland and had not had any sxs or fever.   While is Cleveland, she \ndeveloped a temperature of 99.3 F.   The CDC cut-off is 101 F.   The nurse (Amber \nVinson) called the CDC and asked if she could fly home and the CDC person cleared her \nto fly.   When she got to Dallas, it was clear that she was febrile and that theoretically, \nshe had exposed the passengers on the flight from Cleveland back to Dallas.   Major, \nmajor lapse in judgment on the part of CDC in letting her fly since she did not fulfill the \nprecise definition of febrile.   Now a massive contact tracing of the passengers is taking \nplace with many of them already having taken connecting flights.   This is causing a \nmajor crisis of confidence in the CDC and specifically for Tom Frieden.\n The fact that the CDC gave her permission to fly back to Dallas was made public on \nOct. 15\nSylvia called me on my cell after a TV show and asked me to help her prepare over the \nphone for her media interviews the next day.   She also tasked me to write 2 memos for \nher to the POTUS to explain why PCR screening at airports is not a good idea (Bill Gates \nsuggested this to the POTUS) and also the explain to the POTUS what we are doing with \ntherapies (a Senator told him that HHS is not doing enough on therapies.\nPress →   CNN New Day; WTOP radio; Fox and Friends; NBC News; MSNBC with \nAndrea Mitchell; CBS Evening News; MSNBC Hardball with Chris Matthews; CNN \nwith Wolf Blitzer; FOX News with Megyn Kelly; Good Morning America with Robin \nRoberts.\nOct. 14, 2014 – USG criticism high.   Bill O’Reilly calling for resignation of Tom \nFrieden.  I meet by phone with the New York Times Editorial Board.   Also, I do NBC \nNightly News, Fox News with Greta Van Susteren and MSNBC with Rachel Maddow.   \nAfter I got off the air, Rachel tells her audience how proud she was of herself to have \ngotten me on her show since I was such an icon in medicine and public health.\nOct. 14 -21, 2014 - From October 14 through October 21, the situation was so intense \nthat I do not have time to document historical notes on a day by day basis. I am only \ndoing this retrospectively now and will give dates as I recall. However over this period of \ntime in light of the crisis of confidence against CDC and Tom Frieden related to a \nnumber of issues culminated by the fact that  was allowed to fly back from \nCleveland to Dallas, this was clear that Tom Frieden was in significant trouble over \nseveral days Sec. Burwell would call me usually in the late evening and nighttime asking \nfor my advice about what we should do the CDC. At one point, I believe on October 14 \nor 15, she called me at night as I was in my car driving home. I parked the car in front of \nmy house and continued to speak with her. Approximately 9 o'clock at night. She asked \nme what I thought about the possibility of removing Frieden from the job and wanted my \nReleased by Chairman Rand Paul\n\n382correctly; you are not at risk of infection.”.   I was horrified to hear this.  Now comes the \nrevelation.\nCliff Lane and I stop off at Chris Grady’s office on 1st floor of the Clinical Center, now \nlate at night and I tell Chris the story about the CDC person.   While Cliff and I are \ntalking, Chris pulls up the CDC website and to my amazement she reads what its \nguidelines are for PPE.   It is exactly what said she was wearing including the fact \nthat it resulted in open skin.   And so the CDC recommendations are much less stringent \nthan the MSF and the NIH PPEs.  In other words, the CDC guideliens are in fact \ninadequate and  was following them when she likely got infected.   I got goose-\nbumps.   I was incorrectly assuming that the CDC guidelines were like the NIH strict \nPPEs.   In fact they are not.\nThat night I e-mail Tom Frieden to call me and I explain the situation and he says that his \npeople tell him that if you follow the guidelines even with that PPE protocol, the \nexperience in Africa says that you are protected unless you break protocol.  He then says \nthat we really cannot tell exactly how and when  got infected.  We could \nnot distinguish between the first 2 days and the days after they went to more stringent \nprotocols.   I went ballistic over the phone.   I begged him to please not listen to his staff.   \nI told him frankly as a friend and as someone who care about him that his staff “had no \nfucking idea of what they were talking about since none of them who are advising him \nhave ever taken care of a patient, or if they have it was 10 years ago”.   I pleaderd with \nhim not to say that the nurses must have had a breach of protocol and to realize that the \nCDC protocol was entirely inadequate for a tertiary hospital intensive care setting which \nis where  got infected.  I told him that common sense tells you that open \nskin is much more dangerous than full PPE and that it is essential to change the CDC \nrecommended PPE to insist on no open skin.  He agreed somewhat reluctantly and said \nhe would have to check with his staff.   I told him that I love him, but I really do not give \na shit what his staff says, he must change the protocol.   In fact, within the next couple of \ndays with help from me and Cliff and others, the CDC did change the protocol.\n \nOct. 21, 2014 – Jey Johnson, Secertary of DHS, announces that all flights from Liberia, \nSierra leone and Guinea must now enter the USA at one of the 5 designated airports \n(O’Hare, Newark, IAD, JFK and Atlanta) that are now having entry screening.\nCDC issues the new PPE guidelines emphasizing the 3 principles that I have insisted \nupon during my many discussions with CDC (Frieden): 1) Training and drilling in \nprocedure of donning/doffing; 2) no exposed skin anywhere; 3) trained monitors for \ndonning and especially a WATSAN for doffing.\nDid Weill Cornell Grand Rounds by video to an SRO audience. \nAlso, the White House now wants me to instruct physicians around the country on Ebola \nvia White House run teleconferences.   Now I am a press coach.   Did one today and now \nthey want me to do one tomorrow or next day. On the call were Rich Carmona, Zeke \nReleased by Chairman Rand Paul\n\n384\nReleased by Chairman Rand Paul\n\n385No press today since HHS and White House wanted nothing on but the announcement of \nthe new PPEs by CDC and the DHS announcement of the 5 airports only.\nReleased by Chairman Rand Paul\n\n387might ultimately lead to collapse of the structure of the country and spread to other West \nAfrican countries. We repeat what we have said many times that the best way to protect \nAmericans from Ebola is to suppress the epidemic at its source in West Africa.\nI went over to see  and her family including sister Kathy and mother Diane in \nour special clinical studies unit at around 6:30 PM. As I have done every day, I was \naccompanied by Rick Davey and Cliff Lane. has had four consecutive negative \nPCRs and so we made the decision to move her out of the strict isolation room and put \nher in a room where there was no need for contact isolation. In other words and we could \nwear regular clothes and visit her.  Also, her dog Bentley had been shown to be PCR \nnegative at USAMRIID. On a visit tonight we began to plan her discharge exit from the \nhospital and discussed just what course we would take regarding public announcements \nand a press conference. I emphasized to  and her family that the choice was entirely \nup to her and that we would help her to implement any decision that she makes. She is \nleaning towards making a public announcement in front of the Clinical Center and having \na written statement that she reads and that she does not answer any questions. Hopefully \nwe will discharge her on Friday, 24 October.\nOct. 23, 2014 - Today was another hectic day regarding the possibility of implementing a \nrandomized controlled trial for a Ebola vaccine. As mentioned several times above there \nis a nefarious attempt on the part of Jeremy Farrar of the Wellcome Trust  to derail plans \nfor an RCT of vaccine in Liberia. Cliff Lane has known him for a long time from when \nhe was in Vietnam with the Pasteur Institute. Jeremy feels that we should do open access \nfor distribution of vaccines particularly to healthcare workers without doing a controlled \ntrial. Jeremy has been a self-promoter and in my mind a hypocritical advocate for fairness \nin global health. He completely does not get the fact that if we widely distribute a vaccine \nto a black African country we run the risk of never knowing if it works and possibly \nhaving a paradoxical harmful effect similar to what we saw in the STEP trial of an HIV \nvaccine where the trial looked good in phase 1 following good animal data and when we \nwent into a double-blind, placebo-controlled trial, we found out that the people who \nreceived the vaccine had a 41% greater chance of getting infected with HIV. If the same \nhappened with Ebola this would be a catastrophe. Yet the WHO, mostly in the form of \nMarie-Paule Kieny, are acting in an extraordinarily unscientific way, even going so far as \nto say that a randomized controlled trial is unethical. In fact, we feel that a wide \ndistribution of an unproven and potentially harmful vaccine would in fact be unethical. In \naddition, they want to give it to the healthcare workers on open access and then possibly \ndo a randomized controlled trial on the rest of the people at  risk such as family members. \nI cannot imagine how they do not realize that this in and of itself is unethical and violates \nethical equipoise. There is a big struggle going on with the USA led by Cliff Lane the \nFDA, and Glaxo Smith Kline to be able to do a randomized controlled trial to as quickly \nas possible determine efficacy so that we can ultimately distribute the vaccine to the \npeople who need it. WHO, who was been wrong on almost everything they have done \nwith this epidemic, is arguing that we really should distribute the vaccine according to \nhow they want to do it. We already have designed a phase 2/3 trial and it is ready to go. \nWe have buy-in from the Ministry of Health of Liberia. Glaxo Smith Kline is on board. \nYet WHO wants to be deeply involved in deciding how we do it vaccine trial. There is a \nReleased by Chairman Rand Paul\n\n390\nReleased by Chairman Rand Paul\n391\nReleased by Chairman Rand Paul\n392Oct. 24, 2014 - Today was an extraordinary day in the history of NIH. We discharged our \npatient  via a densely attended press conference outside the north entrance of \nReleased by Chairman Rand Paul\n\n393the Clinical Research Center. It was a beautiful fall day, crisp air and 60° and sunny. At \n12:30 PM, I walked out of the Clinical Center with my arm around and \naccompanied by her sister Kathy and her mother Diana. Also, accompanying us was Dr. \nFrancis Collins, Dr. Cliff Lane, Dr. Richard Davey, and the nurses and technicians from \nthe Special Clinical Studies Unit of the NIH Clinical Center. Francis introduced me and I  \nannounced to the world that was Ebola free. I gave a shout-out to the physicians and \nnurses at Texas Presbyterian for taking such good care of her while she was there patient, \nand I thanked our own staff of doctors and nurses for also taking extraordinary care of \nI have come to become very fond of as she is such a sweet human being who \nwas so brave in taking care of the patient with a deadly disease caused by an infection she \ncontracted while taking care of him ( ). Over the past couple of days \nwhile she was in the Unit, we would talk a lot about how she wants to exit the hospital \nand she finally decided that she would give a very brief statement that we would help her \ncraft. She would give her own ideas and we would  put it in prose for her. It worked out \nvery well. They were in essence her own words and they were heartfelt. As I called her \nup to the podium, I gave her a warm embrace in front of all the cameras. This embrace \nwas ultimately on the front page of the Washington Post the next day (Saturday, Oct. 25), \nand on hundreds of newspapers, blogs, and Tweets and other social media.   It went \ncompletely “viral”.    In addition, she gave me a ribbon of the colors of the nursing school \nfrom which she graduated, Texas Christian University School of Nursing. And so I gave \na shout out to all the nurses of the world  as personified by the nurses at Texas Christian. \nI answered a bunch of questions from the press after the press conference.\nAnd then following the press conference something extraordinary also happened. \nPresident Obama invited , and I(together with \nRick Davey and Cliff Lane) to the White House for a photo shoot as well as to talk and \nchat with the President. The President was charming as usual, and gave her a public hug \nin front of his photographers. We met for several minutes in the Oval Office with the \nPresident and Sylvia Burwell.  Then Ronny Jackson, the President's physician showed us \naround the White House and gave us a tour of the medical clinics in the White House.   \nThe White House transportation group picked us up at the Clinical Center, drove us to the \nWhite House, and then drove  her mother, his sister to a private plane in Baltimore \nwhich flew her to her mother's home in Fort Worth, TX. It was a bittersweet goodbye \nsince we have become so fond of her and her family. I gave  and her family my \ncontact information including my cell phone number and told her to make sure if there \nwas any issues that they want to talk to me about that I am available to them 24 hours a \nday.\nI returned to the NIH completely exhausted but ready to get back to work of crafting \npolicies related to the emerging situation with healthcare workers returning from West \nAfrica infected as did Craig Spencer last night.\nOct. 25, 2014 -  An important meeting today Situation Room of White House. We \ndiscussed the topic of what the movement and monitoring protocol would be for the \nUnited States Government regarding HCWs who are returning from service in the 3 \nAfrican countries. . The CDC has been changing their guide old journals and in a 27 June \nReleased by Chairman Rand Paul\n\n395Larry Kerr, among others. The discussions centered around modifying the guidelines for \nmonitoring and movement of returning health care providers who have served in West \nAfrican countries. The CDC continues to be shakey. They in my mind are not definitive \nor clear enough with their guidelines. However, at the meeting,we at least decided that \nwe would have to scale up from passive monitoring to active monitor and in many cases \nultimately to direct monitoring.  The definitions of these are as follows: passive \nmonitoring - you take your temperature and evaluate your symptoms and do not tell \nanyone unless there is a problem; active monitoring - you do the same as passive but you \ntell someone; direct active monitoring is when you have someone else visit you at least \nonce a day and folow-up with a phone call, take your temperature evaluate your \nsymptoms and make a determination has to the degree of restriction that you might have \non a daily basis.  In this way, you have a repetitive clinical judgment concering restriction \nas opposed to a broad sweeping quarantine for evryone.  We all decided that we need to \npoint out that healthcare workers are heroes and that if we in fact quarantine them \nindiscriminately regardless of their stratification of risk that we would clearly \ndisincentivize them for wanting to volunteer as well as stigmatize them, which is already \noccurring anyway.\n The White House has decided that I will be the face of the administration in explaining \nthis to the public and have now put me out today (Sunday) on all five major Sunday \nmorning shows. This includes ABC This Week (Martha Raddatz), CBS Face the Nation \n(Charlie Rose), Fox News with Chris Wallace, CNN State of the Union with Candy \nCrowley, and Meet the Press ( Chuck Todd). It is interesting and ironic after all of the \naggravation I have received from media people that I am now their hero and they want \nme out there. This includes Jen Palmieri the head of White House communications, \nAndrea Purse the director of media broadcast of the White House, and this gets translated \nnow down to the HHS level. There is still a lingering distrust by the public in the \ngovernment largely because of the missteps and lack of firm, definitive, clear, concise \nand understandable guidelines of the CDC. I feel very badly for Tom Frieden since he is \nan extraordinarily fine person and an outstanding public health official. However I \nbelieve that his staff does not serve him well and the White House and HHS are now \ngiving me the extra burden of having to check their documents which makes it very \ndifficult since I have a lot of work to do and I am getting quite exhausted by all of this.   \nOct. 26, 2014 - Today I did all five of the Sunday morning TV shows. As indicated \nabove this is referred to as the \"Full Ginsburg\" related to the fact Ginsburg, the \nlawyer/family friend for Monica Lewinsky at the time that she blew the whistle on \nPresident Clinton related to the now famous sex scandal appeared on all 5 Sunday TV \nshows. I did this last week.   Since I had done a \"Full Ginsburg\" last week several of the \nproducers of the TV shows told me that this is the first time in their memory that any \nindividual has done all five TV shows for two weeks in a row. And so they are now \nreferring to this as a \"Full Fauci\". The shows went very well;  however, it became clear \nthat I was at odds with what Gov. Christie and Gov. Cuomo had done two days ago by \ninitiating a full quarantine for flights into New Jersey and New York. On each of the \nshows I articulated two fundamental principles: 1) the safety of the American people \ncomes first and is the major goal; 2) all of our policy decisions relating monitoring \nReleased by Chairman Rand Paul\n396movement and restrictions should be based on sound scientific principles and scientific \nevidence. I reiterated that all scientific data show that a person who is without symptoms \ndoes not transmit Ebola and that one must come into contact with bodily fluids of a \nperson who is sick with Ebola in order to contract people. Therefore, the principles \nleading to a broad general quarantine for returning health care workers is deeply flawed. \nImmediately following the shows, other shows and blogs and tweets pitted me against \nChristie and Cuomo. In my discussions on the five TV shows, I did not criticize them. I \nmentioned that I understood why they may feel that this is the best way to go; however, I \nmentioned that if they had asked my advice I would have told them not to institute a \nbroad sweeping quarantine. I am being praised by people who are standing up for \nscientific evidence and data and I'm getting hate mail from people who feel I am trying to \nprotect Obama. I am listing below cuts and pastes from a couple of representative e-mails \nthat I have received:\n-----------------------------------------------------\nFrom: M G >\nDoctor,\nAs you parrot the bullshit that came out of The Obomination, it makes you sound like a \nmoron. \nNo quarantining these infected boobs because it might hamper them volunteering? Are \nyou fucking serious? Do you KNOW how STUPID that sounded?\nYeah, we should just let them walk around, coughing, spewing,. sweating, touching other \npeople until we have a serious Ebola outbreak in the USA! If pray that if Ebola DOES \nbreak out in the USA that somehow it only attacks dumbass liberals like you and removes \nyou from your misery. Idiot.\nNo wonder you're a member of Ovomit's Kakistocracy.\n------------------------------------------------------------------\nFrom: Unarmed Civilian >\nWhere did you get your degree from North Korea? You love Africa and Ebola so much \nyou go there. And don't come back. NO QUARANTINES....its the answer you'd expect \nfrom a government agency whose greatest accomplishments are in the areas of corruption \nand incompetence.\nDoes half of America have to come down with Ebola and be standing there bleeding from \nthere eyes before the EXPERTS know they are wrong.\nFuck you and Fuck your Opinions. Go take your expertise somewhere else.\nLD \n-----------------------------------------------------------------------\nReleased by Chairman Rand Paul\n\n397It is really rather disturbing that people feel so strongly about this, with all the undertones \nof racism and what clearly is  Hate for president Obama.\nDuring the times between shows, I exchanged e-mails with  checking on how \nshe was doing.   Below are some of those e-mails:\nFrom Sunday, 26 Oct., 2014 at 10:41 AM:\nReleased by Chairman Rand Paul\n\n398I just saw you on Meet the Press! You did so great :) I will definitely keep you posted \nwith everything. \nReleased by Chairman Rand Paul\nReleased by Chairman Rand Paul\n402•         Katie Fallon, Assistant to the President and Director of the Office of Legislative \nAffairs\n•         Jennifer Palmieri, Assistant to the President and Director of Communications \n•         Rajiv Shah, Administrator of the U.S. Agency for International Development\n•         Suzanne George, Deputy Assistant to the President and Executive Secretary and \nChief of Staff of the National Security Council\n•         Rand Beers, Deputy Assistant to the President and Deputy Homeland Security \nAdvisor\n•         Ron Klain, Ebola Response Coordinator\n•         Amy Pope, Special Assistant to the President and Senior Director for Energy and \nClimate Change\n•         Gayle Smith, Special Assistant to the President and Senior Director for Development \nand Democracy\n•         Caroline Tess, Special Assistant to the President and Senior Director for Legislative \nAffairs\n•         Corey Gruber, Senior Director for Preparedness Policy\n•         Edward ‘Ned” Price, Assistant Press Secretary for National Security Affairs\n•         Larry Kerr, Director for Medical Preparedness and Policy Rajiv Shah, Administrator \nof the U.S. Agency for International Development\nThe discussion centered around developing a policy of direct, active monitoring to \npreserve the scientific principles as well as to avoid the issue of a broad quarantine that \nhad been initiated by Christie and Cuomo as indicated above. There was a two and one \nhalf-hour discussion at a meeting that was supposed to take one hour. When the President \nfirst came in he appeared extremely tired and somewhat detached. However, he quickly \nperked up and got involved in discussion. There was some disagreement around the room \nwith Jeh Johnson of DHS feeling uncomfortable with just a direct, active monitoring \nsince he felt that there would soon be many more healthcare workers entering the country \nand the social issues of public fear and concern would not be satisfied by just a direct \nactive monitoring. Chuck Hagel has already indicated that returning military personnel \nfrom West Africa would be confined to barracks for 21 days following return from West \nAfrica. However this is a much different story than civilians since military have the \ncapability of easily confining personnel to barracks and providing them with all the \nnecessary comforts and not demeaning them or stigmatizing them. I articulated several \ntimes, and the P resident referred to me and asked me questions multiple times regarding \nmy recommendation that a direct active monitoring guided by matching the stratified risk \nexperienced by the healthcare worker to a stratified stringency of restriction we could \nfunctionally accomplish the same thing as a broad quarantine for everyone. The president \nagreed mostly with what I said but he felt we should go a little bit further and encourage \nthe healthcare workers to restrict themselves to some degree even if technically they were \ncleared to move around. Samantha Power was connected to the meeting by \nteleconference from Guinea where she had just landed. She mentioned that the West \nAfricans there were very concerned about a possible quarantine.   We had been with her \nthe day before at the prior PC meeting. Again, Tom Frieden was relatively reserved \nduring the discussion; however, it was tough since he was connected by teleconference. \nThe final decision which has not yet been implemented since it awaits a document from \nReleased by Chairman Rand Paul\n404able to be done by Skype or Face Time.   However, Ron Klain thinks that the POTUS and \nJeh Johnson want actual physical presence of monitor (health official, nurse, etc.).   \nTrying to reconcile.  \nHad important conversation with Jen Cohn of MSF Switzerland who kindly got on a \nteleconference reps from MSF of many countries (Brussels, Paris, Geneva) to discuss the \nRCT Ebola vaccine trial that Cliff is actively planning to start in Monrovia in December \nfollowing completion of the Phase 1 trial that started in Maryland in Sept. (ChAd3) and \nOct (VSV).   Looks like MSF wants to be helpful.   They are asking good questions about \nsupply for post-trial distribution, etc.   They seem to not be against an RCT.\nCDC came out with new interim guidelines for Monitoring and Movement of people \n(including HCWs) returning from West African Ebola countries.   Now based a lot on \nwhat I and Tom have been articulating at the recent White House meetings.   First \nstratification of risks to the person; and then matching the risk to the degree of \nmonitoring and then using clinical judgment when needed to determine level of \nrestriction.   All based on knowledge of how virus is spread.   Risks:  high, some, low but \nnot zero.  Monitoring: passive – take your own temperature and sxs and no need to \nactively tell anyone; active – take your own temp and sxs and report to a health official; \ndirect, active – someone else takes your temp at least 1x per day and evaluates sxs and \nthen makes clinical judgment as to your restriction on a daily basis\nImmediately following their release of guidance and the press briefing by Tom Frieden, \nthe White House put my out on all the evening TV shows that were either taped or live \nfrom studio in Building 10:  PBS NewsHour; CNN Situation Room; ABC, CBS, and \nNBC Evening News.\nOct. 28, 2014  - The political issues are heating up around Ebola with the elections only 1 \nweek away. Gov. Christie is standing firm in saying that the US government, particularly \nthe CDC, are playing catch-up with Ebola and that his initiation of a quarantine for 21 \ndays for healthcare workers and other travelers returning from West Africa is the way to \ngo. I have been on multiple television programs specifically indicating that I respect the \nopinion of the governors and that I understand that they are trying in good faith to do the \nbest for their constituents. However, several TV commentators have now pitted me \nagainst Gov. Christie, feeding him with somewhat out-of-context quotes from TV \ninterviews indicating that I am directly challenging him as being unscientific. He is \nlashing back saying that I am just defending the administration. He sometimes mixes me \nup with CDC. However, he has mentioned me by name several times in discussions on \nTV interviews. I am very concerned about this politicizing of an important global health \nproblem. I was on Good Morning America with George Stephanopoulos, CNN with \nSanjay Gupta, and MSNBC with Morning Joe early this morning. In fact the ABC \nproducer came all the way into the NIH to make sure that the interview with George \nStephanopoulos went well. Immediately after I appeared on GMA, Gov. Christie \nappeared and Matt Lauer was instigating him telling him that scientists like me was \nsaying that he \"got it wrong on\" thus instigating Christie to lash back at the scientific and \npublic health community including me. This is really a very unfortunate evolution of \nReleased by Chairman Rand Paul\n405events since as has always been the case, I stay out of politics and try to just do the right \nthing for public health.\nI appeared via Skype on the Diane Rehm Show this AM and made it clear that I was not \ncriticizing Christie.\nThe POTUS made a brief speech in front of Marine 1 as he was about to take off re-\naffirming what I said on Sunday TV (without invoking my name) that we are driven by \nscience and not by fear and so there is no reason to do a blanket quarantine on all \nreturning HCWs since they are heroes and we do not want to discourage them from \nvolunteering.\nBen Bradlee died at age 93 a few days ago and I have been invited to the service at \nNational Cathedral and to the family reception at Ben and Sally Quinn’s home in \nGeorgetown.   However, with the Ebola AM calls and the fact that I have to be at the WH \nlater for the POTUS greeting and honoring the HCWs (see below), I cannot make the \nservice.   Too bad.   I really liked Ben.\nI am completely exhausted now and I have hundreds and hundreds of e-mails to catch up \non. It feels like I'll never catch up since the White House, the department, and the media \nare making extraordinary demands on me. The White House has decided because of my \nability to be quick on my feet and articulate a clear and concise message in front of the \nTV camera that they are putting me out on TV for virtually every issue that comes up \nregarding Ebola. What a change of pace from just a short while ago when for one reason \nor another HHS and/or the White House never approved any big TV for me. Now they \nactually set  up shows and have Andrea Purse working closely with me. Such is life.\n \nThe POTUS came out today and reiterated the reasons (my reasons) for following the \nscience and not having a quarantine for returning HCWs.   Typically, HHS shut me down \non the many requests for TV appearances for me since they never let anyone out there \nwhen the POTUS speaks.   Believe it or not, I am glad since I am exhausted.\nToday and yesterday, there have been a considerable number of false alarms with people \nfrom West Africa (just arriving) having fever, vomiting, etc. and getting worked up only \nto have any of a number of other diseases from malaria to rhinovirus.   \nStill getting much hate mail!\nGot e-mail from Andrea Purse asking about the safety of returned HCWs  from West \nAfrica (USA people) who have been invited to the WH tomorrow to be congratulated by \nthe POTUS (with handshakes).  Some came back less than 21 days ago and so they \nwanted to be sure it was OK.   Cannot violate our own principles, but people are \nsomewhat nervous.   I looked at list and said it was OK.   Then Sylvia Burwell called me \nup and wanted me to speak with Ronny Jackson to make sure that Ronny asks them if \nthey were in high risk category.\nReleased by Chairman Rand Paul\n407on their website. Of the people involved in this forum were Secretary of State John \nKerry, Chris Matthews of NBC, and a large number of other notables. \nAfter that I went back to the NIH and hosted a whole group of network producers with \nfull camera TV coverage on the process of donning and doffing for personal protective \nequipment. I demonstrated to them what we do in the process of taking care of patients \nwith Ebola, in this case specifically  Following the demonstration which was \ndone by nurse specialist Kevin Barrett and hospital epidemiologist Tara Palmore, I did a \nlong series of TV interviews with the cameras that were there during my step-by-step \ndemonstration of the donning and doffing.   Clips appeared on a variety of news outlets.\nAn extraordinary situation occurred last night in which the state of Louisiana made an \nannouncement that certain scientists and others who were planning to attend the annual \nmeeting of the American Society of Tropical Medicine and Hygiene during the first week \nof November in New Orleans would not be allowed to attend the meeting. In essence they \nsaid that these people need to be quarantined if they came from a West African country or \nif they had taken care of the patient with Ebola within the last 21 days. This is an \nextension of the quarantine craziness that was started by Governors Christie and Cuomo.   \nIn essence, they are barring scientists from a meeting where their expertise and \nexperience is most needed.\nFinally, I have been informed that I have been named in the civil action lawsuit against \nPres. Obama, me, Thomas Friedman, Secretary Burwell, and DHH Secretary Jeh Johnson \nfor promoting terrorism and discrimination. They are accusing us of colluding with \npresident Obama who is a Muslim citizen of Kenya and trying to destroy African \ncountries by introducing Ebola into society. You just cannot make this stuff up.\nReceived a note today (dated Oct. 16, 2014) from Hilary Rodham Clinton  saying that \nshe was thinking of me and cheering me on saying that “The American people are \nfortunate to have your leadership at NIH as we face the challenge of Ebola”.\nOct. 31, 2014 – Jeff Drazen, Editor of NEJM, contacted me to put him in touch with \nsome of the trusted AIDS activists with whom I have worked over the years to get them \nto write a piece in the NEJM on the similarities between the stigma of HIV/AIDS and the \ncurrent “stigma” against HCWs (regarding the quarantine discussed above).   I pointed \nhim to Peter Staley and Gregg Gonsalves and they are willing to do this.\nKaci  Hickox  still defying orders from the Governor of Maine to remain in quarantine.   \nA court judge upheld her right to not be quarantined.   I did an interview for yahoo.com \nand refused to get into the battle between Kaci and the State of Maine.\nHHS does not want me to do TV since the news is focused on Kaci and it would be better \nfor me not to get into that battle.\nNov. 1, 2014 – Things calming down.   Reports of decreased infections in Liberia, \nparticularly Monrovia.   Not sure if this is real or if the infections are now occurring in \nReleased by Chairman Rand Paul\n\n408remote areas without good reporting.   Also, the issue of second waves in Guinea and \nSierra Leone.   CDC having to put much effort into investigating Person Under \nInvestigation (PUIs).   These are people who are from West Africa who get a fever or \nnausea or vomiting for any of a number of benign reasons.   Since they are from West \nAfrica, these are being investigated, sometimes using PPEs, which is an “abundance of \ncaution”, but a major investment (?waste) of effort.\nCliff Lane is in Monrovia doing spade work for the hopefully upcoming RCT for the \nEbola vaccine.\nHeard on Secretary’s call this AM (8:30 AM on Saturday) that now WHO (likely Marie-\nPaule Kieny) wants WHO to be responsible for the DSMBs of all clinical trials in West \nAfrica.   This is an egregious attempt on the part of WHO to stay “relevant” in an area in \nwhich they have no expertise.   It is “stunning” to me how they just want to insert \nthemselves into things where they quite frankly are incompetent.  They already have \nmade it clear that they just want to distribute unproven interventions (vaccines and \ntreatments) and even though we seem to be winning the argument, they keep coming \nback in insidious ways to try to derail the scientific clinical trials process.   Amazing!!\nNov. 2, 2014 – Quiet Sunday.   Trying to catch up on piles on my desk.  Election on \nTuesday.   Concern that the GOP will take the Senate, which means Obama is in trouble \nwith both House and Senate in GOP", "summary": "Watcher-discovered document from paul-readingroom (2026.08.05_Diary-Prequel-_Redacted.pdf), auto-indexed 2026-08-06.\n\nExcerpt: Hotel Excelsior on  81st St. between Columbus Avenue and Central Park West. The ceremony at the  Museum of Natural History was stunning in the positive sense. I completely  underestimated the importance of this particular function. The annual function makes  Released by Chairman Rand Paul 326three major awards to biotech companies, pharmaceutical companies, and companies that  develop devices. It is essentially the Academy Awards of pharmaceutical/biotech  companies. I gave the keynote address associated with my receiving the Pro Bono  Humanum Award.   This award is given every year.   Over the past 3 years it has been  won by Francis Collins, Paul Farmer, and Bill Clinton.   The dinner gala was held in the  Whale Room of the Museum of Natural History. All the elite of the biotech world,…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/08/2026.08.05_Diary-Prequel-_Redacted.pdf", "pdf_url": "/archive-docs/fauci-files/b5b0ed807aff8eaf2c6607cc328a591e/pdf", "doc_date": "2026-08-06", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-08-05-diary-prequel-redacted"], "part_number": 6, "page_count": 465}
{"title": "Read Tony's Diary: The Prequel (Part 7 of 7)", "content": "control.\nDespite reports that the number of cases in Liberia are decreasing rapidly, new reports \ntoday indicate that the cases in Sierra Leone are sharply increasing.   I have warned that \nEbola comes in waves and that we should not be complacent and the WH should refrain \nfrom saying that things are “turning around”.\nNov. 3, 2014 – Ron Klain visited NIH today (He had visited CDC last week).   He \nwanted to familiarize himself with what the various components of government were \ndoing in Ebola.   I made a presentation to him in the VRC, showed him the lab where \nNancy Sullivan works and where she developed the ChAd3 Ebola vaccine.   Then we \ntook him over to the Clinical Center to see Julie Ledgerwood’s vaccine clinic where the \nphase 1 trial took place.   Then we showed him the SCSU and the room where we took \ncare of    Ron was impressed and wants me to come to the WH on Friday to \ngive a shortened version of my presentation at a meeting where the POTUS is hosting \ncertain Congressional leaders.\nTom Frieden spontaneously called me up to thank me for being so supportive of him.   I \nhave been continually serving as a late night (by phone or e-mail) sounding board for him \nin his attempts to negotiate his having to deal with some many factions (ASPR, HHS, \nUSAID, etc.)   Last night I helped him out by strongly suggesting that he not listen to the \nmodelers who tell him “exactly” how many news cases of Ebola to expect in the USA \nover a period of time.   I warned him that the models are based on assumptions and \nmultiple variables and can be very misleading and he should not “own” data that comes \nReleased by Chairman Rand Paul\n\n409from models or else it will come back to bite him.   I urged him to totally resist such \npredictions.   He was very grateful for my advice.\nNov. 4, 2014 – GOP takes control of the Senate in today’s elections.   Frenzy calming \ndown.   Little press interest – like shutting off the faucet.\nNov. 5, 2014 – Preparing for Hearings of the Senate Full Appropriations Committee \n(Mikulski).   Tom Frieden and I will testify together with Sylvia Burwell.   POTUS \npublicly requests $6.18 Billion in “emergency” funds for Ebola.   We will dwefend this at \nHearing on Nov. 12.\nNov. 6, 2014 – Still calm.  No Ebola Press.   Did Hearing prep by teleconference with \nSylvia.\nNov. 7-11, 2014 – Still calm.   Mostly  preparing for Senate Appropriations Hearing on \nNov. 12.   POTUS  asking for $6.18 Billion in emergency funding for Ebola (Domestic \nand International).   NIH portion is $238 million.  Went to EEOB on Nov. 10 to rehearse \nfor Hearing with Ron Klain.\n \nNov. 11 – very good meeting in Building 10, 4th Floor Medical Board Room with clinical \ninvestigators who took care of Ebola patients at Emory, Nebraska, NIH.   Also, DoD and \nHHS present with presentation of individual clinical data from the USA patients.  It \nbecame clear to me that it is impossible to determine if any of the experimental drugs \ngiven to the patients (ZMapp, Brincidofovir, favipiravir, convalescent sera, TKM-Ebola) \nhelped or did harm (likely did some harm.   Decision was to develop a clinical protocol \nfor future USA patients and also to be used as prototype for Africa.   Protocol should be \nRCt with standard medical care (fluid and electrolyte replacement) as the control arm.   \nThe data also suggested to me that if you keep patients alive with medical care, that the \nbody’s immune system will almost always clear the virus (likely without experimental \ndrugs).\nNov. 12, 2014 – Successful Hearing today before the Full Senate Appropriations \nCommittee chaired by Barbara Mikulski with Richard Shelby as Ranking Minority.   \nSylvia Burwell, Jeh Johnson (DHS), Michael Lumpkin (DoD), Heather Higginbottom \n(DoS) testified and then accompanying witnesses went to the Table.   Tom Frieden and I \nwere the “accompanying” witnesses for Sylvia.   All went well. About 18-20 Senators \nappeared.  Tom Harkin made a statement that this was his last official Hearing and he \nwanted to specifically call me out as a great public servant with whom he has worked on \nthis committee for 30 years.   This elicited a round of applause from the audience.   \nPatrick Leahy also remarked that he has been working with me “forever”.   All-in-all, a \nvery good Hearing.\nNov. 13, 2014 – Difficult situation arising regarding the conduct of the Phase 2/3 trials of \nEbola vaccine in Liberia/Sierra Leone.   The companies (first GSK; now also J & J, who \ndo not even have a candidate ready) are balking at going ahead with the trials unless they \nget “global indemnification”.   This is unprecedented to demand for a Phase 2/3 trial \nReleased by Chairman Rand Paul\n410since we (NIH) are the sponsors and we are liable.   Nonetheless, GSK feels that although \nthe PREP act would protect us and indirectly them, they feel that in international courts \nGSK (even though they are not the sponsors of the trial) could be sued given the sensitive \nnature of the situation (African countries, instability in the countries, brand new vaccine \nplatform for them –Cad3 vector -, accelerated development with questions regarding lot \nconsistency (because of the fast pace of development).  This would be terrible if the trials \nare stalled because of this.   I have phone call today with Moncef Slaoui, Chairmen of \nGSK for Global Vaccines.\nAlso, despite our conclusions from meeting on Nov. 11 (see above) the Oxford/Wellcome \nTrust people are working with MSF to start “open label” trials with various therapeutics \nwithout a control arm.   What the hell is going on here?   I am very disappointed in the \nBrits, especially the Wellcome Trust and Oxford people who clearly are grandstanding.\nCall with Moncef Slaoui went well.   Reasonable discussion.  I stated that the USG could \nnever give “global indemnification” since it would invite frivolous lawsuits.   Moncef felt \nthe same about our providing insurance for them since it would also invite lawsuits.   We \nagreed upon some form of a process that provides for limited liability and cpas on \nsettlements.   I will follow-up with summary e-mail to Moncef with copy to Ron Klain \nwith who I spoke tonight and relayed to him the conversation with Moncef.   Ron is \nflexible, but said that we cannot “guarantee” anything to Moncef, but we will proceed in \ngood faith to find a solution.\nNov. 15, 2014 –  Sierra Leone surgeon, resident of Maryland, green \ncard resident, married to US Citizen hospitalized at University of Nebraska having gotten \ninfected in Sierra Leone.  He is critically ill and may not survive.   He entered Nebraska \nHospital with Creatinine of 16, pH of 7.1 and K+ of 2.0.  NIH is thus up next for a \npatient.\nNov. 17, 2014 –  dies at Nebraska Medical Center.\nNov. 19, 2014 - Today I testified before a  Congressional Hearing of the House \nCommittee on Commerce and Energy, Health Subcommittee chaired by Congressman \nPitts from Pennsylvania with Dr. Burgess of Texas as the vice chair, and Mr. Henry \nWaxman of California as the ranking member. It was a lively hearing that went very well \nbut with some interesting sharp interchanges between me and Dr. Cassidy from \nLouisiana. He is a physician who tried to show off about his medical knowledge in the \nhearing; however, during the exchange it became clear that he really did not know what \nhe was talking about. In addition, Congressman Tim Murphy somewhat attacked me \nsaying that I have been condescending to people who question the issue of conmtrolled \ntrials with placebo limb, transmission, patient isolation and quarantine. I did not have the \nopportunity to refute him; however, after he had left when Mr. Burgess who took over the \nchair of the committee when Mr. Pitts left gave us the opportunity of a summary \nstatement, I question Mr. Murphy's characterization of me as being condescending and \nclearly stated that our most important goal with interventions is to first do no harm and \nthen hopefully benefit people and although many individuals feel that this is insensitive, \nReleased by Chairman Rand Paul\n\n411in fact it is not insensitive, but is the time-honored way of determining the safety and \nefficacy of interventions. In addition, after she had left I countered the somewhat snide \nremark of Mrs. Blackburn who had also made a statement without giving me the \nopportunity to respond. She said that we were negligent in not getting countermeasures \ndone quickly and that industry can do better than we can. I stated after she left that we \nhave been trying to get partnerships with industry for over 10 years in the development of \nEbola vaccines and that only recently were pharmaceutical companies willing to partner \nwith us.\nAll in all it was a very positive Hearing.\nNov. 20, 2014 – Did Newsmaker Luncheon talk at the National Press Club on Ebola.   \nGot much play in the printed press.   Things still calm regarding Ebola with attention \nswitching from the threat in the USA to background issues like the $6.18 billion request \nfrom the POTUS (see above Senate Hearing).   Also, some increasing noise from \nCongressman Tim Murphy (R-PA) regarding his pushing for the leaders of the 3 Ebola \nhospitals (NIH, Emory, Nebraska) to quarantine for 21 days their staff that took care of \nEbola patients and not allow them to see other patient for 21 days.   We are all adamantly \nagainst this and I have been the vocal one saying that we must stick with the science and \nthe CDC recommendation of stratification of risks to HCWs balanced by the stratification \nof monitoring and restrictions.   Murphy is not happy with me.\nHad dinner with Danny Hultzen and his father Chris.   Discussed the situation with his \nshoulder injury.   He feels good and looks great.   I have a strong feeling that if his \nshoulder holds out, he will make it to the MLB with the Seattle Mariners.\nNov. 25, 2014 – Did Webcast for Harvard School of Public Health on Ebola.  Panel \ndiscussion with Barry Bloom and others.\nNEJM paper to come out of Thursday (Thanksgiving) reporting on the results of the \nphase 1 trial of the NIAID/GSK Ebola vaccine (Ledgerwood et al).  Embargoed until \nWednesday (Nov 26) at 5:00 PM.   And so press starting to get excited about it.\nThus, did CBS Evening News tape for Friday PM?  Also, Medscape Interview. And \nplenty of embargoed print interviews.   As expected, the Brits (Wellcome Trust, Adrian \nHill from Oxford) are downplaying the study saying the required dose is too high and the \ndurability is low without a booster.  They are amazing.\nNov. 26, 2014 – Much press associated with the NEJM paper.   Did AP TV, BBC TV, \nCox TV, Bloomberg print, Reuters print, BBC radio and then later at night BBC TV \nagain.\nPOTUS comes out with White House statement congratulating “Francis Collins and Tony \nFauci and their teams….” On the successful phase 1 trial of an Ebola vaccine and \nannounces that he will visit NIH on Dec. 2 to congratulate the NIH teams and to \nemphasize the need for the requested $6.18 billion supplemental for Ebola.\nReleased by Chairman Rand Paul\n412Nov. 27, 2014 (Thanksgiving) – Again, still interest in the NEJM paper.   Did BBC TV \nvia phone plus my photo, CNN International via phone plus my photo.  Also did \nNewsHour with Judy Woodruff.   WETA picked me up with an Uber car and promised to \ntake me to the studio in Arlington, do interview, and get me back in time for \nThanksgiving visit and dinner at 4:00 PM at Joanne and Jim’s house.   They did it on \ntime.\nNov. 30, 2014 – Did CNN International discussing Ebola vaccine\nDec. 1, 2014 – World AIDS Day.   Went to White House and gave main lecture at the \nWAD ceremonies in the South Court Auditorium.   My talk went over so well that they \nstarted clapping at the final sequence of slides of the maps of USA and the world \nbecoming free of AIDS even before my talk ended.   Also speaking were Susan Rice, \nSecretary of State John Kerry (shouted out to me), Secretary Burwell (many shout outs to \nme), Gayle Smith (also praised me), Bishop Yvette Flunder (gave moving \nsermon/speech).   Then panel with Debbie Birx, Mark Dybul, Greg Millett, Helene Gayle \n– chaired by Sylvia Burwell.\nCame back to NIH to do walk-through for the POTUS visit to NIH tomorrow.\nDid CNN International and NPR Morning Edition radio with Scott Horsley.\nDec. 2, 2014 - Today was most extraordinary day. Began with a  presentation that I made \ntogether with Debbie Birx (PEPFAR) at the Russell Senate office building.  We made a \ndual presentation in celebration of world AIDS Day to a group of Senate and House \nstaffers. It went over very well. I rushed back to the NIH in time to do an interview with \nAndrea Mitchell on MSNBC about the successful phase 1 Ebola vaccine trial conducted \nhere at NIH that was recently published in the New England Journal of Medicine. When I \ngot back to NIH we began the preparation for the 4:00 PM visit by Pres. Obama. It was \nan extremely  successful visit. I led him on a tool of the Vaccine Research Center, gave \nhim a brief introduction of the history of the center, telling him the story about my \nconversation with Pres. Clinton in December of 1996 when Clinton promised me that he \nwould have a vaccine center built for us on the NIH campus. Nancy Sullivan presented to \nhim on the 2nd Floor of the VRC her work on the development of an Ebola vaccine. We \nthen took him to the 5th floor where Mario Roederer showed him the intricacies of the \nFACS machine.  The President was very relaxed, warm, and highly complementary of me \nand the NIH. Following the tour of the VRC, I rode with the president in the presidential \nlimousine from the VR across campus to Building 10 where he addressed an overflow \ncrowd of the entire NIH community in Masur auditorium. He thanked me specifically \nseveral times during the talk and he thanked various components of the NIH community \nfor their work on Ebola and other important diseases. He specifically gave a shout out to \nthe VRC people, the people who conducted the phase 1 trial, and to the nurses and staff \nwho took care of  in October.  During his talk to the NIH community, the \npresident gave me many compliments and shout outs. In particular he joked about how \nhad told me how to use FaceTime. In addition, he joked that \"Tony and I were \nfindly reminiscing about SARS and H1N1\". He then said after a big laugh \"that's what \nReleased by Chairman Rand Paul\n\n413these guys do for fun\".  The President mentioned my name multiple times during the talk. \nIt was a great day for NIH.\nFollowing the visit, I rushed downtown to the Mellon Auditorium on 13th St. and \nConstitution Avenue to participate in the dinner given by the Friends of the Global Fight, \nchaired by Mike Gerson (Washington Post).  On the panel with me were Mark Dybul and \nDeborah Birx. I ran into many people who I know and like at the dinner. These include \nPeter Staley who I am very fond of from our many experiences over the years in the \nactivist days. Peter looked bright and alert but rather thin and drawn likely due to his \nmany years of being on antiretroviral therapy.   They showed a short clip of his icon \nspeech at the International AID Meeting in San Francisco in 1990 when he said that \nsomeday people will speak of the deadly plague and how some stood up to confront it.   I \ncry every time I hear that speech.   In 1990, I gave a speech at the meeting right after \nPeter.  Former Sen. Chris Dodd gave me several shout outs about the work that I have \ndone over decades, calling me a national hero. Nancy Pelosi gave a talk in which he \nmentioned several times our extraordinary relationship over the years in fighting HIV \nAIDS.  All this praise was quite moving and gave me an added perspective about the \nmany years (decades) that I have been involved in this struggle.  All in all it was a great \nevening.   The following day the story with my picture (with the POTUS, Nancy \nSullivan, and Sylvia Burwell) were in the Washington Post and New York Times as well \nas on the Evening News programs.\nDec. 3, 2014 – At his request, went to the Rayburn Office Building office of Chairman \nTimothy Murphy (R-PA).  Murphy was upset with me at a recent Hearing (see above) \nwhen he said that I was making condescending statements about quarantine and why we \nshould not have quarantines.   He invited me down to his office to discuss further at a \n10:00 AM meeting.  With him was Committee Staffer Alan Slobodin (of past outside \nactivity investigation fame) and Murphy’s Chief of Staff Susan Mosychuk and his \nlegislative Director Brad Grantz.   Murphy had also been giving Tom Frieden grief about \nthe same issue.   Meeting actually went well – cordial, respectful.   The underlying theme \nwas still the need in his mind for quarantining of all West African entrants to USA or \nbetter restrict travel of West Africans (3 countires0 to USA and provide an “air bridge” to \nbring in USA HCWs.   Also, he was concerned that with the latest proposal for 32 \nadditional Ebola-ready hospitals in the USA that we should quarantine the USA HCWs \nafter seeing Ebola patients.  He was OK with just direct, active monitoring of the NIH, \nEmory and Nebraska HCWs, but he felt that since the other 32 hospitals were less trained \nand so would likely have a greater chance of getting infected, then they should be \nquarantined since (as a former Clinical Psychologist) he feels that people deny sxs and so \nhe does not trust them.   He is against the part of the $6.18 billion supplemental request \nfor Ebola on the grounds that we do not needs all the additional hospitals (I actually do \nnot entirely disagree with him as I have expressed to our own people).   The meeting \nended cordially.\nDec. 4, 2014 – Gave Ebola talk at the new FDA facility in White Oak.   Quite a place!  \nHuge!   They loved the talk.   Also,  new infectious diseases issue.   The H3N2 \ncomponent of the 2014-2015 influenza vaccine is mismatched to the early circulating \nReleased by Chairman Rand Paul\n414strain of H3N2, which is predominant over H1N1 and B, the latter of which match the \nvaccines.   The match for H3N2 is only 48%.   I was on WTOP explaining this.   Could \nbe a bad influenza winter.\n \nDecember 5, 2014 - I participated with Ron Klain at a Georgetown University event \nchaired by Pres. Jack DiGoia in Gaston Hall at the Healey Building. We discussed \nvarious aspects of the Ebola outbreak. I have grown to become truly fond and respectful \nof Ron Klain since he assumed the position as the Ebola Response Coordinator for the \nUSG. He will be leaving the USG employment and will return to his position as CEO of \nCase Holdings and General Counsel for Revolution, L.C. \nAlso did some press with the London Times print and Bloomberg TV today.\nHad a call with Jack Whitescarver. I am concerned with him since he does not appear \nwell. His hematocrit is low and he is short of breath. I believe he is having a slow \ngastrointestinal bleed and is likely experiencing mild to moderate congestive heart \nfailure.\nDecember 6, 2014  - I participated at the PRIM&R conference in Baltimore where I gave \nthe keynote address on ethical considerations in HIV/AIDS. This was on a Saturday \nmorning. Christine is a major player in this organization and spent the weekend there. I \ndrove to Baltimore on Friday night and had dinner with Chris at the Baltimore Hilton \nHotel Bar (lots of fun) and stayed with her in her hotel room that night. The following \nmorning (Sat. Dec. 6) gave my talk to an audience of around 2500 people and got a \nstanding ovation.  \nDrove back to DC and had dinner with Alec Whyte at Matisse restaurant.   Caught up on \nstuff.   Always great to see Alec\nDecember 8, 2014 -  I am getting particularly concerned with what I feel is noncollegial \nbehavior on the part of the UK, particularly Dame Sally Davies (Chief Health Officer of \nUK) as well as the Oxford group personified by Adrian Hill and Jeremy Ferrar who are \nbad mouthing our randomized controlled trial idea behind our backs. However, this is the \nstuff that we deal with all the time.\n I am also getting concerned that the incidence of infection of Ebola in Liberia is so low \nthat this may have an issue with our conduct of the randomized controlled trial in Liberia. \nCliff will leave Dec. 10 for Liberia for the third time in 5 weeks. We have to consider the \npossibility of doing a trial also in Sierra Leone.\nHad contentious IC Director meeting concerning the issue of presenting reports (that I \nbelieve are flawed) to the Advisory Committee to the Director (ACD) on the Intramural \nresearch Program (IRP) and the AIDS Portfolio.   Issue is that some outside group (ACD) \nwant to homogenize the IRP to make it “trans-NIH” as opposed to being directed to the \nmandate of the IC in question.   I am totally against this since this flies in the face of the \nNIAID mandate of being a “strike force” for emerging IDs such as AIDS, SARS, and \nReleased by Chairman Rand Paul\n416Susan Rice, Denis McDonough, Ron Klain, Sylvia Burwell, Chairman, Joint Chiefs \nMartin Dempsey, Tom Frieden by teleconference from Atlanta, Samantha Powers by \nteleconference from NYC – UN, Assistant Secretary Heather Higginbottom from State, \nNancy Lindborg from USAID, Raj Shah – USAID.   Ron Klain asked me to review for \nthe POTUS the status of the vaccine plans as well as to explain the situation with the \nVSV adverse event of arthritis (see above).   POTUS asked a few other questions of me.   \nHe referred a few times to his trip to NIH.   Good meeting\nDid WTOP today\nDecember 12 – 14, 2014 – Cliff Lane has now gone to Liberia for the fourth time in \norder to set the stage for the upcoming randomized, placebo controlled, double-blind, \nclinical trial for the GSK/NIAID and the VSV vaccines. We are still getting nefarious \ncomments and undermining of our efforts by the people from the UK, particularly Jeremy \nFarrar and Adrian Hill among others. They continue to inappropriately talk about the \ninadequacy of our vaccine efforts even though they are working with the same vaccine. It \nis unbelievable to me how nefarious they can be when the main goal should be to develop \na vaccine to save the lives of so many unfortunate people in the West African countries. \nNonetheless we will forge on and hopefully prove the safety and efficacy of this vaccine.\nDecember 15, 2014 -  traveled to George Washington University to give a lecture for \nBopper Deyton’s course given at the Marvin Center at GW. It was an inspiring crowd of \nfirst-year medical students who were very excited to hear from me about the history of \nHIV and my involvement in it. That afternoon I participated by teleconference in an \nEbola meeting that took place at the IOM sponsored dually by the IOM and the \nRockefeller Foundation. The meeting was chaired by Secretary-General of the WHO, Dr. \nMargaret Chan. Many players were there in person or by phone including Paul Farmer \nfrom Liberia, as well as several Liberian and Sierra Leoneon and Guinean health \nofficials.  I presented the efforts in the development of vaccines and therapeutics\nDecember 16, 2014. Participated in a panel discussion on Ebola vaccines and \ntherapeutics at the Center for Strategic and International Studies (CSIS) at 1616 Rhode \nIsland Ave. NW. The panel was chaired by Steve Morrison. Other panelists included \nJulie Gerberding of Moncef Slaoui of GSK, Johan Von Hoof (Janssen and J & J), and \nRohit Malpani (MSF).   Good discussion about response to the epidemic.\n December 17, 2014 -  Feature article about me including a picture on the Federal Page \nof the Washington Post. I gave credit in the article to many of the people involved in \nEbola effort. It is noteworthy that although I saved Tom Friedman's job by convincing \nSylvia Burwell not to fire him during the missteps by the CDC,  Time magazine included \nTom Friedman as one of the Persons of the Year in their “Ebola Fighters” issue. They did \nnot even mention my name once.   Years ago – Time did the same thing with making \nDavid Ho “Man of the Year” and now this.  Such is life…\nDecember 19, 2014 – The puzzle of why Adrian Hill (and Jeremy Farrar) have been bad-\nmouthing the NIH/GSK approach of a high dose prime without the necessity of a boost.   \nReleased by Chairman Rand Paul\n418early years (1981-1984) when he was Director.   He was gay, but closeted.   KLarry \nKramer outted him and said that his closet status prevented him from asking for more \nAIDS money.   I succeeded Richard and immediately asked for more money.\nJan 8, 2015 – Did a 1 hour interview of a prolife on me by Brian Lamb to show in 2 \nweeks on C-SPAN.\nJan. 15, 2015 – Number of cases very low in Liberia.   Surge in cases in Sierra leone \nstarting to come down.  Liberian vaccine trial getting ready to start at end of January, \nbeginning of February.   Cliff Lane in Liberia now.   I will go within a few weeks (likely \nearly February).\nReceived award today at the Willard Hotel of 2014 Washingtonian of the Year from \nWashingtonian magazine.   Seven other winners including Gerry Sigal and Arch \nCampbell.\nTo White House tomorrow to update the “Deputies” on the upcoming vaccine trials in \nWest Africa.\nOver past week terrible tragedy of terrorism in Paris with Jihadists murdering 12 people \nat the Charlie Hebdo satirical magazine offices.   Today another thwarted terrorist attempt \nin Belgium.   Europe on high alert.\nJan. 16, 2016  - White House (EEOB – 374) meeting with Deputies chaired by Ron \nKlain.   Subject matter was vaccine trials and if there is any change in approach now that \ninfections are so low, particularly in Liberia.   Also discussed indemnification, liability \nand compensation for trials.  Also discussed the need (or not) for 46 hospitals to be \n“ready” to receive Ebola patients (see above).   I have always been against this since, in \nmy mind, most of the hospitals that have volunteered to be “Ebola treatment Units” in the \nUSA are really after the government funds that go with it.   The Deputies group was \ndiscussing reluctance to tell other hospitals that 46 is enough and we will not support any \nmore.   I made myself clear that we should just stop recruiting hospitals that we do not \nneed and that could likely not be able to handle an Ebola patient if they had to.\nAlso, met in the AM with Delegation from India (“Vijay) to discuss NIAID – India \ncollaborations, particularly the Vaccine Action program (VAP), which has been onging \nfor many years. and importantly, a delegation from Liberia and Sierra Leone.   The \ndeputy Minister of Sierra Leone (SL) is Dr. Madina Rahman.   She definitely “gets it” \nabout the advantage of a RCT and wants to have us conduct such a trial in SL.   This is \nkey, since SL is where all the infections are right now with very few in Liberia.   I will \nhook her up with Cliff Lane who is on his way back to USA from Liberia.\nJan. 17, 2015 – Writer and photographer from Financial Times (of London)  came to my \nhome today (Saturday) to do story on personal aspects of me.\nJan. 20, 2015 – Visit to NIH of Chairman Tom Cole (R-OK) of the Appriopriations \nSubcommittee.   Accompanied by Rosa DeLauro, Nita Lowy, Andy Harris , Dent, \nWomack.   I presented work on universal flu vaccine, Ebola, Antimicrobila resistance.   \nReleased by Chairman Rand Paul\n420Jan. 29, 2015 – Here comes a sticky issue.   The CDC (Anne Schuchat) give press \nconference updating on measles situation.   Today I got several requests to go on TV with \nCNN (Anderson Cooper), Bloomberg, other networks such as CBS Morning Show.   Sara \nBaldauf at HHS tells Patty and Courtney to hold on all TV appearances since “CDC has \nthe lead”.   Yet, I have been on multiple shows over the past couple of weeks on measles.   \nThis idiot Sara is stuck on the Obama Administration theme that you can only have one \nmessage and one Federal official talking about anything.    She does not understand that \nthe press want me.\nJan. 30, 2015 – Happens again.   Martha Raddatz wants me for ABC This Week on \nSunday and other Sunday shows.    She says no.   Courtney calls up and asks for an \nexplanation.   Sara says CDC has lead.   As usual, Courtney says but the Shows are \nasking specifically for Tony and there was an agreement between Francis Collins and Bill \nCorr that when networks and cable ask for me they can get me.   Sara says she does not \nknow anything about this agreement. Sara also says, I am not really saying no to Dr. \nFauci, I am just saying that you should give it to CDC.   Courtney insists that “You are in \nfact saying no to Dr. Fauci”.  \nI must include in my book this unbelievable controlling theme for the Press of the HHS \nand Obama Administration.   They would rather have a jerk out there than violate their \ninexplicable rule of various lanes for various topics.   Truly a bunch of assholes.  \nJan. 31 – Feb. 1, 2015 – Francis Collins sent an e-mail to Sylvia Burwell explaining the \nsituation with ASPA and my media appearances.   Sylvia says that she will ask Leslie to \ntake care of it and that there should not be any restrictions on me.   However, over the \nweekend, approval for several requests for me are delayed making it very inconvenient \nfor Patty Conrad to arrange them, and some requests are denied.   Also, Sarah Baldauf \nnow sends me talking points on things that are actually scientific issues!!   Unbelievable.   \nShe monitors my TV appearances and comments on them to me via e-mail. She even \nmakes suggestions on scientific issues.  I told Francis and he agrees that this must stop. \nHe spoke to the ASPA today and he will speak with Leslie Dach.\n   (Feb. 1) -The big feature on me in the Sunday “Home” section of the Financial Times \ncame out today.   Many tweets and e-mails from people all over the world who loved the \npiece.   It was a feature about me as a person and my home with great pictures of the \nvarious rooms in the house and the deck, which they described as my favorite \n“object/thing”.   That is what they do with all of these features – they ask the “celebrity’ \nwhat his/her favorite thing is.   Mine was my deck.\n      Also, today (Sunday – Feb. 1) the crew from “CBS- Sunday Morning” visited my \nhouse and filmed the last part of what will be an hour feature on me within the next few \nweeks.   Producer is Emmy-nominated Sari Aviv and famous NPR correspondent (now \ndoing CBS) Scott Simon.  They filmed Chris and I running on the track at American \nUniversity and then back in the kitchen making a typical Sunday breakfast.   \n      Also, BBC is doing a feature on me similar to the CBS feature.  Theirs will show \nglobally.   They followed me around NIH and interviewed a bunch of people including \nactivists.\n   \nReleased by Chairman Rand Paul\n421Feb. 2, 2015 – Now Governor Chris Christie is saying that parent should have the choice \nof not vaccinating their children.   He said this juxtaposed against the POTUS saying on a \nSunday Morning Show that parents should vaccinate their children and “there really is no \ngood reason not to”.   Now the media are playing up the conflict between Christie and the \nPOTUS similar to the quarantine for Ebola issue.   Everyone wants me on the press to \ncomment.   I am picking and choosing with whom I speak since the press definitely wants \nto put me between Christie and Obama.\n     Was on NBC Nightly New and NPR with Richard Harris about the measles issue.  \nThis is becoming the media hype similar to the Ebola issue.   Now Rand Paul is weighing \nin saying parents should decide about vaccinations.   Mike Gerson did a great job in his \nPost column describing the issue.   He quoted me directly.   Chris Wallace of Fax News \nSunday wants me to debate Rick Perry or Carla Fiorina.   We shall see.\n     Cooked dinner tonight at my house (Linguine with scampi and marinara sauce) for \nHarold Varmus and Chris.   I have Harold over the house and cook dinner for him about \n4X per year.   Also, used to do this with Gary Nabel when Gary was Director of VRC \nbefore he went to Boston to Sanofi to be with his wife Betsy Nabel who is CEO of \nBrigham and Women’s Hospital.   I do this since Harold is alone in DC without his wife \nConnie who stayed in NYC when Harold came down to be Director of NCI.   He stays in \nDC in an apartment on Connecticut Avenue near the Zoo on Monday-Thursday and then \ntakes Amtrak back to NYC for Thursday night through Sunday night.  Always an \nenjoyable evening.\nFeb. 3, 2015 – Testified today at Congressional Hearing of Commerce and Energy \noversight Committee (Tim Murphy (R-PA) Chair on Influenza and why the match of \nvaccine was wrong.   Multiple things putting me at the forefront – measles, Ebola, bad flu \nseason.\nWill do Rachel Maddow Show tonight.   Measles is all over the news.   Also, ISIS sent a \nvideo where they burned alive a captive Jordanian pilot.\nSee e-mail below from Cliff.   Serious problem with integrity of the Welcome trust \npeople and Chimerix.   The Welcome trust Oxford group were the ones that criticized us \nfor wanting to do RCTs.   We insisted that it was the safest and best way to determine \nefficacy or harm.   They said we were unethical.   They are unethical and we cannot say \nanything because of “confidentiality”.\nFrom:  Lane, Cliff (NIH/NIAID) [E] \nSent: Tuesday, February 03, 2015 5:08 PM\nTo: Borio, Luciana (FDA/OC); Fauci, Anthony (NIH/NIAID) [E]\nCc: Margaret Hamburg\nSubject: Re: Daily Mail: Low infection rate halts Ebola vaccine trials in Liberia\nConfidential - \nReleased by Chairman Rand Paul\n422This is a complete distortion. The trial was stopped because patients died and the FDA \nsent a threatening letter to the company.  Questions on this will undoubtedly come up as \nwe launch the ZMapp trial.  These same individuals accused us in print of being unethical \nfor doing RCTs.  \nLu - I need to know what I (or Tony) can say publicly.  For the first time in a 35 year \ncareer at the NIH I am taking my gloves off.\nTony - I intend to severe any and all collaborations we have with the Wellcome Trust \nover what I consider to be completely unethical behavior and lack of integrity. \nPeggy - if I had not worked with you when you were a special assistant in Tony's off ice \nthere is no chance I would see such a note to the FDA Commissioner.  I apologize in \nadvance.\nSomewhere in HHS we need to move from political correctness and deference to our \ncolleagues in other agencies to doing the right thing and trying our best to identify \neffective countermeasures for Ebola virus disease.  It is possible my judgement is being \nskewed by spending too much time in West Africa.  In fact, however, it  I think it has \nbeen honed.  I think we need a blunt meeting with the Secretary and Leadership of FDA, \nCDC and NIH to put the cards on the table face up. \nCliff\nOn Feb 3, 2015, at 7:27 PM, Doepel, Laurie (NIH/NIAID) [E] \n<LDOEPEL@niaid.nih.gov> wrote:\nLow infection rate halts Ebola vaccine \ntrials in Liberia\nBy Afp \nPublished: 14:17 EST, 3 February 2015 | Updated: 14:17 EST, 3 February 2015 \nBritain's Wellcome Trust said that clinical trials it was funding for a new \nEbola vaccine in Liberia were halted on Tuesday due to a fall in new \ncases.\n\"The current position is that there is no realistic prospect of the trial \nenrolling sufficient patients to be able to reach a conclusion about the \nReleased by Chairman Rand Paul\n423efficacy of the drug,\" the Wellcome Trust, Britain's biggest scientific \nresearch charity, said in a statement.\n\"Therefore the trial has been terminated,\" it added.\nThe Wellcome Trust said the decision was taken on Tuesday after the \npharmaceutical company Chimerix, which manufactures the brincidofovir \nvaccine, said it was withdrawing from the trial on Friday.\nThe first large-scale trials of two other Ebola vaccines -- \nGlaxoSmithKline's Chad3-EBO-Z and rVSV-ZEBOV, manufactured by \nMerck and Newlink -- began in Liberia on Monday.\nTuesday's decision was taken by the Trial Steering Committee, which \nincludes scientists from Liberia, the University of Oxford and Medecins \nSans Frontieres.\n\"We're delighted that infections are falling, but fewer patients makes it \nmore difficult to carry out the robust scientific studies needed,\" Peter \nHorby from the University of Oxford, who was leading the trial, said in a \nstatement.\nJeremy Farrar, director of the Wellcome Trust, which is funding a multi-\nmillion pound therapeutics platform for experimental Ebola treatments, \nsaid it was \"disappointing\" that the trial could not continue.\n\"It is essential that other studies of potential treatments and vaccines \ncontinue and hopefully will still be able to deliver meaningful results for \nthis and the inevitable future epidemics of Ebola,\" he said.\nStephen Kennedy, a study investigator from the Pacific Institute for \nResearch and Evaluation in Liberia added: \"The scientific community will \nmove on without any clear evidence regarding the role of brincidofovir in \nthe management of Ebola.\"\nWeekly Ebola infections in west Africa have dropped to below 100 for \nthe first time in more than six months, the WHO said last week, raising \nhopes the worst-ever outbreak of the virus is coming to an end.\nReleased by Chairman Rand Paul\n424The World Health Organisation said it had now shifted its efforts in \nGuinea, Liberia and Sierra Leone -- the countries worst-hit by the \nepidemic -- from slowing the spread to stamping it out completely.\n \nFeb. 4, 2015 – Max Cooper gave WALS Lecture at NIH.   Went to dinner with him and \nChris last night at Cesco Osteria on Woodmont Avenue in Bethesda.  Still great press \ninterest in the Measles situation now that Presidential hopefuls Chris Christie, Rand Paul \nand others have commented on it.   Rand Paul put his foot in his mouth by saying that \nthere are reports of children who walk and talk normally before MMR and then \nimmediately after, they can no longer walk, talk, and are autistic.\nGood experience on Rachel Maddow Show last night.   We stuck to the science and did \nnot get involved with the politics, although she dumped all over Christie and Paul.   Ran \ninto Gov. Howard Dean in the NBC Green Room and he was very critical of Paul.\nDid Geraldo Rivera Radio Show today and Jose Diaz Belart on MSNBC.   The Sunday \nShows want me on several times.   Let us see if HHS allows it vis-a-via prior discussions.\nISIS burns alive and shows the video on the internet a Jordanian jet fighter pilot shot \ndown over Syria.   The Jordanians are outraged and execute Al-Qaeda prisoners in \nretaliation.  Big news\nFeb. 5, 2015 –  Media continues over measles.   Was on Fox National news.  Also, \nBuzzfeed print; Wall Street Journal.   Gave talk on Ebola at the Columbia Country Club \nin Bethesda on Connecticut Avenue.   Biggest crowd they have ever had at these events \n(Distinguished Lecture Series)\nFeb. 6, 2015 – HHS approving all my media now.   Today did CNN New Day; The Hill.  \nAlso did radio interview with John Castamidas for  his NYC Sunday Show.  Was \nsupposed to do MSNBC with Andrea Mitchell and another ABC Show but was cancelled \nbecause Jordanian aircraft bombed ISIS in Syria and the ISIS claims that the bombs \nkilled and American woman whom ISIS had kidnapped and was holding hostage.   Now \nall news stations are covering this.\nFeb. 7, 2015 – Measles still hot.   Emerging reaction by press and bloggers against \nmothers who do not vaccinate their children.\nI appear on CNN with Poppy Harlow about measles\nFeb. 8, 2015 – Appear on Sunday TV “Face the Nation” with Bob Shieffer.   Appear with \nCBS Dr. Jon LaPook.\n  Fly to Austin, TX for LaMontagne Lecture tomorrow.\nFeb. 9, 2015 – Give Inaugural John Ring La Montagne Lecture at University of Texas.  \nJohn did undergraduate and Masters at U of T.  His widow Elaine was present and his \nbrother Greg.   Freezing weather in DC and major historic snow storms in New England \nReleased by Chairman Rand Paul\n426I so rarely go out to lunch -- so I was completely crushed that I \nmissed the extraordinary moment when one of the world's leading doctors \npaid me a house call.  Thank you so much for the wonderful letter and \nincredible gift.  I can tell people now that while infamously do NOT \nhave a medical degree I DO have a certificate from the NIH!!!!\nOn a serious note, I cannot tell you how grateful I am personally for \nyour counsel, candor and wisdom during my tenure at the White House.  \nAnd as an American, I can't tell you how grateful I am for your \nleadership for our country and the world.  \nI hope our paths cross again some day.  Until then, I am your greatest \nfan and admirer....\nWith thanks,\nRon\nSent from my iPhone\nFeb. 20, 2015 – Outbreak of CRE (Carbapenem-resistant enterobacteriaceae) infections \nat UCLA related to a contaminated duodenoscope for ERCP (endoscopic retrograde \ncholangiopancreatography).\nWent on WTOP to discuss the CRE situation at UCLA.   Never a dull moment!\nFeb. 21, 2015 – Went on CNN to discuss the 7 cases of CRE that occurred with 2 deaths \nat UCLA in association with contamination of duodenoscope used for ERCP.   Press is \ntrying to blame FDA since FDA knew about the problem with duodenoscope \ncontamination for a few years.   I did not throw FDA under the bus since there is not \nmuch they can do about it except to alert hospitals to clean the instruments as best as \npossible.   Cannot pull the 20,000 or so instruments (made by Olympus) since 500,000 \nprocedures are done in the USA each year and many are life-saving and avoid serious \nsurgery.   It is a risk/benefit issue.   Peggy Hamburg ran into Chris in Safeway and Peggy \nmust have seen the CNN interview since she told Chris to thank me for not throwing \nFDA under the bus.\nFeb. 23, 2015 – I am finally convincing Tom Frieden not to oppose the therapeutic RCT \nfor ZMapp that Cliff wants to expand from Liberia to Sierra Leone since there are very \nfew cases of Ebola in Liberia and still several new cases each day in Sierra Leone.   The \nRCT for the vaccine trial is coming along well in Liberia.  I was supposed to go to \nLiberia yesterday, but have postponed the trip since my back is hurting badly and also \nbecause the president of Liberia (Ellen Johnson Sirleaf) is visiting HHS and I need to be \nthere to help greet her.\nMeasles still in the press.  Will discuss live tonight on BBC TV with Katty Kay\nFeb. 24, 2015 – Went to NYC for the DDCF Board of Trustees Meeting.  Good to see the \nBoard.   Have missed a couple of meetings due to the Ebola crisis.\nReleased by Chairman Rand Paul\n427Big breakthrough in food allergy published in the NEJM.   NIAID funded the study.   \nShowed that early age consumption of peanut products in children with diathesis for \nallergic reaction significantly decreases incidence of peanut allergy after 60 months.\nI appeared and was interviewed by Jeff Green on The NewsHour to discuss it.\nFeb. 27, 2015 – Still in an amazing cold wave in Washington, D.C.   A few days ago it \nwas 2 below at IAD.  \nWent to Humphrey Building today at 8:00 AM to meet with Liberian President Ellen \nJohnson Sirleaf.   Hosted by Sylvia Burwell.   Her staff included Liberian Minister to the \nUSA, among others.   On our side was Peggy Hamburg, Cliff Lane, Francis Collins, Tom \nKenyon (CDC).   Has good conversation about our efforts in Liberia, particularly the \nvaccine trial and the ZMapp trial that was announced today in Liberia.   The President \nprofusely thanked us for helping out with their Ebola issue.   She is a very sharp lady.\nFeb. 28, 2015 – Had another one of those great dinners hosted by Catherine and Wayne \nReynolds at the Book Room of the Jefferson Hotel.   Freezing weather.   Great guests \nincluding Vernon Jordan and his wife Ann; David Petraeus and wife Molly, Jim Johnson \nand his date Heather (?), Buffy Cafritz.   Interesting discussions by Jordan on the political \narena of Hilary Clinton and her candidacy.  Petraeus spoke about the ISIS treat, Iraq and \nthe Middle East.   One of the best of the Reynolds’s dinners.   Chris could not be there.   \nShe was in Northern California cheering on Ali who was running a marathon in the Napa \nValley.\nMarch 3, 2015 – Testified before the House Labor – HHS Appropriations Subcommittee \nfor the NIH budget.   As usual for the past few years, it was only a 2 hour Hearing with \nFrancis Collins testifying and me backing him up at the table together with Gary Gibbons \n(NHLBI), Tom Insel (NIMH), Nora Volkow (NIDA) and Jon Lorsch (NIGMS).   Hearing \nstarted early (8:30 AM)   since Benjamin Netanyahu was speaking before a Joint Session \nof Congress at the invitation of Speaker Boehner and against the wishes of Obama.  He \nwas making the argument that the USA was making a “bad deal” with Iran on nuclear \ncontrol versus sanctions.\n     During the Hearing Congressman Andy Harris (R-MD) made the point that he felt that \nwe were spending too much on AIDS compared to other diseases with much more of a \nmorbidity and mortality impact on the USA.   He wants to allocate money strictly \naccording the disease burden in the USA.   Hence, this would destroy funding for malaria \nand TB and greatly hurt funding for AIDS.   Obviously, I will be opposing this.\n     Still record cold weather and lots of snow in DC.\nMarch 5, 2015 – Was supposed to go to Boston yesterday evening in order to speak at an \nEbola Forum at Harvard today.   However, a big snow storm was forecast for DC for \ntoday and I was afraid that I would get stuck in Boston. I wisely, did not go and actually \ngave my talk and Panel discussion via “GoToMeeting”, which worked very well.   Paul \nFarmer was on the panel in Boston.   Good thing that I did not go since DC got 8 inches \nReleased by Chairman Rand Paul\n428of snow and all flights were cancelled from Boston to DC.  I would have been stuck \nthere.\nMarch 6, 2015 – Met with Nina Russell and Emilio Emini from the Bill and Melinda \nGates foundation (BMGF),  Emilio is taking over as the Director of Global Health for \nBMGF and he wanted to review our mutual commitments for the AIDS vaccine plans \n(i.e. the P5 follow-up of the RV144 study).   He wanted to re-examine the criteria for \nmoving forward with candidates.   Emilio generaly thinks that he knows everything; \nhowever, on this one he has a valid point and so we will do this together.\nCliff Lane in Liberia (also Sierra Leone) now for the 7th time in a few months trying now \nto expand the RCT vaccine trial to Guinea and also expand the therapeutic trials with \nZMapp to Sierra Leone and possibly Guinea since there are virtually no patients in \nLiberia.   Cliff and I had phone call early (6:30 AM) with Cliff in Sierra Leone, me in DC \nat home, and Yves Levy and Jean-Francois Delfraissy in Paris to try and get a \ncollaboration going in Guinea for the trials since the French have a presence in Guinea.\nMarch 9, 2015 -  Went downtown today to be the BBC studio to do the final taping of \nthe segment that they will be doing on HIV/AIDS were I am the moderator and narrator. \nIn the afternoon, I attended the FDA/NIH Leadership Council meeting to discuss better \nways of collaboration between the NIH and FDA. \nMarch 10, 2015 -  Gave the after dinner talk at the Project Hope Board meeting at the \nWillard Hotel in Washington DC. I spoke on Ebola: The Perfect Storm. It was extremely \nwell received and the evening was pleasant. Ran into former Secretary of HHS Louis \nSullivan.\nMarch 11, 2015 -  Was Visiting Professor at the John's Hopkins Hospital and Medical \nSchool. Gave two major talks: 1) a formal lecture on Ebola, and 2) a lecture to the \nstudents and fellows on my career as a scientist, clinician, policymaker. \nMarch 12, 2015 - There was a considerable misunderstanding involving a situation in \nSierra Leone. Cliff Lane is trying to expand the randomized controlled trial of ZMapp \nversus standard of care in countries in addition to Liberia with the protocol he has already \nstarted. As it turns out the commanding general in charge of the British military hospital \nin Sierra Leone, Brig. Gen. Tim Hodgetts, was under the misimpression regarding the \nprotocol was standard of care to see ZMapp + standard of care versus standard of care \nalone . And so he said that this trial was unethical and refused to participate in it. The \nreason why this is important  is because an American citizen who works for Partners in \nHealth became infected while working in Sierra Leone. We had made arrangements to air \nevacuate the patient to the NIH clinical Center as soon as possible. Because the patient \nwas in the British facility, we wanted to start the randomization to one or the other arm of \nthe protocol while the patient was still in Sierra Leone before flying back the United \nStates. Brigadier General Hodgetts stated that he would give ZMapp as a compassionate \nuse but would not participate in the randomized protocol. He felt it was unethical to delay \nthe flight to the USA by giving the person a placebo if in fact the person randomized to \nReleased by Chairman Rand Paul\n430did not see any droplets coming out of his mouth as he coughed; however,  I remember \nthinking thank goodness for the PPE. This experience brought into sharp relief for me the \nreason for the high case fatality of Ebola and why so many HCWs get infected. If were in \nWest Africa, would be dead and Rick, Anthony and I would have gotten infected \ntaking care of him if we did not have the state-of-the-art PPE.  After an hour and 45 min. \nwe doffed and waited for his parents.  \nThey came with Bible in hand to visit their son. Rick Davey, Cliff \nLane, and I spent well over an hour with them explaining the situation and the \nseriousness of it. We then brought them into the nurse’s station where they were able to \nspeak with their son through video link. They could see him but he could not see them. \nOf note before we brought them into the nurse’s station to see him through the video,  we \nmentioned to that we were going to bring them into the room. He got very \nconcerned that he wanted to get cleaned up from the diarrhea that soiled his bed and was \nover parts of his leg. In addition, his PIC line was bleeding around site and so that needed \nto be cleaned up. It took the nurses about 45 min. to an hour to get him perfectly clean so \nthat he could feel comfortable talking to his parents even though his parents would not be \nable to see any of the soiled linen or pajamas from the distance that they were at the video \nlink. It was a very moving conversation between the parents and  \nended up the conversation by reading a passage from the Old Testament. And then he \nturned to us in the room and said “what a wonderful country we live in that would put so \nmuch effort into the saving the life of one person - our son. There was not a dry eye in the \nroom.\nI went home that night completely exhausted and went with Christine to Bourbon Steak \nbar and restaurant at the Four Seasons Hotel in Georgetown to unwind.\nMarch 15, 2015. Came into work again today which is Sunday. The day has turned into a \nvery bright sunny day with a brisk wind. Again, I went to the SCSU and Rick Davey and \nI went in together to take care of . Some lab parameters are better and some are \nworse. The most worrisome of all is his respiratory situation. We have corrected what we \nbelieve is over hydration by cutting down on his fluids and giving him a diuretic. \nHowever his temperature is still 39 and he is still breathing at 35 to 40 breaths per \nminute. Of particular concern is the fact that on 2 L/min of nasal oxygen, his oxygen \nsaturation is still only about 88%. Also, on call is Bob Danner from the ICU. Bob \nincreased the nasal oxygen to 4 L/min and we had a discussion about the possibility that \nwe might need to intubate the patient since he will likely soon get soon very tired from \nbreathing at 35 to 40 breaths per minute. Cliff Lane was on a phone conversation with the \npeople from Emory and Nebraska and they mentioned that even when they thought that \nthey had very good control of intake and output of fluids, around day 8 to 10 of illness, \npatients often had unexplained accelerated respiratory difficulty requiring prolonged \nintubation. I hope that it does not come to that with  however, it is entirely \nconceivable that it will. I will go over to the SCSU again tonight for a conference with all \nof the team to make these decisions.\nDrama tonight in the SCSU.        Some change in status.  All metabolic \nnumbers, BP and cardiovascular, kidneys etc. were fine and even improving.   However, \nReleased by Chairman Rand Paul\n\n440Larry Kramer’s Novel ‘The American \nPeople’ Adds a Gay Dimension to History\nBy ALEXANDRA ALTER APRIL 7, 2015 \nPhoto \nLarry Kramer, the author of a hefty new novel (or, as he would have it, history) of the \nUnited States. He is working on a second volume. Credit Todd Heisler/The New York \nTimes \nFourteen years ago, the playwright and activist Larry Kramer was preparing to die. His \nliver was failing, and the prognosis was grave.\nReleased by Chairman Rand Paul\n441He summoned an old friend, Will Schwalbe, editor in chief of Hyperion Books, and made \nhim the steward of his novel in progress, a rambling history of homosexuality and AIDS \nin the United States. He told Mr. Schwalbe to self-publish it if necessary, using money \nfrom Mr. Kramer’s estate.\nIt didn’t come to that. Mr. Kramer survived a liver transplant and finished the book, a \nproject he had begun more than 30 years ago. Now, at 79 and against all odds and \nexpectations, he has lived to see it published. The first volume, “The American People, \nVolume 1: Search for My Heart,” weighing in at 775 pages, comes out Tuesday from \nFarrar, Straus and Giroux. Mr. Kramer has already thrown himself into finishing the \nsecond volume, which is to come out in 2017.\n“Larry lives to write,” said Mr. Schwalbe, who is now an executive vice president at \nMacmillan. “There’s no doubt in my mind that Larry’s writing is what keeps him alive.”\nPhoto \nMr. Kramer, 79, defied the odds and lived to see the publication of “The American \nPeople.” Credit Todd Heisler/The New York Times \n“Magnum opus” doesn’t seem like a robust enough phrase to describe the scope of “The \nAmerican People,” which stretches back to the prehistoric swamps of the Everglades and \nconcludes, in the second volume, in contemporary New York City. When Farrar acquired \nthe two volumes in 2010, the narrative had swelled to around 4,000 pages.\nBlending farce and tragedy, autobiography and fiction, it opens as Fred Lemish, a stand-\nin for Mr. Kramer, is struggling to finish writing a book titled “The American People,” a \nfar-reaching historical exposé that describes Alexander Hamilton, George Washington, \nAbraham Lincoln, Mark Twain and other major historical figures as gay. “He’s been \nstruggling with this history for many years,” Mr. Kramer writes of his fictional \ncounterpart.\nReleased by Chairman Rand Paul\n442Mr. Kramer said he was driven to write the book because he had long felt that gays had \nbeen excluded from history books, written out or ignored. “Most history is written by \nstraight people, and they don’t have gaydar,” Mr. Kramer said during an interview at his \napartment in Greenwich Village. “People say, ‘Can you prove to me that George \nWashington was gay?’ and I say, ‘Can you prove to me that he wasn’t?’ ” (As evidence, \nMr. Kramer notes that Washington “was surrounded by men, and he designed all their \nuniforms himself.”)\nIn the novel, and in conversation, Mr. Kramer criticizes historians and scholars like Stacy \nSchiff, Ron Chernow and Doris Kearns Goodwin for glossing over homosexuality in \nAmerican history. If he had had his way, he would simply have called the book a work of \nhistory rather than fiction, he said.\n“Farrar Straus said call it a novel, that way the lawyers will leave you alone,” he said. \n“But I believe everything in the book is true. It may look like fiction, but to me, it’s not.”\nMr. Chernow, the author of a well-regarded 2004 biography of Alexander Hamilton, said \nhe was surprised to be called out in Mr. Kramer’s novel, particularly as he brings up in \nhis book the possibility that Hamilton might have been bisexual. “I’m glad that Larry \nKramer is raising the issue, I’m just mystified at why he’s attacking me, when I thought \nhe would have applauded the fact that I take this seriously,” Mr. Chernow said. “It’s a \nlegitimate issue for historians or novelists, but we also have to be careful not to ransack \nhistory in service of a political agenda.”\nAs for Mr. Kramer’s theory about Washington, Mr. Chernow countered that it was \ncommon in that era for generals to design soldiers’ uniforms. If conflicting early reviews \nare any indication, “The American People” is likely to be as polarizing and controversial \nas Mr. Kramer’s other works. While Kirkus Reviews praised the novel as “breathtakingly \nwell-written,” others have taken a dimmer view. “To call it a rough read at times would \nbe an understatement,” a reviewer wrote in Publishers Weekly.\n“It’s like being hit by a truck, the book is so all over the place,” the novelist Andrew \nHolleran, who has known Mr. Kramer since the 1970s, said of the book. “What I admired \nas a writer was the imaginative energy and the amount he takes on.”\nJonathan Galassi, the president and publisher of Farrar, Straus and Giroux, said the book \nstruck him as ambitious and provocative, both as a work of literature and as an act of \nprotest.\n“This book is, in a way, a culmination of all his artistic activity,” he said. “Larry is a great \npolemicist and a fighter, and this book is part of his polemic about gay history and the \nroles of gays in our society. He’s still fighting and he’s using art to do it.”\nMr. Kramer never set out to be a political activist and said that in some ways he was ill-\nsuited to the role. “They say I’m obnoxiously noisy and angry, but I’m actually a bit of a \nshy person,” he said.\nReleased by Chairman Rand Paul\n443Early in his career, Mr. Kramer wanted to write comedy. After graduating from Yale, he \nworked in the film industry, and was nominated for an Oscar for his screenplay \nadaptation of the D. H. Lawrence novel “Women in Love” (1969). In 1978 he published a \ncontroversial novel, “Faggots,” a satire of rampant drug use and promiscuity among gays \nin New York. “It’s meant to be a comic novel — it made me laugh,” he said.\nHis mission changed in the early 1980s, when H.I.V. and AIDS began spreading rapidly \namong gays and claimed the lives of two friends. He was a founder of the Gay Men’s \nHealth Crisis, a nonprofit support organization for those affected by the disease, and later \nstarted Act Up, a protest group that brought attention to the AIDS crisis. His activism \nspilled into his writing, with plays like “The Normal Heart” and “The Destiny of Me,” \nwhich center on gay characters confronting the AIDS epidemic and take aim at \nindifferent politicians and institutions.\nMr. Kramer’s activism was closely and messily intertwined with his personal life. In \n1989, he learned he was H.I.V. positive and suffering from liver damage, the result of \nhepatitis B. He credits Dr. Anthony Fauci, director of the National Institute of Allergy \nand Infectious Diseases, for being among a handful of doctors who saved him by giving \nhim experimental drugs. Mr. Kramer once vilified Dr. Fauci in print, calling him “an \nincompetent idiot” and a murderer, for his early approach to fighting the spread of AIDS. \n“The man who I criticize for allowing the virus to spread is the man who saved my life,” \nMr. Kramer said.\nMr. Kramer’s acerbic and belligerent style has often alienated friends and supporters. He \nand the playwright Tony Kushner had a blowout over Mr. Kushner’s screenplay for the \nSteven Spielberg movie “Lincoln” (2012), because Mr. Kramer felt that Mr. Kushner \nshould have depicted Lincoln as a gay man. “He and I had a major falling out over this,” \nMr. Kramer said. “I so wanted him to put that in the movie.” (In “The American People,” \nMr. Kramer strikes back with his own fictional Lincoln, who has a male lover and often \nlustily utters “mighty fine” after their encounters.)\nThese days, Mr. Kramer seems much less bellicose, though no less passionate. He speaks \nin a tremulous near-whisper and relies on a hearing aid and a cane. He spent much of last \nyear in hospitals being treated for abdominal infections and almost died twice, he said. \nHe was bedridden in 2013 when he and his longtime partner, the architect David \nWebster, were finally married in the intensive care unit of NYU Langone Medical \nCenter.\nMr. Kramer’s writing has taken on a greater urgency lately. He has been writing for five \nor six hours every day, seven days a week. His progress is visible in the towering stacks \nof manuscript pages that cover a large table in his living room, which doubles as a work \nspace. He is also working on a screenplay for a sequel to “The Normal Heart” and is the \nsubject of an HBO documentary, “Larry Kramer: In Love and Anger,” which will be \nshown in June, just after his 80th birthday.\nReleased by Chairman Rand Paul\n445take them back to Dallas, TX.   He could have flown commercial; however, we wanted to \navoid the ignorant panic if anyone found out that he did so.\nVery cold day here in Bethesda/DC.   Went doe to HHS to reception honoring retiring \nDeputy Secretary Bill Corr.   He was very pleased that I came down there.   Bill was \nChief-of-Staff to Donna Shalala for 8 years and then 6 years with this administration as \nDeputy Secretary.   A fine man and excellent Public Servant.\nAmazing thing happened to Dan Chertoff who has been a leading player in the care of \n   Dan wore himself out taking day call every day in the SCSU (as well as coming \nin at night during the crisis periods).   To make matters worse, his father passed away \nduring all of this.   And so now that it is over, he took his wife Jessica and his child for a \nvacation in the Dominican Republic.   His went through all of the appropriate \nnotifications of travel via our OMS, the State of Maryland, the CDC, and the embassy of \nDominican Republic.   Somewhere along the way, someone, including the CDC, dropped \nthe ball and did not inform him that the DR has a policy of not accepting people who \nhave taken care of Ebola patients even though by our criteria, he is “low, but not zero \nrisk” and so should have no travel restrictions.   Bottom line is that the DR kicked him \nout of DR soon after he landed.   They were waiting for his at his hotel and with \napologies, put him and his family on a plane at their expense and sent him back to the \nUSA.   Amazing bullshit!   Truly unbelievable how stupid they are and how incompetent \nwere the people that should have warned Dan.\nApril 10, 2015 – Jack Whitescarver and Wendy Wertheimer sent in to Francis Collins \ntheir letter of resignation from the OAR.   Jack is 78 and wanted to stay until he reached \n80.   However, he and Francis have not been getting along since Francis feels that Jack \nhas been too slow and non-specific in shifting the AIDS money to focus on the high \npriority areas such as vaccine, prevention, cure and co-morbidities.  The relationship has \nsoured and so Jack feels that it is time to go.  I, myself, love Jack, but am not satisfied \nwith how they are handling the re-distribution of the AIDS money.   Clearly there is too \nmuch AIDS money in NIDA and in NCI that is not being used for AIDS projects and to \ncall it AIDS-related is a stretch.   We had a meeting in my library today with Larry \nTabak, Wendy W. and Jack to discuss this issue.   I got pissed off at Wendy since she \nessentially accused me of saying (which I did not) that behavioral research grants were \nnot good science.   That is not what I said.   I said that we were doing proportionately too \nmuch behavioral research out of NIDA and that the Congress (Rep Andy Harris R-MD et \nal) are trying to decrease the AIDS budget (see above) and we had better be spending it \nall on research that is high priority such as vaccine and cure; otherwise, they will have an \nexcuse to cut the budget.   Larry Tabak is totally in my corner and even Jack admitted \nthat he agreed.   However, the behavioralist community keeps pushing to do a lot of \nbehavioral research.   Clearly, the studies might be sound, but they do not contribute to \nthe end of the pandemic.   You can study behavior when it comes to AIDS; however, it \nhas been very difficult to “change” behavior.\nApril 11, 2015 – Went to Reception/dinner at Jamie Gorelick (former assistant attorney \ngeneral in Clinton Adm) and Rich Waldron’s home in Chevy Chase in honor of Roger \nReleased by Chairman Rand Paul\n\n446Glass winning the Sabin Medal for developing a rotavirus vaccine.  Mostly NIH people \nand some of Roger’s old friends.\nApril 13, 2015 – Washington Nationals getting off to a very bad start.   Many errors and \nno hitting.   Also, their excellent pitching staff is getting blasted.\nWent to Tyson’s Corner Ritz-Carlton at invitation of David Rubenstein (CEO of Carlyle \nGroup) to talk to their annual meeting (~600 top CEO managers of Carlyle activities).   \nFormat was David interviewing me on Stage 1-on-1 right after lunch.   David obviously \nis very taken up by me and really likes me (likewise).   Remember, he tried to recruit me \nto Carlyle several years ago for $1 million flat salary plus commissions.   Many in the \ngroup said to me that I was the best invited speaker at any of the former annual meetings.   \nBesides, they pay the others a handsome honorarium.\nAAAS (new CEO Rush Holt) chose me to be one of a couple of people to give the \nlaudation for Alan Leshner who is retiring as CEO of AAAS.   Very elegant function at \nthe Women’s Museum of the Arts on New York Avenue and 12th Street, N.W.   Alan was \nvery moved by my remarks.\nApril 15, 2014 – Testified at a House Appropriations Subcommittee Hearing at 10:00 \nAM in Room 2358B of the Rayburn Building.   Topic was Ebola response.   I represented \nNIH.  Also testifying was Nicki Lurie (ASPR), Tom Frieden and Robin Robinson \n(BARDA).   I did well, but Nicki and Tom caught some criticism for the fact that the \nETUs that they recommended got built and only 2 of 11 actually admitted a patient and of \nthe 2 that admitted patients, only 25 patients were seen.   Criticism was the lack of \nflexibility to stop the building when it became clear that the epidemic was decreasing \nrapidly as they were building the ETUs.   Committee nevertheless complimented us on \nthe Ebola response.   Rep. Harris (R-MD) was a bit snarky with Tom Frieden saying that \nhis daughter is an ICU nurse at Hopkins and she does not know how to don PPE and that \nreflects a lack of planning on the part of the USG.   He is misguided.\nHad disturbing meeting with Francis Collins, Larry Tabak, Jim Anderson, and Kathy \nHudson in Building 1, Room 116 concerning the re-prioritization of the AIDS budget \nthrough OAR.   It is now clear that Francis not only wants to assure that the highest \npriority AID research is done with AIDS dollars, he actually wants to decrease the \namount of money going for AIDS research and redirect it to non-AIDS, i.e. decrease the \nAIDS allocation.   He is using the review of the AIDS portfolio as an excuse for this.   I \nwarned him that this is not a good idea and will be met with pushback from the \ncommunity.   I also believe that Francis might be trying to ingratiate himself with the \nGOP since he may be covering his bets in case a Republican becomes POTUS and he \nwants to keep his job as NIH Director.   Just a thought.\nApril 17, 2015 – Had meeting at HHS in Room 305A in Humphrey Building with the \nPresidents of Liberia (Ellen Johnson Sirleaf), Sierra Leone (Ernest Koroma) and Guinea \n(Alpha Conde) to discuss the status of the Ebola outbreak.   Much good will with \nexpressions of cooperation and collaboration.   The Presidents insisted (appropriately) \nReleased by Chairman Rand Paul\n447that we cannot rest until the cases go to zero.   Also, they spoke of developing sustainable \ninfrastructure that will be available for the next outbreak of Ebola or any other disease.   \nPresident Koroma spoke of his desire to establish an African CDC.   I described for \nPresident Sirleaf the successful implementation of the RCT for vaccine (in Liberia) and \nthe RCT for ZMapp (in Liberia and Sierra Leone).   She obviously already knew about \nthis since we had briefed her previously and she knew that we were also helping to \nrenovate clinics in Redemption Hospital and JFK Hospital in Monrovia.   Of note, when \nPresident Conde heard that we were doing these trials in Liberia he expressed (through a \nFrench translator) his strong desire for us to do such trials in Guinea.   Obviously, this is \ngood news for Cliff who is trying to get around the nonsense of the Norwegians and \nWHO regarding their trying to stop us from doing the trial (see above).   Meeting ended \nvery well.\nApril 19, 2015 (Sunday) – Was inducted in the Washington, D.C. Hall of Fame \n(Historical Society of the District of Columbia).   Category of Science and technology.   \nBlack tie affair at the Liason Hotel on New Jersey Avenue, N.W.   DC Mayor Muriel \nBowser was present and ceremony MC’d by Former DC mayor Sharon Pratt.   Of note is \nfact that I was the only white person to be inducted (total of 12 inductees for various \ncategories (arts, literature, law, business, etc.).   Also, of the approximately 300 people in \nthe ballroom, except for one other person, Chris and I were the only white people – all \nwere African-American.\nApril 21, 2015 – Pat White who now works for “ACT for NIH” got Chris and I invited to \nan affair at the Eisenhower Theater at the Kennedy Center.   It was an interview \nconducted on stage by Bob Shieffer (CBS Face the Nation) with Bill Clinton and Colin \nPowell.   The evening was MC’d by Norah O’Donnell (NBC).   Great interview.   Elegant \ndinner followed upstairs in the Atrium.   Had opportunity of nice conversations with \nPresident Clinton and especially Colin Powell who is always extremely friendly with me.   \nAlso chatted with Nancy Pelosi, Majority Whip Kevin McCarthy, Mack McCarty, Sen. \nRichard Durbin among others.   Really a fun evening.\nDuring the day, met with Mike Gerson who is interested in partnering with a producer to \nmake a documentary of the global response to HIV, concentrating on the PEPFAR story.   \nAnd so he met with me in my office for 1 hour to discuss various aspects of the historical \nevolution of PEPFAR.\nApril 23, 2015 – Conference call with MSF (Joanne Liu and Sophie Delaunay), Tom \nFrieden and Cliff Lane about”BioBank” and study of specimens that had been stored \nfrom Ebola patients.   Interesting that MSF, who has never been interested in research \nand who often put down research since that focused on care now want to lead the effort.   \nJoanne and Sophie are good people and this manifests the dichotomy and heterogeneity \nof MSF.   Many conflicts within their ranks.   Bottom line is that we agreed since we all \nare interested in this that we do the best possible science with true transparency and that \nabove all, the data belong to the West Africans.\nReleased by Chairman Rand Paul\n448April 25, 2015 – Went with Chris to the Annual Garden Party at the Beall-Washington \nHouse at 2920 – R Street, N.W. that precedes the White House Correspondents’ Dinner \ntonight.   Usual DC scene of TV stars and Hollywood stars such as Michael Kelly from \n“House of Cards” among others.   Many people commented about my performance on \nTV during the Ebola crisis this past Fall.  The Brunch was sponsored by Steve and Jean \nCase, Tammy Haddad, Mark Ein, etc..\nThat evening went to WH Correspondents’s Dinner at the Washington Hilton on \nConnecticut Avenue and Florida Avenue.   Was guest of Tom Burton and the Wll Street \nJournal.   President Obama gave good comedy show followed by Saturday Night Live’s \nCecily Johnson.  She was not particularly funny, but OK.\nApril 26, 2015 – Went to the Annual NAS Garden Party at NAS Headquarters on C \nStreet and 22-23rd Street, N.W.   Usual scene of seeing old friends.  As always, great to \nsee Max and Rosalie Cooper.\nApril 28, 2015 – Wonderful evening at the home of Ambassador Esther Coopersmith \n(2230 S Street, N.W.) who gave “A List” party in honor of Barbra Streisand who is a \nstrong advocate of the Women’s Heart Alliance, an organization calling attention to the \nunrecognized burden of heart disease among women.   Beautiful DC Spring evening \n(magical) – perfect temperature, crystal clear sky.   I had the pleasure of spending much \nface-to-face time with Barbra.   She clearly knew who I was when introduced.  She knew \nthe connection to Larry Kramer as she was supposed to produce “The Normal Heart” for \nHollywood, but did not as it went to HBO.   I was seated directly across from her at a \nnarrow table and right next to Esther Coopersmith, the hostess.   Amazing crowd with \nmany politicians – Nita Lowy and Rosa DeLauro (who kept shouting me out in their \nremarks); Ed Markey who gave a short speech and said “Wow, what a party – I am sitting \nhere with Tony Fauci!”; Sen John McCain, Chris Dodd, Lloyd Hand, James Brolin \n(Barbra’s husband and father of Josh Brolin), Kathleen Kennedy Townsend, Gary \nGibbons (the only other NIH person), Catherine and Wayne Reynolds, Diane Rehm, \nhenry Waxman, Irene Pollin, Anita Mcbride, Rima Al-Sabah, Sen. Franken, Debbie \nDingel, and many other notables.   Barbra was amazingly nice – warm, sincere, funny, \nfriendly.   I was surprised since Harold Varmus had told me that on a prior visit by \nBarbra to NIH when he was Director and I was not present, Harold said that Barbra was \naloof and not friendly.   Totally opposite tonight.   You get the feeling you could really be \nher friend.\nApril 30, 2015 – testified before the Senate Appropriations Subcommittee with Francis \nCollins, Gary Gibbons, Tom Insel, Jon Lorsch, and Doug Lowy.   Committee now \nchaired by Roy Blount (R-MO).   Hearing went well.   Concomitantly with Hearing has \nbeen the drafting and revising of the 21 Century Cures Act developed by Fred Upton (R-\nMN) and Diane DeGette (D-CO).   Clearly, Francis Collins (who denies it) had a lot to do \nwith this since it authorizes (and appropriates – weird for an authorization committee) $2 \nbillion per year for 5 years to NIH Director to ONLY be spent on Precision Medicine, \nyoung investigators, and “other research” TBD.   This is a bad idea to earmark that much \nmoney in the NIH budget.\nReleased by Chairman Rand Paul\n449May 2, 2015 – Went to Children’s Inn Gala at the Ritz-Carlton at Tyson’s Corner.   Big \nshout out for me by the MC for my Ebola and other work.  \nMay 5, 2015 – Dedicated Building 4 today as the Lowell Weicker Building.   I gave the \nmain laudatio and Lowell loved it as did his wife Claudia, who I knew from the old days \nwhen she was his staffer.   He divorced his wife to marry Claudia.   Nice ceremony \nattended by Sen. Tom Harkin, Rep. Dave Obey, Tim Schriver. \nWas visited today by Harry Jaffe the National Editor at The Washingtonian.   Harry \nwants very much for me to write a book.   Says he has been following my career and that \nI have a “couple of books in me”.   He wants to help as an editor, co-writer and/or agent.   \nHe has written several books himself, including the best seller “Dream City” about \nMarion Barry.\nMay 6, 2015 – Went to Detroit to receive honorary doctorate of LAWS from Wayne \nState Univerity.  President Roy Wilson whom I know from his years ta NIH and he was \non the Search Committee that I co-chaired with Gary Gibbons for the Director of \nNIMHD.  Very nice trip.   Absolutely beautiful weather – 50-60 and bright sun.  Had \nvery pleasant dinner in Roy spectacular apartment near Wayne State Univ.   Roy was \nborn in Japan of African-American father (officer in Air Force) and Japanese mother.   \nHe is fit and handsome guy.   His apartment was a combination of modern American and \nKyoto-like Japanese décor.   Really nice.\nMay 7, 2015 -  Received degree today from WSU.   On plane back, zsat behind an \nAfrican American man and his wife/girlfriend.   He looked around 60 years old and in \ngreat shape.   I helped him open the upper luggage bin and our eyes met.   He looked \nstraight at me and said with a big smile: “Did you dye your hair gray so that a young man \nlike you would look more distinguished?”.   I told him that unfortunately it was age.   He \nasked me how old I was and I told him 74.   He smiled and said he was 69 and gave me a \nfist pump.   I noticed a massive diamond-studded ring on his finger.   He pointed to it and \nsaid: “Do you know what this is?”   I said no and he said it was a Hall of Fame Ring.   I \nlooked at him and apologized and said I am very sorry, but I do not recognize you.   He \nsaid:   I am Lem Barney, Hall of Fame cornerback for the Detroit Lions from 1967 \nthrough 1977, and you are that wonderful doctor who does so much for the world.   I told \nhim how much I admired his play over so many years with the Lions.   We hugged and \nshook hands for a long time.   Wonderful encounter!\nMay 9, 2015 – Chris has been in Zimbabwe and South Africa for the past 2 weeks giving \nlectures on Ethics.   She wrote me a wonderful 30th Anniversary letter:\nDear Tony.docx\nMay 2015\nReleased by Chairman Rand Paul\n452May 14, 2015 - I am very disturbed by the situation regarding the conflict of principles \nbetween scientists (ourselves) and certain health officials in Europe concerning the \nconduct of randomized controlled clinical trials in the Ebola outbreak in West Africa. I \nam absolutely astounded by the lack of scientific rigor demonstrated by people like \nJeremy Farrar the head of the Wellcome Trust and certain scientists at Oxford University \nincluding Peter Horby and Adrian Hill. I am also surprised that Peter Piot is also sharply \ncriticizing any placebo-controlled trials particularly of drugs. We have considerable \nexperience with HIV and in other arenas where the artificial show of compassion in a \nserious disease that results in wide distribution of unproven drugs leads to a double \njeopardy of never proving that an intervention works or not, and more importantly misses \nthe possibility that they are actually harming people. The British and as well as people at \nWHO and Doctors without Borders by taking somewhat of a self-righteous approach that \nany research done in the setting of an Ebola outbreak is unethical are actually hurting \npeople.   The Oxford group actually covered up that several patients given open access to \nBrincidofavir died and they never reported it.   They said that the study was stopped \nbecause there were no more infections, when this was a blatant misrepresentation. There \nhave been dueling criticisms in the press between our approach and theirs about this. A \nrecent Wall Street Journal article by reporter Tom Burton analyzed this carefully and \nblasted the Europeans for giving out medicines in an open access manner while likely \nhurting people with drugs that have clear toxicity that have really no pre-clinical \nindication that they would work. In my mind Cliff Lane is a true hero in this as he is \ndesigned and implemented randomized controlled trials for vaccines in Liberia as well as \ncontrolled randomized trials without a placebo for certain drugs like ZMapp.\nI am terribly disappointed with Tom Frieden who continues to insist that you cannot do a \nrandomized controlled trial of the vaccine in countries like Guinea because this would \ninterfere with the public health effort of getting the epidemic down to zero. Clearly, as \nwell-meaning as he may be, he does not have a clue about how to design or implement a \nclinical trial. Again I am really very disappointed with him, with the WHO, with the \nWellcome Trust, and with individual characters such as Jeremy Farrar and Marie-Paule \nKieny at WHO. They really should be ashamed of themselves.\nMay 17, 2015 – Received honorary doctorate of Public Service from George Washington \nUniversity in a beautiful ceremony on the National Mall right in front of the Washington \nMonument.   Commencement Speaker was Tim Cook, CEO of Apple.   At the ceremonial \ndinner the night before at the Corcoran Gallery of Art on 17th Street, N.W., a student \nmember of the Board of Trustees got a piece of meat stuck in his throat and was choking.   \nI did a Heimlich maneuver and dislodged the piece of steak.   Obviously, the crowd was \ndelighted and gave me a big round of applause.  The next day (today) at the graduation \nceremony, President Knapp mentioned this in his citation for my honorary doctorate.   It \nalso got tweeted around.\nMay 19-21, 2015 -   Honorary doctorates at Columbia University in NYC (Doctor of \nScience) on May 20 and The Johns Hopkins University in Baltimore (Doctor of Humane \nLetters) on May 21.\nReleased by Chairman Rand Paul\n454Elijah Cummings – Congressman from Baltimore gave very moving comments (in his \nwonderful preacher fashion) about the recent riots in Baltimore related to the police \nkilling of Freddie Gray.  He spoke of his own growing up and still living in the \nneighborhood where the riots took place.  \nLeon Fleisher – world renowned concert pianist.   He was wonderful and they showed a \nclip of his playing the piano.   He gave words of wisdom.   “Listen and do not be afraid of \nsilence.”   Also, “Procrastination saves time”\nEdwin Catmull, the CEO of Pixar Animation Studio.   Produced the first computer \nanimated film “Toy Story” and also “Frozen”.   Has won 5 Academy Awards.\nMay 21, 2015 – Received the Special Recognition Award for Science and Medicine at \nthe Sons of Italy Foundation Gala at the National Building Museum.   Phil Piccigallo \ngave a very nice and warm laudation of me with many old photos of me in different \n“historic” situations.   Also, met at the dinner;  Anita McBride (former chief-of-Staff to \nLaura Bush), General Ray Odierno and his wounded warrior son Anthony (arm blown off \nby an IED in IraQ).\nMay 26, 2015 – Gave an “Interview” talk with Joe Palca (NPR) at the Ripley Center of \nthe Smithsonian.  Good crowd, good questions.\nMay 27, 2015 – Hosted 30 Staff members from the Senate Appropriations and Oversight \ncommittees at the Special Clinical Studies Unit (SCSU) at the Clinical Center where we \ntook care of  and    I did for them the complete donning and \ndoffing procedure, which they absolutely loved.   Many questions.\nDid a telebriefing for the release of the START study data (DSMB recommended \nstopping the study due to highly positive results).   Clearly starting ARVs at greater than \n500 CD4+ T cell count was much more beneficial (p <0.001) than waiting until counts \ndrop to 350.   Got much attention.   Front page of NY Times with my picture in ONLINE \nversion of Times.   Also the next night (May 28), I appeared with Judy Woodruff on the \nNewsHour.\nMay 28, 2015 – Went to UN to participate in Panel at ECOSOC Council (Economic and \nSocial Council), chaired by Paul Farmer to discuss sustainable health systems in light of \nthe Ebola outbreak.   Bill Clinton gave the Keynote and we shook hands and exchanged \npleasantries.   On the panel with me was the actor Jeffrey Wright (“Angels in America”   \n“Boardwalk Empire”.   He has won an Emmy, a Golden Globe and a Tony.   Very nice \nman.   Says that he has been a fan of mine for years.   He is working to improve the \nconditions of miners in Sierra Leone.\nJune 1, 2015 – Gave lecture at the Sulgrave Club on Dupont Circle.   Upper Crust old \nwomen’s club.   Quite charming and elegant Building between P and Massachusetts Ave, \nright on DuPont Circle.   Spoke on Ebola.   Adoring crowd.   Met John Quinnan with \nReleased by Chairman Rand Paul\n\n455whom I did my first research project in the summer between my 1st and 2nd year at \nCornell – the summer that I met Lynne Williams.\nJune 2, 2015 – Spoke with Doug brooks (ONAP) about setting up a meeting with him, \nme, Valeria Jarrett and Denis McDonough to discuss possibility of starting a PEPFAER \nfor the USA to end the AIDS pandemic here.\nJune 3, 2015 – Chris and I went to function in the Mansfield Room of the US capitol as \ngusts of Wayne and Catherine Reynolds in one of their usual wonderful social events.   \nThey were honoring Congresswoman Debbie Dingel, Sens. Roy Blount, Thad Cochrane \nand Diane Feinstein for their contribution to the Arts.  I introduced Debbie Dingel.   \nGreat crowd.   I chatted with old friends Fred Hiatt of Washington Post, Rick Atkinson, \nChris Matthews, Bob Barnett, etc.   Great evening.\nJune 5, 2015 – Things heating up with MERS in South Korea.   Now at 40 cases and 4 \ndeaths – largest outbreak outside of the Arabian Penisula.   Index case is a 68 year \nKorean man who travelled in the Arabian Penisula (KSA, Qatar, UAE, etc) came back to \nKorea was hospitalized and set off a chain of infections among people in same room and \neven on same ward as well as family members and HCWs.\nI appeared on Wolf Blitzer (CNN) to discuss the situation.\nJune 6, 2015 – Steve Holland admitted a patient (25 year old woman from India) with \nXDR TB today.   NSC heard about it and as usual pushed the panic button and wanted us \nto provide a press statement and Qs and As.   We did and this triggered much press \ninterest.\nJune 8, 2015 – Did my BSC presentations or LIR Overview and Immunopathogenesis \nSection accomplishments.   My primary reviewers were Arturo Casadevall and Larry \nCorey.   Review went extremely well.\nPress interest now heating up for both MERS and the XDR patient here at NIH.\nDid interview with Katty Kay for BBC on MERS.\nJune 9, 2015 = Did WTOP interview on MERS and XDR TB.   Also, for XDR TB did \nMSNBC with Andrea Mitchell, NBC Nightly News, CBS Nightly News and Telemundo \nTV, Channel 8 News, ABC Nightly News\nHarold Varmus came back to Bethesda and visited with me.   He is doing fine at Weill-\nCornell.   Came down for a dinner with Francis Collins, Shirley Tilghman, Marc \nKirschner, and Ron Daniels to discuss the systemic problems with the biomedical \nresearch enterprise related to the paper that Harold, bruce Alberts, Kirschner and \nTilghman wrote in PNAS.\nReleased by Chairman Rand Paul\n456June 10, 2015 -   Long interview with me on XDR TB patient by Denise Grady appeared \ntoday in the NY Times.   Also, did FOX Channel 25 Local News this AM.\nGot report from BSC and was told that “Outstanding” was not a sufficient adjective to \ndescribe how good my laboratory and my section was.   Praised my leadership and it was \nthe first time that every single person in a given laboratory got “outstanding”.  Called the \nlab a “National Treasure”.\nJune 12, 2015 – Did Bloomberg TV on MERS, which is still going on in South Korea.   \nNow up to 133 cases and 14 deaths.   We here at level of HHS are already having the \nusual conference calls of preparedness regarding development of therapeutics and \nvaccines.\nJune 15, 2015 – had dinner over my house with Eric Goosby and Chris – the now \ntraditional sausage and rigatoni dinners that I have had with Eric, Harold Varmus, and \nGary Nabel over the years.   Eric is in town for and IOM workshop.   He also is seeking \nmy assistance in obtaining a grant from the DDCF and also NIH now that he is out of \ngovernment and pursuing global health issues.  Of note, he has recently been appointed as \nthe UN Secretary General’s Special Envoy for TB.\nTom Frieden is balking at supporting the proposal for the IOM Study on lessons learned \nin the Ebola response.   I will be supporting the study with NIAID funds.  Tom still is not \nreally on the same page with me about what went on during the response.   He is still \nfixating on have the IOM study focus on “alternative clinical trial designs” instead of the \nRCT.  Also, he is still against Cliff trying to extend the RCT to Guinea.   Tom feels that \nthe Guineans will react badly to a trial and be paranoid that we are trying to kill them.   \nThis conflicts with the fact that the WHO is already doing a ring vaccination (poor \ndesign) study in Guinea.   Anyway, conversation with Tom are still very cordial and I like \nhim – just disagree with him sometimes.\nJune 16, 2015 - I am in the midst of preparing my talk for the International AIDS Society \nto take place in Vancouver. As usual I am taking this very seriously and doing multiple \ndrafts.\nCliff Lane and I had a teleconference with individuals from Drs. Without Borders (MSF); \nin particular, we spoke with Sophie Delaunay along with Jennifer Cohen of MSF. The \ndiscussion was the interest on the part of MSF to be a major player in the development of \na Biobank for specimens in West Africa related to the Ebola outbreak. Cliff and I are \nsomewhat skeptical about this issue since MSF rarely, if ever, gets involved in \nbiomedical research, and when they do, we have had concerns about their capability in \nthis regard. CDC (Tom Frieden) agrees completely with us on this and has skepticism \nabout their involvement.  They are a wonderful organization when it comes to taking care \nof patients; however, we have had some difficult experiences with their inability to really \nappreciate the importance of the scientific method when doing research.\nReleased by Chairman Rand Paul\n457Today I had the first meeting for the search committee for the director of the division of \nintramural research to replace Kathy Zoon.   The Committee is co-chaired by Cliff Lane \nand Gary Gibbons.\nJune 17, 2015 -  I gave a talk at the HPTN/IMPAACT meeting at the Crystal Gateway \nMarriott Hotel on Jefferson Davis Hwy. in Crystal City, Virginia. This was an important \ntalk because I introduced to the investigators the difficulty that we are having now with \ncertain members of Congress wanting to decrease the AIDS budget and even move \nmoney out of the AIDS bucket into other institutes. I showed the audience a C-SPAN clip \nof my debating with Senator Cassidy (R-Tea Party) from Louisiana where he was talking \nabout matching allocation of funds with the number of disability adjusted life years  \n(DALYs) in this country. If this approach were followed, it would have a serious negative \nimpact on all global health research, particularly research on infectious diseases. I \narticulated well my objection to this. Some people have picked this up and put it on \nYouTube, and the clip has gone viral. In addition, I spoke to the group about future \ndirections of focusing the AIDS research specifically on ending the epidemic so that \nultimately we will not have to spend any money on AIDS.  This would be an important \npublic health accomplishment, and it would silence the people who want to take money \nfrom AIDS prematurely before we have ended the AIDS epidemic. \nTonight, I flew to Atlanta to participate in the Charles C Shepard Science Award \nCeremony in Atlanta at the CDC headquarters.\nJune 19, 2015 -  I gave a lecture at the CDC on the subject of \" Ending the HIV AIDS \npandemic: From scientific advances to public health implementation\". The lecture was \nextremely well accepted by the CDC community. I had time to chat with my dear friend \nTom Frieden about a number of issues of mutual interest. I was shown around the \nabsolutely beautiful new CDC campus that I had not been on for several years. The \ncampus has been completely transformed by beautiful, architecturally creative buildings. \nIt is very clear that I am highly respected and revered by the CDC community. Tom \nintroduced mew as a “living legend”.   It was a great visit that I enjoy very much and it \ncemented my relationship with our colleagues at the CDC.\nJune 20, 2015 -  I viewed the preview of the soon to be shown on HBO documentary on \nLarry Kramer entitled “Larry Kramer: In Love and Anger”. It was played at the Naval \nHeritage Center on 701 Pennsylvania Ave. NW. The documentary is a moving story of \nLarry Kramer's complicated life. I was prominently featured in the documentary \ninteracting on multiple occasions with Larry.\nJune 22, 2015  - I gave a lecture at Georgetown University O’Neill Institute at the Law \nSchool on New Jersey Avenue, NW Summer Program on Infectious Diseases and the \nLaw. Again very well received by the group there.\nWe are in the middle of an extraordinary heat wave now in Washington DC with \ntemperatures reaching 95- 100° with sunny skies during the day and massive \nthunderstorms at night.\nReleased by Chairman Rand Paul\n458June 23, 2015 -  I had a very nice breakfast meeting at the American City Diner with Bill \nSchultz who is the general counsel for the Department of Health and Human Services. I \nmet with Bill at the suggestion of Pulitzer Prize winning author and close friend of mine \nRick Atkinson. Rick was concerned if I got involved with Don Fehr, who offered to be an \nunofficial agent for me and read over my manuscript as well as tell me how to write a \nbook proposal for an editor, that this informal arrangement could spell out to the a legal \nissue later.  This arrangement might also be something that is frowned upon by the \ndepartment. And so Rick recommended that I meet with Bill and get his legal advice. My \nmeeting with Bill was terrific. He was extremely encouraging to me about writing my \nbook. He agreed with Rick that I should hold off making even any informal arrangements \nwith anyone and I should just go ahead and continue to write my chapters and when I am \nready to leave the government to then put together my proposal and “shop” it around to \ndifferent publishers and agents. I will take his advice and go that way.\nThis evening I gave a presentation to the AIDS Clinical Trials Group (ACTG) annual \nmeeting at the Renaissance Hotel Downtown at 999 – 9th Street Northwest. The talk was \nvery similar to what I gave to the HPTN/IMPAACT group.\nJune 24, 2015 -  I participated with the NIH and CDC team here at NIH in Wilson Hall \nof Building 1 as well as in Room 151 in the meeting with the Vice Premier of China Jiu \nYandong.  The meeting was hosted by Sylvia Burwell (Sec., HHS).  I presented a talk on \nthe role of NIH in the response to the Ebola Outbreak.   I interacted with several of my \nChinese colleagues including the Director of the Chinese CDC.   An agenda of the \nmeeting is given in the PDF below:\ndraft agenda.pdf\nJune 25 – June 27, 2015 -  I travel to Aspen, Colorado to be a participant in the 2015 \nAspen Ideas Festival, Spotlight health. It was a most enjoyable experience as I attended \nseveral of the panels on areas that were of my own interest and expertise, and even some \nareas that are not my areas of expertise. With regard to my direct participation, on the \nmorning of Friday, June 26 , I participated in a “Tutorial Session” which was a panel on \nthe topic of “Be Preared: Infectious diseases are here to stay”. On the panel with me were \nLarry Brilliant, Neeraj Mistry, and Storn Kabuluzi of Malawi.  The Panel was chaired by \nJudy Woodruff of The NewsHour (PBS). Judy is an old friend and it was a very lively \npanel. An added plus for the experience was that I finally got to meet Larry Brilliant who \nis one of the icons of global health, having participated actively in the eradication of polio \nfrom India during his time at WHO. He is the kind of person who I think could be a really \ngood friend. He obviously has an incredible amount of respect for me. The panels that I \nenjoyed watching were the health and Healthcare session on the morning of June 26, \nwhich was a breakfast session right before my session. The speakers with Tom Daschle, \nHenry Waxman, Bill Frist and the panel was chaired by Steve Clemons, Editor-at-Large \nfor Atlantic magazine. It was a most joyful time for so many of us in Aspen because the \nReleased by Chairman Rand Paul\n459Supreme Court had voted by 6 to 3 to uphold the Affordable Care Act and the tax credit \nfor those who live in states that do not have their own exchanges. In addition, the \nfollowing day the Supreme Court ruled by 5 to 4 to strike down the prohibition on gay \nmarriage. The Obama administration has had an amazing couple of days. \nOn Friday evening of June 26 it was a wonderful reception at the home of Gail and Al \nEngelberg who live on a beautiful mansion overlooking the mountains of Aspen and \nAspen Valley. The reception was in honor of former secretaries of Health and Human \nServices. These included David Matthews, Kathleen Sebelius, Donna Shalala, Tommy \nThompson.  It was great to see Tommy Thompson again as well as all of the others. Of \nnote Donna Shalala wanted to talk to me in her new capacity as the CEO of the Clinton \nFoundation.  Apparently Chelsea Clinton had been approached by people from MSF and \nWHO to help fund the controversial “ring vaccination” study of the Ebola vaccine that \nthey are conducting in Guinea. As I had mentioned, both Cliff and I feel that this is a \nflawed study since it has no control group. Donna wanted to know whether the Clinton \nFoundation should get involved. I recommend strongly to her that they do not support \nthis study and if, in fact, Chelsea Clinton feels that she wants to support it, then it is \nimportantfor the Clinton Foundation to get an outside group to look seriously at the \ndesign of the study, which I have a lot of trouble with, as well as to examine the data that \nis a ready been collected. Donna thanked me for :”Covering my back as you always do”.\nThe reception was idyllic in that views were breathtaking, the skies were crystal clear and \nthe weather was warm without any humidity. I met many wonderful people at the \nreception including a nice conversation with my old friend Ashley Judd, who looked \nabsolutely beautiful. She complimented me on “how great I looked”  and on the \nimportant work that I have been doing for so long. She was with a little dog and was \nbarefoot. She is an amazing looking woman and a really devoted global health advocate. \nShe was there to talk about her reflections on global health on the following day. One of \nthe people I ran into who was very complimentary was a Zoe Baird, who called me the \nepitome of the true public servant. She said that I was incomparable in what I have done \nover so many years for the people of the country in the world. It was a very moving and \nsincere compliment to me. The following day on Saturday, June 27,  I participated in a \npanel on the “Looming Antibiotic Crisis”.  On the panel with me was Peggy Hamburg \nand Ramanan Laximinarayan, who heads the Global Network for Neglected Tropical \nDiseases.   He is a terrific guy with whom I had the opportunity to fly back to Denver \nwith that same morning. All in all it was one of the best trips that I had taken in that the \natmosphere was beautiful, the social interactions were in extremely positive, and I got the \nopportunity to do my thing in front of a lot of important people who have also become \nover the years good friends.\nJune 29, 2015 - I had two interesting encounters today by telephone with very interesting \npeople on very interesting subjects:\n1) Mark Zuckerberg, the CEO and founder of Facebook was introduced to me a few \nweeks ago by e-mail by Susan Desmond Hellman, the current CEO of the Bill and \nMelinda Gates Global Foundation. We arranged to have a teleconference between \nMark and me today to discuss the issue of Mark wanting to get involved in a \nReleased by Chairman Rand Paul\n460philanthropic  way with promoting biomedical science. The call lasted one hour \nfrom 4 PM to 5 PM on an absolutely brilliantly beautiful day in Washington with \nclear skies and relatively no humidity(an unusual event in the summer in \nWashington). Mark was very engaging and we went over the multiple possible \nways that he may contribute.  He asked probing, highly insightful questions about \nhow we fund biomedical research through grants in the extramural program and \nby funding the investigators in the intramural program. He was very interested in \nthe concept of funding projects versus funding people. We went over several \nmodels of how research is funded. We discussed the issue of creating an institute \nthat is an infrastructure with walls like the Rockefeller University. We also \ndiscussed the possibility of an institution that makes grants like the Howard \nHughes Medical Institute. He asked a lot of questions about the NIH and he \nwanted to continue the conversation at a later date after he thought a bit about \nwhat I had told him. I found him to be a very engaging, highly intelligent young \nman.\n2) Gary Nabel, who is currently at Sanofi in Boston, called me on my cell phone to \ntell me that he had just been in California and had a conversation with Gov. Jerry \nBrown. The California State Assembly has put a Bill on the desk of Gov. Jerry \nBrown that would prohibit exemptions from vaccinations on religious and \nphilosophical grounds. Gov. Brown had spoken to Gary when he was in \nCalifornia today about this since he finds this to be a difficult decision as to \nwhether or not he should sign the bill.   Gary spoke to him about me and my \nknowledge of the subject and Gov. Brown gave Gary his cell phone number to \ngive to me to have me call him. I did so and had about a half an hour conversation \nwith Gov. Brown in which I explained to him the reasons why I feel that he \nshould sign the bill prohibiting religious and philosophical exemptions from \nvaccinations in the state of California. He asked probing questions. We had a very \ngood conversation and he thanked me heartily for giving him the time. Based on \nthe discussion, I believe that he will sign the bill. We shall see.\nThe TedMed people got back to me and really like my draft.   They have made some \nsuggestions that are easy.\nJune 30, 2015 – I must have been convincing to Gov. Brown yesterday – he signed into \nlaw the California vaccine legislation (see above).\nJuly 1, 2015 – The California law has attracted some attention.   I appeared on CNN with \nJake Tapper to discuss it.\nJuly 2, 2015 - Today I appeared on the Diane Rehm Show where I did somewhat of a \ndebate with Dr. Robert Sears, a pediatrician from California who was concerned about \nthe law recently signed by Gov. Brown in California. On the show with me was Liz \nSzabo from the newspaper USA Today. In addition, there was a pediatrician who is an \nexpert in parental response to vaccines for their children. Her name is Dr. Allison Kemp. \nThe show went very well and it was clear that Dr. Sears misrepresented certain facts and \nReleased by Chairman Rand Paul\n461cherry-picked information for his own advantage. Following the interview, when I got \nback to my office, I received several e-mails telling me that I did a very nice job in being \nbalanced in my approach.\nThere has been an additional case of Ebola in Liberia. A 17-year-old boy was found dead \nand was shown by PCR to have had Ebola. Since then, there has been an additional case \nor two. Therefore, we are concerned that this may be the beginning of another outbreak in \nLiberia and perhaps in other West African countries. \nDrew Faust, President of Harvard had e-mailed me a couple of days ago to ask me for \nsuggestions for Dean of Harvard School of Public Health to replace Julio Frenk who had \nleft to become President of University of Miami.   I gave her several names and then she \nresponded this AM thanking me and telling me that she had just watched “Larry Kramer:   \nIn Love and Anger “ (HB0) and this was her comment to me:\n  I spent the evening tonight watching the Larry Kramer HBO documentary in which you \nfigure so prominently—and impressively.  The footage throughout is amazing, (I kept \nthinking what it would be like to have such a record of the Civil War…), and the story \nboth tragic and triumphant.  I was powerfully struck by your comment towards the end \nabout how Act Up permanently changed everything in how officials, the state and \norganized medicine deal with patient communities. The film will remain in my mind for a \nlong time…\nVery best, Drew\nJuly 7, 2015 – Met with team from Gilead Sciences who presented data on their new \ncompound GS 5734 that has impressive preclinicakl activity against Ebola.   They want \nour help in testing it in West Africa.   It is an RNA Polymerase with activity against \nMERS, and likely RSV, Chik, and others.   We will help them and do a trial in West \nAfrica after we finish the ZMapp trial that is moving along well (47 subjects thus far) in \nSierra Leone and soon in Guinea.   Infections persist in both countries.   Also, last week \nthere was an infection in Liberia with 2 secondary cases.\nThe Gilead people were: Andrew Chang (Head of HIV Therapeutics & Development \nOperations; William Lee (Head of research); Howard Jaffe (Senior Advisor); and Tomas \nCihlar (Head of Discovery Virology).\nAlso, Cliff is back from Guinea and it looks like (despite the continued objections of tom \nFrieden), we will expand the RCT Vaccine trial into Guinea where there are persistent \ncases.\nHad diner tonight at Grapeseed restaurant in Bethesda with the BMGF people who are in \ntown for our yearly joint gates/NIH meeting.   Francis Collins and I and Doug owy were \nthe senior NIH people there and Trevor Mundel, Emilio Emini, Chris Carp, Chris Wilson \nwere senior Gates people among others.\nReleased by Chairman Rand Paul\n463  \nReleased by Chairman Rand Paul", "summary": "Watcher-discovered document from paul-readingroom (2026.08.05_Diary-Prequel-_Redacted.pdf), auto-indexed 2026-08-06.\n\nExcerpt: control. Despite reports that the number of cases in Liberia are decreasing rapidly, new reports  today indicate that the cases in Sierra Leone are sharply increasing.   I have warned that  Ebola comes in waves and that we should not be complacent and the WH should refrain  from saying that things are “turning around”. Nov. 3, 2014 – Ron Klain visited NIH today (He had visited CDC last week).   He  wanted to familiarize himself with what the various components of government were  doing in Ebola.   I made a presentation to him in the VRC, showed him the lab where  Nancy Sullivan works and where she developed the ChAd3 Ebola vaccine.   Then we  took him over to the Clinical Center to see Julie Ledgerwood’s vaccine clinic where the  phase 1 trial took place.   Then we showed him the SCSU…", "source_url": "https://www.paul.senate.gov/wp-content/uploads/2026/08/2026.08.05_Diary-Prequel-_Redacted.pdf", "pdf_url": "/archive-docs/fauci-files/b5b0ed807aff8eaf2c6607cc328a591e/pdf", "doc_date": "2026-08-06", "doc_kind": "document", "case": "covid-19-origins", "sub_case": "watcher-discovered", "tags": ["fauci-files", "fauci", "covid", "covid-19", "wuhan", "wuhan-institute-of-virology", "wiv", "gain-of-function", "gof", "niaid", "nih", "ecohealth", "ecohealth-alliance", "dni", "gabbard", "tulsi-gabbard", "lab-leak", "lab leak", "declassified", "intelligence-community", "ic", "cdc", "gabbard drop", "gabbard release", "gabbard files", "gabbard dump", "fauci exposed", "fauci files", "fauci wuhan", "fauci nih", "fauci coverup", "fauci congress", "fauci testimony", "fauci diary", "fauci diaries", "tonys diary", "rand paul", "covid origins", "covid origin", "covid release", "covid cover up", "covid coverup", "covid declassification", "wuhan biolab", "wuhan lab", "wuhan virology", "wuhan leak", "lab-leak", "lab-leak theory", "biolab", "biolabs", "dni release", "dni declassification", "odni release", "intelligence release", "intelligence declassification", "niaid grant", "nih grant", "gain of function research", "z program", "lawrence livermore", "llnl", "trump transparency", "biden coverup", "coronavirus origins", "sars-cov-2", "sars cov 2", "pandemic origins", "watcher-discovered", "paul-readingroom", "2026-08-05-diary-prequel-redacted"], "part_number": 7, "page_count": 465}